Questions & Replies: Health
2011-09-06
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QUESTION NO. 1069
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether the National Health Laboratory Service has experienced, or is experiencing, backlogs which are affecting the provision of services to other departments; if so, what type of backlogs;
(2) (a) what has his department done, or does it intend doing, to ensure that these backlogs are alleviated, (b) how long is the action expected to take and (c) how much will it cost?
NW1189E
REPLY:
(1) The NHLS does experience backlogs at specific laboratories from time to time like any other diagnostic laboratory. This may arise from equipment or IT down time or absenteeism.
The specific area where the NHLS has challenges is Cytology. Cytotechnology is a very scarce skill.
(2) (a) When backlogs arise the NHLS generally diverts specimen to other NHLS laboratories in the vicinity to ensure that turn-around times are not compromised. In addition from time to time small amount of histology specimens are sent to a Private laboratory due to shortages in pathologists.
(b) It is expected that the NHLS will not have backlogs when the next batch of pathologists qualify in June 2011.
To respond to the increased demand in Cytology services and to maintain an acceptable turn-around time the NHLS is testing a new more automated cytology platform called Liquid Based Cytology.
(c) The NHLS currently spends about R250,000 per month to clear backlogs.
QUESTION NO. 1068
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) (a) Which security company or department provides security services at a certain hospital (name furnished) in Thaba Nchu, (b) how many security personnel are usually deployed at this hospital on Saturday nights and (c) what type of equipment is provided to them in order to perform their protection services to staff and patients;
(2) whether he has found that the security services provided at this hospital are adequate; if not, why not; if so,
(3) whether he will make a statement on the matter?
NW1188E
REPLY:
(1) (a) The Free State Department of Health provides the security services (in-house) at Dr JS Moroka Hospital.
(b) There are 10 security personnel that are deployed at this hospital on Saturday nights.
(c) The following equipment is provided to them to perform the protection services:
§ Hand cuffs
§ Pepper sprays
§ Batons
§ Two way Radios
§ Security uniform
§ Torches
(2) The number of security personnel at Dr J.S. Moroka is not adequate.
(3) The Department is currently reviewing and strengthening the security measures at all the institutions in the province by increasing the numbers of security personnel and installing the CCTV cameras within which Dr J.S. Moroka is one of the hospital earmarked for 2011/12
QUESTION NO. 1050
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Ms E More (DA) to ask the Minister of Health:
(1) Whether any tenders have been awarded for an audit of (a) infrastructure, (b) technical capacity and (c) baseline inspection of competency; if so, in each case, (i) when was the tender awarded, (ii) what is the value of the tender, (iii) to whom was the tender awarded and (iv) what is the scope of the tender;
(2) when will the reports on the tenders be (a) finalised and (b) made public?
NW1168E
REPLY:
(1) The tender was awarded based on service package, human resources, information systems, infrastructure including media (health technology) and non-medical equipment, pharmaceutical supplies, communications systems, compliance with six priority areas e.g. cleanliness of facilities, waiting times, etc) referral patterns.
(i) The tender was awarded on the 01 February 2011;
(ii) The value amount was R25 712 503.00;
(iii) It was awarded to Health Systems Trust (HST) Consortium comprising of HST, ARUP, MRC and HISP;
(iv) The scope on this tender is to conduct a facilities audit for the public sector facilities for the next twelve months.
(2) (a) The final report on the tender will be available in May 2012, since the tender period is over a 12 month period;
(b) The report will be made public once the Minister has approved its release.
QUESTION NO. 1049
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr M Waters (DA) to askthe Minister of Health:
Whether any person has been held accountable for (a) infant and (b) child deaths at any health facility since 27 April 1994; if not, why not; if so, in each case, (i) what are their names, (ii) what positions did they hold, (iii) at which health facility did they work, (iv) how many deaths are involved and (v) what have been the consequences for each person?
NW1167E
REPLY:
All health professionals employed by the public health sector are required to be registered by the relevant statutory council before employment. This practice predates April 1994.
These councils include the Health Professions Council (HPCSA), the South African Nursing Council (SANC) and the South African Pharmacy Council (SAPC).
All professional and ethical transgressions are therefore sanctioned by these Councils should a member be found guilty or culpable.
Should the Honourable Member need a list of people sanctioned by these councils since 1994, then the Honourable Member may make such a request.
QUESTION NO. 1048
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether any monies have been allocated to the employment of inspectors for the Office of Standards Compliance in the (a) 2009-10, (b) 2010-11 and (c) 2011-12 financial years; if not, why not; if so, how much in each case;
(2) whether any of the positions for inspector have been (a) advertised and (b) filled since 1 April 2009; if not, why not; if so, (i) on what date was each advertisement placed, (ii) how many inspectors have been appointed and (iii) on what date did their employment commence;
(3) what are the minimum qualifications required to be an inspector in this office?
NW1166E
REPLY:
(1) (a) In the 2009-10 financial year, no funds were allocated to employ inspectors for the Office of Health Standards Compliance (OSC) as such posts had not been created on the OSC staff establishment. In the 2010-11 financial year R3 073 000.00 was allocated for compensation of employees, although only one post (Director0 was filled; and Inspector posts were created;
(b) For the 2011-12 financial year R3 538 859.00 for the inspectors has been allocated to date. It is anticipated that this would increase with the establishment of the new Office of Health Standards Compliance, once the Amendment Bill to establish this is promulgated.
(2) The process of establishing the inspectorate posts on the staff establishment of the OSC was recently concluded. Ten (10) inspectors have been appointed.
(3) A tertiary qualification in health science, health management or a related field is the minimum requirement needed to be an inspector in the OSC.
QUESTION NO. 1047
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr M Waters (DA) to ask the Minister of Health:
Whether any progress has been made with regard to the reopening of the Kempton Park hospital; if not, why not; if so, what (a)(i) security, (ii) maintenance and (iii) other specified cost has the hospital incurred for each year since the closing of the hospital and (b) are the further relevant details?
NW1165E
REPLY:
The Hospital is still closed, as we said previously.
QUESTION NO. 1036
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 March 2011
(INTERNAL QUESTION PAPER NO. 9)
Mr M Swart (DA) to ask the Minister of Health:
(a) What are the reasons for the anticipated under-expenditure against the budget of approximately R283 million by the end of the current financial year on (i) goods and services and (ii) transfers, in particular (aa) delays in transfers in respect of hospital revitalisation projects and (bb) zero transfers to LoveLife and (b) what steps are being taken to rectify the situation?
NW1154E
REPLY:
(a) As at year end March 2011, the final under expenditure was R743 million which was made out as follows:
(i) Accrued accounts amounting to R57 million could not be paid prior the end of the financial year due to delayed deliveries and or verification of services being rendered. Commitments amounting to R192 million could not be paid during the financial year.
(ii) Transfers were paid by year end.
(aa) The poor spending by the provinces for the Revitalization of Hospitals Grant, has led to the withholding of transfer payments in 6 provinces namely: Eastern Cape, Free State,Gauteng, Limpopo KwaZulu- Natal and Northern Cape. The six affected provinces also sent letters to NDOH to surrender the money that they are unable to spend.
The reasons for poor spending are as follows: There were some delays in awarding tenders by the Implementing Agents which are the Department of Public Works and/or IDT in various provinces. Termination of the contracts by the Implementing Agents due to poor performance by the Contractors was a major contribution to under expenditure. Some of the Contractors have taken both the Implementing Agent and Health Departments to court, which also contributes to the performance of the grant.
It was also reported that some of the contractors claim less cash flow than what they projected to spend in the beginning of the financial year.
(bb) Love Life was paid R 38 million before year end.
(b) Transfers were made before the end of the financial year and an intervention plan is being implemented for the Revitalization of Hospitals Grant.
QUESTION NO. 961
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mr M Waters (DA) to ask the Minister of Health:
Whether his department has adopted a definition for (a) district (level 1), (b) regional (level 2) and (c) tertiary (level 3) hospitals in terms of (i) what services should be available and (ii) the norms and standards that apply at each level; if not, why not; if so, what is the definition for each level of hospital?
NW1079E
REPLY:
Yes, currently the Department has health definitions per level of care. The current definitions are under review and should be approved by the Minister of Health in the 2011/12 financial.
QUESTION NO. 946
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mr P J C Pretorius (DA) to ask the Minister of Health:
(a) Who acts as the accounting officer of the Compensation Commissioner for Occupational Diseases and (b) what was the seniority level of the accounting officer (i) in the (aa) 2008-09 and (bb) 2009-10 financial years and (ii) during the period 1 April 2010 up to the latest specified date for which information is available?
NW1064E
REPLY:
(a) The Director-General of Health.
(b) (i) (aa) 2008-09: The Director-General of Health – level 16
(bb) 2009-10: The Director-General of Health – level 16
(ii) From 01 April 2010 to current date: The Director-General of Health – level 16
QUESTION NO. 945
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mr P J C Pretorius (DA) to ask the Minister of Health:
(1) (a) How many controlled (i) mines and (ii) works are there in terms of the Occupational Diseases in Mines Act, Act 78 of 1973, and (b) what was the income in levies paid by controlled (i) mines and (ii) works in each of the past three financial years for which information is available;
(2) how many (a) mines and (b) works are currently not controlled, but could qualify as controlled mines and works;
(3) what estimated annual levy is lost to the State as a result of (a) mines and (b) works not having been declared as controlled;
(4) whether steps are being taken to declare more mines and works as controlled; if not, why not; if so, what steps?
NW1063E
REPLY:
(1) (a) (i) As at 31 March 2010 there were 209 mines
(ii) A total of 36 works that were controlled
(b) The amounts that have been received by the office of the Compensation Commissioner for Occupational Diseases for the past three years are illustrated in the table below;
| Years | Levies | Interest received | Grants received | Total |
| 2007/ 2008 | R 82,275,166 | R 110,472,718 | R 3,591,735 | R 196, 342, 619 |
| 2008/2009 | R 131,819,307 | R 123,950,146 | R 2,355,000 | R 258, 097, 453 |
| 2009/2010 | R 130 463 702 | R 100,446,380 | R 3,679,000 | R 234, 589, 082 |
(2) A total of 1 327 mines and works are not controlled. This is the total universe of the mines that were registered with Department of Mineral Resources that is including both opened and closed mines.
(3) The office of the Compensation Commissioner can only provide the estimated amount if it had the number of risk shifts performed in the said mines or the number of employees working on the risk area per mine. However, the table below gives the number of mines that are not contributing to the fund, the commodity and the rate per risk shift worked.
| Commodity | Number of Mines in operation | Mines contributing (controlled mines) | Mines not contributing (uncontrolled mines) | Rate per risk shift worked (2010) |
| Andalusite | 5 | 2 | 3 | 2.57 |
| Chrome | 27 | 13 | 14 | 5.95 |
| Coal | 100 | 71 | 29 | 0.82 |
| Copper | 5 | 1 | 4 | 5.02 |
| Diamond | 394 | 10 | 384 | 2.77 |
| Flourspar | 3 | 2 | 1 | 2.49 |
| Gold | 88 | 23 | 65 | 4.08 |
| Iron | 14 | 5 | 9 | 2.57 |
| Lead | 1 | 1 | 0 | 2.94 |
| Magnesite | 3 | 1 | 2 | 5.95 |
| Manganese | 18 | 2 | 16 | 3.80 |
| Mica & Feldspar | 8 | 4 | 4 | 2.17 |
| Phospate | 5 | 1 | 4 | 2.49 |
| Quarry | 817 | 51 | 762 | 4.17 |
| Uranium | 2 | 1 | 1 | 5.95 |
| Vanadium | 7 | 2 | 5 | 2.17 |
| Platinum | 14 | 0 | 1.02 | |
| Asbestos | 1 | 0 | 22.21 | |
| Works | 36 | 0 | 4.74 | |
| Other mines that their commodities are not listed on the rate table | 79 | 4 | 75 | 5.95 |
| TOTALS | 1572 | 245 | 1327 |
(4) In the amendment of the Act which is in progress we are planning to revisit the declaration process of controlled mines and works.
QUESTION NO. 922
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mrs H Lamoela (DA) to ask the Minister of Health:
(1) With reference to his reply to question 96 on 8 March 2011 and the proposed review of professional categories relating to Emergency Medical Services (EMS), who will form part of the review process;
(2) whether he intends to establish a committee to conduct the review; if not, (a) why not and (b) how will the review be conducted; if so, (i) who will decide which persons will serve on the committee and (ii) by what date is the review envisaged to be completed?
NW1039E
REPLY:
(1) All the relevant stakeholders will form part of the review process.
(2) Yes.
(a) Not applicable.
(b) Through assessing the service delivery needs and education training and of EMS professionals
(i) The Minister of Health
(ii) Details will be provided once the review committee has been established.
QUESTION NO. 918
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Ms E More (DA) to ask the Minister of Health:
(1) Whether he has been informed that no health professional categories are listed in the scarce skills register of the Department of Home Affairs; if not, why not; if so, what does he intend to about it;
(2) whether his department has ever in the past five financial years provided the Department of Home Affairs information with regard to the vacancy rate for health professionals within his department; if so, (a) on what dates and (b) what was his department's response in each case?
NW1035E
REPLY:
(1) No, there is no need for the Department to make use of the provision of Section 19(1) of the Immigration Act, 2002 (as amended in 2004) to apply for a quota work permit as there are adequate provisions in Section 19(2) of Act as well as the subsequent sections to allow the Department to employ foreign health professionals with scarce skills in the South African Public Health Sector. The Minister of Home Affairs decided to grant a waiver of the following prescribed requirements in terms of Section 31(b) of the Immigration Act:
(a) The requirements to submit proof of qualifications evaluated by the South African Qualifications Authority, in respect of work permit applications;
(b) Proof of publication of an advertisement in the national media, in respect of work and permanent residence permits; and
(c) Certification by the Department of Labour, in respect of work permits.
(2) No.
QUESTION NO. 916
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether any measures are in place with regard to HIV testing at schools to ensure (a) proper pre and post testing counselling and (b) counselling of parents of HIV positive children;
(2) whether any additional staff are to be employed to ensure that pre and post testing counselling is implemented; if not, who will be responsible for implementing the (a) testing and (b) counselling; if so, (i) how many new staff members are to be employed, (ii) in what positions and (iii) who will be responsible for their salaries;
(3) what is the total cost of the HIV testing at schools campaign?
NW1033E
REPLY:
I wish to thank the Honourable Member for this very important question regarding the issue of HIV and AIDS in our schools. This issue affects the present as well as the future of our country.
A decision has been taken that there shall be no stand-alone HCT (HIV Counselling and Testing) in schools as it is done in other sectors. Rather, the HCT in schools shall be part of an overall school health programme that will not be once off but a permanent feature of schools. This school health programme is being planned by a broad range of stakeholders – universities, NGOs, professional bodies, children's sector of SANAC, the Department of Health, the Department of Basic Education, the Department of Social Development and many other organisations with experience and various issues affecting children.
When such a programme is ready, it will be officially launched by both the Ministers of Health and of Basic Education. At that moment, the Honourable Member shall be furnished with further details
QUESTION NO. 915
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 March 2011
(INTERNAL QUESTION PAPER NO. 8)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether any nurses have been (a) disciplined or (b) fired for their involvement in the 2010 illegal strike; if not, why not; if so, how many (i) in each case and (ii) with regard to each province;
(2) whether any nurses who have been involved in the 2010 illegal strike have been subjected to the no work, no pay policy; if not, why not; if so, (a) for which period was money deducted from their salaries and (b) how many nurses have been affected by the no work, no pay policy?
NW1032E
REPLY:
(1) (a) Yes.
(b) No.
(i) Disciplined: North West: 1321
Western Cape: 0
Free State: 0
Mpumalanga: 0
Northern Cape: 0
Gauteng: 0
No misconduct cases during the strike were reported.
(ii) Fired: North West: 0
Western Cape: 0
Free State: 0
Mpumalanga: 0
Northern Cape: 0
Gauteng: 0
The resolution that gave effect to the general public service cost of living adjustment made provision that no essential service employees will be dismissed for participating in the strike that preceded the signing of the agreement with the recognized labour unions.
(2) Yes.
(a) North West: 01/09/2010 to 31/12/2010
Western Cape: 29/07/2010 to 07/09/2010
Free State: 18/08/2010 to 08/09/2010
Mpumalanga: 01/08/2010 to 30/09/2010
Northern Cape: Not applicable
Gauteng: 07/08/2010 to 06/09/2010
(b) North West: 1321
Western Cape: 104
Free State: 1484
Mpumalanga: 4094
Northern Cape: 0
Gauteng: 8022
We are still waiting for responses from Limpopo, KwaZulu/Natal and the Eastern Cape Provinces.
QUESTION NO. 877
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether the SA Medical Research Council has completed conducting its (a) clinical and (b) epidemiological trials of (i) HIV and (ii) tuberculosis in an attempt to find a vaccine for HIV; if not, why not; if so, what are the relevant details?
NW857E
REPLY:
The Medical Research Council (MRC) through the South African AIDS Vaccine Initiative (SAAVI) is conducting clinical trials on HIV vaccines. One candidate HIV vaccine is currently in a phase 1 trial, another is in a phase 2 trial. Other trials are in preparation. The MRC is not conducting any trials on a TB vaccine but the South African TB Initiative, based at the University of Stellenbosch has candidate vaccines in clinical trials.
QUESTION NO. 806
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Mr I M Ollis (DA) to ask the Minister of Health:
Whether (a) his department or (b) any of its affiliated entities have purchased any tickets for the ICC Cricket World Cup 2011; if not, why not; if so, (i) what process has been followed to purchase these tickets, (ii) how many tickets have been purchased, (iii) for which matches, (iv) what has been the total cost of these tickets, (v) what are the reasons for purchasing these tickets, (vi) to whom will each of these tickets be allocated and (vii) on what was the decision for the allocation of these tickets based?
NW877E
REPLY:
(a) and (b) Neither the National Department of Health nor its entities (National Health Laboratory Service, South African Medical Research Council, and the Council for Medical Schemes) have purchased any tickets for the ICC Cricket World Cup 2011., because it is neither the core business nor policy of either the Department nor entities to engage in such sporting events.
The latter part of the Honourable Member's question is irrelevant:
(i) to (vii) Not applicable.
QUESTION NO. 800
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Ms E More (DA) to ask the Minister of Health:
(1) How many funded posts are currently (a) vacant and (b) frozen at each hospital for each specific (i) health profession, (ii) technical staff and (iii) administrative staff;
(2) (a) when last did each province update their human resources structure for each hospital and (b) what factors are taken into account when doing so?
NW871E
REPLY:
The requested information for this question is not available and the Department is in the process of obtaining verified data from the respective Provincial Departments of Health due to the magnitude and detail required. We will provide such information once all the relevant data has been obtained.
QUESTION NO. 799
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Mr M Waters (DA) to ask the Minister of Health:
How many (a) infants and (b) children have died at each hospital in the past five years?
NW870E
REPLY:
(a) For the period January 2008 to March 2011, there were 38,949 inpatient deaths of under one year olds.
(b) For the period January 2008 to March 2011, there were 42,835 inpatient deaths of under 5 year olds.
QUESTION NO. 798
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether he has developed any strategy in conjunction with the Minister of Basic Education to deal with the increasing number of high school learners who fall pregnant; if not, why not; if so, what are the relevant details;
(2) how many learners have been recorded as having fallen pregnant whilst enrolled in high school in each province in the past three years?
NW869E
REPLY:
(1) The Department of Health in conjunction with the Department of Basic Education is currently in the process of developing a strategy in the form of School Health Programme, as part of the three streams of re-engineered Primary Health Care.
(2) The Department of Health does not have data regarding the number of students who left school because of pregnancy. The Department of Basic Education may have the information required.
QUESTION NO. 781
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether any (a) antiretrovirals (ARVs), (b) tuberculosis (TB), (c) multi-drug resistant tuberculosis (MDR TB), (d) extensively drug-resistant tuberculosis (XDR TB) and (e) any other chronic medication have been out of stock (i) in the 2009-10 financial year and (ii) since 1 April 2010; if so, (aa) which medication has been out of stock, (bb) in which provinces, (cc) on which dates was this information recorded and (dd) what were the reasons for the medicines being out of stock in each case;
(2) whether any patients could not access any of their chronic medication due to the medicines being out of stock; if not, why not; if so, (a) how many patients, (b) in which provinces, (c) for how many days in each case did each patient not have access to his/her medication and (d) what alternative plans were made in each case;
(3) whether any steps have been taken to ensure that sufficient stock of these medications are available; if not, why not; if so, what (a) steps and (b) target has been set by his department to reduce the level of insufficient stock of each medication?
NW852E
REPLY:
Stock out reports from provinces reflect non-availability of specific items at the respective provincial depots. Through improved monitoring and management during the 2010/11 financial year, the Department has been able to decrease stock outs for ARVs and TB medicines respectively to 2,4% and 4,12% during the last quarter as reflected in the Annual Performance Plan. This ultimately affects medicine availability at facility level but does not necessarily mean that patients went without the necessary medicine as all facilities normally keep buffer stock and contingency measures are implemented.
(1) (i) (a) Yes
(b) Yes
(c) Yes
(d) Yes
(e) Yes
(ii) Yes
(aa) (a) ARVs:
Abacavir suspension and tablets, didanosine tablets, efavirenz tablets, emtricitabine/tenofovir, lopinavir/ritonavir tablets and solution, nevirapine tablets and solution, ritonavir capsules and solution, stavudine 15mg and 30mg capsules and suspension, tenofovir tablets, zidovudine 100mg and 300mg tablets and zidovudine/lamivudine tablets.
(b) TB
Ethambutol 400mg tablets, isoniazid 100mg and 300mg tablets, rifampicin/INH 60/30mg and 150/75mg, rifampicin/INH/PZA 60/30/150mg tablets, rifampicin 150, 450 & 600mg capsules, rifampicin 100mg/5ml syrup 180ml, rifampicin 300mg injection and streptomycin vials.
(c) MDR TB:
Capreomycin 1g vials, ethionamide 250mg tablets, kanamycin 1g vials, ofloxacin tablets and pyrazinamide 500mg.
(d) XDR TB
Moxifloxacin 400mg tablets, para-aminosalicylic acid 4g sachets (non-registered product imported under Section 21) and terizidone 250mg capsules.
(e) Chronic medication:
Blood pressure & cardiovascular:
Amiodorone tablets, amlodipine, atenolol tablets, aspirin, digoxin tablets, diltiazem tablets, enalapril tablets, furosemide tablets, glyceral trinitrate 0.5mg, hydrochlorothiazide 25mg tablets, hydralazine tablets, isosorbide dinitrate, methyldopa tablets, nifedipine XL 30mg tablets, spironolactone tablets and verapamil tablets.
Diabetes:
Insulin: short-acting, medium and mixed, metformin 500mg and 850mg, gliclazide 80mg and glibenclamide 5mg.
Anti-Epileptics:
Carbamazepine tablets & syrup, phenytoin tablets & syrup, sodium valproate tablets & syrup.
Asthma:
Salbutamol inhaler, theophyllin tablets, budesonide inhaler, salmeterol inhaler, fenoterol hydrobromide and ipratropium bromide inhalant solution (adult & paediatric).
Psychiatric medicines:
Amitryptiline, zuclopenthixol (depot & acuphase), haloperidol 1,5 mg + 5mg, flupenthixol long- and short-acting, fluphenazine 25mg injection, fluoxetine 40 mg capsules, chlorpromazine 25mg and oxazepam 10mg & 30mg.
(bb) All provinces had medicines stock-outs at some time during the period under review.
(cc) The reported stock-outs are as recorded on the various depot systems across all dates during the period under review – out-of-stock situations are recorded and followed up as they occur.
(dd) Reasons for stock-outs vary between the various products, suppliers and provinces – the following is a summary of reasons provided by the provinces:
· Expansion of new ARV Treatment Guidelines in the middle of a running contract without consideration of supplier capacity.
· Quality problems of combination TB medicines.
· Financial constrains within provincial Departments, resulting in non- or late payment of accounts and subsequent accounts being put on hold.
· World wide shortage of active pharmaceutical ingredients resulting in supply constraints.
· Sub-optimal stock management and system constraints.
· Lack of human resources for monitoring and evaluation at medical depots.
· The mass immunization campaigns for polio, measles and influenza, coinciding with the World Cup preparations as well as launch of HCT over-extended available capacity at the provincial depots.
· Irrational medicine usage and lack of functional Pharmaceutical and Therapeutic Committees (PTCs).
(2) Yes.
(a) There is no integrated computerized stock management system and computerized patient management system in place to enable reporting on the number of patients affected.
(b) All provinces were affected to a greater or lesser extent.
(c) There is no integrated stock management computerized system and computerized patient management system in place to enable reporting on the time periods patients were affected.
(d) Alternative plans made are as follows:
· Borrowed stock from nearby facilities and even from community pharmacies.
· Redistributed available stock.
· Issued patients for a shorter period of time to stretch available stocks amongst more patients while attempting to resolve shortages.
· Sent warning letters to suppliers & implement penalties to defaulting suppliers.
· Bought out from alternative suppliers where possible.
· Took corrective measures to improve monitoring of supplier performance and stock levels including revision of estimates and improved communication with suppliers.
· Requested NGO partners to assist with medicine supply management training.
· Improved communication between the programmes and pharmaceutical services.
· Continuous and effective feedback from depots to all levels of care.
· Endeavour to improve procurement planning.
(3) Yes.
(a) As mentioned under 2 (d) plus the following:
· The Directorate: Affordable Medicines established a bi-weekly reporting system for ARVs and TB medicines, where shortages are being investigated and supplier performance monitored.
· Meetings with defaulting and problematic suppliers are arranged at a national level, with feedback given to the provinces.
· NDoH arranged for the availability of critical items when no local supplier of a registered product was available, using special exception in terms of Section 21 of the Medicines Act.
· Provinces to send regular supplier performance reports to NDoH.
(b) Essential medicines availability at facilities to be at 95%.
QUESTION NO. 777
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 March 2011
(INTERNAL QUESTION PAPER NO. 6)
Ms E More (DA) to ask the Minister of Health:
(1) On what grounds was the decision taken to extend the contract of a certain person (name and details furnished) as chief executive officer of the East London Hospital Complex;
(2) whether his department intends extending this contract further beyond March 2011; if not,
(3) whether his department will advertise the position from the end of March 2011; if not, why not; if so, what qualifications are required for this position?
NW846E
REPLY:
(1) The (5) year employment contract of the previous Chief Executive Officer of the East London Hospital Complex (ELHC), terminated on the 30th November 2010. In terms of Section 15 of the Public Service Regulations (2001), the Department extended his employment contract for a further two periods of 3 months each i.e. from 01st December 2010 to 28th February 2011, and 01st March 2011 to 30th June 2011, pending the finalization of a formal job evaluation process for the post of CEO (Level 14) for the East London Hospital Complex prior to its advertisement as prescribed for hospital CEOs by the Department of Public Service and Administration, as well as the completion of the recruitment and selection procedures for a suitable candidate of the Chief Executive Officer: East London Hospital Complex.
(2) The said person was moved from position of CEO on 30 June 2011. As indicated above, the Department did extend his employment contract for a further period beyond March 2011 which ended on the 30th June 2011.
(3) In addition to the outcome of the formal job evaluation process for the post of CEO (Level 14) for the East London Hospital Complex, the Department also needed to complete the de-complexing process for the East London Hospital Complex, as well as for the other two hospital complexes in Mthatha and Nelson Mandela Bay Metro. The completion of the de-complexing process resulted in Frere Hospital and Cecilia Makiwane Hospital being managed as separate hospitals (de- complexed). After the completion of the abovementioned two strategic processes, the posts of CEO for Frere Hospital and CEO for Cecilia Makiwane Hospital was advertised at level 14 and level 13 respectively, during early 2011. The academic qualifications and other suitability requirements for both CEO posts are extensive and are contained in the advertisements. They include an MBChB degree, management qualification, 10 years clinical and management experience and strong leadership and management capability.
QUESTION NO. 748
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether his department has undertaken a detailed analysis of the availability and functioning of essential hospital equipment to ensure that hospitals would be able to provide the services expected of them; if not, why not; if so, what are the relevant details;
(2) whether this analysis included an improved patient management system; if not, why not; if so, what are the relevant details?
NW823E
REPLY:
(1) A process is underway, conducting an audit of essential medical equipment, in all clinics and hospitals in every province in the following clinical areas:
(a) Theatres
(b) ICU
(c) ICU paediatrics
(d) Accident and Emergency Unit
(e) Radiology
(f) Maternity
(g) Out-patients Department
With regard to the functionality, the Department recruited and trained technicians to test the functionality of medical equipment and they have already commenced with the testing of equipment functionality in four provinces, namely, Limpopo, KwaZulu/Natal, Gauteng and Eastern Cape.
(2) Yes, an analysis of information management systems has been conducted before.
An audit was conducted as part of the Health Information System Strengthening projects and it included IT equipment, Human Capacity for health information systems as well as skills and training amongst others.
QUESTION NO. 747
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether his department has investigated the reasons for the significant escalation in the number of women, especially first-time mothers, giving birth by caesarean section, mostly in private hospitals; if so, what were the findings, if not;
(2) whether his department will embark on such an investigation; if not, why not; if so, (a) when and (b) what are the further relevant details;
(3) whether he will make a statement on the matter?
NW822E
REPLY:
(1) No, the Department has not investigated the reasons for this escalation. However, the Council for Medical Schemes (CMS), a statutory body that regulates the medical schemes industry, has been trying to obtain this type of information from private hospitals. They are still busy trying to establish ways and regulatory means to enable them to do so for caesarean section and many other procedures.
(2) No, the Department will leave this to the CMS for now.
(3) No.
QUESTION NO. 746
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether, in view of his announcement that the National Health Insurance (NHI) was to be implemented in two years' time, the Green Paper is now ready for release; if not, why not; if so, when will it be released;
(2) what (a) are the tax implications for the introduction of the NHI and (b) will the implication be for those who are already on private medical aid?
NW821E
REPLY:
(1) The National Department of Health in conjunction with the National Treasury, is steadfastly reviewing the policy document on the implementation of the National Health Insurance (NHI). Work has reached an advanced stage and will soon be finalised with regard to the policy framework for the NHI and the phased implementation plan. When this phase of work is completed, the Department will submit the document to Cabinet for consideration and approval in readiness for the initiation of the stakeholder engagement and consultation processes. The intention of the Department is to release the draft NHI policy document soon.
(2) (a) The exact details of the tax implications associated with the implementation of the NHI are still being worked out. As was recently announced by the Minister of Finance in his budget speech, the Department and the National Treasury are still working out the tax implications of the potential alternative sources of funding for the NHI. Information on the implications of each of the proposed sources will be made available when the work has been completed;
(b) The tax implications for those already on private medical aid are also being considered within the scope of the potential alternative sources of funding for the NHI. Information on the implications for medical scheme members will be made available when the work has been duly completed.
QUESTION NO. 722
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mrs H S Msweli (IFP) to ask the Minister of Health:
Whether he is prioritising educating our youth (a) against having unprotected sex and (b) the effects of unwanted teen pregnancies; if not, why not; if so, what are the relevant details?
NW787E
REPLY:
(a) & (b) Yes, we have prioritised youth and adolescent health by advocating for promotion of healthy lifestyles and reducing risky behaviour amongst youth and adolescents through an intensive programme in line with the four (4) outcomes of the Negotiated Service Delivery Agreement:
(i) Increase life expectancy;
(ii) Reduce maternal and child mortality and morbidity rates;
(iii) Combat HIV and AIDS and decreasing the burden of disease from Tuberculosis
(iv) Improve health services efficiency, effectiveness and responsiveness
The pillars of the education are:
(i) Abstention and delaying sex;
(ii) Knowing one's HIV status and acting healthily;
(v) Practice of safer sex – use of condoms and non-penetrative sexual intercourse.
All interventions addressing the health needs of youth and adolescents are aligned to the Primary Health Care (PHC) approach that focuses on prevention and promotion. Health education and informed decision-making form the integral part of all inventions.
The school health programme that is being planned by various stakeholders, which shall in due course be launched by the Ministers of Basic Education and of Health, shall be the key strategy in terms of youth health programmes and will furnish further details as it is concluded.
QUESTION NO. 721
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 March 2011
(INTERNAL QUESTION PAPER NO. 4)
Mrs H S Msweli (IFP) to ask the Minister of Health:
(1) Whether he intends launching an investigation into an incident that occurred at the Butterworth Hospital in the Eastern Cape (details furnished); if not, why not; if so, what are the relevant details;
(2) whether any disciplinary action has been taken against the hospital staff involved; if not, why not; if so, what action?
NW786E
REPLY:
According to the Eastern Cape Provincial Department of Health –
(1) Yes an enquiry has been ordered and is currently underway.
(2) The investigation is not concluded yet.