Questions & Replies: Health
2013-06-18
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Reply received: December 2013
QUESTION NO. 851
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 have submitted the prescribed (a) monthly financial reports and (b) quarterly reports on National Health Insurance;
(2) when will these reports be made public?
NW1070EREPLY:
(1) The Division of Revenue Act (DORA) 2012/13 requires that all pilot districts must submit quarterly performance information on progress achieved with respect to the activities and targets outlined in approved business plans. This information must be in the form of financial and non-financial data and reports. All the Provincial Departments of Health have submitted the prescribed monthly financial reports which are collated in the In-Year Monitoring template as distributed by the National Treasury, and quarterly performance reports which are used to compile consolidated quarterly performance report that is submitted to National Treasury.
(2) The reports are readily available at the National Department of Health and/or through the National Treasury.
Reply received: June 2013
QUESTION NO. 782
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 APRIL 2013
(INTERNAL QUESTION PAPER NO. 13)
Prof B Turok (ANC) to ask the Minister of Health:
Are there openings for plastic surgeons in the public health system; if not, what are the constraints?
NW991E
REPLY:
Yes.
Reply received: May 2013
QUESTION NO. 781
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 26 APRIL 2013 lNTERNAL QUESTION PAPER NO. 13)
Prof B Turok (ANC) to ask the Minister of Health:
(1) How many foreign specialists are working in South Africa;
(2) are there any obstacles to their coming in; if so, what obstacles?
REPLY:
(1) A total of 404 foreign specialists are working in the public service. The Health Professions Council of South Africa (HPCSA) indicated that a total of 1 570 foreign specialists are registered to practice in South Africa. This includes doctors who are practising in the public sector, private sector as well as those who hold registration but are not necessarily residing in South Africa.
(2) No, but they have to meet the requirements of the HPCSA as well as the Immigration Act, 2002 (Act No 13 of 2002).
Reply received: June 2013
QUESTION NO. 772
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013
(INTERNAL QUESTION PAPER NO. 12)
Dr W G James (DA) to ask the Minister of Health:
(1) In terms of his department's Regulations Relating to the Reduction of Sodium in Certain Foodstuffs and Related Matters published on 20 March 2013, does Foodstuff Category 9 referring to raw-processed meat sausages (all types) and similar products include chicken which has been subjected to brining; if not, will his department create a foodstuff category for chicken which has been subjected to brining; if so,
(2) will his department ensure that the brine content in chicken is reduced with regard to (a) whole chicken carcasses and (b) chicken pieces?
NW983E
REPLY:
(1) No, this category does not include chicken that has been subject to brining. In the consultation process in preparation for the regulations on the Reduction of Sodium in Certain Foodstuffs, it came to the attention of the Department of Health that for purposes other than only health risk, the Department of Agriculture is currently deciding on the legal amount of brine allowed in chicken. Rather than having two simultaneous processes dealing with brined chicken, the Department of Health withdrew this category from its sodium regulation – with the understanding that the levels of brine that will be permitted through regulation by the Department of Agriculture will be acceptable to the Department of Health. However, if following the intervention by the Department of Agriculture, sodium levels permitted in chicken are still deemed to be a health risk, an additional category with sodium reduction targets will be added to the abovementioned salt regulation.
(2) Acceptable sodium levels apply to both whole chicken carcasses and chicken pieces.
Reply received: August 2013
QUESTION NO. 759
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013
(INTERNAL QUESTION PAPER NO. 12)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) (a) How many volunteers are there who deal with HIV treatment adherence in each province and (b) what amount of stipend do they get;
(2) (a) what is the average period that these volunteers serve and (b) what is the (i) lowest and (ii) highest academic qualification of the volunteers;
(3) whether any of the volunteers were appointed as permanent staff; if not, why not; if so, what are the relevant details?
NW969EREPLY:
(1) (a) and (b) Volunteers by definition Honourable Member are people who offer themselves to perform work without any remuneration.
(2) As stated above, volunteers offer themselves on their own volition.
(3) I have never heard of a volunteer who is permanent.
Reply received: May 2013
QUESTION NO. 728
728: Mr TW Coetzee (DA) to ask the Minister of Health:
With regard to the Professional Board for Psychology complaint reference number 0055581145612007 filed on or about 9 May 2007, (a) what is the status of the complaint and (b) what has been the reason for the six-year delay in the finalization of this matter?
REPLY
In response to the question; the Health Professions Council of South Africa has advised as follows:
1. Adv. Mapholisa was appointed as the pro forma complainant in this matter and was placed in a position to proceed with a disciplinary inquiry into the conduct of Ms Estelle De Wit psychologist with registration number PS0055581.
2. The letter of complaint dated 25 April 2007, was received by council whereupon the letter of explanation dated 16 June 2007 was requested.
3. The matter served before the Prelim Committee in April 2008 where the Committee resolved that an inquiry into the conduct of Ms De Wit be held.
4. On 05 May 2008 Adv. Mapholisa obtained an expert opinion from Prof Charl Vorster, who's report exonerated the Respondent/Ms De Wit.
5. On 1 September 2008 Adv. Mapholisa referred the matter back to the Prelim Committee for reconsideration of the committee's previous resolution, based on Prof Vorster's report.
6. On the 24 October 2008, the matter served before the Prelim Committee. The Committee resolved that the matter be referred back to inquiry as the committee was not in agreement with the opinion of Prof Voster.
7. Adv. Mapholisa then sought a second opinion from Dr Suzanne Bester who was of the opinion that the Respondent/ De Wit contravened Ethical Rules and an inquiry into her conduct should be held.
PARLIAMENTARY QUESTION NO. 728
8. In the light of the above, Adv. Mapholisa set the matter down for hearing on the 17 and 18 September 2009.
9. On the above date, the Respondent/ De Wit raised a point in limine demanding the first report of Prof Vorster, which exonerated her. She brought an application before the professional conduct committee of which was successfully opposed by Adv. Mapholisa and the application was refused.
10.The Respondent/ De Wit then lodged a review application with the Eastern Cape Port Elizabeth High Court demanding the report of Prof Vorster be made available by the HPCSA.
11.HPCSA outsourced the matter to Ledwaba Mazwai Attorneys who proceeded to handle the review application in the Eastern Cape High Court in Port Elizabeth.
12.The application was heard on 23 September 2010 and the High Court of Port Elizabeth ordered the HPCSA to avail the report to the Respondent De Wit, to which the HPCSA obliged.
13.Subsequent to that, Adv. Mapholisa set down the matter for hearing in November 2011. The Respondent/ De Wit objected through her attorneys and demanded that, based on Prof Vorster's report, the charges against her be withdrawn by the HPCSA.
14. However, the HPCSA refused to have the matter withdrawn on the basis that the opinion is not necessarily binding on the Professional Conduct Committee especially if regard is had to the VRM v HPCSA and others (see Annexure A attached).
15.As a result of the HPCSA's refusal to withdraw the charges, the Respondent/ De Wit, on 6 June 2012, lodged an interdict application against the HPCSA, requesting the South Gauteng High Court to interdict HPCSA from proceeding with an inquiry against her.
16. Judgement in this matter has been reserved by Judge Classen.
17.0n the 25 April 2013, Adv Mapholisa contacted Mazwai Attorneys to ascertain the status on this matter. Currently, the attorneys are still awaiting the judgement and are further considering reporting Judge Classen to the Judge President of the South Gauteng High Court due for his delay in delivering the required judgement.
Reply received: May 2013
QUESTION NO. 726
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013 (INTERNAL QUESTION PAPER NO. 12)
Mrs S P Kopane (DA) to ask the Minister of Health:
(I) List the countries that his department has agreements with for the training of medical students;
(2) (a) when did the agreements come into effect, (b) when will they end, (c) at what institutions are the students taught, (d) how many students are at each institution, (e) at what cost per student per year and (f) in what language are they taught;
(3) what are the contractual obligations imposed on the students during their period of study?
NW934E
REPLY:
(1) Cuba
(2) (a) - The first Agreement between the Government of the Republic of South Africa and the Government of the Republic of Cuba on Cooperation in the Fields of Health and Medical Sciences was signed on 30 October 1996 following the 1995 Declaration of Intent signed between the two countries under the leadership of former Presidents Nelson Mandela and Fidel Castro. The purpose of the Agreement was for the Government of South Africa to recruit doctors to serve in the rural areas of South Africa as well as professors to teach medicine at Walter Sisulu University
- In October 1997 the Agreement was again revised to include the training of medical students in Cuba.
- In 2001 the Agreement was again revised to allow students to come back for integration.
- In 2012 the New Agreement was signed. The Agreement will expire on 24 May 2017 but is renewable.
- Technical Agreement "Contract for Academic Services between the Ministry of Public Health of the Republic of Cuba and the Ministry of Health of the Republic of South Africa", The Agreement is valid for seven (7) years.
(b) (i) The Agreement between the Government of the Republic of South Africa and the Government of the Republic of Cuba on Cooperation in the Field of Public Health and Medical Sciences signed on 25 May 2012 will expire on 24 May 2017, but is renewable.
(ii) The "Contract for Academic Services between the Ministry of Public Health of the Republic of Cuba and the Ministry of Health of the Republic of South Africa" signed on 22 June 2012 is valid for seven (7) years.
(c) - Sancti Spiritus;
- Santa Clara;
- Cienfuegos;
- Sagua de la Grande;
- Havana School of Medical Sciences
(d) The following table reflects the situation in this regard:
| Medical School | No. of students |
| Sancti Spiritus | 72 |
| Santa Clara | 139 |
| Cienfuegos | 142 |
| Sagua de la Grande | 80 |
| Havana School of Medical Sciences | 911 |
| TOTAL | 1 344 |
Reply received: May 2013
QUESTION NO. 716
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013 (INTERNAL QUESTION PAPER NO. 12)
Mrs D Robinson (DA) to ask the Minister of Health:
How many cases of litigation have been instituted against hospitals on the grounds of negligence caused by medical staff shortages (a) in (i) 2010, (ii) 2011 and (iii) 2012 and (b) since 1 January 2013?
W922E
REPLY:
There are no cases of litigation that have been instituted against hospitals on the grounds of negligence caused by medical staff shortages in the period mentioned.
Reply received: July 2013
QUESTION NO. 715
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013
(INTERNAL QUESTION PAPER NO. 12)
Mrs D Robinson (DA) to ask the Minister of Health:
How many man days were lost due to absenteeism in each province for (a) doctors and (b) nurses?
NW921EREPLY:
According to the five provinces mentioned below, the following table reflects the situation in this regard
| MAN DAYS LOST DUE TO ABSENTEEISM | ||
| PROVINCE | DOCTORS | NURSES |
| Free State | 20 969 | 235 539 |
| KwaZulu Natal | 8 560 | 200 298 |
| Limpopo | 5 903 | 103 053 |
| North West | 75 | 419 |
| Western Cape | 73 814 | 437 275 |
Will furnish responses from other provinces as soon as they arrive.
Reply received: July 2013
QUESTION NO. 714
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 19 APRIL 2013
(INTERNAL QUESTION PAPER NO. 12)
Mrs D Robinson (DA) to ask the Minister of Health:
What national system is in place to record absenteeism of medical staff at hospitals?
NW920EREPLY:
The Personnel and Salary Administration System (PERSAL) is the national system that is in place to capture and record absenteeism at each hospital or institution within the Department of Health.
Reply received: August 2013
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?
NW786EREPLY:
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: June 2013
QUESTION NO. 622
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 28 MARCH 2013
(INTERNAL QUESTION PAPER NO. 10)
Mrs D Robinson (DA) to ask the Minister of Health:
Which provinces have not convened a provincial health consultative council in terms of the National Health Act, Act 61 of 2003?
NW781E
REPLY:
· Eastern Cape;
· Free State;
· Limpopo;
· Mpumalanga; and
· Western Cape.
Reply received: July 2013
QUESTION NO. 550
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 MARCH 2013
(INTERNAL QUESTION PAPER NO. 9)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether any provinces (a) overspent or (b) underspent their overall budget in the (i) 2010-11 and (ii) 2011-12 financial years; if so, (aa) which provinces and (bb) by how much, in each case;
(2) whether any provinces underspent on infrastructure in the same period; if so, (a) which provinces and (b) by how much, in each case?
NW707EREPLY:
(1) The following table reflects the information in this regard, according to the Provincial Departments of Health:
| PROVINCE | 2011/12 Budget Allocations (including Roll-overs) | Actual Expenditure (by end of March 2012) | Comments |
| R000' | R000' | R000' | |
| Eastern Cape | 376 764 | 328 912 | Underspent by R45 852 |
| Free State | 131 717 | 75 052 | Underspent by R56 665 |
| Gauteng | 142 694 | 136 957 | Underspent by R5 737 |
| KwaZulu Natal | 358 471 | 364 758 | Overspent by R6 287 |
| Limpopo | 270 802 | 253 093 | Underspent by R17 709 |
| Mpumalanga | 146 368 | 129 152 | Underspent by R17 216 |
| North West | 145 466 | 136 695 | Underspent by R8 771 |
| Northern Cape | 89 501 | 104 891 | Overspent by R15 390 |
| Western Cape | 119 179 | 124 836 | Overspent by R5 657 |
(2) (a) In the 2010/11 financial year there was no Health Infrastructure Grant until the 2011/12 financial year. Prior to 2011/12, the Health Infrastructure Grant was fully managed by the National Treasury.
(b) Information on the 2011/12 financial year spending is as indicated in the above table.
Reply received: April 2013
QUESTION NO. 538
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 MARCH 2013
(INTERNAL QUESTION PAPER NO. 9)
Mrs D Robinson (DA) to ask the Minister of Health:
What is the turnaround time by the Medicine Control Council for registrations of (a) pharmaceutical entities, (b) new clinical indications and (c) new doses of already existing registered molecules?
NW695E
REPLY:
The average turn-around times are as follows:
(a) New Chemical Entities: 39 months;
(b) New indications: 26 months;
(c) New doses of already existing registered molecules: 18 months.
Reply received: April 2013
QUESTION NO. 537
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 MARCH 2013
(INTERNAL QUESTION PAPER NO. 9)
Mrs D Robinson (DA) to ask the Minister of Health:
(a) How is the supply level of Diamox (i) measured and (ii) monitored in public hospitals and (b) what procedures are in place to ensure sufficient levels are stocked in public hospitals?
NW694E
REPLY:
(a) (i) Supply and re-order levels are determined on usage figures;
(ii) Each hospital pharmacy manager is responsible for the monitoring of the availability and also identify potential or actual supply problems. Any red flags are immediately auctioned jointly among the relevant facilities, provincial pharmaceutical depots and contracted supplier. If unable to resolve at provincial level, the National Department of Health (Contract Manager) is informed for further engagement with suppliers. If necessary, remedial action is then taken as stipulated in the general conditions of contract.
(b) Availability of essential medicines is a non-negotiable for public health facilities. Sufficient stock levels should be maintained at all facilities and challenges experienced are communicated to the provincial pharmaceutical depots for further action. Managers of provincial depots have been requested to inform facilities of availability of alternative pack sizes if a shortage is experienced. In order to mitigate risk, critical items are awarded to more than one supplier on contract. Acetazolomide (Diamox) is cuttently available in two pack sizes i.e. 30's and 100's. After a meeting with the contracted supplier it was confirmed that the outstanding orders are being actioned.
Reply received: April 2013
QUESTION NO. 489
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 MARCH 2013
(INTERNAL QUESTION PAPER NO. 9)
Mrs H S Msweli (IFP) to ask the Minister of Health:
What is his department doing to align itself with the National Development Plan?
NW642E
REPLY:
The goals and priorities of the National Department of Health (NDOH) are aligned to the National Development Plan. There is complete alignment between the nine priorities of the National Development Plan, the NDOH 10 Point Plan (2009-2014) and the Negotiated Service Delivery Agreement.
Reply received: April 2013
QUESTION NO. 454
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 MARCH 2013
(INTERNAL QUESTION PAPER NO. 8)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether he intends to request that the SA Revenue Service audit all overtime claims submitted by doctors in state hospitals; if not, why not; if so, what are the relevant details;
(2) whether he has found that gross irregularities in overtime claims submitted by doctors at state hospitals have also been committed in provinces besides the instances that were discovered in Gauteng; if so, what are the relevant details?
NW607E
REPLY:
No, the audit of all financial transactions related to salary and allowances is the mandate of the Auditor-General. The Office of the Auditor-General will be requested to perform audits of overtime claims as part of their annual regulatory audits.
No, no such information was made available to me.
Reply received: June 2013
QUESTION NO. 464
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 15 MARCH 2013
(INTERNAL QUESTION PAPER NO. 8)
Ms C K K Mosimane (Cope) to ask the Minister of Health:
With reference to the addition of Amajuba District in KwaZulu-Natal as a further National Health Insurance pilot site, (a) what criterion was used to make this decision and (b) why?
NW619E
REPLY:
(a) The National Department of Health officially selected ten (10) pilot districts across the country. The KwaZulu/Natal Provincial Department of Health used its own discretion and exercised its own provincial budget allocation to add Amajuba District as one of the pilots. As National Department, we are very happy about the KwaZulu-Natal initiative.
(b) Because they believe they have more districts than any province in the country, and they have a bigger burden of disease than any province.
Reply received: April 2013
QUESTION NO. 379
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mr I O Davidson (DA) to ask the Minister of Health:
(1) (a) How many medical students that are sponsored by his department are studying in Cuba, (b) what are the terms of the agreement with the students, (c)(i) what allowances are paid and (ii) what accommodation facilities are available to them;
(2) (a) what grievances has his department received from the students and (b) what steps are being taken to alleviate them?
NW526E
REPLY:
(1) (a) There are 1 314 medical students sponsored by the Department of Health studying in Cuba.
(b) That they will work for the State, especially in rural areas, on completion of their studies.
(c) (i) Personal allowance paid to the students is Cuban dollars (CDC) 200 per month (1 CDC = )
(ii) Students are accommodated in shared rooms in student residences on university campuses.
(2) (a) The students have raised the following grievances:
· The students demand that their $200 stipend be increased to $700;
· Variety of food available at the universities: The students have complained that the menu consists mainly of rice, beans, port or fish, and that this menu hardly changes. An added complaint is that there are a few students who, for religious reasons, do not eat pork;
· The students are demanding that there be a Health Attache in Cuba, to support them, and that there be a direct liaison with the Department of Health
(b) The following steps are being taken to alleviate the grievances:
· The stipend of $200 is considered adequate, and there shall not be any change made to that;
· On various occasions when the Department has been to Cuba to look into the food issue, it has always been found that the students' complaint has been exaggerated: for the main meals, there is a fair amount of variety in the protein foods they are offered, i.e port, fish, chicken, eggs, beans and lentils, and vegetables. Whatever else that the students may wish for, and are not getting, is largely as a result of the economic situation in Cuba – and affected everybody else.
However, on the matter of religious exemptions, the Cubans have undertaken to consistently offer an alternative equivalent menu.
· The Minister decided as far back as last year to send a Health Attache to Cuba. This process is still on and if all goes well, the person assigned as Health Attache will depart to Cuba soon.
Reply received: April 2013
QUESTION NO. 371
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mr M Swart (DA) to ask the Minister of Health:
What plans does he have to introduce mobile health facilities for primary health care in rural areas?
NW518E
REPLY:
· Mobile health facilities operating in the rural areas are already part of the service delivery platform of the public health sector;
· There are 794 mobile health facilities that form part of the service delivery platform;
· Each mobile facility has a number of visiting points and the frequency of the visits is determined by the size and needs of the community it serves;
· Individual plans at Provincial level include details of improved service coverage where required.
Reply received: April 2013
QUESTION NO. 365
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mr M S F de Freitas (DA) to ask the Minister of Health:
How many people have had gender reassignment surgery in a public hospital since 15 March 2004?
NW512E
REPLY:
The Department of Health does not keep a database of gender reassignment surgical procedures that are performed in public sector facilities.
There are currently two public sector clinics in South Africa with specialised and skilled healthcare providers that perform gender reassignment surgical procedures and they are linked to the Universities of Pretoria (UP) and of Cape Town (UCT).
Information at hand suggests that the UP clinic has performed more than a hundred procedures since inception in 1990 and the UCT clinic more than 10 since 2009.
Reply received: August 2013
QUESTION NO. 349
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mrs A Steyn (DA) to ask the Minister of Health:
(1) How many inspections in terms of the Foodstuffs, Cosmetics and Disinfectants Act, Act 54 of 1972, did his department oversee in respect of compliance with labelling by food suppliers (a) in the (i) 2009-10, (ii) 2010-11 and (iii) 2011-12 financial years and (b) since 1 April 2012;
(2) how many recorded violations have there been of section 3 and section 5 of the Act (a) in the (i) 2009-10, (ii) 2010-11 and (iii) 2011-12 financial years and (b) since 1 April 2012?
NW496EREPLY:
(1) The following table reflects the details on inspections overseen.
| Financial Year | Number of overseen infections |
| 2009-2010 | 11 423 |
| 2010-2011 | 13 938 |
| 2011-2012 | 18 417 |
| 2012-2013 | 17 651 |
(2) The following table reflects the details on violations recorded
| Financial Year | Number of overseen infections |
| 2009-2010 | 398 |
| 2010-2011 | 451 |
| 2011-2012 | 480 |
| 2012-2013 | 127 |
Reply received: July 2013
QUESTION NO. 336
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mr M Johnson (ANC) to ask the Minister of Health:
Whether he intends taking any steps in respect of state and private doctors who continue to give false medical reports about farm workers who sustain injuries on duty (details furnished); if not, why not; so, what are the relevant details?
NW480EREPLY:
The issuing of "false medical reports" by medical practitioners, whether in the employ of government or in private practice is covered by complaints and disciplinary procedures under the Health Professions Council of South Africa (HPCSA). The HPCSA is a statutory body and is committed to protecting the public and guiding the professions which include medical practitioners. The mission of the HPCSA is quality healthcare standards for all. The Council is mandated to regulate the health professions in the country in aspects pertaining to registration, education and training, professional conduct and ethical behaviour, ensuring continuing professional development and fostering compliance with healthcare standards. In order to safeguard the public and indirectly the professions, registration in terms of the Act is a prerequisite for practising any of the health professions with which the Council is concerned.
In addition, the Department of Health in the affected province can investigate the issuing of "false medical records" by medical practitioners in their employ within the prescripts of the labour laws applicable to the public service and take the necessary actions thereafter. The National Department of Health through the Occupational Health section can support the provincial Departments of Health with the investigations.
Complaints about the issuing of "false medical certificates" can be made in writing to the Registrar of the HPCSA and to the Head of the Department of Health in a province where the medical practitioner is in the employ of that provincial Department of Health.
The farm workers who were "injured on duty" can report the incident to the nearest Department of Labour office for investigation, payment of medical expenses and compensation under the Compensation for Occupational Injuries and Diseases Act (COIDA), 1993 (as amended), if found to be a work-related incident that led to injury and disability. In addition the Occupational Health section within the National Department of Health will be willing to assist the farm workers with their assessment and claims process.
Reply received: June 2013
QUESTION NO. 334
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 08 MARCH 2013
(INTERNAL QUESTION PAPER NO. 6)
Mr B M Bhanga (Cope) to ask the Minister of Health:
What assessment has he made of the effects on the health of South Africans as a result of the (a) goat, (b) buffalo and (c) donkey meat found in processed food products, as was recently published in the international Food Control journal by the Stellenbosch University Department of Animal Sciences?
NW470E
REPLY:
The study did not suggest that it was unsafe or unhealthy to consume (a) goat, (b) buffalo and (c) donkey meat, actually there are communities in South Africa which eat these types of meat.
The study was rather showing mislabelling of meat products, which will mislead and greatly offend those who do not eat such meats. Of course for those who are allergic to any meat product, be it beef, mutton, chicken, goat, buffalo or donkey, mislabelling will cause problems but these will be detected when people present to health centres with increasing incidents of such allergic reactions. Up to so far no such incidents have been reported.
Hence no special assessment has been deemed necessary. What is necessary is to label correctly.
Reply received: April 2013
QUESTION NO. 238
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 2)
Mr D A Kganare (Cope) to ask the Minister of Health:
(1) Whether he has been informed that ambulances in KwaZulu-Natal (details furnished) are not being utilised because of a lack of equipment; if so, (a) how many ambulances are not being utilised and (b) for what period after the specified delivery dates have they been standing unutilised;
(2) what (a) is the name and designation of the person responsible for procuring the specified ambulances and (b) specifications for equipment were (i) included and (ii) not included in the procurement document;
(3) whether the said person had noted the deficiencies at the time of ordering the ambulances; if not, why not; if so, what (a) action has been taken against the said person and (b) are the further relevant details;
(4) (a) what steps have been taken to ensure that the specified ambulances are made functionally mobile and (b) when will they be operational?
NW255E
REPLY:
(1) Yes, I am aware about the newspaper article on this issue.
(a) None.
(b) Since May 2012 to February 2013.
(2) (a) Supply Chain Management of the KwaZulu/Natal Department of Health was responsible for the procurement of the specified ambulances using the RT57 National Treasury Contract.
(b) The equipment for ambulances were procured through the National Treasury Transversal Contract RT4 and
(i) Specifications were included
(ii) Not applicable
(3) The Province procures vehicles on the National Treasury Contract, RT57 and equipment on National Treasury Contract RT4. However, the conversion of some vehicles such as the Toyota Land Cruisers and Toyota Hilux, plus the installation of the ratios including the tracking devices is not on both National Treasury Contracts and therefore, the KwaZulu/Natal Department of Health followed its provincial supply chain process to have these vehicles converted and to install the radios and the tracking devices.
(a) The delays were not caused by the deficiencies in the ordering of ambulances, but resulted from the appeal processes where the service provider appealed against the company that was appointed to convert these vehicles (Toyota Land Cruisers Hilux). This matter was referred to the Provincial Treasury to satisfy itself with the tender processes.
(b) None.
(4) (a) All the ambulances have been installed with radios and tracking devices and all are functional;
(b) The vehicles were handed over to the districts by the MEC on 04 February 2013.
Reply received: April 2013
QUESTION NO. 200
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 2)
Ms E More (DA) to ask the Minister of Health:
(1) With reference to his reply to question 3372 on 12 December 2012, on which dates did his department (a) attend and (b) not attend meetings of the Central Drug Authority;
(2) whether he will provide Ms E More with a copy of the report on harm reduction; if not, why not; if so, what are the relevant details?
NW214E
REPLY:
(1) (a) The officials from the Department of Health appointed to serve in the Central Drug Authority (CDA) attended the CDA General Meetings that were held on 27 July 2012 and 28 September 2012.
(b) All CDA General Meetings were attended.
(2) The CDA Annual Report 2011/12 has been submitted and is now a public document. Please consult it for the report on harm reduction.
Reply received: April 2013
QUESTION NO. 169
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mrs J D Kilian (Cope) to ask the Minister of Health:
(1) With reference to recent reports of malaria-related deaths and infection in Gauteng, what is the prevalence of malaria contracted by persons who were infected without having visited a malaria endemic area;
(2) what measures are in place to avoid migration of malaria mosquitoes into nonendemic areas;
(3) what is the status of cooperation between the Government and neighbouring countries in terms of (a) controlling and (b) eradicating malaria in the Southern African Development Community (SADC) region?
NW175E
REPLY:
(1) A total number of three (3) cases of odyssen malaria (acquisition of malaria in a non-endemic area by the bite of an imported mosquito), with one (1) death, were detected in Gauteng Province. They were detected in Donkerhoek and Mooiplaats, in the Tshwane District, in December 2012. In addition, there were four (4) similar cases but no deaths in Glen Marais, Kempton Park, and Ekurhuleni District. All entomological investigations revealed that there were no local mosquito vectors and the conclusion from the experts were that malaria-infected mosquitoes could have been imported through road travel. It should be noted that the number of imported malaria cases into Gauteng Province for December 2012 were 44 and 367 for January 2013.
(2) Government's main focus is to prevent the migration of malaria into non-endemic areas through the use of Indoor Residual Spraying in the high transmission parts of the country, as this suppresses malaria populations and prevent onward flight of mosquitoes. Disinfections (spraying of WHO-approved insecticides) of aircrafts and ships and boats from endemic countries is part of the interventions that are used by the Department of Health to curb the spread of malaria vectors into the non-endemic areas. The Department of Health is exploring ways of implementing Disinfection of vehicles from non-endemic areas. However, research will need to be conducted to determine the exact numbers of vectors (malaria mosquitoes) that travel in vehicles and exact types of vehicles that vectors travel in, to justify this approach. As an interim measure, health promotion messaging is being increased to alert the public on the signs and symptoms of malaria and appropriate preventative measures, especially during the malaria transmission months of September to May.
(3) South Africa is currently collaborating with Zimbabwe and Mozambique on Cross-border Malaria Initiatives, where the aim is to ensure harmonisation synchronisation and optimisation of malaria interventions, example, Indoor Residual Spraying which should commence in August and be completed before Christmas each year. Coverage should be more than 80% of the targeted households and chemicals used for spraying should be similar. In addition, South Africa is working very closely with Angola, Botswana, Mozambique, Namibia, Swaziland, Zambia and Zimbabwe on an initiative termed the E8-Elimination Eight, where the aim is to control malaria to less than 5 per 1000 population at risk in the countries such as Angola, Mozambique, Zambia and Zimbabwe and to eliminate the disease in countries such as Botswana, Namibia, South Africa and Swaziland. The key objective for the collaboration is to ensure that there is universal coverage (greater than 80% population coverage) of malaria preventative and curative strategies, in all the collaborating countries.
Reply received: April 2013
QUESTION NO. 133
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mr S B Farrow (DA) to ask the Minister of Health:
(1) How many legal matters were dealt with by his department (a) in the (i) 2009-10, (ii) 2010-11 and (iii) 2011-12 financial years and (b) during the period 1 April 2012 up to the latest specified date for which information is available;
(2) (a) how many of the specified legal matters were dealt with by (i) the State Attorney and (ii) private attorneys during the specified periods and (b) what are the reasons why his department was not represented by the State Attorney in each specified case;
(3) what total amounts were paid by his department to (a) the State Attorney and (b) private attorneys during the specified periods?
NW139E
REPLY:
(1) (a) (i) 2009-10: 21 legal matters;
(ii) 2010-11: 29 legal matters;
(iii) 2011-12: 18 legal matters;
(b) 1 April 2012 to date: 26 legal matters
(2) (a) Matters dealt with by the State Attorney
(i) 2009-10: All 21 legal matters were handled by the State Attorney;
2010-11: All 29 legal matters were handled by the State Attorney;
2011-12: 17 legal matters were handled by the State Attorney;
1 April 2012 to date: All 26 legal matters were handled by the State Attorney.
Matters handled by private attorneys
(ii) 2009-10: None;
2010-11: None;
2011-12: 1 legal matter
1 April 2012 to date: None.
(b) The reasons why the Department was not represented by the State Attorney is that this is a labour matter relating to the dismissal of the Special Advisor to the late Deputy Minister of Health who allegedly absconded amidst his proposed placement. The attorney handling this matter had been advising the Minister on labour issue relating mainly to the reviewing of the management of public hospitals, at the time when this matter was served upon the Minister. This matter being against the Minister, it was logical that the attorney advising the Minister on labour matters should handle it.
(3) (a) Amounts paid to the State Attorney:
(i) 2009-10: R1,260,733.05;
(ii) 2010-11: R616,485.29;
(iii) 2011-12: R35,017,437.96
(iv) 1 April 2012 to date: R1,171,182.37
(b) Amounts paid to the Private Attorney
(i) 2009-10: None;
(ii) 2010-11: None;
(iii) 2011-12: R72,451.00;
(iv) 1 April to date: None.
Reply received: April 2013
QUESTION NO. 100
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Dr D T George (DA) to ask the Minister of Health:
(1) Whether (a) his department and (b) any entities reporting to it paid any bonuses to senior officials in December 2012; if so, in each specified case, (i) to whom and (ii) what amount was paid;
(2) whether the specified bonuses were performance-based; if not, what is the justification for each bonus; if so, in each case, from which budget were the performance bonuses paid;
(3) whether, in each case, (a) a performance agreement was signed with the official and (b) regular performance assessments were conducted; if not, why not, in each case; if so, what are the relevant details in each case?
NW106E
REPLY:
(1) (a) No bonuses were paid by the Department to senior officials in December 2012;
(b) According to information obtained from the entities, no bonuses were paid by the entities in December 2012;
(i) and (ii) Not applicable.
(2) Not applicable.
(3) (a) Not applicable in December 2012. Performance agreements are signed annually;
(b) Performance Assessments are conducted half-yearly for Senior Managers and Annual Appraisals conducted at the end of the performance cycle (31 March of each year).
Reply received: July 2013
QUESTION NO. 67
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mr E H Eloff (DA) to ask the Minister of Health:
(a) How many tickets did (i) his department and (ii) any of its entities purchase to attend business breakfasts hosted by a certain newspaper (name furnished) (aa) in the (aaa) 2010-11 and (bbb) 2011-12 financial years and (bb) during the period 1 April 2012 up to the latest specified date for which information is available and (b) what was the total cost in each case?
NW73EREPLY:
(a) (i) None.
(ii) None.
(b) Zero.
Reply received: April 2013
QUESTION NO. 46
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mrs D Robinson (DA) to ask the Minister of Health:
What (a) number of community service doctors have been allocated to each specified province and (b) is the minimum standard of accommodation provided to community service doctors in remote rural areas?
NW49E
REPLY:
The following table reflects the situation in this regard, according to information received from the Provinces:
| PROVINCE | NUMBER ALLOCATED |
| Eastern Cape | 145 |
| Free State | 64 |
| Gauteng | 202 |
| KwaZulu/Natal | 173 |
| Limpopo | 87 |
| Mpumalanga | 105 |
| North West | 68 |
| Northern Cape | 76 |
| Western Cape | 152 |
| SAMHS | 58 |
| TOTAL | 1 130 |
Reply received: August 2013
QUESTION NO. 39
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mrs D Robinson (DA) to ask the Minister of Health:
(1) What is the total number of (a) neonatal and (b) infant mortality cases reported per province (i) in the (aa) 2009-10, (bb) 2010-11 and (cc) 2011-12 financial years and (ii) since 1 April 2012;
(2) what were the recorded causes of death for each (a) neonatal and (b) infant death;
(3) what is his department's plan of action to reduce (a) neonatal and (b) infant mortality cases;
(4) whether his department keeps separate records for (a) neonatal and (b) infant deaths in (i) rural and (ii) urban areas; if not, why not; if so, how do these differ?
NW41EREPLY:
(1) (a) and (b) The following table reflects the rates in this regard
Early Neonatal Mortality Rates
| Province | 2007 | 2008 | 2009 |
| Eastern Cape | 13.3 | 13.0 | 11.2 |
| Free State | 9.7 | 9.1 | 10.1 |
| Gauteng | 7.4 | 7.8 | 8.6 |
| KwaZulu Natal | 5.4 | 5.9 | 5.0 |
| Limpopo | 11.0 | 9.8 | 10.4 |
| Mpumalanga | 11.2 | 10.2 | 10.3 |
| North West | 10.9 | 10.4 | 9.3 |
| Northern Cape | 9.2 | 9.3 | 9.4 |
| Western Cape | 5.1 | 4.1 | 4.5 |
Infant Mortality Rates based on vital registration data
| Province | 2007 | 2008 | 2009 |
| Eastern Cape | 30.6 | 30.0 | 24.4 |
| Free State | 87.2 | 84.3 | 72.4 |
| Gauteng | 55.3 | 52.2 | 50.1 |
| KwaZulu Natal | 46.5 | 43.0. | 37/2 |
| Limpopo | 35.1 | 36.9 | 32.9 |
| Mpumalanga | 52.9 | 43.6 | 36.5 |
| North West | 77.6 | 70.2 | 48.4 |
| Northern Cape | 53.4 | 54.4 | 48.1 |
| Western Cape | 25.5 | 23.1 | 23.4 |
(2) The most common causes of death in the newborn period are immaturity (45%), intrapartum hypoxia (28%), infection (10%) and congenital abnormalities *8%)
(3) The maternal, newborn, child and women health Strategic Plan outlines a package of key newborn and child health interventions which should be provided to all newborns and children.
The newborn package includes:
(i) Promotion of early and exclusive breastfeeding including ensuring that breastfeeding is made as far as possible for HIV-exposed infants;
(ii) Provision of Prevention of Mother-to-child Transmission of HIV;
(iii) Resuscitation of newborns;
(iv) Care for small/ill newborns according to standardised protocols;
(v) Kangaroo Mother Care for stable premature infants;
(vi) Post-natal visit within six days which include newborn care, and supporting mothers to practice exclusive breastfeeding.
The package of Child Health services include:
(i) Promotion of breastfeeding and appropriate complementary feeding practices for infants and young children;
(ii) Provision of preventative services. These include: immunisation, growth monitoring and promotion, vitamin A supplementation, regular deworming;
(iii) Correct management of common childhood illnesses using the IMCI case management process (including early identification and management of children with HIV and TB);
(iv) Early identification of HIV-infected children and appropriate management (including initiation of Anti-retroviral Therapy (ART) where indicated);
(v) Improved hospital care for ill children especially for those with common conditions (pneumonia, diarrhoea and severe malnutrition) using standardised protocols;
(vi) Expansion and strengthening of school health services;
(vii) Developing services for children with long-term health conditions.
(4) The Department of Health collects statistics from all health facilities and does not separate these into rural and urban areas.
Reply received: April 2013
QUESTION NO. 15
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 FEBRUARY 2013
(INTERNAL QUESTION PAPER NO. 1)
Mrs P C Duncan (DA) to ask the Minister of Health:
Whether, with regard to his reply to question 953 on 3 September 2012, any quality improvement plans based on the District Health Information System (DHIS) data have been (a) developed and (b) implemented; if not, why not; if so, (i) how many, in each case, (ii) how effective are they, (iii) to which districts did they pertain and (iv) what improvements were listed in each plan?
NW17E
REPLY:
(a) and (b) Yes, Data Quality Improvement Plans have been developed and implemented.
(i) Ten (10) Data Quality Improvement Plans. One (1) produced by the National Department of Health and nine (9) developed by Provincial Departments of Health;
(ii) Very effective. The preliminary audit of Performance Information conducted by the Auditor-General South Africa (AGSA) in February 2013, found that data quality in health facilities that were first audited in 2011/12, and audited in 2012/13, reflected great improvement. Key challenges still exists, especially where the manual (paper-based) data collection systems are still being used;
(iii) The Plans pertain to all districts across the nine Provincial Departments of Health;
(iv) Improvements listed in the Data Quality Improvement Plans include:
(a) Enhancing implementation of the District Health Management Information System (DHMIS) policy at all levels of the health care system, to improve data management and data quality;
(b) Printing and dissemination of Standard Operating Procedures (SOPs) for the DHMIS Policy, to provide systematic guidance to health care providers and health information management personnel at facility level. This has been achieved;
(c) Development of a new National Indicator Data Set (NIDS) FOR 2013/14-2014/15, with a smaller set of indicators. This has been achieved;
(d) Rationalisation of the number of registers used in Primary Health Care (PHC) facilities;
(e) All new registers produced by the National Department of Health and Provincial Departments of Health will as from 2013 onwards be pre-numbered. Existing registers will be numbered manually;
(f) All new registers produced by the National Department of Health and Provincial Departments of Health from 2013 onwards will provide space for the signature of the completer and the reviewer. Existing registers will be signed at the end of each page;
(g) An additional 550 data capturers have been employed, which increased the total number to 1 764. A need exists for additional 3 061 data capturers to be appointed.
The policy and procedure-related interventions implemented to improve data quality are sustainable. Enhanced sustainability requires appointment of additional data capturers, provision of appropriate ICT infrastructure and improved connectivity (bandwidth) in all 3 880 public health facilities