Questions & Replies: Health

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2012-06-30

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Reply received: April 2012

QUESTION NO. 683

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

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

(1) Whether he has been informed of the Selentum Scientific Statement of 2011 which recommends that lower limits be established for electromagnetic fields and wireless exposure, based on scientific studies reporting health impacts at much lower levels of exposure; if so, what steps has his department taken to ensure the safety of humans; if not,

(2) whether his department intends to study the statement; if not, why not; if so, what are the relevant details?

NW843E

REPLY:

(1) The International Commission on Non-Ionizing Radiation Protection (ICNIRP) is an independent scientific organization that develops science-based guidelines on limits of exposure and provides recommendations and principles for non-ionizing radiation protection. ICNIRP is a formally recognized non-governmental organization in non-ionizing radiation protection for the World Health Organization (WHO) and the International Labour Office of which South Africa is a member state. The Department is fully aware of the statement and the recommendation which is part of the ongoing discussion on Possible Health Effects of Electromagnetic Fields (EMF).

(2) The Department is currently in a process of establishing a Ministerial Task Team on Electromagnetic Fields. The team will be a multidisciplinary team from scientific, engineering and medical fields. It will further interrogate statements like this, engage stakeholders like researchers and WHO and advise the Minister on steps to be taken.

Reply received: May 2012

QUESTION NO. 682

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

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

Whether the SA Nursing Council has withdrawn permission for qualified nurses to dialyse; if so, (a) when was this enforced, (b) what are the reasons for this decision being taken and (c) who took the decision in this regard?

NW842E

REPLY:

No, the South African Nursing Council (SANC) has not changed Regulations relating to the Scopes of Practice of persons who are registered under the Nursing Act, 1978.

Chapter 2 of Regulations R2598 outlines the Scopes of Practice of Registered Nurses and provides for the following activities that may be undertaken by this category:

(b) The execution of a programme of treatment or medication prescribed by a registered person of a patient; and

(q) Preparation for and assistance with operative, diagnostic and therapeutic acts for the patient.

Chapter 3 of Regulations R2598 outline the Scopes of Practice of a Registered Midwife and provisions (b) and (s) similarly provide for the registered Midwife to be able to undertake the following activities:

(b) The execution of a programme of treatment or medication prescribed by a registered person for a patient; and

(s) Preparation for and assistance with operative, diagnostic and therapeutic acts for the patient;

Chapter 5 (5) (p) of Regulations R2598 (Scopes of Practice of Enrolled Nurse/Staff Nurse) makes the following provision:

(p) Preparation for and assistance with diagnostic and therapeutic acts by a registered person;

(q) Preparation for and assistance with surgical procedures and anaesthetic.

For the Enrolled Nurse Nursing Assistant, Chapter 6 (m) and (n) of Regulations R2598 (Scopes of Practice of Enrolled Nurse Nursing Assistant) makes the following provision:

(m) The preparation of individual and groups for the execution of the diagnostic procedures and therapeutic acts by a registered person;

(n) The preparation for assistance during surgical procedures under anesthesia.

Reply received: May 2012

QUESTION NO. 650

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

Mr P B Mnguni (Cope) to ask the Minister of Health:

Whether, with reference to the appointment of inspectors tasked with the responsibility of reviving failed hospitals, his departments has set timelines for the team of inspectors to help improve the health facilities in the (a) Motheo, (b) Sedibeng, (c) Zululand and (d) Pixley ka Seme districts; if not, why not; if so, what are the relevant details?

NW809E

REPLY:

· Facility Improvement Teams consisting out of managers from National Provincial and Districts management were established for all four districts

· Teams will use the results of the public health facility audit to strengthen service delivery by addressing the identified health systems issues.

· Work has started in 3 of the 4 Districts, namely Motheo; Zululand; Pixley ka Seme Districts

· The high level project plan based on the results of the Audit had been developed. The work in the facilities in Sedibeng districts will start in May 2012.

Honourable Member, no inspectors are going to be appointed to revive failed hospitals or to improve health facilities for that matter. Inspectors are going to be appointed specifically to do inspections to ensure compliance with set standards.

Improvement of health facilities will be done by management and in this case we have already trained and deployed health facility improvement teams to at least four districts to start improvement work.

Reply received: June 2012

QUESTION NO. 645

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

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

Whether he has found that he has sufficient internal capacity to deal with enquiries in the Human Resources section of his department; if so, why are they not being fully utilised?

NW804E

REPLY:

Yes.

Reply received: April 2012

QUESTION NO. 644

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

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

(a) On how many occasions were outside consultants used to deal with disciplinary enquiries in the (i) 2009-10 and (ii) 2010-11 financial years and (b) what was the total cost of using these consultants?

NW803E

REPLY:

The following table reflects the details in this regard:

2009-2010

2010-2011

01 April 2011 to date

01

None

R33 320.00

Reply received: April 2012

QUESTION NO. 643

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 March 2012

(INTERNAL QUESTION PAPER NO. 08)

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

How many disciplinary enquiries were held in his department in (a) the (i) 2009-10 and (ii) 2010-11 financial year and (b) during the period 1 April 2011 up to the latest specified date for which information is available?

NW802E

REPLY:

The following table reflects the details in this regard:

2009-2010

2010-2011

01 April 2011 to date

05

03

03

Reply received: May 2012

QUESTION NO. 562

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 March 2012

(INTERNAL QUESTION PAPER NO. 07)

Mr E H Eloff (DA) to ask the Minister of Health:

(1) Whether his department has an internal audit unit; if not, why not; if so, (a) how many staff members are employed in the unit and (b) what (i) is the structure and (ii) are the functions of the unit;

(2) whether the audit committee considers the internal audit reports; if not, why not; if so, what are the relevant details;

(3) whether he holds meetings to discuss (a) the internal reports and (b) their findings with the audit unit; if not, why not, in each case; if so, (i) on what dates since 1 April 2010 has each specified meeting taken place and (ii) what are the further relevant details?

NW727E

REPLY:

(1) The National Department of Health does have an Internal Audit Directorate.

(a) Seventeen (17) staff members are employed in the unit.

(b) (i) Structure

· 1x Director – Head of Internal Audit

· 4x Deputy Directors

· 1x Audit Supervisor

· 5x Senior Internal Auditors

· 3x Assistant Internal Auditors

· 3x Administrative Staff


(ii) Functions of the unit are as follows:

· Performance Audits – Focusing on Performance Information and Value for Money Audits. The audit scope covers amongst others, the following:

Assisting the accounting officer in achieving the objectives of department by evaluating and developing recommendations for the enhancement or improvement of the processes through which –

(a) Objectives and values are established and communicated;

(b) The accomplishment of objectives is monitored;

(c) Accountability is ensured; and

(d) Corporate values are preserved.

· Compliance/Regularity Audits – Focusing on DORA and other relevant legislation. The audit scope broadly covers amongst others, the following:

Assisting the accounting officer in maintaining efficient and effective controls by evaluating those controls to determine their effectiveness and efficiency, and by developing recommendations for enhancement or improvement. The controls subject to evaluation encompass the following:

(a) the reliability and integrity of financial and operational information;

(b) the effectiveness of operations;

(c) safeguarding of assets; and

(d) Compliance with laws, regulations and controls.

· Information Technology – Focusing on IT Audits and IT control environment. The audit scope broadly covers amongst others, the following:

Assisting the accounting officer in maintaining efficient and effective controls by evaluating those controls to determine their effectiveness and efficiency, and by developing recommendations for enhancement or improvement. The controls subject to evaluation encompass the following:

(a) the information systems environment;

· Forensic Investigations – Focusing on investigations of reported allegations of fraud and corruption within the department and its related entities.

(2) Yes, "Internal Audit Progress Reports to Audit Committee" is a standing agenda item at all meetings of the Audit Committee. Meeting discusses the following:

· Progress against internal audit annual plan;

· Significant audit findings and recommendations for improvement;

· Responses of management to recommendations;

· Schedule of hotline cases reported (allegations of fraud and corruption) and progress report on investigations.

Management is afforded the opportunity to engage Audit Committee on audit findings raised and are discussed accordingly.

(3) No. The Minister did not hold meetings to discuss the internal audit reports and their findings with the audit unit.

The reason is that the Minister has followed the prescribed procedures in dealing with this aspect (i.e. Treasury Regulations, issued in terms of the Public Finance Management Act, 1999 and Published in March 2005), which prescribes as follows:

· In terms of Part 2, Section 3.2.9 of Treasury Regulations, an internal audit function must report directly to the accounting officer and shall report at all audit committee meetings. The function must be independent of activities that are audited, with no limitation on its access to information.

· Part 2, Section 3.2.7 (d) of Treasury Regulations, states that, an internal audit function must prepare, in consultation with and for approval by the audit committee, a quarterly report to the audit committee detailing its performance against the annual internal audit plan, to allow effective monitoring and possible intervention.

· Part 2, Section 3.1.2 of Treasury Regulations, states that, in the case of a non-shared audit committee, the accounting officer of an institution must appoint audit committee members in consultation with the relevant executive authority (Minister).

· Part 2, Section 3.1.7 of Treasury Regulations, states that, the relevant executive authority (Minister) must concur with any premature termination of the services of a person serving on an audit committee.

· Part 2, Section 3.1.15 of Treasury Regulations, states that, an audit committee may communicate any concerns it deems necessary to the executive authority (Minister), the relevant treasury and the Auditor-General.

· Furthermore, Chapter 6, Section 51(1)(a)(ii), of the PFMA, states that, "An Accounting Authority for a public entity, must ensure that the public entity maintains, a system of internal audit under the control and direction of an Audit Committee complying with and operating in accordance with regulations and instructions prescribed in terms of sections 76 and 77.

By implication it means the Audit Committee through its Chairperson, reports to the Minister and the Head of Internal Audit reports administratively to the Accounting Officer and functionally to the Audit Committee.

The Minister also has direct access to the Audit Committee as an oversight governance body and meets with the Chairperson of the Audit Committee to discuss and resolve pertinent governance issues.

Reply received: March 2012

QUESTION NO. 549

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 March 2012

(INTERNAL QUESTION PAPER NO. 07)

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

(1) Whether his department has laid charges of statutory rape with the SA Police Service regarding girls as young as 10 falling pregnant and being infected with HIV/Aids, as reported in the 2010 antenatal HIV prevalence survey; if not, why not;

(2) whether his department is obliged to report such incidents; if not, why not; if so, how many cases were reported in each province?

NW710E

REPLY:

(1) No, the Department's role is to provide health services to all those that require health services, and not to report patients to the police.

(2) We do not feel obliged to report any incidents to the police, if we come across such information in the course of our interaction with patients. There is strict confidentiality between health workers and people who present themselves to the health services. If such confidentiality is breached, people will just stay away from health workers and health facilities. The consequences of such are too dire to contemplate.

We believe that other arms of state or other organs of civil society such as parents, churches, NGOs, social workers, etc, must rather take such a role and not health workers.

Reply received: October 2012

QUESTION NO. 519

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 March 2012

(INTERNAL QUESTION PAPER NO. 07)

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

(1) Whether he has been informed of allegations of financial mismanagement in the SA Nursing Council (details furnished); if not, what is the position in this regard; if so, what are the relevant details;

(2) whether these allegations are being investigated; if not, why not; if so, what are the relevant details?

NW669E

REPLY:

(1) No. I was not informed of financial mismanagement in the South African Nursing Council as indicated in this question. However, may I indicate that according to Sections 4 (a)(b)(c) and 5 of the Nursing Act (2005), in the event of financial mismanagement, the Registrar must promptly inform the chairperson, the Director-General and the Auditor-General, in writing –

· of any unauthorized, irregular or fruitless and wasteful expenditure incurred by the Council;

· whether any person is responsible or under investigation for such unauthorized, irregular or fruitless and wasteful expenditure; and

· of the steps that have been taken –

- to recover or rectify such expenditure; and

- to prevent a recurrence of such expenditure.

· Criminal or disciplinary proceedings will be instituted against a person charged with the commission of an offense relating to unauthorized, irregular or fruitless and wasteful expenditure.

(2) The Minister of Health does not investigate matters that have not been reported to him.

Reply received: April 2012

QUESTION NO. 514

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 March 2012

(INTERNAL QUESTION PAPER NO. 07)

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

Whether his department is taking measures to administer medication to Zimbabwean HIV and TB sufferers in detention centres to prevent the spread of the diseases and their drug-resistant counterparts; if not, why not; if so, what are the relevant details?

NW662E

REPLY:

The Department of Home Affairs is responsible for the management of detention centres and the following inputs have been received from that department.

"The Department of Home Affairs has signed a contract with a company by the name of Bosasa which operates the Detention Centre. The centre has a clinic within the facility which operates 24 hours per day with a male and female sick bay. The clinic has a doctor available who does regular daily checkups and who is on standby or call.

The clinic is able to attend to any kind of diseases and all critical cases are referred to the nearest Hospitals which are Leratong and Paardekraal."

Reply received: May 2012

QUESTION NO. 475

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 March 2012

(INTERNAL QUESTION PAPER NO. 06)

Dr D T George (DA) to ask the Minister of Health:

Whether he met with the internal audit committee in the (a) 2010-11 and (b) 2011-12 financial years; if not, why not; if so, (i) on which dates did they meet and (ii) what are the further relevant details?

NW624E

REPLY:

(a) and (b) Yes.

(i) and (ii) I have direct access to the Audit Committee as an oversight governance body and I meet with the Chairperson of the Audit Committee to discuss and resolve pertinent governance issues. The last meeting I had with the Audit Committee chairperson was on Monday, 08 August 2011 to resolve audit issues with the external auditors, Auditor-General. The Accounting Officer and Auditor-General as well as his Corporate Business Executive were part of this meeting.

Reply received: March 2012

QUESTION NO. 409

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 March 2012

(INTERNAL QUESTION PAPER NO. 06)

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

Whether his department intends taking any steps to (a) monitor the number of children under five years old who are suffering from severe malnutrition, (b) ensure that communities where severe malnutrition is prevalent are assisted to overcome this health problem and (c) provide support to mothers to help combat severe malnutrition; if not, why not; if so, what are the relevant details?

NW546E

REPLY:

(a) Yes, the information is collected in all facilities and reported through the District Health Information System (DHIS).

(b) Health facilities have established clinic and community gardens where food insecure households with underweight children are the main beneficiaries of the vegetables produced.

(c) Yes. Breastfeeding promotion and introduction of safe and healthy foods at six months is one of the cornerstones for preventing malnutrition. All pregnant women are educated on the benefits of breastfeeding, when to introduce solid foods and what foods to give.

Growth monitoring and promotion is one of the interventions implemented to identify children who are growth faltering timeously for prompt intervention.

Parents who have children demonstrating signs of growth faltering are counselled to identify the root cause;

· The first intervention is nutrition counseling and education to assess mother's knowledge and skills in food preparation.

· If food insecurity is the cause, meal supplements are offered, these are in the form of an enriched porridge and drink.

· If an illness is identified, the child will be managed accordingly by a health professional or referred to a doctor.

· If during counseling it is identified that there are other social circumstances contributing to the under nutrition then the mother /child pair are referred to a social worker.

Reply received: March 2012

QUESTION NO. 377

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

Whether any audit has been done with regard to private sector health facilities refusing to accept state patients when they need emergency care; if not, (a) why not and (b) when will one be conducted; if so, what were the findings of the audit?

NW464E

REPLY:

No audit has been conducted of private sector health facilities.


(a) It will be impossible to audit facilities for the number of patients that are refused emergency care. Since it is illegal to refuse such patients care, no facility is going to keep a register of patients that they have refused emergency care, making an audit impossible. As the Department we will be very willing to assist anybody who reports such refusal to us because it is against the Constitution of the country to refuse anybody emergency medical treatment.

(b) No audit will be conducted for the reasons outlined in (a) above.

Reply received: April 2012

QUESTION NO. 375

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

Whether his department has negotiated any fee with private hospitals with regard to treating Government patients who need emergency medical care; if not, (a) why not, (b) how is the Government invoiced and (c) what amount has the Government paid to each hospital group in the (i) 2008-09, (ii) 2009-10 and (iii) 2010-11 financial years; if so, what tariffs have been set?

NW462E

REPLY:

The details are as follows, according to the Provincial Departments of Health that have responded:

Eastern Cape

(a) No, the Department has not negotiated fees with any private hospital;

(b) Because the Provincial Department does not refer their patients to private hospitals;

(c) No financial data is available as the Province has not received any invoices from the private sector as they do not refer their patients to private hospitals;

(d) Not applicable

Free State

(a) No, the Department has not negotiated fees with any private hospital;

(b) The hospitals were invoiced per case;

(c) Payments were as follows, for the financial years 2008/09 and 2010/11:

Hospital

2008/09

2010/11

Netcare

R57,782.40

R0,00

Medi-Clinic

R0.00

R10,490.90

Mine hospitals

R1,111,000.81

R721,392.47

Other

R490,137.39

R1,586,779.05

Total

R1,658,920.00

R2,318,662.42

(d) The private hospitals have their own tariffs which differ from tariffs applicable to public health institutions. The Free State Government was invoiced based on private hospital tariffs (fee-for-service), but have negotiated on a 20% discount where possible.

Gauteng

(a) No, the Department has not negotiated fees with any private hospital;

(b) The Province is invoiced based on per patient referred;

(c) The Department has received claims from both Life Healthcare and Netcare during the financial year 2008/09 strike and the payments were as follows:

· Life Healthcare: R2.1 million; and

· Netcare: R5,850 million

No claims were received for 2009 to 2011.

(d) Private hospitals have their own tariffs which differ from those applicable to public health institutions. The Department was invoiced based on private hospital tariffs (fee-for-service)

Mpumalanga

(a) No, the Department has not negotiated fees with any private hospital;

(b) The Department is billed at private rates on a per patient basis depending on the facility referred to.

(c) Payments were as follows, for the financial year 2008/09 and 2010/11:

Hospital

2008/09

2009/10

2010/11

Medi-Clinic

R4,684,619.30

R714,035.76

R8,492,543.47

Netcare

R6,265.10

R1,326,085.47

R910,491.97

Other

R4,133,519.39

R1,327,593.36

R3,885,931.64

Totals

R8,818,138.69

R3,367,714.59

R13,288,967.08

(d) The medical aid rate offered by Medi-Clinic is based on an average figure.

Northern Cape

(a) No, the Department has not negotiated fees with any private hospital;

(b) The Department is invoiced according to private patient tariffs based on diagnosis, treatment and stay in hospital.

(c) The payments were as follows, for the financial years 2008/09 to 2010/11, for Medi-Clinic:

· 2008/09: R1,233,713.38;

· 2009/10: R611,703.76; and

· 2010/11: R425,861.88

(d) Private hospitals have their own tariffs which differ from those applicable to public health institutions and were invoiced based on private hospital tariffs (fee-for-service)

Reply received: March 2012

QUESTION NO. 373

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

Whether he has found that the (a) Council for Medical Schemes (CMS), (b) the chairperson of the CMS and (c) the Registrar of the CMS have prevented any investigations in the past three years; if so, (i) how many investigations have been stopped, (ii) what was the nature of each investigation that was stopped and (iii) what was the reason for stopping the investigation in each case?

NW460E

REPLY:

The Council for Medical Schemes, its Chairperson and its Registrar have indicated that they have not stopped any investigations in the past three years.

Reply received: April 2012

QUESTION NO. 372

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

Mrs N W A Michael (DA) to ask the Minister of Health:

(1) Whether he has been informed that a certain person (name furnished) was discharged from the Tembisa Hospital before his medical treatment was complete (details furnished); if not, what is the position in this regard; if so, (a) what investigations have taken place and (b) what are the findings of the investigation;

(2) whether it is common practice for public hospitals to discharge patients prematurely in order to free beds for other patients; if not, what is his department's policy in this regard?

NW459E

REPLY:

(1) No, I was not informed. As Minister, I am not routinely informed about every person discharged from the hospital, unless there is a specific reason for doing so.

(a) and (b) Tembisa Hospital is unable to find any record of the said individual within their system. Honourable Member may help by furnishing more details, or better still by presenting him to us.

(2) It is a decision of an attending doctor to decide whether a patient is ready for discharge or not. This will always be the case even though efficient management of the use of beds is of course a consideration in any health system. Such consideration is however never done at the expense of the patient.

Reply received: April 2012

QUESTION NO. 371

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

Mrs N W A Michael (DA) to ask the Minister of Health:

(1) Whether he has been informed that a certain person (name furnished) was discharged from the Tembisa Hospital and died three days later of septicemia (details furnished); if not, what is the position in this regard; if so, (a) what investigations have taken place and (b) what are the findings of the investigation;

(2) why did this person have to wait between four and five hours for an emergency operation;

(3) why did the doctors refuse that this person's family bring (a) his gout medication and (b) him food as prescribed by the dietician to the hospital;

(4) whether it is common practice that nurses in public hospitals wait two and a half hours to clean a patient's bed after the patient had soiled himself; if not, (a) what is the exact prescribed procedure in public hospitals in this regard, (b) which nurses were on duty in the ward at the time and (c) what disciplinary action has been taken against them; if so, why is this the case?

NW458E

REPLY:

(1) No, I was not informed. As Minister I am not routinely informed of people discharged from our hospitals, unless there is a specific reason for doing so.

(a) and (b) No investigation took place because according to facts at our disposal, there is nothing that needs to be investigated.

If the Honourable Member is basing her question on the media statement that was attached, for us to respond adequately, we will be releasing the hospital records of the patient publicly, which we are forbidden by law to do. But I want to assure the Hon Member, that according to our hospital records, the hospital did everything according to good medical principles.

However, if anybody has reason to believe that there was any negligence or bridge of good medical practice, then the matter should be referred/reported to the Health Professions Council fo South Africa (HPCSA). I am willing to assist in that regard.

(2) The person did not just wait. The person was being stabilized and adequately prepared for theatre. The patient went to theatre at the time deemed appropriate by the attending doctor.

(3) According to the report I received from the hospital, the medication required was available for him in hospital.

(4) No, it is not common practice.

(a) Nursing procedure requires that a patient should be assisted as soon as possible after such an unfortunate incident.

(b) and (c) The patient was in hospital for a total of 37 days, and consequently while the incident referred to is something the Department will strongly criticise, it was not possible to identify the exact episode referred to. The Honourable Member should please help us in this case, by providing the episode and the time at which it happened. As things stand, we do not know what the Honorouble Member is referring to.

Reply received: March 2012

QUESTION NO. 369

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

Mr J H Steenhuisen (DA) to ask the Minister of Health:

(1) What was the cost of training the twenty inspectors for the Office of Health Standards Compliance (OHSC) in the United Kingdom;

(2) whether the department had obtained a quotation for the specified training from the Council for Health Service Accreditation of Southern Africa (COHSASA); if not, why not; if so, what amount did COHSASA quote?

NW456E

REPLY:

(1) The training of the 20 newly appointed Inspectors was done in two phases:

Phase 1: Training of 20 Inspectors in a tailored 8 week training programme inSouth Africa. The cost of this training was R394 020 for accommodation, venue, meals, all materials and facilitation;

Phase 2: Training of the 8 Team leaders/managers in the United Kingdome (UK) with the Care Quality Commission (CQC) in successive 2-week periods for 2 groups (3 and 5 people per respective groups). The cost of this training to the Department was R38 139. The remainder was covered by DFID as part of their support to the South African government;

Phase 3: On-site practical training through audits in the field (still ongoing, and total cost not yet known).

(2) We did not request a quote from any organizations (including COHSASA) for training, given the programme outlined above.

Reply received: April 2012

QUESTION NO. 368

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

Mr J H Steenhuisen (DA) to ask the Minister of Health:

(1) Whether any amount has been spent on developing an information technology (IT) system for the National Core Standards (NCS); if so, (a) what amount has been spent to date, (b) what is the expected cost of the completed project and (c) which company was awarded the tender to develop the IT system;

(2) why was the existing IT system that is currently being used for the Council for Health Service Accreditation of Southern Africa Quality Information System (CoQIS) not used?

NW455E

REPLY:

(1) Yes, money has been spent developing a Core Standards database module within the departmental information system, the District Health Information System (DHIS).

(a) The amount spent to date since 2008 (i.e. over 4 years) is R 534 891.

(b) An additional R400 000 is estimated as the cost of refining and supporting the current District Health Information System module; an unknown amount will be spent on a future system to be developed on award of an open tender (specifications currently being developed).

(c) No tender has been advertised or awarded to date. The module is supported by the organisation that developed and supports the DHIS (the Health Information Support Programme)

(2) As the Office of Standards Compliance is a section within the Department of Health, the decision was taken to use the Department of Health DHIS in order to benefit from existing knowledge, access and support across the system, as well as to enable data sharing rather than to contract for a new system.

Reply received: April 2012

QUESTION NO. 367

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

Mr J H Steenhuisen (DA) to ask the Minister of Health:

(1) Whether his department has conducted any costing with regard to the Office of Health Standards Compliance (OHSC); if not, why not; if so, what is the estimated cost for (a) 250 and (b) 500 staff members;

(2) what will the (a) grading and (b) annual salary be for each specified staff member;

(3) whether he intends to provide the full costing report; if not, why not; if so, when?

NW454E

REPLY:

(1) Yes, the costs have been calculated for different possible future scenarios. These include costing 71 staff (without full management complement), 96 staff and133 staff and are estimated (for annual compensation of employees) to be R 28.7m, R44.4 and R68.7M (in 13/14 costs) respectively. The equivalent cost for a larger organization might be (a) R 115.6m for 250 and (b) R 231.3 for 500 staff members (however it should be noted that the increase would not be linear as reflected here because the number of senior staff would not grow in direct relation to total numbers).

(2) The public entity would require a mixed team in order to fulfill the range of functions proposed. The team would include compliance inspectors, information and statistics specialists, complaints investigators, call takers, communication staff, legal experts, managers and admin staff, with different grading and therefore different costs ranging from R200 000 to R500 000 per year for technical and administrative staff.

(3) The full budget for the OHSC can only be finalised once the legal provisions are clear, the Bill has been promulgated and the independent public entity set up. Currently, the Office of Standards Compliance operates within the National Department of Health as a Chief Directorate, with a budget of R48.5m for 2012/13

Reply received: April 2012

QUESTION NO. 366

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

(1) Whether any comparative costing has been conducted with regard to the cost of inspecting each type of health facility by the (a) proposed Office of Health Standards Compliance (OHSC) and (b) Council for Health Service Accreditation in SA (COHSASA); if not, on what basis did a certain person (name furnished) state that Gauteng could not afford COHSASA because they are too expensive; if so, what are the costs in each case for each type of health facility;

(2) (a) how much cheaper was Gauteng's internal accreditation programme compared to that of COHSASA and (b) what was the outcome of this internal accreditation with regard to the (i) outputs and (ii) improvements?

NW453E

REPLY:

(1) and (2) From the tone and type of questions, it seems to me that the Honourable Member is labouring under an impression that there is a structure called COHSASA to which I am held accountable

I am in the process of establishing the Office of Health Standards Compliance through an Act of Parliament, which at this stage as you know is still a Bill.

My accountability will be with that structure and not with any other structure I am not responsible for.

So, the Honourable Member may refer all her questions to this COHSASA, which she seems to be quite excited about.

Reply received: April 2012

QUESTION NO. 286

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

(1) (a) How many persons in (i) 2007, (ii) 2008, (iii) 2009, (iv) 2010 and (v) 2011 (aa) died, (bb) underwent amputations and (cc) were admitted to hospital as a result of (aaa) legal and (bbb) illegal initiations and (b) what was the average age of the persons in each specified category in each specified year;

(2) what were the costs of treatment for these specified persons for (a) each province and (b) his department in each case?

NW364E

REPLY:

(1) Only in provinces where circumcision is practiced as part of initiation are statistics kept on injury and death due to this practice, most notably theEastern Cape.

Eastern Cape

DEATHS

AMPUTATIONS

ADMISSIONS

2007

45

18

823

2008

48

14

675

2009

91

49

713

2010

62

23

658

2011

62

20

651

Information on how many of the above initiates came from legal or illegal schools is not kept. However, the following numbers attended initiation:

LEGAL INITIATES

ILLEGAL INITIATES

AVERAGE AGE

2007

69547

4457

Unknown

2008

55162

2364

Unknown

2009

57119

3366

Unknown

2010

71578

2781

Unknown

2011

55783

3745

Unknown

Free State

DEATHS

AMPUTATIONS

ADMISSIONS

2007

7

0

0

2008

14

0

17

2009

27

0

11

2010

2

1 (died)

0

2011

2

0

Information on how many of the above initiates came from legal or illegal schools is not kept. However, the following numbers attended initiation:

LEGAL INITIATES

ILLEGAL INITIATES

AVERAGE AGE

2007

164

15

Unknown

2008

283

14

Unknown

2009

308

45

Unknown

2010

111

10

Unknown

2011

Unknown

Limpopo

DEATHS

AMPUTATIONS

ADMISSIONS

2007

6

0

4

2008

4

0

15

2009

8

0

35

2010

0

0

0

2011

2

0

13

Information on how many of the above initiates came from legal or illegal schools is not kept. However, the following numbers attended initiation:

LEGAL INITIATES

ILLEGAL INITIATES

AVERAGE AGE

2007

0

Unknown

Unknown

2008

0

Unknown

Unknown

2009

35

Unknown

Unknown

2010

0

Unknown

Unknown

2011

13

Unknown

Unknown

Mpumalanga

There were 2074 initiates in 2011 and no injuries or deaths were reported.

(2) It is impossible to calculate the cost of treatment as each case is different. Cost depends on length of stay, procedures that need to be performed and medicines required. This is different in each case.

Reply received: March 2012

QUESTION NO. 276

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 February 2012

(INTERNAL QUESTION PAPER NO. 04)

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

What are the statistics for abortions that were performed in each province as at the latest specified date for which information is available?

NW344E

REPLY:

The following table reflects the details in this regard, for the year 2011:

Table 1

PROVINCE

NUMBER

Eastern Cape

10 448

Free State

8 093

Gauteng

20 643

KwaZulu/Natal

5 175

Limpopo

8 215

Mpumalanga

2 870

North West

6 924

Northern Cape

1 000

Western Cape

11 157

TOTAL

74 525

Reply received: June 2012

QUESTION NO. 133

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 February 2012

(INTERNAL QUESTION PAPER NO. 02)

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

(1) (a) How many vacancies for health workers are there in each province and (b) in which post classifications are the specified vacancies;

(2) whether his department has implemented a programme to manage the filling of the vacancies; if not, why not; if so, what are the relevant details?

NW144E

REPLY:

(1) The number of vacancies for health workers in each province by post classification is not currently available due to the Persal clean-up process currently underway as per letter received from the Department for the Public Service and Administration (DPSA), dated 23 April 2012 with a deadline of 31 May 2012 for completion of the process.

(2) In October 2011 we launched a Human Resources for Health (HRH) Strategy 2012/13-2016/17. The following measures are in place to implement the HRH Strategy:

(i) To 'fill vacancies' a process is underway as a result of the HRH Strategy to determine funded and unfunded vacant posts, to undertake an audit of staff to verify staff in position, and to determine staffing requirements. The staffing requirements and future filling of vacancies will be determined by the following:

· Results of the Ministerial Task Team on Nursing due for completion in April 2012 and the revitalisation of nursing colleges;

· A Tertiary Services planning exercise due for completion in 5 months;

· Staffing norms work currently underway in consultation with provinces;

· Primary Health Care (PHC) reengineering staffing plans currently being developed;

· A service planning process in provinces which follows the staffing audit;

· Available budget.

Reply received: March 2012

QUESTION NO. 132

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 February 2012

(INTERNAL QUESTION PAPER NO. 02)

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

(1) Whether his department has been informed of PrePex, a device that is designed to speed up circumcision and that is currently being evaluated by the World Health Organisation (WHO); if so,

(2) whether this device can be used by trained nurses; if not, why not; if so,

(3) whether his department intends replacing the Tara KLamp with PrePex if it is approved by the WHO; if not, why not; if so, what are the relevant details?

NW143E

REPLY:

(1) Yes, the Department is aware that the PrePex device is currently under evaluation. However, we have not been formally informed by the WHO about the results of the evaluation.

(2) Given, that the Department has not been informed, the Department is not able to respond to this question.

(3) Given, that the Department has not informed, the Department is not able to respond to this question.

Reply received: November 2012

QUESTION NO. 23

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 February 2012

(INTERNAL QUESTION PAPER NO. 01)

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

(1) Whether any applications have been received for expanding, renovating and building any private hospitals (a) in (i) 2009 and (ii) 2010 and (b) during the period 1 January 2011 up to the latest specified date for which information is available; if so, in each case, (i) how many, (ii) who made the application, (iii) on what date was the application made, (iv) for which areas was the application made, (v) how many additional beds were requested and (vi) what estimated amount would be invested;

(2) whether any of these applications were denied; if so, (a) which applications and (b) on what grounds in each case?

NW27E

REPLY:

(1) Yes.

(a) (i) 2009: A total of 33 applications made;

Applications were made by National Renal Care, Mdantsane Private Hospital, Me v/d Colff City Med Day Clinic, Rustenburg Medi Care, Sunningdale, Rustenburg Platinum Mine Hospital, Mr T J Hugo, Ms E Bezuidenhout, Van Niekerk, Imed, AFri-Care PPMC, Casualty Clinique, Prof L Mazwai, Care Cure, Palm Springs Health & Wellness, Mr P J Lategan, Dr Meyer-M-Care Optima, Dr Mji-Goldenwood Investment Company, Jeany Bormann, H F Prinsloo, Sevencare – M Care Pentagon Park, Green Circle, Dr Mokgokong, Reakopana, Dr Mokoana, Dr Rampedi, Care Cure, Private Health Services: Ms M E Masire, Medi Clinic Limited;

(ii) 2010: A total of 37 applications made;

They were made by Life Beacon Bay, Life Anncorn, Mooimed Hospital, Life E L Private Hospital, Care Cure, Life Mercantile, Border Care Hospital Group, NETCARE Cuyler, Udipa Holdings, Medi-Clinic, Life Health Care, NETCARE Greenacres, Dr Pinzi, Dr L Mosotho, Mr De Vries – Xawa Investment, Dr Motloung – Pheko Sizo Health Care, Kgatelopele Wellness Centre, Rustenburg, Cure Day Clinic Holdings, Moruleng/Private/Public Hospital.

(b) 2011: Only 1

(iii) Between March and December 2009;

(iv) Areas ranged from additional beds, building of new private hospitals or renovations of private hospitals,

(v) A total of 131;

(vi) It is not possible to provide this information.

(2) (a) A total of 36 applications were denied. They vary from application for additional beds, renovations of private hospitals, and building of new private hospitals;

(b) No reasons were provide to us by the provinces.

Reply received: November 2012

QUESTION NO. 16

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 February 2012

(INTERNAL QUESTION PAPER NO. 01)

Mr K S Kubu (DA) to ask the Minister of Health:

Whether he has employed a ministerial special advisor; if so, (a) what are the duties of the advisor, (b) at which post level was the appointment made, (c) what is the salary level of the advisor, (d) what is the duration of the employment contract entered into with the advisor and (e) why was it necessary to appoint this advisor?

NW18E

REPLY:

Yes, a national Cabinet Minister may employ two special advisors.

(a) The appointment of special advisors to executive authorities is regulated by Section 12A of the Public Service Act, 1994 and the dispensation approved by the national Cabinet in terms of Section 12A.

· Dr D L Pearmain acts in an advisory capacity and has been appointed as the legal advisor in terms of the Public Service Act (Section 12A(1)) to –

- advise the Minister on national legislation, including regulations, produced by the National Department of Health;

- advise the Minister on other legal matters concerning the Executive Authority or the National Department of Health; and

- advise the Minister on policy matters relating to other law of the Country

· Dr E T C Moloko acts in an advisory capacity and has been appointed as special advisor in terms of the Public Service Act (Section 12A(1)) to-

- provide policy analysis support to the Executive Authority;

- provide technical support on issues related to service delivery improvement at provincial district level;

- review key bottlenecks to service delivery and make recommendations on how they may be adverted;

- perform any specific task delegated by the Executive Authority

(b) - Dr D L Pearmain: Level III

- Dr E T C Moloko: Level IV

(c) - Dr D L Pearmain: Salary Level III

- Dr E T C Moloko: Salary Level IV

(d) Duration of employment contract is in accordance with Section 12A of the Public Service Act, 1994.

(e) A national Cabinet Minister may employ two Special Advisors to help the Minister as stipulated above.