Questions & Replies: Health
2012-09-30
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Reply received: August 2012
QUESTION NO. 1958
1958. Mr A Watson (DA) to ask the Minister of Health:
Whether any entity reporting to him has budgeted for (a) financial donations or (b) sponsorship in the (i) 2009-10, (ii) 201&11, (iii) 2111-12 and (iv) 2012-13 financial years; if not, why not, if so, in each case, what amount was (aa) budgeted and (bb) spent?
REPLY
Response from the Council for Medical Schemes (CNS) is as follows:
The CMS has budgeted for and spent on (a) financial donations as presented in the table below and the entity has not budgeted for or spent any funds on (b) sponsorship in the (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years:
| (a) Financial Donations | (i) 2009-10 | (ii) 2010-11 | (iii) 2011-12 | (iv) 2012-13 |
| Budgeted amount | 6,000.00 | 5,500.00 | 12,100.00 | 6,413.00 |
| Actual expenditure | 2,000.00 | 5,000.00 | 6,500.00 | 5,534.00 |
Response from the National Health Laboratory Service (NHLS) is as follows:
The NHLS has not budgeted for (a) financial donations or (b) sponsorship in the (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years. The NHLS is an entity that supports the public health sector and reserves are geared towards strengthening both the NHLS and the public health system.
The NHLS has made the following donations:
(i) 2009-10: the NHLS donated 108 computers to the value of R668,574.00 to the KZN Department of Health, for use at the hospital affiliated to the 54 NHLS laboratories in that province. The PCs were to be used by clinicians specifically for accessing lab results.
(ii) 2010-11: No donations made.
(iii) 2011-12: the NHLS donated 200 SMS Printers to the value of R1, 162, 000.00 to every clinic in the country which are being used currently for sending test results.
(iv) 2012-13: the NHLS as part of Mandela Day donated uniforms and clothing to the value of R121, 73572 for poor children in children's homes.
Response from the South African Medical Research Council (MRC) is as follows:
The MRC has not budgeted for (a) financial donations or (b) sponsorship in the (i) 2009- 10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years as it is not part of the mandate of the MRC to provide donations or sponsorship.
Reply received: November 2012
QUESTION NO. 1924
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 03 August 2012
(INTERNAL QUESTION PAPER NO. 21)
Mrs S P Kopane (DA) to ask the Minister of Health:
(1) What is the (a) current availability of (i) basic equipment and (ii) medical supplies in hospitals and (b) ideal level of these resources;
(2) which hospitals in which provinces are in dire need of (a) basic equipment and (b) medical supplies;
(3) whether any deaths have been reported as a result of these shortages; if not, why not; if so, what are the relevant details;
(4) whether he has taken any steps to deal with these shortages; if not, why not; if so, what are the relevant details?
NW2313E
REPLY:
(1) (a) All hospitals have basic equipment however the problem is with the functionality of the equipment at all times. I have as a result established a programme to address these problems.
(b) Availability of medical supplies is variable from one institution to the other. This variation in availability is dependent on various factors and circumstances. Presently there is no ideal level of resources, however there is the Essential Equipment List (EEL) that has been developed and that will be implemented to address these gaps.
(2) An equipment audit has been conducted and will be concluded soon. This will provide valid data about need.
(3) No data is available in the country on deaths where there is a causal link between equipment shortages and deaths.
(4) Yes, see (1) (a) above.
Reply received: August 2012
PARLIAMENTARY QUESTION 1913
1913. Mrs SP Kopane (DA) to ask the Minister of Health
What are the name(s) of the (a) company and (b) members of the Board of Directors of the company or companies who won the tender to supply SD Bioline HIV testing kits
(NW2302E)
REPLY
(a) Company Name Pantec
(b) Name of the Directors are Marc Mathews and Sizwe Makhaye
Reply received: August 2012
PARLIAMENTARY QUESTION 1908
1908. Mrs H Lamoela (DA) to ask the Minister of Health:
(a) How many persons with disabilities utilized the rehabilitation programme within his department since January 2009 ,and (b) what measures are in place to strengthen rehabilitation services? (NW2290E)
REPLY
(a) Below is a table showing the number of persons who utilized the rehabilitation programme:
| PROVINCE | 2009 | 2010 | 2011 |
| Gauteng* | 616,771 | 780,475 | 931,276 |
| Eastern Cape** | 16,822 | 18,116 | 20,747 |
| Free State** | 9,192 | 10,006 | 10,505 |
| KwaZulu-Natal | 101,722 | 148,843 | 100,255 |
| Limpopo | 82,950 | 110,601 | 147,468 |
| Mpumalanga*** | 7,663 | 7,64 | 8,796 |
| North West** | 10,955 | 10,506 | 11,525 |
| Northern Cape**** | 0 | 0 | 0 |
| Western Cape | 110,408 | 117,761 | 128,164 |
| TOTAL | 958,483 | 1,204,072 | 1,358,736 |
*Figures for Gauteng show number of visits rather than number of people. Figures for numbers of people receiving services are not kept.
** Figures for Eastern Cape, Free State and North West are for persons who received devices only.
*** Figures for Mpumalanga are for community services only.
**** No data available from Northern Cape at the time of response
(b) A number of measures are being implemented to strengthen rehabilitation services. These include linkages to the broader plans for Re-engineer of Primary Health Care. Basic rehabilitation is being expanded to take place at Primary Health Care level which improves access to services for all who need them. The Department is collaborating with the Department of Basic Education to strengthen School Health Services to detect hearing, visual and mobility disabilities early and provide timely intervention. The policy for Free Health Care for People with Disabilities at Hospital level extends free Health Care Services for people with disabilities to secondary and tertiary services, including assistive devices. The Human Resources for Health Plan has identified rehabilitation professionals among the group that should have an increased intake at universities. The introduction of community services for therapists has also improved the human resources situation in the public health system.
Reply received: October 2012
QUESTION NO. 1901
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 03 August 2012
(INTERNAL QUESTION PAPER NO. 21)
Mrs J F Terblanche (DA) to ask the Minister of Health:
(1) (a) What indicators are used to determine the best and worst performing health districts and (b) when last was the assessment conducted;
(2) what is the complete list of the ranking of health districts, including the (a) name and (b) province in which they are situated?
NW2290E
REPLY:
(1) (a) The Department uses different groups of indicators from a variety of data sources to assess the performance of districts. The different areas of performance that are assessed include Socio-Economic Status and the impact thereof on Health Outcomes, Child Health, Maternal Health, HIV and AIDS, TB, District Health Expenditure reviews, Core Standards of Quality Health Care, etc.
(b) The performance of the districts is continuously assessed throughout the year.
(2) The National Department of Health uses a variety of data and methodology to evaluate (and rank) individual district's performance on a range of performance on a range of performance areas. One method is the use of composite indicators (using indicators from different sources) to summarise performance across districts.
Reply received: August 2012
PARLIAMENTARY QUESTION NO. 1883
NATIONAL ASSEMBLY
FOR WRITTEN REPLY
1883. Mr D A Kganare (Cope) to ask the Minister of Health:
(1) whether he has been informed of the Medical doctors who were recently arrested by the Department ofHome Affairs for being in the country Illegally and practicing around Parys without having been registered; if not what is the position in this regard; if so, (a) who employed the specified doctors and (b) what (i) steps have been taken in this regard and (ii) are there further relevant details;
(2) whether his department has taken action against the persons who employed medical doctors who were not registered; if not, why not; if so, what are the relevant details?
REPLY
(1) The Minister has not been informed of the Medical Doctors who were recently arrested by the Department of Home Affairs for being in the country illegally and practicing around Parys without having being registered.
The Department of Health's Foreign Workforce Management Unit is the first point of contact for any foreign qualified practitioner to obtain a letter of endorsement prior to the practitioner applying for registration to the relevant professional council i.e. the Health Professions Council South Africa (HPCSA). The HPCSAis mandated to protect the public and to guide the professions as well as to ensure that the standard of education is equivalent to the South African qualification and that practitioners who obtained foreign qualification has the necessary knowledge and expertise to practice their profession.
(2) Section 38 of the Immigration Act, 2002 (Act No. 13 of 2002) as amended, provides that anyone who knowingly employs a foreigner in contravention of the Immigration Act, i.e., an illegal foreigner (not in possession of a valid work permit), is guilty of an offence and is liable on conviction to a fine or imprisonment. In addition, a person who practices a health profession in South Africa without the requisite professional registration with the relevant health professions council is subject to criminal prosecution.
Reply received: August 2012
QUESTION NO 1882 (NW 22711E)
Mr D A Kganare: (Cope) to ask the Minister of Health
(a) How many termination of pregnancy operations were performed in each province in 2010 and 2072, (b) what was the average age of females undergoing the operations and (c) how many underwent the termination of pregnancy operation more than once in the specified years?
REPLY
(a) Provincial breakdown
| GP | MP | FS | KZN | NC | NP | WC | EC | NW | |
| 9,541 | 5,383 | 20,408 | 4,451 | 8,073 | 2,652 | 6,262 | 1,122 | 1,555 | |
| 11,239 | 5,908 | 21,994 | 6,1357 | 8,839 | 3,143 | 6,870 | 1,183 | 12,138 |
(b) The Average Age of females undergoing TOP Operations is unknown. However, the Department of Health has the following statistics on maternal age:
| 2010 Maternal Age | < 18 Years | 3,538 |
| >18 Years | 27,702 | |
| Unknown | 28,207 | |
| TOTAL | 59,447 |
| 2011Maternal Age | < 18 Years | 1,380 |
| >18 Years | 17,966 | |
| Unknown | 58,425 | |
| TOTAL | 77,771 |
© Unknown
Reply received: August 2012
PARLIAMENTARY QUESTION: 1836
1836. Mr T D Harris (DA) to ask the Minister of Health:
QUESTIONS FOR WRITTEN REPLY: FRIDAY, 27 JULY 2012
(1) Whether (a) 111s department and (b) all entities reporting to him make payment to (i) suppliers and (ii) service providers within the 30 day payment period as specified by the Public Finance Management Act (PFMA), Act 1 of 1999; if not, in each case, (aa) how many service providers are awaiting payment, (bb) what is the monetary value of outstanding payments and (cc) how long is payment overdue;
(2) Whether (a) his department and (b) all entities reporting to him are liable for any interest charged on overdue payments in any of the cases mentioned; if not, what is the position in this regard; if so, in each case, what is the (i) percentage and (ii) monetary value of interest charged;
(3) Whether (a) his department and (b) all entities reporting to him have negotiated revised payment schedules with each of the service providers mentioned; if not, why not; if so, in each case, what are the relevant details;
(4) What are the reasons for (a) his department and (b) all entities reporting to him not making payment within 30 days as specified by the PFMA;
(5) Whether (a) his department and (b) all entities reporting to him have implemented any measures to (i) ensure full compliancy with the PFMA and (ii) facilitate immediate payment for overdue accounts; if not, why not; if so, in each case what are the relevant details
RESPONSES:
(l)(a) (i) & (ii) The bulk of payments with all supporting information and correct banking details are processed and paid within the 30 days as prescribed from the date of receipt of the invoice.
(aa) Total number of 34 service providers
(bb) Total amount of R1 ,l5 1,683.59
(cc) The period varies per service provider.
@)(a) No: The service providers are informed and aware of the cause of the delay, mostly caused by the bank details.
(3)(a) No, suppliers were informed that payments will be processed when bank details are verified.
(4)(a) When banking details are received must be verified via the Safetynet System with Commercial Banks for confirmation of the account holder's details held with the banker. Bank rejections are investigated and re-captured causing a small percentage of payments not being paid within 30 days.
(5)(a) (i) Yes,
(ii) Yes
The Director-General issued the departmental circular to inform all departmental Official of the importance of effecting payments within 30 days. The department is in the process of filling vacant positions to reduce the time period for the processing and effecting payments within the prescribed period. The process is driven by the chief financial officer.
Reply received: August 2012
PARLIAMENTARY QUESTION 1812 FOR WRlTTEN REPLY
1812. Mrs S P Kopane (DA) to ask the Minister of Health:
Whether there has been any coordination between (a) (i) his department and (ii) the Department of Higher Education and Training and (b) relevant stakeholders (names furnished) to (i) improve the quality of health services and (ii) remedy the problems in the public health sector; if not, why not; if so, what are the relevant details.
REPLY
(a) (i) (ii) Yes there has been co-ordination between the Department of Health and the Department of Higher Education and Training and their respective technical teams. This Committee has met three times since February 2012 and is due to meet twice during August 2012. Matters under discussion include the financing and organisation of clinical training, improving the quality of training of health professionals and expansion of output of health professions, all of which are important to remedy problems in the public health sector.
(b) (i) Other stakeholders relevant to the process that have been engaged with are the statutory councils and the faculties of health sciences.
Reply received: August 2012
QUESTION NO. 1811
1811 Mrs SP Kopane (DA) to ask the Minister of Health:
Whether the Health Professions Council of SA has an internal capacity to monitor and evaluate medical practitioners with foreign qualifications; if not, why not; if so, what are the relevant details?
REPLY
The purpose of registration at the HPCSA is to grant certification to applicants to enter selected professions as student, qualified practitioners visiting practitioners and to allow them to practice the professions. The Professional Boards have policies, requirements and procedures for the registration of different professional, including foreign qualified professionals.
The main principle driving the registration of foreign trained doctors by the HPCSA is ensuring that these Doctors meet a minimum competency which is required from locally educated and trained doctors.
At administrative level, Council has clearly defined business processes which define the task as well as the tools or instruments needed to perform the tasks. The processing of the applications is as follows:
(i) Applications are received by HPCSA administration and checked if all required documents are submitted.
(ii) Applications with all required information are tabled at the appropriate sub-committee for consideration
a) General Practice application are considered by the Examinations Sub-committee-Medicine
b) Specialist Applications are considered by the Sub-committee for Postgraduate Education and Training (Medicine).
(iii) Sub-committees evaluate standards of education and training to determine whether it meet HPCSA requirements.
(iv) Approved applications from foreign qualified heath professionals are registered in the Public Service.
Reply received: August 2012
QUESTION NO 1810
1810 Mrs SP Kopane (DA) to ask the Minister of Health:
Whether the Medical Dental Professions Board has capacity to regulate health professionals in (a) Medicine (b) Clinical, Associates, (c) Dentistry and (d) Medical Science; If not , what it's the position in this regard; if so what are the relevant details?
REPLY
the Medical and Dental Board is a statutory structure with the overall objective to ensure the establishment and maintenance of acceptable levels of health care services in the professions under its control as provided in terms of Section 15A of the Health Professions Act, 1974(Act No. 15 of 1974).
The Health Professions Council of South Africa (HPCSA) has the capacity to regulate the health professionals in (a) Medicine (b) Clinical Associates, (c) Dentistry and (d) Medical Science through registration and monitoring of continuing professional development (CPD). Council's CPD Department manage, guides and coordinates CPD programmes in order to ensure a culture of lifelong learning and ensuring ongoing professional competence and also to establish and maintain a system for effective keeping of records of practitioners registered with the HPCSA.
An additional mechanism to ensure compliance with the ethical standards is the requirement to adhere to the Ethical Rule of Conduct published in terms of regulation no R 717 of 4 August 2006, as amended by Government Notice No. R. 68 OF 2 February 2006.
Reply received: December 2012
QUESTION NO. 1710
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 June 2012
(INTERNAL QUESTION PAPER NO. 19)
Mrs H Lamoela (DA) to ask the Minister of Health:
(1) Whether he has been informed of the HPTN 052 study which found that effective antiretroviral (ARV) therapy for all HIV-positive individuals greatly diminishes the risk of HIV transmission; if so, what is his department's position on the study;
(2) whether his department has conducted a cost and savings analysis on providing ARVs to all HIV-positive persons; if not, (a) why not and (b) when will such an analysis be conducted; if so, (i) when, (ii) who conducted the analysis and (iii) what were the findings with regard to the (aa) cost of providing ARVs to all HIV-positive persons and (bb) the projected long-term savings in terms of (aaa) reduced infection rate, (bbb) reduced opportunistic infection rate, (ccc) work force productivity and (ddd) other specified savings?
NW2064E
REPLY:
(1) Yes I have been informed of the HIV Prevention Trails Network (HPTN 052). We welcome and support scientific studies such as HPTN 052 that show that high coverage with ARVs reduces morbidity, death and HIV transmission between couples and at the community level.
(2) The Department participated in a wide ranging working study on scaling up of ART.
(b) (i) The study was conducted in 2010.
(ii) The name of the study is: aids2031 Costs and Financing Working Group. The Long-Term Costs of HIV and AIDS in South Africa. Washington DC. The Result for Development Institute: 2010.
(iii) The findings of aids2031 with regard to cost of providing ARV to eligible HIV positive persons in the public sector based on the NSP eligibility criteria of CD4 count of 350 or less were:
(aa) R5,2 billion in 2009,
R9,2 billion in 2011,
R14,3 billion in 2015.
(bb) (aaa) The estimated baseline annual new infection in 2005 was 500,000 per year, by 2009 the annual number of new infection declined to estimated 400,000 per year. Estimated number of new infections under the expanded NSP coverage will be reduced to about 200,000 new infections in the year 2016.
(bbb) Increasing access to people living with HIV to early treatment results in substantial reduction of opportunistic infections, reduced case of new TB infections, reduced hospitalization due to opportunistic infections and substantial reduced AIDS deaths.
(ccc) The initiation of persons at current CD4 count of 350 cells or below together with the national policy of annual testing every citizen will result in a substantial decrease in the burden of disease in the health system, freeing human resources and capacity thereby increase workforce productivity.
(ddd) In the long term, achieving 80% coverage of patients that are eligible for treatment will result in decrease new infections and reduce number of people requiring treatment.
Reducing cost of providing care through efficiency and improved productivity through stock shifting and simplification of service treatment will increase saving money.
Rationalysing laboratory monitoring serve to monitor clinical outcomes treatment failures will also result in saving of the lives.
Source: aids2031 Costs and Financing Work Group. The Long Term Costs of HIV and AIDS in South Africa. Washington, DC: results for development institute; 2010.
Reply received: September 2012
PARLIAMENTARY QUESTION NO.: 1708 OF JUNE 2022 NW2062E FOR WRITTEN REPLY
Mrs SP Kopane (DA) to ask the Minister of Health:
(1) (a)How many nursing agencies are there in each province and (b) how many patients can currently be accommodated at each agency?
(2) Whether all Nursing Agencies are regularly inspected in order to ensure that they meet the minimum prescribed standards; if not, (a) why not, (b) which nursing agencies were not inspected, (c) for how long has each nursing agency which has not been inspected ; if so, for each agency which was inspected, (i) when was the last inspection conducted, (ii) who conducted the inspection and (iii) what are the minimum prescribed standards that a nursing agency must meet:
(3)Whether any nursing agency has failed to meet the prescribed minimum standards; if not, how was this conclusion reached; if so, (a) which nursing agencies and (b) what corrective action has been taken in thisregard?
(4) What amounts were allocated to the funding of each nursing agency in the (a) 2009-10, (b) 2010-21 and (c) 201 1-12 Financial Years.
Response
1 According to the records, the number of active agencies in 2010 in each province are as follows:
TOTAL = 196
(Communication from the South African Nursing Council (SANG) is attached:
Annexure A).
(b) Nursing agencies serve as brokers which supply nursing personnel to the health establishments. Therefore the nursing agencies do not accommodate patients as they are not health establishments.
2. Nursing agencies were not inspected by SANG
(a) Not Applicable
(b) Not Applicable
(c) Not Applicable
(d) Not Applicable
(i) NIA
(ii) NIA
(iii) Nursing agencies were to meet standards set out in me nursing agencies Regulation
(Regulation is attached for ease of reference - Government Gazette R32 of 10 January 196.Q: Annexure 6).
3. Nursing Agencies which failed to meet minimum standards were de-registered.
(a) List of de-registered Nursing Agencies up to 2010(Annexure C).
(b) Itis theNursing Agency's responsibility to ensure that they meetthe SANC standards for their registration, however, the SANC has no obligation to take corrective actions to ensure that Nursing Agencies meet minimum standards since they are private entities (the Regulation itself suffices).
4. The SANC, as a Statutory Body does not provide funding nor have any knowledge in respect to the budget allocated to Nursing Agencies.
(a) NIA
(b) NIA
[c)NIA
Reply received: August 2012
PARLIAMENTARY QUESTION NO.: 1707 OF JUNE 2012 FOR WRITTEN REPLY
Mrs SP Kopane (DA) to ask the Minister of Health:
Whether all nursing agencies are registered with his department; ifnot, (a) whynot and (b) (i) which nursing agencies are not registered and ( l i ) in which provinces are they situated, if so, how many nursing agencies are registered on a (aa) permanent and (bb) temporary basis?
Response
· Nursing Agencies have been registering with the South African Nursing Council (SANC) up to 2010;
· From 2011to date the Ministry of Health put a Moratorium on the registration of New Nursing Agencies till a new regulation on Nursing Agencies is promulgated
· The Department of Health therefore does not register nursing agencies.
(a) The Ministry of Health, in keeping with all Labour Forces id the country views Nursing Agencies as "Labour Brokers" and hence, the Moratorium on the registration of new nursing agencies until a revised regulation on nursing agencies is promulgated.
(b) (i) The Department has no way of knowing nursing agencies which are not registered, and neither does the SANC since these are private entities.
(ii) NIA (aa) Up and until 31 December 2010, Nursing Agencies were being registered on an annual basis bythe SANC and noton permanent basis.
(bb) N/A
Reply received: September 2012
PARLIAMENTARY QUESTlON NO.: 1706 OF JUNE 2012 NW2060E FOR WRITTEN REPLY
Mrs SP Kopane (DA) to ask the Minister of Health:
What is the (a) actual and (b) optimal number of staff for each of the following professions at each Nursing Agency for (i) professional nurses, (ii) staff nurses and (iii) assistant nurses?
Response
Nursing Agencies are Private Recruitment entitles and, as such the Department of Health does not set quotas for them regarding (a) actual and (b) optimal number of professional nurses, staff nurses and assistant nurses.
(i) NIA
(ii) NIA
(iii) NIA
Reply received: July 2012
QUESTION NO. 1644
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 June 2012
(INTERNAL QUESTION PAPER NO. 18)
Mrs P C Duncan (DA) to ask the Minister of Health:
(1) Whether, with reference to the reply to question 1276 on 5 June 2012, a certain person (name furnished) who was admitted to the South Coast Recovery Centre (SCRC) was prescribed (a) benzodiazepine (schedule 5) and (b) methadone (schedule 7) for detoxification from heroin; if so, what are the relevant details;
(2) whether the SCRC is registered to prescribe medication; if not, (a) who prescribed the medication, (b) what baseline test was conducted to determine (i) how much heroin the person had used and (ii) what dosages of medication the person would need and (c) what were the results of the full set of medical tests that were performed; if so, what are the relevant details?
NW1973E
REPLY:
Treatment centres for drug dependency are established and registered in terms of Sections 7 and 9 of the Prevention and Treatment of Drug Dependency Act, 1992 (Act No. 20 of 1992). This Act is administered by the National Department of Social Development and falls under the portfolio of the Minister of Social Development.
I have been informed that a police case was opened at Margate Police Station (Case no. 850/02/2011) following the death of the person referred to in this question and in question 1276 asked by Ms E More to the Minister of Social Development.
A comprehensive inspection in terms of Section 12(1) and regulation 13 of the Prevention and Treatment of Drug Dependency Act, 1992 (Act No. 20 of 1992) will be undertaken by a team of medical experts appointed by the Department of Social Development. Until findings of this inspection, it is not possible to provide the details required in this question.
Reply received: August 2012
PARLIAMENTARY QUESTION 1634 FOR WRITTEN REPLY
MS GCUME (COPE) TO ASK THE MINISTER OF HEALTH
1634. What is the ratio of nurses to patients at the St Elizabeth Mission Hospital in Lusikisiki in the Eastern Cape P Kopane (DA) to ask the Minister of Health
REPLY:
The response from St Elizabeth's Hospital is attached and details the nurse: patient ratio for the various departments of the hospital. It must be noted that the norms proposed in the reply from St Elizabeth's have been determined by the hospital based on professional judgement and local circumstances. A study is underway by the National Department of Health in collaboration with the World Health Organisation to develop national norms and standards for nursing and other categories of health professionals.
Reply received: July 2012
QUESTION NO. 1579
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 June 2012
(INTERNAL QUESTION PAPER NO. 17)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether his department has (a) an ARV programme and (b) a sufficient supply of treatment for rural people; if not, why not; if so, what are the relevant details?
NW1906E
REPLY:
(a) Yes.
(b) Yes, although limited stock of tenofovir and abacavir were available country-wide. Suppliers on contract were encouraged to increase production and availability. Additional suppliers were also identified to fill gaps in supply.
Reply received: July 2012
QUESTION NO. 1577
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 June 2012
(INTERNAL QUESTION PAPER NO. 17)
Ms N P Gcume (Cope) to ask the Minister of Health:
What measures has he put in place to eliminate the shortage of doctors, in the rural areas of the Eastern Cape?
NW1903E
REPLY:
The Eastern Cape Department of Health has undertaken the following measures:
(a) Deployed post-community service doctors to the areas of need;
(b) Allocated community service doctors to areas of need;
(c) Developed a recruitment programme with African Health Placements for foreign health professionals;
The National Department of Health (NDOH) is undertaking the following measures:
(a) The NDOH is in the process of designing and implementing a Rural Health Strategy with a priority towards the Eastern Cape;
(b) The NDOH through the faculties of health sciences has expanded the intake of doctors from 2011 with an emphasis on intake from rural backgrounds, and WSU has increased intake;
Reply received: July 2012
QUESTION NO. 1576
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 June 2012
(INTERNAL QUESTION PAPER NO. 17)
Ms N P Gcume (Cope) to ask the Minister of Health:
Whether he intends to reinstate the training of nurses in tertiary hospitals; if not, why not; if so, what are the relevant details?
NW1902E
REPLY:
Training of nurses in tertiary hospitals has never been officially halted. We however have a programme to revitalize all nursing colleges in all hospitals and not only in tertiary hospitals.
Reply received: July 2012
QUESTION NO. 1562
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 June 2012
(INTERNAL QUESTION PAPER NO. 17)
Dr S M van Dyk (DA) to ask the Minister of Health:
What (a) measures are in place to deal with the lack of spending in the Hospital Revitalisation grant and (b) are the challenges with regard to the implementation of the grant programme?
NW1885E
REPLY:
(a) The National Department of Health (NDOH) in the 2010/11 financial year conducted a review on the provincial capacity to deliver all health infrastructure projects including those funded from the Hospital Revitalisation Projects. The results from the review show that there was a need to have Resident Engineer or Architect in all provinces that will directly monitor the procurement processes and quality of work on site. Following the approval from the National Health Council (NHC), six provinces appointed the Resident Engineer/Architect and those provinces were Eastern Cape, Free State, Gauteng, KwaZulu/Natal, Northern Cape and Western Cape.
Furthermore, the NDOH in partnership with the National Treasury appointed Programme Technical Assistants (TAs) through the Infrastructure Delivery Improvement Plan (IDIP) per province, in both the Departments of Health and of Public Works. The aim of having TAs in the abovementioned sectors is to ensure that all departments are following the IDIP infrastructure implementation processes since it was aimed at fast-tracking government infrastructure service delivery. Currently all nine provinces have the TAs in place.
The NDOH through partnership with Development of Southern Africa (DBSA) appointed the Project Monitoring and Support Unit (PMSU) in the NDOH Infrastructure Unit to assist the Department with the additional capacity required on project planning, implementation, monitoring and evaluation as well as maintenance. The PMSU also has personnel appointed at provincial level to assist and drive the National Programme forward.
These initiatives have shown positive results in the 2010/11 financial year in terms of performance, both financial and non-financial. The level of under-expenditure has improved in all provinces except for Limpopo. Provinces such as KwaZulu/Natal, Free State and Eastern Cape have their expenditure indicating that their planning systems are improving. These provinces' spending expenditure patterns were significantly slow owing to poor performance by the contractors.
(b) Yes, the NDOH is still experiencing challenges of quality of work on site by contractors. As part of the corrective measures in place by the Department, the 2012/13 Division of Revenue Act (DORA) recommended that the provincial adjudication committee should also include Resident Engineers or Infrastructure Technical members to ensure that contractors who are awarded work are qualified to render the required service and are capable of handling the size of projects. The National Treasury together with the NDOH is currently assisting provinces to acquire relevant skills needed to improve performance of the grant.
This financial year, 2012/13, each province has been allocated an amount of R10 million to address the capacity problems encountered in their relevant provinces.
Reply received: July 2012
QUESTION NO. 1526
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 June 2012
(INTERNAL QUESTION PAPER NO. 17)
Mrs H S Msweli (IFP) to ask the Minister of Health:
(1) (a) Why are there areas in KwaZulu-Natal that are not receiving adequate supplies of antiretroviral medication (ARVs) and (b) what steps are being taken to eliminate the causes of the shortage to enable persons in rural areas to access the ARVs;
(2) whether any attempts are being made to ensure that ARV satellite centres are constructed in local areas so that persons in rural areas who require medication do not have to travel too far in order to receive their treatment; if not, why not; if so, (a) what are the relevant details and (b) what processes does he intend putting in place to prevent such a situation from recurring?
NW1844E
REPLY:
(1) (a) Supply shortages were experienced due to the inability of contractual suppliers to meet ARV demand;
No real stock-outs were experienced at hospital level.
(b) Contingency plans were implemented and stock were re-distributed.
The National Department of Health (NDOH) met with suppliers and requested them to increase production and also to improve additional quantities to meet demand.
The NDOH also negotiated with other suppliers to provide stock in order to meet the demand.
(2) (a) Mobile and outreach clinics are used to increase access to treatment;
(b) KwaZulu/Natal is implementing the Nurse initiated treatment (NIMART) programme at PHC in order to ensure ARV access.
PHC mobile teams provide ART services to cover areas where there are access challenges.
The province is also implementing the Centralised Chronic Dispensing Unit (CCMDU) that will ensure that chronic patients receive their treatment as close as possible to their residential places.
Reply received: July 2012
QUESTION NO. 1482
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 01 June 2012
(INTERNAL QUESTION PAPER NO. 15)
Mrs D Robinson (DA) to ask the Minister of Health:
(1) (a) Which preferred service provider does his department use for the maintenance of medical equipment at (i) Letaba Hospital and (ii) all other hospitals in Limpopo province and (b) why is each specified service provider preferred;
(2) whether his department has a fixed contract with each specified service provider; if not, why not; if so, what are the relevant details;
(3) whether the tenders have been awarded on the basis that the successful bidding company offered (a) the best value for money and (b) has a track record to deliver on the contract mandate; if not, why not, in each case; if so, in each case, (i) how was this conclusion reached and (ii) when was the tender awarded;
(4) what is the total cost of all contracts that have been awarded in this regard?
NW1760E
REPLY:
According to the Limpopo Department of Health –
(1) (a) The service provider responsible for the maintenance of medical equipment at –
(i) Letaba Hospital is Folang Medical Supplies cc; and
(ii) In all other hospitals in Limpopo:
· Folang Medical Supplies cc in Mopani, Vhembe and Capricorn Districts;
· Shikenah Medical Supply and Manufacturers cc in Joint Venture with Syncromed Technology cc in Sekhukhune District.
(b) Each specified service provider is preferred because each was found by the procurement processes to be the most preferred bidder. The Department followed the prescribed procurement processed as stipulated in the Preferential Procurement Policy Framework Act No. 5 of 2000 (PPPFA) and the Preferential Procurement Regulations.
(2) The Department has a fixed contract with each specified service provider. The duration of the fixed contract for each specified service provider is three (3) years.
(3) (a) The successful bidding company offered the best value for money as the awarding of the tender was based on the site inspection reports conducted to assess the capacity and capability of bidders to perform in accordance with the terms and conditions of the contract;
(b) The company does have a good track record to deliver on the contract mandate;
(i) the company had a contract with the Department prior to the existing contract (from 01 November 2005 to 31 October 2008) to maintain medical equipment for the department. Although there were minor incidents of poor performance in some instances (which once brought to the attention of the service provider, it would be attended to), the company's performance has in general been acceptable to the Department.
(ii) The tender was awarded on 28 September 2010 and commenced on 01 October 2010.
(4) The total cost can only be arrived at, at the expiration of the contracts because it will depend on how often the repairs and maintenance were done at various institutions.
Reply received: June 2012
QUESTION NO. 1452
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 01 June 2012
(INTERNAL QUESTION PAPER NO. 15)
Dr D T George (DA) to ask the Minister of Health:
(1) When was the current Director-General of his department appointed;
(2) whether the Director-General was appointed in a permanent capacity; if not, what is the position in this regard; if so, what are the relevant details?
NW1729E
REPLY:
(1) On 08 June 2010;
(2) No. The Director-General is appointed on a 5-year renewable contract in terms of Section 12 (1)(a) of the Public Service Act of 1999, as amended.
Reply received: September 2012
QUESTION NO. 1324
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 May 2012
(INTERNAL QUESTION PAPER NO. 13)
Mrs M Wenger (DA) to ask the Minister of Health:
(1) (a) What is the estimated prevalence of asbestosis in the population of the Northern Cape and (b) what are the notable trends in the diagnoses of this disease in citizens of the Northern Cape;
(2) whether his department is working with other departments or spheres of government in order to reduce the incidence of asbestosis in citizens of the Northern Cape; if not, why not; if so, what are the relevant details?
NW1568E
REPLY:
(1) (a) It is not known what the prevalence of asbestosis is in the Northern Cape population. There are a few studies showing incidence of asbestos (newly diagnosed persons) – see details below.
(b) There are no community surveys of asbestos related diseases in South Africa and the diagnosing health facilities and health professionals do not usually report such diagnosis to any authority unless for compensation purposes. Other available data on asbestos related disease is provided through the occupational diseases diagnosed and compensated by the Compensation Commissioner for Occupational Diseases (CCOD).
Table 1: Compensated Persons in Financial Year 2010/11 (CCOD)
| Province of residence | Asbestos related claims Number | Asbestos related claims Percentage |
| Northern Cape | 24 | 42 |
| Western Cape | 0 | 0 |
| Eastern Cape | 1 | 2 |
| Mpumalanga | 8 | 14 |
| Limpopo | 17 | 30 |
| Gauteng | 2 | 4 |
| Free State | 1 | 2 |
| KwaZulu-Natal | 0 | 0 |
| North West | 4 | 7 |
| Total | 57 | 100 |
The Northern Cape accounted for 42% of all asbestos disease compensation claims in 2010/11.
Asbestos related disease certified for compensation for 2011/12 at the Medical Bureau for Occupational Diseases (MBOD)
There were 303 persons with asbestos related disease seen at the MBOD in 2011/12. The 'Province' in the table is based on the location of the mine that most likely resulted in the harmful asbestos exposure.
Table 2: Asbestos disease by province where exposure occurred
| Province | Number Certified | Percentage |
| Gauteng | 35 | 12 |
| Eastern Cape | 0 | 0 |
| Western Cape | 0 | 0 |
| Northern Cape | 13 | 4 |
| North West | 43 | 14 |
| Free State | 4 | 1 |
| Mpumalanga | 17 | 6 |
| Limpopo | 175 | 58 |
| Kwa-Zulu Natal | 0 | 0 |
| Unknown mine | 16 | 5 |
| Total | 303 | 100 |
The majority of persons certified by the MBOD worked in mines in the Limpopo province. This data covers persons assessed by the MBOD in 2011/12 and do not indicate trends but rather persons certified in that year as having work exposure to asbestos. The key message in these results is that there is asbestos related disease where asbestos was historically mined and not only in the Northern Cape.
It is therefore not possible to show the trends in persons with asbestosis
(2) The Department of Health is working with other national departments (Mineral Resources, Labour and Environmental Affairs) to reduce the incidence of asbestos related disease across South Africa. The Department of Health has a section within the Occupational Hygiene division at the National Institute for Occupational Health (NIOH) dealing with occupational related asbestos mitigation and measurement and interventions. Training is provided to inspectors of the Departments of Mineral Resources and Labour about asbestos exposure in workplaces as well as to health professionals, employer bodies and unions through outreach and continuing professional development activities and through academic programs at universities. It must be noted that asbestos use, manufacture and processing has been banned since 2008 in South Africa.
The bulk of the newly diagnosed persons with asbestos related disease are due to asbestos exposure from 20 to 30 years ago. The Departments of Mineral Resources and Environmental Affairs deal with the legacy issues of asbestos mining including the rehabilitation of asbestos mines. The Department of Health does not work directly with provincial or local government departments except if called upon to provided specialist technical and advisory services through NIOH.
Reference
1. Risk from Mesothelioma from exposure to crocidolite asbestos: a 1995 update on South African mortality study .D Kielkowski, G Nelson, D Rees. Occup Environ Med. 2000; 57: 563-567.
2. Trends in mesothelioma mortality rates in South Africa: 1997-2007. Kielkowski D, Nelson G, Bello B, Kgalamono S Philips JL. Occup Environ Med 2011; 68: 547-549.
Reply received: October 2012
QUESTION NO. 1243
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 May 2012
(INTERNAL QUESTION PAPER NO. 12)
The Leader of the Opposition (DA) to ask the Minister of Health:
Whether he intends collaborating with the Minister of Basic Education to ensure that girls attending school are (a) taught about feminine hygiene and (b) provided with sanitary towels on a monthly basis; if not, why not; if so, what are the relevant details?
NW1442E
REPLY:
(a) Yes, this is part of the School Health Programme;
(b) One of the five areas the School Health Programme will deal with is reproductive health rights. Every need of a learner in this regard will be dealt with in terms of this programme.
Reply received: June 2012
QUESTION NO. 1241
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 May 2012
(INTERNAL QUESTION PAPER NO. 12)
Dr W G James (DA) to ask the Minister of Health: [Interdepartmental transfer on 18 May 2012].
With reference to the recently announced pharmaceutical tender worth R 2,5 billion, (a) which of the 70 drugs are (i) on- and (ii) off patent, (b)(i) where is each specified patent held and (ii) who bears the cost of patent fees and (c) what will be the total amount in patent fees under the specified tender?
NW1439E
REPLY:
The tender for Oral Solid Dosage Forms, HP09-2012SD was advertised and included 447 items and not 70. All item specifications are in international Non-Proprietary names and not based on brand names. This tender has not yet been awarded hence it is not possible to provide a response on patent status of drugs.
Reply received: June 2012
QUESTION NO. 1220
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 May 2012
(INTERNAL QUESTION PAPER NO. 12)
Mr E H Eloff (DA) to ask the Minister of Health:
What amount has his department spent on (a) catering and (b) entertainment (i) in the (aa) 2007-08, (bb) 2008-09, (cc) 2009-10, (dd) 2010-11 and (ee) 2011-12 financial years and (ii) since 1 April 2012?
NW1417E
REPLY:
It is confirmed that the figures quoted below are actuals / audited amounts from the financial system.
(a) Catering
(i) (aa) 2007/08 R2 798 072.30
(bb) 2008/09 R3 522 204.71
(cc) 2009/10 R2 526 773.09
(dd) 2010/11 R3 742 896.81
(ee) 2011/12 R2 998 412.78
(ii) 2012 to date R198 072.04
(b) Entertainment
(i) (aa) 2007/08 R205 582.55
(bb) 2008/09 R235 040.83
(cc) 2009/10 R211 498.35
(dd) 2010/11 R245 006.14
(ee) 2011/12 R122 352.26
(ii) 2012 to date R12 850.10
Reply received: September 2012
QUESTION NO. 1193
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 May 2012
(INTERNAL QUESTION PAPER NO. 12)
Mrs S P Kopane (DA) to ask the Minister of Health:
What (a) are the reasons for the under expenditure on hospital revitalisation in the 2010-11 financial year, (b) was the impact of this under expenditure on the performance of the provincial departments and (c) steps have been taken to ensure that under expenditure of this magnitude does not occur in the future?
NW1389E
REPLY:
(a) As at 31 March 2011, the Hospital Revitalisation Grant expenditure was at 79% of the total allocation of R4, 020,667.00 (R4 billion). Under spending was only in the following provinces:
| Province | Budget Allocation R000' | Expenditure (31/03/2011) R000' | % | Reason for under expenditure |
| Eastern Cape | 360,660 | 168,851 | 47% | · There were some delays in the awarding of tender by the provincial department which impacted on the spending. The allocated budget for the equipment could not be spent as planned. · Furthermore the province received a provincial rollover of R78.8 million late in the financial year from the National Treasury which they could not spent however the money was committed to be spent in the 2011/12 financial year. The rollover increased the budget allocation from R360.6 million to R439.5 million. · There has been poor performance by the appointed contractors and as result the department had to terminate some of the contracts and appoint new contractors to carry on with the work. This process had also impacted on the spending because the allocated budget could not be spent as planned. Projects such as Frontier's construction of the mortuary and two medical wards was allocated a budget of R16 million but only R1 million was spent because the contractor was not performing well. |
| Free State | 378,426 | 244,412 | 65% | · There were some delays in the awarding of tender by the department as part of the cost containment measures since the province was experiencing huge over spending at the time. · There were also some challenges with regard to capacity. 85% of the Senior Management staff in the Infrastructure Unit, which includes the Hospital Revitalisation Unit were suspended as a result there was no proper management of projects that are on site. |
| Kwa-Zulu Natal | 500,815 | 272,769 | 54% | · There was a delay with the Department of Transport in the awarding of tender for the access road project for Rietvlei hospital. · There were also some delays in the awarding of tender for Hlabisa. These delays had impact on the spending because money that was budgeted for could not be spent as planned. |
| Limpopo | 323,425 | 234,309 | 72% | · There was lack of capacity in the Revitalisation Project Unit which had serious impact on the management of projects. · Allocation of a site for the Musina hospital project also had financial impact because funds were budgeted for the project to start but because of the site not being acquired, it had to be put on hold. In Thabazimbi the project had to be put on hold because there were some dispute with the community on the issue of the land that the hospital was built on. · Poor performance by the contractors and the termination of some contractors also contributed to the spending pattern. |
| Northern Cape | 420,218 | 261,929 | 62% | The main contributing factor to the poor spending is the court matter between the provincial department of Health and the contractor for the Kimberly Mental Health Facility which had serious implications on the spending. The contractor had to be terminated because of poor performance as a result the contractor took the department to court. |
(b) The impact of this under expenditure was that:
· Projects were delayed because of poor quality of work by the contractors as a result they contracts were terminated.
· Issue of land allocations should be resolved with the municipality before any project can start (LP incidents – Musina and Thabazimbi)
· Lack of capacity which lead to poor management of the programme.
(c) Corrective measures taken:
· NDOH together with the National Treasury has capacitating the provinces by appointing Technical Advisors (TAs) with the aim of improving the infrastructure progress on all revitalisation projects. Residential Engineers were appointed in Eastern Cape, Free State, Gauteng, Northern Cape, Kwa-Zulu Natal and Western Cape Provinces to strengthen the provincial capacity to deliver on infrastructure projects. The process is continuing in the remaining provinces. The National Department of Health together with the National Treasury are also engaging in the process of reviewing provincial capacity and an amount of R10 million per province was put aside in 2012/13financial year to address the capacity issues.
· A revised Monitoring and Evaluation tool will be put in place at both the National and Provincial level to ensure effective management and accountability of the Hospital Revitalisation grant. Currently the National Department, through the Development Bank of South Africa, has approved the Project Management Support Unit (PMSU) in the National Department and also have Coordinators placed in each province. These interventions have shown a positive sight to the grant performance in 2011/12 financial year.
Reply received: June 2012
QUESTION NO. 1170
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 May 2012
(INTERNAL QUESTION PAPER NO. 12)
Mrs S P Kopane (DA) to ask the Minister of Health:
(1) Whether his department has established a framework to deal with the financing of the National Health Insurance District Pilot Projects in order to ensure that (a) patients are not left with any out-of-pocket liabilities and (b) health care providers, particularly district hospitals, are paid; if not, (i) why not and (ii) when will such a programme be finalised; if so, what are the relevant details;
(2) how are service providers currently paid?
NW1363E
REPLY:
(1) The National Department of Health, in liaison with the National Treasury, has established a funding framework for the National Health Insurance (NHI) Pilot Districts. This framework was formally signed by The Presidency as part of the Division of Revenue Act, 2012 (Act No. 5 of 2012) for the financial year 2012/13 in Government Gazette Volume 563 and No. 35361.
(a) the framework for the financing of the NHI pilots is neither intended to ensure that patients are not left with any out-of-pocket liabilities;
(b) nor to ensure that all providers, particularly district hospitals are paid. Instead, the focus of the pilots is to test innovations that are necessary for the implementation of NHI, to undertake health system strengthening initiatives in identified districts as well as to provide strategic resources for supporting the pilot districts in implementing selected health service delivery interventions.
(2) Service providers in the NHI pilot districts are paid as per the budgeting and resource allocations provided for within the National and Provincial Treasury Prescripts and Regulations. However, one of the key interventions that will be tested in the NHI pilots is the ability of the districts to contract with General Practitioners within their geographical boundaries. The General Practitioners will be given sessional contracts to render specified services at the Primary Health Care facilities located within the districts.
Reply received: June 2012
QUESTION NO. 1083
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 May 2012
(INTERNAL QUESTION PAPER NO. 11)
Ms A M Dreyer (DA) to ask the Minister of Health:
(1) (a) What are the (i) yearly rental and (ii) floor space of the (aa) current and (bb) previous premises occupied by his department's head office and (b) when (i) was the current building occupied and (ii) does the current lease expire;
(2) whether his department publicly invited tenders prior to the leasing of the current premises; if not, why not; if so, (a) when, (b) where was it published and (c) which (i) companies and (ii) properties were shortlisted;
(3) what (a) floor space was offered and (b) annual rental was tendered (i) by each shortlisted company and (ii) with regard to each shortlisted property?
NW1271E
REPLY:
(1) (a) (i) R67,980,042 for the 2012/13 financial year which is payable to the Department of Public Works.
(ii) (aa) the total floor space for the Civitas building is 102,335 square metres. This includes all space, for example office space, workspace support areas, core areas, structural space, parking bays, etc.
(bb) the total floor space for the Hallmark, FedLife, HTI and MBA buildings was 46,169 square metres (only office space and workspace support) and 120 parking bays.
(b) (i) September 2010;
(ii) The agreement with the Department of Public Works expires in 2030.
(2) Neither the Department of Health nor the Department of Public Works went out on an open tender as the Civitas building is a Government-owned building.
(a), (b) and (c) Not applicable.
(3) Not applicable.
Reply received: September 2012
QUESTION 1067
1067. Mrs. SP Kopane (DA) to ask the Minister of Health:
whether any employee within his Ministry is currently on suspension following the finalisation of the disciplinary process: if so in each case (a) what is the name of the suspended person, (b) what is his/her designation, (c) what are the terms of reference for his/her suspension an (d) what is the duration of the suspension? NW123E
REPLY
a) It is not the policy of the department to divulge to the names of officials under suspension or misconduct; however it is on record that Ms. LJ Ligudu is the one on suspension.
b) Senior Secretary .Office of the Deputy Minister.
c) Precautionary suspension with full pay pending disciplinary hearing.
d) The suspension policy of the department requires that official should not be suspended for more than 60days and Ms Ligudu suspension is currently two weeks.
Reply received: June 2012
QUESTION NO. 1066
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 May 2012
(INTERNAL QUESTION PAPER NO. 11)
Mrs S P Kopane (DA) to ask the Minister of Health:
Whether his department currently owes any grant funding to the Vita Nova Centre for Cerebral Palsy in Springs; if not, what is the position in this regard; if so, (a) why have the funds not been paid over to the centre and (b) for what period have the specified funds been outstanding?
NW1252E
REPLY:
Yes.
(a) All funds for the 2011/12 financial year have been paid. The only outstanding funding is for April 2012. This has been due to the fact that the Regional office has not yet submitted their Service Level Agreement/Contract and the claim forms for the new financial year 2012/13 to enable the Financial Accounting Directorate to process their payment.
(b) One month.
Reply received: July 2012
QUESTION NO. 1025
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 May 2012
(INTERNAL QUESTION PAPER NO. 11)
Mrs P C Duncan (DA) to ask the Minister of Health:
(1) With reference to his reply to question 367 on 16 April 2012, what has the nearly R50 million annual budget for the Office of Standards Compliance achieved in the past four and a half years in terms of validated improvements in the quality and safety of healthcare establishments;
(2) when will the National Core Standards (NCS) be ready for full implementation instead of in the priority areas;
(3) what has been the cost to the State in the (a) 2008-09, (b) 2009-10, (c) 2010-11 and (d) 2011-12 financial years for meeting the (i) legal and (ii) compensatory costs related to incidents in which patients have been harmed as a result of poor and unsafe care;
(4) what scientific evidence has been produced during the development period of the NCS that (a) they have the potential to (i) reduce the number of adverse events and consequent harm to patients and (ii) improve the safety and quality of service delivery in healthcare establishments and (b) users of the National Health Insurance (NHI) can be assured that they will receive safe, quality care in facilities that meet the NCS?
NW1189E
REPLY:
(1) The budget for the Office of Standards Compliance over the past 4 years has been –
- 2008/09: R7.8m
- 2009/10: R5.3m
- 2010/11: R17.2m
- 2011/12: R28.5m
- 2012/13: (in course) – R48.5m;
(a) The drafting of the National Health Amendment Bill and its successful tabling Parliament;
(b) The development of a common set of national standards accepted by the National Health Council (NHC), with widespread knowledge across the public health sector and increasing incorporation into performance agreements, planning and budgeting;
(c) The development, piloting and revision of the tool over a period of 4 years to audit compliance with the standards, used in the baseline audit of all public sector facilities (as well as by sections of the private sector and non-for-profit organizations);
(d) Focused improvement support to close gaps identified during baseline audit;
(e) The management of all complaints directed to the National Office or to the Minister and testing of procedures for investigation and resolution of these in coordination with other relevant bodies;
(f) Strengthening the monitoring systems for ongoing measurement of quality.
Validation of improvements is envisaged as the next stage.
(2) The baseline audit was deliberately focused on the priority areas as a first stage. The full version of the National Core Standards has been widely distributed and the respective audit tool is already available and is being used in a number of facilities.
(3) The cost to the state for meeting –
(a) 2008/09: (i) R26.28m
(ii) R57.08m
(b) 2009/10: (i) R34.98m
(ii) R103.37m
(c) 2010/11: (i) R24.33m
(ii) R86.83m
(d) 2011/12: (i) R41.22m
(ii) R97.75m
(4) The final version of the National Core Standards was published in early 2011 and the baseline audit started in mid-2011.
(i) From the preliminary results obtained from the baseline health facility audits, it can be verified that this potential exists;
(ii), (iii) and (iv) Follow-up through inspections is required and this is being planned. This will be the basis on which information on assurances can be made.
Reply received: September 2012
Mrs P Duncan (DA) to ask the Minister of Health
(1) Whether with reference to his reply to question 368 on 16 April 2012 any research evidence has been produced to show that the information technology (IT) programme on the District Health Information System (DHIS) has the capacity to provide the required information to assist his department and the participating facilities to (a) understand the causes of poor quality and safety in all departments and services within health care establishments that have been assessed against the National Core Standards (NCS) and (b) support the required quality improvement programmes to bring about compliance with the MCS; if not why not; if so what are the relevant details
Answer:
a) A tailor made module for capturing of the national core standards assessments data was programmed for the DHIS.
b) Provinces are able to capture facility specific data to measure compliance against the national core standards
c)This Information is being used to develop quality improvement plans for facilities
(2) whether any comparative studies of alternative IT systems, including cost benefit analysis, have been carried out; if not, why not ; if so, what were the findings?
Reply received: June 2012
QUESTION NO. 940
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 April 2012
(INTERNAL QUESTION PAPER NO. 10)
Mrs C Dudley (ACDP) to ask the Minister of Health:
(1) Whether the latest statistics on teenage pregnancy represents a decline; if not, (a) what is the position in this regard and (b) how do the numbers compare with previous years; if so, what are the relevant details;
(2) whether the statistics on teenage pregnancy include terminations of pregnancy in terms of the Choice on Termination of Pregnancy Act, Act 92 of 1996; if not, what is the position in this regard; if so, what are the relevant details?
NW1115E
REPLY:
(1) No.
(a) It has increased by 2.8%.
(b) According to Youth Risk Behaviour Survey Reports of 2002 and 2008, the statistics on teenage pregnancy were 19,1% and 21,9% respectively.
(2) No.
Teenage pregnancy statistics are captured through antenatal records whereas statistics on Termination of Pregnancy are captured through designated health facilities (private/public and Non-Governmental Organisations).
Reply received: June 2012
QUESTION NO. 939
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 April 2012
(INTERNAL QUESTION PAPER NO. 10)
Mrs C Dudley (ACDP) to ask the Minister of Health:
Whether the figures for Choice on Termination of Pregnancy (CTOP) have been released; if so, (a) how can the information be obtained and (b) what are the further relevant details?
NW1114E
REPLY:
(a) Yes. The data for all terminations performed according to the provision of the Choice on Termination of Pregnancy Act, as amended, are captured on the District Health Information System (DHIS) as and when they are reported by service providers. They are availed according to valid requests to the Department, for example, upon request by Parliament.
(b) There are no further details.
Reply received: June 2012
QUESTION NO. 935
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 April 2012
(INTERNAL QUESTION PAPER NO. 10)
Mr M Waters (DA) to ask the Minister of Health:
Whether his department reports incidences to the SA Police Service (a) of minors falling pregnant and being infected with HIV/Aids in the process and (b) when statutory rape or rape is likely to have occurred; if not, (i) why not, (ii) what steps has his department taken to rectify the situation and (iii) who has the responsibility for reporting such incidences; if so, what are the relevant details?
NW1110E
REPLY:
(a) No. I do not think it is advisable for health workers to routinely report minors falling pregnant and being infected with HIV/AIDS in the process to the South African Police Service (SAPS). However, since these will also indicate social problems, such matters will be referred to relevant people like social workers and relevant child protection services but never to the Police.
(b) (i), (ii) and (iii) Same with statutory rape, there are relevant social workers, child protection societies, etc, who will have to be informed by health workers to deal with such matters.
Reply received: June 2012
QUESTION NO. 884
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 April 2012
(INTERNAL QUESTION PAPER NO. 09)
Mrs J F Terblanche (DA) to ask the Minister of Health:
(1) With reference to his reply to question 66 on 7 March 2012, (a) in which newspapers were advertisements placed, (b) on what dates were the advertisements placed and (c) for which hospitals were positions advertised;
(2) whether there is a minimum level of qualification that a person must have before he/she can be appointed; if not, why not; if so, (a) what is this level of qualification and (b) who will ensure that the applicant meets this minimum level of qualification;
(3) whether any deviation from the minimum qualification is allowed; if so, (a) what is the range of the deviation, (b) who can decide to deviate and (c) on what basis is the deviation allowed?
NW1062E
REPLY:
(1) (a) Sunday Times and Sunday Independent
(b) 26 February 2012
(c) The table overleaf reflects the details in this regard
(2) Yes, there is a minimum level of qualification that a person must have before appointment.
(a) First and foremost, the person must have a health-related tertiary qualification;
(b) The shortlisting panel
(3) No, except if the person has already been doing that job and there is very clear and ambiguous evidence of a high competency level.
Reply received: July 2012
QUESTION NO. 883
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 April 2012
(INTERNAL QUESTION PAPER NO. 09)
Mrs H Lamoela (DA) to ask the Minister of Health:
(1) With reference to her reply to question 66 on 13 March 2012, (a) by whom will the management support be offered and (b) what are the exact details of the management support;
(2) (a) when will the leadership institute be opened, (b) where will it be based and (c) what will be the cost of (i) establishing and (ii) running the institute?
NW1061E
REPLY:
(1) (a) Management support will be offered by a number of the universities in South Africa and international universities that have expressed interest in providing management support programmes.
(b) Management support will be provided to assist new CEOs.
(2) (a) The Leadership Institute will, in the first phase, definitely be a virtual institution playing a co-ordinating and accrediting role. The work of the Institute has in essence begun with the development of management support programmes for the CEOs through co-operation with local and international universities. We will make an official announcement soon.
(b) and (c) The location of the Institute is still under discussion but at this stage will be located at the NDoH in Pretoria.
Reply received: June 2012
QUESTION NO. 816
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 April 2012
(INTERNAL QUESTION PAPER NO. 09)
Mrs C Dudley (ACDP) to ask the Minister of Health:
(a) How many new doctors are currently doing their (i) internships and (ii) community service and (b) at which hospitals in each case?
NW989E
REPLY:
(a) (i) Interns:1349
(ii) Community Service Doctors: 1103
(b) The attached table reflects the situation in this regard
Health Facilities where Community Service Doctors were placed see attached
Reply received: June 2012
QUESTION NO. 815
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 April 2012
(INTERNAL QUESTION PAPER NO. 09)
Mrs C Dudley (ACDP) to ask the Minister of Health:
How many (a) South African doctors are currently working abroad and (b) foreign doctors are currently working in South Africa?
NW988E
REPLY:
(a) Our latest data was in 2006 when there were 8 921 doctors working abroad.
(b) Out latest available data was in 2011 when there were 3 004 foreign doctors working in South Africa.
Reply received: June 2012
QUESTION NO. 814
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 April 2012
(INTERNAL QUESTION PAPER NO. 09)
Mrs C Dudley (ACDP) to ask the Minister of Health:
How many (a)(i) doctors graduated from medical schools and (ii) nurses graduated from nursing schools in 2011 and (b) additional (i) doctors and (ii) nurses are needed for the National Health Information System to operate effectively?
NW987E
REPLY:
(a) (i) In 2010 (the year for which audited data is available) 1 330 doctors graduated.
(ii) In 2009 (the year for which collated and audited data is available) 15 910 nurses graduated. Of this total 2,638 were Registered Nurses, 7 439 were Enrolled Nurses, and 5 779 were Enrolled Nurse Assistants.
(b) I am not sure why doctors and nurses should be needed for any National Health Information
Reply received: May 2012
QUESTION NO. 777
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012
(INTERNAL QUESTION PAPER NO. 08)
Ms E More (DA) to ask the Minister of Health:
(1) Whether, in view of the increase in the number of maternal deaths (details furnished), all the recommendations of the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD) have been implemented; if not, (a) why not, (b) which recommendations have not been implemented and (c) by which date will they be implemented; if so, on which date was each recommendation implemented;
(2) on what date did his department receive the Saving Mothers 2005-2007: Fourth Report on Confidential Enquiries into Maternal Deaths in South Africa report?
NW948E
REPLY:
(1) All the ten recommendations of the National Committee on Confidential Enquiries into Maternal Deaths are being implemented albeit differentially by individual provinces. During the development of the ten recommendations, all provinces give their input and this is included in the provincial recommendations where priority is put on the provinces specific national recommendation. This prioritization determines the differential implementation of the ten recommendations but at the same time all the recommendations will be addressed. To further reduce maternal deaths the Essential Steps in the Management of Obstetric Emergencies (ESMOE) training of health care providers started in 2008 and will rolled out nationally starting in May 2012.
(a) The provinces are required to give progress reports on the implementation of the ten recommendations on a quarterly basis.
(b) All ten recommendations are being implemented even though there is provincial prioritization depending on the maternal deaths' profile in individual provinces.
(c) The implementation is an ongoing process and cannot be limited to a specific date.
(2) The Saving Mothers Report 2005-2007 was released in 2009.
Reply received: June 2012
QUESTION NO. 776
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012
(INTERNAL QUESTION PAPER NO. 08)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether he has investigated the 1 519 maternal deaths that occurred during the period 2005 to 2007 (details furnished); if not, why not; if so, in each case, (a) what were the findings, (b) who was held accountable, (c) what were the consequences for those who had been held accountable and (d) who conducted the investigations;
(2) whether he has implemented any measures to prevent maternal deaths that result from negligence; if not, why not; if so, what (a) reduction in maternal deaths as a result of negligence does he envisage during the 2011- 2013 period and (b) are the further relevant details?
NW947E
REPLY:
(1) Yes, through the activities of the National Committee on Confidential Enquiries into Maternal Mortality. Confidential enquiries into maternal deaths are a systematic multidisciplinary anonymous investigation of maternal deaths occurring in South Africa and identify the numbers, causes and avoidable or remediable factors associated with them.
(2) Yes, the National Committee on Confidential Enquiries into Maternal Deaths develops recommendations in line with the findings of the Saving Mothers Report.
(a) The Department is not in a position to predict any reduction in negligence cases in the period 2011 to 2013. The Department has set targets to reduce maternal deaths by at least ten percent each year.
(b) Reduction of maternal mortality is one of the objectives of the Negotiated Service Delivery Agreement of the Minister. South Africa has also joined 53 African States in the Campaign for Accelerated Reduction in Maternal Mortality in Africa (CARMMA) and has developed strategies to achieve reduction. The Department has also developed a Maternal, Neonatal, Child and Women's Health Strategy intended to assist in reducing morbidity and mortality in mothers, women and children.
Reply received: May 2012
QUESTION NO. 770
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012
(INTERNAL QUESTION PAPER NO. 08)
Ms E More (DA) to ask the Minister of Health:
(1) What research has been conducted to determine the decline in foetal alcohol syndrome (FAS) in the De Aar area, (b) is the current level of FAS in the De Aar area and (c) what was the previous available FAS level for De Aar;
(2) (a) to which other areas is FAS spreading and (b) what are the current levels of FAS in each of these areas?
NW939E
REPLY:
(1) (a) A Foetal Alcohol Spectrum Disorder (FASD) Prevention Study was conducted from 2002-2006 by the Foundation for Alcohol Related Research in three phase:
· Phase 1: Pre-intervention.
· Phase 2: Universal prevention interventions (in collaboration with the Department of Health and Social Development and other non-governmental organizations).
· Phase 3: Post intervention.
(b) The current level of FASD in De Aar is 80/1000 (8%).
[Phase 3, Post intervention].
(c) The previous level of FASD in De Aar was reported at 112.8/1000 (11.3%) during the Phase 1, pre-intervention.
(2) (a) There is no surveillance mechanism to monitor the spread of FAS but in any community that has pregnant women drinking alcohol during especially the first 9 weeks of pregnancy, there is always the possibility of their offspring developing FAS.
(b) No statistics are currently available for other areas in South Africa, apart from those previously researched.
Reply received: April 2012
QUESTION NO. 743
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012
(INTERNAL QUESTION PAPER NO. 08)
Ms A M Dreyer (DA) to ask the Minister of Health:
Whether any officials from (a) his department and (b) any entities reporting to him were on an official visit to Bloemfontein in (i) December 2011 and (ii) January 2012; if so, in each case, what (aa) is the (aaa) name and (bbb) position of the specified official, (bb) was the (aaa) purpose and (bbb) date of such visit and (cc) was the cost of (aaa) transport, (bbb) accommodation and (ccc) other expenses?
NW911E
REPLY:
Yes.
(a) Officials of the Department of Health were on an official visit to Bloemfontein in January 2012 and not in December 2011. The details are as follows:
(aa), (aaa) and (bbb)
| Names of officials | Positions of officials. |
| Ms MP Matsoso | Director-General |
| Mrs APR Cele | Director: Environmental Health |
| Mr Peter Fuhri | Director: Disaster Medicine and Major Events |
| Mr MAM Ramathuba | Deputy Director Environmental Health (Port Health Services) |
(bb) (aaa) The Purpose of the visit was –
· To assist both the Free State Province and Mangaung Municipality in preparing and coordinating response to the anticipated Environmental Health related risks associated with mass gatherings as defined by the WHO. The WHO guide on Communicable disease alert and response for mass gatherings: key considerations, June 2008, experience of the 2010 soccer world cup and other similar events around the world was considered in developing the plan of action.
· To support the Province in prevention of potential International Spread of Communicable Diseases associated with International Travel of people and their baggage through Points of Entry and any events of International concern as defined by the International Health Regulations 2005.
· To assist through coordination of the National and Provincial Health Operating Centre for mass gatherings as we did in a larger scale during the 2010 Soccer World Cup in a cooperative governess principles of the Constitution of South Africa.
· A report on the event reflecting the activities engaged, anticipated health challenges, experienced challenges, how they were handled and related matters is available as reference.
(bb) (bbb) The visits were made from the 04 January 2012 to 09 January 2012 for the other 3 officials, and only 1 day for the Director-General.
(cc) The Costs were as follows:
(aaa) Transport: R 19 268.91 (travelling to Bloemfontein and within for six days);
(bbb) Accommodation: R 9 064.24
(ccc) Other expenses: R2 795.44 (Parking expenses, Daily allowance and Toll gates).
(b) We are not aware of any entities having been involved in this regard.