Questions & Replies: Health

The Hospital has a budget allocation of R10.103 million for the current financial year which is inclusive of an HIV/AIDS conditional grant. The Department has even recently advertised the position of a facility manager for this Hospital.

Reply received: October 2014

QUESTION NO. 1179

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 29 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 12)

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

(1) Whether (a) he and (b) the Deputy Minister has each employed a ministerial special advisor; if so,

(2) (a) what is the name of the special advisor, (b) when was the advisor appointed, (c) what are the duties of the advisor, (d) at what post level was the appointment made, (e) what is the salary level of the advisor, (f) what is the duration of the employment contract entered into with the advisor and (g) why was it necessary to appoint the advisor?

REPLY:

(1) No.

(2) Not applicable.

Reply received: October 2014

QUESTION NO. 1081

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 29 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 12)

Mr T Makondo (ANC) to ask the Minister of Health:

In view of operation Phakisa and the perception that the health sector is collapsing due to non-maintenance, (a) when will these central hospitals be refurbished, equipped and staffed, (b) does his department have the budget for the refurbishments, (c) when will his department start with the refurbishments, (d) have project managers been appointed, (e) has the procurement been done and (f) when is the deadline for the completion of these tasks?

REPLY:

The table in Annexure 1 gives an overview of the maintenance projects that are being undertaken at Central Hospitals across the country. In terms of staffing, all provinces have budget for staffing through the equitable share and conditional grants. Provinces fill posts as they become vacant. Subsequent to that, pertaining to the appointment of Project Managers, provinces were given a budget of R29 million to appoint technical staff to manage projects through the Health Facility Revitalisation Grant. The process is still underway.

See the link for Annexure 1: www.pmg.org.za/files/rnw1081a.pdf

Reply received: November 2014

QUESTION NO. 1080

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 29 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 12)

Ms J M Maluleke (ANC) to ask the Minister of Health:

How far is his department with regulating the private health care sector tariffs that are above the rate of inflation?

REPLY:

The process regulating the private health sector tariffs does not only apply to those that are above the rate of inflation. It is going to be a comprehensive process and is still in early stages.

Reply received: October 2014

QUESTION NO. 1077

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 29 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 12)

Ms D Carter (Cope) to ask the Minister of Health:

Whether his department has commissioned an investigation into the high prevalence of respiratory diseases and cancer in areas adjoining mines, due to toxic spills into the atmosphere and the water surrounding mine operations; if not, why not; if so, what are the relevant details and outcomes thereof?

REPLY:

No, at a national level, the Department of Health has not commissioned any investigation regarding the high prevalence of respiratory diseases and cancer in mining areas as a result of toxic spills into the atmosphere and the water surrounding mine operations. The primary function of investigations is under municipal health services (MSH) which are conducted by Environmental Health Practitioners (EHPs) employed by metropolitan (category A) and district municipalities (category C) as stipulated in the National Health Act, 2003 (Act No. 61 of 2003) as amended in the country. The Act lists the nine components of municipal health services which includes, amongst others, the following:

1. Water quality monitoring;

2. Waste management;

3. Food control;

4. Surveillance of health premises;

5. Surveillance and prevention of communicable diseases excluding immunisations;

6. Vector control;

7. Chemical safety;

8. Disposal of the dead; and

9. Environmental pollution control.

The amended scope of practice for Environmental Health dated 26 June 2009 delineates the activities pertaining to each of the above components of municipal health services, specifically to water quality monitoring, environmental pollution control and surveillance and prevention of communicable diseases. In addition, municipalities have air pollution control monitoring devices located at strategic points within their areas of jurisdiction to monitor the pollutants released into the environment. This system assists and supports in detecting the pollutants that can adversely impact negatively on human health, for example, causing respiratory diseases. Furthermore, municipalities have water sampling programmes in place to test the quality of water also within their areas of jurisdiction from various sources including the mines. At a municipal level, Environmental Health Practitioners are law enforcers ensuring compliance and enforcement of their municipal by-laws thereby assisting and supporting any deviations and transgressions thereof.

Reply received: November 2014

QUESTION NO. 954

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 10)

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

(1) How many (a) investigations were conducted for (i) overbilling and (ii) overcharging for goods and services rendered by external contractors and service providers for the (aa) 2009-10, (bb) 2010-11, (cc) 2011-12, (dd) 2012-13 and (ee) 2013-14 financial years, (b) of these investigations were conducted (i) internally, (ii) by the Office of the Public Protector, (iii) by the SA Police Service, (iv) by the Special Investigating Unit or (v) by external private sector entities ;

(2) what (a) amount was lost by his department due to (i) overbilling or (ii) overcharging and (b) was the (i) outcome of each investigation and (ii) breakdown of monies recovered for each specified financial year?

REPLY:

(1) (a) None

(b) The National Department of Health did not receive any allegations related to overbilling nor conduct any investigations related to the aforesaid matter. The Department has also not conducted the investigations on overbilling and overcharging of goods and services rendered by external contractors and service providers on the financial years specified above.

The National Department of Health is not aware of any of these investigations conducted or referred to:

(i) By the Office of the Public Protector,

(ii) By the SA Police Service,

(iii) By the Special Investigation Unit, or

(iv) By external private sector entities.

(2) (a) There were no financial losses.

(b) Not applicable.

Reply received: August 2014

QUESTION NO. 937

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 10)

Dr P J Groenewald (FF Plus) to ask the Minister of Health:†

(1) What specific measures have been implemented to prevent people who may be infected with the Ebola virus from entering the country;

(2) what measures have been implemented to prevent the Ebola virus from spreading further if someone who is actually infected with the virus is already in the country;

(3) how effective are the sensors installed at airports in identifying people who have possibly been infected with the suspected virus;

(4) whether any sensors have been installed at border posts other than airports to identify persons possibly infected with the specified virus; if not, (a) why not and (b) how infected persons may be identified without making use of sensors; if so, at which border posts;

(5) whether he will issue a statement regarding the matter?

REPLY:

(1) The following measures are being implemented to prevent spread of Ebola into South Africa:

(a) Cabinet decision was taken to implement a travel ban for all non-essential travel to high risk countries (Guinea, Sierra Leone and Liberia).

(b) All South Africans and residents are advised to avoid non-essential travel to Liberia, Guinea or Sierra Leone. All returning travellers from these countries will be subjected to rigorous screening and medical assessments before being allowed entry into the country.

(c) Enhanced surveillance are implemented at points of entry (air, land and sea ports). Travellers must request approval to travel to and from the high risk countries before departure and arrival into South Africa.

(2) The following measures have been implemented:

(a) Viral Hemorrhagic Fever and Ebola Virus Disease guidelines have been disseminated to all provinces.

(b) Hospitals in each province have been designated for the management of cases. The private sector also has designated facilities for the treatment of private patients.

(c) Training of health care workers was conducted at designated hospitals - including Port Health, emergency medical services, outbreak response teams, and Civil Aviation Authorities.

(d) Public awareness has been raised through press releases, media interviews and travel advisory to highlight the risks and preventive measures.

(3)

(a) Scanners are a screening tool to detect people who may have a fever, which is a non-specific symptom for an infective illness. Scanners do have limitations, however, they do fulfill a very valuable role in detecting ill passengers.

(b) To compensate for the limitations of the scanners, other measures have been implemented including:

- Administration of a travel health questionnaire to assess risk that may be posed by the traveler.

- Follow-up of all passengers arriving from Guinea, Sierra Leone and Liberia for a period of 21 days from date of departure from the affected countries.

(4) No.

(A) Risk assessment of the current situation in South Africa is that airports in Gauteng, Western Cape and KwaZulu-Natal are at highest risk for importation of cases. Priority ports of entry are determined to be OR Tambo and Lanseria International airports. Thermal scanners have been installed at these airports. Procurement of thermal scanners for King Shaka and Cape Town International airports are in an advanced stage.

(B) In absence of scanners, other measures have been implemented including:

- Administration of a travel health questionnaire to assess risk posed by the traveller.

- Follow-up of all passengers arriving from Guinea, Sierra Leone and Liberia for a period of 21 days from date of departure from the affected countries.

(5) I have already addressed many press conferences regarding this matter.

I have presented to the Portfolio Committee on Health and outlined all the above issues to them.

Reply received: August 2014

QUESTION NO. 936

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 22 AUGUST 2014

(INTERNAL QUESTION PAPER NO. 10)

Ms D Carter (Cope) to ask the Minister of Health:

Whether his department has approved a programme of vaccinating children against Hepatitis B at birth and not at six weeks or later in order to prevent mother-to-child transmission; if not, why not; if so, what (a) success was being achieved and (b) what are the further relevant details?

REPLY:

The immunisation schedule in South Africa includes three doses of Hepatitis B vaccine that are given at 6, 10 and 14 weeks. Most transmission of Hepatitis B in South Africa is horizontal and occurs in early childhood (when children start going to preschool and school).

Until recently, the World Health Organisation (WHO) recommended that a dose of Hepatitis B vaccine should be given within the first 24 hours of birth only in countries which are classified as countries of high endemicity (prevalence of Hepatitis B Surface Antigen of between 2% and 8% in the general population) also administer a birth dose of Hepatitis B vaccine to all newborns.

As South Africa falls into this category, and in view of the revised WHO recommendations, the National Advisory Group on Immunisation (NAGI – a committee appointed to advise the Minister) is currently deliberating on this issue and a recommendation is expected soon.

Reply received: October 2014

QUESTION NO. 914

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 12 SEPTEMBER 2014

(INTERNAL QUESTION PAPER NO. 16)

Mr W M Madisha (Cope) to ask the Minister of Health:

Whether his department's efforts since 2009 have resulted in a year-on-year decline in the incidence of HIV infection in South Africa confirming that the present policies, processes and programmes are assisting the Government in fully meeting its targets of substantially reducing new infections; if not, why not; if so, what are the relevant details?

NW1005E

REPLY:

According to the 2012 South African National HIV Prevalence, Incidence and Behavior Survey, HIV incidence has been stabilizing within the 15-49 year age group. Incidence in this group has declined from 2.2% (2002-2005) to 1.9% between 2008-2012. This illustrates that Government policies are working but need to be accelerated to more rapidly reduce the number of new infections.

Reply received: August 2014

QUESTION NO. 802

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 JULY 2014

(INTERNAL QUESTION PAPER NO. 06)

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

(1) Whether (a) he, (b) the Deputy Minister, (c) the Director-General or (d) any of his staff (i) attended, (ii) accepted an invitation and/or (iii) received tickets to the 2014 Soccer World Cup in their official capacity; if so, what are the relevant details including the (aa)(aaa) names and (bbb) positions of those who attended and (bb) breakdown of the amounts spent by his department on (aaa) travel, (bbb) accommodation, (ccc) entertainment and (ddd) any further specified expenses;

(2) (a) what is the breakdown of the amount spent by his department on any persons accompanying (i) him, (ii) the Deputy Minister, (iii) the Director-General or (iv) any of his staff to attend the 2014 Soccer World Cup including (aa) travel, (bb) accommodation, (cc) entertainment and (dd) any further costs and (b) in each case, what is the (i) relationship and (ii) reason for accompanying the relevant person?

REPLY:

(1) No.

(2) Not applicable.

Reply received: November 2014

QUESTION NO. 753

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 JULY 2014

(INTERNAL QUESTION PAPER NO. 06)

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

(a) How many (i) judgments and (ii) court orders were made against his department in the (aa) 2010-11, (bb) 2011-12, (cc) 2012-13 and (dd) 2013-14 financial years and (b) in each case, (i) how many of these (aa) were implemented and (bb) await implementation by his department and (ii) what was the nature of the (aa) judgment and/or (bb) court order?

REPLY:

(a) (i) (aa) One

(bb) None

(cc) One

(dd) None

(ii) (aa) None

(bb) None

(cc) One

(dd) None

(b) (i) (aa) Three

(bb) None

(ii) (aa) Ms G Khulong//Director-General. This was the Labour Court Judgement regarding the dismissal of an employee. The judgement was to the effect that the employee be reinstated to her post.

(bb) Rausa Beleggings CC//Director-General. This was the case of sale of unregistered medical products which were seized. There was a Court Order ordering that the medical products which were seized for allegedly being illegal (unregistered medical products) must be returned to the owner.

Apart from the judgement against the Department of Health, there are also Court Judgements in favour of the Department of Health. These include judgement in the case of the South African Dental Association//Minister of Health, Health Professions Council of South Africa (HPCSA), Chairperson of the Professional Board for Dental Therapy and Oral Hygiene, and Dental Assistants Association of South Africa regarding the validity of regulations relating to the registration of Dental Assistance. The Court found that the regulations are valid.

Reply received: August 2014

QUESTION NO. 694

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 JULY 2014

(INTERNAL QUESTION PAPER NO. 06)

Ms D Carter (Cope) to ask the Minister of Health:

Whether his department has taken any steps to determine on an ongoing basis the relationship of good nutrition and how obesity, diabetes and other lifestyle diseases are proliferating and burdening the health system; if not, why not; if so, what steps does he intend to take to encourage the Government to review its policy so as to subsidise essential nutrients and tax those that are proven to be causing health problems?

REPLY:

Yes. The Department of Health partnered with the Human Sciences Research Council who conducted the first South African Nutrition and Health Examination Survey (SANHANES) that was published in 2013. This comprehensive health and nutrition study yielded critical information on emerging epidemics of non-communicable diseases and their relation to nutritional factors. In the current financial year a Demographic and Health Survey (DHS) will be conducted. Future studies will be decided upon as and when required.

Subsidisation of essential nutrients and taxation of "unhealthy" foods is only one of a number of interventions to improve nutrition and will be considered (together with other cost-effective options) and in consultation with other government departments by the National Health Commission once this structure has been established.

The Department is certainly mindful of the relationship between good nutrition and preventon of non-communicable diseases and has taken steps to protect consumers and has taken various measures to minimise risk factors.

· Firstly, the regulation on reduction of sodium in certain foodstuffs and related mattes was promulgated in March 2013 with the intention of making sure that consumers are protected from foodstuffs that are known as risk factors to non-communicable diseases such as high blood pressure and stroke;

· The Department launched the non-communicable disease (NCD) strategy in 2013;

· Regulations relating to the labelling and advertising of foods: Amendments. No. R429 of May 2014 which amongst other things address issues of advertising and marketing of unhealthy foodstuffs to children;

· The Ministry is in the process of developing a strategy for the prevention and management obesity;

· On an ongoing basis the Department participates in radio and TV Programmes to increase public awareness on the health risks of obesity, including its contrition to non communicable diseases;

· The Department has developed partnerships with various stakeholders to increase screening at population level for early identification of individuals at risk of Diabetes and hypertension.

Reply received: August 2014

QUESTION NO. 693

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 JULY 2014

(INTERNAL QUESTION PAPER NO. 06)

Mr W M Madisha (Cope) to ask the Minister of Health:

Whether his department will introduce legislation comparable to that of the United States of America permitting smokers or their families to sue tobacco manufacturers and suppliers in our courts of law for compensation as a result of serious ill effects to the health of smokers due to smoking; if not, why not; if so, what are the relevant details?

REPLY:

No, the National Department of Health will not introduce legislation.

South Africa as a signatory to the World Health Organisation Framework Convention on Tobacco Control (WHO FCTC), is continuously developing and strengthening legislation and regulations to control and prevent tobacco use that aligns with the obligations of Articles of the WHO FCTC.

Article 19(1) of the WHO FCTC on Liability states that: "For the purpose of tobacco control, the parties shall consider taking legislative action or promoting their existing law where necessary, to deal with criminal and civil liability, including compensation where appropriate".

The Law of Delict in South Africa already allows for a person to institute civil action against any person or institution for intentional or negligent wrongful conduct that caused damage, loss or harm to the claimant.

Reply received: August 2014

QUESTION NO. 687

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 JULY 2014

(INTERNAL QUESTION PAPER NO. 06)

Ms J Steenkamp (DA) to ask the Minister of Health:

(a) What is the status of the forensic investigation into the death of infants in hospitals and clinics in North West in May 2014 and (b) when will a report be finalised in this regard?

REPLY:

According to information obtained from the North West Provincial Department of Health, there was no forensic investigation done in May 2014.

Reply received: December 2014

QUESTION NO. 678

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

Ms J Steenkamp (DA) to ask the Minister of Health:

Did the Bloemhof Clinic have adequate supplies of pediatric medication on Monday 26 May 2014; if not, why not; if so, why was Ms Maserame Mogoregi and her son turned away from that facility when her son required this medication?

REPLY:

According to the North West Provincial Department of Health –

Yes, Boitumelo Clinic had adequate supplies of paediatric medication on 26 May 2014. Ms Maserame Mogoregi was never turned away. She brought her child (Onalenna Mogoregi) to Boitumelo Clinic on 26 May 2014 complaining of cough. The child was attended to and given medication. On 29 May 2014 the child was taken to Bloemhof Community Health Centre, this time presenting with diarrhoea and vomiting, and visibly dehydrated. He was put on a drip, given Vitamin A and was admitted. He was subsequently referred to Klerksdorp Hospital and unfortunately passed away en route to the Hospital.

Reply received: August 2014

QUESTION NO. 613

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

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

(1) How many (a) international and (b) domestic hotel bookings were made by (i) him, (ii) his predecessors and (iii) departmental officials attending (aa) workshops, (bb) seminars, (cc) oversight visits or (dd) any other relevant meetings of the relevant portfolio committee from 1 April 2013 up to the latest specified date for which information is available;

(2) in respect of each specified booking, what was the (a) date, (b) name of the hotel, (c) number of delegates, (d) cost of the hotel booking for each delegate and (e) the nature of the relevant portfolio business dealt with?

REPLY:

(1) None, as neither the Ministerial nor the Departmental officials were invited to accompany the Portfolio Committee to any such meetings.

(2) Not applicable.

Reply received: August 2014

QUESTION NO. 588

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

Dr H C Volmink (DA) to ask the Minister of Health:

Have any steps been taken with regard to the recommendations made in the National Health Care Facilities Baseline Audit 2012 relating to (a) provision of services, (b) human resources, (c) infrastructure and (d) health technology; if not, why not; if so, what steps have been taken?

REPLY:

(a) Provision of service recommendation

The recommendations are been taken into consideration for health service planning at all levels of the Health Care System.

(b) Human Resources

The Department has developed draft normative guidelines for Human Resources at Primary Health Care. The next step will be to implementation similar process for hospitals.

(c) Facility audit recommendations are considered in the implementations of the Health Infrastructure plans. 46 Sets of Norms and standards to improve the quality of Health Infrastructure have been developed and are been implemented. The results from the Health facilities Audit are being used to prioritised health infrastructure projects

(d) Health Technology

During the 2012/13 financial year essential equipment was purchased for Primary Health Care facilities. During 2013/14 essential equipment was purchased for Hospitals. The Department is in the process of purchasing Continuous Positive Airways Pressure (CPAP) machines for 65 hospitals. These machines are essential for keeping airways open in preterm infants whose lungs have not fully developed and will assist in decreasing neo-natal mortalities.

Reply received: November 2014

QUESTION NO. 587

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

Dr H C Volmink (DA) to ask the Minister of Health:

(1) How many public sector facilities currently offer psychiatry services in each province;

(2) whether his department has identified barriers with regard to patients' access to psychiatry services; if not, why not; if so (a) what are these barriers and (b) how are they being addressed?

REPLY:

(1) There are 63 public health establishments or part of a health establishment that are designated in terms of section 5 of the Mental Health Care Act to serve as psychiatric hospitals, or care and rehabilitation centres.

Furthermore, as prescribed by Section 3 (iii) of the Mental Health Care Act the provision of mental health care services is integrated into the general health services environment. This brings South Africa in line with the World Health Organisation recommendations to integrate mental health provision in all levels of care. In this regard this includes all primary health clinics, district hospitals, and tertiary health establishments include components of mental health services such as 72 hours assessment of involuntary users, outpatient services for chronic mental users, etc.

(2) Yes.

(a) The following barriers of access to psychiatric services were identified through consultations with mental health stakeholders that took place in 2012. These and solutions to them are included in the Mental Health Policy Framewok and Strategic Plan 2013-2020:

- Stigma;

- Inequitable distribution on health services, especially between urban and rural areas;

- Certain mental health services are underdeveloped. For example, community-based mental health services including community residential facilities, day-care centres; for chronic mental health users. This causes over-reliance on psychiatric hospitals as a mode of mental health care;

- Lack of public awareness of mental health issues.

(b) The Mental Health Policy Framework and Strategic Plan 2013-2020 that was adopted by the National Health Council provides the detail of what the health sector together with all mental stakeholders committed to in the Ekurhuleni Declaration on Mental Health will do. Eight objectives which we felt will be catalytic in further transforming mental health services in the country were identified and are being implemented. These are elaborated in the Mental Health Policy Framework and Strategic Plan 2013-2020.

Reply received: November 2014

QUESTION NO. 586

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

Dr H C Volmink (DA) to ask the Minister of Health:

(1) How many (a) psychiatrists and (b) clinical psychologists are employed in the public sector in each province;

(2) what percentage of posts for (a) psychiatrists and (b) clinical psychologists in the public sector are currently filled (i) nationally and (ii) in each province;

(3) what is the number of (a) psychiatrists and (b) clinical psychologists per 10 000 population (i) nationally and (ii) in each province;

(4) whether his department has a target for the densities per 10 000 population of (a) psychiatrists and (b) clinical psychologists; if not, why not; if so, what are the targets for the years (i) 2014, (ii) 2015, (iii) 2016, (iv) 2017, (v) 2018 and (vi) 2019?

REPLY:

(1) (a) Number of Psychiatrist in each province

(b) Number of Clinical Psychologists in each province

(2) (a) Percentage of psychiatrists' posts currently filled in each province

(i) Based on the information provided by provinces the national average for psychiatrists is 68.2%

(b) Percentage of clinical psychologists' posts currently filled in each province

(ii) Based on the information provided by provinces the national average for clinical psychologists is 68.4%

(3) (a) Number of Psychiatrists per 10 000 population in each province

(Please note these ratios were calculated using the Statistics South Africa mid-year population estimates by province 2013)

(i) Number of psychiatrists per 10 000 population nationally is 0.32

(b) Number of clinical psychologists per 10 000 population in each province

(ii) Number of clinical psychologists per 10 000 population nationally is 0.7

(4) (a) and (b) No.

The National Department of Health has embarked on a process to develop work force staffing norms to ensure equitable distribution of human resources for health. The World Health Organisation Workload Indicators of Staffing Need (WISN) tool has been adopted and is currently being used to determine all the categories of human resources that we need. A report will be available once this work has been completed.

Reply received: August 2014

QUESTION NO. 575

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

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

What steps has been taken by his department to (a) rebuild the Senoane Clinic in Soweto which has not been operational since it was burned down and (b) ensure that the Chiawelo Clinic in Soweto is fully stocked at all times with suitable medical supplies?

REPLY:

(a) Senaoane Clinic, situated at 1928 Komati Street in Senaoane is fully operational and rendering Primary Health Care services. The Clinic was not burned recently. The burnt clinic referred to in the question may be the one that was burnt during the riots before 1994. A new clinic was subsequently built on the current land where services are currently being provided.

(b) The District has instituted a system of monitoring medical supplies stock in facilities using the weekly stock-out rate monitoring tool. Through this system, medical supplies are now available in the facility as orders are made at correct replenishment levels.

Reply received: August 2014

QUESTION NO. 551

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

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

(1) Whether any health facilities have experienced shortages of medicines or supplies to treat diabetes; if so, (a) which facilities have experienced shortages and (b) what has his department done to address the shortages;

(2) whether his department has campaigns in place to raise awareness of diabetes; if so, please provide the details (a) for the (i) 2010-11, (ii) 2011-2012, (iii) 2012-13 and (iv) 2013-14 financial years and (b) during the period 1 April 2014 up to the latest specified date for which information is available;

(3) whether his department has been conducting public testing to raise awareness of diabetes; if so, please provide the details (a) in the (i) 2010-11, (ii) 2011-2012 (iii) 2012-13 and (iv) 2013-14 financial years and (b) during the period 1 April 2014 up to the latest specified date for which information is available;

(4) whether his department has any long-term programmes in place to tackle the rising incidences of diabetes; if not, why not; if so, what are the relevant details?

REPLY:

(1) No, no health facilities or depots reported any shortages of medicines or supplies to treat diabetes.

(2) Yes.

(i) and (ii)

§ Between 2010 and 2012 the Department of Health conducted a communication campaign together with the Government Communication and Information System (GCIS) to promote healthy lifestyle practices. Diabetes was highlighted as one of the critical diseases associated with unhealthy lifestyles like poor diet, physical inactivity, alcohol abuse and tobacco use. The main mass media channel that was used was community radio.

§ Annually, in November, the department of health and its stakeholders commemorates World Diabetes Day targeting approximately 5 000 to 10 000 community members who are provided with appropriate information on diabetes by health officials.

§ During the past 4 years (2010 – 2014) the Department of Health and its stakeholder trained more than six hundred community health workers which included health promoters in all nine provinces to provide information to communities on diabetes and hypertension.

§ In addition information and educational material on Diabetes is distributed during health events. A healthy lifestyles booklet was developed which includes information on chronic diseases of lifestyle.

§ Within the health system countrywide all health promoters and community health workers provide health education in most days of the week on diabetes using community Radio stations and daily in health facilities.

§ Awareness raising is a shared responsibility with civil society, industry, professional organizations and other stakeholders and as such during the above period we have joined with organizations such as the Bongi Zuma Foundation, the Independent Community Pharmacy Association, Government Employees Medical Scheme and a number of other groups to educate and test the public for diabetes.

(3) Yes. The Department and its stakeholders have provided public health screening including blood glucose test in various provinces:

(i) 2010-11 - Screening was conducted mainly in health facilities

(ii) 2011-12 - In addition to screening in clinics twenty health screening events were held in five provinces - Gauteng, EC, KZN, Limpopo and North West.

The Independent Community Pharmacy Association in collaboration with the Department of Health offered free testing and education at all its affiliate pharmacies as part of a campaign to encourage the public to be aware of and test for diabetes.

(iii) 2012-13 - Health screening events were held in Western Cape and Free State.

(iv) 2013-14 Twenty one screening events were held in five Provinces – Gauteng, EC Mpumalanga, KZN and NC and Western Cape. Screening was also conducted during events organized by various Government departments including Sports and Recreation and the Presidency, Department of Social Development, Arts and Culture.

(4) Yes. The Department of Health has developed a Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2013-2017. This plan recognises that while diabetes prevention, treatment and control have certain unique elements, this needs to be done as part of a comprehensive plan to prevent and control a range of Non-communicable Diseases. The major risk factors for diabetes i.e. unhealthy diet, physical inactivity, tobacco use and alcohol abuse are common with other non-communicable diseases and therefore tackling the rising incidence of diabetes involves redressing these factors. In each of these areas activities to change current patterns have either started or are being planned in accordance with the abovementioned strategy. The plan covers three main objectives i.e. prevention and promotion, health systems strengthening and surveillance and research.

In addition this year the Department of Health published the "Management of type 2 diabetes in Adults at primary level". This document was developed in conjunction with the Society for Endocrinology, Metabolism and Diabetes for South Africa and is an up to date and cutting edge guideline aimed at tackling the rising incidence of diabetes.

Diabetes is also an integral part of our new model for tackling all chronic diseases in South Africa called the Integrated Clinical Diseases Management model. This was piloted in 3 districts in North-West, Gauteng and Mpumalanga and is now been rolled out in targeted clinics in other districts. We promote a public health approach to empower the individual to take responsibility for their own health, whilst simultaneously intervening at a community/population and health service level.

Early identification through screening is recognised as critical to tackling diabetes. Adults at risk can be accessed through clinics, social development pay points and other government service points. Moreover, we have started to utilise the HIV Counselling and Testing (HCT) campaign for screening for diabetes and this will be strengthened.

Reply received: August 2014

QUESTION NO. 550

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

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

(1) How many (a) registered and (b) practicing podiatrists are there in (i) public and (ii) private healthcare facilities across the country;

(2) has his department taken any steps to increase the number of podiatrists in the (a) public and (b) private healthcare sector; if not, why not; if so; what are the relevant details;

(3) has his department taken any steps to support practicing podiatrists, specifically in terms of their role in treating diabetes-related illnesses; if not, why not; if so; what are the relevant details?

REPLY:

(1) (a) (i) 38

(ii) 419

(b) (i) 38

(ii) Information is not available as some practitioners may be practicing abroad or only maintain their registration, but are not practicing the profession.

(2) (a) and (b) No, the public health sector employs relative small numbers of podiatrists. They are mostly produced to fulfil a demand in the private health care sector.

(3) No. The current training in podiatry is regarded as sufficient for practitioners to perform the scope of practice for the profession. However, the Health Professions Council of South Africa is assessing the curriculum on an ongoing basis and will where required take steps to enhance the training to meet the demands of the profession.

Reply received: November 2014

QUESTION NO. 537

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 18 JULY 2014

(INTERNAL QUESTION PAPER NO. 05)

Ms D Carter (Cope) to ask the Minister of Health:

Whether his department has any measures in place to ensure that conditions which are prevailing at the Tintswalo Hospital in Acornhoek, Mapulaneng Hospital and other hospitals in the country, arising from a combination of accumulating factors and failing leadership, were brought to an end; if not, why not; if so, (a) what measures and (b) how effective did they prove to be?

REPLY:

(a) The Mpumalanga Department of Health took measures to stabilize the management and corporate governance of both Tintswalo and Mapulaneng hospitals by appointing CEOs and representative Hospital Boards. The CEO of Tintswalo Hospital assumed duties on the 17 February 2014 while the CEOP of Mapulaneng Hospital started on 01 March 2013;

(b) The CEOs and Hospital Boards of both hospitals have been effective in ensuring that the hospitals fulfill their mandates of providing good quality services to the people of Bushbuckridge in consultation with all stakeholders, by holding open days with communities and also providing regular performance reports to the Head Office through its District Office.

The health care waste and scrap metals which made news in the national media some months ago, have been disposed of after the Department made a month-to-month agreement with the service provider. At the moment, contractors have been appointed to repair and renovate the building infrastructure of the hospitals according to the priorities which have been identified by the management of the hospitals.

Reply received: July 2014

QUESTION NO. 445

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 JULY 2014

(INTERNAL QUESTION PAPER NO. 03)

Dr H C Volmink (DA) to ask the Minister of Health:

(1) Whether, following the recent spread of the Ebola virus in West Africa, his department has put any measures in place to prevent the spread of the virus to South Africa;

(2) whether his department has taken any steps to increase the surveillance for viral haemorrhagic fevers at the country's borders since the beginning of 2014; if not, why not; if so, what are the relevant details;

(3) whether his department instructed public and private health practitioners to be on high alert for any ill persons who have travelled to or from West Africa; if not, why not; if so, what are the relevant details?

REPLY:

(1) Yes.

· The key response of the Department of Health was to:

- Inform all stakeholders (both public and private) of the Ebola Virus Disease (EVD) outbreak in West Africa and request that they increase their surveillance activities.

- Sensitize all outbreak response teams of the outbreak and the risks of imported cases entering South Africa. Outbreak response teams were alerted to be prepared to respond in the event a suspected case was identified in the country.

· Following the first report of an EVD outbreak in Guinea, the National Department of Health, with support from the National Institute for Communicable Diseases (NICD) drafted an alert and case definitions, that were distributed to the Environmental Health Directorate (including Port Health), provinces and the Civil Aviations Authority (CAA), for further circulation to all stakeholders.

· The CAA convened a meeting with stakeholders on 9 April 2014 to alert them of the outbreak and address challenges that might be experienced. The National Department of Health participated in the meeting and highlighted the International Health Regulations (IHR) issues related to EVD.

· The Department has been monitoring the EVD outbreak in West Africa through updates provided by the NICD, Promed, WHO and the US-CDC. Updates are provided to stakeholders for further circulation as they became available. This is important to keep stakeholders informed and to ensure that response capacity is maintained.

(2) Yes.

· Yes, Port Health officials are on high alert since the beginning of the outbreak.

· Following the first report of the EVD outbreak in Guinea, the National Department of Health, circulated an alert and case definitions to the Environmental Health Directorate (including Port Health), provinces and the Civil Aviations Authority, for further circulation. The alert emphasized that all Port Health Officials should be aware of the EVD outbreak and have a high index of suspicion for travelers with the EVD signs and symptoms. It also emphasized that all health care workers should have a high index of suspicion for EVD when managing patients with a travel history to West Africa.

· The National Health Laboratory Services and the NICD have also intensified their surveillance at the laboratories. The private sector (laboratories and hospitals) are also kept informed of the EVD situation during the monthly Multi-sectoral Outbreak Response Team (MNORT) meetings that are convened by the National Department of Health.

· The OR Tambo International Airport and Lanseria Airport have thermal scanners that detect travelers with raised temperatures. These travellers, when identified, are assessed at the medical facilities at these airports.

· The CAA represents more than 4,000 officials in the aviation industry (both public and private sector). The CAA held a meeting where all the stakeholders in the aviation industry were briefed on the EVD situation in West Africa. The risks and the steps to mitigate the risks of importing an infected person into South Africa were discussed. Organizations that transport sick patients into South Africa for treatment were also represented at the meeting.

(3) Yes, all health care workers (both public and private) were informed to be on high alert for travellers who have visited West Africa. An alert was circulated the day after the announcement of the EVD outbreak was made by WHO. Updates informing stakeholders of the EVD situation are circulated as they become available.

Reply received: August 2014

QUESTION NO. 434

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 JULY 2014

(INTERNAL QUESTION PAPER NO. 03)

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

(1) (a) What public health care facilities, such as (i) clinics, (ii) district hospitals, (iii) regional hospitals, (iv) tertiary hospitals and (v) other facilities are currently available to the residents of Fraserburg, Northern Cape and (b) how many kilometres is each facility from Fraserburg;

(2) how many public health care professionals, such as (a) medical doctors; (b) specialist doctors and (c) nurses currently serve in the town of Fraserburg;

(3) has his department conducted an assessment of the public health care needs of Fraserburg; if not, why not; if so; what are the relevant details;

(4) does his department have plans to expand public health care facilities in Fraserburg; if not, why not; if so, what are the relevant details?

REPLY:

(1) The facilities serving Fraserburg is Fraserburg CHC (Community Healthcare Centre).

(i) It is located 4.34Km from the center of Fraserburg;

(ii) The closest District Hospital is Beaufort West Hospital in the Western Cape, 139.3Km approx. 2h and 12min Drive from the center of Fraserburg.

(iii) The nearest Regional Hospital is GeorgeHospital, located 299.7Km from the center of Fraserburg, approx. 4hr drive.

(iv) The closest Northern Cape Provincial Tertiary Hospital is Kimberly Hospital, 530.3Km with an estimated drive time of 7hrs.

(v) Other Facilities:

(2) The Fraserburg CHC Head count for June 2014 was about 1000 and normally can go up to 1200 per month.

The Abraham Esau Hosp, level 1 hosp, in Calvinia serves as the referral Hosp for the Karoo Hoogland (Fraserburg; Sutherland and Williston CHCs). In Fraserburg CHC there is are medical doctors, however the doctor from Sutherland CHC (110km away) goes there twice a week.

Whereas in the past, the doctors from Calvinia, visited the CHC. There were 2 resignations of professional nurses recently. The managers have made a submission for the filling of 1 post. Recruitment is a challenge due to remoteness of Fraserburg.

The doctor was appointed from 01 June 2014 in Sutherland. The management had a meeting on Tuesday 15 July 2014 with Dr Blakenberg who now resides in Sutherland for possible employment in Sutherland too. She recently moved there.

(3) Yes. The Namakwa Health District has six sub-districts (local municipalities) with a total population of 118 451 and 87% of the population depends on public health facilities for their health care needs. According to the Namakwa Health Plan (2014- 2015) a situational analysis of health care needs was conducted for the 2014-2015 financial year and the following key health priorities were identified: Vitamin A supplementation, cervical cancer screening, waiting rooms for pregnant mothers, antenatal care visits before 20 weeks of pregnancy, reduction in deaths due to HIV, AIDS and TB, school and youth-friendly services and reproductive health services, and improvement of emergency medical services' response times.

(4) No. There are 65 public health facilities in Namakwa Health District and of these four are in Karoo Hoogland health sub-district (local municipality) and one Community Health Centre (CHC) in Fraserburg and it services a population of 3 700. The CHC building does not belong to the provincial Department of Health (Northern Cape) and it is rented by the District Office. The building is presently under renovation. The CHC is situated within a 2km radius of the community it serves.

Reply received: April 2014

QUESTION NO. 379

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 MARCH 2014

(INTERNAL QUESTION PAPER NO. 06)

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

(1) Whether he is aware of allegations made against a certain person (details furnished); if so, when did he become aware of these allegations;

(2) whether he is in possession of a certain report (name furnished); if so, when did he get the report;

(3) whether he acted on the report; if not, why not;

(4) whether he will make the report public; if not, why not; if so, when will he make it public?

REPLY:

(1) Yes, we did say so in our response to Question 1981 by Honourable Kganare in August last year.

(2) The Report from Bell Dewar Inc. was furnished to the Council for Medical Schemes (the Council). The Council studied the report as furnished and compiled their own report in this regard. Both reports were submitted to my office in March 2013.

(3) The abovementioned two reports are currently being reviewed to determine the substance of the allegations and action taken by the Council to address matters concerned.

(4) The Report unfortunately was inconclusive in many areas. Hence I want to be careful as Minister, before arriving at any conclusion. The Council has however reached their own conclusion.

Reply received: April 2014

QUESTION NO. 359

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 14 MARCH 2014

(INTERNAL QUESTION PAPER NO. 06)

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

(1) Did the Eastern Cape Health Department or any of its managers ever instruct any hospitals to dispense Immutides Spray to any patients with tuberculosis; if so, (a) who gave the directive, (b) when was the directive given, (c) which hospitals were instructed, (d) why was the directive given and (e) what is the extent of the directive;

(2) are any hospitals in the Eastern Cape conducting a research project to evaluate the effect of Immutides Spray on patients with tuberculosis;

(3) has the Medicines Control Council authorised the use of Immutides Spray?

REPLY:

(1) According to our records yes.

(a) Dr L P Mayekiso District manager of the N elson Mandela Bay Health District;

(b) On 27 January 2014;

(c) - Empilweni TB Hospital

- Jose Pearson TB Hospital

- Orsmond TB hospital

(d) To instruct the dispensing of Immutides to all patients in TB Hospitals in the Nelson Mandela Bay health district;

(e) The directive was also addressed to the manager of the pharmaceutical depot, the deputy director TB in the district Mrs B Ncanywa. The deputy director clinical support services in the district Mrs M Manuel, district pharmacist in the district Ms T Lategan, senior clinical manager in the district Dr F Fourie.

(2) Not to my knowledge. On receiving information about the instruction to procure Immutides Spray and administer it to patients in TB hospitals as from the 1^st April 2014, inspectors of the Medicines Control Council went to investigate the matter. Officials of the Nelson Mandela Bay district were instructed to stop plans to conduct a clinical trial as it was illegal. MCC approval to conduct a clinical trial must be sought. The plans were stopped. Further an official in the national office that was involved in facilitating the importation of Immutides Spray has been suspended and a disciplinary process will follow. A disciplinary process is under way for all the officials involved in the Eastern Cape. The MCC will also follow further due processes with regard to unprofessional conduct by any official in the Eastern Cape.

It seems that Immutides Spray was earlier supplied to some Primary Health Care facilities in the nelson Mandela Bay District. This was stopped prior the intervention planned for April 1 2014.

(3) No. The MCC has not issued any authorization of the use of Immutides Spray. The MCC's expert committees recommended that this product should not be allowed into the country as it is of bovine origin and the claims made cannot be substantiated.

Reply received: September 2014

QUESTION NO. 335

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 27 JUNE 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(1) What are the details of all flowers purchased by his department for each year between 1 April 2009 up to the latest specified date for which information is available;

(2) what are the details of (a)(i) the address and (ii) the name of the office where the specified flowers were displayed, (b) for whose benefit were the flowers purchased and (c) what was the purchase value of the flowers for each office where it was displayed;

(3) in respect of flowers purchased for individuals, (a) what is the (i) name and (ii) relationship of the person to (aa) him and (bb) the Ministry and (b) what is the cost of each purchase;

(4) what are the details of any (a) contractual arrangements and (b) plans to purchase flowers in the future?

REPLY:

The tables reflect the details in this regard, see the link: http://www.pmg.org.za/rnw335-140904reply

Reply received: April 2014

QUESTION NO. 310

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 MARCH 2014

(INTERNAL QUESTION PAPER NO. 05)

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

(1) Whether the school based vaccination campaign against the human papillomavirus (HPV) has started as per his announcement; if not, why not; if so,

(2) how many girls in the age of (a) 9 and (b) 10 years old have been inoculated?

REPLY:

(1) Yes, it has started.

(2) It is still ongoing, we will compile statistics at the end of April 2014.

Reply received: July 2014

QUESTION NO. 302

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 27 JUNE 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(1) What are the details of office furniture ordered and or purchased for the use of him and/or his staff since 1 May 2014;

(2) in respect of each piece of furniture, (a) what is the description, (b) what is the breakdown of the costs, (c) where will each piece of furniture be used and (d) who will use each piece of furniture;

(3) what are the details of furniture disposed of;

(4) in respect of each piece of furniture disposed of, (a) what is the description, (b) original purchase costs and (c) on what date was it purchased;

(5) (a) how was this furniture disposed of, (b) what disposal method was used, (c) what is the name and contact details of person/s to whom it was disposed and (d) at what price was it disposed of?

REPLY:

(1) There was no furniture ordered and or purchased for the Ministry since 01 May 2014.

(2) Not applicable.

(3) Not applicable.

(4) Not applicable.

(5) Not applicable.

Reply received: April 2014

QUESTION NO. 301

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 07 MARCH 2014

(INTERNAL QUESTION PAPER NO. 05)

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

What measures does his department have in place to ensure that individuals who are on antiretroviral drugs can receive the drugs from any government clinic or hospital in the country?

REPLY:

Every public healthcare facility in the country is allowed to stock antiretroviral drugs (ARVs) and dispense them to patients.

Every facility has a list of medicines that it may stock, and ARVs are always on that list of items.

The availability of ARVs is closely monitored provincially with the head of pharmaceutical services playing an oversight role.

Reply received: July 2014

QUESTION NO. 268

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 27 JUNE 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(1) What are the details of motor vehicles ordered and/or purchased for his use since May 2014;

(2) (a) what is the (i) make, (ii) model, (iii) total cost and (iv) breakdown of the cost of each motor vehicle and (b) where will each motor vehicle normally be stationed?

REPLY:

(1) There were no vehicles ordered or purchased for the Minister's use since May 2014.

(2) Not applicable.

Reply received: July 2014

QUESTION NO. 243

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 27 JUNE 2014

(INTERNAL QUESTION PAPER NO. 02)

Mr H C Schmidt (DA) to ask the Minister of Health:

(a) Since 1 January 2009, (i) on what dates has the Risk Committee met that was established under Section 18 of the Occupational Diseases in Mines and Works Act, Act 78 of 1973 and (ii) what declarations has he made in terms of Section 13 of the Act and (b)(i) who are the current members of the committee and (ii) when did he appoint each member?

REPLY:

(a) (i) The dates that the Risk Committee met since 1 January 2009 were the 12 May 2010 and 25 February 2014

(ii) No declarations have been made since 1 January 2009 of controlled and uncontrolled mines and works in terms of Section 13 of the Act other than the current 249 controlled mines and works.

(b) (i) The current members of the Risk Committee are:

- Mr D Msiza – Department of Mineral Resources (Chairperson);

- * Mr V Nundall – Chamber of Mines – Member;

- * Dr C Badenhorst – Chamber of Mines – Alternate;

- * Mr L McMaster – Solidarity – Member;

- * Ms M M Llale – National Union of Mineworkers – Member;

- * Mr A Letshele – National Union of Mineworkers – Alternate;

- Dr M Zungu – Director of the Medical Bureau for Occupational Diseases.

(ii) * The nominated members of the Risk Committee were appointed on 1 February 2014.

Reply received: March 2014

QUESTION NO. 239

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 04)

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

What steps are being taken by his department to ensure that more doctors who are trained overseas are deployed to work in rural hospitals or clinics?

REPLY:

(1) The National Department of Health has the following strategies in place to ensure that South African doctors who are trained overseas (in Cuba) are deployed to work in rural hospitals or clinics:

(a) Bursary Contract: The National Department of Health has developed in consultation with provincial counterparts a bursary contract, which is used as national tool to commit all newly recruited medical students trained in Cuba to work in their rural health facilities after completion of their studies.

(b) Pre-Departure Workshops: Pre- departure workshops are held with the new medical recruits for five days as part of the orientation in preparation for their new career. The new medical recruits are taken through the bursary contract before they could sign to ensure that they understand what is expected of them including legal implications for all parties involved. Parents or guardians of the medical recruits are also involved and informed about the contents and implication of the bursary contract as signatories.

(c) Provision of Support during medical training: During their vacation, after completion of 4^th year medical students are allocated to a local district hospital for familiarisation and clinical exposure in preparation for their return later to South Africa. District Managers are encouraged to have joint meetings with medical students and their parents/guardians to remind and recommit them to the bursary contract. Copies of students' files are also given to the Districts where they have been recruited for monitoring and support.

(d) Placement after Completion of Medical Studies: The two Units, Human Resource Development (HRD) and Human Resource Management (HRM) work together to ensure appropriate placement of the new doctors in health facilities where they are needed most. This placement starts from community service during which they are monitored on quarterly basis in collaboration with Districts of origin. The medical doctors are expected to serve their rural communities for the number of years that they have been financially supported according to the bursary contract.

Reply received: March 2014

QUESTION NO. 238

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 04)

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

What steps are being taken by his department to (a) ensure that the medicine industry is in line with the new regulations in terms of the Medicines and Related Substances Act, Act 101 of 1965, gazetted on 15 November 2013 and (b) declare cancer as an epidemic?

REPLY:

Several workshops to explain the Regulations and related guidance documents have been held with stakeholders in the Complementary and Alternative Medicines (CAMS) Industry. Explanatory information is also available on the Medicines Control Council website.

A number of CAMS stakeholders have requested extension of the time frame for compliance with labelling requirements under section 36 of the Act. This has been acceded to provided that periodic reports on compliance for each product are furnished to the MCC.

The Law Enforcement arm of the Department will, as part of their routine inspections, monitor the sale of banned substances and compliance with regulations. Appropriate action will be taken where necessary.

Reply received: August 2014

QUESTION NO. 209

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 27 JUNE 2014

(INTERNAL QUESTION PAPER NO. 02)

Ms C N Majeke (UDM) to ask the Minister of Health:

What steps has his department taken to fix the lifts that have not been working, are faulty or too small for a hospital bed to fit in at Potchefstroom Hospital, in North West?

REPLY:

The National Department of Health together with the District Office in the North West Provincial Health Department have initiated the procurement process to appoint a contractor to resolve the challenges related to the lift problem in Potchefstroom Hospital raised by the Honourable Member.

The process is expected to be concluded in before the end of August 2014.

Reply received: April 2014

QUESTION NO. 197

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(1) Whether he is aware that the use of condoms during sexual intercourse has decreased from 85,2% in 2008 to 67,4% in 2012; if not, what is the position in this regard; if so,

(2) whether his department has abandoned the ethos of voluntary counselling and testing; if not, what is the position in this regard; if so, what are the relevant details;

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

REPLY:

(1) The Department is aware of the condom use reported by HSRC between 2008 and 2012. However, the Department has noted that the 67.4% condom use reported for 2012 was an interim report. The Department will comment on the apparent decline between 2008 and 2012 when the final HSRC national household survey report is available. It is expected that the 2012 report will be available on the 1st April, 2014.

(2) HIV counseling and testing (HCT) in the country is voluntary. When patients present at the health facilities they are offered HCT and they have an option to accept or decline the test.

(3) No.

Reply received: July 2014

QUESTION NO. 177

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 01)

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

(1) What are the details of all the costs of the maintenance of the pot plants in his (a) departmental offices and (b) official residence (i) in the (aa) 2009-10, (bb) 2010-11, (cc) 2011-12, (dd) 2012-13 and (ee) 2013-14 financial years and (ii) since 1 April 2014;

(2) in respect of the pot plant maintenance, (a) what is the (i) address and (ii) name of the office where they were/are displayed, (b) for whose benefit are these pot plants, (c) what was/is the value of maintenance for each office and (d) what are the details of any contracts and/or plans for the maintenance of these pot plants in the future?

REPLY:

The issues raised by the Honourable Member in this question are the responsibility of the Department of Public Works and not of Health. The Question can therefore be best answered by that Department.

Reply received: March 2014

QUESTION NO. 147

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 02)

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

What is the (a) optimal and (b) actual number of (i) doctors, (ii) nurses and (iii) other health professionals at the Edenvale General Hospital?

REPLY:

The optimal, actual number of doctors, nurses and other health professionals at Edenvale Hospital as of at 31 January 2014 is as reflected in the following table

Reply received: March 2014

QUESTION NO. 146

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 02)

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

What is the (a) optimal and (b) actual number of (i) doctors, (ii) nurses and (iii) other health professionals at the Tembisa Hospital?

REPLY:

The optimal, actual number of doctors, nurses and other health professionals at Tembisa Hospital as of at 31 January 2014 is as reflected in the following table:

Reply received: March 2014

QUESTION NO. 145

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(1) When will the Kempton Park Hospital be re-opened;

(2) since the closing of the hospital, what has been the annual cost relating to the hospital with regard to (a) security, (b) maintenance and (c) any other costs incurred by the hospital?

REPLY:

(1) The Gauteng Department of Health has done an assessment of the costs of renovation and refurbishment of the Kempton Park Hospital. Based on this assessment, it was determined that the cost of renovation and refurbishment of the hospital will be more than 60% of the cost of construction of a new hospital.

As a result of this, the Department is reviewing this project in relation to its Service Transformation Plan(STP). The outcome of this process will determine when this hospital will re-open.

(2) The hospital site is currently under the jurisdiction of the Gauteng Provincial Department of Infrastructure Development. As such, the Gauteng Health Department is not incurring any costs for (a) security, (b)maintenance or (c)any other costs.

Reply received: August 2014

QUESTION NO. 143

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 01)

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

(1) What are the details of all expenditure that was found to have been (a) irregular and (b) wasteful in his department for each year from 1 April 2009 up to the latest specified date for which information is available;

(2) in respect of each such finding of (a) irregular and (b) wasteful expenditure, (i) what (aa) is the description thereof, (bb) is the value thereof and (cc) action has been taken against the persons accountable for such expenditure and (ii) how much thereof (aa) has been recovered and (bb) from whom?

REPLY:

(1) (a)(i)(aa), (bb), (cc) and & (ii)(bb)

Details and reconciliation of the irregular expenditure is reflected in the –

Ø 2010/2011 Annual Report page 198;

Ø 2011/2012 Annual Report page 144; and

Ø 2012/2013 Annual Report page 187.

(2) (b)(i)(aa), (bb), (cc) and (ii)(bb)

Details of the wasteful expenditure analysis is reflected in the –

Ø 2010/2011 Annual Report page 202;

Ø 2011/2012 Annual Report page 146;

Ø 2012/2013 Annual Report page 191.

Reply received: March 2014

QUESTION NO. 124

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 21 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 02)

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

(a) How many foreign doctors are employed by his department and (b) what is his department doing to ensure that these foreign doctors have the necessary qualifications and documentation?

REPLY:

(a) A total of 2 432 as at January 2014.

(b) All foreign medical doctors have to submit extensive documentation to the National Department of Health as well as to the Health Professions Council of South Africa (HPCSA) regarding their qualifications and registration in their countries where they obtained their qualifications. The HPCSA also obtains verification of all foreign qualifications from the Educational Commission for Foreign Medical Graduates before an applicant may be registered to practice in South Africa. Unless a foreign qualification obtained by an applicant is accredited with the HPCSA, all applicants must pass a pre-registration examination, consisting of both a practical and theoretical parts, before they may be registered in South Africa.

Non-South African citizens who obtained their qualifications in South Africa are obviously exempted from the abovementioned requirements.

Reply received: July 2014

QUESTION NO. 111

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 01)

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

(1) What are the details of official credit cards issued to (a) him and/or (b) his staff;

(2) in respect of each credit card, (a) what is the (i) name and (ii) organogram position of the user, (b) what is the (i) maximum permissible value of each purchase and (ii) total credit limit of the card, (c) what are the details of permissible purchases for which the credit cards may be used and (d) may alcoholic beverages be purchased;

(3) in respect of purchases made with each credit card during the period 8 May 2014 and/or thereafter up to the latest specified date for which information is available, (a) what is the (i) name and (ii) organogram position of the user, (b) what is the (i) value of each purchase made, (ii) what are the details of each item purchased and (iii) for what purpose was each purchase made and (c) were any alcoholic beverages purchased; if so, (i) what are the (aa) details and (bb) value of these purchases and (ii) for what purpose was each purchase made?

REPLY:

(1) The Minister of Health and his staff do not have an official credit card issued to them.

(2) Not applicable

(3) Not applicable

Reply received: July 2014

QUESTION NO. 78

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 01)

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

(1) How many (a) international and (b) domestic flights were undertaken by (i) him and (ii) his predecessors using (aa) aircraft operated by the military, (bb) aircraft chartered by the military or (cc) commercial aircraft during the period 1 April 2013 up to the latest specified date for which information is available;

(2) in respect of each specified flight, what was the (a)(i) date and (ii) place of (aa) departure and (bb) arrival and (b)(i) total cost and (ii) breakdown of such costs?

REPLY:

(1) For the period 01 to 31 May 2014 the information is as follows:

(i) The Minister of Health undertook –

(a) Six (6) international trips; and

(b) Thirty-eight (38) return domestic flights using only commercial flights.

(ii) Not applicable.

(2) (a) International flights:

Total Cost - R430,152.00

(b) Domestic flights:

Total Cost - R379,059.00

Reply received: July 2014

QUESTION NO. 45

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 01)

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

(1) Whether his department has established a Tuberculosis (TB) register;

(2) what are the figures for (a) TB cases, (b) successful treatment rate, (c) cure rate and (d) default rate in (i) 2008, (ii) 2009, (iii) 2010, (iv) 2011, (v) 2012 and (vi) 2013?

REPLY:

(1) The details of all patients are recorded in a TB register at the facility at which they are diagnosed and receive treatment.

(2) TB cases and treatment outcomes are provided in the table below. It should be noted that treatment usually takes at least 6 months, treatment related data for 2013 is not yet available.

Reply received: March 2014

QUESTION NO. 27

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 13 FEBRUARY 2014

(INTERNAL QUESTION PAPER NO. 01)

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

What plans does he have in place to ensure that forensic laboratories improve their turnaround times?

REPLY:

The following action steps have been taken to improve the turnaround times at the Forensic Chemistry Laboratories (FCLs):

(a) In April 2012 the National Department trained 70 individuals who were unemployed and who qualified in Chemistry at both Diploma and Degree levels through an Internship Programme that focused on Forensic Toxicology in order to prepare them for taking employment at the Forensic Chemistry Laboratories. These individuals have completed their intensive 12 months Internship Programme and are now employed as analysts in the Forensic Chemistry Laboratories. They were absorbed within the Forensic Chemistry Laboratories in April 2013 and received on the job training within these facilities for six months. These new analysts are positively contributing towards case analysis and we have seen an increase in output since their appointment. We have therefore increased the human resources capacity at the FCLs from 29 to 57 in Pretoria, 36 to 52 in Cape Town, 35 to 62 in Johannesburg and 17 new positions in Durban Forensic Chemistry Laboratory which we have established in 2013.

(b) We have procured additional equipment in the 2013/14 financial resulting in an increase of the blood alcohol analysis equipment at all the FCLs, resulting in an increase in output. A total of eleven (11) new gas chromatographs with flame ionization detectors and nine automated fluoride analysers have been procured for the 2013/14 financial year. Spending on equipment increased from R 10,738.674.65 in 2012/13 to R 19,260,738.38 in 2013/14. Discussions with the National Treasury led to additional funds approved for capital equipment increasing to R 30,000,000.00 in 2014/15 financial year. This will improve the analyst to equipment ratio and increase output and reduce turnaround times.

(c) All cases with court dates are being prioritized as agreed within the criminal justice system in order not to delay the criminal justice system processes.

(d) Formal regular meetings are held with Major General Johnson who is the Head of the SAPS Detective Service to report on cases and streamline challenges.

(e) We have established a fourth FCL in Durban and allocated analysts to this laboratory. Equipment has already been procured for this laboratory and upon completion of renovations the FCL will be responsible for the Eastern Cape and Kwa-Zulu Natal cases. This will release the caseload currently carried by the Cape Town and Pretoria FCLs respectively.

(f) The space for the Pretoria Forensic Chemistry Laboratory is inadequate for HR and equipment, a building has been identified with the Department of Public Works and processes have already started to ensure that the Pretoria Forensic Chemistry Laboratory receive an adequate building to conduct its analysis.

(g) In July 2013 the Justice Crime Prevention and Security Cluster Inter Departmental Protocol in respect of the ante-mortem analysis of blood for alcohol performed by the Forensic Chemistry Laboratories of the National Department of Health was adopted at a National level. The objective of the protocol is to promote, facilitate and regulate cooperation between the FCLs, National Prosecuting Authority, South African Police Services and the Department of Justice and Constitutional Development to ensure efficient provision and effective use of evidence derived from anti-mortem blood analysis in support of the Criminal Justice System.

A draft Justice Crime Prevention and Security Cluster Inter Departmental Protocol in respect of death scenes, post mortems and toxicology analysis performed by the Forensic Pathology Service, Forensic Pathology Mortuaries and the Forensic Chemistry Laboratories of the National Department of Health is in the final stages of approval. The focus of this protocol is to improve the efficiency of the Criminal Justice System through improved cross departmental interventions that will lead to the accurate and timely testing of toxicology samples in support of magisterial inquests and criminal court matters. It includes the communication lines between South African Police Services, Forensic Pathology Services (mortuaries) and the Forensic Chemistry Laboratories (FCLs) in respect of samples that have been submitted to the FCL, such as enquiries and priority requests.ent-ae �rv� � paragraph;mso-element-anchor-horizontal:margin;mso-element-left:5.4pt; mso-element-top:19.9pt;mso-height-rule:exactly'>1 305

Reply received: July 2014

QUESTION NO. 18

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 17 JUNE 2014

(INTERNAL QUESTION PAPER NO. 03)

Ms A Steyn (DA) to ask the Minister of Health: [Interdepartmental transfer from Agriculture, Forestry and Fisheries on 04 July 2014]

(1) Is he aware that there are flour milling companies that use Azodicarbonamide (ADA), the so-called yoga mat chemical; if not, what is the position in this regard; if so, (a) why are producers allowed to continue using this component and (b) what research has been done to show that the component is safe to use;

(2) why are producers that use ADA not required to disclose its use on their labels;

(3) is he aware that the persons who are most affected by this potential health risk are those who are the most vulnerable;

(4) is he prepared to allow the producers who use ADA to phase out its use of their own volition; if not, what steps will he take to prevent the continued use of this chemical in the production of flour for baking purposes; if so, why?

REPLY:

(1) Yes. Azodicarbonamide (ADA) is a permissible food additive in terms of Regulations Governing the use of Certain Food Additives in Certain Wheaten and Rye Products (R2417/1987).

(a) Producers are allowed to continue using Azodicarbonamide (ADA) as it is a permitted additive in bread as per the Regulation R2417/1987 as published under the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No.54 of 1972). Azodicarbonamide is allowed at a maximum level of 45mg/Kg in all bread.

(b) Based on data provided by various countries, ADA has been evaluated by the internationally acceptable Joint FAO/WHO Expert Committee on Food Additives and found to be safe when ingested at 45mg/Kg bread.

(2) Freshly baked bread is exempted from listing the ingredients as per the Labelling Regulations. The list of ingredients should be available at the point of sale, should consumers request so. Pre-packed bread should have an ingredient list as part of their labelling. ADA need only be declared in such an ingredient list as "flour treatment agent".

(3) According to the Joint FAO/WHO Expert Committee on Food Additives, there is no potential risk associated with the intake of ADA in bread at the maximum levels permitted in bread.

(4) The phasing out of the use of ADA by producers is done so voluntarily in response to unsubstantiated information. Since there is no contravention of any regulation published under the Foodstuffs, Cosmetics and Disinfectants Act, 1972 (Act No.54 of 1972), no steps will be taken by the Department at this stage. The Department will however continue with surveillance of new studies and information in this regard.