OCR Document

DRAFT REPORT ON THE OVERSIGHT VISIT OF THE SELECT COMMITTEE ON SOCIAL SERVICES TO THE WESTERN CAPE PROVINCE 31 JULY - 04 AUGUST 2006

Introduction

The Select Committee on Social Services undertook a study tour to the Western Cape Province from 31 July - 04 August 2006. The purpose of the study tour was for the Committee to exercise its oversight function, as mandated by the Constitution. The primary objectives of the provincial visit included:

· To conduct oversight over the management and quality of services rendered in respect to social development, health and home affairs.

· To inspect various health, social development and Home Affairs facilities, in order to determine the state of physical infrastructure and equipment.

· Identify progress made and challenges that are being experienced by all the stakeholders.

The Committee has prioritized the provinces, which they wanted to visit during the 2006/07 financial year and the Committee identified the Western Cape Province as a priority.

This report aims and envisages that the challenges experienced by the various regions in the Western Cape Province are taken cognizance of and that these challenges are addressed to improve service delivery to our people. The Committee undertook this oversight visit to the Western Cape Province not to "police" the Provincial Departments of Social Development and Health and the Department of Home Affairs, but the aim is to "unblock the blockages" that might be hampering service delivery.

The infonnation was gained by interacting with the MEC's, HOD's and Regional Managers of the Provincial Departments of Social Development and Health and the Department of Home Affairs. Before the oversight was undertaken the Committee identified the regions which they wanted to visit and the aim is to visit the rural areas, where service delivery is not up to standard (Batho Pele).

Limitations of the report:

· The fact that not the whole of the Western Cape Province could not be visited, but only parts of it

· The Committee was unable to visit Oudtshoorn, as was scheduled, due to roads beings blocked due to floods.

1. Social Development

1.1. Foreword by the MEC: Ms Mqulwana

The MEC stated that it is a challenge for the department to separate the SA Social Security (SASSA) from the Provincial Department of Social Development, but in saying this at the same time both SASSA and Provincial Department of Social Development (PDSD) must ensure that beneficiaries get good quality service delivery.

The MEC noted that in the department there is a lack of transformation and this relates to a lack of e.g. redistribution of resources, equity etc. where e.g. in Khayelitsha 1 social worker is serving 17000 people. The MEC noted that a task team has been established to look at transformation in the department.

The MEC said that 25% of the budget has been set aside to establish organisations where there previously was none. She further noted that the bureaucracy is hampering service delivery. The MEC informed the Committee that the Department has changed its name to the Department of Social Development (previously Department of Social Services and Poverty Alleviation).

The MEC stated that 80% of the projects funded by the department are led by woman.

1.2. Briefing by the Department of Social Development

The HOD briefed the Committee on the strategic goals of the department and the budget structure of the Department.

On the issue of children in correctional facilities in the Western Cape, the HOD stated that on average there are 2200 arrests per month. She further noted that a benchmark of 150 children in correctional facilities in the province was set by the department as part of an intervention strategy. It was stated that there are 142 children in prisons awaiting trial and that 86 of these children are in Pollsmoor Prison. The Department informed the Committee that additional probation officers were employed to assist and that an interdepartmental task team has been set up to streamline procedures.

With regard to the management of children the Department stated that every child is assessed by a probation officer within 12 hours of arrest and that follow-ups is done on children in correctional centres for placement at suitable alternatives and that there are monthly reviews on cases of children awaiting trial.

Challenges which are faced by the department concerning Child Headed Households are that census information are not helpful in identifying the extent of the problem. The department further noted that the Draft Children's Amendment Bill 2006 addresses Child Headed Households and sees a child over the age of 15 as a head of a household, and that this is in conflict with other legislation that specifies that to qualify as a foster parent you must be 18 years and older. Another challenge is that organisations do not provide details of child-headed households but rather orphaned and vulnerable children, and that internal statistics reflect children in foster or alternative care and not as a household head. A challenge for the department is that children who are living on their own might not know how to access support services and in some instances children fear being removed from the environment they know. The department stated that preliminary costing of the implementation of the Children's Bill indicate that at least 52% of funds to implement will be spent on orphaned children as a result of HIV/AIDS.

The department stated that in the absence of reliable data the departmental focus has been orphaned and vulnerable children that includes child headed households. The department further noted that foster care placement is one of the options exercised to address the needs of orphans and that the department currently funds 18 shelters for children that accommodates approximately 387 children in the province and that 181 NGO's, CBO's and FBO's are funded that work exclusively with families and children including HIV / AIDS and partners include the departments of Health, Education and Local Government. Much emphasis will be placed on family strengthening programmes in the province that will focus on the care of vulnerable children through building the capacity of communities and families.

1.3. Clarity seeking, comments and questions

With regard to substance abuse in the province, with reference to "Tik", the MEC stated that 1000 young people have been recruited to assist the department in this regard.

The MEC stated that w.r.t. ECD the department is taking the lead in grade R and the department of Education is assisting with the curricula, but that there is a close working relationship with the departments of Education and Health.

The department worked with the Unicity regarding street children and last year the department gave R2 million for this project.

On the issue of soup kitchens the HOD stated that the cut-off time for soup kitchens is 6 months, the reason being that the department do not foster "dependency".

1.4. Visit to Sarepta Home for Older Persons

1.4.1. Introduction and background

The manager of the facility, Ms La Poorta briefed the delegation and stated the following: The facility is registered to accommodate 150 frail and aged persons and falls under the auspices of the Apostolic Faith Mission Church's Welfare

Commission. The board and management have transformed and is representative of the demographics of the Western Cape. The facility is situated in a predominantly coloured residential area and enjoys the support of the local community. The current manager has been in the position for several years.

The facility has a staff component of 52 consisting of 33 nursing staff, 16 general workers, 1 administrative officer, 1 secretary and 1 manager

The residents come from all areas (metro and peri-urban) and not only from the Kuilsriver community, and currently there are 146 residents consisting of 81 women and 64 men with 81 % of the residents being frail.

Other sources of financial income is obtained from donations, bequeaths and fundraising events. The state subsidy is the largest financial support to the facility. The total subsidy transferred to the facility for the period April '05 - March '06 totalled RI, 923525.00.

The manager informed the delegation that the regional office (Eerste River District Office) the facility complied with requirements and the residents seemed contented and happy.

The following challenges exist at the facility:

Start here. Except for administrative staff members, the provision of both the nursing staff

            and the kitchen are outsourced.

            . In the past the department received numerous complaints about the care of the

            residents, and according to the manager, outsourcing these services improved the

            service at the facility.

The delegation enquired whether the facility has a well functioning board. The manager stated that the Board consists of 7 people (2 residents and 5 trom the community) and that it is functioning.

The manager informed the delegation that of the residents that do not have family members and that even those that do have, do not come to visit them regularly. She further noted that the institution buys the residents clothes during the e.g. festive season, mothers day etc and that they look after the residents everyday needs.

The delegation enquired what happens to those "residents" who are unable to pay for their burial, and the manager replied that family and friends are asked to assist in this regard and if they are unable to, then the institution will pay the undertaker for the service who charges the institution a special rate.

With regard to residents visiting their family members, the delegation enquired what is being done by the institution to assist in this regard. The manager stated that some of the resident's family members come to pick them up, but in the event that family members do not have transport to fetch them (the institution does have a combi for home visits), the institution takes them to their family members and collect them agam.

The delegation asked whether or not a well functioning Committee for the residents exist at the institution? The manager stated that many of the residents is mentally incapacitated and because of this that the Committee lapsed.

1.4.2. Recommendations

            . That the institution need to explore best practices in e.g. Northern Cape where

            Old Age Homes pays fees to A VBOB for burial services

            . That the institution can playa greater role w.r.t. home visits.

            . That follow-up visits be made to the Old Age Home.

2. HEALTH

2.1. Foreword by the MEC of Health: Mr P Uys

The MEC stated that 72% of the 4,2 million people in the Western Cape do have medical insurance and that many people come for Primary Health Care (PHC). He further noted that Tuberculosis is very high in the province, but in saying this the Western Cape has one of the highest cure rates of all the provinces in the country; and he further stated that chronic diseases is also on the increase in the province e.g. diabetes, asthma etc.

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The MEC infonned the Committee that there is a major demand for facilities especially PHC, due to the influx of people, from various provinces, to the Western Cape.

2.2. Briefing by the Department of Health

The department stated that the Comprehensive Plan for HIV 1 AIDS in the province are to ensure that those citizens who are not infected, remain uninfected; and to enhance efforts in prophylaxis and treatment of opportunistic infections and to improve nutrient and lifestyle choices; as well as the effective management of HIV infected people who have developed AIDS.

With regard to Voluntary Counselling and Testing (VCT) the department stated that pre-and post counselling is being done and if found that a person is positive, helshe will be referred to appropriate medical care and if negative to re-enforce safe sexual behaviour. VCT is available at all 446 health facility sites and 373 lay counsellors are employed via 23 NGO's. Results of VCT in province include: 283 834 persons older than 15 years counselled and 262 792 person's older than 15 years tested for HIV.

The department stated that the there are 43 operational sites and 16 343 clients on treatment for Antiretroviral (ARV) Treatment Programme (2005/06) and the target for 2006107 is 50 operational sites and 22 489 clients on treatment. The department infonned the Committee that at the end of June 06 there were 18 941 patients on treatment.

Progress W.r.t. Community Home Base Care (CHBC) is that during 2005/06 10 220 HBC clients was seen and of these 1871 were HIV clients, 857 TB clients and 187 TB/HIV. The department stated that 1630 carers were being trained on part qualification of the NQF level 1 ofthe National Ancillary health worker certificate.

The department stated that some of its major challenges include: the integration/mainstreaming of the Comprehensive Plan in the District Health System (DHS); the prevention/promotion of the behavioural change of clients and staff; and the case load in the "high prevalence areas", due to migration.

In conclusion the department stated that the implementation of the comprehensive plan is progressing well; the HBC programme will be expanding rapidly; PMTCT programme has excellent outcomes; and the VCT programme is progressing well.

The department further briefed the Committee on the Hospital Revitalisation Programme in the Western Cape and quality assurance.

2.3. Clarity seeking, comments and questions

The department stated that they do train doctors and that there is a need to re-Iook the policy on those staff who took severance packages, since many have left and that the salary levels of nurses have to be looked at. The department said that six (6) nursing schools are providing in service training, which is taking place at the facility and the department reiterated that the number of nursing schools has to increase.

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2.5.4. Challenges

The facility manager informed the Committee that a challenge at the hospital is to recruit people to work after hours in the trauma unit. Another challenge is the long delays of EMS.

2.5.5. Clarity seeking, comments and questions

The facility manager stated that the waiting time at the hospital is problematic and patients at times have to wait for 4 hours.

The facility manager noted that teenage pregnancies is very high and that it is a problem in the area, and the hospital does not perform Termination of Pregnancy (TOP), but that they do referrals.

The facility manager informed the Committee that there are various vacant posts and that there is high vacancy turnover rate at the hospital. There is a full time social worker at the hospital and on every shift there is a Registered Nurse in charge and even during the electric blackouts the hospital experienced minor setbacks, the reason being that there is generator at the hospital.

2.4.6. Recommendation

            . Members stated that the response time for EMS is a worrying factor and this

            will be taken up with the National Minister of Health and the Provincial MEC

            of Health.

2.5. VISIT TO LANGA WASHINGTON CLINIC

2.5.1. Background

Langa is the oldest "black township" in Cape Town and contains both a formal and informal settlement. A significant percentage of the population resides in the informal settlement. This is a highly mobile sector due to both high rates of urban - rural migration to the former homelands areas of Ciskei and Transkei in the Eastern Cape and the movement between informal areas within Cape Town.

The rate of unemployment in the area is high with many inhabitants existing below the poverty line and the suburb is one of great need with an HIV prevalence and the TB incidence is about 1500/1 00 000.

2.5.2. Infrastructure

Staff at the clinic comprises a facility manager, 2 clinical nurse practitioners, 6 professional nurses, 2 enrolled nurses, 3 enrolled nurse assistants, 1 administrative assistant and 4 lay-counsellors.

The facility manager stated that it is envisaged to extend the clinic and that plans has been approved.

2.5.3. Services rendered

The facility manager informed the Committee that AR V was rolled out in January 2004 and 25% of TB patients are on AR V and that the clinic sees about 800 patients per month for AR V.

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The clinic is open from 8am - 16:30pm, but at times it necessitates that staff comes in earlier because of the TB patients. The clinic has an outstanding cure rate of TB which is at 89%.

With regard to VCT the clinic received a trophy from the City for their services rendered. In 2004/05 the head count was 130000 people and in 2005/06 112000. The facility manager stated that they see about 9000 - 14000 people a month.

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2.5.4. Challenges

The facility manager stated that space is a problem at the clinic. There is also a shortage of clerks for filing, the reason being that files are piling up for data capturing. EMS is a major problem in the area (especially response time), because in certain circumstances staff have to drive patients with the council car to the hospital.

2.5.5. Clarity seeking, comments and questions

The facility manager informed the committee that TB is on the increase in the area and the ~linic does not render antenatal services (there is a clinic close by) and for ARV there is 1 doctor and I doctor for TB who comes in 3 mornings a week and the other doctor twice a week.

With regard to TOP, whoever needs it comes to the clinic for counselling and then gets referred to the appropriate facility. The facility manager stated that many young girls frequently come in for this service (at times - the same girl - up to 4 times) and a study is currently being done as to why they do not come for reproductive health. She further noted that even HIV patients do not want to use condoms.

The facility manager stated that at times the clinic runs out of medicine (at times for a month), and this is very de-motivating for staff, but the clinic does not run out of TB medicine and AR V.

The clinic's waiting time is 60 minutes (1 hour), where the patient comes in, gets a file (every patient has a file), and then waits to be called. There is I doctor for two mornings, I doctor 5 days all day, I doctor 4 days a week (which is to be changed from September 2006 to 5 halve days) and I doctor Friday mornings.

2.6. VISIT TO MICHAEL MAPHONGW ANA COMMUNITY HEALTH CENTER - KHA YELITSHA

2.6.1. Background

Michael Maphongwana Community Health Centre is based in Harare, Khayelitsha and it caters for the previously disadvantaged communities, with low socio-economic status. The facility is rendering all the primary health care services.

The center sees about 8 000 to 12 000 patients per month for different medical reasons. Presently there are 115 staff members from different categories. The operational budget of the centre amounts to R22m for 2006/07. About 62, 8% of the budget goes for the remuneration of employees and the remaining 38, 2% is for goods and services. Operating hours are 07:30 - 16:30 and 24 hours for the MOD labour ward as well as security personnel.

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2.6.2. Clarity seeking, comments and questions

TOP is done by the facility (12 weeks and below) and if 16 weeks then the patient is referred to GF Jooste and there are people who returns for the service.

The center manager stated that submissions has been made to expand the facility with various extensions, but he noted that a district hospital is envisaged to be build across the facility

It was noted by the management that EMS response time is poor as well as transport at the hospital itself.

The center sees about 12 000 patients per month and the center manager noted that Khayalitsha makes up 27% of HIV/AIDS patients in the Western Cape. He further noted that migration has an affect on the center as well.

The center manager further noted that substance abuse is not really significant in the area, but that teenage pregnancy is very.

2.7. Visit to Eben Donges Hospital- Worcester 2.7.1. Background

Eben Donges is a regional hospital, and serves the whole Boland Overberg region. The hospital is currently in a revitalisation phase and when completed in 2008, it will be bigger, with new equipment, and staff trained not only in their fields but also in new methods of management.

In the new out-patient clinics, patients will be able to different kinds of doctors, therapists, social workers and counsellors. The trauma centre is open 24 hours a day and no patient needing emergency medical attention are shown away.

The hospital is one of two hospitals in the Western Cape that is currently being revitalised by the department of Health. The 33 year-old hospital in Worcester will see its exterior and interior completely revamped, with extensive building alterations over the next 4 years. In 2001 three new wards were built as part of a National Hospital Upgrading project by the Department of Health. A casualty wing, a new outpatients department and a new training centre is to be added to the main hospital building.

2.7.2. The Revitalisation project will include:

. A new Emergency Unit, providing an adequate trauma unit, serving as a first

base for trauma on the N 1.

. Day Surgery Unit, providing services for procedures required by out-patients . A kangaroo unit, which will extend the existing capacity to 14 beds

. Extension in the Intensive Care Unit to 7 beds, improving on the existing three

bed ICU

. An 8 bed Bums Unit

. A 6 bed Acute Care Centre for Psychiatry patients

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. A new Human Resource Development section, equipped to serve the training needs of the entire Boland/Overberg Health region with training focussed on

clinical issues.

. A modem training centre with lecture theatre and class rooms will be built.

. A renovated and extended out-patients department.

· 4 operating theatres

. Improved site and emergency unit security to ensure the safety of patients and

staff.

2.7.3. Clarity seeking, comments and questions

The Medical Superintendent informed the delegation that unscheduled leave is under 3% and that the absenteeism rate among nurses is very high. She noted that the moral

varies in the different departments within the hospital. She further noted that many of the nurses are being "lost" to the district health system. The Medical Superintendent said that the hospital is currently in a process to conduct a satisfaction survey amongst its employers.

The delegation enquired what the remuneration is of the interns and the students on leamerships. The Medical superintendent said that interns are being paid R1200 a month and this is in accordance to provincial policy, and it is hoped that these people will be absorbed by the hospital. She also informed the delegation that the hospital intends appointing an IT person in the foreseeable future.

With regard to the under spending the delegation stated raised concerns regarding the under spending. The Medical Superintendent stated that the money was to be used for

the appointment of additional specialists, and she confirmed that the salaries of specialists is very high and because these posts could be filled for this reason the under spending.

On the issue of TOP management informed the delegation that there is a proper and working waste management removal service, which is being done on a regular basis (3 times a week). The Medical Superintendent further noted that the patients percentage of patients coming back for TOP is small and that the hospital provides for pre -and post counselling.

The Medical Superintendent reiterated that the availability of nurses IS a major problem.

The Medical Superintendent stated that the hospital has 10 beds for private patients and the money generated form this was about Rl million, of which the hospital utilized to buy 4 mobile clinics.

The delegation enquired whether the Department of Home Affairs are providing a service of online registration at the hospital. The Medical Superintendent stated that they do have a small office in the hospital and that online registration is being done at the hospital.

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2.8. VISIT TO GEORGE HOSPITAL

2.8.1. Background

A major revitalisation process has completed at the George Regional Hospital recently. This major medical facility serves as a regional hospital for the Southern CapelKaroo region, as well as a district hospital for George itself. The project focussed on the improvement of the hospital's infrastructure, technology and services to them in line with international standards.

The National Minister of Health, Dr Manto Tshabalala-Msimang, officially opened the revitalised section of the hospital.

All 550 000 residents of the Southern Cape and Karoo regions will benefit from this facility. The project was completed during April 2006 and the revitalised hospital was opened on 30 June 2006. The original construction period was 24 months and after an increase in the scope of works the contract was extended to 32 months and amounted to a total cost R152m.

2.8.2. Clarity seeking, comments and questions

Members enquired whether the hospital experiences any problems of TB defaulters due to changes in addresses. The Hospital Manager stated that the TB-programme is managed by the Regional office; the hospital manages acute TB admissions, and discharges them to the local clinics, where DOTS and sometimes Home based Care take over. However, feedback from the Regional office is that there are defaulters, the rate we are unfortunately not able to say.

Do you have a problem with absenteeism? The hospital went through a very bad patch about three years ago, when absenteeism in the nursing group reached 38%, the hospital then had a meeting with their Labour Caucus, and agreed to follow the guidelines on leave and sick leave to the letter. It subsequently improved. Currently it is at an acceptable level, and the fact that the Health Risk Manager has taken over the investigation into applications for temporary disability, has taken a lot of stress away from the manager.

Members wanted to know whether or not there are any problems with EMS, and how does the hospital transport patients, and what are the responses rates like. The Hospital Manager said that EMS does not report to the hospital. Local problems are being addressed by the hospital. Patients are transported by road ambulances from the surrounding towns, as well as by Red Cross Air Mercy helicopter. Patients transferred to Cape Town are transported either by road ambulance or fixed-wing aircraft. The response rates for EMS remains a challenge. Should be 40 minutes in our area and 15 minutes in the metropolitan area; it still needs a lot of improvement to reach target.

There is a shortage of nurses in the country, are you going to start nurse-training? The hospital is working very hard to establish a training facility at George hospital. Their submission to the South African Nursing Council was supposed to be discussed at the meeting on 20 July, but due to a full agenda, has to stand over to the next meeting in October. In the meantime the hospital has appointed (on contract) a manager of the school, as well as a clerk and a secretary. One lecturer has been appointed on a

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fulltime basis, and the advertisement for a second lecturer is in the media this week, also for a contract post. The reason for the contract appointments are because they do not have posts for a training facility on their establishment. The hospital plans to accommodate 60 students, and will focus on assistant to staff nurse and staff nurse to registered nurse training. Accommodation for students from outside of George remains a headache. As part of performance management each nurse has a development plan. These training needs are incorporated into the hospital's Skills Development Plan. Weekly in-service training sessions take place; nurses are sent on short courses eg A TLS, bums, midwifery, etc, and some study with departmental bursaries (theatre, ophthalmology, admin)

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In terms of Waste Management, and incinerators the service is outsourced. There is an Infection Control Committee, meeting every two months, as well as an Infection Control Sister.

Members raised concern that the hospital in the have overspent their budget, where they get the "budget" from? The hospital manager stated that it is policy that the amount overspent should be deducted from the following year's budget. So far it has never happened. However, in the last two years they did not overspend.

Payment patient fees is major concern across the country, and the delegation enquired whether this is so at George Hospital? The hospital management team replied that they found that previously it was usually the older patients who are very conscientious with regards to paying for the services. However, there are patients who lie about their income, and pay minimally for the service. The hospital would like to have a private ward, but because of bed-pressures it is impossible to do so. The hospital does attract private patients and patients on medical aid, who share the ward with our state patients. Because facilities are of a high standard, they actually have little to complain about.

During other oversight visits to provinces the delegation enquired if there are any repeat TOP's and are there strategies to prevent come-backs? The TOP-programme is co-ordinated by the Regional Office and patients are only referred to the hospital for the actual procedure. There are definite repeats, and the Regional director has requested the programme co-ordinator to research the issue of comebacks and the need for TOP's above 12 weeks. Her stance is that the system should work optimally and that all patients should be captured before 12 weeks.

Due to the many power failures that the Western Cape has undergone does the hospital have adequate back-up in terms of electricity to prevent what had happened in East-London? The hospital manager stated that they do have two back-up generators which is tested every week, and maintained on an ongoing basis.

The hospital manager stated that the learnership programme is co-ordinated by the Regional Office, catering for the needs of the whole region. Currently we have learners for basic and post-basic pharmacy assistants and nursing assistants.

The delegation enquired w.r.t. the number of critical posts which are not filled and the hospital responded by stating that currently the nursing crisis is impacting on our service, simply because we cannot recruit enough nurses. In the admin department

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we have a crisis in the HRM-section. For the expansion and commissioning of new areas we need money.

The delegation wanted to know whether the budget in relation to your needs? The hospital manager stated that the standard answer would be the budget is not enough to cover all the needs. However, using population as a guide is dangerous, because the census figures are not reliable. Using the Core Package of Service for Secondary hospitals is also not reliable, as the hospital has a component of Tertiary Services that should actually be funded by the National Tertiary Services Grant. If that could be sorted, as well as the need for a district hospital in George, leaving the hospital only concentrate on secondary care, the budget might be enough.

3. South African Social Security Agency (SASSA)

The Committee was briefed by the Acting Regional Head of SASSA (W estern Cape), Mr D. Plaatjies.

Service delivery improvement initiatives which was embarked on by SASSA includes the application turnaround time. The purpose is to reduce the time from application to approval. The current turnaround time is 35 days. A pilot was launched in the Eastern Cape, Western Cape and Mpumalanga. The pilot was completed in the Bellville office (Western Cape) and rolled out to the Worcester and Atlantis offices. It is envisaged to implement at other 13 local offices as from July 2006 till 31 March 2006. The impact of this is that: there are no backlogs, same day notifications, decrease in enquiries, savings on postage etc.

3.1. SASSA establishment in the Western Cape

With regard to the establishment in the Western Cape the regional office has been established, but certain support functions was still performed at Head office of the Provincial Department of Social Development. The interim management team is in place at the regional office and 16 local offices are delivering full grant administration function.

3.2. Facilities and management systems

The regional office was completed and occupied by SASSA staff since January 2006 and the ICT infrastructure is installed and operational as well as the financial support systems. A total of 18 local offices have been identified to move to new premises.

3.3. Recruitment

Various posts was identified as critical which was subsequently filled at the regional office as well as local office.

3.4. Western Cape Transfer Budget

The budget for 2005/06 amounted to R4 238 905.00 and the budget for 2006/07 amounts to R4 613 710 588.00 and a monthly amount of R368m is paid to beneficiaries. The beneficiaries receive their monthly payments through either banks, post office (Walvis Bay) or ALLP A Y and all expenditures are monitored on a monthly basis.

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Presently there are 755,411 beneficiaries in the Western Cape receIvmg vanous grants.

3.5. Improvement of paypoints

SASSA is continuously evaluating all pay points to improve the conditions under which monthly payments occur and this is done in conjunction with the service provider.

3.6. Protecting beneficiaries: Money lending campaign

Specially designed pamphlets is distributed at pay points and imbizo's and from time to time identified pay points are visited and moneylenders are confronted and warned and stakeholders were identified to assist with the monitoring process. Discussions were held with Black Sash regarding an educational programme for beneficiaries, and a Business plan was finalized but the monetary allocation is still to be made to Black Sash.

3.7. Clarity seeking, comments and questions

The Regional Manager informed the Committee that the current application turnaround time is 35 days.

The Agency stated that service should revolve around the beneficiary where for e.g. where it concerns general payments of grants; if there are older persons in the queue they should receive preference.

With regard to the payment of grants into bank accounts and with this the reduction of banking costs, SASSA stated that there are no reduced costs with the banks, but that SASSA Head Office is in talks with the Commercial Banks to reduce the costs and that this will form part of the new tender.

Members raised concern with regard to the number of contract staff in SASSA's service. It was stated that these contract workers have a fixed term contract of 3 years, and SASSA noted that they are unable to create permanency for these workers. They further noted that in July 2006 Administration Clerk posts was advertised and issues that need to be looked at is racial and gender issues. SASSA explained that posts are firstly advertised internally to ascertain if there are no suitable candidates within and then externally. Members enquired whether the salary these contract workers receive are the only compensation, and SASSA replied that the contract workers do receive and additional 30% benefits.

It was stated by the Regional Manager that SASSA has adopted a Customer Excellence throughout the country and it is envisaged that the level of service should be the same throughout the country, and with this that the Agency have to adopt and change the infrastructure, and one e.g. to enable beneficiaries to obtain their grant anywhere in the country.

3.8. Recommendation

            . Members raised concern when it was stated by SASSA that in the event that a

            beneficiary passes away the day or a couple of days before payment, that that

            money which is due to the deceased beneficiary can only be claimed after the

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person has been buried. Members stated that in many instances that money "owed" will assist the family members to bury the deceased.

3.9. VISIT TO SASSA REGIONAL OFFICE - BELLVILLE

At the Bellville Regional Offices the Agency gave a demonstration to the delegation on the turnaround time of applications.

3.10. VISIT TO SASSA REGIONAL OFFICE - WORCESTER

3.10.1. Introduction

The delegation was briefed on the following: Human Resources, Infrastructure, turnaround time of applications, anti-fraud mechanisms, achievements and challenges at the regional office

3.10.2. Clarity seeking, comments and questions

On the issue of money lenders the Agency stated that this a project which has been running for years and that beneficiaries are educated as to the "dangers" of this and the Agency even went so far as to arrest these people.

The Agency stated that a specific day is set out for the payment of grants to older persons and older persons do get preferential treatment on other pay days and the Agency has been consulting different organisations to educate older persons.

Members enquired what the situation is with regard to the grants which beneficiaries receive which is then given to institutions e.g. old age homes etc. The Agency stated that there is no set formula and that it is a certain process which goes through SOCPEN and that it is an agreement between the institution and the beneficiary. The Provincial Department of Social Development stated that the monitoring of this is huge problem for the department. They further noted that a Monitoring and Evaluation (M & E) Directorate has been established at Head Office which visited about 600 institutions. It is envisaged to decentralize M & E to the districts, since the districts are in a better position to deal with this.

With regard to foster care placements the department stated that after 2 years the social worker must report to the department what has been done to place this child permanently. The department stated that they rely very much on strong community based organisations. The department stated that social workers are a major problem in the rural areas, but there is a 24 hours service at the office to phone the social workers in case of emergencies.

On the issue of the volunteers as commissioners of oaths the Agency stated that they make use of the SA Police Service as well as Commissioners of Oath as appointed by the Department of Justice and Constitutional Development, but that there is still problems. SAPS complained that the Agency was clogging up their processes with the number of documents. What is needed is a network of commissioners.

SASSA stated that they do make available funds for doctors to the Department of Health, where these doctors go to the clinics and hospitals to check where the backlogs are.

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3.10.3. Recommendations

            · That the issue of money lending and the confiscating of cards in the region are

            re-Iooked 3,t and that the culprits must not get away with it and those

            beneficiaries needs to be protected against this "practice".

            . That the shortage of Commissioners of Oaths in the region be addressed.

DEPARTMENT OF HOME AFFAIRS

4.1. Visit to Department of Home Affairs Regional Offices - Worcester

The Provincial Manager (Western Cape) of the Department of Home Affairs briefed the Committee on state of affairs in the province, with reference to Human Resources, Budget, Infrastructure, Service delivery and Partnerships and outreach programmes.

After the presentation of the Provincial Manager, the Regional Manager for the Subregion briefed the Committee.

The Regional Manager informed the Committee that the District Office (DO) Worcester is one of three districts under the jurisdiction of the Paarl Regional Office.

He noted that Worcester is serving various areas including Ceres, Tulbagh, Robertson etc, of which the furthest distance is 85 km. It operates with a personnel of 17 officials. The online hospital in the sub region is Eben Donges Hospital in Worcester.

The present accommodation utilized by the DO Worcester was recently upgraded by the owner and a new counter was installed and renovations was done to the bathroom facilities, etc and the office was painted with the corporate colours of the department. Air-conditioners were installed in 7 offices

4.2. Challenges

To keep rendering the services at mobile points; the expedite the processing of

enabling document applications; to provide the relevant training to officials; to secure suitable, additional accommodation for the current and new additional staff; to get uniformity in the application of the Immigration Amended Act & Birth and death Registration Act.

4.3. Achievements

The establishment of permanent Service points/mobile venues in the regions; capacitating of offices in the regions; rendering service to the poor of the poorest in remote areas with the 2 mobile trucks; filling of all advertised posts; queue management systems implemented; optimal utilization of mobile trucks in the region.

4.4. Clarity seeking, comments and questions

The delegation commented with regard to the migration of clients from the poor provinces. How does this effect service delivery and how does the Department cope with the migration? The department replied that most of the clients in Paarl Sub Region are from the Eastern Cape. Example, Lesotho citizens pretending to be from the Eastern Cape, were questioned at this office by the Regional Manager. It was

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established that they are in fact from Lesotho. The department often receive complaints that people have tried to obtain Identity Documents in their Home Province but were not assisted by Home Affairs officials and the Malmesbury office reports that a councillor presented eight people as South Africans. When interviewed in depth, four of them were found to be from Lesotho. It is unbelievable that

Members enquired W.r.t. the turn around times - and how does the department intend to adhere to turn around times with the little resources (human) to their disposal? The department stated that staff are optimally utilised and recently 51 learners were deployed to assist.

Members raised concern why the approved structure is not capacitated - 878 approved and only 458 filled? Is DHA improving skills and employing unemployed and qualified persons? The department stated that the New Organisational Structure was approved by Minister on 2006.03.16 and out of the 878 approved posts 267 is not funded. All unfunded vacancies were funded over with the MTEF 2007 input. Only 153 funded vacancies remain of which: 76 Mabelane posts on level 2-5, plus 67 was advertised, plus 10 posts reserved for the absorption of contract workers, 153 funded vacanCIes.

Members wanted to know what the province's strategy will be regarding preparation for 2010. The department replied that devolution of powers to Regional Managers for the approval of Temporary Residence applications where management will be streamlined to enhance service delivery. Capacitating Saldanha Bay, Mosselbay

harbour as well as the staff compliment at the Cape Town International Airport. A request has been submitted for a budget (Cape Town Harbour, Mosselbay Harbour, Saldanha Bay Harbour and Cape Town International Airport) in order to activate the above strategies.

The delegation raised concern regarding the deportation list, that only African people are reflected on the presentation. How many white people were deported and why was this not reflected? The department replied that recently a paedophile German was deported as well as a Chinese national - fugitive before justice for fraud and armed robbery. The Cape Town Inspectorate is currently busy with the deportation of Laura Brown (American national) responsible for stem cell fraud. If Europeans are apprehended, they normally have enough funds to leave voluntarily, whereas migrant workers often do not have sufficient funds to leave voluntarily and have to be deported. Whenever an illegal foreigner is apprehended they are given the choice to leave on own funds or be deported on state expenditure. A Belgian Citizen was recently deported from Malmesbury through Lindela.

The department noted that birth registration at hospitals is not compulsory, only if the client wants to register the child the service is at hand. Only one hospital in Paarl Sub Region Online: Eben Donges in Worcester. A total of 281 births were registered since the facility was opened. Paarl General Hospital will go online as soon as building operation at hospital is completed.

What is DHA: Western Cape doing to curb corruption?

. Ensure that proper control measures are in place.

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. Whistle Blowing/fraud prevention policy workshoped with staff

members and written confirmation of adherence requested afterwards. . Supervisors urged to report irregularities. . Capacitated the Counter Corruption component of the Provincial

            Managers Office by the employment ofa Control Security Officer (18

            April 2006)

. All cases of possible corruption are submitted to Directorate Counter

Corruption for investigation. . The Province established a close working relation with Provincial NIA. . Province embarked on a project to vet all managers from level 7-14

            with the buy-in of the National Intelligence Agency.

The delegation wanted to know how tight security at ports of entry is - foreigners smuggling drugs enter the country through International Airports. How many of these cases did you register and how do you manage them? Identification of drug smugglers is the mandate of Customs and Border Police (Organized Crime Unit). Interacting does however exist between immigration and other law enforcement agencies. The Immigration staff facilitates the processing of admission of a person to the RSA. Security at Cape Town Harbour - responsibility of the Maritimes Company and Port of Entry Security Enhancement. Security at Cape Town International Airport Airports Company.

Members enquired what interns and learners receive as remuneration form the department? The Provincial Manager stated that interns receive a monthly stipend of R3000.00 per month and Learners are remunerated with R2000.00 per month from the budget of the Director: Human Resources.

Where do you detain illegal foreigners before deportation? Local Police station for a maximum period of 48 hours, Pollsmoor Prison and Malmesbury.

4.5. VISIT GEORGE REGIONAL DEPARTMENT OF HOME AFFAIRS OFFICES

4.5.1. Introduction

The Office Manager briefed the delegation on the following: Human Resources, Budget, Infrastructure, Service delivery and Partnerships and outreach programmes.

4.5.2. Clarity seeking, comments and questions

The delegation enquired why the vacancies within the Region are not filled and the department replied that all funded vacancies were advertised and are in various stages of filling.

The delegation wanted to know how the regional office distribute ID's to those people whose ID's are still in the office? The Department stated that it has signed a contract with the South Afucan Post Office. SAPO officials are collecting ID's from the offices. After distribution SAPO submits a list of applicants delivered to as well as pink cards where applicant sign when receiving hislher ID. SAPO officials take great care when delivering these ID's by ensuring that the ID is handed to the owner.

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Marriages are conducted at Regional Office George twice a week (Mondays and Wednesdays). It sometimes happen that clients turn up without knowing the

designated day for solemnization of marriages, these clients are never turned away if all necessary documents and witnesses are present. The George Office conducts 15 to 25 per month.

The department noted that this office experienced one incident of fraud in 2004; the case was investigated and finalized early in 2005. The official was dismissed. Since

then the Departmental Fraud Prevention plan was workshopped with all staff. A control measure with regards to the handling of cash was also enhanced.

The delegation enquired why there is no staff at Knysna while it is regarded as a district office and the department replied that the Regional Manager is currently in the process of negotiating office accommodation in the Knysna area. The establishment for District Office Knysna was approved in 2006, but not funded for 2006/07 financial year.

The department informed the delegation that during the migration process from the 1995 establishment to the 2004 establishment a mistake occurred during which the

component number for DO Beaufort West was abolished. At the time the staff deployed at the Beaufort West office was accommodated on the establishment of

Oudtshoorn. A component number for District Office Beaufort West needs to be created. The Provincial Office is addressing the issue.

In its presentation the department talked about the biometric system and the delegation wanted to know whether any problems are experienced with the Biometric system? The department stated that

. The Biometric system is time consuming as the official, registering a birth has to sign on 4 times (one has to put his/her finger on the device), for the registration and issuance of one birth certificate.

. Official emolled on the Biometric System are not able to able to work

on mobile trucks.

The delegation enquired what the turnaround time is for processing certificates and the department stated that unabridged certificates are issued on the spot and at times when computers are offline certificates are posted to the applicant.

During the period of the oversight visit the region was flooded and the delegation enquired what mechanisms are in place to assist people affected by the floods. The Regional Managers is working closely with the local Disaster Management Components of the local Municipalities. After an assessment was made of the flooded

areas and the needs of the affected people, a submission requesting the waiving of fees are directed to the Director General via the Office of the Provincial Manager.

The delegation raised concern that it seems as if its only Africans are targeted by Immigration (evident from the presentation) and deported while non-Africans are left to leave the country on their own? The Provincial Manager stated that the National Immigration Branch of the Department of Home Affairs has a mandate to investigate arrest, detain and deport transgressors of the Immigration Act no 13 of 2002 together with other related Government Act. Well-qualified and trained Immigration Officers

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