Questions and Replies

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10 March 2023 - NW331

Profile picture: Ntlangwini, Ms EN

Ntlangwini, Ms EN to ask the Minister of Health

What (a) number of deaths are associated with the crisis of load shedding in (i) public hospitals and (ii) clinics in each province (details furnished) and (b) is the update from his department in rolling out automated generator power during load shedding at hospitals and clinics?

Reply:

We are not aware of any deaths associated with the crisis of loadshedding as the question alleges. With regard to the details furnished by the Honourable Member, I am assured by the Gauteng Provincial Department of Health that there is no reported incident in Radiology relating to any death in CT/MRI due to loadshedding at the Chris Hani Baragwanath Hospital, as alleged. The Gauteng Provincial Department further confirms that the CT and MRI machines of the Hospital have uninterrupted power supply (UPS) and generators, which ensures the continuity of service during black-outs. It could be of great assistance if details of the abovementioned case can be made available to us for detailed investigation and response.

END.

08 March 2023 - NW196

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Chetty, Mr M to ask the Minister of Health

(1)What are the details of the (a) destination and (b) total costs for (i) accommodation, (ii) travel and (iii) any other costs incurred for international travel of each (aa) Minister and (bb) Deputy Minister of his department since 1 June 2019; (2) what is the total cost incurred for domestic air travel for each (a) Minister and (b) Deputy Minister of his department since 1 June 2019?

Reply:

It is important to remind Honourable Members that all these trips are in fulfillment of the obligations for the Portfolio for various representations of the country in various fora in the world, and further, that the international ones are strictly approved by the Head of State before they can be undertaken.

1. The details of the destination, total costs for accommodation, travelling and any other costs incurred for international trips for each Minister and Deputy Minister since 01 June 2019 are as follows:

  • Minister R3 712 892.05
  • Deputy Minister R1 919 384.33

(aa) The former Minster

The Current Minister

(bb) Former Deputy Minister

Current Deputy Minister

2. The total costs incurred for domestic air travel for each Minister and Deputy Minster since 01 June 2019 were as follows:

a) The total cost for domestic air travel incurred for Minister, Dr. ZL. Mkhize was R1 343 877.00 up to the year 2021, and cost incurred for the current Minister, MP Dr. MJ Phaahla amount to R310 271.79 to date.

b) Costs incurred for former Deputy Minister, Dr. MJ Phaahla since 01 June 2019 until 2021 amount to R616 929,28 and current Deputy Minister, MP Dr. S Dhlomo with effect from 2021 to date sits at R718 054.54.

END.

08 March 2023 - NW297

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

Whether he has been informed that members of Operation Dudula have been protesting and chasing away immigrants from outside and within health facilities in Johannesburg, resulting in the specified individuals being denied the provision of healthcare and increasing the risk of xenophobic violence in healthcare practices; if not, why not; if so, what are the relevant details of the steps that have been taken to uphold (a) the Constitution of the Republic of South Africa, 1996, as well as (b)(i) domestic and (ii) international legal obligations, which ensure the right to health for all?

Reply:

I was made aware of Operation Dudula protesting outside public health facilities around Gauteng province including Johannesburg and Kalafong Hospital.

a) In Kalafong Hospital, Operation Dudula protest caused an obstruction of free access to the facility, hence the need to intervene, which was done in collaboration with the Gauteng Provincial Department of Health and Kalafong Hospital management.

b) (i) Gauteng Provincial Department of Health applied for an urgent court interdict against Operation Dudula. Subsequently, the Court order preventing disruption to free access to the hospital was granted. Over and above working with the Gauteng Provincial Department of Health, we prevailed with the South African Police Service to be more decisive in implementing the interdict, thus ensuring the protection and safety of all healthcare users, including foreign nationals. The court was applied mainly to prevent obstruction of healthcare facilities from being accessible to all users, including foreign nationals.

(ii) I, together with the Director-General gave the leadership of Operation Dudula an audience, who by the way also had other allegations against the Kalafong Hospital management. Operation Dudula leadership was informed that there are other ways of addressing their allegations against the hospital management. Having visited the Kalafong Hospital and assisting the Gauteng Provincial Department of Health and subsequently meeting with Operation Dudula leadership, was done as an attempt to open the lines of communication so that Operation Dudula are free to talk to us about specific matters they might have.

END.

08 March 2023 - NW283

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)What is the total number of senior and/or executive positions in each public hospital in the Republic that are currently occupied in an acting capacity with no permanent contract, where such positions are being held by someone with a total remuneration package of level 6 or higher; (2) what (a)(i) total number of senior staff in the employ of his department with a level 6 remuneration package or higher have disciplinary processes and/or cases pending against them and (ii) are the relevant details of the specified cases and (b) disciplinary measures are being taken by his department in this regard?

Reply:

1. In accordance with information extracted from the PERSAL Data Set of 28 February 2023, a total of 8 employees are occupying positions in acting capacity on senior and/or executive positions in public hospitals in the Republic with no permanent contract on salary level six and higher.

The table below is the data as extracted from PERSAL and its accuracy is being verified with Provincial Departments of Health:

ACTING PERSONNEL WITHOUT PERMANENT CONTRACTS AS Feb 2023

POST CLASS DESC

ACTING PERSONNEL

EC

FS

GAU

KZN

LP

MPU

NC

NW

WC

Grand Total

DEP MAN NURS(LEV1&2)

ASSIST MANAGER NURSI

0

0

1

0

0

0

0

0

0

1

HEAD CLIN DPT MED

HEAD CLIN UNIT MED

0

0

0

1

0

0

0

0

0

1

HEAD CLIN DPT MED

MEDICAL SPECIALIST

0

0

1

0

0

0

0

0

0

1

HUMAN+SUPPORT SR10

HUMAN+SUPPORT SR8

0

0

0

1

0

0

0

0

0

1

LINE FUNC + SUP SR11

LINE FUNC + SUPP SR9

0

0

0

0

0

0

0

0

1

1

LINE FUNC + SUPP SR9

HEALTH AND SUPP SR8

0

0

0

0

0

0

0

0

1

1

MANAGE+SUPPORT SR10

MANAGE+SUPPORT SR9

0

0

0

0

0

1

0

0

0

1

MANAGE+SUPPORT SR13

LINE FUNC + SUP SR11

0

0

0

1

0

0

0

0

0

1

Grand Total

 

 0

 0

2

3

 0

1

 0

 0

2

8

2. The table below indicates total number of senior staff in the employ of his department with a level 6 remuneration package or higher who have a disciplinary process and/or cases pending against them.

(2)(a)(i) total number

(ii)details of cases

Level 6=1

Theft

Level 8=1

Gross Absenteeism

Level 8=1

Corruption and maladministration

   

(b)disciplinary measures

Yes

END.

08 March 2023 - NW428

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)What is the total number of senior and/or executive positions that are currently occupied by acting personnel who holds a position with a total remuneration package of level 6 or higher without a permanent contract in each public hospital in the Republic; (2) what (a) total number of senior staff, with a level 6 remuneration package or higher, have disciplinary processes and/or cases against them, (b) are the relevant details of the specified cases and (c) disciplinary measures are being taken by his department in this regard?

Reply:

The Honourable Member is referred to the response to Question 283 asked on the 17 February 2023.

END.

08 March 2023 - NW465

Profile picture: Chetty, Mr M

Chetty, Mr M to ask the Minister of Health

What (a) is the salary of each (i) chief executive officer and (ii) top executive position in each state-owned entity reporting to him and (b) total amount does each get paid to attend a meeting?

Reply:

There are no state owned entities reporting to the Minister of Health. There are five public entities (Section 3A) reporting to the Minister of Health. (a) The table below depicts the salary of each (i) chief executive officer and (ii) top executive position in each public entity reporting to the Minister of Health

Name of Entity

(a) (i) the salary of each chief executive officer

(a) (ii) the salary of each top executive position in each public entity reporting to the Minister of Health

Council for Medical Schemes

R 2 736 815

  • Executive Manager: Office of CEO - R1 849 744
  • Chief Financial Officer - R1 881 000
  • Chief Information Officer (Vacant) - R1 881 000
  • Executive: Corporate Services - R1 881 000
  • Executive: Regulation - R1 881 000
  • Executive: Policy, Research & Monitoring - R1 849 744
  • Executive: Member Protection (Vacant) - R1 881 000

National Health Laboratory Service

R2 792 380

  • Chief Operations Officer: Strategic Initiatives - R2 117 754
  • Chief Financial Officer - R2 117 754
  • Executive Manager: Human Resources - R2 328 376
  • Executive Manager: Information Technology - R2 117 754
  • Executive Manager: Academic Affairs, Research; Quality Assurance –

R2 703 158

  • Executive Director -NICD - R2 521 313
  • Executive Director -NIOH - R2 398 227

Office of Health Standards Compliance

R2 368 024

  • Chief Financial Officer - R1 431 623
  • Chief Operations Officer – R 1 814 443
  • Executive Manager: HSDAS - R1 370 070
  • Executive Manager: Compliance Inspectorate - R1 540 533
  • Executive Manager: Complaints Management - R1 586 413
  • Health Ombud - R2 354 061

South African Health Products Regulatory Authority

R3 005 567.25

  • Chief Operations Officer - R2 247 799.61
  • Chief Financial Officer - R1 898 253
  • Chief Regulatory Officer - R1 604 650.30
  • Executive Manager: HR - R1 394 372.70
  • Company Secretary - R1 196 010.90

South African Medical Research Council

R3 280 727

  • Chief Financial Officer - R3 149 585
  • Vice President: Extramural Research Units - R2 730 269
  • Chief Research & Operations Officer - R2 594 400
  • Executive Director: Grants, Innovations & Product Development - R2 153 086
  • General Counsel - R2 102 207
  • Executive Director: Human Resources - R2 050 558
  • Executive Director (part-time): Transformation - R1 107 064

(b) Executives of Section 3A public entities do not receive remuneration for the attendance of meetings of their organization.

END.

08 March 2023 - NW264

Profile picture: Macpherson, Mr DW

Macpherson, Mr DW to ask the Minister of Health

(1)Whether, since the implementation of the Health Promotion Levy, his department conducted any research into its effect on levels of obesity in the Republic; if not, why not; if so, (a) who conducted the research, (b) on what date was the research conducted, (c) what did the research reveal about the effectiveness of the levy, (d) what is the reason that the research has not been made public and (e) on what date will the research be made public; (2) whether the research has been shared with the National Treasury; if not, why not; if so, (3) whether there has been any discussion of the research between his department and the National Treasury; if not, why not; if so, what are the relevant details of the discussions; (4) whether there are any plans to conduct such research now or in the future; if not, why not; if so, what are the relevant details?

Reply:

(1) (a) No specific research has been conducted on the effect of Health Promotion Levy (HPL) on obesity, however, studies have been conducted on the effects of HPL on the consumption of Sugar Sweetened Beverages.

(b)-(c) Scientists have shown that the HPL is working, for example, evidence shows that in the first year after the introduction of the HPL, urban household purchases of sugary beverages fell by 51% (Stacey et al, 2021). Similar results were shown in young adults in Langa Cape Town (Essman et al, 2022) where a 37% in volume and 31% in sugar intake was demonstrated. In Soweto, the frequency of Sugar Sweetened Beverages (SSB) intake amongst heavy consumers fell from 10 beverages per week before the tax to 4 beverages per week one year later (Wrottesley et al 2020).

(d) The results on the effectiveness of SSBs on consumption are published papers that are accessible to the public.

(e) Not Applicable

(2) Yes, the research has been shared with National Treasury by the researchers.

(3) There has not been any discussion between the DOH and National Treasury on above mentioned studies by the Department since the researchers shared the results directly with National Treasury.

(4) There is currently no planned research focussing only on the impact of HPL on obesity. The Department is finalising the Dietary intake study which will reveal other foods including those with sugar that are consumed by South Africans. The information will assist the Department to identify additional interventions that should be taken to control obesity and reduce the risks of NCDs. Considering that Obesity is caused by multiple factors, with sugar being the major contributor.

END.

08 March 2023 - NW147

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Chirwa, Ms NN to ask the Minister of Health

(a) What steps does he intend to take in response to the verbal communique issued to the hospital and clinic management of the OR Tambo Memorial Hospital in Boksburg by the Member of the Executive Council (MEC) for Health in Gauteng that they should not engage public representatives who are on oversight without her having granted permission, which was discovered during the unannounced oversight visit at the specified hospital and (b) on what date will his department issue a follow-up communique to correct the assertion and threat to management of hospitals and clinics issued by the MEC?

Reply:

It is our considered view that visitations to healthcare facilities, especially hospitals, are properly arranged ahead of time, with the relevant authorities, for visitors to be accommodated in the schedule and operations of the facility. This is so because all staff in our healthcare facilities are extremely busy all the time and if the visitation is not pre-arranged or arranged in an orderly manner, the operations of the facility will be negatively affected. Honourable Members are very well aware that our facilities are overburdened with demand for healthcare services, while at the same time experiencing shortages of staff of various sorts. We therefore do not want the staff in these facilities to operate in an unplanned and uncoordinated manner as this could even result in the Honourable Members ending up not receiving proper attention being taken on walk-abouts or being attended to by staff during such visits. The risk is therefore that the same Honourable Members will as a result complain that they went on a visit and they were not attended to and that no one was available to answer their questions. Also, the Honourable Member will wonder around in the facility and have a risk of causing even more disruption. It is our considered view therefore that visits by everyone to our healthcare facilities, including public representatives, are pre-arranged, but that in the case of Members of Parliament, such visits are further coordinated under the auspices of the relevant Parliamentary Committee. In this way, the Honourable Members will make a positive contribution in improving the quality of healthcare service delivery in our healthcare facilities in particular, and in the entire healthcare system in general.

The Honourable Member is well aware that a healthcare facility is a very sensitive area and allowing uncontrolled access to any healthcare facility poses risks to staff and patients both in terms of security as well as infection control.

END.

22 February 2023 - NW139

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Buthelezi, Ms SA to ask the Minister of Health

What are the (a) reasons for including Thaba Tshwane in tender specifications for the new Department of Health Headquarters and (b) benefits of the location for providing efficient and effective public services?

Reply:

a) The Thaba Tshwane building had enough space to accommodate the staff of the National Department of Health. And it was complying to all requirements of the Occupational Health and Safety Act.

b) The location of the building is not affecting the mission of the National Department of Health. The compliance of the building to OHS Act brings back the focus of the health staff, it is assisting the National Department of Health to put more focus on measures that can assist the provincial health departments to improve the health status through the prevention of illness, disease and the promotion of healthy lifestyles, and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.

END.

22 February 2023 - NW53

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Ismail, Ms H to ask the Minister of Health

(1)(a) What is the total number of public healthcare facilities that have (i) been assessed and (ii) not been assessed to ensure that they comply with the Health and Safety specifications, (b) by what date will the facilities be assessed, (c) what steps will he take to ensure that the health facilities that do not comply with the health and safety prerequisites will be compliant and (d) by what date will the specified issues be addressed; (2) (a) what total number of healthcare facilities that were assessed need to be demolished and new premises identified and (b) by what date will the new facilities be built?

Reply:

1. (a) According to the information extracted from 2022/23 provincial User Asset Management Plan (U-AMP), all public healthcare facilities have been assessed in accordance with the requirements of GIAMA (Government Immovable Asset Management Act).

(b)-(d) Not applicable

2. (a) None of the facilities that were assessed need to be demolished.

(b) Not applicable.

END.

22 February 2023 - NW7

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Van Staden, Mr PA to ask the Minister of Health

(1)Whether all government (a) hospitals and (b) clinics in each province are exempt from load shedding under the current Eskom crisis of electricity blackouts; if not, why not; if so, (i) which government (aa) hospitals and (bb) clinics in each province are still not exempt from load shedding and (ii) what measures are being put in place to ensure that all state- and provincial hospitals and clinics are exempt from load shedding; (2) whether he will make a statement on the matter?

Reply:

1. (a-b) Not all government facilities have been exempted from the load-shedding. However, the National Department of Health has provided Eskom with a total of 213 hospitals to be considered for possible exclusion from loadshedding. About 67% of these hospitals are supplied by municipalities while Eskom supplies about 33% of the identified hospitals. Out of the 213 hospitals, 76 hospitals have been exempted of which 26 are directly supplied by Eskom and 50 by Municipalities. The number of hospitals exempted to date have doubled since the meeting held on 22 September 2022 between Eskom and National Department of Health.

  1. (aa) See below the number of hospitals that are exempted to date across the country:

Table

Description automatically generated

i. (bb) Clinics and Community Health Centres are going to be covered within the solar energy roll-out programme.

ii. The National Department of Health in partnership with CSIR (Council for Scientific & Industrial Research) is currently conducting a due diligent exercise for the installation of solar panels at all our health facilities

END.

22 February 2023 - NW140

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Buthelezi, Ms SA to ask the Minister of Health

What are the reasons that the seven-year lease of the Exxaro building for his department amounts to R144,7 million more than the lease agreement that was signed by the Department of Cooperative Governance and Traditional Affairs for the same building for the same period?

Reply:

The procurement of the seven-year lease building was done by the Department of Public Works and Infrastructure. However, the National Department of Health has four times the staff compared to those of the Department of Cooperative Governance and Traditional Affairs. The square meterage that was required by the Department of Cooperate Governance and Traditional Affairs was far less compared to the one that was required by the National Department of Health due to the size of the Department. The rental price of the building is based on the required size of the square meterage.

END.

22 February 2023 - NW105

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Clarke, Ms M to ask the Minister of Health

In light of the damage at the Tambo Memorial Hospital in Boksburg caused by the gas tanker explosion that has been fixed very quickly and is of a high standard, by what date will the structural damage of the rest of the hospital be repaired, as it has been declared as unfit for human habitation and was considered to be an occupational hazard in 2017?

Reply:

The National Department of Health is expecting to start fixing the structural damages at the beginning of March 2023.

The implementation work going to cover the following areas:

Part 1 – The Remedial Works caused by the Boksburg LPG explosion;

Part 2 – Health Technology Equipment that were affected by the Boksburg LPG explosion;

Part 3 – Occupational Health and Safety issues (structural damages) that were identified in 2017.

The estimated date of completion is September 2024.

END.

22 February 2023 - NW8

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Van Staden, Mr PA to ask the Minister of Health

(1)Whether the COVID-19 Compensation Fund is in operation; if not, what is the position in this regard; if so, what total (a) number of vaccine injury claims has the fund received since 1 January 2021, (b) number of the claims were successful and (c) amount has been paid out; (2) whether he will make a statement on the matter

Reply:

(1) Yes the adjudication committee has been appointed, trained and the 1st meeting was held on the 14 December 2022. The appeal committee is in the process of appointment 

(a)  82 cases have been linked to the use of the vaccine, and claims are being processed

(b) 3 claims have been approved for payment

  (c) 0

(2) No.

END.

22 February 2023 - NW181

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Groenewald, Dr PJ to ask the Minister of Health

(1)What (a) is the total backlog of toxicological reports at the laboratories currently, (b) is the total number of reports that have been outstanding for (i) 1-5 years, (ii) 5-8 years, (iii) 8-9 years, (iv) 9-10 years and (v) more than 10 years, (c) are the reasons for the specified backlog and (d) how does he intend to eradicate the backlog; (2) whether his department intends to establish public-private partnerships to assist the State in conducting toxicology tests in order to reduce the significant backlog; if not, why not; if so, what are the relevant details?

Reply:

(1) (a) Total backlog for FCLs is 35 776 tests (CPT, JHB and PTA labs

(b) Outstanding reports:

(i) 1-5 years = 11 948

(ii) 5-8 years=3 391

(iii) 8-9 years= 2 158

(iv) 9-10 years = 1 749

(v) more than 10 years = 2555

(c) Backlogs were cause by, amongst others:

● old laboratory equipment that constantly broke down.

● Insufficient goods and services

● Delays in procurement

● Shortage of skilled staff

The nature of the samples that must be tested, and the volume of new samples and a high incidence of urgent requests. There normally are multiple samples per case, thus one case can consist of blood, urine, stomach content, liver, bile and a drug which all linked to one body.

Additionally the import of Certified Reference Materials to confirm and quantify controlled substances, is a very lengthy process which delays laboratory testing.

(d) The NHLS is streamlining activities in this discipline and the focus is on improving productivity to reduce the backlog.

(2) The backlog developed since the National Department of Health did not have the expertise and resources to effectively address the backlog. The laboratories have now been transferred from the NDOH to the NHLS given the efficiency of the NHLS as a specialised laboratory service. NHLS is leveraging its resources and expertise to turn things around and strives to address the backlog.

Public private partnership is a legislated process which requires a defined procurement approach which requires Treasury approval. The NHLS will explore amongst others the possibility of a public private partnership.

END.

22 February 2023 - NW64

Profile picture: Macpherson, Mr DW

Macpherson, Mr DW to ask the Minister of Health

Whether his department possesses any research on the levels of obesity in the Republic prior to the implementation of the Health Promotion Levy; if not, why not; if so, (a) by whom was the research conducted, (b) on what date was the research conducted, (c) what did the research reveal about obesity levels in the Republic and (d) will he furnish Mr D W Macpherson with a copy of the research?

Reply:

Yes, the Department relies on scientific evidence, when analysing South Africa’s risk factors to non-communicable diseases. Obesity is one of the risk factors.

(a) and (b) In this regard please see the two studies below:

  1. Wandai M, Aagaard-Hansen J, Day C, Sartorius B, Hofman KJ. Available data sources for monitoring non-communicable diseases and their risk factors in South Africa. S Afr Med J, March 2017;107(4):331-337. doi: 10.7196/SAMJ.2017.v107i4.11438. https://www.ncbi.nlm.nih.gov/pubmed/28395686
  2. Moodley G, Christofides N, Norris S, Achia T, Hofman KJ. Obesogenic environments in SA: A pilot study in Soweto. Preventing Chronic Disease. DOI: http://dx.doi.org/10.5888/pcd12.140559, 2015
     
  3. South Africa Demographic and Health Survey 2016 https://dhsprogram.com › pubs › pdf

(c) Studies revealed that obesity levels in South Arica are on the increase. The NDHS also revealed that obesity in South Africa was on the increase and that 31% of adult males, 67% of adult females, and 13% of children under five years old were either overweight or obese.

(d) Copies of the studies are available from the links in (a) and (b) above.

END.

22 February 2023 - NW52

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What total number of public (a) hospitals and (b) clinics have attained the ideal status; (2) whether he will furnish Ms H Ismail with a comprehensive report for each province on the stage that each hospital and/or clinic has reached on the ideal hospital and/or clinic status; if not, why not; if so, what are the relevant details; (3) (a) what number of public healthcare facilities are (i) compliant and (ii) not compliant with the requirements for the implementation of the National Health Insurance in each province and (b) by what date will all the public healthcare facilities be compliant with the requirements and pre-requisites of the national health regulations in each province?

Reply:

1. (a) Hospital services

Total number of Hospitals is 394. The hospitals which conducted status determinations are 290. The total number of Ideal Hospitals at the end of 2021/2022 is 146 (37%). The summary of provincial status is as follows:

Province

# of Hospitals

Tot # of Hospitals with Ideal Status

% Hospitals with Ideal status

# of Hospitals with Silver Status

# of Hospitals with Gold Status

# of Hospitals with Platinum Status

Eastern Cape

90

20

22%

19

0

1

Free State

32

16

50%

16

0

0

Gauteng

37

30

81%

23

6

1

KwaZulu-Natal

73

22

30%

20

0

2

Limpopo

41

17

41%

16

0

1

Mpumalanga

33

11

33%

11

0

0

North West

20

10

50%

10

0

0

Northern Cape

15

0

0%

0

0

0

Western Cape

52

20

38%

18

0

2

South Africa

394

146

37%

133

6

7

 

(b) Primary health Care ( PHC) facilities (clinics and Community Health Centres)

The total number of number of PHC facilities are 3477. The total number of PHC facilities that conducted the status determination is 3477. The total number of Ideal clinics and community health centers at the end of 2021/2022 is 1928 (55%). The summary of provincial status are:

Provinces

# of Facilities

# Facilities with IC status REMAINED Ideal

# Facilities with NEW IC status

Total # Facilities with IC status

% of Facilities with IC status

TOTAL # of Facilities with Silver Status

TOTAL # of Facilities with Gold Status

TOTAL # of Facilities with Platinum Status

Eastern Cape

775

138

40

178

23%

27

67

84

Free State

218

123

20

143

66%

12

48

83

Gauteng

369

332

9

341

92%

58

107

176

KwaZulu-Natal

605

472

39

511

84%

40

138

333

Limpopo

482

123

44

167

35%

13

53

101

Mpumalanga

293

136

37

173

59%

20

60

93

Northern Cape

162

29

6

35

22%

10

12

13

North West

310

150

30

180

58%

43

68

69

Western Cape

265

187

13

200

75%

11

23

166

South Africa

3479

1690

238

1928

55%

234

576

1118

2. For a comprehensive report for each province on the stage that each hospital and/or clinic has reached on the ideal status please see attached annexures.

(3) The legislation on the National Health Insurance (NHI) has not been passed yet and NHI compliance of health facilities have therefore not been measured. Clause 39 of the NHI Bill provides for accreditation of all provider establishments, public and private. The regulations and standard operating procedures to achieve accreditation over the coming years is yet to be drafted, published, consulted and adopted.

END.

22 February 2023 - NW148

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

What steps has he taken to ensure that the new information system that is in place at the O R Tambo Memorial Hospital does not inconvenience patients, especially the elderly, who have lodged grievances regarding the wait in long queues for their files?

Reply:

The Patient Information System implemented in OR Tambo Memorial Hospitals is owned and implemented by the Gauteng Department of Health. The Gauteng Provinces adopted the Modernisation Strategy aimed at improving the overall public services. “Gauteng health services will be modernized through effective management of information systems and the development and implementation of e-health strategies towards creating a paperless environment. The implementation of the new Patient Information Systems was to replace the two legacy systems used in the Gauteng facilities, being Medicom 2X and PAAB, the two systems were implemented in early 2000 and were no longer supported by their Original Software Manufacture (OSM).

The implementation of the system was expected to create queues only in the first two weeks of transitioning from the old system to the new system. This was due to data being migrated (data clean-up, data verification, data crossmatch, and data validation) from the old systems to the newly implemented system. To mitigate this expected issue, a change and adoption team was made available to the hospital to interact with patients while waiting in the queues and provided details on the new system and its benefits. The above intervention allowed the hospital to stabilise the system and transition from the old to the new system.

The hospital has a complaint and complement system in place which are monitored regularly. Based on the records for this system such complaints as per the question has not been recorded. The hospital also monitor patient waiting time for retrieval of files and this waiting time is within the benchmark waiting time of 30 minutes

Elderly patients have their own queues and should they come for a follow-up visit with a booking at the hospital, the files are retrieved the day before the booking. This significantly decrease waiting time for the retrieval of files at the administration.

END.

22 February 2023 - NW9

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Van Staden, Mr PA to ask the Minister of Health

(1)Whether there are enough vaccines available for each province for effective treatment of the measles outbreak that is currently taking place throughout the Republic; if not, what (a) measures are in place to overcome the shortages and (b) is the position in this regard; if so, what are the relevant details; (2) whether the Government has taken steps to ensure that the private sector obtains the vaccines as well; if not, why not; if so, what are the relevant details; (3) whether he will make a statement on the matter?

Reply:

The measles outbreak was in five of the nine provinces namely Limpopo, Mpumalanga, Gauteng, Free State in Thabo Mofutsanyane district only, and Northwest.

1. Yes.

(a) In response to the current outbreak and seeing that there is a need to increase the age group from 6 to 15 year, the department worked with the relevant role players to get enough vaccines for the purposes of interrupting transmission.

(b) There is enough stock to conduct a supplementary immunisation campaign for children aged 6 months to 15 years in all provinces. The number of doses procured by provinces for outbreak/campaign is 10 123 300 for the target population of 16,3 million. The doses referred to here above exclude the stock on hand in the province before the campaign and outbreak.

2. In provinces where there is Public Private Partnerships (PPP) exists, with Service Level Agreement, for private sector, their facilities are supplied with vaccines and trained to manage data and submit to the local sub-district for capturing, however PPP is not in all provinces.

3. No.

END.

22 February 2023 - NW65

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Macpherson, Mr DW to ask the Minister of Health

Whether his department conducted any research on the potential effectiveness of the Health Promotion Levy (HPL) to reduce the level of obesity in the Republic prior to the implementation of the HPL; if not, why not; if so, (a) by whom was the research conducted, (b) on what date was the research conducted, (c) what did the research reveal about the likely impact of the HPL and (d) will he furnish Mr D W Macpherson with a copy of the research?

Reply:

(a) A desktop review on studies related to the effect of sugar on obesity and increasing the severity of NCDs was conducted. In 2016, 31% of adult males, 67% of adult females, and 13% of children under five years old were either overweight or obese.

(b) Further studies conducted in South Africa post implementation of the sugar tax, highlighted a decline in the consumption of sugar sweetened beverages by about 29% in the purchase of SSB and 51% in the incidence of persons adding sugar to beverages. The studies were conducted by Wottesley et al, 2020; Essman et al, 2022; Hofman et al, 2021; and Boachie, Thsehla and Hofman 2022. To access these research articles, click the link HPL implications articles.

END.

22 February 2023 - NW86

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Chetty, Mr M to ask the Minister of Health

What are the details of the (a) make, (b) model, (c) year of manufacture, (d) cost and (e) purchase date of all the official vehicles purchased for (i) him, (ii) the former Minister, (iii) the Deputy Minister and the (iv) former Deputy Minister of his department since 1 June 2019?

Reply:

Since 1 June 2019 the department only bought one vehicle for the current Minister: Dr MJ Phaahla, MP, whilst he was the Deputy Minister as per the table below:

Members of Executive Authority

a) Make

b) Model

(c) Year of Manufacture

(d) Cost

(e) Purchase date

(i) Minister:

Dr MJ Phaahla, MP

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

(ii) Former Minister:

Dr. ZL Mkhize

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

(iii) Deputy Minister:

Dr S Dhlomo, MP

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

No Procurement was made

(iv) Former Deputy Minister:

Dr MJ Phaahla

Audi

Q5

2020

R756,489.83

10/5/2020

END.

23 December 2022 - NW4541

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Hlengwa, Ms MD to ask the Minister of Health:

Whether, with reference to the process of applications for the establishment of healthcare clinics about which communities have been complaining of submitting applications and never receiving feedback, his department will furnish Ms M D Hlengwa with the details of (a) how applications for healthcare clinics are processed and reviewed, (b) how long after the application is made by a community can the community expect feedback on the success or failure of the application and (c) what mechanisms will his department use to communicate the feedback to applicants? NW5670E

Reply:

The responsibility and process for receiving and reviewing requests and granting permission for new clinics to be developed is with provincial and district health management.

(a) In the case of a private health facility, applications for new facilities are made to the district management. District management then makes a recommendation to a provincial committee and the provincial committee will make a decision based on documentation received from the district. The provincial committee will make a recommendation to the accounting officer of the provincial health department to approve or not. The district recommendation will be based on the following:

(i) A detailed explanation of why the facility is required
(ii) Is an existing building considered or is a new building required
(iii) Size of population to be served
(iv) Proximity and utilisation rate of facilities in the same catchment area.
(v) Human Resource Plan
(vi) Stakeholder inputs

In the case of a public health facility, a decision will be made based on the size of the community to be served and the proximity and utilization rate at the nearest existing health facilities. If after considering the above factors, it is found that the community does need a new clinic, the construction of the clinic will be planned for in terms of the availability of land, and human and material resources.

(b) In the case of a private facility, it can take up to 90 days since provincial review meetings generally take place once a quarter. In the case of a public facility, the community will be involved in discussions through local community leaders and the district health council. Through these structures continual feedback is provided with regard to progress.

(c) In the case of a private facility communication will be in writing. In the case of a public facility, the community will be informed through community and district structures, whether the building of a clinic has been approved or not, and if approved for which year its planning has been entered into the provincial department’s infrastructure plan. Should community members engage Department’s in writing they should receive responses in writing as well.

23 December 2022 - NW4629

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Ismail, Ms H to ask the Minister of Health

(1) With reference to the high level of lead poisoning in the Republic (details furnished) since 2006, what total number of cases of lead poisoning have been reported to the National Institute for Communicable Diseases nationally and provincially; (2) (a) how will his department ensure that doctors, nurses and medical staff are sufficiently trained to identify lead poisoning and (b) what total number of (i) health facilities, such as clinics and hospitals, and (ii) laboratories in the Republic can identify lead poisoning nationally and provincially; (3) (a) how does his department monitor and enforce adherence to legislation of only 0.009% lead particles allowed in paint and (b) what are the consequences of contravening the Hazardous Substances Act, Act 15 of 1973; (4) how does his department intend to remove lead in buildings that were painted before 2006; (5) (a) on what date did the SA Medical Research Council launch its education campaign and (b) what does the specified campaign entail? NW5751E

Reply:

(1) Since 2006, there has been 4 lead poisoning cases that were notified to the National Institute for Communicable Diseases (NICD) nationally. Two (2) cases were reported in 2017, one from Free State Province and the other one from Mpumalanga province. The other two (2) cases were reported in 2022, one from Eastern Cape province and the second one from Western Cape province.

According to the World Health Organization (WHO), clinical diagnosis of lead poisoning is difficult, as a result, it can be misdiagnosed. The reason being most lead poisoned individuals are often asymptomatic and even when signs and symptoms are present, they are difficult to differentiate and relatively non-specific poisoning symptoms such as anorexia, nausea, vomiting, abdominal pain, constipation, poor concentration, headache, fatigue, language and speech delay, behavioral problems, etc. Lack of clear history of exposure, also contributes to difficulty in making a clinical diagnosis. Laboratory investigation which can only happen based on the clinician/medical practitioner`s perception of the need for it, is the only reliable way to diagnose leadexposed individuals (WHO. 2011.Brief Guide to Analytical Methods for Measuring Lead in Blood; WHO.2010. Childhood Lead Poisoning).

(2) (a) Education and training on lead poisoning is part of doctors and nurses undergraduate education and training and there are continual in service initiatives that are ongoing to raise awareness and improve the knowledge on lead poisoning and other related matters.

(b) The fact that nurses and doctors receive under-graduate training plus the continuous awareness programmes that are currently underway, means that all health facilities should be able to act (get patients tested/refer for tests) on suspicion. Tests from health facilities are done at the National Health laboratory Services.

(3) (a) The 0.009% lead content limit in paint is not yet in force. The relevant government Gazette Notice where this 0.009% lead content limit was legislated was published for public comments and comments are in the process of being incorporated. Therefore, the current lead in paint declaration as a hazardous substance law, Gazette Notice No. 801 of July 2009, is still applicable until repealed by the new law. The lead paint law is monitored by Environmental Health Practitioners (EHPs) at national, provincial and at municipal level. Chemical safety and hazardous substances control functions fall within the work scope of EHPs in terms of the Scope of Profession for Environmental Health, R888 of 26 June 1991. Monitoring is done through inspections, sampling, seizure and detaining paint products and subjecting suspected or randomly selected sampled paint product to laboratory analysis and taking any further necessary legal action.

(b) The consequences of contravening the Hazardous Substances Act, Act 15 of 1973; range from a fine to imprisonment for a period between 6 months and 10 years depending on the offence or to both a fine and such imprisonment.

(4) The Department does not remove lead from buildings. According to WHO, as long as the paint on painted wall surfaces remains intact, the lead content is not a hazard unless it deteriorates or ages showing peeling, chipping, chalking or cracking as it releases lead into dust (WHO. 2020. Global elimination of lead paint: Policy brief). It is the responsibility of each building owner to ensure that its building paint is in intact condition.

(5) (a) The South African Medical Research Council (SAMRC) started its education campaign on lead in 2004.

(b) The campaign has developed a number of lead hazards awareness raising materials, including training toolkit in collaboration with the Department of Health. The leaflets embraced various lead exposure sources and pathways such as paint, painted surfaces, toys, cookware, lead bullet ammunition, and melting fishing sinkers. It has also shared information on lead exposure, research findings and recommended intervention measures for government and communities in various government events and academic platforms through presentations, exhibitions, and lectures, targeting various health and education professionals and students.

END.

23 December 2022 - NW4566

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Chirwa, Ms NN to ask the Minister of Health

(1) What (a) is the detailed breakdown of the costs of the National Health Insurance (NHI), considering the provincial demands and requirements and (b) are the details of the envisaged and/or proposed means of how the money will be sourced, noting the proposed reallocations; (2) (a) what are the details of the reallocation of funds meant to accommodate the NHI, (b) how will the reallocation impact the current public health system and (c) what are the further, relevant details in this regard? NW5696E

Reply:

(1) (a) The National Health Insurance (NHI) will fund health care for 60m people. The Fund will be established once the Bill is enacted. The current spending on healthcare in the country is R554bn, which is split as follows:
 

FY21/22

Rand (bn)

%

Total public sector health

265 844

48,9%

Total private sector health

277 402

51,1%

543 246

Donors contribute R11 095bn, bringing total spend to R554 341bn

The NHI Bill provides that the bulk of the public sector health spend will be allocated to the NHI Fund by the normal appropriation route through Parliament.

(b) There is a provision in section 49 of the Bill for progressive introduction of taxes to move voluntary contributions into the Fund. In 2021/22 financial terms around R500bn is the equivalent funding of the present health system and it is these funds that will constitute the resource available to the NHI. This is in the order of 8,5% of GDP. Funds for non-personal health services, and capital for infrastructure development, will remain with the provincial departments.

(2) (a) The sources of funds that are presently spent in the health care system are as follows:

GOVERNMENT DEPARTMENT AND ENTITY

R (millions)

National Department of Health core

12 947

National Department of Health Indirect Conditional Grants

85

National Department of Health Direct Conditional Grants

60 000

Provincial Departments of Health Provincial Equitable Share

175 892

Defence (SAMHS)

5 474

Correctional Services

1 216

Local government (own revenue)

5 138

Workmen's Compensation contributions

* 3 502

Road Accident Fund levies

** 1 675

Compensation for Occupational Injuries and Diseases (COIDA)

***?????

Medical schemes (Employer contribution public service)

230 618

Medical schemes (Employer contribution private employer)

 

Medical schemes (Employee contribution)

 

Out of pocket

38 653

Medical insurance

5 501

Employer private (including Occupational Health)

2 630

Donors

11 95

* Unclear what portion is for medical expenses as opposed to other benefits
** Unclear what portion is for medical expenses as opposed to other benefits
*** Unclear what portion is for medical expenses as opposed to other benefits

(b) The public health system will continue to receive the present budget allocation but once the NHI is established the route of funding will change from te current route of Provincial Equitable Shares (PES) via block allocations to provincial governments and managed by provincial treasuries, through the National Vote to the Fund (as the South African Medical Research Council, Council for Medial Schemes and other entities are funded presently). The Fund will pay for the benefits and services provided. The leverage of the monopsony will obviate the challenges of patients moving between provinces and will allow for national interventions to communities that are under-funded (through strategic purchasing). By setting prices nationally the Fund will be able to control excessive pricing and purchase more care with the same funds.

(c) The Fund will also purchase benefits (patient care) from private providers who are presently not accessible to people who do not have medical scheme cover. This will increase the footprint of available services and improve accessibility.

END.

23 December 2022 - NW4540

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Hlengwa, Ms MD to ask the Minister of Health

Whether his department has any particular oversight mechanisms put in place to ensure the adequate functioning of rural healthcare clinics; if not, why not; if so, what are the relevant details? NW5669E

Reply:

Yes, the department does have an oversight mechanism for all healthcare clinics in the country irrespective of the area of location. The district health system of the country has been set up to take supervision of health facilities closer to where they are, and to ensure a fair and realistic management workload. The provinces have gone a step further in ensuring responsive supervision and support to all clinics and community health centers including rural clinics by dividing the 52 health districts into subdistricts. In addition, the clinics committees comprising members from the communities play a vital oversight role for service delivery in each primary health care facility.

END.

23 December 2022 - NW3869

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Wilson, Ms ER to ask the Minister of Health

Since his reply to question 2474 on 15 September 2022, what (a) is the current extent of the backlog of surgeries in the public health sector and (b) steps has his department taken to address the specified backlog?

Reply:

NW4823E

a) The National Department of Health is still consulting with Provincial Departments of Health to verify the figures in each province. This information will be furnished to the Honourable Member as soon as it is received from Provinces.

b) The table below illustrates the steps taken to address the backlog

Province

(b) What steps have been taken to address the specified backlog

Eastern Cape

Information not yet received

Free State

  • Increased number of days for Elective slates: from 2 days (2021) to 4 days (2022) theatre allocation.
  • Prioritized emergency surgery within first 6 to 12 hours.
  • Developed quality improvement plan to monitor theatre utilization and efficiency via Theatre User Committee Meeting.
  • Expedite appointment and transfer of two Theatre trained nurses form KZN and other areas by 31 October 2022
  • Submission to temporarily use four agency nurses from 1 November 2022
  • Appoint one medical officers by 01 January 2023.
  • All the backlog patients have elective dates for surgery.
  • Emergencies done daily.
  • Gynaecologist electives are reduced with seven (7) operations weekly.
  • Obstetric electives or backlogs are reduced with ten (10) operations weekly.
  • Electives will stop on 31 December 2022, and resume 2nd week of January 2023.

Gauteng

  • Procurement of Brachytherapy machines and rental of mobile units as an interim measure.
  • Filling of critical posts at institutional level.
  • Setting up surgical camps within clusters.
  • Extending sessional work to private sector staff to assist to reduce surgical backlogs at public hospitals.
  • Utilising the Public Private Partnerships to address the backlogs, depending on the budget.
  • Working with Eskom to exempt most facilities from load shedding schedules.
  • Working with Johannesburg water to exempt facilities from water shedding.
  • Maximise the referral pathways and channel the patients to the appropriate level of care for surgical procedures by down referring and up referring patients.
  • Working with Department of infrastructure to strengthen maintenance issues at facility level.

KwaZulu Natal

  • Catch-up has been done by increasing theatre times.
  • Elective slates done over the weekend to catch up.
  • Camps have also been planned.
  • Using after-hours to reduce backlog.
  • Elective theatre slates run after hours.
  • Maximum utilization of theatres with added slates on weekends.
  • An elective marathon is planned to further reduce the backlogs.
  • Cataract camps are regularly conducted.
  • All slates have re-commenced with increased theatre times and using after-hours to reduce backlogs.

Limpopo

  • The Outreach Surgical Services occur monthly rotating in the five districts to ensure that specialised clinical and surgical operations are conducted at district hospitals. Teams of specialists allocate each other for seven days a month to conduct these surgeries, thus address the backlog.
  • Limpopo Department of Health has a Public Private Partnership with three private hospitals, wherein some of the elective surgery like hysterectomies, hip replacements, urology and general surgery cases are conducted for an agreed fee

Mpumalanga

Rob Ferreira Hospital:

  • A sessional Orthopaedic Surgeon was appointed during the second quarter and operating days has been increased to four days in a week. Additionally, the orthopaedic team also operates in Barberton District Hospital four days in a week.

Witbank Hospital:

  • Expanded outreach to Ermelo, Evander, Middelburg and Kwa Mhlanga.
  • Increased operating times for orthopaedics from office hours to after hours and weekends.
  • Improved efficiencies in orthopaedics by streamlining its functions into responsible units.
  • Theatre time during office hours, was increased.

Ermelo Hospital:

  • Appointed fulltime orthopaedic surgeon with effect from 01 October 2022.

Mapulaneng Hospital:

  • Appointed fulltime orthopaedic surgeon who conduct surgeries and does outreach to surrounding district hospitals.
 

Themba Hospital:

  • Increased theatre time by opening the 4th theatre.

Northern Cape

Information not yet received

North West

  • Currently Klerksdorp/Tshepong theatres are undergoing revitalisation and multiple theatres are being renovated. Most of the theatres are likely to be handed over back by the end of the year. However, all efforts are made to make theatres functioning efficiently to reduce backlog. Weekend blitz is planned next year once theatre renovations are completed.
  • Outreach to Moses Kotane Hospital. First round started 13 October 2022.
  • General Surgery recruited a Surgeon commencing on 01 October 2022
  • In Ophthalmology weekend blitz was started on 22nd October 2022
  • Urology specialist employed and planned outreach to start as soon as new ordered equipment is delivered
  • In Gynaecology number of theatre days have been increased
  • Ear, Nose and Throat Specialist was recruited starting on 01 November 2022
  • Daily optimization of operations thus increasing output during working hours.
  • Doctors on call to perform minor procedures whilst on call.
  • Every weekend, 2 doctors on call with an intern to continue with some cases from the backlog.
 
  • First part of the recruitment of additional nursing staff required for maximum theatre utilization has been completed, and the process of other staff member is underway.
  • Utilization of other facilities for referring minor cases such as cataracts.
  • Planned weekend marathons have been started particularly in orthopaedic cases.
  • Procurement of autoclave and sterilising machines underway.

Western Cape

  • Operations increased by dedicated budget increase and efficiency gains.
  • Operations increased by outreach support and efficiency gains.

END.

23 December 2022 - NW4615

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Alexander, Ms W to ask the Minister of Health

What (a) total amount has the National Health Insurance (NHI) cost to date and (b) is the breakdown for each financial year that a budget was allocated toward the NHI, indicating how the money was spent? NW5737E

Reply:

(a) The expenditure that has been ascribed to National Health Insurance (NHI) money has been used to fund efforts to strengthen the health system’s performance in preparation for NHI and not on the actual functions of the NHI Fund. This funding has been allocated through the NHI Grant and has been used to develop and test provider payment mechanisms, expanding the national insurance beneficiary registry, and purchasing and providing a prioritised set of health services. The funding has also been allocated for quality improvement initiatives within the non-personal services component of the NHI indirect grant with the aim of helping facilities meet the envisaged standards required for NHI accreditation.

(b) The breakdown of the NHI Grant allocation is based on both the Direct and Indirect Grants allocated as follows:

Find here: National Health Insurance Direct Grant

23 December 2022 - NW4576

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Thembekwayo, Dr S to ask the Minister of Health

Whether he has considered not rushing the implementation of the National Health Insurance Bill and instead pay attention to the infrastructure challenges faced across the Republic; if not, why not; if so, what are the relevant details? NW5705E

Reply:

The Department is not implementing the National Health Insurance (NHI) Bill in a rushed manner. The Department is following the provisions outlined in the approved 2017 NHI White Paper that provides for the NHI to be implemented in a phased manner. Section 309 of the White Paper provides for Health Systems Strengthening initiatives to continue being undertaken concurrently as the finalisation of the legislative process and the establishment of institutional arrangements for the NHI Fund are undertaken.

Furthermore, Clause 57 in the NHI Bill makes provision in the Transitional Arrangements where-in Clause 57 (1)(a) states that despite anything to the contrary the NHI must be implemented over two phases. Clause 57 (1)(b) states that National Health Insurance must be gradually phased in using a progressive and programmatic approach based on financial resource availability. Clause 57 (2) further provides health system’s strengthening initiatives such as addressing of infrastructure challenges to be undertaken during the transitional period.

It is indisputable that public hospitals do need infrastructure maintenance and investment. The Department quantified the anticipated cost at close to R200bn, which is clearly not going to be available in the short to medium term. There are nonetheless projects that are being attended to within the limits of available budget.

END.

23 December 2022 - NW4697

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Hlengwa, Ms MD to ask the Minister of Health

In light of the fact that the National Student Financial Aid Scheme (NSFAS) has stated that students who have already completed a qualification and are looking to gain a second qualification do not qualify for NSFAS funding, and considering that the SA Medical Association is calling for urgent action to address the scarcity of healthcare workers in public hospitals, especially doctors, as they report that there is currently less than one doctor per a thousand patients, what plans does his department have in place to collaborate with the Department of Higher Education, Science and Innovation to provide funding for students who are pursuing their undergraduate degree in the medical field whilst already having an undergraduate degree in a different field? NW5820E

Reply:

The Department of Health provides bursaries that are administered by Provinces for students in the medical field to ensure supply of these professionals for the sector. In addition, funding of undergraduate training in the health sciences is subsidized by the Department of Higher Education through allocations to higher education institutions.

Admission to an undergraduate medical training programme is the prerogative of a medical school where the student has applied. Each provincial Department of Health would then evaluate its ability to support such students. The Minister encourages the provincial Departments of Health to provide funding assistance to undergraduate students in the medical field as much as possible.

END.

23 December 2022 - NW4678

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Motsepe, Ms CCS to ask the Minister of Health

What measures have been taken by his department in each province to make provision for an increase in the number of porters in public hospitals? NW5801E

Reply:

The National Department of Health can confirm that from the total of 3 510 posts for porters, 3 193 are filled. The 148 posts were filled during the current financial year 2022/2023 in the nine (9) Provincial Health Departments, respectively, as recorded in the PERSAL date set of 31 October 2022.

Due to financial constraints, Provinces have implemented a systematic process of approving funding and advertisements of both health related and administrative posts by accounting officers in consultation with Provincial Treasuries. This process, supersedes filling of vacant posts to avoid exceeding Cost of Employment (COE) budgets. END.

23 December 2022 - NW4580

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Marais, Ms P to ask the Minister of Health

Which methods of intervention have been put in place to deal with the dilapidated mental health care facilities? NW5709E

Reply:

Mental health facilities are being renovated as part of the Health Facilities Revitalisation Grant (HFRG) projects. Provinces also make renovations to health facilities including mental health facilities utilising their equitable share. Furthermore, mental health units are being built in general hospitals in compliance with the Mental Health Care Act, 2002 (Act No 17 of 2002) which prescribes integration of mental health into the general health services environment. Attaching mental health units to general hospitals is also relieving pressure on specialised psychiatric hospitals as these units provide mental health care, treatment and rehabilitation services and only refer to specialised psychiatric hospitals, those persons who require specialised and complex mental health interventions. The table below shows mental health infrastructure projects that are currently underway and funded through the HFRG.
 

Province

Facility

Project

Stage

Gauteng

Weskopies Specialised Psychiatric Hospital

Forensic mental observation unit

Tender stage

 

Sebokeng Hospital

Attaching a new mental health unit

Design stage

Limpopo

Hayani Specialised Psychiatric Hospital

Forensic mental observation unit

Tender stage

 

Evuxakeni Specialised Psychiatric Hospital

Hospital revitalisation

Clinical brief stage

 

Thaba Moopo Specialised Psychiatric Hospital

Forensic mental observation unit

Design stage

Mpumalanga

KwaMhlanga Hospital

Attaching a new mental health unit

Tender stage

 

Witbank Hospital

Revitalisation of the mental health unit

Design stage

 

New facility

Building a new mental health hospital

Clinical brief stage

KwaZuluNatal

Benedictine Hospital

Attaching a new mental health unit

Design stage

 

Bethesda Hospital

Attaching a new mental health unit

Design stage

 

Estcourt Hospital

Attaching a new mental health unit

Design stage

 

Ladysmith Hospital

Attaching a new mental health unit

Design stage

 

Murchison Hospital

Attaching a new mental health unit

Design stage

 

Northdale Hospital

Attaching a new mental health unit

Design stage

 

Port Shepstone Hospital

Attaching a new mental health unit

Tender stage

 

Prince Mshiyeni Hospital

Attaching a new mental health unit

Design stage

 

RK Khan Hospital

Attaching a new mental health unit

Design stage

 

Stanger Hospital

Attaching a new mental health unit

Tender stage

 

Umphumulo Hospital

Attaching a new mental health unit

Design stage

 

Umzimkhulu Hospital

Forensic mental observation unit

Design stage

North West

Bophelong Specialised Psychiatric Hospital

Building the general psychiatry section

Tender stage

 

General De La Ray Hospital

Attaching a new mental health unit

Design stage

 

Itsoseng Hospital

Attaching a new mental health unit

Design stage

Western Cape

Swartland Hospital

Attaching a new mental health unit

Design stage

 

Belhar Hospital

Attaching a new mental health unit

Design stage

END.

23 December 2022 - NW4539

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Hlengwa, Ms MD to ask the Minister of Health

Whether his department, in collaboration with the Department of Basic Education, has any specified programmes in place to provide spectacles to learners who are visually impaired and who are unable to afford them; if not, why not; if so, what are the relevant details of (a) the number of learners who have been provided with glasses through the specified programmes and (b) how citizens can access the programmes? NW5668E

Reply:

The department of Health, in collaboration with the Department of Basic Education provides integrated school health program (ISHP) to learners in schools, to among others prevent barriers to teaching and learning. Some of the service include provision of spectacles to learners who are visually impaired. The service provided through this programme include visual assessment which may result in referral of the learner to the next level of care for possible provision of spectables.

(a) the number of learners who have been provided with glasses through the specified programmes and

The actual number of learners who were provided with spectacles are in provinces and Districts as the programme implementerand are reflected here below:

 

Province

Data Element

Apr 2020 to Mar 2021

Apr 2021 to Mar 2022

Apr 2021 to Sep 2022

Totals to date

Eastern Cape

Spectacles issued to child - total

160

362

264

366

Free State

Spectacles issued to child - total

33

401

23

142

Gauteng

Spectacles issued to child - total

1 284

3 405

2 109

3 091

KwaZulu-Natal

Spectacles issued to child - total

3 374

4 620

3 466

3 912

Limpopo

Spectacles issued to child - total

329

494

590

732

Mpumalanga

Spectacles issued to child - total

213

659

469

703

Northern Cape

Spectacles issued to child - total

28

56

27

36

North West

Spectacles issued to child - total

21

188

127

218

Western Cape

Spectacles issued to child - total

384

3 511

1 702

3 184

South Africa

Spectacles issued to child - total

5 826

13 696

8 777

12 384

 

(b) The programme is a school health-based intervention, which is tailor-made for the learners only, due to limited number of school health nurses, hence the modality is delivered for specific grades and not all learners in a school. Citizens can still visit their nearest health care facilitities, where they can be screened for vision and referred to Optometrist for further diagnosis and provision of spectacles if indicated.

 

END.

23 December 2022 - NW4679

Profile picture: Marais, Ms P

Marais, Ms P to ask the Minister of Health

What are the details of the measures of intervention that have been taken recently by his department to tackle the challenge of the shortage of medication, especially antiretroviral drugs, in health facilities? NW5802E

Reply:

There are no current systems-wide shortages of medication in health facilities although facilities do run out from time to time owing to operational reasons.

It is the Departments of Health’s policy to ensure equitable access to quality healthcare through availability of safe, effective and cost-effective medicines at the appropriate level of care. The National Department of Health manages contracts of approximately 1 200 essential medicine items. Contracts are awarded to suppliers (manufacturers) following an open tender process in accordance with the Public Finance Management Act. Provinces procure medicines directly from contacted suppliers. Note that the public sector services the healthcare needs of 84% of South Africa’s population.

The NDOH continuously engages with the contracted suppliers to identify any possible supply challenges, to adjust the demand forecast (where necessary) and to work together to mitigate the risks. Furthermore, the NDOH established a decision-making forum where all provinces are represented; to identify interventions aimed at addressing any medicine supply challenges, to improve medicine availability and to reduce the potential impact of stock outs.

Where supply constraints are identified, the NDOH works with the provinces to identify and implement interventions to minimize stock outs and impact on patients. These interventions are informed by the cause of the supply challenge:

Where the supply constraint is due to operational matters e.g., machine breakdown, labor unrest, theft, post importation testing, etc. the NDOH would source products from alternative local suppliers with registered products using the quotation process.

Should the supply constraint result in a longer term supply challenge, such as regulatory matters including amendments to the dossier that requires approval from South African Health Products Regulatory Authority (SAHPRA), including a change/addition of an active pharmaceutical ingredient source and/or manufacturing site, the transfer of ownership of dossiers which results in a change of marketing authorization, delays in the issuing of the permits for imported medicines, manufactured products requiring additional quality checks by SAHPRA, etc. and no alternative local suppliers with registered products are available; an application would be made to SAHPRA for the acquisition of unregistered medicines for human use in terms of Section 21 of the Medicines and Related Substances Act.

With regard to antiretroviral medication, there are no wide-spread supply challenges. As on 05th December 2022,

Overall medicine availability across all facilities is 87.1%
Availability of antiretrovirals is 91.1% Availability of 1st line antiretrovirals is 97.4%

END.

23 December 2022 - NW4568

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

When will the municipal clinic in Merafong, Khutsong Extension 3 be opened 24/7, as it is the only public healthcare facility that operates during the week and only until 4pm? NW5697E

Reply:

In line with the Primary Health Care Package Norms and standards, clinics operates 8 hours a day and 5 days a week and a Community Health Centres (CHC) operates 24 hours a day and 7 days a week. For the PHC facility to qualify to operate for 24 hours, the following criteria need to be met:

• Annual facility head count should be ± 120 000
• Monthly average headcount of 10 000.

According to the District Health Information System (DHIS) Annual Report 2021/2022, the head count for the Clinic in Extension is 22 779 which is far below the required head count, whilst monthly average headcount was 1898. For the current year, the monthly average headcount is 2170. In addition, acceptable travelling distance to the nearest facility is 5 km. The Clinic in question is within 3.8 km radius to the Khutsong CHC which is open for 24 hours and 7 days a week. The Clinic in Extension 3 therefore does not meet the criteria to operate for 24 hours and 7 days a week.

END.

23 December 2022 - NW4497

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What (a) number of (i) people claimed from the COVID-19 Vaccine Injury No-Fault Compensation Scheme, (ii) claims were (aa) rejected and (bb) processed, (b) are the (i) reasons that the claims were rejected and (ii) full relevant details of the (aa) types of vaccines that were administered and (bb) age groups of people who were affected after vaccinations? NW5625E

Reply:

(a) (i) As on 02 December 2022 a total of 48 claims were received.
(ii)(aa)-(bb) To date none of the claims were assessed.

(b) (i) The adjudication panel has been appointed and assessments of claims will be conducted.
 

(b)(ii)

Types of vaccines administered

Age groups of people affected

 

(aa)

(bb)

 

Johnson & Johnson

Pfizer

Age group

Number

 

21

27

80+

3

     

70-79

2

     

60-69

11

     

50-59

8

     

40-49

9

     

30-39

2

     

20-29

7

     

12-19

6

23 December 2022 - NW4613

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health:

(1) What is the (a) total number of acting positions in each hospital in the Republic and (b) breakdown of the specified number in each province; (2) what total number of the acting positions are held by senior staff; (3) what (a)(i) total number of such senior staff have disciplinary processes and/or cases against them and (ii) are the relevant details of the specified cases and (b) disciplinary measures are being taken by his department in this regard? NW5735E

Reply:

The Honourable Member is requested to indicate the levels of the positions she is referring to. The manner in which the question is phrased is very broad as there are many categories and levels.

END.

23 December 2022 - NW4565

Profile picture: Siwisa, Ms AM

Siwisa, Ms AM to ask the Minister of Health

What (a) total number of cancer awareness campaigns have been initiated in black communities, especially in rural areas and (b) total number of cancer centres have been opened across the Republic in the past two financial years? NW5694E

Reply:

(a) Total number of cancer awareness campaigns:

1. Nine (9) provincial cancer awareness programs were conducted for Traditional Health Practitioners on identifying and referring the most common cancers in collaboration with CANSA.

2. One (1) cancer awareness campaign on breast, cervical and prostate cancer was conducted in Upington in Northern Cape in collaboration with Pink Drive.

3. Five (5) lung cancer awareness programs were conducted in collaboration with CANSA in KwaZulu-Natal.

(b) Cancer centres:

1. Three (3) Regional Breast Units were established.

2. There are twelve national oncology centers in the public health sector which provide access to cancer care for all citizens nationally. One of these has been established the last two years. This is the Mpumalanga medical oncology center. There are an additional eight centers across the country that are in various stages of being built. This will bring the total number of national oncology centers to 21 throughout the country.

END.

23 December 2022 - NW4627

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1) Whether, given that adolescents are more likely than youth and adults to stop taking their tuberculosis (TB) medication before the end of their regimen, his department has a TB treatment programme specifically geared towards the needs of teenagers; if not, why not; if so, what are the relevant details of the specified programme; (2) whether his department has conducted research into adjusting TB treatment programmes for teenagers; if not, why not; if so, what are the findings of the research; (3) whether he will furnish Ms H Ismail with the findings of the research; if not, why not; if so, what are the relevant details? NW5749E

Reply:

The department has no evidence that adolescents are more likely to stop TB treatment compared to youth and adults. Given that this speculation is not backed by any scientific evidence, the department does not have specific programmes that are focused at preventing TB treatment interruption among adolescents, instead, the National TB Programme, through TB recovery plan, is aimed at essentially finding people with TB, linking them to care and retaining them in care until they finish their treatment, irrespective of age.

(1) Considering data at our disposal, there is no justification for such a programme, as we have a comprehensive programme.

(2) There are no research findings to share with Ms. H Ismail, because no research has been conducted by the National Department of health regarding prevention of treatment interruption among adolescents. END.

02 December 2022 - NW4149

Profile picture: Van Staden, Mr PA

Van Staden, Mr PA to ask the Minister of Health

Whether new units have been set up in the Bela-Bela Public Hospital in Limpopo; if not, (a) why not and (b) what are the reasons that the new intensive care unit is not equipped with sufficient staff for the specified unit to be fully functional; if so, are the new units operational?

Reply:

(a) The Limpopo Provincial Department of Health has confirmed that there was no new ICU that was recently constructed for the Bela Bela hospital because the existing ICU is still in good condition.

(b) The existing intensive care unit is fully functional.

 

END.

02 December 2022 - NW4160

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)Regarding the tragic death of 15-year-old Zenizole Vena in Motherwell in Gqeberha (details furnished), what is the normal and/or standard procedure to be followed at a (a) public health facility and/or (b) police station when assisting a rape victim; (2) whether the standard procedures were followed in the specified person’s case; if not, why not; if so, what are the relevant details; (3) whether he has launched an investigation into the case; if not, why not; if so, what are the relevant details?

Reply:

The National Department of Health is still consulting with the Eastern Cape Provincial Department of Health to gather all the information required to respond to this Question. The full response will be furnished to the Honourable Member and Parliament as soon as all details have been received from the Province.

 

END.

25 November 2022 - NW4021

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)Following reports that the current nursing shortage in public health care stands at 1 nurse per 218 patients and noting that a total number of 12 000 posts are vacant in the public health sector, (a) what steps has his department taken to fill such posts and (b)(i) in which provinces will the specified vacancies be filled and (ii) what number of the total number of vacant posts will be filled; (2) whether his department will be partnering with Temporary Employment Services to address the shortages; if not, what is the position in this regard; if so, what total number of posts in each province will be filled using the specified partnership?

Reply:

After consulting with the Provincial Departments of Health, the Minister is convinced that Provincial Departments of Health have developed efficient and effective plans to ensure that despite financial challenges they encounter within the Cost of Employment (COE), viable plans have been developed to sustain service delivery across all nine Provinces. This is substantiated by the information in the table below:

Question

EC

FS

GAU

KZN

LIM

MPU

NW

NC

WC

1(a) what steps has his department taken to fill such posts

The Department has approved its Annual Recruitment Plan for 2022/23 which comprises 1057 critical posts (including nursing) to be filled. The funding emanated from equitable share and conditional grants.

Advertisements are published monthly and posts have been filled, whilst others are still in selection phases.

Due to the current pressure on the compensation of employees, the department has appointed a Recruitment Task Team that looks at reprioritization of critical posts in line with the available budget

As of the 30th September 2022, there were 4 392 unfunded vacant nursing posts in the organisational structure of the Gauteng Department of Health. The Department has requested for additional funds to fill the critical vacant nursing posts.

As at 31 October 2022, the Department has prioritized filling of 426 Nursing posts:

Professional Nurses 176

Staff Nurses 164

Nursing Assistants 86

The Department has advertised professional nurses’ posts, already shortlisted and interviews have been conducted.

The Department Annually identifies critical posts and demands that need to be filled throughout the year.

The Department has the following posts with no funding to fill them however, identified to be critical to ensure continuity of quality health care in the province.

The Department identified critical vacant nursing posts vacated prior to 01 April 2022 to be filled during the 2022/23 financial year within the available compensation of employees' budget. Posts are filled as soon as possible considering the Department of Public Service and Administration (DPSA)'s prescripts in terms of advertising, shortlisting, interviews and verification processes

The Department prioritised the filling of the critical and scarce skills within the nursing fraternity. The HR Plan addresses the need as a priority for the 2022/2023 financial

Vacancies are filled on a continuous basis through block adverts and recruitment throughout the year in response to the service demands.

1(b)(i) in which provinces will the specified vacancies be filled and (ii) what number of the total number of vacant posts will be filled)

The department prioritized the filling of 867 posts (i.e. 230 permanent vacant posts in different categories, including Operational Managers, Professional Nurses: General, Professional Nurses: Specialty, Staff Nurses and Nursing Assistants and 637 Professional Nurses: General under the Vaccination Programme for a contract period of twelve (12) months).

The department prioritized the filling of 477 nursing posts dependant on availability of the budget

Awaiting for approval of additional funds

The department prioritized the filling of nursing posts in levels of care as they become vacant

A total of 254 posts ranging from Nursing Manager to the level of Nursing Assistant will be filled

A total of 155 staff Nurses for various hospitals and PHC Centres and 142 posts that are vacated, earmarked to be filled by Specialised nurses in the following fields of speciality: Oncology, Trauma, Advanced Midwifery, Surgery, Ophthalmic, ICU, Theatre, and Nephrology.

A total of 233 nursing posts will be filled (Professional Nurses for District Health Services = 147and Professional Nurses for Hospital and Clinical Support Services = 86)

The department is prioritising the filling of speciality and supervisory/managerial posts. The following total number per category will be filled; Operational Manager General/Speciality – 30, Assistant Managers General/Speciality – 20 and Professional Nurse General/Speciality – 30. Total - 80

As at 17 October 2022, the Western Cape had 808 vacant funded nursing posts that are being in the process of being filled.

2. Eight Provincial Departments of Health conduct their own advertisement and recruitment processes; and do not involve any other Employment Services. Only the Western Cape has partnered with agency personnel to supplement its capacity details of which were not provided in the response.

END.

25 November 2022 - NW4054

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

By what date will the critical shortages of (a) contraceptives and (b) 1 500 other essential medicine supplies, including dosages of Metformin, Betagesic, Nepamol, Ponstan paediatric suppositories and pain patches and/or options to treat severe pain, be addressed as the shortages are putting persons’ lives at risk?

Reply:

a) The supply constraints related to contraceptives have been resolved. Currently, there are no challenges related to the availability of contraceptives. As on 04 November 2022, availability of contraceptives across all facilities in the public sector was 91.3%.

b) It is the Departments of Health’s policy to ensure equitable access to quality healthcare through availability of safe, effective and cost-effective medicines at the appropriate level of care. The National Department of Health manages contracts of approximately 1 200 essential medicine items. Contracts are awarded to suppliers (manufacturers) following an open tender process in accordance with the Public Finance Management Act. Provinces procure medicines directly from contacted suppliers. Note that the public sector services the healthcare needs of 84% of South Africa’s population.

The NDOH continuously engages with the contracted suppliers to identify any possible supply challenges, to adjust the demand forecast (where necessary) and to work together to mitigate the risks. Furthermore, the NDOH established a decision-making forum where all provinces are represented; to identify interventions aimed at addressing any medicine supply challenges, to improve medicine availability and to reduce the potential impact of stock outs.

Where supply constraints are identified, the NDOH works with the provinces to identify and implement interventions to minimize stock outs and impact on patients. These interventions are informed by the cause of the supply challenge:

  • Where the supply constraint is due to operational matters e.g., machine breakdown, labor unrest, theft, post importation testing, etc. the NDOH would source products from alternative local suppliers with registered products using the quotation process.
  • Should the supply constraint result in a longer term supply challenge, such as regulatory matters including amendments to the dossier that requires approval from South African Health Products Regulatory Authority (SAHPRA), including a change/addition of an active pharmaceutical ingredient source and/or manufacturing site, the transfer of ownership of dossiers which results in a change of marketing authorization, delays in the issuing of the permits for imported medicines, manufactured products requiring additional quality checks by SAHPRA, etc. and no alternative local suppliers with registered products are available; an application would be made to SAHPRA for the acquisition of unregistered medicines for human use in South Africa Act use in terms of Section 21 of the Medicines and Related Substances Act

With regard to:

  • Metformin – there were no supply challenges in the public sector.
  • Betagesic – i.e. ibuprofen. There were no supply challenges as contracts were awarded to four different suppliers to ensure security of supply of ibuprofen.
  • Napamol – i.e. paracetamol 500 mg tablets. There were no supply challenges as contracts were awarded to four different suppliers to ensure security of supply of paracetamol.
  • Ponstan – i.e. mefenamic acid. This medicine is not an essential medicines and therefore there is no contract for this item.

The availability of ibuprofen and paracetamol at facility level as on 04 November 2022 was 92% and of metformin, 91.2%.

The question from the Honourable Ismail is reflective of stock outs experienced in the private sector over which the Department has no control. Private sector services the healthcare needs of only 16% of South Africa’s population.

Private sector pharmacies procure medicines from wholesalers based on Single Exit Price. In this context, there is no aggregation of demand. Furthermore, availability is dependent on market forces based on supply and demand. The situation makes the private sector vulnerable to supply challenges.

However, with the implementation of National Health Insurance, in the context of one health system, these supply challenges will also be addressed.

 

END.

25 November 2022 - NW4055

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

What plans are in place to (a) strengthen the efforts to address the mental health of our people, particularly those living with chronic conditions such as HIV and tuberculosis, as they are at risk of developing mental health conditions, often suffering from depression and anxiety as they adjust to their diagnosis and adapt to living with a chronic infectious disease, and (b) implement effective interventions to reduce transmission of diseases especially among persons who are using needle-administered drugs?

Reply:

a) The Department has prioritised Mental Health as an important aspect of health that is

crucial to the overall well-being of individuals and society. The Mental Health Care Act, 2002 (Act No.17 of 2002), its Regulations and guidelines as well as the National Mental Health Policy Framework and Strategic Plan 2013-2020 that is currently under review guide the efforts to address the mental health of our people.

There are many risk factors for developing mental health problems, and these include living with a chronic condition such as HIV, tuberculosis, cancers, diabetes, cardiovascular diseases, women around childbirth and poverty. The Health Sector’s strategy is to focus on comprehensive efforts for prevention, early identification, early intervention and strengthening follow-up care for mental health problems at all the levels of the health care system as this would ensure that all at-risk populations are cared for. Among the plans that are in place to strengthen the efforts to address the mental health of our people, including those living with chronic conditions are the following:

  • Progressive integration of mental health into the general health service environment

including primary, secondary, and tertiary level health establishments as envisaged by the Mental Health Care Act, 2002, to among others improve access to mental health services and reduce the stigma associated with mental illness.

  • Improving skills and capacity of health care providers for early identification and

management of mental health problems at primary health care through training as well as complementing the numbers of available staff through contracting private mental health care providers (psychiatrists, psychologists, social workers and occupational therapists) to render mental health services at primary health care level.

  • Strengthening clinical mental health skills among health care providers working in health

facilities listed to conduct 72-hours assessment of involuntary mental health care users as well as in mental health units that are attached to general hospitals.

  • Screening and management for common mental disorders including depression, anxiety and alcohol and other drugs abuse at primary health care.
  • Integration of mental health screening and referral in the school health programme as well as in the community health worker programme.
  • Using various platforms and media to educate the public on mental health issues in collaboration with other stakeholders including civil society.
  • Strengthening collaborations with other departments and stakeholders to ensure that the upstream determinants of mental health that lie within their mandates are addressed.

b) The updated National Health Sector HIV prevention Strategy (2020-2025), ensures that

combination HIV prevention strategies are employed for the people who inject drugs (PWID), and the strategy calls for capacity building and skilled health practitioners to deal with substance abuse disorders.

In terms of interventions to reduce transmission the following combination prevention interventions are available in the public health facilities for PWID:

Biomedical interventions: Collaboration with partners for needle exchange support programmes, male and female Condoms and lubricants, post-exposure prophylaxis for unintended exposure, and Pre-exposure prophylaxis (for prevention of acquisition), including monitoring of PrEP retention, HIV testing services (HTS) and referral to treatment for those who test HIV positive, STI management (screening and treatment).

Socio-behavioural interventions: Mental health screening, referral, and linkage to psychosocial support services. Accurate and appropriate sexual and reproductive health information and messages.

 

END.

25 November 2022 - NW4101

Profile picture: Thembekwayo, Dr S

Thembekwayo, Dr S to ask the Minister of Health

What are the relevant details of the measures that have been taken to intervene in the Oakley Clinic in Ward 24, Bushbuckridge, in respect of (a) posts that were advertised for nurses but have been frozen since 2019 and (b) COVID-19 staff who work as general workers?

Reply:

a) There were no posts advertised for Oakley clinic. The facility was operationalized using nurses from the old clinic.

b) Oakley Clinic only received one (1) COVID-19 Professional Nurse on contract and she never worked as a general worker.

 

END.

25 November 2022 - NW4125

Profile picture: Hlengwa, Ms MD

Hlengwa, Ms MD to ask the Minister of Health

(1)Whether, in light of the lack of human resources and shortage of equipment and medicine in hospitals and clinics which limit the right to health care for many South Africans on a daily basis, his department has put any measures in place to reduce the effects that the specified challenges have had on the quality of healthcare in the Republic and its communities; if not, what is the position in this regard; if so, what are the further, relevant details; (2) whether his department has mechanisms in place to address issues relating to (a) inadequate recruitment practices, especially in rural areas and (b) poor retention and staff mismanagement; if not, what is the position in this regard; if so, what are the further, relevant details?

Reply:

1. As part of addressing the lack of human resources in hospitals and clinics, the Department of Health has developed and published (in February 2021), a 2030 Human Resources for Health Strategy that serves as a guideline of the Human Resources Agenda for the Public Health sector at various levels of care. The 2030 HRH Strategy modelling, indicates a current shortfall of skilled health professionals in South Africa and makes a call for investing in the Health workforce to address human resources deficits and inequalities across provinces and between private and public health sectors. However, due to stringent budgets, the implementation is at a snail’s pace.

Despite available limited resources, in the public service generally, the Department has managed put measures in place to close the vacancy-rate gap for health care related posts to 12.4% and administration positions to 11.80%, respectively, as at the 30 September 2022, across all the provinces.

In relation to Medical Equipment, the department has been experiencing budget cuts over the past few years impacting negatively on issues such as maintenance of equipment and facilities. However, new interventions in the form of conditional grants have been put in place to help provinces cope with revitalisation and maintenance backlogs.

The following are some of the conditional grants that have been introduced to help with acquisition, maintenance and revitalisation of facilities inclusive of Medical Equipment and are in addition to Equitable Share granted to provinces:

a) Health Facilities Revitalisation Grant (HFRG), Managed National Health, but transferred to provinces with conditions and oversight by National Health.

b) National Tertiary Services Grant (NTSG): Managed by National Health, but transferred to provinces for equipment gaps/shortages and repairs.

c) National Health Insurance Indirect Grant (In-kind grant): Managed and implemented under National Health through implementing agents.

Other interventions include:

a) Integration of maintenance plans and Service Level Agreements within transversal contracts administered under National Treasury to help ensure functioning equipment.

b) Development of Medical Equipment Maintenance Strategic Framework within the Office of the Chief Procurement Officer within National Treasury, and the related transversal Contract for Maintenance of Medical Equipment.

2. Provincial Departments of Health are implementing various plans that include the following:

  1. Annual Recruitment Plan – with prioritisation of critical posts where funding permits
  2. Utilisation of conditional grant funding where it allows for prioritisation of posts
  3. Filling of approved replacement posts
  4. Employment of health professionals on contract basis to strengthen capacity and where funding permits these contract employees are absorbed on permanent employment at the end of their contracts
  5. Awarding of bursaries yearly to internal and external candidates to study further in various disciplines where there are shortages
  6. Provision of internship and community service programme

 

END.

25 November 2022 - NW4022

Profile picture: Clarke, Ms M

Clarke, Ms M to ask the Minister of Health

(1)Whether, following reports that the current nursing shortage in public health care stands at 1 nurse per 218 patients, his department will form a partnership with Temporary Employment Services (TES) in terms of (a) training nurses and (b) induction courses; if not, why not; if so, by what date will this commence; (2) (a) what medical training will TES offer and (b) has the training been accredited; (3) (a) how is TES funded and (b)(i) what percentage of nurses are they able to train and (ii) at what total cost; (4) what training will be prioritised in terms of the agreements?

Reply:

1. (a) The National Department does not have any agreement with Temporary Employment Services (TES) in terms of the training of nurses. The Department does not form partnerships with labour brokers or agencies for the training of nurses.

Prospective providers for Nursing Education programmes have to register with Department of Higher Education and need to apply for accreditation from the South African Nursing Council (SANC) and the Council on Higher Education (CHE). Applications are done per programme leading to registration in any of the prescribed categories of nursing according to the Nursing Act, 2005 (Act No 33 of 2005). The SANC accredits nursing education institutions and programmes in terms of professional integrity, standards of education, clinical training and placement in appropriate health facilities. SANC also consider whether programmes demonstrate relevance, responding to a specific population’s health service needs. The CHE accredit programmes based on the academic standards of Higher Education.

(b) Induction is done by the health establishment for every cohort of new recruits, focussing on, amongst other subjects, national-, provincial-, and the health establishment’s policies. Health professionals are additionally inducted on the health establishment’s standard operating procedures for the professional group. This function cannot be outsourced, as it forms an integral part of orientation of new employees to a workplace and is seen as letting new employees feel welcome and appreciated by their employers.

2. (a) The National Department of Health has no plans to utilize TES for medical training. Medical training is the exclusive domain of medical schools.

(b) The Department has not established the accreditation status of the TES training programmes

(3)(a), (b) (i), (ii) See reply to (1) (a) here above.

 

END.

25 November 2022 - NW3850

Profile picture: De Freitas, Mr MS

De Freitas, Mr MS to ask the Minister of Health

(a) What total budget and/or grants were provided to the South Rand Hospital in Johannesburg (i) in the past three financial years and (ii) from 1 April 2022 to date, (b) what mechanisms and processes exist to ensure that the highest level of service is provided at the specified hospital and (c)(i) what is the current staff vacancy rate, (ii) what are the reasons that the specified positions have not yet been filled in each case, (iii) how are the functions being fulfilled whilst the respective posts are unfilled in each case and (iv) on what date will the current staff vacancies be filled in each case and (d) what are the time frames and deadlines for filling each vacancy?

Reply:

According to information received from the Gauteng Provincial Department of Health, the response is as follows:

a) (i)–(ii) The total budget and/or grants provided to the South Rand Hospital in Johannesburg in the past three fiscal years and from 1 April 2022 to date

VOTED FUNDS

 

Budget allocated

Expenditure

Over/Under spending

i) Voted funds 2019/20

     

i) Voted funds 2020/21

R 302,152,000.00

R 318,170,000.00

-R 16,018,000.00

i) Voted funds 2021/22

R 310,035,000.00

R 339,099,000.00

- R 29,064,000.00)

ii) Voted funds 2022/23

R 328,027,000.00

R 161,235,000.00

R 166,792,000.00

CONDITIONAL GRANTS

 

Budget allocated

Expenditure

Over/Under spending

i) HIV Conditional grant 2019/20

     

i) HIV Conditional grant 2020/21

R 16,309,000.00

R 14,517,018.22

R 1,791,981.78

i)  HIV Conditional grant 2021/22

R 22,150,000.00

R 15,300,366.32

R 6,849,633.68

ii) HIV Conditional grant 2022/23

R 21,653,000.00

R 10,892,673.01

R 10,760,326.99

 

Budget allocated

Expenditure

Over/Under spending

i) COVID-19 Conditional grant 2019/20

     

i) COVID-19 Conditional grant 2020/21

R 5,199,000.00

R 6,694,786.78

-R 1,495,786.78

i) COVID-19 Conditional grant 2021/22

R 18,641,000.00

R 20,064,170.97

-R 1,423,170.97

ii) COVID-19 Conditional grant 2022/23

R 1,305, 000.00

R 1,497, 383.80

-R 192,383.80

b) The hospital conducts the mandate as stipulated by the strategic objectives of Gauteng Department of Health. It shares the vision of a responsive, value-based and people centred health system.

The hospital also ensures delivery of highest level of health care by strengthening clinical governance and building a culture and practice that ensures that quality assurance, patient safety and accountability are a priority.

To realize clinical effectiveness, the hospital’s management continue to monitor annual performance plan clinical indicators and make appropriate adjustments within the available human, material, and financial resources to ensure delivery of services.

c) (i) The current staff vacancy rate is s at 4% and is derived from the following:

  • Funded posts - 655
  • Filled posts - 629
  • Funded vacant posts – 26

(ii) All vacant posts are in the process of being filled and are at various stages of the recruitment and selection process.

iii) The provision of essential services continues despite the vacant posts within the hospital. The hospital renders effective and efficient health services with the available resources while awaiting the formal appointment of the officials in all the critical vacant posts.

iv) The process is currently at various stages of the recruitment and selection. Filling of the posts depends on a number of processes and cannot be definitely calculated at this stage. However, it is envisaged that a number of these posts will be filled by the first quarter of 2023.

d) It takes an average of 3 months to complete the recruitment and selection process for a position. The hospital will fill all the funded vacant posts by the first quarter of 2023.

END.

25 November 2022 - NW3936

Profile picture: Ismail, Ms H

Ismail, Ms H to ask the Minister of Health

(1)What (a) number of bursary programmes does his department run annually, (b) is the (i) total monetary value and (ii) breakdown of all programmes, (c) number of persons receive bursaries from his department annually and (d) total amount has his department lost because of the irregularities in the allocation of the specified bursaries; (2) whether any officials of his department have been suspended, disciplined and/or dismissed from his department because of the alleged irregularities; if not, what is the position in this regard; if so, what are the relevant details with regard to the (a) number of the officials who were suspended, disciplined and/or dismissed from his department, (b) date on which they were suspended, disciplined and/or dismissed, (c) positions of the officials against whom the steps were taken and (d) number of persons who have been found to have benefited irregularly from the bursaries and how they allegedly benefited irregularly; (3) whether any officials of his department have been suspended, disciplined or dismissed from his department because of the irregularities; if not, what is the position in this regard; if so, what are the relevant details with regard to the number and the positions of the officials?

Reply:

(1. a) The National Department of Health has one Corporate Bursary Programme which targets only employees of the National Department of Health and its satellite offices.

(b) (i) The funding allocation for audited years:

Audited Year

Allocation

Expenditure

2020/21

R1,200,000.00

R408,240.88

2021/22

R1,500,000.00

R746,040.45

(ii)

The department has only 1 Corporate Service Bursary programme.

(c) Employees who received bursaries are as follows:

Audited Year

Number of beneficiaries

2020/21

06

2021/22

16

2022/23

The Study Assistance Committee is finalizing the adjudication process

(d) The department did not encounter any irregularity for the audited financial years and as such did not lose any money. The programme is audited on a regular basis and no findings were flagged during the audited financial years.

(2) (a) there are no officials that were suspended, disciplined and/or dismissed because there has not been any reported irregularly in relation to the bursaries offered by the National Department of Health.

(b) based on the response in part (a) above, the question is therefore not applicable

(c) based on the response in part (a) above, the question is therefore not applicable

(d) based on the response in part (a) above, the question is therefore not applicable

(3) There are no officials that were suspended, disciplined and/or dismissed because there has not been any reported irregularly in relation to the bursaries offered by the National Department of Health

 

END.

25 November 2022 - NW3995

Profile picture: De Freitas, Mr MS

De Freitas, Mr MS to ask the Minister of Health

With reference to the South Rand Hospital in Johannesburg, what (a) is the current staff complement, (b) was the absentee record (i) in each month (aa) in the (aaa) 2020-21 and (bbb) 2021-22 financial years and (bb) from 1 April 2022 to date and (c) processes, procedures and mechanisms are in place to ensure that staff is always present during all required working hours in each case?

Reply:

(a) According to the South Rand hospital management the current staff complement in the hospital is six-hundred and twenty-nine (629) with a vacancy of twenty-six (26).

(b) (i)(aa)(aaa) Table 1 below indicate absentee record in each month for financial year 2020/21

Financial year 2020/21

Absentee record (raw number)

Absentee record (percentage) (N=629)

 

April

19

3%

May

31

5%

June

38

6%

July

57

9%

August

25

4%

September

38

6%

October

31

5%

November

25

4%

December

25

4%

January

25

4%

February

25

4%

March

19

3%

Annual average

31

5%

(b) (i)(bbb) Table 2 below indicate absentee record for financial year 2021/22

Financial year 2021/22

Absentee record (raw numbers

Absentee record (percentage)

(N=629)

April

19

3%

May

25

4%

June

57

9%

July

31

5%

August

31

5%

September

25

4%

October

13

2%

November

31

5%

December

57

9%

January

38

6%

February

16

2.5%

March

19

3%

Annual Average

31

5%

(bb) Table 3 below indicate absentee record for financial year 2022/23

Financial year 2022/23

Absentee record (raw numbers

Absentee record (percentage)

(N=629)

April

25

4%

May

25

4%

June

31

5%

July

38

6%

August

25

4%

September

25

4%

     

(c) The hospital has processes, procedures and mechanisms to always ensure staff attendance

  • All employees are required to record their attendance in the Z8 register daily by entering the time they report for and leave work.
  • The leave register is also used to manage staff attendance for both sick and vacation.
  • Shift supervision in each department to verify employee attendance during all required working hours.

END.

25 November 2022 - NW4081

Profile picture: Chirwa, Ms NN

Chirwa, Ms NN to ask the Minister of Health

Noting that there are over 3 800 healthcare facilities and 400 hospitals in the Republic, on what date will the rest of the hospitals and clinics be included in the exemption from load shedding?

Reply:

A total of 213 hospitals has been submitted to Eskom to be considered for possible exclusion from loadshedding. About 67% of these hospitals are supplied by municipalities while Eskom supplies about 33% of the identified hospitals. Out of the 213 hospitals, 76 hospital has been exempted of which 25 are directly supplied by Eskom and 50 by Municipalities. The number of hospitals exempted to date have doubled since the meeting held on 22 September 2022 between Eskom and National Department of Health. It is still work in progress.

END.