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22 September 2023 - NW2809

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Shaik Emam, Mr AM to ask the Minister of Health

Whether, noting that a large number of medical students who have studied in the People’s Republic of China at great expense are now having great difficulty in writing their board examinations in the Republic, his department has intervened to ensure that medical students who have studied abroad, particularly in the People’s Republic of China, are given the opportunity to write their board examinations so that they could seek employment in the public and/or private sector; if not, why not; if so, what interventions?

Reply:

The Department regularly engages with the Health Professions Council of South Africa (HPCSA) on matters pertaining to functions and functioning of the HPCSA, including challenges experienced relating to finalisation of the service level agreement with the service provider to conduct the board examination.

According to the response received from the HPCSA, registration with the HPCSA for foreign qualified applicants is only approved after assessment of the training. The relevant board must satisfy itself that, the curriculum and/or training received is equivalent to that offered in South African institutions, or at least, satisfactory. For the relevant board to make the necessary determination, it relies on the submission of documentary evidence by the applicants for review.

Such documents must respond to requirements as set by the relevant board, including hours of training received, domains and evidence of satisfactory clinical exposure during training. The documents, usually written in foreign languages, may also need to be translated into English and notarised. A Task Team of the relevant board will review the submissions and may decide to either reject the application or subject the applicant to a board examination. Once the board has approved the application for a board exam, the applicant may need to wait until a board examination is available according to set schedules (exams are available frequently set, and sometimes, may happen only twice in a year). These processes are lengthy, and may sometimes take several months, especially as applicants sometimes do not provide all the documentary evidence as required timeously (a non-compliant application will not be processed).

Medical Board examinations are managed on behalf of the Medical and Dental Board (MDB) by an appointed service provider. Previously, this was the Sefako Makgatho University (SMU) whose contract expired, following extensions, in March 2023. The HPCSA had already started a supply chain management process to seek a replacement service provider, with initial bids advertised in March 2022. There was only one bidder that responded, which sadly did not meet the requirements. A closed bid was subsequently advertised in July 2022 to all universities with medical schools.

The same institution again was the sole respondent, still not meeting requirements. Management resultantly sought deviation from Council to enable negotiations with the same institution to provide guidance to ensure that requirements are met. The process took a long time, and it is only being concluded now, with a draft contract negotiated, and will soon be ready for signing.

The HPCSA is still planning to have a round of theory and practical examinations before the end of this year, followed by another round as early as possible next year to address the current backlog of applications received.

 

END.

22 September 2023 - NW2866

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Ceza, Mr K to ask the Minister of Health

What are the details of the steps of intervention that have been taken to ensure that patients with clinical referrals are not turned away at the H A Grove Hospital in Mpumalanga, as it is the case currently?

Reply:

According to Mpumalanga Department of Health patients were never turned away. H A Grove Hospital is one of the two district hospitals servicing patients from Emakhazeni sub-district in Nkangala district, as direct patients or referrals from the local clinics both as emergencies and outpatients. The outpatient department has a booking system to avoid long queues and long waiting times. Patients are booked according to the different outpatient clinics.

END.

22 September 2023 - NW2612

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Komane, Ms RN to ask the Minister of Health

With reference to his reply to question 1754 on 12 June 2023, what are the relevant details of the personnel who were placed at the clinic when it was operational, (b) on what date did each person (i) start to work at the clinic and (ii) leave the service of the clinic and (d) what are the reasons that the satellite clinic was closed?

Reply:

According to the North West provincial health department:

(a) Makolokwe Ward 29 in Rustenburg has a mobile service point and staff are not appointed to the service point but are assigned from the Sub-district office to perform the mobile service. The current staff that are on the mobile clinic are: 1 x Professional Nurse; 1 x Enrolled Nursing Assistant and 1 x Driver.

(b) (i) and (ii) Please see response to (a) above. Furthermore, there are no staff members specifically allocated to the mobile services as they are from the fixed clinic the mobile is attached to, hence when the professional nurse for the mobile is not available, one professional nurse from the facility will be rendering mobile services.

(c) The health service point has never operated as a satellite clinic but operated as a mobile point since 2002 as indicated in the response (a) (i) to question 1754 on 12 June 2023. This mobile point was not closed but in pursuit of better conditions (parking space, waiting area for patients) moved to the Community Hall in the same Ward 29. The mobile service is still operational to date.

END.

22 September 2023 - NW2615

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Mogale, Mr T to ask the Minister of Health

Which health facilities has he found account for the most medico-legal claims in each province?

Reply:

The following table reflects the details in this regard:

Table 1.

NAME OF THE PROVINCES

HEALTH FACILITIES HAS HE FOUND ACCOUNT FOR THE MOST MEDICO-LEGAL CLAIMS IN EACH PROVINCE?

Eastern Cape

1. Livingstone Hospital

 

2. Frere Hospital

 

3. Mthatha Regional Hospital

 

Free State

1. Pelonomi Regional Hospital

 

2. Mofumahadi Manapo Mopeli Regional Hospital

 

3. Bongani Regional Hospital

 

Gauteng

1. Chris Hani Baragwanath Academic Hospital

 

2. Thelle Mogoerane Regional Hospital

 

3. Tembisa Hospital

 

Kwazulu-Natal

1. Prince Mishyeni Memorial Hospital

 

2. King Edward the 8th Hospital

 

3. RK Kahn Hospital

 

Limpopo

1. Tshilidzini Hospital

2. Pietersburg Hospital

3. Mankweng Hospital

 

Mpumalanga

1. Rob Ferreira Hospital

 

2. Themba Hospital

 

3. Witbank Hospital

 

Northern Cape

1. Robert Mangaliso Sobukwe Hospital

 

2. Kuruman Hospital

 

3. Dr Harry Surtie Hospital

 

NorthWest

1. Mahikeng Provincial Hospital

 

2. Klerksdorp Hospital

 

3. Job Morolong Memorial Hospital

 

Western Cape[1]

1. Tygerberg Hospital

 

2. Groote Schuur Hospital

 

3. Mowbray Maternity Hospital

END.

  1. According to Western Cape’s response: The Department has not identified any specific facility with any disproportionate number of claims, compared to other facilities. Tygerberg, Groote Schuur and Mowbray Maternity Hospitals together account for 31.15% of active claims.

22 September 2023 - NW2808

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Shaik Emam, Mr AM to ask the Minister of Health

What are the latest developments in his department with regard to medical graduates who have completed community service and remain unemployed, as he had previously indicated that he was in talks with the Minister of Finance, Mr E Godongwana, for funding to employ such medical graduates?

Reply:

To date from January 2023, a total of 3 974 posts of medical doctors were advertised and filled as compared to 2 053 medical doctors posts of the previous year (2022) for the same periods of employment. This means that an additional 1 921 posts for medical doctors were funded to accommodate unemployed medical doctors.

It is also acknowledged that not all unemployed medical doctors after completing community service, applied for these positions due to their different personal interests (e.g. Preference of urban areas rather than rural).

It remains the obligation for the Department of Health to ensure that sufficient employment is available for all eligible South African Citizens and Permanent Residents for medical internship and community service. This is to enable them to fulfil the legal requirements to qualify for independent practice, after which they can to seek employment either in public or private sector.

The National Department of Health remains accessible/open to refer unemployed medical doctors, either individually or through their Associations, to Provinces for recruitment to available funded posts.

 

END.

22 September 2023 - NW2617

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Montwedi, Mr Mk to ask the Minister of Health

(a) What is the current status of the backlog on elective surgeries in the (i) Robert Mangaliso Sobukwe Hospital in Kimberly and (ii) in the province and (b) how does he plan to address the issue of elective surgery backlogs in each province?

Reply:

The Honourable Member is kindly referred to the attached Annexure 1, containing the response to the same question asked by Honourable Christians of the DA.

END.

Annexure 1

NCOP

QUESTION: 187

FOR ORAL REPLY

DATE: 06 SEPTEMBER 2023

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 AUGUST 2023

(INTERNAL QUESTION PAPER NO. 30)

Ms D C Christians (Northern Cape: DA) to ask the Minister of Health:

(a) What is the current surgery backlog at Robert Mangaliso Sobukwe Hospital in Kimberley and (b) to what extent are elective surgeries taking place as opposed to emergency operations? CO724E

REPLY:

a) According to the Northern Cape Department of Health, the current surgical backlog at Robert Mangaliso Sobukwe Hospital in Kimberley is standing at 6000 cases as at 31 August 2023. This backlog was accumulated during the Covid-19 period. The following table shows the breakdown per specialty field:

Area

Surgery backlog

Type

Waiting time

Urology

471

Multiple type of operations

20 months

General surgery

201

Multiple type of operations

4-5 months

Orthopaedics

Emergency – 41

Elective – 481

Arthroplasty – 509

Hands – 131

Wards – 59

Total = 1221

Multiple type of operations

2-3 months

Ear-Nose-Throat (ENT)

977

Multiple types of operations

6 months

Ophthalmology

Cataract – 2060

Other – 634

Total 2694

Blind patients

Partially sighted

Pterygium

Oculoplastic and strabismus

Children with squint

2-3 months

Plastic Surgery

52 electives

Multiple type of operations

No waiting time

Oral and Maxillo-Facial

65 patients

Multiple type of operations

No waiting time

Obstetrics and Gyneacology

250 patients

Multiple type of operations

Gynae 6 months

b) Robert Mangaliso Sobukwe Hospital has the possibility to operate in 8 theatres, but due to severe speciality nursing staff shortage the hospital can only operate in 3 theatres on a daily basis Monday to Friday. One operating theatre is reserved for elective surgeries which are performed daily from 08h00 - 16h00 Monday to Friday.

Emergency surgeries are done daily on a 24/7 surgical list basis. During weekends the hospital only performs emergency cases. The average number of emergencies per week is 105 cases.

 

END.

22 September 2023 - NW2555

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Clarke, Ms M to ask the Minister of Health

What steps will his department take to address the brain drain of medical professionals to foreign countries, which is an apparent rebellion against the Government’s proposed National Health Insurance?

Reply:

The department has noted media reports regarding apparent rebellion against the Government’s proposed National Health Insurance. Brain drain of health personnel in search of a better standard of living and life quality, higher salaries, access to advanced technology and more stable political conditions in different places worldwide is a common global phenomenon.

As long ago as 1998 Weiner, Mitchell, Price published findings that data from South African medical schools suggested that a third to a half of medical graduates emigrated to the developed world. There are many well documented ‘push’ and ‘pull’ factors, such as:

Push Factors

  • Financial reasons
  • Limited career opportunities
  • Poor working conditions and management (corruption, limited     resources, equip. etc.)
  • Political instability, war, violence

Pull Factors

  • Financial reasons
  • Greater career opportunities
  • Better opportunities for family (schooling, living conditions, etc.)
  • Recruitment by destination countries

Policies that are currently in place to control healthcare worker migration have, since May 2010, included the WHO Global Code of Practice on the International Recruitment of Health Personnel. This is a voluntary protocol that sets principles and recommendations for health workers and associated stakeholders concerning migration. The key components of the code include:

  • Commitment to assisting countries facing critical health workforce shortages
  • Investment in information systems to monitor international migration of health workers
  • Emphasis on education and efforts to retain health workforces in member states
  • Protection of migrant worker’s rights
  • Responsible recruitment policies by destination/receiving countries and fair treatment of migrant health workers

Our own policy considers directly addressing some of the push and pull factors that drive health workers to migrate. But the issue is complex and multifaceted, particularly because demand remains for healthcare workers in developed countries.

END.

22 September 2023 - NW2606

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Chirwa, Ms NN to ask the Minister of Health

(1)On what date will his department open and operationalise the 30-bed mental health facility in the Gert Sibande District Municipality in Mpumalanga; (2) whether the mental health needs of the patients in the region will be catered for in their entirety and the demand for mental health services be met through the specified facility; if not, what is the position in this regard; if so, what are the relevant details; (3) how does the facility plan to ensure that mental health awareness is part and parcel of the nearby communities it will serve; (4) what services will the facility offer in the wide spectrum of mental health needs and/or services?

Reply:

1. The mental health facility was opened and operationalised with effect from 14 April 2023.

2. The facility provides a comprehensive package of mental health services to voluntary, assisted and involuntary mental health care users. It also provides child and adolescent mental health services on an outpatient basis and forensic mental observations that are conducted on an outpatient basis. The facility does not have capacity to admit State patients or accused that require forensic mental observations by a panel in terms of Section 79 of the Criminal Procedures Act, 1977. The facility also does not have inpatient beds for children and adolescents. Mpumalanga province is in a process of constructing a 220 bedded specialised psychiatric hospital that will provide specialised mental health services including forensic mental health services, inpatient child and adolescent mental health services as well as services for those mental health care users whose conditions and treatment plans require medium to long term hospital stay. This facility when commissioned will service the entire population of Mpumalanga.

3. The facility plans to collaborate with other stakeholders including schools, primary health care clinics, school health nurses, NGOs and mental health care users themselves in the area to educate the surrounding communities and raise awareness on mental health.

4. The facility offers:

  • Inpatient and outpatient mental health services to voluntary, assisted and involuntary categories of mental health care users
  • Outpatient child and adolescent mental health services
  • Mental disorders, substance abuse and dual diagnosis treatment programmes
  • Psychogeriatrics programmes
  • Outpatient single psychiatrist forensic mental observations of accused in terms of the Criminal Procedures Act, and also
  • Conduct mental health research and training

END.

22 September 2023 - NW2577

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Havard, Dr X to ask the Minister of Health

What is the status of improving (a) mental health facilities and (b) health education programmes in rural and township communities?

Reply:

(a) The Mental Health Care Act 2002, (Act No 17 of 2002) (the Act) prescribes adherence to human rights principles in rendering mental health services which includes humane and fit for purpose facilities. Furthermore, the Act prescribes integration of mental health into the general health services environment. The Department has made strides in improving mental health facilities to comply with the human rights prescripts in the Mental Health Care Act, 2002. Among these are the following:

  • Mental Health Infrastructure norms were developed and gazetted in 2014. These guidelines ensure that new mental health infrastructure construction and revitalisation of the current infrastructure complies to the Mental Health Care Act, 2002 and the other health and human rights prescripts.
  • Mental health units have been attached to forty-two (42) general hospitals to increase access to mental health services and strengthen integration of mental health into the general health services environment. We continue with this expansion of service within the annual available budget.

(b) The Department is implementing different approaches to educate the public in urban, rural and townships communities on communicable diseases, risk factors to non-communicable diseases including mental health, mother and child health and safety from injuries. This is done in partnership with other government departments, professional bodies, schools, provincial communicators and NGO’s. The department has developed targeted message for priority conditions and these are communicated through role playing, poetry community dialogues and platforms such as radio and social media.

In PHC facilities, clients are educated on different topics on a daily basis. Fact sheets are developed and translated into different languages, these are accessible in health facilities and distributed during campaigns. Different Apps such as Mom Connect and B-Wise are used to send messages to different target groups. The B-Wise App aims to engage youth on health and the content includes mental health issues. Health experts respond to young people through this App.

END.

22 September 2023 - NW2662

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Clarke, Ms M to ask the Minister of Health

(1)Whether, with reference to the Conference of the Parties (COP) to the World Health Organisation (WHO) framework Convention on Tobacco Control (FCTC), the Meeting of the Parties (COP) to the Protocol that will be held in November 2023 in Panama, as well as the WHO Framework Convention on Tobacco Control AFRO (AFRO) regional meeting taking place in Rwanda from 23 to 27 October 2023, (a) the delegation, including potential members from other government departments, public sector entities and participants not working in the public sector have been mandated to agree to any new stipulations under the COP Treaty; if not, why not; if so, what is the extent of this mandate; (2) whether any part of the mandate to agree to any new stipulations falls outside of current legislation; if not, what is the position in this regard; if so, what are the relevant details; (3) whether public comment from the legislative process related to the Tobacco Products and Electronic Delivery Systems Control Bill has been incorporated into the delegation’s mandate as well as into the mandate of delegations for MOP and AFRO; if not, why not; if so, what are the relevant details; (4) whether any measures, in terms of the delegations to COP, MOP and AFRO’s decision-making and mandate formation, have been put in place to ensure its work does not pre-empt the legislative process and nullify public participation process on the live bill; if not, why not, if so, what are the relevant details?

Reply:

(1) The delegates would agree with mandates that are in-line with the country’s goals, existing and planned regulatory frameworks to control the use of Tobacco and related products.

(2) The current Tobacco Products and Electronic Delivery Systems Control Bill has not been passed yet, if during the consultative process there individual or stakeholders that would propose amendments that can advance public health without compromising the health of vulnerable groups they may be considered.

(3) The mandate of the delegation is to engage on matters that will advance public health, as indicated in earlier responses, the country position on various agenda items has not been finalised.

(4) South Africa follows its own legislative process as mandated by Parliament.

 

END.

22 September 2023 - NW2568

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Thembekwayo, Dr S to ask the Minister of Health

With reference to his reply to question 1975 on 17 September 2020, (a) what are the reasons that none of the envisaged improvements occurred at the Pacaltsdorp Clinic in George, Western Cape, which is the only clinic servicing four wards and (b) how does he intend to provide access to the 23 000 residents in the specified area to proper medical care?

Reply:

a) According to the Western Cape Department of Health and Wellness, the following factors and occurrences have caused delays on the project:

  • Construction Tender delays.
  • COVID-19 pandemic delayed the commencement of construction.
  • An Implementer (in terms of the IDMS) was appointed in 2023 to manage the implementation of the projects.
  • Professional Service Providers (PSP) Contracts came to an end and new PSP’s had to be appointed who need to familiarise themselves with the project documentation.

b) Provision of access to healthcare to the affected community:

  • The Pacaltsdorp Clinic is a fixed facility operating from Monday to Friday (07h30 to 16h00), providing comprehensive health including acute, mother and child and chronic diseases management including HAST, with full doctor and pharmacy services daily. The facility is congested, and an appointment system is being implemented to try and relieve this.

In addition

  • A dentist and oral hygienist visit the facility once a month, patients are pre-booked for these services. Emergency cases are referred to the Regional Hospital.
  • A Mental Health nurses visits the facility twice a week to see booked cases and uncontrolled mental health clients.
  • There are three external pick-up points located within the facility catchment area where stable chronic patients collect their medication.
  • Mobile outreach services providing comprehensive PHC are provided at 4 sites (one site per week) in 4 different areas furthest away from the clinic in Pacaltsdorp.
  • Health promotion outreach is done twice a month where preventive services are provided (family planning, immunisations, screening for HIV and TB, health promotion talks, etc.). The outreach is done to different sites on a rotational basis throughout the suburb so as to reach as many people as possible.
  • Where specific health related concerns are identified, ad-hoc outreach is done to address the specific concern and to conduct surveillance as part of our outbreak response.
  • Schools and creches are visited quarterly according to a roster for health promotion and dental outreach.
  • Psychiatry outreach to the facility is provided by George Regional Hospital, twice a month. Patients requiring urgent specialist psychiatry consultations or urgent and routine specialist services by other medical disciplines, are referred to the Regional Hospital.
  • Our partner, SAHARA, does substance rehabilitation on an outpatient basis at the facility, once a week.
  • Allied health services are provided on a rotational basis i.e. Occupational Therapy, Speech Therapy, Physiotherapy visits the facility once a week, one speciality per week on a rotational basis. Patients are booked to see these specialists in advance. Patients requiring emergency consults with Allied Health Specialists are discussed with the specialist and seen on special outreaches (additional to planned visits) or refereed to the Regional Hospital Allied Health services.
  • Social Work services are provided by DSD and instances where the DSD Social Worker is not available, the Sub-district Social Worker will attend to the case on an urgent basis.
  • SASSA Dr does remote file assessment and so doing considers approximately 40 client applications per week.

To increase space in the limited size-facility, space has been extended with standalone containers wherein some of these services are delivered. until the facility is upgraded

Once the building is upgraded and there is a full-time security, we will explore extended hours at the facility and flexible hours for staff to decrease pressure on the facility.

END.

22 September 2023 - NW2661

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Clarke, Ms M to ask the Minister of Health

(1)With reference to the Conference of the Parties (COP) to the World Health Organisation (WHO) framework Convention on Tobacco Control (FCTC), the Meeting of the Parties (COP) to the Protocol being held in November 2023 in Panama as well as the WHO Framework Convention on Tobacco Control AFRO (AFRO) regional meeting, taking place in Rwanda from 23 to 27 October 2023, (a) what is the Government’s position and/or mandate of the delegations in relation to the COP, MOP and AFRO agendas and (b) which policy and/or other legislative document support and/or inform this mandate; (2) (a) what is the delegations’ mandate on combustible cigarettes and (b) which policy and/or other legislative document support and/or inform the mandate; (3) (a) what is the mandate of the delegations on non-combustible nicotine products and (b) which policy and/or other legislative document support and/or inform the mandate; (4) (a) what is the mandate of the delegations on harm-reduction policies, technologies and evidence-led scientific findings and (b) which policy and/or other legislative document support and/or inform this mandate?

Reply:

(1) (a) The Department has not yet finalised its position on the various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions

(2) (a) The Department has not yet finalised its position on various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions.

(3) (a) The Department has not yet finalised its position on the various agenda items.

(b) The country’s mandate is based on the latest scientific evidence and country policy decisions.

(4) (a) The Department has not yet finalised its position on various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions.

END.

22 September 2023 - NW2575

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Jacobs, Dr KL to ask the Minister of Health

What is the progress in building an integrated national health information system that will enable any healthcare institution to access patients' medical records from anywhere in the Republic in order to improve patient care in preparation for the National Health Insurance system?

Reply:

  • Building a uniform and integrated a National Health Information System (NHIS) which caters for both the current public and private health sectors for the purposes of National Health Insurance is complex and requires a standardised approach. The Department has, over the past few years, worked on the development of the backbone and technology platform to enable the development and implementation of the National Health Information System:

“To date the building of the NHIS platform and architecture focussed on answering the following question WHO the user (Patient Registry) is who receives services - WHERE (Health Establishment Registry) they receive those services - FROM WHOM (Service Provider Registry) -FOR WHAT (Clinical, Diagnostic and Procedural Coding)”

  • Critical to a successful NHIS is ensuring that each citizen and legal resident (USER) has a Master Patient Index (MPI) or Health Patient Registration number (HPRN). This number is the thread that will enable healthcare service providers and establishments to be able to access anywhere in the health system the correct and relevant patient information required to render a service. The National Department of Health built and implemented the Health Patient Registration System (HPRS) which creates and issues a unique number for the USER of health care services. This number is the number that will link all health service encounters within the South African health sector to a single person. Since 2014 extensive work was done to implement the HPRS in public health establishments and to conduct the relevant change management. To date (28 August 2023) we have implemented the HPRS in 3 220 public health facilities ( 3 136 PHC establishments and 84 hospitals). We are engaging with the private sector on the implementation of the HPRS and the use of the MPI as the unique identifier for patient information systems deployed in the sector. The HPRS will be the authoritative source for ALL demographic details of a USER and is the cornerstone on a portable electronic health record.
  • WHERE a USER accesses health services is obtained from the Master Health Facility List (MHFL) platform. The MHFL provides for the identity of ALL health establishments and community-based health service points that provide health services in the country. The MHFL was used extensively during the COVID-19 pandemic for both public and private establishments (facilities). Currently there are 51131 establishments registered on the Master Health Facility List (MHFL) and there are continuous efforts to enhance the register. A Health Establishment Registry Technical Working Group with stakeholders from public and private sector was established in beginning of 2023 to review existing practices and make recommendations to the National Health Council for a standardised Health Establishment Registry data framework and its governance.
  • Management of data regarding from whom a USER receives services (clinical professional) is in concept phase and the plan is for this system to be fully functional within the next financial year. All systems that currently maintain healthcare service provider information must be interfaced with this Service Provider Registry.
  • Knowing what services were rendered at a health establishment for a USER is key to ensuring quality and efficiencies in the provision of health services. A Technical Working Group was established in 2022, comprising both public and private sector. Recommendations on Clinical Diagnostic and Procedural Coding of health services were made and tabled at the National Health Council. These recommendations will be published in the Government Gazette.
  • Work has also been done on building a Health Information Exchange which is a platform that allows different computer systems to communicate in a clear manner ensuring that data can be exchanged across the system. The Health Normative Standards Framework (HNSF) for Digital Health were gazetted in 2014 and more recently 2022. These standards provide guidance for anyone developing systems within the South African health sector and are regarded as the minimum technical standards that must be included. Both the HIE and HNSF assist in ensuring that interoperability of health systems is upheld and maintained.
  • Ultimately every USER must have a portable Electronic Health Record (EHR). Work has started on the development of a modular Electronic Medical Record (EMR) system, to be deployed in public health facilities, which contains data collected during care episodes and which send data to our EHR. The first EMR module, focussing on HIV and TB will be introduced by March 2023 while a fully-fledged EMR will take approximately 5 years.
  • Integrated digital patient solutions are critical to a functional health system but require appropriate and quality broadband connectivity to function. Reliable electricity and connectivity require a government wide approach.

END.

22 September 2023 - NW2660

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Clarke, Ms M to ask the Minister of Health

(1)With reference to the Conference of the Parties (COP) to the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC), the Meeting of the Parties (COP) to the Protocol being held in November 2023 in Panama as well as the WHO Framework Convention on Tobacco Control AFRO (AFRO) regional meeting, which is taking place in Rwanda from 23 to 27 October 2023, what are the details of the (a) size and (b) composition of the delegation from (i) her department and (ii) public sector entities reporting to him; (2) what is the total cost estimate and breakdown thereof for the delegation in terms of (a) research, (b) training, (c) policy formulation, (d) travel and (e) subsistence; (3) whether the costs are being funded fully by his department; if not, (a) which external parties have provided funding and (b) what total amount; if so, what are the relevant details?

Reply:

(1) (a) and (b) In response to the meeting to be held in Panama, the Department has not yet decided on the size of the Delegation (no decision has been taken about a delegation due to cost containment). South Africa has not rectified the Illicit trade protocol and therefore does not participate in MOP.

(i) The Department is not aware of a meeting taking place in Rwanda.

(ii) There is no public sector entities reporting to Minister that will be attending as part of the delegation.

(2) (a),(b) and (c) There is no planned research, training, or policy formulation budget for the anticipated delegation.

(d) and (e) Travel, and substance will be determined once the delegation is approved.

(3) (a) In previous meetings one delegate was funded by WHO and one by the DOH.

 

END.

22 September 2023 - NW2567

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Chirwa, Ms NN to ask the Minister of Health

With regard to persistent complaints by South African doctors who received training abroad, such as board exams, registration with HPCSA and internship registration, which his department has not been able to address positively and permanently, (a) what has he found to be the causes of these persisting issues and (b) by what date will his department resolve these issues permanently?

Reply:

a) According to the response received from the Health Professions Council of South Africa (HPCSA), registration with the HPCSA for foreign qualified applicants is not guaranteed. The relevant Board must satisfy itself that, the curriculum and/or training received is equivalent to that offered in South African institutions, or at least, satisfactory. For the relevant Board to make the necessary determination, it relies on the submission of documentary proof by the applicants for review. Such documents must respond to requirements as set by the relevant Board, including hours of training received domains and evidence of satisfactory clinical exposure during training. The documents usually written in foreign languages may also need to be translated into English and notarised.

A Task Team of the relevant Board will review the submissions and may decide to either reject the application or subject the applicant to a Board examination. Once the Board has approved the application for a Board exam, the applicant may need to wait until a Board examination is available according to set schedules (exams are available frequently set and sometimes may happen only twice in a year).

These processes are lengthy and may sometimes take several months especially as applicants sometimes do not provide all the documentary evidence as required timeously (a non-compliant application will not be processed).

Internship placements is the responsibility of the National Department of Health. Applicants for internship registrations must submit proof of placement to perform internship in an accredited facility. This requirement is in terms of the regulations relating to registration of interns. Those who are waiting placement are therefore not registrable until such time that they have been placed.

b) Based on the above it is evident that there are a number of factors that an applicant must comply with before an application can be processed. If applicants fail to comply with these requirements, then they will unfortunately be delayed. Thus the only way these issues would be permanently resolved is when applicants are in full compliance of the HPCSA requirements.

END.

22 September 2023 - NW2823

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Clarke, Ms M to ask the Minister of Health

Whether, noting that the SA Nursing Council has allegedly conducted an investigation into the circumstances surrounding the death of Ms Louisa Radcliffe's baby in January 2022 at the Tambo Memorial Hospital in Gauteng, he will furnish Mrs M O Clarke with the specified investigative report; if not, why not; if so, what are the relevant details?

Reply:

According to the South African Nursing Council (SANC), the case was reported to them in February 2022, however the Council experienced difficulty accessing the records from the Hospital. The matter was discussed at the Preliminary Investigating Committee in terms of section 47(3) of the Nursing Act, 2005 (Act No. 33 of 2005), which found that there was a case to be answered and in terms of section 47(3)(b) of the Act. The matter was therefore referred to the Professional Conduct Committee for hearing (PCC). The matter has been set down to be heard at the next PCC.

 

END.

22 September 2023 - NW2633

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Yako, Ms Y to ask the Minister of Health

Whether 23% of the acquired Pfizer and Johnson & Johnson COVID-19 vaccines in stock will be destroyed by his department as the vaccines are nearing their expiry date; if not, what is the position in this regard; if so, what (a) is the monetary value of the vaccine that will be destroyed and (b) steps will he take to avert such waste?

Reply:

Yes, unused Pfizer and Johnson & Johnson COVID-19 vaccines have been destroyed. Doses of vaccine doses that are yet to expire will also be destroyed.

A total of 70 573 820 does of COVID-19 vaccines were acquired, either as a donation or purchased in line with the bilateral agreement.

  • For Johnson & Johnson COVID-19 vaccine, 453 600 doses were received as a donation and 30 848 000 doses were purchased.
  • Similarly, for Pfizer COVID-19 vaccines, 7 877 610 doses were received as donation and 31 million doses were purchased.
  • 76 800 doses of Paediatric Pfizer vaccine were received as a donation.

To date, 27 536 318 doses have been destroyed, i.e. 20 643 322 doses of Johnson & Johnson COVID-19 vaccine and 6 892 996 doses of Pfizer vaccine.

This is 39% of all doses that were acquired and includes both donated and purchased doses.

a) The estimated monetary value of vaccines to be written off:

  • Jannsen vaccine = R 2 501 583 564
  • Pfizer vaccine = R 1 328 606 043 (value of donated vaccine written off)

b) Steps to avert such waste

  • There is no possibility of any further extension of shelf life of the vaccines from manufacturers and SAHPRA.
  • Covid-19 vaccination has been integrated into routine health services.
  • The NDoH continues to promote vaccinations to the public until the last dose expires. Various demand creation strategies including vaccinating hard to reach communities through outreach services have been implemented to increase uptake of the vaccine.

END.

22 September 2023 - NW2578

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Xaba, Mr N to ask the Minister of Health

What (a) is the surveillance and intervention capabilities of his department with regard to pandemics and epidemics, which are health risks that will continue to occur in the future and (b) is the capacity of his department to fulfil its role on the continent to respond to pandemics and epidemics?

Reply:

(a) The current surveillance capabilities to respond to epidemics and pandemics to health risks include the existence of Notifiable Medical Conditions system managed by the National Institute for Communicable Diseases (NICD), National Emergency Operation Centre, nine NICD Epidemiologists placed across nine provinces, as well as Surveillance Sub-Directorates under Communicable Disease Directorates and Outbreak Response Teams within the Department of Health across nine provinces. The list of priority diseases is being expanded to include subtropical diseases as guided by the World Health Organization. Capacity building workshops are being conducted across the provinces to ensure that clinicians, managers and epidemiologists are ready and equipped for pandemics and epidemics.

The existing surveillance capacity has been reviewed in May 2023 to inform the current draft Integrated Disease Surveillance and Response (IDSR) Strategic Plan 2030 which aims to –

(i) institute early warning systems to prevent the mass spread of infectious diseases and other health risks;

(ii) revive event and community-based surveillance systems;

(iii) strengthen one health approach by linking human health to animal health;

(iv) improve Infection Prevention and Control (IPC) surveillance systems at hospital level; and

(v) build an integrated health information system that uses existing electronic platforms through the mediator approach of linking webDHIS2 with Notifiable Medical Conditions electronic system, Port Health Surveillance, event-based and community surveillance, Animal Health surveillance system and disease specific surveillance systems.

(b) The Department is working with the Presidency in supporting the role of the President of the Republic in the African continent. The Department is supported by WHO to ensure compliance to the International Health Regulations of 2005 and participates in the Intergovernmental Negotiating Body in order to ensure readiness to respond to epidemics and pandemics. This includes establishing an integrated platform for surveillance early warning system for early detection and curb the spread of emerging diseases.

END.

22 September 2023 - NW2744

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Chetty, Mr M to ask the Minister of Health

(a) What total amount did (i) his department and (ii) each entity reporting to him pay for printed copies of the integrated annual reports in the (aa) 2020-21, (bb) 2021-22 and (cc) 2022-23 financial years, (b) who were the suppliers in each case and (c) what total number of copies of the report were printed (i) in each case and (ii) in each specified financial year?

Reply:

(i) National Department of Health

(aa) The National Department of Health annual report was not printed in the 2020/2021 financial year due to the COVID-19 pandemic. Electronic copies were circulated to the stakeholders and uploaded on the departmental website.

(bb) For the 2021-2022 Annual Report –

(a) R279,900 was paid for printing

(b) Ribola Holdings

(c) 500 copies

(cc) The procurement process of printing of the 2022-2023 annual report is underway and the appointment of the successful service provider is expected to be finalised before the end of September 2023.

(ii) Public Entities

Council for Medical Schemes

Financial Years

(a)(ii) Total amount spent on printing

(b) who were the suppliers

(c)(ii)(i) Total number of copies printed in each specified year

(aa) 2020-21

R109 940.00

Kashan Advertising

300

(bb) 2021-22

R336 974.70

Shereno Printers

500

(cc) 2022-23

R 42 535.57

Lebone Litho Printers

150

Office of Health Standards Compliances

Financial Years

(a)(ii) Total amount spent on printing

(b) who were the suppliers

(c)(ii)(i) Total number of copies printed in each specified year

(aa) 2020-21

R138 600

The Link Institute

200

(bb) 2021-22

R29 900

Creative Boost

200

(cc) 2022-23

R166 310

Rebuild Group

200

National Health Laboratory Service

Financial Years

(a)(ii) Total amount spent on printing

(b) who were the suppliers

(c)(ii)(i) Total number of copies printed in each specified year

(aa) 2020-21

R88 456

Milk Brown Design and Communications

150

(bb) 2021-22

R82 245.70

45TH Media (Pty) Ltd

200

(cc) 2022-23

R37 600.40

Litha Communications (Pty) Ltd

200

South African Health Products Regulatory Authority

Financial Years

(a)(ii) Total amount spent on printing

(b) who were the suppliers

(c)(ii)(i) Total number of copies printed in each specified year

(aa) 2020-21

R159 988

45th Media

500

(bb) 2021-22

R192 860

Shereno Printers CC

500

(cc) 2022-23

R156 319.50

Shereno Printers

300

South African Medical Research Council

Financial Years

(a)(ii) Total amount spent on printing

(b) who were the suppliers

(c)(ii)(i) Total number of copies printed in each specified year

(aa) 2020-21

R83 288.75

Blackburn Solutions

100

(bb) 2021-22

R55 549.60

Lebonelitho Printers

100

(cc) 2022-23

R87 429.90

Blackmoon Advertising

100

END.

17 July 2023 - NW2501

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Arries, Ms LH to ask the Minister of Health

In each of the past five years, (a) which provinces witnessed a rise in child malnutrition, (b) by what percentage has malnutrition risen in each province and (c) what interventions have been put in place for such provinces?

Reply:

In each of the past five years,

(a) The Department of Health monitors the incidence of severe acute malnutrition which represents the number of children under five years of age who are diagnosed with severe acute malnutrition (SAM) per 1,000 children in this age group. Increases in the incidence may represent a real increase in cases or better case detection as a result of intensified case-finding and early identification and intervention.

Provincial figures for SAM incidence for the past five financial years are shown in the table below:

 

2018/2019

2019/2020

2020/2021

2021/2022

2022/2023

South Africa

1,9

1,9

1,5

2,0

2,4

Eastern Cape

0,7

0,9

1,6

2,0

2,7

Free State

4,9

5,9

4,2

5,5

6,4

Gauteng

1,6

1,4

1,1

1,6

1,9

KwaZulu-Natal

2,1

2,0

1,3

1,6

1,9

Limpopo

1,2

1,1

1,5

2,2

2,9

Mpumalanga

1,6

0,8

0,7

1,0

1,3

Northern Cape

5,5

6,9

4,6

6,1

6,2

North West

3,7

4,2

2,1

2,7

3,7

Western Cape

1,7

1,6

1,0

1,3

1,5

The following provinces have reported an increase in the incidence of SAM over the past five years: Eastern Cape, Free State, Gauteng, Limpopo and Northern Cape.

(b) The percentage increase (or decrease) in SAM incidence in each province per financial year is shown in the table below.

 

2018/19

2019/220

% increase

2020/21

% increase

2021/22

% increase

2022/23

Over five year period

South Africa

1,9

1,9

0,0%

1,5

-21,1%

2,0

33,3%

2,4

26,3%

Eastern Cape

0,7

0,9

27,1%

1,6

79,8%

2,0

25,0%

2,7

285,7%

Free State

4,9

5,9

20,4%

4,2

-28,8%

5,5

31,0%

6,4

30,6%

Gauteng

1,6

1,4

-12,5%

1,1

-21,4%

1,6

45,5%

1,9

18,8%

KwaZulu-Natal

2,1

2,0

-4,8%

1,3

-35,0%

1,6

23,1%

1,9

-9,5%

Limpopo

1,2

1,1

-8,3%

1,5

36,4%

2,2

46,7%

2,9

141,7%

Mpumalanga

1,6

0,8

-50,6%

0,7

-15,2%

1,0

49,3%

1,3

-18,8%

Northern Cape

5,5

6,9

25,5%

4,6

-33,3%

6,1

32,6%

6,2

12,7%

North West

3,7

4,2

13,5%

2,1

-50,0%

2,7

28,6%

3,7

0,0%

Western Cape

1,7

1,6

-5,9%

1,0

-38,8%

1,3

32,7%

1,5

-11,8%

(c) Interventions implemented in the past five years:

Eastern Cape

  • A mother and child development programme forum was established, facilitated by the Department of Social Development to foster collaboration by all departments to play their part in addressing child malnutrition.
  • Growth monitoring at community level by the Ward Based Outreach Teams (WBOT’s) with periodic door to door campaigns in areas identified with high malnutrition incidence.
  • Implementation of a multi-sector action plan to address prevention and management of acute malnutrition.

Free State

  • Provision of nutrition supplements to eligible children to improve their nutritional status.
  • Immediate reporting of children with SAM to the district nutrition managers to conduct disease surveillance for further management.
  • Community health workers conduct tracing and tracking of SAM patients who are treated at home.
  • Ongoing efforts on screening, assessments and referrals of malnourished children for care and support.
  • Collaboration between Health, Social Development and Agriculture to ensure that identified malnourished children benefit from social protection support measures on malnutrition, hunger and food insecurity.

Gauteng

  • Implementation of the food supplementation programme in all registered ECD in collaboration with the Department of Basic Education
  • Continuous capacity building of health workers on infant and young child feeding, nutrition assessment classification and support.

KwaZulu-Natal

  • Implementation of poverty eradication focusing on the most deprived municipalities (Operation Sukuma Sakhe).
  • Ongoing online training and competence assessment for all clinicians on inpatient management of severe acute malnutrition, led by the provincial office.
  • Capacity building has been conducted on infant and young child feeding to prevent malnutrition in children under 5, and optimise nutritional status.
  • A draft multi-sectoral Food and Nutrition Security Plan 2022-2025 has been developed and implementation is monitored and reported on quarterly.

Limpopo

  • Provincial Child health and Nutrition Strategy for 2023-2027 was developed.
  • Nutrition assessment counselling and support at all facilities including Primary Health Care and hospital level.
  • Monitoring of the SAM incidence at all levels of the province, district, sub-district and facility

Mpumalanga

  • Anthropometric equipment (length boards and height metres) were procured for all hospitals.
  • Annual capacity building of clinicians on the Integrated Management of Common Childhood Illnesses (IMCI) was conducted in all districts which include growth monitoring and promotion and management of children with SAM, as well as ongoing Breastfeeding and Infant and young child feeding training at district level.
  • Nutrition assessment counselling and support at PHC and hospital level.
  • Implementation of the provincial multi-sector Food and Nutrition Security Plan to address malnutrition, hunger and food insecurity.

Northern Cape

  • Community nutritional screening and classification through community outreaches and outreached to ECD centres for early identification of acute malnutrition and referral for care and support.
  • Severe acute malnutrition is included as discussion point at perinatal mortality meetings.
  • Auditing and reporting of all SAM deaths to identify factors influencing the occurrence of malnutrition to inform prevention strategies.
  • Malnutrition and early identification has been included in the Provincial multi-sector Food and Nutrition Security plan that is still being finalized.

North West

  • Community-based nutritional screening of all children under 5 years of age by CHWs
  • Continuous capacity building of front-line staff in the initial management of children with SAM including on emergency triage and treatment.
  • Collaboration between the districts WBOT’s with other government departments such as DSD, DHA, SAPS and SASSA to address social determinants of health.
  • Implementation of Food and Nutrition Security plan to address malnutrition in collaboration with other Departments.

Western Cape

  • Continuous capacity building of front-line staff in the initial management of children with SAM including on emergency triage and treatment.
  • Nutrition assessment counselling and support at PHC and hospital level
  • Community Based growth monitoring using MUAC tapes.
  • Skills development for facility-based staff to improve growth monitoring practices and frequency. Endorsement of District trainers to cascade growth monitoring and promotion (GMP) training in the districts.
  • Training of health care workers
  • Implementation of Nutrition Therapeutic Programme across the service platform including in secondary and tertiary hospitals.
  • Implementation of the Multi-sectoral plan to address food insecurity, malnutrition and hunger.

Cross-provincial interventions implemented

In 2020-2022, the National Department of Health in collaboration with centre for Rural health, University of KwaZulu-Natal supported five Districts in Gauteng (City of Johannesburg, Ekurhuleni and Tshwane) and KwaZulu-Natal (Zululand and Umzinyathi) to roll-out a pilot project to build capacity of community health workers to train mothers to screen for acute malnutrition at household level to encourage early health seeking behaviour. This project has been formally evaluated. The 2 provinces developed plans to scale up this intervention in other districts.

 
  • 6 districts (Ekurhuleni, City of Johannesburg and Tshwane), North West (Dr Ruth Sekgomotsi Mompati), Eastern Cape (Oliver Tambo) and KwaZulu-Natal (eThekwini) are currently conducting an evidence-based planning bottleneck analysis to analyse barriers in scaling up and delivery of quality services for maternal and child malnutrition and plan interventions to address the gaps with support from National Department of Health and UNICEF.

END.

04 July 2023 - NW2444

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Singh, Mr N to ask the Minister of Health

Whether his department conducted any studies and/or live monitoring to assess the current extent of electromagnetic pollution in urban and rural areas caused by (a) Internet Wi-Fi [5G], (b) Low Earth Orbit satellites, (c) mobile phone towers and (d) Internet fibre cables; if not, why not; if so, what are the relevant details of any (i) potential negative impacts on human, animal and environmental health and (ii) legislative and/or regulatory measures (aa) currently being considered and (bb) already in place to manage and mitigate the pollution to acceptable levels?

Reply:

  1. (b) (c) (d) No, the Department of Health has not commissioned any studies and or live monitoring to assess the current extent of electromagnetic pollution in urban and rural areas.
  1. -(ii) The South African Products and Regulatory Authority (SAPHRA), which is an entity of the National Department of Health is responsible, from the viewpoint of human health, for regulating electronic products producing non-ionising electromagnetic fields (EMF), i.e. where the frequency of such EMF is less than 300 GHz. In carrying out this responsibility, SAPHRA has been utilising the World Health Organization’s (WHO) International EMF Project (www.who.int/peh-emf/en/) as its primary source of information and guidance with respect to the health effects of EMF. The International EMF Project was established by the WHO in 1996 to (i) assess the scientific evidence for possible adverse health effects of non-ionising electromagnetic fields on an on-going basis, (ii) initiate and coordinate new research in this regard, and (iii) compile health risk assessments for different parts of the electromagnetic spectrum. The Department of Health has been a member of the International Advisory Committee of the International EMF Project since 1998.

In June 2005 the International EMF Project hosted a workshop that was specifically aimed at considering the possible health consequences of the emissions from cellular base stations and wireless networks. The findings of this workshop were summarised in a 2-page Fact Sheet (http://www.who.int/peh-emf/publications/facts/fs304/en/). The following extract from this Fact Sheet is still considered by the WHO as a summary of the findings to date, i.e. “Considering the very low exposure levels and research results collected to date, there is no convincing scientific evidence that the weak RF signals from base stations and wireless networks cause adverse health effects.”

Another WHO Fact Sheet was published in June 2011 and reviewed in October 2014, i.e. Electromagnetic fields and public health: mobile phones. This Fact Sheet can be found at http://www.who.int/mediacentre/factsheets/fs193/en/) and the conclusion is stated as follows: A large number of studies have been performed over the last two decades to assess whether mobile phones pose a potential health risk. To date, no adverse health effects have been established as being caused by mobile phone use.”

The WHO recommends utilising internationally recognised exposure guidelines such as those published in 1998 by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) and reconfirmed in 2009 for the frequency range 100 kHz – 300 GHz (i.e. including all the frequencies employed by the cellular industry). The Department of Health likewise recommends the use of these ICNIRP guidelines to protect people against the known adverse health effects of EMF.

The numerous measurement surveys, which have been conducted around the world and in South Africa, have shown that the actual levels of public exposure as a result of base station emissions invariably are only a fraction of the ICNIRP guidelines, even in instances where members of the public have been really concerned about their exposure to these emissions. At present there is no confirmed scientific evidence that points to any health hazard associated with the very low levels of exposure that the general public would typically experience in the vicinity of a cellular base station. The Department is therefore satisfied that the health of the general public is not being compromised by their exposure to the microwave emissions of cellular base stations. This also means that local and other authorities, in considering the environmental impact of any particular base station, do not need to and should not attempt, from a public health point of view, to set any restrictions with respect to parameters such as distance to the mast, duration of exposure, height of the mast, etc.

The Department of Health is not able to make any pronouncements about the specific levels of EMF that a member of the public would experience at any particular base station site when it is in operation. However, generally-speaking unless a person would climb to the top of a mast (or other structure supporting an antenna) and position him/herself not more than a few meters away right in front of the active antenna, such a person would have no real possibility of being exposed to even anywhere near the afore-mentioned ICNIRP guideline limits. Since these base stations are typically cordoned off by means of barbed wire fencing and locked gates/doors in order to protect the sensitive and expensive technology, getting to a mast and actually climbing it despite the afore-mentioned security measures would certainly not be considered responsible behaviour. Even then the only real threat to the health of the person would be falling at any height from the structure in question. Based on the results of numerous global and local surveys, the experience has been that the exposure to base station EMF at ground level is typically in the range of between 0.001 – 1.0 % of the afore-mentioned ICNIRP guideline limits. Against this background of available data, there would be no scientific grounds to support any allegation that adverse health effects might be suffered by a responsible member of the public due to the EMF emitted by a base station.

Although the Department of Health currently neither prescribes nor enforces any compulsory exposure limits for electromagnetic fields, the Department does advise all concerned (whether they be a government department, the industry or the public) that voluntary compliance with the afore-mentioned ICNIRP exposure guidelines is the recommended and science-based way to deal with any situation involving human exposure to the non-ionising electromagnetic fields emitted by cellular base stations and handsets.

In addition, the National Environmental Management Regulations, 2014, as amended, published under the National Environmental Management Act 1998 (Act 107 of 1998), is the national legislation prescribing requirements for Environmental Impact Assessment to be conducted for various activities, prior to their commencement, depending on their scale and their potential to result in environmental and health impacts. The installation and use electromagnetic of Internet Wi-Fi [5G], Low Earth Orbit satellites, mobile phone towers and Internet fibre cables have not been identified as activities with a potential to result in significant pollution to the environment and therefore do not require an EIA to be conducted.

END.

04 July 2023 - NW2441

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Hlengwa, Ms MD to ask the Minister of Health

Whether, considering that public hospitals and mortuaries have been burdened with unclaimed corpses and noting that corpses are now decomposing at a faster rate due to loadshedding, his department has put any measures in place to ensure that such facilities are not burdened and overpopulated with unclaimed corpses; if not, why not; if so, what (a) measures and (b) steps has his department taken to trace the families of the deceased?

Reply:

The public hospitals and forensic pathology mortuaries have continuous backup generator capacity. This helps mitigate the potential of mortal remains decomposing. There are continuous discussions with ESKOM to exempt public hospitals and Forensic pathology mortuaries from loadshedding. Most of the decomposed bodies are received by forensic pathology mortuaries mostly due to these bodies being discovered in public spaces after a longtime.

  1. Measures taken to trace families for both public hospitals and forensic pathology mortuaries.
  • In relation to Forensic Pathology Mortuaries, all unclaimed bodies are managed according to (i) the regulations for rendering Forensic Pathology Services (No R341 of 2005) – Section 43, 44, and 45 and (ii) the National Code of Guidelines for Forensic Pathology Practice in South Africa – Chapter 13 Section 460 to 464.
  • It is the mandate of the South African Police Service (SAPS) to manage all unidentified cases from both the public hospitals and Forensic Pathology Service facilities. The SAPS has the competency of identification and tracing of families.

(b) Steps taken by the Department of Health to trace the families of the deceased?

The Department of Health collaborates with the SAPS, Department of Home Affairs (for finger prints), Department of Social Development (for tracing of families) and local municipalities (for paupers’ burial where families are not successfully traced).

The steps are as follows:

  • In case of an unclaimed body where there are addresses provided, their next of kin are contacted.
  • Tracing is also done by the social worker using details provided by the hospital.
  • Community development/health workers are also used in tracing at last address that was given on the deceased patient’s file.
  • The unclaimed deceased details and photos also get published through public media outlets.
  • Should the tracing not be successful, the deceased’s DNA is extracted and sent to the SAPS Forensic Science Laboratory for storage in the database for future reference. It is only at this stage that the Department of Health makes an application to the Municipality for a Pauper burial.  

END.

30 June 2023 - NW2421

Profile picture: Stander, Ms T

Stander, Ms T to ask the Minister of Health

(1)What total number of state mortuaries in each province are currently over capacity;

Reply:

  1. Table 1 below indicates the current status of overcapacity in state mortuaries, as provided by provinces.

 

Table 1:

Province

Total number of State Mortuaries with over capacity

KwaZulu Natal

None

Limpopo

3

Mpumalanga

None

Northern Cape

1

Northwest

None

 

  1. Even though all facilities in provinces have a back-up generator capacity, there are however, there increased expenditure costs due to diesel and maintenance of generators and this has an impact somewhat.
  1. Table 2 below indicates the current status of unclaimed bodies at state mortuaries as provided by provinces.

Table 2

Province

Total number of unclaimed bodies

KwaZulu Natal

1362

Limpopo

136

Mpumalanga

54

Northern Cape

51

Northwest

174

  1. No. There is continuous are discussions between Forensic pathology service, local municipalities, South African Police service with regards to unclaimed bodies.

Responses are still awaited from the Eastern Cape, Free State, Gauteng and Western Cape Provinces. The updated information will be submitted as soon as it is received from these Provinces.

END.

30 June 2023 - NW2435

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Clarke, Ms M to ask the Minister of Health

What total number of staff members were involved in the incident where newborn babies were placed in cardboard boxes and (b) consequence management steps will be taken with regard to each staff member who was involved in the incident?

Reply:

(a) According to the report from the North West Provincial Department of Health, there are 5 staff members who were involved in the incident where newborn babies were placed in cardboard boxes.

(b) The consequence management process is under way and the steps to be taken will be determined after the completion of the investigation.

END.

30 June 2023 - NW2420

Profile picture: Stander, Ms T

Stander, Ms T to ask the Minister of Health

Whether he will furnish Mr P A van Staden with the (a) total number of (i) state mortuaries and (ii) state crematoriums in each province and (b) names, (c) locations and (d) maximum capacity of each specified facility; if not, why not; if so, what are the relevant details?

Reply:

(a) (i) Table 1 below indicate the response.

Table 1:

Province

Total Number of state mortuaries

Eastern Cape

22

Free State

11

KwaZulu Natal

25

Gauteng

11

Limpopo

12

Mpumalanga

20

Northern Cape

11

Northwest

7

Western Cape

17

National

136

 

(ii) There are no crematoriums operated by the state, as state hospitals do not cremate corpses on site. From the information received from Provinces, Persons that pass on in hospitals are transferred to private mortuaries or crematoriums by family members, and other human remains such as stillborn babies are disposed off as anatomical waste and the disposal thereof is handled as part of the health risk waste contracts outsourced to various private companies in all 9 (nine) provinces.

(b)(c)(d) Names, locations and capacity of state mortuaries are attached as Annexure A.

 

ANNEXURE A

State Mortuaries Names, locations and capacity are reflected below

EASTERN CAPE PROVINCE

 

Facility(b)

Town(c)

Capacity(d)

1

New Brighton

New Brighton

60

2

Mount Road

Mount Road

44

3

Gelvandale

Gelvandale

18

4

Grahamstown

Grahamstown

48

5

Graaff-Reinet

Graaff -Reinet

40

6

Woodbrook

Woodbrook

35

7

Mdantsane

Mdantsane

33

8

Bizana

Bizana

12

9

Butterworth

Butterworth

32

10

Bhisho

Bhisho

12

11

Queenstown

Queenstown

32

12

Adelaide

Adelaide

9

13

Aliwal North

Aliwal North

32

14

Middelburg

Middelburg

9

15

Mthatha

Mthatha

96

16

Mount Fletcher

Mount Fletcher

10

17

Mount Frere

Mount Frere

32

18

Molteno

Molteno

12

19

Lusikisiki

Lusikisiki

32

20

Port Alfred

Port Alfred

9

21

Uitenhage

Uitenhage

12

22

Joubertina

Joubertina

6

FREE STATE PROVINCE

No

Facility(b)

Town(c)

Capacity(d)

1

Bloemfontein

Bloemfontein

248

2

Botshabelo

Botshabelo

9

3

Jagersfontein

Jagersfontein

16

4

Bethlehem

Bethlehem

16

5

Harrismith

Harrismith

9

6

Ficksburg

Ficksburg

9

7

Smithfield

Smithfield

16

8

Phuthaditjhaba

Phuthaditjhaba

21

9

Welkom

Welkom

72

10

Kroonstad

Kroonstad

22

11

Sasolburg

Sasolburg

40

GAUTENG PROVINCE

No

Facility(b)

Town(c)

Capacity(d)

1

Johannesburg

Johannesburg

3000-4500

2

Roodepoort

Roodepoort

1000-2000

3

Germiston

Germiston

3000-4500

4

Carlentonville

Carletonville

250-500

4

Springs

Springs

1000-2000

5

Heidelberg

Heidelburg

250-500

6

Diepkloof

Diepkloof

2000-2500

7

Sebokeng

Sebokeng

2000-2500

8

Pretoria

Pretoria

2000-2500

9

Bronkhorstspruit

Bronkhorspruit

250 – 500

10

Garankuwa

Garankuwa

1000-1500

KWAZULU NATAL PROVINCE

No

Facility(b)

Town(c)

Capacity(d)

1

Phoenix

Phoenix

540

2

Pinetown

Pinetown

124

3

Park Rynie

Park Rynie

177

4

Port Shepstone

Port Shepstone

112

5

Harding

Harding

12

6

KwaDukuza

KwaDukuza

102

7

Pietermaritzburg

Pietermaritzburg

433

8

New Hanover

New Hanover

22

9

Howick

Howick

18

10

Richmond

Richmond

15

11

Ladysmith

Ladysmith

25

12

Estcourt

Estcourt

51

13

Dundee

Dundee

100

14

Greytown

Greytown

53

15

Newcastle

Newcastle

85

16

Madadeni

Madadeni

56

17

Dannhauser

Dannhauser

6

18

Kokstad

Kokstad

48

19

Ixopo

Ixopo

12

20

Umzimkulu

Umzimkulu

9

21

Bulwer

Bulwer

12

22

Nongoma

Nongoma

24

23

Paulpietersburg

Paulpietersburg

06

24

Vryheid

Vryheid

12

25

Pongola

Pongola

12

26

Richards Bay

Richards Bay

136

27

Eshowe

Eshowe

150

28

Richards Bay

Richards Bay

136

29

Mkhuze

Mkhuze

Hospital facility

30

Mosvold

Mosvold

Hospital facility

31

Manguzi

Manguzi

Hospital facility

32

Nkandla

Nkandla

Hospital facility

33

Ulundi

Ulundi

Undertaker holding facility

LIMPOPO PROVINCE

No

Facility(b)

Town(c)

Capacity(d)

1

Polokwane

Polokwane

72

2

Lebokwakgomo

Lebowakgomo

48

3

Bela Bela

Bela Bela

60

4

Elim

Elim

54

5

Maphutha Malatjie, Phalaborwa

Phalaborwa

54

6

Nkhensani, Giyane

Giyani

24

7

Kgapane, Tzaneen

Tzaneen

78

8

Tshilidzini

Thohoyandou

66

9

Letaba, Tzaneen

Tzaneen

54

10

St Ritas

Glen Cowie

54

11

Mokopane

Mokopane

60

12

Groblersdal

Groblersdal

102

MPUMALANGA PROVINCE

 

Facility(b)

Town(c)

Capacity(d)

1

Standerton

Standerton

18

2

Balfour

Balfour

15

3

Carolina

Carolina

18

4

Bethal

Bethal

24

5

Witbank

Witbank

36

6

Delmas

Delmas

15

7

Belfast

Belfast

15

8

Mmamethlake

Mmametlhake

36

9

KwaMhlanga

KwaMhlanga

21

10

Middelburg

Middelburg

32

11

Tonga

Tonga

24

12

Themba

Themba

66

13

Mapulaneng

Mapulaneng

12

14

Tintswalo

Acornhoek

18

15

Barberton

Barberton

18

16

Lydenburg

Lydenburg

18

17

Volksrust

Volksrust

18

18

Evander

Evander

30

19

Ermelo

Ermelo

30

20

Embhuleni

Elukwatini

18

21

Piet Retief

Piet Retief

30

NORTHERN CAPE PROVINCE

No

Facility (b)

Town(c)

Capacity(d)

1

Kimberley

Kimberly

30

2

Upington

Upington

36

3

De Aar

De Aar

18

4

Kuruman

Kuruman

36

5

Calvinia

Calvinia

15

6

Springbok

Springbok

13

7

Postmasburg

Postmansburg

12

8

Hartswater

Hartswater

6

9

Douglas

Douglas

6

10

Prieska

Prieska

6

11

Victoria West

Victoria West

6

NORTHWEST PROVINCE

No

Facility(b)

Town(c)

Capacity(d)

1

Phokeng

Rustenburg

 80

2

Vryburg

Vryburg

 44

3

Klerksdorp

Klerksdorp

 50

4

Lichtenburg

Lichtenburg

 20

5

Brits

Brits

 100

6

Potchefstroom

Potchefstroom

 20

7

Mafikeng

Mafikeng

 15

WESTERN CAPE PROVINCE

No

Facility(b)

Town©

Capacity(d)

Outstanding

1

Salt River

Salt River

 

2

Tygerberg

Tygerberg

 

3

Paarl

Paarl

 

5

Vredendal

Vredendal

 

6

Malmesbury

Malmesbury

 

7

Vredenburg

Vredenburg

 

8

Worcester

Worcester

 

9

Wolseley

Wolseley

 

10

Hermanus

Hermanus

 

11

George

George

 

12

Laingsburg

Laingsburg

 

13

Mossel Bay

Mossel Bay

 

14

Knysna

Knysna

 

15

Oudtshoorn

Oudtshoorn

 

16

Beaufort West

Beaufort West

 

17

Riversdale

Riversdale

 

END

30 June 2023 - NW2260

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What are the (a) reasons that the Mafikeng Provincial Hospital does not have enough beds and space for new-borns who are currently being placed in boxes and (b) details of intervention steps he has taken (i) regarding this matter and (ii) to ensure that this never occurs in any hospital across the Republic?

Reply:

  1. It is not true that Mahikeng Provincial Hospital does not have enough beds and space for the newborn babies. The hospital has enough bed space to accommodate the new babies who were placed in boxes. The babies were not placed in the cardboard boxes because of the shortage of beds and/or space.
  1. The details of intervention steps are:
  1. The hospital has started with the procurement of additional medical equipment; enforcement of referral policy, diversion of patients who need treatment at some other facilities, to ease up the pressure from the hospital, improved proactive planning based on the workload that determines and anticipates the sudden increase in deliveries.
  1. The hospital managers are advised to make provision for sudden increase of the workload such as the one of increases deliveries. The situation will be attained through proper planning based on the health service information. The hospital managers are also encouraged to ensure that they enforce optimal utilisation of available resources and sharing of resources within the catchment area.

END.

30 June 2023 - NW2308

Profile picture: Stander, Ms T

Stander, Ms T to ask the Minister of Health

(1) What total number of crematoriums across the Republic are currently over capacity; (2) what total number of crematoriums are currently non-functional; (3) how does his department intend to address the specified matter; (4) whether he will make a statement on the matter; if not, why not; if so, what are the relevant details? NW2625E

Reply:

  1. The question on the operational issues related to the running of Crematoria in the Country should be directed to the Department of Cooperative Governance and Traditional Affairs, which is the relevant department responsible for the crematoria regulation and monitoring.
  1. This question should also be referred to the Department of Cooperative Governance and Traditional Affairs.
  1. The above-mentioned department would be in a better position to make a pronouncement on how the matters as questioned will be addressed.
  1. The above-mentioned department would be in a better position to make a statement in this regard.

END.

30 June 2023 - NW2261

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

With reference to his department’s campaign to compensate former miners with Tuberculosis and/or Silicosis outlined in January 2023, (a) what was the duration of the programme, (b) what is the total number of persons who were assisted in comparison to the past three years and (c) how does his department ensure that former miners are aware of the campaign and participate should they be eligible?

Reply:

  1. According to the Compensation Commissioner the campaign to compensate former miners with Tuberculosis and/or Silicosis began in 2014 and is ongoing.. The programme has received renewed attention in the past 8 years.
  1. The total number of persons who were assisted in the past three years is indicated in the table below:

Details

1 April 2020 to 31 March 2021

1 April 2021 to 31 March 2022

1 April 2022 to 31 March 2023

Total

Number of TB claims paid

3 264

3 900

4 742

11 906

Amount of TB paid

R32 126 827

R33 696 731

R46 106 033

R111 929 591

Number of Silicosis claims paid

1 419

1 034

1 236

3 689

Amount of Silicosis paid

R121 276 176

R88 201 178

R102 547 449

R312 024 803

  1. The Deputy Minister of Health, (Hon) Dr Sibongiseni Dhlomo, working closely with the Deputy Ministers of Employment and Labour and Mineral Resources and Energy, provincial and neighbouring country governments, other social protection and class action settlement funds, trade unions and the ex-miners’ associations. has been leading the programme on outreach activities for former miners There is also a call centre (080 100 0240) that former miners can call to query their claim status.

It must be noted that the majority of former miners are in labour sending areas such as the Eastern Cape, Lesotho and Mozambique and thus the outreach campaigns assist in bringing services closer to the towns / districts where the former miners live. In the last five months of 2023, outreach activities were undertaken in two districts in KwaZulu-Natal and three districts in the Eastern Cape. Former miners can also access compensation claims services at fixed hospital facilities in Mthatha, Carletonville, Kuruman and Burgersfort.

END.

30 June 2023 - NW2457

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

Regarding the case of medical negligence that the Health Professions Council of South Africa failed to investigate (details furnished), in what way will his department assist the forensic investigator to get to the bottom of all the queries and/or allegations?

Reply:

The Honourable Member is advised that this Question is a repeat of the Honourable Member’s Question 2046 on the same matter, which we have already responded to. The Honourable Member is referred to that response accordingly.

END.

19 June 2023 - NW1611

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

Noting how numerous facilities do not have floor plans and/or adequate fire detection systems in place, (a) what is the current status of healthcare facilities regarding this in each province, (b) what measures will he put in place to resolve the issue and (c) on what date will he ensure intervention with resolve is enacted?

Reply:

(a) (i) Floor plans are available for all our health care facilities. However, most of them are outdated due to the aging of many facilities. (ii) See below existing health facilities with adequate fire detection systems:

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(b)-(c) Aging public health facilities remains a challenge and growing concern for the Department of Health. The short-, medium- and long-term focus is thus more on restoring many of these facilities to an acceptable state of operability. The National Department of Health is currently busy with the following interventions:

(i) CSIR is currently busy with an investigation into how to become more green in future and will include the OHS Compliance issues and fire detection systems for all the healthcare facilities.

(ii) Provinces have been requested to include the update of the floor plans and fire detection systems during the condition assessment audits of their facilities. This request is aligned with the requirements of the Government Immovable Asset Management Act (GIAMA).

In the same Act the User, which in this case is the Provincial Departments of Health, should annually revise its User Asset Management Plan (UAMP) in alignment with the guidelines provided by Public Works. The User Immovable Asset Management Plan (UAMP) for the Department of Health informs the budget allocation process in terms of the overall and annual strategic plans of the Department. The objectives of the UAMP are to:

  • assess the utilisation of accommodation in terms of the Department of Health’s service delivery objectives.
  • assess the functional performance of the accommodation.
  • prioritise the need for repair, refurbishment or reconfiguration of all state-owned accommodation.
  • plan for future accommodation requirements and
  • secure funding for the acquisition and utilisation of assets according to the strategic objectives of the relevant department.
  1. All major upgrades and new installations must cover the upgrading of the fire detection systems.

END.

19 June 2023 - NW2256

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

Whether there are any plans to build a clinic for the residents of Goba in Ward 11 in the Nkomazi Local Municipality; if not, why not; if so, what are the relevant details?

Reply:

No.

According to the Mpumalanga Department of Health, Goba in Ward 11 has an estimated population of 860. The nearest Primary Health Care (PHC) facility is 6km away in Mbangwane. The population size does not meet the norm of 8 000 - 10 000 which allows for a fixed PHC facility to be constructed. Currently, a mobile clinic is visiting the village once a month. The number of patients seen per visit are between 35 to 40.

END.

19 June 2023 - NW2255

Profile picture: Matumba, Mr A

Matumba, Mr A to ask the Minister of Health

(1)What are the reasons that the Figtree Clinic at Ward 11 in the Nkomazi Local Municipality was left in a dilapidated state since it was constructed without any maintenance and/or upgrades despite the increase in the population it serves; (2) whether there are any plans to upgrade the specified clinic; if not, why not; if so, what are the relevant details?

Reply:

1. The Figtree clinic is not dilapidated. A major renovation was last done in 2017 and minor maintenance is done as and when the need arises. The current challenges are that it still has a pit latrine and the fence that has become worn.

The clinic has an average monthly headcount of 2445 visits, which equates to an average of 122 patients per day. It has 4 consultation rooms and uses the nurses’ home as an extension to accommodate the facility manager’s office and HIV testing, screening and counselling services.

2. Mpumalanga Department of Health has identified forty (40) projects for comprehensive maintenance and Figtree Clinic is one of the clinics to benefit. The renovation of the first batch of health facilities started in April to June 2023. Fig Tree clinic is falling under the second batch which will start from July to September 2023.

END.

19 June 2023 - NW2148

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Considering that a number of provinces in the Republic have been hit by cholera which has led to the death of more than 23 persons in Hammanskraal, Gauteng, with 48 more persons in hospital, by what date did his department first become aware of the crisis around unsafe and undrinkable water in the specified area; (2) what steps, other than the current measures that have been implemented, has his department taken since it first became aware of the specified issue; (3) whether, in light of a cholera outbreak in 2023, he has found that this is related to the deterioration of the quality of governance in the past two decades; if not, what is the position in this regard; if so, what are the relevant details?

Reply:

The incident is currently under investigation, the outcome thereof will be shared upon finalisation .

END.

19 June 2023 - NW2187

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

Whether he will furnish Mrs M O Clarke with the 2017 Tambo Memorial Hospital Report; if not, why not; if so, what are the relevant details?

Reply:

The Honourable Member is kindly requested to specify what report she is referring to exactly (the proper name of the report), to enable the Minister to respond to this question appropriately.

END.

19 June 2023 - NW2146

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)In light of the urgent need at the time to attend to the babies who were placed in cardboard boxes, what has been the position of his department in this regard; (2) whether any action will be taken against the specified nurses who placed newborn infants in cardboard boxes; if not, why not; if so, what are the relevant details; (3) what are the reasons that his department does not have contingency plans in place in all hospitals, such as emergency incubators in the event that such a problem arise?

Reply:

Background to the reply: 

A hospital that has the deliveries of 56 babies at a time, would generally require a minimum of approximately 25 Midwives at a particular time to ensure maximum coverage. This means that these midwives would have to take care of the 56 newborn babies, while also continuing to monitor the new arrival and those mothers who are in the active stage of labour. In this situation these nurses must ensure that the mothers and their newborn babies receive quality clinical care which would not result in unnecessary litigations. At this hospital, the picture derived from the letter that was received from MEC about this incident, it means that this was the reality at the time. The nurses, like all workers, are at times faced with acute shortage of resources, because of the sudden (unexpected rise in service demands) and at times these sudden increases outstrip the actual resource envelope. The nurses at this time were faced with the hard choice of either leaving the babies on unrestrained on the beds, with a risk of them falling or creating safe mechanism of keeping them safe and unharmed/unhurt).  

1.. The Minister of Health stated during the interview about this incident that the unfortunate incident of placing the newborn babies in the cardboard boxes instead of cribs is unacceptable and apologised to the families of the newborn babies. The position of the department, which is in line with standard clinical practice, is that not all the newborns delivered will require incubators. Incubators are used in situations where the new-born baby is sick and requires supportive machine or continuous oxygen for survival. Healthy new-born babies may require crip/ basinet, not a permanent arrangement but, as a backup support in case the mother is unwell to take care of the baby, need to take a bath or go to the toilet. In general, where both the mother and the baby are well, babies are safe to be kept on the mothers’ chest in what is called Kangaroo Mother Care (KMC).  

2. The Provincial Department of Health instituted the investigation on the matter and the details will be made available when the report has been finalised. 

3. Contingency plans are in place in all hospitals; however, contingency plans are developed based on the average delivery rates per facility.  The department has a plan in place for the procurement of essential equipment in all the hospitals, however there are times where the sudden increase in the number of patients such as admissions cannot be preplanned. The contingency measures in place include the enforcement of the referral system, which ensures that a hospital that cannot manage the situation for various reasons, including the lack of capacity such as equipment, human resources etc, such a hospital can refer the patients to the next facility which has capacity. The report from the province indicated that Mahikeng Hospital had a capacity of 16 incubators and 31 cribs and on the night in question, which is enough for the normal day to day management of the workload. The report from the province further indicates that on the day in question, 56 babies were delivered, thus outstripping the available capacity. This means that 47 babies had been placed in accordance with proper prescribed procedures, leaving the nurses to place 09 babies in cardboard boxes. It is reported that four babies were placed in card boxes and others were placed two babies in each crib.  

END.

19 June 2023 - NW2097

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

(1)What total number of COVID-19 vaccines have been administered since 1 January 2020; (2) whether there has been any fatal adverse effects; if not, what is the position in this regard; if so, what were the common adverse effects; (3) (a) how (i) accessible are the processes of reporting adverse effects and (ii) does his department ensure that the public knows how to report such adverse effects and (b) what total number of the reported cases were investigated?

Reply:

1. The COVID 19 Vaccination programme started on 17 February 2021. According to the Electronic Vaccination Data System the total number of COVID 19 vaccines administered for the period 17 February 2021 and 5 June 2023 are 38 977 115.

2. Yes, three deaths resulting from Guillain Barre Syndrome (GBS) following administration of the Janssen COVID-19 vaccine have been causality linked to the vaccine. The common adverse events following immunisation includes fever, pain at the injection site, pain, nausea, local reaction, headache, fatigue, dizziness and chest pain.

3. (a) An adverse event following immunisation (AEFI) can be reported three ways a) on the MedSafety app b) at any private or public health facility on the MedSafety app or on a paper-based form emailed to [email protected] c) on the COVID-19 hotline (now the National Health Hotline). The NDoH in collaboration with SAHPRA has widely communicated to the public how to report AEFI, including on social media, training of health care workers and on various webinars/media engagements. Only serious and severe AEFI are investigated; 3075 clinically significant AEFI have been reported and the investigations are either underway or concluded. It should be noted that the majority of AEFI are found to be related in time, but not causally linked, to immunisation.

(b) A total of 49 claims have been received by the Covid-19 Vaccine Injury No Fault Compensation Scheme. All the claims have been adjudicated by the Adjudication Panel and finalised.

Breakdown:

Claims – No evidence of temporary or permanent disability

30

R0.00

Claims – Death benefit (R150,000.00) each

3

R450,000.00

Claim – Permanent Disability

1

R171,000.00

Claims – Temporary Disability

2

R45,000.00

Claim – Private Doctor consultation

1

R5,600.00

Claims – re-directed to Sisonke Trial – vaccinate before 17 May 2021

6

R0.00

Claims – assessed – wait for additional information

6

R0.00

TOTAL

49

R671,600.00

END.

19 June 2023 - NW2180

Profile picture: Van Dyk, Ms V

Van Dyk, Ms V to ask the Minister of Health

(1)(a) What is the name of each town in the Kamiesberg Local Municipality that has (i) functional clinics and (ii) no clinics and (b) how regularly do the health professionals visit each town that has no clinics; (2) what number of (a)(i) ambulances are available in the specified municipality and (ii) towns are serviced by each ambulance and (b) where is each ambulance stationed; (3) whether each ambulance (a) is roadworthy and (b) has a valid licence; if not, in each case, why not; if so, what are the relevant details in each case?

Reply:

1. (a) (i) The following towns has functional clinics; Kamieskroon, Kharkams; Leliefontein ; Hondeklipbaai (Fixed clinics);

(ii) Towns (small settlements) with no clinics: Kheis; Lepelsfontein; Spoegrivier; Tweerivier; Klipfontein ;Soebatsfontein; Nourivier; Rooifontein; Kamassies and Paulshoek.

(b) The Health Professionals in mobile clinics visit these 10 smaller settlements twice a month.

2. (a) (i) Two (2) ambulances are allocated to Kamiesberg Local Municipality.

(ii) These ambulances service all towns within the municipality.

(b) All ambulances are stationed in Garries which is a centrally located town within the municipality.

3. (a) All ambulances are roadworthy and undertake roadworthy tests annually.

(b) All ambulances have valid licences.

END.

19 June 2023 - NW2244

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

Whether he has been informed that more than 100 nurses were offered employment at the Jubilee District Hospital during the recent cholera outbreak and that after working for 12 hours they were asked to go home since there was no more work for them, yet the specified hospital is short-staffed; if not, what is the position in this regard; if so, what are the relevant details of the steps he will take to intervene in the matter?

Reply:

The Minister was not informed about the 100 nurses who were offered employment at the Jubilee District Hospital during the recent cholera outbreak.

According to the Gauteng Provincial Department of Health, a group of 137 Nurses presented at the Hospital on the 22nd of May 2023. It is not clear who had made arrangements for the group to come to the hospital as there was no formal arrangement for them to come to the facility.

The group presented themselves to the Assistant Manager Nursing indicating that they have been instructions to report for duty. The Assistant Manager Nursing, without first verifying the status of the said nurses, allocated them to the wards where 41 of them commenced duties immediately. When the matter was brought to the CEO's attention some hours later the same day, the CEO immediately rescinded the allocation as the presence of the nurses at the facility could not be accounted for.

This matter is currently being investigated by the district. Once the investigations are finalized, details shall be provided, and the recommendations will provide the possible way forward.

END.

19 June 2023 - NW2098

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

(1)Following the reported crisis of food shortages at the Chris Hani Baragwanath Academic Hospital earlier in the month, what intervention measures were implemented to date to resolve the crisis other than the visit by the Member of the Executive Council of Health for Gauteng to the specified hospital; (2) how is his department monitoring the day-to-day status of the hospital and other hospitals facing similar concerns; (3) what (a) total number of other hospitals have reported similar concerns over food shortages and (b) are the names of such hospitals; (4) what (a) was the initial cause of the food shortage crisis at the Chris Hani Baragwanath Academic Hospital and (b) is the long-term solution of his department to avoid the specified situation from occurring again in future?

Reply:

1. Key intervention to ensure continuity of protein supply was to substitute meat with beans which is also a source of protein.

(2) (a) Only one hospital reported food shortages.

(b) Chris Hani Baragwanath Academic Hospital

3.(a) The initial cause was the supplier is contracted to supply a number of hospitals in Johannesburg South with the inclusion of Chris Hani Baragwanath Academic hospital and one of the facilities failed to make a payment on time and the supplier stopped food supply in all facilities, including those whose contractual obligations were met.

(b) A long term solution would be to have more suppliers who are having a mix of items on contract, rather than depending on one supplier for most items. Moreover to construct a cold-room to keep buffer stock for reserves rather than daily deliveries.

END.

19 June 2023 - NW2147

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether, considering that the North West Health Department has sought action against its employees who were on duty when newborn babies were put in cardboard boxes instead of incubators and/or cribs at the Mahikeng Provincial Hospital with one of the issues being that the acting chief executive officer was not made aware of the improvisation, this is an admission that hospital management is not aware of crucial shortages in their hospital and that the only way to be aware of this is if the nurses inform them directly; if not, what is the position in this regard; if so, what are the relevant details?

Reply:

No. This is not an admission that management is not aware of the critical shortage of the hospital management is aware of the crucial shortages in their hospital. The hospital management relies on the subordinates who are responsible for day to day running of their sections to alert them if there is any crucial shortages of supplies and equipment in their respective sections. This is standard management practice. It is true that they become aware of the shortages when nurses inform them directly, through relevant management processes.

19 June 2023 - NW1609

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

With reference to the Chris Hani Baragwanath Hospital that had their cooling systems compromised in December 2022 when copper piping supplying the theatres with water was stolen, what (a) other incidences of this nature have occurred at other healthcare facilities across the Republic and (b) has he done in response to the rising security and crime threat at public facilities?

Reply:

a) The National Department of Health has been informed by the Gauteng Department of Health about the stolen copper pipes/cables at Charlotte Maxeke, Steve Biko and Chris Hani Baragwanath Academic Hospitals. There were other similar incidents that were reported by the Free State Department of Health regarding copper pipes being stolen from the following hospitals:

  1. Bongani hospital (Welkom)
  2. Boitumelo hospital (Kroonstad)
  3. Thebe hospital (Harrismith)
  4. Monapo hospital (Qwa Qwa)
  5. Elizabeth Ross hospital (Qwa Qwa)
  6. National hospital (Bloemfontein)
  7. Universitas hospital (Bloemfontein)
  8. JS Maroka hospital (Thaba Nchu)
  9. Mohau hospital (Hoopstad)

All these incidents were reported to the nearest police stations and case numbers were issued accordingly.

b) Minster of Health has appointed Ministerial Task Team for safety and security in all public health facilities. The purpose of the task team was to assess the effectiveness of security measures and make recommendations. The task team has conducted security assessments at all public health facilities. Subsequently reports were drafted with the following recommendations:

  • Improve security infrastructure like perimeter fencing and security guard rooms.
  • Installation of security technology like CCTV camera systems, access control and alarm systems.
  • Development of standardised security framework.
  • Effective security contract management to hold Service Providers accountable.
  • Regular security patrols at public health facilities by SAPS especially in hotspot facilities.
  • Deployment of police reservists at hotspot public health facilities.
  • Implementation of intelligence driven security measures at hotspot facilities
  • Escort of EMS by SAPS to hotspot communities.

In this regard, memorandum of understanding was entered into between SAPS and NDoH to ensure regular patrols and deployment of police reservists.

Ministerial task team meet on regular basis to monitor the implementations of the recommendations and to assist provinces with any required security intervention.

END.

19 June 2023 - NW2185

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)(a) What are (i) the age demographics of all nurses employed in the public health sector and (ii) their specialisation as a percentage of each category and (b) in which provinces are they employed; (2) what is the (a) current vacancy rate for all the specified nursing specialties in each province and (b) envisaged time frame to fill the vacant positions?

Reply:

1. (a) (i) In accordance with the Persal data set as extracted for the month of May 2023 below is the table of the age demographics of all nurses employed in the public health sector and

(ii) Persal does not provide the breakdown percentage of each specialized category since they are all grouped under category specialty

(b) The data also specifies the Provinces in which they are employed-

Professional Nurse (Specialized) 2023

Province

25-34yrs

35-44yrs

45-54yrs

55-64yrs

*above 65

Eastern Cape

87

376

652

586

7

Free State

12

100

345

378

1

Gauteng

293

1105

1693

1448

28

KwaZulu-Natal

386

1975

2545

1689

12

Limpopo

109

527

1072

1160

8

Northern Cape

16

55

154

154

11

Mpumalanga

57

293

578

431

4

North West

59

282

535

406

14

Western Cape

225

673

912

631

6

Total

1244

5386

8486

6883

91

* Aged above 65 are regulated in accordance with the Public Service Regulation and Act- to employ professionals over the age of 65

(2) (a) Current vacancy rate for all the specified nursing specialties in each province and

 

Nursing Specialty Vacancy Rate  

Province

Vacant

Vacancy rate %

Eastern Cape

498

13.0%

Free State

46

2.8%

Gauteng

1096

15.2%

KwaZulu-Natal

1984

22.7%

Limpopo

340

10.2%

Mpumalanga

170

9.1%

Northern Cape

120

33.0%

North West

318

19.1%

Western Cape

488

13.6%

Total

5060

15.7%

(b) The Department is unable to state the envisaged time frame to fill the vacant positions due to general budget cuts that negatively affects the Compensation of Employment (CoE) a specific date of when the specified challenges will be eradicated. However, it can confirm that measures are applied across Provinces to prioritize filling of vacant posts where the budgets permit.

END.

19 June 2023 - NW2186

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

Whether he will furnish Mrs M O Clarke with his department’s 2030 Human Resources Health Strategy; if not, why not; if so, what are the relevant details?

Reply:

The 2030 Human Resources for Health Strategy is available and can be accessed on the National Department of Health’s website on the following link:

https://www.health.gov.za/wp-content/uploads/2023/06/2030-HRH-Strategy-Final.pdf

Attached as Annexure 1 is a copy for ease of reference.

END.

12 June 2023 - NW1953

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Chirwa, Ms NN to ask the Minister of Health

(a)What (i) were the reasons that patients at Katlego Hospital in Virginia, Free State, did not receive adequate nutrition at the facility for the months prior to February 2023 and (ii) steps has he taken to intervene in the matter and (b) in what way does he intend to resolve general nutrition concerns in the facilities in the province at large?

Reply:

a) (i) According to the Free State Department of Health there was no time where patients were left without food. However, there were challenges with the supplier who partially delivered few stock items on large quantity order which was placed on the 26 October 2022.

This supplier also decided to verbally cancel the order and refused to write a cancellation letter when a follow up was done by the hospital. This impasse therefore led to the hospital being unable to place a new order as this order was still active.

(ii) This matter was reported to Provincial Treasury and the incident number was issued. The Provincial Treasury was also requested to cancel the order for the hospital to create a new order. A process for a new order was re-initiated.

However other surrounding institutions have been assisting with the provision of food supplies and the hospital management is regularly monitoring food supplies to ensure that patients are fed.

(b) The Free State Department of Health has the following plans to resolve general food supply concerns in the facilities in the province:

  • In the current financial year 2023/2024,the Free State Department of Health will screen and contract suppliers with good track record in this area.

There will also be alternative reliable suppliers list that hospitals can rely on in the event the contracted supplier fail in their contract.

END.

12 June 2023 - NW1792

Profile picture: Zungula, Mr V

Zungula, Mr V to ask the Minister of Health

Whether, with regard to the implementation of remedial action from the Public Protector’s report on allegations of undue delay by the National Department of Health to address the challenges experienced by Clinical Associates that was released on 30 November 2021 (details furnished), his department has notified the National Treasury about the remedial actions recommended by the Public Protector; if not, why not; if so, what are the relevant details?

Reply:

At this stage, it is premature to approach National Treasury to lobby for additional funding for the remedial actions from the public protector. The matters of conditions of service for Clinical Associates have been presented to the Department of Public Service and Administration (DPSA) and are being considered as part of the wider process of the Personnel Expenditure Review exercise that includes the review of OSDs in the public sector. Engagement with National Treasury will subsequently be informed by the outcomes of the DPSA process.

END.

12 June 2023 - NW2044

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Clarke, Ms M to ask the Minister of Health

(1)With reference to the DA having received complaints that 4th year B Nursing students are working double the number of hours required by the SA Nursing Council (SANC) and that they might not graduate at the end of May 2023 due to this discrepancy and the impact of the Nehawu strike earlier this year, what number of work-integrated learning hours are 4th-year B Nursing students required to complete in order to graduate; (2) should the specified students meet the 1 830 hours required by SANC, but not the 3 000 hours, (a) would he ensure that they are assisted to graduate and (b) in what way will the students be assisted to graduate?

Reply:

1. According to the North West University (NWU), the B. Nursing curriculum outlay, the number of work-integrated learning hours as per accreditation document submitted and approved by the South African Nursing Council (SANC). The total required clinical hours over the 4 years, are 3000 hours. This is in line with South African Nursing Council’s Nursing-Education-and-Training-Standards, page 12, Bachelor degree (Regulation R174). The 3000 hours include laboratory hours for Anatomy, Physiology, as well as simulation laboratory hours for all the nursing modules and does not refer to clinical placements in accredited facilities only.

With regards to the NEHAWU strike earlier this year, the NWU nursing students were placed in facilities where there was no strike activities and their clinical hours were therefore not affected.

2. Students are allowed ample opportunities and are supported to catch up on any missed hours before they exit in December (not May) and graduate in March of 2024, according to the yearbook outcomes and academic calendar of the university.

END.

12 June 2023 - NW1886

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether his department has any alternatives in place should the current negotiations with private hospitals to admit detainees needing pretrial psychiatric assessments fail; if not, what is the position in this regard; if so, (a) what are the relevant details of the alternatives and (b) how does his department intend to ensure that the standard of the services offered are of the same quality as the services offered in private hospitals?

Reply:

The response is based on an assumption that the term pre-trial psychiatric assessments refers to an enquiry into a mental condition of an accused in terms of Section 77, 78 and 79 of the Criminal Procedure Act, 1977 (Act No 51 of 1977) as amended.

(a) The Department is not aware of any negotiations regarding private hospitals admitting detainees needing pre-trial psychiatric assessment.

(b) Currently, private hospitals do not offer services for detainees needing pre-trial psychiatric assessment.

(c) Provincial Departments of Health contract psychiatrists and psychologists from the private sector to assist with pre-trial assessments in public sector facilities.

Enquiries into a mental condition of an accused in terms of the Criminal Procedure Act is a service that the Department of Health renders at the request by courts to assist the Criminal Justice System in evidence gathering and prosecution of accused as required by the Criminal Procedures Act, 1977. It is therefore not a health service, but a function of criminal justice. Furthermore, the budget for this function is with the Department of Justice and Constitutional Development who also remunerate the Department of Health as well as the professionals that are appointed by the courts to conduct the enquiries.

END.

12 June 2023 - NW1989

Profile picture: Montwedi, Mr Mk

Montwedi, Mr Mk to ask the Minister of Health

(a) What plans are in place to deal with dilapidated health facilities and (b) at what total cost in the current financial year?

Reply:

a) The National Department of Health has developed a 10-year infrastructure plan regarding the needs of our health facilities. The programme is focusing on projects that are still in planning (pre-tendering phase) while projects that are already under construction and in the tender phase will continue in the processes that have already commenced. Facilities that require part or full rehabilitation or replacement and infrastructure that needs to be newly built lend themselves to management through this programme while routine maintenance needs to be the primary responsibility of provinces managed through other programmes. The quantification and sequencing of the need and financing requirements are based on the 10-Year Health Infrastructure Plan (YHIP). Initial focus will be on PHC facilities as these are the first points of contact for patients and scale can be reached easier and quicker while planning for hospitals is underway.

b) In the current financial year, the National Department of Health has put aside R7 119 867 billion through Health Facility Revitalisation Grant (HFRG) to be shared by the provincial health departments. The aim of this grant is to accelerate and improve on the conditions of the existing health infrastructures. The budget will also use to provide new health facilities which address population growth and changes in burden of diseases. And there are few large projects that are currently in construction and implemented by the National Department of Health funded through the National Health Insurance Indirect Grant: Health Facility Revitalization Component (In-Kind Grant). The budget for the grant in the 2023/2024 financial year is R1.4 billion. The needs of health infrastructure are funded through (i) the Equitable Share; (ii) HFRG; and (iii) In-Kind Grant. See below the allocations from the three funding streams for 2023/24FY:

END.

12 June 2023 - NW1925

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

In light of the National Institute for Communicable Diseases having confirmed mumps outbreak in the Republic, what are the relevant details of his department’s contingency plan to curb the spread of the specified disease in the Republic?

Reply:

A retrospective review of data from National Health Laboratory Service data shows that outbreaks occur approximately every three to six years. Mumps is considered a common and mild disease with few complications which does not pose a major public health threat to the country. The Department has responded by providing information to the public and other stakeholders. Individuals with mumps are advised to stay at home until symptoms resolve and to seek health care should they develop complications.

END.

12 June 2023 - NW1954

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

With reference to orthopaedic surgery backlogs that continue to haunt the Free State due to the high demand of services, a shortage of specialists and operating theatre time, (a) what plans does he have in place to (i) resolve the shortage of specialists to address the orthopaedic surgery backlog in the Free State and (ii) solve the crisis of operating theatre times that also influences the orthopaedic surgeries backlog and (b) by what date is it envisaged that the interventions would become a reality?

Reply:

(a) (i) The Free State Provincial Department of Health has informed the Minister that it is engaging in a number of interventions to solve the shortage of specialists to address the orthopaedic surgery backlog. This amongst others includes:

  • Creating of more nursing posts and headhunting of more Specialists with relevant experience is underway and it is envisaged that more staff will be recruited in the next few months;
  • Requested the National Department of Health to recruited Orthopaedic Specialists through the Nelson Mandela Fidel Castro Government to Government Agreement;
  • Improvement of appointment practices to minimise delays that could deter applicants (Reduced from 6 weeks to 2 weeks);
  • Filling of critical posts to enable increased theatre time;
  • Increased Theatre Capacity – from 3 to 5 elective Orthopaedic list;
  • Outreach to neighbouring Hospitals both Orthopaedic Wards and Theatre immediately; and
  • Increase pool of Specialists in the Province in conjunction with the Academic Hospital.

(ii) In solving the crisis of operating theatre times that also influences the orthopaedic surgeries backlog, the Province is/has-

  • Rationalised the budget and prioritize relevant surgical equipment and services;
  • Strengthen the Outreach Programme at Level 1 Hospital by increasing rate outreach to lower levels of care;
  • Encourages the improvement on theatre time and usage;
  • Increased the usage of back-up generators during load shedding or unscheduled power cuts;
  • Surgical marathons or blitzes;
  • Improved monitoring of the backlogs through an electronic system;
  • Better management of Theatre time through improving efficiencies;
  • Developed and implemented a Quality Improvement Plan (QIP) on optimum Theatre Utilization;
  • Strengthened Theatre User Committee with attendance by Head Specialists and Matrons; and
  • The budget for orthopaedic implants to continue these services and increase arthroplasties (Total Hip & Knee Replacements) has been increased in the current financial year.

(b) The above-mentioned interventions are being implemented simultaneously to address the orthopaedic surgery backlog, even though a specific date of realizing the ultimate goal cannot be stated, the monitoring of the backlogs through the electronic system will be able to inform of progress being made.

END.