Questions and Replies

Reply:

a) According to the NHLS,

(i) the FCLs do not have toxicologists specifically appointed in their establishments. Instead, FCLs have analytical chemists who also perform the toxicology analyses. They are known as Forensic Analysts and are able to do toxicology tests because they possess and use the same skills / equipment to do the work as a toxicologist would do.

(ii) Analysts employed at each of the FCLs as follows:

FCL	Number of Forensic Analysts
Cape Town	Twenty-four (24) Forensic analysts in total. Of the twenty-four (24), eight (8) analysts are in the toxicology section.
Johannesburg	Thirty-six 36 Forensic analysts in total. Of the thirty-six (36), twenty-nine (29) are in the toxicology section.
Pretoria	Twenty-five (25) Forensic Analysts in total. Of the twenty-five (25), eleven (11) are in the toxicology section.
Durban	Eight (8) Forensic Analysts in total. Durban FCL will expand its service offering to include toxicology testing as soon as the laboratory has relocated to a larger and more suitable building.

 

b) The vacancy rates are as follows: Cape Town (4%), Durban (20%), Johannesburg (2%) and Pretoria (28%). In the calculation of the vacancy rate for the Pretoria FCL, ten new positions were included in the total staff establishment. These ten new positions were created to establish the new toxicology section at the Pretoria FCL. The new positions have been advertised and recruitment processes are underway.

c) (i) and (ii) The table below indicates the number of toxicology samples that were completed over the three months from 01 December 2023 to 29 February 2024 across the three laboratories that deliver toxicology testing services. The table also shows the monthly and daily averages achieved over this period. As indicated in the paragraphs below the table, the daily number of toxicology samples completed does not indicate productivity in the laboratories as tests run concurrently and completion periods vary.

Laboratory	Total completed over 3 months	Monthly average	Daily average
Cape Town	146	49	2
Johannesburg	431	144	7
Pretoria	243	81	4

Toxicology cases are allocated in batches of 15 cases per analyst per month. When cases are received for toxicology testing, the requesting pathologist does not always specify a specific substance to be tested for detection and quantification. Most cases that are received, require a general “screen” for various recreational or illicit drugs, pharmaceutical drugs, poisons, or other substances. Once a substance is detected, additional tests are required to confirm the presence of the substance and to quantify the amount of the substance that was detected.

If a new or rare (unusual) substance is detected through screening tests, a standard to confirm the substance must be procured. Some standards are procured from international suppliers and require special permits to be imported, resulting in delays in the process.

Each toxicology case that is registered in the laboratory may include a varying number of biological specimens that were taken during the autopsy and each specimen may require to be tested more than once or on different sets of instruments, depending on the test requirements. In the pre-analytic stage, specimens may require specialised preparation, depending on the tests that will be conducted.

As a result, it is difficult to quantify the number of toxicology tests that are processed in a day as tests run concurrently and completion periods differ vastly between cases.

END.

Reply:

(1) Surgeries are conducted at the hospital level and every hospital monitors and maintains records of the number of patients awaiting surgery at all public hospitals in the Republic. Surgical backlogs numbers are not static. As provinces do operations, the numbers under each category and in each province change.

Province	Types of surgery backlogs
	a) at each specified hospital	(b) in each province
Limpopo	Mankweng Hospital Orthopaedic Trauma of femur and Tibia Paediatric surgery Hernia Operations (Inguinal and Umbilical hernia Plastic surgery Cleft lips	Orthopaedic Trauma of femur and Tibia Paediatric surgery Hernia Operations (Inguinal and Umbilical hernia Plastic surgery Cleft lips Urology Ear, Nose and Throat General Surgery Maxillofacial Cardio thoracic Orthopaedics Neurosurgery Paediatric cardiology Radiation oncology
	Polokwane Hospital: Urology Ear, Nose and Throat General Surgery Maxillofacial Cardio thoracic Orthopaedics Neurosurgery Paediatric cardiology Radiation oncology

Province	Types of surgery backlogs
	a) at each specified hospital	(b) in each province
Free State	Universitas hospital General Surgery Opthalmology Urology Orthopaedic Ear, Nose and Throat	Urology General Surgery Opthalmology Orthopaedic Maxillo Facial and Oral Surgery Obstetrics and Gynaecology Ear, Nose and Throat
	Pelonomi hospital Urology General Surgery Orthopaedic Maxillo Facial and Oral Surgery Obstetrics and Gynaecology
	Bongani hospital General Surgery Gynaecology Elective Surgery Urology Orthopaedic Elective Surgery Orthopaedic Trauma
	Boitumelo hospital General Surgery Elective Surgery Orthopaedic Emergencies Orthopaedic Electives
	Dihlabeng hospital General Surgery Gynaecology Elective Surgeries Opthalmology Orthopaedic Trauma Orthopaedic elective surgeries
	Mofumahadi Manapo hospital General Surgery Elective Surgeries

Province	Types of surgery backlogs
	a) at each specified hospital	(b) in each province
Kwa Zulu Natal	Prince Mshiyeni Hospital General Surgery Orthopaedics Obstetrics and Gynaecology Ophthalmology	General Surgery Orthopaedics Obstetrics and Gynaecology Ophthalmology
	Addington General Surgery Orthopaedics Obstetrics and Gynaecology
	Greys Hospital General Surgery Orthopaedics Ophthalmology
	Inkosi Albert Luthuli Hospital Obstetrics and Gynaecology
	RK Khan Hospital Orthopaedics Obstetrics and Gynaecology
	RK Khan Hospital Orthopaedics Obstetrics and Gynaecology

Province	Types of surgery backlogs
	a) at each specified hospital	(b) in each province
Mpumalanga	The hospitals that are affected by the backlogs are the following: Rob Ferreira Tertiary Hospital Witbank Tertiary Hospital Themba Regional Hospital Mapulaneng Regional Hospital Ermelo Regional Hospital Types of surgery backlogs Orthopaedics Gynaecology General Surgery Cataracts	Orthopaedics Gynaecology General Surgery Cataracts
Northwest	Klerksdorp / Tshepong Hospital Urology Ophthalmology Orthopaedic Ear, Nose & Throat (ENT) Neurosurgery	Urology Ophthalmology Orthopaedic Ear, Nose & Throat (ENT) Neurosurgery General Surgery Obstetrics and Gynaecology
	Job Shimankana Tabane Hospital Urology Ophthalmology Orthopaedic Ear, Nose & Throat (ENT) General Surgery
	Potchefstroom Hospital Ophthalmology Orthopaedic Ear, Nose & Throat (ENT) Obstetrics and Gynaecology Surgery
	Mafikeng Provincial Hospital Urology Ophthalmology Orthopaedic General Surgery Obstetrics and Gynaecology
	Joe Morolong Memorial Hospital Ophthalmology General Surgery Gynaecology

• According to Gauteng Department of Health, the province does not have any backlogs.
• The response from the Western Cape Department of health did not address the question that was asked.
• Response from Eastern Cape and Northern Cape Provinces still outstanding.

END.

Reply:

1. The table below reflects vacancy rates as provided by provinces with the Nurses being a consolidated rate across the 3 different categories of nurses (namely: Professional, Registered and Assistant).

PROVINCIAL VACANCY RATES (%)
Category	EC	FS	GP	KZN	LP	MP	NC	NW	WC
Medical Officers	15.0	23.7	11.4	4.9	20.37	9.62	15.2	22.0	5.85
Nurses	9.0	26.5	11.2	11.2	2.96	8.0	17.4	39.0	7.39
Physiotherapist	18.0	38.8	11.0	10.4	2.03	7.0	11.8	26.0	1.73
Occupational Therapist	26.0	39.7	14.3	27.7	3.36	16.0	30.3	56.0	10.5
Psychologist	17.0	17.7	21.4	36.3	4.55	7.0	41.7	61.0**	9.90
Psychiatrist	20.0*	30.0*		15.4	87.9	73.0	50.0	50.0	8.89
Environmental Health Pract.	14.0	25.5	8.9	12.6	6.90	7.0	11.1	13.0	N/A

* Rate reflecting Medical Specialists combined

**Inclusive of the Vocational Counsellors

Community Health Workers are contract workers that are appointed on annual contract against abnormal appointments (extra ordinary staff) and vacancy rate not applicable. Furthermore, in the Western Cape the category is appointed through agency and NGO organisation and not accounted for directly under the department.

Provincial Departments are in the process of identifying positions which will be filled during the 2024/25 financial year through the Annual Recruitment Plan (ARP). Once the process is concluded and costed, within the available budget, provinces will be in a position to indicate which positions will be filled by when and recruit accordingly with adverts. There has also been ongoing communication with Provincial Departments of Health to establish the extent of the challenges experienced in this regard.

Table 1: Compensation of employees allocation to provinces

R Thousands	Financial Year
Programme	2023/24 Adjusted appropriation	2024/25 Revised Baseline
Eastern Cape	20 028 901	20 011 717
Free State	8 961 049	9 516 387
Gauteng	38 159 905	40 078 685
KwaZulu-Natal	33 031 152	32 976 479
Limpopo	16 441 824	17 351 170
Mpumalanga	10 927 652	11 706 368
Northern Cape	3 767 510	3 740 702
North west	10 567 007	11 281 207
Western Cape	17 340 851	18 055 309
Total	159 225 851	164 718 024

END.

Reply:

As was debated in the Portfolio Committee of the National Assembly during 2023 and described in Clause 49 of the National Health Insurance Bill, the possible tax amendments will be introduced through a Money Bill by the Minister of Finance as and when appropriate and earmarked for use by the Fund, subject to the transitional arrangements as provided in Section 57 of the Bill.

END.

Reply:

(1) and (2) Please see table below

Responses were received from the Free State, Gauteng, Limpopo, Mpumalanga, North West and Western Cape Provinces only. Information from other provinces is yet to be received.

Free State Department of Health
Name of facility	Date of last service	How often are they serviced	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan
1. Bloemfontein Forensic Mortuary	December 2023	Every 3 months	5	Date of repair or replacement: awaiting infrastructure approval	Bloemfontein FPS currently has 12 functional refrigerators. Surrounding state hospitals like Pelonomi and Universitas, Botshabelo provide refrigeration and storage of bodies when the demand exceeds capacity of Bloemfontein Forensic mortuary.
2. Botshabelo Forensic Mortuary	December 2023	Every 3 months	0	N/A	Bloemfontein Forensic mortuary has enough capacity to provide refrigeration and storage of bodies when the demand exceeds capacity at Botshabelo mortuary
3. Phuthaditjhaba Forensic Mortuary	December 2023	Every 3 months	6	Date of repairs or replacement: appointed service provider for repairs to visit facility on the 28 March 2024
4. Bethlehem Forensic Mortuary	December 2023	Every 3 months	3	Date of repair or replacement: Appointed service provider for repairs to visit facility on the 28 March 2024	State hospitals in the region including Elizabeth Ross, Thebe and Phekolong hospital provide additional 26 body storage capacity for contingency refrigerating and storage of bodies, when the demand exceeds the capacity in the Forensic Mortuaries, in Phuthaditjhaba and Bethlehem
5. Welkom Forensic Mortuary	February 2024	Every 3 month	6	Date of repair or replacement: awaiting infrastructure approval.	Bloemfontein Forensic mortuary has enough capacity to provide refrigeration and storage of bodies when the demand exceeds capacity at Welkom mortuary.
6. Kroonstad Forensic Mortuary	March 2024.	Every 3 months	0	N/A
7. Sasolburg Forensic Mortuary	November 2023	Every 3 months	15	Date of repairs or replacement: awaiting infrastructure approval	Bloemfontein Forensic Mortuary has enough capacity to provide refrigeration and storage of bodies when the demand exceeds capacity for both Kroonstad and Sasolburg mortuary

Limpopo Department of Health
Name of facility	Date of last service	How often are they services	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan
1. Polokwane FPS	March 2024	Every 6 months	0	N/A	All refrigerators are functional, continue to monitor the gauges.
2. Lebowakgomo FPS	February 2024	Every 6 months	0	N/A	All refrigerators are functional, continue to monitor the gauges.
3. Mokopane FPS	December 2023	Every 6 months	0	N/A	All refrigerators are functional, continue to monitor the gauges.
4. Warmbaths FPS	27 November, 11 December, 1 February 5th March 2024	Every 6 months	3	May 2024	Contingency plan is available, all refrigerators functional, continue to monitor the gauges
5. Tshilidzini FPS	February 2024	Every 3 months	4	June 2024	Purchase order is in progress to procure compressors
6. Elim FPS	October 2023	Every 3 months	0	N/A	All refrigerators are functional, continue to monitor the gauges.
7. Groblersdal FPS	February 2024	Every 6 months	0	N/A	All the refrigerators functional, continue to monitor the gauges.
8. St Rita’s FPS	March 2024	Every 6 months	0	September 2024	Contingency plan available, all refrigerators functional, continue to monitor the gauges.
9. Letaba FPS	March 2024	Every 6 months	0	N/A	Contingency plan available, all refrigerators functional, continue to monitor the gauges
10. Kgapane FPS	November 2023	Every 6 months	4	April 2024	Contingency plan available,
11. Maphutha Malatji FPS	25 August 2023	Every 6 months	6	April 2024	Request to repair the broken refrigerators is under way, continue to monitor the gauges
12. Nkhensani FPS	21 November 2023 25 March 2024	Every 6 months	0	N/A	Contingency plan available, all refrigerators functional, continue to monitor the gauges

• 3 months vs. 6 months depends on the manufacturer specifications.

Western Cape Department of Health
Name of facility	Date of last service	How often are they services	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan
1. Beaufort West FPS	January 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
2. Ceres FPS	January 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
3. George FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
4. Hermanus FPS	December 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
5. Knysna FPS	November 2023	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
6. Laingsburg FPS	February 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
7. Malmensbury FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
8. Mossel Bay FPS	January 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
9. Observatory FP Institution	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
10. Oudtshoorn FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
11. Paarl FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
12. Riversdale FPS	November 2023	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
13. Tygerberg FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
14. Vredenburg FPS	March 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
15. Vredendal FPS	November 2023	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.
16. Worcester FPS	February 2024	Every 3 months	0	N/A	Maintenance plans are in place. Refrigerators are repaired immediately either via maintenance contracts or emergency delegations.

North-West Department of Health
Name of facility	Date of last service	How often are they services?	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan
1. Mafikeng FPS	March 2024	When need arises	0	N/A	N/A
2. Lichtenburg FPS	December 2023	When need arises	0	N/A	N/A
3. Brits FPS		When need arises	0	N/A	N/A
4. Phokeng FPS		When need arises	0	N/A	N/A
5. Potchefstroom FPS	March 2024	When need arises	0	N/A	N/A
6. Tshepong FPS		When need arises	0	N/A	N/A
7. Vryberg FPS		When need arises	0	N/A	N/A

Gauteng Department of Health
Name of facility	Date of last service	How often are they services	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan
1. Johannesburg FPS	October 2023	Every 3 months	0	N/A	N/A
2. Roodepoort FPS	October 2023	Every 3 months	0	N/A	N/A
3. Germiston FPS	November 2023	Every 3 months	0	N/A	N/A
4. Springs FPS	December 2023	Every 3 months	1	Awaiting appointment of service provider
5. Heidelberg FPS	December 2023	Every 3 months	0	N/A	N/A
6. Diepkloof FPS	October 2023	Every 6 months	6	11/04/2024
7. Sebokeng FPS	February 2024	Every 3 months	0	N/A	N/A
8. Pretoria FPS	December 2023	Every 3 months	0	N/A	N/A
9. Bronkhorstpruit FPS	January 2024	Every 3 months	0	N/A	N/A
10. Ga-Rankuwa FPS	March 2024	Every 3 months	0	N/A	N/A
11. Carletonville FPS	October 2023	Every 6 months	0	N/A	N/A

• 3 months vs. 6 months depends on the manufacturer specifications

Mpumalanga Department of Health
Name of facility	Date of last service	Hoe often are they services?	Number of refrigerators not functional	Dates for repairs or replacements	Contingency plan in place
1. Themba FPS	8 April 2024	On request	2		Replacements 2022/2023 : 4-New body storage cabinets loading 6 bodies per unit (Completed) 2024/25:Cool room – work in progress New walk-in freezer – Work in progress
2. Tonga FPS	8 December 2023	On request	0	N/A	N/A
3. Mapulaneng FPS	20 March 2024	On request	0	N/A	N/A
4. Tintswalo FPS	22 March 2024	On request	1	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
5. Lydenburg FPS	16 March 2024	On request	0	N/A	N/A
6. Barberton FPS	26 June 2023	O request	1	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
7. Middelburg FPS	4 April 2024	On request	0	N/A	N/A
8. Witbank FPS	New units installed	On request	0	N/A	N/A
9. KwaMhlanga FPS	6 October 2023	On request	0	N/A	N/A
10. Belfast FPS	5 April 2024	On request	1	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
11. Mammethlake FPS	Reconstruction of the cold room	On request	1	Currently under construction	New facility
12. Delmas FPS	26 March 2024	On request	0	N/A	N/A
13. Ermelo FPS	6 December 2023	On request	2	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
14. Evander FPS	18 August 2023	On request	1		Contingency plans are available. Repairs are done between scheduled minor and major repairs.
15. Piet Retief FPS	23 February 2024	On request	0	N/A	N/A
16. Standerton FPS	25 January 2024	On request	1
17. Volkrust FPS	4 August 2023	On request	0	N/A	N/A
18. Embhuleni FPS	3 August 2023	On request	1	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
19. Balfour FPS	New refrigerators	On request	0	N/A	N/A
20. Bethal FPS	22 June 2023	On request	2	Not stated	Contingency plans are available. Repairs are done between scheduled minor and major repairs.
21. Carolina FPS	10 January 2023	On request	0	N/A	N/A

END.

Reply:

The National Department of Health requested the Minister of Public Service and Administration to consider a request for strengthening the NHI Branch of the department on 16 May 2022.

On 2 June 2022, the Minister of Public Service and Administration approved the creation of 44 new technical positions for the NHI Programme in the Department.

The posts were advertised in the media (Sunday Times) on 28 August 2022. All job descriptions, duties and remuneration levels were advertised as per the Public Service requirements. The relevant remuneration levels of public servants are available in public domain. Details are contained in the annexure.

There are currently no plan for posts addition to the 44 posts mentions above to be created within the National Health Insurance Branch in the Department.

END.

Reply:

From the Department’s PERSAL records, there are 21 posts on salary levels 13 to 16. Of these posts, the NHI Branch has managed to fill ten (10).

a) The respective salary levels for each of the filled posts are shown in the column named ‘Notch’ of the table below.

b) Additionally, the Job Titles are listed in column 2 of the table. Detailed job descriptions for each post and key performance duties as were published in the advertisements for the posts are included as an annexure to this response.

	POST JOB TITLE DESCRIPTION	FILLED/ VACANT	FILLED/ VACANT DATE	POST SALARY LEVEL	NOTCH
1	DEPUTY DIRECTOR-GENERAL: NHI	FILLED	20210606	15	1663581
2	TECHNICAL SPECIALIST: HEALTH ECONOMIST	FILLED	20180401	15	1817142
3	DIR: MEDICAL DEVICES & HEALTH TECHNOLOGY PROCUREME	FILLED	20230701	13	1268919
4	CD: SECTOR WIDE PROCUREMENT	FILLED	20230201	14	1371558
5	TECHNICAL EXPERT	FILLED	20130201	14	1476000
6	DIR: PHARMACEUTICAL ECONOMIC EVALUATION	FILLED	20110401	13	1306665
7	DIR: BUSINESS INTELLIGENCE & DATA ANALYTICS	FILLED	20230601	13	1306665
8	CHIEF DIRECTOR: HEALTH SYSTEM DIGITAL INFORMATION	FILLED	20230101	14	1433289
9	CD:USER & SERVICE PROVIDER MANAGEMENT	FILLED	20230915	14	1371558
10	CD: HEALTH CARE BENEFITS & PROVIDER PAYMENT	FILLED	20230904	14	1371558

END.

Reply:

The following information is as received from the provinces.

PROVINCES	a) TOTAL AMOUNT OF ACCRUALS OUTSTANDING	b) AGEING - PERIOD THE AMOUNT BEEN OUTSTANDING IN EACH CASE	(C)TOTAL NUMBER OF SERVICE PROVIDERS NOT PAID WITHIN THE REQUIRED 30-DAY PERIOD 2023/2024
R THOUSAND	2022/23 FY	2023/24FY (29 FEB 2024)	2022/23 FY	2023/24 FY
Eastern Cape	R4, 764, 773	R5,132,000	Current: R1, 626, 945 More than 30 days R3, 137, 828	Above 30 days R525,685 Above 60 days R268,465 Above 90 days R345,637 Above 120 days R2,746,364	534 suppliers
Free State	R682,362	R922,130	Current: R369,764 More than 30 days R312,598	>R621,746 < Above R300,383	3121 number of suppliers/ invoices were not paid within 30 days
Gauteng	R6, 827, 872	R5, 926, 667	Current: R2, 040, 370 More than 30 days R4, 787, 502	Above 30 days R874, 366 Above 60 days R618, 711 Above 90 days R2, 928, 777	2, 099 number of suppliers
Kwazulu-Natal	R1, 838, 121	R1,694,242	Current: R1, 548, 239 More than 30 days R289, 882	R355,000 was more than 80 days overdue	514 service providers affected
Limpopo	R 767, 038	R 358 023	Current: R718, 330 More than 30 days R48, 708	1957 transactions amounting to R356 2667 are within 30 days. 40 outstanding transactions amounting to R1 756 are more than 30 days.	28 service providers were not paid within the required 30-day period.
Mpumalanga	R825, 870	R 87 081	Current: R706, 780 More than 30 days R119, 090	R952	1439 suppliers
Northern Cape	R514 622	R842 875	30 Days-R56 991 30+ Days R457 631	Current R153 429 Above 30 Days R689 446	170 354 service providers
North West	R 959 137	R339,687	Current: R619, 450 More than 30 days R339, 687	More than 30 days R339,687	4 330 suppliers
Western Cape Accruals (A) Payables (P)	R 589 529 R 289 746 (A) R 299 783 (P)	R 135 622 R 88 093 (A) R 47 528 (P)	R251 531 (A) (0-30days) R 38 215 (A) (30+ days) R293 951 (P) (0-30days) R 5 832 (P) (30+ days)	R 31 535 (A) (0-30 days) R 56 558 (A) (30+ days) R 42 869 (P) (0-30 days) R 4 659 (P) (30+ days)	1094 (for the period 1 April 2023- 29 February 2024) (equates to 1.75% of all payments)

END.

Reply:

1. According to the Internship and Community Services Placement (ICSP) programme and confirmation from South African Military Health Services (SAMHS), only five (5) Medical Interns were allocated to military facilities for 2024 and all of these have been appointed and already commenced duty in various Military Hospitals in January 2024.

2. As stated above (a) all 5 medical interns were successfully placed and have commenced duty in January 2024, (b)(i) they all have received payment of their salaries and (ii) where they have required accommodation formally the relevant Military Hospital has provided accommodated accordingly.

END.

Reply:

a) The National Department of Health has no list of planned events specifically for celebration of the 30 years of democracy, however the Department will continue to have events planned for administration of government.

b) As indicated in (a) above, there are no planned events specifically for 30 years of democracy in the Republic scheduled to take place before 29 May 2024 and therefore no description can be provided.

c) The questions asked relating to projected total cost or expenditure of each event and breakdown thereof in terms of expenditure for catering, entertainment, venue hire, transport and accommodation are not applicable as there is no cost that can be attached when there are no event planned.

END.

Reply:

a) The official report from Mpumalanga Head of the department (HOD) of Health, Tintswalo hospital has not experienced a lack of nutritional food or food. Food is one of the Department’s non-negotiable priorities to ensure that patients have access to nutritious meals. A specific budget is allocated for food, enabling the hospital to seamlessly provide meals tailored to patients’ dietary needs. Strict food safety standards are adhered to, ensuring the safety of all meals served in the hospital.

b) In 2022, the Department effectively tackled the issue of water scarcity by drilling an additional borehole and installing twenty-eight (28) Jojo tanks, each with a capacity of 10,000 litres, at strategic locations. As a result of these initiatives, access to water is no longer a problem.

c) Temporary measures were implemented to address roof leaks in the wards while awaiting hospital refurbishment in the new financial year.

d) The hospital has sufficient medical staff to provide 24-hour services. It has a complement of 49 medical doctors comprising of 34 full-time doctors, 15 sessional doctors

END.

Reply:

According to the KZN Provincial Health:

1. The hospital electricity supply was disrupted by the breakdown of the eThekwini Metro Council managed substation which supplies the area. The disruption continued for 3 days starting from around 11H35 on Monday 04 March 2024 up to around 11h35 on Wednesday 06 March 2024.

2. The issue was resolved at 11h35 on Wednesday, March 6, 2024. (a) The delay in resolving the situation was caused by the eThekwini Metro workers' strike which prohibited the required staff from responding swiftly. (b) All six generators at the hospital were active during this time preventing the hospital from being completely shut down. This allowed vital services such as critical care, intensive care units, and four theatres to continue operating.

END.

Reply:

a) Policy of Unclaimed Bodies

Regulation 341 of 2005: Regulations Regarding the Rendering of Forensic Pathology Service, sections 43 and 44 of the make provision that:

43. A body not identified must be moved to a freezer within seven days of admission, and if such body remains unidentified for 30 days, the municipal council under whose jurisdiction the designated facility is, must ensure that a pauper burial for such body is undertaken.

44. The person in charge of a facility where there is an unidentified body must ensure that complete details of such body, including a photograph, fingerprints, and blood or tissue sample, are taken from the body and archived.

b) Table 1: Total number of unclaimed bodies per Province as of 15 March 2024

Province	Number of unclaimed bodies
Free State	73
KwaZulu-Natal	1336
Limpopo	283
Mpumalanga	82
Northen Cape	51
Northwest	266
Western Cape
Eastern Cape
Gauteng
Total	2091

END.

Reply:

The responses to (a), (b) and (c) are provided in the Table below, according to the Provincial Departments of Health.

Table 1.

Province	(a) Full Details of last inspection	(b) Outcomes	(c) Personal Protective Equipment
	Name of Unit	Date of last inspection
Eastern Cape	a. Mount Frere b. Mbizana c. Butterworth d. Adelaide e. Woodbrook f. Bhisho g. Mdantsane h. Queenstown i. Aliwal North j. Mt Fletcher k. Mount Road l. Uitenhage Provincial Hospital m. Gail Road n. Lusikisiki o. Graaff Reinet p. Grahamstown	23/08/2023 07/07/2023 15/03/2024 22/01/2024 19/03/2024 14/03/2024 28/09/2023 19/02/2024 08/11/2023 15/03/2024 31/01/2024 10/2023 06/2023 11/05/2023 10/10/2023 05/12/2023	- 13 Units non-compliant with health norms and standards. - 3 Units have certificates of competence	- Adequate in 9 Units. - Inadequate in 7 Units.
Free State	a. Bloemfontein b. QwaQwa c. Welkom d. Bethlehem e. Kroonstad f. Sasolburg	30/01/2024 22/02/2024 14/11/2023 16/01/2024 04/03/2024 20/02/2023	No Certificate of Competence issued at Bloemfontein and Kroonstad Units due to: - Mechanical failure of fridges. - Lack of or poor maintenance of infrastructure. - Poor health and unhygienic conditions. - Lack or poor medical waste management. 4 Units have certificates of competence	Adequate in all 7 Units.
Gauteng	a. Germiston Forensic Pathology b. Springs Forensic Pathology c. Hillbrow Forensic Pathology d. Roodepoort Police Station Forensic Pathology Services e. Diepkloof f. Pretoria Forensic Pathology g. Garankuwa Forensic Pathology h. Bronkhorstspruit Forensic Pathology i. Sebokeng Forensic Pathology j. Carltonville Forensic Pathology	17/01/2024 15/01/2024 08/11/2023 11/09/2023 20/09/2023 January 2024 February 2024 August 2023 May 2023 23/01/2024	9 Units have certificates of competence Others have not due to: - Poor management of medical waste. - Poor maintenance and infrastructure.	Adequate in 10 Units.
Mpumalanga	a. Themba b. Tonga c. Mapulaneng d. Tintswalo e. Lydenburg f. Barberton g. Witbank h. Middelburg i. KwaMhlanga j. Belfast k. Mammethlake l. Delmas m. Ermelo n. Evander o. Piet Retief p. Standerton q. Volkrust r. Embhuleni s. Balfour t. Bethal u. Carolina	19/03/2024 14/03/2024 22/02/2024 15/03/2024 18/03/2023 12/03/2024 Inspected in 2022 31/08/2023 Last inspected before COVID 01/12/2023 Not inspected 19/02/2024 24/11/2023 01/11/2023 21/02/2024 29/09/2023 24/01/2024 22/11/2023 22/09/2023 20/03/2024 24/01/2024	12 Units issued with Certificates of competence 9 Units not compliant due to: - Poor maintenance (Fridges not working properly). - Poor infrastructure.	Adequate in all 21 Units.
Limpopo	a. Elim b. Letaba c. St Rita’s d. Groblersdal e. Warmbaths f. Polokwane g. Bela-Bela h. Nkhensani i. Lebowakgomo j. Tshilidzini k. Mokopane l. Kgapane	February, November, December 2023 Not inspected Not inspected Not inspected Not inspected	-Elim Unit was non-compliant with health norms and standards. Bela-Bela and Nkhensani were issued with certificates of competence	Adequate in all Units.
North West	a. Brits Forensic b. Rustenburg Forensic c. Matlosana Forensic d. JB Marks, Potchefstroom e. Joe Morolong Hospital Mortuary f. Lichtenburg Forensic Pathology g. Mahikeng Forensic Pathology	No date provided No date provided 18/03/2024 20/03/2024 No date provided No date provided No date provided	Only Matlosana and Potchefstroom have certificates of competence Other units do not have due to: - Poor housekeeping at the storage areas	- Adequate in 2 Units - Inadequate in 5 Units.
Northern Cape	a. Kimberley b. Harstwater c. Springbok d. Calvinia e. De Aar f. Upington	01/11/2022 13/10/2023 28/02/2024 06/03/2024 13/07/2023 29/06/2022	- 4 Units non-compliant to health norms and standards - 2 Units have certificates of competence	Adequate in all 6 Units.
Western Cape	a. No name provided b. Beaufort West c. Laingsburg d. Tygerberg Forensics e. No name provided f. Hermanus g. Vredenburg h. Vredendal i. Malmesbury j. Mossel Bay FPS k. Observatory FP Institution l. Oudtshoorn FPS m. Riversdale FPS n. Swellenndam FPS o. Worcester FPS p. Ceres q. Paarl	11/10/2023 12/12/2023 13/02/2024 19/03/2024 20/03/2024 No date provided No date provided No date provided No date provided 19/01/2023 19/03/2024 20/03/2024 October 2023 Not Inspected 01/02/2023 11/10/2023 14/05/2021	15 Units have certificates of competence - One Unit was not certified with Certificate of Competence	Adequate in 16 Units. No report for 1 unit
Kwa Zulu Natal	a. Madadeni Forensic Mortuary b. Newcastle forensic Mortuary c. Phoenix Medico Legal Mortuary d. Pinetown Forensic Mortuary e. uMzimkhulu Forensic Mortuary f. Ixopo Forensic Mortuary g. Bulwer Forensic Mortuary h. Kokstad Forensic Mortuary i. Kwadukuza Forensic Mortuary j. Richards Bay Forensic Mortuary k. Eshowe Forensic Mortuary l. Park Rynie Forensic m. Port Shepstone Forensic n. Harding Forensic o. Pietermaritzburg Forensic p. New Hanover Forensic Mortuary (SAPS) q. Howick SAPS r. Dundee Forensic Mortuary s. Ladysmith Forensic Mortuary t. Escourt Forensic Mortuary u. Vryheid Forensic Mortuary v. Nongoma Forensic Mortuary w. Greytown Forensic Mortuary	19/03/2024 No date provided 11/12/2023 03/11/2023 06/12/2021 09/11/2021 No date provided 07/05/2020 29/06/2023 18/03/2024 14/01/2024 05/03/2024 18/03/2024 02/02/2024 19/03/2024 01/02/2023 19/03/2024 18/03/2024 December 2023 18/03/2024 22/12/2023 12/03/2024 11/03/2024 None/ not in use 20/02/2024	- 13 Units have certificates of competence - 10 Units are not compliant with health norms and standards due to: - Poor infrastructure. - Poor maintenance. - Areas of continuous improvements highlighted in terms of risk management, infrastructure, and incident reporting.	- Adequate in 19 Units. - Inadequate in 4 Units.

END.

Reply:

a) (i) See Table 1

(ii) See Table 2

Table 1.

Province	(i) Number of facilities conducting autopsies	(i) Number of facilities not conducting autopsies	Names of facilities unable to deliver services	(ii) Reasons for not conducting autopsies
Mpumalanga	17	3	Barberton FPS	Holding facility
			Belfast FPS	Holding facility
			Standerton FPS	Infrastructure challenges
Free State	7	0	N/A	N/A
Kwa-Zulu Natal	22	0	N/A	N/A
Northen Cape	5	1	Calvinia FPS	No medical officer/pathologist appointed, infrastructure challenges
Limpopo	12	3	Musina	No operational resources
			Lephalale	No operational resources
			Thabazimbi	No operational resources
Northwest	7	0	N/A	N/A
Gauteng
Eastern Cape
Western Cape

Table 2.

Mpumalanga Department of Health

Forensic Pathology Sites
a)(ii) names	Conducting autopsies	Not Conducting autopsies	Reasons for not conducting autopsies
Themba FPS	YES	N/A
Tonga FPS	YES	N/A
Mapulaneng FPS	YES	N/A
Tintswalo FPS	YES	N/A
Lydenburg FPS	YES	N/A
Barberton FPS		YES	Holding facility
Middelburg FPS	YES	N/A
Witbank FPS	YES	N/A
KwaMhlanga FPS	YES	N/A
Belfast FPS		YES	Holding facility
Mammethlake FPS	YES	N/A
Delmas FPS	YES	N/A
Ermelo FPS	YES	N/A
Evander FPS	YES	N/A
Piet Retief FPS	YES	N/A
Standerton FPS		YES	Challenges of Infrastructure
Volkrust FPS	YES	N/A
Embhuleni FPS	YES	N/A
Balfour FPS	YES	N/A
Bethal FPS	YES	N/A
Carolina FPS		YES	Challenges of Infrastructure
	17	4

Frees State Department of Health

Name of facility	Conducting autopsies (YES/NO)	Not conducting autopsies (Y/N)	Reasons for not conducting autopsies
Bloemfontein Forensic Mortuary	YES	N/A	N/A
Botshabelo Forensic Mortuary	YES	N/A	N/A
Phuthaditjhaba Forensic Mortuary	YES	N/A	N/A
Bethlehem Forensic Mortuary	YES	N/A	N/A
Welkom Forensic Mortuary	YES	N/A	N/A
Kroonstad Forensic Mortuary	YES	N/A	N/A
Sasolburg Forensic Mortuary	YES	N/A	N/A

Kwa-Zulu Natal Department of Health

Name of facility	Conducting autopsies (YES/NO)	Not conducting autopsies (Y/N)	Reasons for not conducting autopsies
Port Shepstone Forensic Mortuary	YES	N/A	N/A
Park Rynie Forensic Mortuary	YES	N/A	N/A
Pinetow Forensic Mortuary	YES	N/A	N/A
Phoenix Forensic Mortuary	YES	N/A	N/A
Welkom Forensic Mortuary	YES	N/A	N/A Wrong Province
Kokstad Forensic Mortuary	YES	N/A	N/A
Mzimkhulu Forensic Mortuary	YES	N/A	N/A
Ixopo Forensic Mortuary	YES	N/A	N/A
Kwadukuza Forensic Mortuary	YES	N/A	N/A
Pietermaritzburg Forensic Mortuary	YES	N/A	N/A
New Hanover Forensic Mortuary	YES	N/A	N/A
Howick Forensic Mortuary	YES	N/A	N/A
Estcourt Forensic Mortuary	YES	N/A	N/A
Ladysmith Forensic Mortuary	YES	N/A	N/A
Greytown Forensic Mortuary	YES	N/A	N/A
Dundee Forensic Mortuary	YES	N/A	N/A
Vryheid Forensic Mortuary	YES	N/A	N/A
Newcastle Forensic Mortuary	YES	N/A	N/A
Madadeni Forensic Mortuary	YES	N/A	N/A
Nongoma Forensic Mortuary	YES	N/A	N/A
Eshowe Forensic Mortuary	YES	N/A	N/A
Richardsbay Forensic Mortuary	YES	N/A	N/A
Harding Forensic Mortuary	YES	N/A	N/A
	23	0	No 5 to be removed

Limpopo Department of Health

Name of facility	Conducting autopsies (YES/NO)	Not conducting autopsies (Y/N)	Reasons for not conducting autopsies
Polokwane FPS	YES	N/A	N/A
Lebowakgomo FPS	YES	N/A	N/A
Mokopane FPS	YES	N/A	N/A
Warmbaths FPS	YES	N/A	N/A
Tshilidzini FPS	YES	N/A	N/A
Elim FPS	YES	N/A	N/A
Groblersdal FPS	YES	N/A	N/A
St Rita’s FPS	YES	N/A	N/A
Letaba FPS	YES	N/A	N/A
Kgapane FPS	YES	N/A	N/A
Maphutha Malatji FPS	YES	N/A	N/A
Nkhensani FPS
Musina		YES	Holding facility
Lephalale		YES	Holding facility
Thabazimbi		YES	Holding facility

Northwest Department of Health

Name of facility	Conducting autopsies (YES/NO)	Not conducting autopsies (Y/N)	Reasons for not conducting autopsies
Mafikeng FPS	YES	N/A	N/A
Lichtenburg FPS	YES	N/A	N/A
Brits FPS	YES	N/A	N/A
Phokeng FPS	YES	N/A	N/A
Brits FPS	YES	N/A	N/A
Potchefstroom FPS	YES	N/A	N/A
Tshepong FPS	YES	N/A	N/A

Western Cape

Name of facility	Conducting autopsies (YES/NO)	Not conducting autopsies (Y/N)	Reasons for not conducting autopsies
Beaufort West FPS	YES	N/A	N/A
Ceres FPS	YES	N/A	N/A
George FPS	YES	N/A	N/A
Hermanus FPS	YES	N/A	N/A
Knysna FPS	YES	N/A	N/A
Laingsburg FPS	NO	N/A	Currently serving as a holding facility
Malmensbury FPS	YES	N/A	N/A
Mossel Bay FPS	YES	N/A	N/A
Observatory FPInstitution	YES	N/A	N/A
Oudtshoorn FPS	YES	N/A	N/A
Paarl FPS	YES	N/A	N/A
Riversdale FPS	NO	N/A	Currently serving as a holding facility
Swellenndam FPS	NO	N/A	Training facility
Tygerberg FPS	YES	N/A	N/A
Vredenburg FPS	YES	N/A	N/A
Vredendal FPS	YES	N/A	N/A
Worcester FPS	YES	N/A	N/A

END.

Reply:

a) As per the details furnished by the member of Parliament, the Department confirms that 16 of the 17 names received to be unallocated were actually allocated and have since commenced duty as indicated by the Persal report extract for the February 2024. The one outstanding applicant is not allocated because he has not met the Registration requirements as set by the Health Professions Council of South Africa (HPCSA).

b) The unallocated applicant will be only be assisted during the mid-year cycle on condition that he has met the HPCSA Registration requirements. The table below for individual details of the applicants are avaiable on request.

 

Reply:

a) According to the HPCSA, the case of treatment of a patient at Ngwelezana Hospital in KwaZulu-Natal was duly investigated. The case was considered by the Preliminary Committee of Inquiry and finalised in line with applicable regulations. The outcome of the Inquiry was communicated to both the complainant and the respondent. In terms of the query related to the Certificate of Status (COS), the issue of a pending case against the practitioner was resolved internally and a clean COS was subsequently issued (clean COS for Case no. 25504608 was issued on 7 August 2023);

b) (i) There were delays in the finalisation of the case. This was due to the referral of the practitioner to the Health Committee of the Board for consideration of possible impairments that the practitioner may have had before the case was finalized. This is a necessary step in HPCSA’s internal processes. Also, there were system errors that led to the COS indicating a “pending complaint” against the practitioner when that was not the case;

(ii) Following this case, processes of referral between Committees were reviewed and subsequently streamlined. A new online complaints management system was introduced which allows for ease of monitoring of cases and proper tracking by both complainants and respondents, with regular updates.

END.

Reply:

On 21st February 2024, the Minister of Finance announced 2024 MTEF allocation of R848 billion for the health sector which is inclusive of the following obligations:

• Payment of current employees and the impact of the wage bill agreement
• Provision of the health services in all facilities
• Medical equipment and consumables
• Maintenance and construction of new facilities

The consolidated assessment of equipment and consumables was not undertaken, however, health facilities do develop a demand plan for their equipment and consumables. Upon the budget allocation by the Provincial Treasury, Provincial Departments of health allocates the budgets and develop annual procurement plans.. The total allocated budget over the 2024 MTEF is R15,5 billion for machinery and equipment combined and R7.2 billion for consumables of which are medical supplies and laboratory services. Due to budgetary constraints, it is possible that the equipment and consumables needs will not be met based on the allocated budget.

END.

Reply:

Since 1 June 2019 the department only bought one vehicle for the current Minister: Dr. MJ Phaahla, MP, when 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, MP	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	R 756,489.83	10/5/2020

END.

Reply:

The National Department of Health (NDoH) collaborates with the Department of Higher Education, Science and Innovation through the National Health Research Committee (NHRC). NHRC is an NDoH Ministerial Advisory statutory body established in terms of National Health Act of 2003. It responsible for determining the nature, scope, as well as the co-ordination of health research. NHRC is made up of researchers and representative of various academic institutions.

It is a prerequisite that all health research proposals and protocols are reviewed and approved by the health research ethics committee which is registered with the National Health Ethics Council (NHREC) to ensure transparency and integrity of health research. The NHREC is mandated by the Health Act of 2003 to develop guidelines for institutional research ethics committees (IRECs), register and audit IRECs, advise the department of health on all research ethics matters, and adjudicate complains about health research ethics committees.

END.

Reply:

(a) and (b)

The Minister of Health, through the Foodstuffs, Cosmetics and Disinfectants Act (FCD), 1972 (Act. 54 of 1972) regulates foodstuffs with the aim of promoting food safety and to prohibit the misleading advertising of foods. The regulations relating to foodstuffs are aligned to the global best practice of the joint World Health Organisation and Food and Agricultural Organisations’ Codex Alimentarius.

The Department of Health is committed to the improvement of the health and nutrition of South Africans through regulating the labelling of foodstuffs sold in South Africa. This would allow South Africans to make healthy food choices without being misled through inaccurately labelled and advertised foodstuffs thereby assisting consumers to make good nutritional choices and adopt a healthy lifestyle.

In terms of the legislation “it is an offence’ to sell foodstuff that does not bear a label indicating the kinds or grades of ingredients and their proportions or amounts present in a mixed, blended or compounded foodstuff.

The Minister of Health has published the following regulations to help reduce premature death from noncommunicable diseases which is Goal 3.4 of the Sustainable Development Goals:

1. Regulations relating to Trans-Fats in foodstuffs (No.R.127 of 2011), prohibit the sale, manufacture and importation of oils and fats, including continuous phase emulsions, either alone or as part of processed foods. An increased intake of trans fat (>1% of total energy intake) is associated with increased risk of coronary heart disease (CHDs) mortality and relevant events. South Africa is one of the global leaders in protecting the heart health of its citizens through the regulation of Trans Fats.

2. Regulations relating to the reduction of sodium in certain foodstuffs and related matters (No.R.214 of 2013) to help in reducing salt (sodium chloride) intake to less than 5g per day. Excessive salt intake is associated with high blood pressure (hypertension) which is a major risk factor for CVDs. Scientific evidence suggests that reducing sodium intake significantly reduce blood pressure and risk of cardiovascular diseases in adults particularly its contribution towards coronary artery disease and stroke. South Africa is the first country in the world to legislate salt levels to help reduce the amount of salt in processed foods.

3. Regulations relating to foodstuffs for infants and young children (No.R.991 of 2012) aims to protect and promote optimal infant and young child feeding practices and to encourage the safe and appropriate use of commercially processed foods through regulating the labelling, advertising, sale and promotion, and the provision of information and education relating to infant and young child feeding and nutrition.

4. Regulations governing general hygiene requirements for food premises, the transport of food and related matters (No.R.638 of 2018) ensures that all food products are safe for consumption by the public. The regulations apply to all food establishments, including restaurants and hotels, and cover a range of topics including hygiene, food handling, transportation, storage and food preparation. All food establishments that comply with these regulations are issued with the Certificate of Acceptability.

The Minister has also published draft regulations to improve food labelling requirements so that consumers are clear about the contents of food. (No.R.146/2010). These regulations include the following :

(i) a model to classify healthy foods

(ii) specifying criteria for health claims, and,

(iii) a mandatory Front of Pack Label in the form of a easily understood logos, to assist consumers in identifying foods that exceed the threshold of certain “negative” nutrients (added sugar, sodium, and saturated fats) that contribute to the rising obesity and non-communicable disease and death burden in South Africa.

These regulations are implemented at local government level where health inspectors would do inspections to check compliance with regulatory requirements outlined above.

The purpose of regulating the sale and marketing of foods is to inform the consumer of the risk associated to the consumption of particular foods. Evidence from several countries suggests that consumers make healthy food choices when provided with information about the food they consume.

END.

Reply:

The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Guidelines for implementation of Article 5.3 recommends that Parties monitor the activities of the tobacco industry. The Convention Secretariat assisted countries with the establishment of tobacco industry observatories in some interested Parties. One of the Observatories is based in South Africa specifically to monitor tobacco industry interference. These observatories inform policy makers and governments on Tobacco industry activities. The South Africa based observatory is called Africa Centre for Tobacco Industry Monitoring and Policy Research (ATIM).

The Department works closely with ATIM- one of their functions is to interrogate research by the industry and they have been able to identify studies and scientist that are funded by the tobacco industry. The Department has access to ATIM findings which have demonstrated how industry has manipulated, suppressed or used data incorrectly to suit the needs of the tobacco industry.

The Department also is also influenced by research and analysis conducted by the South African Medical Research Council (SAMRC), who analyse studies conducted by the Tobacco industry, further citations from other reputable research organisations that are pro-tobacco control and pro-protection of public health are available for use.

The current and proposed laws on tobacco control warrant that the tobacco industry discloses the research conducted by a manufacturer or by a person conducting research paid for in whole or in part by a manufacturer.

END.

Reply:

(a) (i), (ii) and (b)

The official report form Western Cape Department of Health and Wellness is that they do not have any records, nor reports of staff from Swellendam hospital not receiving their remuneration. Also, contractors of Swellendam hospital have also reported that they are not aware of any of such claims emanating from themselves nor their employees. However, it will be appreciated if the honourable member could provide any further specific details regarding any person who has not been paid as it is pointed out in the question.

END.

Reply:

According to the Health Professions Council of South Africa (HPCSA):

(a) It is a legal requirement that all practising health professionals register with their Professional Council namely the HPCSA, South African Nursing Council, South African Pharmacy Council, Dental Technicians Council and the Allied Health Professions Council. The Health Professions Act, 1974 (Act No. 56 of 1974) requires health professionals to register with the HPCSA before practicing. As section 17 of the Health Professions Act, 1974 (Act No. 56 of 1974) states the following:

If the registrar is satisfied that the qualifications and the other documents submitted in support of the application satisfy the requirements of this Act, he or she shall, upon payment by the applicant of the prescribed registration fee, issue a registration certificate authorising the applicant, subject to the provisions of this Act or of any other law, to practise the health profession in respect whereof he or she has applied for registration, within the Republic.

The HPCSA legislation does not require that unemployed practitioners (non-practising) to pay registration fees. Infact a person not practising a health profession registrable with the HPCSA may apply for voluntary erasure from the register in writing before 31 March of the year that he/she wishes to be voluntarily erased in line with section 19 (1) (c) of the Act.

When the health professional decides to resume practice then a restoration fee is payable and the person could be restored to the register. There may be additional requirements such as continuous professional development, depending on the number of years the health professional is unregistered with the Council.

(b) There is no need for an intervention since there is no obligation on a non-practising health practitioner to registered with the HPCSA.

END.

Reply:

1. According to the KZN Department of Health, the responses are as follows:

(a) There were no persons admitted at Mahatma Gandhi Memorial Hospital due to contaminated water

(b) There were no persons admitted at King Edward VIII Hospital due to contaminated water.

(c) There were no persons admitted at Addington Hospital due to contaminated water.

(d) There were no persons admitted at surrounding hospitals in eThekwini due to contaminated water.

(2) According to the KZN Department of Health, there were (a) no children and (b) no elderly persons admitted as a result of contaminated water.

END.

Reply:

1. No, the Hospital and Emergency Centre Tracking Information System (HECTIS) is not available in all hospitals. The system has only been implemented by the Western Cape Provincial Department of Health. It has not been implemented in any other province as it is not part of the national Emergency Medical Services Plan.

2. (a) HECTIS is not in a pilot phase. It has been successfully integrated into a total of 64 health facilities in the Western Cape in both hospitals and Primary Healthcare facilities (see annexure showing HECTIS Sites List).

(b) HECTIS is a web-based hospital and emergency centre tracking information system. The system was developed as an in-house custom-built system by an emergency physician from Mitchells Plain Hospital in the Western Cape for their internal processes. It is a Clinician driven innovative healthcare technology initiative, focused on improving the management and efficiency of Emergency Centres.

END.

Reply:

1. (a) The National Department of Health has received 306 generators.

(b) 34 generators per province. In order to meet the minimum demand for each clinic, it’s going to be two generators per clinic. 6KW x 2 = 12KW. Therefore, it’s going to be 19 clinics earmarked for the generators.

2. (a) The National Department of Health is currently finalising the procurement process. The procurement process covers both the collection and installation of the generators directly to the main electrical distribution board of the clinics.

(b) (i) The details of the Service Providers will be provided after the completion of the procurement process.

(ii) the total cost will also be provided after the completion of the procurement process.

3. The National Department of Health will ensure that there is enough budget allocation for the fuel consumption of generators across the country. Currently, there is no fuel expenditure on these new generators.

4. (a) None installed yet.

(b) 306 to be installed.

END.

Reply:

a) The National Department of Health requirements is that each facility should have clean water. New clinics that are constructed in the Northen Cape province, particularly around Kimberley since 2011/12 are provided with water supplied though municipality line and back up water system through boreholes. Facilities that were build prior 2011/12 that does not have back up water system are attended to through Borehole Water Programme.

A service provider has been appointed during 2003/24 financial year in Robert Mangaliso Sobukwe Hospital (RMSH) in Kimberley to build a 2 Mega Liters (2 million litters) water tanker as additional water capacity to the current 360,000 Liters.

b) All facilities around Kimberley have electricity and some also have back up generators. There is a program running to provide generators to facilities that don’t have any back up system. The province is also benefiting from People Republic of China donated generators. Robert Mangaliso Sobukwe Hospital is also equipped with GenSets in case of electricity went off during loadshedding.

c) Ideally the Department of Health wishes to fill all health care worker posts in order to improve the health outcomes of the population. Due to current financial constraints, annually, the Provinces appoint Employment Recruitment Teams led by Heads of Health Departments or delegated officials at senior level to develop recruitment plans, prioritising the filling of critical posts with required skills mix. However, they must guard against overspending on provided / available budgets.

END.

Reply:

a) The National Department of Health requirements is that each facility should have clean running water. All clinics that are constructed in the Northen Cape province, particularly around Kimberley are having water, and also provided with back up water system through boreholes. Most of the old facilities are getting water from municipalities and those that don’t have borehole are prioritised in 2024/25 to get back up water.

b) No clinics have been closed as a result of poor water supply or quality.

c) Provision of water is the competency of municipalities, the Department interacts with other departments like Water and Sanitation and municipalities to ensure that communities have access to safe clean water. The challenges of unsafe water negatively impact on the health of communities. Random samples are taken to check safety of water at laboratories if there is a sudden increase of diarrhoea cases at certain areas as a precautionary measure.

The tap water in Carnavon was tested and results were positive faecal organisms and therefore not fit for human consumption. Information from District Health Information System (DHIS) for Carnavon CHC and Carnavon clinic for the past six month showed only 1 new case of diarrhoea reported. The matter is dealt with Water and Sanitation Department and outbreak response team has been activated for health education in the community.

END.

Reply:

1. Based on the current Occupational Specific Dispensation (OSD) salary scales of 1 April 2023, the appointed medical officers will be remunerated as follows:

 

Category	Salary Structure
	Basic Salary	Commuted Overtime (8-12 hours weekly)	Total Cost of Employment (per capita)
Medical Officer Grade 1	R 906 540	R 253 135	R1 159 657
Note: Designated facilities may also offer Rural Allowance at R 148 740

2. The Department is not reviewing the approach of employing medical doctors. Instead, the review is on conditions of service and relatively all employment categories will be included in the process. The envisaged outcome of the review is to optimize the retention of health care workforce in the public health sector and for the department to remain the employer of choice.

END

Reply:

As a standard practice, staff submit their annual leave plans to their managers in the beginning of the year. Managers analyse the plans and allocate the leave days in such a way that there will be service coverage at all times. Managers discuss the allocations with the staff, reach agreements and finalise the unit or section leave plans. Any unavoidable deviation from the agreed upon plan is managed by seconding staff from other facilities so that service coverage is adhered to.

END.

Reply:

The Department of Health does not keep a database of unemployed health professionals including the nurses. However, all health professionals, including nurses, whether employed or unemployed, are required to remain registered with their relevant statutory health councils, this being the South African Nursing Council in the case of nurses.

END.

Reply:

A meeting was held on 9 November 2022 with Mountain City Community Leaders whereby the issue of the clinic was addressed at length. During the meeting, it was communicated to the Community Leaders that there are two clinics at close proximity to Mountain City, namely Thulamntwana clinic which is 2.8 km and Weilers Farm Clinic which is 3.4 km from Mountain City. The two facilities provide health services to the community of Mountain City, thus ensuring access to health services. Both health facilities are within the national norm of the 5km radius access to communities. The Department of Health will continue monitor the situation Mountain City area and respond appropriately.

END.

Reply:

The Deputy Minister of Health, Dr Sibongiseni Dhlomo, has made plans to visit the Lenasia South District Hospital, with the MEC for Health, to assess the state of affairs at the Hospital. This visit will take place on Wednesday, 13 March 2024 and the Minister will then provide the Honourable Member with a full report on the state of health services in that Hospital.

END

Reply:

(a) (b) There were no sponsorship, donations and financial transfers that were received from the State of Qatar and the Islamic Republic of Iran by the Minister, Officials and the National Department of Health.

(c) A mobile laboratory, various laboratory equipment and the associated consumables were donated to the National Department of Health by the Russian Government during COVID-19. The Russian government paid for the importation of both the laboratory and other items, but unfortunately the test kits were not approved by the South African Health Products Regulatory Authority (SAHPRA) and were not used. The vehicles (a large truck and a trailer) have been stationery and parked since importation while alternative applications are sought, either in South Africa or in another SADC country.

END.

Reply:

The Minister’s delegation included one technical official and one Personal Assistant.

1. (a)-(d) Yes.

(i) Total cost: R1 101 726.83

(ii) Daily allowance: R 57 390.94

Air Travel: R 211 876.63

Accommodation: R 827 461.51

Travel agent service fee: R 1 083.00

Service fees for accommodation: R 258.75

International handling fee: R 828.00

Back-office processing fees: R 828.00

Meals: R 2 000.00

2. As indicated in (1) above, the costs were born out of the budget of the National Department of Health.

END.

Reply:

1. The Department has, in terms of governance, developed and gazetted the “National Environmental Health Norms and Standards for Premises and Acceptable Monitoring Standards for Environmental Health Practitioners” in 2015. In terms of these Norms and Standards, the Department has since 2016 included the “Assessment of Municipalities” in its Annual Performance Plan (APP) to monitor the 1:10 000 ratio of EHP per population in the country. The reports generated from the assessments play a vital role in providing municipalities with evidence to use to motivate for additional human resources at their respective Municipal Councils.

2. The following table reflects the details in this regard.

YEARS	NUMBER OF VISITS TO ECDs
2019	48035
2020	29376
2021	39913
2022	52561
2023	54533

 

END.

Reply:

1. The employment of Foreign Health Professionals is subject to the conditions contained in South African employment legislation (including, for the public sector, those conditions contained in the Public Service Act, 1994, as amended and the Public Service Regulations, 2001), as well as the provisions of the Immigration Act, 2002 as amended in 2004 (Immigration Act) and the Refugees Act, 1998 (Refugees Act) where applicable.

In accordance with Section 19(2)(a) of the immigration Act 2002, as amended, the employment of Foreign Health Professionals shall only be allowed on condition that there is record that no South African Citizen or Permanent Resident was available or found suitable to fill the particular post. In addition, no Foreign Health Professional is allowed to initially take up employment in a professional capacity or continue with such employment without a valid Work Permit or Refugee's Permit or Treaty Permit and with the appropriate registration with the relevant Health Professional Council in South Africa.

In line with the above Regulations, the Policy on Recruitment of Foreign Nationals informs that posts for internship and community service will be offered to non-South African citizens and refugees within available resources only after all South African citizens and Permanent Residents have been accommodated. The policy further states that, once South African citizens and permanent residents are accommodated, priority will be given to the allocation of non-South African citizens who graduated from South African Universities and finally non-South Africans who have been recognised by the relevant statutory council as being suitable for practice in South Africa. The allocation algorithm will continue to place applicants in this order until all applicants have been allocated or available sites have been exhausted.

a) (i) Applications received for Foreign Nationals for ICSP in each year since 2019:

Non-South African Applications
Field of study	2019	2020	2021	2022	2023	2024
Audiologist	1	3	4	2	3	1
Clinical Psychologist	7	9	12	5	2	5
Dentist	18	6	10	11	18	11
Diagnostic Radiographer	17	23	33	13	13	12
Diagnostic Sonographer	0			0	1
Dietician	6	9	16	4	7	3
Environmental Health Practitioner	1	63	39	8	1	2
Medical Practitioner	83	27	38	13	11	5
Nuclear Medical Radiographer (Comm Service)	1	5	7	2	0	1
Occupational Therapist	8	7	11	6	4	2
Pharmacist	103	121	140	139	145	43
Physiotherapist	5	11	17	10	6	7
Professional Nurse	40	41	75	49	53	13
Radiotherapy	0	2	4	6	2	3
Speech Therapist	2	6	7	4	3	2
Internship	143	76	107	90	74	48
Grand Total	435	409	520	362	343	158

(ii) & (iii) In the reporting period of 1 January 2019 to 1 January 2024 only 2 foreign nationals were allocated in 2019 and 2023 on a self-funded accredited post or where resources permitted.

(b) There is no backlog of allocations as each Cycle is managed according to the number of applicants received against the number of available posts pertaining to the Cycle. Instead, applicants are always advised to apply in each cycle and treat that as a new application.

(c) Medical training offered across the 10 Medical Schools in South Africa has been accredited and accepted to fulfil the requirements to obtain Medical Degree. To register to practice as a Medical Doctor in South Africa as per the HPCSA Regulations, graduates are expected to undergo a two-year Internship Training programme. Accredited and funded posts for Internship programme are limited and as such unable to accommodate most Foreign Nationals.

It should be noted that the intention of hosting Foreign National African students to study in South Africa is to improve the human resources for health in the Region. Therefore, it is expected that foreign health professional graduates will return to their countries of origin to serve. Similarly, we expect our professionals to undergo Community Service before they can be recognised for independent practice registration.

2. Foreign students who study at various South African Medical Schools are continuously made aware of the above-mentioned processes and legislation throughout their duration of study. Furthermore, the Internship and Community Service Placement (ICSP) website clearly stipulates the allocation criteria. Lastly, the foreign graduates who would have applied still get reminded through the letter of decline the reasons for their ineligibility.

END

Reply:

1. (a) (i) The total number of Internship and Community Service applicants who rejected their allocation for the 2024 Annual Cycle is 70. The table below provide a breakdown of the total applicants who rejected per field of study.

2024 Annual Cycle - Medical Internship and Community Service - Allocation rejections
Community Service	61
Audiologist	2
Dentist	1
Dietician	5
Environmental Health Practitioner	1
Medical Practitioner - Community Service	29
Occupational Therapist	6
Pharmacist	2
Physiotherapist	8
Professional Nurse	4
Speech Therapist	3
Internship	9
Medical Practitioner - Internship	9
Grand Total	70

(ii) The total number of applicants who were not eligible for placement to commence duty on 1 January 2024 is 619.

(b) The table below provide a breakdown per field of study with reasons why they were not eligible to be placed

2024 Annual Cycle - Medical Internship and Community Service - Not eligible applicants
Row Labels	Can only register and commence duty between March to August 2024	Not eligible for Registration with HPCSA	Grand Total
Clinical Psychologist	-	2	2
Diagnostic Radiographer	4		4
Environmental Health Practitioner	15	8	23
Medical Officer Community Service	215	1	216
Pharmacist	-	177	177
Physiotherapist	-	5	5
Radiotherapy	-	1	1
Speech Therapist	-	72	72
Medical Internship	-	119	119
Grand Total	234	385	619

(c) Statutory placements are managed as replacements posts that requires applicants to commence duty on 1 January of each year to ensure that there is constant availability of health professionals to render health services at a certain required time including after-hour roster cover. As a result, the department targets to release allocation outcomes between October and November of the preceding. This allows allocated applicants enough time to make necessary arrangements to commence duty on time and avoid late start that affects health services and the Cycle management.

When applicants timeously declare their late start dates, due to various reasons, a provision is made to align their date to the allocation. However any applicant that has a date beyond 1st April is then expected to apply for the Mid-year Cycle which allocates for 1st July commencements.

2. The department continues to assist applicants who were unable to commence duty on the required date. However, this is done in consultation with Provincial Departments of Health where budgets permits.

In terms of the HPCSA regulations, medical interns has to comply with a three months rotation in one domain. Therefore there are 0 medical interns that can legally commence duty on 1 March 2024.

According to the ICSP records, only 11 Medical Community Service doctors have proclaimed that they will assume duty on 1 March 2024. Provinces have been requested to assist with their appointment to 1 April 2024.

3. They have not accepted posts as yet.

END.

Reply:

1. Health sector relies on employment of doctors, nurses and other critical posts hence most of the budget is allocated to compensation of employees. Currently in 2023/2024 about 63% of total budget has been allocated to compensation of employees and 64% in 2024/2025 financial year.

2. As reflected during the media briefing hosted on 05/02/2024, we do acknowledge fiscus challenges the country is facing and the impact in the health care system. The Provincial Departments of Health continue to actively engage their Provincial Treasuries to find ways of addressing the unemployment of health professionals, including medical doctors. The ongoing provincial engagements will allow provinces to get leverage of activating the posts that were previous unfunded due to the budget pressures and subsequent austerity measures encountered last year.

Indeed the “several bilateral engagements” with National Treasury have yielded very positive results and become a confirmatory expression that government departments work together to better the lives of the people. On 21st February 2024, the Minister of Finance announced allocation of R848 billion for the health sector which is inclusive of the following obligations:

• Payment of current employees and the impact of the wage bill agreement
• Provision of the health services in all facilities
• Medical equipment
• Maintenance and construction of new facilities

Included in the budget above is an additional budget of R3.7 billion has been allocated towards compensation of employees in the sector for the financial year 2024/25 to address the wage bill increase and recruitment of additional staff including nurses and medical doctors.

As a result of the provincial inter-departmental engagements, Provincial Departments of Health have already advertised 823 since December 2023 and have reported projections of 1103 Medical Officer appointments by 1st April 2024. According to the 09th February 2024 persal print out, 425 Medical Officer appointments were captured for January 2024 of which 371 are Grade 1 category.

END.

Reply:

The following table reflects the details in this regard:

NAME OF THE PROVINCE	1 (a) Total number of medico-legal claims filed	1 (b) Total number of the claims paid out	1 (b) (i) Total number of claims paid out as settlements	1 (b) (ii) Total number of claims paid out as court ordered payments	2 (a) (i) Total number of claims that were awarded based on lost patient files	2 (a) (ii) Total number of duplicate claims that have been filed	2 (b) (i) Total amount spent on legal cost	2 (b) (ii) Total amount of claim cost
Eastern Cape[1]
Free State	651	53	50	3	0	0	R37 259 798.24	R2 484 606 393.54
Gauteng	322	449	0	449	108	0	R634 637 738.31	R1 897 283 000.00
KwaZulu- Natal	779	94	0	94	0	1	R328 252 675.68	R8 677 266 708.80
Limpopo	903	30	2	28	0	1	R63 145 941.00	R266 804 823.43
Mpumalanga	569	62	32	30	15	0	R224 990 555.00	R245 485 320.00
Northern Cape	57	28	27	1	7	0	R24 670 478.26	R152 235 223.45
North West	241	22	15	7	0	0	R59 270 605.65	R99 136 357.41
Western Cape[2]
Totals	3522	738	126	612	130	1	R1 372 227 792,14	R23 637 317 204,63

1. Eastern Cape still verify the figures. ↑

2. Still waiting the information from WC. We have been advised that the responses have been forwarded to the HoD for approval. ↑

Reply:

According to the National Health Laboratory Service (NHLS):

a) (i) There is no backlog of toxicology cases at the Durban FCL.

The Durban FCL does not offer a full toxicology service. Postmortem cases referred from the Kwazulu-Natal and regions of the Eastern Cape provinces that require analysis for carbon monoxide testing only are processed and completed at the Durban FCL. These comprise a small number of samples and no backlog has developed.

(ii) There is no backlog of toxicology cases at the Durban FCL.

(iii) The Durban FCL receives on average 12 carbon monoxide cases for analysis per month and completes these cases each month.

b) There is no backlog of toxicology cases at the Durban FCL.

END

Reply:

a) The disclosure/ declaration of financial interests by employees in the public service is regulated by Regulation 18 of the Public Service Regulations, 2016, which requires designated employees to submit particulars of their financial interests to their respective heads of departments and non-compliance in this regard is handled in line with the provisions of Section 16A of the Public Service Act, which require the head of the department to take appropriate disciplinary steps against an employee who does not comply with a provision of a regulation.

b) Some of the reasons for failure to comply with the disclosure processes include forgetting the personal log-in details (usernames and passwords). In some instances, it is with regard to properties that employees acquired a long time ago and are no longer in possession of, but those properties are still registered in their names. As a result, they are of the view that they are not required to disclose such properties, while that is not the case.

c) Ethics Officers inform designated officials that are required to disclose their financial interests timeously before the period of disclosure starts and they are constantly reminded about the process of disclosing their financial interests. There are also dedicated officials who are responsible for providing assistance and technical support to all officials who are experiencing challenges in accessing the e-disclosure system.

END.

Reply:

a) The position of the department is to implement the recommendations of the Public service Commission (PSC).

b) The department has implemented some of the recommendations which have no financial implications, the implicated employees are still in the employ of the department and the findings have not been challenged by the implicated employees and/or the PSC reports have not been taken on judicial review.

 

END.

Reply:

Responses as received from the provincial departments of health.

a) (i) Gauteng Department of Health underspent the total allocated budget with R2.7 billion of which R937 million was for provincial equitable share and R1,7 billion for conditional grants,

The reasons for underspending are -

• Late receipt of invoices and claims from suppliers that are subjected to a verification process.
• The reduced number of nursing students enrolled for the academic year and delays in the submission of Non-Profit institution's claims.
• Claims for the South African Cuban Doctor programme was received and subjected to reconciliation and review and could not be processed for payment at year-end.
• Slow construction and contractors abandoning sites due to poor contractors performance.
• Underspending on conditional grants was due to the unavailability of contracts, and probity audit processes towards procurement of high-value medical equipment that could not be delivered and paid at year end.
• Underspending was also incurred due to price reductions of antiretroviral drugs, non-contracting of general practitioners performing voluntary medical male circumcision (VMMC) and shortage of condoms within the country.

Rollover application of R582.2 million was submitted and R279 million was approved as follows;

• National Tertiary Services Grant R515.8 million requested and R226.8 approved
• District Health Services Grant (HIV/AIDS component R38.4 million requested and R32.8 approved and
• Statutory Human Resources component R27,9 million requested and R19.4 approved

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

Name of the province	Underspending in 2022/2023 FY R’million	Reasons for underspending
Eastern Cape	R62,2 R31.7 Conditional grants R30.5 Voted funds	Delays in the payment of medico-legal settlement due to Trust registration delays by plaintiff attorneys. The rollovers amount to R24,8 million for the National Tertiary Services Conditional Grant and R6,1 million for the District Health Programme Conditional Grant (Comprehensive HIV Component) has been approved.
Free State	-R’4.4 R85 Conditional grant -R89 voted funds	The underspending on the grant totalling R85 million was as a result of the process of reconciliation for payment at year end and could not be finalised. The roll over amount of R84 million on Health Revitalization Grant was requested and approved to be spend in 2023/2024
Kwa Zulu Natal	R’000	The Province spent the total allocated budget in 2022/23 financial year.
Limpopo	R103,5 R49.3 Conditional grant R54.2 voted funds	The unspent budget of R103 million is attributable to delayed deliveries of medical equipment caused. The Department successfully secured R78 million through roll over request to be paid during 2023/2024 financial year.
Mpumalanga	R25,3 R12.8 conditional grants R12.5 Voted funds	Department experienced delays in the procurement of equipment due to revised Public Procurement Regulations.
Northern Cape	R141,4 R131.3 conditional grants R10.1 Voted funds	Underspent funds due to delay in the supply, delivery, installation and commissioning of the linear accelerator. National Health Insurance grant rollover amount was requested and R47,484 million was approved to be spent in 2023/24 financial year. National Health Revitalisation Grant underspent by R82,211 million, attributed by the delay in the monitoring and implementation of infrastructure projects.
North West	R4.8 R200.6 conditional grants -R209 voted funds	Delays in submission of invoices by service provider, late delivery of medical equipment (Catheterization and Lab Thyroid Stimulating Hormone). Rollovers were requested and approved to be spent in 2023/24 financial year, Health Facility Revitalisation Grant - R178,9 million, National Tertiary Services Grant - R1,9 million and National Health Insurance Grant -R15 million
Western Cape	R180 R14.4 conditional grants R165.6 voted funds	Savings on approved post list due to delays in the filling of funded vacancies and in-year attrition rates. Delayed in the implementation of contracts with training providers resulting in training that could not be implemented as planned. The use of covid-19 rapid ag tests instead of the more expensive laboratory based PCR tests and decrease in audit fees and legal fees.

END.

Reply:

According to the National Health Laboratory Service (NHLS):

a) Toxicology tests are conducted at three of the four Forensic Chemistry Laboratories namely, Cape Town, Johannesburg, and Pretoria. The toxicology tests are supposed to be tested within 90 days from the date the samples are registered in the testing laboratory. Any test that has not been completed and authorised within 90 days is classified as backlog. Multiple factors have contributed to the backlogs that developed at the three laboratories, including incomplete information on the request forms, inadequate infrastructure, aging analytic equipment, interruptions in power supply, inadequate water supply, the COVID-19 epidemic, and shortages in human resources.

The current backlog at the Cape Town Forensic Chemistry laboratory is 6,792 cases with Johannesburg and Pretoria laboratories at 15,358 and 16,824 cases respectively

 

b) The measures taken by the NHLS to eradicate the backlog include:

• • Increasing laboratory processing capacity to analyse samples and ensuring the optimal use of resources within the laboratories.
  • Acquiring additional laboratory space in Pretoria to process both the toxicology and blood alcohol samples.
  • New posts for toxicology analysts were created for the new laboratories in Pretoria.
  • The new toxicology laboratory will analyse new cases and the old laboratory will focus on the backlogged cases only.
  • Similar plans are in process to increase laboratory capacity for toxicology cases at the Johannesburg and Cape Town laboratories and to offer a toxicology service at the Durban laboratory.
  • The NHLS, in conjunction with the Forensic Pathology Services (FPS) in the Department of Health, is developing strategies to address ageing samples in the backlog and how to best manage these samples.

c) Each toxicology case that is registered in the laboratory may include a varying number of biological specimens that were taken during the autopsy and each specimen may require to be tested more than once or on different sets of instruments, depending on the test requirements. In the pre-analytic stage, specimens may require specialised preparation, depending on the tests that will be conducted.

As a result, it is difficult to quantify the number of toxicology tests that are processed in a day as tests run concurrently and completion periods differ vastly between cases. Hence, Toxicology cases are allocated in batches of 15 cases per analyst per month.

d) It is difficult to estimate when the backlog will be eradicated, however, the NHLS remains committed to improving service delivery at all four Forensic Chemistry Laboratories and to accelerating the reduction of the toxicology backlogs at these laboratories.

END.

Reply:

The details of the food contract is as follows:

Tender Number: HEDP021/19/20

Duration: 01/07/2023 to 31/04/2024

Contract description: Supply and delivery of perishable provisions at all hospitals in the Limpopo Department of Health for 36 month.

Items covered in the tender:

• Fresh fruits and vegetables
• Bread
• Chicken Breast and Wings
• Fish
• Full Cream Milk/ Low-fat milk
• Eggs
• Cheese
• Yogurt plain low-fat
• Mageu

END.

Reply:

a) The options are as follows:

1. Permanent method
2. Long-Acting Reversible Contraceptives
3. Short term hormonal contraceptives
4. Barrier methods
5. Emergency contraceptives

b) Name and method:

1. Permanent method Sterilizations (Vasectomy and Tubaligations)
2. Hormonal (Oral Contraceptive (OC), Subdermal implants and Injectables)
3. Barrier (Intra uterine contraceptive device (IUCD) and Condoms)
4. Emergency (Combined Oral Contraceptives and IUCD)

END.

Reply:

According to information received from the Provincial Departments of Health, the responses are as follows:

EASTERN CAPE

a) One robbery and two-armed robberies.

b) (i) Empilweni TB Hospital, Helenvale and Zigidlo Clinic.

(ii) 1

(c) At Empilweni TB Hospital, the Security Company on-site decided to re-imburse its own personnel for the loss of their belongings (Security Officers). The criminal cases were opened at SAPS with CAS Number 11/09/2023 and 16/2/2024.

FREE STATE

a) The Department has not experienced any robberies in the past six months.

GAUTENG

a) Three robberies.

b) (i) Zola Clinic, Sebokeng Clinic and Rahima Moosa Hospital

(ii) 1

c) All robberies were reported to law enforcement agencies for further investigation.

KWAZULU NATAL

a) One-armed robbery.

b) (i) Ndlangubo Clinic

(ii) 1

(c) SAPS was contacted and called to the crime scene and the criminal case was opened at SAPS with CAS Number 222/09/2023.

LIMPOPO

a) One-armed robbery.

b) (i) Zebediela Hospital.

(ii) 1

c) The criminal case was opened at SAPS with CAS Number 97/09/2023. Furthermore, the physical infrastructure of the guard house is being improved to include bullet proof and one way mirror from the inside only and the Hospital has been included in the SAPS patrol list.

MPUMALANGA

a) One-armed robbery.

b) (i) Nkangala District, Empumelelweni CHC

(ii) 1

(c) The criminal case was opened at SAPS with CAS Number 135/11/2023. Furthermore, the Infrastructure Unit fixed the palisade fence that was broken.

NORTH WEST

The Department has not experienced any robberies in the past six months.

NORTHERN CAPE

The Department has not experienced any robberies in the past six months.

 

WESTERN CAPE

a) One armed robbery. (b) (i) Khayelitsha CHC in Site B (ii) 1 (c) Immediately after the incident, the Department deployed the Provincial Security Team to safeguard the facility to provide additional support to the onsite security officers. Counselling Services and wellness debriefing were made available to staff based at the facility. The CCTV camera system at the facility is currently undergoing upgrade and maintenance to include remote monitoring capabilities. The Department is in the process of re-constructing the entrance into the facility. The new entrance will include a double gate vehicle lock system as well as turnstiles.

END.

Reply:

According to the Health Ombud:

a) Since the inception of the Office of the Health Ombud (OHO) in 2016, there have been inadequate investigative human resources to support optimal functionality. Commencing with two senior investigators in 2017, OHO had only five investigative staff between 2018 – and 2023 (Two senior investigators and three investigators). Due to the severe staff shortages, the two senior investigators were tasked with administrative, management, and operational responsibilities, in addition to their technical investigative responsibilities. Therefore, only three investigators were attending to the complaints lodged. During this period, the OHO received 307 high and extreme-risk complaints. Despite the enormous workload, 148 complaints were resolved during this period, and a total of 159 complaints remain unresolved.

b) The OHO budget constitutes an average of 13% of the OHSC overall budget from 2016/17 to 2022/23. The OHO's budget increased by an average of 7% per year. The provision of short-term relief in the form of surplus funding from 2018/19 to 2023/24 was made to remedy this predicament. This funding was used to enable the hiring of contract staff on 12-month contracts during the 2023/24 financial period. Although the ad hoc funding helped to reduce the number of backlog cases, there remains a large number of unresolved cases, in addition to new cases.

In 2024/25 the OHO will work towards converting the current contracted staff into permanent employment to boost the number of investigators from the additional R10 Million allocated over the MTEF. However, additional funding will still be required to appoint permanent staff to augment the capacity and ensure that the mandate of OHO is fulfilled.

c) In 2022 a Health Ombud Bill was developed to address the governance challenges experienced by the Ombud. The Bill sought to establish the Health Ombud Office as an autonomous entity.

The Ombud Bill served at the Social Protection, Community and Human Development Cluster (SPCHD). The National Treasury raised concerns with the financial implications of creating a Schedule 3A Public entity considering the current economic and fiscal challenges.

The National Treasury recommended that the Department explore alternative options that would establish the independence of the Ombud – one such structure recommended was the Tax Ombud or a shared service option.

While the two options are being explored, the department has earmarked the budget of the OHO for the 2024/25 financial year. This approach would provide greater financial certainty to the Ombud so that the budget for human resources, equipment and other goods and services can be effected.

 

END.