Questions & Replies: Health

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2013-06-20

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Reply received: December 2013

QUESTION NO. 3201

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 37)

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

(1) (a) How many vehicles were bought by (i) his department and (ii) its institutions for the 2010 Fifa Soccer World Cup tournament and (b) what (i) amount was spent on these vehicles, (ii) happened to these vehicles and (iii) amount is spent to maintain them;

(2) whether he will make a statement on whether this was value for money?

NW3761E

REPLY:

(1) (a) (i) A total of 450 ambulances were bought for the country.

(ii) A total of 50 ambulances were purchased by each province through their procurement process.

(b) (i) Each ambulance was purchased at a cost of R300,000 and the total amount spent on these ambulances was R135,000,000.

(ii) These vehicles were absorbed into the daily operational fleet in the provinces for normal service delivery.

(iii) The fleet is managed through the normal equitable share for fleet management of EMS.

(2) Yes, the purchase of these ambulances was value for money as the National Treasury tender for ambulances was used to procure these vehicles. The vehicles were absorbed into the operational fleet post 2010 FIFA World Cup for normal service delivery.

Reply received: December 2013

QUESTION NO. 3183

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

Ms D Kohler-Barnard (DA) to ask the Minister of Health:

(1) (a) How many government laboratories process toxicology samples and (b) where is each laboratory located;

(2) what was the total backlog of (a) toxicology samples and (b) samples relating to (i) homicide, (ii) rape and sexual assault and (iii) drunk driving at these laboratories (aa) in the (aaa) 2010-11, (bbb) 2011-12 and (ccc) 2012-13 financial years and (bb) from 1 April 2013 up to the latest specified date for which information is available;

(3) on average (a) how many samples have been received in each month and (b) what is the turnaround time for processing samples;

(4) (a) what is the total number of (i) vacancies and (ii) temporary appointments at the laboratories and (b) how long has each (i) vacant and (ii) temporary position remained unfilled?

NW3741E

REPLY:

(1) (a) Three Forensic Chemistry Laboratories (FCLs).

(b) Cape Town (120 Albert Road, Woodstock), Johannesburg (110 Joubert Street, Constitutional Hill, Braamfontein), Pretoria (271 Visagie Street, Burgers Park).

(2) (a) Table 1 below indicates the number of unprocessed Toxicology samples.

Table 1: Toxicology unprocessed samples by FCL as at 31 October 2013

Forensic Chemistry Laboratory

Total Unprocessed

Cape Town FCL

3667

Johannesburg FCL

7431

Pretoria FCL

5919

(b) (i) Terms such as "homicide" are not included in the request for analysis.

(ii) Terms such as "rape and sexual assault" are not included in the request for analysis and the Forensic Chemistry Laboratories do not perform DNA analysis.

(iii) (aaa) Blood Alcohol Drunken Driving(DD)and Blood Alcohol Postmortem(PM) 2010-11

Cape Town FCL

The Blood Alcohol (DD) backlog was 7161 and has been cleared.

The Blood Alcohol (PM) backlog was 652 and has been cleared.

Johannesburg FCL

The Blood Alcohol (DD) backlog was 9179 and has been cleared.

The Blood Alcohol (PM) backlog was 6656 and has been cleared.

Pretoria FCL

The Blood Alcohol (DD) backlog was 6518 and has been cleared.

The Blood Alcohol (PM) backlog was 3148 and has been cleared.

(bbb) Blood Alcohol Drunken Driving (DD) and Blood Alcohol Postmortem (PM) 2011-12

Cape Town FCL

The Blood Alcohol (DD) backlog was 15963 and has been cleared.

The Blood Alcohol (PM) backlog was 1689 and has been cleared.

Johannesburg FCL

The Blood Alcohol (DD) backlog was 29169 and has been cleared.

The Blood Alcohol (PM) backlog was 795 and has been cleared.

Pretoria FCL

The Blood Alcohol (DD) backlog was 10915 and has been cleared.

The Blood Alcohol (PM) backlog was 494 and has been cleared.

(ccc) Blood Alcohol Drunken Driving (DD) and Blood Alcohol Postmortem (PM) 2012-13

Cape Town FCL

The Blood Alcohol (DD) backlog was 20856 and 15361 was cleared and 5945 is outstanding.

The Blood Alcohol (PM) backlog was 186 and has been cleared.

Johannesburg FCL

The Blood Alcohol (DD) backlog was 23807 and has been cleared.

The Blood Alcohol (PM) backlog was 597 and has been cleared.

Pretoria FCL

The Blood Alcohol (DD) backlog was 10790 and has been cleared.

The Blood Alcohol (PM) backlog was 367 and has been cleared.

(b) (bb) Blood Alcohol Drunken Driving (DD) and Blood Alcohol Postmortem (PM) April 2013 to October 2013 (as at 31 October 2013)

Cape Town FCL

The Blood Alcohol (DD) backlog was 26307 and 12408 samples have been cleared in this period.

The Blood Alcohol (PM) backlog was 4635 and 1403 samples have been cleared in this period.

Johannesburg FCL

The Blood Alcohol (DD) backlog was 24551 and 14690 samples have been cleared in this period.

The Blood Alcohol (PM) backlog was 3941 and 3920 samples have been cleared this period.

Pretoria FCL

The Blood Alcohol (DD) backlog was 12889 samples and 7959 samples were cleared in this period.

The Blood Alcohol (PM) backlog was 1321 samples and 3028 samples were cleared in this period.

(3) Monthly averages of blood samples received are as follows:

Cape Town Laboratory

Toxicology: 61 per month

Blood alcohol (Post Mortem): 691 per month

Blood alcohol (Drunken Driving: 2 000 per month

Johannesburg Laboratory

Toxicology: 116 per month

Blood alcohol (Post Mortem): 514 per month

Blood alcohol (Drunken Driving: 1 700 per month

Pretoria Laboratory

Toxicology: 137 per month

Blood alcohol (Post Mortem): 481 per month

Blood alcohol (Drunken Driving: 1 600 per month

(3) (b) Please note that in all the FCL's analysts are working on both old as well as new incoming cases in order to prevent the newer cases from getting old as well. Analysts have been assigned into groups. Turnaround times are determined based on the current number of samples and are indicated below.

Average Turnaround Time

Cape Town

Johannesburg

Pretoria

Toxicology: from allocation to analyst

4 weeks for 15 cases per analyst

4 weeks for 15 cases per analyst

4 weeks for 15 cases per analyst

Drunk Driving: from allocation to analyst

5 days per batch of 200 per analyst

5 days per batch of 200 per analyst

5 days per batch of 200 per analyst

Drunk Driving: estimated time to process all currently unprocessed samples at current output rate

12,4 months

13,5 months

7,6 months

(4) (a) (i) We have two vacancies for the Laboratory Information Management System (LIMS) administrator. The Johannesburg FCL LIMS administrator candidate has been recommended, in the process of finalisation after interviews. For the LIMS administrator for Cape Town there was no suitable candidate and will be re-advertised.

(ii) No temporary employees are appointed at any of the FCLs.

(b) (i) The LIMS administrator posts are new posts in the Forensic Chemistry Laboratories.

(ii) No temporary employees are appointed at any of the FCLs and we do not have vacancies for temporary positions.

These backlogs occurred over a long period of time. To finally deal with them the Department recruited 70 Chemistry and Biochemistry graduates and hired them as interns. They were sent for training in toxicology analysis at the University of Pretoria. They have completed training and all 70 of them have been hired on a full-time basis. They have helped a lot to clear these backlogs.

Reply received: December 2013

QUESTION NO. 3182

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

(1) What are the backlogs at the Medicine Control Council in the 2012-13 financial year;

(2) have additional funds been approved to compensate evaluators more in line with industry norms; if so, what are the relevant details?

NW3740E

REPLY:

(1) 1913 in the registration backlog.

(2) No.

Reply received: December 2013

QUESTION NO. 3181

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

(1) With regard to the SA Nursing Council (SANC), what is (a) the number of resignations of personnel who were managed by the chief financial officer in the (i) 2010-11, (ii) 2011-12 and (iii) 2012-13 financial years and (b) its financial position;

(2) whether permanent staff of SANC are involved in the recruitment of nurses from India for (a) Mediclinic, (b) Netcare and (c) Life private hospitals;

(3) whether staff of the SANC have been sent to India to do examinations on behalf of the specified private hospitals;

(4) whether it is within the mandate of SANC to send staff to do the examinations in India on behalf of those private hospitals?

NW3739E

REPLY:

(1) (a) With regard to the South African Nursing Council (SANAC), the number of resignations of personnel who were managed by the Chief Financial Officer per the three financial years under review were as follows:

(i) 2010/11: None;

(ii) 2011/12: 02;

(iii) 2012/13: 03

(b) The SANC has confirmed its financial position to be positive in that the assets of SANC were higher than its liabilities over the mentioned three financial years. In terms of Going Concern, SANC confirmed that its financial position reflects that SANC will continue to operate in the foreseeable future.

(2) No, none of the permanent staff of SANC are involved in the recruitment of nurses from India for Mediclinic, Netcare and Lifecare Private Hospitals.

(3) Yes, the staff of the SANC in the Assessment Section have accompanied invigilators to conduct examinations in India, since the recruits are required to write SANC examinations before they can practise in South Africa. The SANC has entered into a Memorandum of Understanding (MOU) with the Mediclinic, Netcare and Lifecare Private Hospitals for this purpose. The cost of this exercise is borne by each respective hospital.

(4) Yes, it is within the mandate of the SANC as legislated in the Nursing Act, 2005 (Act No. 33 of 2005), to conduct examinations for the purpose of the registration to practise in South Africa.

Reply received: December 2013

QUESTION NO. 3180

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

What was the rate of (a) teenage pregnancies and (b) Vitamin A coverage across the country in the (i) 2010-11, (ii) 2011-12 and (iii) 2012-13 financial years?

NW3738E

REPLY:

(a) Teenage pregnancies

The National Department of Health does not collect statistics on teenage pregnancies per ser, but the number of teenage pregnancies can be estimated by taking into consideration the number of deliveries by women < 18 years of age during a specific period. The Table 1. below reflects the situation in this regard.

YEAR

2010-2011

2011-2012

2012-2013

Total female population between the ages of 12 and 17 years

3,152,543

3,150,791

3,144,585

Number of deliveries (women < 18 years)

73,980

75,287

72,891

(b) The Vitamin A coverage across the country was as follows:

(i) 2010-2011: 97.4% for 6-11 months old children, 34.6% for 12-59 months old children, and 92% for postpartum women;

(ii) 2011-2012: 107,9% FOR 6-11 months old children, 43,4% for 12-59 months old children, and 95,4% for postpartum women;

(iii) 2012-2013: 93,0% for 6-11 months old children, 42,8% for 12-59 months old children, and 75,0% for postpartum women.

Reply received: December 2013

QUESTION NO. 3179

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

Mrs D Robinson (DA) to ask the Minister of Health:

With regard to the National Development Plan, (a) when will the framework on social determinants of health be finalised and (b) what innovative actions will his department take to increase the use of primary health care services?

NW3737E

REPLY:

(a) The development of the framework for social determinants of health will be completed by the end of the financial year.

(b) The Department makes use of the Ward-based primary health care outreach teams to educate communities about the need to make us of the primary health care services. The Department is also in the process of assigning doctors to work in primary health care clinics for a number of hours per day for a number of days per week, depending on the need at the specific clinic. This is to facilitate increased confidence of communities in primary health care facilities. In addition, the National Department of Health in cooperation with Provincial Departments of Health, district management and primary health care facility management is currently reorganising patient flows within primary health care facilities to improve waiting times and patients' experience in the primary health care facility.

Reply received: December 2013

QUESTION NO. 3178

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

Mrs D Robinson (DA) to ask the Minister of Health:

(1) What is the (a) required number in terms of staffing norms and (b) registered number of practising (i) psychiatrists and (ii) clinical psychologists;

(2) how is his department fulfilling its obligations with regard to the Child Justice Act, Act 75 of 2008, for the assessment of children by psychiatrists or clinical psychologists given the lack of such professionals in the public sector?

NW3736E

REPLY:

(1) (a) There are no formal staffing norms for psychiatrists and clinical psychologists, however comparisons with other countries gives some indication of provision. South Africa has slightly more psychiatrists and substantially more psychologists than the world average. In comparison with upper-middle income countries South Africa has less psychiatrists but more psychologists than the median for upper middle-income countries.

However distribution is unequal between the private and public sectors and hence while professional to population ratios in South Africa as a whole are higher than world averages, ratios in the public sector – especially for psychiatrists - are lower than the world average and substantially lower than the middle income country median.

Psychiatrists Psychologists

South Africa 1.47 5

South Africa (public sector) 0.28 0.32

Upper middle[1] 2.03 1.8

World 1.27 0,33

(b) According to the Health Professions Council, 765 psychiatrists and 2650 clinical psychologists were registered in 2013.

Fulfilling the obligations with regard to the Child Justice Act, Act 75 of 2000 for the assessment of children is a challenge in view of the limited number and availability of psychiatrists and clinical psychologists in the public sector and due to the lack of willingness of most private sector mental health professionals to conduct these assessments. Moreover forensic mental health requires specific skills that are generally not integral to professional training.

In order to improve this limited capacity the College of Medicine has created forensics as a specialty for psychiatrists and Forensic psychology has recently been made a sub-specialty by the Health Professions Council of South Africa. The Department of Justice and Constitutional Development, after liaison with the Department of Health, reviews and increases payment of a periodic basis to encourage more mental health professionals to conduct assessments, including with regard to the Child Justice Act.


[1] Figures for world and middle income countries taken from the Lancet Journal 2011 – Kakuma et al. Vol 378.

Reply received: December 2013

QUESTION NO. 3177

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

Mrs D Robinson (DA) to ask the Minister of Health:

What is the current vacancy rate in percentage (a) in his department, (b) in each division of his department and (c) at senior management level?

NW3735E

REPLY:

(a) 5.2% as at 4th December 2013.

(b) Division 1: Administration is 8.2%

Division 2: National Health Insurance is 0.0%

Division 3: HIV&AIDS, TB, MWH& Child Youth Health is 6.5%

Division 4: Primary Health Care is 2.9%

Division 5: Hospital, Tertiary Health Care Services is 4.4%

Division 6: Health Regulations and Compliance Management is 4.1%

(c) 15.7 % as at 4th December 2013.

Reply received: December 2013

QUESTION NO. 3176

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

(1) What (a) processes and (b) interventions are in place to ensure access to obstetric care for rural women;

(2) whether a study was carried out to determine the number of midwives needed in rural areas; if so, what number is required in each province;

(3) what is the number of trained midwives in rural areas in each province?

NW3734E

REPLY:

(1) (a) and (b) The Department of Health launched the Campaign for Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA) in May 2012. The Campaign aims to strengthen existing maternal health services by prioritising seven key focus areas which will of necessity benefit rural women as well, namely –

· Strengthening and promoting access to comprehensive Sexual Reproduction Health services with specific focus on family planning services;

· Advocacy and health promotion for early antenatal care attendance/booking;

· Improving access to Skilled Birth Attendants;

· Establishing maternity waiting homes and providing dedicated obstetric ambulances;

· Strengthening Human Resources for Maternal and Child Health by providing training on Essential Steps in Management of Obstetric Emergencies (ESMOE) to doctors and midwives and intensifying midwifery education and training;

· Intensifying management of HIV positive mothers and children by, amongst others, improving access to treatment.

The Revitalisation of Primary Health Care initiative which is based on establishment of District Clinical Specialist Teams (DCSTs) and Ward-Based Outreach Teams (WBOTs) is also intended to improving the quality of care provided to rurally situated women.

(2) There was no specific study commissioned to determine the number of midwives needed in rural areas. In the Human Resources for Health South Africa Strategy 2012/13-2016/17, a National Department of Health modelling was developed to look at staffing benchmarks and ratios per 10 000 population using other countries to benchmark against. This is ongoing and the Department has embarked on the process of developing staffing norms and standards using the Workload Indicators for Staffing Needs (WISN) process, assisted by the World Health Organisation (WHO).

(3) The Department of Health does not keep statistics of the number of midwives in rural areas. In addition, the number of trained midwives in rural areas has not bee determined and the South African Nursing Council (SANC) does not have a database that distinguishes the number of midwives from professional nurses that provide maternity nursing care.

Reply received: December 2013

QUESTION NO. 3175

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

(1) What was the reason for the District Health Services and Environmental Health budget in the 2011-12 financial year to increase from the appropriated amount of R23,5 million to the audited amount of R45 million;

(2) what was the breakdown of the (a) R23,5 million budget and (b) R45 million spent?

NW3733E

REPLY:

(1) In line with the National Department of Health's vision of "A Long and Health Life for All South Africans", the Department is working towards universal health coverage for all South Africans. Universal health coverage is about access for all South Africans to quality health care services. We needed to do a health facilities audit to begin to correct areas of poor quality. The audit was conducted during the 2011/12 financial year. The component of the costs of the audit that was to be paid by the District Health Services and Environmental Health for this period amounted to R22 million. Therefore the budget for District Health Services and Environmental Health was augmented with this amount to cover the costs of the audit.

(2) (a) The R23,500,000 was for the running costs of the Cluster. The budget was for all standard charts of accounts, namely compensation of employees, goods and services and machinery and equipment for the four offices under the Cluster. The breakdown per Directorate is as follows:

Sub-Programme

Amount

Chief Director's Office

R5,838,494

District and Development

R2,691,611

Primary Health Care

R3,247,042

Environmental Health

R7,780,853

Audit (as part of MTEF)

R4,000,000

TOTAL

R23,558,000

(b) The amount of money that was spent outside the appropriated budget was R21,500,000. These funds were paid to the consortium that conducted the audit of 3 880 facilities for professional services.

Reply received: December 2013

QUESTION NO. 3174

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

(1) What are the (a) infant and (b) under-5 mortality rates in the (i) 2011-12 and (ii) 2012-13 financial years;

(2) where there has been an improvement in the rate, what (a) were the main driving forces for the improvement in the (i) infant and (ii) under-5 mortality rates in each case and (b) further steps does his department intend to take to accelerate the specified improvements;

(3) how many baby-friendly facilities are in the country?

NW3732E

REPLY:

(1) Data from vital registration and the Rapid Mortality Surveillance system indicate that the infant mortality fell from 37 deaths per 1 000 live births in 2010 to 30 deaths per 1 000 in 2011. During the same period the under-five mortality rate declined from 53 to 42 deaths per 1 000 live births. Figures for 2012 are not yet available.

(2) (a) The declines in both infant and under-five mortality rates can primarily be attributed to a decline in deaths due to HIV infection as a result of improvements in prevention of mother-to-child transmission (PMTCT) programmes, and improved identification and management of children with HIV infection. Other programmes aimed at reducing child poverty and improving child health and development, including the introduction of new vaccines which prevent diarrhoea and pneumonia, have also contributed to the decline.

(b) In order to sustain and accelerate these gains, the Department of Health is focussed on the following interventions:

· Improving nutrition in young children through the promotion of exclusive breasfeeding (for six months);

· Reducing neonatal mortality by ensuring that all mothers and their newborn infants have access to a package of quality maternal and newborn services;

· Reducing deaths from diarrhoea and pneumonia by focusing on both preventing these conditions and ensuring appropriate case management at community, primary health care and hospital levels.

· Maintaining and extending the gains achieved through the PMTCT programme.

(3) There are currently 54.1% (295/545) facilities with maternity beds accredited as baby-friendly facilities, at the end of the 2nd quarter of the 2013/2014 financial year.

Reply received: December 2013

QUESTION NO. 3156

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

Mr M R Sayedali Shah (DA) to ask the Minister of Health:

(1) Whether his department received any funds for the Expanded Public Works Programme in the (a) 2010-11, (b) 2011-12 and (c) 2012-13 financial years;

(2) whether any of these funds were earmarked for (a) capital or (b) infrastructure-related projects; if so, (i) what are the names of these projects, (ii) where are these projects situated, (iii) what is the value of each project and (iv) how many jobs have been created by each project

(3) in each case, what process was followed to appoint project (a) implementers and (b) consultants;

(4) in each case, were funds transferred to project implementers (a) in a lump sum or (b) through progress payment;

(5) whether any projects have been impeded due to maladministration or corruption; if so, (a) which projects have been affected and (b) what action has been taken in each case?

NW3714E

REPLY:

(1) The EPWP budget allocation is handled at the provincial level. The Table 1. below shows the amount of the budget allocated to the Provincial Departments of Health in different financial years.

Table 1.

EPWP funding per financial year

2010/2011

2011/2012

2012/2013

Province

Budget

Province

Budget

Province

Budget

EC

887,010

EC

845,042

EC

508,643

NW

52,509

KZN

331,505

FS

2,032

NW

353,650

KZN

723,998

NC

347,163

NW

277,111

TOTAL

939,519

TOTAL

1,530,197

TOTAL

1,858,947

(2) The above budget allocations fund capital related projects. The detailed project list and project related information is in various provinces. We are still awaiting for them to furnish information.

(3) to (5) The information requested in these questions is not available in the National Office since the budget and procurement of the projects is also handled at the provincial level. As such as the provinces have furnished the relevant information, we shall present it to the Honourable Member.

Reply received: December 2013

QUESTION NO. 3082

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 38)

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

What (a) steps are being taken by his department to ensure that the ambulance services are being improved and (b) steps will be taken by his department to deal with the shortages of ambulances in hospitals?

NW3621E

REPLY:

(a) The Department is indeed ensuring that ambulance services are improved and has taken steps to do that. The following is the status by Provinces for 2011/12 and 2012/13 financial years:

(i) Eastern Cape: Increased ambulances from 286 to 354 operational ambulances plus 63 being obstetric ambulances;

(ii) Free State: Increased ambulances from 188 to 212 operational ambulances plus 18 being obstetric ambulances;

(iii) Gauteng: Increased ambulances from 313 to 343 operational ambulances plus 13 being obstetric ambulances;

(iv) KwaZulu-Natal: Increased ambulances from 482 to 628 operational ambulances plus 40 being obstetric ambulances;

(v) Limpopo: Increased ambulances from 402 to 421 operational ambulances plus 38 being obstetric ambulances;

(vi) Mpumalanga: Increased ambulances from 175 to 190 operational ambulances plus 4 being obstetric ambulances;

(vii) North West: Increased ambulances from 126 to 140 operational ambulances;

(viii) Northern Cape: Increased ambulances from 191 to 242 operational ambulances plus 10 being obstetric ambulances;

(ix) Western Cape: Increased ambulances from 243 to 257 operational ambulances plus 4 being obstetric ambulances.

In the financial year 2011/12 there were a total of 2,406 operational ambulances and increased them to 2,787 for the 2012/13 financial year in the whole country.

Obstetric ambulances have recently been introduced to help reduce the maternal and infant mortality rate. There are a total of 190 of obstetric units to date.

Other details

(i) The Eastern Cape has procured 100 vehicles and these will be converted this financial year;

(ii) Gauteng plans to procure 120 vehicles during this financial year;

(iii) KwaZulu-Natal has procured a total of 554 vehicles and will be for operational use during 2013;

(iv) Limpopo plans to procure 30 vehicles in this financial year;

(v) Northern Cape procured 52 vehicles during this financial year;

(vi) Western Cape will be procuring 4 new 4x4 vehicles in this financial year.

Information on vehicles written off and disposed of

(i) Mpumalanga has written off 3 vehicles in this financial year;

(ii) Northern Cape has written off 40 vehicles during this financial year and were replaced.

The Provinces have addressed the poor state of ambulances through the intervention of clinical governance officers within emergency medical services. The role of clinical governance officers is to ensure compliance to clinical issues in the EMS sector. In addition, these officers also check the state of the operational ambulances.

Gauteng, Free State and Western Cape provinces have appointed dedicated clinical governance officers. The remaining provinces of the Eastern Cape, KwaZulu-Natal, Limpopo, Mpumalanga, Northern Cape and North West are addressing quality control gaps in ambulances through dedicated quality assurance officers.

(b) Currently ambulances are stationed at ambulance bases within a hospital boundary and some in hospitals. The intention is for an ambulance to respond from a strategically identified satellite/high profile point that provides for an efficient response to communities. The reason for any placement of an ambulance is to improve the response time but also to fully utilise them.

Reply received: December 2013

QUESTION NO. 3074

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 37)

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

(1) What (a) amount has been allocated to the budget of the Directorate: Radiation Control in the (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years and (b) work has been done by this directorate in each specified case;

(2) (a) how many consultants were appointed to work within this directorate and (b) how much were they paid;

(3) whether the recommendations made by these consultants were implemented; if not, what is the position in this regard; if so, what are the relevant details?

NW3632E

REPLY:

(1) (a) (i) 2009-2010: was R12,843,000;

(ii) 2010-2011: was R12,500,000;

(iii) 2011-2012: was R13,223,000;

(iv) 2012-2013: was R13,761,000

(b) - Ionizing Radiation devices (e.g x-ray units, linear accelerators, etc);

- Non-ionizing Radiation devices (e.g Lasers, MRI units, etc);

- Radioactive materials that are used for medical, scientific, agricultural, industrial and commercial;

- high- and medium risk electro-medical devices.

Functions performed by Directorate include assessment of applications and issuing of a range of different licenses and authorities; on-site inspections for compliance investigation of incidents and accidents; advising License and Authority Holders regarding radiation safety aspects.

The next Table provides information on some of these activities for the requested periods.

Table 1.

2009-10

2010-11

2011-12

2012-13

Licenses and authorities issued for the use of Ionizing and non-ionizing radiation devices

7216

7066

6668

7895

New licences issued for the import/sale of various electro-medical devices models

518

552

1158

1372

Inspections carried out on X-Ray units and authority holders

3799

3018

1816

2211

Various incidents/accidents investigated

163

343

313

247

(2) There were no consultants appointed to work within the directorate.

(3) Not applicable.

Reply received: December 2013

QUESTION NO. 3064

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 37)

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

(1) How many (a) doctors, (b) psychologists and (c) dieticians were found guilty of professional misconduct for sexual-related offences in the 2011-12 financial year;

(2) how many (a) doctors, (b) psychologists and (c) dieticians have been (i) removed from the Health Professions Council of South Africa (HPCSA) register, (ii) barred from practising and (iii) suspended?

NW3618E

REPLY:

(1) Table 1. below presents the situation in this regard.

Table 1.

Professional Boards

Number of Professionals

Doctors

01

Psychologists

02

Dieticians

-

Total

03

(2) Table 2. Below reflects the situation in this regard.

Professional Board

Removed

Barred

Suspended

Doctors

-

01

07

Psychologists

01

-

01

Dieticians

-

-

-

Total

01

01

08

Reply received: December 2013

QUESTION NO. 3046

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 NOVEMBER 2013

(INTERNAL QUESTION PAPER NO. 37)

Mr F A Rodgers (DA) to ask the Minister of Health:

(1) What is the (a) average doctor-to-patient ratio and (b) number of (i) deaths and (ii) cases resulting from motor vehicle accidents treated in the past 12 months at the (aa) East Griqualand and Usher Memorial Hospital in Kokstad and (bb) Port Shepstone Hospital;

(2) whether each of these hospitals receive rural allowances; if not, why not?

NW3600E

REPLY:

(1) (a) Average doctor-patient ratio:

(aa) East Griqualand and Usher Memorial hospitals: 1:14;

(bb) Port Shepstone hospital: 1:28

(b) Number of deaths and motor vehicle accidents:

(i) - East Griqualand and Usher Memorial hospitals recorded 4 deaths for a period of 12 months;

- Port Shepstone recorded 47 deaths for a period of 12 months;

- The number of patients treated at Port Shepstone is 1 439 for 12 months.

(ii) The number of patients in relation to motor vehicle accidents was 835 for 12 months;

(2) All health professionals are receiving rural allowance.

Reply received: December 2013

QUESTION NO: 3021
Mr MG Lekota (Cope) to ask the Minister of Health:

1) Whether serious health problems such as depression, inflammation, diabetes, obesity, insulin resistance, high blood pressure, cardiovascular diseases and learning disorders, which are caused or exacerbated by excessive consumption of sugar, warrant legislation requiring (a) warnings, (b) quantities and (c) educational messages being prominently displayed on packages of all products containing sugar, if not, why not, if so, what steps does he intend to take to help stem these problems before they become bigger problems.

Answer

1) Sugar, especially when consumed in large quantities, is a major risk factor for significant morbidity and mortality globally, including in South Africa. Though the full extent of health harm is still subject to scientific study and review, the American Heart Association has estimated that around 180 000 deaths a year globally can be directly attributed to sugary soft drinks alone. Moreover soft drinks are only one of many sources of excess sugar intake so the overall health impact is much larger. The Department of Health is currently reviewing the evidence to determine whether legislation is required on packages of all products containing sugar or not.

a) Warnings. While this warrants serious consideration there are a number of complex issues involved. For example it would have to be determined what levels of sugar in a product should contain in order to carry a warning label, and this is controversial. It would not be rational to put warnings on all products containing sugar as some products contain small and relatively harmless amounts.

Moreover as so many products contain sugar, putting a warning on every product containing sugar may become ineffectual as it will be too common to have impact. A cut-off point would therefore be necessary but also complex should warnings be introduced.

b) Quantities. In a draft working document under discussion called Phase 2 labelling Regulations it is proposed that:

▪ Front-of-pack labelling (FOP): total sugars (mono-and-disaccharides) must be declared;
▪ Total sugars must declared in nutritional information labelling at all times for almost all foods;
▪ Added fructose will not be permitted when making a health or nutrition claim or when carrying an endorsement which is related to the reduction of risk for developing a non-communicable disease or foods to be commercially marketed to children;
▪ High sugar content will result in a product failing the nutrient profiling model resulting in that product not being permitted to make any health or nutrition claims as well such foods shall not be permitted to be commercially marketed to children.

c) Educational messages. Education messages are a variant on warning labels though they may differ in tone and content. However these carry the same potential challenges as warning labels.

Warnings/quantities/education on packages is important though they rely on the individual taking note and acting on the basis of the information. Such intervention is only likely to be effective if accompanied by other public health interventions that are currently being discussed such as restricting the advertising of foods that contain high amounts of sugar - especially to children; taxing goods with high amounts of sugar; restricting the container size per serving; restricting sales of sugary products in school tuck-shops and educating children in schools of the dangers of excess sugar intake. While no decisions have been taken on any of these interventions these are possible steps that may be taken to help stem health problems arising from high sugar intake before they become bigger problems.

Reply received: December 2013

QUESTION NO. NW3567E
3017. Mrs H S Msweli (IFP) to ask the Minister of Health:


a) How many of his department's suppliers are importing goods from outside the country instead of sourcing them locally and (b) what is his department doing to ensure that its suppliers adhere to the Government's supply chain policies by sourcing material locally;

Where these suppliers will be stopped from providing services to his department until they can show that they source material locally; if not, why not; if so, how will his department ensure that services are not interrupted during such a time?
NW3567
REPLY:

(a) The majority of medically related items are imported into South Africa since there is no local source for such products. Local industry is involved in packaging and related end stage production activities. In the minority of cases pharmaceutical products are formulated locally however South Africa does not produce active pharmaceutical ingredients.

(b) The Department of Trade and Industry has introduced policy to support local manufacturer through designation. This requires departments to designate tenders (or a portion thereof) exclusively for local suppliers where they exist.

To this extent the National Department of Health has been giving preference to local producers.

Reply received: December 2013

Parliamentary Question no. 3016
Friday, 01 November 2013

3016. Mrs H S Msweli (IFP) to ask the Minister of Health:

(1) Why were normal tender procedures .not followed in granting a certain company (name furnished) the tender to supply hospital linen and patient gowns to the Zola-Jabulani District Hospital in Soweto, Gauteng:

(2) Why did his department pay the specified company almost four times the initial quoted tender amount for the supply of such linen and gowns?
NW3566E

RESPONSE:

(1)The company granted the tender is Gauteng Linen Bank and the concept was approved by the Provinces (Premier's) Budget Council. It is allocated for use by various hospitals and not only limited to the one mentioned. The Accounting Officer thus invoked Section 16A 6.4 of Treasury Regulations to ensure that linens were urgently procured and delivered to public hospitals. This represents less than 10 percent of the linen requirement for this financial year. Linen shortages are being addressed by this order and delivery is currently underway.

A decision to urgently purchase linens and to assure human dignity of patients was taken in order to address the critical shortages of linens at public hospitals in Gauteng. In view of the magnitude of the problem and to ensure that the problem does not arise again; it was further decided to establish a 'linen bank' which will cater for the linen needs of all public hospitals in the Province.

The Department has issued a public tender of R183 million for procurement of the rest of its current linen requirement.

(2) The Department did not pay four times the initially quoted amount, the suppliers were paid in accordance with the ordered quantities.

The Supplier provided a quotation based on quantity of 1 per item and that amounted to R3, 649.14 and therefore the Department requested the supplier to provide a quote for 5000 items that resulted in a total cost of R18,245,700.00. See copies of the RFQ documents attached.

Reply received: December 2013

QUESTION NO. 2957

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

Ms C K K Mosimane (Cope) to ask the Minister of Health:

What is the number of persons who were diagnosed with e-coli bacteria in Carolina Hospital as the result of eating contaminated food from a dumpsite?

NW3508E

REPLY:

According to the Mpumalanga Provincial Department, Carolina Hospital has seen a few diarrheal cases in the past year. Due to the fact that these cases were sporadic they were never referred to the laboratory for testing and as such they could not be confirmed as caused by e-coli. However these cases were managed in line with clinical protocols for management of diarrhea.

Reply received: December 2013

QUESTION NO. 2941

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

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

(1) How much has (a) his department and (b) each of the entities reporting to him spent on advertisements placed on the Africa News Network 7 (ANN7) news channel;

(2) were these advertisements placed through the Government Information and Communications System?

NW3492E

REPLY:

(1) As already indicated in our responses to Questions 2564 by Honourable Van Der Merwe and 2819 by Honourable Lorimer, the Department of Health has not spent any money on the Africa News Network 7 (ANN7) news channel. We are also informed by our public entities (Council for Medical Schemes; South African Medical Research Council and National Health Laboratory Services) that they have not spent any monies to this effect.

(2) Not applicable.

Reply received: December 2013

QUESTION NO. 2908

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

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

(1) What amount has (a) his department and (b) each of the entities reporting to him spent on advertising (i) in The New Age newspaper and (ii) on its website between 1 December 2012 and 31 August 2013;

(2) were these advertisements placed through the Government Information and Communication System?

NW3459E

REPLY:

(1) As already indicated in our response to Question 2564 by Honourable Van Der Merwe, neither the Department of Health nor the public entities (Council for Medical Schemes; South African Medical Research Council and National Health Laboratory Services) spent any money to this effect.

(2) Not applicable.

Reply received: December 2013

QUESTION NO. 2872

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

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

(a) When was the last maternal mortality ratio study completed by his department and (b) what is the latest maternal mortality ratio for every 100 000 live births in each province?

NW3422E

REPLY:

(a) The National Department of Health does not conduct stand alone maternal mortality ratio studies. These rates are typically conducted as part of larger studies such as the Demographic and Health Survey (DHS). The National Department of Health will conduct the next DHS in 2014 – previous surveys were conducted in 1998 and 2003.

In 1997, every maternal death was declared a notifiable event, which initiated a confidential enquiry into the maternal death, managed by a ministerial committee known as the National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD). The confidential enquiry into maternal deaths process captures deaths that occur in health facilities. This translates to a national and provincial institutional maternal mortality ratios.

(b) The maternal mortality ratio (MMR) published in the 2013 South African country report on the Millennium Development Goals (MDGs) suggests that the MMR was 269/100 000 live births.

The Table 1. below is from the data collected by the NCCEMD for the 2008-2012 period and shows that institutional mortality ratios (deaths that occur in health facilities) has decreased.

Table 1.

Province

2008

2009

2010

2011

2012

Eastern Cape

180.4

215.2

197.0

158.26

146.44

Free State

267.0

350.9

263.5

240.08

124.54

Gauteng

136.0

160.2

159.2

121.45

142.52

KwaZulu Natal

183.8

194.2

208.7

186.74

160.33

Limpopo

176.6

160.4

166.7

195.51

185.80

Mpumalanga

North West

Northern Cape

Western Cape

South Africa

Reply received: November 2013

QUESTION NO. 2819

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 33)

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

(1) What amount has (a) his department and (b) each of the entities reporting to him spent on advertisements placed on the SABC 24 hour news channel;

(2) were these advertisements placed through the Government Communication and Information System?

NW3324E

REPLY:

(1) The National Department of Health and the entities to the Ministry of Health did not place any advertisements on the SABC 24-hour news channel either directly or through the GCIS.

(2) See response above.

Reply received: December 2013

QUESTION NO. 2785

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

Ms H S Msweli (IFP) to ask the Minister for Health: [Interdepartmental transfer on 25 October 2013]

Whether his department has any plan in place to deal with the current challenges facing National Health Insurance pilot projects?

NW2389E

REPLY:

Honourable Member, I find it very difficult to deal with your question. Challenges can be so many. May I humbly ask you to be specific about the challenges you are referring to, including what actual challenges do you wish to know about.

Please help me so that I may be able to give you a specific answer.

QUESTION NO. 2785

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 35)

Ms H S Msweli (IFP) to ask the Minister for Health: [Interdepartmental transfer on 25 October 2013]

Whether his department has any plan in place to deal with the current challenges facing National Health Insurance pilot projects?

NW2389E

REPLY:

Honourable Member, I find it very difficult to deal with your question. Challenges can be so many. May I humbly ask you to be specific about the challenges you are referring to, including what actual challenges do you wish to know about.

Please help me so that I may be able to give you a specific answer.

Reply received: November 2013

QUESTION NO. 2777

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 33)

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

(1) Whether his department keeps records of the prevalence of malnutrition (a) nationally, (b) provincially and (c) locally; if not, why not; if so,

(2) whether he will provide Mrs A Steyn with the statistics for the (a) 2010-11, (b) 2011-12 and (c) 2012-13 financial years; if not, why not; if so, when?

NW3279E

REPLY:

(1) Prevalence of malnutrition is monitored through surveys. The National Food Consumption Surveys of 1999 and 2005, and the recently released South African National Health and Nutrition Examination Survey of 2012 reported on the prevalence of malnutrition. The Department of Health routinely monitors incidences of under-5 severe (acute) malnutrition, and underweight for age in children 5 years of age and the data is disaggregated to provide in National, Province, District and sub-district information.

(2) Reports are available in the Department of Health for the 1999, 2005 and the 2012 surveys. Attached we provide the District Health Information System (DHIS) data for the (a) 2010-11, (b) 2011-12 and (c) 2012-13 financial years.

Reply received: November 2013

Reply received: November 2013

QUESTION NO. 2669

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 32)

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

(1) (a) How many disciplinary cases are outstanding in his department and (b) what is the nature of each case;

(2) (a) how long have these cases been on-going and (b) when will most of them be concluded;

(3) have the persons who are being charged been suspended; if not, why not; if so, for how long will they be suspended;

(4) whether the specified persons are still receiving their salaries; if so, what has been the total cost of their salaries to the State?

NW3158E

REPLY:

(1) (a) Two (2)

(b) Prolonged absenteeism

(2) (a) Ten (10) months.

(b) The officials' whereabouts is unknown and efforts to locate them have not been successful

(3) Yes, they have been suspended for six months.

(4) Yes, the amounts earned by employees since suspension amount to R94,933.44.

Reply received: November 2013

QUESTION NO. 2630

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 32)

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

(1) Whether any performance bonuses were paid to employees in his department in the 2012-13 financial year; if so, what is the total (a) number of employees that received bonuses and (b) amount paid out by his department for these bonuses;

(2) what percentage of outputs were achieved by his department as measured against each target set in its Annual Performance Plan in the 2012-13 financial year?

NW3118E

REPLY:

(1) No performance bonuses have been paid to employees in the National Department of Health (NDoH) for the 2012/13 financial year.

(a) Department is in the process of concluding performance moderation of employees for the afore-mentioned financial year. In the interim, Moderating Committees appointed to moderate performance of employees at salary levels 1-12 have recommended that four hundred and seventy one (471) employees at salary level 1-12 be considered for performance bonuses. The moderation of SMS members will take place in the last week of October 2013.

(b) None.

(2) The outputs in the Annual Performance Plan (APP) 2012-13 can be broadly categorised into two groups, namely, qualitative and quantitative. Qualitative outputs are non-numerical in the manner they are written (for example, NHI Bill) and others may be numerical (for example, number of sets of regulations passed). Quantitative ones are outputs and outcomes having targets expressed in terms of percentages, rates, ratios, incidences and prevalence. 46% of the outputs in APP 2012-13 were fully achieved and 54% were partly achieved. Most of the partly achieved, the targets have been reached.

Reply received: November 2013

QUESTION NO. 2564

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 32)

Mr A P van der Westhuizen (DA) to ask the Minister of Health:

What total amount has (a) his department and (b) each of the entities reporting to him spent on promotional events organised by The New Age newspaper during the period 1 September 2012 to 30 August 2013?

NW3051E

REPLY:

(a) The National Department of Health did not spend money on promotional events organised by The New Age newspaper during the period in question.

(b) According to the Public Entities reporting to the National Department of Health (i.e Council for Medical Schemes; South African Medical Research Council – MRC; and the National Health Laboratory Services – NHLS), none of them spent money on promotional events organised by The New Age newspaper during the period in question.

Reply received: November 2013

QUESTION NO. 2510

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 11 OCTOBER 2013

(INTERNAL QUESTION PAPER NO. 32)

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

What are the latest statistics on abortion in each province?

NW2997E

REPLY:

The following table reflects the situation in this regard, according to information received from the Provinces:

Table 1.

Province

April

May

June

July

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

April

Eastern Cape

907

1 193

1 021

1 173

1 303

1 322

1 346

1 300

954

1 232

1 439

1 167

14 357

Free State

409

475

476

531

562

446

422

539

300

480

510

438

5 588

Gauteng

1 445

2 158

1 564

1 717

1 814

1 646

2 319

1 947

1 618

1 846

2 063

1 657

21 794

KwaZulu Natal

582

783

673

778

803

637

851

753

592

740

837

646

8 675

Limpopo

654

753

672

748

814

615

728

646

512

753

787

544

8 226

Mpumalanga

209

304

179

314

321

224

227

233

223

352

256

316

3 158

North West

469

653

521

599

705

597

641

600

416

606

610

395

6 812

Northern Cape

66

79

73

29

38

45

83

124

67

87

120

54

865

Western Cape

887

1 244

1 067

1 170

1 262

1 009

1 328

1 172

851

1 234

1 241

980

13 445

Total

5 628

7 642

6 246

7 622

7 622

6 541

7 945

7 314

5 533

7 330

7 863

6 197

82 920

Reply received: November 2013

QUESTION NO. 2477

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 31)

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

What strategies are being considered to ensure that patient files are not misplaced or lost in hospitals?

NW2966E

REPLY:

The National Department of Health commenced with the National Support Programme, in May 2012 with 362 post-graduate interns and the programme earmarked three (3) central hospitals in Gauteng Province, namely Charlotte Maxeke Academic Hospital, George Mukhari and Steve Biko Academic hospitals.

The objective of the programme was to focus on areas that displayed great bottleneck that infringed on patient access, such as patient file management (files are either misplaced, or taken home). In May 2013, the Provincial Technical Support officers (PTSOs) were appointed on a two-year contract and the intern programme was rolled out. The PTSOs are working with existing hospital staff to clear the back-log in patient files. The financial gain was that the hospital ceased paying of over-time. The PTSOs also support work in the following areas:

(a) Clearing out duplicate files at Pharmaceutical departments and merged it electronically with the original patient file. The time to request for patient files was reduced;

(b) Guard patient with leaving with their and instituted a system that deterred patients from taking home their files;

(c) Assist with the disposal/discard of expired files. They had to prioritize patient files according to active or files due for disposal, as hospitals are experiencing shortage in office space to safeguard patient files.

The National Department of Health during 2012 introduced an Internship Programme for unemployed graduate, supported by the European Union's PrimCare SPSP, to support the implementation of key strategies to improve the health system. A total of 371 interns were recruited and placed across the country in the following provincial departments for a twelve (12) calendar month period, namely Eastern Cape, Free State, Gauteng, KwaZulu Natal, Limpopo, North West and Northern Cape and the National Department of Health respectively, in three central hospitals of Gauteng and Compensation Commission for Occupational Diseases. One of internship programme interventions was to develop a model for patient records and revenue management model.

During 2012/13 the internship programme was instrumental in the implementation of a project for the improvement of patient records and revenue management which was implemented in Charlotte Maxeke Hospital, George Mukhari and Steve Biko Hospitals. This project model for record management and revenue collection and the rollout of the model are being scaled to include central and regional hospitals in seven (7) provinces. In order to ensure sustainability and maximum benefits from the gains made, the internship programme was extended. As from May 2013 the interns were appointed as the Provincial Technical Support Officers (PTSOs) on a two-year contract.

Reply received: November 2013

QUESTION NO. 2476

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 31)

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

Whether he has been informed about (a) the shortages of (i) drugs and (ii) oxygen and (b) the lack of (i) electricity and (ii) ambulances for the 1 800 persons that are treated at the Philani Clinic in the Eastern Cape daily; if not, what is the position in this regard; if so, what action has been taken by his department in this regard?

NW2965E

REPLY:

In terms of the shortage of:

(a) (i) Drugs – we were aware of a transient shortage of oral hydration solution. This product is now back in stock at the clinic.

(ii) Oxygen – there had been delays in delivery of oxygen due to a supplier dispute. This has been resolved and regular supplies have resumed.

(b) No problems have been reported regarding availability of electricity or ambulances.

Reply received: December 2013

QUESTION NO. 2405

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 31)

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

(1) What number of (a) general practitioners and (b) nurses in his department are currently (i) on suspension and/or (ii) awaiting appeals for cases related to theft in each province;

(2) what number of (a) nurses and (b) doctors employed in his department applied to do work in the private sector;

(3) whether his department has done a study to determine if all of its employees followed the correct procedures when doing extra work outside of the health department; if not, why not; if so, what are the relevant details?

NW2889E

REPLY:

The following information is as obtained from the Provincial Departments of Health:

(1) The information we received from the Free State, KwaZulu Natal, Limpopo, North West and Western Cape Provinces indicate that there are no general practitioners nor nurses currently on suspension and/or awaiting appeals for cases related to theft. No information was received from the Eastern Cape, Gauteng and Northern Cape as yet, at the time of the submission of this response.

(2) The Table 2. below reflects the details in this regard as obtained from Provinces:

PROVINCE

NURSES

DOCTORS

Free State

25

115

KwaZulu Natal

None

None

Limpopo

15

27

Mpumalanga

None

None

North West

16

04

Western Cape

1 251

340

No responses were received from the Eastern Cape, Gauteng and Northern Cape Provinces at the time of submitting this response.

(3) Remunerative Work Outside of the Public Service (RWOPS) is a national policy, that every employee must apply annually for and that it is considered against service and where applicable teaching and training needs.

Reply received: October 2013

QUESTION NO. 2402

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 20 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 31)

Mr G R Krumbock (DA) to ask the Minister of Health:

With reference to the reply to question 2066 on 3 September 2013, how long did it take on average in (a) 2012, (b) 2011, (c) 2010, (d) 2005 and (e) 2000 to analyse a blood sample at the forensic laboratory in Pretoria from the time it was dispatched from a SA Police Service station to the time the results were received?

NW2886E

REPLY:

The average turn-around time was calculated by using the difference between the date the sample was received at the Forensic Chemistry Laboratory (FCL) in Pretoria and the date that the result was authorised for the various samples received in the specific year. Two weeks were added to allow for the printing, signing and collecting of reports.

The average turnaround time for ante-mortem blood samples analysed for alcohol was as follows:

(a) In 2012: 26 weeks. The FCL received 23,862 ante-mortem blood samples during 2012.

(b) In 2011: 30 weeks. The FCL received 17,686 ante-mortem blood samples during 2011.

(c) In 2010: 24 weeks. The FCL received 11,553 ante-mortem blood samples during 2010.

(d) In 2005: 14 weeks. The FCL received 7,829 ante-mortem blood samples during 2005.

(e) In 2000: 20 weeks. The FCL received 6,299 ante-mortem blood samples during 2000.

Reply received: December 2013

QUESTION NO. 2355

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 13 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 30)

Ms C K K Mosimane (Cope) to ask the Minister of Health:

With reference to his reply on 10 December 2012 to question 1261 transferred for oral reply, what progress has been made with the installation of an IT software system in provinces to enable his department to monitor the supply chain of medicines in all provinces?

NW2847E

REPLY:

Various IT systems have been implemented in each of the provinces. Linkages currently exist for IT systems at Depot level and the National Department of Health. There are also IT system linkages between facilities and the Depot.

The National Department of Health monitors stock levels in Depots and intervenes where the risk of a stock out is detected. Provincial Pharmaceutical Services monitors stock levels at each of the provincial facilities through district pharmacists and facility managers.

All ten Provincial Depots have computerised systems. Approaches have been developed to filter this data into a national data warehouse. This data is then analysed on a fortnightly basis and corrective measures are implemented where appropriate. There is however no direct link between the National Department of Health and the Provincial Depots which is being addressed by SITA.

For the planned National Health Insurance roll out, all prototype primary health Care sites have been computerised and linked to the National Department of Health in order to improve efficiencies in the supply chain and facilitate monitoring of stock levels.

Twenty Gauteng Provincial Hospitals have been computerised and linked to the Provincial and National Department of Health and direct deliveries are being implemented.

An open source pharmacy system, Rx Solution, has been made available to facilities and has been successfully installed at 290 sites. Of these sites, 142 are primary health care facilities and 146 hospitals. Currently six Provinces have participated which include the Eastern Cape, Free State, Gauteng, Kwazulu Natal, Mpumalanga and North West. A June 2013 analysis of 23 of the Eastern Cape primary health care facilities showed that implementation of this system had achieved a 96% stock availability.

The Western Cape has rolled out the JAC system to 35 facilities, predominantly hospitals. This system allows for participating facilities to share information and the Provincial Department of Health has access to health information for monitoring and planning purposes.

Reply received: October 2013

QUESTION NO. 2354

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 13 SEPTEMBER 2013

(INTERNAL QUESTION PAPER NO. 30)

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

(1) Whether he has been informed that the clinics in the areas around Mabopane and Winterveld are out of stock of Lamivudine; if not, what is the position in this regard; if so,

(2) (a) what measures has he put in place to ensure that enough stock of these essential drugs is available countrywide and (b) how many times have the clinics experienced a shortage of the specified drugs;

(3) whether he will make a statement on the matter?

NW2846E

REPLY:

(1) The National Department of Health (NDoH) had been alerted to low stocks in the Mabopane and Winterveld areas on 22 July 2013. An investigation revealed that the Provincial Depot had stock available however the Mabopane sub depot ran out of stock. The National Department of Health facilitated delivery of stock to the Mabopane District sub depot. Additional stock was also sent to Winterveldt.

(2) (a) The NDoH conducts regular stock monitoring and meet monthly with suppliers in order to address challenges. The medicines stock out reporting toll free number, 0800012322 has been given to all Mabopane clinics and they have been instructed to display the number in their waiting room so that patients can report any future stock outs.

(b) The pharmacist at Winterveldt reported on the 19 September 2013 that they had sufficient stock of lamivudine and since July there had been no stock outs. It should be noted that there are two strengths of lamivudine, 150mg and 300mg and both are available in monthly treatment packs. In the last quarter, supply of the 300mg lamivudine has been under pressure and it seems that Winterveldt took a precautionary measure and rationed supply by only issuing patients with one month treatment as opposed to the three months treatment they were accustomed to. Based on reports it seems that patients were not turned away without treatment however, it is conceivable that patients may have been reporting receiving 150mg tablet instead of 300mg or alternatively not receiving their 3 monthly supplies.

(3) There is no need to make a statement in this regard since the problem was limited to the Mabopane sub depot and was resolved speedily through movement of stock from the provincial depot.

Reply received: September 2013

QUESTION NO. 2340

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 30)

Mr F A Rodgers (DA) to ask the Minister of Health: [ê271] [Question submitted for oral reply now placed for written reply because in excess of quota [Rule 108(8)]]

What principles are applied by his department in determining rural allowances for health professionals?

NW2806E

REPLY:

The South African Government introduced the rural allowance in order to encourage health workers to accept posts in under-served areas. The rural allowance benefits designated categories of employees in the Public Health Sector appointed on a full-time basis.

Rural allowance is applicable to public sector health professionals working in hospitals or health facilities in –

· the 13 Integrated Sustainable Rural Development Strategy (ISRDS) Nodes and

· rural areas

· Inhospitable health institutions with definite recruitment and retention needs as determined by Provincial Heads of Health Departments, dependent on the availability of funds.

Reply received: November 2013

QUESTION NO. 2337

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 30)

Mr M G P Lekota (Cope) to ask the Minister of Health:

Whether the Government has undertaken or sponsored third party research to determine if bottled water (a) hold the health benefits that bottlers advertise or visually suggest, (b) was in any way significantly different from tap water provided by municipalities, (c) is worth the price being asked and (d) is environmentally friendly in respect of production and distribution; if not, what is the Government's position in this regard; if so, what are the relevant details?

NW2800E

REPLY:

The Department has not conducted ay research with regard to bottled water to determine:

(a) The health benefits that the advertisers suggest;

(b) and (d) If the water is significantly different from the water supplied by the municipalities as well as to determine if the water is environmentally friendly in respect of production and distribution; and

(c) With regard to the price, the Department of Health is not responsible for determining the prices of goods and services.

However, claims relating to any medicinal effect, either preventative or curative, are prohibited in terms of regulations (R718) of Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No. 54 of 1972). Statements or pictorial devices about the nature, origin, composition or properties of bottled water that may create confusion are also forbidden. Health claims are also not permitted.

Reply received: November 2013

QUESTION NO. 2265

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 28)

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

(1) (a) How many bidders were awarded contracts and/or tenders without submitting declarations of whether they were (i) employed by the State or (ii) connected to any person employed by the State and (b) how much did these contracts cost;

(2) whether any action has been taken against these bidders; if not, why not; if so, what (a) actions and (b) are the further relevant details?

NW2697E

REPLY:

(1) (a) No bidders and/or tenders were awarded to suppliers that did not submit their declarations, however it was established that –

(i) Thirteen (13) suppliers belong to individuals within the employ of the State, seven (7) from the National Department of Health and six from other departments;

(ii) Yes, the 13 suppliers are connected to persons employed by the State.

(b) The value of the contracts amount to R1,689,302.55 of which R1,443,467.04 paid to suppliers connected to 7 officials within the National Department of Health and R245,835.51 to officials from other departments.

(2) (a) and (b) Appropriate disciplinary action has been taken against the 7 employees of the National Department of Health.

Reply received: December 2013

QUESTION NO. 2251

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 28)

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

What plan is in place to ensure that (a) hospitals receive urgent infrastructure upgrades in order to reduce overcrowding and cross-infections, (b) staff members are recruited to vacant posts to prevent the current staff from becoming overburdened and (c) provincial and local officials are held accountable for (i) the poor state of hospitals and (ii) not dealing with complaints from the public?

NW2670E

REPLY:

(a) The National Department of Health has put aside a total R19 billion over three years from the conditional grant to address the issue of health facilities infrastructure, Health Technology and strengthening the Organisational Systems. The funding is split into two, namely a national allocation and a provincial allocation. Both national and provincial departments have a three year plan on how these facilities would be revitalised.

(b) There are numerous adverts weekly in all major newspapers and government gazettes for vacant posts in all the provinces. There is normally a concerted effort to recruit health professionals. We are training and filling other vacant posts with Cuban and Tunisian professionals to address the shortages where necessary.

(c) (i) Officials in various provinces and local health facilities are being sanctioned appropriately on poor performance and/or inaction within the confines of the Public Finance Management Act (PFMA), and Labour Relations prescript;

(ii) National keeps a database of all complaints received from the facilities. We record the time and date of complaints and attempt to get those complaints to be resolved on the spot where it is possible or within 25 working days as prescribed.

Reply received: December 2013

QUESTION NO. 2249

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 23 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 28)

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

(a) How many provincial departments still owe money to service providers and (b) what (i) are the amounts owed and (ii) is his department doing to ensure that provinces service these debts?

NW2668E

REPLY:

(a) All provincial departments owe money to service providers.

(b) (i) The amounts owed beyond 90 days as end July 2013 are detailed in the table below as received from suppliers. Because the focus has been on reconciling aged debt there is no comprehensive data available on current total debt outstanding at present.

PROVINCE

AMOUNT OUTSTANDING

Eastern Cape

R45,327,235

Free State

R102,942,775

Gauteng

R456,440,498

KwaZulu Natal

R1,821,623,071

Limpopo

R49,636,656

Mpumalanga

R37,165,283

North West

R85,522,527

Northern Cape

R11,655,831

Western Cape

92,995,093

(ii) The suppliers that have debt owing over 30 days alert the National Department of Health to this and the National Department of Health writes to Heads of Departments and request them to settle the account with the supplier.

Reply received: September 2013

QUESTION NO. 2170

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

Ms C K K Mosimane (Cope) to ask the Minister of Health:

With reference to his reply to question 1061 on 12 June 2013, (a) how many obstetric ambulances with trained emergency medical staff have been allocated to each district and (b) how much has been spent on this venture?

NW2593E

REPLY:

(a) There is a total of 187 operational obstetric ambulances in the country. Each obstetric ambulance is allocated two (2) Emergency Care Practitioners. The trained Emergency Care Practitioners have not received any specific obstetric training and currently operate as basic emergency care practitioners.

Annexure A details the number of obstetric ambulances operational per District with the allocated number of staff.

(b) Approximately R261,800,000, excluding running costs, has been spent on this project thus far.

Reply received: November 2013

QUESTION NO. 2169

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

(1) Whether he has been informed that 10 brand new ambulances, donated to the Kuruman Hospital by the John Taolo Gaetsewe Developmental Trust last December, are still standing unused at the back of the hospital; if so,

(2) whether his department provides an alternate mode of transport for pregnant women who are in need of obstetric services; if not, why not; if so, what are the relevant details?

NW2592E

REPLY:

(1) Yes, I have been informed that the ambulances were donated to the Northern Cape Department of Health Emergency Medical Services (EMS) John Taolo Gaetsewe Development Trust in December 2012. Given the fact that they were donated the Trust itself handled the procurement process and the sourcing of the required medical equipment to be used. Some of the challenges experienced is that –

(a) the Trust did not provide the necessary documentation required to register the vehicle as ambulances and this delayed the registration;

(b) the Department had to start the process of registration and five (5) of the ambulances have been registered and operational. The other five were incorrectly registered and this error is being rectified. Once the registration of these five is completed, all the ten (10) will be operational.

(2) Maternity and obstetric cases are classified as priority one (1) in terms of emergency medical services classification and therefore considered as such in terms of call dispatch. These calls are afforded the first available ambulance to ensure prevention of maternal and neonatal deaths.

Reply received: December 2013

QUESTION NO. 2155

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

(1) How do the nursing staff shortages differ in the respective approved organograms;

(2) whether his department has budgeted for these posts; if not, why not; if so, what are the relevant details;

(3) what steps are being taken by his department to ensure that hospitals are adequately staffed?

NW2577E

REPLY:

According to the Provincial Departments of Health, the following information reflects the situation in this regard:

(1) The details are as follows:

Eastern Cape: Whilst the Department is experiencing Nursing staff shortages, the Department has enough posts created on the approved organograms, created in terms of need and size.

The vacancy rate for the nursing category is reflected hereunder as at the end of March 2013 in terms of nursing subcategories:

Category

Filled

Vacant

Vacancy rate

Planned recruit

Professional Nurse

9 465

2 585

21%

391

Staff Nurse

3 237

278

8%

94

Nursing Assistant

5 821

695

11%

147

TOTAL

18 523

3 558

632

(2) and (3) The Department has budgeted for filling of nurses vacancy and a recruitment plan has been developed and approved where 632 Nursing critical posts were identified in all health facilities. Replacement posts are filled as soon as they become vacant.

KwaZulu Natal:

(a) Currently the status of filled and vacant nursing posts as reflected on Persal is as indicated below. The approved establishment/organograms of institutions reflect post which have been created based on the work-study assessment needs and are filled as and when funds are available. Vacant Nursing posts reflected below are funded and are being used for the placement of nurses with contractual obligation after completion of nurse training by the Department and these posts are activated in line with the approved establishment/organograms. Additionally, the Department of Public Service and Administration (DPSA) has issued a directive that all non-funded posts must be abolished off the Persal System.

The following table reflects the situation in this regard:

Category

Filled

Vacant

Total Posts

Vacancy rate

Professional Nurse

13 749

1 147

14 896

8%

Staff Nurse

10 248

515

10 763

5%

Nursing Assistant

6 413

388

6 801

6%

TOTAL

30 410

2 050

32 460

6%

(b) Vacant posts mentioned above are funded vacant posts on Persal.

(c) The Department is functioning on a decentralised basis in which, amongst other HR activities, the recruitment and placement is don, approved and finalised at the facility level to avoid delays in the filling of posts.

The Department has a training programme for Professional Nurses, Staff Nurses and Nursing Assistants, in which after completion of training they are offered employment by the Department as a recruitment strategy. Additionally the Department offers bursaries to students in the Health Sciences and on completion of their studies they are also placed in posts in the Department in order to fulfil their bursary obligations.

Africa Health Placement in collaboration with the National Department of Health is assisting Provincial Departments of Health with the recruitment and placement of health professionals particularly in rural health facilities.

Limpopo:

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

Category

Approved posts

Filled posts

Vacant

Professional Nurse

14 478

8 153

6 325

Staff Nurse

5 732

4 252

1 480

Nursing Assistant

7 076

5 620

1 456

TOTAL

27 286

9 261

(2) No budget allocated, the Department has requested Provincial Treasury to fund critical posts.

(3) Currently vacant posts are not funded, but the request has been made to Treasury.

North West:

(1) The table below reflects the situation in this regard

Category

Approved posts

Funded posts

Unfunded posts

Professional Nurse

6 072

4 332

1 740

Staff Nurse

1 931

978

953

Nursing Assistant

4 112

2 965

1 147

TOTAL

12 115

8 275

3 840

(2) The number of unfunded posts will be reduced as the structure is being revised to be in line with the MTEF allocations.

(3) Posts for health professionals are prioritised for filling when funds are available and replacement of health professionals receive preference. The training of health professionals is actively supported through registrar training programmes, inter-country agreements such as the training of students in Cuba, scholarship programmes, increasing capacity of nursing training colleges as well as mid-level health professionals such as Clinical Associates, Emergency Care Technicians and Pharmacy Assistants.

I will furnish you with information from Free State, Gauteng, Mpumalanga, Northern Cape and Western Cape as soon as these become available.

Reply received: November 2013

QUESTION NO. 2121

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

(1) Whether any staff member in his department (a) performed work in addition to the responsibilities related to his or her work, outside normal working hours, in the (i) 2008-09, (ii) 2009-10, (iii) 2010-11, (iv) 2011-12 and (v) 2012-13 financial years and (b) has been performing such work during the period 1 April 2013 up to the latest specified date for which information is available; if not, how is it determined whether such work is being performed or not; if so, in each case, (aa) how many staff members and (bb) in what job or work categories are the specified staff members employed;

(2) whether approval for such work was obtained in each case; if not, what are the relevant details; if so, (a) what is the policy of his department in this regard, (b) by whom are such applications considered and approved, (c) how many contraventions of this policy were brought to the attention of his department in the (i) 2010-11, (ii) 2011-12 and (iii) 2012-13 financial years and (d) what steps have been taken against transgressors?

NW2543E

REPLY:

(1) (a) (i) No;

(ii) No;

(iii) No;

(iv) Yes;

(v) Yes.

(2) For the three (3) employees of 2011/12, yes approval was obtained. For the 2012/13 financial cycle, the seven (7) employees had not approval.

(a) Chapter 2 C.5.5 of the Public Service Regulations, 2001 as amended is used;

(b) Up until the end of 2012/13 the function was delegated to Chief Directors;

(c) (i) None;

(ii) None;

(iii) Seven (7) employees

(d) Appropriate disciplinary steps have been taken.

Reply received: September 2013

QUESTION NO. 2088

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

(a) Does his department prepare quarterly interim financial statements and (b) are these statements considered by the Audit Committee?

NW2510E

REPLY:

(a) Yes, the Department prepares quarterly interim financial statements.

(b) No, these statements are not considered by the Audit Committee. The completed interim financial statements are submitted to Internal Audit for review, the Audit Committee reviews the interim financial reports (i.e In-Year Monitoring and Conditional Grants)

Reply received: September 2013

QUESTION NO. 2055

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

Mr T W Coetzee (DA) to ask the Minister of Health:

(1) Whether, with reference to his reply to question 1599 on 17 July 2013, judgment has been received; if so, under what case number; if not,

(2) whether the Health Professions Council of South Africa (HPCSA) has (a) instructed its attorneys to make a formal representation to the Judge President of the South Gauteng High Court to assist in obtaining the judgement and (b) reported a certain advocate (name furnished) to the Judge President?

NW2477E

REPLY:

According to the Health Professions Council of South Africa (HPCSA), -

(1) Judgement in the above matter has not been received as yet and the reasons for the delay are as follows:

(a) As indicated previously Advocate Wise, who was the Acting Judge in the above matter on 12 June 2012, indicated to Ledwaba Mazwai Attorneys that he needed a period of four weeks to get the judgement ready (i.e end of July 2013);

(b) The Office of Ledwaba Mazwai Attorneys phoned Advocate Rob Wise who has since indicated that to date he has not delivered the judgement as he was occupied (See attached letter from Ledwaba Mazwai Attorneys marked Annexure "A.1").

(2) The HPCSA has –

(a) informed the attorneys that they are dissatisfied about the prevailing circumstances and that it should be reported to the Judge President of the South Gauteng High Court with immediate effect;

(b) the Office of Ledwaba Mazwai Attorneys made a formal representation to the Judge President of the South Gauteng High Court, Honourable Dustan Mlambo (see attached letter dated 05 July 2013 from Ledwaba Mazwai Attorneys marked Annexure "A.1"). The Office of the Judge President has since indicated that because the judgement has been overdue for more than twelve (12) months, the matter had been reported to the Chief Justice for further handling.

Reply received: November 2013

QUESTION NO. 2054

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

How many public health facilities in each province (a) currently provide antiretroviral treatment, (b) have rolled out Fixed Dose Combination (FDC) pill treatment to eligible groups and (c) have clinical health professionals trained on the FDC pill treatment to roll out the treatment?

NW2476E

REPLY:

The following tables reflect the information as provided by the Provinces:

(a) Number of health facilities providing ART.

Province

Number of facilities

Eastern Cape

820

Free State

253

Gauteng

364

KwaZulu-Natal

608

Limpopo

486

Mpumalanga

306

Northern Cape

179

North West

323

Western Cape

213

TOTAL

3,552

(b) Number of health facilities that have rolled out Fixed Dose Combination

Province

Number of facilities

Eastern Cape

820

Free State

253

Gauteng

364

KwaZulu-Natal

608

Limpopo

486

Mpumalanga

306

Northern Cape

179

North West

323

Western Cape

213

TOTAL

3,552

(c) The National Department of Health conducted a workshop to train nurses, doctors and pharmacists to roll-out FDCs. The table in Annexure A shows how many health professionals by category were trained by districts in each province.

Reply received: November 2013

QUESTION NO. 2053

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

How many public health facilities are there in each province?

NW2475E

REPLY:

The following table reflects the information in this regard, as supplied by the Provinces:

Table 1

Province

Total number of public health facilities

Eastern Cape

852

Free State

253

Gauteng

392

KwaZulu/Natal

651

Limpopo

501

Mpumalanga

313

North West

340

Northern Cape

208

Western Cape

402

TOTAL

3 916

Reply received: September 2013

QUESTION NO. 2052

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

Mrs D Robinson (DA) to ask the Minister of Health:

How many patients have been initiated on the new Fixed Dose Combination (FDC) pill treatment in each province since its introduction?

NW2474E

REPLY:

The following table reflects the information in this regard.

Table 1.

Province

ART clients started on FDC – total

Eastern Cape

17 556

Free State

13 153

Gauteng

18 939

KwaZulu Natal

38 874

Limpopo

9 929

Mpumalanga

5 086

North West

10 014

Northern Cape

2 687

Western Cape

2 681

Total

118 919

Reply received: September 2013

QUESTION NO. 2038

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 16 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 27)

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

(1) (a) How many lawsuits for medical malpractice and/or negligence are currently pending against his department and (b) what amount has his department spent on medical malpractice lawsuits since 1 January 2009;

(2) how many cases of medical negligence were reported to his department in (a) 2009, (b) 2010, (c) 2011 and (d) 2012?

NW2453E

REPLY:

I wish to refer the Honourable Member to the response I recently furnished to the Question posed by Honourable S P Kopane (copy attached as Annexure 1) on this matter.

ANNEXURE 1 NATIONAL ASSEMBLY

FOR WRITTEN REPLY

QUESTION NO. 627

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 MARCH 2013

(INTERNAL QUESTION PAPER NO. 10)

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

(1) How many claims were instituted against his department (a) in the (i) 2007-08, (ii) 2008-09, (iii) 2009-10, (iv) 2010-11 and (v) 2011-12 financial years and (b) during the period 1 April 2012 up to the latest specified date for which information is available;

(2) in respect of each specified financial year, (a) what amount was claimed, (b) how many claims were (i) finalised in court, (ii) settled out of court and (iii) are still outstanding and (c) what amount has been paid to each plaintiff in each case that was (i) finalised in court and (ii) settled out of court?

NW786E

REPLY:

The challenge raised by the above Parliamentary Question, in our view, will not be surmounted by the submission of raw numbers and figures of statistical data which in itself may not be accurate or provide any useful context. The issue of the escalation of medico-legal claims and associated legal costs is the top priority of the Department as the same is viewed as posing a serious threat to the survival of both public and private health. As a response to this challenge, I have set up a Medico Legal Task Team to investigate the root causes and make recommendations on the policy options. In addition to this ongoing research I have sensitized Cabinet on the medico-legal claims and legal costs crises. I will only be able to shed any light on the matter after the team has finalised its work.

Reply received: September 2013

QUESTION NO. 2015

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 25)

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

(1) What amount was (a) budgeted for the revitalisation of the Moses Kotane Hospital, (b) spent in total, (c) paid to each contractor which was appointed to build the hospital and (d) recovered from the first contractor who was removed from the site;

(2) whether any action has been taken against the second contractor to repair structural deficiencies at this hospital; if not, why not; if so, what action?

NW2373E

REPLY:

(1) (a) and (b) Moses Kotane Hospital approved amount for the project was R233,611,451.53, and the total amount paid to the contractor was R233,611,451.53.

(c) Only one contractor was appointed for the main building, there was never a second contractor appointed, therefore this question is not applicable.

(d) Not applicable.

(2) No action was taken because it was only one contractor.

Reply received: December 2013

QUESTION NO. 1981

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 25)

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

(1) Whether there was an independent investigation into a certain person (details furnished); if so, (a) on what basis was it instituted and (b) what were the allegations;

(2) whether a final report of the investigation was compiled; if so, (a) when and (b) when did he receive the report;

(3) what are the (a) findings and (b) recommendations of the report;

(4) when will the report be made public;

(5) what (a) actions will be taken based on the report and (b) are the reasons for any action or recommendation not to be taken?

NW2337E

REPLY:

(1) Yes, there was an independent investigation into the conduct of the Registrar of the Council for Medical Schemes (CMS).

(a) The CMS instituted the investigation on the basis of grievances raised by senior managers of the CMS to the Council. The legal firm Bell Dewar Inc. was appointed by Council to probe the claims.

(b) The allegations were numerous, and included inter alia irregular appointments, irregular expenditure, wrong appointments of curators, unsubstantiated decision-making, exceeding authority, undermining senior management and favouring certain employees, and disregard of policies and procedures.

(2) A report from Bell Dewar Inc. was furnished to the Council. The Council studied it and compiled their own report. Both reports have been submitted to me as Minister. There are a lot of areas in which the reports seem to be at variance. Moreso, some of the allegations fall within the purview of the Auditor General and these do not seem to have been picked up or mentioned in the audit report.

Hence, I have decided to thoroughly study the three documents before I can fully respond to your questions.

Reply received: September 2013

QUESTION NO. 1978

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 25)

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

(1) How many clinics has he found to be performing illegal abortions in each province;

(2) (a) how many clinics performing illegal abortions has his department closed and (b) what are the relevant details in each case?

NW2334E

REPLY:

(1) Abortions are performed via the Termination of Pregnancy Act in our clinics. We do not perform illegal abortions.

(2) (a) and (b) There has never been any clinic performing illegal abortions that was brought to our attention.

In our understanding, illegal abortions are done criminal back-street. If found, the matter must be reported to the Police.

Reply received: December 2013

QUESTION NO. 1963

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 24)

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

With reference to the alterations at a certain hospital (name furnished), that led to the construction delays and the rising costs to R1 billion, (a) when were these alterations decided upon and (b) by whom?

NW2315E

REPLY:

(a) The alteration to construct additional two surgical theatres was decided in 2011.

(b) The decision was taken by the Gauteng Provincial Department of Health and the National Department of Health peer-reviewed the design of the theater

Reply received: September 2013

QUESTION NO. 1901

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 24)

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

What was the (a) make, (b) model, (c) year, (d) purpose, (e) date and/or dates, (f) financial cost and (g) sum total of kilometres driven in respect of each vehicle hired for use by (i) him and (ii) the Deputy Minister since 1 January 2012?

NW2250E

REPLY:

Summary of vehicle hire for Minister of Health, Dr A Motsoaledi since 1 January 2012 to date:

Date

Make

Model

Year

Purpose

Financial cost

Km travelled

15 - 16 Feb 2012

Mercedes

C180

2011

Address opening of Dusi Canoe Marathon, KZN

R1 732-37

262

27- 28 Feb 2012

BMW

320I

2011

NHI Pilot Project, NC

R 1 010-54

59

13 - 14 April 2012

Mercedes

C180

2011

Executive Commitment, KZN

R 1 838-20

221

4 May 2012

Mercedes

C180

2011

Launch of CARRMA & Special NHC meeting, KZN

R 1 268-31

144

6 - 11 May 2012

BMW

X6

2011

NHI Pilot Project, NC & FS

R 43 211-30

1 905

6 - 7 July 2012

BMW

320I

2011

Address Progressive Women Movement, EC

R 3 341-41

600

14 July 2012

Mercedes

C180

2012

NHI Pilot Project, KZN

R 1 718-82

269

14 August 2012

Mercedes

C180

2012

Executive Commitment, WC

R 1 030-50

43

7 Sept 2012

Mercedes

C180

2012

UKZN Medical School

R 1 225-02

131

30 Sept - 2 Oct 2012

Mercedes

C180

2012

NHI Pilot Project, EC

R 4 081-18

641

4 - 5 Oct 2012

Mercedes

C180

2012

SANAC Plenary meeting, KZN

R 2 803-48

380

12 - 13 Nov 2012

Mercedes

C180

2012

3rd All Africa Congress, KZN

R 1 593-33

165

3 – 4 Dec 2012

Mercedes

C180

2012

Executive Commitment, FS

R 1 295-65

75

11 – 12 Jan 2013

BMW

320

2013

Executive Commitment, KZN

R3 031-30

405

6 - 8 March 2013

Mercedes

C180

2012

NHI Pilot project and GP contracts, KZN

R 5 457-96

1 081

14 April 2013

Mercedes

C180

2012

NHI Pilot Project, EC

R 2 705-56

127

27 – 28 May 2013

Mercedes

C180

2012

Executive Commitment, KZN

R 1 266-62

131

3 - 4 June 2013

Mercedes

C180

2012

UNAIDS Symposium & NIH-MRC meeting, KZN

R 2 209-32

252

4 June 2013

Mercedes

C180

2012

NHI Pilot Project, WC

R 3 485-45

672

17 – 20 June 2013

Mercedes

C180

2012

Joint NIH-MRC SA Research Summit on HIV & TB

6th SA AIDS Conference

R 4 952-06

755

20 – 21 June 2013

Mercedes

C180

2012

Executive Commitment, EC

R 5 379-00

285

27 July 2013

Mercedes

C180

2012

NHI Pilot Project, NC

R 1 035-70

24

8 – 9 August 2013

BMW

320

2013

Executive Commitment, KZN

R 1 809-58

269

R97 482-66

8 896

Reply received: September 2013

QUESTION NO. 1887

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 02 AUGUST 2013

(INTERNAL QUESTION PAPER NO. 24)

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

When was the last time that the Medicine Control Council submitted a report to the Central Drug Authority?

NW2236E

REPLY:

The Medicines Control Council submitted the last report to the Central Drug Authority on 13 August 2013.

Reply received: August 2013

QUESTION NO. 1857

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

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

(1) How many (a) nurses have graduated from nursing colleges in each province since the reopening of each college and (b) of these nurses were appointed in his department;

(2) how many of these nurses received specialised training in specific fields;

(3) in which fields is the country still experiencing a shortage?

NW2209E

REPLY:

Please refer to the attached Annexure 1, which reflects the information as obtained from the Provincial Departments of Health.

Reply received: August 2013

QUESTION NO. 1816

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Mr F A Rodgers (DA) to ask the Minister of Health:

(1) How many consultants has his department contracted and/or appointed (a) in the (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years and (b) since 1 April 2013;

(2) how many consultants contracted and/or appointed by his department (a) in the (i) 2009-10, (ii) 2010-11, (iii) 2011-12 and (iv) 2012-13 financial years and (b) since 1 April 2013 are former officials of his department and/or former public servants?

NW2164E

REPLY:

(1) The Department contracted and/or appointed

(a) (i) 2009-10: Three (3);

(ii) 2010-11: One (1);

(iii) 2011-12: Two (2); and

(iv) 2012-13: One (1)

(b) Since 1 April 2013: One (1)

(2) Consultant who were former officials of the Department

(i) 2009-10: None;

(ii) 2010-11: One;

(iii) 2012-13: None; and

(iv) Since 1 April 2013: None

Reply received: August 2013

QUESTION NO. 1783

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Mr N J van den Berg (DA) to ask the Minister of Health:

What (a) buildings under the administration of (i) his department and (ii) entities reporting to him are national key points and (b) criteria were used to classify them as such?

NW2130E

REPLY:

(a) (i) The following buildings under the administration of the Department are national key points:

Civitas Building : Head Quarters of National Department of Health

FCL [Pretoria] : Forensic Chemistry Laboratory

FCL [Johannesburg] : Forensic Chemistry Laboratory

FCL [Cape Town] : Forensic Chemistry Laboratory

FCL [Durban] : Forensic Chemistry Laboratory

MBOD Building : Houses the Medical Bureau for Occupational Health & Compensation Commissioner

RC [Cape Town] : Radiation Control

(ii) The South African Medical Research Council and the Council for Medical Schemes have no national key points building under their administration however; the National Health Laboratory Service has one building under the entity's administration classified as national key point facility, namely the BSL4 Laboratory at the National Institute for Communicable Diseases (NICD).

(b) Their strategic importance to the country.

Reply received: August 2013

QUESTION NO. 1749

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Dr W G James (DA) to ask the Minister of Health:

What is the (a) make, (b) model, (c) year and (d) purchase price of each vehicle that was bought for official use by (i) him and (ii) the Deputy Minister since 1 January 2012?

NW2096E

REPLY:

No vehicles were purchased for either the Minister or the Deputy Minister during the period in question.

Reply received: August 2013

QUESTION NO. 1712

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Mrs M Wenger (DA) to ask the Minister of Health:

How many cases of (a) cholera, (b) botulism, (c) giardiasis and (d) Weil syndrome have been reported in each province in (i) 2008, (ii) 2009, (iii) 2010, (iv) 2011 and (v) 2012?

NW2059E

REPLY:

According to Provinces, the following tables reflect the information on reported cases:

(a) Cholera

EC

FS

GP

KZN

LIMP

MPU

NW

NC

WC

TOTAL

2008

Nil

Nil

Nil

Nil

1,282

Nil

Nil

Nil

Nil

1,282

2009

2

1

286

2

4,238

6,855

90

1

8

11,483

2010

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

0

2011

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

0

2012

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

Nil

0

(b) Botulism – no cases reported

(c) Giardiasis – no cases reported.

(d) Weil syndrome/Leptospirosis

Unfortunately the figures we have are for the whole country and not presented according to the breakdown in provinces, and they are as follows:

- 2008: 55

- 2009: 40

- 2010: 31

- 2011: 43

- 2012: 36

Reply received: August 2013

QUESTION NO. 1685

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Mrs D Robinson (DA) to ask the Minister of Health:

(1) Has the cancer register been updated since 2004; if so, what were the findings;

(2) how many people died from cancer in the (a) 2009-10, (b) 2010-11, (c) 2011-12 and (d) 2012-13 financial years;

(3) in respect of each year, how many deaths resulted from each type of cancer respectively?

NW2032E

REPLY:

(1) The National Cancer Registry (NCR) has been updated since 2004 and has published the 2005 pathology-based cancer incidence data for South Africa on its website (www.ncr.ac.za). If Basal Cell Carcinomas are excluded, the number one cancer amongst males in South Africa (all races) for 2005 was prostate cancer.

Amongst females in South Africa (all races) breast cancer was the most common cancer followed by cervical cancer. However, for African females, cervical cancer was the most common cancer.

(2) The National Cancer Registry does not collect information on cancer deaths.

(3) The National Cancer Registry does not collect information on cancer deaths.

Reply received: September 2013

QUESTION NO. 1684

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 JULY 2013

(INTERNAL QUESTION PAPER NO. 23)

Mrs D Robinson (DA) to ask the Minister of Health:

(1) What amount was spent by his department on infrastructure in and around Mvezo, in Transkei (a) in the (i) 2010-11, (ii) 2011-12 and (iii) 2012-13 financial years and (b) from 1 April 2013 up to the latest specified date for which information is available;

(2) (a) what were the amounts spent on in each year and (b) who authorised the expenditure?

NW2031E

REPLY:

May I kindly request the Honourable Member to be specific. We do not spend money on infrastructure in and around areas. We spend money on infrastructure on health facilities.

Which facilities is the Honourable Member talking about?.

Reply received: July 2013

QUESTION NO. 1645

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 JUNE 2013

(INTERNAL QUESTION PAPER NO. 22)

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

How many people are covered by medical aid in each province?

NW1991E

REPLY:

According to the latest, verified information that was published by the Council for Medical Schemes in their annual report for the 2011/12 financial, the number of people covered by medical schemes in each province is illustrated in the table below:

Membership per province as at December 2011

Province

Members

Dependants

Beneficiaries (Members plus Dependents)

Gauteng

1 399 765

1 688 660

3 088 425

Limpopo

174 576

261 815

436 391

Mpumalanga

235 123

347 516

582 639

North West

227 586

273 903

501 489

Free State

167 820

229 092

396 912

KwaZulu-Natal

557 917

751 294

1 309 211

Western Cape

592 518

713 935

1 306 453

Eastern Cape

297 819

416 949

714 768

Northern Cape

73 091

108 592

181 683

Outside the Republic of South Africa

4 350

4 088

8 438

Total membership

3 730 565

4 795 844

8 526 409

The province with the highest number of beneficiaries is Gauteng and the Northern Cape has the lowest number of beneficiaries. The total number of people covered by medical schemes in the country is estimated at 16.2 % (i.e. 8,526,409 lives) of the national population.

� pc(o^ �U ormal style='margin-top:6.0pt;margin-right:0in;margin-bottom:6.0pt; margin-left:0in;text-align:justify;tab-stops:0in'>(b)

Competition Commission

The international expenditure is incurred in order to attend Competition or Law related conferences such as the OECD and ICN conferences, and locally travel occurs in relation to the attendance of hearings related to Competition Appeals Court, meetings with stakeholders and parliamentary briefing sessions.

Competition Tribunal

The above-mentioned amounts were incurred in support of the Tribunal hearings attended by the 12 part-time members as part of the panel; attendance of four (4) Portfolio Committee meetings in Cape Town by the Tribunal officials and attending international conferences.

ITAC

The international expenditure was incurred for the attendance of the Tripartite Trade Negotiations forum, WTO Committee and SACU meetings. Domestically the costs were incurred for Portfolio Committee meetings, stakeholder meetings and attendance of workshops.

Industrial Corporation Development (IDC)

The expenditure was incurred for 15 SMS members whilst discharging the entity's mandate in the form of 47 meetings related to management responsibilities, 2 employee engagement feedback attendance, 14 parliamentary portfolio committees attendance, the launches of SEFA and the Upington office and the attendance of 5 conferences. Internationally, senior officials participated in 26 meetings with various institutions, attended 5 conferences, the signing of 3 MoU's and the attendance of training by 2 officials.

SEFA

In the financial year 2012/13 sefa Executives and a number of Board members travelled to Parliament for the Minister's Budget Vote and sefa media launch (April 2012) and relevant Portfolio Committee meetings.

Senior managers from the regional offices undertook travel to Pretoria for three workshops related to Change Management which was required because of the merge between the two entities. Other travel included occasional meetings with their superiors at the head office and compliance training (OHSA in March 2013). Regional Managers very seldom travel to other branches as they operate in their geographical area.

Head Office senior managers travelled for business purposes (i.e. meeting with clients, site visits).

Within sefa approximately 40 senior managers (this includes Executives, Line Managers as well as Middle – and Regional Managers) travel.

Reply received: July 2013

QUESTION NO. 1620

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 JUNE 2013

(INTERNAL QUESTION PAPER NO. 22)

Mrs D Robinson (DA) to ask the Minister of Health:

What are the (a) targets and (b) time frames to administer the human papillomavirus (HPV) vaccines as part of the school health programme in the 2014 academic year?

NW1966E

REPLY:

(a) We are targeting 9 and 10 year olds in quintile 1, 2, 3 and 4 schools.

(b) We are hoping to start in February 2014.

Reply received: July 2013

QUESTION NO. 1601

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 JUNE 2013

(INTERNAL QUESTION PAPER NO. 22)

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

How many (a) public sector (i) doctors, (ii) clinical associates and (iii) nurses are employed in each province since 1 April 2013 and, in each case, (b) vacancies are in each province to date?

NW1947E

REPLY:

(a) and (b) See the following table for the relevant information, according to the Provincial Departments of Health, as at May 2013:

PROVINCE

POSTS FILLED

EASTERN CAPE

Medical Practitioners

Clinical Associates

Nurses

1 595

53

18 641

FREE STATE

Medical Practitioners

Clinical Associates

Nurses

992

5

5 256

GAUTENG

Medical Practitioners

Clinical Associates

Nurses

4 808

30

24 034

KWAZULU NATAL

Medical Practitioners

Clinical Associates

Nurses

4 040

19

32 920

LIMPOPO

Medical Practitioners

Clinical Associates

Nurses

1 159

9

18 485

MPUMALANGA

Medical Practitioners

Clinical Associates

Nurses

846

13

8 128

NORTH WEST

Medical Practitioners

Clinical Associates

Nurses

708

3

7 598

NORTHERN CAPE

Medical Practitioners

Clinical Associates

Nurses

405

4

2 450

WESTERN CAPE

Medical Practitioners

Clinical Associates

Nurses

2 746

0

11 447

For now, we have provided numbers of posts filled. We are not yet in a position to provide you with vacancies because the numbers provided by provinces are not in keeping with any norms and standards. We have just completed our WISN (Workload Indicators for Staffing Norms) tool for each health facility in the country. We are going to present the results for adoption first to the National Health Council before I could furnish them. WISN is a recently developed tool from WHO (World Health Organisation).

Reply received: July 2013

QUESTION NO. 1599

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 JUNE 2013

(INTERNAL QUESTION PAPER NO. 22)

Mr T W Coetzee (DA) to ask the Minister of Health:

(1) Whether, with reference to his reply to question 728 on 28 May 2013, judgment has been received; if not, what are the reasons for the delay;

(2) whether the attorneys have reported Judge Classen to the Judge President of the South Gauteng High Court for his delay?

NW1945E

REPLY:

According to the Health Professions Council of South Africa (HPCSA) –

(1) Judgement in the above matter has not been received as yet and the reasons for the delay are as follows:

(a) At the beginning of May 2013 Ms Kgoadi from the office of Ledwaba Mazwai Attorneys phoned Adv Rob Wise (whom we erroneously referred to as Judge Classen in our response to Question 728) who was the Acting Judge in the above matter on 12 June 0212;

(b) Adv Wise indicated to Ledwaba Attorneys that he needed a period of four weeks to get the judgement ready (see attached letter from Ledwaba Attorneys dated 07 May 2013 marked Annexure A);

(c) Amongst others, he advised that the reasons for the delay in giving judgement was due to the complexity of the matter and the systems of the South Gauteng High Court in not allowing the judges access to the court file prior to the date of the hearing, so as to familiarise themselves with the issues at hand before time.

(2) As indicated above, we erroneously referred to Judge Classen in our response to Question 728 of 28 May 2012, however the HPCSA Attorneys have not reported Adv Wise to the Judge President of the South Gauteng High Court, as they deem it necessary to afford him the opportunity to deliver judgement within four weeks from the time of the query after the judge himself gave such undertaking of which the time period has already lapsed on the 7th June 2013.

(a) They further advised that in the event that he fails to deliver judgement after that period, they shall proceed to make a formal representation to the Judge President of the South Gauteng High Court to assist in obtaining the judgement to be handed down by Adv Wise;

(b) On 28th June 2013, the HPCSA sent an urgent email to Ledwaba Mazwai Attorneys requesting progress on the matter. However, since the period of four weeks has expired without judgement being delivered by Adv Wise, the HPCSA has expressed its dissatisfaction to Council's Attorneys and have implored them to report Adv Wise to the Judge President as a matter of urgency;

(c) On the 1st July 2013, the HPCSA received correspondence from its attorneys informing them that they again spoke to Adv Wise on 1st July 2013, who informed them that he needs another month to finalise the judgement specifically by the end of July 2013;

(d) The HPCSA has informed their attorneys of their dissatisfaction regarding the prevailing circumstances and that they should report him to the Judge President of the South Gauteng High Court with immediate effect (see attached email dated 1 July 2013 from Ledwaba Mazwai Attorneys marked Annexure B).

Reply received: July 2013

QUESTION NO. 1535

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 JUNE 2013

(INTERNAL QUESTION PAPER NO. 21)

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

In which provinces does his department finance nongovernmental organisations involved in providing communities with palliative care?

NW1882E

REPLY:

The Department of Health is funding non-governmental organisations for palliative care services provided in eight (8) provinces except in Mpumalanga.

Reply received: July 2013

QUESTION NO. 1533

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 JUNE 2013

(INTERNAL QUESTION PAPER NO. 21)

Mr M G P Lekota (Cope) to ask the Minister of Health:

With reference to the observation of the head of Medicine at Groote Schuur Hospital in respect of high blood pressure and diabetes (details furnished), (a) what preventative measures has his department implemented in this regard and (b) how has his department been dealing with these particular health problems in an attempt to adequately contain it?

NW1880E

REPLY:

What Professor Bongani Mayosi said is very true. In fact, some of the department's plans are based on these findings. Prof Mayosi was one of the researchers and scientists who were commissioned by the Lancet (a very prestigious British Medical Journal) to research the burden of disease in South Africa.

The findings were that the country is going through a quadruple burden of disease:

(i) HIV/AIDS and TB;

(ii) Maternal and Child Mortality (mainly driven by HIV/AIDS);

(iii) Non-Communicable Diseases; and

(iv) Injury and Trauma/Violence

We refer to these four as the colliding pandemics bedevilling the country.

The Non-Communicable diseases are broadly four main categories:

(i) Hypertension/High blood pressure and chronic heart diseases;

(ii) Diabetes Mellitus;

(iii) Cancer; and

(iv) Chronic lung diseases like Asthma

Unlike the other three pandemics, the Non-Communicable diseases, referred to commonly as the NCDs, are a global phenomenon, responsible for 60% of global deaths.

For those reasons, the United Nations (UN) called a high level meeting of Heads of State in the UN General Assembly in September 2011, to discuss this threat of an explosion of Non-Communicable diseases and how to curb them.

The African Union (AU) also called a Summit of Health Ministers of the African Regional Council of African Health Ministers (CAHMS) in April 2013 in Addis Ababa to develop strategies.

In South Africa, a Summit of all stakeholders was held to discuss NCDs just a week prior to the UN High Level meeting.

All these Summits and meetings came up to the same conclusion and strategies, viz, that the NCDs are driven mainly by the following four risk factors:

(i) Tobacco use;

(ii) Harmful use of alcohol;

(iii) Poor diet; and

(iv) Lack of exercise

All the strategies around the world must be geared towards dealing with these four risk factors.

Hence our strategies in South Africa are about restrictions and regulations on these four risk factors.

I am sure Honourable Member will know the calls we have been making about smoking and alcohol intake. We are also making calls on regulations and restrictions on diet, e.g regulations to limit trans-fatty acids in foodstuffs, regulations to reduce high salt intake in six basic foodstuffs, viz:

(i) Bread;

(ii) Brine in chicken;

(iii) Soups;

(iv) Spices;

(v) Snacks; and

(vi) Cereals

The very high incidence of High blood pressure in our country leading to strokes, heart failure, kidney damage and heart attacks is mainly due to the fact that South Africans consume in average 9-10 grams of salt a day, whereas the World Health Organisation (WHO) recommends an average of 5 grams per day for normal physiological function.

It is imperative that the targets we set for industry to reduce this salt intake, first target to be met by 2016 and second targets by 2019, be supported by all leaders in our country.

Reply received: August 2013

QUESTION NO. 1505

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 JUNE 2013

(INTERNAL QUESTION PAPER NO. 22)

Mr M Waters (DA) to ask the Minister of Health: [Interdepartmental transfer on 21 June 2013]

When will the detoxification policy be finalised?

NW1851E

REPLY:

The draft substance abuse detoxification policy guidelines have been developed by the National Department of Health. A task team of selected addiction specialists has been selected to integrate inputs that were received from provinces as well as to align it with Essential Drug List. The policy guidelines will be finalised within the 2013/14 financial year.

Reply received: July 2013

QUESTION NO. 1456

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 JUNE 2013

(INTERNAL QUESTION PAPER NO. 20)

Mr M G P Lekota (Cope) to ask the Minister of Health:

(1) Whether government-funded (a) clinics and (b) hospitals have systems in place to ensure that (i) the most pressing and deserving cases are attended to immediately, (ii) the collection of prescriptions is managed on a type by type basis to achieve swift and expeditious dispensing to patients with the same prescriptions, (iii) patients are pre-screened to allocate them to the correct queues at the very outset, (iv) group counselling of categories of diagnosed patients is routinely and separately taking place on-site in a language of the patients' choice to educate patients on their illnesses without every doctor having to do the same on a case by case basis and (v) doctors are supported by qualified aides to assist them in the swifter processing of patients; if not, why not; if so, what are the relevant details;

(2) whether he will make a statement on the matter?

NW1801E

REPLY:

(1) (a-b) (i-v) Currently there is no uniform model with respect to the management of queues and subsequent dispensing of prescriptions across provinces and facilities. In some facilities chronic repeat prescriptions are managed through a separate queue. Queues for new prescriptions are determined by the organisation of clinical services in the facility. In primary health care facilities a different approach is followed according to patient numbers and human resource capacity. In certain provinces repeat prescriptions for stabilised long term treatments are processed at a central dispensing unit and distributed to the clinic, for collection by clients. Various approaches have been adopted by hospitals, many collections by clients. Various approaches have been adapted by hospitals, many have dedicated queues for collection of repeat prescriptions.

(2) The Department is investigating the feasibility of various options for the supply of chronic medicine. When the policy on this matter is finalised, we will make a statement.

Reply received: July 2013

QUESTION NO. 1450

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 JUNE 2013

(INTERNAL QUESTION PAPER NO. 20)

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

(1) Whether he has been informed of the moratorium on the replacement of staff at Glen Grey Hospital in the Eastern Cape; if so, what have been his findings on the impact of the moratorium on the provision of quality health care;

(2) whether any steps have been taken to lift the moratorium; if not, why not; if so, what are the relevant details?

NW1795E

REPLY:

(1) No. There is no moratorium on the replacement of staff at Glen Grey Hospital. Nineteen (19) appointments at the institution have been made for the period 01 January 2013 to date. This appointments have improved the quality of health care and were made as follows:

- Eight (8) professional nurses for community service;

- Three (3) professional nurses for general nursing;

- Five (5) medical officers of which three (3) are for community services;

- One (1) Diagnostic Radiographer;

- One (1) Dentist; and

- One (1) Pharmacist

(2) Not applicable.

Reply received: July 2013

QUESTION NO. 1444

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 JUNE 2013

(INTERNAL QUESTION PAPER NO. 20)

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

How many cases of litigation have been instituted against (a) his department and (b) each provincial department of health due to negligence allegedly caused by medical staff shortages in public hospitals in the (i) 2010-11, (ii) 2011-12 and (iii) 2012-13 financial years?

NW1787E

REPLY:

There are no cases of litigation that have been instituted either against the National or Provincial Department of Health due to negligence, specifically allegedly caused by medical staff shortages in public hospitals in the 2010-11, 2011-12 and 2012-13 financial years.

We do have cases of litigation but none of them says it is specifically due to shortage of staff in public hospitals.

Reply received: July 2013

QUESTION NO. 1405

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 JUNE 2013

(INTERNAL QUESTION PAPER NO. 20)

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

What amount did his department spend on (a) promotional items and (b) cocktail receptions on the occasion of his 2013 Budget Vote debate?

NW1747E

REPLY:

(a) None.

(b) R42 194.00

Reply received: July 2013

QUESTION NO. 1313

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 31 MAY 2013

(INTERNAL QUESTION PAPER NO. 19)

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

(1) Whether (a) he, (b) his deputy minister, (c) any specified officials and (d) any other persons have been issued with a government or official credit card (i) in the (aa) 2011-12 and (bb) 2012-13 financial years and (ii) since 1 April 2013 up to the latest specified date for which information is available; if so, in each instance, what is the (aaa)(aaaa) name and (bbbb) job title of each person to whom a credit card was issued, (bbb) credit limit, (ccc) outstanding amount as at the latest specified date for which information is available, (ddd) monthly expenses incurred for each month since receiving the credit card, (eee) reason for such a person being issued with a credit card and (fff) uses that such a credit card is intended for;

(2) whether the credit limit of any specified credit card was exceeded at any time since it was issued; if so, (a) whose credit cards are over the limit and (b) what is the reason for the credit card exceeding the limit?

NW1643E

REPLY:

(1) We issue no credit cards in this Department.

(2) Not applicable.

Reply received: July 2013

QUESTION NO. 1261

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 MAY 2013

(INTERNAL QUESTION PAPER NO. 17)

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

(a) Which districts have district clinical specialist teams, (b) how are these teams financed and (c) what are the details of the outcomes these teams have had on the provision of quality health services?

NW1508E

REPLY:

170 members of the District Clinical Specialist Teams (DCST's) have been appointed.

(a) All districts have at least one (1) member of the DCST.

(b) The provinces have appointed these teams using funding from their equitable share.

(c) The teams focus on improving clinical governance. In this context they have strengthened clinical practice through training and mentorship of especially clinicians responsible for maternal and child health, including:

(i) Strengthening morbidity and mortality review meetings;

(ii) Audit of emergency maternal, neonatal and paediatric care.

(iii) Training of doctors and midwives in the essential steps of the management of obstetric emergencies.

(iv) Training of midwives in the use of the Partogram.

Reply received: June 2013

QUESTION NO. 1216

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 24 MAY 2013

(INTERNAL QUESTION PAPER NO. 17)

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

What amount has his department spent on (a) catering and (b) entertainment in the (i) 2012-13 financial year and (ii) since 1 April 2013?

NW1462E

REPLY:

(a) The Department spent an amount of –

(i) R2,916,591.75 during the 2012/13 financial year on catering; and

(ii) R418,684.12 since 01 April 2013.

(b) It is not clear what is meant by entertainment. But if it means serving guests of the Minister and Deputy Minister, then the amount is as follows:

(i) R72,249.33 during the 2012/13 financial year; and

(ii) R12,360.30 since 01 April 2013.

Reply received: June 2013

QUESTION NO. 1113

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

Mr N J van den Berg (DA) to ask the Minister of Health:

(a) What total amount has (i) his department and (ii) each specified entity reporting to him spent on conferences in the (aa) 2009-10, (bb) 2010-11, (cc) 2011-12 and (dd) 2012-13 financial years and (b) what (i) amount was spent on, and (ii) is the breakdown of the expenditure for, each specified conference?

NW1346E

REPLY:

(a) Total amount spent on conferences in each financial year;

(i) by the Department,

(aa) 2009-10 = R23 678 659.53,

(bb) 2010-11 = R14 446 168.87,

(cc) 2011-12 = R12 396 161.98 and,

(dd) 2012-13 = R10 074 877.62

(ii) by the Entities,

(aa) 2009-10 = R3 547 985.83,

(bb) 2010-11 = R2 830 889.67,

(cc) 2011-12 = R4 152 504.26 and,

(dd) 2012-13 = R3 537 836.69.

(b) The breakdown of the expenditure spent on in each specified conference;

(i) by the Department from 2009/10 to 2012-13 amount to R60 595 868.00, please refer to Annexure A for a detailed breakdown.

(ii) by the entity from 2009-10 to 2012-13 amount to R14 069 216.45 , please refer to Annexure B for a detailed breakdown.

Reply received: June 2013

QUESTION NO. 1161

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

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

Whether the funds allocated to the National Health Insurance pilot projects on health services were found to be adequate; if not, why not; if so, what are the relevant details?

NW1400E

REPLY:

The National Health Insurance Conditional Grant was allocated the sum of R150 million for the 2012/13 financial year.

It is difficult for me to understand what the Honourable Member means by funds allocated being adequate. We believe Treasury is providing whatever it finds feasible at any one time.

Reply received: June 2013

QUESTION NO. 1081

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

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

(1) What total amounts has (a) his department and (b) each specified entity reporting to him spent on (i) print and (ii) broadcast advertising in the (aa) 2009-10, (bb) 2010-11, (cc) 2011-12 and (dd) 2012-13 financial years;

(2) in each case, (a)(i) by which radio or television station were the advertisements broadcast and (ii) in which newspapers were the advertisements published in the (aa) 2009-10, (bb) 2010-11, (cc) 2011-12 and (dd) 2012-13 financial years and (b) at what cost in each specified case?

NW1314E

REPLY:

(1) (a) (i) Total spending by the Department for printing;

(aa) 2009-10 amount to R10 993 526.84,

(bb) 2010-11 amount to R10 615 995.75,

(cc) 2011-12 amount to R17 253 844.60 and,

(dd) 2012-13 amount to R7 419 975.85.

(ii) Total spending by the Department for broadcast advertising;

(aa) 2009-12 amount to R12 380 136.36,

(bb) 2010-11 amount to R4 442 804.71,

(cc) 2011-12 amount to R11 685 143.66 and,

(dd) 2012-13 amount to R22 531 308.30.

(b) (i) by the Entity for printing;

(aa) 2009-12 amount to R110 730.68,

(bb) 2010-11 amount to R453 857.54,

(cc) 2011-12 amount to R 448 905.36 and,

(dd) 2012-13 amount to R579 765.56.

(b) (ii) by the Entity for broadcast advertising;

(aa) 2009-12 amount to R50 951.20,

(bb) 2010-11 amount to R44 520.96,

(cc) 2011-12 and,

(dd) during 2012-13 no expenditure incurred.

(2) (a) The specified cost spent by the Department for advertisement on Radio and television stations from 2009/10 to 2012/13 amounts to R43,835,024.11 as reflected in the attached Annexure A.

(b) The specified cost spent by the Department for advertisement on Newspapers from 2009/10 to 2012/13 amounts to R9,015,251.61 as reflected in the attached Annexure B.

Reply received: June 2013

QUESTION NO. 1065

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

Mrs D Robinson (DA) to ask the Minister of Health:

(1) What is the intervention plan for the 2013-14 financial year to reverse the HIV prevalence increase trends in (a) Mpumalanga, (b) the Free State, (c) the North West and (d) the Ugu district in KwaZulu-Natal;

(2) what is the budget breakdown for each component of the intervention plan?

NW1296E

REPLY:

(1) (a)-(d) In the three provinces of Mpumalanga, Free State, North West and in the Ugu District of KwaZulu/Natal, there were slight increases in the antenatal sero-prevalence rates between 2009 and 2011 but these increases were not statistically significant. The HIV antenatal sero-prevalence rates in Ugu and North West were virtually identical in 2009 and 2011.

However in the Gert Sibande District of Mpumalanga there was a significant increase in the prevalence of HIV among pregnant women who attend public sector health facilities. In order to address the high prevalence in Gert Sibande, the South African National AIDS Council (SANAC) held its most recent meeting in this district and we will shortly be announcing interventions to address the challenges in this district.

The same prevention and treatment strategies that are being implemented in the country as a whole are being implemented in the provinces and district in question. These strategies include:

- HIV Counselling and Testing (HCT);

- Provider initiated counselling and testing (PICT);

- Male Medical Circumcision (MMC);

- Prevention of mother-to-child transmission (PMTCT);

- Anti-retroviral treatment (ART);

- Behavioral change interventions; and

- Targeting of key populations.

(2) The table below outlines the budget allocated to the four (4) provinces for implementing various HIV-related interventions funded through the HIV and AIDS Conditional Grant in the 2013/14 financial year:

Province

ART

High Transmission areas (HTAs)

Condoms

Social Mobilisation

MMC

Total

Free State

518,052

10,199

17,700

16,968

23,461

586,380

KwaZulu-Natal

1,665,075

12,990

45,000

49,072

99,312

1,871,449

Mpumalanga

426,475

20,648

15,219

32,568

35,260

530,170

North West

486,554

3,752

23,640

49,345

30,476

593,767

Total

3,096,156

47,589

101,559

147,953

188,509

3,581,766

Reply received: June 2013

QUESTION NO. 1064

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

Mrs D Robinson (DA) to ask the Minister of Health:

When will the Rapid Mortality Surveillance Report for 2013 be (a) finalised and (b) made public?

NW1295E

REPLY:

The Medical Research Council is aiming to (a) finalise their next Rapid Mortality Surveillance Report by the end of August 2013 and (b) to make it available for public by the end of the year.

Reply received: June 2013

QUESTION NO. 1063

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

Mrs D Robinson (DA) to ask the Minister of Health:

When will a report be released on the (a) progress and (b) impact of the eight key strategies of the Campaign on the Accelerated Reduction of Maternal Mortality in Africa?

NW1294E

REPLY:

A dashboard of indicators that monitors the seven (7) elements of the Campaign on the Accelerated Reduction of Maternal Mortality in Africa (CARMMA) which will be used by the National and Provincial Departments of Health has been finalised. The dashboard will be updated and reported quarterly to the National Health Council (NHC).

The report will be made available during the International Conference on Child and Maternal Health to be held in South Africa in conjunction with the African Union over the period 01-03 August 2013.

Reply received: June 2013

QUESTION NO. 1062

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

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

What is the (a) total number of childbirth facilities and (b) the total number of these facilities that have operational obstetric ambulances?

NW1293E

REPLY:

(a) The total number of childbirth facilities is 788. They are in the following types of health facilities:

· Community day centres

· Community health centres

· Maternity obstetric units

· District, regional, provincial tertiary and national central hospitals

(b) Obstetric ambulances are not currently allocated by facility see attached.

Reply received: June 2013

QUESTION NO. 1061

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

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

(1) What amount has been budgeted for the Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA) component of allocating obstetric ambulances to every facility where deliveries are conducted;

(2) has the amount been ringfenced?

NW1292E

REPLY:

(1) On a point of correction, obstetric ambulances are not allocated per health facility but per district depending on the need. With respect to the financing of 190 obstetric ambulances purchased by provinces, these are purchased with funds from the provincial equitable share in the same way as other emergency medical service vehicles.

(2) Provinces have not ring-fenced funding for these ambulances.

Reply received: July 2013

QUESTION NO. 1060

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 MAY 2013

(INTERNAL QUESTION PAPER NO. 16)

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

What additional (a) financial, (b) human or (c) equipment resources will his department allocate to reduce the stagnant neonatal mortality rate?

NW1291E

REPLY:

(a)-(c) The Department of Health has put in place several interventions to reduce neonatal mortality.

Firstly, a Ministerial Committee to review neonatal mortality and to advise the Minister on the major causes of mortality as well as to recommend specific interventions to reduce mortality. The recommendations from the latest report of this committee have been shared with all hospital CEOs as well as members of the District Clinical Specialist Teams.

Secondly, as part of the re-engineering of primary health care, District Clinical Specialist Teams (DCSTs) have been appointed in most districts. At present 174 members of these teams have been appointed nationally. The role of the DCSTs is to strengthen clinical governance in each district with specific reference to maternal and child health outcomes as well as HIV and TB. The DCSTs are working with primary health care facilities as well as hospitals to strengthen the quality of work – which will include strengthening the use of guidelines and protocols in health facilities, training health providers and attending morbidity and mortality review meetings at facilities.

Thirdly, the Department has additional financial and technical resources through UK Development AID to strengthen maternal and child health in 25 of the worst performing districts. Their support focuses on strengthening systems as well as clinical care through mentorship and training, working in close collaboration with the district management teams, hospital CEOs as well as the district clinical specialist teams.

Reply received: July 2013

QUESTION NO. 959

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 10 MAY 2013

(INTERNAL QUESTION PAPER NO. 15)

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

(1) Since 1 January 2011, how many applications under the Promotion of Access to Information Act, Act 2 of 2000, were received by (a) his department and (b) entities reporting to him, and in each case, how many were (i) granted, (ii) refused and (iii) deemed refused under section 27;

(2) since 1 January 2011, how many internal appeals under the Act were received by (a) his department and (b) entities reporting to him, and in each case, how many were (i) granted, (ii) refused and (iii) deemed refused under section 77(7);

(3) who is the information officer for (a) his department and (b) each entity reporting to him, and in each case, what are the contact details of the officer?

NW1182E

REPLY:

(1) (a) Number of applications received and finalised by NDoH since January 2011 to 13 May 2013 is 98 of which 74 applications were transferred to other public bodies in terms of section 20 of the Act.

(i) Number of applications granted is 20.

(ii) Number of applications refused is 4.

(iii) Number of applications deemed refused under section 27 is 0.

(b) Number of applications received by entities reporting to Minister the since January 2011:

(i) Number of applications received by the Council for Medical Schemes (CMS) is 18 (2010-2011); 23 (2011-2012; 27 (2012-2013) and 4 (1 April 2013 to date).

(aa) Number of applications granted is 15 (2010-2011); 22 (2011-2012); 23 (2012-2013); and 0 (1 April 2013 to date);

(bb) Number of applications refused is 3 (2010-2011); 1 (2011-2012); 4 (2012-2013); and 0 (1 April 2013 to date);

(cc) Number of applications deemed refused under section 27 is 1 (2010-2011); 1 (2011-2012); 0 (2012-2013); and 0 (1 April 2013 to date).

(ii) Number of applications received by the South African Medical Research Council (MRC).

(aa) Number of applications granted is 0.

(bb) Number of applications refused is 0.

(cc) Number of applications deemed refused under section 27 is 0.

(iii) Number of applications received by the National Health Laboratory Service (NHLS).

(aa) Number of applications granted is 0.

(bb) Number of applications refused is 0.

(cc) Number of applications deemed refused under section 27 is 0.

(2) (a) Number of internal appeals received by NDoH since January 2011 is 1.

(i) Number of internal appeals granted is 0.

(ii) Number of internal appeals refused is 1.

(iii) Number of internal appeals deemed refused under section 27 is 0.

(b) Number of internal appeals received by entities reporting to Minister since January 2011 is 0.

(i) Number of internal appeals granted is 0.

(ii) Number of internal appeals refused is 0.

(iii) Number of internal appeals deemed refused under section 27 is 0.

(3) (a) The information officer for National Department of Health (NDoH) is MS M P MATSOSO in her capacity as the Director General as indicated in Schedule 1 of the Public Service Act, 1994 (Proclamation No. 103 of 1995) and her contact details are as follows.

Postal Address: Private Bag X 828, Pretoria, 0001

Physical Address: 27th Floor, Civitas Building, Corner Thabo Sehume and Struben Street, Pretoria, 0002;

Tel 012 395 9150;

Fax 012 395 8422

Email [email protected]

(b) The information officers for entities reporting to Minister and their contact details.

(i) The information officer for the Council for Medical Schemes (CMS) is Dr Monwabisi Gantsho in his capacity as the Chief Executive Officer/Registrar of CMS and his contact details are as follows:

Postal Address: Private Bag X34, Hatfield, 0028

Physical Address: Block E Hadefields Office Park; 1267 Pretorius Street, Hatfield, Pretoria

Tel: 012 431 0501

Fax 012 431 0606

Email [email protected]

(ii) The information officer for the South African Medical Research Council (MRC) is Professor Salim S. Abdool Karim in his capacity as the President of the MRC and his contact details are as follows:

Postal Address: PO Box 19070, Tygerberg, 7505 Cape Town

Physical Address: Francie van Zijl Drive, Parrow Valley, Cape Town

Tel: 021 938 0212

Fax: 021 938 0201

Email: [email protected]

(iii) The Information officer for the National Health Laboratory Service (NHLS) is Mr Sagie Pillay in his capacity as the Chief Executive Officer of the NHLS and his contact details are as follows:

Postal Address: Private Bag X8, Sandringham, 2131

Physical Address: 1 Modderfonyein Road, Sandringham

Tel: 011 386 6070

Fax: 011 386 6073

Email: [email protected]

Reply received: June 2013

QUESTION NO. 946

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 10 MAY 2013

(INTERNAL QUESTION PAPER NO. 15)

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

What monitoring and evaluation (a) strategy and (b) tools is his department using to determine the progress of each of the five focus areas of the National Health Insurance pilot projects?

NW1168E

REPLY:

(a) The NHI pilot sites submit detailed monthly and quarterly financial and non-financial performance information. The Department also undertakes monthly and quarterly monitoring and evaluation visits in all the pilot sites to proactively engage with responsible managers regarding the progress being reported as well as to assist in identifying potential hurdles and practical solutions to addressing them.

(b) The Department has developed a monthly financial data reporting template which the NHI pilots must use in submission of monthly actual expenditure and commitments information. Furthermore, the Department has developed a quarterly monitoring and evaluation template which pilot sites are supposed to use in the submission of the quarterly performance reports.

Reply received: July 2013

QUESTION NO. 945

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 10 MAY 2013

(INTERNAL QUESTION PAPER NO. 15)

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

What is the (a) total amount and (b) breakdown of the National Health Insurance (NHI) grant diverted for national and provincial departmental expenses?

NW1167E

REPLY:

(a) The National Treasury has allocated the sum of R339.5 million towards the National Health Insurance Conditional Grant (NHI-CG) for the 2013/14 financial year.

(b) The R339.5 million allocation is entirely directed towards funding activities and interventions in the NHI pilot districts. R48.5 million (14.3%) has been directed towards interventions that will be directly implemented by the NHI pilot districts, with each district receiving an allocation of R4.85 million. The difference of R291 million (85.7%) is an indirect allocation that is intended to focus on two components, namely the contracting of general practitioners (which receives an allocation of R251 million) and the development of an alternative reimbursement tool for central hospitals in the form of a Diagnosis Related Groups (which receives an allocation of R40 million) for the financial year.

None of these funds has been diverted for either national nor provincial departmental expenses.

Reply received: July 2013

QUESTION NO. 944

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 10 MAY 2013

(INTERNAL QUESTION PAPER NO. 15)

Mrs D Robinson (DA) to ask the Minister of Health:

With reference to his reply to question 538 on 28 April 2013, what is the breakdown in the (a) processing and (b) time frame of the Medicine Control Council for registrations in respect of the (i) 39 months for pharmaceutical entities, (ii) 26 months for new clinical indications and (iii) 18 months for new doses of already existing registered molecules?

NW1166E

REPLY:

(a) Processing:

(i) 21 months for New Chemical Entities (NCEs);

(ii) 14 months for new clinical indications; and

(iii) 12 months for generics

(b) Evaluation towards registration:

(i) 18 months for NCEs;

(ii) 12 months for new clinical indications; and

(iii) 6 months for generics

Reply received: June 2013

QUESTION NO. 935

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 10 MAY 2013

(INTERNAL QUESTION PAPER NO. 15)

Mrs D Robinson (DA) to ask the Minister of Health:

(1) What position does a certain person (name furnished) of the National Health Laboratory Service hold;

(2) whether the said person has been suspended; if so, what were the grounds for the suspension?

NW1157E

REPLY:

According to the National Health Laboratory Service (NHLS) –

(1) The person in question is a regional executive for the coastal region of the NHLS.

(2) The person was suspended pending serious allegations of inappropriate conduct. The allegations were properly investigated following due processes consistent with the organisation's values and policies and he has been duly charged.

Reply received: June 2013

QUESTION NO. 919

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 03 MAY 2013

(INTERNAL QUESTION PAPER NO. 14)

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

Whether he has been informed that the Madibeng subdistrict does not pay a rural allowance; if not, what is the position in this regard; if so, what are the relevant details?

NW1145E

REPLY:

Madibeng Sub-District does not pay rural allowance because it has not been gazetted as such. Gazetting of areas for payment of rural allowance is the responsibility of the province that then advises National Department of Health on the need to gazette the areas based on their own assessment.

Reply received: July 2013

QUESTION NO. 907

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 03 MAY 2013

(INTERNAL QUESTION PAPER NO. 14)

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

(1) Whether the cancer register has been established and is functioning; if not, why not; if so, what are the relevant details;

(2) what are the challenges with regard to the implementation of the specified register?

NW1130E

REPLY:

(1) The National Cancer Registry (NCR) is based within the National Health Laboratory Service (NHLS) and has been in operation since 1986 as a pathology-based registry. It has produced various reports on cancer incidence in South Africa - the most recent being the report on Cancers in South Africa in 2005. The Regulations Relating to Cancer Registration were gazetted on the 26 April 2011 and covered the establishment of a population-based cancer.

The NCR has developed a business plan for the development of the population-based cancer registry. This is being reviewed by the Ministerial Advisory Committee for Cancer Prevention and Control. The outcome of this review will be available on the 22 August 2013 when the Ministerial Advisory Committee meets again.

(2) The NCR is currently supported by a small grant from the Department of Health with its major support coming from the NHLS. Some NGO partners such as CANSA have provided support as well. A lack of funding is the main obstacle to the successful implementation of the new Regulations and the expansion of the pathology-based registry. Considerable information technology infrastructure is required country-wide across health facilities and within the NCR to enable data transfer (as hard copy reporting is not practicable). The NCR is in discussions with various public and private sector partners to establish methods of electronic reporting to the NCR. The first data transfer has been received from the Department of Health of the Province of the Western Cape.

Additional staff members are required by the NCR to conduct training, provide support for registration of cancers by the cancer units in hospitals, analysing the data and preparing reports for the registry. The population-based registry requires additional support for field workers in a designated local geographic area to cover registration and verification of cancer reporting from households and health facilities in that area. There is also a lack of will by health professionals to fill in the prescribed form for Cancer Registration and send these forms to the NCR. This is being addressed through various awareness and outreach activities to selected health facilities and health professional groups.

Reply received: May 2013

PARLIAMENTARY QUESTION 853 FOR WRITTEN REPLY NW1072E

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


Whether his department will undertake an impact assessment study to evaluate the effectiveness of the National Health insurance pilot projects before proceeding to the second phase; if so, what are the relevant details? NW1072E

REPLY

The National Health lnsurance Conditional Grant (NHI-CG) was created as per the prescripts of the Division of Revenue Act (DORA) 2012113 for the financing of all NHI pilot activities. Part of the DORA requirements indicate that all pilot districts must submit quarterly performance information on progress achieved with respect to the activities and targets outlined in approved business plans. The Department undertakes regular monitoring and evaluation visits in all the pilot sites to proactively engage with key officials on the progress being reported as well as to assist in identifying hurdles and solutions to address them. The performance and impact of the pilots is documented in the form of a consolidated quarterly performance report that is submitted to National Treasury. Additionally, for the financial year 2012113, the Department has requested an external partner to assist in undertaking an independent assessment of the performance of all the pilot districts.


The Department has resolved not to increase the number of pilots in the financial year 2013/14. Instead, the focus is to strengthen key systems within existing NHI pilot districts particularly in the areas of strengthening the roll-out of the Primary Health Care teams and enhanced monitoring and evaluation capacity.

Reply received: June 2013

QUESTION NO. 852

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 03 MAY 2013

(INTERNAL QUESTION PAPER NO. 14)

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

(1) Which provincial health departments submitted business plans for the selected central hospitals on the revenue collections and management model by 15 February 2013;

(2) when will the plans be made public?

NW1071E

REPLY:

(1) and (2) The National Health Insurance Conditional Grant (NHI-CG) has been reformed for the financial year 2013/14. No central hospital is going to be given a direct allocation and hence they are not expected to submit any business plan. The indirect component of the NHI-CG will be held at the National Department of Health and work will be funded directly for all the work undertaken in the central hospitals as per the provisions of the Division of Revenue Act 2013/14.

Reply received: May 2013

PARLIAMENTARY QUESTIONNO 818 FOR MINISTER'S REPLY
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 06 MAY 2013

Mr MGP Lekota (COPE) to ask the Minister of Health:

Whether the department (a) involves the i) media and (ii) public broadcaster and (b) uses any other means to implement a holistic and comprehensive policy on adolescent and youth health to advice young people on (i) sound nutrition, (ii) calcium depletion through incorrect diet choices, (iii) obesity and the consequence thereof, (iv) inappropriate use of medication and (v) the need to build up immunity; if not, why not; if so, what are the relevant details?

REPLY

(a) (i) and (ii) YES, The Department of Health, uses various media to communicate nutrition messages to the public. Media coverage include press releases and articles in magazines and newspapers, radio interviews and where possible TV interviews. In the year 2012 alone, during the National Nutrition Week NNW which is commemorated on the 9 - 15 October, the Department in collaboration with other stakeholders, focused on healthy eating among South Africans. Healthy eating messages were discussed on eleven local and regional radio stations. The messages focused on importance of healthy eating and prevention of Obesity throughout the lifecycle which also covers Youth and Adolescents.

(b) (i) and (iii) YES, A booklet titled "Healthy eating is the way to go" and healthy eating puzzles and games were developed and shared with Department of Basic Education, these were targeting youth and are also distributed during various health awareness events.

(ii) the department has also developed food based dietary guidelines and one of the key messages within the guidelines for healthy eating encouraging South Africans to consume dairy products with the aim of increasing intake of calcium and other nutrients.

(iv) There has not been any publications that specifically target youth on the inappropriate use of medication. This will be the focus in the near future.

(v) Good nutrition has been advocated as the first option for building up immunity for the general public. There hasn't been a drive to promote the use of immune boosters for youth and Adolescents. The need for use of immune boosters has not emerged as a major need among Youth and Adolescents.

Reply received: June 2013

QUESTION NO. 803

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 APRIL 2013

(INTERNAL QUESTION PAPER NO. 13)

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

What (a) financial and (b) technical assistance has his department received from the (i) European Union, (ii) Department for International Development of the United Kingdom and (iii) any other international source for the National Health Insurance pilot projects?

NW1016E

REPLY:

(a) and (b) (i) and (ii)

Neither the European Union (EU) nor the Department for International Development of the United Kingdom (DFID) have given the Department any money specifically earmarked for NHI Pilot projects.

The EU money is for Agreement on Primary Health Care Sector Policy Support Programme. Since re-engineering Primary Health Care is part of NHI Piloting, we use part of EU money in that respect only.

Similarly, the DFID money is to support Health System strengthening and for HIV and AIDS. If any of the NHI pilots need Health system strengthening in any manner, we use the DFID money in that respect.

As such these monies are also utilised in any other district other than the NHI Pilots.

Reply received: August 2013

QUESTION NO. 802

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 APRIL 2013

(INTERNAL QUESTION PAPER NO. 13)

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

(1) What is the (a) breakdown of deadlines for the National Health Insurance pilot projects and (b) budget completion rate;

(2) what are the components of the plan to improve the underspending on National Health Insurance pilot projects?

NW1015E

REPLY:

(1) (a) The deadlines for the budget breakdowns for the National Health Insurance pilot projects are stipulated in the Division of Revenue Act published annually by the National Treasury. The Division of Revenue Act clearly stipulates the various deadlines on which the pilot districts and provinces must submit information pertaining to financial and non-financial performance on a monthly, quarterly and annual basis. The monthly financial data must be submitted to the Department of Health within 30 days of the following month; the quarterly performance reports by provinces, selected pilot districts and central hospitals on the quarterly achievements against the outputs and targets as stipulated in the approved district business plans must be submitted to the Department of Health within 30 days after the end of each quarter; and the Annual Performance Evaluation Report must be submitted to the Department of Health 45 days after the end of the financial year. (b) The table below summarises the expenditure levels for each province, including commitments:

Province

Allocated Budget

Expenditure

(31 March 2013)

Percentage (%)

Eastern Cape

11 500 000.00

10 465 000

91 %

Free State

16 500 000.00

9 361 000

81.4 %

Gauteng

31 500 000.00

20 097 000

64 %

KwaZulu-Natal

33 000 000.00

30 129 000

91.3 %

Limpopo

11 500 000.00

6 049 000

53 %

Mpumalanga

11 500 000.00

6 049 000

53 %

North West

11 500 000.00

10 902 000

95 %

Northern Cape

11 500 000.00

8 004 000

70 %

Western Cape

11 500 000.00

11 397 000

99.1 %

NATIONAL

150 000 000.00

112 453 000

77.7 %

(2) The intervention plan to improve spending in the National Health Insurance pilot districts focuses on three key areas, namely (i) strengthening Supply Chain Management systems at the district level to unblock procurement and service delivery hurdles; (ii) increasing capacity within the pilot district to effectively roll-out the three Primary Health Care streams and how they link into the referral system; and (iii) strengthening the monitoring and evaluation systems at the district level to ensure timely identification of blockages, implementation of proactive solutions to deal with identified blockages and improved compliance with stipulated reporting requirements.