Health | PMG

2011-03-07

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QUESTION NO. 3852

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr I O Davidson (DA) to ask the Minister of Health:

(1) Whether he will reply to (a) all outstanding parliamentary questions and (b) the points contained in each question before parliamentary questions lapse in accordance with Rule 316 of the National Assembly; if not, in each specified case, (i) why not and (ii) which questions, by its allocated number, will not be replied to; if so, what are the relevant details in each case;

(2) whether it is the policy of his Ministry that he submit to the mechanism of parliamentary questions as a measure of constitutional accountability to the National Assembly; if not, why not; if so, what are the relevant details?

NW4643E

REPLY:

(1) (a)-(b) Yes. However where information is only obtainable from sources outside the Department, there is usually a delay.

(2) Yes.

QUESTION NO. 3820

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr T D Harris (DA) to ask the Minister of Health:

Whether any other persons have driven (a) his and (b) his Deputy Minister's official blue light fitted vehicles; if not, what is the position in this regard; if so, in each case, in respect of the (i) 2009-10 and (ii) 2010-11 financial years, (aa) what is each specified person's (aaa) name and (bbb) designation, (bb) which vehicle and (cc) why?

NW4611E

REPLY:

(a) and (b) No other person except for the Ministers and Deputy Ministers designated VIP protectors have driven the official blue light fitted vehicles.

(i) and (ii) Not applicable.

QUESTION NO. 3783

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Dr L L Bosman (DA) to ask the Minister of Health:

(1) With reference to the Green Paper on National Health Insurance (NHI) (details furnished), what effect did the introduction of minimum membership requirements have on the reduction of the number of medical schemes as introduced in terms of the Medical Schemes Act, Act 131 of 1998;

(2) whether it has been his department's policy since 1998 to reduce the number of medical schemes; if not, what is the position in this regard; if so,

(3) whether he can provide Mr M Waters with the policy document stating this; if not, why not; if so, what are the relevant details?

NW4574E

REPLY:

(1) The Medical Schemes Act, Act 131 of 1998, does stipulate minimum membership requirements for registration as a medical scheme. The minimum membership requirements for a medical scheme has never been used as the main reason to de-register a medical scheme.

The financial viability of a medical scheme / governance is the main reasons for the Council for Medical Schemes (CMS) de-registering a medical scheme. The CMS does not de-register a scheme when the membership falls below the minimum requirement.

(2) The Department of Health has never implemented any policy that is intended to reduce the number of medical schemes registered in the country.

The number of medical schemes registered with the Council for Medical Schemes has been reducing over the years due to a number of reasons. The reasons include weakening financial sustainability, poor governance arrangements and amalgamation of schemes. The position of the Department in this respect is to ensure that the medical schemes environment remains stable and that members are adequately protected for their health needs.

(3) The Department never had a policy of reducing the number of medical schemes in the country. Therefore, no document can be provided to Mr M Waters as requested.

QUESTION NO. 3782

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr J J van der Linde (DA) to ask the Minister of Health:

(a) Which countries' qualifications are recognised by the Health Professions Council of SA (HPCSA) and (b) which qualifications are recognised in each case?

NW4573E

REPLY:

(a) The Health Professions Council of South Africa (HPCSA) accepts applications from any foreign qualified health professional who has obtained a qualification from universities which are listed by the World Health Organization and present proof of registration as a health professional with a regulatory body of the country of origin.

(b) The Council recognizes all 21 professions regulated under the Health Professions Council. Although most applications tend to be medicine, dentistry and psychology, all health professionals who apply for registration with the HPCSA are assessed to determine whether their competencies are comparable to those required from South African Universities. Applicants who are found to be in possession of the required competencies are registered with the HPCSA.

QUESTION NO. 3776

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr J J van der Linde (DA) to ask the Minister of Health:

(1) (a) How many mortuaries are there in each province, (b) where are they situated, (c) how many positions are there at each mortuary for (i) doctors, (ii) mortuary technicians and (iii) other specified personnel and (d) what (i) minimum qualifications are required for each specified position and (ii) is the salary level of each specified category of worker;

(2) whether all persons working at mortuaries must be registered with the Health Professions Council of SA (HPCSA); if not, why not; if so, (a) which workers that should be registered with the HPCSA are not registered at present, (b) when last were they registered and (c) why are they not registered with the HPCSA;

(3) what are the qualifications of each mortuary technician at each mortuary?

NW4567E

REPLY:

(1), (2), (3) Please see the responses per province attached as Annexure C.

QUESTION NO. 3775

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mrs J F Terblanche (DA) to ask the Minister of Health:

How many (a) positions are there in each province for (i) specialists, (ii) pharmacists, (iii) doctors and (iv) technicians and (b) of these positions are (i) filled and (ii) vacant (aa) with and (bb) without funding?

NW4566E

REPLY:

There are two main sources of data which are necessary to answer this question, namely:

1. Registrars of various statutory bodies or health professions councils; and

2. The Government PERSAL system – both National and in Provinces.

The information in possession of statutory bodies is not helpful for this type of question because it only reflects the number of people registered.

The problem of the various PERSAL systems is that they have not been regularly updated and hence provide inconsistent information.

If we were to use this information, we will definitely arrive at misleading answers.

Hence, the Department is currently performing an audit of human resources as part of a comprehensive audit of all public health facilities in preparation for the implementation of the National Health Insurance (NHI). This process involves a head count of all personnel. At the moment some 70% of facilities were audited and it is expected that the rest will be finalised early in 2012.

QUESTION NO. 3774

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mrs J F Terblanche (DA) to ask the Minister of Health:

Whether a framework has been developed to determine how traditional medicine will fit into the health workforce; if not, (a) why not and (b) when will such a framework be developed; if so, what are the relevant details of this framework?

NW4566E

REPLY:

Yes.

The Strategic Framework for traditional medicine was published in the Government Gazette No. 31271 of 25 July 2008. The Traditional Health Practitioners (THP) Act was finalised in 2007. The Regulations for the establishment of a THP Council has been published. The THP Council will provide guidance on the integration of the THP into the health workforce.

QUESTION NO. 3773
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011
(INTERNAL QUESTION PAPER NO. 41)
Mr J R B Lorimer(DA) to ask the Minister of Health:

(1) (a) When were the mortuaries of each province transferred to his department and (b) what was the budget allocated to each province for this transfer to occur;

(2) whether he has found that the procedures regarding the identification and release of bodies from mortuaries are being observed at all times; if not, (a) why not and (b) how many bodies have been disposed of due to being unclaimed in (i) 2008, (ii) 2009 and (iii) 2010; if so, (aa) how is compliance with these procedures monitored and (bb) what are the further relevant details? NW4564E

REPLY:

(a) (1) (a) Mortuaries were transferred from the South African Police Services to Department of Health in April 2006.

((b) Table 1 indicates the budget per province: table is here: www.pmg.org.za/questions/3773-Table1.htm

(2) Yes, procedures regarding the identification and release of bodies from mortuaries have been observed at all times in all the nine provinces.

(a)Not applicable;

(b)Table 2 below indicate the number of bodies disposed during 2008, 2009 and 2010 due to being unclaimed by Province. Table is here: www.pmg.org.za/questions/3773-Table2.htm

(aa) A record of bodies in each mortuary is kept by the respective mortuaries. The monitoring tool is inspection of the Death Register and Pauper Register which is kept in each facility.

(bb)The records include photographs and finger prints of the bodies.

QUESTION NO. 3765

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Dr L L Bosman (DA) to ask the Minister of Health:

With reference to the statement in the Green Paper on National Health Insurance (NHI) regarding the three trends that have been identified in the 2008 World Health Report of the World Health Organisation that undermine the improvement of health outcomes globally (details furnished), (a) where is the specified statement found in the 2008 World Health Report, (b) from which document is the specified statement derived and (c) who is responsible for attributing the specified statement to the World Health Organisation?

NW4555E

REPLY:

Honourable Member, I wish to refer you to the 2008 World Health Organisation Report, which you may please obtain from this link, as it is too big to be transmitted with this response: http://www.who.int/whr/2008/en/index.html

QUESTION NO. 3751

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr M Swart (DA) to ask the Minister of Health:

Whether the pilot sites for the introduction of the proposed National Health Insurance scheme have been (a) identified and (b) accredited; if not, why not, in each case; if so, what are the (i) details of the areas where the pilot sites will be established and (ii) estimated costs of (aa) establishing and (bb) operating the pilot sites?

NW4540E

REPLY:

The National Department of Health, in consultation with the Provincial Departments of Health, is undertaking technical work to inform the development of systematic, evidence-based and objective criteria and methodology for the selection of the 10 pilot districts for the National Health Insurance (NHI).

(a) Currently, data has been analysed and a ranking of the health districts has been done. Nonetheless, the specific districts in which the first phase of the NHI pilots will be undertaken have not been identified yet;

(b) The pilot sites for the NHI will not be accredited. Instead, the health facilities located within the selected districts will be accredited;

(i) The process of identifying the 10 pilot sites for the establishment of the NHI is underway;

(ii) (aa), (bb) Once the methodology and criteria for selecting pilot sites is finalised, the required financial, human and other resources will be budgeted for in order to provide a clear indication of the costs associated with establishing and operating the pilot sites.

QUESTION NO. 3741

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mrs J F Terblanche(DA) to ask the Minister of Health:

What (a) were the old and (b) are the new minimum qualification requirements for appointment as (i) chief executive offices and (ii) hospital managers at state hospitals?

NW4530E

REPLY:

The Honourable Member is referred to the attached responses (No. 5, No. 2091 and No. 2183) tabled in Parliament already.

QUESTION NO. 3701

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Dr C P Mulder (FF Plus) to ask the Minister of Health:†

Whether he and/or his department have (a) entered into an agreement with, (b) signed a contract with and/or (c) received services from a certain company (name furnished) since 2006; if so, what was the (i) nature of the (aa) agreement, (bb) contact and/or (cc) services and (ii) cost in each case?

NW4482E

REPLY:

(a) No, the National Department of Health did not enter into an agreement with the said company.

(b) No, the Department of National Health did not sign any contract with this company.

(i)(aa) Not applicable

(i)(bb) Not applicable

(i)(cc) Not applicable

(ii) Not applicable

QUESTION NO. 3690

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether a certain person (name furnished) is a legal adviser for (a) the Ministry or (b) his department; if so, (i) when was the said person appointed, (ii) in which capacity is the said person appointed, (iii) how many legal opinions has the said person given since the appointment and (iv) in relation to what were the legal opinions;

(2) whether the said person gave a legal opinion to the Board of Healthcare Funders (BHF) during the same period she was giving a legal opinion to (a) the Ministry or (b) his department; if so, (i) on which dates were the legal opinions given, (ii) in relation to what were legal opinions given to the BHF, (iii) what action does he intends taking with regard to this conflict of interest and (iv) on which date was he informed of the conflict of interest?

NW4469E

REPLY:

(1) (a) Yes.

(b) No.

(i) 01 March 2010

(ii) Special Advisor to the Minister

(iii) She has given multiple written and verbal legal opinions since her appointment.

(iv) The opinions were in relation to various matters of policy and legislation falling within the jurisdiction of the Minister of Health.

(2) (a) No.

(b) No

QUESTION NO. 3689
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011
(INTERNAL QUESTION PAPER NO. 41)
Mr M Waters (DA) to ask the Minister of Health:

What steps has his department taken to assist a certain person (details furnished) with regard to her case? NW4468E

REPLY:

This incident is extremely regrettable and should not have happened. The Province has reported to me that a morbidity review was held and that preventive measures have been strengthened. I am informed that since the complainant's medical complications were identified following a Caesarean Section in 2009, she has been treated by the best teams available at the King Edward and Inkosi Albert Luthuli Central Hospitals with support from Nelson R Mandela School of Medicine, University of KwaZulu/Natal. Any medical care she might require in future, that relates to her initial complications or general health, will be available to her. It is also noted that she has instituted legal proceedings against the Department as per her right as a citizen and patient.

QUESTION NO. 3688

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 41)

Mr M Waters (DA) to ask the Minister of Health:

Whether all regulations have been developed and implemented with regard to the Tobacco Act, Act 83 of 1993; if not, (a) which aspects have not been regulated or implemented and (b) by which date will the regulations be implemented?

NW4467E

REPLY:

(a) Only regulations relating to Reduced Ignition Propensity have been developed and implemented from 16 May 2011.

(b) (i) Regulations relating to the Display of Tobacco Products at the Point of Sale have been developed, published in the Government Gazette for public comments on the 29 October 2010. Public comments were received, analyzed and have been considered. The final regulations are expected to be published by the end of the 2011/12 financial year;

(ii) Regulations relating to Smoking in Public places have been developed and are expected to be published for public comments by the end of the 2011/12 financial year;

(iii) Regulations relating to Pictorial Messaging are in the process of being developed and finalized for publication and public comments by the end of the 2011/12 financial year;

(iv) Regulations on Product Control and Regulations on Industry Reporting System are under discussion with International bodies through WHO Framework Convention on Tobacco Control (FCTC) member countries to develop uniform regulations.

QUESTION NO. 3675

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mr P J C Pretorius (DA) to ask the Minister of Health:

(1) (a) When did construction of the Zola Hospital in Soweto commence, (b) what was the value of the original tender, (c) what are the details of the bidding companies who were shortlisted and (d) which company was awarded the tender;

(2) whether the contractor's services have been suspended; if not, what is the position in this regard; if so, (a) at what stage of the project and (b) why;

(3) whether any cancellation fees or penalties had to be paid; if not, how was this conclusion reached; if so, what total amount in fees was paid;

(4) whether a new contractor has been appointed to complete the project; if not, why not; if so, what are the relevant details;

(5) whether the project has been completed; if not, when is it envisaged to be completed; if so, what total cost was incurred for this project as at the latest specified date for which information is available?

NW4457E

REPLY:

(1) The construction of Zola hospital in Soweto starting in 2006 and the value of the contract was R334, 9 million. Since the shortlist was done by department of public works in Gauteng province the department is not in possession of list of the bidders. However, the contract was apparently awarded to Ilima construction.

(2) The services of the contractor were terminated by the province in view of noncompliance with contractual issues when they found out that one of the joint venture presented invalid tax clearance certificate. The time that the contract was suspended in 2008 when the gate way clinic was about to complete.

(3) Since the public Works department was managing the contract on behalf of the provincial health department the national office is not possession of the penalty fees charged to the contractor, hence the question should be forwarded to the Department of Infrastructure and Development in the Gauteng Province. However, further information will be submitted when the matter is further investigated.

(4) In January 2009 the new contract for the value of R680 million was awarded to Maziya General Service to complete the gate way clinic and construction of the hospital.

(5) The construction of the hospital is projected to be completed in June 2012. The Gate way Clinic has been completed and is operating.

QUESTION NO. 3670

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Ms A M Dreyer (DA) to ask the Minister of Health:

With reference to a certain company (name furnished) that won multiple tender awards from his department for the construction of hospitals and clinics, (a) what is the name of the (i) chairperson of the board of directors, (ii) chief executive officer of the company and (iii) chief financial officer of the company and (b) why were multiple tenders awarded to the specified company?

NW4452E

REPLY:

(a) A web search was conducted; as a result the following information was obtained as requested. However, it is possible that some of the members mentioned may have been altered. A CIPRO publication in 11 October 2010 also highlighted that this company is still deregistered pending some of the outstanding returns.

(i) Chairperson: Philisiwe Buthelezi;

(ii) Members of board of directors: (executive committee):

- MJ Allie,

- P le Sueur,

- AJ McJannet,

- GD Mottram,

- ECJ Vener,

- JA Wallace, and

- WI Zeelie.

(iii) Chief Financial Officer: Cristina Teixeira

(iv) CEO: Mike Upton

(b) Honourable Member should note that awarding of contracts to the service providers is the responsibility of Implementing Agents (e.g. Public Works Department) on behalf of provincial departments of Health. Hence this question must be forwarded to the Department of Public Works.

QUESTION NO. 3660

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mrs S P Kopane (DA) to ask the Minister of Health:

(1) Whether his department has a policy in place regarding children who are wards of the State; if not, why not; if so, what are the relevant details;

(2) whether his department is obliged to provide support for children in different alternative care options in accordance with the Children's Act, Act 38 of 2005; if not, why not; if so, what are the relevant details;

(3) whether his department has the required number of personnel to implement the Children's Act, Act 38 of 2005; if not, why not; if so, what are the relevant details;

(4) how many cases of litigation have been brought against his department with regard to the children who are wards of the State during the period 1 April 2011 up to the latest specified date for which information is available?

NW4441E

REPLY:

(1) The Department is guided by the Children's Act of 2005, that makes provision for children in need of care and protection to be made wards of the state in special circumstances outlined in the said Act. In particular, Section 156(1)(g) of this Act provides for children with physical or mental disabilities and chronic illnesses to be placed in a facility designated by the court. In terms of Section 156(1)(i) medical, psychological or other treatment should (if needs be) be provided at state expense at such facility. In this regard health care services for people with disabilities, including children, have been provided free at the point of care since 2003.

(2) Yes, as above. Where a child has severe or profound intellectual disability and cannot be cared for within the family and community environment the Department of Health provides inpatient care within designated Care and Rehabilitation Centres – many of which are attached to psychiatric hospitals.

(3) No. Provincial Departments of Health subsidize NGOs in certain instances to provide care to children with intellectual disabilities.

(4) No cases of litigation during the specified period.

QUESTION NO. 3612

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether his department has conducted an audit on the need for infrastructure improvement in preparation for the implementation of the National Health Insurance; if not, why not; if so, (a) how many nursing colleges require (i) minor refurbishment, (ii) major and (iii) complete rebuilding in each province and (b) what is the (i) backlog in each province and (ii) targeted number of units to be built in each province for the (aa) 2011-12 and (bb) 2012-13 financial years? NW4391E

REPLY:

The audit to asses all health facilities country wide is currently in the process. The outcome of this audit will assist in preparation of NHI implementation.

(a)-(c) The NDOH also commissioned a national audit of the 122 public nursing colleges, campuses and schools. The audit started in November 2009 and extended to the first half of 2010. The purpose of the audit was to evaluate the functionality of these colleges and schools in terms of staff, facility and equipment. These facilities are distributed as follows:

· Eastern Cape 18

· Free State 10

· Gauteng 6

· KwaZulu-Natal 26

· Limpopo 28

· Mpumalanga 16

· Northern Cape 1

· North West 7

· Western Cape 10

The following table highlights the number of nursing colleges/schools requiring various interventions and association.

Category	Number
Required replacement	24
Critical repairs	12
Serious repairs	36
Marginal repairs	50
Total	122

It is planned to revitalize all the 122 nursing colleges/schools within a four year revitalisation program with the special grant dedicated for this purpose with its cash flow projections.

QUESTION NO. 3601

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mrs H S Msweli (IFP) to ask the Minister of Health:

(1) Whether any officials in his department (a) have been investigated, (b) are currently under investigation and (c) have been charged for alleged (i) corrupt or (ii) fraudulent activity; if so, what are the relevant details;

(2) whether any disciplinary action has been taken against employees of his department for (a) fraud and/or (b) corruption; if so, (i) how many instances of disciplinary actions have (aa) been finalised and (bb) not been finalised and (ii) in each case, (aa) what sanctions have been meted out and (bb) how long has it taken to finalise such disciplinary actions;

(3) whether he has found that his department has adequate investigative capacity inclusive of manpower and infrastructure in respect of disciplinary proceedings; if not, why not; if so, what are the relevant details?

NW4378E

REPLY:

(1) (a) Yes.

(b) Yes, one (1) for fraud on travel bookings.

(ii) Yes, one (1) for fraud in resettlement cost & 2 (two) for fraud on travel bookings.

(2) (a) Yes

(b) Yes

(i) (aa) One (1);

(bb) One (1).

(ii) (aa) Dismissal;

(bb) Seven (7) months.

(3) The Department has no investigative and prosecutional capacity. However, we have commissioned a work study to determine the required capacity.

QUESTION NO. 3581

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mrs C Dudley (ACDP) to ask the Minister of Health:

Whether he has put safeguards in place to ensure the (a) integrity of donor vaccines and (b) protection of these vaccines against contamination (details furnished); if not, in each case, (i) why not and (ii) what action does he intend to take in this regard; if so, what are the relevant details in each case?

NW4356E

REPLY:

South Africa, through the Department of Health has received donated stock of 1,600,000 of pneumococcal conjugate vaccine which is part of the tender process as added value. The vaccine that is part of the company's tender bid is pneumococcal conjugate vaccine (PCV) 13 valent.

There is nothing which is peculiar to this donated stock of vaccines which does not apply to routine stock, normally purchased. All vaccines used in South Africa in the immunisation programme are WHO pre-qualified. Further, they have to be registered with the Medicines Control Council (MCC), here in the country. MCC looks at safety of the vaccines and all pharmaceutical products. To take further precautions as vaccines are special biological products, MCC requires that for each batch of vaccines that is released in the country (South Africa) further tests be conducted by the National Control Laboratory (NCL) in Bloemfontein on safety and on its viability. This process is conducted for each and every batch with no fail. These doses will be subjected to the same test as all routine doses and there is no separation or discrimination, all vaccines in the country have to undergo the same vigorous safety requirements.

QUESTION NO. 3559

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether he intends introducing legislation to compel cell phone manufacturers to place warning notices on the packaging of cell phones, similar to those on tobacco products (details furnished); if not, why not; if so, (a) when and (b) what are the further relevant details;

(2) whether any cell phone manufacturers and providers have given his department any guarantees that the use of cell phones are safe to use from a health perspective; if not, why not; if so, what are the relevant details?

NW4244E

REPLY:

(1) No, because the World Health Organization does not consider any adverse health effects to be caused by mobile phone use. The following quote is taken from an information document (Electromagnetic fields and public health: mobile phones) that was published in June 2011 by the World Health Organization: "To date, no adverse health effects have been established as being caused by mobile phone use."

The notion therefore of having a warning notice about some alleged health effect, without any confirmed scientific evidence to support such an action, should be regarded as rather frivolous at the very least, or worse even as downright irresponsible and alarmist.

(2) No, because the Department of Health has not requested any such guarantees. Instead the Department of Health takes its lead from the World Health Organization's International Electromagnetic Fields Project as being the most independent, scientifically sound and authoritative voice on the health effects of non-ionising electromagnetic fields. As indicated in (1) above, the World Health Organization does not consider any adverse health effects to be caused by mobile phone use.

QUESTION NO. 3558

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 40)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any progress has been made with the implementation of the Medicines and Related Substances Amendment Act, Act 72 of 2008, with specific reference to the SA Health Products Regulatory Authority (SAHPRA); if not, (a) why not and (b) by which date will the specified Act be fully implemented; if so, what aspects have been implemented;

(2) (a) what is the total cost of implementing the SAHPRA and (b) what amount has been allocated in the current budget for this purpose?

NW4226E

REPLY:

(1) (a) Approval for the establishment of SAHPRA has been secured from Cabinet. An Amendment Bill expanding on the definition of medicines, Medical Devices, In-Vitro Diagnostics, Food and Cosmetics will be published for comment after parliamentary processes have been finalized. Draft regulations on Complementary Medicines, Medical Devices, In-Vitro Diagnostics and some aspects of Food Control were published for public comment and comments are currently being analysed.

(b) It will be implemented as soon as parliamentary processes have been finalized.

(2) (a) The contribution of implementing SAHPRA over three years amounts to R10m. This amount is funded from Development Partners' contribution.

(b) R73 761 000.00 is allocated in the current budget (2011/12) of the Cluster: Pharmaceutical & Related Product Regulation & Management. There is no specific amount for the establishment of SAHPRA in the current budget. Work on the establishment of the new authority is undertaken within the framework of general operational plans.

QUESTION NO. 3540

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any cell phone manufacturers and providers have given his department any guarantees that the use of cell phones are safe to use from a health perspective; if not, why not; if so, what are the relevant details;

(2) whether he intends introducing legislation to compel cell phone manufacturers to place warning notices on the packaging of cell phones, similar to those on tobacco products; if not, why not; if so, (a) when and (b) what are the further relevant details?

NW4244E

REPLY:

(1) The Department of Health takes its lead from the World Health Organization's International Electromagnetic Fields Project as being the most independent, scientifically sound and authoritative voice on the health effects of non-ionising electromagnetic fields, and the Department therefore utilises this Project as its primary source of information and guidance on this and related subjects, rather than guarantees from manufacturers.

The following quote is taken from an information document (Electromagnetic fields and public health: mobile phones) that was published in June 2011 by the World Health Organization: "To date, no adverse health effects have been established as being caused by mobile phone use."

(2) No, I do not intend to do this. As was previously pointed out, the World Health Organization does not consider any adverse health effects to be caused by mobile phone use. The notion of having a warning notice about some alleged health effect, without any confirmed scientific evidence to support such an action, should be regarded as rather frivolous at the very least, or worse even as downright irresponsible and alarmist.

QUESTION NO. 3520

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr D A Kganare (Cope) to ask the Minister of Health:

(1) (a) How many minors attended prenatal clinics at health facilities during the period 1 March 2010 up to the latest specified date for which information is available, (b) which districts have reported the highest number of cases and (c) how many cases of statutory rape have been reported to the SA Police Service as a result;

(2) whether health workers are trained to handle these cases; if not, why not; if so, what are the relevant details?

NW4221E

REPLY:

(1) (a) Antenatal data routinely collected at health facilities is not disaggregated by age. However, survey date from the 2010 National Antenatal Sentinel HIV & Syphilis Prevalence report found 121 pregnant gilrs aged 10-14 years and 6,171 pregnant women between the ages of 15-19 years. Kindly note that the survey data was collected from a sample drawn from all provinces during October 2010.

(b) Not applicable.

(2) Yes, all health workers are trained to handle these cases. Prenatal or antenatal care training is ongoing and delivered as the BANC (Basic antenatal care) package. Over and above basic training, continuous in-service education is given to keep abreast with recent advances. The Department of Health is currently providing Comprehensive Management of Sexual Assault and Rape training in the various provinces.

QUESTION NO. 3509

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr S Z Ntapane (UDM) to ask the Minister of Health:

(1) Whether he has taken any steps to expedite the resolution of a certain case (name furnished) where the said person (name furnished) allegedly suffered brain damage at birth due to the negligence of staff members of a certain hospital (name furnished); if not, why not; if so, what (a) steps and (b) are the further relevant details;

(2) whether any disciplinary action was taken against these staff members; if not, why not; if so, what disciplinary action?

NW4208E

REPLY:

(1) There was no need for the Minister to take any steps because the matter was dealt with by the Gauteng Department of Health & Social Development. The matter was discussed in a court of law that concluded that 'The State' failed its duty to provide. This verdict was communicated to the CEO of Pholosong Hospital.

(2) No disciplinary action was required, because no member of staff was found to have been negligent.

QUESTION NO. 3465

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any employee of the Council for Medical Schemes (CMS) has received any salary increases in the (a) 2008-09, (b) 2009-10 and (c) 2010-11 financial years; if not, why not; if so, in each case, what (i) is the employee's name, (ii) position does the employee hold, (iii) was the percentage increase and (iv) is the employee's current annual remuneration package;

(2) who determines the salaries of CMS employees?

NW4082E

REPLY:

(1) (a) All employees of the Council for Medical Schemes (CMS) received general increases of 9%, 9% and 8% in 2008/09, 2009/10 and 2010/11 respectively. During 2008, the financial year of the Office changed to end at 31 March 2009 instead of December 2008. This led to a longer period before annual increase could be given and another general increase of 3% was approved by Council in 2008/09. In 2008/09 there were no promotions or other structural changes to remuneration;

(b) In 2009/10, structural adjustments to senior manager remuneration were made based on the results of an independent salary survey, whereby the salaries of all staff were benchmarked against that of other regulators, and regulated entities. Council did not accept the full recommendation of the independent consultants' recommendation, and agreed only to partially addressing the gap between the CMS officials and that of the benchmarks. This resulted therein that Council approved an average increase of 17% for ten (10) senior managers in the Office. Nine (9) staff members were promoted to more senior positions, and this resulted in an average increase of 19% for these employees;

(c) (i)-(iv) In 2010/11, there were no structural adjustments to remuneration for employees. Since 2010/11, top performers received an additional increase based on their performance. In 2010/11, a total of 52 of the 89 employees received a 1% increase. Specific detail of individual employees can be provided if requested. However, all staff has received increases during this period and it would be unfair to those individuals to have their salary packages made public knowledge. Executive remuneration is reported in the CMS annual reports as an additional disclosure note.

(2) Council determines and approves the salaries of CMS employees on the recommendation of the Council subcommittee on Human Resources.

QUESTION NO. 3464

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr M Waters (DA) to ask the Minister of Health:

Whether the Council for Medical Schemes (CMS) has approved the investigation of any medical schemes in (a) 2006, (b) 2007, (c) 2008, (d) 2009 and (e) 2010; if not, why not; if so, (i) which medical schemes and (ii) in each case, (aa) on which date (aaa) was the decision taken and (bbb) did the investigation start, (bb) who conducted the investigation, (cc) what were the terms of reference and (dd) what was the outcome?

NW4081E

REPLY:

The following table reflects the situation in this regard.

YEAR	SCHEME	DATE AUTHORIZED	DATE EXECUTED	BY WHO	TERMS OF REFERENCE	OUTCOME
2006	Resolution Health	March 2006	29 March 2006	Compliance Unit (CMS)	To investigate the fitness and propriety of the BoT and the contracts with the administrator, managed care organization and other service providers.	The accreditation of the administrator and managed care organization were withdrawn. New BoT was elected after the old BoT resigned. New administrator and managed care organization appointed. Old administrator and managed care organizations became dormant. Criminal charges laid with the then Scorpions. The criminal case is now with the Hawks – no developments.
2006	Bonitas	March 2006	15 March 2006	Compliance Unit (CMS)	Contract between scheme and an insurance company	Product offering cancelled. No further steps taken.
2007	Bonitas	17 October 2007	31 October 2007	Compliance Unit (CMS)	Alleged corruption regarding sponsorship of trips	Removed managing director of marketing company of scheme. Removed Chairman of BoT of scheme.
2007	Telemed	August 2007	20 August 2007	Compliance Unit (CMS)	Alleged irregular payments to brokers	Principal Officer dismissed. Marketing manager of scheme removed. Broker contract cancelled and accreditation removed.
2008	Sizwe	10 June 2008	10 June 2008	Compliance Unit (CMS)	Failure by scheme to submit annual report	Penalties and final warning
2008	Resolution Health	1 October 2008	6 October 2008	Compliance Unit (CMS)	Possible duplication of duties regarding service providers to the scheme.	See the inspection of Bonitas in 2006. The two inspection reports together finally lead to the withdrawing of the accreditation of the administrator and managed healthcare organization.
2009	Commed	June 2009	18 June 2009	Compliance Unit (CMS)	Fitness and propriety of BoT and administrator	Funeral cover programme stopped. Scheme instructed to investigate R14 million marketing contract awarded by previous Board of Trustees. Nothing found that impacted on fitness and propriety of current BoT and administrator.
2009	Bonitas	9 July 2009	July 2009	Private Forensic Investigator	Principal Officer Conflicts of interests Irregular payments	Principle Officer dismissed. Curatorship applications. Compliance officers at scheme appointed. BoT members resigned. Scheme to recover losses and lay criminal charges.
2010	Protea	2 July 2010	7 July 2010	Compliance Unit (CMS) and forensic company	Irregular payments, broker commissions, and conflicts of interests.	Scheme placed under curatorship and finally liquidated. Criminal charges will be laid.
2010	Commed	15 January 2010	15 January 2010	Private forensic Investigator	Marketing contract and various irregular payments by former Principal Officer of scheme and former BoT members	Criminal charges registered with Commercial Branch and Specialized Commercial Court Union – ongoing.
2010	Hosmed	29 June 2010	19 July 2010	Compliance Unit (CMS)	Irregular loyalty programme	Loyalty Programme cancelled. No further action as BoT members and Principal Officer involved no longer in office.
2010	Sizwe	27 May 2010	October 2011	Private Forensic Investigator	Irregular procurement by trustees and PO Improperly constituted BOT	The Inspection could not be finalised due to officers of the scheme being uncooperative.
2010	Fedhealth	March 2010	June 2010	Compliance Unit (CMS)	Contravening Regulation 8 of the Medical Schemes Act	Scheme complying

QUESTION NO. 3463

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 38)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether the Council of Medical Schemes (CMS) decided to investigate a certain medical scheme (name furnished); if so, (a) on what date was the decision taken, (b) when was the registrar informed of such a decision and (c) on what dates did the chairperson of the CMS and the registrar receive communication from the chairperson of the Portfolio Committee on Health;

(2) whether the (a) chairperson of the CMS, (b) registrar and (c) Chairperson of the Portfolio Committee on Health met at (i) OR Tambo International Airport or (ii) any other venue to discuss the investigation into the specified medical scheme; if so, in each case, (aa) on what date, (bb) at what venue, (cc) what was the purpose of the meeting and (dd) who else attended the meeting?

NW4080E

REPLY:

(1) (a) and (b) The Registrar instituted an investigation into Medshield on 09 February 2011. The Inspectors appointed for this assignment were Ernst & Young Advisory services Ltd, with Adv. James de Villiers acting as the lead inspector. The inspection could not be completed due to the misunderstanding on the terms of reference between the scheme and the CMS thus leading to the scheme's refusal to grant the inspectors access to the premises of the scheme.

(c) The Registrar and the chairperson of the CMS received communication on 6 June 2011 from the Chairperson of the Portfolio Committee on Health. This communication referred to a complaint by Medshield to Chairperson of the Portfolio Committee on Health about abuse of authority/power by the Council for Medical Schemes. The Chairperson of the Portfolio Committee on Health sought to mediate between the parties on the terms of reference for the inspection. Both parties could not reach agreement and CMS further resolved that the Chairperson and the Registrar meet the Chairperson of the Portfolio Committee on Health to inform him that CMS would no longer participate in the mediation initiatives between the scheme and CMS.The scheme apparently complained again to the Chairperson of the Portfolio Committee on Health that the CMS is abusing its power and the Chairperson of the Portfolio Committee on Health wrote to the Chair of Council and the Registrar on 11 October 2011 communicating those sentiments and requested that the matter be resolved. The Council then resolved on 27 October 2011 that the inspection proceed without any further delay. This resolution was actioned by the Registrar on 2 November 2011.

(2) The Chairperson of the CMS, the Registrar of the CMS and Chairperson of the Portfolio Committee on Health met on 22 June 2011 at Southern Sun, OR Tambo International Airport to discuss the scheme's complaint about the terms of reference for the CMS inspection into Medshield Medical Scheme and to explore possible alternative dispute resolution. The following persons attended:

(i) Dr. B Goqwana-Chairperson of the Portfolio Committee on Health;

(ii) Dr. M Gantsho-Registrar of the Council for Medical schemes;

(iii) Prof. W Pick-Chairperson of the Council for Medical Schemes;

(iv) Mr. S Mmatli-Head: Compliance & Investigations –Council for Medical Schemes;

(v) Mr. C Burton-Durham-Head: Legal Services-Council for medical Schemes

Medshield Medical Scheme

(i) Mr. T Mabeta- Chairperson of the Board of Medshield;

(ii) Ms. P Moiloa-Board member for Medshield;

(iii) Mr. B Sermony-Board member for Medshield;

(iv) Dr. M Wright-Board member for Medshield;

(v) Adv M. Hellens SC-Counsel for Medshield;

(vi) Adv. A Bezuidenhout-Counsel for Medshield;

(vii) Mr. M Versfeld-Attorney for Medshield;

(viii) Mr. M Tlali-Attorney for Medshield

QUESTION NO. 3423

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 36)

Mr I M Ollis (DA) to ask the Minister of Health:

(1) (a) How many copies of each annual report that was produced by (i) his department and (ii) the entities reporting to him were commissioned for print in the 2010-11 financial year, (b) how many copies were actually printed and (c) what were the (i) total and (ii) individual costs of printing these reports;

(2) (a) who printed each specified report, (b) how was the specified printer decided upon and (c) on what date did the specified printer deliver the report to the specified entity;

(3) whether any of the specified reports that had been printed were found to be unsatisfactory; if not, what is the position in this regard; if so, in each case, (a) which reports, (b) for which entity, (c) by which printer, (d) what action was taken and (e) what were the costs?

NW4109E

REPLY:

(1) (a) (i) The department commissioned the printing of 1 500 departmental annual reports.

(ii) The entities submit their Annual Report directly to Parliament, not through the National Department of Health.

(b) All 1 500 commissioned copies of the National Department of Health's Annual Report were printed.

(ii) The total cost for the printing of the Departmental's Annual Report was R210 875,00.

(2) (a) The service provider responsible for the printing of the Department's Annual Report was Tshepa Motheo 211 Trading.

(b) The printer was appointed by following normal procurement processes through the Supply Chain Management Directorate of the Department.

- 1 400 copies: on 12 October 2011.

(3) All annual reports printed were found to be of satisfactory quality and are in the process of being distributed.

(a) Not applicable for the National Department of Health.

(b) Information can be obtained directly from the entities.

(d) Not applicable.

(e) Not applicable.

QUESTION NO. 3409

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 36)

Mr J F Smalle (DA) to ask the Minister of Health:

Whether all state hospitals have contracts with service providers for the collection and transportation of deceased human remains; if not, (a) why not, (b) which state hospitals do not have such contracts and (c) what processes are in place to assist bereaved families with the collection and transportation of deceased human remains at hospitals where this service is not provided; if so, (i) which state hospitals provide this service and (ii) what are the further relevant details?

NW4094E

REPLY:

It should be understood that neither the burial of unidentified bodies nor the transportation of corpses from the hospital to the destination identified by the family is the responsibility of the Department of Health. The state hospitals carry these measures out of the desire to help.

There are state hospitals that have entered into contracts with service providers for the collection and transportation of deceased human remains.

(a) The families of the deceased use service providers to collect corpses from the hospital to arrange for burials;

(b) Hospitals in the following Provinces do not have such contracts: Eastern Cape, Gauteng, KwaZulu/Natal, Limpopo, Mpumalanga and Northern Cape. In North West there is a mixture of both;

(c) Hospitals have Forensic Pathology vehicles that collect corpses from the referral hospital and families use their own transport to collect and prepare for funerals. Hospitals use quotations to assist with the burial of unidentified corpses;

(i) State hospitals in the Free State, Western Cape and some hospitals in North West have signed contracts with service providers;

(ii) In the case of North West, the contract includes the collection of unclaimed bodies from the hospital, transportation to the grave side, coffin and burial.

QUESTION NO. 3373

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 NOVEMBER 2011

(INTERNAL QUESTION PAPER NO. 36)

Mr M Waters (DA) to ask the Minister of Health:

Whether he has received correspondence (details furnished) from Mr M Waters; if so, what are the relevant details?

NW3960E

REPLY:

Yes, correspondence was received with regard to the said person's circumstances, and it is receiving attention.

QUESTION NO. 3341

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2011

(INTERNAL QUESTION PAPER NO. 34)

Mr D A Kganare (Cope) to ask the Minister of Health:

(1) Whether his department has conducted any population-based surveys to determine how HIV prevalence varies according to (a) gender, (b) level of education and (c) location; if so, what were the findings; if not,

(2) whether he intends conducting such surveys, similarly to 30 other countries in sub-Saharan Africa; if not, why not; if so, (a) when and (b) what are the relevant details?

NW4002E

REPLY:

(1) No, the Human Science Research Council (HSRC) has conducted three population based surveys for surveillance of the HIV epidemic in South Africa. This was in 2002, 2005 and 2008. These surveys are known as the South African Behavioural, Serostatus Survey and Mass Media Impact Survey (SABSSM).

(a) Not applicable;

(b) Not applicable;

(2) No, the HSRC will conduct SABSSM 4 in 2012.

(a) Not applicable;

(b) Not applicable.

QUESTION NO. 3293
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2011
INTERNAL QUESTION PAPER NO. 34)
Ms E More (DA) to ask the Minister of Health: [*230] [Question submitted for oral reply now placed for written reply because in excess of quota [Rule 108(8)]]

(1) Whether his department has conducted any research to ascertain whether the quality of the equipment received by hospitals has had any impact on services; if not, why not; if so, (a) how was the research carried out, (b) what were the findings and (c) what steps have been taken in this regard;

(2) whether he has put any mechanisms in place to evaluate the quality of equipment that is procured for heavily burdened hospitals; if not, why not; if so, what mechanisms?

REPLY:

(1) No research has been conducted because equipment quality is assessed during the procurement phase using users specifications.

(2) The Medical Device Regulations that will soon be implemented will put in place a Post Market Surveillance Mechanism that would address quality issues such as Adverse Events related to medical equipment.

QUESTION NO. 3292
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 October 2011
[INTERNAL QUESTION PAPER NO. 35)
Ms E More (DA) to ask the Minister of Health: [*229] [Question submitted for oral reply now placed for written reply because in excess of quota [Rule 108(8)]]

(1) Whether any (a) multidrug-resistant tuberculosis (MDR-TB) and (b) extensively drug resistant tuberculosis (XDR-TB) patients who have been referred from the Prince Cyril Zulu Communicable Disease Centre in KwaZulu-Natal to the King George Hospital are awaiting admission to be isolated and treated; if so, (i) how many patients are on the waiting list and (ii) how long has each specified patient been awaiting admission;

(2) whether they are being accommodated by the State while they are awaiting admission; if not, (a) why not and (b) what is his department's plan of action in order to ensure that the specified patients do not infect their immediate families and the community at large during this waiting period; if so, (i) where are they being accommodated whilst awaiting admission and (ii) who cares for these patients during the period before admission?

REPLY:

(1) (a) There are MDR TB patients on waiting lists

(i) Four

(ii) Female - booked 25/Sept/2011 (31 days); Female - booked 27/Sept/2011 (29 days); Male - booked 17/0ct/2011 (11 days); Male – booked 21/0ct/2011 (7 days)

(b) There are no XDR-TB patients on waiting lists

(2) (a) All 4 patients are not currently admitted and stay at home pending arrangements for admission as beds are insufficient

(b) The patients and their families are counselled on home infection control (cough hygiene I ventilation - open window policy, and isolation from high risk family members such as children and those infected with HIV), and maintained on their normal TB treatment. The district is also trying to make arrangements to start patients' treatment in a alternative TB hospital, or directly via community based management. The province specifically is expanding decentralised MDR-TB management units (Doris Goodwin with 64 beds and Catherine Booth with 40 beds opened recently), increasing mobile injection teams (70 new teams established) and employing more personnel as part of the overall solution.

QUESTION NO. 3291

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 October 2011

(INTERNAL QUESTION PAPER NO. 35)

Mrs C Dudley (ACDP) to ask the Minister of Health:

(1) Whether, in view of the serious problems that were identified in the Auditor-General's report, measures are being implemented to ensure the monitoring of construction sites; if not, what is the position in this regard; if so,

(2) whether the measures include the employment of engineers and technical assistants in his department; if not, why not; if so, how will he ensure that they access the requisite skills?

NW3912E

REPLY:

(1) The National Department of Health (NDOH) has already put a plan in place to remedy the situation.

(2) The challenges of capacity to deliver in the provinces were reviewed and each province was requested to appoint a Resident Engineer, who will look after the provincial infrastructure issues. Currently, five provinces already have engineers in place, namely Eastern Cape, Free State, KwaZulu/Natal, Gauteng and the Western Cape. The NDOH has also appointed a Project Management Support Unit (PMSU) to capacitate the NDOH and also assist provinces on the delivery of the infrastructure projects. The cash flow in all provinces were reviewed and provinces were asked to bring other priority projects if there are challenges that might take long to resolve on the existing projects.

QUESTION NO. 3288

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 October 2011

(INTERNAL QUESTION PAPER NO. 35)

Mr M Waters (DA) to ask the Minister of Health:

(a) When does he envisage that the diagnosing of Foetal Alcohol Syndrome (FAS) at birth will commence, (b) which areas will be targeted first and (c) what criteria will be used to determine which babies are to be tested?

nNW3851E

REPLY:

(a) The diagnosis of fetal alcohol syndrome (FAS) at birth has always been part of standard medicine management of pregnant women.

(b) Fetal alcohol syndrome can occur anywhere as long as the mother was heavily ingesting alcohol during pregnancy. While it is more prevalent in the Northern Cape and Western Cape, diagnosis has to be made anywhere for any women with history of heavy ingestion.

QUESTION NO. 3286

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 October 2011

(INTERNAL QUESTION PAPER NO. 35)

Mr M Waters (DA) to ask the Minister of Health:

Whether his department applied for funding for the South African Demographic and Health Survey since the 2007-08 financial year; if so, in each case, (a) on which dates, (b) what amount was requested and (c) what was the response from the National Treasury?

NW3811E

REPLY:

Yes.

(a) The National Department of Health applied for funding for the South African Demographic and Health Survey on the 18 September 2009.

(b) R51 million.

QUESTION NO. 3285

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 October 2011

(INTERNAL QUESTION PAPER NO. 35)

Mr M Waters (DA) to ask the Minister of Health:

(1) With reference to his replies to questions 2090 and 2099 on 15 September 2011, (a) how many application for accreditation as nursing education institutions have been received since 1 January 2011, (b) in which provinces are they situated, (c) which aspects of the minimum requirements did they fail to meet and (d) what are the minimum requirements for accreditation as nursing education institutions;

(2) whether his department has conducted inspections of the existing nursing institutions since 1 January 2011; if not, why not; if so, (a) which nursing institutions and (b) in which provinces are these nursing institutions situated;

(3) whether any of these existing nursing institutions have failed to meet the specified minimum requirements; if so, (a) which nursing institutions, (b) which aspects of the minimum requirements did they fail to meet and (c) what action has his department taken in respect of each of these specified nursing institutions?

NW3810E

REPLY:

(1) (a) 173 applications received to open a new private nursing school,

(b)

PROVINCE	NUMBER OF APPLICATIONS
EASTERN CAPE	22
FREE STATE	1
GAUTENG	24
KWAZULU-NATAL	24
LIMPOPO	22
MPUMALANGA	5
NORTHERN CAPE	0
NORTH WEST	9
WESTERN CAPE	8
UNSPECIFIED APPLICATIONS	58

(c) All applicants have to adhere to guidelines relating to opening new private nursing education institution and forward the South African Nursing Council with completed documents with the set criteria, e.g. they fail to secure permission from provincial Departments of health and service level agreement with Chief Executive Officers (CEO,s) of hospitals for placement for experiential learning which is a requirement for student training.

(d) The minimum requirements for accreditation as nursing education institution are as follows:

A. CURRICULUM DEVELOPMENT

Details required:

· Name of institution

· Vision

· Mission

· Programme

· Title of the Qualification

· Applicable Regulation

· Sub Field

· NQF Level

· Motivation for the proposed programme(s)

· Duration of the course:

· Full Time / Part Time

· Mode of Instruction:

· Centralized

· Decentralized

· Contact

· Distance learning

· A statement of the purpose of the qualification

· Assumptions of learning already in place

· Entry requirements

· Proposed number of pupils /students per intake

· Proposed number of intakes per year

· Programme objective / Exit level outcomes according to SANC relevant regulations and the associated assessment criteria

· Critical cross-field outcomes and the associated assessment criteria

· Summary of subjects and include:

· Minimum credits required at specific level

· For theory – convert SANC periods into notional hours and credits

· For practical – convert practical hours into credits

· Add both theoretical and practical credits to get;

· Total credits / weighting required

· Subject content

· Integrated assessment appropriately incorporated to ensure that the purpose of the qualifications is achieved

· Articulation possibilities with other qualifications

· Criteria for the registration of assessors

· Moderation options including the recommendation of a moderating body / bodies i.e. Internal or external

· International comparability

· Human Resources

· Names and qualifications of persons responsible for programme

· Theory and clinical accompaniment

· Teaching and learning resources

· Clinical learning objectives/outcomes

· Psycho social support for staff and learners

· Indemnity

· Annexures: Master plan spreading both theoretical and clinical learning opportunities over total programme, programme time table for one week only, structured academic support for weak students/pupils, examination / Assessment Policy where applicable, sample of test / memorandum, Clinical evaluation tool, disciplinary Code, learner/student contract, governing structure where applicable, name of authorized person indicating qualification, contact details and signature of such a person.

B. CRITERIA FOR APPROVAL

· An application for accreditation of each programme should be accompanied by an application for accreditation of the clinical facilities (off-site practice areas) that an institution intends using for placement of students/pupils.

· Cognisance should be taken of the following criteria applied by the
Council for the approval of a clinical/additional clinical facility:

· The application for approval should be submitted to the Council by the approved nursing education institution (NEI) prior to the placement of students/pupils in the proposed clinical/additional clinical facility

· Retrospective approval of clinical facilities will not be granted.

· The period for which students have been placed at a clinical facility that has not received prior approval, will not be recognized by this Council.

· Approval of a clinical facility is granted for a specific programme for a particular NEI. Automatic blanket approval for any programme for a particular NEI is not accommodated.

· A situational analysis of each clinical facility based on the norms and standards of the facilities must be carried out by the school and submitted to the Council.

· The situational analysis should, among others, include:

· Identity details of the facility (Name, physical address, postal address, telephone numbers and e-mail address)

· Geographical location and specific distance from the Nursing Education Institution

· Bed capacity of the facility and of each unit (exclude for clinics)

· Bed occupancy i.e. total and per unit (exclude for clinics)

· Human resource (nursing) according to approved filled and vacant posts

· Medical and other support staff according to approved filled and vacant posts

· Security system

· Relevant clinical learning opportunities for the particular programme

· Disease profile

· Names, SANC reference numbers and professional qualifications of clinical accompanists

· Other NEI's utilizing the facility for placement of students including programmes and number of students per programme

· A copy of the final agreement between school and the facility.

· The agreement should specify: Name of nursing school, name of clinical facility (ies), name of the programme(s)

· Terms of reference: indicating the responsibilities of the nursing education institution and responsibilities of the clinical facilities

· Names and qualifications of clinical accompanists according to relevant disciplines

· Indemnity cover for learners

· Number of pupils/students per placement and per programme (per programme means on a twelve hour shift and refers to the same pupils/students)

· Duration of placement

· Termination clause

· Signatures of authorized persons and dates

· Official stamps of each institution

· Each and every page of the memorandum of agreement should be initialled by both parties, depending on the volume of the document

· In the event of the alternative clinical facility not being an approved facility, the same application procedure should be followed in order to obtain approval.

· The full name(s), identity number, SANC reference number and professional qualifications of the person(s) responsible for the structured clinical guidance and the clinical accompaniment, as well as the number of students/pupils each preceptor is responsible for, should be submitted by the NEI at the time of application to the Council, whenever there is a change in the staff structure annually, for as long as the clinical facility is to be used by the NEI.

· Documented evidence of clinical accompaniment must be kept for all basic, supplementary basic and post basic nursing education and training programmes.

· The Council has the mandate to visit all facilities where students/pupils are placed for clinical practical at any time. The Council may also interview students and personnel during such an accreditation visit

D. MEMORANDUM OF AGREEMENT/FORMAL AGREEMENT OF CO- OPERATION BETWEEN THE NURSING EDUCATION INSTITUTIONS AND CLINICALFACILITIES ON CLINICAL PLACEMENT OF LEARNERS

· Name of nursing School

· Name of clinical facility (ies)

· Name of programme(s)

· Terms of reference

· The responsibilities of the nursing education institution

· Clinical accompaniment of learners by the NEI. Full time/part time clinical accompanists employed/contracted. If contracted clinical accompanists are rendering the service, indicate the number of hours spend per week with the learners as per contract.

· Names and qualifications of accompanists

· Reference number(s) of the accompanists

· The responsibilities of the clinical facilities

· Indemnity cover for learners

· Number of learners per placement and per programme (per programme means on a twelve hour shift and refers to the same learners without breaking a day/night into shift)

· Duration of placement

· Termination clause of the contract between the NEI and the (circumstances) clinical facility(ies)

· Signatures of authorized persons and dates

· Official stamps of both institutions with dates

· Every page of the memorandum of agreement should be initialled by both parties

· Nursing Education Institutions placing learners at the clinical facilities

· Programme

· Number of learners per programme

(2) Inspections were conducted in the all provinces.

(3) (a) Nursing institutions that have failed to meet the specified minimum requirements

· North West University: Potchefstroom campus

· Henrietta Stockdale Nursing College

· Open Learning Academy of Nursing

(b) Aspects of the requirements not met

North West University: Potchefstroom campus

Students undergoing a programme in Clinical Nursing Science, Health Assessment, Treatment and Care (Primary Health Care Nursing)

Identified gaps were:

· Students are practicing in clinical facilities that are not accredited by SANC

· Students are not accompanied by the nursing education institution staff

· Students have to identify their own mentors to guide them during clinical exposure

Students undergoing a programme in Diploma in nursing (general, psychiatry, community) and Midwifery)

Identified gaps were:

· Theoretical instructions were conducted in an area where there were no adequate learning materials such as study guides, library materials and the quality of assessment

· Insufficient clinical facilities

Open Learning Academy of Nursing

Students undergoing a bridging programme of an enrolled nurse leading to registration as a general nurse

Identified gap were:

· There was no clear indication about ownership of the nursing education institution as this was approved as a joint venture between University of Zululand and a private person and that relationship was broken as a founder retired because leadership was left to principal of the school.

· Clinical placement of students were in clinical facilities where there was no service level agreement between nursing education institution and CEO's of the clinical facilities

North West University: Potchefstroom campus

Students undergoing a programme in Clinical Nursing Science, Health Assessment, Treatment and Care (Primary Health Care Nursing)

It was decided that:

· The nursing education institution submit a situational analysis for approval by SANC and students on the pipeline to be placed only in clinical facilities that are accredited

· No intake of students until the matter is resolved

· Pipelines students to write a SANC examination in order to be registered for the above mentioned Programme

· Three monthly progress reports to be submitted to SANC by the nursing education institution

Henrietta Stockdale Nursing College

Students undergoing a programme in Diploma in nursing (general, psychiatry, community) and Midwifery)

· It was decided that:

· The nursing education institution to work on identified gaps in order to offer quality nursing education

· No intake of students until the matter is resolved

· Pipeline students to continue with their training

· Three monthly progress reports to be submitted to SANC by the nursing education institution

Open Learning Academy of Nursing

Students undergoing a bridging programme of an enrolled nurse leading to registration as a general nurse

It was decided that:

· There must a clear declaration under which ownership does the nursing education institution operate.

· No intake of students until the matter is resolved

· Pipeline students to continue with their training

· Three monthly progress reports to be submitted to SANC by the nursing education institution

QUESTION NO. 3184
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 October 2011
(INTERNAL QUESTION PAPER NO. 33)
Mr L W Greyling (ID) to ask the Minister of Health:

What amount in orders has been placed, with each specified travel agency that has been contracted by his office, (a) in the 2010-11 financial year and (b) during the period 1 April 2011 up to the latest specified date for which information is available?NW3743E

REPLY:

No orders were placed by the office of the Minister since no contract was entered into with any travel agent by his office.

The office of the Minister utilizes the Departmental travel agency contract.

(a) In the 2010-11 financial year, during the period 01 April 2010 to 31 August 2010, Travel with Flair travel agent was used and the Minister's portion amounted to R783 562.02. The amount includes foreign and domestic flights; accommodation and service fees.

From 01 September 2010 to 31 March 2011, BCD Connex was used by the Department and the Minister's portion amounted to R360,391,19. The amount includes foreign and domestic flights; accommodation and service fees.

(b) During the period 01 April 2011, BCD Connex was used by the Department and the Minister's portion amounted to R165 991.00. The amount includes foreign and domestic flights; accommodation and service fees.

From 01 May 2011 till 31 October 2011, Duma Travel was used by the Department and the Minister's portion amounted to R734 601.74. The amount includes foreign and domestic flights; accommodation and service fees.

QUESTION NO. 3173

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 October 2011

(INTERNAL QUESTION PAPER NO. 33)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether a system to (a) monitor and (b) measure the levels of responsiveness, particularly regarding (i) the treatment of patients with dignity, (ii) confidentiality, (iii) ensuring a prompt response time and (iv) promoting autonomy for persons, will be implemented under the National Health Insurance (NHI); if not, why not; if so, what are the relevant details;

(2) whether any guidelines will be put in place to ensure a health care system that is responsive to the wants and needs of patients, particularly regarding ensuring dignity, confidentiality, a prompt response time and promoting autonomy for persons; if not, why not; if so, what guidelines will be put in place under the NHI to prevent (a) maltreatment, (b) discrimination and (c) abuse of patients in the public sector?

NW3529E

REPLY:

(1) It is not possible at this stage to give details of monitoring or assessment systems to be implemented under NHI, as this process is at an early stage of piloting to determine the best models of delivery. However systems that already exist to monitor the concerns raised such as the review of patient complaints and the use of patient satisfaction surveys will certainly continue to be used. The National Core Standards do cover respect for patients' dignity, confidentiality, waiting times and provision of information and informed consent; and the audit tool is already being used to assess current practice; external inspections by the Office of Health Standards Compliance will reinforce the measurement of these aspects in the future.

(2) A discussion of specific new guidelines to be produced under the NHI is rather premature; however the Patient Rights Charter that is already in place does cover the concerns raised as do the National Core Standards which are already being disseminated across the health services. The future Office of Health Standards Compliance is also envisaged to have a strong role in investigating breaches of such guidelines through the investigation of complaints or incidents that come to its notice.

QUESTION NO. 3172

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 October 2011

(INTERNAL QUESTION PAPER NO. 33)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any studies have been conducted to assess the level of (a) responsiveness in the health sector, (b)(i) dignity and (ii) confidentiality in treatment of patients, (c) prompt response times and (d) the promotion of autonomy for persons in the public health sector; if not, why not; if so, how are these levels measured;

(2) whether there are any guidelines for health care workers to ensure treatment of patients conform to levels of dignity, confidentiality, promptness and promotion of autonomy; if not, why not; if so, what guidelines are in place to prevent (a) maltreatment, (b) discrimination and (c) abuse of patients in the public sector?

NW3528E

REPLY:

(1) (a)-(d) No, there are no studies conducted. The Public Service Commission (PSC) has process and tools to monitor government departments' performance on the 8 Batho Pele principles.

(2) (a)-(c) The guidelines that are in place are the Batho Pele Principles which are more comprehensive and cover components of responsiveness of the health system. To recap the principles are: 1) consultation 2) service standards 3) access 4) courtesy 5) information 6) openness and transparency 7) redress and 8) value for money. This is done in order to ensure objectivity in the measurement as the department cannot be the referee and a player at the same time.

QUESTION NO. 3171

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 October 2011

(INTERNAL QUESTION PAPER NO. 33)

Mr M Waters (DA) to ask the Minister of Health:

Whether studies have been conducted to establish whether the private health sector is directly taking resources away from the public health sector; if not, on what evidence was this stated in the National Health Insurance Green Paper based; if so, (a) who conducted the studies and (b) what were the findings?

NW3527E

REPLY:

The Department of Health is not aware of any such studies being conducted. However, analyses have been undertaken in the past by the Health Economics Unit at the University of Cape Town where it was shown that the number of key health professionals such as specialists, doctors, pharmacists and nurses to patients served were significantly higher in the private health sector compared to those in the public sector. The gap in the number of providers to patients has relatively improved in the past 5 years as a result of some key interventions by the Department. Nonetheless the disparities remain large and are a reflection of the fragmentation and resource inequities between the two sectors.

QUESTION NO. 3138
Ms. N P Gcume (Cope) to ask the Minister of Health

(1) Whether he has been informed about the medical treatment of a girl (name furnished) who was admitted to St Elizabeth Hospital and thereafter referred to Bedford Hospital in Umtata in the Eastern Cape after she broke her leg in a motor vehicle accident and after which doctors at the hospital joined her leg at the femur with a nail; if so what are the relevant details; if not,

(2) Whether he will investigate the matter; if not, why not: if so what are the relevant details? NW3663E

REPLY

(1) The Minister has not been informed of the incident mentioned in part (1) of the Parliamentary Question.

(2) After receiving the Parliamentary Question, the Minister has written to the Member of the Executive Committee for Health in the Eastern Cape, Mr Sicelo Hamilton Gqobana to investigate the matter, take all necessary steps to address the same and report back to him so that he can in turn report back to Parliament.

QUESTION NO. 3053

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Ms M Smuts (DA) to ask the Minister of Health:

(1) Whether (a) he, (b) the Deputy Minister and (c) any senior officials of his department intend to visit or have visited New Zealand during the 2011 Rugby World Cup Tournament; if so, what is the (i)(aa) name, (bb) rank and (cc) position or designation of each specified person accompanying (aaa) him, (bbb) the Deputy Minister and (ccc) each specified senior official and (ii)(aa) nature and (bb) official reason for the visit;

(2) what (a) total amount will be spent or has been spent on the trip and (b) is the (i) description and (ii) detailed breakdown of the amounts that will be spent or have been spent on (aa) accommodation, (bb) travel and (cc) subsistence costs?

NW3575E

REPLY:

(1) (a)-(c) No, there were no such visits by the persons listed.

(i) Not applicable;

(ii) Not applicable.

(2) Not applicable.

QUESTION NO. 3010

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Dr A Lotriet (DA) to ask the Minister of Health:

(1) Whether (a) his department and (b) any entity reporting to him was approached by a certain political organisation (name furnished) to contribute to its 66^th birthday celebrations; if so, in each case, (i) which entities and (ii) what was the (aa) nature and (bb) value of the contribution that was requested;

(2) whether (a) his department and (b) any of the specified entities reporting to him agreed to the request; if not, what is the position in this regard; if so, in each case, (i) who approved the request, (ii) what was the justification for the agreement to the request and (iii) from which budget will the contribution be paid;

(3) whether (a) his department and (b) any of the specified entities reporting to him made financial contributions to the said political organisation without being approached for such financial contributions; if so, in each case, (i) what amount will be contributed, (ii) from which budget, (iii) who made the decision to provide the specified funds to the said political organisation and (iv) how is this (aa) decision and (bb) amount justified;

(4) whether (a) his department and (b) any of the entities reporting to him rely on any (i) statutory and (ii) policy provisions in (aa) agreeing and (bb) making such contribution; if not, in each case, what is the position in this regard; if so, in each case, what are the relevant details?

NW3494E

REPLY:

(1) (a) The National Department was not approached by any political party to contribute to its 66^th birthday celebrations.

(i) Not applicable;

(ii) Not applicable.

(2) Not applicable.

(3) Not applicable.

(4) Not applicable.

QUESTION NO. 3007

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Dr P J Rabie (DA) to ask the Minister of Health:

(1) With reference to his reply to question 361 on 15 March 2011 and question 1766 on 23 August 2011, (a) what progress has been made with regard to the (i) drunk driving alcohol, (ii) post-mortem alcohol, (iii) toxicology and (iv) food analysis backlog at each specified forensic chemistry laboratory (FCL) and (b) how long will it take to eliminate each category of backlog at each FCL with the current staffing levels;

(2) whether there are any vacancies at any of the FCLs; if so, in each case, (a) how many, (b) in what category of work and (c) how long has each post been vacant;

(3) whether any additional funding has been allocated to any of the three FCLs in the (a) 2008-09, (b) 2009-10 and (c) 2010-11 financial years; if not, (i) why not and (ii) how much has been requested in each case; if so, how much in each case;

(4) whether the Johannesburg FCL is fully operational after the renovations to their laboratory; if not, (a) why not and (b) when is it anticipated that they will be fully operational; if so, (i) on what date did they become fully operational, (ii) on what date were the renovations completed, (iii) what were the final costs of the renovations and (iv) what action has been taken against the initial contractor who deserted the site?

NW3491E

REPLY:

(1) (a) Blood alcohol

In the Cape Town FCL the blood alcohol backlog (both ante and post mortem) has increased due to preparations and training for the SANAS Technical Signatory assessment that was done in September 2011. The lack of technical signatories was still impacting on the output in October, but should start improving within the next two months. Only SANAS certified technical signatories are allowed to sign reports containing the SANAS Logo. The FCL Cape Town only has four technical signatories currently performing ante-mortem drunken driving analysis, and four who are awaiting final SANAS approval before they could become operational.

The Post-mortem blood alcohol backlog in the Pretoria FCL has decreased to 2711 in November when compared to 3856 in September 2011, but the ante-mortem backlog has slightly increased in the same period, as they have experienced some equipment breakdowns which have now been repaired and output will improve.

In the Johannesburg FCL there was a decrease in the post-mortem blood alcohol backlog from 10225 in September 2011 when work has commenced after the renovations, to 7022 in November 2011. Overtime was effected as of September 2011.

Toxicology

In Cape Town FCL the Toxicology backlog has shown a decrease from 3 963 in August 2011 to 3688 in November 2011. This can be attributed to overtime being worked by analysts.

In the Pretoria FCL there was a slight increase when compared to August 2011 due to the fact that 22 new analysts are currently in training, decreasing the output of senior staff that conducted the training. The output will start improving from January 2012 when the training is scheduled to be completed.

The Johannesburg Toxicology backlog has decreased from 7678 in August 2011 to 7612 in November 2011. Toxicology analyses only resumed in October 2011.

Food

The Food analysis backlog has decreased from 772 in August to 622 in September 2011 in the Cape Town FCL.

Commencing in September the Pretoria laboratory has showed a decrease in the backlog from 427 in September to 191 in November 2011. With overtime measures implemented on 22 October it is expected that the backlog will further decrease.

(b) In the Johannesburg FCL the ante and post mortem alcohol backlog should be worked down by September 2012 and the toxicology backlog by September 2013. In the Pretoria FCL ante and post mortem alcohol backlog should be worked down by March 2012 with toxicology backlogs worked down by September 2013. The Cape Town FCL should have worked down the ante and post mortem alcohol backlogs by July 2012 and toxicology by October 2013.

Yes. The response for (a), (b) and (c) is summarised below as at 30 November 2011:

FCL Johannesburg
a) How many	b) In what category of work	c) How long has each post been vacant
0	Not applicable.	Not applicable.

FCL PRETORIA
a) How many	b) In what category of work	c) How long has each post been vacant
1	Level 12 Head of Laboratory (Deputy Director)	Since May 2011. Post was advertised (closing date was 22 August 2011). No suitable candidates could be short-listed. Has been re-advertised.

FCL CAPE TOWN
(a) How many	(b) In what category of work	(c) How long has each post been vacant
1	Level 10: Head of Blood Alcohol (now Assistant Director on OSD level)	01 March 2011. Inter-views were held on 21 November 2011.
2	Level 9 forensic analysts (now Chief Forensic Analysts on OSD level)	1 existing post and 1 newly created post. Both posts advertised on the 23 October 2011 and closing date 21 November 2011.
10	Level 8 forensic analysts (now Forensic Analysts on OSD level)	Interviews for these newly created posts were conducted on the 7-11 November 2011.
1	Level 6 forensic analysts (now Forensic Analysts on OSD level)	01 August 2011. Interviews were conducted on the 7-11 November 2011.
1	Specialized Auxiliary Services Officer, previously level 4, now upgraded to level 6	01 February 2011. Interviews were conducted on the 7-11 November 2011.

(3) (a) Yes, additional funding has been received. A total budget of R32,303,000 has been allocated by Treasury in 2008/09 in comparison with R26,930,000 that was allocated in 2007/08.

(b) Yes, additional funding has been received. A total budget of R35,259,000 was allocated by Treasury in 2009/10.

(4) (a) Yes, the Johannesburg FCL is fully functional.

(b) N/A

(i) See above.

(ii) 31 May 2011 excluding the snag-list.

(iii) R28,675,191.

(iv) The Department of Public Works has initiated legal action against the contractors.

QUESTION NO: 2996
Mrs SP Kopane (DA) to ask the Minister of Health:

1) Whether his department has developed regulations for reducing salt in all foods; if not, (a) when were the regulations completed, (b) what maximum levels of salt will be allowed in foods and (c) when will the regulations come into effect?

REPLY:

No regulations have as yet been developed with regard to reducing salt in all foods.

a) The process for developing regulations is well under way and these will be published as soon as scientific and technical processes being undertaken in the Department have been finalised. A technical Committee convened by the Department has already obtained international benchmarks and norms as well as feedback from major local industry stakeholders and will be meeting before the end of this month to recommend the specific salt content that should be permitted in different foodstuffs that have been identified as the major products through which South African's consume salt.

South Africa has received extensive national and international support for reducing salt content in processed foods. At a summit I hosted on the Prevention and Control of Non-communicable Diseases in September this year all stakeholders agreed to work together to reduce salt intake from current levels of 7.8 grams per day in black people, 8.5 grams per day in those of mixed race, and 9.8 grams per day in whites to an average intake of less than 5 grams per day for all groups by 2020. This is in line with World Health Organization targets for salt intake. Moreover the need to reduce salt content in food was highlighted at the High Level meeting of the General Assembly of the United Nations on Non-communicable Diseases, also held in September, where salt reduction was adopted as one of the key strategic objectives for prevention of premature death and illness from non-communicable diseases worldwide. The Director-General of the World Health Organization specifically congratulated South Africa on setting defined targets for, amongst other objectives, reduction of salt in food.

b) Salt intake will be reduced from current levels of 7.8 grams per day in black people, 8.5 grams per day in those of mixed race, and 9.8 grams per day in whites to an average intake of less than 5 grams per day for all groups by 2020. This is in line with World Health Organization targets for salt intake

c) Regulations are in the process of being developed and publication for public comment is expected within the current financial year.

QUESTION NO. 2995

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mrs S P Kopane (DA) to ask the Minister of Health:

Whether he intends taking steps to provide foetal alcohol syndrome (FAS) testing at birth (details furnished); if not, why not; if so, (a) when will the diagnosing of FAS at birth commence, (b) in which areas will implementation start and (c) what criteria will be applied in this regard?

NW3479E

REPLY:

(a) The diagnosis of fetal alcohol syndrome (FAS) at birth has always been part of standard medicine management of pregnant women.

QUESTION NO. 2994

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mrs P C Duncan (DA) to ask the Minister of Health:

With reference to his reply to question 2197 on 3 November 2010, (a) why does the Free State still not have a helicopter for emergency services that can fly at night, since the previous contract for helicopter services expired in May 2011 and (b) for what period has the Free State not had access to a helicopter for emergency services that can fly at night?

NW3478E

REPLY:

(a) The current contract comes to an end on 31 December 2011 and the Free State Department of Health has planned towards the implementation of a twenty-four hour aeromedical service for the Province when the new contract is introduced.

(b) The Free State Department of Health has not had a twenty-four hour service since the inception of the aeromedical service in 2008. A twenty-four hour aeromedical service would have come to a substantial cost for the Province and therefore it could not be implemented in the current contract.

QUESTION NO. 2993

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) Whether any health institutions have terminated contracts in the (a) 2008-09, (b) 2009-10 and (c) 2010-11 financial years with agencies to which services have been outsourced; if so, (i) which health institutions, (ii) in which province are they situated, (iii) what was the nature of the service in each case, (iv) how many people were employed by the agency in respect of the outsourced service and (v) what was the value of the outsourced service;

(2) whether any of the specified health facilities employed any additional staff members once the contract with the outsourced agency had been terminated; if so, (a) how many were employed, (b) how many were employed from the affected agency whose services were terminated and (c) what is the cost of providing the service in-house in each case?

NW3477E

REPLY:

(1) In terms of construction of health facilities 210 contracts were cancelled in 2010/11 financial year. The analysis from October 2011 report from Infrastructure Reporting Model (IRM) shows that 87 contracts were also cancelled by the provincial office. The table below shows the number of contracts cancelled, name of the province, the Implementing Agent involved and the location of the facility. The number of the people employed under these facilities will be provided to the honorable member as soon as it is available.

(2) The information regarding whether the facilities employed additional staff when the contract was outsourced to an agency will also be provided to the Honourable Member as soon as it will be received from the facilities.

The table here provides details from the provinces listed: www.pmg.org.za/questions/2993-table.doc

QUESTION NO. 2991

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mr M Waters (DA) to ask the Minister of Health:

Whether he has identified any of the proposals contained in the Green Paper on the National Health Insurance (NHI) to have constitutional implications; if so, (a) which aspects in particular and (b) in relation to which sections of the Constitution of the Republic of South Africa, 1996?

NW3475E

REPLY:

Yes.

(a) Under the principles of National Health Insurance (NHI), access to health as a right is invoked;

(b) Section 27 of the Bill of Rights.

QUESTION NO. 2990

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mr M Waters (DA) to ask the Minister of Health:

(1) With regard to the reengineering of the health care system and the ward based teams, (a) how many ward teams will be established, (b) what formula will be used to determine the size of each ward team, (c) how often will they be required to visit each household, (d) what qualifications will they be required to have and (e) how will these teams be monitored;

(2) whether there is a current shortfall in the number of health professionals needed to complete the specified ward teams; if so, (a) in which category of health professionals, (b) how many in each case, (c) how long will it take to train the required number of health professionals in each case, (d) how will this be achieved and (e) on what date will each team commence with their duties?

NW3474E

REPLY:

(1) (a) As many as there are wards;

(b) We will initially start with 10 per ward;

(c) The frequency of the visits of Primary Health Care (PHC) outreach teams will be performed by the health needs of each household and therefore different households will be visited at varying intervals;

(d) Professional nurses as team leaders of PHC outreach teams require a qualification in nursing and be recognised as such by registration with the South African Nursing Council (SANC). Community health workers attend any recognised training programme, for example 59-69 day training programme and any training meeting requirements of National Qualification Framework levels 1-4.

(2) (a) and (b) Yes of course, there is always a shortage of any type of health worker in the whole continent;

QUESTION NO. 2989

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mr M Waters (DA) to ask the Minister of Health:

(1) With reference to the reengineering of the health care system and the district based model, how many districts are there currently in the public health care system;

(2) whether he intends to create any additional districts; if not, why not; if so, (a) how many, (b) when will they be created and (c) in which areas will they be created;

(3) with reference to the team of five specialists or clinicians that will be deployed in each district, (a) how many (i) principal (aa) obstetricians, (bb) paediatricians and (cc) family physicians, (ii) advanced midwives and (iii) senior primary care nurses are there currently in the public sector and (b) what is the current shortfall of staff in each specified category in the public sector in order to ensure that each district has a full team;

(4) (a) where will each team be based, (b) on what date will each team commence with their duties and (c)(i) what is the size of the population in each district and (ii) how were these figures derived in each case?

NW3473E

REPLY:

(1) We are referring to the municipal districts not necessarily health districts.

(2) Municipal districts are not created by the Minister of Health.

(3) (a), (b) The establishment of these teams should not depend only on what is in the public sector and within the country only.

(4) (a) Each team will be based in any public health facility which is convenient within a district;

(b) The teams will commence with their duties when the recruitment process is concluded;

QUESTION NO. 2988

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 October 2011

(INTERNAL QUESTION PAPER NO. 31)

Mrs S V Kalyan (DA) to ask the Minister of Health:

Whether principals of state hospitals are allowed to run a private practice during working hours; if so, what are the relevant details; if not, why does a certain principal (name and details furnished) operate a private practice and book beds at two private hospitals (names furnished)?

NW3472E

REPLY:

The full time equivalent (FTE) employees have to get approval before they can do remunerative work outside the public service (RWOPS) in line with existing policy. The policy on RWOPS, clearly stipulates that an official should seek the permission of the Head of the Department (HOD) and receive written approval before they can do work outside the public service.

In the event that an employee does not get approval from the HOD but engages in RWOPS they are breaching their terms of service. This is a serious transgression which has to be followed by the institution of appropriate disciplinary measures.

However, if approval is granted, it is based on the principle that the work will be done after the normal working hours of the employee. However, if the work is performed during the stipulated "normal working" hours based on the Basic Condition of Employment, this is also a transgression which needs disciplinary action as necessary.

If an employee is not a full time equivalent (FTE) or is on a sessional appointment, the contractual agreement becomes the basis for the dispute. In general, for this type of arrangement there is no transgression unless proven otherwise.

QUESTION NO. 2932

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs J F Terblanche (DA) to ask the Minister of Health:

Whether, considering the potential risks that babies or young children face through opportunistic infections, there are specific times or days available for babies and young children to obtain vaccinations within the South African clinic system to allow them a safer space; if so, what are the relevant details, if not, why not?

NW3403E

REPLY:

The Department of Health has a policy of "Every Day is an Immunisation Day". This policy is aimed at minimising missed opportunities and takes into consideration the circumstances of health facility users. It aims to reduce inconvenience and increase accessibility to services.

Most facilities have specific designated rooms for providing immunisation services and other services like the Integrated Management of Childhood Illnesses (IMCI) and Nutrition.

QUESTION NO. 2894

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mr I M Ollis (DA) to ask the Minister of Health:

(1) Whether his department has placed any (a) companies or (b) persons on the List of Restricted Suppliers, thereby prohibiting the public sector to do business with them; if so, in each case, what is the (i) name of said entity or person, (ii) nature of their business, (iii) reason for restricting this service and (iv) date on which they were restricted;

(2) whether any of the implicated (a) companies or (b) persons have since been removed from the list; if so, in each case, (i) which entity or person, (ii) when and (iii) what is the reason for removing the specified company or person from the list;

(3) whether his department has conducted any business with any of the (a) companies that or (b) person who have been removed from the list; if so, in each case (i) with which companies or persons, (ii) with regard to which services, (iii) for which time period and (iv) why did his department engage the specified company or person despite previous conduct?

NW3365E

REPLY:

(1) No.

(2) Not applicable.

(3) Not applicable.

QUESTION NO. 2886

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs S P Kopane (DA) to ask the Minister of Health:

Whether any costing has been conducted of the (a) training and (b) salaries with regard to the re-engineering of the Health Care System according to the three main streams of (i) district teams of five specialists, (ii) the School Health Programme and (iii) the deployment of at least 10 well-trained Primary Health Care (PHC) workers in each ward; if not, why not; if so, in each case (aa) how much will it cost and (bb) how was the figure calculated?

NW3356E

REPLY:

The Department of Health is still in the process of finalising the costing with respect to the (a) training and (b) salaries with regard to the re-engineering of the Health Care System according to the three main streams of (i) district teams of five specialists, (ii) the School health programme and (iii) the deployment of at least 10 well-trained Primary Health Care (PHC) workers in each ward. This work is still in the initial stages and will be finalized

QUESTION NO. 2885

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs H Lamoela (DA) to ask the Minister of Health:

(1) With reference to the Support of the Comprehensive Plan for HIV and Aids Care, Management and Treatment (SuCoP) agreement between South Africa and the European Union, what (a) were the objectives of the funding, (b) was the duration of the programme, (c) was the value of the funding, and (d) amount of funding was allocated to each province;

(2) whether any evaluation has been conducted on the effectiveness of the programme; if not, why not; if so, (a) what are the findings with regard to each province, (b) who conducted the evaluation, and (c) when was the evaluation concluded?

NW3355E

REPLY:

(1) (a) The objective of the funding were to contribute to the improvement of the health status of the country, in particular of the poor, trough the strengthening of health services delivery at National, Provincial & District levels by providing focused support for identified Health Priorities.

(b) The duration programme was signed by 14February 2005 and ended at 31^st May 2009.

(d) The funding intended to be used for the following items: To provide comprehensive care and treatment for people living with HIV and AIDS; and to facilitate the strengthening of the national health system in South Africa

(2) (a) There are no findings with regards to each province since SuCoP was not implemented per province but was implemented on 8 programme level. Effectiveness:

The SuCoP Programme was effective in twofold:

(i) integrated health and social service delivery to meet the challenges outlined in the Comprehensive Plan for HIV and AIDS; and

(ii) Ameliorate the direct and indirect impact of HIV and AIDS on economic, social, and, particularly, in educational and health development in South Africa.

While some projects, such as the TB Defaulter Tracing Project and the District Hospital Referral System Project, made significant progress in both these areas, the overall achievement of SuCoP in terms of the Programme Purpose was severely limited by implementation delays, the cancellation of a number of important activities and the lack of alignment with other major health strengthening programmes such as the EC's own Partnerships for the Development of Primary Health Care Programme (PDPHCP). Furthermore, the tendency of SuCoP projects to operate in silos, and the lack of mechanisms to enable project managers to co-ordinate their activities and share lessons learnt meant that much of the potential to promote integrated service delivery and ameliorate the impact of HIV and AIDS was not realised. The contribution of the various projects to HIV and AIDS mitigation was more of an indirect rather than a direct nature, in that their main outputs were related to health system strengthening rather than explicit measures designed to reduce HIV and AIDS prevalence.

(b) The evaluation was conducted by an independent consultant: Evaluation Team consisted of: Ben McGarry (Team Leader) Fitzroy Ambersley Marco Keijzers. The evaluation was commissioned by the European Commission with National Department of Health.

QUESTION NO. 2883

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs H Lamoela (DA) to ask the Minister of Health:

What were the reasons for the late start of the Partnerships for the Delivery of Primary Health Care including HIV and AIDS (PDHCP) with the European Union (EU), which was meant to be launced in 2001 and resulted in the first tranche of the 25 million euro being cancelled?

NW3353E

REPLY:

The reasons for the late start of the Partnerships for the Delivery of Primary Health Care including HIV and AIDS (PDPHCP) was due to operational constraints mainly in the recruitment of Programme managerial personnel. This period was effectively used to prepare Programme specific manuals and guidelines as they relate to EU procedures. This preparatory work assisted the Programme substantially in getting off ground when required staff was in place.

The Programme was approved as a 50 million Euro six year Programme with funding in two instalments, each of 25 million Euro, in 2001 and 2004. During this phase five provinces were supported namely, Western Cape, Eastern Cape, Limpopo, Gauteng, and KwaZulu Natal. The 2004 contribution was deferred to 2006, and it was included in the financing of a 45 million Euro Expanded Programme for Partnerships for the Delivery of Primary Health Care, HIV and AIDS services (EPDPHCP) supporting all nine provinces. The first tranche of 25 million Euro was therefore not cancelled.

QUESTION NO. 2884

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs H Lamoela (DA) to ask the Minister of Health:

(1) Whether, with regard to the recently announced R1.2 billion 2011 Primary Health Care Sector Budget Support programme between South Africa and the European Union (EU), (a) which nodal areas has been identified to benefit from the funding, (b) in which provinces are they situated, (c) on which date will the programme start and (d) what is the funding intended to be used for;

(2) whether any targets have been set for each aspect of the programme; if not, why not; if so, what are the targets in each case?

NW3354E

REPLY:

(1) (a) The Minister still has to decide which areas will benefit from the funding

(b) The programme covers all the provinces

(d) The programme is intended to strengthen the Primary Health Care Systems in SA

(2) The following table reflects the situation in this regard

Indicator	Target	Measurement
Utilisation rate of Primary Health Care facilities	2.7	DHIS
PHC per Capita Expenditure per district	380	DHIS
Number of district managers with written delegations	48	PQRS
Percentage of fixed PHC facilities that were visited by a supervisor at least once every month	90%	PQRS
Immunisation coverage of children under 1 year	90%	DHIS
Percentage of Primary Health Care facilities providing Basic Antenatal Care (BANC)	70%	DHIS
Percentage of mothers and babies reviewed through post natal care within 6 days after the delivery	60%	DHIS
% of HIV positive pregnant women on antiretroviral treatment to reduce the risk of mother-to-child transmission	85%	DHIS
New smear positive Pulmonary Tuberculosis (PTB) cure rate	75%	ETR
Number of national and provincial DOHs with an Unqualified Audit Opinion	6/10	PQRS

QUESTION NO. 2870

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs S V Kalyan (DA) to ask the Minister of Health:

Whether his department has taken steps to educate Health Professionals in the (a) private and (b) public sector about measures to improve their (i) individual environmental footprints and (ii) the environmental footprints of the health facilities in which they work; if not, why not; if so, what are the relevant details?

NW3339E

REPLY:

(a) and (b) (i) Yes, the Department has developed and produced information, education and communication (IEC) materials on health care risk waste management. This information has been disseminated to the provinces for education purposes to the health professions, community and public at large.

(ii) The Department has for years now closed down all incinerators that were operating at health care facilities due to the non-compliant and uncontrolled emissions to the atmosphere. This has resulted in the reduction of the environmental pollution at the health care facilities.

QUESTION NO. 2870

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs S V Kalyan (DA) to ask the Minister of Health:

NW3339E

REPLY:

QUESTION NO. 2862
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011
(INTERNAL QUESTION PAPER NO. 30)
Mr J Selfe (DA) to ask the Minister of Health: (Interdepartmental transfer on 03 October 2011)

In each province, (a) how many bodies are awaiting autopsies as at the latest specified date for which information is available, (b) how long is the average waiting time before an autopsy is conducted on a body, (c) what is the longest waiting time before an autopsy was conducted on a body and (d) what is the average waiting time to receive blood test results?

NW3330E

REPLY:

The following table reflects the details in this regard.

Table 1.

Province	(a) As at 30 Nov 2011	(b)	(c)	(d)
Eastern Cape	14	3 days	7 days	Histology
Free State	Unknown	2 hours	3 days	Histology: longer than 90 days
Gauteng	16	2 days	4 days	Histology: 6 weeks
KwaZulu/Natal	10	1 hour to 7 days	8 days	Histology: up to 1 year
Limpopo				Histology
Mpumalanga				Histology
North West				Histology
Northern Cape				Histology
Western Cape	63	3.04 days	7.47 days	Histology: 6 weeks

It is not clear for me what blood test results the Honourable Member is referring to. Is it ante- or post- mortem results, and for which blood test? Tests in blood can be so numerous and varied that unless the Honourable Member specifies I will not be able to answer.

QUESTION NO. 2848

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs P C Duncan (DA) to ask the Minister of Health:

Whether any helicopters that are used for medical emergencies in each province have been unable to fly due to (a) not having lights or (b) any other specified reasons (i) in (aa) 2009 and (bb) 2010 and (i) from 1 January 2011 up to the latest specified date for which information is available; if so, (aa) what are the reasons in each case, (bb) for what period was the helicopter unable to fly and (cc) what was the cost of the repair in each case?

NW3316E

REPLY

(a) There were no helicopters that were used for medical emergencies in each province which were unable to fly due to not having lights

(b) (i) (aa) (bb) (ii) (aa)(bb) The South African Red Cross Air Mercy Services was available and ready for missions between 95% - 100% during 2009, 2010 and from the 01 January 2011, as indicated on the tables below (aa) & (bb):

Service Availability April 2009 – March 2010

Service	(aa) Service Availability	(bb)Reason for Variance
Free State Rotor Wing	98%	2% Maintenance & bird strike
KZN Fixed Wing	100%
KZN Rotor Wing (Durban)	95%	4% Maintenance & 1% no EMS crew from Department of Health
KZN Rotor Wing (Richards Bay)	98%	2% Maintenance
Limpopo Rotor Wing	98%	2% Maintenance
Mpumalanga Rotor Wing	97%	3% Maintenance
Northern Cape Fixed Wing	96%	4% Maintenance
Western Cape Fixed Wing	99%	1% Maintenance
Western Cape Rotor Wing Metropole	96%	4% Maintenance
Western Cape Rotor Wing Southern Cape	97%	3% Maintenance

Service Availability April 2010 – March 2011

Service	(aa) Service Availability	(bb) Reason for Variance
Free State Rotor Wing	98%	2% Maintenance & bird strike
KZN Fixed Wing	100%
KZN Rotor Wing (Durban)	95%	4% Maintenance & 1% no EMS crew from Department of Health
KZN Rotor Wing (Richards Bay)	99%	1% Maintenance
Limpopo Rotor Wing	97%	2% Maintenance, 1% Medical crew
Mpumalanga Rotor Wing	97%	3% Maintenance
Northern Cape Fixed Wing	96%	4% Maintenance
Western Cape Fixed Wing	99%	1% Maintenance
Western Cape Rotor Wing Metropole	96%	4% Maintenance
Western Cape Rotor Wing Southern Cape	97%	3% Maintenance

Service Availability April 2011 – October 2011

Service	(aa)Service Availability	(bb)Reason for Variance
Free State Rotor Wing	98%	2% Maintenance
KZN Fixed Wing	100%	Spare Aircraft available
KZN Rotor Wing (Durban)	95%	4% Maintenance & 1% no EMS Crew from Department of Health
KZN Rotor Wing (Richards Bay)	96%	4% Maintenance
Limpopo Rotor Wing	92%	8% Maintenance
Mpumalanga Rotor Wing	97%	3% Maintenance
Northern Cape Fixed Wing	100%
Western Cape Fixed Wing	100%
Western Cape Rotor Wing Metropole	99%	1% Maintenance
Western Cape Rotor Wing Southern Cape	99%	1% Maintenance

(cc) The cost of the repairs are as stipulated below:

2009/10		2010/11		March 2011 – Sep 2011
Fixed Wing	Rotor Wing	Fixed Wing	Rotor Wing	Fixed Wing	Rotor Wing
R2 356 001 .00	R4 036 651.00	R10 659 081.00	R10 568 767.00	R3 781 728.00	R6 660 123.00

The North West province does not have aero-medical services at present.

The Eastern Cape has a private contract with the National Airways Corporation (NAC), which started from 2009 – 2011. NAC has 1 fixed wing aircraft and 2 rotor wing aircrafts. All aircraft maintenance is covered by the service provider as part of the Service Level Agreements. No downtime has been experienced due to maintenance.

Gauteng Province does not have a contract with any aero medical service. The province use privately owned helicopters on a fee for service. The province does not have records of mechanical repairs and the only time when this service is not available, is when the weather does not permit a helicopter to fly.

QUESTION NO. 2847

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) Whether any studies with regard to baby deaths at hospitals have been conducted into the level of competencies of nurses operating respirators; if not, why not; if so, (a) which hospitals were included in the study, (b) in each case, what period was included in the study, (c) how many babies died in each case, (d) what were the (i) findings and (ii) recommendations and (e) on which date was the study completed;

(2) whether any of the (a) findings and (b) recommendations have been implemented; if not, why not; if so, (i) which (aa) findings and (bb) recommendations and (ii) what is the time frame of the implementation of these (aa) findings and (bb) recommendations?

NW3315E

REPLY:

(1) No studies have been conducted with regard to baby deaths at hospitals into the level of competencies of nurses operating respirators. All neonatal intensive care nurses and advanced midwives have extended training on operating respirators. Priority is given to supervision, maintenance of ward standards and to quality assurance and improvement.

(2) Not applicable.

(3) Not applicable.

QUESTION NO. 2845
2845 . Mr M Waters (DA) to ask the Minister of Health:

(1) Whether there are any minimum standards for Emergency Medical Services (EMS) with regard to the number of (a) emergency vehicles and (b) personnel, including advanced life support personnel, for (i) rescue services , (ii) emergency medical services, (iii) planned patient transport and (iv) inter-hospital services; if not, why not; if so, What are the minimum standards in each case:

(2) whether minimum standards direr between local, district and metropolitan local authorities, if so, what are the relevant details;

(3) whether the Government is obliged to meet any minimum international standards with regard to EMS; if not, what is the position in this regards: if so, what are the relevant details? NW3313E

REPLY:

(1) The National Department of: Health: EMS is currently in the process of finalizing the norms and standards governing EMS country wide. The above Regulations are currently being discussed with the Legal unit of the National Department of Health to ensure that all legal requirements and other related matters are appropriately addressed.

These norms and standards will include inter alia (a) the number of emergency vehicles in operation and (b) the number of personnel in emergency vehicles for (if emergency rescue services, (ii) emergency medical services, (iii) planned patient transport as well as (iv) inter-hospital transfers

(2) Minimum standards do not differ between local, district and metropolitan local authorities, there are informed by the requirements of the Professional Board for emergency medical care on registered and practising emergency medical care personnel.

(3) There are currently no prescribed National standards as far as ambulances are concerned. There is no International Organisation/ s) that has set holistically adopted standards by all participating countries as far as ambulances are concerned.

QUESTION NO. 2820

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mr K P Sithole (IFP) to ask the Minister of Health:

(1) (a) What is the current status of completion of the R1 billion hospital at Vosloorus on the East Rand, Gauteng, (b) when did construction start and (c) what are the (i) full details of and (ii) reasons for the delays with the construction related to the project;

(2) whether the problems causing the delays have been solved; if not, why not; if so, what are the relevant details;

(3) what is the anticipated date of (a) completion and (b) opening of the project?

NW3283E

REPLY:

(1) (a) Construction programme is at 73% and ICT cabling at 60%. Tenders for transversal contracts for medical equipment were advertised and the closing date set for 23 September 2011;

(b) Construction commenced in November 2006;

(c) The project was underfunded and the allocations could not meet the cash-flow requirements, and that resulted in extension of time approved. Furthermore, due to delays in payment of contractors, that has also resulted in slowing down of the construction work from the contractors' side.

(2) The Department has established the Health Steering Committee and Technical Steering Committee to jointly coordinate, monitor and control the programme. That amongst others includes resolving disputes that may arise, contractor performance, payment delays, and any other outstanding issues.

(3) (a) The anticipated completion date for the construction is 31 March 2012.

(b) The Hospital will be handed over as an integrated unit and therefore opening of the project will be determined three months after the client is fully satisfied on the contractor's performance.

QUESTION NO. 2820

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 September 2011

(INTERNAL QUESTION PAPER NO. 30)

Mr K P Sithole (IFP) to ask the Minister of Health:

(2) whether the problems causing the delays have been solved; if not, why not; if so, what are the relevant details;

(3) what is the anticipated date of (a) completion and (b) opening of the project?

NW3283E

REPLY:

(1) (a) Construction programme is at 73% and ICT cabling at 60%. Tenders for transversal contracts for medical equipment were advertised and the closing date set for 23 September 2011;

(b) Construction commenced in November 2006;

(3) (a) The anticipated completion date for the construction is 31 March 2012.

(b) The Hospital will be handed over as an integrated unit and therefore opening of the project will be determined three months after the client is fully satisfied on the contractor's performance.

QUESTION NO. 2769

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr D A Kganare (Cope) to ask the Minister of Health:

(1) Whether the lives of the patients at Chris Hani Baragwanath Hospital were put at risk due to the oxygen and gas supplies to wards and theatres that were cut off on 12 July 2011; if not, what is the position in this regard; if so, what are the relevant details;

(2) whether the police are investigating (a) sabotage and (b) the full circumstances of the cut-off; if not, why not; if so, what are the relevant details?

NW3232E

REPLY:

(1) Yes, the lives of patients were put at risk when the supply of medical gas to wards and theatres was interrupted at Chris Hani Baragwanath Hospital. The alarm systems gave out a warning signal when the gas supply was interrupted. In this way the lives of the patients were saved.

It emerged that the gas tanks supply the wards and were closed by unauthorized personnel.

(2) A case of sabotage has been opened with Diepkloof Police Station. The measure to restrict access to the institution has been put in place. Razor wire securing the tanks was installed and security beefed up (patrols) around the tanks. An emergency upgrading plan is being implemented to promote the security of major sensitive supply such as gas electricity.

QUESTION NO. 2768

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether all health care facilities are administering the provision of post-exposure prophylaxis (PEP) in accordance with the guidelines; if not, why not; if so, what are the relevant details?

NW3231E

REPLY:

· All health care facilities have got trained designated staff on the management of needle pricks and administration post exposure prophylaxis;

· Post Exposure prophylaxis treatment is administered according to and as advised in the National guidelines;

· The infection control coordinators and staff responsible for Employee Wellness ensure that the guidelines are implemented appropriately.

QUESTION NO. 2767

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether the qualitative and quantitative data and statistics on the (a) adolescent fertility rate and (b) unmet need for contraception is available to help measure the progress of Millennium Development Goal 5 to improve maternal health; if not, why not; if so, what are the relevant details?

NW31230E

REPLY:

Yes – quantitative data is available.

(a) According to data from the South African Demographic and Health Surveys 1998 and 2003 the adolescent fertility rates (that is births per 1 000 women of ages 15-19) were:

- 60.3 per 1000 women aged 15-19 in 1998

- 58.4 per 1000 women aged 15-19 in 2003

According to the SADHS 2003, almost 14% of South African women in marital union have unmet need for family planning as compared to the 15% recorded in 1998 SADHS and it varies from province to province.

QUESTION NO. 2723

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr I M Ollis (DA) to ask the Minister of Health:

(1) (a) Who is the preferred service provider that is used by his department for the hiring of vehicles and (b) why is the specified service provider preferred;

(2) whether his department has a fixed contract with the specified service provider; if not, why not; if so, what are the relevant details;

(3) what is the (a) name of the service provider and (b) reason for using the specified service provider in each instance where vehicles have been hired for use by him or his Deputy Minister since March 2010?

NW3184E

REPLY:

(1) (a) There is no preferred service provider with regard to the hiring of vehicles instead the Department is participating in the transversal contract for road transport initiated by the Department of Transport and a contract with an in-house Travel Agent that was appointed through an open bid process.

(b) There is no preferred supplier with regard to the hiring of vehicles, the contractors were appointed via bid procedures.

(2) With PhakisaWorld Fleet Solution (Department of Transport is the custodian of the contract) which is a five year contract that expires at the end of November 2011 and Duma Travel which is a three year contract that expires at the end of April 2014.

(3) (a) PhakisaWorld Fleet Solution for road transport; and Duma Travel for traveling services.

(b) Vehicles are hired according to the above-mentioned contracts. Only in the event of –

· the Department being in the process of purchasing a new vehicle for either the Minister or the Deputy Minister;

· when the vehicles are at the suppliers for services and at arrival points; and

· when the Minister or Deputy Minister fly to any destination, other than Cape Town or Oliver Tambo Airport.

QUESTION NO. 2720

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mrs S P Kopane (DA) to ask the Minister of Health:

Whether the report Toolkit for Accreditation Programmes was used in developing the Office of Compliance assessment model and systems; if not, (a) why not and (b) what other reference documents were used in this regard; if so, what aspects have been adopted into our own assessment model and systems?

NW3181E

REPLY:

(a) Yes the "Toolkit for Accreditation Programmes" was one of the reference materials used in the early development of the Office of Standards Compliance model and system.

(b) Many sources of reference have been used to develop the standards and assessment tools, including "Standards for Better Health" from the UK National Health Service and the International Finance Corporation's "Self assessment guide for Health care Organizations" as well as extensive research and/or inputs from the Care Quality Commission in the UK, the Haute Authorite De Sante in France, Joint Commission International and the Quality Association on Accreditation (HQAA) in the US, as well as the Council for Accreditation in Southern Africa (COHSASA). From all of these we have adapted or incorporated the priority areas of focus, the structure of the standards (the cross-cutting domains), the formulation of the standards themselves, and the tools for measurement. With respect to the model, addition to the sources listed above, we have conducted desk-top research followed by interviews or discussions with a number of international and local organisations involved in the field of regulation and quality of health care. This material is in the process of being integrated into proposals for the future organisational design and model.

QUESTION NO. 2718

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mrs S P Kopane (DA) to ask the Minister of Health:

Whether the (a) Childhood Cancer Foundation of SA (CHOC) and (b) any other cancer-fighting organisations have given any donations to any hospital in the (i) 2008-09, (ii) 2009-10 and (iii) 2010-11 financial years; if so, in each case, (aa) what donation, (bb) which hospitals benefited and (cc) what was the value of the donation?

NW3179E

REPLY:

(a) The Childhood Cancer Foundation of SA (CHOC) has given the following donations in:

Year	(aa)	(bb)	(cc)
(i) 2008/2009	Medical Nursing Staff Salaries	- Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Tygerberg Hospital - Grootte Schuur Hosptial	R547,321.00
	Transport Funds	- Frere Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Steve Biko Academic Hospital - Tygerberg Hospital	R397,031.00
	Medical equipment purchases	- Universitas Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital	R155,324.00
	Medical equipment maintenance	- Chris Hani Baragwanath Hospital	R39,390.00
	Treatment Rooms	- Chris Hani Baragwanath Hospital	R122,243.00
	Ward maintenance and support	- Frere Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Steve Biko Academic Hospital - Tygerberg Hospital	R409,358.00
(ii) 2009/2010	Medical / Nursing staff salaries	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Red Cross Children's Hospital - Tygerberg Hospital - Grootte Schuur Hospital	R1,064,216.00
	Transport funds	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Dora Nginza Hospital - Tygerberg Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Steve Biko Academic Hospital	R474,928.00
	Medical equipment purchases	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Inkosi Albert Luthuli Hospital - Steve Biko Academic Hospital	R189,122.00
	Medical equipment maintenance	- Chris Hani Baragwanath Hospital - Steve Biko Academic Hospital	R98,437.00
	Ward maintenance and support	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Dora Nginza Hospital - Tygerberg Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Steve Biko Academic Hospital	R402,766.00
(iii) 2010/2011	Medical/Nursing staff salaries	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Red Cross Children's Hospital - Universitas Hospital - Steve Biko Academic Hospital - Grootte Schuur Hospital	R1,568,411.00
	Transport funds	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Dora Nginza Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Steve Biko Academic Hospital	R358,895.00
	Medical equipment purchases	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Steve Biko Academic Hospital	R244,487.00
	Medical equipment maintenance	- Universitas Hospital - Chris Hani Baragwanath Hospital	R81,662.00
	SACCSG Medical and nursing staff	- Frere Hospital	R9,873.00
	Treatment rooms	- Chris Hani Baragwanath Hospital	R5,700,000.00
	Ward maintenance and support	- Frere Hospital - Charlotte Maxeke Hospital - Chris Hani Baragwanath Hospital - Dora Nginza Hospital - Tygerberg Hospital - Inkosi Albert Luthuli Hospital - Universitas Hospital - Steve Biko Academic Hospital - Red Cross Children's Hospital - Grootte Schuur Hospital	R355,854.00

(b) The Cancer Association of South Africa (CANSA) has given the following donations in:

Year	(aa)	(bb)	(cc)
(i) 2008/2009	- Feeding scheme for thirty (30) children @ R300 per child	Chris Hani Baragwanath Hospital	R9,000.00
(i) 2008/2009	- 20 x hydraulic high/low hospital beds as R1 700 - 6 x Juvenile hospital beds @ R1 200 - 30 X mattresses @ R400 - Linen the value of R15 000 - 1 x Electrocardiography machine @ R150 000 - 3 x Reusable bone marrow aspirators @ R2 500	Kalafong Hospital	R225,700.00
(ii) 2009/2010	- 50 x Ports @ R1 700	Kalafong Hospital	R85,000.00
(iii) 2010/2011	- Refurbishment of building housing the CANCA Nicus Lodge to the value of R1,700,000.00 - Duvets and linen for thirty-eight (38) beds @ R200 - Clothing Scheme R5 000	Steve Biko Academic Hospital	R1,712,600.00

QUESTION NO. 2712

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mrs S V Kalyan (DA) to ask the Minister of Health:

Whether his department is involved with the evaluation of the country's (a) uranium and (b) dust levels; if not, why not; if so, what are the relevant details?

NW3173E

REPLY:

(a) The Department is not involved in any aspect of Uranium or any other fuel cycle radioactive materials, as these materials fall under the Regulatory control of the National Nuclear Regulator (Department of Energy).

(b) There is no evaluation of dust levels done by the Department at this stage and no plans to do so in the near future.

QUESTION NO. 2711

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr I O Davidson (DA) to ask the Minister of Health:

(1) Whether there are guidelines in respect of the minimum amount that each health facility must allocate and spend on maintenance in each financial year; if not, (a) why not and (b) when will such guidelines be set; if so, (i) what is the minimum amount that each health facility must allocate towards maintenance in each financial year, (ii) who is ultimately responsible for ensuring compliance with these guidelines and (iii) what action is taken against health institutions that do not adhere to these guidelines;

(2) (a) which health institutions in each province have failed to adhere to these guidelines for the past three financial years and (b) what percentage of their budgets do private health institutions allocate towards maintenance in each the specified financial years?

NW3172E

REPLY:

(1) There are National Treasury guidelines in respect of the minimum amounts that each health facility must allocate and spent on maintenance in each financial year.

(a) See comment above

(b) See comment above

(i) The target set was between 3 and 5% of the overall budget (Source Integrated Health Planning Framework).

(ii) There are gaps in terms of ensuring compliance with the guidelines. The aim is to develop norms and standards for facility development and maintenance. The guidelines will be more detailed than the guidelines and will be developed in partnership with the Council for Scientific and Industrial Research (CSIR).

(iii) see comment under (ii) above.

(2) (a) During the past two years most health institutions did not comply due to budgetary constraints.

(b) Information on the budget that private sector health institutions allocate towards maintenance was not readily available.

QUESTION NO. 2708

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr T D Lee (DA) to ask the Minister of Health:

(1) On what date did each municipality last submit food samples for analysis;

(2) whether there is an obligation on the part of municipalities to submit food samples within specified time periods; if not, why not; if so, what are the time periods;

(3) whether his department keeps track of municipalities that fail to submit food samples and contacts them to find out when food samples will be submitted; if not, why not; if so, (a) when last were such municipalities contacted, (b) by whom and (c) what was the response for each municipality?

NW3169E

REPLY:

(1) As part of the Department of Health, Directorate: Food Control national food sampling programme for 2011/12, provinces and municipalities were requested to submit food samples for chemical analysis to the Forensic Chemical Laboratories of the Department in Cape Town and Pretoria during August 2011. A total number of 877 samples were submitted by a number of forty municipalities and district offices of provinces. More details in this regard are provided in the attached schedules compiled by the laboratories in question.

(2) No, depending on the availability of financial and human resources, provinces and municipalities could submit samples for: (a) chemical analysis when participating in the annual national food sampling programme as indicated under point (1); (b) chemical analysis to the laboratories of the Department in Cape Town and Pretoria on an ad hoc basis as part of for an example, an investigation, or for routine purposes; or, (c) microbiological analysis of foodstuffs such as milk, dairy products, fruit juices, packaged waters, etc. on a routine and/or ad hoc basis, submitted to the National Health Laboratory Services, in accordance with their own work programmes.

(3) No, as mentioned above, the participation of provinces and municipalities in the routine food sampling programme of the Department depends on the availability of financial and human resources provided for this purpose by the relevant authorities. In addition, it is expected of them to collect samples at the premises within their areas of jurisdiction where such foodstuffs are manufactured or packaged before distribution for sale to retail level to ensure that the laboratories of the Department will be able to cope with the workload related to the amount of samples submitted to them.

QUESTION NO. 2707

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr T D Lee (DA) to ask the Minister of Health:

(a) When will the Report on the Confidential Enquiries into (i) Maternal Deaths in South Africa 2002-2004 and (ii) Mothers, Saving Babies and Saving Children be released, in each case, and (b) what amount had been budgeted to compile the report in each case?

NW3168E

REPLY:

(a) (i) The Saving Mothers 2002-2004: Fourth Report on Confidential Enquiries into Maternal Deaths in South Africa was released in 2006.

(ii) There is no report on Confidential Enquiry into Mothers, Saving Babies and Saving Children. The Reports on the Saving Babies and the Saving Children are not confidential and they were released in 2010 and 2011 respectively.

(b) The amount that has been budgeted for the process is Saving Mothers is R2,270,000.

QUESTION NO. 2706

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr T D Lee (DA) to ask the Minister of Health:

(1) Whether the latest National Antenatal Sentinel HIV and Syphilis Prevalence Survey of 2010 has been released; if not, (a) when will it be released and (b) what are the relevant details;

(2) what steps has he taken to ensure that the survey is released on time next year?

NW3167E

REPLY:

(1) No.

(a) World AIDS Day on 01 December 2011;

(b) The details of the 2010 report will be known when the report is released.

(2) The National Antenatal Sentinel HIV and Syphilis Prevalence Survey report is conducted in October 2011 every year. The process of data collection, collation, analysis, statistical modelling and extrapolation is complex, and time-consuming. The National Department of Health has to allow all scientific reviews of the data to be completed. The Department therefore cannot commit itself to shorter timeframes for the future, since scientists require adequate time to complete their work satisfactorily.

QUESTION NO. 2697

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Ms E More (DA) to ask the Minister of Health:

(1) With reference to his reply to question 777 on 26 August 2011, to which position was the specified person moved;

(2) whether the specified position had been advertised; if not, why not; if so, what minimum qualifications are necessary for the position?

NW3157E

REPLY:

(1) The previous Chief Executive Officer of the East London Hospital Complex was moved to the Provincial Department of Health. The Chief Executive Officer was on a five-year contract which expired in June 2011 and he has since left the Department.

(2) The specified position has not been advertised and an Acting Chief Executive Officer was appointed. The Provincial Department of Health is in the process of decomplexing the two hospitals. Once this process has been completed, the post of the CEO will be re-evaluated and then advertised.

QUESTION NO. 2696

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Ms E More (DA) to ask the Minister of Health:

(1) Whether any factors other than A/D (Activity Ratio) had been taken into account in categorising the lost radiation sources as presented to the Portfolio Committee on Health on 24 August 2011; if not, what were the reasons for this omission;

(2) whether the International Atomic Energy Agency report entitled Categorisation of radioactive sources stipulates other factors to be taken into consideration when categorising radiation sources; if so, (a) what additional factors and (b) under which circumstances should they apply;

(3) whether his department intends to re-categorise the lost source list based on additional factors; if not, why not; if so, when?

NW3156E

REPLY:

(1) The International Atomic Energy Agency's (IAEA) Categorisation scheme which is based largely on A/D (activity ratio) has already been followed with respect to all radioactive sources without any omissions, including the lost sources.

(2) While the A/D (activity ratio) is the primary principle on which the IAEA Categorisation scheme is based, other risk factors can also be taken into consideration. For example, all Industrial Radiography sources are deemed to be Category 2 sources. This is despite the fact that based on A/D values alone, many of these sources are actually Category 3 sources. The reason for this is that these sources are continuously being moved from one location to another and that enhanced security measures should be in place to make provision for this aspect.

(3) The Department does not intend to re-categorise the lost sources at this stage. The categorisation scheme provides guidance for Regulators in prescribing physical protection measures that must be in place while the sources are being used. Lost sources are no longer controlled and it would therefore serve no purpose to change their categorisation to a higher level. In reality the sources decay continuously and taking the A/D values in consideration, the categorisation level can be adjusted downwards in time.

QUESTION NO. 2686

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether the (a) staffing, (b) training and (c) funding resources of the Office of Standards Compliance (OSC) have been estimated; if not, (i) why not and (ii) when will it be done; if so, what are the costs in each case;

(2) whether funding will be made available in time to meet the current timetable; if not, why not; if so, what are the relevant details;

(3) whether assessment procedures have been documented and evaluated; if not, why not;

(4) how will the quality of assessments be assured nationally if the function is delegated to provinces?

NW3146E

REPLY:

(1) Yes, initial staffing, training and funding resources of the Office of Health Standards Compliance were estimated at the time of developing the budgets for the National Department in 2010 and an amount of R28 million was allocated for the year 2010/11, covering both the planned external inspection and other functions as well as internal quality improvement and support functions. The total costs are R21.72m broken down as follows:

(a) Staffing (including new inspectors) R10.25m;

(b) Training course for new inspectors R0.68m;

(2) This amount is therefore already available as follows in order to initiate inspections and other activities as planned. Funding beyond this financial year is being reviewed as part of the budgeting process.

(3) Assessment procedures have been fully documented and are currently undergoing a third round of evaluation based on widespread use over the past year.

(4) The function will not be delegated to the provinces but will be conducted by nationally-located teams of inspectors.

QUESTION NO. 2684

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 September 2011

(INTERNAL QUESTION PAPER NO. 29)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any public health facility has been inspected and/or accredited by (a) his department or (b) any other specified organisation since the adoption of the Millenium Development Goals (MDGs); if not, why not; if so, (i) which health facilities, (ii) on what dates and (iii) who conducted the (aa) inspection and (bb) accreditation;

(2) whether any reports were submitted to his department with warnings of (a) faulty equipment, (b) possible loss of life, (c) lack of consumables and (d) any other specified aspect; if so, (i) which health institution did each report pertain to, (ii) when was each report received, (iii) what were the warnings highlighted in each report and (iv) what action was taken in each instance?

NW3144E

REPLY:

(1) At the time of this question, no public facilities were inspected or accredited by this Department. Accreditation is a voluntary process and is conducted by private accreditation organisations such as the Council for Health Service Accreditation of Southern Africa (COHSASA) who enables healthcare professionals to measure themselves against generally accepted standards and monitor improvements using quality improvement methods, internationally accredited standards and a web-based information system.

The current National Health Act does not adequately provide for the inspection and certification of health establishments and is in the process of being amended to provide for these functions which are envisaged to be executed by the Office of Health Standards Compliance (OHSC), a public entity independent from the Department of Health. This OHSC will be established once this Act has been amended.

(2) Public health establishments have started assessing themselves since February 2011 using the National Core Standards (NCS) as part of the national quality improvement programme/health system strengthening initiative. In addition Health Systems Trust (HST) was contracted to conduct a baseline audit of all public health establishments focusing on the six priority areas (a subset of the NCS), infrastructure, human resources and health technology to gather information which can be used for integrated health planning and quality improvement based on the gaps identified during the audit and the assessments. Based on the findings during the assessments, health establishments developed their individual quality improvement plans in order to systematically close the gaps.

With regard to the baseline audit, findings had to be validated and the reports were presented to the National Health Council (NHC). The process is ongoing and health establishments are continuously addressing the issues that have been identified as underperforming and others that impact negatively on patients care.

QUESTION NO. 2664

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 September 2010

(INTERNAL QUESTION PAPER NO. 29)

Mr M Waters (DA) to ask the Minister of Health:

Whether he intends introducing any legislation similar to legislation pertaining to tobacco products that will restrict the advertising of alcohol products; if not, why not; if so, (a) when will such legislation be introduced and (b) what are the further relevant details?

NW3323E

REPLY:

(a) The relevant legislation concerning advertising of alcohol products is the Liquor Act, 2003 (Act 59 of 2003). This Act is administered by the Department of Trade and Industry. Notwithstanding, the Department of Health is concerned about the role of advertising in promoting alcohol abuse and the consequent repercussions for health and health services. The Department has engaged with, and will continue to engage the relevant department(s) to enact legislation that will reduce alcohol abuse. Should additional legislation be required, we will consider introducing this in time.

(b) One area where legislation pertaining to advertising/counter-advertising of tobacco products has been mirrored by the Department of Health with regard to alcohol, is regulations around messaging on containers. As with tobacco products, in terms of the regulations to the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act 54 of 1972), producers are compelled to put visible warning labels on all alcohol containers – taking up at least one eighth of the total label size.

QUESTION NO. 2639

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether the quality of the antiretroviral intervention is monitored in both the public and private health sector; if not, why not; if so, what are the relevant details?

NW3090E

REPLY:

Yes, the quality of the Antiretroviral Intervention is monitored through the implementation of clinical guidelines, training of Health Care Professionals and reporting of adverse events through the pharmacovigilance system.

QUESTION NO. 2638

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether his department has entered into partnership with stakeholders with regard to antiretroviral management; if not, why not; if so, what are the relevant details?

NW3089E

REPLY:

The Department of Health does have relationships with partners implementing the Anti Retroviral Therapy programme since its inception. There are implementing partners in all provinces assisting with the following service delivery activities:

(a) Capacity building and skills development for health care workers.

(b) Mentoring and support of nurses rendering ART services.

(d) Offer direct patient care e.g. counseling and consultations.

(e) Monitoring, evaluation and data quality issues.

QUESTION NO 2637
Mr DA Kganare (Cope)o ask the Minister of Health

2637 Whether there are any health care workers that had to take post-exposure prophylaxis after needle-prick injuries in the past three financial years; if not, what is the position in this regard; if so, what are the relevant details? (NW3088E)

REPLY

Yes. There are health care workers who had to take post exposure prophylaxis after needle-prick injuries in the past three (3) years.

All health care institutions have protocols and guidelines to deal effectively and efficiently with all incidents of needle-prick injuries.

QUESTION 2615
2615. Mr M Waters (DA) to ask the Minister of Health:

(1) Whether reviews of (a) perinatal and (b) maternal deaths have been conducted in each province since 1 January 2010; if not, why not; if so, how many in each province?

(2) Whether any deviations from guidelines regarding obstetric care were identified; if not, why not; if so, (a) how many in each province, (b) what corrective action has been taken by the clinical manager for each case that was identified, (c) what was the outcome of the corrective action and (d) what is the follow-up procedure to ensure that guidelines and protocols are maintained and adhered to after corrective action? (NW3031 E)

REPLY

(1 )(a)-(b) Yes

Both (a) perinatal and (b) maternal deaths reviews have been conducted in each province since January 2010, these are conducted in each hospital on a monthly basis. In addition the National Committee for the Confidential Enquiry into Maternal Deaths (NCCEMD) and the National Perinatal Mortality Committee (NaPemCO) monitor the report of maternal and perinatal deaths as recorded in the provinces.

(2)(a)-(d) Deviations from guidelines that may have contributed to maternal or perinatal mortality are noted during perinatal an maternal death reviews. Corrective action is taken at individual facility level. A national list of these corrective actions is not available.

QUESTION NO. 2594

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr I O Davidson (DA) to ask the Minister of Health:

(1) Whether his department has conducted a diseases profile of the population; if not, (a) why not and (b) when will this be done; if so, (i) when was it completed, (ii) who conducted the profile, (iii) what was the cost of the profiling and (iv) what were the findings;

(2) whether a costing of each disease has been conducted; if not, (a) why not and (b) when will this be done; if so, what are the costs associated with each disease?

NW3009E

REPLY:

(1) Yes.

(a) Not applicable.

(b) Not applicable

(i) The initial report on the Burden of Disease Study, focusing on the year 2000, was published in 2003. A second report was published in 2007.

(ii) The South African Medical Research Council (MRC), a public entity established by an Act of Parliament.

(iii) The annual operational costs of the MRC Unit that produced the Burden of Disease Estimates are as follows:

Line Item	Expenditure
Personnel salaries	R3 million
Data collection, including the appointment of fieldworkers and data capturers.	R1,2 million
Goods and Services	R0,6 million
Total	R4,8 million**

** This amount excludes the costs of travelling to, and accommodation at different data collection sites across the country.

(iv) Key findings of the MRC are reflected below.

DALYs ATTRIBUTED TO SELECTED RISK FACTORS COMPARED WITH THE UNDERLYING CAUSES OF SALYS

Rank	Risk factor	% total DALYs	Rank	Disease, injury or condition			% total DALYs
1	Unsafe sex/STIs	31.5	1		HIV/AIDS	30.9
2	Interpersonal violence (risk factor)	8.4	2		Interpersonal violence injury	6.5
3	Alcohol harm	7.0	3		Tuberculosis	3.7
4	Tobacco smoking	4.0	4		Road traffic injury	3.0
5	High BMI (Excess bodyweight)	2.9	5		Diarrhoeal diseases	2.9
6	Childhood and maternal underweight	2.7	6		Lower respiratory infection	2.8
7	Unsafe water sanitation and hygiene	2.6	7		Low birth weight	2.6
8	High blood pressure	2.4	8		Asthma	2.2
9	Diabetes (risk factor)	1.6	9		Stroke	2.2
10	High cholesterol	1.4	10		Unipolar depressive disorders	2.0
11	Low fruit and vegetable intake	1.1	11		Ischaemic heart disease	1.8
12	Physical inactivity	1.1	12		Protein-energy malnutrition	1.3
13	Iron deficiency anaemia	1.1	13		Birth asphyxia and birth trauma	1.2
14	Vitamin A deficiency	0.7	14		Diabetes mellitus	1.1
15	Indoor air pollution	0.4	15		Alcohol dependence	1.0
16	Lead exposure	0.4	16		Hearing loss, adult onset	1.0
17	Urban air pollution	0.3	17		Cataracts	0.9

(2) No.

(a) It was not part of the objectives of the Burden of Disease Study to conduct an economic impact assessment of each disease.

(a) When resources become available to conduct such an economic impact assessment study.

QUESTION NO. 2593

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr I O Davidson (DA) to ask the Minister of Health:

(1) (a) Which entity has the responsibility of awarding licences to pharmacists and (b) on what date did this entity initially obtain the responsibility to award such licences;

(2) whether (a) the distance from existing pharmacies, (b) number of employees and (c) any other specified criteria are taken into account when a pharmacy is licensed; if not, why not, in each case; if so, what are the relevant details, in each case;

(3) whether the person who owns a pharmacy must be a pharmacist; if not, why not; if so, (a) who is responsible for ensuring that this is the case and (b) how many owners of pharmacies are not pharmacists;

(4) whether any pharmacy has been closed in the past three years for any period of time due to no pharmacist being on the premises; if not, why not; if so, (a) which pharmacies, (b) on which date(s) and (c) for what length of time was it closed?

NW3008E

REPLY:

(1) (a) National Department of Health in consultation with the South African

Pharmacy Council.

(b) May 2003.

(2) (a) Yes. A guideline of 500m from existing pharmacies is used. However, a

closer proximity may be accepted if the applicant submits acceptable motivation for this, as well as in smaller, densely populated towns.

(b) No. There are no prescribed staffing norms for new pharmacies; the number of employees in established pharmacies may also fluctuate as needed.

(c) Information submitted by the applicant in accordance with Sub-regulation 7(2) of the Regulations Relating to the Ownership and Licensing of Pharmacies is also considered.

With regards to Sub-regulation 7(2)(e), a population of 5 000 per pharmacy is used as a guideline. In malls (large enclosed shopping complexes) the guideline is a foot count of 50 000 per month (and not the general population of the area).

(3) No, the owner of a pharmacy does not have to be a pharmacist. In terms of the above-mentioned Regulations any person may own a pharmacy, provided that the owner complies the requirements of these Regulations.

(a) Not applicable.

(b) Whether an owner of a prospective pharmacy premises is a pharmacist or non-pharmacist is not captured when the premises is being licensed, nor when the pharmacy is being recorded by the South African Pharmacy Council.

(4) This information is not supplied to the National Department of Health.

QUESTION NO. 2567

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr M Waters (DA) to ask the Minister of Health:

Whether the (a) SA Nursing Council (SANC), (b) SA Pharmacy Council, (c) Health Professions Council of SA (HPCSA) and (d) any specified health profession association had been consulted (i) before or (ii) after the release of the (aa) Green Paper on the National Health Insurance and (bb) bill on the Office of Health Standards Compliance; if not, why not; if so, in each case, (aaa) on which dates and (bbb) with regard to which document?

NW2882E

REPLY:

(aa) The Statutory Councils (a) the SA Nursing Council (SANC), (b) the SA Pharmacy Council (SAPC), and (c) the Health Professions Council of SA (HPCSA) have not yet been consulted independently on the Green Paper on the National Health Insurance (NHI).

(ii) Nonetheless, the Department of Health has already proposed dates on which it intends to meet with these Statutory Councils to brief them about this policy document. The dates are yet to be agreed upon.

(d) As part of the Department's consultation plan on the Green Paper on NHI, the officials of the Department and I have invited and met with 85 stakeholder entities and professional associations since the publication of the Green Paper on 12 August 2011, to initiate the public consultation process.

(bb) (a-d) (i) (bb/bbb) Yes, the SANC, SAPC, HPCSA, the South African Medical Association (SAMA), the Democratic Nursing Organisation of South Africa (DENOSA) and the Colleges of Medicine were consulted on the National Core Standards (a fundamental aspect of the Bill) and aspects of future regulation prior to the release of the Bill on the Office of Health Standards Compliance (though not directly on the Bill itself). A large meeting on 01 July 2010 involved HPCSA, SAPC, SANC, DENOSA, SAMA, Board of Healthcare Funders (BHF), Council for Medical Schemes (CMS), as well as representatives of private hospital groups. A second meeting with HPCSA was Medical Disciplines and SANC in August 2010 in the ambit of the Service Delivery Agreement.

A large consultative workshop on regulation in health care with international speakers was chaired by the Minister of Health on 06 October 2010, to which all the stakeholders listed above were invited. Meetings have also been held with the Colleges of Medicine on 25 February and on 27 November 2010.

(ii) (bb/bbb) After the release of the Bill, organisations were asked to make public comments. A meeting was also held with the SAPC in April 2011 to discuss the Bill. The HPCSA, SANC and SAPC have already been approached for further meetings once the State Law Advisors have certified the revised Bill.

QUESTION NO. 2566

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 September 2011

(INTERNAL QUESTION PAPER NO. 28)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether, with reference to his reply to oral question 66 on 22 June 2011, he intends to amend the means test which determines which patients at public health institutions should pay for medical services; if not, (a) why not and (b) when last was it amended; if so, when will this be done;

(2) what percentage of the costs are they expected to pay with regard to the current means test?

NW2878E

REPLY:

(1) The Department is in the process of amending the Means test as per STATSSA Income and Expenditure Survey (IES-2011).

(2) Patients are classified according to their income and ability to pay for health care and are categorised accordingly; H1, H2 and H3;

Category	Subsidy	Payment	Remarks
H1 Single income (R0-R36,000 pa)	80%	20%	OPD visits: Patients only pay for the consultation,
	100%	0%	All other services are free,; Medicine, X-Rays, Theatre, etc.
	99%	1%	In Patient (IP): 1% of the Full paying patients. The fee is charged per 30 days or part thereof and all services during his/ her IP stay is free.
H2 Single income (R36,001-R72,000 pa)	35%	65%	OPD and Emergency consultation:
	93%	7%	Inpatient day per stay is 7% with differentiation per bed type (ICU, High Care, General Ward)
	85%	15%	Patient and Emergency Transport:
	50%	50%	Assistive devices :
	50%	50%	Procedures, X-rays, Theatre etc
	100%	0%	All other services : Free
H3: Single income: Patients that exceed the means test> R72, 000 pa. Patients who are not covered by medical scheme	20%	80%	All services are paid at 80% of the full amount (100%)

QUESTION NO. 2537

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Mr D A Kganare (Cope) to ask the Minister of Health:

Whether any patients in need of emergency medical treatment failed to get such immediate treatment in any hospital in the past five years for which information is available; if not, what is the position in this regard; if so, what are the relevant details?

NW2958E

REPLY:

1. The responses to this question were received from the Free State, Gauteng, Northern Cape and Western Cape Provinces. Generally, hospitals do not have any records of patients who needed emergency medical treatment and failed to get such immediate treatment in the past five years.

2. Patients are assessed in the casualty department and either discharged or admitted to hospital. They are categorised based on their acuity levels using the triage system. The system is based on the triage score and patients are classified as either priority 1 or 2 or 3. Priority 1 refers to patients whose illness is severe and/or life threatening, and as a result have to get medical treatment immediately.

3. If a transfer to a facility offering a higher level of care is required, this will be arranged with the receiving hospital and transport will be undertaken by Emergency Medical Service ambulance (including aeromedical services if needed).

QUESTION NO. 2536
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011
(INTERNAL QUESTION PAPER NO. 27)
Mr D A Kganare (Cope) to ask the Minister of Health:

Whether his department has any programmes in place to sensitise (a) doctors, (b) nurses, (c) counsellors, (d) pharmacists, (e) facility managers and (f) the police on the science of HIV and post-exposure prophylaxis; if not, why not; if so, what are the relevant details?NW2957E

REPLY:

The newly revised HIV counselling and testing guidelines were approved in June 2010. The following health care workers were trained on the revised guidelines which include modules on Post-exposure Prophylaxis (PEP) for survivors of sexual assault (children and adults) as well as work place needle stick injuries:

A total of 12 000 lay counsellors;

All professional nurses providing HIV Counselling and Testing (HCT) in public health facilities;

All doctors involved with HCT through Provider Initiated Counselling and Testing (PICT) in public health facilities;

All HCT coordinators; and

All HIV and AIDS, STI and TB managers in health districts.

QUESTION NO. 2467

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Mr M Waters (DA) to ask the Minister of Health:

Whether he will reinvestigate the deaths of babies at the Cecilia Makiwane Hospital in order to determine who is responsible for these deaths; if not, why not; if so, (a) when will this reinvestigation take place and (b) what are the further relevant details?

NW2877E

REPLY:

Honourable Member, this question has been answered numerous times. There is absolutely no need to answer it many times.

QUESTION NO. 2448

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether any hospital have been revitalised; if not, why not; if so, (a) what are the names of these hospitals, (b) where are these hospitals situated, (c) why were these specific hospitals earmarked for revitalisation ahead of other hospitals and (d) what was the cost incurred for each revitalisation programme;

(2) whether there is a system in place to (a) monitor and (b) capture the amount of patients being treated for different diseases; if not, why not; if so, what are the relevant details;

(3) whether there are systems in place to ensure effective oversight by his department (a) over (i) public hospitals and (ii) clinics and (b) where no programmes exist; if not, in each case, (aa) why not and (bb) when will such systems be implemented; if so, what are the relevant details;

(4) whether his department has reviewed hospital budgets; if not, why not; if so, (a) what (i) are the timeframes between reviews and (ii) factors are taken into account when budgets are deliberated and (b) who is responsible for deciding what amount is allocated for each hospital?

NW2856E

REPLY:

(1) The National Department is revitalising public hospitals through hospital revitalisation grant. Through this process provinces are requested to develop project priority lists which indicate which hospital should be revitalised. The table below gives a list of completed hospital projects and the costs thereof.

Province	Name of hospital	Project cost R'000
Eastern Cape	Dr Malizo mphehle (new Hospital in Tsolo): Main Hospital	326,464
	Madzikane Ka Zulu	152,364
	Frontier Eye Clinic	23,637
Gauteng	Mamelodi	335,904
Limpopo	Lebowakgomo	125,067
	Jane Furse	120,643
	Nkhensani	214,881
Mpumalanga	Piet Retief	198,073
Northern Cape	Colesburg	45,000
	Calvinia	45,000
	Barkly West (Prof ZK Mathews)	92,605
North West	Swartruggens	43,000
	Moses Kotane	337,600
	Vryburg	553,478
Western Cape	George	156,000

(2), (3) and (4) Not relevant to infrastructure.

QUESTIONS FOR ORAL REPLY
TUESDAY, 13 SEPTEMBER 2011
PRESIDENT
2446. MI M Waters (DA) to ask the Minister of Health:

(1) Whether he placed a moratorium on the awarding of tenders for the disposal of medical waste in each province; if not, what is the position in this regard; if so, (a) which provinces are affected, (b) on what date did the moratorium come into effect, (c) what were the reasons for the moratorium and (d) how is medical waste in each province currently disposed of;

(2) Whether Cabinet revisiting the awarding of tenders for medical waste: if not, when will Cabinet do so: if so, what are the relevant details? NW2854E

REPLY:

(1) The Minister of Health has not placed any moratorium on the awarding of tenders for the disposal of medical waste. In response to pan (d), currently each province has outsourced medical waste services to service providers or contractors who collect, remove, transport, treat and dispose off the waste.

(2) There is no information currently from Cabinet regarding revisiting the awarding of tenders for medical waste

QUESTION NO. 2424

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Mr I M Ollis (DA) to ask the Minister of Health:

What amount was (a) claimed by and (b) paid to (i) him and (ii) his deputy minister for subsistence and travel in each month in the 2010-11 financial year?

NW2819E

REPLY:

The following table reflects the information in this regard.

BENEFICIARY	MONTH	AMOUNT CLAIMED	AMOUNT PAID

Minister	May 2010	R 19 354.29	R 18 056.47
	June 2010	R 25 761.00	R 26 612.12
	October 2010	R 2 823.02	R 2 851.01
	November 2010	R 14 366.80	R 14 267.21
	January 2011	R 5 346.49	R 5 415.11
	February 2011	R 7 825.88	R 7 878.09
	May 2011 (for March 2011)	R 1 637.50	R 1 687.40
	June 2011 (for March 2011)	R 10 759.16	R 10 759.16

		R 87 874.14	R 87 526.57


Deputy Minister	December 2010	R 3 914.49	R 3 608.50
	May 2011 (for Feb & March 2011)	R 15 720.08	R 15 028.94


		R 19 634.57	R 18 637.44

QUESTION NO. 2411

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Mr A M Figlan (DA) to ask the Minister of Health:

Whether (a) his department and (b) entities reporting to it have (i) awarded any tenders and (ii) concluded any (aa) contracts and (bb) financial transactions with certain companies (names and details furnished) in each specified financial year since 2005-06; if so, (aaa) which company or entity, (bbb) what are the relevant details, (ccc) what was the value of each (aaaa) tender, (bbbb) contract or (cccc) financial transaction and (ddd) what was the name of the companies who failed for each tender, contract or financial transaction that was awarded?

NW2802E

REPLY:

(a) No

(b) According to our Public Entities, namely the South African Medical Research Council (MRC), the Council for Medical Schemes (CMS) and the National Health Laboratory Service (NHLS), none of them do or have ever done any business with the listed companies.

QUESTION NO. 2391

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 September 2011

(INTERNAL QUESTION PAPER NO. 27)

Ms C C September (ANC) to ask the Minister of Health:

Whether (a) his department and (b) the entities reporting to him have implemented any energy-saving (i) practices or (ii) devices for buildings, offices and boardrooms in the 2010-11 financial year; if not, why not, in each case; if so, what are the relevant details in each case?

NW2780E

REPLY:

The Department is investigating ways and means of implementing appropriate energy saving measures and devices as recommended by the new building regulations that need to be incorporated and added to the design, construction and operation stages of all health facilities.

QUESTION NO. 2348

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Mr M Waters (DA) to ask the Minister of Health:

Whether he has made any progress in investigating the claim (copies furnished) by a certain person (name furnished) that she fell ill while working at the Johannesburg Hospital; if not, why not; if so, (a) when will the investigation be completed and (b) what are the relevant details of the findings he has made as at the latest specified date for which information is available?

NW2724E

REPLY:

Some progress has been made with the investigation of the claim entered by the person in question.

(a) The investigation will be completed as soon as the Compensation Commissioner can provide proof that compensation was paid to the person in question;

(b) The Compensation Commissioner accepted liability for the payment of benefits to the person in question in terms of the Compensation for Occupational Injuries and Diseases Act 130 of 1993. Furthermore, the person in question was placed on early retirement and is now receiving a monthly pension from the Government Employee Pension Fund (GEPF).

QUESTION NO. 2319

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Ms L D Mazibuko (DA) to ask the Minister of Health:

(1) Whether (a) his department and (b) any entity reporting to him was approached by a certain political organisation (name furnished) to contribute to its centenary celebrations; if so, in each case, (i) which entities and (ii) what was the (aa) nature and (bb) value of the contribution that was requested;

(2) whether (a) his department and (b) any entity reporting to him has a policy that provide for such funding; if so,

(3) whether (a) his department and (b) any specified entity reporting to him has (i) agreed to the request or (ii) made financial contributions to the said political organisation in the absence of such an approach for funding; if not, why not, in each case; if so, in each case, (aa) who approved the request, (bb) on what grounds was the decision made, (cc) from which budget was it (aaa) agreed to pay the contribution or (bbb) paid, (dd) what amount was paid, (ee) who made the decision to provide the specified funds to the said political organisation and (ff) how is this (aaa) decision and (bbb) amount justified?

NW2695E

REPLY:

(1) No.

(2) Not applicable.

(3) Not applicable.

QUESTION NO. 2287

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Mr M J Ellis (DA) to ask the Minister of Health:

Whether he intends to implement any changes to the training of nurses in order to reintroduce bedside training to ensure that nurses have a better understanding of caring; if not, why not; if so, (a) when are these changes coming into effect and (b) what is the nature of these changes?

NW2660E

REPLY:

The training of nurses in better and more caring health provision is a priority for the Department of Health. To this end, a Nursing Summit was held from 5-7 April 2011, to guide the reconstruction of the Nursing profession for a long and healthy life for all South Africans. The Commission on Nursing Education and Training came up with the following recommendations aimed at strengthening the production and quality of nursing training in our country:

· To improve practical clinical aspects of training in a supervised training environment;

· To ensure that ward staff and students in health facilities understand their roles and responsibilities, and display the attitudes that facilitate caring and service delivery;

· Nurse educators are to be involved more intensively in clinical teaching and learning issues through their practice, and through research and scholarly work; and

Following the Summit, a Ministerial Task Team on Nursing Education and Training has been appointed by the Minister of Health to facilitate the implementation of the Summit recommendations, and to develop a detailed plan for the achievement of the Summit recommendations. The Task Team will finish its work before August 2012.

QUESTION NO. 2286

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether the routine monitoring of maternal health care programmes takes into account (a) all the emergency obstetric care indicators and (b) the United Nations (UN) process indicators, as they are widely known; if not, (i) why not, in each case, (ii) when will they be monitored and (iii) what are the implications of not routinely monitoring these indicators;

(2) whether the UN Special Rapporteur has indicated these indicators as essential; if so, when?

NW2659E

REPLY:

(1) (a)-(b) Yes.

(2) The current UN Special Rapporteur on Physical and Mental Health, Mr. Anand Grove, has not made a direct pronouncement on the indicators for Emergency Obstetric Care (EmOC).

QUESTION NO. 2285

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Mr M J Ellis (DA) to ask the Minister of Health:

Whether, with reference to his reply to question 476 on 15 March 2011, the third South Africa Demographic and Health Surveys (SADHS) are currently being conducted; if not, (a) why not and (b) when will the SADHS commence; if so, (i) when did the SADHS commence, (ii) who is conducting the SADHS, (iii) what is the estimated cost of the SADHS and (iv) when are the SADHS expected to be (aa) completed and (bb) published?

NW2658E

REPLY:

No.

(a) and (b) The South African Demographic and Health Survey (SADHS) will be conducted next year. A request for funding has been submitted to National Treasury.

In the interim, the South African National HIV, Behaviour and Health Survey (SABSSM4) and the South African National Health and Nutrition Examination Survey (SANHANES) are being conducted by the Human Sciences Research Council (HSRC).

(i) The SADHS will commence in October 2012.

(ii) Field work for the SADHS will be conducted by an external service provider. The National Department of Health (DoH) will capture the survey data, conduct quality assurance and produce the preliminary and final SADHS reports.

(iii) The estimated cost of the SADHS is R50,760,004.

(iv) (aa) 2013

(bb) 2014

QUESTION NO. 2273

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 August 2011

(INTERNAL QUESTION PAPER NO. 26)

Mr D A Kganare (Cope) to ask the Minister of Health:

(1) What are the costs to each province of providing health care services to (a) legal and (b) illegal immigrants;

(2) whether his department intends recouping these costs from the countries of origin of these immigrants; if not, why not; if so, what are the relevant details?

NW2644E

REPLY:

(1) Healthcare services in South Africa are not financed on the basis of allocations to legal and illegal immigrants. Services are provided in accordance with international obligations that South Africa is signatory to.

(2) Institutions do collect user fees from those that are eligible to pay, including immigrants.

QUESTION NO. 2214

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mr J R B Lorimer (DA) to ask the Minister of Health:

(1) Whether (a) he, (b) his deputy minister, (c) any specified officials and (d) any other persons have been issued with a government or official credit card during the period 1 April 2010 up to the latest specified date for which information is available; if so, what are the relevant details for him, his deputy minister and each holder of a credit card in respect of the (i) name, (ii) job title, (iii) credit limit, (iv) outstanding amount as at the latest specified date for which information is available, (v) monthly expenses incurred for each month since receiving the credit card, (vi) reason for such persons being issued with a credit card and (vii) uses that such a credit card is intended for;

(2) whether any such credit cards are over their credit limit; if so, (a) whose credit cards are over the limit and (b) what is the reason for the credit cards exceeding the limit;

(3) whether any action has been taken against such persons for exceeding their credit card limits; if not, why not; if so, what are the relevant details?

NW2589E

REPLY:

(1) No.

(2) Not applicable.

(3) Not applicable.

QUESTION NO. 2196

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs J F Terblanche(DA) to ask the Minister of Health:

Who (a) serves on the National Committee on Confidential Enquiries into Maternal Deaths Report (NCCEMD), (b) how often do they meet, (c) what (i) is their function and (ii) are their responsibilities and (d) how is the composition of the NCCEMD determined?

NW2570E

REPLY:

(a) Members of the National Committee on Confidential Enquiry into Maternal Deaths:

- Prof Jagidesa Moodley, Obstetrician-Gynaecologist (Chairperson)

- Prof Sue Fawcus, Obstetrician-Gynaecologist (Deputy-Chairperson)

- Dr Gregory Mbambisa, Obstetrician-Gynaecologist

- Prof Marthinus Schoon, Obstetrician-Gynaecologist

- Dr S Seabe, Obstetrician-Gynaecologist

- Prof Robert Pattinson, Obstetrician-Gynaecologist

- Prof CC Rout, Anaesthetist

- Dr Busisiwe Kunene, Advanced Midwife

- Ms Dimpho Chweneyagae, Midwife and South African Military Health Services representative

- Dr Raul Fuentes, Obstetrician-Gynaecologist (resigned to further studies)

- Dr Ntando Godi, Obstetrician-Gynaecologist

- Ms Nana Molefe, Advanced Midwife

- Dr Zane Farina, Anaesthetist

- Prof Nomafrench Mbombo, Advanced Midwife

- Dr Delis Nilda, Obstetrician-Gynaecologist (Alternate is Ms Magdeline Lekhoathi, Advanced Midwife)

- Dr Neil Moran, Obstetrician-Gynaecologist

- Ex-Officio members:Senior and Middle managers in the Maternal, Child and Women's Health Cluster, National Department of Health.

(b) They meet quarterly and once annually with all the provincial maternal death assessors.

(c) (i) and (ii) The function of the NCCEMD is to analyse all reported maternal deaths and to make practical recommendations to reduce mortality.

The Committee is responsible for producing interim and triennial reports.

(d) The composition of the Committee is a Ministerial prerogative and it is based on members having known skills in the fields of obstetrics, midwifery and anaesthesia.

QUESTION NO. 2195

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs J F Terblanche(DA) to ask the Minister of Health:

Whether his department has conducted an analysis of resources and competencies needed to implement the findings of the Confidential Enquiries into Maternal Deaths (CEMD) report; if not, why not; if so, (a) when was it completed and (b) what was the result of this analysis?

NW2569E

REPLY:

The Department has analysed the competencies needed to implement the recommendations of the National Committee for the Confidential Enquiry into Maternal Deaths (NCCEMD). This has resulted in the upgraded training in essential steps in the management of obstetric emergencies (ESMOE). The analysis is part of the normal activities of the NCCEMD. The human and financial resources need not have been analysed. These are complex and change as health provider movement occurs within the facilities.

QUESTION NO. 2194

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs J F Terblanche(DA) to ask the Minister of Health:

(1) What were the recommendations of the Confidential Enquiries into Maternal Deaths (CEMD) report of 1997;

(2) whether his department monitors how each province implemented the recommendations of the CEMD since 1997; if not, why not; if so, (a) which recommendations have been implemented in each province, (b) in which year were they implemented, (c) in which health facilities have they been fully implemented and (d) which official from his department conducts oversight visits to ensure that these recommendations have indeed been implemented;

(3) whether each province reports to his department annually on the progress made in respect of the implementation of these recommendations; if not, (a) why not, (b) in which years has each province submitted such reports and (c) what action did his department take for each year that a province did not report on its implementation of the CEMD recommendations; if so, what are the relevant details?

NW2568E

REPLY:

(1) The key recommendations of the Confidential Enquiries into Maternal Deaths (CEMD) Report of 1997/98 included:

· Development and distribution of guidelines;

· Establishment of referral routes;

· Developing staffing norms;

· Expansion of number of sites that can provide termination of pregnancy services;

· Strengthen the use of the partogram;

· Strengthening family planning services;

· Development of a national HIV and AIDS policy.

(2) (a) The Department monitors implementation of the CEMD recommendations;

(b) All provinces have implemented the recommendations with some variation across health facilities largely dependant on availability of skilled personnel;

(d) Officials from the National Department of Health Cluster: Maternal and Child Health visit provinces and facilities to oversee the implementation of the recommendations.

(3) Provinces provide quarterly reports to the National Department of Health.

QUESTION NO. 2193

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) Whether his department has any programmes in place in respect of (a) health workers' motivation and commitment to provide good, quality, patient-centred care and (b) strengthening health system accountability; if not, why not; if so, (i) how many health workers have attended such programmes in each province for the three most recent financial years for which information is available and (ii) who conducts these programmes;

(2) whether the effectiveness of these programmes are measured; if not, why not; if so, (a) how, (b) by whom, (c) what aspects are taken into account to determine if the programme is (i) working or (ii) not working and (d) what were the results of the effectiveness of the programmes in each province?

b)NW2567E

REPLY:

(1) (a)-(b) (i) Yes. The following table reflects the details in this regard

Province/National	Programme	2008/09	2009/10	2010/11
National	(a) Motivation and commitment - Employee health and wellness - Commemoration days - Health screenings - Motivational sessions - Sports and recreation - Wellness days - Personal Financial Management (b) Strengthening health system and accountability - Patient entrapment - Health leadership programme - Basic life support - Advance Trauma - Cytology update - Palliative care - RMR Data elements and definitions - Advanced dissolution - SAAPI - Aseptic process - Chemical monitoring - Analytic conference	380	492 13 13 4 2	480 211 310 25 34 15 35 77
Free State	(a) Motivation and commitment - Employee assistance programme - Staff indabas - Service excellence awards - Cecilia Makiwane Nominations for National awards (b) Strengthening health system accountability - Leadership courses for Managers	330	200	189
Limpopo	(a) Motivation and commitment - Personal financial management - Empowerment sessions - Employee wellness referral procedures and services - Stress management - Sports and recreation activities - Promotion of healthy lifestyle (b) Strengthening health system accountability - HIV and AIDS workplace management programme - Supervisors role on employee health and wellness	763 1645 347 679 1489 107	819 596 414 1153 474 144	82 596 63 459 1288 144
Mpumalanga	(a) Motivation and commitment - Employee health and wellness - Service delivery improvement programme - Human Resource Development programme - Occupational health and safety programme - Health information system (b) Strengthening health system accountability - Leadership and governance - Financial and Human Resources management policies - Quarterly monitoring and evaluation strategy - Human resources plans and performance system
Northern Cape	(a) Motivation and commitment - Awards systems (b) Strengthening health system accountability - District health expenditure review - Departmental Batho Pele Forum - Clinic committees	1294	3159	3500
Western Cape	(a) Motivation and commitment - Staff satisfaction survey - Health and wellness (b) Strengthening health system accountability - Barret value survey		600
Gauteng	(a) Motivation and commitment - Employee health and wellness (b) Strengthening health system accountability - Employee assistance programme	5964	7410	10329
KwaZulu/Natal	(a) Motivation and commitment - Employee assistance programme (b) Strengthening health system accountability - Human resource development			3176 41306
North West	(a) Motivation and commitment - Stress management - Men and women's health talks - Employment assistance programme supervisory - HIV and AIDS in the workplace			317 749 2334

(ii) Who conducts these programmes

The following providers cut across all the provinces in conducting programmes:

· Employee Health and Wellness Practitioners or coordinators;

· Government Employee Medical Scheme (GEMS);

· Public Administration and Leadership Academy (PALAMA);

· National Credit Regulator;

· Banking Ombudsperson;

· ICAS;

· Accreditation Programme by Council for Health Service Accreditation in Southern Africa (COHSASA)

(2) Yes.

(a) Through Departmental monitoring and evaluation systems;

(b) By the Departmental Monitoring and Evaluation Unit;

- Absenteeism rates;

- Number of prevention and motivational training programmes done;

- Level of productivity by employees;

- Complaints from the public;

- Number of grievances reported on that financial year.

(d) The results of the effectiveness are -

- Low level of absenteeism;

- Decreased number of complaints;

- High level of productivity;

- Positive attitude of the employees;

- Decreased number of grievances

QUESTION NO. 2192

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) Whether any mechanisms are in place with regard to patient complaint procedures at all health care facilities; if not, (a) why not and (b) when will such mechanisms be put in place; if so, what are the minimum standards that each of these facilities must have in place with regard to (i) informing patients that such a facility exists, (ii) standardised complaint forms, (iii) languages of complaint forms, (iv) assistance for those who need to complete the complaint forms, (v) the complaints desk and (vi) any other matters;

(2) whether the complaints received from all these facilities are analysed to (a) identify systematic failures of the public health system, (b) hold accountable those responsible for any violations, (c) identify reforms and (d) prevent the recurrence of any violations; if not, why not, in each case; if so, how is this done in each case;

(3) whether health professionals receive any education with regard to the patient complaints procedures; if not, why not; if so, how (a) often and (b) is the training monitored?

NW2566E

REPLY:

According to the Provinces, the answers to these questions are as follows:

(1) Minimum Standards for each facility

Western Cape: A formalised, documented policy and procedure for the management and monitoring of complaints is in place.

North West: A formalised complaints' management system is in place.

Free State: A complaints management system is in place in all health facilities.

Eastern Cape: The provincial complaints management system is managed in accordance with the provincial Complaints Guideline.

Gauteng: A provincial complaints procedure is in place at all health care facilities.

Northern Cape: A provincial procedure to manage complaints is in place.

Mpumalanga: A complaints procedure is not available in all health care facilities due to non-compliance by some facility managers. This is currently being addressed through in-service training in the non-complying facilities.

KwaZulu-Natal: A complaints procedure is available in all health facilities.

Limpopo: Still waiting for a response from the Province.

(i) Informing patients that such a facility exists?

Western Cape: All facilities have notices visible to patients detailing how to lodge a complaint and the management thereof.

North West: The complaints mechanism is displayed on notice boards in local languages especially in waiting and in patient care areas. Complaints management forms part of patient orientation during admission and health education programmes.

Free State: The complaints management procedure is displayed at all facilities.

Eastern Cape: During the development phase of the provincial Complaints Guideline, community/ governance structures were consulted and clear turnaround times agreed to. Subsequent to the approval of the said guideline, citizens/ patients were made aware through workshops and via the printed media (local newspapers). Furthermore, complaints boxes and registers are available in all health institutions.

Gauteng: Guidelines on how to lodge and respond to complaints were developed in three languages (i.e. English, Zulu and Tswana) for patients and staff. Posters displaying the relevant complaints management detail are in all front line and patient care areas in all facilities.

Northern Cape: Notices informing patients that they have a right to complain and how to complain are displayed in all health facilities.

Mpumalanga: The complaints procedure is displayed in facilities and suggestion boxes are also in place.

KwaZulu-Natal: There are help desks at the entrances to the Casualty and Outpatients departments of health facilities that are manned 12 hours per day. Complaints boxes labelled in common languages are in place at strategic points, and above these boxes the complaints procedure is displayed, also written in the common languages.

(ii) Standardised complaint forms

Western Cape: Complaints forms and boxes are available at all facilities.

North West: Standardised complaints/ compliment forms are available at service delivery points. Suggestion boxes are opened on a weekly basis.

Free State: Standardised complaints forms are available as well as suggestion boxes.

Eastern Cape: Complaints forms are standardised as per departmental policy.

Gauteng: Standardised complaints forms exist and are regularly reviewed for both telephonic and written complaints.

Northern Cape: Each facility utilises a form developed by the facility.

Mpumalanga: The Nkangala and Gert Sibande Districts have standardised complaints forms, but in the Ehlanzeni District these forms are not standardised for the whole district.

KwaZulu-Natal: A standardise complaints for is being used. The form allows the client to document the nature of the complaint, the date when it occurred, and where it happened in the facility. Although the form makes provision for the name and contact details of the complainant, it is not obligatory to fill in these fields.

(iii) Languages of complaint forms

Western Cape: Forms are available in three official languages, i.e. English, Xhosa and Afrikaans.

North West: Complaints forms are available in the local languages.

Free State: Complaints forms are available in the common languages of the Free State, i.e. English, Afrikaans and Sesotho.

Eastern Cape: Currently, only English is being used on complaints forms.

Gauteng: Complaints forms are available in English, Zulu and Tswana.

Northern Cape: Four languages are being used, i.e. English, Afrikaans, Tswana and Xhosa.

Mpumalanga: User friendly complaints forms written in Zulu, Sotho, Ndebele, Swazi, Tonga and English are available in relevant areas.

KwaZulu-Natal: English, Afrikaans, Zulu, Xhosa and Sotho are used.

(iv) Assistance for those who need to complete the complaint forms?

Western Cape: The complaints notices indicate who the complainant should approach should he/ she require assistance with the completion of a complaint form.

North West: Patients are encouraged to write down complaints themselves, but if unable to do so, the QA Manager or Client Relation/ Customer Care Officer will assist.

Free State: Assistance in completing the complaints form is offered by the customer care officer, but where no such officer exists in a facility, the facility manager act as a complaints desk assistant.

Eastern Cape: Assistance is provided to complainants when required.

Gauteng: Assistance is provided to those that need to lodge a complaint. Information booklets for patients are also available in the three languages mentioned. These booklets guide patients and the public.

Northern Cape: Assistance is provided to those that want to lodge a complaint. Although complainants are encouraged to give written complaints, many patients prefer to lodge complaints verbally only and these complaints are recorded in a register kept by the facility.

Mpumalanga: Help desks are available in some health facilities and are manned by administrative staff. Where there are no help desks, complaints are directed to the operational managers who then assist complainants.

KwaZulu-Natal: Staff members that man the help desks assist clients to write and lodge complaints.

(v) The complaints desk

Western Cape: Some facilities have help desks.

North West: Most hospitals do have well established help desks.

Free State: The customer care officer manages the help desk in facilities where such desk exists. Where no such desk exists, the facility manager fulfils the role of complaints desk.

Eastern Cape: No dedicated complaints desks exist, but information desks are available in some facilities.

Gauteng: A complaints help desk is functional as per quality standard at all facilities.

Northern Cape: Some hospitals do have a help desk that attends to more than merely complaints.

Mpumalanga: See answer to question 1(iv) above.

KwaZulu-Natal: All help desks are manned for 12 hours per day.

(vi) Any other matters

Western Cape: Complaints may be lodged telephonically, verbally or in writing.

North West: Complaints registers are kept centrally and at sectional level to ensure entry of all types of complaints, i.e. verbal, written, telephonically and media related. Complex clinically related complaints are reported through Patient Safety Groups.

Free State: There is a dedicated toll free line for complaints and compliments.

Eastern Cape: No other matters reported.

Gauteng: A 24-hour/ 7 days-per-week Health Complaints Call Centre with dedicated staff was sourced in 2010 to improve access for the public to complain.

Northern Cape: The province is in the process of revising the provincial complaints procedure that will include guidance on risk assessment, how to gain evidence, record keeping and response times.

Mpumalanga: A complaints profile is not received from sub-districts every month. Complaints are reported in a template which captures most of the issues on a monthly basis.

KwaZulu-Natal: No other matters reported.

(2) (a) Identify systematic failures of the public health system

Western Cape: All facilities maintain a complaints register. A statistical return, inclusive of a narrative, is forwarded to the Quality Assurance Unit on a quarterly basis. The returns are collated into a single Provincial Profile. The data and narrative is analysed to monitor trend and variances between various quarters. The narrative, which accompanies the statistical return, reflects what action was taken to resolve the complaint inclusive of the number of complaints resolved within the stipulated 25-day period.

North West: All reported complaints are registered and analysed. Redress meetings are held and feedback is provided to complainants. Monthly and quarterly reports are compiled and submitted to the provincial QA Unit. Complaints involving adverse events are reported through Patient Safety Groups and are analysed to identify systems and human behaviour failures. Suitable action is taken with regard to health care providers involved in adverse events, while system failures are addressed through making recommendations to the relevant managers.

Free State: Complaints are registered and analysed monthly by facilities' Quality Management Meetings. The decisions taken at the latter meetings are monitored through the District Health Information System (DHIS) to check and promote case completion.

Eastern Cape: All complaints are registered and analysed. The Provincial Complaints Committee analyses deaths and cases of negligence.

Gauteng: Complaints received from all facilities are analysed, trends identified and action plans developed to close gaps identified.

Northern Cape: Primarily, the focus of the complaints procedure has been to satisfy the complainant in terms of addressing the reason(s) why he/ she complained in the first place. This focus will however expand to also remedy systemic problems once the new policy had been promulgated in the province.

Mpumalanga: Complaints committees including governance structures are in place to analyse complaints received on a monthly basis.

KwaZulu-Natal: Analysis of complaints is done at facility level. However, there is an acknowledgement that this analysis is at time inadequate at a facility, district and provincial level.

(b) Hold accountable those responsible for any violations

Western Cape: Actions taken to resolve complaints could include addressing issues of accountability.

North West: See answer to 2(a) above.

Free State: Should the outcome of an investigation require disciplinary action, the province initiates the disciplinary procedure and applies sanctions for those found guilty.

Eastern Cape: Employees are held accountable should the outcome of investigations demand such route. The latter could include reporting officials to the relevant statutory councils for the various categories of health professionals.

Gauteng: Disciplinary action is instituted against individuals found guilty of professional or clinical negligence.

Northern Cape: In instances where investigation into complaints reveals gross negligence or professional misconduct, health professionals are disciplined accordingly.

Mpumalanga: Those responsible for any violation are counselled. Depending on the severity of the violation, the immediate supervisor refers the case to the next level. An investigation is conducted and where necessary, disciplinary measures are taken.

KwaZulu-Natal: Staff is seldom held accountable.

Western Cape: See answer to 2(a) above.

North West: See answer to 2(a) above.

Free State: The need for systemic reform is identified through independent Patient Satisfaction Surveys that are conducted annually to determine the impact of the customer services programmes and to review the programmes.

Eastern Cape: Redress is done by the heads of institutions.

Gauteng: Reforms are informed by the outcome of the investigation of complaints.

Northern Cape: See answer to 2(a) above.

Mpumalanga: Reforms are identified and quality improvement plans are developed in accordance to the identified gaps.

KwaZulu-Natal: Reforms are informed by the analyses of complaints that do take place.

(d) Preventing the recurrence of any violations

Western Cape: See answer to 2(a) above.

North West: See answer to 2(a) above.

Free State: The sanctions the province applies are progressive disciplinary measures while proven gross violations could culminate in discharge from the public sector.

Eastern Cape: Discussions are held with the implicated parties and focussed Quality Improvement Plans developed to avoid recurrence.

Gauteng: Corrective measures are instituted to close gaps identified to avoid recurrence of incidents of similar nature.

Northern Cape: See answer to 2(a) above.

Mpumalanga: The monitoring and evaluation of quality improvement plans (QIPs) are done to determine whether recurrence of violations are avoided/ are declining. In-service training is often conducted as part of the QIP.

KwaZulu-Natal: Monitoring is done at a facility and district level to prevent recurrence.

(3) Whether health professionals receive any education with regard to the patient complaints procedures

Western Cape: All staff is fully conversant with the provincial complaints procedure. The provincial induction programme for new appointees includes training on the management and monitoring of complaints.

North West: The Customer Care & Redress sub-directorate conducts monthly visits to all facilities for support and training on Customer Care Standards, including Complaints Mechanisms. Facility inspections to monitor compliance on complaints management are also conducted and guidance is provided where deficiencies are identified. The said sub-directorate also coordinates annual hospital peer reviews on Customer Care Standards including complaints management.

Free State: During orientation all health professionals are provided with information on complaints management. The provincial Staff Development Units also conduct in-service training on the complaints management system at least quarterly.

Eastern Cape: Customer Care workshops which involves complaints management are continuously held throughout the Province, but at times these workshops are suspended due to budgetary constraints.

Gauteng: Health professionals receive training on the complaints procedure and ongoing in-service training is given to staff at facility level. The complaints procedure forms an integral part of the induction programme for newly appointed staff members.

Northern Cape: The relevant training is conducted during induction of newly appointed staff and also during continuous in-service training that takes place in the province on Customer Care.

Mpumalanga: Training on Batho Pele that includes training on complaints management is being conducted quarterly per facility. This is done by the provincial Gender & Transformation Unit.

KwaZulu-Natal: In-service education on complaints management is done by the Provincial Human resource Development Unit.

(a) How often

Western Cape: Frequent provincial induction programmes are conducted per year.

North West: See answer to question 3 above.

Free State: See answer to question 3 above.

Eastern Cape: See answer to question 3 above.

Gauteng: Provincial induction programmes are conducted as the need arises.

Northern Cape: See answer to question 3 above.

Mpumalanga: Training takes place on a quarterly basis and when the need arises.

KwaZulu-Natal: In-service education is done annually by targeting facilities per district. Training on complaints management is also part of induction courses that do continuously take place at facility level throughout the year.

(b) Training monitored

Western Cape: Facilities maintain a record of all staff who has attended the induction programme.

North West: Training is monitored as part of officials' individual Performance Management & Development agreements.

Free State: All training is monitored on a monthly basis through reports as well as complaint trends in the DHIS.

Eastern Cape: (no response)

Gauteng: (no response)

Northern Cape: Training registers are kept at facility level on who has been trained on complaints management, and records are kept at the provincial Human Resource division as part of the provincial Skills Development Plan.

Mpumalanga: Training compliance is monitored by the Gender & Transformation Unit of the provincial health department and subsequent reports are submitted to the management of each facility.

KwaZulu-Natal: Monitoring of training is done by the Provincial Human Resources Development Manager and by the Facility Chief Executive Officer through the Public Relations Officer.

QUESTION NO. 2186

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) Whether he has been informed of a certain study conducted by a certain person (name and details furnished), which found that more than 80% of persons who died of certain types of cancer in the city of Belo Horizonto lived fewer than 500 meters away from 300 identified cellular phone masts; if not, what is the position in this regard; if so, what steps does he intend taking in this regard;

(2) whether he will commission a similar study; if not, why not; if so, when?

NW2559E

REPLY:

(1) The Department of Health has noted the media reports relating to this study, but does not intend to take any steps at present. The reported outcome of the study and especially the conclusions reached are in total conflict with numerous similar studies and still needs to be subjected to international peer review.

(2) The Department will not commission a similar study into the effects of radiation from cellular phone base stations and masts, because this type of research typically requires huge resources in terms of funds, personnel, expertise and research infrastructure, none of which are readily available to the Department at present. Instead the Department of Health utilises the World Health Organisation (WHO)'s International Electromagnetic Fields Project as its primary source of information and guidance. The Department of Health has been a member of the International Advisory Committee of the WHO International Electromagnetic Fields Project since 1998.

The WHO currently summarise the International scientific position as "Considering the very low exposure levels and research results collected to date, there is no convincing scientific evidence that the weak RF signals from base stations and wireless networks cause adverse health effects."

QUESTION NO. 2184

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether he has been informed that a certain medical scheme (name furnished) plans to deliver antiretrovirals to 62 000 of its members that are on the medication via courier; if not, what is the position in this regard; if so,

(2) whether he has found that such distribution is in accordance with good pharmacy practice including the proper (a) storage of the medication and (b) timing of the delivery; if not, why not, in each case; if so, what are the relevant details in each case?

NW2557E

REPLY:

(1) The Medical Scheme in question is under the oversight of the Minister for the Public Service and Administration. Nevertheless, we are aware that several medical schemes, including the one mentioned in this question, have appointed a courier pharmacy to supply anti-retroviral medicines or other chronic medicines to scheme members.

(2) A number of courier pharmacies have been issued with licences to operate as such by the South African Pharmacy Council (SAPC). The South African Pharmacy Council independently evaluates each application against a range of norms and standards before approving the licence. Where the SAPC finds that medicine distribution/storage or any other aspect of a good pharmacy practice has been contravened, the licence of the pharmacy can be withdrawn. We have not received any evidence to indicate that the distribution or storage of medicines by such a pharmacy is not in compliance with these standards.

QUESTION NO. 2183

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mr M Waters (DA) to ask the Minister of Health:

What (a) was the cost and (b) were the terms of reference of the report concerning the competencies of hospital chief executive officers?

NW2556E

REPLY:

(a) The total cost of the contract between DBSA and HLSP was not only for CEOs but was an all inclusive one involving the District Managers, the introduction of new delegations, prioritizing specialized training curricula, improving performance management systems and informing future recruitment processes.

(b) The terms of reference for this work are:

(i) Survey hospital CEOs and District Managers on policy and institutional matters and processes, the delegations of authority and the sequencing of their introduction, and the national health priorities and the National Department of Health's Ten-Point Plan;

(ii) Better understand how hospital CEOs and District Managers assess their own competencies and development needs;

(iii) Gather information about the readiness of hospital CEOs and District Managers and health institutions for the introduction of new delegations of authority;

(iv) Determine the training and development needs of individual hospital CEOs and District Managers and of groups or clusters of these managers;

(v) Act as a platform for the design and prioritise specialized training curricula to meet the current and future needs of hospital CEOs and District Managers;

(vi) Form an input into initiatives to improve performance management systems and criteria and to assist with the development of Personal Development Programmes (PDPs);

(vii) Inform future recruitment processes and methodologies of hospital CEOs and District Managers; and

(viii) Test ideas about post definitions or job descriptions.

QUESTION NO. 2183

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 August 2011

(INTERNAL QUESTION PAPER NO. 25)

Mr M Waters (DA) to ask the Minister of Health:

What (a) was the cost and (b) were the terms of reference of the report concerning the competencies of hospital chief executive officers?

NW2556E

REPLY:

(b) The terms of reference for this work are:

(ii) Better understand how hospital CEOs and District Managers assess their own competencies and development needs;

(iii) Gather information about the readiness of hospital CEOs and District Managers and health institutions for the introduction of new delegations of authority;

(iv) Determine the training and development needs of individual hospital CEOs and District Managers and of groups or clusters of these managers;

(v) Act as a platform for the design and prioritise specialized training curricula to meet the current and future needs of hospital CEOs and District Managers;

(vi) Form an input into initiatives to improve performance management systems and criteria and to assist with the development of Personal Development Programmes (PDPs);

(vii) Inform future recruitment processes and methodologies of hospital CEOs and District Managers; and

(viii) Test ideas about post definitions or job descriptions.

QUESTION NO. 2099

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mrs H Lamoela (DA) to ask the Minister of Health:

(1) Whether any training institutions for nurses have been granted training licences since the moratorium was lifted; if not, why not; if so, (a) how many and (b) in each case, (i) where are they situated and (ii) on what date was the license issued;

(2) (a) how many applications are currently with the SA Nursing Council (SANC) and (b) on what date was each application received;

(3) whether any accreditation meetings have been held (a) in (i) 2009 and (ii) 2010 and (b) during the period 1 January 2011 up to the latest specified date for which information is available; if not, why not; if so, (aa) on what date did each meeting take place and (bb) who attended each meeting?

NW2373E

REPLY:

(1) No. Applications submitted to the SA Nursing Council did not meet minimum requirements for accreditation as nursing education institutions.

(2) (a) 171.

(b) The applications were received on various dates.

(3) (a) (i) Yes

(ii) Yes

(b) Yes

(aa) Year 2009:

14 and 15 January 2009

18 and 19 March 2009

13 May 2009

15 July 2009

17 November 2009 and 11 December 2009

Year 2010:

29 January 2010

25 and 26 February 2010

13 and 14 April 2010 and 25 August 2010

Since 1 January 2011:

25 January 2011

14 April 2011 and 23 August 2011

(bb) Five Council members that serve on the Accreditation Committee and Council employees that act as secretariat.

QUESTION NO. 2097

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mrs P C Duncan (DA) to ask the Minister of Health:

(1) What are the reasons for the final report of January 2011 into neonatal deaths at the Cecilia Makiwane Hospital failing to stipulate any recommendations on remedial action to deal with (a) gross mismanagement due to the lack of cleaning materials, (b) the lack of a culture of hand washing and (c) the failure to wear masks in the neonatal intensive care unit;

(2) whether he intends referring the report back to the authors in order to include recommendations; if not, why not; if so, when;

(3) whether any of the parents of the deceased babies that have been referred to in the report have taken any legal action against his department; if so, (a) how many and (b) what is the status of such legal action?

NW2371E

REPLY:

(1) (a) to (c) The Report did actually makes recommendations, as attached.

(2) Not applicable.

(3) Not to the knowledge of the National Department of Health.

QUESTION NO. 2091

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mrs P C Duncan (DA) to ask the Minister of Health:

Whether the appointment as chief executive officers of hospitals is based on a persons' qualifications; if not, what other qualities are assessed to determine if a person is suitable for the job; if so, what are the relevant details?

NW2365E

REPLY:

CEOs are appointed based on the Public Service Regulations related to the requirements of the job. The job requirements will determine the level of education in line with the stated regulations. Specific qualities are identified during the selection and interview processes.

QUESTION NO. 2090

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mrs H Lamoela (DA) to ask the Minister of Health:

(1) Whether any new nursing colleges have been opened during the period 1 January 2011 up to the latest specified date for which information is available; if not, why not; if so, (a) where are they located and (b) when were they opened, in each case;

(2) whether any nursing colleges that were closed have been reopened during the period 1 January 2011 up to the latest specified date for which information is available; if not, why not; if so, in each case, (a) which ones, (b) on what dates were they reopened and (c) where are they located?

NW2363E

REPLY:

(1) No. Applications that were submitted to the SA Nursing Council did not meet minimum requirements for accreditation as nursing education institutions.

(2) No. See answer at (1) above.

QUESTION NO. 2066

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mr M Waters (DA) to ask the Minister of Health:

(1) Whether, with reference to his reply to question 945 on 10 September 2009, the final results of the pilot project have been released; if not, (a) why not and (b) when will the results be finalised; if so, what were the results;

(2) whether there is any finality with regard to plans to implement such a system across the country; if not, why not; if so, what plans?

NW2292E

REPLY:

(1) Yes, the pilot project has been completed.

(a) Falls away;

(b) The pilot phase has shown clearly that the concept of a Centralised Chronic Medicines Dispensing Unit (CCMDU) with a variety of medicine collection points is a feasible way to decongest hospital pharmacies, as well as providing quicker and easier access to chronic medicines for patients. It also provides an opportunity to support the rapid scale-up of the provision of anti-retroviral treatment (ART). A new facility of adequate size is being considered for the up scaling of the current facility (for eThekwini District) to provide a province-wide dispensing service that includes ARVs.

(2) KwaZulu/Natal Department of Health is currently working on a Request for Proposal (RFP) to evaluate the feasibility of implementing the system with current resources.

QUESTION NO. 2065

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 August 2011

(INTERNAL QUESTION PAPER NO. 23)

Mr M Waters (DA) to ask the Minister of Health:

Whether, with reference to his reply to question 2280 on 10 December 2009, his department intends classifying all drugs according to the harm caused to the user; if not, why not; if so, when?

NW2291E

REPLY:

The Medicines Control Council (MCC) classifies drugs on the basis of the active ingredients they contain, into eight (8) schedules. The scheduling is based on safety- related risk. The higher the schedule, the tighter are control measures attached to the drug. A substance may be rescheduled to a higher schedule should it be found to be less safe than originally thought or when reports of abuse are received.

Narcotic and psychotrophic substances which may be listed under any of the International Drug Control Conventions are included in the schedules in a manner consistent with the recommendations of the World Health Organisation (WHO), and the United Nations International Drug Control Programme.

QUESTION 2000 NW2391E

FOR REPLY BY THE MINISTER

Mr. MJ Ellis (DA) to ask the Minister of Health

(1) Why was medical waste from clinics not included in the initial contract that the Limpopo Department of Health awarded to a certain company (name furnished) in 2005 to dispose of medical waste;

(2) Whether all the prescribed procurement process were followed in awarding this contract to the said company in 2005; if not what ore the relevant details; if so, how was the conclusion reached;

(3) (a) What extra amount per month was paid to the said company when the contract, was eventually extended to include thedisposal of medical waste from the province's clinics and (b) what happened to the medical waste that was generated during the period for which there was no contract to dispose of medical waste from these clinics;

(4) Whether the said company has put upa treatment facility in terms of the requirements of the initial tender; if not, why not, if so

(5) Whether the treatment facility has been licensed and is operating; if not why not, in each case; if so, what are the relevant details in each case?

REPLY

(1) Clinics were not included due to insufficient funding at the time.

(2) Yes, all prescribed procurement were followed. The bid was awarded to the company that compliedwith all the evaluation criteria.

(3) (a) R667 000

(b) The Department was guided by the following basic principle on safe handling and storage of health waste:

· The World Health Organization (WHO) recommends that where legal requirements cannot be met, health care facilities can burn hazardous health care waste in open trenches within their premises, (Safe Management of waste from health care facilities: 1999 WHO, Geneva).

· TheSouth African National Standards (SANS} 10248:2004, sec A.5,5 strongly recommends that for safety reasons, health care facilities that are without adequate treatment facilities dispose off their hazardous health waste within their own premiSe5.(SANS 10248:.2004: Management of health care waste, edition 2)

(4) Yes, all requirements were adhered to. (Please see the attached document)

(5) Yes, the treatment facility has been licensed and is operating_ (Please to the attached document)

(a) Solid Waste Technologies SA (Pty) LTO (SWTSA)

· it was licensed or permitted in 2002

· it is operating from City Deep Johannesburg and Cape Town

· it is managed by Mr. Edgar Adams

(b) Thermopower Process Technology (Pty) Ltd

QUESTION NO. 2004
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 05 August 2011
(INTERNAL QUESTION PAPER NO. 21)
Mr D J Maynier (DA) to ask the Minister of Health:

(a) At how many (i) international and (ii) domestic hotels/guest houses were (aa) he and (bb) his Deputy Minister accommodated during the period 1 April 2009 up to the latest specified date for which information is available and (b) what (i) was the (aa) name, (bb) star rating and (cc) city location of each specified establishment, (ii) was the (aa) duration and (bb) purpose of the stay in each case and (iii)(aa) was the total cost of the accommodation and (bb) is the breakdown of the accommodation cost in each case?

NW2250E

REPLY:

(a)-(b) Honourable Member I am unable to answer this question now because I am still investigating the information received from the travel agency and the Department of International Relations and Cooperation (DIRCO). Some of the information provided to me is unacceptable to me because it even mentions places I have never been to, or amounts I cannot associate with.

I will be able to answer as soon as I am satisfied with information provided to me.

2011-03-07

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