ATC130510: Report of the Portfolio Committee on Health on the Annual Performance Plan for 2013/14 – 2015/16 and Budget Vote 16 of the Department of Health and its Entities, dated 8 May 2013
OF THE PORTFOLIO COMMITTEE ON HEALTH ON THE ANNUAL PERFOMANCE PLAN FOR 2013/14
2015/16 AND BUDGET VOTE 16 OF THE
DEPARTMENT OF HEALTH AND ITS ENTITIES, DATED 8 MAY 2013
Committee on Health has a mandate to conduct oversight over the Department of
Health and its entities (Council for Medical Schemes, Medical Research Council,
National Health Laboratory Service, and the Compensation
for Occupational Diseases in Mines and Works and the Medical Bureau for Occupational
briefing on the budget vote and the Annual Performance Plan (APP) of the
Department of Health took place on the 17 April 2013.
The Committee also considered the Strategic
Plans, APPs and budget of the entities that reports to the Department as
Council for Medical Schemes (CMS) :
20 March 2013
Medical Research Council (MRC):
16 April 2013
National Health Laboratory Service (NHLS):
16 April 2013 and
The Compensation Commissioner for Occupational
Diseases in Mines and Works (CCOD) and the Medical Bureau for Occupational
Diseases (MBOD): 24 April 2013
Yogan Pillay, the Deputy Director-General led the delegation. The delegation
included: Ms Nobayeni Dladla Acting Director-General, Ms Nthari Matsau
Deputy Director-General, Ms Tiny Rennie Head Corporate Services, Mr Ian van
der Merwe Chief Financial Officer (CFO), Ms Jeanette Hunter Deputy
Director-General: Primary Health Care, Ms Milani Wolmarans Policy
Coordination and Integrated Planning, Mr Moremi Nkosi Acting Deputy
Director-General: Health Regulation and Compliance, Ms Mihlati Mushwana
Director: Public Entities Governance and Mr Joe Kgatla Parliamentary Liaison
Officer in the Office of the Minister.
OF THE DEPARTMENT OF HEALTH (DOH) ANNUAL PERFORMANCE PLAN FOR 2013/14 2015/16
Medium Term Expenditure Framework priorities of the Department of Health are
The 10 Point
Plan for 2009-2014;
from the National Development Plan (NDP) 2030; and
Sector Negotiated Service Delivery Agreement (NSDA) - Governments
outcome-based approach to service delivery. The Health sector is
responsible for the achievement of Outcome 2 which is A long and healthy
life for all South Africans.
focus of the health sector over the planning cycle is on the four outputs
entailed in the Ministers Performance Agreement with the President of the
Republic, and elaborated on in the NSDA for 2010-2014. These are:
Output 1: Increasing Life Expectancy;
Output 2: Decreasing Maternal and Child
Output 3: Combating HIV and AIDS and decrease
the burden of disease from Tuberculosis (TB);
Output 4: Strengthening Health System
OF THE HEALTH SECTORS RESPONSE DURING 2013/14
2015/16 WILL BE AS FOLLOWS:
Improving Life Expectancy by implementing the
following key strategies:
Expansion of the Antiretroviral (ARV) coverage;
Reduce new HIV infections;
Reduce burden of Tuberculosis;
Reduce Maternal Mortality;
Reduce Infant, Child and Youth morbidity and
Improve collaboration and reduce burden of
Communicable and Non Communicable diseases.
HEALTH SYSTEMS EFFECTIVENESS
Improved health systems effectiveness by
implementing the following key areas:
Improve quality of health services;
Re-engineering of Primary Health Care;
Functional District Health System;
Preparation for the implementation of the
National Health Insurance (NHI);
Improve health workforce planning, management
Efficient management of health technology; and
Accelerate delivery of health infrastructure.
NEW HIV INFECTIONS
Conduct at least 600 000 Medical Male
Circumcisions during 2013/14.
increase to 1 000 000 during 2015/16;
Test at least 98% of all TB patients for HIV by
Increase contraceptive prevalence from 32.5%
during 2011/12 to at least 38% during 2015/16;
Expanded Prevention of Mother-to-Child
Transmission (PMTCT) Programme for pregnant women.
THE ARV COVERAGE
Key interventions include:
Initiate at least 500 000 new clients on ARVs
per annum; and
Initiate at least 85% of all TB and HIV
co-infected patients on ARVs with up to 97% by 2015/16.
PMTCT PROGRAMME FOR HIV POSITIVE PREGNANT WOMEN
Key interventions include:
Increase HIV+ pregnant women initiated on ARVs
from 80.4% in 2011/12 to at least 97% in 2015/16; and
Reduce the proportion of HIV+ babies born to
HIV+ mothers from 4% in 2011/12 to at least 2% by 2015/16.
Increase the proportion of antenatal clients
attending a health facility before 20 weeks from 40.2% in 2011/12 to at least
68% in 2015/16;
Increase the proportion of deliveries taking
place in health facilities under the supervision of trained personnel in a
public health facility from 89.3% in 2011/12 to at least 97% in 2015/16; and
Increase the percentage of mothers and babies
who receive post-natal care within six days of delivery from 56.9% in 2011/12
to at least 84% in 2015/16.
INFANT, CHILD AND YOUTH MORBIDITY AND MORTALITY
Key interventions include:
Maintain the percentage of children fully
immunized under 1 year of age at minimum 90% throughout they MTEF period;
Maintain the measles immunization coverage rate
at 90% throughout the MTEF period;
Expand the implementation of the Integrated
School Health Programme as follows:
Seventy percent (9 666 of 13 809) of quantile 1
and 2 schools to benefit from the Integrated School Health Programme (ISHP)
during 2013/14, with up to 95% schools benefiting during 2015/16; and
Nine thousand and sixty six schools translate to
297 000 grade 1 learners and 80 200 grade 8 learners benefitting from the ISHP
THE BURDEN OF TUBERCULOSIS (TB)
interventions will include:
Increase the TB cure rate from 73.1% in 2011/12
to the World Health Organization (WHO) target of 85% by 2015/16;
Reduce the TB treatment defaulter rate from 6.8%
in 2011/12 to less than 5% by 2015/16; and
Reduce turnaround time of TB test results by
increasing the number of tests conducted using the GeneXpert. Estimated 800 000
tests to be conducted using GeneXpert during 2013/14, increasing to 1 million
COLLABORATION BETWEEN TB AND HIV PROGRAMMES TO REDUCE THE CO-INFECTION BURDEN
interventions will include:
Increase the percentage of TB patients tested
for HIV from 82.9% in 2011/12 to at least 98% in 2015/16; and
Increase the number of HIV positive patients
that receive Isoniazid Preventative Therapy (IPT) from 360 168 patients in
2011/12 to at least 525 000 in 2015/16.
MANAGEMENT OF NON-COMMUNICABLE DISEASES
Conduct public education campaign on salt reductions
in line with published regulations;
Expanding the chronic care model to 15 districts
Revision to the regulations of warning labels on
Development and implement the Health Promotion
Develop regulations for graphic health warnings
on tobacco products; and
Establishment of the National Health Commission
to develop and implement an intersectoral approach for the prevention of NCDs.
THE BURDEN OF DISEASES FROM COMMUNICABLE DISEASES
Establish a National Public Health Institute to
reform and strengthen the capacity of National Institute of Communicable
Diseases (NICD) over the MTEF;
Improve access to cataract surgery to at least
1500 operations per million population in all nine provinces;
Increase the cervical cancer screening coverage
from 55% in 2011/12 to at least 60% by 2015/16; and
Decrease the incidence of malaria from 0.58
cases per 1000 population in 2011/12 to at least 0.45 per 1000 population at
risk in 2014/15, in keeping with the target to eliminate malaria by 2018.
QUALITY OF HEALTH SERVICES
Improve complaint resolution by ensuring that at
least 85% of all resolved complaints have a turnaround time within 25 days;
Develop and implement standardized protocol for
conducting patient satisfaction surveys;
Increase the number of districts supported by
Facility Improvement teams to 20;
Ensure gap assessment are conducted at all
health facilities by 2015/16 (30% facilities to be assessed during 2013/14);
Fully establish the Office of Health Standards
Compliance by 2015/16.
OF PRIMARY HEALTH CARE
Increase the number of municipal ward based
primary health care teams to 750 in 2013/14, 1000 in 2014/15 and 1500 in
Improve access to primary health care services
with an increased utilization rate of at least three visits by 2015/16;
Expand the number of districts with the full
complement of members of the District Clinical Specialist teams to at least 20
districts in 2013/14, up to 25 during 2015/16;
Improve access and quality of PHC supervision
focusing on two areas which are:
Develop and implement a manual for capacity
building for PHC supervisors and facility managers; and
Increase the monthly supervisor visit rate from
66.6% in 2011/12 to at least 85% in 2015/16.
Implementation of the Integrated School Health
IMPROVE HEALTH WORKFORCE PLANNING, MANAGEMENT AND DEVELOPMENT
Development and implementation of norms and
standards for health workforce planning;
Increase the number of medical students
registered at South African Universities by at least 10% every year over the
MTEF. This will increase the number of new students from 1 800 in 2012/13 to at
least 2 395 in 2015/16; and
Increase the number of hospital managers trained
as per the training programme developed by the Academy for Leadership and
Management in Health 105 during 2013/14, 100 during 2014/15 and 100 during
DISTRICT HEALTH SYSTEM
Develop and implement an Intersectoral Framework
for addressing the social determinants of health;
A district quarterly review guideline will be
developed during 2013/14 to institutionalise district quarterly reviews;
Strengthen the disease outbreak response by
establishing trained disease outbreak teams in 20 districts by 2013/14.
This intervention will be implemented in all
52 districts by 2015/16 financial year; and
Revise the District Health System Strategy which
is inclusive of a District Health Authority.
FOR THE IMPLEMENTATION OF THE NATIONAL HEALTH
Key interventions include:
Preparation of the legal framework for the
establishment of the NHI:
During 2013/14 the White Paper on NHI will be
finalized and gazetted;
In 2014/15 the NHI Bill will be tabled in
The implementation of regulations will be in
A conceptual framework for the creating of the
NHI fund will be developed in 2013 with the first phase of implementation in
The increase Revenue collection in central
hospitals will be held as follows, four in 2013/14, seven in 2014/15 and ten in
The contracting of General Practitioners (GPs)
and other health service providers will be conducted as follows, 600 GPs in
2013/14 to work in 533 in NHI pilot districts.
MANAGEMENT OF HEALTH CARE TECHNOLOGY
the implementation of the Health Technology Strategy;
Essential Equipment lists for all levels of care in 2013/14; and
the standards for the use and maintenance of Health Care Technology.
THE DELIVERY OF HEALTH INFRASTRUCTURE
delivery of health infrastructure through the following key activities
Issue request for proposals (RFP), procure and
sign agreement for Chris Hani Baragwanath;
Request for quotations (RFQ) and RFP for
Completed feasibility studies for Dr George
Five of the
seven planned tertiary hospitals (Nelson Mandela in the Eastern Cape,
Chris Hani Baragwanath and Dr George Mukhari in Gauteng, Limpopo Academic
in Limpopo and King Edward VIII in KwaZulu Natal) would have commenced
with construction by 2015/16.
expenditure grew from R19.2 billion in 2009/10 to R27.9 billion in 2012/13
at an average annual rate of 13.3%.
Over the Medium
Term period, expenditure is expected to grow to R36.7 billion, at an
average annual rate of 9.4%.
The increase in
both periods is driven largely by transfers to provinces for the
conditional grants, with the main increase being on the HIV and AIDS and
the introduction of the NHI grant.
TERM ALLOCATION FOR 2013/14 2015/16
: Health Budget for 2013/14 medium term
The Department receives
R30.7 billion for 2013/14, up from R28.1 billion in the previous financial
year, which is an increase in nominal terms of 9.4% and by 3.6% in real terms.
The two largest programmes namely Programme 5: Hospitals, Tertiary Services and
Human Resource Development and Programme 3: HIV and AIDS, TB, Maternal and
Child Health receive almost 95% of the total budget. Less than half a per cent
(0.4%) is allocated to Programme 4: Primary Health Care Services (R109.4
million) which receives less than the budget allocated to Programme 1:
Administration (R411 million). In this budget, Programme 4: Primary Health Care
is the only programme to decline in both nominal (13%) and real terms (17.6%).
Programme 2: National Health Insurance, Health Planning and Systems Enablement
increased the most in percentage terms both nominally (56.1%) and in real terms
In terms of economic
classification, the bulk of the Health Budget (R28.2 billion or 92.0%) consists
of transfers and subsidies to provinces and municipalities, and departmental
agencies and accounts. This figure includes R193.6 million to non-profit institutions.
Current payments constitute
a total value of R1.6 billion, which represent 5.3% of the total budget
allocation. Most of the current expenditure is allocated to Goods and Services,
taking up 67.2% of the total current payments. Expenditure items that receive
the largest share of the goods and services budget are Contractors at R313
million up from R20.9 million, Consultants and professional services: Business
and advisory services at R150.3 million, Medical Supplies at R140.8 million,
and Travel and Subsistence at R111.7 million. Stationery and printing receive
R46.6 million whilst Advertising dropped to R23.7 million from R56.3 million
and Communication increased from R25.7 million to R27.6 million.
Unlike the previous
financial year, when 100% of capital payments, amounting to R35.6 million was
allocated to Machinery and Equipment, this year, R807 million is allocated to
Buildings and other fixed structures and R18.7 million to Machinery and
The following additional
allocations have been made in the 2012/13 - 2014/15 financial years:
includes additional allocations of R800 million for 2015/16 for the scale
up of the provision of antiretroviral treatment.
for 2014/15 and R384 million for 2015/16 partly offset the decrease in
funding over the medium term from the US Presidents Emergency Plan for
AIDS Relief (PEPFAR).
programme has contributed roughly R4 billion per year towards the South
African national HIV and AIDS and tuberculosis response.
The amount is
likely to decrease by 50% over the next five years.
R100 million and R250 million for the Medical Research Council to
strengthen its capabilities and infrastructure and to support partnership
on high priority diseases such as HIV and AIDS, tuberculosis and malaria
with development partners, such as Gates Foundation.
R30 million and R31.5 million to strengthen the National Institute of
Communicable Diseases and address the decrease in PEPFAR funding support.
R30 million and R30.3 million most of which comes from internal
reprioritization savings, for the infrastructure unit systems support
programme, which provides capacity building support to the department and
R15 million in
2015/2016 for the South African National AIDS Council for HIV and AIDS
R28.3 million and R41 million for improved conditions of service to cover
high personnel costs.
R6 million in
2013/2014 for emergency medical services during the 2014 African Nations
expects to reprioritize R19.6 million, R37 million and R51.8 million over
the medium term in non-core goods and services items.
approved reductions of R531 million over the medium term.
health infrastructure grant will be reduced due to slow spending and
weaknesses in performance.
R26 million (R11 million, R10 million and R5.2 million) over the MTEF
period have been made to the National Health Insurance due to slow
reviewed the staff establishment in 2010/11 to its human resources needs
and the functions assigned in terms of the approved budget structure.
The establishment is projected to
increase moderately to strengthen skills and experience.
To give effect to Cabinet approved reductions of
R531 million over the medium term, the department will reduce spending on the
three conditional grants related to health infrastructure, due to slow spending
and weaknesses in performance.
Reductions of R26 million over the MTEF have been
made to the national health insurance (NHI) grant due to slow spending.
health infrastructure grant (Hospital Revitalisation, Health
Infrastructure and Nursing Colleges and school grants) have been
consolidated into a single direct grant, called the Health Facility
Revitalisation Grant with three windows.
envisioned that the new configuration will allow more flexibility to shift
funds in between and ensure timely delivery of health infrastructure.
infrastructure increased from R3.2 billion in 2009/2010 to R5.8 billion in
2012/2013, and is expected to increase to R.5 billion over the medium
Facility Revitalisation Grant has been allocated R14.9 billion over the
MTEF period (R5.1 billion, R4.7 billion and R5 billion).
indirect schedule 6A grant has been established called National Health
This grant will have two components,
one for National Health Insurance (NHI) and one for Health Facility
National Health Grant contains a Health Facility Revitalisation
This grant has been
allocated R4.2 billion over the MTEF period (R897 million, R1.7 billion
and R1.7 billion) and is a grant in kind to the provinces.
OF THE ANNUAL PERFRORMANCE PLANS OF ENTITIES
of Entities reporting to the Committee:
Council for Medical Schemes (CMS);
Medical Research Council (MRC);
National Health Laboratory Service (NHLS); and
Compensation Commissioner for Occupational
FOR MEDICAL SCHEMES ANNUAL PERFORMANCE PLAN
The CMS, is the
national medical schemes regulatory authority and a public entity responsible
for regulating the medical schemes industry to protect the interests of
members, promoting fair and equitable access to private health financing.
The vision of
the CMS is to be a fair custodian of equitable access to medical schemes in
order to support the improvement of universal access to healthcare. The
Councils mission is to regulate the medical schemes industry in a fair and
Access to good quality medical scheme cover is
To make sure that medical schemes are properly
governed, are responsive to the environment, and beneficiaries are informed and
CMS should be responsive to the needs of the
environment by being an effective and efficient organization;
CMS provides influential strategic advice and
support for the development and implementation of strategic health policy,
including support to the National Health Insurance development process.
Council noted that membership has grown faster than the employment growth.
The difference in scheme risk has worsened
over the past two years, leaving more than a million beneficiaries
Some schemes have challenged
the payment in full provisions in the regulations.
Discovery has refused to accept Transmed members,
in spite of a ruling by the Registrar and Council.
The matter will be heard by the appeal board
GEMS have appealed the decisions
by the Registrar, Council and the appeal board, and have taken the decision to
the High court for revision.
The CMS budget increased by approximately 11.8% from R98.4 million in
2012/13 to R110.1 million in 2013/14. Income from levies increased by
approximately 11.4% from R92.6 million to R103.2 million.
The levy amount
increased by 9.85% from R24.39 (2012/13) to R26.79 (2013/14). Current expenses
increase by approximately 6.7% from R92.6 million to R103.2 million.
The CMS expenses
are as follows:
Council Members Fees increased 61.1% from
R930 986 to R1.5 million;
Research and Monitoring increase by 165.6% from
R288 890 to R767 297;
Legal services increased 38.4% from R4.8 million to
R6.7 million, whilst Legal Fees increased by 42.9% from R4.2 million to R6
Financial Supervision increases 37.1% from R498 197
to R683 302;
Stakeholder relations increased by 29.9% from R2.1
million to R2.8 million;
Complaints and adjudication decreased by 29.8% from
R184 500 to R129 500;
Benefit management decreased by 25.4% from
R316 410 to R235 788;
Accreditation increased by 29.4% from R575 819
to R745 500;
A new line item is cellphone contracts which total
Council Committees increased 8% from R1.775 million
to R1.917 million;
Investigation costs declined 37.1 per cent from
R795 000 to R500 000;
Software licence subscription increased 85.28% from
R484 900 to R898 400;
Rental fees increased by 13.7% from R5.2 million to
Operational Projects is a new line item with a R1.1
million allocation; and
Spending on telephone and fax remains constant at
COUNCIL ANNUAL PERFOMANCE PLAN
The mission of the MRC is
to generate knowledge for policy and practice to improve the health of the
One of South Africas proudest achievements
was that people are living 10% longer than 5 years ago due to AIDS
The MRC also has proved that mother-to-child
transmission of HIV has decreased to 2.7% in 2011.
In 2011, only 2.7% of newborns acquired
HIV from their mothers down from 25% ten years ago.
The MRC has four strategic
goals that link with the 4 outputs of the Health Sector NSDA which contribute
to outcome 2 which is A long and healthy life for all South Africans.
The goals are as follows:
Promote health and quality of life through
Promote health and quality of life through
public heath innovation, technology development and transfer;
Collaborate sub-national, national, super
national and global partners to improve health outcomes for South Africa
and citizens of our collaborative partners; and
Improve organisational performance as a health
Challenges identified by the MRC
Declining scientific stature of medical
MRC not fulfilling custodianship role in
medical research in South Africa; and
MRC intramural units spend 90% of their
budgets on salaries.
Activities implemented to revitalise the MRC
The following activities
have been implemented to revitalise the MRC:
Prioritising in-house research to focus on the
ten most common causes of death and disease in South Africa;
Increasing extramural funding to universities
and medical schools in order to rebuild their health and research;
Creating new funding approaches for the
development of new drugs, vaccines and diagnostic tests;
Improving the efficiency and effectiveness of
the MRCs administrative systems;
Improving peer-review and the quality of MRC
Improving the MRCs laboratory and space
Improving research support functions like
The 2013/14 budget increased by 8% to R313
million, in 2014/15 and in 2015/16 increasing to R333 million and R350
The annual baseline allocation for 2013/14 is
R90 million, R100 million 2014/15 and R250 million 2015/16.
Flagship programmes are taking up 76% of
the total budget.
Transfers received from National Department
increased from R296 840 million in 2012/13 to R416 460 million in 2013/14.
Grants and contracts decreased from R311 000
to R277 750.
LABORATORY SERVICE ANNUAL PERFOMANCE PLAN
Health Laboratory Service (NHLS) provides laboratory and diagnostic services to
public health facilities in South Africa.
Created by the National Health Laboratory Act (No. 37 of 2000) the NHLS also
provides health science training and education, and supports health research.
As the largest provider of diagnostic pathology services in South Africa, the
NHLS services over 80 per cent of the population through its 265 laboratories
The NHLS has identified 10
key strategic drivers over the next 5 years in its commitment to Governments
vision of a long and healthy life for all. These include:
Developing a new service delivery model that is
more affordable for the public sector;
Determine a best-fit service delivery model;
Deliver a quality, customer focussed service;
Align resources, support services and
infrastructural development for service delivery;
Become laboratory services Employer of Choice;
Prioritise innovation and research to be relevant,
appropriate and leading edge;
Become the health information powerhouse;
Drive stakeholder collaboration;
Position NHLS as the Provider of Choice for
National Health Insurance (NHI); and
Protect the community and environment.
The NHLS is also embarking
on an NHI (National Health Insurance) readiness assessment in support of NHI. The
NHLS has identified a number of challenges and returns including:
Threat of new entrants to the pathology services
market in the country, partnering with cost-cutting international companies.
Optimising logistics to reduce costs, improving
billing systems and maintaining skills and technical capacity.
The NHLS should become a member of the technical
committee to be established by the Minister to understand and influence policy
The NHLS reports that it
aims to remodel or restructure the organisation and is undergoing a
comprehensive review via the Roadmap Project, which looks at governance,
service model, financial and funding models, and human resources amongst other
things. It cautions that such processes inadvertently may result in increased
short-term financial requirements, substantial infrastructural changes and
staff establishment amendments- all outcomes that warrant careful consideration
in carving out a long-term strategy.
NHLS intends increasing average prices by 4% in the 2013/14 financial year. It
sees overheads increasing by 9% and materials increasing by 5%. The budget
increases 9.1% from R2.9 billion (2012/13) to R3.2 billion (2013/14). The
number of tests planned to be done remains at just over 87 million, with the
average selling price per test increasing 12% from R48.51 (2012/13) to R55.18
(2013/14). The forecast number of tests remains at the same level as the
previous financial year as the National and Provincial Departments of Health
implement initiatives to manage down the current levels of NHLS service
reports a shortfall of R123 million for the NICD (National Institute for
Communicable Diseases) and NIOH (National Institute for Occupational Health).
The impact of the KwaZulu-Natal Department of Health NHLS arbitration means
that R1.5 billion is not expected to be recovered in the current financial
The NHLS does not present its Annual Performance Plan in terms of
programmes and sub-programmes. Instead, in order to achieve its strategic
objectives, the NHLS has identified 4 perspectives as follows:
Employee Perspective; and
Perspective has the highest weighting of the four perspectives at 40%. Three
Strategic objectives have been identified under Customer Perspective, namely:
Improve Customer Satisfaction by obtaining 69.6% on
the Customer Satisfaction Survey (CSI);
Improve total turnaround time (TAT) by obtaining
between 85% and 90% TATs for TB microscopy, CD4, Viral Load, and HIV PCR
testing, and 65% TAT for Cervical Smear; and
Improve Quality of Tests by using independent
perspective weighting is at 10%. Its strategic objectives include:
Achieving budgeted turnover and spending overheads
as well as materials within budget;
Minimum cash collection of R4 786 million;
Improve payment to creditors from 62 days average in
2010/11 to 40 days in 2013/14; and
Improve collections from debtors from 154 days on
average in 2010/11 to 45 days in 2013/14.
perspective has a weighting of 30%. Strategic objectives include:
Improving employee satisfaction from a score of
2.66 in 2010/11 to 2.80 in 2013/14;
Maintaining low staff turnover rate at 10%;
Maintain low vacancy rate at 5% down from 20% in
Improve Employment Equity profile (which was at 88%
in 2009/10) which is targeted at 60% for this financial year, the same as it
was in the two previous financial years;
Improve Broad Based Black Economic Empowerment
(BBBEE) status and procurement (target 5); and
Maintain high Registrar pass rate (60%).
perspective has a weighting of 20%. Its two strategic objectives are:
Achieve SANAS Laboratory accreditation target to
75% (currently 70%) for academic labs and 50% (currently 30%) for regional
Improve translation of research into service by
submitting three research reports to influence policy and three research
reports translated into service.
COMMISSIONER FOR OCCUPATIONAL DISEASES (CCOD) ANNUAL PERFOMANCE PLAN
Commissioner for Occupational Diseases (CCOD) is established in terms of the
Occupational Diseases in Mines and Works Act (No. 78 of 1973). It compensates
miners and ex-miners (or their estate) for impairment of lungs or respiratory organs.
In particular, the CCODs function includes:
Administering the Mines and Works Compensation Fund
to compensate ex-miners disabled by occupational lung disease;
Determining and recovering levies from controlled
mines and works;
Awarding benefits to miners and ex-miners suffering
from occupational lung related diseases; and
Investing levies collected and interest earned from
The CCOD and
Medical Bureau for Occupational Diseases (MBOD) strives to deliver an
accessible and effective occupational health system and services that ensure
prevention, care and compensation for workers with occupational health diseases
and injuries and their beneficiaries.
the health system to prevent occupational diseases and provide clinical
services and compensation to workers and ex-workers in controlled mines and
deficiencies in the working of the CCOD have been documented. There was an
Appeal Court judgement in favour of the CCOD with respect to the recovery of
monies from owners of controlled mines and works for the deficit in the Mines
and Works Compensation Fund. It allows for the Compensation Fund to levy owners
accordingly, and also notes that separate books of accounts should be kept i.e.
a Mines Account, a Works Account, a State Account and a Research Account.
Planned policy initiatives identified by the CCOD include:
Amendments to the Occupational Diseases in Mines
and Works Act, No. 73 of 1973 (ODIMWA);
Expanding the coverage of mines and works beyond
the current 246 controlled mines and works;
Development of decentralised services for workers
and ex-workers. An occupational health system and services is envisaged with
the introduction of NHI and the re-engineering of Primary Health Care (PHC)
Determining models of service delivery to
ex-workers in labour sending areas
the wider SADC region; and
Working with the Department of Labour and Treasury
to align compensation systems.
The CCOD identified the following factors for its poor performance in
the past financial year:
26% vacancy rate;
Inadequate information technology system;
Lack of inspections of controlled mines and works;
Non-functioning Risk Committee;
Inability to verify claims data; and
Concerns about the valuation of the Fund and its
Five strategic goals have been identified as follows:
Changes to the policy and legislative framework of
the CCOD and MBOD.
Improve the governance of the CCOD and MBOD.
Optimise management and human and other resource
capacity of the CCOD and MBOD.
Enhance service delivery to workers and ex-workers
in controlled mines and works.
Ensure the sustainability of the Compensation Fund.
increased 35.1% from R34.3 million (2012/13) to R52.8 million in the current
financial year (2013/14). Highlighted is a decrease in compensation of ex-mine
workers from R139.9 million to R102 million, whilst the compensation of
tuberculosis (TB) increased from R5 million to R50 million. The Eastern Cape
project continues to get R500 000 budget allocation.
indicated that about R255.9 million will be from tax revenue, R94.6 million from
non-tax revenue with R197.1 million in surplus. Capital expenditure on infrastructure
and computer equipment were allocated R5 million and R1.4 million, respectively.
No budget allocation for land and buildings, as well as for leased motor
engagement between the Portfolio Committee on Health and the Department of
Health and its entities, the Committee expressed the following concerns:
The Committee was concerned about the high TB rates
in South Africa.
The Committee also raised concerns regarding the
slow progress towards meeting the MDG target on maternal health and whether the
Departments budget is sufficient to meet these goals by 2015.
The Committee was of the view that the Department
of Public Works was not rendering a good service to the Department of Health in
terms of building and maintenance of health infrastructure. For example the
Northern Cape Mental Health Hospital which was not maintained and the delays in
the construction of the Jabulani Hospital in Gauteng.
The issue of the CCOD not producing an annual
report was also a concern to the Committee and expressed the urgent need to
address this going forward.
The budget allocated to the MRC was also raised a
serious concern as it is not enough to meet its obligation of leading research
to inform the policy of the country especially where health is concerned.
recommends that the Minister of Health should ensure the following:
The Department of Health should embark on
strengthening the National TB Control Programme so as to decrease the burden of
TB in the country.
Accelerate efforts in meeting the MDG target on
maternal health through proper implementation of strategies aimed at reducing
Ensure monitoring and management of contractual
agreements with the Department of Public Works so as to improve services
The Department should consider ways of increasing
the MRCs budget to meet the research demands so as to address the burden of
disease in the country.
considered the Annual Performance Plans of the Department and its entities, the
Committee will continue to closely monitor the performance of the entities and
that of the Department of Health.
Committee commends the Department of Health and the MRC for the good work they
have done in dramatically increasing life expectancy in South Africa.
to be considered
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