Reply:

1. No 40-bed mobile hospital was set up in Sierra Leone by the Department as there were sufficient Ebola treatment units put in place by other countries and the subsequent request by the Government of Sierra Leone, the African Union and other partner countries was for health professionals to staff the Ebola treatment units. The Department sent 5 professional nurses and 1 medical doctor for 1 month initially and 16 professional nurses and 3 emergency health professionals for 6 months to Sierra Leone under the African Union response to the Ebola outbreak.
2. The Department had considerable support from the private sector in South Africa with initial meetings with the mining, retail, financial services and mobile communication sectors about the movement of their personnel from South Africa to West Africa and especially to the affected countries of Guinea, Liberia and Sierra Leone. A meeting held at the Johannesburg Stock Exchange 16 listed companies and non-governmental organisations realised cash and in-kind donations of personal protective equipment, ambulances, scooters, food and drugs amounting to approximately R10 million for the external response to the affected countries.

3. South Africa set up a field Ebola Molecular Diagnostic Facility in August 2014 with laboratory infrastructure, technical and personnel support from the National Institute of Communicable Diseases (NICD) in Freetown, Sierra Leone. A total of 8 teams of 2 to 5 members from the NICD rotated through the facility in Sierra Leone every 4 to 6 weeks between August 2014 and March 2015. The unit assisted with the laboratory diagnosis of Ebola in patient blood and buccal swab specimens.

4. (a) The Department convened a committee known as the Multi-sectoral National Outbreak Response Team (MNORT) which comprised the following departments, supported by the private health sector, development partners and multilateral agencies:

1. Department of Agriculture, Forestry and Fisheries;
2. Department of Basic Education;
3. Department of Communications;
4. Department of Correctional Services;
5. Department of Defence and Military Veterans;
6. Department of Finance;
7. Department of Higher Education and Training;
8. Department of Home Affairs;
9. Department of International Relations and Cooperation;
10. Department of Cooperative Governance and Traditional Affairs;
11. Department of Safety and Security;
12. Department of Social Development;
13. Department of Sport and Recreation;
14. Department of Tourism;
15. Department of Transport;
16. Department of Water and Sanitation.

(b) The University of the Witwatersrand ‘Wits Health Consortium’ coordinated the external response effort of receiving goods and cash donations to the affected countries with the deployment of health professionals to Sierra Leone, supported by “Right to Care”, the African Union and the World Health Organisation. The laboratory professionals’ travel and logistics were coordinated by the Wits Health Consortium, the NICD and the World Health Organisation.

(c) The flights of all the personnel from South Africa to Ghana were supported by a major South African private sector financial services partner and travel agency with flights from Ghana to Sierra Leone supported by the United Nations response. The donated goods were transported by road to Durban from the warehouse in Centurion and shipped to the 3 affected countries through a partnership with a major international shipping company that provided free transportation from Durban.

5. The total monetary value of the country’s contribution in the fight against the Ebola epidemic since 1 December 2013 cannot be quantified as it comprises the domestic response which covered provincial departments of health and national departments’ interventions.

These included border protection interventions such as installation of thermal scanners at designated ports of entry into South Africa, recruitment and deployment of additional Port Health Officers and introduction of screening questionnaires at ports of entry, training of immigration, airline and port health staff in South Africa and also for SADC countries, health professionals and support personnel in the management of Ebola suspect and infected patients and bio-hazardous waste management, provision of an Emergency Operations Response Centre operating on a 24-hour basis, enhancing health screening and surveillance systems and laboratory diagnostic support for South Africa and the SADC Region. The external response to the affected countries of Guinea, Liberia and Sierra Leone comprised the donation of personal protection equipment by the Department and donation of other goods by the private sector and provision of laboratory support and deployment of health professionals in Sierra Leone. Some South African companies contributed to the Ebola response by direct contributions to the African Union response or to the affected countries directly.

In addition, various Committees such as the Inter-Ministerial Committee on Ebola, the Multi-sectoral National Outbreak Response Team (MNORT) and the Ministerial Advisory Committee on Ebola outbreak in West Africa were set up to support the country’s efforts in the domestic and external response to the Ebola outbreak in West Africa. Communication to the public, various stakeholders and role players was maintained at all times through media releases presentations.

END.

Reply:

a) Two One Stop Centres were opened in April 2014 in Mthatha in the Eastern Cape and Carletonville in Gauteng and are currently operational. Two further One Stop Service Centres will be opened in this financial year in Burgerfort in Limpopo and Kuruman in the Northern Cape and are at an advanced stage of planning.

b) (i) As at the end of September 2015, a total of 4 165 ex-mineworkers were assessed at the Mthatha facility and 4 013 ex-mineworkers at the Carletonville facility.

(ii) The Mthatha facility referred 1 456 claimant files and the Carletonville facility referred 1 474 claimant files to the Medical Bureau for Occupational Diseases (MBOD). A total of 413 claimant files were processed at the MBOD and 6 were paid by the Compensation Commissioner for Occupational Diseases (CCOD). There are substantial backlogs in the claims assessment, processing and payment of claimant files at the MBOD and CCOD.

The management of the MBOD and CCOD, with the support of the Chamber of Mines is making interventions to improve the claims management process by deployment of medical personnel seconded from the mining sector, ensuring access to records of service from the mining companies and development of an electronic database of claimant records.

END.

Reply:

1. (a) The sale of Portion 87, 148, 149 was sold by the Department of Local Government and Housing. The Land Availability Agreement that was signed between the Department and Local Government requires that the Department signs a relocation agreement for the Sizwe Tropical Disease Hospital. This agreement between the Developer and the department of Health is not yet finalised.

(b) The agreement to relocate would not have been captured in the Final Environmental Impact Assessment report. As per the Land Availability Agreement, the sale was for the whole of Portion 87, 148,149 for the development of residential houses which necessitated the relocation of the hospital to make way for the proposed residential development.

2. There has not been any consultation with the residents nearby the new site as yet. The Department has not finalised the relocation agreement with the developer and all necessary consultations will be done as part of the stakeholders’ engagement on the project which has not commenced as yet.

(3) The proposed relocation site is government owned. It is part of the Edenvale hospital site portion 87 Rietfoitein No 61-IR.

END.

Reply:

1. The matter of communicating how the proposed development will impact the nearby residents is not the responsibility of the Department of Health. Such assessments and communication of the impact to the nearby residents will be done by the Developer and the Department of Local Government and Housing.

(2) The proposed development was initiated by the Department of Local Government and Housing. Any consultation and notifications as to the dangers and potential health risks posed by the proposed development will be dealt with by them and not the Department of Health.

END.

Reply:

The environmental Assessment report has cleared the development at Rietfontein. There is no basis for concern over the small pox infection as suggested. The residents have no reason to be concerned about small pox.

END.

Reply:

The tender for the awarding of the development of Portion 87, 148, 149 and the remainder of Portion 1 of the farm Rietfontein 61 IR was done through the Department of Local Government and Housing. Since the Department of Health is not involved in the planned development on the site except for the relocation of the Sizwe Tropical Disease Hospital, any legislative requirements and compliance relating to future development of the land (including but not limited to soil tests) would not be handled by this Department and all queries regarding this can be referred to the Department of Local Government and Housing.

END.

Reply:

(a) This department did not make a decision to demolish the Sizwe Tropical Disease Hospital, The land was part of the land awarded for development through the Department of Local Government and Housing. This Department is not in a position to confirm when this decision was taken.

(b) The decision was taken by the Department of Local Government and Housing.

END.

Reply:

The Department of Health acknowledges that skin lighteners are as much a social problem as a medical problem. The public regards skin lighteners as cosmetics and do not see the harm in the use of these products.

a) Previously the Department of Health conducted awareness campaigns on the dangers of using specific hydroquinone containing products through posters and pamphlets, sensitizing the public in this regard. It is the intention of the Department to continue with these awareness campaigns.

b) The Department, in conjunction with Commercial Crime, Directorate for Priority Crime Investigation, SARS, Interpol, SAPS, National Regulator for Compulsory Specifications (NRCS) and the Company of Intellectual Property Commission (CIPC) ran joint operations in Pretoria, Johannesburg, Durban, Port Elizabeth and Cape Town from 19-21 August 2015. During the raids, illegal counterfeit and skin lighteners to the value of about R26m were confiscated, people arrested and a number of case dockets opened.

As per the legal processes, these matters will be attended to by the courts with appropriate fines imposed to the traders selling these products.

c) Recently in a case brought by the Department in a matter against traders selling illegal medicines in the Tembisa Magistrate’s Court (1 September 2015), the court found the accused guilty as charged with a fine of 1 year imprisonment or payment of a fine of R10 000.

END.

Reply:

(a), (b), (c) and (d) Honourable Member, the final target for MDGs is end of September 2015. The United Nations General Assembly is meeting then to finalise and release the final results for each country. You may have to be a bit patient until that final moment. But generally the United Nations is of the view that MDGs 4, 5 and 6 are going to be included in the new Sustainable Development Goals (SDGs).

END.

Reply:

1. (a)-(c) The latest data for maternal mortality ratio was published in 2013, by the Medical Research Council in the Rapid Mortality Surveillance Report. The maternal mortality ratio in 2011 was estimated to be 197 per 100,000 live births.

The National Committee on Confidential Enquiries into Maternal Deaths monitors maternal deaths that occur within health facilities. The most recent data from this Committee is reflected below.

Institutional Maternal Mortality Ratio (Saving Mothers report 2011-2013)

	PROVINCE	2011	2012	2013
	Eastern Cape	164.74	153.71	172.73
	Free State	246.84	149.34	185.08
	Gauteng	136.44	163.67	114.99
	KwaZulu-Natal	197.60	170.19	146.54
	Limpopo	196.40	192.89	201.21
	Mpumalanga	199.74	177.39	150.25
	North West	173.05	164.80	168.48
	North West	193.62	166.53	158.32
	Western Cape	62.64	81.81	83.91
	South Africa	174.56	157.81	153.50

2. Yes the causes are known through the work done by National Committee on Confidential Enquiry into Maternal Death (NCCEMD) established by the Minister of Health.

a) The main causes of Maternal Mortality according to the latest NCCEMD triennial, 2011-2013 report are as follows:

• HIV/AIDS which accounts for 50% of the deaths;
• Obstetric Hemorrhages;
• Hypertension;
• Health professional training;
• Health system strengthening

(b) Interventions to address the main causes of maternal deaths being implemented include:

(i) Option B plus to eliminate mother to child transmission of HIV

This policy was adopted and implemented from 01 January 2015. The policy stipulates that all HIV pregnant and breastfeeding women must be initiated on lifelong antiretroviral treatment (ART) for the prevention of mother to child transmission of HIV and their own health regardless of CD4 count and on diagnosis.

(ii) Essential Steps in the Management of Obstetric Emergencies (ESMOE) and Emergency Obstetric Simulation Training (EOST)

• ESMOE are trainings for doctors and midwives to improve their skills to manage, among others, hemorrhage and hypertension and are currently being done in all facilities rendering maternity care;
• EOST are fire drills to simulate the real obstetric emergency situations to refine and reinforce the clinical skills;
• To date, 1937 doctors and 5110 professional nurses have been trained on ESMOE. This has led to a 30% decline in maternal mortality due to improved health care providers’ skills in the management of mothers, neonates and children in the districts that we have conducted ESMOE training in;

(iii) Community mobilization efforts

• Mom-Connect services which is an electronic cellular system to give health messages to pregnant women to help them access care early in pregnancy as well as post delivery. Currently over 508 000 women have been registered and receive weekly messages about their pregnancy and care for the infant post delivery;

(iv) Efforts of Health System Strengthening

• The District Specialist Teams (DCST’s) include specialists in maternal, newborn and child care, have been appointed in all 52 districts. This team is responsible for clinical governance within all public facilities and specifically focusing on Maternal Neonatal and Child Health;

​(v) Efforts to address access to services

• Maternity waiting homes: Currently there are 81 maternity waiting homes + 18 on site beds nationally;
• Nationally there are 241 dedicated obstetric ambulances to improve access to health facilities;

(vi) Family planning

The launching of the family planning campaign in 2014 and introduction of sub-dermal implant as a long term method of family planning had a positive impact on family planning practices. The Couple Year Protection Rate has improved from 37.7% in F/Y 2013/2014 to 52.7% in F/Y 2014/15. Improvement of family planning strategies assists in preventing unwanted pregnancies as well as teenage pregnancies which may lead to maternal mortality.

END.

Reply:

1. (a) A total of 127,830 tests were conducted from October 2013, the time the Department of Health got involved with the management of TB in Correctional Services, until August 2015. Those confirmed with TB were 6,273 (4.9%) of whom, 263 (4.2%) had MDR-TB. The yearly breakdown is indicated in the Table below.

(b) There are 8 Management Areas with the highest number of inmates with TB disease. The list of these management areas by region are shown in the table below.

Region	Department of Correctional Services Management Areas with highest number of inmates infected with TB
Eastern Cape	St Albans
	Mthatha
Free State	Groenpunt
Northern Cape	Kimberly
Gauteng	Kgoši Mampuru
	Johannesburg
KZN	Durban Westville
	Pietermaritzburg
Western cape	Pollsmoor
	Allandale

(2) The Department of Health, in collaboration with the Department of Justice and Correctional Services, has conducted infection risk assessments in selected correctional facilities to determine the risk for the spread of TB infection. There is routine screening of inmates for TB. Inmates with TB are isolated until they are non infectious. Inmates are also provided with education/information about TB, including information on how TB is spread and the symptoms of TB.

(3) Information about inmates with TB is contained in relevant TB registers kept at the respective correctional facilities.

(4) The National Department of Health developed “Guidelines for the Management of Tuberculosis (TB), Human Immunodeficiency Virus (HIV) and Sexually Transmitted Infections (STIs) in Correctional Facilities” and were launched by the Deputy President in March 2013.

(5) The following interventions are implemented in correctional facilities to combat tuberculosis and MDR-TB:

1. Infection control measures;
2. Preventive therapy is provided to inmates who are at high risk of developing the TB disease, especially those living with HIV;
3. Screening all inmates for TB at least twice a year and testing those with TB symptoms using GeneXpert;
4. All inmates with TB are retained on treatment until completion;
5. Inmates living with TB and HIV are initiated on ARVs.

END.

Reply:

a)  A total of 309 Xpert instruments of varying sizes (GX4: 110; GX16:190; GX48: 3; GX80:8) have been placed in 221 sites. The placement includes seven Correctional Service facilities and six mobile vans.

b)  The Table 1 below reflects the details in this regard

Province and District	GX4	GX16	Infinity GX48	Infinity GX80	Total
Eastern Cape	15	27		2	44
Alfred Nzo		4			4
Amathole	3	6		1	10
Cacadu	3	1			4
Chris Hani	3	5			8
Nelson Mandela Bay Metro		2		1	3
O.R Tambo	3	4			7
O.R. Tambo		3			3
Ukhahlamba	3	2			5
Free State	8	10		1	19
Fezile Dabi		2			2
Lejweleputswa	6	1			7
Motheo	2			1	3
Thabo Mofutsanyane		6			6
Groenpunt Correctional Facility		1			1
Gauteng	12	28		2	42
City of Johannesburg	5	8		1	14
City of Tshwane	3	8			11
Ekurhuleni	2	3		1	6
Sedibeng		3			3
West Rand		6			6
Westrand	2				2
Kwazulu-Natal	34	49	1	1	85
Amajuba	1	2			3
eThekwini	9	13		1	23
iLembe	2	4			6
Sisonke	4	3			7
Ugu		4			4
uMgungundlovu	1	6			7
Umkhanyakude	4	4			8
Umzinyathi		4			4
Uthukela	3	3			6
Uthungulu	8	2	1		11
Zululand	2	4			6
Limpopo	15	25			40
Capricorn	1	7			8
Greater Sekhukhune	1	5			6
Mopani	3	4			7
Sekhukhune	2				2
Vhembe	2	5			7
Waterberg	6	4			10
Mpumalanga	4	14		1	19
Ehlanzeni	2	6		1	9
Gert Sibande	2	3			5
Nkangala		5			5
North West	6	16			22
Bojanala Platinum	3	4			7
Dr Kenneth Kaunda (Southern)	2	5			7
Dr Ruth Segomotsi Mompati (Bophirima)	1	3			4
Ngaka Modiri Molema (Central)		4			4
Northern Cape		3			3
Frances Baard		2			2
John Taolo Gaetsewe (Kgalagadi)		1			1
Nothern Cape	2	3			5
Namakwa	2				2
Pixley ka Seme		1			1
Siyanda		2			2
Western Cape	16	13		1	30
Cape Winelands		4			4
City of Cape Town	11	5		1	17
Eden	3	3			6
Karoo		1			1
West Coast	2				2
Grand Total	112	188	1	8	309

END.

Reply:

1. (a), (b) and (2)

The categories of nurse and midwife specialists and production is covered in the template provided below depicting Universities and Public Colleges that offered such specializations.

UNIVERSITIES
NURISNG EDUCATION INSTITUTIONS	PROGRAMME	YEAR OBTAINED
		2010	2011	2012	2013	2014	TOTAL
CPUT	Clinical Nursing Science, Health Assessment,	15	12	1	12	1	41
	Treatment and Care	0	0	0	0	0	0
	Occupational Health Nursing	28	21	28	21	0	98
	Oncology	12	6	0	12	6	36
	Nursing Administration	39	20	0	20	39	118
UNIVERSITY OF PRETORIA	Nursing Education	6	10	19	10	19	64
	Nursing Administration	8	23	84	25	78	218
	Community Nursing	28	43	117	28	100	316
	Operating Theatre Nursing	10	3	14	3	12	42
	Nursing Science: Neonatal Nursing	0		27	0	0	27
	Advanced Psychiatric Nursing	7	3	8	9	8	35
UNIVERSITY OF STELLEBOSCH	Advanced Psychiatric Nursing	14	13	14	12	13	66
	Nursing Administration	8	61	18	12	25	124
	Clinical Nursing Science, Health Assessment,	58	142	58	34	45	337
	Treatment and Care	0	0	0	0	0	0
	Nursing Education	42	26	59	42	36	205
TUT	Occupational Health Nursing	62	99	25	35	24	245
	Oncology	23	10	14	13	20	80
							0
	Nursing Administration	54	25	46	34		159
UNIVERSITY OF VENDA	Nursing Administration & Community Health	23	16	15	23	26	103
	Psychiatric Nursing	15	31	73	34	13	166
UNISA	BA Cur Health Science Education & community	18	63	164	45	32	322
	Specializing in Occupational Health
	BA Cur Health Science Education & Health Service	7	36	42	48	23	156
	Management
	Health Science Education, Community Health Nursing	58	48	36	40	41	223
WITS UNIVERSITY	Nephrology Nursing	6	10	13	10	8	47
	Nursing Education	1	2	10	5	7	25
	Nursing Administration	5	1	8	5	6	25
	Trauma & Emergency Nursing			1			1
	Occupational Health	11	4	0	0	0	15
KZN UNIVERSITY	Clinical Nursing Science, Health Assessment,	3	24	70	68	73	238
	Treatment and Care
	Nursing Administration	55	42	25	38	40	200
DURBAN UNIV OF TECHNOLOGY	Clinical Nursing Science, Health Assessment,	3	1	1	7	8	20
	Treatment and Care
NELSON MANDELA METROPOLITAN	Nephrology Nursing	9	11	15	14	19	68
UNIVERSITY	Nursing Education	0	3	0	0	0	3
	Critical Care Nursing	4	5	7	6	3	25
	Advanced Midwifery& Neonatal Nursing Science	4	8	7	9	5	33
	Clinical Nursing Science, Health Assessment,	2	5	8	9	9	33
	Treatment and Care
	Advanced Psychiatric Nursing	1	3	5	2	1	12
	Nursing Administration	5	8	9	5	12	39
UNIVERSITY OF FREE STATE	PSYC (880)	6	5	6	6	6	29
	PSYC (212)	3	7	3	2	3	18
	Occupational Health Nursing	32	26	29	24	23	134
	Clinical Nursing Science, Health Assessment,	80	25	44	45	40	234
	Treatment and Care
	Child Nursing Science	12	14	2	8	12	48
	Critical Care	8	4	4	6	5	27
	Advanced Midwifery& Neonatal Nursing	7	17	9	9	6	48
	Operating Theatre	17	14	5	7	9	52
	Nursing Administration	81	15	22	26	23	167
	Nursing Education	10	15	10	15	17	67
POTCHEFSTROOM UNIVERSITY	Nursing Management	50	141	21	34	22	268
	Nursing Education	82	23	23	26	25	179
UNIVERSITY OF JOHANNESBURG
	Diploma: Clinical Nursing Science, Health Assessment,	13	10	9	13	15	60
	Treatment and Care
	Advanced Midwifery & Neonatal Nursing Science	2	14	7	3	6	32
		12	35	26	19	20	112
	Occupational Health Nursing	22	35	31	25	32	145
	Nursing Administration	13	38	16	17	20	104
	Nursing Education	12	14	15	18	16	75
	Community Health Nursing	5	6	1	8	5	25
	Medical & Surgical Nursing Science Critical care	1	1	5	7	6	20
	Psychiatric Mental Health Nursing Science	2	1	1	3	4	11

NURSING COLLEGES

NURSING EDUCATION INSTITUTIONS	PROGRAMME	YEAR OBTAINED
		2010	2011	2012	2013	2014	TOTAL
NET CARE EDUCATION	Critical Care Nursing: General	12	6	7	13	10	48
	Operating Room Nursing	8	9	11	11	14	53
	Trauma and Emergency Nursing	14	17	4	4	18	57
SG LOURENS NURSING COLLEGE	Psychiatric Nursing Science	15	17	19	32	10	93
	Clinical Nursing Science, Health Assessment	32	29	28	89	45	223
	Treatment & Care
BARAGWANATH NURSING SCIENCE	Nephrology Nursing Science	12	10	3	25	15	65
	Child Nursing Science	12	12	6	30	30	90
	Critical Care Nursing: General		35	8	43	34	120
	Ophthalmic Nursing Science	16	13	5	34	15	83
	Trauma and Emergency	21	13	3	37	22	96
	Oncology Nursing Science	6	12	2	20	13	53
	Operating Theatre Nursing Science	17	20	2	39	17	95
	Orthopeadic Nursing Science	17	10	6	33	28	94
	Clinical Nursing Science, Health Assessment	45	23	5	73	56	202
	Treatment & Care
	Advanced Midwifery & Neonatal Nursing	35	25	16	76	23	175
FREE STATE COLLEGE	Critical Care Nursing	11	12	10	15	15	63
MCCORD HOSPITAL SCHOOL OF NURSING	Clinical Nursing Science, Health Assessment	45	38	43	42	36	204
	Diagnosis, Treatment & Care
LILITHA COLLEGE OF NURSING	Ophthalmological Nursing Science	9	12	10	10	16	57
	Orthopeadic Nursing Science	12	8	13	11	14	58
LIFE COLLEGE	Operating Theatre Nursing	6	4	9	13	8	40
	Emergency Nursing	19	13	10	29	12	83
	Critical Care Nursing: General	5	14	10	19	13	61
KZN COLLEGE OF NURSING	Critical Care Nursing Science	15	15	15	15	15	75
	Child Nursing Science	14	14	14	14	14	70
	Orthopeadic Nursing Science	15	15	15	15	15	75
	Midwifery & Neonatal Nursing Science	24	24	24	24	24	120
	Child Nursing Science	16	16	16	16	16	80
	Ophthalmic Nursing Science	15	15	15	15	15	75
ANN LATSKY NURSING COLLEGE	Clinical Nursing Science, Health Assessment	61	59	44	53	41	258
	Treatment & Care
GA-RANKUWA	Midwifery & Neonatal Nursing Science	35	32	36	23	20	146
	Child Nursing Science	30	21	20	12	23	106
	Operating Theatre Nursing	20	18	12	12	16	78
	Critical Care Nursing: General	18	12	12	16	15	73
	Clinical Nursing Science, Health Assessment	18	16	27	30	23	114
	Treatment & Care

SUMMARY PRODUCTION OF SPECIALIST NURSES: NURSING COLLEGES

PROGRAME	2010	2011	2012	2013	2014
Advanced Midwifery& Neonatal Nursing Science	94	77	76	123	67
Advanced Psychiatric & Mental Health Nursing Science	15	17	19	32	10
Child Nursing Science	72	63	62	54	62
Clinical Nursing Science Health Assessment Treatment & Care	201	165	147	287	201
Community Nursing Science	0	0	0	0	0
Critical Care General	61	94	69	121	108
Critical Care Trauma	0	0	0	0	0
Critical Care Trauma & Emergency	14	17	4	4	18
Nephrology Nursing Science	87	36	16	81	55
Nursing Administration	0	0	0	0	0
Nursing Education	0	0	0	0	0
Occupational Health Nursing Science	0	0	0	0	0
Oncology Nursing Science	6	12	2	20	13
Operating Theatre Nursing	51	51	34	86	100
Ophthalmological Nursing Science	24	27	25	25	72
Orthopaedic Nursing Science	27	23	28	26	73

SUMMARY PRODUCTION OF SPECIALIST NURSES: UNIVERSITIES

PROGRAME	2010	2011	2012	2013	2014
Advanced Midwifery& Neonatal Nursing Science	13	39	50	21	17
Advanced Psychiatric & Mental Health Nursing Science	48	63	110	68	48
Child Nursing Science	12	14	2	8	12
Clinical Nursing Science Health Assessment Treatment & Care	169	219	182	238	176
Community Nursing Science	62	73	136	84	126
Critical Care General	13	10	16	19	14
Critical Care Trauma	0	0	0	0	0
Critical Care Trauma & Emergency	0	0	1	0	0
Nephrology Nursing Science	15	21	28	24	27
Nursing Administration	290	366	260	225	263
Nursing Education	162	125	218	139	136
Occupational Health Nursing Science	155	185	113	105	79
Oncology Nursing Science	35	16	14	25	26
Operating Theatre Nursing	27	17	19	10	21
Ophthalmological Nursing Science	0	0	0	0	0
Orthopaedic Nursing Science	0	0	0	0	0

(3) (a) Yes, the University of Johannesburg and University of Pretoria;

(b) A total of 310 since 1 January 2009, however, this programme has been discontinued after it was identified that there were no Regulations related to the offering of such programme. It should also be noted that candidates who underwent such training were duly registered based on Council resolution.

END.

Reply:

1. (a) ADVANCED QUALITY ONE STEP ANTI-HIV (1&2) Test (InTec Products Inc): Used for screening;

          (b) ABON HIV 1/2/O Tri-Line Human Immunodeficiency Virus Rapid Test (ABON Biopharm Hangzhou Co., Ltd): Used for confirmatory;

     2. No, the specified test kits are not from the same manufacturer as specified below:

ADVANCED QUALITY is used for screening and ABON is used for is used for confirmatory. ADVANCED QUALITY is supplied by 2 suppliers because it is used for screening and needed in large quantities, while ABON is supplied by another different supplier and is from a different manufacturer.

END.

Reply:

Advanced Quality met all the specifications for award as per the advert. This included two pre-qualifications by the World Health Organisation (WHO).

END.

Reply:

1. (a) In the NHI Pilot Districts 16 clinics and 5 CHCs will be built in accordance with the relevant infrastructure plan.

(b) The clinics are located as follows: Limpopo Province (Magwedzha, Makonde, Mulenzhe, Thengwe and Kutama), Free State Province (Borwa, Clocolan and Lusuka) and Eastern Cape Province (Lusikisiki, Sakhele, Nolita, Genqe, Lutubeni, Maxwele, Lotana and Nkanga). The CHCs are located in Mpumalanga (Mkhondo, Msukaligwa, Nhlazatshe 6, Vukuzakhe, Balfour).

(c) Relevant timeframes for building clinics range from 12 to 18 months.

2. (a) The Department of Health is busy with the repair and upgrade of Primary Health Care (PHC) facilities in the Pilot Districts of the NHI programme. The first phase currently of the programme includes the implementation of a multi-disciplinary building condition technical assessment and to establish the status-quo of the relevant services and installations, recommend appropriate remedial interventions, where required, prioritise these in terms of criticality, and determine the associated cost estimates. This will put the Department in a position to appoint contractors to do repairs to PHC facilities and to plan any facility upgrades and/or replacements within annual allocated funding.

(b) The Department intends to repair and upgrade all the health facilities in the NHI pilot districts to a set standard.

(c) Relevant timeframes for the refurbishment of each clinic can range from 1 to 12 months.

END.

Reply:

(1) The Department has identified 17 districts as TB hotpsots for enhanced intervention (See Table 1).

Table 1: TB hotspots

Province	TB Hotspots Districts
Eastern Cape	Buffalo City
	Cacadu
	Chris Hani
Free Sate	Lejweleputswa
Gauteng	Johannesburg Metro
	West Rand
KwaZulu Natal	eThekwini
Limpopo	Sekhukhune
	Waterberg
Mpumalanga	Ehlanzeni
North West	Bojanala
	Dr Kenneth Kaunda
Western Cape	City of Cape Town
	West Coast

(2) The following criteria were used to identify TB hotspots:

1. Number of people diagnosed with TB (exceeding 5,000 per year);
2. Treatment success (below 80%);
3. Defaulter Rate (exceeding 6.2%);
4. Death Rate (exceeding 5.6%);
5. Transferred Out Rate (exceeding 2.4%);
6. Drug resistant TB burden;
7. High concentration of (especially gold) mining

END.

Reply:

Patients with Tuberculosis are diagnosed and started on treatment in all public sector hospitals and clinics as well as 154 facilities in the private sctor and 243 owned by the South African Military Health Services and NGOs. Patients with MDR and XDR TB are treated in 9 specialised central hospitals and 298 decentralised sites and 272 satellite sites. There are also 150 injection teams that manage some of the patients at home (on an ambulatory basis).

END.

Reply:

The production of nurses and midwives are provided in the template below indicating the Public Colleges, Universities and Private Colleges from 2010-2014.

OUTPUT 4-YEAR PROGRAMME (2010-2014) NURSING COLLEGES

2010 2011 2012 2013 2014 EASTERN CAPE 364 580 502 549 558 LIMPOPO 207 248 339 220 271 NORTH WEST 327 234 297 322 230 MPUMALANGA 216 140 120 197 145 GAUTENG 784 663 757 793 842 FREE STATE 182 174 147 174 153 KWAZULU NATAL 555 570 604 586 630 NORTHERN CAPE 62 56 3 0 0 WESTERN CAPE 269 301 456 420 392 OUTPUT 4YEAR PROGRAMME(2010-2014)UNIVERSITIES     2010 2011 2012 2013 2014 LIMPOPO 81 24 109 72 94 NORTH WEST 18 44 60 57 64 MPUMALANGA   0   0   0  0   0 GAUTENG 127 92 110 113 100 FREE STATE 47 33 49 35 32 KWAZULU NATAL 69 70 70 62 124 NORTHERN CAPE 0   0   0   0   0 WESTERN CAPE 168 191 227 170 179 EASTERN CAPE 119 136 127 142 147 OUTPUT MIDWIFERY PROGRAMME PUBLIC INSTITUTION 2010-2014   2010 2011 2012 2013 2014 LIMPOPO 300 132 242 161 136 NORTH WEST 35 45 41 22 79 MPUMALANGA 163 93 122 180 102 GAUTENG 61 18 39 187 138 FREE STATE 44 63 22 74 18 KWAZULU NATAL 343 355 356 499 263 NORTHERN CAPE   0  0 19 26 8 WESTERN CAPE 10 5 0 0 70 EASTERN CAPE 118 87 81 69 77             OUTPUT MIDWIFERY PROGRAMME PRIVATE INSTITUTION 2010-2014   2010 2011 2012 2013 2014 LIMPOPO           NORTH WEST   0   0   0  0  0 MPUMALANGA  0 0  0  0   0 GAUTENG   0   0   0 4 0 FREE STATE   0   0   0   0   0 KWAZULU NATAL 22 40 36 52 53 NORTHERN CAPE           WESTERN CAPE   0   0   0   0   0 EASTERN CAPE   0   0   0 3 1                         OUTPUT NURSING AUXILIARIES PUBLIC COLLEGES 2010-2014   2010 2011 2012 2013 2014 LIMPOPO 237 123 38 55 30 NORTH WEST 102 110 76 40 202 MPUMALANGA 43 137 107 68 7 GAUTENG   0   0   0   0   0 FREE STATE 106 165 180 190 110 KWAZULU NATAL 18   110 108 15 NORTHERN CAPE 7   0   0   0   0 WESTERN CAPE 40 50 53 53 64 EASTERN CAPE 346 380 323 666 539             OUTPUT NURSING AUXILIARIES PRIVATE COLLEGES 2010-2014   2010 2011 2012 2013 2014 LIMPOPO 272 146 130 147 174 NORTH WEST 37 60 57 85 74 MPUMALANGA 93 186 243 276 305 GAUTENG 2276 2293 2253 2441 2696 FREE STATE 83 79 59 108 109 KWAZULU NATAL 929 993 959 1075 1134 NORTHERN CAPE   0   0   0   0  0 WESTERN CAPE 454 405 361 436 478 EASTERN CAPE 82 105 60 161 204 OUTPUT ENROLLED NURSES PUBLIC COLLEGES 2010-2014   2010 2011 2012 2013 2014 LIMPOPO 494 436 409 162 134 NORTH WEST   0   0   0 23 41 MPUMALANGA 211 219 211 271 216 GAUTENG 401 396 540 802 394 FREE STATE 139 126 173 129 154 KWAZULU NATAL 413 524 536 634 297 NORTHERN CAPE  0   0   0  0   0 WESTERN CAPE 257 164 119 212 164 EASTERN CAPE 399 368 501 416 377             OUTPUT ENROLLED NURSES PRIVATE COLLEGE 2010-2014       2010 2011 2012 2013 2014 LIMPOPO 105 92 99 120 132 NORTH WEST 165 171 103 183 153 MPUMALANGA 12 34 34 46 25 GAUTENG 2099 2079 1978 2345 1998 FREE STATE 39 47 41 62 57 KWAZULU NATAL 2383 2278 2448 2951 2301 NORTHERN CAPE   0   0   0  0  0 WESTERN CAPE 296 307 345 387 260 EASTERN CAPE 98 150 195 211 246 OUTPUT PSYCHIATRIC NURSING PROGRAMME 2010-2014 PUBLIC COLLEGES   2010 2011 2012 2013 2014 LIMPOPO   0 9 7 55 57 NORTH WEST 12 7 6 10 2 MPUMALANGA 0 0 0 0 0 GAUTENG 1 2   0 6 16 FREE STATE 0 0 0 0 0 KWAZULU NATAL 14 37 28 35 37 NORTHERN CAPE 0 0 0 0 0 WESTERN CAPE 15 0 0 17 0 EASTERN CAPE

END.

Reply:

1.   The National Health Insurance pilot districts are significantly varied in terms of institutional and organizational capacity. This variability is partly due to the selection methodology that was applied but also reflective of the geographic areas within which they are located.
​
​a)   Nonetheless, many of the programmes that have been piloted in the past few years have recorded significant successes such as establishment of fully functional Primary Health Care (PHC), namely Municipal Ward-based Outreach, District Clinical Specialists and Integrated School Health teams; strengthening of monitoring and evaluation capacity through appointment of key personnel; improved coordination and oversight of district planning through appointment of the provincial NHI coordinators; improved infrastructure maintenance and planning through involvement in the Operation Phakisa Ideal Clinic Realisation project; innovation dispensing and distribution of chronic medication as well as making steady progress towards e-Health-based patient registration systems, among many others.

b)    Given the nature of the pilot districts, it is anticipated that challenges will exist in some districts, such as OR Tambo and Pixley Ka Seme, the ability to attract key health personnel to form part of the District Clinical Specialist Teams. Weak supply chain management systems and unforeseen delays in procuring key items is a key challenge that characterizes majority of the districts.

2.   To date, 307 health practitioners have been contracted to render health services in public clinics across the pilot districts.

END.

Reply:

We are indeed aware of the findings. This investigation was in fact initiated by the National Department of Health. The investigations you refer to forms part of a more holistic assessment of the project. The initial phase of the investigation, focussed on technical issues, has been concluded. The team is now busy with an assessment of procedural and contractual issues. For obvious reasons, we cannot at this stage discuss the detail of the findings, as this will jeopardise the balance of the investigation.

END.

Reply:

1.  Public Hospitals use the following regulations as stipulated in the National Health Act No. 61 of 2003 to dispose of foetuses:​

(i)   ​R. 177 Regulations relating to the use of human biological material Section 2. In terms of section 68 of the Act, - regulates who should remove human biological material from health institutions.

(ii)   R. 180 Regulations regarding the general control of human bodies, tissue, blood, blood products and gametes, Section 68(1) – regulates handling of deceased bodies/human biological material.

(iii)  R. No. Regulations relating to health care waste management in health establishments – the Environmental Health Directorate within the National Department of Health has developed the above mentioned regulation and it has just been approved.

2.  (a)-(b) Contracted companies for disposal of foetuses in both public hospitals and abortion clinics are:

Province	Company
Eastern Cape	Compass Waste Management Services
Free State	Solid Waste Management Services
Gauteng	Buhle Waste Management Services
KwaZulu-Natal	Compass Waste Management Services
Limpopo	Buhle Waste Management Services
Mpumalanga	Buhle Waste Management Services
North West	Buhle Waste Management Services
Northern Cape	Tshenolo Waste Management Services
Western Cape	Solid Waste Management Services

3.   (a) The Department of Health is currently guided by the following regulation:

• R. 180 Regulations regarding the general control of human bodies, tissue, blood, blood products and gametes section 68 (1) in conjunction with section 90 of the National Health Act stating

“Any person who acquires the body of a deceased person or any tissue, blood or gamete by virtue of any provision of the Act and these regulations, shall, subject to any restrictions in terms of the Act or any other law and provided she or he uses the body, tissue, blood or gamete for the purposes for which it has been donated, handed over or supplied to her or to him, on receipt of that body, tissue, blood or gamete acquire exclusive rights in respect thereof.”

(b)  The National Health Research Ethics Council (NHREC) is a statutory body established in terms of The National Health Act (NHA) to set norms and standards for conducting research on humans, to monitor and institute appropriate disciplinary actions in cases of violation of ethics and human rights. It monitors ethical conduct in research, including the use of fetuses for experimental purposes. Section 72(7) particularly makes provision for “clinical trials” which includes experiments involving human subjects for research purposes. (NHA s 73(1)) requires that every organisation/institution, health agency and health establishment at which health and health-related research involving human participants must have access to a registered Human Research Ethics Committee (REC) that review research involving human participants must be assessed and register with the NHREC (NHA s 73(1)). The NHA (s 72(1)) requires that proposals to conduct ‘health research’ must undergo independent ethics review before the research is commenced.

• Section 3.3.5 of the 2015 Ethics Guidelines relates to Restrictions on collection of biological materials. The document highlights certain persons who are specially protected. The guidelines explains that without Ministerial permission, biological materials may not be taken from mentally ill persons; biological materials that are not naturally replaceable may not be taken from a minor; no gametes may be taken from a minor; and no fetal biological material except for umbilical cord progenitor cells may be collected from anyone. These restrictions are absolute which means that research with the categories of person mentioned requires special permission. RECs must satisfy themselves that the necessary special permission has been obtained, where appropriate.

Furthermore, the Department has established a National Health Research Database (NHRD) to register and monitor all research being conducted in the country. All research studies have to be approved by the Ethics committee and registered in the database before commencement.

END.

Reply:

1.  Ms. Joyce Mogale was appointed as the full-time CEO of the NHLS on the 28th of August 2015.

2.  Three officials were involved with the recruitment process, namely Mr Andre Venter and Dr Devanand Moonasar – in their capacity as Members of the Board of the NHLS, and Ms Malebone Precious Matsoso in her capacity as an independent technical expert;

3.  Ms. Matsoso attended the second round of interviews, but provided no instruction to the Selection Panel. Ms. Matsoso as the Director-General: Health did not participate in any discussion or process that resulted in a preferred candidate being identified.

The process of appointing the CEO of the NHLS was as follows:

The NHLS placed an advert in the Mail and Guardian for a CEO on a 5-year contract in November 2015. The NHLS board determined that a selection panel would oversee the recruitment process, from the short-listing through to interviews and making a recommendation to the NHLS board on a preferred candidate. Mr. Andre Venter as the chair of the Finance Committee of the NHLS and a NHLS Board member was appointed as a member of the selection panel.

Both Mr. Venter and Dr Moonasar participated in the shortlisting process. During the shortlisting 8 candidates were identified as meeting the requirements as advertised.

A first round of interviews was conducted. The panel established constituted the selection panel as well as any other board members who were available. Both Mr. Venter and Dr Moonasar participated in the first round of interviews.

The result of the first round of interviews was that the top 4 candidates were called in for a second round of interviews. In addition to the selection panel members, any NHLS board member who was available was invited to participate in the interviews.

In the second round, the Director-General: Health (Ms MP Matsoso) was the only official from the NDOH that participated. Mr Venter (due to ill health) and Dr Moonasar (prior commitments) did not attend.

Ms Matsoso’s role was only to provide an external assessment of the candidates, and upon completion of the interviews she excused herself from the process. The Selection panel, after the departure of Ms Matsoso, consolidated the scores of each candidate.

The selection panel made a recommendation to the NHLS Board, that the top 2 candidates are subject to a proficiency assessment. Following which, a teleconference was convened to inform all those present during the second round interviews of the outcome of the proficiency testing. Ms Matsoso and Mr. Venter participated in this teleconference.

Following the disclosure of the results of the proficiency test, Ms. Matsoso informed the NHLS chairperson, that her role was complete and asked to be excused. The Chairperson thanked Ms Matsoso for her contribution and confirmed that she was excused. Once Ms Matsoso was excused, the selection panel deliberated on the interview and proficiency results. A recommendation was then drafted and tabled to the NHLS board at the meeting held on the 29th of July 2015. Mr. Venter participated in the in drafting of the recommendation.

The NHLS board mandated the NHLS Chairperson to inform the Minister of Health of the outcome of the selection process. Both Mr. Venter and Dr Moonasar participated in the Board meeting in their capacity as Board Members of the NHLS.

The Minister of Health duly noted the outcome and was satisfied that the Board had followed a fair and rigorous process. As such, the Minister supported the recommendation of the NHLS Board to appoint Ms. Mogale as the CEO of the NHLS on a 5-year contract.

END.

Reply:

(1) (a) The Department spent R2 424 728 on air travel for a total of 62 employees attending Parliament business on different occasions during that financial year.

     (b) Undertook 31 trips.

(2) (a) Spent R339 663 on accommodation

     (b) Spent R41 200 on car rental

 

END.

Reply:

No, the Department has not yet met this target. However, the Department has disabled people who refuse to be classified as such. Hence the Department dropped below 1% on this target.

END.

Reply:

1. Yes Honourable Member, the Department has definitely made serious strides in the war against TB. The treatment success was 76% in 2009 and it is 89% now. By 2009 70 000 people were dying of TB per annum but now the figure has dropped to 40 000. However, TB still remains the biggest killer in our country.

2. Yes the measures are doing well but we need to do more to eradicate TB. Hence the President announced in the State of the Nation Address this year that we are going to focus on TB.

The Deputy President launched a massive TB screening campaign on 24 March this year, focusing on high prevalence districts, the mineworkers and the inmates in Correctional Service facilities.

We used to have only 9 centralised treatment centres to treat MDR-TB and XDR-TB. Now we have 298 decentralised sites, 272 satellite sites and 150 injection teams to help decentralise management of MDR-TB and XDR-TB.

We have trained 1 700 nurses to manage MDR-TB and 230 of them can even initiate treatment of MDR-TB in the absence of a doctor.

3. According to Stop TB Partnership, the measures in South Africa are far ahead of many countries, for instance there are 700 patients globally who are on Bedaquiline treatment. A total of 400 of these are in South Africa alone. The remainder is scattered all over the world. We are now putting 3 000 on Bedaquiline this financial year.

END.

Reply:

Yes, the Department of Health is aware of the water problem in the John Taolo Gaetsewe District in the Northern Cape, but it is not in most facilities as claimed by the question. The problem is in 10 out of 42 Primary Health Care facilities (PHCs). Most of these facilities are located in the deep rural areas of the District where there is no connection to the municipality’s water supply source. In areas where there is a connection it has been difficult for the municipality to meet the demand.

The District engaged the municipality to supply water tanks and fill them regularly with water. Interruptions have been very minimal.

The following were done as remedial action:

1. Skilled technical officials have been appointed by the Department;
2. An action plan has been developed;
3. The District and the Department are in the process of procuring service providers to erect boreholes to supplement water supply;
4. Approval has been granted to procure 5 000 litre water tanks for all 10 facilities; and
5. The procurement process was anticipated to commence in the week of 24 August 2015.

END.

Reply:

Patients with Tuberculosis are diagnosed and started on treatment in all public sector hospitals and clinics as well as 154 facilities in the private sctor and 243 owned by the South African Military Health Services and NGOs. Patients with MDR and XDR TB are treated in 9 specialised central hospitals and 298 decentralised sites and 272 satellite sites. There are also 150 injection teams that manage some of the patients at home (on an ambulatory basis).

END.

Reply:

The Workload Indicators for Staffing Norms (WISN) method is an evidence-based Human Resource planning and management tool developed by the World Health Organisation (WHO). This tool was applied in sampled facilities located within the NHI pilot sites to determine the number of health workers of a particular category required to cope with the workload of the given health facility. The findings from this work were subsequently used to develop health workforce normative guides and standards for Primary Health Care (PHC) facilities.

Implementation guidelines of health workforce normative guides and standards for fixed PHC facilities are available. This guideline will be used in the process of determining staffing requirements in all fixed PHC facilities by benchmarking facility staffing against normative guides using facility headcount as a proxy of workload.

END.

Reply:

(1) Yes the batches were tested by the NICD prior to distribution. Pre distribution reports attached. At the time of initial testing, the batches met the requirements.

Advanced Quality Titima Medical 2015011616_PMS FEB 2015

Advanced Quality Titima Medical 2015010602_PMS JAN 2015

Advanced Quality Titima Medical 201501 615_PMS FEB 2015


(2)

	SUPPLIER	NO. OF BATCHES RECEIVED AND TESTED
	ABON	26
	TITIMA MEDICAL	13
	ADVANCED QUALITY ARMADA	9

(3) (a)-(c) Reports attached with batch numbers. All reports met the required specifications.

Herewith the batches distributed by Armada / Advanced Quality as from the start of the new tender in 2014:

2014071401

2014071701

2014080101

2014090221

2014091821

2014092308

2014112702

2014121510

2014122409

Total of 9 batches distributed to date.

 

END.

Reply:

Honourable Member, as a Member of the Legislature and an Honourable Member of this House, I am sure you are well aware that the matter you are raising is clearly a Constitutional matter and not for the National Minister of Health and any Minister from the National Sphere of Government for that matter, to participate in.

If I can just assist the Honourable Member, please refer to Section 91(2) of the Constitution of the Republic of South, 1996 (Act No. 108 of 1996), on the appointment of Ministers by the President of the Republic. Similarly, the Honourable Member may refer to Section 132(2) of the Constitution, on the appointment of MECs by the Premier of a Province.

Therefore from these provisions of the Constitution, the Honourable Member will see that the matter of the appointment and/or dismissal of MECs is clearly articulated. Nowhere in the Constitution, as Supreme Law, or in any law of this Country is it provided for that a Minister should be involved in the appointment or dismissal of MECs in anyway whatsoever.

END.

Reply:

No, we do not think that it is the job of Provincial Legislatures to undertake extensive audits of –

a) maintenance;

b) management;

c) functioning hospitals

The Provincial Departments of Health are doing so already, through various projects in partnership with the National Department of Health.

The National Department of Health has implemented a multi-disciplinary technical assessment of health facilities starting in the NHI Pilot Districts, to establish the status of the relevant services and installation, recommend appropriate remedial interventions, where required, prioritise these in terms of criticality and determine the associated cost estimates.

On the issue of management of hospitals, the Development Bank of Southern Africa (DBSA) conducted a comprehensive assessment on management of hospitals. This led to a policy change whereby only people with a health background may be CEOs of hospitals.

On the issue of functioning of hospitals, the Office of Health Standards Compliance (OHSC) conducts inspections on quality of health services.

END.

Reply:

The Minister visited China to attend the World Economic Forum’s Annual Meeting of New Champions 2014, in Tianjin, People’s Republic of China from 10 to 12 September 2014. Minister used this opportunity to honour a long standing invitation to pay an official visit to China from Minister Li Bin, the Minister of Health and Family Planning of the People’s Republic of China. This official visit took place on the 9th of September 2014.

He was accompanied by Dr Anban Pillay: Deputy Director General: Health Regulation and Compliance Management and PA, Ms M Sethosa.

Return Air Tickets: R 316 576.00

Accommodation: R 78 000.00

Daily allowances: R 35 249.34

Vehicles: R 75 000.00

VIP Lounges: R 20 000.00

The total cost for the visit was R 524 825.34.

 

Another delegation of Senior Officials visited China from 18 to 22 August 2014 to attend the Global Health Diplomacy Executive Training Course in Beijing, China. The delegation consisted of Deputy Director-General: International Health Development and Support, Ms MK Matsau, Mr M Modisenyane, Director: Africa Relations and the Deputy-Director: South-South Relations, Ms T Khosa.

Return Air Tickets: R 135 108.00

Accommodation: R 24 717.00

Daily allowances: R 16 756.20

The total cost for the visit was R 176 581.20

Please note that the trip was sponsored, tickets, accommodation and local transport were paid for by the National Health and Family Planning Commission (NHFPC) of the People’s Republic of China.

END.

Reply:

Honourable Member, let me mention upfront that the establishment of initiation schools is under the control of the Department of Coorperative Governance and Traditional Affairs (Cogta).

As Health, we play a supportive role in terms of the health needs of initiates. Together with Cogta, we have negotiated with CONTRALESA (the Congress of Traditional Leaders of South Africa) whereby the Department will make available a sum of R20 million per Province. With this money, the traditional leader should look for medical doctors who are also practitioners and affiliates of that particular culture and have themselves gone through cultural initiation schools, to take care of the health needs of the initiates and to perform the actual circumcision, including post-operative care.

Some traditional leaders have accepted this option and where it is implemented, there is absolutely no death or no amputations.

However, some are still very resistant to this proposal and that is where death commonly occurs. A large number of deaths happen in illegal schools which are unknown even to the traditional leaders.

END.

Reply:

Honourable Member, I have repeatedly mentioned that our methods of determining the number of posts for health workers cannot be deemed reliable as it is derived from organograms which were drawn up long ago and not based on any scientific tool. The World Health Organisation (WHO) has come up with a new scientific tool called WISN (Work Indicators for Staffing Norms). We have just finished calculating WISN norms for Primary Health Care facilities only. We have just started working out the numbers in hospitals.

WISN will be the only reliable indicator of staffing in the healthcare system.

END.

Reply:

Honourable Member, the same question was asked by Honourable LV James of the DA (see Annexure A - Question 2059 asked on 29 May 2015).

END.

ANNEXURE A

NATIONAL ASSEMBLY

FOR WRITTEN REPLY

QUESTION NO. 2059

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 29 MAY 2015

(INTERNAL QUESTION PAPER NO. 17)

Ms L V James (DA) to ask the Minister of Health:

Whether his department has any programmes to improve education about multidrug-resistant tuberculosis, specifically about the importance of testing; if not, why not; if so, what are the relevant details?

NW2322E

REPLY:

The National Department of Health has several programmes and platforms that are being used to inform, educate and raise awareness about TB, including MDR-TB at community level.

(a) The national and provincial TB programmes have Advocacy, Communication and Social Mobilisation units with focal persons whose role is to, on a regular basis, disseminate information to members of the community on the importance of being screened, tested and treated for TB, including MDR-TB. Each of these units have focal persons who, sometimes with support from partner organisations, use various platforms including the media (radio, television, and print) to educate communities about TB. The units also disseminate information through posters, fliers and billboards and sometimes conduct door-to-door campaigns to engage household members on TB.

(b) In 2010, during the advert of the FIFA World Cup hosted in South Africa, the Department and Stellenbosch University conceptualised and implemented a communications platform called “Kick TB and HIV”, which uses community activations (campaign style) to educate members of the community on TB. Over the past year, 266 activations were conducted, and 467 817 people were reached.

(c)  The Deputy President launched, on 24 March 2015, a massive TB campaign that aims to mobilise millions of South Africans to be screened, tested and treated for TB, including MDR-TB.

(d) An integrated mass media communication and education campaign that will focus on HIV/AIDS, TB (including MRD-TB), maternal and child health, non-communicable diseases, violence and injuries, has been developed and a tender is currently being evaluated to appoint a service provider to manage the campaign over the next 3 years.

END.

Reply:

1. The Department of Health has not commissioned any studies on the safety of genetically modified organisms (GMOs). However, the Department participates in the regulatory systems of GMOs.

The safety of Genetically Modified Organisms is regulated in terms of the Genetically Modified Organisms Act, 1997 (Act No. 15 of 1997), (GMO Act), which is administered by the Department of Agriculture, Forestry and Fisheries (DAFF). The GMO Act provides for safety of human and animal health, as well as the environment. There are specific regulatory systems which have been set up for the rigorous evaluation of GMOs and Genetically Modified foodstuffs, so as to ensure access to sufficient, safe and nutritious food. These regulatory systems evaluate both human health and the impact that these organisms may have. The regulatory system consists of scientists, including food safety experts, who conduct food safety assessments before the GMO crops are approved for human consumption. The Department of Health participates in this regulatory system which also focuses on risk assessments of GMOs.

2. All GMO foodstuffs approved by government are safe to eat.

All foodstuffs from GMOs are thoroughly assessed during the developmental phase to ensure that they are safe for animal and human consumption. This is done before they are made available to the public. The safety assessments of Genetically Modified foodstuffs are based on guidelines and principles developed by Codex Alimentarius Commission (Codex), an international body involved in food safety, under the World Health Organization (WHO) and Food and Agriculture Organisation (FAO) of the United Nations. The Codex guidelines and principles include the need for a case-by-case safety assessment, i.e., the use of scientific risk-based assessment methods that would take into consideration the newly introduced genetic material in crops, including new proteins and other characteristics of the Genetically Modified foodstuffs. This is also done in comparison with conventionally produced foods. All the Genetically Modified foodstuffs that are on the market have been approved by government and are considered as safe as their conventional counterparts.

The details of all the GMOs approved in South Africa are as a result of the safety assessment by scientists who are experts in fields related to GMOs as appointed by the Minister for Agriculture, Forestry and Fisheries, in terms of the GMO Act and evaluate risk assessments (scientific data relating to food, feed and environmental impact). The decisions for approval are by the Executive Council, which consists of officials from six government departments responsible for matters relating to Agriculture, Health, the Environment, Labour, Trade and Industry and Science and Technology, as well as the chairperson of the Advisory Committee.

END.

Reply:

The Minister visited China to attend the World Economic Forum’s Annual Meeting of New Champions 2014, in Tianjin, People’s Republic of China from 10 to 12 September 2014. Minister used this opportunity to honour a long standing invitation to pay an official visit to China from Minister Li Bin, the Minister of Health and Family Planning of the People’s Republic of China. This official visit took place on the 9th of September 2014.

He was accompanied by Dr Anban Pillay: Deputy Director General: Health Regulation and Compliance Management and PA, Ms M Sethosa.

Return Air Tickets: R 316 576.00

Accommodation: R 78 000.00

Daily allowances: R 35 249.34

Vehicles: R 75 000.00

VIP Lounges: R 20 000.00

The total cost for the visit was R 524 825.34.

 

Another delegation of Senior Officials visited China from 18 to 22 August 2014 to attend the Global Health Diplomacy Executive Training Course in Beijing, China. The delegation consisted of Deputy Director-General: International Health Development and Support, Ms MK Matsau, Mr M Modisenyane, Director: Africa Relations and the Deputy-Director: South-South Relations, Ms T Khosa.

Return Air Tickets: R 135 108.00

Accommodation: R 24 717.00

Daily allowances: R 16 756.20

The total cost for the visit was R 176 581.20

Please note that the trip was sponsored, tickets, accommodation and local transport were paid for by the National Health and Family Planning Commission (NHFPC) of the People’s Republic of China.

END.

Reply:

(1) (a) (i) The following provinces do not have provincial contracts:

• Free State, Mpumalanga, Limpopo, Northern Cape and North West.

Officials in provinces who sign off on provincial tenders are:

• Eastern Cape: Depot Manager and Director: Supply Chain Management.
• KwaZulu-Natal: Head of Department.
• Gauteng: Chairperson of the Provincial Bid Adjudication Committee.
• Western Cape: Officials according to financial delegations.

(ii) Provincial officials who sign off on the payments for medication are:

 

• Eastern Cape: Director: Finance at the depot.
• Free State: CEO, Depot Manager, Head of Pharmaceutical Services and Finance Manager, according to financial delegations.
• Gauteng: Director: Finance at the medical supplies depot.
• KwaZulu-Natal: Assistant Manager: Pharmaceutical supply depot.
• Limpopo: Senior Manager: Pharmaceutical Services and Financial Manager.
• Mpumalanga: Chief Financial Officer.
• Northern Cape: Director: Financial Services, Depot Manager, Deputy Director: Finance, Administrative Officers and Clerks according to financial delegations.
• North West: Head of Department, Chief Financial Officer and Director: Supply Chain Management.
• Western Cape: Assistant Director as Head of Finance Division at the depot.

(b) (i) The list of pharmaceutical companies is attached as Annexure A.

 

(ii) The companies are contracted using a competitive bidding process. Provinces purchase medicines from these contracted suppliers unless there is a breach of contract.

(2) (a) & (b) Medicine shortage is never a permanent problem. It changes almost everyday. Please supply the list of medicines which you believe we are short of and we will provide you with a reason.

(3) No. Medicines procured on tender are either approved essential medicines or formulary items reviewed by Provincial Pharmaceutical and Therapeutics Committees. The approval of an essential medicine includes a systematic evaluation of affordability which involves application of various pharmaco-economic tools.

(4) In the tendering process a competitive bidding process is used. Prior to advertisement of tender, provinces submit estimates and sign off on the estimated expenditure. In addition, price negotiations are entered into before a tender is finalised.

END.

Reply:

The investigation reports are not made public and they remain confidential between the employee and the employer in terms of the disciplinary code.

(a)  (i) One.
(ii) Five.
(iii) Three.

(b) Financial:

Facts / Findings	Parties responsible	Total cost	Steps taken
Misuse of state vehicle	Employee & Employer	Cost not determined

Forensic: All forensic audits have been referred to the Accountant General.

Other Investigations:

Facts / Findings	Parties responsible	Total cost	Steps taken
Abuse of leave	Employee vs employer	Cost is not yet determined	Draft in progress
Alleged Assault	Employee vs employer	No cost	Disciplinary hearing in progress
Alleged corruption related to leave forms	Employee vs employer	No Cost	Investigation in progress

END.

Reply:

1. Yes there is a plan to upgrade the Hospital as part of our hospital revitalisation programme – but not necessarily through a private-public-partnership (PPP).
2. No. The Hospital has had its casualty upgraded before the FIFA 2010 World Cup but not through a PPP. It was done by the Department of Public Works in Gauteng.

END.

Reply:

(a)  (i) Post Mortem unprocessed drunk driving blood alcohol samples:

28 February 2015: 6 980

31 July 2015; 3 964

(ii) Pre Mortem unprocessed drunk driving blood alcohol samples:

28 February 2015: 54 129

31 July 2015; 39 433

(b)  (i) New samples that have been received from January 2015 to 31st July 2015: 41 925

(ii) New samples that have been processed from January 2015 to 31st July 2015: 63 431

This means that new samples received by the 31 July 2015 since the beginning of the year are 41 925, but in that period 63 431 samples were processed.

This is because we have divided all samples into two categories. One category is for new samples which must be done immediately to avoid backlogs. The second category is for historically backlog samples. These are done bit-by-bit as soon as the current samples are done. Hence the 20 000 extra samples are from this backlog category.

END.

Reply:

1. The Provincial Departments of Health have conducted patient satisfaction surveys in health facilities during 2014/15.2.
2. Nationally 42% of public health facilities conducted patient satisfaction surveys during 2014/15 financial year;
3. In total 1 810 334 patients participated in surveys at these facilities, and from these 1 377 851 patients were satisfied with services rendered at public health facilities.
4. In addition STATSA conducts patients satisfaction surveys as part of the Annual Household surveys.

END.

Reply:

CIVITAS BUILDING:

(i) No. The National Department of Health has not installed any generator since 1 January 2015.

(ii) The existing generator installation costs were included in the overall major upgrading of the building four which was completed in 2010. The running costs are included in the monthly rental payment to Public Works.

Forensic Chemistry Laboratories buildings (4)

(i) No generators were installed at the three forensic chemistry laboratories ( Pretoria; Johannesburg and Cape Town) since 1st January 2015.. The National Department of Health has not installed any generator since 1 January 2015.

A new generator has been installed at the newly operational Forensic Chemistry Laboratory in Durban (85 Magwaza Maphalala street) on 31 March 2015 at a cost of R294,120.00 as a standard feature for any of our forensic laboratories.

(ii) The maintenance costs are included in the monthly rental payment to the Department of Public Works.

Medical Bureau for Occupational Disease (MBOD) /Compesation Commissioner for Occupational Diseases (CCOD)

(i) No. The National Department of Health has not installed any generator since at the MBOD/ CCOD building since 1 January 2015.

(ii) The generator installation costs were included in the overall major upgrading of the building four which was completed in 2007. The running costs are included in the monthly rental payment to Public Works.

PUBLIC ENTITIES:

The South African Medical Research Council

(i) In the process of replacing the generator at an estimated cost of R1 500 000.00.

(ii) There is no actual fuel consumption data to provide cost nor associated maintenance cost as the installation has not been started. The specifications for fuel consumption for the generator that will be installed are 199 g/kwh to 206 g/kwh at 100% capacity.

The Council for Medical Schemes

(i) In the current year the old generator was replaced at a total cost of R569, 621. The amount includes a trade in / rebate amount on the old generator set.

 

The Council for Medical Schemes has a service level agreement with the supplier to test and maintain the generator at a contractual rate. Actual running costs of the generator for the period 1 January 2015 to 30 May 2015, including total cost paid to the supplier for servicing and replacing parts amounts to R19, 618. R27, 221 was spent on diesel. (The estimated running costs of diesel are estimated at R1, 575 per load shedding event.)

END.

Reply:

Portions 87, 148, 149 were sold through an open tender by the Department of Local Government and Housing. As part of the agreement with the successful bidder, the Sizwe Tropical Disease Hospital will be relocated to a site opposite Edenvale Hospital.

(a)   The patience currently at the Hospital will remain at the Hospital until relocation. Any patients that will be at the Hospital when the new premises is complete will be relocated to the new premises.

(b)   New patients will continue to be admitted at the Hospital until the relocation, after which all new patients will be admitted at the new premises.

(i) The Hospital will be relocated to a site opposite Edenvale Hospital;

(ii) As part of the agreement with the successful bidder, the successful bidder will relocate the Hospital at his own cost;

(iii) The relocation will only commence once the developer complete the construction and commissioning of the new premises.

END.

Reply:

1. The EMS Priority 1 (P1) response rate under 60 minutes in the Odi District is 78.7%;

The EMS Priority 1 (P1) urban response rate under 15 minutes in the Odi District is 40.4%.

The provincial average response times are indicated below:

Indicator	Period
Sort Order	Indicator Name	Jan	Feb	Mar	Apr	Grand Total
104	EMS call transport rate	89.2	97.7	92.1	90.4	92.5
105	EMS inter-facility transfer rate	0.0	0.0	88.5	90.4	42.9
106	EMS obstetric client transport rate	36.5	31.1	31.9	34.9	33.4
107	EMS operational ambulance coverage (annualized)
109	EMS operational Obstetric Emergency Unit coverage
110	EMS P1 call response under 60 minutes rate	46.7	100.0	50.0	100.0	78.7
111	EMS P1 rural responses under 40 minutes rate
112	EMS P1 urban response under 15 minutes rate	46.7	28.6	50.0	45.0	40.0
334	EMS P1 Urban Maternity and obstetric call under 15 minutes response rate	100.0	100.0

(a)   It serves Ga-Rankuwa, Mabopane, Soshanguve and Winterveldt, in Gauteng Province.

(b)    Botshabelo, Hebron, Hoekfontein, Kgabalatsane, Klipgat, Koedoespoort,Kromkuil, Madidi, Makau, Makaunyane, Mothutlung, Odinburg, Rabokala – all in North West Province.

2.  Odi Hospital, which refers to Dr George Mukhari Academic Hospital.

END.

Reply:

1. (a) Interns

Year	Number
2009 2010 2011 2012 2013 2014 2015	350 371 374 361 369 384 271

 

(b) Community Service Medical Officers

Year	Number
2009 2010 2011 2012 2013 2014 2015	223 229 202 193 198 215 230

 

(c) Registrars

Year	Number
2009 2010 2011 2012 2013 2014 2015	150 170 209 194 165 39 0

2.  (a) 2014:

(i)  Interns – Yes.

As a result of the Nelson Mandela School of Medicine at the University of KwaZulu Natal (UKZN) reverting to a six-year programme for medical students there were no students in 2014 completing the sixth year and this reduced the number of students that could be placed for internship.

(ii)  Community Service Medical Officers – No decrease.

(iii)  Registrars – Yes, due to limited available funding.

3.  (a) (i) and (ii) No fixed amount was allocated.

(b) (i) 2013-14

Interns: R363,583,000.00

Community Service Medical Officers: R138,136,500.00

Registrars: R471,970,000.00

(ii) 2014-15

Medical Interns: R373,614,200.00

Community Service Medical Officers: R155,466,000.00

Registrars: R430,000,000.00

END.

Reply:

Yes.

1. (i) A total of 210 Cuban medical doctors.

(ii) A total of 26 Cuban medical doctors.

1. Medical Practitioners.

1. The following table reflects the details on the skills profile

(i) Currently employed:

Clinical Discipline	Number
Anaesthesia	7
Anatomy	1
Biochemistry	1
Biostatistics	1
Cardiology	1
Clinical Laboratory	1
Dermatology	3
Embryology	1
Ear Nose and Throat	4
Epidemiology	2
Family Medicine	105
Gastroenterology	1
General surgery	13
Internal Medicine	20
Maxillo Facial	3
Neurology	1
Obstetric and Gynaecology	12
Opthalmology	4
Orthopaedics	8
Paediatrics	8
Pathology	1
Pharmacology	1
Plastic and Reconstructive Surgery	2
Psychiatry	3
Public Health	1
Urology	3
Total	210

(ii) Due to be employed

Clinical Discipline	Number
Cardiology	1
Emergency Medicine	1
Family Medicine	10
Internal Medicine	1
Maxillo Medicine	1
Obstetrics and Gynaecology	1
Opthalmology	2
Orthopaedics	2
Paediatrics	4
Plastic & Reconstructive Surgery	1
Radiology	1
Rheumatology	1
Total	26

 

1. It is generally acknowledged that there is a big shortage of medical doctors in the public health care system.

1. The doctors recruited from Cuba earn the same remuneration as other doctors employed by the Government based on the years of experience and expertise.

END.

Reply:

1. None of the entities reporting to the Minister of Health provided any type of sponsorship.
2. None of the entities reporting to the Minister of Health intends to enter into any type of sponsorship deal or contract in the 2015 and 2016 financial years and the reasons provided are as follows:

• The National Health Laboratory Service (NHLS) - due to the current financial situation; and
• The South African Medical Research Council (SAMRC); the Council for Medical Schemes (CMS) and the Office of Health Standards Compliance (OHSC) – do not provide any sponsorship deals or contracts.

END.

Reply:

1. (a) 60% of patients on bedaquiline are in South Africa, i.e 361 patients in South Africa out of a total of 600 worldwide.

(b) A tender to procure Linezolid is being prepared. Linezolid is available off code in the meantime.

2.  (i) and (ii) For year 1 (1st April 2015 to 31 March 2016) we are prioritising XDR-TB, pre-XDR-TB and MRD-TB with hearing impairment, renal impairment and those to be operated.

Because the main focus will be on XDR-TB, we have started rolling out at our 12 facilities responsible for treating XDR-TB which are:

• Jose Pearson and Fort Grey Hospitals (Eastern Cape);
• Dr J S Moroka (Free State);
• Sizwe Hospital (Gauteng);
• King Dinuzulu Complex Hospital (KZN);
• FH Odendaal (Limpopo);
• Witbank TB Hospital (Mpumalanga);
• Dr Harry Surtie and West End (Northern Cape);
• Tshepong Hospital (North West);
• Brooklyn Chest and Khayelitsha (Western Cape)

The 12 facilities treat all XDR-TB patients in the country.

• Jose Pearson, Fort Grey, King Dinuzulu, Sizwe and Brooklyn Chest Hospitals treat 50% to 60% of all MDR-TB in the country.

• So we believe that there will be a good coverage to years 1, 2 and 3;

• Mines and prisons will follow after 2 to 3 years.

3. A costed plan to make the drugs available has been developed and budgeted for in the HIV Conditional Grant. The drugs will be made available to 3 000 patients in year 1 (1st April 2015 to 31 March 2016), and then gradually increase to 6 000 at the end of year 3.

END.