Questions & Replies: Health
2012-12-31
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Reply received: December 2012
QUESTION NO. 3372
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 November 2012
(INTERNAL QUESTION PAPER NO. 42)
Mrs P C Duncan (DA) to ask the Minister of Health:
(1) Whether his department has submitted its report to the Central Drug Authority (CDA) for the 2011-12 annual report; if not, why not; if so, when;
(2) what are the reasons for his department's failure to attend meetings of the CDA in the 2011-12 financial year?
NW4272E
REPLY:
(1) A report was submitted by the department covering harm reduction.
(2) The department attended meetings of the CDA in the 2011-12 financial year.
Reply received: December 2012
QUESTION NO. 3342
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 November 2012
(INTERNAL QUESTION PAPER NO. 42)
Ms E More (DA) to ask the Minister of Health:
Whether the Medicine Control Council (MCC) of his department has submitted its report to the Central Drug Authority (CDA) for the 2011-12 annual report; if not, (a) why not and (b) what are the reasons for the MCC's failure to attend the meetings of the CDA Board in the 2011-12 financial year; if so, (i) when was the report submitted and (ii) what are the further relevant details?
NW4239E
REPLY:
The Medicines Control Council (MCC) did not submit a report to the Central Drug Authority (CDA) for the 2011-12 annual report. A report of activities during 2011-12 is attached.
(a) This was an oversight on the part of the MCC;
(b) Representatives of the MCC attended the meetings of the CDA Board on 20 September 2011 and 27 July 2012. An apology was tendered for the meeting held on 27 September 2012.
Reply received: December 2012
QUESTION NO. 3199
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 November 2012
(INTERNAL QUESTION PAPER NO. 41)
Ms B T Ngcobo (ANC) to ask the Minister of Health:
(a) What progress has been made since the commencement of the National Health Insurance (NHI) in the 10 identified districts and (b) what (i) successes have been achieved and (ii) challenges have been experienced in this regard?
NW4039E
REPLY:
(a) and (b) (i) The Department has done a comprehensive analysis for each of the 10 pilot districts focusing on the following dimensions: demography, socio-economic status, health service delivery status and baseline assessment of all facilities. In response to this the department has established facility improvement teams in 7 of the 9 Pilot Districts. Quality Improvement plans have been developed for facilities that focus on short, medium and long term interventions.
The rollout of the 3 streams of Primary Health Care (PHC) namely; school health services, district clinical specialist teams and municipal ward-based teams are prioritized for implementation in the NHI pilot districts. The implementation of all 3 streams in the pilot districts has shown good progress.
A detailed database has been created with information on Private providers and models for the expansion of the service delivery platform utilizing the private providers had been developed.
(ii) The challenges experienced vary from district to district. It is realized that both the quality and level of health service provision is complex and require a multi-dimensional systemic approach. There is not a "one size fits all models" that can be applied and this demanded from the department to develop detailed analysis and planning processes that is very time consuming.
Reply received: December 2012
QUESTION NO. 3196
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 November 2012
(INTERNAL QUESTION PAPER NO. 41)
Dr M B Goqwana (ANC) to ask the Minister of Health:
(a) What steps does he intend taking to improve the health indicators in (i) rural areas and (ii) peri-urban African settlements and (b) how does he intend applying the universal health coverage plan in this regard?
NW4032E
REPLY:
(a) (i) and (ii) The Health Status Indicators and the socio-economic status of communities were considered in the selection of the NHI Pilot districts. Most of the NHI Pilot districts are within underserved rural areas and interventions are focused to overcome identified inequities.
Different service models for the implementation of Universal Coverage will be explored during the p
Reply received: November 2012
QUESTION NO. 3157
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 November 2012
(INTERNAL QUESTION PAPER NO. 39)
Mrs D Robinson (DA) to ask the Minister of Health:
How many qualified (a) South African medical doctors are employed abroad and (b) foreign medical doctors are employed in South Africa as at the latest specified date for which information is available?
NW3995E
REPLY:
(a) The Health Professions Council of South Africa does not have information relating to South African medical doctors employed abroad as some of them keep dual registration and do not inform the Council when they return to South Africa.
(b) The Health Professions Council of South Africa confirmed that currently 5875 foreign doctors are registered to practice in South Africa.
Reply received: December 2012
QUESTION NO. 3143
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 November 2012
(INTERNAL QUESTION PAPER NO. 39)
Mrs D Robinson (DA) to ask the Minister of Health:
(1) With reference to his reply to question 814 on 22 June 2012, how many (a) doctors and (b) nurses graduated from medical schools and nursing colleges at the end of the 2011 academic year;
(2) how many additional (a) medical doctors and (b) nurses will be required for the National Health Insurance (NHI) to operate effectively?
NW3981E
REPLY:
(1) (a) 1 338.
(b) 18 552 (Professional nurse: 4-year comprehensive course = 2 966, professional nurse: bridging course = 2 964, enrolled nurse = 7 390, enrolled nursing auxiliary = 5 232).
(2) (a) and (b) The numbers are not available yet. The Department is currently in the process of developing staffing norms for health facilities in collaboration with the World Health Organisation (WHO) and provincial departments of health.
Please note that there is no specific number of health professionals identified by any entity, structure or international organizations specifically required for NHI.
Reply received: December 2012
QUESTION NO. 3112
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 09 November 2012
(INTERNAL QUESTION PAPER NO. 39)
Ms A M Dreyer (DA) to ask the Minister of Health:
(1) Whether he has been informed of the urgent need for qualified and specialist nurses in certain parts of the country (details furnished) to provide services to bedridden patients who require round-the-clock home care; if not, what is the position in this regard; if so, what (a) action plan has he put in place and (b) are the further relevant details;
(2) whether he has been informed of the letter that the practice code number system project specialist of a certain health care funding organisation (name and details furnished) forwarded to his department on 25 June 2012 (copy furnished); if not, what is the position in this regard; if so, what (a) action has been taken and (b) are the further relevant details?
NW3898E
REPLY:
(1) (a) The Department of Health, in response to the general shortage of nursing staff in some areas, during this financial year established a number of strategies to improve the shortage of personnel. These include inter alia:
- Development of a Human Resource Strategy;
- Currently finalizing the Norms and Standards for the various health care categories, in collaboration with the World Health Organisation (WHO);
- Establishment of the Ministerial Task Team on Nursing Education and Practice which addresses all issues of nursing education and clinical practice. A National Nursing Strategy has recently been finalized.
(b) The Department is in the process of reopening all the Nursing Colleges. This is work-in-progress, aimed at increasing the number of trained nurses countrywide.
(2) (a) A response letter was written to Ms Nel, explaining the current situation with regard to registration of nursing agencies;
(b) Yes. The registration of new nursing agencies has been traditionally done by the South African Nursing Council (SANC). With new developments this responsibility will in future be taken over by the Department of Health. During this interim period, therefore the registration of new nursing agencies has been put on hold, so as to get the operational structures in place.
Currently the SANC and the Board of Healthcare Funders (BHF) continue to renew registration and practice licenses, only for those agencies that were registered before the moratorium was effected.
Reply received: December 2012
QUESTION NO. 3100
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 November 2012
(INTERNAL QUESTION PAPER NO. 38)
Dr D T George (DA) to ask the Minister of Health:
(1) Whether his department is currently subscribed to The New Age (TNA) newspaper; if so, (a) how many subscriptions does his department have, (b) when was each subscription initiated, (c) what has been the annual subscription fee for each specified subscription since it was initiated and (d) what is the exact purpose of each subscription;
(2) whether a discount was negotiated for any of the specified subscriptions; if so, (a) for which specified subscriptions and (b) what discount in each case;
(3) whether his department has mass-purchased the TNA on an ad hoc basis since the inception of the newspaper; if so, (a) on what dates, (b) how many copies in each case and (c) why were the papers purchased in each case;
(4) whether (a) the publishers of the TNA and (b) any other entity donated copies of the paper to (i) his department and (ii) any entity reporting to him; if so, in each case, (aa) which entity donated the papers, (bb) to which entity were they donated and (cc) how many copies were donated?
NW3929E
REPLY:
(1) Yes, the National Department of Health is currently subscribed to the New Age Newspaper.
(a) The NDOH was supplied with between 160 to 330 newspapers per month.
(b) The subscription was initiated in May 2011 and since then increased on ad hoc basis.
(c) Between May to December 2011 the National Department of Health was billed for the amount of R6.550.00.
During the period January to December 2012 the NDOH was billed for the amount of R11 720.00.
(d) The newspapers are delivered on request of the Information Centre, as well as individual requests from members of senior management.
(2) No discounts were negotiated for the New Age Newspapers.
(a) Not applicable.
(b) Not applicable.
(3) The National Department of Health did not mass-purchase any copies of the TNA newspaper.
(a) Not applicable.
(b) Not applicable.
(c) Not applicable.
(4) (a) and (b) (i) The National Department of Health did not receive any official donations of newspaper from the publishers or any other entity.
(aa) Not applicable.
(cc) Not applicable for the NDOH.
Although no official donations were made or any form of agreement reached with the Department, copies of The New Age newspaper were delivered and placed outside the entrance of the Civitas building.
Reply received: November 2012
QUESTION NO. 3026
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 November 2012
(INTERNAL QUESTION PAPER NO. 38)
Mr D A Kganare (Cope) to ask the Minister of Health:
What immediate measures has his department put in place to deal with the (a) high health budget in comparison with other developing countries and (b) inadequate performance of the health system?
NW3709E
REPLY:
(1) (a) Over the MTEF period the health budget is projected to increase by 7%. The table below presents the health budget in 2011/12 – 2014/15 financial years.
Table 1: Health expenditure over the MTEF, 2011/12 – 2014/15
| R million | 2011/12 | 2012/13 | 2013/14 | 2013/14 | Average annual growth |
| Revised estimate | Medium-term estimates | ||||
| Health | 113 796 | 121 051 | 129 576 | 139 322 | 7.0% |
| Total government expenditure | 972 547 | 1 058 321 | 1 149 125 | 1 239 699 | 8.4% |
Source: National Treasury Budget Review 2012
Over the Medium Term Expenditure Framework (MTEF) period, the health sector budget is projected to increase by 7 percent, which is less than the overall projected budget increase of 8.4 percent. South Africa spends comparatively well with other middle income countries. The figures in Table 2 below show for example that Argentina, Botswana and Russia per capita expenditure on health was just over US$1 000. While South Africa and Brazil spent just over US$900 per capita on health. Above that, the burden of diseases in other middle income countries is far less than South Africa. This country have got high prevalence of HIV and AIDS, high maternal mortality, high child mortality and low life expectancy comparative to most middle income countries. Therefore, it is important that a clear balance is established when making a comparison on health financing between countries.
Table 2: Comparison of healthcare expenditure and health status indicators of selected middle income countries
| Country | Healthcare expenditure as percentage of GDP, 2009 | Per capita expenditure on health (PPP) international $),2009 | Life expectancy at birth, 2009 | Infant mortality rate per 1000 live births, 2010 |
| South Africa | 9.2 | 930 | 55 | 41 |
| Argentina | 9.5 | 1386 | 75 | 12 |
| Brazil | 8.8 | 921 | 73 | 17 |
| India | 4.2 | 124 | 65 | 48 |
| Russia | 5.6 | 1043 | 68 | 9 |
| Botswana | 10.0 | 1296 | 61 | 36 |
| China | 5.1 | 347 | 74 | 16 |
(b) Inadequate performance of the health system.
On the contrary health outcomes in South Africa are improving. Refer to data below from the Medical Research Council (MRC), 2012. MRC reported that the life expectancy at birth for both males and females is 60 years in 2011. It has increased from 56 years in 2009 and the infant mortality rate per 1000 live births between 2009 and 2011 has decreased from 40 to 30.
Furthermore, the introduction of the National Health Insurance (NHI) in pilot phases starting in this current financial year, as a financing healthcare system will ensure that all South Africans have access to quality healthcare services irrespective of their ability to pay. The current two-tier system benefits only a privileged few not the general South African population. The NHI seeks to ensure universal coverage for all South Africans. Budget allocated for NHI is amounting to R150 million, R350 million and R500 million over the MTEF period have been set aside for NHI pilot projects.
Table 3: Key Mortality indicators
| TARGET 2014 | 2009 | 2010 | 2011 | |||||
| Life expectancy at birth: Total | 58.5 (increase of 2 years) | 56.5 | 58.1 | 60.0 | |||||
| Life expectancy at birth: Male | 56.0 (increase of 2 years) | 54.0 | 55.5 | 57.2 | |||||
| Life expectancy at birth: Female | 61.0 (increase of 2 years) | 59.0 | 60.8 | 62.8 | |||||
| Adult mortality (45q15): Total | 43% (10% reduction) | 46% | 43% | 40% | |||||
| Adult mortality (45q15): Male | 48% (10% reduction) | 52% | 49% | 46% | |||||
| Adult mortality (45q15): Female | 37% (10% reduction) | 40% | 37% | 34% | |||||
| MATERNAL AND CHILD MORTALITY (OUTPUT 2) | |||||||||
| INDICATOR | TARGET 2014 | 2009 | 2010 | 2011 | |||||
| Under-5 Mortality Rate (U5MR) per 1 000 live-births | 50 (10% reduction) | 56 | 53 | 42 | |||||
| Infant Mortality Rate (IMR) per 1 000 live-births | 36 (10% reduction) | 40 | 37 | 30 | |||||
| Neonatal Mortality Rate1 (< 28 days) per 1 000 live-births | 12 (10% reduction) | 14 | 13 | 14 | |||||
| Maternal Mortality Ratio2 (MMR) per 1 000 live-births | 270(reverse increasing trend and achieve 10% reduction | 310 | 333 | ||||||
· Rapid Mortality Surveillance Report: MRC; 2012
Reply received: December 2012
QUESTION NO. 3025
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 November 2012
(INTERNAL QUESTION PAPER NO. 38)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether his department has reviewed its organogram in the (a) 2008-09, (b) 2009-10 and (c) 2010-11 financial years in order to conduct job evaluations and abolish redundant posts; if not, why not; if so, what are the relevant details in each case?
NW3708E
REPLY:
(1) (a) No;
(b) No;
(c) Yes.
The organogram was reviewed in 2010/11 and aligned to the new priorities of the Health Sector, as reflected in the Negotiated Service Delivery Agreement (NSDA). As a consequence of the revised organogram, there was abolition of redundant posts and creation of new relevant ones.
Reply received: November 2012
QUESTION NO. 3024
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 November 2012
(INTERNAL QUESTION PAPER NO. 38)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether any action was taken against officials who violated the Public Finance Management Act, Act 1 of 1999 in the (a) 2010-2011 and (b) 2011-12 financial years; if not, why not; if so, what are the relevant details?
NW3707E
REPLY:
All irregular expenditure by officials who violated the Public Finance Management Act, Act 1 of 1999 in the 2010-2011 and 2011-2012 financial years were disclosed in the Department's Annual Financial Statements. The Loss Control Officer investigated the cases and compiled a situation analysis and submitted it to management.
Management requested that a detailed report on the details of the violators be submitted to the Accounting Officer. On 02 October 2012 the Accounting Officer instructed that letters be drafted to the relevant Programme Managers (Deputy Directors-General) for them to take action against the violators.
Letters to the Programme Managers were issued on 23 October 2012 requesting them to indicate the action taken. The due date of reports to be submitted to the Loss Control Officer was indicated as 09 November 2012.
Reply received: November 2012
QUESTION NO. 3018
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 October 2012
(INTERNAL QUESTION PAPER NO. 36)
Dr D T George (DA) to ask the Minister of Health:
Whether the accounting officer submitted the annual financial statements for the financial year ending 31 March 2012 to him by 31 August 2012; if not, (a) why not and (b) on what date (i) were the statements submitted to him and (ii) did he submit the annual report and financial statements to Parliament?
NW3785
REPLY:
Yes, the Accounting Officer submitted the audited Annual Financial Statements for the financial year ending 31 March 2012 to the Minister of Health by 31st August 2012.
(a) Not applicable
(b) (i) Submitted by the 31st August 2012.
(ii) The Minister of Health submitted the Annual Report and audited Annual Financial Statements to Parliament.
Reply received: November 2012
QUESTION NO. 2971
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 October 2012
(INTERNAL QUESTION PAPER NO. 36)
Ms A M Dreyer (DA) to ask the Minister of Health:
(1) Whether any progress has been made in the process to allow further nursing agencies to register with the Board of Healthcare Funders (BHF); if not, why not; if so, what are the (a) relevant details with respect to (i) timelines, (ii) actions and (iii) obtaining a practice code number and (b) further relevant details;
(2) (a) what are the reasons for the delay in the process of allowing qualified and registered nurses, licenced to practise their profession as per the South African Nursing Council (SANC), to register a new nursing agency and (b) when will further agencies be allowed to register as service providers?
NW3735
REPLY:
(1) No, the Department does not have a mandate to allow and/or disallow nursing agencies to register with the Board of Healthcare Funders (BHF).
(a) Not applicable;
(b) Not applicable.
(2) (a) The Department has placed a moratorium on the registration of new nursing agencies while the regulations on regulating Nursing Agencies are being revised.
(b) Not applicable.
Reply received: December 2012
QUESTION NO. 2956
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 October 2012
(INTERNAL QUESTION PAPER NO. 36)
Mrs D Robinson (DA) to ask the Minister of Health:
(1) (a) When last was the cancer register updated, (b) what are the top 10 types of cancer and (c) how many people died from each type of cancer (i) in the (aa) 2009-10, (bb) 2010-11 and (cc) 2011-12 financial years and (ii) since 1 April 2012;
(2) whether his department has established norms that include how often cancer registries must be updated; if not, why not; if so, what are the relevant details;
(3) (a) on what basis does his department allocate funding towards the treatment of cancer and (b) what was the budgeted amount towards fighting cancer (i) in the (aa) 2009-10, (bb) 2010-11 and (cc) 2011-12 financial years and (ii) since 1 April 2012?
NW3716
REPLY:
(1) (a) The last report was in 2004.
(b) The top ten cancers are indicated in the table below:
| RANK | MEN | WOMEN | RANK |
| 1 | Basal Cell Carcinoma | Breast | 1 |
| 2 | Prostate | Cervix | 2 |
| 3 | Squamous cell carcinoma of skin | Basal Cell carcinoma | 3 |
| 4 | Primary site unknown | Primary site unknown | 4 |
| 5 | Lung | Squamous cell carcinoma of skin | 5 |
| 6 | Colorectal | Uterus | 6 |
| 7 | Oesophagus | Colorectal | 7 |
| 8 | Bladder | Melanoma | 8 |
| 9 | Melanoma | Oesophagus | 9 |
| 10 | Kaposi's sarcoma | Non-Hodgkin's Lymphoma | 10 |
(c) (i) (aa) According to the Statistics South Africa report on Mortality and Causes of Death in South Africa, 2009: 6.3% of deaths were due to cancers in 2009;
(bb) no data available for 2010-11; and
(cc) no data available for 2011-12.
(ii) No mortality data available since 01 April 2012.
(2) The South African National Cancer Registry plans to produce reports every 3 years, which is in line with the International Agency for Research on Cancer (IARC). IARC recommends that cancer incidences should be reported over a period of 3 to 5 years, when sufficient numbers of persons diagnosed with cancer have accumulated.
(3) (a) Health services in provinces are allocated their budget through the equitable share.
(b) The cancer services in the Provincial Departments of Health utilize the budget from the equitable share and it is not possible to separate out the budget for cancer services from other health services.
Reply received: November 2012
QUESTION NO. 2897
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 October 2012
(INTERNAL QUESTION PAPER NO. 34)
Mrs S P Kopane (DA) to ask the Minister of Health:
Whether he received the provincial department of health of the (a) Western Cape and (b) Eastern Cape's 10-year service transformation plans for 2010 – 2020; if not, in each case, why not; if so, in each case, what are the relevant details?
NW3573E
REPLY:
Yes, the Department has received the draft 10 Year Plan for 2020 from the Province;
No. The Province has had major challenges from different communities accepting the proposals in the service transformation plans (STP). These communities were very unhappy with proposed changes and would like the respective health facilities to remain with original responsibilities. The communication from the communities came in the form of petitions, submissions and request for the MEC for Health in the Province to address these communities or stakeholders. The five hotspots were Cecilia Makiwane Hospital in Mdantsane, Mt Ayliff Hospital in Alfred Nzo, Elliot Hospital, Willem Stahl Hospital and Mjanyana Hospital. The Eastern Cape Department of Health is continuing the engagement of these stakeholders.
Reply received: November 2012
QUESTION NO. 2864
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 October 2012
(INTERNAL QUESTION PAPER NO. 34)
Mrs S P Kopane (DA) to ask the Minister of Health:
(1) With reference to his reply to question 1193 on 5 September 2012, what further steps will he take to ensure that underexpenditure on hospital infrastructure in provinces come to an end;
(2) whether he has taken any action in relation to the underexpenditure; if not, why not; if so, (a) what action and (b) against whom?
NW3538E
REPLY:
(1) Based on the 2010/11 financial year expenditure, there has been significant improvement in terms of spending on the Hospital Revitalisation grant by provinces. By end of 2011/12 financial year, the expenditure was at 92% of the total budget allocation. It should also be noted that there was approved roll-over funds from 2010/11 financial year amounting to R417,765 million. This implies that without these rolled-over funds, expenditure was at 102% but with the roll-over funds it came to 92%, which is a tremendous improvement from the 79% in 2010/11 financial year.
(2) The improvement in the spending by provinces was as a result of the interventions by the National Department of Health (NDOH) in consultation with the National Treasury. One of the major interventions by the NDOH is on the provincial planning processes, which has significantly improved, particularly on large hospital projects. Furthermore, provinces were allowed to appoint independent Implementing Agents if they were not happy with the services provided by the Department of Public Works as the government's Implementing Agent.
Furthermore, the NDOH introduced the Project Management Support Unit (PMSU) which was established at both the National and Provincial levels. The mandate of this unit is to assist with the implementation of the programme from a technical point of view. Resident Engineers have been appointed through the Development Bank of Southern Africa (DBSA) and placed in the National Office as well as in all Provincial Departments of Health. Funding for these appointments was made available by the National Treasury.
Reply received: November 2012
QUESTION NO. 2814
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Ms D Kohler-Barnard (DA) to ask the Minister of Health:
(a) How many mortuaries are there in each province and (b) what is the current case backlog at each mortuary?
NW3469E
REPLY:
The following table reflects the details in this regard.
(a) How many mortuaries are there in each province?
| Province | Mortuaries | Holding Facilities | Total |
| Eastern Cape (EC) | 14 | 12 | 26 |
| Gauteng (GP) | 10 | 0 | 10 |
| Free State (FS) | 8 | 0 | 8 |
| Kwa-Zulu Natal (KZN) | 40 | 0 | 40 |
| Limpopo (LP) | 15 | 0 | 15 |
| Mpumalanga (MP) | 6 | 13 | 19 |
| Northern Cape (NC) | 7 | 12 | 19 |
| North West (NW) | 8 | 5 | 13 |
| Western Cape (WC) | 14 | 3 | 17 |
| Totals | 121 | 45 | 167 |
(b) All Forensic Pathology Mortuaries do not have case backlogs at as 17 October 2012
Reply received: November 2012
QUESTION NO. 2813
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mrs S P Kopane (DA) to ask the Minister of Health:
Whether an impact analysis study has been conducted on all 60 sets of regulations produced by his department if not, why not; if so, what are the relevant details?
NW3467E
REPLY:
The impact assessment on the regulations is a continuous process where specific line functions, statutory council and public entities responsible for the implementation of regulations conduct continuous review of regulations and, where gaps are identified, proposed amendments to the regulations.
Reply received: November 2012
QUESTION NO. 2812
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mrs S P Kopane (DA) to ask the Minister of Health:
(1) Whether the national project management support unit (NPMSU) of his department has assisted all provinces with their major infrastructure delivery projects; if not, in respect of each province, why not; if so, what are the relevant details for each province;
(2) what major infrastructure delivery projects does the NPMSU (a) monitor and (b) assist with in each province in the 2011-12 financial year?
NW3466E
REPLY:
(1) The function of the NPMSU is to assist the National Department of Health Infrastructure Unit in its monitoring and oversight role coupled with improving the infrastructure delivery capacity of the provincial health departments and their implementing agents based on the existing capacity of the provinces.
The major support areas of the NPMSU are as follows:
· At National level
- Project-based financial, physical and contractual monitoring and reporting covering all projects in all provinces;
- Up keep and updating of project database covering all projects in all provinces;
- Management and monitoring and coordination of all Provincial PMSU Coordinators and their work programme in all provinces and reporting;
- Support in Infrastructure Support Programme (ISP) for NHI districts and reporting;
- Support in PPP flagship projects and reporting;
- Any adhoc professional works that may arise during the monitoring process and reporting.
· At Provincial level
- Support in the project planning, estimation and procurement;
- Support in project construction and contract administration and management;
- Support in maintenance and upkeep planning and execution;
- Any other areas of professional support as and when necessary.
The above support at provincial level are rendered through professionally qualified Provincial Coordinators of the PMSU as well as the National Coordinators and discipline managers of the PMSU, totaling to 23 in numbers.
(2) The operation of PMSU as described above was practically initiated as from September 2011. Within this short span of time, under the close management and leadership of the Infrastructure Unit of the National Department of Health, the PMSU could assist with the IUSS turnaround strategy of the Infrastructure Unit, resulting into improvement of the quality and quantity of spending in all projects in all provinces from 80% to 91%, improving the health infrastructure spending by R2 billion over the average of the previous three financial years. The monitoring and support of the PMSU did cover all projects funded by Hospital Revitalization Grant (HRG) Health Infrastructure Grant (HIG) and Equitable Share (ES).
Reply received: December 2012
QUESTION NO. 2810
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mrs S P Kopane (DA) to ask the Minister of Health:
Whether his department has implemented a turnaround strategy for (a) improving audit outcomes and (b) reducing the concerns of the Auditor-General; if not, why not, in each case; if so, what are the relevant details in each case?
NW3463E
REPLY:
(a) and (b) Yes.
The Department of Health developed an intervention at dealing with all audit queries raised by the Auditor-General. The objective of the plan is to ensure that by 2014, all provinces receive clean audits. In the intervention plan, the department has focused on ensuring that there are dates at which reports have to be received from the provinces to all relevant policy structures in the Department, e.g National Health Council (NHC). Ensuring that deadlines as outlined in the Division of Revenue Act are met will lead to clean audit queries. This plan has been discussed with provinces. In detail the plan touches on the following:
Human Resources Management and Compensation
Employees were appointed without following a proper process to verify the claims made in their applications, in contravention of PSR 1/VII/D.8. With effect from 01 August 2012 an in-house audit on verification checks on all volume files from 2008 to 2011 is being conducted. SAQA verification for all qualifications on all appointments between 2008 and 2011 has been completed. Copies of IDs for appointments made between 2008 and 2011 were recorded for submission to the State Security Agency. Appointments made in 2012 are only implemented after verification results have been received. A checklist has been developed to ensure that all steps in the recruitment process are followed prior to appointment.
Not all Senior Managers signed performance agreements as required by PSR 4/III/B/.1. With effect from 01 August 2012, all outstanding Performance Agreements for 2011/12 were sourced from relevant SMS Members. Internal communiqué indicating the due dates for submission for half-yearly reviews are periodically circulated to SMS Members. This is followed up by telephonic reminders. Ongoing support and training on the implementation of the performance management and development system is provided to employees.
Human Resources Plan was not in place as required by PSR1/III/B.2(D). While the Department does not have an approved corporate Human Resources Plan, due to the implementation of the recently approved organogram, the development of an HR Plan is at an advanced stage. An alignment of the functional structure with the objectives of the Negotiated Service Delivery Agreement (NSDA) began in April 2012. Functions have been streamlined. A Persal Clean-up process has been concluded. This involved the identification and verification process on posts that were vacant for more than 6 months. These together with non-priority posts were abolished. In the coming months, an HR needs analysis (demand and supply) will be conducted. After consultation with all stakeholders and approval process, the HR plan will be submitted to the Department for the Public Service and Administration (DPSA). It is envisaged that this process will be conducted by February 2012.
The timely payment of transfers to providers
Despite the late promulgation of the Division of Revenue Act (DoRA) this year, the National Department of Health is transferring funds to provinces as per payment schedule. The plan has proposed a uniform payment date for all health sector grants. To further facilitate payments, the Chief Financial Officer (CFO) at the National Department of Health has been delegated authority to approve the monthly or quarterly transfer of payments to provinces. This function was previously vested with the Director-General.
Strengthening management and communication of Conditional Grants
Branch Managers have been appointed as Grant Champions to further promote accountability and management of health sector conditional grants. The plan also suggests provincial visits lead by the CFO at the National Department of Health to address issues of compliance and performance of the health sector grants at a higher level.
· Moreover, the plan proposes a central point where all challenges will be raised and a united intervention approach is pursued. This may include a review of grant frameworks, business plan or project implementation plans. Such a step will enhance monitoring and evaluation, but also afford the National Department of Health to assist earlier.
Transfer of funds to non-profit institutions and conditions
The Department of Health has transferred funds to the provinces in the last three months within specified time-frames as stipulated in the payment schedule. However, there were certain challenges that were experienced in the first quarter which resulted to the delays in the provincial transfers. Some of these challenges relate to the late promulgation of the Division of Revenue Act, 2012.
Reply received: November 2012
QUESTION NO. 2765
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mr M Waters (DA) to ask the Minister of Health:
(1) Whether he has brought the Government's definition of a stillborn baby in line with that of the World Health Organisation (WHO); if not, (a) why not and (b) how does the Government's stated period of gestation differ from the WHO's stated period of gestation; if so, what is the position in this regard;
(2) whether medical professionals are compelled to complete a death certificate for all babies who (a) are stillborn and (b) die shortly after birth, after a gestation period of less than 26 weeks; if not, why not; if so, what are the relevant details;
(3) whether parents of babies who have died before reaching a gestation period of 26 weeks have the automatic option of burying or cremating their child; if not, why not; if so, what are the relevant details?
NW3414E
REPLY:
(1) Yes.
The World Health Organisation (WHO) defines stillbirth as a foetus born without signs of life after 28 weeks of gestation and uses this for standardizing international comparison of countries when dealing with stillbirths.
The Births and Registration Amendment Act, Act 18 of 2010 which vests under the Department of Home Affairs, defines "Stillbirth and Stillborn" as follows: "it means that it has had at least 26 weeks of intrauterine existence but showed no sign of life after complete birth".
Therefore the South African definition of stillbirth is in line with WHO definition.
(2) A death certificate may be issued for a stillborn baby for funeral/burial purposes for those parents who request such and can afford the costs of a funeral or burial and it is primarily the responsibility of attending health care providers to complete the death certificate if a baby dies after birth, i.e after showing signs of life after complete birth. The clinic or hospital can offer to incinerate a stillborn foetus for those parents who cannot afford a funeral/burial and who have given and signed the consent for incineration of such foetus of gestational age below 26 weeks.
(3) All those parents who, irrespective of gestational age of the stillbirth, indicate the need to take the foetus home for either burial or cremation are afforded the chance to do so as indicated in (2) above.
Reply received: December 2012
QUESTION NO. 2762
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Ms E More (DA) to ask the Minister of Health:
Whether he has been informed of any incidents of corruption that were recorded in any of the provinces in the (a) 2008-09, (b) 2009-10 and (c) 2010-11 financial years; if not, what is the position in this regard; if so, (i) what amount was recorded in each province in each financial year, (ii) what amount was recovered and (iii) how many people were charged with corruption in each province in each financial year?
NW3409E
REPLY:
The attached table reflects the details in this regard.
Kindly note:
1. Financial Misconduct cases where stolen items were confiscated at the exit gates of institutions are not included in the above list and no rand amounts are given because the state did not suffer a financial loss.
2. A number of recorded cases were withdrawn due to lack of evidence or the non-availability of witnesses.
3. A number of cases were subjected to the progressive disciplinary procedure.
Reply received: November 2012
QUESTION NO. 2747
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mr L S Ngonyama (Cope) to ask the Minister of Health:
Whether he has conducted any assessment of the implications for his department on the recent findings of the study conducted in France on the long-term health effects of genetically modified maize which allegedly poses a health threat to consumers; if not, what is the position in this regard; if so, what are the relevant details?
NW3392E
REPLY:
South Africa has a legal framework in place, which among others, provides for a rigorous and robust regulatory system for the approval of GMOs in terms of the Genetically Modified Organisms Act, 1997 (Act No.15 of 1997), as amended by the Genetically Modified Organisms Amendment Act, 2006 (Act No. 23 of 2006). The Regulations published in terms of the GMO Act by the Minister of Agriculture, Forestry and Fisheries, are among others, specifically aimed to address the regulatory process of assessing GMOs produced, imported, exported and in transit in this country.
The GMO Act further provides for the establishment of the Executive Council (EC), with representation of six Government Departments, where applications concerning GMOs are tabled and final decisions being made before the issuance of permits in terms of the Act. As you might be aware, the members of the EC are appointed by the Minister of Agriculture, Forestry and Fisheries, in term of the GMO Act, with the Department of Health currently being represented by the Director: Food Control for this purpose. The GMO Act also makes provision for a Scientific Advisory Committee (SAC) that evaluates dossiers submitted by applicants for the approval of their GMOs activities. The SAC and its sub-committees, consisting of scientific experts, (these experts are not in the employment of Government), deal with the evaluation of specific applications. The individual tabling of applications, together with the SAC reports and recommendations, at the EC meetings allows for a case-by-case approach and evaluation of GMOs in the country. Should there be health concerns of any degree, the relevant application is likely to never be allowed for import or local production purposes in South Africa. Only if the health risk is negligible and/or there is no evidence of negative effects in terms of toxicity, allergenicity, and pathogenicity is the application of a specific GMO considered for approval.
The GMO named Monsanto's RoundUp Ready Maize (NK 603) event, has been approved for general release in terms of the GMO Act 1997 since 2002. RoundUp has also being registered in South Africa in terms of the Fertilizer, Farm Feeds, Agricultural Remedies and Stock Remedies Act, 1947 (Act 36 of 1947), by Monsanto in 1969 as a herbicide containing glyphosate as an active ingredient, by the then Department of Agriculture.
It is also our understanding that in terms of available literature, glyphosate and glyphosate-based herbicides are backed by one of the most extensive worldwide human health and safety databases ever compiled for a pesticide product.
In addition to the above-mentioned legislation, the Regulations Governing the Maximum Limits for Pesticide Residues that may be present in Foodstuffs, (R.246 of 11 February 1994), published in terms of the Foodstuffs, Cosmetics and Disinfectants Act, (Act 54 of 1972) by the Minister of Health, includes MRLs related to glyphosate for maize, sugar cane and soya, (the latter which a default MRL provided for in the mentioned Regulations currently applies). To monitor compliance to the mentioned Regulations, the Directorate: Food Control included in its National Sampling Programme for 2012/13 a sampling run for maize meal and soya meal, to be sampled by the various Environmental Health Practitioners (EHP's) of the metro and district municipalities rendering Municipal Health Services (MHS), and analysed by the Forensic Chemistry Laboratory of the Department in Cape Town.
Regarding the article published on 27 September 2012 in the Journal of Food and Chemical Toxicology of the study by Professor Gilles-Eric Séralini of the University of Caen in France related to NK 603, the following should be noted:
· The Directorate: Food Control has proposed to the Office of the Registrar: GMO Act to refer the matter to Scientific Advisory Committee, with a specific request that the Committee obtain full details regarding the study in question; arranges for the assessment thereof; and, to advise the Executive Council of their findings and on the way forward in this regard.
· The Department has also been made aware of the response to the publication of the article, by the French Government as well as the European Food Safety Authority (EFSA) at the end of September 2012, who called for an urgent review of what was referred to by them as a 'controversial' study. As a result, EFSA issued a press release on 4 October 2012 related to its initial review of the study, which contained, among others, the following statements: 'The European Food Safety Authority has concluded that a recent paper raising concerns about the potential toxicity of genetically modified (GM) maize NK603 and of a herbicide containing glyphosate is of insufficient scientific quality to be considered as valid for risk assessment. EFSA's initial review found that the design, reporting and analysis of the study, as outlined in the paper, is inadequate. To enable the fullest understanding of the study the Authority has invited authors Séralini et al to share key additional information. ...based on the information published by the authors, EFSA does not see a need to re-examine its previous safety evaluation of maize NK603 nor to consider these findings in the ongoing assessment of glyphosate.'
Reply received: November 2012
QUESTION NO. 2729
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether his department has implemented the Promotion of Administrative Justice Act, Act 3 of 2000, if not, why not; if so, what are the (a) relevant details with regard to (i) public inquiries, (ii) notice and comment procedure, (iii) notice of administrative action and rights and (iv) requests for reasons and (b) further relevant details?
NW3243E
REPLY:
Yes, the Department of Health has implemented the Promotion of Administrative Justice Act 2000, Act No 3 of 2000).
(a) (i) Public enquiries – No;
(ii) Notice and comment procedure – when taking an administrative action (Regulations and Notices), the Department publishes the proposed action in the Government Gazette and calls for public comments within reasonable period;
(iii) Notice of administrative action and rights – The Department when taking an administrative decision also informs the person to be affected by particular administrative action of his / her right to appeal to the Director-General or the Minister who will then appoint an appeal committee to adjudicate on the appeal;
(iv) Request for reasons – The Department provides reasons for an administrative action. Should the person who is affected or likely to be affected by such action feels that the reasons provided are insufficient, such a person is entitled to make a request for further reasons.
(b) None.
Reply received: November 2012
QUESTION NO. 2729
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 October 2012
(INTERNAL QUESTION PAPER NO. 32)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether his department has implemented the Promotion of Administrative Justice Act, Act 3 of 2000, if not, why not; if so, what are the (a) relevant details with regard to (i) public inquiries, (ii) notice and comment procedure, (iii) notice of administrative action and rights and (iv) requests for reasons and (b) further relevant details?
NW3243E
REPLY:
In terms of the Promotion of Administrative Justice Act (PAJA) certain administrative actions, in order to be procedurally fair, certain requirements are compulsory, for example:
(i) Adequate notice of the nature and purpose of proposed action;
(ii) Reasonable opportunity to make representations;
(iii) Clear statement of the action;
(iv) Adequate notice of right of review;
(v) Adequate notice of right to request reason;
(vi) Departure from compulsory requirements.
If it is reasonable and justifiable, the administrator may depart from the compulsory requirements for example where the Medicines Control Council (MCC) declares certain medicines undesirable, it may be urgent that the public be protected against the medicines and it may therefore be proper for the MCC to make a declaration without affording the affected persons an opportunity to make representations.
(vii) Procedures provided in other laws.
The Department of Health's procedures and practices are in line with the requirements of PAJA as set out above.
(a) (i) Where the public enquiry process is required, the Department will –
- determine procedure for public enquiry which will include public hearings;
- compile a written report on the enquiry and give reasons for administrative action taken or recommended;
- publish in the Gazette, a summary of the report and details of where the report can be obtained.
(ii) Where notice and comment procedure is required, the Department will:
- communicate the proposed administrative action to those likely to be affected and call for comments;
- consider any comments received;
- decide whether or not to take administrative action, with or without changes.
(iii) If it is reasonable and justifiable, the Department may depart from the procedures in (i) and (ii) above. The following factors will be taken into account in determining whether it is reasonable and justifiable:
- objects of empowering provision;
- nature and purpose of and the need to take administrative action;
- need to promote an efficient administration and good governance.
(iv) A person affected and not given reasons for an administrative action may ask the Department for reasons within 90 days of becoming aware. The Department must give reasons within 90 days of being asked and has done so in many instance
(b) Legislation of the Department is also in line with the provisions of PAJA. For example the Medicines and Related Substances Act and the Pharmacy Act have provisions that set out appeal procedures. The National Health Act has a provision making it compulsory for the Department to publish all new regulations in the Gazette in order to give the public three months time to comment on the relevant regulations.
Reply received: October 2012
QUESTION NO. 2695
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
The Leader of the Opposition (DA) to ask the Minister of Health:
Whether his department has awarded any contracts to a certain company (name furnished) since its establishment in 1996; if so, in each case, (a) when was the contract awarded and (b) what was the (i) nature of the contract and (ii) total accumulative value of the tender?
NW3313E
REPLY:
The Department of Health was unable to locate the supplier in question, on the BAS system. The current BAS version only goes as far back as the 2008/09 book year. No record was found of this company being utilised by the Department of Health.
Reply received: October 2012
QUESTION NO. 2690
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs D Robinson (DA) to ask the Minister of Health:
What measures have been put in place to educate HIV-positive pregnant women on how to prevent the transmission of HIV from mother to child?
NW3308E
REPLY:
The Department of Health has in response to the Global Call to Eliminate Mother-to-child-transmission and Keep Mothers and Partners Alive by 2015, developed an Action Framework for Elimination which aims to target both the health care system and the wider community. The Framework addresses empowerment of women and social mobilisation. The following interventions are currently being provided:
· Development and distribution of information, education and communication materials like posters, pamphlets and booklets which inform women about HIV and interventions available in health facilities. The posters are available in all facilities rendering maternal and child health services;
· Radio messages and information sessions are aired on local radio stations. These educate women and families on prevention of HIV transmission services and how to access the services;
· At district level, partner organisations are working with facilities to conduct imbizos, door to door campaigns and dialogues;
· Community-based organisations, faith-based organisation and traditional leaders and healers have been mobilised to talk to the community on HIV and pregnancy (PMTCT);
· Currently, through the Global Fund R6 grant; Soul City, Treatment Action Campaign (TAC) and Mindset have been funded to work with existing social and community mobilisation organisations in strengthening the Advocacy, Communication and Social Mobilisation aspect of the programme.
Reply received: October 2012
QUESTION NO. 2689
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs D Robinson (DA) to ask the Minister of Health:
Whether he intends to introduce the use of telemedicine in order to provide primary health care to improve access to medical services, especially in remote rural areas; if not, why not; if so, what are the relevant details?
NW3307E
REPLY:
1. A Telemedicine Strategy for South Africa was produced in 1998, and updated in 2010.
2. By May 2010, a total of 101 Telemedicine sites had been established. These have expanded gradually from 28 sites in six provinces in 1998 to 101 sites in 2012, covering all provinces.
3. A total of 87 sites are found in the predominantly rural Provinces, namely, Eastern Cape (34), KwaZulu/Natal (35), Limpopo (10) and Mpumalanga (8). The predominantly urban provinces, Gauteng and Western Cape have one site each.
4. Commonly used telemedicine applications are: tele-radiology, tele-dermatology, tele-consultation, tele-opthalmology, tele-ECG and tele-education.
5. Telemedicine is an integral part of healthcare service delivery and is reflected in provincial clinical support to underserved and rural areas.
6. A Telemedicine Research Unit has been established at the South African Medical Research Council (MRC) with the purpose of monitoring and evaluating telemedicine projects and to investigate new research opportunities and appropriate, cost-effective technologies to be used.
TELEMEDICINE SITES PER PROVINCE
| PROVINCE | SITE |
| Eastern Cape | 34 |
| Free State | 4 |
| Gauteng | 1 |
| KwaZulu/Natal | 35 |
| Limpopo | 10 |
| Mpumalanga | 8 |
| North West | 6 |
| Northern Cape | 2 |
| Western Cape | 1 |
| TOTAL | 101 |
Reply received: October 2012
QUESTION NO. 2669
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs H Lamoela (DA) to ask the Minister of Health:
Whether his department has established staffing norms for each type of health institution; if not, (a) why not and (b) when will the specified norms be established; if so, what are the relevant details?
NW3287E
REPLY:
(a) No. The process to develop staffing norms, which commenced earlier this year has not yet been completed.
(b) At the end of the current financial year (31 March 2013).
The Workload Indicators of Staffing Need (WISN) model developed by the World Health Organization will be piloted in 11 NHI districts in order to determine staffing levels in the health institutions. The results from the pilot will be used to determine national staffing norms. Piloting of the model in the 11 districts will be undertaken over a six (6) month period: up to the end of the financial year.
Reply received: October 2012
QUESTION NO. 2666
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs D Robinson (DA) to ask the Minister of Health:
(1) What measures have been put in place to ensure that the required instruments and medication are available to health care workers;
(2) whether any incentives are provided to encourage (a) health care workers, (b) nurses and (c) doctors to remain in primary health care facilities, especially in deep rural areas; if not, why not, in each case; if so, in each case, what are the relevant details?
NW3284E
REPLY:
(1) The essential medicines lists identify the medicines that are required at facility level. Institutions are required to maintain a standard stock level of medicines / instruments at the facility. The manager is expected to ensure that an order is placed timeously before the minimum stock level is reached. The National Department of Health monitors stock levels at provincial departments to ensure that supplies are available at the depot in adequate quantity. Where stocks are low, alternative supplies are contacted to provide stock.
(2) (a)-(c) The Government initiated policy measures to attract and retain health workers in rural areas. A non-pensionable recruitment allowance is paid in accordance with the Public Health and Welfare Sector Bargaining Council Resolution 2 of 2004. The amount of the allowance is determined by the specific area and for the relevant health occupations covered by the Agreement.
Reply received: October 2012
QUESTION NO. 2657
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs H Lamoela (DA) to ask the Minister of Health:
(1) Whether, with reference to his reply to question 945 on 10 September 2009, the report on the pilot trials on using private pharmacies to distribute medicine for state patients has now been completed; if not, what is the position in this regard; if so, what were the findings;
(2) whether a strategic plan has been drawn up for implementing such a system across the country; if not, why not; if so, what are the relevant details?
NW3275E
REPLY:
(1) The pilot trial was for a Central Chronic Medication Dispensing Unit (CCMDU) not specifically for using private pharmacies to distribute medicine for state patients. The alternate models for collection of medicines by patients (including private pharmacies) were also considered. There was limited cooperation from the retail pharmacies as there was no fee provided for the service in the pilot trial. Those that participated acknowledged the possible increased revenue from patients who would come in to collect their chronic medication and further identify items of interest to purchase from the retail pharmacy. The pilot was completed and further investigations had to be made. The request for information to investigate outsourcing the CCMDU is in progress to get input from the industry.
(2) A strategic plan will be developed once the experiences of the pilots are evaluated.
Reply received: October 2012
QUESTION NO. 2617
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mr D A Kganare (Cope) to ask the Minister of Health:
What has he found to be the level of access to contraception services?
NW3227E
REPLY:
The 2003 SADHS shows that the contraceptive prevalence rate is at 65%. Routine data collection of Couple Year Protection Rate (CYPR) has remained relatively steady at 31% since 2008.
To strengthen contraception services the Department recently adopted a revised Contraception and Fertility Policy which include strategies to increase access to contraception service, including expanding the range of contraceptives that will be available in public health facilities.
Reply received: November 2012
QUESTION NO. 2603
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs H S Msweli (IFP) to ask the Minister of Health:
Whether he has identified hospitals in KwaZulu-Natal that are underspending their budgets at present; if not, what is the position in this regard; if so, (a) which hospitals, (b) what are the reasons for the underspending in each case and (c) what are the further relevant details?
NW3212E
REPLY:
None of the hospitals in KwaZulu/Natal are underspending on their budgets at present.
Reply received: October 2012
QUESTION NO. 2602
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mrs H S Msweli (IFP) to ask the Minister of Health:
What is the current (a) doctor-patient ratio at each specified rural hospital and (b) waiting time for patients to see a health care professional?
NW3211E
REPLY:
(a) The doctor-patient ratio for each specified rural hospital is not available in a single national data set. Data is available on doctor-patient ratios per province, and hospital and district patient activity. Work is underway by the Department of Health to create an electronic database on health professionals by facility and patient activity.
(b) Information on waiting times in rural hospitals is not available in a national data set. Work is underway by the Department of Health to collect this data.
Reply received: October 2012
QUESTION NO. 2601
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 September 2012
(INTERNAL QUESTION PAPER NO. 31)
Mr D A Kganare (Cope) to ask the Minister of Health:
Whether any measures have been put in place to ensure effective emergency obstetric care of high-risk pregnancies; if not, why not; if so, what are the relevant details?
NW3135E
REPLY:
With the support of the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD), the Department of Health has put the following measures in place:
· Development of policies and guidelines on managing high risk pregnancies and establishment of high risk clinics at referral hospitals to diagnose and address high risk conditions;
· Establishment of Maternal waiting homes, providing accommodation for high risk pregnant women due for delivery who are not able to access transport;
· Provision of obstetric ambulances, which are designated for obstetrical calls only;
· Implementation of the Essential Steps for Management of Obstetric Emergency (ESMOE) and Emergency Obstetric Simulation Training (EOST), and use of early warning monitoring charts; and
· Appointment of advanced midwives and obstetricians as members of District Clinical Specialist Teams.