REPORT OF THE OVERSIGHT VISIT OF THE SELECT COMMITTEE ON SOCIAL SERVICES TO THE
FREE STATE PROVINCE 17 – 21 OCTOBER 2005
Introduction
The Select Committee on Social Services undertook a study tour to the
Free State Province from 17 – 21 October 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 visits 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 2005/06 financial year and the Committee identified the
This report aims and envisages that the challenges experienced by the various
regions in the Free State Province are taken cognizance of and that they are
addressed to improve service delivery to our people. The Committee undertook
this oversight visit to the Free State 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 information 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 main aim is to visit the rural areas, where
service delivery is not up to standard (Batho Pele).
The Committee also took tours of health centers; social development centers and
Home Affairs offices to ascertain whether what has been said in the meeting
with the various stakeholders are a true reflection of what is happening.
Limitations of the report: • The fact that not the whole of the Free State
Province could not be visited, but only parts of it;
• The fact that the delegation could not visit for e.g. pay points on the day
of payouts. It is the intention of the Committee to arrange for future visits
to arrange this.
The delegation had meetings with the various MEC’s, HOD’s, Regional Managers and
undertook tours of the institutions, which they visited. This report will
highlight the important issues raised during these meetings.
1.1.
The Regional Manager informed the delegation that previously, the ID’s
could not be locked up because there was no strong room and the office has
currently 2000 undelivered ID’s in the office.
The Manager stated that since the beginning of September 2005 no ID’s were delivered,
due to the 3-month period that is in place, and only after this period has
expired the office will begin to deliver the ID’s. He further noted that ID’s
is locked up and that the office does not give ID’s to councilors to give to
clients.
The Manager stated that they try to obtain the telephone numbers of the clients
to inform them of their ID’s, but that this exercise is very costly and that
the department is in the process to finalize the process of sending SMS’ to
clients.
The manager informed the delegation that the office is making use of interns
and that their contracts will be expiring soon (end of November 2005) as well
and that the office has already lost 12 people and this places a heavy burden
on the remaining staff to deliver an excellent service. With regard to the 12
people, the manager stated that some are under investigation and that 3 have
returned and some were either dismissed or suspended.
The office is servicing 17 towns.
The manager stated that there are 3 people working on the mobiles and they only
go out twice a week and that they work out of any space that is available and
that they are “at the mercy of the local municipality” and conditions under
which these people at times work is not conducive.
With regard to the infrastructure, the manager stated that it is better than
what it was previously. A problem at the current offices is the escalators and
that at times people have fallen and broken their legs. There is security at
the front to assist people, but at times it is difficult for disabled persons
to enter e.g. person in wheelchair. There is also no parking at the offices,
and the manager stated that their contract expires in 2006.
The manager stated that the deliveries of ID’s in not as successful as they
would want it to be e.g.
many give the wrong addresses and this delays the process.
The manager noted that there is not sufficient
personnel dedicated to do registration of births at the hospitals.
With regard to fraudulent marriages, 6 fraudulent marriages are under
investigation, but the response from Head Office is very slow.
With regard to IT, the computer systems has improved and the office has
received a number of new computers, but that they are still working on old
passwords and when the passwords expires it takes time. The manager stated that
the printers on the new system do not work well and that the back-up system is
problematic.
The manager informed the delegation that the new fingerprints system is going
to be installed in December 2005.
1.2.1. Departmental Fraud Prevention Plan and Risk management strategies
(including focus on outstanding identity documents)
The office is implementing the objectives of the fraud prevention plan that
was compiled for the whole province, the dynamics thereof being:
• Ensuring that cash received is banked daily, that cash registers are
programmed in such a way that only one transaction can validate per transaction.
• The daily intake or transactions are controlled and checked by supervisors
daily and also weekly by the officer in charge.
• Two officers do banking i.e. one official cannot do banking without being
accompanied by a witness, thus ensuring that it is not easy for one to collude
with the bank official.
• There are no security guards; this is one risk area that the office finds
itself in, as there is no proper access control of people entering the office.
However, alarm systems have been installed in the office to ensure safety of
government assets.
• The office is receiving a reasonable number of identity documents. Currently
the total number of uncollected ID’s in the office is 325. The collection
process is very slow and even if posted to given addresses, about 80 % of them
end up being sent back undelivered due to wrong address. Sometimes they also
end up in the wrong hands, as there is no security that the rightful owners
receive the documents.
• The office has implemented several means of trying to deliver the ID’s e.g.
door-to-door delivery, posting to serviceable addresses, listing ID’s and
handing names to the councilors to inform people in their constituencies to
collect their ID’s at the office.
• It has however been noticed that the method of posting seems to be an easy
one, whereby ID’s are delivered in big numbers, has proved to be risky as there
is no proper and definite confirmation of control whether the rightful
applicant is the one who received the document.
The postman places the ID’s in a postbox at the given address without positive
identity of the applicant. Sometimes where there is no post box identity
documents are just thrown into the yard and this contributes to the risk of
ID’s ending in the wrong hands and thus causing the level of fraud to rise.
• Other risks that are growing and seem uncontrolled is the increasing number
of late registration cases over 15 years, whereby people freely and
fraudulently acquire baptismal certificates and other proofs, clearly being
illegal foreigners. They then apply for ID’s, where they are able to access
different forms of services and grants offered by government.
1.2.2. Quality of service
Quality of service has somewhat improved at Thaba-Nchu
service point to a certain degree especially with the appointment of the
interns.
In order to enhance service delivery, extended working hours during the week
have been implemented, namely
1.2.3. State of physical infrastructure and equipment
• The current accommodation is not user-friendly as there is not sufficient
space inside i.e.
office is too small and allows only a limited number of people to get inside.
• There are no air conditioners, therefore during hot summer days and high
temperatures serious health problems are caused
• Alarm systems have been installed in the office to enhance safety and
security, however;
lack of physical security in the form of security guards still leaves serious
risks.
• Recently in 2004 the department has entered into a five (5) year lease
agreement contract with the owner of the building,
however it is envisaged to move to a bigger office once the contract expires.
There is also no fridge, microwave or stove.
1.2.4. Information Technology (IT systems)
New computer systems with updated programs like GroupWise etc have replaced
five (5) old terminal computers in the office. Additional computers are needed
to allow the smooth running of services e.g. scanner for passport, computer for
E-mails and administrative functions.
Only one (1) printer is allocated to this office to print
Birth/Death/Marriage/Temporary Identification certificates. However, this
causes delays.
The office cannot scan passports, as it has to borrow the scanner from other
offices in the Province i.e. Sasolburg service point
and this results in the delay of passport applications.
User-ID’s (to gain access to departmental programme)
of this service point have often been used to capture fraudulent transactions,
e.g. fraudulent marriages. In all the cases reported, these marriages were
captured in other Provinces or towns e.g.
1.2.5. Clarity seeking, comments
The Provincial Manager stated that overtime is paid out of the Provincial
budget savings (i.e. vacant posts.) It was also clarified to the delegation
that ID’s couldn’t be produced locally as only Head Office has access to the
HANIS system.
It was also put to the delegation that the turn around time for applications is
restricted to one day in the offices, however, there
are constraints to this due to human resource capacity.
It was also made known to the committee that the department has embarked on a
stakeholder forum with other government departments, e.g. Social Development,
Correctional Services, SAPS, NGO’s and Education, to ensure that all services
can be accessed at one point.
Information sessions are constantly held to inform the public about the
services of the Department of Home Affairs and also with chiefs, councillors and church leaders/Ministers to fight
corruption of illegal issuance of fraudulent documents.
1.2.6. Challenges
• Among the challenges facing the office is to capacitate the office in
terms of Human Resource in order to live up to the Department’s vision of
rendering a world-class service.
• To computerize
• Acquisition of the necessary funds/budget as requested by the province.
Filling of all vacant posts in the Province and the Acting Provincial Manager
alluded to the fact that backlogs in terms of service delivery will be resolved
once the new Civic Affairs Establishment is approved and implemented fully.
However as of now the establishment has not been funded thus vacancies cannot
be filled.
1.3. PHUTHADITJHABA REGIONAL OFFICE
1.3.1. Clarity seeking, comments
The delegation enquired why ID Statistics from the
Provincial Manager’s Office and Regional Office differ i.e. 900 and 1100 and
the Provincial Manager replied that his office is only having statistics ending
The delegation stated that this office
has become a Regional Office with the result that the establishment has
expanded which means that the office is going to employ more staff. The provincial
manager replied and stated that the Deputy Director post has already been advertised
and he/she will have to ensure that all the remaining posts are filled.
Management of the office stated that they are understaffed, and the
delegation enquired how the office manages to distribute ID`s
especially during weekends by door-to-door delivery. The management stated that
offices are open on Saturdays and skeleton staff are working whilst other officers
are utilised to go out of office to distribute ID`s.
The delegation asked the management whether they have areas that have no
service points to serve, if so, how do they cover those? Management stated that
they are working together with Traditional leaders, ward councillors
and the Department of Social Development where they identify the areas with
backlogs. Thereafter dates are secured for information sessions to communities
where they are informed of the requirements for applications and after that
dates are identified, the Department will collect applications.
1.3.2. Concern raised by the delegation
• The committee was concerned as to what will happen when the contracts of
interns expire on 31 October 2005, and Home Affairs relies entirely on them.
The committee said that they would motivate that the interns be kept for
another year because they do a good job.
• There is no sign board for direction of Home Affairs or stating HOME AFFAIRS
PHUTHADITJHABA REGIONAL OFFICE
1.4. KROONSTAD DISTRICT OFFICE
1.4.1. Personnel The establishment was discussed with members of the
committee where it was explained that there are 13 clerks, 5 supervisors and
two vacant posts The shortage of staff was discussed,
with the delegation, and they were informed that supervisors are also
performing functional tasks.
There are 3 permanent service points, namely Viljoenskroon,
Parys and Heilbron and
mobile units are visiting Edenville, Koppies, Steynsrus, Lindley, Vredefort, Deneysville, Oranjeville, Petrus Steyn, Hennenman and Ventersburg, only once per month due to staff shortages.
1.4.3. Distribution of ID’s
ID’s are distributed door-to-door or posted to serviceable addresses but at
this stage there are many identity documents in the office due to the problems
experienced with the franking machine.
1.4.4. Accommodation
The lease of the building has expired and the contract has been renewed on
a month to month basis.
The condition of the building is not satisfactory.
1.4.5. Information Technology Some of the staff members still do not
have User-ID’s and computers/printers are off line most of the time due to the
new service provider (SITA).
1.5. Ports of Entry (PoE) in the Free State Province Clarity
seeking, comments
The delegation enquired why the Arrival &
Departure totals so high when
The delegation wanted to know how rife corruption are
at the ports? The department stated that corruption is rife at the ports
because of a lack of manpower and a lack of proper systems. Officials make
themselves guilty of corruption by fixing passports of foreigners and taking
money from persons who have overstayed.
The pedestrian facilities at
The department stated that here are no official unmanned borders on the
Lesotho/South African borderline. The South African Defence
Force is currently responsible for the borderline.
There is sufficient/ adequate transport and even vehicles to transport
officials between the workplace and their residences.
2. SOCIAL DEVELOPMENT
2.1. Meeting with MEC and HOD of Social Development
2.1.1. Clarity seeking, comments
The delegation enquired into Foster Care and
wanted to know whether there are any delays w.r.t.
the Department Of Justice, whether applications are
delayed? At the regional courts there are backlogs and the MEC stated that
there are delays with regard to the Department of Justice and that the
department is in the process to alleviate the situation e.g. they have
campaigns with other stakeholders, a new computer system is being developed to
fast track the process and that they have to strengthen the relationship with
the Department of Justice.
With regard to the roll-over of the budget, the MEC stated that there were
roll-overs to the value of R250 million, and the HOD further noted that the
roll-over was due to the fact that there was a delay in the adjudication of the
tender process, which is centralized and that the tender was awarded at the end
of the last financial year. He further noted that it was the first time that money
was rolledover.
On the issue of the upgrading of pay points the HOD stated that 54 pay points
was upgraded to make it more conducive for beneficiaries, and with the current
budget the department have to prioritise which pay
points to upgrade. He further noted that security at the pay points is an important
part of the department’s programmes.
With regard to old age homes the MEC stated that conditions are unacceptable in
the
The HOD stated that they do provide for people with disability at pay points.
The HOD stated that many of the social workers apply for government positions,
with the result that NGO’s are battling.
Members of the delegation voiced their concerns regarding pay out of the
different grants and whether these grants are paid out on the same day, the
reason being that for e.g. beneficiaries coming for the Child Support Grant
(CSG) pushing for e.g. the pensioners out of the way. The MEC noted that there are different pay out dates for the different grants e.g.
CSG and Old Age Pension The department highlighted to the delegation that
beneficiaries are informed well in advance of the lapsing of their benefits and
this is done in writing.
2.2. Child Support Grant
2.2.1. Challenges:
• Lack of Home Affairs documents
• Decrease in the volumes of applications
• Impact of the indemnity process
• Alleged fraud by caregivers
• Poor access of service by farm communities
2.2.2. Recommendations from Department
• Provincial business plans focused on the registration and awareness drive
has been completed
• Specific operational plans for each district have been completed •
Strengthening partnerships and joint campaigns with, Home Affairs, Education,
Health, Municipalities, NGO’s etc.
• 40 additional staff have been appointed • additional
computers, printers, scanners and photocopiers have been procured for all the district
offices • Additional vehicles including 10 mobile offices have been procured,
to reach out to farming and rural communities.
2.3. Services to Children
2.3.1. Challenges:
• Inadequate funding for Early Childhood Development Centres.
Only 32% of the 74 000 children from the poor communities/families are
benefiting from government funding.
Current subsidy of R4.50 per child per day basically provide for food.
• Shortage of social workers to provide intervention and statutory services to
children.
Currently 259 social workers available and the national norm are 549.
• Inadequate funding to NGO’s to pay market related salaries
• Handling of backlogs of about 2075 i.t.o.
intervention and statutory services
• Shortage of Places of Safety
• Inadequate facilities for statutory placements of multi-disabled children
• Successful implementation of the Children’s Bill
• Competent personnel
• Street Child phenomenon
2.3.2. Recommendations
• To obtain additional funds for more social workers •
Consideration be given to funding of NGO who will specialize in the selection
of training of foster parents
• The establishment of residential places of safety in those areas where needed
• Establishment of a residential Child Care centre for children with
disabilities as well as group foster homes.
2.4. Probation services
• Shortage of Probation Officers
• Training and capacity building of personnel especially those rendering
services in residential care facilities
• Roll out of Home Based Supervision Programme in all
districts
• Insufficient resources for after hour assessment of arrested children and
effective monitoring of children place in diversion programmes
• Delay of finalisation of cases resulting in
blockages in Department of Social development (DSD) facilities
• Lack of reform schools for further rehabilitation of children.
3. Meeting with Concerned People Against Abuse
(CPAA) at Kamohelo Heaven, Thaba
Nchu CPAA is a CBO rendering services to victims of
abuse in Thaba Nchu and the
Trust Areas.
The following services are provided for:
• Accommodation for woman and children
• Support and counselling to victims at the shelter
• Referral of victims for medical attention when needed Since 2002 the shelter
accommodated 479 women and children. Cases handled by the Social Worker
after-hours from June 2004 until April 2005 was 223.
3.1. Challenges include:
• Marketing of services/shelter to other areas to utilize the shelter
effectively • Recruitment of people from the community to form part of the organisation and management
• Appointment of a shelter manager to help with the day-to-day running of the
shelter. The need was identified and will be budgeted for 2006/07
• No assistance from municipality
• No salaries/stipends for volunteers
• No contract that building was donated to shelter
3.2. Clarity seeking, comments
The Chairperson of CPAA stated that the volunteers at the centre are always
there when they are needed and as from 1996 they have not received any monetary
compensation to date.
She further noted that the shelter does not get any assistance from the
municipality.
The building belongs to the Provincial Department of Social Development and she
stated that it was donated to the shelter, but there is no contract stating the
fact.
The SA Police Service use to take victims to the hospital.
3.3. Tour of shelter • There is rooms for administration and counselling • One room is for the matrons with 2 beds •
There are 9 beds for victims and the rooms are clean and tidy.
• There is security at the gate and it was stated that there is very little
break-inns • There is a laundry and the machines are all in well working order.
• During the tour the delegation met with a woman who is a victim of abuse,
where the boyfriend wanted to kill her and her two boys. The victim stated that
they are well looked after at the shelter.
4. Meeting with management of Boiketlong Old Age
Home
Boiketlong is a government institution and the
budget allocation for 2005/06 is R4 835 569.14 and the institution renders a
24hr residential care service as well as, balanced meals, a safe environment, primary
health care services, access to secondary health care services etc.
The staff structure of cares personnel rendering 24hrs services: 1 Chief
Professional nurse, 1 senior professional nurse, 6 Nursing Assistants and 12
care workers. The staff works on shifts between 07h00 – 16h00 and 07h00 –
19h00during the day and 19h00 – 07h00 during the night to sustain the 24 hour
service.
4.1. Challenges
• The newly approved staff structure makes
provision for five professional nurses. Presently there is only one senior
professional nurse.
• There is a need to appoint an administrative officer to assist with the
administration.
Currently there is only one Snr Admin Clerk.
4.2. Tour of Old age Home
• The kitchen has stoves which is in perfect working condition (enquired
from caterer)
• The catering has been outsourced
• The food supply is adequate (shelves was packed with food)
• Older person’s receive 5 meals a day • The ones living in the rondawals eats in the hall.
• Each rondawel has a bed, a cupboard and ablution
facilities are in the hall.
5. Meeting with Regional Manager of Social Development: Kroonstad
5.1. Social Security
The presenter highlighted the number of beneficiaries, physical
infrastructure of pay points, and access to grants at the various pay points in
the region.
5.2. Indemnity process
The process went well and 897 different grants in
the district were stopped. The process is still continuing with the Compliance
Officer investigating cases reported after the deadline and action taken e.g. stopping
of grants and recommending re-payments in some cases.
5.3. Developmental Social Services
5.3.1. Children Awaiting Trial
The presenter informed the Committee that as from 2003 a Probation Unit was
established within the department and currently there are 4 Probation Officers
and 2 Assistant Probation Officers for the whole district.
The main focus is to do assessments to all arrested children that are reported
to the department. In Kroonstad the Probation officer
visits the court every morning to check if there are any children to be
assessed, and the reason being that SAPS do not report all of the cases to the
department. These visits are done to avoid children being given sentences for
minor offences and impacting negatively on their future. The Probation Officer
and the Assistant Probation Officers also visit the prison once a week.
The presenter informed the Committee that in the last 6 months 314 assessments
were done in the district.
The presenter also gave a brief background on the
Programmes at the center include: art and craft,
drama and culture.
The department provides 100% funding to the center annually and in terms of the
Memorandum of Understanding signed between the department and the center, the
department is also responsible for the monitoring of the center to ensure
proper utilization of funding as well as effective service delivery.
5.3.2. Food Security Programme
The district was allocated a budget of R5,8
million for 2003/2004 and the same amount for 2004/2005 and 19 422 food parcels
were distributed to 6474 households over a period of three months in both
financial years.
For the 2004/05, the identification was through Stakeholder Forums that were
established when public meetings were held in all the 15 towns.
5.2.3. Challenges in the region include:
• Only 346 food parcels were issued till the end of September 2005. The MEC’s gesture to issue out food parcels to the needy and
destitute for the festive season will contribute to spending all the funds.
Social security relies in social workers to hand in reports to issue out food
parcels.
• The lapsing of temporary disability grants has caused hardship for a lot of
people, and many of them have appealed, but their still awaiting assessments
and their grants have stopped before the outcome of their appeal.
• The district is struggling to reach the target as set for the children 11-14 years.
• With regard to children awaiting trial, not all children that are arrested
are reported to the department for assessment.
• Court cases take to long to be finalized and children stay for long periods
even for more than a year at Matete Matches Secure
Care Centre • Resistance of the Court to refer children to the center due to
the absence of security, which leads to abscondment.
• Limitation of capacity at Matete Matches for
children who committed serious crimes who end up in prison.
• Due to unemployment and poverty everybody feels that they are legible to
receive food parcels • Venue for distribution of food parcels was a problem.
• Safety of officials was at stake, where they were threatened.
6. Meeting Regional Director of Social Development: Qwa
Qwa (Thabo Mofutsanyane)
Thabo Mafutsanyana
District has an overall population of 725,939. Maluti-A-Phofung
has been declared a presidential node. The nature of leadership is traditional
leadership and political leadership (councilors). Traditional leadership is
very strong at the community level (villages).
The presenter informed the Committee on the location of offices/sub-offices and
satellites, also the institutions e.g. Leratong
Children’s Home and
She further highlighted the status quo regarding the personnel profile of the
various offices in the region, including Qwa Qwa District Head Office, Bethlehem Sub- Office, Ficksburg satellite etc.
The challenges, as indicated by the Regional Manager includes the following:
• shortage of Social Workers, Community Developers. The remote rural areas are
not attracting skilled experienced personnel.
• Backlogs in service delivery especially foster care applications
6.1. Children Awaiting
There are currently 19 children that are awaiting
trial in the region
Challenges: • Children are kept for long periods in the police cells,
before being taken to alternative care like Matete
Matches
6.2. Food Security Programme Allocations were
done according to municipalities.
Maluti-A Phofung 13 216
Lihlabeng 3 428
Setsoto 7 584
Nketoana 1 593
Phumelela 3 085
TOTAL DISTRIBUTION 28 906
Challenges
• Facilitation of formation of forums for identification and distribution
• Role of clarification between the department and the Municipality.
There was confusion who was in control. The criteria for identification of beneficiaries not clear and
concise. The object of the programme
not fully understood by communities and politicians at local level.
• Delays in distribution due to suppliers stock shortage
• The contents of the food parcel not user friendly to
a family without an income. Samp, beans require
electricity or wood to be prepared, i.o.w. it defeats
the objective.
6.3. Social Grants
The presenter explained to the Committee that some
of the pay points were upgraded according to the norms and standards.
Challenges • Documentation is still
a problem where both biological parents and children are without documentation.
• Lapsing of grants, which demand direct physical follow-ups to enable the
applicant to meet the doctor. At times it is difficult to locate the address or
the address has changed since the initial application.
• More transport and officials with driver’s licenses are required to ensure
follow-ups on lapsed grants are made timeously.
• Entering into farms still a challenge although they are aligning their visits
with the Department of Health with their mobile clinic visits is helpful.
• Vandalization of upgraded pay points and service
points by communities rendering the efforts made by the government futile •
Unavailability of farm workers during the week when departmental officials are
at work.
Consequently visits have to be organized.
6.4. NGO and CBO funding With regard to NGO and CBO funding the
presenter informed the committee on the following challenges regarding the
funding of CBO’s and NGO’s.
Challenges • Lack
of capacity on the part of the funded organizations to comply with the
memorandum of agreement. Training was given, they were work shopped, but
still compliance is difficult.
• Late payment of organizations by the department
• Effective monitoring and evaluation and evaluation of funded organizations by
the department provincially and locally.
6.5. Child Headed and Orphaned Children Due their culture and traditions
the number of child headed households is very little as extended family members
come forward to foster immediately the biological parents are deceased. Also
with sibling households some children affected by the death of their parents and
being old enough to can care for their siblings they still leave the
responsibility with elders in the extended family.
There are 3856 families that are receiving foster care and 11568 children who
are fostered and 650 file backlogs for foster care application cases awaiting
home visits and compilation of reports.
Challenges Shortage of social
workers Shortage of transport for social workers to intensively intervene and
follow up on cases Lack of co-operation with some magistrate court regarding
foster care applications. Magistrates not appointed as commissioners of child
welfare Escalation of HIV and AIDS related deaths increases the demand for
foster care Interpretation of political statements by communities creates
dependency on the system.
6.6. Indemnity process
The presenter gave the following information regarding the indemnity
process in the region:
Qwaqwa – 1845
Senekal – 128
TOTAL - 2327
6.7. Recommendations:
Recruitment of social workers for tertiary training is done at matric level to address the current escalating demand for
social workers.
Training of social workers by tertiary institutions to be aligned to the
current demands for service delivery, and this will enable incoming social
workers to be prepared for the situation.
Foster care application process to be reviewed, especially
where proof of death of both biological parents is available.
Availing resources to the social workers to perform their functions
effectively, e.g. transport is always a problem.
Clear and better systems be put in place for
organizations mismanaging funds.
Officials with financial management expertise to be employed
at district level.
NGO’s/CBO’s to be
empowered/capacitated to administer food distribution. Food distribution always
takes precedence over actual service rendering.
A blueprint on procedure to follow for situations where the
parent and the biological children are without documents are availed by the
Department of Home Affairs as an information leaflet.
The issue of unknown parent in the case of single parent death is clarified as
to the investigation procedure of the whereabouts of the reputed parent. This
is still a very sensitive issue.
6.8. Tour of Children’s Home
In the admin. Block there is offices for, the transport officer, registry,
manager’s office and the switchboard At the foyer the disciplinary code and
procedures The Acting manager informed the delegation that all children are
attending school except for 3 boys There are currently 114 children at the home
There are no air conditioning in the rooms There are 32 care workers In the
girls block the girls eat separately and they have their own bathroom
facilities and 5 girls per room The children are getting pocket money according
their age.
6.9. Visit to pay point The pay point which the delegation visited is a
tribal pay point 3000 to 3500 beneficiaries receive pay outs at this pay point Payouts
are being done in period. e.g. 1000 people a day There is sufficient shelter at
the pay point There is sufficient space and chairs for beneficiaries Ablution
facilities are in a good condition On the day of the pay outs members of the
luncheon clubs assists The Regional Manager stated that pay outs if from 08:00
am to 11:00 am She further noted that people are aware on which days they are
to be paid Vandalism is a frequent occurrence at the hall The Regional Manager
informed the delegation that payouts use to take place at the school (which is
opposite the pay point), but a need had arisen to obtain another venue for
these payouts, for this reason Social Development identified this hall.
There is a fence around the hall Security is also visible at the hall
7. HEALTH
7. Meeting with the MEC of
Health and the HOD of Provincial Department of Health The HOD briefed the
Committee on the following:
7.1 Comprehensive plan for treatment and care of HIV and AIDS. (Focus on
Home-based Care, VCT & PMTCT).
The number of people living with HIV & AIDS is about 487 772 and it is
estimated that there will be 62 517 births, of which 4 366 babies will be
infected at birth.
Prevention programmes – 85%of frontline primary
nurses health care nurses have been trained in the Syndromic
Management of STI’s, and 1,6
million male condoms have been distributed per month and female condoms have
been distributed to from 18 functional sites.
VCT has been established in all 81 towns and is available at 242 health
facilities. Training of 175 NGO’s in the past two years in financial, personnel
and project management.
Home Based Care (HBC) – this programme has been
established in all 81 towns and is currently expanded to 10 farms in the
province.
Implementation of ARV – the
Prevention form Mother-to-Child Transmission (PMTCT) – it has been extended to
have one PMTCT facility per district, with 140 feeder clinics and 30 hospitals
participating. Midwives working at maternity facilities are rendering the
service.
7.2. Management and governance of health facilities and quality of care
(focus on hospital Revitalisation.
The clinic committees are functional in more than 90% of the clinics.
Challenges include: training, attendance, transport, identity and motivation.
With regard to the Hospital Revitalisation the
province received R113 m and actual spending up to 30 September 2005 was R18m
(16%), the infrastructure grant the province received R47m and R11, 7 m (25%)
was spent (30/09/2005) and clinic building and upgrading received R21, 4 m spent
(as at 30 September 2005) R4m (19%).
8. Meeting with Regional Manager of Health:
8.1. Summary of briefing Health
facilities within the region:
Xhariep District Facilities: Clinics: 17
Community Health Center: 1
Mobile clinics: 20
District Hospital Complexes: 2
Motheo District Facilities Clinics: 63
Community Health Center: 2 Mobile clinics: 13
District Hospital Complexes: 3
The Regional Manager briefed the delegation on the District hospitals within
the region, Pelonomi Hospital that is a regional
hospital; Dr JS Moraka Hospital and its available
services, clinic information, the upgrading of facilities and the environment,
the equipment and quality of care.
From 1999 – 2005 5023 TOP’s was performed and the age
profile are that below 18 years is less, with the over 18’s increasing.
VCT is not mandatory and it is a localized service in the hospital with a
dedicated professional nurse.
Prevention of Mother- To- Child Transmission (PMTCT) was implemented in 2004
and to monitor the end results for follow up is difficult, due to no feedback
and reporting, it is not systemized.
Recommendation is made for the central reporting to be done locally for
outcomes to be captured.
8.2. Challenges include:
High vacancy rates for professional nurses Recruitment and retention is
difficult even rural and scarce skills allowances and headhunting Budgetary
constraints for medication Maintenance to clinics and hospitals
8.3. Achievements include: Agency nurses to cover the shortage Relaxed
recruitment for rural areas One advance midwife has qualified and acts as
consultant for other midwives Functional and active clinic committees at all
fixed clinics Functional hospital Board for the hospital complex Recently
purchased a park home to accommodate the EMS station Critical equipment
purchased and delivered for the hospital complex Maintenance budget for the
clinics has been increased.
8.5. Clarity seeking, comments The
Regional Manager stated the hospital was built in 1973 and that it is not part
of the revitalization programme.
The Regional Manager further noted that the hospital is experiencing budget
constraints and that the hospital is going to overextend.
She stated that there are no 2-roomed structures, but in one area the community build a structure, which was used as clinic, which
received the Premier’s Award, and this proofed that the people in this region
are not a passive citizenry.
Dr JS Moraka Hospital has a trained professional
infections nurse, which has a master’s degree to do research as well.
A challenge for the hospital is that the IT is not up to standard.
One trained nurse performs TOP at the hospital. They had two, but one left and
the hospital is in the process to appoint another. On the issue of back street
abortions, the Regional Manager stated that this is not performed in the region.
8.6. Tour of Dr JS Moraka Hospital Maternity
ward The maternity ward is modified and painted There are 2 delivery rooms There
is a doctors room for the doctor on call, which is furnished with a TV, a
fridge and bed Post caesarian section Furnished with six beds The bedding is
clean and tidy Sonar room It is under lock and key Equipment in the room is in
good working condition Ablution facilities for disabled 1 room is set aside for
the Department of Home Affairs for online registration new incubators was
bought the ambulances for EMS is not well equipped and has the basic equipment there
is a Occupational Health and Safety officer at the hospital pediatrics ward there
are 20 beds security is visible at the front gate of the ward, for children’s
safety Nursing manager stated that if mortuary is full, the hospital makes use
of private funeral undertakers the hospital has an eye clinic.
8.7. Tour of Thaba Nchu
Clinic The Committee made an unscheduled stop at the clinic there is a dots
room 3 consulting rooms sluice room 2 counselors 4 staff members working at the
clinic in the pharmacy there is a shortage of medicines, and as stated by the
Senior Professional Nurse (SNP), this is because of a shortage from
Bloemfontein.
The SNP stated that a major problem is the training of pharmacy assistants
9. Meeting with Regional Manager of the
9.1. Comprehensive Care, management and treatment of HIV
and AIDS programme
The Regional Manager informed the delegation that Voluntary Counseling
and Testing (VCT) is performed at all health facilities as well as PMTCT. The
current number of patients on ARV treatment is: male adults 245, female adults
792 and children 30.
9.2. Revitalization Programme
At Thebe Hospital the maternity ward
and dental clinic have been completed and currently they are busy with the last
phase, which includes EMS station and administration block.
At Elizabeth Ross the maternity ward, male and female wards, children’s ward,
admin offices have been completed and they are now busy with the last phase,
which includes the casualty, X-ray department.
9.3.
9.4. Challenges Shortage of personnel Accommodation for personnel Limited
budget Equipment Staff recruitment and retention because of the rural ness of
the area Maintenance of facilities Transport Roll out of HIV and AIDS
comprehensive management, care and treatment.
10. Meeting with Northern Regional Manager of Health
10.1. Summary of presentation The General Manager of the
The General Manager stated that all hospitals boards are in place and that all
have business plans and that they are operational. Thirty five (35) out of 37
clinic committees in the region are functional.
With regard to the PFMA, managerial accountants was
appointed, an internal control check list was developed and cost centre
training took place while some hospitals have already implemented cost centres.
With regard to Emergency Medical Services (EMS) the General Manager stated the
following challenges: • EMS is rendered according to a provincial plan
identifying three legs: pre-hospital, interhospital and
planned patient transport
• Provincialisation of EMS from municipalities
without any supporting infrastructure in smaller towns
• An ageing fleet of vehicles that also are being written off by irresponsible
members of EMS
• Vehicle abuse including petrol card fraud.
• Patient transport across the province to receive higher levels of care e.g. a
patient leave Villiers at 3am, arrive in Bloemfontein
by 10am, leave Bloemfontein at 5pm and return home around 10pm.
10.2. Lejweleputswa report in District Plans
The following challenges in the District was highlighted by the District
Manager:
• Recruitment and retention of personnel
• Equipment and facilities maintenance and replacement
• Budget – over expenditure
• Dispensing licenses for nurses
• Finalize process of devolution
• Vehicles for service provision
• Provision of doctors at PHC level – session doctors not meeting needs of
communities
10.3. Bongani – Boitumelo
Complex Challenges:
• Maintaining standards that was set with accreditation
• Implementation of family health to address the level of burden of diseases.
• Implementation of the new Mental health Act to assure a comprehensive
approach
• To reach Employment Equity targets by 2006
• Retention strategy for health professionals.
• To stay within allocated budget
• The replacement and purchasing of equipment.
10.4. Tour of
10.4.1. Emergency Medical Services When the delegation arrived at the
hospital the first thing they wanted to check, was the ambulances and the
equipment in these vehicles. The ambulance, which was parked outside the
hospital, had no drip, but there was oxygen and the ambulance driver informed
the delegation that it is working. The ambulance had a low kilometer reading on
the odometer. The General Manager stated that the hospital has 26 ambulances.
10.4.2. X- ray department • The X-ray department is going to be
revitalized, where the current room is being extended
• They are in the process in ordering a new special machine, because the one
machine they currently have is more than 10 years old and that it is very
costly to repair.
• The general manager stated that R8m is being ring fenced for equipment.
10.4.3. Revitalization programme • The hospital is in the process to finalize building of a
brand new store • A completely new out patients department and ARV site is also
underway and they are envisaging finishing at the end of November 2005 and it
will open in mid November 2005.
• Paving have been laid at the parking • Doctors quarters are being build,
which includes 22 flats (6 double rooms and 16 single rooms), also included are
the parking bays at these flats.
• The theaters are being renovated (all 4), but 2 currently.
• A training college will also be built
• Accommodation for nurses is being built, which will include a TV, stove etc.
in the flat. The Committee Secretary went to the flats and he informed the
delegation that the accommodation that are being built for these nurses and
doctors looks beautiful and it is spacious and comfortable (only about 100
meters away from the hospital).
• A training college will also be built, and the Nursing Manager informed the
delegation that this will be very advantageous to the hospital, as nurses will
be trained there and the hospital will show them the culture of the hospital,
and at the end of their studies that they would not want to “leave” the
hospital.
11. WAY FORWARD • The Committee will undertake follow-up visits to the
province, in order to provide oversight and monitor progress made with regard
to some of the challenges raised by stakeholders during the oversight visit.
• The Committee will take up some of the issues raised with the relevant
Departments, and will continue provide oversight on departmental strategic
plans to ensure that the relevant issues are taken up in strategic and
operational plans.