ATC240315: Report of the Select Committee on Health and Social Services on Its Activities Undertaken During the 6th Parliament (May 2019 – March 2023), Dated 15 March 2024

NCOP Health and Social Services

National Council of Provinces

 

Report of the Select Committee on Health and Social Services on Its Activities Undertaken During the 6th Parliament (May 2019 – March 2023), Dated 15 March 2024

 

SECTION A: KEY HIGHLIGHTS

 

 

1. Reflection on the Committee programme per year and on whether the objectives of such programmes were achieved

 

The Committee held its five-year strategic planning session on 3-4 September 2019. This was subsequently followed by annual planning meetings, which involved reviewing the strategic plan, the Committee’s annual report and the development of an annual performance plan. The annual performance plan meetings were held as follows:

•  28 February 2023,

•  01-02 March 2022,

•  02-03 March 2021, and

•  03-04 March 2020.

 

The Committee developed strategic objectives and a framework of focus areas for the sixth term of Parliament.  This involved integrating strategic priorities as identified in the United Nations Sustainable Development Goals (UN SDGs), African Union (AU) Agenda 2063, Medium Term Strategic Framework (MTSF) 2019–2024, National Development Plan (NDP): Vision 2030, State of the Nation Addresses (SONA), and Executive strategic plan documents.

 

The outcomes approach, which is aligned with the performance agreements and delivery agreements, informed the oversight work of the Select Committee on Health and Social Services (hereafter, the Committee) during this period.

 

1. Committee’s focus areas during the 6th Parliament

 

During the sixth term of Parliament, the Committee was mandated to focus on the following sectors or departments:

•   Department of Health (DoH),

•   Department of Social Development (DSD)

•   Department of Women, Youth and Persons with Disabilities (DWYPD), and

•   Statistics South Africa (Stats SA).

 

The strategic priorities of the Committee were to:

•   Process legislation referred to it and facilitate public participation.

•   Conduct oversight over any organ of state and constitutional institution falling within its portfolio.

•   Facilitate the appointment of candidates to entities, where applicable.

•   Consider relevant international agreements.

•   Consider the departments' annual performance plans, budget, and annual reports and, where possible, entities falling within its portfolio.

•   Conduct a study tour focused on national health insurance and/or universal health coverage.

 

Considering the above-stated strategic priorities, during the 2019-2023 period, the Committee aimed to gain insight into the various programmes the departments offer to enhance people's lives.

 

1. Key areas for future work

 

a)   Collaboration and partnerships: The National Council of Provinces (NCOP) and National Assembly (NA) Committees should continue to conduct joint oversight activities on issues related to departmental annual reports and annual performance plans where possible.

 

b)   NCOP interests: The NCOP Committees should be focused on transversal work and intergovernmental relations. Thus, the NCOP programme should allocate more time for Committee oversight. The work of Select Committees (focus on provincial interests) should complement the work of Portfolio Committees (national interests). Select Committees should conduct oversight at the provincial level, liaise more with Members of the Executive Council (MECs) and counterparts in the legislative sector, and be more visible in communities.

 

c)   Programming: Parliamentary programme revisions should consider the Committee's strategic plan, annual performance plans, and term programmes to minimise revision clashes with approved programme plans. This would strengthen the work of the Committees. The NCOP programme should consider the oversight role of Select Committees – time should be allocated in the NCOP Programme for Committees to strengthen their oversight function and better facilitate inter-governmental relations.

     

d)   Budgeting: Select Committees should have budget allocations that consider their mandate and (work) plans. In addition, there should be an allocated budget for sector-specific capacity-building programmes for Committee Members and staff.

 

e)   NCOP Committees Annual Planning Sessions: Content Advisors should be included in coordinating Committee strategic and annual planning sessions. When allocating time to Select Committees to formulate and review plans, the number of Parliament Committee members who serve should be considered. The period that the Executive tables and reports to Parliament should be considered during the development and review of the NCOP Programme and annual committee planning sessions.

 

f)    Strengthening oversight: Select Committee researchers and Content Advisors should be enabled to conduct primary research or spend time on the field (as part of committee oversight). This would help strengthen the work of committees and the NCOP.

 

g)   Restructuring the NCOP Committees: The composition of Select Committees should be reviewed to ensure that it is in line with the mandate of the NCOP. This will help strengthen the oversight role of Committees. Further, it will delineate the distinct roles of NCOP and National Assembly Committees.

 

h)   Parliamentary public participation programmes: The NCOP public participation programmes (TPTTP and Provincial Week) should have a monitoring system and coordination team to streamline activities better. The coordination team should entail researchers and (provincial) liaison officers. Planning (identification of focus areas and themes; areas that would be visited of the said programmes should be done a year in advance and included in the programmes (and calendars) of all stakeholders and role-players involved. During the year, the same team should monitor the implementation of resolutions and recommendations, identify challenges, and keep NCOP and relevant Committee Members informed of developments.

 

i)    Monitoring by the NCOP: The NCOP should have an internal monitoring system for matters tabled in or referred to the House. There should be synergy in how the different structures of the Core Business Branch function. The NCOP should have a tracking mechanism for resolutions, recommendations, and interventions undertaken. That tracking mechanism should be accessible to structures (Committee Section and the Research Unit) supporting Committees.

 

j)    Coordination at Section-level: The Committee Section should compile a list of planned and completed oversight and international trips. The list should include a reference to the published reports or a summary of the focus areas of those trips. This would help streamline the work of Committees.

 

k)   Committee-specific oversight: In the seventh term of Parliament, the Committee should consider conducting oversight on the following:

 

l) The implementation of the NHI Bill and the funding modalities thereof.

o         NHI Bill regulations

o         Work of the NHI chief directorates

o         Progress in the Health Patient Registration System (HPRS)

o         Health district system, ideal clinics, hospital infrastructure

o         Primary health care reengineering

o         Mental health initiatives

o         South African Demographic Health Survey

o         Burden of disease, illness, and injury in South Africa

 

m) Anti-fraud campaigns (and administration improvement) directed at the SASSA grant pay-outs.

 

n) Food security programmes funded by the DSD.

 

o) Youth development initiatives, and cross-cutting initiatives related to youth and gender.

 

p) Progress in the employment of Social Workers and in strengthening human resources for health.

 

1. Key challenges emerging

 

•  Committee restructuring: At the beginning of the sixth term of Parliament, the Committee was restructured. This altered the mandate of the Select Committee. However, the capacity of the Committee support team was not strengthened. This raised challenges in optimising the work of the Committee and the provision of support to Members of the Committee concerning the work of the DWYPD [including the National Youth Development Agency (NYDA) and Commission for Gender Equality (CGE)].

 

•  Programming: Conflicts between approved committee programmes and the parliamentary programme proved another challenge during this period. To minimise this impact, the Committee held virtual joint meetings with its counterparts from the National Assembly, where possible.

 

•  Planning: At times, the Parliament Programme did not consider the Committee's annual performance plans and term programmes. In addition, the NCOP Programme did not allocate any weeks for oversight trips during this period. This made it challenging to allocate time for oversight visits.

 

•  Aftermath of the coronavirus (COVID-19) pandemic: The pandemic has had dire effects on everyone, specifically on resources, women, and young people. Statistics on homelessness, gender-based violence (GBV) and teenage pregnancy reflect this.

 

1. Recommendations

 

a)  Collaboration and partnerships: NCOP and National Assembly Committees should continue to conduct joint oversight activities on issues related to departmental annual reports and annual performance plans where possible.

 

b)  NCOP interests: NCOP Committees should be focused on transversal work and intergovernmental relations. Thus, the NCOP programme should allocate more time for Committee oversight. The work of Select Committees (focus on provincial interests) should complement the work of Portfolio Committees (national interests) and vice versa. Select Committees should conduct oversight at the provincial level, liaise more with Members of the Executive Council (MECs) and counterparts in the legislative sector, and be more visible in communities.

 

c)  Programming: Parliamentary programme revisions should consider the Committees' strategic plan, annual performance plans and term programmes to minimise revision clashes with approved programme plans. This would strengthen the work of the Committees. The NCOP programme should consider the oversight role of Select Committees – time should be allocated in the NCOP Programme for Committees to strengthen their oversight function and better facilitate inter-governmental relations.

           

d)   Budgeting: Select Committees should have budget allocations that consider their mandate and (work) plans. In addition, there should be an allocated budget for sector-specific capacity-building programmes for Committee Members and staff.

 

e)   Planning: Content Advisors should be included in coordinating Committee strategic and annual planning sessions. The number of Parliament Committees Members who serve should be considered when allocating time to Select Committees to formulate and review plans. The period that the Executive tables and reports to Parliament should be considered during the development and review of the NCOP Programme and annual committee planning sessions.

 

f)     Strengthening oversight: Select Committee researchers and Content Advisors should be enabled to conduct primary research or spend time on the field (as part of committee oversight). This would help strengthen the work of committees and the NCOP.

 

g)    Restructuring the NCOP Committees: The composition of Select Committees should be reviewed to ensure that it is in line with the mandate of the NCOP. This will help strengthen the oversight role of Committees. Further, it will delineate the distinct roles of NCOP and National Assembly Committees.

 

h)     Parliamentary public participation programmes: The NCOP public participation programmes (TPTTP and Provincial Week) should have a monitoring system and coordination team.  The coordination team should entail researchers and (provincial) liaison officers. Planning (identification of focus areas and themes; areas that would be visited of the said programmes should be done a year in advance and included in the programmes (and calendars) of all stakeholders and role-players involved. During the year, the same team should monitor the implementation of resolutions and recommendations, identify challenges, and keep the Members of the NCOP, and relevant Committees informed of developments.

 

i)      Monitoring by the NCOP: The NCOP should have an internal monitoring system for matters tabled in or referred to the House. There should be synergy in how the different structures of the Core Business Branch function. The NCOP should have a tracking mechanism for resolutions, recommendations, and interventions undertaken. That tracking mechanism should be accessible to structures (Committee Section and the Research Unit) supporting Committees.

 

j)    Coordination at Section-level: The Committee Section should compile a list of planned and completed oversight and international trips. The list should include a reference to the published reports or a summary of the focus areas of those trips. This would help streamline the work of Committees.

 

k)   Committee-specific oversight: In the seventh term of Parliament, the Committee should consider conducting oversight on the above-stated areas highlighted under “key areas for future work”:

 

 

 

SECTION B

1.INTRODUCTION

 

1.1.Department/s and Entities falling within the Committee’s Portfolio

 

1.1.1.Department of Health

 

The role of the Department of Health (DoH) is to improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the healthcare delivery system by focusing on access, equity, efficiency, quality, and sustainability.

 

Table 1: Health entities

NAME OF ENTITY	ROLE OF ENTITY
Medical Research Council (MRC)	The objects of the MRC are, through research, development, and technology transfer, to promote the improvement of the health and quality of life of the population of the Republic and to perform such functions as may be assigned to the MRC by or under the Medical Research Council Act (58 of 1991).
National Health Laboratory Services (NHLS)	The NHLS forms a national network of integrated pathology laboratories throughout the country that utilise standard laboratory management systems and transport networks to facilitate the transport of specimens, referral of tests to reference laboratories and delivery of results
Office of Health Standards Compliance (OHSC)	The OHSC was established in terms of Section 77 of the National Health Act to promote and protect the health and safety of the users of health services.
Council for Medical Schemes (CMS)	The CMS is a statutory body established by the Medical Schemes Act (131 of 1998) to regulate private health financing through medical schemes.
South African Health Products Regulatory Authority (SAHPRA)	As amended, SAHPRA was established in terms of the Medicines and Related Substances Act (101 of 1965) to replace the Medicines Control Council (MCC).

 

There are five health entities, as reflected in Table 1.

 

1.1.2.Department of Social Development

 

The role of the Department of Social Development (DSD) is to enable people with low incomes, the vulnerable, and the excluded within South African society to secure a better life for themselves, in partnership with them and with all those committed to building a caring society.

 

Table 2: Social development entities

NAME OF ENTITY	ROLE OF ENTITY
South African Social Security Agency (SASSA)	The role of SASSA is to ensure the provision of comprehensive social security services against vulnerability and poverty within the constitutional and legislative framework and to create an enabling environment for sustainable development.
National Development Agency (NDA)	The role of the NDA is to contribute towards eradicating poverty and its causes by granting funds to civil society organisations to implement development projects in poor communities.
Central Drug Authority (CDA)	The CDA is expected to give effect to the National Drug Master Plan, advise the Minister on any matter affecting the abuse of drugs, and plan, coordinate and promote measures relating to the prevention and combating of alcohol, drugs, and the treatment of persons dependent on alcohol and drugs.

 

There are three social development entities, as reflected in Table 2.

 

1.1.3.Department of Women, Youth and Persons with Disabilities

 

The role of the Department of Women, Youth and Persons with Disabilities (DWYPD) is to provide strategic leadership, coordination and oversight to government departments and the country in mainstreaming empowerment programmes on DWYPD. Its vision is to have a transformed, inclusive society free from all forms of discrimination and capable of self-actualisation.

 

Table 3: Entities under the DWYPD

NAME OF ENTITY	ROLE OF ENTITY
Commission for Gender Equality	To advance, promote and protect gender equality in SA.
National Youth Development Agency	To mainstream youth issues in society and to facilitate youth development in all sectors of society.

 

There are two entities under the DWYPD, as reflected in Table 3.

 

1.1.4.Statistics South Africa

 

The role of Statistics South Africa (Stats SA) is to is to provide relevant and accurate statistics by using internationally approved practices to inform users of the dynamics of the economy and society. Stats SA is mandated through the Statistics Act [No.6 of 1999] to coordinate statistical production from organs of state, the private sector and other institutions to facilitate proper planning, decision making and monitoring and evaluation of policies and projects.

 

1.2.Functions of the Committee

 

Parliamentary Committees are mandated to:

 

• Monitor the financial and non-financial performance of government departments and their entities to ensure national objectives are met.

• Process and pass legislation.

• Facilitate public participation in Parliament relating to issues of oversight and legislation.

 

1.3.Method of Work of the Committee

 

The NCOP adopted a system of scheduling annual planning sessions (called “committees strategic planning [annual review] sessions”). These take place over two days for two (or three Committees) that share Members of Parliament[1] ; the strategic/annual planning sessions usually take place during the 1st week of March of that year. The planning session was used to review and develop committee programmes for the current financial year and the sixth Parliament period.

 

To facilitate planning, the Committee considered strategic priorities as identified in the Medium-Term Strategic Framework (MTSF), the National Development Plan (NDP), the outcomes approach (that is aligned to the performance agreements and delivery agreements) and the State of the Nation Address to inform its oversight.

 

The Committee adopted term programmes in line with the NCOP programme and its strategic and annual plans.

 

The Committee mainly held its meetings on Tuesday mornings (as set out by the institution’s programming) and, if possible, on Wednesdays. When possible, the Portfolio Committee counterparts jointly oversaw annual performance plans (APPs), budget votes, and annual reports.

 

1.4.Purpose of the Report

 

This report provides an account of the Select Committee on Health and Social Services' work during the 6th Parliament and informs the members of the new Parliament of critical outstanding issues regarding the oversight and legislative programme of the Departments of Health, Social Development, Women, Youth, and Persons with Disabilities and Stats SA and its entities.

 

This report provides an overview of the activities the Committee undertook during the 6th Parliament, the outcome of crucial activities, any challenges that emerged during the period under review and issues that should be considered for follow-up during the 6th Parliament. It summarises the key issues for follow-up and concludes with recommendations to strengthen operational and procedural processes to enhance the committee’s oversight and legislative roles in future.

 

2.KEY STATISTICS

 

The table below provides an overview of the number of meetings held, legislation and international agreements processed, and the number of oversight trips and study tours undertaken by the committee, as well as any statutory appointments the committee made, during the 6th Parliament:

 

Table 4: Number of activities conducted by the Committee

ACTIVITY	2019/20	2020/21	2021/22	2022/23	2023/24	TOTAL
Meetings held	31	26	26	20	5	108
Legislation processed	1	0	0	2	2	5
Oversight trips undertaken	1	0	0	0	0	1
Study tours undertaken	0	0	0	1	0	1
International agreements processed	0	0	0	4	0	4
Statutory appointments made	2	1	1	0	0	4
Interventions considered	0	0	0	0	0	0
Petitions considered	0	0	0	0	0	0

 

3.BRIEFINGS

 

The Committee had 108 briefings during the 6th Parliament as reflected by Table 4.

 

1. Health

 

In 2020 and 2021, the briefings included joint meetings with the Portfolio Committee on Health on the coronavirus (COVID-19) pandemic. These included meetings with the National Health Laboratory Services (NHLS) and private hospital groups. The Committee also received briefings from the nine provincial health departments to ascertain progress and challenges in responding to the COVID-19 pandemic. In addition, the Committee met with the Medical Research Council (MRC) to receive the most recent findings on COVID-19-related research, and the Auditor-General (AGSA) to receive a report on the outcome of the COVID-19 stimulus relief fund package.

 

The Committee made the following recommendations to the Minister of Health about the state of public health services in the country:

 

• Strengthen human resources for health: The Department should provide a report on the placement of interns and community service doctors. In addition, the Department should brief the Committee on its strategy to retain critical human resources.

 

• Strengthen inter-governmental relations (IGR) and public-private partnerships (PPP): The Department should collaborate with provincial departments in prioritising the procurement of essential health technology for cancer management and a

 

• Address service backlogs:  The Department should furnish the Committee with a report from the NHLS on the forensic chemistry test backlog. In addition, the Department should provide a detailed report on the obstetric and oncology backlogs at facilities such as Robert Mangaliso Sobukwe Hospital.

 

• Reduce medico-legal claims: The Department should provide the Committee with a detailed report on its efforts to strengthen the management of medico-legal claims and on how it is assisting provincial departments in this regard.

 

• Address infrastructure challenges: The Department should provide infrastructure technical support to provincial departments to develop their capacity to plan and manage health infrastructure delivery. The Department should furnish the Committee with an action plan aimed at addressing infrastructure backlogs and existing gaps. In addition, the Department should provide a detailed report, including the cost thereof, of all planned infrastructure projects.

 

• Ensure quality rural health services: The Department should ensure the implementation and investment on strategies aimed to mitigate the impact of load shedding on the delivery of health services and report to the Committee quarterly.

 

• Provide support to provincial departments: The Department should furnish the Committee with a report on the support it has been providing to provincial departments in relation to financial management. In addition, the Department should facilitate a two—to three-day session with affected provincial departments to review the progress and challenges faced in implementing quality health systems and good financial management.

 

• Strengthen monitoring: The Department should strengthen its monitoring of the implementation of the Auditor-General’s findings on key areas of internal controls and financial management, target-setting, implementation of plans and reporting thereof.

 

1. Social Development

 

In 2021, the briefings included a joint meeting with the Portfolio Committee in Social Development on the COVID-19 pandemic. The Committee also held briefing meetings with the Department of Social Development and the South African Social Security Agency (SASSA) to establish progress on implementing social relief programmes and interventions to address the effects of “unrest” that affected social development facilities in Gauteng and KwaZulu-Natal provinces.

 

The Committee made the following recommendations to the Minister of Social Development:

 

• Expand the SRD grant: The Minister should continue to engage with the National Treasury regarding increasing the SRD grant to help combat poverty and submit a quarterly update report to the Committee.

 

• Strengthen human resources: The Minister should ensure that a viable strategy exists to address the challenge of social work services in the country. The strategy should be tabled in Parliament and implemented subsequently.

 

• Improve policies: The Minister should also ensure that SASSA strengthens its human resource policies on vetting and implementing academic clearance of its employees as one of the measures to prevent fraud and corruption and hold management accountable.

 

• Fill vacant positions: The Minister should ensure that the Department fills vacant positions, particularly those at Executive-level such as the Director-General and Deputy Director-General within the 2023 calendar year. In addition, the Minister should ensure that acting positions do not last more than six months in the Department and entities. An update should be provided to the Committee at the beginning of every briefing meeting. 

 

• Strengthen collaboration: The Minister should ensure that the Department and entities work closely with other departments in the social cluster, civil society, and community members. In this regard, clear and realistic indicators that spell out the programmes that are planned or implemented collaboratively should be set and reported to the Committee every six months. In addition, the Department should facilitate stakeholder workshops to address key issues such as food insecurity and preparedness for future pandemics, substance abuse, and a review of the role the social development sector has played in alleviating poverty.

 

• Strengthen internal controls: The Department should ensure that there are systems in place to prevent irregular, fruitless and wasteful expenditure (within the Department and its entities). In addition, the Department should strengthen its monitoring systems and submit reports to the Committee (in this regard) every six months.

 

1. Women, Youth and Persons with Disabilities

 

The Committee made the following recommendations to the Department of Women, Youth and Persons with Disabilities:

 

• The Department should develop awareness programmes within government structures and communities about its mandate and role. In addition, the Department should present its strategy of how it aims to realise its vision and mission.

 

• The Department should disseminate its research, monitoring, and evaluation reports.

 

• The Department should submit a report to the committee that provides detailed information about the nature, content, and purpose of its training manuals.

 

• The Department should improve its efforts as one of the critical stakeholders in addressing GBV. In this regard, the Department should provide a detailed report of the progress it has made in addressing GBV in the country. In addition, the Department should brief the Committee on how it intends to take better strides.

 

• The Department should help ensure that the work of its entities, CGE and NYDA, reaches the rural and peri-urban communities, whilst considering the needs of those communities.

 

1. Statistics South Africa

 

The Committee made the following to Stats SA, through the Minister in the Presidency:

 

• Finalise the legislative process: Stats SA should expeditiously finalise and table amendments to the Statistics Act (1999) to drive statistical reform in the country timeously to Parliament. The amendments of the Act should firmly respond to the evolving environment, with particular emphasis on statistical coordination, the data revolution, state-wide statistical service, and institutional arrangements.

 

• Strengthen capacity building and inter-governmental relations: Stats SA should consider adopting a programme aimed at capacitating all government departments and local government on key statistical findings to assist all spheres in planning, policy-making, evidence-based decision-making and budgeting.

 

• Reduce vacancies: The vacancy rate of 20.7% must be drastically reduced by undertaking a recruitment drive to strengthen the departmental workforce to continue producing quality, reliable and timeous statistics for the nation and the international world.

 

• Initiate gender mainstreaming and development internally: Stats SA should prioritise balancing its employment equity targets by ensuring capable women are appointed to senior management positions.

 

• Contribute to youth economic development: Stats SA should commit to a certain percentage of youth being equipped with the necessary skills and employed.

 

• Find plausible funding strategies: Stats SA should develop and/or find plausible and cost-effective funding strategies for implementing surveys.

 

• Explore efficient data collection and dissemination tools: Stats SA should explore efficient ways of collecting data and disseminating it to the relevant sectors and the public. However, it should ensure that the efficient methods are effective and do not compromise data quality and the capacity of employees. In addition, Stats SA should use systems that do not compromise the reliability and validity of collected data.

 

4.LEGISLATION

 

The following pieces of legislation were referred to the Committee and processed during the 6th Parliament:

 

4.1.Social Assistance Amendment Bill [B8B-2018]

 

In 2020, the Committee processed the Social Assistance Amendment Bill [B8B-2018], which was tagged as a Section 76 Bill.

 

 The Bill amends the Social Assistance Act of 2004 and aims to provide for additional payments linked to social grants. These include providing for the payment of a social grant to a child responsible for a child-headed household, and social relief of distress (SRD) in the event of a disaster. The Bill also aims to streamline and improve the process of appeals against decisions of the South African Social Security Agency by providing for an Independent Tribunal for these appeals, among other things.

 

4.2.Children’s Amendment Bill [B18B-2020]

 

In 2022 the Committee processed the Children’s Amendment Bill [B18B-2020], which was tagged as a Section 76 Bill.

 

The Bill amends the Children’s Act, 2005, to amend and insert certain definitions; to extend the children’s court jurisdiction; to further provide for the care of abandoned or orphaned children and additional matters that may be regulated; to provide for additional matters relating to children in alternative care; and to provide for matters connected therewith.

 

4.3.Fund-raising Amendment Bill [B29B-2020]                                       

 

In 2023 the Committee processed the Fund-raising Amendment Bill [B29B-2020], which is a Section 76 Bill.

 

The Bill amends certain definitions; provides for the discontinuation of certain funds and for the dissolution of any boards responsible for those funds; to establish the Disaster Relief and National Social Development Fund and to transfer any amounts remaining in the discontinued funds to the Disaster Relief and National Social Development Fund; to empower the Minister to make regulations in respect of the financial year of a fund; and to provide for matters connected therewith.

                  

4.4.National Health Insurance Bill [B11B-2019]

 

In 2023, the Committee processed the National Health Insurance (NHI) Bill [B11B-2019], which is a Section 76 Bill.

 

The objective of the Bill is to establish an NHI Fund and to set out its powers, functions and governance structures; to provide a framework for the strategic purchasing of health care services by the Fund on behalf of users; to create mechanisms for the equitable, effective and efficient utilisation of the resources of the Fund to meet the health needs of the population; to preclude or limit undesirable, unethical and unlawful practices in relation to the Fund and its users; and to provide for matters connected herewith.

                

4.5.           National Council on Gender-based Violence and Femicide Bill [B31B-2022]                        

In 2024, the Committee processed the National Council on Gender-based Violence and Femicide Bill [B31B-2022], a Section 75 Bill.

 

The objective of the Bill is to establish the National Council on Gender-Based Violence and Femicide; to provide for the objects and functions of the Council; to appoint the Board of the Council; to provide for the appointment of members of the Board; to provide for the term of office of members of the Board; to provide for the termination of membership of the Board; to provide for meetings of the Board; to provide for the establishment of committees of the Board; to provide for the appointment of the Chief Executive Officer and the Secretariat Unit of the Council; to provide for the establishment of norms and standards for the provincial and local working groups; to provide for the making of regulations; and to provide for matters connected therewith.

                

4.6.National Youth Development Agency Amendment Bill [B13B-2022]

 

In 2024, the Committee processed the National Youth Development Agency (NYDA) Amendment Bill [B13B-2022]. This is a Section 75 Bill.      

 

The objective of the Bill is to amend the NYDA Act, 2008, so as to insert new definitions; to amend the provisions relating to the objects of the Agency; to amend the functions of the Agency; to amend provisions relating to reporting by the Agency; to provide for organs of state to assist the Agency; to provide for the governance responsibilities of the Board; to provide for additional Board members; to provide that a Board member may not be reappointed for more than two terms; to provide additional grounds for disqualification; to provide for the filling of vacancies during term, to amend matters pertaining to the meetings of the Board; to amend the funding of the Agency; to authorise the Minister to make regulations and to provide for matters connected therewith.

 

4.7.Statistics Amendment Bill [B13B-2023]

 

In 2024, the Committee is currently processing the Statistics Amendment Bill [B31B-2023], a Section 75 Bill.

 

The objective of the bill is to amend the Statistics Act, 1999, so as to substitute certain definitions and insert new definitions; to amend the provisions dealing with the powers and duties of the Statistician-General; to make provision for the development and implementation of the National Statistics System and National Strategy for the Development of Statistics by the Statistician-General; to strengthen co-ordination and enhance collaboration amongst data producers and data users by creating an enabling environment for the production and consumption of quality statistics within the Republic; to make provision for the establishment of statistics units by organs of state, the submission of annual statistics plans and annual reports by organs of state and the establishment of the Statistical Clearing House in order to promote the functions and objectives of the National Statistics System; to empower the Minister to make regulations; and to provide for matters connected therewith.

                

1. Challenge(s) emerging:

 

The following challenges emerged during the processing of legislation:

 

Contentious pieces of legislation received large volumes of written submissions. The process of analysing and summarising written submissions for Section 76 Bills requires legal advisers. However, this has been a challenge in the latter part of this term.

 

1. Issue(s) for follow-up:

 

The 7th Parliament should consider following up on the following concerns that arose:

 

The role of Legal Advisers in providing support during the legislative process should be clarified.

 

 

5.OVERSIGHT TRIPS UNDERTAKEN

 

The conducted one oversight trip during this period. The oversight trip took place on 21-25 October 2019. The Committee visited the Garden Route District Municipality (Kannaland, Oudtshoorn, Mossel Bay and George Local Municipalities) in the Western Cape.       

 

The objective of the oversight trip for the health component was on the availability of medicines, emergency medical services (EMS), infrastructure, and human resources, and the Ideal Clinic initiative will be assessed.

 

The objective in terms of social development was to assess access to social assistance, programmes that are aimed at strengthening community participation, projects aimed at improving household access to food and nutrition, access to Early Childhood Development (ECD), substance abuse prevention programmes, and protecting and promoting the rights of vulnerable groups such as elderly, children, and people with disabilities.

 

The focus of the oversight, in terms of the DWYPD, was to look at programmes and projects related to women empowerment, youth employment, and persons with disabilities.

 

The Committee made the following recommendations:

• The DSD should process the application for funds timeously.

 

• The DoH (National/ Provincial) should support the hospital in their good work and outreach programs and assist in developing functional models in other hospitals.

 

• The DSD should monitor and interact with the shelter management regarding assistance and support offered.

 

• The strong relationship with the community, SAPS and the security company should be maintained. Further, the strong relationship with the rehabilitation centre, old age home, schools and church should be maintained.

 

• The shortage of social workers in South Africa will be discussed at the Ministerial level. A national database is being developed to recruit retired, unemployed, and auxiliary social workers. Gender-based violence is a priority and should be supported by all departments.

 

• The Club and DSD must explore co-operative governance. Further, a memorandum of understanding with the mayor’s office and MEC should be explored for collaborative initiatives.

 

• An intergraded 5-year plan should be developed and consider the requirements of the community.

 

• Financial contributions from members should be supplemented by external funding.

 

• A food garden to be explored by the Club.

 

• Community members should assist members with ailments.

 

• The DSD interns be brought in to assist with various creative initiatives and projects.

 

• The local government, Department of Public Works and DSD should investigate finding a more conducive building for the Club in Calitzdorp. The health requirements of the Club members and community must be considered.

 

• The MEC should investigate allocating Cuba-trained doctors in the area.

 

• There should be full-time security guards at the facility.

 

• The process of establishing a Clinic Committee should be finalised and implemented.

 

• Advocacy in the community is important. The nurses should assist in this regard.

 

• In terms of the “ideal clinic” norms, the national Department should look into the level at which criteria are met (and not met).

 

1. Challenges emerging

 

The following challenges emerged during the oversight visit:

 

• Persistent changes to the NCOP programme have made it difficult for the Committee to conduct its oversight visits.

• Reliance on the information from the Executive about sites that should be visited does not assist the Committee to conduct its oversight optimally. This is because the departments tend to select projects that are doing well.

• Political heads are not always available during site visits. Undertakings made by political heads hold more weight than those made by staff.

• At times, there is no collaboration between the National Parliament and the Provincial Legislatures in relation to oversight visits. Thus, issues of duplication may emerge, thus creating confusion on the ground.

• The Content and Research teams do not conduct primary research before the Committee embarks on its oversight visit. Thus, the issue of the reliability of the information provided by the Executive is questionable.

 

1. Issues for follow-up

 

The 7th Parliament should consider following up on the following concerns that arose:

 

• The 7th Parliament should ensure that the Programming Committee on the NCOP allocate more time for committees to conduct oversight visits.

• A more collaborative approach between the National Parliament and the Provincial Legislatures is warranted. This will address issues of duplication.

• The budget should be made available for the Content and Research team to do primary research before the Committee embarks on its oversight visits.

• Political heads should be available during the Committee’s oversight visits. This would ensure accountability.

 

 

Status of the report: Report adopted.

 

6.STUDY TOURS UNDERTAKEN

 

The Committee conducted one study tour during this period.

 

On 03-07 July 2023 the Committee visited Seoul in South Korea. The study tour included meetings and visiting the following sites:

• Ministry of Health and Welfare in Sejong City,

• National Health Insurance Service (NHIS) in Wonju City,

• Health Insurance Review and Assessment (HIRA) Service in Wonju City and

• Samsung Medical Centre in Gangnum-gu.

 

Objectives

• To explore and learn how the government of Korea has achieved its health care coverage under the NHI system,

• To explore and learn how the government of Korea is funding its NHI system to the benefit of its citizens,

• To explore and learn how the NHI system is provided by the different stakeholders or fundamental institutions, i.e., the HIRA, which is responsible for Korea’s health insurance evaluation and analysis service, and the NHIS, which provides for the Republic of Korea’s national health insurance service. This will enable the Committee to understand the mechanism of the Republic of Korea’s health system.

 

Lessons Learned        

1. Government initiatives should be based on ethical and sound research, monitoring, and evaluation. Departments should submit reports of implemented efficiencies to the respective Parliament Committees.

 

1. Government departments should work closely with industry organisations, garner investment and find ways of collaborating on innovative initiatives that will improve education and health sector goals for the betterment of the country.

 

1. Government departments should share summary reports of local and international feasibility studies that have been conducted. The reports should include key lessons from those studies, the department’s plan of action and progress. Those reports should be submitted to the respective Parliament Committees.

 

1. The Department of Health should provide more information to the Committee and the public on the following:

• How the proposed NHI Bill will ensure an improved health care system.

• The envisaged role the private health sector will play in the rollout of NHI.

• The estimated timeframes to realise UHC.

• What the different phases of implementation will entail.

• The implications of not implementing NHI as set out in the proposed Bill.

• Cost estimates for the different phases of implementation.

• Parliament, through its relevant committees, should monitor the implementation of health policies and legislation, including the NHI. 

 

Status of the report: Report adopted.

 

7.INTERNATIONAL AGREEMENTS

 

The following international agreements were processed and reported on:

 

7.1.Agreement amending the SADC Protocol on Gender and Development

 

On 06 September 2021, the Agreement amending the SADC Protocol on Gender and Development, in terms of Section 231(2) of the Constitution of the Republic of South Africa, was referred to the Committee.

 

The objectives of the agreement are to amend various articles in the Protocol.

 

Status of the report: Report adopted.  

 

7.2.Protocol to the African Charter on Human and Peoples rights on the rights of persons with disabilities in Africa

 

On 08 November 2023, the Protocol to the African Charter on Human and Peoples Rights on the Rights of Persons with Disabilities in Africa, in terms of Section 231(2) of the Constitution, 1996, was referred to the Committee.

 

The Protocol is a transformative legal instrument providing norms and standards to ensure respect and protection of the rights of older persons in Africa. The purpose of the Protocol is to promote and protect the rights of older persons.

 

Status of the report: Report adopted.

 

7.3.Treaty for the establishment of the African Medicines Agency

 

The Treaty for the establishment of the African Medicines Agency (AMA) by the African Union was referred to the Committee on 26 October 2023.

 

The AMA intends to develop improved access to quality-assured medical products. Further, AMA plans to be more visible by facilitating the following core activities: safety monitoring, market surveillance, marketing authorisation, oversight of clinical trials, coordination of quality control laboratory services; and joint assessments and good manufacturing practice inspections.        

Status of the report: Report adopted.

 

1. Challenge(s) emerging:

 

No challenges emerged during the processing of international agreements:

 

1. Issue(s) for follow-up:

 

The 7th Parliament should consider following up on the following concerns that arose:

 

• Conducting oversight on the implementation of these agreements by the Executive.

 

8.STATUTORY APPOINTMENTS

 

The following appointment processes were referred to the committee and the resultant statutory appointments were made:

 

8.1.Appointment of the Central Drug Authority

 

On 28 May 2018, the Committee adopted the Central Drug Authority (CDA) appointment process report. The term of the appointed CDA members is 2020-2025.

 

8.2.Appointment of the NYDA board

 

On 18 November 2019, the Committee adopted the NYDA board recruitment and appointment process report. The term of the NYDA board members is 2021- 2024.

 

1. Challenges emerging:

 

The following challenges emerged during the statutory appointments:

 

• The process was undertaken during COVID-19. Thus, the Committee mainly relied on technology vis a vie in its communication (virtual meetings). There were many delays due to technical issues such as sound and internet connection.

• The process involved going through thousands of applications and nominations, summarising them and creating an online platform to upload those summaries. The process was very time-consuming.

 

1. Issue(s) for follow-up:

 

The 7th Parliament should consider following up on the following concerns that arose:

 

• More administrative support during these processes is required. Thus, the management should ensure that additional support for the content and research team is provided.

 

 

9.SUMMARY OF OUTSTANDING ISSUES RELATING TO THE DEPARTMENT/ENTITIES THAT THE COMMITTEE HAS BEEN GRAPPLING WITH

 

The following key issues are outstanding from the Committee’s activities during the 6th Parliament:

 

Responsibility	Issue(s)
Oversight	The Select Committee on Health and Social Services was expected to follow-up on issues that were raised in the adopted report[s] of the Ad Hoc Joint Committee on Floods i.e., Temporary Shelters. However, the Ad hoc Joint Committee was re-established to follow-up on previous work before the Select Committee could conduct the oversight.
	During the 6th Parliament, the NCOP has undertaken Taking Parliament to the People in KwaZulu-Natal province. Follow-up on recommendations and/or outstanding matters emanating from various reports adopted in the 6th Parliament should be prioritised in the 7th Parliament.
	The Select Committee has mainly interacted with the South African Social Security Agency (SASSA) from its mandated entities. More attention should be given to health sector entities, especially considering the recently processed NHI Bill.

 

10.OTHER MATTERS REFERRED BY THE SPEAKER/CHAIRPERSON

 

Having considered the referral from the Chairperson of the NCOP regarding a letter and list of recommended candidates to fill vacancies in the Independent Tribunal for Social Assistance Appeals, as per the Social Assistance Act (No. 13 of 2004), the Committee met on 7 December 2022. During the meeting, the Committee acknowledged the composition and process of appointing candidates to be members of the Independent Tribunal for Social Assistance Appeals. The Committee also noted that the Department of Social Development was responsible for the appointment process.

 

No other matters were referred to the Committee by the Chairperson.

 

1. Challenges emerging:

 

The following challenges emerged during the processing of the referral:

 

• At times there are delays in receiving communication of matters referred to the Committee.

• External correspondence is not always correctly addressed. There have been instances whereby correspondence that should be referred to a Portfolio and Select Committee is addressed only to the Portfolio Committee or the NA. This affects the programme of the Committee as it needed to revise its programme and accommodate unplanned activities in short notice.

 

1. Issues for follow-up:

 

The 7th Parliament should consider following up on the following concerns that arose:

 

• During the 7th Parliament, the two Houses should have a streamlined process in place of referring internal and external matters to Committees.

• Correspondence should be addressed to both Houses to allow for better planning by the NCOP Programming Committee.

 

 

 

11.RECOMMENDATIONS

 

• During the 6th Parliament, there were instances of collaboration between the NCOP and NA Committees collaborated on certain matters, especially during the COVID-19 pandemic. However, this practice is no longer in place. Therefore, it is recommended that during the 7th Parliament, the NCOP and NA Committees should continue to conduct joint oversight activities, where possible, on issues related to departmental annual reports and annual performance plans.

 

• The referral of recommendations emanating from other Committees’ reports should be formally referred to the Committees in writing, in addition to the referral published in the ATC.

 

12.COMMITTEE STRATEGIC PLAN

 

(Attached as Annexure A)

 

13.MASTER ATTENDANCE LIST

 

(Attached as Annexure B)

 

Report to be noted.

 

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[1] The allocated period for the planning sessions entailed a plenary in the morning with all NCOP Committees, and breakaway sessions following the plenary. The breakaway sessions would then entail two or three Committees sharing the slot to review and formulate their plans.