Reply:

(1) Urgent measures

a) Despite the known challenges of a strained fiscus associated with austerity measures in place to curb public spending; the Limpopo Department of Health has continued to prioritize appointment of,

(i)  Nurses especially midwives in high-risk areas such as maternity wards.

(ii) The Department has further attracted and appointed various Medical Specialists including paediatricians and paediatric surgeons to the Tertiary Hospital Complex.

b) Each facility in the province has adequate Oxygen supply which is routinely monitored and refilled. There were some Oxygen challenges during the peak of COVID-19 second wave however same was swiftly attended to and resolved.

c) The number of theatres currently available throughout the province remains a challenge and measures have been put in place to increase capacity which include a new Central Hospital which is in the pipeline.

d) The delivery rooms require appropriately trained staff to operate optimally. The Department is addressing this by prioritizing appointment of Midwives and appropriately qualified professional nurses in various institutions across the Province.

(e)-(f) Every child in the Province has a right to access to health care, the province however prioritizes all disabled children whether as a result of fault on the part of the Department of not. Furthermore, cases of proven malpractice by the Department results in such children receiving compensation to assist such children with further care including modification of family housing to accommodate a child with a disability.

(2) Intervention

Medical Malpractice claims have become a National crisis. A multipronged approach is required to adequately deal with this problem. It necessarily involves improving the quality of care throughout the country by having proper healthcare infrastructure supported by adequately trained healthcare professionals and a functional healthcare system. Limpopo Department of Health envisage the NHI to be a step in the right direction to address some of these challenges.

The Department has also called for an investigation into the rise of medical negligence cases through the South African Law Reform Commission with a view to introduce legislation that will prevent the collapse of the Health Care System because of uncontrollable litigations against the state.

 

The recently established intergovernmental national litigation forum is also envisaged to assist the Department in dealing with these cases appropriately.

END.

Reply:

a) The SA Health Products Regulatory Authority standard operating procedures and/or measures in place to strengthen controls relating to the preparation and review of financial and performance reports are as follows:

• Finance reporting standard operating procedure has been developed and implemented with standard excel templates to facilitate ease of capture and recording of information
• Business units are required to report on financial and performance management information on a monthly basis by the 7th of each month including upload of supporting evidence
• Supporting evidence is uploaded on an online share drive to prevent loss of information
• Consequence management has been implemented against officials not submitting within specified timeframes
• Internal audit performs quarterly audits on performance information for accuracy and completeness
• A project has been initiated to develop supporting records for audit purpose relating to unavailability of historical records. Listings are created from the bank statements for the 2018/19 and 2019/20 financial years to support the financial statement figures previously reported on. Application numbers are to be listed against the listings derived from the bank statement which will be linked to supporting evidence. The project is planned for completion before submission of the financial statements for audit purposes. Internal audit has been tasked to track progress made against the clearing of the remaining qualification.

b) Internal controls in place to review and/or monitor compliance with legislation relating to:

(i) Supply Chain Management (SCM) include the following:

• Review of SCM policies and alignment to applicable legislation
• Review of the delegation of authority specifically relating to procurement thresholds
• Development of a SCM standard operating procedure detailing step by step actions that must be performed during the procurement process accompanied by various standardized evaluation and compliance templates
• Development of an irregular, fruitless and wasteful operating procedure detailing step by step actions that must be performed to detect, report and corrective actions to be taken
• Filling of SCM vacancies
• Establishment of a panel of experts
• Internal workshopping of SCM process and SCM training provided to key role players
• Establishment of a loss control function and implementation of consequence management

(ii) Regulations regarding contract management include the following:

• Development of a contract management standard operating procedure detailing step by step actions that must be performed during the procurement process accompanied by various standardized evaluation and compliance templates
• Implementation of a contract register and checklist
• Review of the delegation of authority specifically relating to contract approvals and variations
• Weekly contract expenditure management implemented to update contract managers in advance of total spent
• Establishment of a panel of experts

END.

Reply:

The Honourable Member is advised that as this information is not readily available at the National Department of Health (NDOH), the Department is still working with the provinces to source this information. The full response will be furnished to Parliament as soon as we have obtained such from the provinces.

END.

Reply:

The Honourable Member is advised that as this information is not readily available at the National Department of Health (NDOH), the Department is still awaiting specific details from the North West Provincial Department of Health to enable me to respond to the question. The full response will be furnished to Parliament as soon as we have obtained such from the Province.

END.

Reply:

(i) No vehicles were purchased for the Minister since 29 May 2019.

(ii) The following vehicle was procured for the then Deputy Minister:

(a) Audi

(b) Q5

(c) 2020

(d) R756,489.83

(e) 30 September 2020

END.

Reply:

a) This is a requirement stipulated in the current National State of Disaster Regulations. The global community is still grappling with the COVID-19 pandemic and its categorisation as a pandemic by the World Health Organisation COVID-19 calls for countries to decrease the disease incidence through early detection and response. Requiring tourists to produce a polymerase chain reaction (PCR) test is classified as part of the early detection measures South Africa has introduced to reduce transmission of COVID-19. This requirement assists in deterring travellers who are symptomatic from travelling and from potentially infecting others during travel and South Africans on entry into the country.

b) An increase in immunity levels against the virus by the general population and vaccination uptake will allow the country to revise some of these entry requirements as more and more citizens become less susceptible to severe disease caused by COVID infections.

c) Considerations are underway to allow fully vaccinated tourists to enter the country and allow for the use of other less expensive means of tests such as antigen testing in the future also in consideration of the epidemiological circumstances. There are also joint initiatives between accounting officers of Health, Tourism and Home Affairs to work on the electronic screening process of travellers.

END.

Reply:

a) Surgeries are conducted at facility level and the information is also collected here. The current national backlog information can therefore not be provided as there is still outstanding information.

Table below provides information by province who have reported for (b)(i)(ii).

Province	b(i) non-essential surgeries	b(ii) cancer treatment,
Free State	3076	Not specified
Kwa-Zulu Natal	16295	311
Limpopo	5398	120
Mpumalanga	2687	No backlog for cancer treatment
Northern Cape	2542	Not specified
Western Cape	Western Cape Department of Health use operations > 30 mins as a proxy marker for this: 2019 the Department performed 105 882 operations > 30 mins This dropped by 19 % during 2020 Dropped even further to 22 % by 2021	The services have begun re-escalating cervical cancer screening activities again.
Province	c(i)Number of delayed surgeries	c)(ii)Type of surgery
Free State	411	Orthopaedics
	59	Obstetrics and Gynaecology
	350	General Surgery
	722	Ophthalmology
	88	Urology
	98	Maxillo- Facial

(d) (i) The waiting time in Free State facilities for non-essential surgery is as follows:

• Orthopaedics surgery ranges between four (4) weeks for femur fracture to five (5 years) for arthroplasty.
• Obstetrics and Gynaecology between from two (2) weeks to two (2) years.
• General Surgery ranges between two (2) weeks to two (2) years.
• Urology ranges between one (1) month to one (1) year.
• Ophthalmology there is none for Retina surgery from one hospital.

(ii) However for cataract surgery it ranges from one (1) year to three (3) years.

Province	c(i)Number of delayed surgeries	c)(ii)Type of surgery
Kwa- Zulu Natal	2147	Orthopaedics
	721	Obstetrics and Gynaecology
	1653	General Surgery
	6857	Ophthalmology
	2287	Urology
	740	Maxillo- Facial
	650	ENT
	246	Plastic Surgery
	107	Neurosurgery
	887	Paediatric Surgery

(i) The waiting time in Kwa Zulu-Natal facilities for non-essential surgery is as follows:

• Orthopaedics surgery ranges between six (6) months to two (2) years.
• Obstetrics and Gynaecology ranges between three (3) months six (6) months.
• General Surgery ranges between six (6) months to one (1) year.
• Urology ranges between twelve (12) months to three (3) years.
• ENT ranges between six (6) months to one (1) year.
• Plastic Surgery not provided
• Neurosurgery not provided
• Paediatric Surgery not provided

(ii) Ophthalmology which includes cataract surgery ranges between six (6) months to one (1) year.

Province	c(i)Number of delayed surgeries	c)(ii)Type of surgery
Limpopo	141	Orthopaedics
	74	Obstetrics and Gynaecology
	5000	Ophthalmology
	97	Urology

(i) The waiting time in Limpopo facilities for non-essential surgery is as follows:

• Orthopaedics surgery ranges between six (6) months to two (2) years.
• Obstetrics and Gynaecology ranges between six (6) months to one (1) year.
• Urology ranges between six (6) months to one (1) year.

(ii) Ophthalmology which includes cataract surgery ranges between one (1) year to four(years)

Province	c(i)Number of delayed surgeries	c)(ii)Type of surgery
Mpumalanga	325	Orthopaedics
	369	Obstetrics and Gynaecology
	80	General Surgery
	1913	Ophthalmology

(i) The waiting time in Mpumalanga facilities for non-essential surgery is as follows:

• Orthopaedics surgery ranges between seven (7) days to one (1) year.
• Obstetrics and Gynaecology ranges between four (4) weeks to six (6) months.
• General Surgery is one (1) year.
• Urology ranges between six (6) months to one (1) year.

(ii) Ophthalmology which includes cataract surgery ranges between four (4) weeks to one (1) year.

Province	c(i)Number of delayed surgeries	c)(ii)Type of surgery
Northern Cape	425	Orthopaedics
	190	Obstetrics and Gynaecology
	492	General Surgery
	1440	Ophthalmology
	471	Urology
	750	ENT
	100	Plastic Surgery
	62	Maxillo Facial

(i) The waiting time in Northern Cape facilities for non-essential surgery is as follows:

• Orthopaedics surgery ranges between two (2) days to three (3) months
• Obstetrics and Gynaecology not specified.
• General Surgery not specified
• Urology ranges one (1) year eight (8) months
• ENT not specified
• Plastic Surgery not specified

(ii) Ophthalmology which includes cataract surgery ranges between two (2) to three (3) years.

We still await information from the Eastern Cape, Gauteng, Northwest, and Western Cape Provinces. This will be furnished to Parliament as soon as it is received.

Reply:

The following table provides the response in this regard.

Provinces	Number of babies stolen
	2019		2020		2021
	Public hospitals	Private hospitals	Public hospitals	Private hospitals	Public hospitals	Private hospitals
Eastern Cape	Outstanding	Outstanding	Outstanding	Outstanding	Outstanding	Outstanding
Free State	0	Not reported	0	Not reported	0	Not reported
Gauteng	Outstanding	Outstanding	Outstanding	Outstanding	Outstanding	Outstanding
Kwa-Zulu Natal	0	Not reported	0		0	Not reported
Limpopo	0	Not reported	0	Not reported	0	Not reported
Mpumalanga	0	Not reported	0	Not reported	0	Not provided
North West	0	Not reported	0	Not reported	0	Not reported
Northern Cape	0	Not reported	0	Not reported	0	Not reported
Western Cape	0	Not reported	0	Not reported	1	Not reported

 

We still await information from the Eastern Cape and Gauteng Provinces. This will be furnished to Parliament as soon as it is received.

 

END

Reply:

The National Department of Health is indeed the custodian of Health Services in the country, the Constitution has, in Schedule 4B, assigned some of the Health Services to Municipality later defined in section 1 of the National Health Act, 2003 (Act No 61 of 2003) as Municipal Health Services. The District Municipality is therefore responsible for the services but monitored and supported by both the Provincial and National Departments of Health.

The matter was investigated through the King Cetshawayo District Municipality lead by the Air Quality Management Unit in collaboration with the Environmental Health Unit (Municipal Health Services) thereof.

(a) The results of the investigations are as follows: There was no substantive or adequate information provided on the type of gas that was inhaled by the pupils during the interviews with the affected school (Richards Bay High School) and their neighbouring schools. The authorities could not access the main complainants through the Richards Bay Clean Air Association (RBCAA) Arboretum Station that would have provided adequate information on the type of fumes/smell experienced, times, duration and the areas (location). In addition, the available ambient monitoring data and emission data does not provide a conclusive source of emissions due to the reported symptoms not related to the monitored sulphur dioxide.

(b) The authorities to conduct a further investigation until the root cause is identified; availability of public awareness posters on how to log air quality complaints; conduct awareness in local schools on air quality. Fire, rescue and disaster management as well as the community are urged to log complaints through the authorities’ (City of uMhlathuze and King Cetshwayo District Municipality). The available complaints systems telephone numbers are 035 907 5000 and 080 011 1258 respectively).

END.

Reply:

a) Breakdown of R49 million unauthorised expenditure

Programme 4: Primary Health Care: (R37,886 million)

Per economic classification	Amount in R’000
Compensation of Employees	(43 763)
Goods and Services	4 936
Transfers and Subsidies	-
Capital Assets	941
Net Results	(37 886)

Programme 6: Health Systems Governance: (R11,841 million)

Per economic classification	Amount in R’000
Compensation of Employees	151
Goods and Services	13 708
Transfers and Subsidies	(30 568)
Capital Assets	4 868
Net Results	(11 841)

Grand total: R49,727 million

b) The National Department of Health did not incur irregular expenditure to the value of R922 million for the 2020/21 financial year. The irregular expenditure disclosed in the Annual Financial Statements for the 2020/21 financial year amounts to R297,888 million and is composed as follows:

Actual Irregular expenditure incurred in 2020/21 R131,752 million

Irregular expenditure incurred in previous financial years R166,136 million

Accumulative amount as at 31 March 2020/21 R297,888 million

c) The National Department of Health did not incur R849 million for the 2019/20 financial year. The irregular expenditure disclosed in the Annual Financial Statements for the 2019/20 financial year amounts to R166,136 million and is composed as follows:

Actual Irregular expenditure incurred in 2019/20 R 58,784 million

Irregular expenditure incurred in previous financial years R107,352 million

Accumulative amount as at 31 March 2019/20 R166,136 million

With regards to disciplinary procedures, cases have been sent for assessment in terms of the Irregular Expenditure Framework as published by National Treasury, dated 16 May 2019 to determine whether the transactions are indeed irregular or not. Some of these transactions have been sent to the Office of the Accountant-General to determine if indeed the findings of AGSA are valid or not in terms of the Mechanism for Resolving Disagreement Between the Auditor (AGSA) and Auditee dated 01 June 2021, the auditee in this cases is (NDOH). Some of the officials implicated in the cases mentioned had been suspended and disciplinary hearings are underway/ in progress.

END.

Reply:

1. (a)(i)(aa) The total number of doctors who were confirmed as having met the requirements of completing their degrees in December 2021 that made them eligible for medical internship for January 2022 are 2 419;

(a)(ii)(aa) The total number of Nurses who were confirmed as having met the requirements of completing their degrees in December 2021 that made them eligible for community service for January 2022 are 3 196;

(a)(bb) The total number of Interns who have completed their medical degrees and were eligible to be placed for medical internship in the Annual 2022 cycle are 2 419;

(a)(cc) The total number of community service doctors who have completed their medical internship and were eligible to be placed for community service doctors in the Annual 2022 cycle are 2 155.

(b) A total of 43 Medical Community Service doctors, 10 Medical Interns and 12 Community Services Nurses were placed, respectively into positions. However, they have since rejected their placements due to various reasons and therefore remain unemployed.

(b)(i)(ii)The budget for placing Interns and Community service Doctors and Nurses in the healthcare system have since increased from the year 2016 baseline with 75%, making the budget demand to be R 4 898 440 063.00 p/a. The increased numbers demanding additional positions for placements, are due to returning medical students who studied in Cuba through the Nelson Mandela Fidel Castro (NMFC) Programme and additional intakes by local Universities, (b) the National Department of Health, had to approach National Treasury to introduce new funding as Human Resources Training Grant (HRTG) to cover the shortfalls as Provincial Departments of Health were unable to the shortfalls demands within their equitable share budgets.

END.

Reply:

The scientific evidence is that where people must unavoidably congregate every protective measure should be taken including masking, ventilation, social distance from one another where possible, physical barriers such as screens, and increasing individual immunity through vaccination. The approach taken by institutions of higher learning is in line with this evidence and is therefore supported.

END.

Reply:

The Department of Health has Outbreak Response Teams at National, Provincial, District and facility level. These teams are activated on notification of an outbreak of any communicable disease in the province and in the country, typhoid fever inclusive. The teams meet regularly to discuss and monitor the trajectory of all prevalent notifiable medical conditions, one of which is the Typhoid disease.

Typhoid (Salmonella Typhi) is a Notifiable Medical Condition, meaning that all confirmed cases must be officially reported to the Department of Health through the Notifiable Medical Conditions Surveillance System (NMCSS). The NICD Notifiable Medical Condition (NMC) system helps to notify cases of Typhoid and other communicable diseases in real-time. These timely notifications assist members of the Outbreak response teams to respond urgently to any Typhoid case and any communicable disease outbreak at all levels of service delivery. In addition, the district team downloads cases daily on the NMC system if any have been reported and liaise with the IPC nurses to get the demographics of the cases so that the clusters can be correctly identified, and contact tracing can commence.

Environmental Health Practitioners regularly go inside communities where there are possibilities of community members drinking from streams, dams, rivers, and lakes. They collect samples of water from these water entities and measure levels and concentration of E. coli in these waters. These levels are proxy indicators of the levels of the Typhoid fever pathogens.

They also use the opportunity to educate community members about the Typhoid disease and how to prevent this disease. Social mobilization and Risk Communications are ongoing in the communities towards the prevention and control of Typhoid disease. The provinces make use of community radio stations and secure slots where communities are educated about typhoid.

END.

Reply:

The KwaZulu-Natal Provincial Department of Health informed that-

a|) The Circular was issued by the Department as a cost containment plan for the management of budget allocated. The primary aim is to ensure that there is no over expenditure on COE amongst other things as a turnaround strategy to reduce the over expenditure in the budget allocated.

b) The Department will closely monitor the spending of budget in which it will allow the filling of critical posts whilst the moratorium is in place as a cost containment plan.

c) The resolution by the Provincial Executive Council, Provincial Treasury and relevant Portfolio Committees is that the accounting officer submits and implements a turnaround plan that will ensure the Department does not over-spend its budget allocation as envisaged in section 39(2)(a) of the Public Finance Management Act of 1999, as amended.

END.

Reply:

No, I was not informed about the matter.

However, on enquiry Northern Cape Department of Health (NCDOH) indicated that petrol cards were placed on hold by the service provider due to nonpayment and during this period ambulances did not stop operating as there was an arrangement made with the service providers.

The NCDOH has engaged with the service provider and has come to an arrangement for payment of outstanding accounts. The agreement included partial payment on a scheduled basis towards the accumulated outstanding balances from November 2021 and that essential vehicles fuel cards would not be placed on hold.

There is also an additional contingency plan in place of using alternative service providers as a last resort to ensure that there is no disruption of ambulance services in the province.

END.

Reply:

The following table reflects the details in this regard, as received from the provinces:

PROVINCE	(a) Legal fees (cost)	(b) Disciplinary procedures
Eastern Cape		Legal practitioners and employees with competencies to handle cases.
Free state	R 2 790 446.55	Legal practitioners and employees with competencies to handle cases.
Gauteng	R 130 346 197,23	Outstanding
Kwazulu Natal		Outstanding
Limpopo		Legal practitioners and employees with competencies to handle cases.
Mpumalanga	R 35 798 383.52	Legal practitioners and employees with competencies to handle cases.
North West	R 3 748 814.05	Lawyer, consultants and employees
Northern Cape	R 2 854 890.69	Lawyers and employees
Western Cape	R 8 526 308.99	No lawyers are used in the province for disciplinary hearing
National department of Health	R 6,092,749.98	Employees with competencies to handle cases hearing

END.

Reply:

The cumulative figures for the 2020-21 financial year in terms of irregular expenditure as stated in the Annual Reports are as follows:

a) The Department: R297 888.00.

b) The SA Health Products Regulatory Authority: R10 369 880

END.

Reply:

1. (a) Findings raised related to prior year material misstatements not corrected.

(b) SAHPRA has established a Loss Control Function which reviews determination reports and recommends appropriate consequence management.

2. Timelines are factored into the audit action plan for overall improvement requirements in the SAHPRA control environment. The Finance Unit embarked on a project to correct prior year material misstatements. The Project Plan was executed for the period September 2021 and January 2022. The successful implementation of the Project Plan, envisages the following outcomes:

• Reconstructed 2018/2019 & 2019/2020 Financial Years
• Deferred Income listing for 2019/2020 (By implication, this will also result in a listing of the Deferred Income balance for 2018/2019)
• Adjustments Schedule

For irregular expenditure transgressions, a detailed Standard Operating Procedure has been developed together with the establishment of a Loss Control Function which reviews determination reports and recommends appropriate consequence management in line with our internal disciplinary policy and labour relation directives

Financial reporting/record keeping – business units are required to report on financial and performance management information on a monthly basis by the 7th of each month. Consequence management has been implemented against officials not submitting within specified timeframes

Irregular expenditure – Determinations are initiated once transgressions have been confirmed either through the SAHPRA internal control system or through internal or external audits. All transgressions confirmed have been condoned by the National Treasury with the exception of one which is still under consideration by National Treasury.

3. (a) None, no change in overall audit opinion and reduction of one qualification.

(b) Three officials from the Supply Chain Management, Office of the Board Secretary and Inspectorate departments.

(c) To date, disciplinary action has been taken against three officials relating to irregular expenditure as follows:

• Official 1 – R1 920 309
• Official 2 – R5 672
• Official 3 – R97 750

The remainder of the condonation approved by NT related to employees who have subsequently left the organisation. Disciplinary action has also been taken against three officials relating to internal process and procedures for financial reporting and record keeping.

4. Financial reporting/record keeping: business units are required to report on financial and performance management information on a monthly basis by the 7th of each month.

Historical information (remaining qualification) is a challenge. A project has been initiated to develop supporting records for audit purposes. Listings are created from the bank statements for the 2018/19 and 2019/20 financial years to support the financial statement figures previously reported on. Application numbers are to be listed against the listings derived from the bank statement which will be linked to supporting evidence. The project is planned for completion before submission of the financial statements for audit purposes. Internal audit has been tasked to track progress made against the clearing of the remaining qualification.

Performance reporting: management is required to upload their portfolio of evidence to support the reported performance on the Performance Information SharePoint Group. Furthermore, management is required to sign the official sign-off page to confirm accuracy of the information reported and that the relevant evidence has been loaded. Furthermore, the reported performance is also audited by Internal Audit prior to submission.

END.

Reply:

a) Covid-19 showed that there are challenges within the province that are because of fiscal constraints and the impact of medico-legal litigations which impact quality of care provisioning. This was also because of critical staff shortage because of the fiscal constraints impact. Further exacerbating staff morale. The pull of these already tight resources to mitigate Covid-19 resulted in service backlogs in other priority programmes such as HIV and Aids, TB, and Immunisation.

b) The department has developed a five-pillar strategic approach to mitigate and improve the quality of care within the province. These are –

(i) Financial sustainability.

(ii) Medico-legal mitigation strategy

(iii) Service Optimisation.

(iv) Digitalisation and eHealth implementation.

(v) Healthy Communities initiatives with focus on:

• Maternal and child health.
• Communicable and non-communicable diseases.
• Mental health.
• Clinical governance.
• NHI implementation strategies.

On Covid-19 mitigation, the department had an intra-action review sessions in-between the covid-19 waves and shared the lessons were learnt that led to improvement of the response. These included:

(i) Empowering the Community Health Workers to use oxymeters for monitoring home isolated patients and educating communities to seek early intervention and hospital admissions.

(ii) Increased bed capacity to ensure all patients could be accommodated. This was further supported with increased oxygen point availability.

(iii) Improved clinical protocols and monitored management of patient care by clinical managers including ensuring all patients were seen daily including weekends.

END.

Reply:

The No Fault Compensation Scheme is not operational as the regulations and directions are still being finalised.

a) Not applicable.

b) So far there are 33 causally linked adverse events following immunisation with reported injuries.

(i) All 33 will be considered for compensation

(ii) None.

END.

Reply:

(a) The Independent Committee appointed by the Ministry of Health to accelerate the implementation of redress to complainants of forced/coerced sterilization has concluded its work. Unfortunately, the CGE was unable to provide the committee with particulars of the 48 women identified in the report as women who were allegedly coerced into sterilisation due to their HIV status. Instead, names of 106 women were finally submitted to the committee of which only 16 were part of the original list.

After further searching a final list of 24 women’s names were submitted by the CGE (of an original allegation of 48 women) with only 14 accompanied by affidavits. The CGE was also not confident that they had identified the women that they originally believed had made allegations. A further complication was that most cases were many years old (2005 to 2010) so patient records were incomplete or completely missing. The committee did what they could to document the details but could confirm that a tubal ligation had been done in only 4 cases.

Despite best endeavours the detailed clinical histories of the women from the original group of complainants could not be adequately verified. There are no grounds to proceed to compensation at this stage other than continued health care in public health facilities.

Since this matter is of such importance it is imperative that the medico-legal reform process in the department for the health sector is being pursued with vigour to address the plight of the 82 who attended a dialogue although they were not part of those in the CGE report.

Rather than pursue a separate committee consideration is being given to amending the terms of reference of the Ministerial Advisory Committee (MAC) on Maternal Child and Women’s Health to include strengthening of action around sterilisation or women, with specific guidance from:

• South African Maternal, Perinatal and Neonatal Health Policy (23-6-2021)
• Sterilisation Act [No. 44 of 1998]

(b) All the women who reported to have medical problems associated with the sterilization were evaluated at major public hospitals in the country (16 in KwaZulu Natal and 8 in Gauteng) and the report is available.

Psychological services were initiated by the Office of the Premier in KZN for women who attended the dialogue. In addition, HODs in various provinces were asked to ensure that each woman is supported with appropriate clinical and psychological care in the public hospital closest to their place of residence. The responsibility for ongoing clinical and psychological care is part of the clinical services that will be provided in the public health services of the provinces.

To my knowledge there was no commitment from the Department to compensate the alleged victims. There is no mechanism for financial reward for any damages to be determined by the department. The intention of the medico-legal reform process also is not to provide financial compensation but to ensure that the health needs of the patient are assured.

END.

Reply:

Matlapaneng Clinic within the Greater Taung Sub-District operates 24 hour, 7 days a week service and renders the full package of primary health care services. This Clinic refers to Pudimong Community Health Center which is 8 km away. There are two clinics within the neighbouring villages to Matlapaneng, namely Leshobo Clinic and Mokgareng Clinic and both clinics are within 13 km from Matlapaneng Clinic.

Matlapaneng Clinic has 13 professional nurses and 3 Enrolled Nursing Assistants. The Clinic provides services to a population of 3,608 from the Matlapaneng Village, with an average headcount of 1,431 per month.

The province is of the view that there is currently no need to build another clinic within the surrounding villages, because the priority is in other villages where there are no clinics at all.

END.

Reply:

The department acknowledges the magnitude of health care services provided by the health COVID-19 contract workers in assisting with addressing the required daily routine health services to the public, assisting with responses to the fourth wave demands and also the vaccination drive.

However, it is not possible for the department to employ the health COVID-19 contract workers permanently as their services are of a temporary nature (for the Pandemic) and that funding for their positions is through the Covid-19 earmarked funding and the Presidential Stimulus package, which is only for a specific period. Ideally, the Stimulus package was meant to support hospitals in responding to COVID -19 demands by addressing the capacity requirements at the peak of the pandemic.

END.

Reply:

a) The current total number of persons employed as nurses (all categories of nursing) in the Public Health Sector is 149 025.

b) The current retirement age in the Republic of South Africa is 65 years (Public Service Act, 1994, as amended). The total number of nurses that will reach this retirement age in the year 2025 is 1 359 which is 0.9% of the total number nurses employed in the Public Health Sector.

END.

Reply:

No, neither my office nor the Department of Health received any such correspondence.

(a), (b), (c) Not applicable.

END.

Reply:

The following table reflects the details in this regard.

(a)(i) NDOH	a)(i) What number of supplier invoices currently remain unpaid by his department	(aa) 30 days	(bb) 60 days	(cc) 90 days	(dd) 120 days	c) by what date is it envisaged that the outstanding amounts will be settled
National Department of Health	3,513	Nil	Nil	Nil	3,513	Payment dates will depend on the identification of funding to allow settlement of outstanding medico-legal claims received from Provincial Health Departments.
(b) what is the total amount outstanding in each case		Nil	Nil	Nil	R72,080,183.92

(a)(ii) Entities	a) (ii)What number of supplier invoices currently remain unpaid by each entity reporting to him	(aa) 30 days	(bb) 60 days	(cc) 90 days	(dd) 120 days	c) by what date is it envisaged that the outstanding amounts will be settled
Council for Medical Schemes	10	1	1	1	7	The outstanding amounts for 30 days, 60 days and 90 days will be settled In February. However, the outstanding amounts for 120 days will be settled once the queries with the billings and Service Level Agreement are resolved.
(b) what is the total amount outstanding in each case		R2,548.80	R26,580.94	R8,711.63	R2,690,826.82
National Health Laboratory Service	10,043	6	2,247	1,287	5,318	The NHLS aims to pay the total outstanding amount by the 31 March 2022, however, it must be noted that the NHLS total current payables amount stands at an amount of R785 million as at the end of 31 January 2022. Currently the NHLS has paid its suppliers an average of R607 million per month (R6,078m – 1 April 2021 to 31 January 2022). The NHLS’s ability and endeavour to pay its suppliers accurately and timeously is demonstrated by the NHLS’s creditors days being 29.61 days as at the end of January 2022.
(b) what is the total amount outstanding in each case		R5,882,763	R62,445,992	R60,596,022	R200,258,904
South African Health Products Regulatory Authority	5	2	Nil	1	2	Payment will be made by 28 February 2022 or earlier depending on disputes being cleared.
(b) what is the total amount outstanding in each case		R286,259	Nil	R21,866	R18,873,189
South African Medical Research Council	Nil	Nil	Nil	Nil	Nil	N/A
(b) what is the total amount outstanding in each case		N/A	N/A	N/A	N/A
Office of Health Standards Compliance	Nil	Nil	Nil	Nil	Nil	N/A
(b) what is the total amount outstanding		N/A	N/A	N/A	N/A

END.

Reply:

The decision that asymptomatic persons who test positive for COVID-19 infection do not need to isolate was based on advice from the COVID-19 Ministerially Advisory Committee. This is a committee of scientists that have been advising the Minister and the country on Covid-19 throughout the duration of the pandemic. The evidence underlying this decision can be summarised as follows:

From a public health perspective, the utility of isolation is dependent on rapidly identifying individuals with COVID-19. There is good evidence that the rate of case ascertainment in South Africa during the fourth wave (Omicron variant) is low and this due to a number of reasons including:

• There has been a small percentage of cases (perhaps 16%) that are symptomatic.
• Only a limited proportion of symptomatic cases access testing, and even when testing is performed, they come out with false negative results, leading to only a small proportion of positive cases are identified.
• By the time that the cases are correctly identified and timeously isolated, the onward transmission has likely already occurred between the person testing and the release of the results. This is due to SARS-CoV-2’s high transmissibility around the time of symptom onset, including substantial pre-symptomatic transmission.

At the same time, isolation has a substantial economic and social burden in the current climate, including significantly reducing economic and other activities especially amongst health care workers. On an individual level, extended periods of isolation can result in loss of income, loss of employment, and loss of schooling time.

The period of isolation should therefore be seen as a trade-off between its (limited) benefits and its costs, rather than as an effort to reduce the chances of onward transmission to zero for the small proportion of cases that are identified.

Asymptomatic persons are less likely to transmit the virus, and it is difficult to know when the period for which they are infectious starts and ends. As a result, the costs of isolating asymptomatic cases are considered to outweigh the benefits thereof. It should be noted that though people with asymptomatic infection do not have to isolate, such people should be advised to engage in COVID avoidance practises such as observing strict mask wearing, avoiding social gatherings and avoiding socially meeting with others in indoor spaces.

END.

Reply:

The following table reflects the details in this regard, as received from the provinces.

PROVINCE	1. Whether a certain company (name furnished) has all the relevant waste storage licences in each province; if not, what is the position in this regard; if so, will he furnish Ms E R Wilson with copies of the licences	2. where is each medical waste disposal site located that the company uses to dispose waste in each province;	3. where are the furnaces of the company located for the disposal of body parts in each province?
1. Eastern Cape	The Company, Buhle Waste has the relevant storage licences in the Eastern Cape (attached).	The disposal site is Enviro-Serv Waste Management and Landfill site – Holfontein in Springs.	Averda in George – Western Cape Averde in Klerksdorp – North West
2. Free State	Free State Health has currently signed an agreement with Limpopo DoH to participate on contract HEDP 027/18/19 Validity of agreement is from 01/09/2020 - 30/04/2022. Contractor: Buhle Waste (Pty) Ltd (attached).	Buhle Waste Waste (Pty) Ltd uses the following treatment plant for disposal:  Averda (Pty) Ltd located in Gauteng (COVID -19 waste  and anatomical waste). Biomed  (Pty) Ltd located in Gauteng Ekurhuleni ( Infectious waste and sharp waste). Buhle (Pty) Ltd Treatment plant in Polokwane, Limpopo (Infectious and sharps waste) Enviro-Serv (Pty) Ltd  located in Roodepoort, Gauteng ( COVID-19 waste , anatomical waste and pharmaceutical waste).	Buhle Waste Waste (Pty) Ltd uses the following treatment plant for disposal of anatomical waste:   Averda (Pty) Ltd located in Klerksdorp Enviro-Serv (Pty) Ltd  located in Gauteng (Roodepoort).
3. Gauteng	No response received	No response received	No response received
4. Kwa-Zulu Natal	Buhle Waste has a waste storage in Mkhondeni in Umsunduzi Municipality. The license is attached.	The waste is being disposed in Holfontein landfill site in Gauteng	Anatomical waste is being incinerated in Averda, Klerksdorp, North West and Enviro-Serv in Roodepoort, Gauteng.
5. Limpopo	The company (Buhle Waste (Pty) Ltd) has a licenced storage in Limpopo Province license 12/9/11/L/1906103812/5/Rand variation 12/9/11/L/200211114048/5/V (attached).	Enviro-Serv Waste Management in Holfontein: Located in portion 23&24 of the farm Holfontein 71 IR and Portion 8 of the farm Moderfontein, Benoni , Ekurhuleni 236 IR Metropolitan Municipality.	Biomed: Located in 13 Licon Road Dunswart, Benoni, Ekurhuleni, Metropolitan Gauteng Province Averda SA (Pty) Ltd located at Goudweg Street Dawnkinsville Klerksdorp, North West.
6. Mpumalanga	Buhle Waste does not have waste storage facility in the Province,	The service provider uses five (5) treatment plants for disposal. A. Enviro-Serv@Roodeport Pixer Rd, Rand leases Roodepoort 1724 B. Biomed@Benoni 13 Lincoln rd BENONI 1505 C. AVERDA@City Deep, 82 Heidelburg rd Citydeep 2197 D. AVERDA@Klerksdorp Golden Ave, Dawkinsville, Klerksdorp 2571 E. Limpopo WT@buhle Waste 25 Freedom Dr Seshego 0751	Eviro-Serv in Roodepoort, Gauteng Averda in Klerksdorp, North West
7. Northern Cape	Tshenolo Waste does not have waste storage facility in the Province, They transport waste for disposal after collection using cooler trucks (Trucks with freezers).	There is no waste disposal site in the Northern Cape or treatment site.	No treatment site in the Northern Cape.
8. North West	Tshenolo and Putting Waste Services does not have waste storage facilities in the Province.	Tshenolo and Putting Waste Services does not have waste disposal sites in the Province.	Putting Waste Services uses Averda SA (Pty) Ltd City Deep Treatment Facility in Gauteng Province.
9. Western Cape	Both Compass and Averda has Waste Management Licences in place for handling, storage and treatment of HCRW	Averda make use of two (2) HCRW treatment and storage sites; this is Averda, Killarney Gardens in Cape Town, Du Noon area and also Optimum Waste Treatment and storage facility in George, Garden Route District. Compass Medical Waste Services has a treatment and storage facility at Blackheath, Cape Town.	Compass Medical Waste Services make use of BCL Medical Waste Services Delft for disposal and treatment of anatomical waste Averda make use of their Optimum Incinerator for disposal and treatment of anatomical waste.

NB.

1. Information still outstanding from Gauteng Department of Health
2. “Name furnished” refers to Buhle Waste (Pty) Ltd.
3. Five (5) Provinces (Kwa-Zulu Natal, Mpumalanga, Free State, Eastern Cape & Limpopo) has contracted Buhle Waste (Pty) Ltd for Health Care Risk Waste (HCRW) management.

END.

Reply:

The following table reflects the details in this regard, as received from the provinces.

Province , Tender No. & Description	(1) (a) Date of Advertisement	(1) (b) Names of Bidders who Applied as SP	(1) (a) Name(s) a of Successful Bidder	(2) (a) Total Value of Top 5 Bidders	(2) (b) Value of Tender Awarded incl JV Partners	(2) (c ) Total Amount Paid to a Successful Bidder To Date
EASTERN CAPE SCMU3-18/19-0461-HO: Supply of Containers, Safe and Effective Handling of HCRW, Through Appropriate Segregation, Packaging, Carting Storage, Loading, Transportation, Treatment And Safe Disposal Of Health Care Risk Waste/Medical From PHC Facilities, Nursing Colleges, Ems, And Forensic Pathology, Psychiatric Hospitals And Tb Hospitals For A Period Of 36 Months With An Option To Extend For 24 Months.	01 February 2019	1. Phuting Medical Waste 2. Wastegro Project 3. Seane Medical Waste JV Diponto Investment 4. Compass Waste Services JV DOH Enterprise 5. Compass Medicall Waste Services 6. Enerwaste Solution 7. Mampuru Waste Management CC 8. Zikhumbuze Aborist and General Service 9. Ecocycle Waste Solution (Pty) Ltd 10. Power Sprinks JV Vikela Afrika Waste Care CC 11. Tshenolo Waste (Pty) Ltd 12. Buhle Waste (Pty) Ltd 13. Cycle Sol CC	Buhle Waste	Bidder 1 – R214 582 468.81 Bidder 2 – R316 069 497.15 Bidder 3 – R325 535 297.26	R214 582 468.80 (value based on rates and indicative quantities)	FY 20/21 - R44 264 070,38 FY 21/22 - R48 862 888,33 (Based on actual waste collected)
LIMPOPO HEDP027/18/19: Collection, Treatment & Disposal of Health Care Risk Waste	14 December 2018	1. Stericycle Medical Waste Management 2. NTC Group JV Ngwako a Maloa Farming 3. Averda South Africa 4. Q Waste Management Services 5. Enerwaste Solutions 6. Ingwe Waste Management Services 7. Tshenolo Waste 8. Buhle Waste 9. Seane Medical Waste	Buhle Waste	Compass Medical Waste Services Eco-cycle Waste Solutions Limpopo Supllements Traders	Per kg = R28.00 Training cost = R700.00 pp Service & Repair = No charge Chest Freezer outright purchase 130L = R2 279.05 195L = R2 564.00 207L = R2 659.05 210L = R2 659.05 270L = R3 609.05 285L = R3 609.05 320L = R5 129.05 530L = R5 984.05	R160,369,231,55
MPUMALANGA Heal/038/19/MP: Provision of Health Care Waste Management for Mpumalanga Department of Health for a period of three (03) years	Tender Bulletin No. 276 Advertised: 09 April 2019 Closing: 06 May 2019	1. Vumani Waste Solution 2. Erner Waste Solutions Gauteng 3. Ingwe Waste/Hitekani Trading 4. Healthcare Waste Services 5. Compass Medical Waste Service 6. Tshenolo Waste (Pty) Ltd 7. Mampuru Waste Management 8. Averda South Africa (Pty) Ltd 9. Cinding Enterprise 10. Zenzeleni Cleaning and Transport 11. Nyembe Waste Management JV Clinix Medical Waste Management 12. Buhle Waste (Pty) Ltd	Buhle Waste Medical (Pty) Ltd	None of the Service Providers were evaluated in terms of the Preferential Points	Tendered Rates	R 124 824 713,13
Kwazulu Natal Department of Health is currently participating on contract awarded by Mpumalanga Province and approval to participate was obtained. The participation is in line with Treasury Regulation 16A6.6 which states that "The accounting officer or accounting authority may, on behalf of the department, constitutional institution, or public entity, participate in any contract arranged by means of a competitive bidding process by another organ of State, subject to written approval of such organ of State and the relevant contractors."
KWAZULU-NATAL HEAL/038/19/ MP: Appointment of the service provider for the provision of healthcare waste management for Mpumalanga Department of Health for a Period of 3 Years	Date Advertised 9 April 2019 (Bid information and Document available online): Duration 3 year period from 1/12/2019 to 30/11/ 2022	1. Vumani Waste Solution 2. Ener Waste Solutions Gauteng 3. Ingwe Waste/ Hitekani Trading 4. Buhle Waste (Pty) Ltd 5. Healthcare Waste Services 6. Compass Medical Waste Services 7. Tshenolo Waste (Pty) Ltd 8. Mampuru Waste Management 9. Averda South Africa (Pty) Ltd 10. Cinding Enterprise 11. Zenzeleni Cleaning and Transport Nyembe Waste Management	Buhle Waste	Refer to Mpumalanga Department Contract Heal/038/19/MP	Refer to Mpumalanga Department Contract Heal/038/19/MP	Fin Year 2019/2020 R 63 753 398.63 (From 1/12/2019 to 31/03/2020) Fin Year 2020/2021 R 159 409 734.90 Fin Year 2021/2022 R 130 685 862.96 (1 April 2021 to 31st December 2021) Grand Total R354,004,326.73
Northern Cape did not award to Buhle Waste
NORTHERN CAPE NCDOH/ENV/001/2018: Removal of medical waste	10 March 2017	1. Tshenolo Waste 2. Buhle Waste 3. Eco Cycle 4. Compass Waste 5. Averda 6. Thari Waste	Tshenolo Waste (Pty) Ltd		R 154 008 00.00	R 214 799 626,89
North West did not award to Buhle Waste
NORTH WEST NWDOH 270/2019: Supply Of Containers, Collection, Removal, Transportation And Treatment Of Health Care Risk Waste (Hcrw) And Final Disposal Of Residues From Public Health Care Facilities Of The North West Department Of Health For A Period Of Four (04) Years	20 February 2019	1. Reagetswe Trading and Waste Management services 2. Dodi Medical waste Enterprise 3. Enerwaste Solutions 4. Averda South Africa 5. Phuting Medical Waste 6. Buhle Waste 7. Seane Medical Waste. 8. Ingwe Waste Man 9. Anele Masego Project JV Vikela Waste Management 10. Mohaumolotsi Civils Works 11. Nyembe Waste Management 12. Tshenolo Waste Management 13. T & T Group & Projects 14. Black Stone Enviro Solutions 15. HealthCare Waste Services 16. Compass Medical Services 17. Mampuru Waste Management CC 18. Golden Skips PTY LTD	Phuting Medical Waste Tshenolo Waste Management	Value not applicable as it is as in when required	N/A	1.R 49,008,676.60 2.R 37,449,215.37
WESTERN CAPE	Indicated that they do not have a contract with Buhle Waste

We still await information from Gauteng and Free State Provinces. This will be submitted to Parliament as soon as it is received.

END.

Reply:

Noting the growing concerns by various stakeholders on lack of progress in repairing the damages done to Charlotte Maxeke Johannesburg Academic Hospital, following the devastating fires more than nine months ago and the hospital allegedly running only at 40% capacity. A joint intervention between NDOH and the province was initiated. Its objective was to identify the following:

i) The latest progress of the remedial work; and

ii) The best approach that can be applied in order:

1. To speed up the execution of remedial work.
2. To ensure compliance with the COJ (City of Johannesburg) Occupational Health Safety requirements.
3. To ensure that the hospital is fully functionally and operationally.

1. The latest progress reports on the repair work at the hospital

It covers the following areas:

i) The assessment and Identification of the gaps that are related to the infrastructure requirements of health care facilities, particularly areas in Charlotte Maxeke that are required to be recommissioned for occupancy after the fire incident dated the 16-17th of April 2021.

ii) Outlining the Health and Safety Requirements and approach that will be used during the refurbishment and maintenance of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) Hospital and to ensure that the remedial works programme and compliance monitoring are aligned with the requirements of the Occupational Health and Safety Act 85 of 1993, National Building Regulations 103 of 1977 and National Health Act 61 of 2003 and its latest regulations.

i) Advising the hospital management on standard to comply with on the Occupational Health and Safety Act 85 of 1993, City of Johannesburg By-Laws and other related Health and Safety Legislation for the proposed functional and support services such as the Mortuary, Kitchen, Laundry and Waste Management Areas.

ii) Providing specific recommendations in addressing gaps and over and above that, ensuring that the priority concern areas are addressed to comply as a matter of urgency.

iii) Proposing mitigation measures to improve the overall condition, efficiency and functionality of the Hospital to prevent Health and Safety Incidents.

iv) Ensuring that the monitoring, evaluation, reporting and review methods for this OHS inspection report are implementable and appropriate measuring tools to ensure effectiveness are put in place.

v) Listing the outcomes to be expected through the implementation of this Site Assessment Report recommendations and monitor its effectiveness.

vi) Providing guidance and assistance in the development of the Health, Safety and Environmental Systems during Construction and Operation that will include Risk Assessment, Risk Management, Methodologies, Documentation Control, communication, Training, Management Approach and reviews. This will ensure continual improvement of the hospital management.

2. Status provided by the appointed service providers

The has been some progress through the Solidarity Funding. They have covered some of the remedial work related to electrical, mechanical, fire safety, structural and architectural works for the following Blocks:

# Block 1 – 17% complete

# Block 2 – 18% complete

# Block 3 – 20% complete

# Block 4 – 22% complete

# Block 5 – 29% complete

3. The timeframe for the remedial work

The project plan has been submitted to the National Department of Health (NDOH) covering all the milestones including the timelines of the indicators. The duration of the project is estimated as being 22 months long. Over this period the hospital remedial works will be completed to achieve compliance with the applicable COJ requirements.

Additionally, the project is intending to cover the remedial work for the following Blocks as indicated in Table 2 below:

REMEDIAL WORK FOR THE BLOCKS	EXPECTED DATE OF COMPLETION
Emergency Unit	March 2022
Block 1	March 2023
Block 2	July 2023
Block 3	October 2023
Block 4	November 2023
Block 5	November 2023

Table 2 – High Level Plan for the Blocks

END.

Reply:

1) State hospitals have employee wellness programmes which are aimed at supporting the staff that have any workplace-related health problems including those who have mental health problems. These programmes are staffed by professionals who are trained in Employee wellness, including mental health support. Whenever there are staff members who are faced with a case that is beyond their level of expertise, they refer such cases to the relevant professionals for further management.

2) Health care workers who are suffering from Covid-19 burnout are managed on the case-by-case basis, as the situation differs from person to person. Whenever cases are reported in the health establishments, these are referred to the Employee Wellness programme manager, who makes a determination on the recommendation for leave of absence. Some of these health care workers make use of family doctors and such cases have been accepted by health establishments as genuine cases deserving leave.

(3) (a) The department has no record of any hospital management that has marginalised staff who admit to needing mental health leave as a result of the extreme pressures they have been subjected to as a result of COVID-19, and loss of life they have seen in the past 20 months. To the contrary, the department has been very appreciative of all health care workers including hospital managers who have equally been affected by the Covid-19 pandemic.

(b) The department is also not aware that there have been people that were stigmatised as a result of being in need of mental medical leave. The department is working on the sector wide productivity management and wellness services as part of post Covid-19, management for psycho-social support and reintegration.

END.

Reply:

(1) (a) Material misstatements of receivables, payables, immovable tangible assets, and commitments identified by the auditors in the submitted financial statement were corrected. Effective and appropriate steps were not taken to prevent irregular expenditure, as required by section 38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1. The majority of the irregular expenditure disclosed in the financial statements was caused by contravention of procurement processes. Some of the contracts were awarded to suppliers whose tax matters had not been declared by the South African Revenue Service to be in order, as required by treasury regulation 16A9.1(d). Some of the contracts were awarded to bidders who did not submit a declaration on whether they are employed by the state or connected to any person employed by the state. Some of the goods and services of a transaction value above R500 000 were procured without inviting competitive bids, or deviations were approved by the accounting officer, but it was practical to invite competitive bids.

(b) The Department has a Loss Control Committee which will investigate and determine if there are any officials accountable. Subsequently, appropriate measures in line with the labour relations prescripts will be applied.

(2) The labour relations directives and prescripts have prescribed timelines on dealing with consequence management once accountability issues have been dealt with and determined.

(3) (a) Non-compliance with the prescripts such as Public Financial Management Act no.1 of 1999, National Treasury Instruction note 3 of 2016/2017, Departmental Policy and SARS requirements;

(b) Departments that were guilty are as follows:

a) Nature of Transgression	b) Guilty Department
AGSA had indicated that the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to render emergency support services to Project Management Office (PMO) during Covid-19.	Supply Chain Management
AGSA had indicated that the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to investigate an urgent transaction on expenditure that was deemed irregular.	Supply Chain Management
AGSA had indicated that the transaction was Non-compliant with Local production and content for designated sector and noncompliance with tax requirements on foreign procurement. The services were for emergency procurement of vaccines for the country.	Affordable Medicines
AGSA had indicated that the services were rendered outside the approved period without sourcing the necessary approval from the accounting officer / delegated official / approving authority such as National Treasury.	Workforce Management
The service was for rendering of strategic communication services for NHI and emergency communication for Covid-19: Non adherence with SCM processes and National Treasury prescripts on emergency procurement.	NHI and Communication

4. (a) Other cases have been sent for assessment in terms of the Irregular Expenditure Framework as published by National Treasury, dated 16 May 2019 to determine whether the transactions are indeed irregular or not. Some of these transactions have been sent to the Office of the Accountant-General to determine if indeed the findings of AGSA are valid or not in terms of the Mechanism for Resolving Disagreement Between the Auditor (AGSA) and Auditee dated 01 June 2021, the auditee in this cases is (NDOH). Some of the officials implicated in the cases mentioned had been suspended and disciplinary hearings are underway/ in progress.

Below is the table indicating all transactions declared irregular by AGSA in terms of NDOH Final Management Letter. The table below provide details in so far as question 4(a) is concerned on the nature, the amount and the status.

Nature of the services	Amount	Status on Disciplinary Action	Non-compliance with the law, regulations and documents, internal policies and procedures
According to AGSA, the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to render emergency support services to PMO during Covid-19.	R14 671 755	Referred to NT to mediate between AGSA and NDOH to determine if transaction are irregular.	Non-compliance with NT instruction note.
According to AGSA, the transaction did not meet the definition of emergency procurement in terms of National Treasury prescripts. Management should have requested pre-approval from National Treasury. The service was to investigate an urgent transaction on expenditure that was deemed irregular.	R592 250	Referred to NT to mediate between AGSA and NDOH to determine if transactions are irregular.	Non-compliance with NT instruction note.
Non-compliance with Local production and content for designated sector and non-compliance with tax requirements on foreign procurement. The service was for emergency procurement of vaccines for the country.	R4 350 502	Referred for assessments to determine if the transgression is non-compliance or irregular.	Non-compliance with SARS requirements
Services were rendered outside the approved period without sourcing the necessary approval from the accounting officer / delegated official /approving authority such as National Treasury.	R14 984 000	Referred for assessments to determine if the transgression is non-compliance or irregular.	Non-compliance with NT instruction note.
The service was for rendering of strategic communication services for NHI and emergency communication for Covid-19: Non adherence with SCM processed and National Treasury prescripts on emergency procurement.	R150 000 000	Disciplinary hearings are currently in emotion.	Non-compliance with NT Instruction.

(b) The status above encompasses both non-compliance and irregular expenditure.

(5) The National Department of Health developed and implemented the online National Quarterly Reporting System (NQRS) in 2017 to ensure quarterly progress on the Annual Performance Plan (APP) is tracked and on-line evidence storage. The system tracks progress towards attaining the objectives and targets set in the APP, highlighting achievements, deviations, factors enhancing or inhibiting progress, as well as corrective action when targets are not achieved. The Portfolio of Evidence for reported performance is uploaded on the online NQRS to support indicator performance reports. By Day 6 of the reporting month, the Quarterly Performance Information is captured and signed-off by Directors/Cluster Managers together with the Portfolio of Evidence which is uploaded on the online NQRS. The Quarterly Performance on APP targets is reviewed and signed off by Branch Managers. The Internal Audit Unit of the National Department of Health reviews the Performance Information and supporting evidence every quarter and reports to the Audit and Risk Committee. The primary objective is to review reported Performance Information against the Portfolio of Evidence and provide feedback to the Department to address any shortcomings identified. The NQRS system provides a single online storage for all Performance Information updated during quarterly reporting which is also used by Auditor General for auditing purposes

END.

Reply:

According to the Eastern Department of Health -

(1) An inspection was carried out by the Environmental Health Practitioners (EHPs) from Buffalo City Metropolitan Municipality and a report was written with full recommendations to the company. It was established that the company was operating legally and at the site that is suitable for storage of medical waste as per the investigation.

(2) The report of the investigation is attached (Annexure A).

(3) The company has registered with the Department of Environment, Forestry and Fisheries (DFFE) for a waste storage licence for two (2) sites in Eastern Cape, East London and Gqeberha (Annexure B).

(4) The company has no medical waste disposal site located in Eastern Cape, but has arrangments with companies outside the province where it disposes medical waste.

(5) The company makes use of the following facilities which are equiped for appropriate disposal of medical waste and body parts:

1. Averda in George – Western Cape
2. Averda in Klerksdorp – North West

END.

Reply:

a) The following factors were considered to convene the Appeal Committee

Section 24A (1) of the Medicines and Related Substances Act, 1965 (Act 101 of 965) as amended ("the Act") provides that any person aggrieved by decision of the SAHPRA may appeal against such decision by notifying the Chief Executive Officer (CEO) within 30 days of becoming aware of such decision of his or her intention to appeal and setting out the full grounds of appeal. The Act also provide for a mechanism where CEO must meet with the Appellant to try to resolve the matter, especially if the appeal involves administrative matters (Section 24A (2). This process is done without the presence of the legal representative.

Section 24A (3) and (4) of the Act provides as follows:

‘‘24A. (3) Should the Chief Executive Officer and the appellant fail to resolve the matter as contemplated in subsection (2), the appellant shall within 30 days of being notified by the Chief Executive Officer of the failure to resolve the matter and upon payment of a prescribed fee, request the Minister in writing to convene an appeal committee.

(4) The appeal committee contemplated in subsection (3) shall -

(a) comprise the chairperson who shall have knowledge of the law and four other persons who shall have knowledge of the subject matter of appeal but with no financial or business interests in the affairs of the parties to the appeal, two of them nominated by the appellant and the other two by the Chief Executive Officer; and

(b) conduct the appeal hearing and make a decision within 30 days from the day when it first meets to hear the appeal.’’

Free the Children Save the Nation NPC represented by Mr John Taylor launched an appeal in terms of Section 24A (4) of the Act. The Appellant and the CEO of SAHPRA met to try and resolve the issues raised by the Appellant as provided for in the Act. However, the matter could not be resolved.

If the issues raised by the Appellant had not been resolved through the mechanism of a meeting between the CEO of SAHPRA and the Appellant, the Act compels the Minister to convene an Appeal Committee. Therefore, the Appeal Committee was convened after the processes envisaged in section 24A (1) to (3) were done but the matter remained unresolved.

b) (i) The process for hearing of evidence by the Appeal Committee

In terms of Regulation 48 (2) (a) and (b) of the General Regulations made in terms of the Act, the Appeal Committee has to determine the procedure for its hearings and may in this regard, if it deems necessary, call for oral evidence or argument.

The Appeal Committee in its meeting of 21st January 2022 agreed that it will conduct the hearings through oral submissions together with both medical and legal representation. The Parties may call their experts to lead evidence in support of their case.

(ii) The Appeal Committee in its meeting with the Parties held on 08 February 2022 had agreed that both the media and the broader public be invited and have access to the link of the hearings. Therefore, the expert testimonies will be open to the public as the hearing will be open to the general public.

END

Reply:

1. Food Control is one of the 9 Municipal Health Services that has been devolved since July 2004 in terms of the Municipal Structures Act, 1998, (Act no 117 of 1998) to the 44 district municipalities and 8 metropolitan municipalities. The department continues to develop policies and provides support on municipal health services delivery in all 9 provinces, 44 districts and 8 metropolitan municipalities that are rendering food control. The department has developed National Environmental Health Norms and Standards to ensure that the provision of food control and other municipal health services is standardised throughout the country. Municipal Health Services Assessments (Audits) are continuously conducted to assess compliance with National Environmental Health Norms and Standards (NEHNS).

2. (a) The department through the authorised municipalities monitors all schools on a number of areas including food safety. The above-mentioned document, NEHNS which guides municipalities on the frequency of inspection requires that schools be inspected once a year. This is just a guide as municipalities conduct risk assessment to determine whether a school is a high risk facility which would require constant monitoring or it falls in a low risk category. Investigations are only carried out if incidents take place relating to food. The school in question was visited on the 1st of February 2022 after receiving the complaint on the 31st January 2022. The municipality conducted an investigation at the school where field visits were done, samples of the affected products were taken for laboratory analysis and a follow up investigation on the 2nd February 2022 was done and the outcome was that most of the affected victims had recovered. Further samples will be submitted for chemical analysis.

(b) The department will eventually publish the outcome of the investigation once all the areas of concern have been finalised. The department takes precautionary measures when dealing with such cases to avoid being sued if things are not correctly handled.

END.

Reply:

(1) (a) There are four vaccines approved for use in the Republic.

(b) (i) Covid-19 vaccine Jannsen

(ii) Pfizer Comirnaty

(iii) Coronavac (Curanto Pharma); and

(iv) BBIBP-CortV-Vaccine (Sinopharm) [MC Pharma]

(2) (a) (i) Covid-19 vaccine Jannsen - 31 000 000 doses

(ii) Pfizer Comirnaty - 30 002 310 doses plus 1 392 300 doses through the COVAX Facility

(b) The pricing information cannot be shared as we are bound by non-disclosure agreements with manufacturers.

(3) There is no law that gives the government exclusive rights to procure vaccines from approved suppliers. However, with regards to COVID-19 vaccines, manufacturers opted to contract exclusively with government to make vaccines equitably available.

(4) The Department has spent approximately R 6 billion on vaccines to date.

END.

Reply:

 

The following interventions are made to assist the Robert Mangaliso Sobukwe Hospital:

(a) The hospital has an annual turnover of about 30 – 50 community service doctors;

(b) The hospital annually plans by commencing interviews with community service doctors who may be interested to continue working at the hospital around June – July;

(c) The hospital has completed the human resources process on time and the applicants were informed of the outcome of the interviews and the list of recommended applicants has been sent to the Head of Units;

(d) The hospital is currently filling 31 posts, following a resignation of a medical officer

​2. Yes.

(a) The hospital always had backlogs in ophthalmology, general surgery, and orthopaedics. This is due to an ongoing challenge of a shortage of nurses trained in theatre technique. The hospital does, from time to time, arrange blitz sessions to reduce the backlog;

(b) The total backlog for general surgery currently stands at 492;

(c) The long-term plan is active recruitment, coupled with training nurses in theatre technique to cover the rest of the province. This will allow the hospital to plan outreach programmes into the districts to minimise the burden on the tertiary hospital for beds.

(3) The Ministry and National Department of Health will continue to support the province as we do with us provinces in the identified area of staff shortages across all categories.

END.

 

Reply:

 

(a). All gazetted hospitals in the country are declared ready for the Covid-19 variant. These hospitals are able to manage Covid-19 cases in the context of the hierarchy of health services per type of facility. This arrangement ensures that the patients are referred the next level of care as and when the condition of the patient changes, from mild, moderate to severe state.

(b). The department has prepared all the 336 gazetted public hospitals plus the private sector hospitals for Covid-19 variant depending of the packages of services and hierarchy of care for each level of the hospital. At the start of the pandemic in 2020, the department did the following in order to determine the state of readiness for Covid-19 admissions:

• • conducted an audit for oxygen reticulation capability;
  • identification of respiratory support devices needs;
  • determined infrastructure needs as well as Human Resource needs.

This is the information that has been used to ensure that the hospitals are ready for all various Covid-19 variants, including preparations for this current variant. Based on the Intra-Action Review that was conducted for the third wave, the department was confident to confirm during the planning for the fourth wave that all hospitals are ready for this new variant.

END.

Reply:

 

The outbreak of Covid–19 brought new challenges in the Traditional Health Practice, which led to the Department of Health developing Guidelines for Traditional Health Practitioners in dealing with Covid-19.

The Department supported the role played by Traditional Health Practitioners during the hard lockdown period by providing them with travel permits to allow them to continue looking after their patients and assist in the prevention and control of COVID-19. Traditional Health Practitioners have also been supported by the South African National AIDS Council (SANAC), by providing them with PPE procured through the Global Fund money.

END.

Reply:

 

No COVID-19 vaccines are currently approved for use in South Africa in children under the age of 12 years.

Trials in young children have been completed for two inactivated vaccines (Sinovac-CoronaVac and BBIBP-CorV), and these products have been approved by Chinese authorities for use in children 3-17 years. However, although these vaccines have received emergency use approval from the World Health Organization (WHO) for adults, they have to date not been approved by WHO for use in children1. Several additional COVID-19 vaccines are undergoing trials in young children (including children as young as 6 months of age). Results from these trials are expected in late 2021 or early in 2022, and it is likely that the manufacturers will then apply for regulatory approval for the vaccines to be administered to children under five years of age. Decisions to vaccinate young children in South Africa will require approval by SAHPRA, and will be guided by recommendations of the Vaccine Ministerial Advisory Committee.

It should be noted that whilst initial COVID cases caused by the Omicron variant included a large proportion of children under five years of age, this pattern has changed with more cases now being seen in older (adult) age groups. The incidence and severity of disease in young children is being carefully monitored in order to understand the impact of the new variant on young children.

Caregivers should protect young children from COVID infection by ensuring that all household members and other close contacts who are eligible to be vaccinated, are fully vaccinated, and that standard COVID prevention practices are followed at all times.

END.

1 World Health Organization. Interim statement on COVID-19 vaccination for children and adolescents. 24 November 2021

Reply:

 

1. There are four officials from the National Department of Health (NDOH) that have been suspended and are currently undergoing a disciplinary hearing. Charges were served on the officials and the Disciplinary Hearing commenced on 22 November 2021, it is currently underway.
2. Kindly refer to (1) above, charges have been served on the four implicated officials.
3. The NDOH has resolved to minimize the use of deviations, and these will only be resorted to under extremely exceptional circumstances. In addition, the NDOH is the process of improving its contract management processes to ensure efficient and effective contract management.

END.

Reply:

 

The Honourable Member is kindly informed that this kind of information is not readily available at the National Department of Health. This information must be sourced from hospitals in provinces, and therefore the department is busy collating the information from the hospitals through the provinces. The information will be shared with the Honourable Member and Parliament as soon as it is received from the provinces.

END.

Reply:

 

1. (a) There are 10 nursing colleges in the Republic. One located in each of the nine provinces and the 10th being the South African Military Health Service (SAMHS). These colleges have 45 campuses and 40 sub-campuses located in district and subdistrict level in each of the provinces to ensure access to nursing education by local communities

(b) (i) None of these colleges were shut down in the past two financial years.

(ii) Not applicable

1. The colleges are running effectively and smoothly, phasing in new programmes whilst phasing out the legacy (old) programmes in compliance with relevant legislation guiding nursing education. While the accreditation process by the Council for Higher Education (CHE) for some programmes has been slower than expected, department is communicating with the CHE to expedite the accreditation of these programmes.

1. (a) Table 1 overleaf reflects the number of graduates who were produced by South African Nursing Colleges in the past five-years in question:

Table 1. Number of graduates produced by South African Nursing Colleges in the past five years

Province	Name of the College of Nursing	Graduates produced per year:
		2016	2017	2018	2019	2020	Total
Eastern Cape	Lilitha College of Nursing	358	331	426	336	322	1773
Free State	Free State School of Nursing	165	155	144	152	145	761
Gauteng	Gauteng College of Nursing	620	614	507	593	847	3181
KwaZulu Natal	KwaZulu Natal College of Nursing	316	533	393	512	164	1918
Limpopo	Limpopo College of Nursing	218	188	200	235	169	1010
Mpumalanga	Mpumalanga College of Nursing	322	76	304	243	146	1091
Northern Cape	Henrietta Stockdale Nursing College	25	44	18	46	13	146
North West	North West College of Nursing	275	130	118	200	269	992
Western Cape	Western Cape College of Nursing	243	250	77	34	6	610
SAMHS	SAMHS Nursing College	61	40	56	14	41	212
Total	11 694

(b) The following table reflects the number of eligible graduates who were absorbed into statutory posts for Professional Nursing Community Service in the past five years (The numbers below are inclusive graduates from Nursing Colleges and Universities)

Table 2.

Province	Graduates absorbed as Community Service Nurses in each year:
	2016	2017	2018	2019	2020	Total
Eastern Cape	582	514	621	551	587	2855
Free State	217	195	211	173	164	960
Gauteng	683	781	677	655	970	3766
KwaZulu Natal	648	700	684	687	439	3158
Limpopo	171	212	276	323	279	1261
Mpumalanga	265	208	217	295	251	1236
Northern Cape	74	53	102	74	92	395
North West	390	304	394	471	268	1827
Western Cape	384	381	364	323	364	1816
SAMHS	61	40	56	14	41	212
Total	17 486

NB. After completing Community Service, Professional Nurses are not automatically absorbed into permanent posts. They need to apply and compete for advertised positions either Public Service or Private Sector. Based on the individuals performance during the selection process the favourable candidate is appointed into a post.

END.

2

Reply:

 

The department regrets to report that there has been no additional budget for demand generation. The additional resources have been provided by the private sector and voluntarily placement of advertisements and radio slots. The investments include making vaccination mean more to people (through demand creation) and making it easier to get vaccinated (through establishing more vaccination sites, using outreach and extending vaccination site times, primarily to weekends). Doses in the arms, especially of older people mean a lot fewer admissions and savings to the health system. Calculations have been done which show that vaccination of people over 65 years saves the health system around R850 per vaccination based on a cost of admission which is about R75 000 per admission. It has also been estimated that vaccinating 83 men over 65 years could prevent 1 admission, saving R903 in admission cost for this group.

The cost of vaccines and associated supplies remains the major investment. The cost of the logistics to provide the vaccinations increases exponentially as it becomes more difficult to reach people. Increasingly more effort and investment are required to drive towards critical thresholds of coverage. People who are willing to vaccinate if their personal costs or constraints are reduced cost the vaccination programme more to reach than those who have no limitation on access at their own costs.

The public investment case is that COVID-19 has had a devastating effect on both society and the economy:

• COVID-19 has increased the number of deaths by about 30% since May 2020. There were 238,949 excess deaths in South Africa recorded between 3 May 2020 and 14 August 2021 (age-standardised excess death rate of 401 per 100,000 population).

• Vaccination against COVID-19 will provide a return on investment of 11 to 20 times in terms of infections averted and costs to the economy.

• COVID-19 related mortality is concentrated in older age groups: 82% of COVID-19 deaths recorded in South Africa have been among people over fifty years of age and 61% of recorded deaths among people over 60 years.
• The net saving to the health system of vaccinating all men and women over 65 years of age is approximately R1.3 billion (R500 and R250 per person respectively), based on a mortality hazard ratio of approximately 2:1,4 an average cost per hospitalisation managed in a public general ward of R75,0005 and an unit cost of vaccination of R350.

• The vaccination of younger people (aged 18-39 years) is crucial in securing the social and economic returns on investment in the medium-term. In the short-term, the vaccination of younger people will incur a net cost to the health sector (about R300 p.p.). However, they constitute over half (56%) of the total population and their uptake patterns will largely determine whether or not we reach critical thresholds of coverage.

END.

2

Reply:

 

1. Total number of –

• 1. Number of Hospital beds

The country has a total of 108 805 general beds and 5616 critical care beds all available for admission of Covid-19 patients.

• 1. Oxygen tanks that have been made available in each province

The oxygen tanks are allocated per hospital and not per province. The size of the tank is based on the size of the hospital and its capability to manage patients that require oxygenation. The oxygen tanks per hospital are attached as annexure A. Over and above these tanks, Afrox has further repurposed the oxygen cylinders and increased the capacity from 9000 cylinders that were available before Covid-19 to 19 000that are available for use during the pandemic.

1. The department held the two day workshop with the provinces, in anticipation of the fourth wave as part of the broad consultative process. This planning was irrespective of the variant, but more focused on the getting all resources ready for the pandemic knowing all variants are different but that they require proper planning. From this workshop, the provinces developed resurgence plans which are currently being implemented. Over and above these plans, the department, through the National Institute, as a partner, communicates with the provinces through the submission of the Situational Report on the variants. The departmental Incident Management Team has also allocated senior managers as provincial leads, who work directly with the provinces and they report to the National IMT every week on Thursday.

END.

Reply:

 

According to the Gauteng Provincial Department of Health,

• The current Covid-19 guidelines were used in the treatment of patients who were admitted with Covid-19;

• This period also coincided with the end of the 3rd wave;

• There is a possibility that the community vaccination has had a positive impact on the number of people getting infected with Covid-10 and a decrease in the number of patients who needed admission.

END.

Reply:

 

The department started planning for the fourth wave based on the experience from other countries and the advice from the scientists about the third wave. In this regard, the department worked with the provinces, the National Institute of Communicable Diseases, the World Health Organisation (WHO), the scientists and all other stakeholders to prepare for this fourth wave. The preparations resulted in the development of the fourth wave resurgence plan for both National Department and the provinces. The planning covered various areas which are provided for in the original surge planning framework. This plan includes the following:

• The number of beds that are available for admission of CoVid-19 patients
• The number of respiratory support devices
• The capacity and capacity of oxygen supply and reticulation including sustainable availability in the hospitals

• Availability of the Human Resources by encouraging that those who were at the front line be allowed to take leave to recover from the pressure of the third wave.

END.

Reply:

 

The community of Ward 11 in Moses Kotane Local Municipality is receiving Health Services through Mobile clinic two times a month (bi-weekly). The next visit was scheduled on the 10 December 2021. The clinic that normally serves ward 11 is Ramokokastad clinic, which is currently closed due to the destruction that was caused during the unrests in the village. This clinic will be re-opened at the end of March 2022, and this will improve access of services in the Ward.

END.

Reply:

 

(a)-(b) The responsibility of the Department of Health is to ensure that the public receives accurate and factual information from reliable sources in a manner that is reassuring and builds national trust. Part of that accurate information is to ensure that everyone understands the risks of not getting vaccinated and not adhering to personal protective practices like mask- wearing, handwashing, good ventilation and social distancing. It is also vital that older people and their families understand the substantially higher risk of Covid-19 related hospital admission and death, should they not get vaccinated as 58.4% of hospital admissions and 81.5% of deaths recorded by the end of the end of October 2021 were among people aged 50 and above.

The most effective reassurance which the National Department of Health can offer the general public is substantially reduced risk through vaccination and adherence to the personal practices described above. At the same time, the Department understands that the ‘messenger is as important as the message’ in persuading people to be vaccinated. For that reason, together with GCIS and other social partners, it engages extensively with national and provincial leadership of faith-based organisations, labour unions, traditional and Khoi-San leadership, community organisations and the business sector. It has also launched a Vooma Vax Champs initiative to encourage ordinary South Africans to become advocates among their friends and colleagues in an effort to tap into personal networks of trust.

The Department makes use of both regional radio stations of the SABC and over 65 Community based organisations to convey messaging in all 11 languages. It also distributes print material available in all 11 languages. Over 30 million brochures have been distributed through the Department of Health and partner retail stores. Print material is also available in Braille and large-print for the partially sighted and a video has been developed for people with hearing disability.

Every effort is to made to ensure that non-binary pronouns are used in the public communication to ensure inclusiveness with respect to gender identity. Where required, information is tailored for specific gendered audiences (e.g. dealing with concerns about male virility and clarifying that the vaccine is safe for men and for women who are pregnant).

A Risk, Community and Community Engagement Committee is responsible for synthesising the feedback from provinces to better understand and respond to regional issues.

The messages we disseminate are based on verified facts and we deliberately do not focus on giving airtime to the myths and misperceptions around the vaccine. Our current campaigns such as Zwakala, GenV Who You Doing It For? And the Vaccine Diaries are all based on positive reinforcement, demonstrating social proof that vaccines are safe and the continual encouragement of taking preventive behaviours.

We develop communication campaigns that are targeted to specific segments of our population, be they in a specific geography or age cohort. For example, the Zwakala campaign is targeted at youth and is primarily on social media and digital mediums. GenV is targeted at the 35+ year olds, and is on national radio and TV.

We also of course create communications for the mass market, but even when we do that, we create that content in multiple languages. Our new safer holiday campaign will be on community and national radio in all 11 official languages.

Finally, all of our communication is based on insights and data that we receive from our social listening and community engagement teams to ensure we are addressing real concerns people have around COVID-19 and the vaccine. We know that if we do this, our messages will resonate better.

Through regular coordination between the national level, provincial, sub-district level and the range of RCCE partners, we are confident that we are doing everything in our means to reach all South Africans in mediums and messages that are understandable and relatable.

The National Contact Centre has branches in six provinces to ensure a good spread of call centre operators fluent in all languages.

At the same time, we appreciate the limitations of nationally designed messaging and communication. Working with social partners and private foundations such as the DG Murray Trust and Tshikululu Social Investments, a network of close to 100 community- based organisations is supported, involving every district, to ensure that information can be contextualised and conveyed in a style and language suitable to all audiences. Partner organisations with the Department of Health, such as the AIDS Foundation of South Africa, NACOSA and Beyond Zero, assist in reaching hard to reach groups (including sex workers and other socially marginalised groups).

The Department has worked with NEDLAC, the business sector and trade unions to ensure that information is both targeted and specific to different occupational groups. The Mining Sector has done exceptionally well in attaining coverage levels of over 70%, while there is active mobilisation of the agricultural sector through joint engagement of agri-business and trade unions.

END.

Reply:

 

There are no corruption charges that have been brought to my attention regarding the Nelson Mandela Fidela Castro Collaboration Programme.

However, when the National Department of Health conducted an internal audit and reconciliation with the Provinces on this Programme from October to December 2021, it was not conducted for the Gauteng Department of Health.

The details from the Gauteng Department of Health are that all files relating to the Nelson Mandela Fidel Castro Collaboration Programme have been taken by the Special Investigating Unit (SIU) for an investigation.

END.