Questions and Replies

Reply:

1. (a) (i) The functionality of the 3480 public health facilities are assessed using the Ideal Clinic Realisation and Maintenance Tool developed by the department of health as part of the Operation Phakisa Ideal Clinic Laboratory. In preparation for the introduction of National Health Insurance (NHI), the Ideal Clinic programme is setting in place a systematic approach to transform all PHC facilities to meet national standards when inspected by the Office of Health Standards Compliance (OHSC). The National Health Amendment Act (12 of 2013) mandates the OHSC to protect and promote the health and safety of health service users through monitoring and enforcing compliance with prescribed norms and standards[1]. The Ideal Clinic programme is the NDoH’s internal mechanism for ensuring PHC facilities’ compliance with these norms and standards in order to satisfy the needs of South African communities.

A dashboard, using the standard traffic-light colours, was developed. The figure below depicts the arrangement of 32 sub-components under 10 components. The 32 sub-components are further subdivided into 206 elements. The number of elements change on an annual basis as the national team receive feedback from clinical staff and managers on clinic and district level about how to improve the framework. Elements are assigned a green colour when they are fully functional, an orange colour if they are partially functional and corrective actions are under way, and a red colour if the element is absent or non-functional.

 

The elements are assigned a vital, essential or important weight in line with the definitions below.

The table below indicates the scores required per element weight.

Weights	Silver	Gold	Platinum
Vital (10 elements)	90%	100%	100%
Essential (86 elements)	70%	80%	90%
Important (110 elements)	68%	78%	89%
AVERAGE	70%-79%	80%-89%	90%-100%

The Ideal Clinic Realisation and Maintenance (ICRM) Programme follows the PLAN, DO STUDY, Act (PDSA) cycle. The first large scale planning took place in October and November 2014. This in-depth planning in a laboratory setting called “Operation Phakisa Ideal Clinic Lab” resulted in a comprehensive implementation plan. The cycle starts with status determinations by PHC facility managers(April to June) and a re-planning session in May. This is followed by the correction of weaknesses (turning red and orange elements green during July to October). In November district peer reviews are done.

Peer review results are immediately captured on the web based ICRM monitoring software tool for the purpose of result analyses (Study). District scale-up teams then assist clinic managers and staff to turn the remaining orange and red elements to green (December to February). In March peer review updates are done to determine achievement for the financial year. The NDoH receives continuous feedback from managers and staff at provincial, district and facility level about changes required to guidelines, standard operating procedures and systems processes that currently cause bottlenecks. The results are used to plan the implementation for the next year. Planning for the following year includes amendments to the framework resulting in a subsequent version.

(ii) Professionals who do the status determinations through peer reviews are from South Africa's 52 health districts. Every year, since the implementation of the programme, 196 professionals are orientated to do the peer reviews.

(b) In the beginning of each financial year since 2015/2016 to date all fixed primary health care facilities in the country are subjected to status determination (assessment) exercise;

(c) The details of the outcome of the assessment from 2015/2016 to 2017/2018 is as follows

District/ Metro	Total Facilities	2015/16 Ideal Clinics	2016/17 Ideal Clinics	No clinics from 2015 to 2017 that remained Ideal in 2017/18	2017/18 Ideal Clinics	Total Ideal Clinics	% Ideal Clinics
Eastern Cape	771	14	128	93	64	157	20.4
Free State	221	22	49	75	39	114	51.6
Gauteng	367	89	133	200	91	291	79.3
KwaZulu-Natal	600	141	204	303	80	383	63.8
Limpopo	477	27	42	49	72	121	25.4
Mpumalanga	288	19	46	46	41	87	30.2
North West	314	7	86	75	46	121	38.5
Northern Cape	164	3	62	58	31	89	54.3
Western Cape	275		36	34	110	144	52.4
South Africa	3,477	322	786	933	574	1507	43.3

(2) The department does not use consultants for this task. District quality assurance and supervisory staff are formed into a team to do peer reviews.

END.

Republic of South Africa.National Health Amendment Act (12 of 2013). Cape Town: Government Gazette No. 367, 24 July 2013. ↑

Reply:

a) The total number of babies born in clinics during 2017 were 34,992;

b) The total number of babies born in hospitals during 2017 were 778,720.

END.

Reply:

Please refer to the attached Annexure 1 for the response to the question.

END.

Reply:

1. (a) (i) Please note that the following details pertain to fleet vehicles rented by the Department, i.e they are not wholly owned by the Department. The Department only pays for excess fee in the event of accidents and damages.

• One hundred and ten (110) accident damages occurred involving departmental rented vehicles for the financial year 2015/16;

• Eighty-nine (89) accident damages occurred involving departmental rented vehicles for the financial year 2016/17;

• One hundred and thirty (130) accident damages occurred involving departmental rented vehicles for the financial year 2018/18.

(ii) No accidents occurred involving departmental rented vehicles since 1 April 2018.

(b) - Insurance excess fee for the financial year 2015/16: R147,518.35

- Insurance excess fee for the financial year 2016/17: R139,897.96

- Insurance excess fee for the financial year 2017/18: R217,455.25

- Insurance excess fee for the period since 1 April 2018: R36,346.96

(c) (i) The details are as follows:

• One (1) accident occurred involving rented departmental vehicle for the financial year 2015/16;

• Two (2) accidents occurred involving rented departmental vehicle for the financial year 2016/17;

• One (1) accident occurred involving rented departmental vehicle for the financial year 2017/18;

• Twenty-four (24) accidents occurred involving rented departmental vehicle since 1 April 2018.

(ii) Supposedly beyond economical repair for the financial years: 2015/16; 2016/17 and 2017/18. No vehicles were written-off since 1 April 2018.

2. Yes, all rented departmental vehicles are fitted with tracking devices.

END.

Reply:

The following table reflects the details in this regard, according to the North West Provincial Department of Health

				Filled Post – Paramedics (April 2018)
	BASIC LIFE UPPORT	INTERMEDIATE LIFE SUPPORT	EMERGENCY CARE TECHNICIAN	PARAMEDICS	Grand Total
North West	360	105	97	1	563
Dr. Kenneth Kaunda	77	26	27	0	130
Ngaka Modiri Molema	88	20	38	0	146
Dr. Ruth Segomotsi Mompati	88	18	14	1	121
Bojanala	107	41	18	0	166
Grand Total	360	105	97	1	563

END.

Reply:

Entity	(1)(a)	(b)	(2)
National Health Laboratory Service	(i) 2016	1	The case involves a male supervisor who gave a lift to one of the junior female staff members after they had completed their shift. The supervisor was alleged to have made inappropriate comments to the lady colleague and also wanted to touch her inappropriately. The matter was reported and the supervisor was subsequently charged and dismissed. He then referred his matter to the CCMA for adjudication. The CCMA ruled in his favour and the NHLS applied to the Labour Court to have the matter reviewed and set aside.	After the matter was reported there was an investigation conducted which led to the conclusion that there was a case to be answered hence the supervisor was charged and dismissed from the NHLS.
	(ii) 2017	1	The case involves a senior manager who is alleged to have shown two junior staff members an inappropriate explicit picture of a pornographic nature. The manager concerned was charged and subjected to a disciplinary enquiry and the matter is still ongoing.	The Matter was investigated and also referred to a disciplinary enquiry as a result of the recommendation from the investigation. This was after prima facie evidence was unearthed.
Council Medical Schemes	(i) 2016	None	None	None
	(ii) 2017	None	None	None
Office of Health Standards Compliance	(i) 2016	None	None	None
	(ii) 2017	None	None	None
South African Medical Research Council	(i) 2016	None	None	None
	(ii) 2017	None	None	None

END.

Reply:

(1) I took a total of 49 international trips in the past five financial years.

a) I travelled with my spouse, Mrs TD Motsoaledi on four of the 49 trips mentioned above. One of these four trips was a fully sponsored trip by the host.

b) None

The table below presents a summary of the trips on which I was accompanied by my spouse.

Purpose of trip	Destination	Total Cost to Dept	Breakdown of cost
			Air ticket	Daily allowance
2013 International Symposium for Design and Health	Doha, State of Qatar	None, the trip was fully paid for by the hosts who invited me to to attend the Symposium	R63 381-00	R6 352-00
Celebration of Diplomatic relations between China and SA World Economic Forum Annual meeting of the New Champions 2014	Tiajin, People's Republic of China	R57 340-47	R51 496-00	R5 844-47
4th meeting of the BRICS Health Ministers	Brasilia, Brazil	R74 038-20	R69 537-39	R4 500-81
Stop TB Partnership Board retreat, meeting and other activities	Paris, France	R71 758-58	R64 996-72	R6 761-86
TOTAL		R203,137.25

(2) Yes, each of the specified trips were approved by the President in terms of the provisions of Section1, Annexure A of the Ministerial Handbook.

END.

Reply:

The Free State Department of Health embarked on a tender process to procure services for Inter Facility ambulance services in order to augment the current Provincial EMS inter facility services within the Province.

The Province took the decision because of shortage of Intermediate and Advance life support staff within the Province that could be deployed on obstetric and critical ambulance inter-facility services.

Since the whole private ambulance matter in the Free State and North West is under investigation by National Treasury, we will have to wait for the findings of the investigation, to arrive at a well informed conclusion.

END.

Reply:

1. (a) The confirmed source of the Listeriosis outbreak, immediately triggered Regulation 4(b) in the Hazard Analysis and Critical Control Point System (HACC) Regulations (R908 of 2003) which requires the mandatory application of the Hazard analysis and Critical Control Point system, audited by the South African National Accreditation System (SANAS) accredited certifying bodies.

The review of the National Health Act, 2003 as well as the Foodstuffs, Cosmetics and Disinfectants Act, 1972 is underway to allow for the incorporation of reporting requirements for food testing.

(b) The South African Meat Processors Association (SAMPA) was consulted through official correspondence as well as a formal meeting.

(c) (i) SAMPA;

(ii) The industry association indicated that as they represent more than 60% of the Ready To Eat (RTE) processing industry, they have no objection that the sector be required to implement the mandatory Hazard Analysis and Critical Control Point system. Levels for Listeria Monocytogenes for the products that they manufactured were clarified in relation to the levels adopted by teh Codex Alimentaius, the joint World Health Organisation and Food and Agricultural Organisation, food standards setting body for protecting consumers and facilitating trade.

2. (a) The guideline levels will be published following extensive consultation with the industry as well as other important stakeholders such as academics, epidemiologists and consumers.

(b) The regulated levels will cover all food categories that are considered as ready to eat.

3. Owing to the risk that these ready to eat meat products pose, a zero tolerance is observed until the outbreak has been contained.

According to the internationally accepted Codex Alimentarius, the current industry practice of 10 cfm/gram in a 25g sample is only applicable for foodstuffs that do not promote the growth of Listeria monocytogenes. Ready to eat processed products implicated in the outbreak promote the growth of Listeria monocytogenes and the internationally agreed level is absent when tested according to the sampling plan.

4. The international guidance has been considered. Consultation referred to in (2)(a) above will need to explore whether a zero tolerance needs to be considered owing to the new scientific research regarding the emerging nature and virulence of Listeria monocytogenes and the current health status of the South African population.

5. (a) The relevant authorities (Department of Health; Department of Agriculture, Forestry and Fisheries; Department of Trade and Industry with its two entities (National Consumer Commission and National Regulator for Compulsory Specifications) have been tasked to review the existing food control system, including legislation and recommend the best way to regulate food safety in the country.

(b) Once the review has been finalised by all parties involved, it will then be taken to the relevant stakeholders for the requisite consultation and comment.

END.

Reply:

(1) (a) Money was spent from the Conditional Grant for the Inter Facility Transfer of patients in the province.

(b) In the 2016/17 and the 2017/18 financial years.

(c) The service procured was for inter facility transfers, that is the moving of patients between health facilities.

(d) The ambulance services procured were for inter-facility transfer of patient and for the financial years mentioned above the costs were as 2016/17 - R45,188,078 and 2017/18 - R207,531,593-50 by March 2018 with other invoices submitted by the service provider for payment amounting to R174,064,224-21, however subject to verification. The contract was for the movement of patient from one health facility to the next so that the patient could get a better level of care. This is for the movement of Priority One, two and three patients.

(e) It is an order based contract.

(2) Some of the invoices were paid in full. When invoices were verified it was noted that some were overcharged. An investigation is underway to try to recover the costs.

END.

Reply:

The following table reflects the details in this regard, according to the Eastern Cape Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
Eastern Cape	1	1	3	1	9	6	16	5	42
BUFFALO CITY					3	2	4	1	10
EASTERN CAPE: DEPARTMENT OF HEALTH					3	2	4	1	10
DISTRICT OFFICE:AMATOLE					3	2	3	1	9
SECTION:PARAMEDICS EMS AMATHOLE						2	2		4
SECTION:BUFFALO CITY STATION EMS AMATHOLE					3		1	1	5
DISTRICT OFFICE:NELSON MANDELA BAY							1		1
SECTION:PARAMEDICS NELSON MANDELA EMS MET							1		1
EMERGENCY RESCUE SERVICES	1	1	2	1	6	4	11	4	30
EASTERN CAPE: DEPARTMENT OF HEALTH	1	1	2	1	6	4	11	4	30
DISTRICT OFFICE:ALFRED NZO							1	1	2
SECTION:PARAMEDICS EMS ALFRED NZO							1		1
SECTION:MALUTI STATION EMS ALFRED NZO								1	1
DISTRICT OFFICE:OR TAMBO					1	1			2
SECTION:PARAMEDICS EMS OR TAMBO						1			1
SECTION:KING SABATA DALINDYEBO STATION EM					1				1
DISTRICT OFFICE:AMATOLE							1		1
SECTION:PARAMEDICS EMS AMATHOLE							1		1
DISTRICT OFFICE:UKHAHLAMBA								1	1
SECTION:PARAMEDICS EMS UKHAHLAMBA METRO								1	1
DISTRICT OFFICE:NELSON MANDELA BAY	1	1	2	1	4	3	8	2	22
SECTION:PARAMEDICS NELSON MANDELA EMS MET					1	1	5	1	8
SECTION:P.E STATION NELSON MANDELA					1				1
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
SECTION:DISPATCH STATION EMS NELSON MANDE					1				1
SECTION:MEDICAL EC EMERGENCY RESCUE			1	1					2
SECTION:RESCUE DRIVING EASTERN CAPE	1	1	1						3
SECTION:PARAMEDICS EMS CACADU METRO						2	3	1	6
SECTION:KOUGA STATION EMS CACADU METRO					1				1
DISTRICT OFFICE:CHRIS HANI					1		1		2
SECTION:PARAMEDICS EMS CHRIS HANI					1		1		2
EASTERN CAPE: DEPARTMENT OF HEALTH			1				1		2
EASTERN CAPE: DEPARTMENT OF HEALTH			1				1		2
DISTRICT OFFICE:NELSON MANDELA BAY			1				1		2
SECTION:MEDICAL EC EMERGENCY RESCUE			1						1
SECTION:PARAMEDICS EMS CACADU METRO							1		1

END.

Reply:

Responses were received from the following Provinces. We are still waiting for responses from the remaining six Provinces and will submit such as soon as we get them.

1. GAUTENG PROVINCE

a) (i) The total number of items of medical equipment that each hospital has is 61 884 (sixty one thousand, eight hundred and eighty four); and

(ii) The total number of items of medical equipment that each clinic has is 10 151 (ten thousand, one hundred and fifty one).

The information is as at the 6th March 2018 per the consolidated departmental asset register.

(b) (i) These equipments fall under the category of medical and allied medical equipment;

(ii) The dates of the equipment for both hospitals and clinics range from 15 March 2000 to 27 February 2018; and

(iii) The total purchase price for the hospitals' equipment is R3 477 066 479.41 (three billion four hundred and seventy seven million, sixty six thousands and four hundred and seventy nine rand and forty one cents) and in respect of the clinics, the total purchase price is R264 962 790.54 (two hundred and sixty four million, nine hundred and sixty two thousands, seven hundred and ninety rand and fifty four cents).

(c) (i) The total number of the dysfunctional equipment and / or require service for the hospitals is 668 (six hundred and sixty eight); and

(ii) The total number of the dysfunctional equipment and / or require service for the clinics is 165 (one hundred and sixty five).

2. EASTERN CAPE

(a) (i) The total number of items of medical equipment that each hospital and

(ii) each clinic combined are 233 206 (two hundred and thirty three thousand two hundred and six).

(b) (i) These equipments fall under the category of medical and allied medical equipment ;

(ii) The dates of the equipment for both hospitals and clinics range from prior 2011/2012 to 2016/2017; and

(iii) The total purchase price is R1 834 734 38 (one billion eight hundred and thirty four million seven hundred and thirty four thousand three hundred and eighty eight).

(c) (i) (ii) The total number of the dysfunctional equipment and / or require service for the hospitals and clinics not indicated.

3. FREE STATE

a) (i) The total number of items of medical equipment that each hospital and

(ii) each clinic combined are 28 594 (twenty eight thousand five hundred and ninety four).

(b) (i) These equipments fall under the category of medical and allied medical equipment ;

(ii) The dates of the equipment for both hospitals and clinics are available

(iii) The total purchase price is R749 691 340 (seven hundred and forty nine million six hundred and ninety one thousand three hundred and forty).

(c) (i) (ii) The total number of the dysfunctional equipment and / or require service for the hospitals and clinics are 365.

END.

Reply:

A total of 1 291 South African medical practitioners who were eligible for community service were appointed. From month-to-month new interns complete and are accommodated as we become aware of them. To date an additional 37 have been allocated.

 

END.

Reply:

All health facilities including hospitals and clinics in the country do have water supply services. However, like any other services there might be interruptions from time to time for various reasons such as breakdowns, drought, etc. in such cases temporary supply services, i.e water cartage takes place to remedy the emergency situation. Depending on the geographical location of the facilities, local authorities like municipalities do assist in emergency cases. Since such activities are at operational level for a short span of time, it is not necessary to keep detailed recording of these activities at the National Department of Health.

END.

Reply:

All health facilities including hospitals and clinics in the country do have water supply services. However, like any other services there might be interruptions from time to time for various reasons such as breakdowns, drought, etc. in such cases temporary supply services, i.e water cartage takes place to remedy the emergency situation. Depending on the geographical location of the facilities, local authorities like municipalities do assist in emergency cases. Since such activities are at operational level for a short span of time, it is not necessary to keep detailed recording of these activities at the National Department of Health.

END.

Reply:

All health facilities including hospitals and clinics in the country do have electricity supply system except for those that are listed in the attached Annexure 1. However, like any other services when there are interruptions from time to time for various reasons such as system breakdowns, etc. standby generator(s) of the facility kicks in and allow the operation of the facilities to continue. All hospitals do have backup generators and those Primary Health Care facilities that do not have backup generators are as reflected in Annexure 1. Since power interruptions are at operational level for a short span of time, it is not necessary to keep detailed recording of these activities at the National Department of Health.

END.

Reply:

All health facilities including hospitals and clinics in the country do have electricity supply system except for those that are listed in the attached Annexure 1. However, like any other services when there are interruptions from time to time for various reasons such as system breakdowns, etc. standby generator(s) of the facility kicks in and allow the operation of the facilities to continue. All hospitals do have backup generators and those Primary Health Care facilities that do not have backup generators are as reflected in Annexure 1. Since power interruptions are at operational level for a short span of time, it is not necessary to keep detailed recording of these activities at the National Department of Health.

END.

Reply:

(1) Not all SMS members declared their financial interests;

(a) The SMS member submitted the form day after the system closure (30 April 2018);

(b) Only one SMS member did not declare his financial interest for past year (2017/2018).

(i) Mr. Kgereshi Mokwenal

(ii) Interim Registrar: Interim Traditional Health Practitioners Council of South Africa

(2) The process of instituting disciplinary action against the member is currently underway;

(3) (a) One official currently suspended on full salary;

(b) Longer than 120 days;

(4) R191 115.76

END.

Reply:

I am not clear as to what the Honourable Member means by a medical machine. Perhaps if the Honourable Member is specific then I would be able to help.

END.

Reply:

The following table reflects the details in this regard, according to the KwaZulu Natal Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
KwaZulu-Natal	2	1	14	5	18	25	43	108
AMAJUBA DISTRICT					2	1	2	5
KWAZULU-NATAL: HEALTH					2	1	2	5
MINISTER: HEALTH					2	1	2	5
EMS AMAJUBA: MADADENI STATION					1	1		2
EMS AMAJUBA: NEWCASTLE STATION					1		2	3
ETHEKWINI DISTRICT					4	7	17	28
KWAZULU-NATAL: HEALTH					4	7	17	28
MINISTER: HEALTH					4	7	17	28
EMS ETHEKWINI: PLANNED PATIENT TRANSPORT					1		1	2
EMRS ETHEK:INTERIM STRUCTURE						1	2	3
EMS ETHEKWINI: ILLOVO STATION						1		1
EMS ETHEKWINI: WARWICK AVENUE STATION						3	4	7
EMS ETHEKWINI: PHOENIX STATION							3	3
EMS ETHEKWINI: WENTWORTH STATION							1	1
EMS ETHEKWINI: MARIANHILL STATION						2	2	4
EMS ETHEKWINI: UMLAZI STATION					1		3	4
EMS ETHEKWINI: KWAMASHU STATION					2		1	3
HARRY GWALA DISTRICT					1	1		2
KWAZULU-NATAL: HEALTH					1	1		2
MINISTER: HEALTH					1	1		2
EMS HARRY GWALA: UNDERBURG STATION						1		1
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
EMS HARRY GWALA: IXOPO STATION					1			1
HEALTH-HEAD OFFICE PMB	2	1	14		1	1	4	23
KWAZULU-NATAL: HEALTH	2	1	14		1	1	4	23
MINISTER: HEALTH	2	1	14		1	1	4	23
HO: EMS COLLEGE	2	1	14				1	18
HO: EMS AERO MEDICAL SERVICES					1	1	2	4
EMS ETHEKWINI: PHOENIX STATION							1	1
ILEMBE DISTRICT					1	1	6	8
KWAZULU-NATAL: HEALTH					1	1	6	8
MINISTER: HEALTH					1	1	6	8
ILEMBE EMRS:INTERIM STRUCTURE							1	1
EMS ILEMBE: ISITHEBE STATION						1		1
EMS ILEMBE: KWADUKUZA STATION							5	5
EMS ILEMBE: NDWEDWE STATION					1			1
KING CETSHWAYO DISTRICT					3	1	2	6
KWAZULU-NATAL: HEALTH					3	1	2	6
MINISTER: HEALTH					3	1	2	6
EMS KING CETSH:UMLALAZI STATION					1		1	2
EMS KING CETSH:MELMOTH STATION							1	1
EMS KING CETSH:UMFOLOZI STATION					2	1		3
UGU DISTRICT					3	4	3	10
KWAZULU-NATAL: HEALTH					3	4	3	10
MINISTER: HEALTH					3	4	3	10
EMS UGU: PORT SHEPSTONE STATION					2	1		3
EMS UGU: UMDONI STATION						1		1
EMS UGU: VULAMEHLO STATION					1		2	3
EMS UGU: UMZIWABANTU STATION						2	1	3
UMGUNGUNDLOVU DISTRICT				1		7	9	17
KWAZULU-NATAL: HEALTH				1		7	9	17
MINISTER: HEALTH				1		7	9	17
EMS UMGUNGUNDLOVU: APPELSBOSCH STATION				1		1	2	4
EMS UMGUNGUNDLOVU: IMBALI STATION						2	2	4
EMS UMGUNGUNDLOVU: PIETERMARITZBURG STATIO						1	3	4
EMS UMGUNGUNDLOVU: HOWICK STATION							2	2
HO: EMS OPERATIONS SERVICES						3		3
UMZINYATHI DISTRICT				2	1	1		4
KWAZULU-NATAL: HEALTH				2	1	1		4
MINISTER: HEALTH				2	1	1		4
EMS UMZINYATHI: NQUTHU STATION				1		1		2
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
EMS UMZINYATHI: UMVOTI GREYTOWN STATION				1				1
EMS UMZINYATHI: DUNDEE STATION					1			1
UTHUKELA DISTRICT				2	1	1		4
KWAZULU-NATAL: HEALTH				2	1	1		4
MINISTER: HEALTH				2	1	1		4
EMS UTHUKELA: ESTCOURT STATION				1		1		2
EMS UTHUKELA: BERGVILLE STATION				1				1
EMS UTHUKELA: LADYSMITH STATION					1			1
ZULULAND DISTRICT					1			1
KWAZULU-NATAL: HEALTH					1			1
MINISTER: HEALTH					1			1
EMS ZULULAND: ULUNDI STATION					1			1
Grand Total	2	1	14	5	18	25	43	108

END.

Reply:

The following table reflects the details in this regard, according to the Free State Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 2	PARAMEDIC GRADE 4	Grand Total
Free State	10	3	1	2	16
FREE STATE: HEALTH	10	3	1	2	16
CONTROL SUBCOMPONENT	10	3	1	2	16
FREE STATE DEPARTMENT OF HEALTH	10	3	1	2	16
ACADEMIC (COLLEGE OF EMS) HEALTH	10	3			13
EMERGENCY MEDICAL SERVICES: XHARIEP DISTR			1		1
EMERGENCY MEDICAL SERVICES: MANGAUNG DIST				1	1
EMERGENCY MEDICAL SERVICES: FEZILE DABI				1	1
Grand Total	10	3	1	2	16

END.

Reply:

The following table reflects the details in this regard, according to the Gauteng Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
Gauteng	3	4	6	8	11	16	9	57
EMERGENCY MEDICAL SERVICES	2		1	8	11	16	9	47
GAUTENG HEALTH	2		1	8	11	16	9	47
DEPARTMENT OF HEALTH	2		1	8	11	16	9	47
EMS SERV JHB			1	3	2	2	2	10
EMS SERV EKURHULENI				1	3	1	1	6
EMS SERV TSHWANE				2	3	3	4	12
EMS SERV WEST RAND				1	2	5	1	9
PPT SERV SEDIBENG	1			1	1	5		8
EMS SEDIBENG PROV	1						1	2
LEBONE COLLEGE OF EMERGENCY CARE	1	4	5					10
GAUTENG HEALTH	1	4	5					10
DEPARTMENT OF HEALTH	1	4	5					10
ACADEMIC SERVICES	1	4	5					10
Grand Total	3	4	6	8	11	16	9	57

END.

Reply:

The following table reflects the details in this regard, according to the Limpopo Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
Limpopo Province	1	2	2	5	1	14	25

VERTICAL PROGRAMMES: HEALTH	1	2	2	5	1	14	25
CONTROL SUB-COMPONENT: HEALTH	1	2	2	5	1	14	25
MEC HEALTH	1	2	2	5	1	14	25
POLOKWANE (L) EMS						1	1
W.F. KNOBEL (S) EMS						1	1
MASHASHANE (NEW STATION) EMS				1			1
MANKWENG (M) EMS						1	1
MAKHADO (L) EMS				1			1
THOHOYANDOU (L) EMS						2	2
GIYANI (L) EMS				1			1
SEKORORO (M) EMS						1	1
TZANEEN (L) EMS						1	1
MECKLENBERG (NEW STATION) EMS				1			1
DILOKONG (M) EMS						2	2
MOKOPANE (L) EMS						2	2
MODIMOLLE (M) EMS						1	1
THABAZIMBI (S) EMS					1		1
MOOKGOPHONG (S) EMS						1	1
BELA-BELA (S) EMS			2				2
LEPHALALE (S) EMS				1		1	2
AUXILLIARY TRAINING: SUBSECTION	1	2					3
Grand Total	1	2	2	5	1	14	25

END.

Reply:

The following table reflects the details in this regards, according to the Northern Cape Provincial Department of Health

	Filled Post – Paramedics (April 2018)
Row Labels	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 2	Grand Total
Northern Cape	2	1	1	4
DEPARTMENT OF HEALTH HEAD OFFICE	1	1	1	3
NORTHERN CAPE:HEALTH	1	1	1	3
PIXLEY KA SEME	1			1
NORTHERN CAPE:HEALTH	1			1
Grand Total	2	1	1	4

END.

Reply:

The following table reflects the details in this regard, according to the Western Cape Provincial Department of Health

	Filled Post – Paramedics (April 2018)
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
Western Cape	1	1	5	11	41	26	35	37	157
EMERGENCY MEDICAL SERVICES	1	1	5	11	41	26	35	37	157
DEPT OF HEALTH	1	1	5	11	41	26	35	37	157
CSP:DDG SPECIALISED AND EMERGENCY SERVICESTH & EMS	1	1	5	11	41	26	35	37	157
WESTERN DIVISION.					10	2	6	6	24
SOUTHERN DIVISION					4	7	3	2	16
EASTERN DIVISION					4	5	6		15
NORTHERN DIVISION					5	6	5	3	19
METRO MEDICAL RESCUE SERVICES					1		3	4	8
OUDTSHOORN EMS								1	1
MOSSEL BAY EMS							1	1	2
GEORGE EMS					1	1	1	1	4
KNYSNA EMS					2		1		3
UNIONDALE EMS					1				1
HERMANUS EMS							1	1	2
SWELLENDAM EMS								1	1
CALEDON EMS						1			1
MEDICAL RESCUE SERVICES OVERBERG								1	1
GRABOUW EMS						1		1	2
RIVIERSONDEREND EMS						1			1
	EMS LECTURER (PARAMEDIC) GRADE 1	EMS LECTURER (PARAMEDIC) GRADE 2	EMS LECTURER (PARAMEDIC) GRADE 3	EMS LECTURER (PARAMEDIC) GRADE 4	PARAMEDIC GRADE 1	PARAMEDIC GRADE 2	PARAMEDIC GRADE 3	PARAMEDIC GRADE 4	Grand Total
VREDENDAL EMS							1	1	2
CLANWILLIAM EMS							1		1
VREDENBURG EMS					2	1		1	4
MALMESBURY EMS					2		1	2	5
MEDICAL RESCUE SERVICES WEST COAST								1	1
LAINGSBURG EMS					1				1
EMERGENCY MEDICAL SERVICES BEAUFORT WEST					1				1
LEEU GAMKA EMS					2				2
EMS CERES HOSPITAL					2		1		3
ROBERTSON EMS					1				1
WORCESTER EMS					2		2	2	6
PAARL EMS							1	2	3
STELLENBOSCH EMS						1	1	2	4
EMS QUALITY ASSURANCE								3	3
OCCUP & HEALTH SAFETY EMS								1	1
ILS TRAINING		1		2					3
ALS TRAINING			2						2
ECT TRAINING			2	4					6
DISTRICT TRAINING	1		1	5					7
Grand Total	1	1	5	11	41	26	35	37	157

END.

Reply:

The response is as follows, according to the Provincial Departments of Health:

Eastern Cape (110 facilities)

The table below indicates the facilities that do not have electricity:

Facility Name	Facility Type (Clinic/CHC/Hospital)	District Municipality Name
Mnceba clinic	Clinic	Mzimvubu (Alfred Nzo)
Mngungu clinic	Clinic	Mzimvubu (Alfred Nzo)
Qobo clinic	Clinic	Mzimvubu (Alfred Nzo)
Amantshangase Clinic	Clinic	Mzimvubu (Alfred Nzo)
Hlamandana clinic	Clinic	Mzimvubu (Alfred Nzo)
Ntlenzi clinic	Clinic	Mzimvubu (Alfred Nzo)
Meje clinic	Clinic	Mzimvubu (Alfred Nzo)
Zulu clinic	Clinic	Mzimvubu (Alfred Nzo)
Qaqa clinic	Clinic	Mzimvubu (Alfred Nzo)
Matubeni clinic	Clinic	Mzimvubu (Alfred Nzo)
Mwaca clinic	Clinic	Mzimvubu (Alfred Nzo)
Tela clinic	Clinic	Mzimvubu (Alfred Nzo)
Lugangeni clinic	Clinic	Mzimvubu (Alfred Nzo)
Ntlabeni clinic	Clinic	Mzimvubu (Alfred Nzo)
Mzongwana clinic	Clinic	Mzimvubu (Alfred Nzo)
Qasa	Clinic	Mzimvubu (Alfred Nzo)
Ntlola clinic	Clinic	Mzimvubu (Alfred Nzo)
Cancele	Clinic	Mzimvubu (Alfred Nzo)
Machibini	Clinic	Mzimvubu (Alfred Nzo)
Umtumase	Clinic	Mzimvubu (Alfred Nzo)
Baleni clinic	Clinic	Mzimvubu (Alfred Nzo)
Ndela clinic	Clinic	Mzimvubu (Alfred Nzo)
Mpetsheni Clinic	Clinic	Mzimvubu (Alfred Nzo)
Sigidi	Clinic	Mzimvubu (Alfred Nzo)
Shepard’s hope clinic	Clinic	Maluti (Alfred Nzo)
Likhetlane clinic	Clinic	Maluti (Alfred Nzo)
Queen’s Mercy clinic	Clinic	Maluti (Alfred Nzo)
Paballong clinic	Clinic	Maluti (Alfred Nzo)
Rolweni clinic	Clinic	Maluti (Alfred Nzo)
Magadla clinic	Clinic	Maluti (Alfred Nzo)
Madlangala	Clinic	Maluti (Alfred Nzo)
Mpharane	Clinic	Maluti (Alfred Nzo)
Makwantini	Clinic	Maluti (Alfred Nzo)
Mount Hargreaves	Clinic	Maluti (Alfred Nzo)
Dundee	Clinic	Maluti (Alfred Nzo)
Daliwe	Clinic	Amahlathi
Cumakala 1	Clinic	Amahlathi
Cumakala 2	Clinic	Amahlathi
Stutterheim Town	Clinic	Amahlathi
Nqabarha	Clinic	Mbhashe
Qwaninga	Clinic	Mbhashe
Keti	Clinic	Mbhashe
Mpozolo	Clinic	Mbhashe
Mahasana	Clinic	Mbhashe
Guba Clinic	Clinic	Emalahleni
Mhlanga Clinic	Clinic	Emalahleni
Tsembeyi Clinic	Clinic	Emalahleni
Xonxa Clinic	Clinic	Emalahleni
Rodana Clinic	Clinic	Emalahleni
Rwantsana Clinic	Clinic	Emalahleni
Lanti Clinic	Clinic	Emalahleni
Sinqumeni Clinic	Clinic	Ngcobo
Eluhewini	Clinic	Ngcobo
Tylenol Clinic	Clinic	Lukhanji
Fransbury Clinic	Clinic	Lukhanji
Braakloof Satellities	Clinic	Lukhanji
Enoch Mgijima Clinic	Clinic	Lukhanji
Sada Clinic	Clinic	Lukhanji
Ncedolwethu Clinic	Clinic	Sakhisizwe
Thembalethu Clinic	Clinic	Sakhisizwe
Mhlwazi Clinic	Clinic	Sakhisizwe
Nieu Bethesda Clinic	Clinic	Camdeboo
Willowmore Clinic	Clinic	Camdeboo
Baviaans Clinic	Clinic	Camdeboo
Rietbron Clinic	Clinic	Camdeboo
Kwanonqubela Clinic	Clinic	Makana
Marselle Clinic	Clinic	Makana
Kenton on Sea Clinic	Clinic	Makana
Nolukhanyo Clinic	Clinic	Makana
Kwanonzwakazi Clinic	Clinic	Makana
Misgund Clinic	Clinic	Kouga
Imizamo Yethu Clinic	Clinic	Kouga
Masakhane Clinic	Clinic	Kouga
St Francis Clinic	Clinic	Kouga
Lukhanyiso Clinic	Clinic	Kouga
Woodlands Clinic	Clinic	Kouga
Loerie Clinic	Clinic	Kouga
Mtambalala Clinic	Clinic	Nyandeni
Ngcoya Clinic	Clinic	Nyandeni
Lutshaya Clinic	Clinic	Nyandeni
Qandu	Clinic	Nyandeni
Kanyayo Clinic	Clinic	Qaukeni
Bala Clinic	Clinic	Qaukeni
Xopozo Clinic	Clinic	Qaukeni
Lubala Health Post Clinic	Clinic	Qaukeni
Nxotwe Clinic	Clinic	Mhlontlo
Shawburry Clinic	Clinic	Mhlontlo
Mdyobe	Clinic	Mhlontlo
Maxhwele Clinic	Clinic	KSD
SOS Clinic	Clinic	KSD
Sonwabile Clinic	Clinic	Elundini
Mangoloaneng Clinic	Clinic	Elundini
Tsitsana Clinic	Clinic	Elundini
Mqokolweni Clinic	Clinic	Elundini
Seqhobong	Clinic	Elundini
Bethania	Clinic	Elundini
Ulundi	Clinic	Elundini
Isikhoba Clinic	Clinic - Paid	Chris Hani
Meje	CHC -Paid	Alfred Nzo
Nkwenkwana Clinic	Clinic - Paid	Chris Hani
Sipetu Hospital	Hospital _ Paid
Magwa	Clinic - Paid	OR Tambo
Ntshentshe	Clinic - Paid	OR Tambo
Sulenkama Hospital	Hospital
Gengqe Clinic	Clinic - Paid	OR Tambo
Mahlubini	Clinic	Chris Hani
Zabasa	Clinic	Chris Hani
Qebe	Clinic	Chris Hani
Nyaniso	CHC
Flagstaff	CHC

Free State (One facility)

Only one facility does not have electricity, but does have a generator on-site.

Facility Name	Facility Type (Clinic/CHC/Hospital)	District Municipality Name
Memel Clinic	Clinic	Thabo Mafutsanyana

Gauteng (One facility)

Only one facility was identified as having no electricity.

Facility Name	Facility Type (Clinic/CHC/Hospital)	District Municipality Name
Thusanong 2	Clinic	West Rand

KwaZulu Natal

All health facilities have electricity.

Limpopo

All health facilities have electricity.

Mpumalanga

All health facilities have electricity.

North-West

All health facilities have electricity.

Northern Cape

All health facilities have electricity.

Western Cape

All health facilities have electricity.

END.

Reply:

Yes.

Medico-legal Workshop

A Medico-legal Workshop was held in Pretoria on the 13th January 2015 to look at medico-legal claims. The workshop looked at the following issues:

• Patient safety;
• The impact of medico-legal litigation on the recruitment of specialists and on access to care in South Africa;
• Management of claims; and
• Ensuring access to justice for patients harmed.

This workshop culminated in the Medico-Legal Summit which was held on 09 -10 March 2015.

Medico-legal Summit

The Medico-Legal Summit was attended by various stakeholders which included medical and legal personnel (public and private sectors); private and public health establishments (hospitals) and the World Health Organisation among others. The Medico-Legal Summit came up with the Medico-Legal Declaration. The Declaration recommended interventions in 3 areas namely: medical (patient safety), administration and legal solutions.

1. Medical Solution (Patient Safety) - This is aimed at reducing the incidences of the negligence, medical malpractice or unethical behaviour and adverse events amongst others.

2. Administrative Solution - This strives to ensure proper record keeping that will minimize the loss or theft of medical records and proper communication with patients and members of the public.

3. Legal Solution - This looks at various legal interventions including but not limited to mediation; contingency fees; the common law rule of “once and for all”; the periodic or staggered payment instead of a lump sum payment.

Medical Solution (Patient Safety)

In implementing the Medical solution (Patient Safety), the following interventions are being implemented:

(a) Ensuring that there is a Patient Experience of Care;

(b) Ensuring that there is Patient Safety Incident and Reporting, Complaints and Compliments Guidelines;

(c) The Office of Health Standards Compliance and the Health Ombud are also critical role players on the compliance with norms and standards for the provision of health services in South Africa;

(d) Ensuring that there are also Committees on Confidential Enquiries into Maternal, Neonatal and Under 5 Deaths; and

Administration

In implementing the Administrative solution, the Department has started with the following interventions:

(a) Improvement of Filing and record systems (from manual record keeping to electronic filling and record keeping);

(b) Patient Record Management;

(c) Patient Registers; and

(d) Health Patient Registration System.

Legal

In implementing the Legal solution, the Department with the assistance of Department of Justice and Constitutional Development is currently busy with the following interventions:

(a) The South African Law Reform Commission (SALRC) under Project 141 – Medico-Legal Claims has undertaken an investigation on various interventions such as mediation; contingency fees; the common law rule of “once and for all”; the periodic or staggered payment instead of a lump sum payment among others. These investigations will lead to legislative reform. In this regard, the SALRC had issued the Issue paper calling for public comments. The closing date was 30 September 2017.

(b) The Department of Justice and Constitutional Development is also introducing the State Liability Amendment Bill, 2018 to introduce periodic or staggered payment of claims instead of a lump sum payment. The State Liability Amendment Bill, 2018 is to provide for the periodic payments instead of lump sum as it is currently and the treatment of Medico-Legal claimants to be provided for in the public sector facilities (Hospitals), free of charge.

The National Health Council (“MinMEC”) passed a resolution to standardize the patient admission forms across Provinces to also include language that allow for mediation as the first compulsory step for resolution of Medico-Legal disputes. This is done with the assistance of the Department of Justice and Constitutional Development (Judge Cassim Sardiwalla and the State Attorney).

END.

Reply:

(1) (a) There are 50 538 doctors (Medical and dental) on the HPCSA register.

(b) (i) The following table reflects the details in this regard.

Province	No. of Doctors in Province
Eastern Cape	3494
Free State	2102
Gauteng	18062
KwaZulu Natal	8747
Limpopo	1976
Mpumalanga	2001
North West	1614
Northern Cape	775
Western Cape	11765
TOTAL	50538

(ii) The HPCSA does not keep a register/record of practitioners leaving the country to practice elsewhere.

(2) (a) Total number of doctors facing disciplinary hearing are as follows:

• Preliminary- 1523
• Professional Conduct – 418

PRELIMINARY

TYPE OF OFFENCE	MEDICAL AND DENTAL
Unethical Advertising	2
Incompetence	607
Over servicing	13
Breach of confidentiality	20
Damaging Professional Reputation of Colleague	12
Insufficient Care/Treatment & Mismanagement of Patients	263
Negligence	2
Unacceptable/Inappropriate Relationship with Patients	25
Refusing to treat patients	53
Misdiagnosis	0
Practicing Outside Scope of competence	0
Fraudulent Certificates/Incorrect Information on Death Certificates	95
Refusing to complete forms / producing inaccurate reports	74
Overcharging / charging for Services not Rendered	56
Issues relating to Consent	23
Fraud and theft	77
Bringing the Professions into disrepute	25
Employing unregistered practitioners	0
Unethical dispensing, using of unregistered medicine and prescribing of drugs	5
Contempt of Council	0
Supersession / Contravening the Hazardous Substances Act, 1973	37
Incorrect Accounts	49
Bad Communication	27
Touting	5
Expose patients to danger	40
Section 51	2
Practicing without registration	11
TOTAL	1523

 

PROFESSIONAL CONDUCT CASES FOR PROSECUTION

TYPE OF OFFENCE	MEDICAL AND DENTAL
Unethical Advertising	4
Incompetence	51
Breach of confidentiality	1
Insufficient Care/Treatment & Mismanagement of Patients	58
Negligence	98
Unacceptable/Inappropriate Relationship with Patients	18
Refusing to treat patients	4
Misdiagnosis	4
Practicing Outside Scope of competence	14
Fraudulent Certificates/Incorrect Information on Death Certificates	16
Refusing to complete forms / producing inaccurate reports	6
Overcharging / charging for Services not Rendered	40
Issues relating to Consent	14
Fraud and theft	52
Bringing the Professions into disrepute	7
Employing unregistered practitioners	6
Unethical dispensing, using of unregistered medicine and prescribing of drugs	2
Contempt of Council	15
Practicing without registration	8
TOTAL	418

(b) This is a matter for South African Police Services

END.

Reply:

(a) (i) Practical completion of the facility was taken on 15 December 2017. The facility keys were officially handed over to the District by the Contractor on 22 February 2018. The CHC has been fully operational since the 22 April 2018.

(ii) The CHC has been fully operational since 22 April 2018. The facility currently provides full 24 hour open door services since April 2018.

(b) The facility is operational.

END.

Reply:

(a) (i), (ii), (iii)

On managing the protocol on Asbestos components in our various public health facilities, in terms of Government Notice R155, covering Regulation 2001 based on which Asbestos guide for Asbestos Regulation 2001 and guide for demolition work all issued in March 2003, a total of 4 394 public health facilities were inspected.

The situation is as follows:

• Asbestos ceilings: 657 (see Annexure 1)
• Asbestos roof: 571 (see Annexure 2)
• Asbestos internal walls: 116 (see Annexure 3)
• Asbestos external walls: 75 (see Annexure 4)

(b) The reason is that in most buildings, especially ceilings, were made of asbestos. We are following the protocol to deal with them as and when necessary according to the guidelines.

END.

Reply:

.(a)-(b) In terms of Government Gazette No R 185 issued in 2012 and the national norms and standards only central hospitals provide transplant services.

There are ten (10) Central Hospitals in South Africa:

1. Groote Schuur in Cape Town (Western Cape)
2. Tygerberg in Stellenbosch (Western Cape)
3. Nelson Mandela Central Hospital in Mthatha (Eastern Cape)
4. King Edward VIII Hospital in Durban (KwaZulu Natal)
5. iNkosi Albert Luthuli Hospital in Durban (KwaZulu Natal)
6. Universitas Hospital in Bloemfontein (Free State)
7. Chris Hani Baragwanath Hospital in Soweto (Gauteng)
8. Charlotte Maxeke Hospital in Parktown (Gauteng)
9. Steve Biko Hospital in Tshwane (Gauteng)
10. George Mukhari Hospital in Ga-Rankuwa (Gauteng)

END.

Reply:

(a) The recommendations were as follows:

(1) To institute disciplinary and incapacity proceedings against the Registrar/CEO, COO and General Manager of Legal Services;

(2) To appoint an interim executive management team;

(3) That the incoming and future Councils of the HPCSA should undergo a structured induction process to ensure an understanding and appreciation by all its members of their legal and governance obligations;

(4) To address the recommendations of the KPMG Forensic Report of November 2011; and

(5) To institute a full organisational review and a proposal for a new governance and administrative structures for the future.

(b) (i) 4 out of 5 have been carried out and finalised, namely –

To institute disciplinary and incapacity proceedings against the Registrar/CEO, COO and General Manager of Legal Services –

Amicable settlement agreements were reached with the previous Registrar/CEO and COO. The settlement was done according to the legal advice the Council obtained.

To appoint an interim executive management team

Council had resolved that should the need arise to fill a vacuum within the Executive Management team, Council would attend to the appointments in line with the Act and the prescribed policies of Council.

All critical vacant senior management positions were filled with a diverse team that was able to ensure that the HPCSA upholds its mandate of protecting the public and guiding the professions.

That the incoming and future Councils of the HPCSA should undergo a structured induction process to ensure an understanding and appreciation by all its members of their legal and governance obligations;

The Council noted the recommendations and the inductions did occur and training was provided. Training of the Council and its structure are ongoing as detailed in the Council’s Annual Performance Plans.

See Council’s mid terms performance report attached under Annexure G1. As well as Councils Annual Performance Plan for 18/19 under Annexure G2.

To address the recommendations of the KPMG Forensic Report of November 2011

The Council reviewed the KPMG reports and its recommendations and resolved as follows –

1. Recommendation One: Waymark Contract

Extract from KPMG Report –

“Although the Waymark contract provides for the rectification of errors by Waymark at their own cost, provided that the HPCSA informs Waymark of such faulty execution to the remedied, this course of action was not taken by the HPCSA.

We strongly recommend that the HPCSA obtain an independent legal opinion with regards to possible recourse in respect of the Waymark contract to remedy the ERS implementation issues.”.

Action by the previous Council

(i) The matter was referred to legal counsel (i.e. Bowman Gilfillan) in 2012/2013.

(ii) Further to the opinion, Bowman Gilfillan advised that it would be necessary to interview Adv B Mkhize, the former Registrar/CEO. Unfortunately the previous Council went out of office before doing so because Adv Mkhize is no longer an employee of the Council.

Action by current Council

Council RESOLVED that the matter be closed due to effluxion of time and prescription having set in.

2. Recommendation Two: Delegation of Authority

Extract from KPMG Report –

“Although the Delegation of Authority provides for various levels of authority for Senior Managers, the COO and the CEO, it places no limit on the amounts that EXCO could approve. Good governance suggests that the mandate, responsibilities and levels of authority of the EXCO be well-defined.

We recommend that the HPCSA review and revise its Delegation of Authority to provide more specific levels of authority to EXCO and indicate instances that may require referral to Council for consideration and approval.”.

Action by previous Council

(i) The recommendation was noted and Management and the Human Resources and Remuneration Committee of Council in 2013 commenced with the revision of the Delegation of Authority (DOA) document, which was last reviewed in 2009;

(ii) The DOA served at the Council workshop in March 2015 and again in June 2015. Council resolved that the DOA be revised to incorporate all of the Council’s inputs and same will be tabled to the newly appointed Human Resources and Remuneration Committee of Council for final review prior to submission to Council for approval;

(iii) The Finance and Investment Committee of Council also ensured that the newly approved Supply Chain Management policy clearly defines the limit delegation of Council and Management

Action by current Council

Council noted the work undertaken by the previous Council and the resolved that the Delegations of Authority document would be considered and approved by the relevant Council structures;

The Delegations of Authority was approved by Council at its 3rd Ordinary Meeting held in September 2016 and is being implemented across all structures of Council.

3. Recommendation Three: Possible Disciplinary Action

Extract from KPMG Report –

“The appointment of at least two consulting firms, namely BPLC and Kakanyo, were not done in accordance with the HPCSA’s procurement policies and procedures. Furthermore, certain expenses paid to service providers could potentially have been avoided, had the Registrar acted in the best interest of the HPCSA by demanding that Waymark rectify the implementation problems at their own cost. In addition, a number of payments to Kakanyo were approved without the proposals having been appropriately approved in terms of the HPCSA’s procurement policies and procedures.

We recommend that the HPCSA considers whether there are sufficient grounds to institute disciplinary action against the following officials for non-compliance with the HPCSA’s procurement policies and procedures and possible failure to act in the best interest of the HPCSA:

• Ms O’Reilly;

• Adv Boikanyo; and

• Mr Mphahlele.

More in-depth investigations may be required into the matters referred to above in order to prepare specific reports and supporting evidence that could be used during a disciplinary hearing, if necessary.”.

Action by previous Council: MMC O’ Reilly

(i) The matter was considered by Council in December 2011 and Council resolved to institute disciplinary action against Ms O’Reilly. The matter was further handled through the office of the President and Legal Counsel: Mponyana Ledwaba Inc.

(ii) The matter was closed.

Action by previous Council: Adv Boikanyo & Mr S Mphahlele

(i) The matter was considered by Council in December 2011 and no action was taken.

(ii) The Matter was reconsidered by Council and in February 2013, the Registrar/ CEO, Dr Mjamba-Matshoba, addressed correspondence to Adv Boikanyo and Mr Mphahlele requesting them to provide explanations for the alleged non-compliance.

(iii) Both parties provided a response to the Registrar/CEO and the matter was closed in line with the Disciplinary Code of Council.

Action by Current Council

In reference to Adv T Boikanyo and Mr S Mphahlele, Council resolved that the matter be closed as the explanations provided by the employees were considered and accepted therefore re-opening the matter would be tantamount to double jeopardy and contrary to law.

4. Recommendation Four: Compliance with the HPCSA’s policies and procedures

Extract from KPMG Report –

“We recommend that the HPCSA communicates its policies and procedures to its staff on a regular basis, through, for example, annual declarations in which the staff acknowledge that they are familiar with the contents of such policies and procedures. This will ensure compliance therewith to avoid the recurrence of, inter alia, the following:

• That a contract, used by another government department, was used as the basis for concluding a contract with a service provider; and
• That the contract was signed without it having been reviewed by the HPCSA’s Legal Department.”.

Action by previous Council

(i) The recommendation was noted and Management in 2012 introduced a process for contract review and developed a contract document control sheet which details the relevant line managers that needs to sign off and approve the contract prior to final sign off.

(ii) The contracts are then housed with the Senior Manager Legal Services and the Office of the Registrar.

Action by current Council

Council noted the mechanisms implemented by Council and resolved that it be monitored accordingly.

(b) (ii) None

(iii) Recommendation number 5. Full organizational review and submit proposals to the Minister for the reform of the administrative and governance structures of the health professions”

In executing the MTT recommendation No. 5, Council embarked on a Turnaround Strategy, to enhance our effectiveness and efficiencies through streamlined services.

Thus, for the past 12 months, Council has been moving towards building a new organisation that will be reputable for its innovation, professionalism and excellence in service delivery.

The Turnaround Strategy has focussed on five key workstreams that are critical to achieving the above-mentioned objective, namely: Vision & Design (Operating Model design), Business Process Re-engineering, Structure & People (Organisational Design), IT and Governance.

Benefits from the Turnaround Strategy are already being realised by HPCSA and their customers through the reduction of turnaround times in the Registration Department and the elimination of backlog practitioner registration applications. Implementation of additional Quick-Wins are underway. A Complaints Handling Unit within Ethics & Professional Conduct is being piloted with the objective of reducing the turnaround time and accuracy of the initial perusal of complaints received by the HPCSA. A complaints backlog reduction plan is also being developed for immediate implementation. Analysis on HPCSA’s governance structure is still underway.

Council at its 9th Ordinary meeting in March 2018, tasked Fever Tree Consulting and Secretariat to embark on a consultative process with all the relevant structures of Council and submit a comprehensive report in the subsequent meetings of Council inclusive of the following:

• 1. Revised Terms of Reference for all Committees of Council including the proposed Inter-Board Committee of Council
  2. Terms of Reference for the Proposed Committees of the Professional Boards including the Joint Standing Committee/s of Professional Boards
  3. New Delegations of Authority
  4. A clear framework on the functioning of Council, Professional Boards and Secretariat in view of the Proposed Committees of Council & Professional Boards, the New Functional/Organizational Design and the New Delegations of Powers/Duties.
  5. The rationale behind the proposed new committee structures of Council and Professional Boards

Other Issues in MTT Report: Council further resolved that all the Professional Board incidents that form part of the report was reviewed and addressed as a matter of urgency. This was done in consultation with the relevant constituencies (e.g. Professional Boards and its committees).

(c) Not Applicable

END.

Reply:

(a) (i), (ii), (iii)

On managing the protocol on Asbestos components in our various public health facilities, in terms of Government Notice R155, covering Regulation 2001 based on which Asbestos guide for Asbestos Regulation 2001 and guide for demolition work all issued in March 2003, a total of 4 394 public health facilities were inspected.

The situation is as follows:

• Asbestos ceilings: 657 (see Annexure 1)
• Asbestos roof: 571 (see Annexure 2)
• Asbestos internal walls: 116 (see Annexure 3)
• Asbestos external walls: 75 (see Annexure 4)

(b) The reason is that in most buildings, especially ceilings, were made of asbestos. We are following the protocol to deal with them as and when necessary according to the guidelines.

END.

Reply:

(a) Ash removal, if the ash is generated from coal, happens in the same way as domestic waste removal. It is removed by municipalities to dumping sites as it happens with ordinary households. No other ash is generated from our facilities because incinerators or other combustion waste treatment facilities have been shut down. However the following facilities are not receiving the service from their municipalities:

NORTH WEST PROVINCE

Name of Healthcare Facility	Location	District	Patient Capacity
1. Morokweng	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
2. Tlakgameng	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
3. Tseoge	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
4. Phaposane	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
5. Kudunkgwane	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
6. Piet Plessis	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
7. Moswana	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
8. Austrey	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
9. Kgokgole	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
10. Kgokgojane	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
11. Tlapeng	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
12. Eckron	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
13. Morokwaneng	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
14. Kokoano	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
15. Setabeng	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
16. Bona-Bona	Kagisano-Molopo Sub-district	Dr RS Mompati	Clinic
17. Bray (CHC)	Kagisano-Molopo Sub-district	Dr RS Mompati	CHC
18. Jericho	Madibeng	Bojanala	Clinic
19. Fafung	Madibeng	Bojanala	Clinic

 

EASTERN CAPE

(i) Name of the healthcare facility	(ii) Location	(iii) Patient capacity
	District	Sub-district
Amabele Clinic	Amathole DM	AmahlatiSD	Clinics
Bolo Clinic
Burnshill Clinic
Cata Clinic
Daliwe Clinic
Dohne Clinic
Donnington Clinic
Ethembeni Clinic
Frankfort Clinic
Gxulu Clinic
Kati-Kati Clinic
Khuze Clinic
Kubusi Clinic
Lenye Clinic
Lower Zingcuka Clinic
Masincedane Clinic
Mgwali Clinic
Mxalanga Clinic
Ntaba ka Ndoda Clinic
Rabula Clinic
St Matthew's Clinic
Qeto clinic
Tyutyu Village Clinic
Wartburg Clinic
Amahleke Clinic	Buffalo City Metro	Clinics
Bhele Clinic
Bulembu Clinic
Cwili Clinic
Gwabeni Clinic
Hamburg Clinic
Horton Clinic
Imidange Clinic
Jaji Clinic
Jama Clinic
Komga Rural Clinic
Kwelera Clinic
Masele Clinic
Matomela Clinic
Mdingi Clinic
Mncotsho Clinic
Mooiplaas Clinic
Mount Coke Clinic
Mpongo Clinic
Mtombe Clinic
Mtyholo Clinic
Ncera Clinic
Ndevana Clinic
Ndwayana Clinic
Needs Camp Clinic
Newlands Clinic
Ngqwele Clinic
Nier Clinic
Noncampa Clinic
Norah Clinic
Openshaw Clinic
Pikholi Clinic
Pirie Clinic
Potsdam Clinic
Qurhu Clinic
Robert Mbelekana Clinic
Soto Clinic
Tshabo Clinic
Tshatshu Clinic
Twecu Clinic
Tyamzashe FP Clinic
Tyutyu Clinic
Zikhova Clinic
Empilweni CHC		CHC
Badi Clinic	Amathole DM	Mbhashe SD	Clinics
Bolotwa Clinic (Idutywa)
Bomvana Clinic
Fort Malan Clinic
Gwadana Clinic
Gwadu Clinic
Idutywa Nqabara Clinic
Jingqi Clinic
Kwa-Mkholoza Clinic
Lota Clinic
Mahasana Clinic
Melitafa Clinic
Mpozolo Clinic
Mqhele Clinic
Msendo Clinic
Nkanya Clinic
Nqabara Clinic
Nqabeni Clinic
Nqadu Clinic (Mbhashe)
Nyhwara Clinic
Soga Clinic
Sundwana Clinic
Taleni Clinic
Vukukhanye Gateway Clinic
Xhora CHC			CHC
Madwaleni Hospital			Hospital
Dr CL Bikitsha Clinic	Amathole DM	Mnquma SD	Clinics
Gcaleka Clinic
Gqunqe Clinic
Grainvalley Clinic
Hebe-Hebe Clinic
Highview Clinic
Kotana Clinic
Mnyibashe Clinic
Mqambeli Clinic
Ncizele Clinic
Ndabakazi Clinic
Ngqusi Clinic
Nqancule Clinic
Ntseshe Clinic
Qina Clinic
Qolora-By-Sea Clinic
Springs Clinic
Tafalofefe Gateway Clinic
Tanga Clinic
Tutura Clinic
Tyali Clinic
Zazulwana Clinic
Nqamakhwe CHC			CHC
Tafalofefe Hospital	Amathole DM	Nkonkobe SD	Clinics
Adelaide Gateway Clinic
Amathole Basin Clinic
Assina Mandla Clinic
Balfour Clinic
Bedford Clinic
Bezuidenhoutville Clinic
CC Lloyd Clinic
Debe Nek Clinic
Gilton Clinic
Gxwederha Clinic
Healdtown Clinic
Hillside Clinic (Nkonkobe)
Kolomana Clinic
Lower Regu Clinic
Lulama Kama Clinic
Melani Clinic
Mgwalana Clinic
Msobomvu Clinic
Mzamomhle Clinic (Bedford)
Njwaxa Clinic
Nomakhwezi Makhenyane Clinic
Perksdale Clinic
Qibira Clinic
Rwarwa Clinic
Seymour Clinic
Sheshegu Clinic
Thozamile Madakana Clinic
Upper Ncera Clinic
Victoria Gateway Clinic
War Memorial Clinic
Washington Clinic
Zigodlo Clinic
Zihlahleni Clinic
Bengu Clinic	Chris Hani DM	Emalahleni SD	Clinics
Boomplaas Clinic
Guba Clinic
Hlala Uphilile Clinic
Lanti Clinic
Maqashu Clinic
Mhlanga Clinic
Mkapusi Clinic
Mount Arthur Clinic
Ndonga Clinic
Nompumelelo Clinic
Qoqodala Clinic
Queen Nonesi Clinic
Rodana Clinic
Rwantsana Clinic
Swartwater Clinic
Tsembeyi Clinic
Vaalbank Clinic
Xonxa Clinic
Ngonyama CHC			CHC
Banzi Clinic	Chris Hani DM	Intsika Yethu SD	Clinics
Bilatye Clinic
Bolotwa Clinic (Confimvaba)
Cwecweni Clinic
Gqogqora Clinic
Isikhoba Clinic
Keti Clinic
Lower Mncuncuzo Clinic
Lower Seplan Clinic
Lubisi Clinic
Luthuli Clinic
Magwala Clinic
Mahlubini Clinic
Mawusheni Clinic
Mbulukweza Clinic
Mcambalala Clinic
Mtingwevu Clinic
Ncora Clinic
Ngceza Clinic
Ngxabangu Clinic
Nququ Clinic
Ntshingeni
Plumstead Clinic
Qamata Clinic
Qitsi Clinic
Qombolo Clinic
Qumanco J Tribal Clinic
Sabalele Clinic
St Mark's Clinic
Tsakana Clinic
Upper Mncuncuzo Clinic
Bacclesfarm Clinic	Chris Hani DM	Inxuba Yethemba SD	Clinics
Baroda Clinic
Fishriver Clinic
Kleinbulhoek Clinic
Mitford Clinic
Rocklands Clinic
Springrove Clinic
Thornhill CHC
Tentergate Clinic
Zola Clinic
Cimezile Clinic	Chris Hani DM	Lukhanji SD	Clinics
Didimana Clinic
Ekuphumleni Clinic
Eluhewini clinic
Engojini Clinic
Gwatyu Clinic
Hackney Clinic
Haytor Clinic
Hukuwa Clinic
Kamastone Clinic
KB Siswana Clinic
Lahlangubo Clinic (Queenstown)
Lesseyton Clinic
Machibini Clinic (Queenstown)
Oxton Clinic
Pricesdale Clinic
Shiloh Clinic
Tsitsikamma Clinic
Yonda Clinic
Zingquthu Clinic
Zweledinga Clinic
Bokleni Clinic	Chris Hani DM	Ngcobo SD	Clinics
Clarkebury Clinic
Elucwecwe Clinic
Gqaga Clinic
Gubenxa Clinic
Lahlangubo Clinic (Ngcobo)
Manzana Clinic
Mdanjelwa Clinic
Mgudu Clinic
Mhlopekazi Clinic
Mjanyana Clinic
Mnyolo Clinic
Nkwenkwana Clinic
Ntsimba Clinic
Qebe Clinic
Qumanco Clinic
Tora Clinic
Zabasa Clinic
Zadungeni Clinic
Zwelakhe Dalasile Clinic
Mjanyane Hospital			Hospital
Askeaton Clinic	Chris Hani DM	Sakhisizwe SD	Clinics
Beestekraal Clinic
Manzimahle Clinic
Ncedolwethu Clinic
Nyalasa Clinic
Sifonondile Clinic
Tembelihle Clinic
Thembalethu Clinic
Tsengiwe Clinic
Upper Lafuta Clinic
Efata Clinic	OR Tambo DM	King Dalindyebo SD	Clinics
Hlabatshane Clinic
Jalamba Clinic
Kambi Clinic
Lutubeni Clinic
Mahlungulu Clinic (KSD)
Mapuzi Clinic
Maxwele Clinic
Mpeko Clinic
Mpindweni Clinic
Mpunzana Clinic
Mqhekezweni Clinic
Ncambele Clinic
Ndibela Clinic
Ngcengane Clinic
Ngqungqu Clinic
Ngwenya Clinic
Nqwathi Clinic
Ntlangaza Clinic
Ntshabeni Clinic
Ntshele Clinic
Nzulwini Clinic
Phakamile Clinic
Qokolweni Clinic
Qunu Clinic
Sangoni Clinic
Sitebe Clinic
Tabase Clinic
Tshezi Clinic
Tyelebana Clinic
Upper Xongora Clinic
Wilo Clinic
Xhwili Clinic
Zidindi Clinic
Zitatele Clinic
Zitulele Gateway Clinic
Zwelichumile Clinic
Ngcwanguba CHC
Mbekweni CHC
Baziya CHC
Mqanduli CHC
Zitulele Hospital			Hospital
Caba Clinic	OR Tambo DM	Mhlontlo SD	Clinics
Ezingcuka Clinic
Gura Clinic
Kalankomo Clinic
Langeni Clinic
Lotana Clinic
Lower Gungululu Clinic
Mahlungulu Clinic (Mhlontlo)
Mbokotwana Clinic
Mdyobe Clinic
Mhlahlane Clinic
Mjika Clinic
Nessie Knight Clinic
Ngwemnyama Clinic
Nqadu Clinic (Qumbu)
Nxotwe Clinic (Qumbu)
Qanqu Clinic
Shawbury Clinic
Sidwadweni Clinic
St Lucy's Clinic
Tina Falls Clinic
Tsilitwa Clinic
Mhlakulo CHC			CHC
Nessie Knight Hospital			Hospital
St Lucys Hospital			Hospital
Bambisana PHC Clinic	OR Tambo DM	Nyandeni SD	Clinics
Bomvini Clinic
Buchele Clinic
Buntingville Clinic
Caguba Clinic
Canzibe Gateway Clinic
Cwele Clinic
Double Falls Clinic
Isilimela Gateway Clinic
Kohlo Clinic
Ludalasi Clinic
Lujizweni Clinic
Lutshaya Clinic
Lwandile Clinic
Majola Clinic
Makhotyana Clinic
Malusi Clinic
Mampondomiseni Clinic
Mangcwanguleni Clinic
Mantusini Clinic
Mbalisweni Clinic
Mevana Clinic
Mgwenyane Clinic
Mtambalala Clinic
Mzintlava Clinic
Ndanya Clinic
Ngcolora Clinic
Ngcoya Clinic
Nkanga Clinic
Nkanunu Clinic
Nkumandeni Clinic
Nolita Clinic
Nontsikelelo Biko Clinic
Nqanda A Clinic
Ntafufu Clinic
Ntapane Clinic
Ntibane Clinic
Nyandeni Clinic
Old Bunting Clinic
Pilani Clinic
Qandu Clinic
St Barnabas Gateway Clinic
Maqanyeni CHC			CHC
Tombo CHC			CHC
Bambisana Hospital			Hospital
Canzibe Hospital			Hospital
Isilimela Hospital			Hospital
Amadiba Clinic	OR Tambo DM	Qaukeni SD	No information on patient headcounts.
Amandengane Clinic
Amantshangase Clinic
Bala Clinic
Baleni Clinic
Bodweni Clinic
Daliwonga Clinic
Dungu Clinic
Goso Forest Clinic
Hlamandana Clinic
Holy Cross PHC Clinic
Imizizi Clinic
Isikelo Clinic
Kanyayo (Bizana) Clinic
Khanyayo (Holy Cross) Clinic
Magwa Clinic
Makwantini Clinic
Malangeni Clinic
Malongwana Clinic
Mangqamzeni Clinic
Mantlaneni Clinic
Matubeni Clinic
Meje Clinic
Mfundambini Clinic
Mfundisweni Clinic
Mkambathi Clinic
Mnceba Clinic
Mpetsheni Clinic
Mpoza Clinic (Lusikisiki)
Ndawenzima Clinic
Ndela Clinic
Nkozo Clinic
Ntlenzi Clinic
Ntshentshe Clinic
Palmerton Clinic
Qaqa Clinic
Qasa Clinic
Qaukeni Clinic
Qobo Clinic
Sigidi Clinic
Tsawana Clinic
Xopozo Clinic
Xurana Clinic
Zulu Clinic
Holly Cross Hospital			Hospital
Hlangalane Clinic	Joe Gqabi DM	Elundini SD	No information on patient headcounts.
Hlankomo Clinic
Katkop Clinic
Lower Tsitsana Clinic
Mangoloaneng Clinic
Mqokolweni Clinic
Ncembu Clinic
Ngxaza Clinic
Queen Noti Clinic
Seqhobong Clinic
Sonwabile Clinic
St Augustine's Clinic
Ulundi Clinic
Umnga Flats Clinic
Bensonvale Clinic	Joe Gqabi DM	Senqu SD	Clinics
Bluegums Clinic
Esilindini Clinic
Hillside Clinic (Senqu)
Hlomendlini Clinic
Masibulele Clinic
Musong Clinic
Ndofela Clinic
Palmietfontein Clinic
Pelandaba Clinic
St Michael's Clinic
Sunduza Clinic
Umlamli Gateway Clinic
Wittebergen Clinic
Umlamli Hospital			Hospital

(b) The local municipalities are unable to provide the service hence these clinics resort to pit burning.

We are still awaiting responses from other provinces. As soon as we get them we will send the list to the Honourable Member.

END.