Department on Priorities for 2002: briefing

HEALTH PORTFOLIO COMMITTEE
19 February 2002
DEPARTMENT ON PRIORITIES FOR 2002: BRIEFING

Acting Chairperson: M Njobe

Relevant Documents
Key Activities to Portfolio Committee on Health PowerPoint Presentation

SUMMARY
Department of Health briefed the committee on its programme for the year 2002. Key Policy areas were divided into nine clusters of strategic Health Programmes. The areas covered  were Pharmaceutical Services, Medicines Regulatory Affairs, Maternal Health, District Development, Health Monitoring and Evaluation, Mental Health,International Liaison and Gender Focal Point.

Non-Personal Health Services focused on the areas of morbidity and mortality through strategic intervention. Prevention of communicable diseases and human resource development were some of the programmes planned for this year.

It was noted that conditional grants for HIV/AIDS had increased significantly from the initial grant of R34 million to R157 million.

MINUTES
Briefing by Ms Matsau
Ms.K M Matsau, Deputy Director General of health, outlined the key policy areas. The first area was monitoring and evaluation where a National Health Information had been set up with 30 Tele-medicine sites. The Department had plans to connect Universities to this site so that learners did not need to come to cities for continuing education. The Medical Research Council would monitor the Tele-medicine site on a regular basis.

Constant surveillance systems were put in place to monitor HIV/AIDS. The Department had developed ethics guidelines, which were standardised. A Quality Council had been created to guide the Department on issues of health nationally and in particular the question of equity.

Another key policy area was Pharmaceutical Policy and Planning. The Department had created the Directorate of Medicine and Drugs Control to foresee the implementation of this critical area. Regulations regarding alcohol advertising had been formulated and the Department was in the process of finalising the controversial regulations on Act 90 of 1997.

Ms Matsau noted that the Department was reviewing the availability, accessibility and affordability of ten key drugs on major diseases and that this process would seek to unravel what might be the major weakness in the distribution of the drugs.

The Department would also institute investigation into common complaints on food poisoning. South Africa currently holds the Chair of SADC Pharmacy division which had the mandate to purchase drugs for the region hence this gave the Department an opportunity to look into the whole question of parallel importation and compulsory licensing of drugs.

Ms Matsau informed the committee that the Department would partner with World Health Organisation and other multi-nationals in research and that the process would take aboard the local drug manufacturers. The Department had created a Pricing Committee to look into the critical issue of medicine pricing noting that this was a new venture since few countries had such a set up.

The other key policy area, according to Ms Matsau was Maternal, Child and Women's Health. The Department was working with industry to ensure nutritional needs of the mother and child are met. A National nutrition surveillance agency had been set up to ensure child health, reduction of morbidity and mortality from common conditions and the reduction of immunisable conditions.

Ms Matsau said that HIV/AIDS and TB were some of the most crucial policy areas that the Department would focus on this year. The Department was looking at prevention methods, youth programmes, partnership support and care and counselling. The Department would endeavour to finalise important policies such as the condom policy about where issues like quality, social marketing and distribution would be addressed.

STI guidelines and training of health workers would be major pre-occupation for the Department. The Department would strengthen traditional healer programme and periodic surveillance, monitoring and evaluation system. Youth programmes, campaign and life skills in addition to monitoring and evaluation of funded NGOs would be prioritised.

In the area of TB control, Dr. Matsau said that the Department would develop provincial implementation plans with all the nine provinces and that the University of Cape Town had been contracted to train health personnel in electronic TB register, which was now in use.

The other key policy area the Department had formulated was the creation of Medicines Regulation Authority to ensure proper regulation of medicines importation and to check the influx of fake medicine in the county's medical stores. Ms Matsau said that the main function of the Authority would be inspectorate and setting up a proper inspectorate unit to ensure effective control of medical importation.

The Mental Health & Substance abuse legislation was on course this year which was another major policy area for the Department. In this area, she noted, alcohol advertising and counter advertising would be regulated and that provision was made for standardised norms and standards.

Ms Matsau said that International Health Liaison was another vital policy area for the Department. There were programmes for networking with NEPAD and SADC in health research and training. The Department would review the existing bilateral agreements and if need be re-negotiate some of them.

Finally, the Gender Focal Point was a key policy area that the Department had set its sights on this year. She said there was an office within the Department that dealt with this particular issue. Capacity building for gender human resource and policy for gender issues would be some of the tasks to be pursued in this regard.

Briefing by Dr Chetty
Dr Chetty, Deputy Director General, in her presentation concentrated on non-personal health services. One key policy area in this regard would be decreasing morbidity and mortality through strategic intervention. The Department would pursue the issue of compensation for occupational diseases brought about by hazards such as mining.

The Department would liase with the Department of Labour to rationalise compensation methods.

Dr Chetty said that the Department would ensure the improvement of the effectiveness of Emergency medical services. She revealed that the world summit on sustainable health development would be hosted here this year.

The Department would emphasise health promotion especially at district hospitals and the distribution and implementation of prevention of blindness programme guidelines. The Department is working together with the NGO 's bureau and private practitioners for the prevention of blindness..

The programmes on the eradication of communicable diseases and malaria control would be intensified. South Africa was voted the best in Africa on malaria control programmes last year. Cholera control programmes would be expanded as well.

Dr Chetty noted that due to the September 11, 2001 terrorist attack in the USA an alert had been set up on dangers of bio-terrorism such as the anthrax scare. She said that the Department had finalised the integrated Health Planning Framework where human resource issues have been incorporated.

In the area of human resource development, the process of transforming the educational and training of health professionals would be carried forward. The Department would look at the whole question of recruitment and retention strategy for departmental personnel. The troublesome area regarding the rural strategy and migration of health personnel would be reviewed to facilitate an equitable international allocation of health professionals and to ensure implementation of a proper community service.

On legal services, Dr Chetty informed the committee that the Department was to table a National Health Bill and a Medicines Control Act amendment together with the regulation of smoking of tobacco products. The other bill in the pipeline was the Dental Technician's amendment Bill.

Lastly, Dr Chetty said that communication was another priority area that was set to improve significantly. In this regard the Department was looking afresh at the whole issue of collective agreements with the trade unions.

Briefing by Mr Miller
Mr Miller, the Chief Financial Officer for health briefed the Committee on the layout of the budgetary allocation for last year. The original budget was approved and that the reason why there was a significant amount of saving was that the amount was allocated very late in the year and hence necessitating a rollover.

The incidence of over-expenditure was relatively small but cautioned that it was not practical to quantify some expenditure items; for instance foreign bodies like WHO's fees was determined in dollars. The volatility of the Rand, he noted was such that it rendered such quantification almost entirely impractical.

A problematic area was that of poverty relief since the provincial chain of paper work was too slow making it difficult to assess the money that has been spend. He said that the HIV/AIDS grant was a new feature but whose flow of funds was very slow. He explained that the R39 million under expenditure was money already committed but not spend.

Mr. Miller said that the next budget would see the expenditure for HIV/AIDS increase considerably. More money has been committed for mental health and pharmacy. Conditional grants for HIV/AIDS had seen a significant growth from the initial R34 million to the current R157 million. Mr. Miller concluded his brief presentation by noting that the health professional's training grant had increased over the years.

Discussion
Ms Dudley (ACDP) said that some, if not most, mental health problems were caused by material circumstances. How did the Department of Health link up with other Departments to address this issue?

Ms Matsau replied that the committee working on the issue of Mental Health was addressing this issue within the social cluster.

Ms Dudley asked what role do traditional healers play in the whole set-up?

Ms Matsau replied that traditional healers played an important liaison role between government and the communities in which they live. She said that traditional healers were known to communicate government policy more effectively to the communities than would otherwise have been the case were government to undertake the mandate.

Ms Dudley asked further why there was a surplus of R39 million on HIV/AIDS yet more money had been allotted to the HIV/AIDS NGOs.

Ms Matsau replied that the increase in HIV/AIDS funding was meant to ensure the programmes funded impact positively on the beneficiaries and that there was need for more funding.

Dr Rabinowitz (IFP) asked how toxicity was tested and whether it was on animals or humans. Why did MPs play no role in disciplinary committees for health professionals? She, again asked how effective or otherwise were the NGO accounting firms referred to by Ms Matsau.

The acting chair asked members to defer their questions to another session with the Department coming in a fortnight. At which point the meeting adjourned.