World Health Organisation Framework Convention on Tobacco Control: Adoption; Nursing Bill: briefing

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Meeting Summary

A summary of this committee meeting is not yet available.

Meeting report


8 March 2005

Ms J Masilo (ANC)[North West]

Documents handed out:
World Health Organisation Framework Convention on Tobacco Control
Health Department PowerPoint presentation on WHO Framework Convention on Tobacco Control
Health Department PowerPoint presentation on the Nursing Bill


The Committee, having been briefed before by the Department of Health on the provisions of the WHO Framework Convention on Tobacco Control, met to consider provincial voting mandates. The Committee approved the ratification of the Convention.

The Department also provided a brief overview of the proposed Nursing Bill. Among other matters, the following concerns were raised:
- what was envisaged with the introduction of the Bill;
- the outflow and poaching of SA nurses by the private sector and other countries;
- the importance of community service in the education and training of nurses; and
- that legal action should be taken against those illegal institutions purporting to be nursing institutions.

When the Department declined to answer some of the questions because they related to a bill that had not yet been tabled, or referred the question to another unit within the Department, Members clearly expressed their disappointment.

The Chairperson reminded Members that the Committee had already been briefed on the Framework Convention on Tobacco Control by the Department of Health and they would simply be refreshed on the document so that they could vote on it. Then the Department would give Members a brief overview on the content of the Nursing Bill, since the Bill had not yet been tabled.

Health Department briefing: WHO Framework Convention on Tobacco Control
The Department delegation included Dr P Mahlathi: Deputy Director-General: Human Resources; Mrs R Mdlalose, Director: Human Resource Development; Ms Z Mthembu Director: Health Promotion; Ms N Makhanya, President: Nursing Council and Ms H Subedar, Registrar and CEO: Nursing Council.

Ms Z Mthembu (Director: Health Promotion) briefly refreshed Members’ memory regarding the content of the Convention. She noted that FCTC was the first international public heath treaty negotiated by Member States of WHO and it aimed at counteracting the crises posed by tobacco worldwide to ensure that people’s lives were saved. While recognising that legal and cultural environments varied from country to country, the FCTC had proposed various courses of action that would enable a country to develop effective control measures. She noted the vital role played by South Africa throughout the process of finalisation of the FCTC and that the Convention would not contradict the provisions of the Constitution, and asked the Committee to adopt it. Furthermore, she noted that apart from financing the Conference of the Parties, there would be no further expenses incurred by South Africa. Instead, it would save several billion Rands.

Mr J Thlagale (UCDP)[North-West] asked the Department to explain what would become of those countries whose economy depended entirely on the production of tobacco, such as Zimbabwe, Brazil and the like.

Ms Mthembu responded that in terms of the FCTC, the Conference of the Parties had a mandate to develop financing mechanisms to support those countries that use tobacco as a cash crop to sustain their economies.

Ms F Mazibuko (ANC)[Gauteng] also sharing Mr Thlagale’s concern, asked what sustaining mechanisms were in place to ensure that such countries that use tobacco as a cash crop were developed to produce other cash crops.

Ms Mthembu responded that in developing these financing mechanisms, the Conference of the Parties would also have to come up with various technical measures to support these countries to develop other alternative crops away from tobacco growing. Therefore it was important that many African and other developing countries ratify this Convention in order to ensure that they formed part of the first session of the Conference of the Parties to influence the decision-making process.

Mr T Setona (ANC)[Free State] however felt that it was important for South Africa to take into account the socio-economical global evolution when crafting its domestic laws and policies. He said that notwithstanding the good intentions behind this Convention, it would however be a mammoth task to convince countries such as Zimbabwe, whose entire population depended on tobacco cash cropping to survive, to sign it. Such resistance might come as the result of a decline in global development aid to Africa since 1997 and the fact that the superpowers often resisted committing themselves to international treaties without any penalties imposed on them.

Ms Mthembu said that the Convention acknowledged the fact that some superpowers were the biggest culprits in international law and therefore provision had been made in Clause 18 encouraging countries to institute actions against tobacco industries. However, South Africa would not be pursuing that route, as government believed that the best medicine was to strengthen our domestic laws and pursue other avenues such as awareness campaigns.

Dr P Mahlathi (Deputy Director-General: Human Resources) added that the mere fact that superpowers tended to shy away from their international commitments did not necessarily mean that other countries should not push forward in saving the world. He noted that it should be borne in mind that the majority of superpowers did not really care about the consequence of their actions so long as their industries were protected.

Ms Mazibuko (ANC)[Gauteng] noting that there were still tobacco farmers in South Africa asked to what extent would they be assisted to ensure that the alternative crops they grew sustained them.

Dr Mahlathi responded that any good government, which had adopted a principle of reducing bad occurrences within its borders, also had the responsibility to come up with alternative methods in order to sustain its people. Hence, government had developed numerous alternatives, such as community agricultural support programmes, to fund subsistence farming and skilling both the farmers and workers in sustaining the alternatives.

In her response, Ms Mthembu said that it should be noted that out of more than a thousand tobacco farms that existed in South Africa fifteen years ago there were now less than six hundred in existence. The result of such reduction was primarily not government policies but was mainly due to tobacco manufacturers who preferred to buy foreign cigarettes, as they were cheaper and of higher quality. Therefore the argument that these tobacco farmers were cast out of the market while contributing to the economy of the country was unfounded.

Mr Thlagale (UCDP)[North West] asked whether the Convention would not open a gap between the Members of the society, namely those who smoked and those who did not smoke tobacco.

Ms Mthembu was of the view that people did not smoke out of choice but out of addiction and as such, the Convention did not necessarily clamp down on smokers. On the contrary, it saved them from tobacco related diseases.

Ms Mazibuko (ANC)[Gauteng] noted that some popular sports in some countries were still sponsored by tobacco companies, such as Formula 1 with its Marlboro and Camel sponsorships. She asked what would be done in order to ensure that these sports with their widely televised coverage stopped using their tobacco-sponsored products.

Ms Mthembu while acknowledging the strides that had been made by the South African government in ensuring the prohibition of tobacco’s advertisement, promotion and sponsoring, was however weary of the impact of cross-border advertisement. She noted that the danger posed by the advertisement of tobacco products on television during the coverage of sports like Formula 1 was something that would be prevented through the ratification of the Convention. Furthermore, South Africa through its domestic laws ought to banish such advertisement, whether they may be direct or indirect, as they created the wrong impression, especially on the youth.

Mr Setona (ANC)[Free State] was of the opinion that South Africa, socially, economically and health -wise, had not yet reached a stage where it could truly enact policies and regulatory frameworks aiming at banishing smoking. He felt that the best thing would rather to come up with regulations aiming at building consciousness amongst people to help them to voluntarily realise the dangers of smoking.

Dr Mahlathi acknowledged that everyone had the constitutionally protected right to smoke or not to smoke. However, notwithstanding that he contended that it was government’s responsibility to put in place laws to ensure that people behaved appropriately, especially taking into account the recuperative consequences of smoking to the economy of the country. Nevertheless, he agreed that it should not be done in such a way that an unnecessary burden was created for the law enforcement agencies.

Ms Mazibuko (ANC)[Gauteng] asked what measures were in place to ensure that municipalities tightened their laws and policies to prevent people selling cigarettes in street corners and traffic points, especially noting the low quality of such products.

Ms Mthembu acknowledged the challenge in this regard as there were families that were dependent on selling cigarettes for survival but nonetheless noted that government had no choice but to strengthen tobacco regulations to minimize the consequences. She said that there were a number of campaigns aiming at strengthening such including those initiated at workplaces, schools and even at homes since they formed part of public places.

Rev E Adolph (ID)[Western Cape] while acknowledging the importance of this Convention, was however concerned whether government would really be able to sustain the long-term financial implications coming with its ratification.

The Chaiperson then called on Members to present their provincial responses on the Convention for adoption.

Mr M Sulliman (ANC)[Northern Cape] noted that the Northern Cape Provincial Legislature supported the Convention as it deemed it necessary for the country.

Mr N Madlala (ANC)[Gauteng] noted that the Gauteng Provincial Legislature supported the Convention.

Rev E Adolph (ID)[Western Cape] noted that the Western Cape Provincial Legislature supported the Convention.

Mr J Thlagale (UCDP)[North West] noted that the North West Provincial Legislature supported the Convention.

Mr Setona (ANC)[Free State] noted that the Free State Provincial Legislature supported the Convention.

Mr B Tolo (ANC)[Mpumalanga] noted that the Mpumalanga Provincial Legislature supported the Convention.

Ms J Vilakazi (IFP)[Kwazulu-Natal] noted that the KwaZulu-Natal Provincial Legislature supported the Convention.

The Committee report on the Framework Convention on Tobacco Control was read for the Members and it was unanimously adopted.

Department briefing on Nursing Bill
Ms R Mdlalose (Director: HR Development) took the Committee through the presentation and briefly gave a historic overview of nursing legislation in South Africa. The four pre-1994 Nursing Councils had since been replaced by the Interim Nursing Council, which consisted of 39 Members. Taking the Members through the content of the Bill, she noted that the Bill was published for public comment during the period December 2003 and March 2004 and its purpose was to ensure that public interests were protected and promoted by the Council. The Bill proposed that the Membership of the Council be reduced to 25 and that all nurses registering for the first time undergo community service. It was worth noting that at the end of 2003 there were approximately 177 721 nurses registered in South Africa.

Dr Mahlathi said that Members would note that the Bill tried to address three issues, namely shuffling the role of the strategic Councils, transformation issues and introducing good corporate governance in the nursing profession. The reason why the Bill had not been tabled was that it was still with the State Law Advisors.

Ms Mazibuko (ANC)[Gauteng] asked whether the Bill would result in the creation of one system for all nurses in South Africa.

Dr Mahlathi said that it should be noted that the Bill was not aiming at the protection of the nurses but rather at the public interest and as such issues relating to the nursing profession, such as remuneration and creation of one system, were not dealt with in the Bill.

Ms Mazibuko (ANC)[Gauteng] asked how the Bill addressed the issue of poaching of nurses by the private and other sectors.

Mr Sulliman (ANC)[Northern Cape] also noted that there was a huge outflow of nurses from South Africa in search of greener pastures elsewhere, and asked what mechanisms were in place to deal with this as a lot of taxpayers’ money had been spent training these nurses.

Dr Mahlathi acknowledged the concern but said it should however be noted that only a few nurses with specialised skills and expertise were being lost to foreign countries.

Mr Setona (ANC)[Free State] commended the Department for its introduction of community service for the nursing profession saying that that they were the first of all government’s Departments to do so.

Ms Mazibuko (ANC)[Gauteng] noting that the statistics presented were two years old and thus obsolete, asked the Department to provide the Committee with recent nursing statistics.

Ms H Subedar (Registrar and CEO: Nursing Council) said that they would indeed provide the Committee with such information.

The Chairperson then asked the Department to also provide the Committee with recent statistics on the annual nursing intake and their training.

Mr Madlala (ANC)[Gauteng] noting that there were a number of illegal institutions pretending to offer nursing training asked how the Bill envisaged dealing with these fly-by-night institutions.

Ms Subedar said that those institutions that provided nursing training in contravention of the regulations and the minimum requirements set out in the Bill would be prosecuted since it was illegal to operate an unregistered institution.

Mr Setona (ANC)[Free State] noting that clause 48 dealt with impairment asked whether the Bill defined issues of misconduct, especially in relation to mental and physical disabilities.

Ms Subedar responded that the Bill provided for the definition of impairment in relation to persons who could not continue to practice due to incompetence at a mental, social or physical institution.

Dr Mahlathi noted that some of the questions raised dealt with matters not covered in the Bill but falling under the jurisdiction of other units within the Department. These questions are listed in bold below. He felt that it would therefore be proper if Members were to wait until being briefed thoroughly on the Bill. That would be advantageous as Members would be asking questions from an informed position and the Department could provide responses without hesitation. Furthermore, he voiced concern that the briefing was open to the public as the matter under discussion was still being considered by the State Law Advisors and as such, the documents might have changed completely when the Bill was finally introduced in Parliament.

Ms Mazibuko (ANC)[Gauteng] asked how long community service would last.

Ms Mazibuko (ANC)[Gauteng] asked whether the Bill also required nurses to respect their Service Charter, Patient Charter and other relevant charters in the execution of their duties.

Mr Madlala (ANC)[Gauteng] asked why the Chairperson of the Council should be appointed by the Minister and not by the Members, as they would be Ministerial appointees as well.

Mr Setona (ANC)[Free State] asked who would be undergoing the training, mentioned in Chapter 3.

Ms Mazibuko (ANC)[Gauteng] however was very concerned as she felt that the contention was not very convincing since there were a number of provisions in the Bill which dealt with the nurses as a profession and not only with regard to their interaction with the public.

Mr Setona (ANC)[Free State] agreed and felt that in the future, while it was paramount for them to be briefed by the Department on new proposed policies and legislation, they should be informed beforehand about the purpose of every meeting.

The Chairperson acknowledged the concerns raised by Members, but noted that it was important for the Committee that Members be given an overview of the proposed legislation so that they could prepare themselves accordingly.

The meeting was adjourned.


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