ATC170908: Report of the Select Committee on Social Services on an oversight visit to the Ethekwini Local Municipality in Kwazulu-Natal Province, 04-08 September 2017

NCOP Health and Social Services











2.1      Health. 3

2.2      Human Settlements. 4

2.3      Water and Sanitation. 5

2.4      Home Affairs. 5


2.1      Addington Hospital 6

2.1.1       Background. 6

2.1.2       Findings. 6

2.1.3       Challenges. 8

2.1.4       Recommendations and Issues for follow-up. 9

2.2      Cato Manor Community Health Centre. 9

2.2.1       Findings. 9

2.2.2       Challenges. 9

2.2.3       Recommendations and Issues for follow-up. 10

2.3      Human Settlements, title deeds, military veterans housing, Cornubia Housing Development 10

2.3.1       Title Deeds. 10        Findings. 10         Challenges and Interventions. 11

2.3.2       Military Veterans’ Housing. 12        Findings. 12        Construction of Units. 13        Challenges. 13        Interventions. 14

2.3.3       Cornubia Housing Development 15        Findings. 15        Challenges. 15        Recommendations and Issues for follow-up. 15

2.4      Durban Harbour 15

2.4.1       Background. 15

2.4.2       Findings. 16

2.4.3       Challenges and Commitments. 17

2.4.4       Recommendation and Issue for follow-up. 17

2.5      Water and Sanitation. 17

2.5.1       Findings. 17

2.5.2       Status of water resources. 18

2.5.3       Challenge(s) 18

4.     CONCLUSION. 18









  1. Ms LC Dlamini – Chairperson: Select Committee on Social Services

2. Mrs LL Zwane

3. Ms TK Mampuru – Whip

4. Mrs TG Mpambo-Sibhukwana

5. Ms PC Samka

6. Mr C Hattingh

7. Mr M Khawula

8. Ms D Ngwenya

9. Mr D Stock

10.Ms L Moshodi





  1. Ms Marcelle Williams – Committee Secretary
  2. Ms Thabile Ketye – Content Advisor
  3. Ms Zukiswa France – Committee Assistant
  4. Mr Mkhululi Molo – Committee Researcher
  5. Ms Jeanie Le Roux – Committee Researcher






The Select Committee on Social Services (hereinafter, the Committee) conducted an oversight visit to the Kwazulu-Natal Province. The oversight visit took place during the week of 04–08 September 2017. The decision to conduct an oversight trip to Kwazulu-Natal followed a decision taken during the National Council of Province’s (NCOP) Strategic Planning session held on 1-2 September 2014 and Annual Planning Session held on 28 February-1 March 2017.


In line with the National Development Plan (NDP), Medium Term Strategic Framework (MTSF), priorities of the Fifth term of Parliament, and the mandate of the Committee, the oversight undertaken in Kwazulu-Natal focused on five key portfolios: Health, Water and Sanitation, Human Settlements and Home Affairs. This was done by visiting specific projects and programmes implemented by the above-stated Departments. In Kwazulu-Natal, the Committee visited the eThekwini Local Municipality.


The Committee identified the key focus areas per Department. The oversight that was conducted included site visits of two health facilities, namely: Addington District and Regional Hospital, and Cato Manor Community Health Centre/Day Hospital; human Settlements project - the Cornubia Housing development; Durban Harbour as a Home Affairs port of entry; and interacted with Umgeni Water Board.


This report provides an overview of the areas the oversight focused on. It highlights the findings from the sites that were visited and reported challenges. Based on these, recommendations and issues for follow-up have been identified and made.




The NDP serves as a premise to the Committee’s plan and programme of implementation as it highlights the importance of reaching a minimum standard of living for all South Africans by 2030. A key mechanism of realising this is through a holistic multi-pronged approach.



2.1   Health


A long and healthy life for all South Africans is Outcome/Priority 2 in the MTSF and NDP. Some of the targets geared at improving the health of the South African population include:


  • Raising life expectancy to at least 70 years.
  • Ensuring that the generation of under-20 year olds is largely free from HIV.
  • Significantly reduce the burden of disease.
  • Achieving an infant mortality rate of less than 20 deaths per 1,000 live births, and an under-5 mortality rate of less than 30 per 1,000.
  • Construction of 213 clinics and community health centres, 43 hospitals; and refurbishment of over 870 health facilities in 11 national health insurance (NHI) pilot districts.
  • Doubling of the number of people on ARTs from the present 2.4 million to a projected 5.1 million.
  • Intensifying TB screening and treatment programmes for vulnerable groups, including 150,000 inmates of correctional services facilities, 500,000 mineworkers and an estimated 600,000 people living in mining communities.
  • Vaccination of all girls in Grade 4 against the human papilloma virus, to significantly reduce their risk of acquiring cervical cancer in future.


For the purposes of this aspect of the oversight visit, the Committee visited the Addington District and Regional Hospital, and Cato Manor Community Health Centre. The focus visiting these two sites was on the availability of medicines, emergency medical services, infrastructure, human resources and Ideal Clinics status.


2.2   Human Settlements


Human settlements as defined in the NDP and other strategic policy documents, refers to a provision of not only houses but elements that will ensure people live in a community with all the basic amenities. A lot of infrastructure comes into play in relation to provision of human settlements. These include but are not limited to planning, building and provision of water and electricity. This also has its complexities because planning takes place at the local level; building of houses is a provincial level responsibility; and provision of water, sanitation and electricity is split between the departments responsible for bulk services and reticulation. Due to this the Committee met with all the respective role-players and stakeholders.


For the purposes of this aspect of the oversight visit, the Committee focused on the Cornubia Housing development project.


2.3   Water and Sanitation


According to the NDP, water is a strategic resource for critical socio-economic development. Further, it is acknowledged that South Africa is a water scarce country hence greater attention should be paid to water management and use. Moreover, it is acknowledged that water supply and sanitation services are vital for community health, development, cohesion and continued economic activity (National Planning Commission, 2012). It is within this context that the Committee focused on this sector during its oversight.


For the purposes of this aspect of the oversight visit, the Committee was briefed by the Provincial Manager of the Department of Water and Sanitation on bulk water supply.


2.4   Home Affairs


The NDP (National Planning Commission, 2012) notes the need for people living in South Africa to feel safe and enjoy a community life free of fear, which has a direct impact on the need for effective internal control of immigration detention centres in the country. Likewise, Outcome 6 of the MTSF (also) highlights the requirement that the identity of all persons in South Africa be known and secured, which would not be possible without effective border management and immigration control.


For the purposes of this aspect of the oversight visit, the Committee visited Durban Harbour, which is as a port of entry. The focus was on the management of the facilities and the types of services offered.





The Committee received briefings from the role-players and stakeholders in the form of PowerPoint presentations prior to undertaking site visits. The briefings were followed by discussions where the Members of Parliament (MPs) asked questions to explore and probe on issues raised (during the presentations), and during the site visits.


Information presented in this report therefore comes from the information collected from presentations, discussions and observations.




2.1   Addington Hospital


2.1.1    Background


The hospital was opened in 1878. It consists of several interlinked buildings. Since that period there have been renovations. The initial renovations entailed the building of the “O and “S” blocks in the 1930s, and the opening of the Tower block on 10 November 1967.


2.1.2    Findings


The Committee visited Addington District and Regional Hospital which operates in Ward 26 of Ethekwini Municipality. The hospital offers tertiary services which include oncology and medical physics. It supports two primary healthcare Clinics: Addington Gateway Clinic, weekdays from 07h00 to 16h00, and Beatrice Street Clinic, weekdays from 07h00 to 16h00.


The hospital’s outpatient services department is operational weekdays, from 07h00 to 16h00. The accident and emergency department, and the in-patient services departments are operational 24 hours a day, 7 days a week.


  1. Bed utilisation


According to the hospital CEO, the hospital has 571 authorised beds but only 450 are usable. They are allocated per ward as shown in the table below.





87 (loss of 13 beds 2016)






109 (loss of 10 beds in 2015/16 and 6 2016/17)




16 (and 4 for multidisciplinary use)





Critical Care:


    -Adult ICU /HC




    Coronary Care






  1. Finances


The delegation was presented with the hospital’s budget allocation for 2016/17 and 2017/18 as reflected in the table below. The table shows that there was a nominal increase in the allocated budget between the two years.


It was reported that a bulk of the allocation (R601,053,000.00) goes to salaries (Compensation of Employees). The second largest allocation (R180,537,000.00) is for goods and service.






  1. Medicine Availability


The delegation was informed that all tracer medicines were in stock at the time of the visit. Thus there was a 100% availability of medication. The hospital Pharmacy utilizes web-based stock control treatment systems with stock cards as a back-up system. Further, overall medicine availability for the current financial year, as per the National Dashboard, ranges from % to 91% and currently stands at 87%.


The delegation was informed that in cases were medical items are not available it is generally due to supplier constraints and, includes items that are not on contract or tender.


  1. Infrastructure


Recently the hospital had a “total refurbishment and rehabilitation of the 16 floors of the hospital core block” project. The project includes the replacement of all windows with new aluminum windows, installation of aluminum sun louvers, roof water proofing, lightning protection, the refurbishment of two cooling towers, aluminum auto sliding doors at the main entrance, replacement of central chilled water air conditioning plant serving theaters, wards and a new chiller pipes. The contract for this project commenced on 19 March 2012 and was completed on 16 December 2016. The value of the contract was: R 167,937,846.59.


The other infrastructure project included the refurbishment of 7 theatre rooms with new X-Rays equipment, the renovation of 3 ablution facilities, 2 change rooms, kitchen and tea lounges, vinyl flooring, tilling, a a Doctors lounge, Porters lounge, 3 sleep areas for Doctors, fire protection and detection, a Nurse call system, new ceilings, new shelving, medical gas, and instrument washers. The contract for the project commenced on 20 February 2014 and was completed on 20 January 2015. The contract was valued at: R 26,235,207.87.


The provincial Head of Department indicated that the Infrastructure Head Office is progressively implementing an “Infrastructure Maintenance and Renewal Programme”.


2.1.3              Challenges


The delegation visited a number of units/wards in the hospital. During the “ward rounds” it was informed, and observed the following key challenges -

  • Human Resource challenges:
    • Filling of posts is prioritised according to budget availability.
    • Aging workforce resulting in increased retirements and potential ill. health/decreased capacity.
    • Lengthy recruitment process resulting in loss of potential candidates.
    • Staff shortages in the labour and antenatal wars.
    • Registrars from the University are used (to assist) due to the shortage of qualified Doctors.


  • Infrastructure challenges:
    • Aging infrastructure.
    • Plumbing problems.
    • Electrical problems
    • Leaking roof.
    • Non-functional fire detection and insufficient firefighting system.
    • The PA system was not functional.
    • Lift-dependent structures.


  • Supply Chain Management (SCM) challenges:
    • Lengthy SCM processes.
    • R200 000 delegation prevent the placement of bulk orders.
    • Inappropriate companies tendering for items and then cannot supply.
    • Lack of transversal contracts.
    • Casualty area is small and has a shortage of beds.


  • Bed shortages:
    • High risk patients are diverted to other hospitals, high maternal mortality rate.


  • Medical equipment:
    • Not all machines are functional. The oncology machine was not working at the time of the visit.


2.1.4              Recommendations and Issues for follow-up


The delegation was informed that a streamlined ratification process has been implemented. As part of this process, a critical post list is being established in order to expedite the human resources replacement process at facility level.


The Committee recommended to the provincial Department of Health that the following takes place in the 2017/18 to 2019/20 financial years:

  • Transversal contracts for commonly utilised items be put in place.
  • Both Financial and SCM delegations be increased to R500 000.
  • Additional staff be employed.
  • Additional beds be acquired.


2.2   Cato Manor Community Health Centre


2.2.1              Findings


The Committee visited the Cato Manor Community Health Centre (CHC). The delegation found that the facility is fully functional. It offers an array of services, such as: maternity, paediatrics, x-ray unit, dentistry and pharmacy, physiotherapy and speech therapy. It was reported that medication is available 99% of the time.


2.2.2              Challenges


The main challenges reported are:

  • The CHC operates with 1 acute nurse, who is a Professional Nurse. Further, there is a shortage of midwives.
  • It has a combined waiting area, with a 3 hours waiting period.
  • There is a shortage of consultation rooms.
  • There is no Home Affairs office at the CHC.
  • It has infrastructure challenges.


2.2.3              Recommendations and Issues for follow-up


  • The facility management staff should conduct a survey to assess various patient needs, with 2017/18.
  • The national and provincial Department of Health should assist with equipping the CHC with staff and infrastructure needs, in 2018/19.


2.3   Human Settlements, title deeds, military veterans housing, Cornubia Housing Development


2.3.1              Title Deeds           Findings


The Committee was briefed by the Department of Human Settlements on title deeds. The table below provides a summary of title deeds transfers that have occurred pre-1994 and post-1994.










  1.       Challenges and Interventions





2.3.2              Military Veterans’ Housing           Findings


The Committee was briefed by the Department of Human Settlements on military veterans’ housing. It was reported that to date 252 beneficiaries have been approved on the Housing Subsidy System (HSS). This means that these beneficiaries are on the Department of Military Veterans (DMV) database and have been verified by the DMV. Further, the department has identified some serviced sites from the residential sites owned by the department for the construction of houses for military veterans. These are listed below:

  • Ten (10) serviced sites in uMkumbaan – Ethekwini Municipality
  • Seven (7) serviced sites in Savannah Park -  Ethekwini Municipality
  • Four (4) serviced sites in KwaMakhutha – Ethekwini Municipality
  • Thirty (30) serviced sites in Glenwood -  Msunduzi. Municipality
  • Twenty (20) serviced sites in Copesville – Msunduzi Municipality


The Council Resolution was obtained from Ethekwini Municipality for the release of serviced sites to build military veterans houses. To date, 131 serviced sites have been verified for construction of houses. The Council Resolution was obtained from Alfred Duma Municipality for the release of 13 serviced sites in Acaciaville. Approximately 130 sites were donated by Msunduzi Municipality for this programme and sites still need some planning activities and installation of bulks.Twenty (20) serviced sites have been made available for this programme in Ray Nkonyeni Municipality. The sites are being enrolled with the National Home Builders Registration Council in preparation for the start of construction.  The Newcastle Municipality has committed to release serviced sites for the Military Veterans Programme. The Council Resolution still needs to be obtained. The KwaDukuza Municipality committed to release sites for the implementation of the Military Veterans Programme.  The Endumeni Municipality indicated that there are sites which could be made available for this programme. Fifteen serviced sites have been made available for this programme in Mpofana Municipality. The Implementing Agent will be undertaking process of National Home Builders Registration Council enrolment in preparation for the start of construction.           Construction of Units


In terms of actual construction of military veterans’ houses, the following has been achieved:

  • 1 show house completed in Chesterville – Ethekwini Municipality
  • 4 houses are at roof level in uMkumbaan – Ethekwini Municipality
  • 5 house at wall plate level in uMkumbaan – Ethekwini Municipality
  • 2 platforms cut in KwaMakhutha –Ethekwini Municipality
  • 2 houses currently being painted in Mbumbulu – Ethekwini Municipality
  • Contractor is cutting platforms in Glenwood, Msunduzi for construction of 14 military veterans’ houses as part of the first phase of the 30 units.           Challenges


The following challenges were reported by the Department to the delegation.


  • There has been slow progress in the approval of military veterans by the DMV.
  • Most of the military veterans approved in the HSS currently reside in the Ethekwini Metro, where technical verification of sites is currently on-going. 
  • Where serviced sites have been identified and are ready for construction, the beneficiaries are not approved on DMV and HSS. For example, in Ray Nkonyeni and Alfred Duma Municipalities.
  • The process of enrolling houses with NHBRC before construction commence on site is taking long due to geo-tech assessments that need to be done prior to enrolment.
  • Social issue in Umkhumbane within Ethekwini have resulted in work stoppage on site due to Ridgeview Gardens home owners not wanting 50sq.m houses for military veterans built within their homes as they view these houses to reduce the value of their homes in the market.
  • Some Military Veterans have invaded houses BNG houses in Ethekwini on the following projects: Cornubia (39), Hammonds Farm (7), Kingsburgh West (22) and Philani Valley (33).           Interventions


  • In addressing some of the challenges confronting the Department in the Implementation of the military veterans housing programme, the following has been done:
  • The Department is working with Military Veterans Associations to finalize the list of beneficiaries in those municipalities that have committed sites and get them urgently approved.
  • With 131 serviced sites already verified in Ethekwini, the Implementing Agent is commencing with the process of NHBRC enrolment on these sites in preparation for construction.
  • The issue of houses built in uMkumbaan is being addressed at a political level by Ethekwini Metro, DMV, the National Rapid Response Task Team (NRRTT) and the Department.
  • Engagements are being convened with regional structures of military veterans to sort out the lists and take them to DMV for finalisation of the database.  Rural houses included as well.
  • The policy of beneficiation of military veterans’ businesses is being finalised to give direction on matters relating to what constitute a military veteran company, ownership issues.
  • The municipality is in the process of regularising these military veterans who invaded houses.


2.3.3              Cornubia Housing Development           Findings


The Committee was taken to view the Cornubia Housing Development. It comprises different informal settlements/ transit camps. It caters for those who earn below R3.500, are unemployed or disabled.           Challenges


The main challenges reported are:

  • The quotes received, doesn’t accommodate the budget allocation.
  • It was reported that some Somalians take houses from the beneficiaries.
  • There are maintenance issues (of the houses).           Recommendations and Issues for follow-up


  • The Committee recommended that a national intervention occur.
  • It was reported that a court order had been obtained to evict illegal tenants. It was also reported that verification exercises will be carried out by the Department. In this regard, the Department must submit a report to the Committee on the size/scale of the problem, with a detailed intervention strategy by the end of this calendar year


2.4   Durban Harbour


2.4.1              Background



The Republic of South Africa shares borders with six countries, Lesotho; Swaziland; Mozambique; Zimbabwe; Botswana; and Namibia.


On 12 March 2015 the Department of Home Affairs Director-General announced the approval of the new organisational structure of the Department, the relocation of the ports of entry (POE) with effect from 1 April 2015 from Civic Services to the Head Office – Chief Directorate Port Control. The Chief Directorate Port Control is responsible for the facilitation of legal entry and departure of all persons into and out of the Republic through 72 designated ports of entry (11 airports, 8 harbours and 53 land ports). 


The movement of 41 908 876 travellers were processed during 2016. This was an increase of 4.78% from 2015. Being faced with an ever increasing number of travellers, the balance between efficient and effective traveller facilitation and security considerations becomes critical.


The key focus is on facilitating the movement of bona fide visitors and tourists with the highest possible degree of certainty, security and efficiency in support of national security, priorities and interests whilst preventing illegal migration through the ports of entry. Movement of persons and goods is managed with the participation of other border management stakeholders who have clear responsibilities at the ports of entry and borderline.


Government agencies face the difficult task of identifying high-risk travellers as early as possible in the travel process and target resources accordingly. By building risk-assessment profiles and conducting analysis against watch-lists, it enables governments to make fast, accurate and informed decisions to secure borders whilst protecting legitimate travel, tourism and trade. Whilst facilitating the legitimate movement of travellers and goods, border management staff are also faced with threats posed by transnational crime, terrorism, illegal migration, corruption, pandemics and environmental hazards.


2.4.2              Findings


Durban Harbour is Africa’s largest sea port. The length of the harbour along the quayside is 26km. It  includes two areas for leisure craft (yachts) situated in different areas of the harbour.


Due to the amount of cargo received, the harbour traffic in and around the harbour area can be very congested making it very difficult to travel from one berth to the next to clear vessels. Passenger liners visit Durban Harbour from October to April, when 2 – 4 vessels will dock per week.


2.4.3              Challenges and Commitments


The following challenges were noted by the delegation:






Three offices are utilised for all functions. There is no filing space. The port control office is situated outside the port which poses a security risk.

The Department to negotiate with the Department of Public Works and TNPA to acquire suitable office space in the harbour.


A large number of stowaways are detected in the port.


A stowaway and trespasser Committee has been formed. Joint operations within the port and surrounding areas are undertaken on a regular basis.

Information Technology (IT) system

There is a lack of data points. There is only one computer.

Require a 3G card to access the internet. Utilise the Umgeni Office to access the other functions. New accommodation to be acquired.

Inspectorate establishment

The establishment has not been approved.

Seconded members from Admissions to form Inspectorate Unit.


All existing vehicles are not in a good condition. Need a cage van.

Utilise vehicles from offices to conduct operations and deportations.


2.4.4              Recommendation and Issue for follow-up


  • The Committee recommended that the national Department of Home Affairs assist with staff shortage issues at the harbours, in 2018/19.
  • The Committee embark on an oversight programme of all 8 South African marine ports of entry from 2017/18.


2.5  Water and Sanitation


2.5.1              Findings


The Committee received a presentation by the Department of Water and sanitation (DWS).


The Department reported that the Universal Access Plan (UAP) study is a collaborative initiative undertaken by Umgeni Water, Co-operative Government and Traditional Affairs the DWS. The focus of the study is backlogs, projected demands and estimates of the cost of infrastructure needed to provide universal regional bulk access.


2.5.2              Status of water resources


In the 12-month period since July 2016, rainfall over the northern to central parts of South Africa was mostly average to above average. The remainder of the country, including the Umgeni Water area of operation, received mostly average or below-average rainfall during this period. The rainfall measured over the last quarter has not been sufficient to improve the storage of the uMgeni system. With rainfall, foreca

sts for the next quarter being inconclusive, restrictions and curtailments are still required in the uMgeni system. The latest data on the status of El Niño or La Niña shows an inconsistent trend and it is inconclusive as to which event is likely to take place in the next summer season. Close monitoring of the water resources of the uMgeni Catchment - dam storage, abstractions and demand patterns are continuing with mitigation measures implemented where necessary.


Water restrictions are at 50%. Municipalities are paying their Bills. Education programmes on saving water are visible.


2.5.3              Challenge(s)


  • There is a 7% backlog currently (as reported at the time of the visit., and a 1,300mL/a day future water demand.
  • R78 billion is needed to eradicate the backlog.
  • The cost estimate for universal access is R3.1Billion. The average cost per household is R63,950.00.




The Committee undertook oversight on the Departments of Health, Human Settlements, Water and Sanitation and Home Affairs.


The sites were visited with various stakeholders and role-players, provincial and national Departmental officials. This proved to be a fruitful exercise as it enabled the stakeholders and role-players to see and understand progress made in relation to the projects.


The Committee deliberated and concluded that in the main, the following are crucial in strengthening the projects visited:

  • Funding issues to be taken up with National Treasury- Kwazulu –Natal has ageing infrastructure across the Province, which has not been maintained and thus contributed to this enormous problem.
  • Funding issues relating to employment of staff at key government facilities, that is, health facilities and ports of entry.
  • The importance of taking into account policy implications during the planning phase of projects.
  • The need for strengthened inter-governmental relations and thus better coordinated collaboration.
  • Comprehensive monitoring and reporting of progress.


Following this undertaking, the Select Committee on Social Services will (continue to) undertake oversight on the identified projects.



Report to be considered



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