Reply:

(a) (i) Nurses employed at Job Shimankana Tabane Provincial Hospital in Rustenburg, North West is 578.

(ii) Vacant positions is 106 (vacancy rate of 15%).

(b) The vacancies will be advertised before the end of this financial year (2019/2020), and filled during the 2020/2021 financial year.

END.

Reply:

The table attached indicates a summary of (a) funded filled positions and (b) vacant funded positions in the public health sector in each (i) province, (ii) and for all health categories or specialities.

Province	Health related Funded Filled / Vacant posts as at end September 2019
	Filled	Vacant	Grand Total
Eastern Cape	26311	85	26396
Free State	12340	22	12362
Gauteng	41042	135	41177
KwaZulu-Natal	44992	108	45100
Limpopo Province	31589	57	31646
Mpumalanga	12644	19	12663
North West	11466	28	11494
Northern Cape	4279	13	4292
Western Cape	20042	107	20149
Grand Total	204705	574	205279

END.

Reply:

 

(a)  (i) Magogong clinic

(aa) There have been no stock outs of any HIV medicines at the clinic this year. (bb) There has been a National challenge with the supply of metformin. Until supply is normalized facilities were requested to use alternative strengths.

(b) Supplies were delivered to the clinic on 28 Oct 2019.

(cc) There has been a National challenge with the supply of enalapril. Until supply is normalized facilities were requested to use alternative strengths.

(a) (i) Buxton clinic

(aa) There have been no stock outs of any HIV medicines at the clinic this year. (bb) There has been a National challenge with this supply of metformin. Until supply is normalised facilities were requested to use alternative strengths.

(b) Supplies were delivered to the clinic on 4 Nov 2019.

(cc) Hypertension medicines

There has been a National challenge with the supply of enalapril. Until supply is normalised facilities were requested to use alternative strengths.

(b) Supplies were delivered to the clinic on 28 Oct 2019.

END.

Reply:

(1) The names of all the approved clinics/institutions where abortions are legally allowed are attached in Appendix A.

(2) In terms of training the National Department of Health conduct a ten (10) days theoretical training for nurses followed by ten (10) clinical cases practical sessions before they are certified as competent.

Provincial offices contract the General Practitioners (GPs) and private organizations like Marie Stopes to provide Termination of Pregnancy (ToP) services. The National contracting stopped when the CToP Act was amended in 2008.

The focus for training is currently mainly on medical termination.

(3) Efforts to reduce illegal ToP providers. KZN provincial officie, with the previous MEC, embarked on the process of removing the advertisements of illegal abortions on street poles and some of the findings were:

- Adverts are put up by young people who do not even understand what abortion means, mainly boys;

- They were confronted and they could not provide details of the people who gave them the adverts, they just received the money given and started putting up the adverts.

- Most numbers provided, will lead you to different places, sometimes they send you to hotel reception or individuals on the street.

Mobile units are not providing abortions because they do not have backup of MVA equipment in case there is a need for surgical evacuation following the medical abortion.

Provincial Departments have an assessment tool to assess the readiness of facilities both private and public sector to perform abortions.

END.

APPENDIX A

Name of Facility

Frere Hospital

Tembisa Hospital

Kalafong Hospital

Mankweng Hospital

Klerksdorp-Tshepong Tertiary Hospital

Job Shimankana Tabane Hospital

Dr George Mukhari Hospital Chris Hani Baragwanath Hospital Steve Biko Academic Hospital

Tygerberg Hospital Groote Schuur Hospital

Mthatha General Hospital Dora Nginza Hospital Frontier Hospital St Elizabeth's Hospital Cecilia Makiwane Hospital

Thelle Mogoerane Regional Hospital Sebokeng Hospital Leratong Hospital

Queen Nandi Regional Hospital Addington Hospital Prince Mshiyeni Memoral Hospital Newcastle Hospital Stanger Hospital RK Khan Hospital Edendale Hospital Ladysmith Hospital Port Shepstone Hospital Mahatma Gandhi Hospital

Tshilidzini Hospital St Rita's Hospital Philadelphia Hospital Letaba Hospital Mokopane Hospital

Ermelo Hospital Mapulaneng Hospital

Dr Harry Surtie Hospital

Potchefstroom Hospital Joe Morolong Memorial Hospital Mahikeng Provincial Hospital

New Somerset Hospital Paarl Hospital Worcester Hospital George Hospital

Butterworth Hospital Tayler Bequest Hospital (Matatiele) Bisho Hospital Empilisweni Hospital Uitenhage Hospital Victoria Hospital Settlers Hospital Elliot Hospital Cofimvaba Hospital Humansdorp Hospital Andries Vosloo Hospital Midland Hospital Cala Hospital Glen Grey Hospital Cradock Hospital Nompumelelo (Peddie) Hospital Port Alfred Hospital All Saints Hospital Bambisana Hospital Tafalofefe Hospital SS Gida Hospital Bedford Hospital Cloete Joubert (Barkly East) Hospital Hewu Hospital Adelaide Hospital Lady Grey Hospital Madzikane kaZulu Memorial Hospital Isilimela Hospital SAWAS Memorial (Jansenville) Hospital

Elizabeth Ross Hospital National District Hospital Katleho Hospital Fezi Ngumbentombi Hospital Botshabelo Hospital Dr JS Moroka Hospital

Tokollo Hospital Phekolong Hospital Albert Nzula District Hospital Thusanong Hospital

Dr Yusuf Dadoo Hospital Bertha Gxowa Hospital Heidelberg Hospital Carletonville Hospital Odi Hospital Jubilee Hospital Kopanong Hospital

Norhtdale Hospital Benedictine Hospital Itshelejuba Hospital Wentworth Hospital Vryheid Hospital Manguzi Hospital Nkonjeni Hospital Estcourt Hospital Charles Johnson Memorial Hospital Rietvlei Hospital Greytown Hospital Murchison Hospital Dundee Hospital Eshowe Hospital GJ Crooke's Hospital Emmaus Hospital St Andrew's Hospital Christ the King Hospital Nkandla Hospital St Apollinaris Hospital Montebello Hospital Untunjambili Hospital Umphumulo Hospital Betesda Hospital Catherine Booth Hospital Mbongolwane Hospital Appelsbosch Hospital KwaMagwaza Hospital Niemeyer Memorial Hospital Ekhombe Hospital

Elim Hospital Seshego Hospital Donald Fraser Hospital Ellisras Hospital Lebowakgomo Hospital Jane Furse Hospital

Helen Franz Hospital Zebediela Hospital Malamulele Hospital Nkhensani Hospital Warmbarths Hospital Botlokwa Hospital WF Knobel Hospital Siloam Hospital Voortrekker Memorial (Potgietersrus) Hospital Dilokong Hospital Mecklenburg Hospital Matlala Hospital Sekororo Hospital FH Odendaal (Nylstroom) Hospital Louis Trichardt Hospital Dr CN Phatudi Hospital Kgapane Hospital Thabazimbi Hospital George Masebe Hospital Witpoort Hospital

Embhuleni Hospital KwaMhlanga Hospital Evander Hospital Tintswalo Hospital Mmametlhake Hospital Sabie Hospital Standerton Hospital Bernice Samuels Hospital Piet retief Hospital Barberton Hospital Carolina Hospital Amajuba Memorial Hospital Bethal Hospital Elsie Ballot Hospital

Tshwaragano Hospital Postmasburg Hospital De Aar (Central Karoo) Hospital

Moses Kotane Hospital Brits Hospital Nic Bodenstein Hospital Taung Hospital Ganyesa Hospital Koster Hospital Gelukspan Hospital

Karl Bremer Hospital Khayelitsha Hospital Mitchells Plain Hospital Helderberg Hospital False Bay Hospital Westfleur Hospital Vredenburg Hospital Hermanus Hospital Stellenbosch Hospital Knysna Hospital Mossel Bay Hospital Oudtshoorn Hospital Vredendal Hospital Eerste Rivier Hospital Clanwilliam Hospital Victoria Hospital Radie Kotz Hospital Caledon Hospital Ceres Hospital Montagu Hospital Swellendam Hospital Otto Du Plessis Hospital Robertson Hospital

Kgotsong (Welkom) Clinic

Dr Moeti Surgery

Klipdrift Health Post

SAMHS 2 Military Hospital

Cape Town Reproductive Health Centre

Harry Comay TB Hospital

Elim Satellite Clinic

Marie Stopes Port Elizabeth Clinic New Rest Clinic Civic Centre Clinic (Mthatha) Lanti Clinic Philani Clinic (Cradock) Addo Clinic

Molemo Healthcare Clinic Karabo Clinic Bren Health Care Clinic Marie Stopes Bloemfontein Clinic

Vaal Woman's Choice Clinic (Vereeniging) Protop Women's Clinic (Vereeniging) Vaal Woman's Clinic (Evaton) Phedisong 1 clinic

Marie Stopes Durban Clinic Marie Stopes Isipingo Clinic Khululeka Clinic TSM Health Care Clinic

Nancefield Clinic Seloane Clinic Levubu Clinic Mamotshwa Clinic Dendron Clinic Mariveni Clinic Northam Clinic Raphahlelo Clinic Matoks Clinic Willows Clinic Buffgelshoek Clinic (Blouberg) Mashishimale Clinic Jamela Clinic Seshego IV Clinic Motsepe Clinic Mashamba Clinic Witfontein Clinic Mabins Clinic Mankuwe Clinic

Renee Clinic

Katrina Koikoi Clinic

Makapanstad (Seaparankwe) Clinic Hartebeesfontein Clinic Schweizer-Reneke Town Clinic Preshco Clinic Mononono Clinic

Site C Youth Clinic Mediclinic Constantiaberg Hospital Empiliseni (Worcester) Clinic De Doorns Clinic Zolani Clinic Nkqubela Clinic Railton Clinic Bergsig Clinic Swellendam PHC Clinic Caledon Clinic Heidelberg Clinic

Villiersdorp Clinic Annie Brown Clinic Montagu Clinic Wolseley Clinic Nduli Clinic Prince Alfred Hamlet Clinic Tulbagh Clinic Groendal Clinic Mediclinic Durbanville Hospital Touws Rivier Clinic Happy Valley clinic Idas Valley Clinic McGregor Clinic Suurbraak Clinic Marie Stopes Cape Town Clinic Marie Stopes Bellville Clinic Barrydale Clinic Great Brak Rivier Clinic

Michael Mapongwana CDC Lady Michaelis CDC Kuyasa CDXC Noulungile CDC TC Newman CDC Bishop Lavis CDC Thebalethu CDC Town w CDC Mbekweni CDC Wellington CDC Dr Abdurahman CDC Worcester CDC Ceres CDC Cloetesville CDC

Motherwell CHC Empilweni Gompo CHC Nontyatyambo CHC Idutywa Village CHC Laetitita Ban CHC Duncan Village CHC Nqamakwe CHC Xhora CHC

Soshanguve CHC Chiawelo CHC Zola CHC Lenasia South CHC Kgabo CHC Johan Heyns CHC Pedisong 4 CHC Laudium CHC Jabulane Dumane CHC Hillbrow CHC

Phoenix CHC Nseleni CHC Inanda C CHC Tongaat CHC Pomeroy CHC eDumbe CHC Sundumbili CHC Dannhauser CHC Turton CHC Hlengisizwe CHC St Chads CHC Ndwedwe CHC

Rethabile CHC Makhado CHC HC Boshoff CHC Tshilwavhusiku CHC Tiyani CHC Mookgophong CHC Nchabeleng CHC Ratshaatshaa CHC

Matsulu CHC Kanyamazane CHC Nelspruit CHC Phola-Nzikasi CHC Naas CHC M'Africa CHC Kabokweni CHC Bhunga CHC Thulamahashe CHC Perdekop CHC

Galeshewe Day Hospital

Bafokeng CHC Letlhabile CHC Bapong CHC Mogwase CHC Mabeskraal CHC

Atamelang CHC JB Marks CHC Mamusa CHC

Mitchells Plain CHC Kraaifontein CHC Guguleto CHC Vanguard CHC Hanover Park CHC

Mediclinic Welkom Hospital

Mediclinic Cape town Hospital Mediclinic Cape Gate Hospital Mediclinic Paarl Hospital Mediclinic Worcester Hospital Life Kingsbury Hospital Mediclinic George Hospital Mediclinic Hermanus Hospital Life Bay View Private Hospital

Data Source: DHIS DATA (2018 Jan to August 2019) accessed 17 September 2019.

END.

Reply:

1. Number of mobile units does each (i) national, (ii) provincial and (iii) local public health clinic in the City of Ekurhuleni have,

(i) Number of mobile units National: None

(ii) Number of mobile units provincial: 15

(iii) Number of mobile units in local public health clinics: 2

(iiii) Number of the specified clinics have established clinic committees

DISTRICTS/ REGIONS	TOTAL NUMBER OF CLINICS	NUMBER OF CLINICS WITH CLINIC COMMITTEE MEMBERS
EKURHULENI
Ekurhuleni East	30	28 (93%)
Ekurhuleni North	28	20 (71%)
Ekurhuleni South	35	30 (86%)
TOTAL	93	78 (84%)

1. The name of each service provider of each clinic?

Please refer to Annexure A list of City of Ekurhuleni Facilities and Ekurhuleni Health District Facilities (Provincial)

END.

Reply:

(a)-(b) The National Department of Health has in place the National Mental Health Policy Framework and Strategic Plan 2013-2020 which is currently being implemented in all nine provinces. Progress reports obtained from provinces in 2017/18 and 2019/20 financial years show that implementation of the plan has gained traction but a lot more still needs to be done.

In addition to the implementation of the National Mental Health Policy Framework and Plan, the following have been undertaken:

- A call for expression of interest to render mental health services was made to psychologists, psychiatrists and registered counsellors. Practitioners per province have been identified for provinces to contract using the Human Resources Capacitation Fund.

- In order to improve the quality and access to mental health services a Mental Health Training Programme was developed. The programme targets health practitioners working at primary health care clinics as well as district hospitals to improve their competencies in detection of mental disorders and provision of good quality mental health care, treatment and rehabilitation. A total of 30 training workshops were conducted during this financial year reaching 920 health practitioners in 8 Provinces. This programme will be expanded in the coming financial years to train more health practitioners.

- The National Department of Health evaluated the health systems cost of mental health services and programmes in South Africa in 2018/19. This was aimed at helping us understand what we are currently spending on mental health across all service levels and the potential resource envelop to be augmented to address the key mental health service gaps. The study found that the total costs of inpatient and outpatient mental health services and known transfers for contracted hospitals and NGO mental health sevices across all nine provinces amounted to R8.37 billion in the 2016/17 financial year. This represented 5% of the total health budget in the2016/17 (provincial range: 2.1-7.7%), and equated to a national average of R180.9 per capita uninsured.

We have embarked on the second phase of the project, to determine a prioritized package of mental health services and the resource estimates that should be made available to address the gaps and implement the prioritized interventions. The “investment case for mental health” will be finalized during the course of next year.

(c) Mental health infrastructure additions, upgrades and renovations are funded through the Indirect Conditional Grant: Health Infrastructure Revitalization Grant. In the 2019/20 financial year 21 mental health infrastructure projects are funded and they are at different stages of implementation.

END.

Reply:

1. For 1 (a) and (b) for Western Cape (updated 14 September 2019), please refer to Table 1 below:

The Western Cape does not appoint their Forensic Pathologists to the mortuaries, as they (outside of the Metro) are a resource that provides services across a geographic area. In the Metro they are linked to the two Departments of Forensic Medicine (University of Stellenbosch & University of Cape Town) and they also have academic responsibilities. Registrars are excluded, as they are not qualified pathologists. This also supports the deployment of pathologists beyond their specific area when they have service pressures elsewhere or during major incident response. In the rural areas either the doctors travel or the case travels to the doctor.

Please refer to the table overleaf.

Table 1: Western Cape
Facility / Area	FPS Facilities supported	Title / Portfolio	Number	Comment
Cape Town Metro East /US	Metro East / Tygerberg FPL	Head of Department	1	Not only service delivery responsibilities. The HOD should not be counted towards service delivery due to the nature of their responsibilities
		Head Clinical Unit	1
		Pathologists	3
Sub Total			5
Cape Town Metro West / UCT	Metro West / Salt River	Head of Department	1	Not only service delivery responsibilities The HOD should not be counted towards service delivery due to the nature of their responsibilities
		Head Clinical Unit	1
		Pathologists	5
Sub Total			7
West Coat / Winelands	Paarl, Malmesbury, Vredenburg, Vredendal	Head Clinical Unit	1	Doctor travel or case travel
		Pathologist	1
Sub Total			2
Winelands / Overberg	Worcester, Hermanus, Ceres; Swellendam	Head Clinical Unit	1	Doctor travel or case travel
		Pathologist	1
Sub Total			2
Garden Route / Central Karoo	George, Knysna, Mossel Bay, Riversdale, Oudtshoorn, Laingsburg, Beaufort West	Head Clinical Unit	1	Doctor travel or case travel
		Pathologist	1
Sub Total			2
Total with HODs			18
Total without HODs			16

For 1 (a) and (b) for Mpumalanga (updated 30 June 2019), please refer to Table 2 below:

Table 2: Mpumalanga
Mortuary	No of Pathologists
Themba	1
Mapulaneng	0
Tonga	0
Tintswalo	0
Barberton	0
Lydenburg	0
Kwamhlanga	0
Middelburg	0
Witbank	1
Belfast	0
Delmas	0
Mmamethlake	0
Ermelo	1
Evander	0
Piet Retief	0
Embhuleni	0
Carolina	0
Standerton	0
Volksrust	0
Balfour	0
Bethal	0
Total	3

For 1 (a) and (b) for North West (updated 30 June 2019), please refer to Table 3 below:

Table 3: North West
Name of Mortuary	No of pathologists
Klerksdorp	0
Potchefstroom	1
Lichtenburg	0
Mahikeng	0
Phokeng	1
Brits	0
Vryburg	0
Total	2

For 1 (a) and (b) for Eastern Cape (updated 16 September 2019), please refer to Table 4 below:

 

Table 4: Eastern Cape
Name of Mortuary:	No of Pathologists
Mdantsane	0
Woodbrook	0
Bisho	0
Butterworth	0
Pe Region	0
Gelvandale	0
Uitenhage	0
Mount Road	1
New Brighton	0
Grahamstown	0
Graaff Reinet	0
Mthatha	0
Lusikisiki	0
Mt Frere	0
Mt Fletcher	0
Bizana	0
Aliwal North	0
Queenstown	0
Regional	1
Total	2

For 1 (a) and (b) for Free State (updated 16 September 2019), please refer to Table 5 below:

Table 5: Free State
Name of Mortuary	No of Pathologists
Botshabelo	0
Bloemfontein	4
Smithfield	0
Jagersfontein	0
Bethlehem	0
Phuthaditjhaba	0
Harrismith	0
Ficksburg	0
Sasolburg	0
Kroonstad	0
Welkom	1
Total	5

For 1 (a) and (b) for Gauteng (updated 16 September 2019), please refer to Table 6 below:

Table 6: Gauteng
Name of Mortuary	No of Pathologists
Pretoria	4
Ga-Rankuwa	2
Bronkhorstspruit	0
Diepkloof	2
Sebokeng	0
Johannesburg	6
Springs	0
Germiston	2
Heidelberg	0
Roodepoort	1
Total	17

(a) and (b) for Kwa-Zulu Natal (updated 16 September 2019), please refer to Table 7 below:

Table 7: Kwa-Zulu Natal
Name of Mortuary	No of Pathologists
Gale Street	2
Phoenix	2
Pinetown	1
Park Rynie	0
Port Shepstone	0
Harding	0
KwaDukuza	0
Pietermaritzburg	0
New Hanover	0
Howick	0
Richmond	0
Mooi River	0
Ladysmith	0
Estcourt	0
Bergville	0
Dundee	0
Nqutu	0
Tugela Ferry	0
Greytown	0
Newcastle	0
Madadeni	0
Utrecht	0
Dannhauser	0
Kokstad	0
Ixopo	0
Umzimkulu	0
Bulwer	0
Ulundi	0
Nongoma	0
Paulpietersburg	0
Vryheid	0
Pongola	0
Mtubatuba	0
Mkhuze	0
Mosvold	0
Mseleni	0
Manguzi	0
Richards Bay	1
Eshowe	0
Nkandla	0
TOTALS	6

For 1 (a) and (b) for Northern Cape (updated 16 September 2019), please refer to Table 8 below:

Table 8 Northern Cape
Name of Mortuary	No of Pathologists
Kimberley	1
Upington	0
Kuruman	0
De Aar	0
Sprongbok	0
Calvina	0
Total	1

For 1 (a) and (b) for Limpopo (updated 22 February 2018), please refer to Table 9 below:

Table 9: Limpopo
Name of Mortuary:	No of Pathologists
Lebowakgomo	0
ST. Ritas	0
Groblersdal	0
Mokopane	1
Bela-Bela	1
Letaba	0
Kgapane	0
Nkhensani	0
Maphutha-Malatji	0
Elim	0
Tshilidzini	0
TOTAL	2

(2) (a) A special HPCSA Board meeting was held in March 2019 and the Board resolved to:

“a. To rescind the resolution taken in October 2018 to approve the revised Regulations relating to registration Forensic Pathology Officers which had provided for five (5) categories / designations.

b. The Regulations relating to the registration of Forensic Pathology Officers as amended during the meeting be approved.”

It was concluded that the Regulations relating to the registration of Forensic Pathology Officers approved on 27 March 2019 and the response to public comments would be submitted to the Department of Health for final promulgation once the Department of Planning Monitoring and Evaluation has issued the socio-economic impact certificate.

(b) No forensic pathology officers have been registered to date.

END.

Reply:

The following table reflects the details in this regard.

Department of Health
Details	(aa) 2016-17	(bb) 2017-18	(cc) 2018-19
(1) (a) (i) Amount was spent on advertising	R2 878 917.97	R16 181 705.22	R582 010.39
(2) (a) (i) black-owned media company:
Black Owned Media Company	R207 600.00	Nil	Nil
Kone Staffing Solution	R2 671 317.97	R14 912 472.77	Nil
Media House (Sadmon)	Nil	R1 269 232.45	R582 010.39
(2) (a) (ii) Total expenditure incurred on outdoor advertising
Media House (Sadmon)	Nil	R972 660.89	Nil
(2) (c) black-owned media company:
Media House (Sadmon)	Nil	R972 660.89	Nil

State Owned Entities
Details	(aa) 2016-17	(bb) 2017-18	(cc) 2018-19
Council for Medical Schemes
(1) (a) (ii) Amount was spent on advertising	R2 400 090,08	R1 965 244,48	R950 714,11
(2) (b) (i) black-owned media company: Independent Media	R741 592,80	R836 336,68	R917 035,86
Message Platform	R7 980,00	Nil	Nil
Mahogany Trading	Nil	R419 554,20	Nil
(2) (ii) Total expenditure incurred on outdoor advertising	R202 874,40	R507 653,40	Nil
(2) (c) black-owned media company: Mohagany Trading	Nil	R419 554,20	Nil
National Health Laboratory Service
Details	(aa) 2016-17	(bb) 2017-18	(cc) 2018-19
(1) (a) (ii) Amount was spent on advertising	R799 079.47	R287 792.73	R120 768.13
(2) (b) (i) black-owned media company: Human Communication (Pty) LTD	R799 079.47	R287 792.73	R120 768.13
(2) (ii) Total expenditure incurred on outdoor advertising	R799 079.47	R287 792.73	R120 768.13
(2) (c) black-owned media company: Human Communication (Pty) LTD	R799 079.47	R287 792.73	R120 768.13
Office of Health Standards Compliance
Details	(aa) 2016-17	(bb) 2017-18	(cc) 2018-19
(1) (a) (ii) Amount was spent on advertising	R412 337	R2 943 463	R620 482
(2) (b) (i) black-owned media company: Human Communication	R127 807	R119 804	R70 128
Basadzi Media and Personnel	R178 326	R46 039	R126 346
Ultimate Recruitment Solution	R102 954	R22 696	R24 501
Pheta Trading Enterprise	Nil	Nil	R302 140
Kone Solutions	Nil	Nil	R78 122
Druzmia Project Trading	Nil	Nil	R6 383
Government Printing Works (Tender Advertisements)	R3 250	R1 000	R12 862
Government Communication and Information Systems (Radio Advertisement)	Nil	R2 753 923	Nil
(2) (ii) Total expenditure incurred on outdoor advertising	Nil	Nil	Nil
(2) (c) black-owned media company:	Nil	Nil	Nil
South African Medical Research Council
(1) (a) (ii) Amount was spent on advertising	R1 417 593.45	R1 828 522.83	R1 893 653.72
(2) (b) (i) black-owned media company: African Directory	R29,900.00	Nil	R 14,950.00
African News Agency	Nil	R196,000.00	R84,000.00
Ayanda Mbanga Communications	R846,885.13	R674,367.43	R930,409.28
Black Moon Advertising	Nil	Nil	R358,300.40
Human Communications	R378,243.10	R505,250.54	Nil
Robin Events & Services	Nil	R1,300.00
Phanda Personnel	Nil	Nil	R9,956.95
(2) (ii) Total expenditure incurred on outdoor advertising	R48,400.00	R16,000.00	R358,300.40
(2) (c) black-owned media company: Black Moon	Nil	Nil	R358,300.40
South African Health Products Regulatory Authority
(1) (a) (ii) Amount was spent on advertising	Nil	Nil	Nil
(2) (b) (i) black-owned media company:	Nil	Nil	Nil
(2) (ii) Total expenditure incurred on outdoor advertising	Nil	Nil	Nil
(2) (c) black-owned media company	Nil	Nil	Nil

END.

Reply:

1. Yes, the Department hosted the function;

(a) It was held at the Parliamentary restaurant in the Good Hope building, in the Parliamentary precinct.

(b) R16,768.00;

(c) The list of guests invited is attached as Annexure 1.

2. No.

END.

Reply:

A patent allows the pharmaceutical manufacturer an exclusivity over the sale of a medicine. During this time the manufacturer price is very high and unaffordable to low and middle income countries. Companies argue that the high prices are intended to recoup their costs of research and development, however these companies have been reluctant to be transparent about such costs. There is much evidence to suggest that the cost of research and development is actually much lower than claims made by the pharmaceutical industry.

South Africa has been at the forefront of challenging the high prices of medicines globally including where patents are the barrier to access. There currently are legislative provisions which would allow us to access a medicine that is protected by a patent. These provisions are included in Section 15C of the Medicines and Related Substances Control Act, 1965 (Act No. 101 of 1965). It is important to bear in mind that in order for one to access medicines using Section 15C, such a medicine must first be registered by the South African Health Products Regulatory Authority (SAHPRA) in terms of efficacy, safety and quality. SAHPRA will consider an application of a generic even while a patent remains in effect. So the provisions to address patent barriers already exist in South Africa however a product must be registered by SAHPRA before we can implement such a provision.

South Africa has never had to use the patent legislation to access a lower priced generic medicine. The patent holders have in many cases negotiated either through bilateral agreements or have participated in the Medicines Patent Pool which provides manufacturers in developing countries like South Africa access lower cost generic antiretroviral (ARV) drugs at an affordable price. This has allowed us to afford the world’s largest ARV programme.

END.

Reply:

The following tables reflect the details in this regard.

(a)(ii) Entities	(aa) total amount spent on cleaning	(bb) total amount spent on security	(cc) total amount spent on gardening services
	(aaa)2017/18	(bbb) 2018/19	(aaa)2017/18	(bbb) 2018/19	(aaa)2017/18	(bbb) 2018/19
Council for Medical Schemes	R890,379.82	R858,726.38	R36,813.10	R409,294.50	R154,370.08	R130,995.60
National Health Laboratory Service	R30,851.489	R4,620.615	R13,588.664	R1,054.711	R402,477	In-sourced
Office of Health Standards Compliance	R131,644	R190,521	R0	R249,814	R0	R0
South African Health Products Regulatory Authority	R0	R0	R0	R0	R0	R0
South African Medical Research Council	R4,100,616.27	R5,458,526.90	R8,885,876.97	R9,428,708.73	R671,297.44	R245,290.80

(b) Amount paid to each service provider to provide each specified service and (c) total amount paid to each service provider

(a)(ii) Entities	Service provider	Specified Service	Amount paid 2017/18	Amount paid 2018/19
Council for Medical Schemes	FSG Property Services	Cleaning chemicals	-	R12,778.45
	PTY Trade 242	Cleaning consumables	R58,845.80	R21,558.04
	Cannon Hygiene	Hygiene consumables	R134,139.41	R8,516.30
	Rentokil Initial (Pty) Ltd	Hygiene services	R26,886.72	R136,571.72
	Salaries of cleaners	Salaries	R622,888.89	R661,953.87
	Temporary Services	Temporary Services	R47,619.00	R17,348.00
	Perfect Solutions Security	Security Guards	R318, 680.19	400,888.40
	TFS Africa (Pty) Ltd		R34,728.89	-
	Sefeko Guard Security	Security Handsets	R8,404.02	R8,406.10
	Bidvest Execuflora	Gardening/Plant hire	-	R63,467.35
	Servest Interior Solutions	Gardening/Plant hire	R154,370.08	R67,528.25
National Health Laboratory Service	Afriboom (Pty) Ltd	Cleaning Services	R2,878.819	-
	Amandla Ahlanene Trading Enterprise CC		R7,433.137	R1,254.206
	Amararo Trading(Pty)Ltd		R36, 309	-
	Ambius		R16,784	R18,100
	Basan S A Trading		R11,628	R8,280
	Botho Ubuntu Cleaning		R838,981	R804, 299
	Clean Room Maintenance CC		-	R5,244
	Columbus Hygiene Systems		R8,884	R18,530
	Greater Kokstad Municipality		R1,833	-
	H Coetzee t/a Milandi's Skoonmaakdienste		R600	-
	HDS Interprise and Medispeed Pty Ltd		R172,827	-
	Masana Hygiene Services CC		R5,946.359	R2,283
	Masango Cleaning Services and Construction CC		R5,945	-
	Masutlhadokgwa Construction & Project CC		R19,947	-
	Mathasani Construction and Cleaning		R4,646.418	R16,213
	Nondumiso Cleaning Services (Pty)Ltd		R2,678.782	-
	Nontobeko Mketi		R1,500	R2,800
	Omnilab Supplies CC		-	R6,443
	Prestige Cleaning Services (Pty) Ltd		R3,173.655	R214,852
	Pristene Health Services (Pty) Ltd		R280,198	-
	Pronto Kleen		R18,989	R1,854
	Prospect Cleaning Services		R1,004.657	-
	Red Alert Alarms		-	R15,741
	Sanitech a division of Waco Africa (Pty)		R1,352,587	R1,361,855
	Servest Pty Ltd		R35,435	R222,506
	Shanbar Property Development cc		R3,852	-
	Siyaya Teledata Comm & Courier CC		R2,256	-
	Steiner Hygiene (Pty) Ltd		R35,248	R981
	Steiner Services (Johannesburg):		R211,388	R240,746
	Thistle Lab Services		R34,471	R23
	Vetus Schola Protection Services Pty Ltd		-	R28,870
	Steiner Hygiene (George)		-	R854
	Industro Clean OFS cc		-	R993
	Bidserv Industrial Products Pty Ltd T/a G Fox & Company		-	R2,989
	Kenglo Holdings (Pty) Ltd		-	R58,286
	Gcinasande Projects		-	R1,288
	Supra Later Pty Ltd		-	R3,367
	N Hiliza Trading (Pty) Ltd		-	R2,533
	MM629K Projects (Pty) Ltd		-	R300,070
	Satis-Vaction Cleaning Services		-	R23,407
	Sebaeng Construction		-	R3,000
	Armand Trading CC	Security	R8,892	-
	Atlas Security Systems		R26,231	R19,332
	Bonolo Claudina Sefularo		R2,720	R4,590
	Chubb Security South Africa (Pty) Ltd.		R7,167	R3,826
	Electroalarm-Monitor cc		R6,301	R5,729
	Enforce Security Services (Pty) Ltd		R782,232	-
	Fidelity Cash Solutions Pty Ltd		R79,198	R61,738
	Hi Tec Security		R7,533	R6,519
	Home At Kimberely		R4,809	R6,228
	Ingwempisi Security Services		R7,218,569	-
	Juanique R van Zyl		R991	R100
	Nextec Industrial Technologies		-	R556,309
	Red Alert Alarms		R4,626.498	R121,876
	Roman Business Management		R5,970	R6,223
	Saayman's Security Services CC / Capital Security Services CC		R6,767	R4,533
	Sanitech a division of Waco Africa (Pty) Ltd		R2,019	-
	Secureco		R314,701	R28,484
	Separations		R153	-
	Top Security Systems Pty Ltd		R12,562	R668
	Top Ten catering and Security		R108,922	R12,209
	Transfire Pty Ltd		R11,159	-
	Vetus Schola Protection Services Pty		R353,628	-
	World Focus 799 CC		R1,642	-
	Minatlou Trading 331		-	R80,000
	Signal Network Telecom cc		-	R107,364
	No 1 Corporate Promtional		-	R18,012
	B & M Scientific B035		-	R8,970
	C Kader		-	R400
	Valencia Z Jokazi		-	R1,600
	Katanga Property Care Pty Ltd	Gardening	R402,477	-
Office of Health Standards Compliance	Medical Research Council	Cleaning	R131,644	R120,115.41
	Khumoetsile Vision Group		-	R70,405.59
	Imvula Quality Protection	Security	-	R191,439.50
	Rise Security Services		-	R58,374.10
South African Health Products Regulatory Authority	N/A	N/A	N/A	N/A
South African Medical Research Council	Bidvest Services (Pty) Ltd T/A Bidvest Steiner	Cleaning Services	R110,535.33	R25,043.13
	Bidvest Managed Solutions (Pty		R2,003848.56	R2,661 757.19
	Bright Idea Projects 2806 cc		-	R1 200.00
	Nvirogreen Solutions (Pty) Ltd		R20 586.00	-
	Galactic Pest Control		R4 342.11	-
	Rhumbu Trading And Projects (P		R17 375.00	-
	Ethekwini Pest Control Cc		R1 312.50	-
	Ndabazasembo Trading Enterpris		R59 812.00	-
	2 Oceans Computer Consumables	Cleaning Consumables	R18,146.20	-
	AB Holdings		R6,670	-
	ABD Fuels (Pty) Ltd		R7,386	-
	Afri Zonke Enterprises (Pty) Ltd		R10,089.03	-
	Amanthi TRAD		-	R3,649.39
	Ambicion11 (PTY)		-	R520
	Armada Supplies (Pty) Ltd		R8,908	-
	As Premium Holdings (Pty) Ltd		R5,650.80	-
	Atlantic Laundromat		R16,832.83	R13,255.91
	Atur Trading (Pty) Ltd		R5,248.88	-
	Aylu Civils And Construction C		R6,300.00	-
	Azura Suppliers (Pty) Ltd		R3,680.00	-
	Black Wealth Institute		-	R1,700
	Bidserv Industrial Products (Pty)Ltd		R12,399.40	-
	Bidvest Management solutions		-	R97, 662.23
	Bidvest Services (Pty) Ltd T/A Bidvest Steiner		R1,280 515.73	R1,854 382.49
	Biofarm		-	R1,757.28
	Bkj Holdings (Pty) Ltd		R5,055.90	-
	Bongukulunga Cleaning Services		R8,089.16	-
	Bonwepy Management Entertainme		R-2 832.48	-
	Bralmor Business Administrator		R395.07	-
	Breez Villiage		-	R1,020.60
	Cape Africa Marine Supp		R1,594.99	R11,303.18
	Capital Ship Trading 605 Pty Ltd		R8,361.90	-
	Caprichem Saccs (Pty) Ltd		R746.25	R1,958.20
	Cishumlilo SA		-	R15,250.00
	Clean Hygiene CC		R4,530.00	-
	Corpchem (Pty) Ltd		R4,155.30	-
	Cross Country Pest Control And		R7,500	-
	DBZN Trading		-	R12,509.96
	Deejay Industries (Pty) Ltd		R12,000	-
	Devershan Naicker T/A Buckingham		R1,794.50	-
	Diesel Innovations		-	R120,462.53
	Dixinox Cc T/A Exitol Cleaning		R10,734.80	R3,302.08
	Drivers Licence Test Control C		R8,640	-
	Dwm Cleaning And General Tradi		R4,420	-
	Eagles stationers		-	R56,536.20
	Emergency Diesel		-	R56,935.00
	Emtek Industrial Supplies Tpy		R2,554.80	-
	End Wise (Pty) Ltd		R700	-
	Ethekwini Pest Control Cc		R6,462.28	-
	Execuflora		-	R348.00
	Formax		-	R12,979.63
	Galactic Pest Control		R4,342.11	-
	Geo-Vul Constructions And Gene		R40,480	-
	Growing In Faith Entrepeneurs		R4,651.20	-
	Grundnorm Industries (Pty) Ltd		R13,350	-
	Hat Agencies - Hardware Abrasi		R4,729.70	-
	Hobozola		-	R5,541.00
	Husbandoncall (Pty) Ltd T/A Hu		R8,368.40	-
	Ikamva Trading (Pty) Ltd		R2,140.80	-
	Impilwenhle Trading Enterprise		R5,521.06	-
	Industrial And Proactive Solut		R14,487.06	-
	Inkosazana		-	R16,007.00
	Izinyanyeni (Pty) Ltd		R24,817.56	-
	Jamilo Sales And Services (Pty		R4,520	-
	JT Maritz		-	R15,354.00
	K2014085852 (Sa) (Pty) Ltd T/A		R6,046.45	-
	Kb2 Distributors		-	R4,235.00
	KA SALARI		-	R4,391.22
	Kopanang 7 Projects (Pty) Ltd		R5,083	-
	Laborem Investment Trading (Pty)		R-5,034	-
	Laborem Lab Supplies		R50	-
	Lazer chemicals		-	R3,000
	Legg & Wessels		-	R21,885.61
	Lum Mila (Pty) Ltd		R2,274	-
	Manjapha Trading Enterprise Cc		R3,670	-
	Maphallang Projects		R1,800	-
	Melokuhle Envoy (Pty) Ltd		R14,566.30	-
	Msanzi		-	R9,003
	Njikelela Constructand Project		R6,480	-
	Nrb Liquid Dream (Pty) Ltd		R647	-
	Nvirogreen Solutions (Pty) Ltd		R38,258.50	-
	Nyazile Building Construction		R22,670.86	-
	Ojenny And Sons (Pty) Ltd		R400	-
	Okamkhathini Trading		R4,373.60	-
	OMH Projects		-	R1,200
	Ophilayo Trading Enterprise CC		R5,968	-
	OQ Detergents		-	R2,344.00
	Phat group		-	R2,517.35
	Pula Pele (Pty) Ltd		R3,200	-
	R-5 Distributors		-	R198.30
	Rhumbu Trading and Projects (Pty) Ltd		R17,375	-
	Sibanye Office Solution		R29,890.02	R160,807.77
	SMJ Group Cc		R8,145.25	-
	Sthezeh Business Solutions (Pty) Ltd		R30,841	-
	Take Note Trading 35 Cc		R10,684.22	-
	Techris Tech		-	R76,399.91
	Telegenix Trading 429 CC		-	R1,048.55
	Togu Civils (Pty) Ltd		R-0.26	-
	Trans Africa Medicals		R850	-
	Trat Z Trading (Pty) Ltd		R5,347.40	-
	Tshiamo		-	R24,251.49
	XV Ntsinde		R75,081	-
	Yukon	Cleaning Consumables	-	R1,476.00
	Petty Cash			34,937.39
	Adt Security (Pty) Ltd (Durban	Security Services	R44,903.52	R16,176.97
	Blue Apple Trading Enterprise		-	R483,046.00
	Blue Light Monitoring & Armed		R1,862.30	-
	Chubb Integrated Systems		R1,539.05	R- 3,383.93
	Eric And Son Pty Ltd		R3,150	-
	Fidelity Cash Solutions (Pty)		R129,284.20	R138,962.64
	Hiway Integrated Security (Pty		R5,140	-
	Imvula Quality Protection Afri		R8,478 636.93	R8,340 356.92
	Jt Maritz Electrical		R32,930.04	R7,777.95
	Liberty Technologies (Pty) Ltd		R6,425	-
	Masibambisane Maswati (Pty) Lt		R13,528	-
	Mzansi Fire And Security (Pty)		R99,811.59	R199,597.02
	Oostenberg Patrols Cc		R47,340	-
	Panther Procure (Pty) Ltd		R13,535.96	-
	Petty Cash		R2,085.38	R105.00
	Sakh`Ikhaya Suppliers Cc		R2,926	R112,299.03
	Shanken Security Solutions Cc		R2,779	-
	Techris CC		-	R179,771.13
	Dway Projects (Pty) Ltd	Gardening Services	R34,355.00	-
	Full Flow Projects (Pty) Ltd		R205,533.00	-
	K R A S Agencies Cc		R1,650.00	-
	Mecam Industrial (PTY)		-	R5,197.40
	Ngula Constraction property		-	R18,900.00
	Pamper Zone Trading And Projec		R162,000.00	-
	Sakh’ikhaya suppliers		-	R58,913.04
	Seteline (Pty) Ltd		R38,660.00	-
	Sotobe Farming And Enterprizin		R20,000.00	-
	STRATOSTAFF Prev. ADECCO (DBN)		R24,099.44	R17,875.00
	Thokad Group		-	R22,697.06
	Weymer Construction And Mainte		R185,000.00	R121,708.30

END.

Reply:

The following information is currently available to the National department of Health. An updated audit of equipment is underway and additional information can be provided once the audit is completed.

 

Province	Facility	No of Bunkers	Total No. Linear accelerators available	No. of Linear accelerators Needing Replacement		No. Linear accelerators in Procurement with funding allocated
Eastern Cape	Frere	2	2	1
Free State	Universitas	5	2	2		2
Gauteng	Steve Biko	4	3			2
Gauteng	CMAH	4	4			1
Kwa Zulu-Natal	Greys	2	1	2		1
Kwa Zulu-Natal	Ngwelezane
Kwa Zulu-Natal	IALCH	3	3	0
Kwa Zulu-Natal	Addington	2	2	0
Limpopo	Polokwane
Northern Cape	RMSH			2
Western Cape	Tygerberg	3	3
Western Cape	Groote Schuur	5	3
TOTAL		30	23

END.

Reply:

The health system strengthening initiatives were implement in the NHI pilot districts. There initiatives were funded through conditional grants. The grant funding related to the following activities:

The ward based primary healthcare outreach teams which were responsible for the provision of primary healthcare to families/households; community outreach services; preventative, promotive, curative, rehabilitative and palliative services.

The Integrated school health programme focused on screening of health-related barriers to learning such as vision, hearing, cognitive, and related developmental impairments.

General Practitioners and Pharmacy Assistants were contracted to primary care facilities to support clinics in service delivery.

The ideal clinic realisation model was introduced in response to the existing insufficiencies in quality of PHC services and to lay the foundation for NHI implementation.

The centralized chronic medicines dispensing and distribution model involves the centralized dispensing of medicines for chronic stable patients and the collection of the medicine at a point close to patients,

The purpose of the health patient registration system is to serve as an online registry of all patients using healthcare services in South Africa that can be accessed at any facility to provide health workers with patients’ demographic information and their most up-to-date health records.

The stock visibility system is used in PHC clinics to monitor and report on stock availability levels for essential medicines like ARVs, TB medication and vaccines. The purpose of the SVS is to enable more informed decision-making and proactive stock management at the PHC facility level.

The infrastructure grant was intended to fund nursing college infrastructure as well as the maintenance, repair and construction of primary care facilities

The expenditure below outlines the grants allocated to the National Health Insurance as reported in Departmental annual reports over the period

Name of the Grant	Grant Deliverables	(R 000') 2017/18	(R 000') 2016/17	(R 000') 2015/16	(R 000') 2014/15	(R 000') 2013/14	(R 000') 2012/13
National Health Insurance	Equipment for PHC facilities and outreach teams, training of staff in SCM, impact assessment of pilot interventions		99 665	63 491	63 605	71 614	78 019
Ideal Clinics	Evaluate clinics against ideal clinic criteria and support facilities to reach ideal clinic status	26 590	9 792
Human Papillomavirus Vaccine	Two dose vaccination	199 534	189 992	158 719	189 489
Health Professionals Contracting	Contracting health professionals and CCMDD	549 035	361 580	279 780	R82,261	9 457
Health Facility Revitalisation	Nursing Education Institutions, maintainance, repair and refurbishment	657 099	686 496	612 623	292 345	373 483
Information Systems	Health Patient Registration System, PHC Stock Visibility System and Hospital Stock Visibility System.	83 807

END.

Reply:

The attached Annexure 1 indicates detailed information as requested. It should be noted that the Minister has a prerogative to delegate to the Deputy Minister any trip or invitation he is not in a position to honour.

With regards to cost implications to the trips, it is not possible to provide such information only until the logistical arrangements are done. It must also be noted that not all the trips indicated are funded from the State, but are sponsored by the relevant host governments and/or organisations.

END.

Reply:

1. The primary reasons why the Republic has a shortage of doctors and nurses is the fact that the Public Health Sector budget has not been increasing in real terms for the past ten years, impacting on the number of staff that can be appointed. Furthermore, the demand for health services in the country is increasing while there is no additional funding to address the change, which results primarily from immigration into the Country and the increasing burden of disease.

The shortage of health professionals is a global phenomenon and is more pronounced in low and middle income countries as health workers are more likely to migrate to upper middle income countries in search of better living and working conditions.

(2) I am not aware of any nurses being in trained in Cuba under the auspices of the Nelson Mandela/Fidel Castro Medical Collaboration except for the training of medical doctors. The aim of training doctors in Cuba are multifold:

(a) It is to expose medical doctors to a preventative approach to health care which is the cornerstone of the Public Health System in Cuba Health Care provision initiatives focus on community needs assessments and health indicators. The health care system is divided into three levels, namely primary, secondary and tertiary, but implemented differently from the South African setting.

(i) The primary care level focuses on providing health promotion and protection, along with the resolution of the minor health issues that account for an estimated 80% of total health concerns of Cuba. Clinics, Community Health Centres and patients’ homes are key sites that provide primary level care;

(ii) Secondary care level is focusing on 15% of health problems that result in patient hospitalisation; and

(iii) Tertiary care focuses on the remaining 5% of health problems, particularly where illness has resulted in severe complications. Such illnesses are handled in specialised hospitals and institutes throughout the country.

(b) The Cuban Public Health System is thus a model that we want to learn from, and apply in our health care system as we reorient the Health System towards Primary Health Care, to prevent diseases, promote health and reduce the number of patients that are admitted to hospitals. Our Medical Schools still focus on a curative and hospicentric health care system, with limited focus on Primary Health Care, which is also evident in their Curriculum;

(c) By training medical students in Cuba, we also want to produce a new cadre of a medical doctor who understands prevention, and how to tailor health services to specific community needs;

(d) Another reason for training medical students in Cuba is to give an opportunity to students who would not have been admitted to the South African medical schools because of their socio-economic conditions, in particular those from poor rural communities.

(3) Yes I will make a statement on this matter.

END.

Reply:

(a, b, c, d & e) The following table reflects the details in this regard

Q (1)	(a) Total # of Clinic Health Committees 2019/20	(b) Total Budget for Clinic Health Committees 2019/20	(c)Total No of members served on Clinic Health Committees 2019/20	(d) Remuneration package of each Committee member 2019/20
PPROVINCES
EC	696	R16 240.00	10 440	R 500.00 p/p p/q
GP	1488	No budget allocated	11 904	No remuneration
FS	139	No budget allocated	973	No remuneration
KZN	592	R7 104 000	8880	R200.00 p/p p/q
LP	492	No budget allocated	4428	No remuneration
MP	263	No budget allocated	3156	No remuneration
NC	169	No budget allocated	845	No remuneration
NW	301	R4 214 000	2107	R500.00 p/p p/q
WC	200	1 958 400	2400	S&T only p/p p/q
(e) Purpose of the clinic Committee	Clinic Committees facilitate the following: 1. Serve as a link between Primary Health Care, community based services and households; 2. Participate in the achievement of improved health outcomes; 3. Promote community participation, local accountability and intersectoral collaboration; 4. Engage with the management of PHC facilities with regards to planning, monitoring and oversight of Health Services; and 5. Engages with other governance structures e.g. Ward committees to ensure streamlining of initiatives which provide a broader platform in engaging with stakeholders.

END.

Reply:

a) The contract for the renovations of Nessie Knight Hospital project has been cancelled due to non-performance by the contractor on 15 March 2019. The progress at this stage is at 9% on the renovation works. The contract start date was 12 July 2018 with the contract value of R37,67 million and incurred expenditure of R1,04 million. Currently there is no work happening because the contractor has abandoned the site. The Eastern Cape Provincial Department of Health is in the process of facilitating the appointment of a replacement contractor; however, some emergency works have been implemented to ensure that hospital services and operations are not disrupted.

b) The latest total number of in-patients that have been treated in the hospital is 1 022. This is according to the end of August 2019 statistics.

c) The Eastern Cape Department of Health plans to have the substitute contractor by March 2020 with the anticipated project completion date of April 2021.

d) The total budget allocated for the renovation is R38 million.

END.

Reply:

A total number of One Million Five Hundred and Sixty One Thousand and Seventy Seven (1,561,077) births have been recorded at public health facilities since 01 January 2018.

END.

Reply:

(a) The number of public health clinics

(i) National Facilities – None

(ii) Provincial Facilities – 16

(iii) City of Ekurhuleni – 77

(b) Number of staff members employed at each specified facility.

Please refer to Annexure A as requested list of staff members employed per Facility.

(c) Are the hours of operation of each specified clinic.

Please refer to Annexure B as requested list of hours operating of each Facility.

(d) Type of services does each clinic offer

Please refer to Annexure C as requested list of type of services each clinic provided.

(e) Mechanisms have been implemented at each clinic to eliminate long queues and waiting times.

• Appointment system of patients visiting healthcare facilities in chronic and maternal and child health care streams are implemented.
• District-wide consultations with stakeholders were conducted to get buy-in for waiting times Implementation Plan
• Standardized waiting time tool is designed to measure the time the patients spend in the health facilities
• Chronic Central Medicine Dispensing and Distribution is implemented (CCMDD), where stable chronic patients collect the medicines from the pick-up-points in the community that are convenient to them. In this way they do not have to wait in the queues in the clinics.
• Guideline for waiting times of patients in health facilities is implemented.
• Facilities will be visited on a regular basis to ensure that appropriate and effective measures are implemented.
• Facilities are monitored to ensure that available protocols, guidelines and policies pertaining management and reduction of waiting time are adhered.
• Provide feedback to all staff members on monthly basis on patient waiting times
• Keeping track and monitoring Patient Waiting Time report for reference.

END.

Reply:

According to the attached report from the Department of Correctional Services as at 1 August 2019, the name and total number of State patients housed at each facility is as follows:

REGION	CORRECTIONAL CENTRE (a)	TOTAL NUMBER OF STATE PATIENTS (b)
Eastern Cape	Grahamstown	5
	King William's Town	9
	East London Medium B	14
	Mount Fletcher	5
	Mthatha Remand	26
	St Albans Medium A	28
Total		87
Gauteng	Kgoši Mampuru II Local	4
Total		4
Kwazulu Natal	Durban Med A	3
	Qalakabusha	1
	Ladysmith	4
	Ncome Med A	3
	Vryheid	10
	Pietermaritzburg Medium A	10
	Waterval Medium B	3
	Newcastle	1
Total		35

REGION	CORRECTIONAL CENTRE (a)	TOTAL NUMBER OF STATE PATIENTS (b)
Limpopo Mpumalanga North West	Nelspruit	6
	Ermelo	7
	Potchefstroom	1
	Witbank	3
Total		17
Free State Northern Cape	Grootvlei Medium A	29
	Kimberley	10
Total		39
GRAND TOTAL		182

(c) The budget for prison facilities is allocated to the Department of Correctional Services

(d) The standard of care in prison facilities is monitored by the Department of Correctional Services

END.

Reply:

A significant proportion of the South African population use traditional medicine as part of primary healthcare. It is therefore important that government integrates traditional medicine as part of the mainstream western medicine.

As a first step in this direction, Parliament established the Traditional Health Practitioners Act, which regulates and recognises traditional health practice in South Africa. An interim Council has been was established which will regulate the practice of Traditional medicine in South Africa. The Council will register persons as practitioners that meet the requirements to be a Traditional Health Practitioner. Registered persons will be required to adhere to a code of conduct and practice guidelines.

In addition to the regulation of the practitioner we need to also understand the “medicine”. In many cases the medicine is a plant or a mixture of plants and other products recommended by the traditional practitioner for the treatment of an ailment. Understanding the composition of these products and more importantly the potential active ingredients that influence diseases is crucial.

Traditional medicines offer massive opportunity for the treatment of diseases especially in areas where western medicine has been ineffective in addressing diseases. The Medical Research Council has been investigating the potential that traditional medicine could offer. They have established a Herbal Drugs Research Unit.

The Herbal Drugs Research Unit, based at Tshwane University of Technology, uses modern scientific techniques to understand the true value of herbal-based traditional medicine (phytomedicines). The unit has developed extraction techniques that would contribute to the global understanding of how the “active ingredients” can be extracted from plant based materials. After the extraction of these “active ingredients” the unit also describes the chemical characteristics of the product and the plant. This information becomes part of a larger online database so that other researchers can also access information of such medicinal plants.

Government provides a platform across various sectors for research into ATM. This is through collaboration with institutions including the Centre for Scientific and Industrial Research (CSIR), Agricultural Research Council (ARC), the Medicines Research Council (MRC), Department of Agriculture (DoA) as well as Department of Science and Technology (DST). Traditional medicine research is conducted at several institutions, facilitated by funding from government through the National Research Foundation (NRF), and other parastatal organisations as part of indigenous knowledge systems (IKSs). Flagship programmes are presently running in key institutions with a focus on medicinal plants for the development of immunomodulators, microbicides, anti-diabetic medicines, anti-tuberculosis medicines, antimalarial agents and anti-cancer medicines. Across other institutions, there is a focus on the research in ATM for antihypertensive, anti-diabetic, antimalarial, antimicrobial and anti-HIV medicines. This work would form the opportunity for public private partnership in the commercialisation of molecules that have shown pre-clinical potential.

END.

Reply:

1. (a) No, I have not been informed of the allegations as stated above as the HPCSA management has only been made aware of the allegations of racism at a recent meeting held with representatives of some of these medical graduates;

b) The HPCSA has since advised the representatives to submit these allegations to the Special Investigations Unit (SIU) as they have a broad investigation by the SIU on similar allegations made against the HPCSA in general, as proclaimed by the President of the Republic;

c) The Registrar has since informed the SIU of these allegations and the representatives have been put into contact with the SIU;

d) The HPCSA, represented amongst others by the President and Registrar, has engaged extensively with the foreign qualified medical graduates, their parents and their lawyers at various levels, either at meetings both in Pretoria and Durban, as well as several email correspondences over the last few months; and

e) In assisting the foreign-qualified medical graduates, the HPCSA has arranged a new examination process that can accommodate more of the foreign-qualified medical graduates and more than 250 of these graduates have registered and have participated in these exams during the month of September 2019.

(2) Yes, in due course I will call a meeting between the department and Mr N Singh and representatives of the South African foreign qualified medical professionals. In the meantime, meetings between the representatives of the foreign-qualified medical graduates and the HPCSA have already taken place over the last few months. At the last meeting some agreements were reached, and a proposal has been made to sign a Memorandum of Understanding between the HPCSA and the representatives of the foreign-qualified medical graduates so that rules of engagement could be developed and agreement be reached on how to address pertinent questions as they arise.

END.

Reply:

The Council for Medical Schemes (CMS) instituted an investigation into racial profiling by medical schemes on 16 May 2019, following allegations of racial profiling raised by General Practitioners, as directed by the Ministry of Health. The investigation is called the “Section 59 Investigation” in line with the Section in the Medical Schemes Act, 131 of 1998, which unpacks the charges by suppliers of service. The CMS on 25 June 2019 published the Terms of Reference for the Section 59 Investigation Panel in CMS Circular 45 of 2019. Circular 45 of 2019 is attached as Annexure A.

The Section 59 investigation is in terms of CMS’s regulatory mandate, under section 7(a)(b)(c)(d), 8(a) and (k) and 9(2) of the Medical Schemes Act, 131 of 1998. The CMS appointed an independent investigation panel chaired by Advocate Tembeka Ngcukaitobi together with Advocates Adila Hassim and Kerry Williams. The investigation will examine allegations made by medical practitioners, that they are being treated unfairly, and their claims are being withheld by medical schemes based on their ethnicity and colour of their skin. The panel will ultimately make recommendations to the CMS in relation to addressing the complaints, the appropriate administrative, legal and policy interventions.

Accordingly in terms of the circular 45 above, Section 59 Investigation panel was to receive written submissions from interested parties until 19 July 2019, extended from 30 June 2019. Interviews and public hearings were to be conducted from 29 July 2019 to September 2019, and the final report is to be delivered by the Investigation Panel in November 2019.

A total of 75 submissions were received within the open period for submissions and 163 submissions were received after the closing date. All submissions were handed over to the Investigation Panel for further deliberations and scrutiny. To date the CMS held 2 sessions of hearings consisting of 9 days. Session 1 had 221 attendees and 9 stakeholders appeared before the Investigation Panel. The 9 stakeholders were:

1. Solutionist Thinkers Group – 29 July 2019
2. Competition Commission – 29 July 2019
3. Council for Medical Schemes – 30 July 2019
4. Board of Healthcare Funders of Southern Africa – 30 July 2019
5. Health Professions Council of South Africa – 31 July 2019
6. National Healthcare Professionals Association – 31 July 2019
7. South African Medical Association – 1 August 2019
8. Independent Practitioners Association Foundation – 1 August 2019
9. Health Funders Association – 2 August 2019

Session 2 had 134 attendees and 10 stakeholders. The 10 stakeholders were:

1. South African Private Practitioners Forum – 20 August 2019
2. Independent Community Pharmacy Association – 20 August 2019
3. Elsabe Klinck and Associates – 21 August 2019
4. Health Man – 21 August 2019
5. South African Medical and Dental Practitioners – 21 August 2019
6. South African Optometric Association 23 August 2019
7. Wim Trengove (SC) – 23 August 2019
8. Dental Professions Association – 23 August 2019
9. South African Society of Psychiatrists – 29 August 2019
10. NHC Healthcare Centre – 29 August 2019

The next public hearings took place on the 25th, 26th and 27th September 2019 where individual complainants were heard. The dates of the 17th, 18th, 21st, 22nd, 23rd, 24th/25th October will be reserved for Medical Schemes and Administrators.

END.

Reply:

The National Department of Health is working with the Ministerial Committees, the National Confidential Enquiry into Maternal deaths (NCCEMD) and the National Perinatal Mortality and Morbidity Committee (NaPeMMCo) to review the proposal on norms and standards as recommended by the International Federation of Obstetricians (FIGO). The provincial representatives in both committees are consulting with provincial managers to adapt the standards and norms to address staff and facility shortages in maternity wards across the country so that they fit the South African context. The pre final report together with the Saving Mothers, Saving Babies 2018 recommendations will be presented to the National Health Council in November 2019 for ratification and adoption.

END.

Reply:

Yes the Department is aware of shortage of doctors and nurses at Tonga Hospital. The Hospital is in a deep rural area, which makes it very difficult to recruit and retain professionals to provide services in the area.

The Hospital is currently running at 28.6% vacancy rate for doctors. There are 11 permanent doctors, 14 sessional doctors and 6 Community Service Professionals against the 35 posts for doctors on the establishment in the Hospital.

There is a greater need for nurses because the Hospital is currently running at 53.7% vacancy rate for nurses (39% vacancy rate for Professional nurses, at 32 vacancy rate for Enrolled nurses and 65% for Assistant nurses).

The Department has conducted an analysis and realised that there is a misdistribution of resources especially the nurses in Nkomazi Municipality. The sub-district is being serviced by two district hospitals, Shongwe and Tonga Hospitals, that are less than 50km apart. Shongwe is currently overstaffed, especially with professional nurses, yet their workload is very low, while Tonga is understaffed with a high workload, especially in the maternity section because of the cross-border patients.

The Department has initiated a project that will address efficiency in the two hospitals and their surrounding clinics by looking at rationalisation of resources and to distribute them more equitably. It will also consider advertising vacant posts if there is still a need to do so. According to the timelines of the project, the initiative should be completed by end of November 2019.

END.

Reply:

1. (a) and (b) The referenced article does not report on a monitoring programme commissioned by the Department of Health. Ingredients that may be in bread are regulated under the Agricultural Products Standards Act, 1990 (Act No. 119 of 1990).

2. (a) and (b) The referenced article indicates that the African Centre for Biosafety conducted tests on white bread. The organisation has not shared the report nor their concerns with the Department. The article states that genetically modified soya was found in white bread. This is to be expected as the South African Government (Executive Council comprising eight (8) Departments as prescribed by the Genetically Modified Organisms Act, 1997 (Act No. 15 of 1997) has approved three genetically modified products. These are maize, soya, and cotton.

3. The Department of Health has regulations in place to cover certain aspects of labelling that the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No. 54 of 1972) mandates the Minister of Health to publish. The Regulations Relating to the Labelling of Foodstuffs Obtained through Certain Techniques of Genetic Modification (R 25 of 2004), requires mandatory labelling for genetically modified foodstuffs that are not substantially equivalent to the non-genetically modified conventional counterpart. Labelling is thus only required for genetically modified foodstuffs when they differ significantly from the conventional counterpart in terms of:

Composition, nutritional value, mode of storage, preparation or cooking;

i) If it contains an allergen

ii) or if derived from genes of human or animal.

iii) This is in conformance to the joint WHO/FAO Codex Alimentarius Commission, the international food labelling and safety standards setting body.

The Africa Centre for Biosafety has been at the forefront of campaigning for general labelling of genetically modified ingredients. The Department of Trade and Industry included provisions for such labelling in the Consumer Protection Act, 2008 (Act No. 68 of 2008). This covers the aspect of “the right to know” and not safety matters as per the Foodstuffs, Cosmetics & Disinfectants Act, 1972 (Act No. 54 of 1972), for which the Minister of Health is responsible. The Department of Health is not aware of any undue impact on health from genetically modified food as it participates in the country’s robust internationally bench marked approval system for Genetically Modified Organisms and foodstuffs derived therefrom.

END.

Reply:

a) (i) No;

(ii) No;

(iii) Yes.

b) Yes.

(aa) The cost implication are as follows:

(aaa) For 2018/19 amounted to R 47 million and since 1 April 2019 to date R 24 million.

(bbb) For both financial years mentioned which are 2018/19 and since 1 April 2019 to date, the purpose was to transport South African students studying medicine in Cuba to South Africa. Because of the big numbers and the logistics involved in transporting them all at once a charter option was deemed most effective.

These are students in different categories as follows:

i) those who have completed their 5th year in Cuba and would be commencing their 6th year in the South African Medical in Schools;

ii) those that are on vacation;

iii) those that come to do Electives in our health facilities in their Provinces to gain clinical experience;

iv) Sometimes those who have medical problems during the time the charter is available and need to be brought to South Africa for further medical treatment and intervention. In particular, when the Medical Schools Cuba have made a determination that they may not be able to cope with their Academic activities during the period of illness. The opportunity to bring them on a Charter is also used.

 

(ccc) For 2018/19 the following flights:

Date	From	To
03 July 2018	OR Tambo, SA	Havana, Cuba
06 July 2018	Havana, Cuba	OR Tambo, SA
08 July 2018	OR Tambo, SA	Havana, Cuba
11 July 2018	Havana, Cuba	OR Tambo, SA
15 July 2018	OR Tambo, SA	Havana, Cuba
18 July 2018	Havana, Cuba	OR Tambo, SA
31 July 2018	OR Tambo, SA	Havana, Cuba
03 August 2018	Havana, Cuba	OR Tambo, SA
26 August 2018	OR Tambo, SA	Havana, Cuba
30 August 2018	Havana, Cuba	OR Tambo, SA

Since 1 April 2019 to date the following flights:

Date	From	Destination
03 July 2019	OR Tambo, SA	Havana, Cuba
05 July 2019	Havana, Cuba	OR Tambo, SA
08 July 2019	OR Tambo, SA	Havana, Cuba
10 July 2019	Havana, Cuba	OR Tambo, SA
12 July 2019	OR Tambo, SA	Havana, Cuba
14 July 2019	Havana, Cuba	OR Tambo, SA

(bb) The number of passengers aboard each flight were as follows:

For 2018/19 the passenger numbers:

Date	From	To	Passenger Number
03 July 2018	OR Tambo, SA	Havana, Cuba	01
06 July 2018	Havana, Cuba	OR Tambo, SA	281
08 July 2018	OR Tambo, SA	Havana, Cuba	95
11 July 2018	Havana, Cuba	OR Tambo, SA	244
15 July 2018	OR Tambo, SA	Havana, Cuba	04
18 July 2018	Havana, Cuba	OR Tambo, SA	217
31 July 2018	OR Tambo, SA	Havana, Cuba	0
03 August 2018	Havana, Cuba	OR Tambo, SA	281
26 August 2018	OR Tambo, SA	Havana, Cuba	300
30 August 2018	Havana, Cuba	OR Tambo, SA	75

During 2018/19 financial year, the department chartered 282 (1 + 281) passengers on 3 to 6 July 2018; 339 (95 + 244 passengers from 8 to 11 July 2018; 221 (4 + 217) passengers from 15 to 18 July 2018; 281 (0 +281) passengers from 31 July 2018 to 03 August 2018; and 375 (300 + 75) passengers from 26 to 30 August 2018.

Since 1 April 2019 to date the passenger number:

Date	From	Destination	Passenger Number
03 July 2019	OR Tambo, SA	Havana, Cuba	7
05 July 2019	Havana, Cuba	OR Tambo, SA	214
08 July 2019	OR Tambo, SA	Havana, Cuba	5
10 July 2019	Havana, Cuba	OR Tambo, SA	214
12 July 2019	OR Tambo, SA	Havana, Cuba	193
14 July 2019	Havana, Cuba	OR Tambo, SA	222

In 2019 the department chartered 221(7+214) passengers on 3 to 5 July, on the 08 to 10 July chartered 219 (5+214) passengers and on the 12 to 14 July chartered 415 (193+222) passengers.

END.

Reply:

The Constitutional Court found Section 22A(9)(a)(i) of the Medicines and Related Substances Act, 1965 (Act No. 101 of 1965) (“the Medicines Act”) to be unconstitutional, as it renders the use or possession of cannabis by an adult in private for that adult’s personal consumption in private a criminal offence. In terms of this ruling, it is no longer an offence for an adult person to use or be in possession of cannabis in private for his or her personal consumption in private, and to grow cannabis in a private place for his or her personal consumption in private. Furthermore, the Constitutional Court has required that the relevant provisions of the Medicines Act, as well as that of other applicable legislation, be amended accordingly.

The Medicines Act allows the South African Health Products Regulatory Authority (SAHPRA) to regulate cultivation of cannabis for research purposes and the cultivation, production and manufacture of cannabis containing products for medicinal use. Thus enables effective control, and facilitates patient access to safe, effective and quality products. Cannabis grown for medicinal purposes, as well as any resulting products prepared form the plant material, are subject to stringent security and quality control measures. In this regard, SAHPRA has published guidelines on the cultivation of cannabis and manufacture of cannabis-containing medicines intended for therapeutic and research purposes.

The five applicants whose applications were compliant and were recommended by the SAHPRA Licensing Unit to be issued with licences, were as a result of site inspections and subsequent corrections of inspection findings found to be deficient.

To date no applications have been rejected. There is ongoing review of these applications by SAHPRA and correspondences have been sent to applicants to address deficiencies identified in the original licence applications. A few applicants communicated withdrawal of their licence applications, however, they did not indicate whether the withdrawal was temporary or permanent.

END.

Reply:

1. (a) The reasons for the high infant mortality rate and the neonatal mortality rates are:

i. Severe prematurity;

ii. Birth asphyxia;

iii. Infections;

iv. Severe congenital disorders;

v. Diarrhoeal disease;

vi. Pneumonia;

vii. HIV/AIDS; and

viii. Injuries.

(b)-(c) Health sector preventive measure to address the causes of neonatal and infant mortality rates and date put in place are summarized in the table below.

Preventive measures	Date put in place
(1)(b)	(1)(c)
Integrated Management of Childhood Illnesses	1996
Prevention of vertical (mother-to-child) transmission of HIV infection.	The PMTCT guidelines began in 2002, and it is revised periodically to include new evidence and the latest revision is the 2019 version
Comprehensive care, management and treatment of HIV infected children.	2004
Immunization against pneumococcal and rotavirus infection to protect children against the commonest forms of diarrhoea and pneumonia.	2009
Promotion of breastfeeding especially exclusive breastfeeding for 6 months.	The Tshwane Declaration in 2011.
The improvement of staff skills through the Essential Steps for Management of Obstetric Emergencies (ESMOE)- so that they are able to manage high risk pregnancies which may result in neonatal deaths.	2010
Introduction of District Clinical Specialist Teams and Ward-based Outreach teams.	2012
Helping Babies Breathe (HBB) and Management of Small and Sick Neonates (MSSN).	2013
Continuous Positive Airway Pressure (CPAP) to manage very small babies.	2015
Basic Antenatal Care Plus (BANC Plus) which is the increase of antenatal visits to 8 visits during the pregnancy period so that abnormalities such as hypertension can be detected early and managed to prevent stillbirths.	2017
Safe Ceasarean Section Standards for accre-ditation of hospitals to be able to conduct high risk pregnancies safely.	2017
Side by side under-five campaign.	April 2018

(2) Yes.

END.

Reply:

1. (i) The total number of vacancies on the National Department Health establishment is 25 after the reprioritization process.

(ii) Information on provinces according to Persal report reflects a total of 42,926 vacancies for the nine provincial departments. A verification process is currently underway for provinces to match the Persal report with their actual existing funded vacancies.

2. Identified critical vacancies for the National Department of Health will be filled in the current financial year by 31 March 2020.

Information still awaited from provinces to confirm timelines for filling their vacant posts.

END.

Reply:

1. The Directorate Radiation control (formerly part of the Department of Health, now transferred to the South African Health Products Regulatory Authority – SAHPRA) has the mandate in terms of the Hazardous Substances Act (Act 15 of 1973) to exercise regulatory control over devices and installations that have been declared Group III hazardous substances, i.e. all devices and installations covered by the Schedule of listed Electronic Products (Reg R1302, 14 June 1991).

The Directorate Radiation Control does not have the mandate, resources or infrastructure to engage in or support research with respect to the health effects of any such listed electronic product. Instead, the Directorate (in performing its regulatory responsibility with regard to listed electronic products that purposely produce non-ionising electromagnetic fields) has opted since 1998 to follow the recommendations and guidelines of the WHO International Electromagnetic fields Project (www.who.int/peh-emf).

Since the publication of exposure guidelines by the International Commission on Non-Ionising Radiation Protection (ICNIRP) in 1998, the WHO International Electromagnetic Fields Project has constantly been recommending the use of these guidelines (updated periodically) as the science-based way to deal with any situation where a person might be exposed to non-ionising electromagnetic fields. Compliance with the applicable ICNIRP limit will afford protection against the known adverse health effects of any such electromagnetic fields.

Surveys conducted around the world and also in South Africa have consistently indicated that the levels, to which the general population is exposed as a result of various wireless technologies, invariably are orders of magnitude below the applicable ICNIRP limit.

The WHO International Electromagnetic Fields Project has not published any report or statement to the effect that 5G technology would have any deleterious effect on the health of either the users of this technology or the population in general.

2. See (1) above.

(3) The methodology in the US National Toxicology Program involved exposing rats for long period of time to levels of microwave radiation well above the applicable ICNIRP limit for humans.

Compliance with the applicable ICNIRP limit is expressly aimed at avoiding any significant heating of the body or part of the body. Given these high levels of microwave radiation, it would not be unreasonable to suspect that the effects that were noticed in some rat populations were indeed mainly or exclusively due to excessive heating caused by the exposure to microwave radiation.

Although no human subject would knowingly be exposed to the high levels of microwave radiation to which the rats are exposed, this study does serve as confirmation of (a) the fact that the ICNIRP limits would have to be exceeded significantly before any health effects would become apparent, and (b) that compliance with the applicable ICNIRP limit will indeed protect against significant heating and hence the health effects that could be associated with heating.

In making policy recommendations to the Department of Health on the health effects on non-ionising electromagnetic fields, the Directorate Radiation Control does not consider it appropriate to even attempt to look at the results of any single study in isolation. The WHO International Electromagnetic Fields Project has rigorously been reminding member countries that a single study on its own could never by an adequate basis for setting or changing policy, no matter how significant or even ground breaking it may seem. Only in the event that other researchers independently make the effort to replicate a single study under the same conditions and their results turn out similar to those yielded by the initial study, could the process even of looking closer at the results of that initial study start. In all of this the implicit assumption would be that the initial study had been properly designed in the first instance, and carried out according to a scientifically justified methodology, and that the statistical analysis had been executed properly. The guidance and recommendations of the WHO International Electromagnetic Fields Project have therefore always been based on reviews which were conducted by multi-disciplinary panels of scientists employing a health-oriented, science-based weight-of-evidence approach involving all of the available scientific evidence.

The US National Toxicology Program has as yet not been replicated independently. The Japanese and Korean Ministries of Health announced in April 2019 that they were embarking on a five-year joint research effort aimed at verification of the results of the US National Toxicology Program. Regardless of the outcome, any replication/verification of these results would then still need to be evaluated in terms of the overall weight of evidence with respect to the health effects of exposure to high frequency electromagnetic fields.

END.

Reply:

1. (a) According to the information provided by the Health Professions Council of South Africa (HPCSA), the total number of doctors registered is as follows:

Province	Public	Private	(b) number of the specified doctors are currently practicing in each case
Eastern Cape	376	2761	HPCSA does not keep a record of whether a doctor is practising in the public or private sector, nor of the province in which they are working.
Free State	151	1713
Gauteng	1237	14304
Kwa-Zulu Natal	781	6944
Limpopo	229	1521
Mpumalanga	249	1449
North West	249	1172
Northern Cape	121	540
Western	443	9115
Foreign	47	504
No Province shown	120	649
Total	4003	40672

2. (a) Nurses are not required to register with the HPCSA to practice as nurses in South Africa. However, according to South African Nursing Council (SANC), a total number of nurses registered in each province is as follows:

2(a) Province	(i) Public and (ii) Private	(b) number of the specified nurses are currently practicing in each case
Eastern Cape	29533	SANC does not register nurses by employment authority (i.e. public or private) but registration is done in line with the categories of nurses as provided for in the Nursing Act, 2005 (Act. No. 33 of 2005)
Free State	13398
Gauteng	74044
Kwa-Zulu Natal	71030
Limpopo	28839
Mpumalanga	14878
North West	18002
Northern Cape	3747
Western Cape	32233
Total	285704

3. The following South African (a) Medical and (b) (i) Nursing Students who met requirements of being registered with their relevant Professions Council, were allocated since 1 January 2019:

Province	Medical Practitioner	Professional Nurse
EC	125	591
FS	67	168
GP	260	672
KZ	222	747
LP	138	331
MP	170	313
NC	82	50
NW	144	485
WC	205	302
SAMHS	47	14
Grand Total	1460	3673

No South African (a) Medical and (b) (ii) Nursing Students who met requirements of being registered with their relevant Professional Council have not been allocated for community service in each province since 1 January 2019 (i.e. all medical and nursing students who registration requirements were placed).

END.

Reply:

Management of Mental Health users at different levels is a function of a Multi -disciplinary team. The first line service are rendered by the Psychiatric nurses

a) The following table reflects the details in this regard

Province	Clinical Psychologists	Psychiatrists	Counsellors
	(a)(i)	(a)(ii)	(a)(iii)
Eastern Cape	29	10	1
Free State	20	13	0
Gauteng	63	110	1
KwaZulu-Natal	59	29	0
Limpopo	16	6	8
Mpumalanga	7	3	7
North West	21	5	0
Northern Cape	12	4	1
Western Cape	31	37	0

b) The following table reflects the details in this regard

Province	Name of Health Establishment	Psychiatrists	Clinical psychologists	Counsellors
Eastern Cape	Elizabeth Donkin Hospital	1	5	0
	Fort England Hospital	5	12	0
	Komani Hospital	1	4	0
	Tower Hospital	0	2	0
	Mthatha Mental Health Unit	2	3	1
	Dora Nginza Mental Health Unit	1	3	0
Free State	Free State Psychiatric Complex Hospital	9	9	0
	Pelonomi Regional Hospital	2	3	0
	National District Hospital	0	1	0
	Gateway	0	1	0
	J.S. Moroka District Hospital	0	1	0
	Dihlabeng Regional Hospital	0	1	0
	MMM Regional Hospital	1	1	0
	Boitumelo Regional Hospital	1	1	0
	Heidedal Clinic	0	1	0
	MUCCP Clinic	0	1	0
Gauteng	Sterkfontein Hospital	16	11	0
	Tara H Moross Centre Hospital	9	9	0
	Weskoppies Hospital	11	16	1
	Cullinan Care and Rehab Centre	0	0	0
	Sizwe TB	2	0	0
	Tshwane Rehabilitation	1	0	0
	Chris Hani Bara	12	9	0
	Charlotte Maxeke	6	4	0
	Dr George Mukhari	12	4	0
	Steve Biko	3	2	0
	Helen Joseph	2	3	0
	Tembisa	5	1	0
	Kalafong	1	0	0
	Rahima Moosa	4	1	0
	Edenvale	0	0	0
	Leratong	6	1	0
	Pholosong	1	0	0
	Sebokeng	2	1	0
	Tambo Memorial	2	1	0
	Far East Rand	3	0	0
	Mamelodi	1	0	0
	Thelle Mogoerane	2	0	0
	Dr Yusuf Dadoo	0	0	0
	South Rand	0	0	0
	Bertha Gxowa	1	0	0
	Heidelberg	1	0	0
	Kopanong	0	0	0
	Pretoria West	1	0	0
	Jubilee	2	0	0
	Odi District	2	0	0
	Carletonville	0	0	0
	Tshwane District	1	0	0
	Bheki Mlangeni	1	0	0
	Bronkhorspruit	0	0	0
KwaZulu-Natal	Ekhulengeni Sanatorium Hospital	1	0	0
	Fort Napier Hospital	2	2	0
	Umgeni Waterfall Institute Hospital	0	0	0
	Townhill Hospital	4	7	0
	Umzimkhulu Hospital	0	2	0
	Madadeni Psychiatric Hospital	2	3	0
	Psychiatric Unit in King George V Hospital	4	0	0
	Psychiatric Unit in Ladysmith Hospital	1	0	0
	Psychiatric Unit in Port Shepstone Hospital	1	2	0
	Addington Hospital	3	0	0
	EThekwini District Office	1	0	0
	GJG Mpanza	1	0	0
	Ngwelezane	3	2	0
	Prince Mshiyeni	1	2	0
	RK Khan	2	1	0
	King Edward	3	1	0
	East Griqualand and Usher District Hospital	0	1	0
	Edendale Regional Hospital	0	3	0
	Estcourt District Hospital	0	3	0
	Ethekwini DHO	0	1	0
	GJ Crookes District Hospital	0	1	0
	Grey's Tertiary Hospital	0	3	0
	Head Office	0	1	0
	Hlabisa District Hospital	0	1	0
	Inkosi Albert Luthuli Central Hospital	0	1	0
	King Dinuzulu District Hospital	0	5	0
	KwaMashu CHC	0	1	0
	Mahatma Gandhi Regional Hospital	0	3	0
	McCord Specialized Eye Hospital	0	1	0
	Mseleni District Hospital	0	1	0
	Murchison District Hospital	0	1	0
	Newcastle Regional Hospital	0	1	0
	Northdale District Hospital	0	3	0
	Queen Nandi Regional Hospital	0	1	0
	Stanger Regional Hospital	0	1	0
	Tongaat CHC	0	1	0
	Vryheid District Hospital	0	1	0
	Wentworth District Hospital	0	2	0
Limpopo	Evuxakeni Hospital	0	0	0
	Hayani Hospital	1	1	0
	Thabamoopo Hospital	1	3	0
	Psychiatric Unit in Donald Fraiser Hospital	0	1	0
	Psychiatric Unit in Elim Hospital	0	1	2
	Psychiatric Unit in Letaba Hospital	1	3	1
	Psychiatric Unit In Malamulele Hospital	0	0	1
	Psychiatric Unit in Mankweng Hospital	3	5	0
	Psychiatric Unit in Matlala Hospital	0	2	0
	Psychiatric Unit in Siloam Hospital	0	0	2
	Psychiatric Unit in Tshilidzini Hospital	0	0	2
Mpumalanga	Psychiatric unit in Rob Ferreira Hospital	2	2	0
	Psychiatric Unit in Witbank Hospital	1	3	0
	Psychiatric Unit in Tintswalo Hospital	0	2	0
	Lydenburg Hospital	0	0	1
	Shongwe Hospital	0	0	1
	Witbank	0	0	1
	Ermelo	0	0	1
	Carolina	0	0	1
	Embhuleni	0	0	1
	Evander	0	0	1
Northern Cape	West End Specialised Psychiatric Hospital	3	3	0
	Frances Baard District	0	3	1
	Robert Mangaliso Sobukwe Hospital	0	1	0
	Pixley Ka Seme District	0	1	0
	Namakwa District	0	1	0
	ZF Mgcawu District	0	1	0
	Dr Harry Surtie	0	2	0
North West	Witrand Psychiatric Hospital	1	8	0
	Bophelong Psychiatric Hospital	1	5	0
	JST Hospital	1	2	0
	Klerksdorp Tshepong Hospital Complex	1	2	0
	Brits Hospital	0	2	0
	Joe Morolong Hospital (Vryburg)	0	1	0
	Mahikeng Provincial Hospital	0	1	0
Western Cape	Alexandra Hospital	1	4	0
	Lentegeur Hospital	11	10	0
	Stikland Hospital	8	8	0
	Valkenberg Hospital	10	6	0
	Tygerberg Hospital Adult Psychiatry	4	0	0
	Tygerberg Hospital: Child and Adolescent Psychiatry Unit	3	3	0

(c) Information on the official language that each person who provides a service in is not collected and reported on in the current health information systems. Information that was provided by provinces shows the following generic or regional trends.

Province	Languages used in providing services
Eastern Cape	Afrikaans; Xhosa; and English
Free State	Afrikaans; English; and Sotho
Gauteng
KwaZulu-Natal	Information not provided
Limpopo	Information not provided
Mpumalanga	Isizulu; Isiswati; IsiNdebele; Tshonga; Sotho; English; Afrikaans; and Pedi.
North West	Information not provided
Northern Cape	English; Afrikaans; and Setswana.
Western Cape	English; Afrikaans; and Xhosa.

(d) Currently the district Health Information system, which is the agreed upon information system between the National and Provincial Departments of Health collects and reports on nine mental health data elements on a monthly basis in terms of the National Indicator Data Set. One of the nine data elements is "mental health client total" which is utilized to calculate and report on caseloads on clients who attended ambulatory (non-patient) services for mental health conditions per facility. The current system does not collect information and report on caseload per health practitioner that provides a service.

Information on the average Mental Health Case Load per Province
Province	April 2018 to March 2019
Eastern Cape	2.2
Free State	3.1
Gauteng	2.5
KwaZulu-Natal	1.7
Limpopo	2.7
Mpumalanga	1.2
Northern Cape	2.2
North West	1.4
Western Cape	1.6

END.