Questions and Replies

Reply:

Yes the department maintain an updated asset register.

(a)  Five motor vehicles

(b)  Total value for five vehicles is R2 926 330.69

All these vehicles are more than five years old and purchased as follows;

• BMW 525i (Kept and being used when other vehicles went for service)

Price; R349 561.40

Purchase date: 30 June 2004

MINISTER

• Mercedes-Benz E200

Price; R451 804.00

Purchase date: 08 January 2010

• Mercedes-Benz E500

Price; R760 794.01

Purchase date: 08 January 2010

DEPUTY MINISTER

• BMW 520d

Price; R466 449.30

Purchase date: 15 February 2011

• BMW 740i

Price; R897 721.99

Purchase date: 07 March 2011

END.

Reply:

The Department of Health has several initiatives to assist young people to access contraceptive and family planning services.

-  Ensuring that all primary health care facilities are adolescent and youth friendly. Facilities that are classified as youth friendly need the following standards:

• Policies and processes to support adolescent and youth health rights available;
• Provision of safe and supportive environment;
• Systems to train and develop staff on youth issues;
• Individualised care with privacy and confidentiality maintained; and
• Effective referral systems in place.

The Department has contracted and NGO (loveLife) to assist with the training of clinic personnel and to ensure that standards listed above are in place. We have trained 615 health professionals during the past year and will be training an additional 375 during this financial year.

• An effort to increase condom use among the youth in particular, the Department has decided to procure coloured and scented male condoms. A contract to supply 50 million coloured and scented condoms has been awarded and 38 million have already been distributed in universities and TVET colleges. The distribution of these condoms is a partnership between the Departments of Higher Education and Training and of Health – the ‘First Things First’ campaign for institutions of higher learning – which has been implemented on an annual basis since 2011. The aim of this campaign is to offer HIV counselling and testing, Medical Male Circumcision (MMC), TB screening, condom distribution, appropriate prevention messages and treatment referrals to the students in Universities and TVETs. Condoms are also distributed during HCT as dual protection against unplanned pregnancies, STIs and HIV. Over 100 000 students were reached in the last financial year;
• In order to expand the range of contraceptive commodities available the Department introduced the sub-dermal implant in April 2014 and to date more than 850,000 women have had the implant inserted. Although the implant method was not specifically targeted at the youth, earlier indications seem to be showing that the majority of the 850 000 women are actually young people who have never been on any contraception before;

• In collaboration with Soul City, the Society for Family Health and Stellenbosch University and funding from a development partner, the Department is implementing the ‘Families Matter’ project whose objective is to prepare youth to make informed health choices, including sexual and reproductive health choices. The project is currently running in Gauteng, KwaZulu Natal, Free State, Mpumalanga, Northern Cape and Western Cape;

• With funding from the Department of Health and Global Fund, Soul City is implementing the Rise Women’s clubs (the clubs target young women between 15-24 years of age with health education messages and has currently reached 17,000 young women through 1 000 Rise Young Women’s clubs) and Soul Buddies clubs (to empower primary school children to make healthy life choices). In addition, the Department of Health funds loveLife’s ground breakers programme which is a peer-to-peer programme that focuses on learners in high school and out of school and empowers them to make healthy life choices;

• As part of the Integrated School Health Programme (which is a collaborative programme between the Departments of Health and of Basic Education), school health teams provide age-appropriate messages and information to learners in both primary and secondary schools.

END.

Reply:

1. (a) 1 623;

(b) No nurse is ever registered with the HPCSA;

(c) I do not understand what “other medical practitioners” means.

2. (a) 6 729;

(b) 61;

3.  (a) 22;

(b) There is no remedy available for practitioners who have failed the examination three times.

4. There is currently no list of accredited qualifications obtained outside South Africa.

5. Since registration is a pre-requisite for practising the profession of medicine in South Africa, applicants will not be able to work as medical practitioners until such time as they are appropriately registered with the Medical and Dental Board.

END.

Reply:

The following Tables reflect the situation in this regard:

(a) The Department of Health

Newspaper	2012/13	2013/14	2014/15
Sowetan	R564,376.17	R153,029.57	R256,159.31
Daily Sun	R245,149.33	R230,794.39	R175,800.71

(b) Entities

Neither the Council for Medical Schemes, the Office of Health Standards Compliance, nor the South African Medical Research Council spent on advertising in either of the newspapers in questions during the stated period.

The National Health Laboratory Service spent on advertising as follows:

Newspaper	2012-13	2013-14	2014-15
Sowetan	R226,896.48	Nil	Nil
Daily Sun	Nil	Nil	Nil

END.

Reply:

In June 2012 the Department of Health requested Professor Jack Moodley (Chairperson of the National Committee on Confidential Enquiry into Maternal Deaths), and Dr Nat Khaole (then Acting Chief Director for Maternal and Women’s Health) to investigate allegations that HIV positive women have been sterilized without their consent. They visited two hospitals in Durban, namely, Addington Hospital and King Edward Hospital and found two evidence of systematic abuse of the consent process as alleged by the researchers.

When the issue was first brought to the attention of the Department of Health, I requested that details be provided, including names of the complainants, to enable the Department to investigate the matter fully. However, the Department was informed that the complainants did not wish to be identified to the Department as they were afraid of being victimised, despite our reassurance that I would personally ensure that the complainants are not victimised.

In 2015 the issue of forced sterilisation was raised with the Department of Health again. The Department again requested the NGO, Her Rights Initiative, to provide the names of the complainants, to enable the Department to fully investigate the allegations. In addition, a commitment was made that an independent team would investigate the allegations, if need be. However, to date, there has been great reluctance in providing the Department with the information necessary to investigate this matter.

The Department’s policy on any surgical procedure, including sterilization, is very clear – all surgical procedures require informed consent. In this regard, transgression will not be tolerated and disciplinary action will follow transgression when there is evidence to this effect.

END.

Reply:

(a) The table below reflects the details in this regard.

PROVINCE	ADMISSIONS
Eastern Cape	284

Other provinces do not collect this information as the boys arrive at health facilities as general patients and not as initiates. The Eastern Cape Province is able to collect the information because the boys are brought by members of initiation monitoring teams at hospitals.

(b) The types of injuries suffered by the initiates in this period requiring them to be hospitalised were as follows:

• Penile mutilations including amputations
• Assaults

END.

Reply:

(1) (a) A total of 6 facilities in Mpumalanga are currently operational.

(b) Please refer to the Choice on Termination of Pregnancy Act, 1996 (Act No. 92 of 1996)

(c) and (d) The Department of Health provides the service at no cost to the clients if indigent and costs are determined depending on the income of the patient in public hospitals as for any other medical condition.

(2) (a) (i) Legal termination of pregnancy statistics are recorded below:

	(aa) 2012-2013	(bb) 2013 - 2014	(cc) 2014- 2015
	3,104	3,046	2,539

(ii) The National and Provincial Departments of Health do not keep a record of illegal abortion statistics.

(b) This is not known as statistics for illegal abortions are not recorded separately.

(c) (i) (aa)-(bb) The Department does not keep a record of separating legal and illegal abortion statistics.

(ii) Statistics of children between the age 12 and 16 years who had terminations of pregnancy over the periods are:

PERIOD	NUMBER
2012-2013	55
2013-2014	49
2014-2015	52

(d) “The provisions of the Choice of Termination Act, Act No. 92 Of 1996: Choice on Termination of Pregnancy Act92, 1996. Is applicable with respect to consent.

(3) (a)-(b) No study has been conducted by both National Department of Health or the Mpumalanga Health Department that we are aware off.

(4) The Department of Health provides Termination of Pregnancy (TOP) in the designated health facilities which comply with the prescripts of the CTOP Act for safe performance of the procedure. The Department is continuously conducting value clarification workshops to address the issue of limited TOP services.

In addition the Department is conducting Manual Vacuum Aspiration training in partnership with partners that support the implementation of TOP services has introduced medical abortion services to increase access to this service.

However, the key to reducing unwanted pregnancies is to increase knowledge and access to sexual and reproductive health services. In line with this the department launched a revised Contraceptive Policy and introduced the contraception implant as a new and additional contraception method to increase the range of contraceptives available to woman.

END.

Reply:

Yes, there are clear criteria set for the removal of underperforming hospital managers as per the goals listed in the National Development Plan (NDP).

END.

Reply:

The Eastern Cape Province is considering this matter and will be making a decision shortly.

The key imperatives in considering this matter are:

1. Our policy to provide Primary Health Care free at the point of delivery; and

1. The need to increase our EPI coverage in a manner that also makes access to immunization services as easy as possible.

END.

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 construction of Cool Air clinic was decided upon as part of the need to expand services to the underserved areas. The Cool Air clinic will be one of the clinics to be built out of the In-Kind-Grant in the 10 NHI Pilot Districts. Currently, the residents of Cool Air are serviced through the provision of a mobile clinic that visits the area twice a month as per schedule.

1. (a) (i) The budget for the proposed clinic is R31 million;

(ii) The budget will be allocated during the 2016-2017 financial year.

(b) The clinic is expected to be in operation in 2018.

END.

Reply:

Attached find here: (a) (i) The Department

Reply:

Yes.

1. The Department is currently providing school primary preventive oral health programmes to Quintile 1 and 2 schools in collaboration with the Department of Basic Education, as part of the Integrated School Health Programme (ISHP). The services consist of:

a. Dental screening;
b. Oral health education;
c. Tooth brushing sessions;
d. Tooth fissure sealant applications; and
e. Basic treatment services.

2. The Department has purchased Mobile Dental Clinics, equipped with dental equipment and instruments, for the NHI pilot districts, to provide oral health services to children at schools and areas that are difficult to reach. This serves to improve access to services to communities that are poor.

3. The Department conducts quarterly visits to facilities in districts and provinces to assess the quality of oral health services that are used by the poor. Reports with recommendations are then sent to relevant provinces to take remedial action where necessary. Such exercises help to improve quality of oral health services.

4. The Ideal Clinic initiative aims to include and improve oral health services at Primary Health Care Level by ensuring availability of appropriate infrastructure, equipment and human resources to render quality oral health services.

5. Placement of Community Service Dentists in rural areas and also to areas where there were no oral health services have increased and therefore the access to oral services has increased to poor communities.

END.

Reply:

Yes.

There are plans to upgrade the Lenasia South Community Health Centre into a 250 bedded district hospital. These plans are still in the design phase.

In the mean time there are plans to have seventy six (76) step down beds activated in the Community Health Center and a 24 hour casualty and an emergency service.

The project for the step down beds is at an advanced stage and it is planned that the patients will be admitted by 01 June 2015.

Minor renovations are currently underway in the casualty and emergency area.

It is envisaged that provision of 24 hour emergency services will thus commence on 01 October 2015.

END.

Reply:

(i) In Namakwa there are 2 district hospitals; Dr van Niekerk Hosp in Springbok and Abraham Esau Hosp in Calvinia. No public hospital was closed in the Namakwa District during the past 10 or more years.

(ii) Kleinzee Hospital is a private facility owned by De Beers Mining Company and was closed due to the down scaling of the mining activities in Kleinzee.

(aa) - (bb) The Department has no record of any Government Hospitals that have closed in Namaqualand nor in Kleinzee.

(cc) The only Hospital in Namakwa or in Kleinzee that closed in the past 5 years is the Private Hospital which is still owned by De Beers. In this regard there is an engagement process for the facility to be donated to the Northern Cape Department of Health.

The facility was closed due to De Beers scaling down their operations and moving their staff to other business units across SA and Southern Africa.