Questions and Replies

Reply:

While it is customary for women of the Muslim faith to have their heads covered, not all Muslim women cover their heads. The nursing profession has members of the Muslim faith who currently do not wear head gear.

It is the employer’s responsibility to provide the uniform or give a cash allowance to its employees if the wearing of a uniform is a condition for their work. This is also aligned to the prescripts and regulatory framework of the nursing profession as reflected in the SA Nursing Council regulations. Chief amongst these is the imperative to uphold and portray professional identity and image, in addition to minimising any potential risk to patient safety. The regulations stipulate that the wearing of the uniform should enable all nurses to display the devices which distinguish a nurse providing care in line with her professional qualifications from others.

The dress code for nurses has always served as an administrative instrument to give effect to all these service obligations that are imposed by the profession on their members. However, since 2005 nurses were provided with an allowance to purchase own uniform. The unintended consequence has been a lack of standardisation in terms of colour, material composition and quality of garment. Thus, posing a threat to historic professional image of a nurse. Hence the recent circular intended to restore standardisation in wearing of uniform. In addition to affirming the historic position of the department regarding wearing of adornment while on duty

The National department of Health is aware of the objection raised by Muslims organisations. This is the first time that the decade old practice reading wearing of adornment while on duty is being challenged. The Department remains open to engage with any affected stakeholder in this regard.

END.

Reply:

The responsibility for the payment of electricity bills resides with the respective provincial Departments of Health. Indicated below are the amounts owing as received from the provinces for various hospitals as appears in the tables:

a) The amounts owing to the various municipalities shown here are as the end of July 2023.

EASTERN CAPE

No.	Municipality	Outstanding Debt
	Sarah Baartman	R
1	Sarah Baartman DM	1 044 492,88
2	Blue Crane Route	1 047 910,64
3	Camdeboo	0,00
4	Kouga	1 363 996,64
5	Koukamma	564 841,14
6	Makana	1 902 886,27
7	Ndlambe	332 805,52
8	Sundays River Valley	628 719,94
9	Baviaans / Ikwezi / Dr Beyers Naude	1 215 075,41
Total	8 100 728,44
	Nelson Mandela
10	Nelson Mandela Metro	24 145 981,30
Total	24 145 981,30
	Amathole
11	Amathole DM	15 204 200,95
12	Amahlathi	1 004 040,50
13	Great Kei	128 909,13
14	Mbashe	75 952,00
15	Mnquma	29 136,00
16	Ngqushwa	76 581,50
17	Nkonkobe / Nxuba / Raymond Mhlaba	20 811 489,12
Total	37 330 309,20
	Buffalo City
18	Buffalo City Metro	6 600 804,35
Total	6 600 804,35
	Chris Hani
19	Chris Hani DM	20 986 174,81
20	Emalahleni	1 964 407,15
21	Engcobo	522,35
22	Sakhisizwe	2 478 085,35
23	Intsika Yethu	468 884,20
24	Inxuba Yethemba	844 200,73
25	Inkwanca / Lukhanji /Tsolwana / Enoch Mgijima LM	4 539 032,16
Total	26 742 274,59
	Joe Gqabi
26	Joe Gqabi DM	1 382 332,82
27	Elundini	103 544,30
28	Senqu	1 410 656,03
29	Garriep / Maletswai / Walter Sisulu	3 464 505,18
Total	6 361 038,33
	OR Tambo
30	OR Tambo	7 085 527,07
31	KSD	9 608 874,60
32	Mhlontlo	8 429,53
33	Nyandeni	844 423,00
34	Ingquza Hill	8 686,65
35	Port St Johns	2 120,31
Total	17 558 061,16
	Alfred Nzo
36	Alfred Nzo DM	18 052 297,74
37	Matatiele	6 987 581,43
38	Mbizana / Winnie Madikizela	4 828 870,90
39	Ntabankulu	3 900,69
40	Umzimvubu	69 166,84
Total	29 941 817,60
	Grand Total	161 320 047,13

a) Acknowledgement of debt has been made to the relevant municipalities. There are ongoing mechanisms in place to ensure disconnection by the municipalities is avoided. After Budget Adjustment Estimates the Department will further engage relevant municipalities again with a purpose of re-arranging payments terms for this financial year and negotiate the payment terms for the next financial year.

The Department has engaged Reonet (Pty) LTD through the EC Department of Public Works with the aim of verifying all outstanding debts and billings by certain municipalities are valid and accurate.

FREE STATE

a) The Free State Department of Public Works & Infrastructure is responsible for payment of all property rates, sanitation and refuse removal accounts for all Provincial Departments. The Department of Public Works & Infrastructure is also responsible for the electricity and water accounts excluding for the schools and leased out properties where the electricity and water is metered separately and paid for by the user.

The following table indicates hospitals in the Free State province with verified outstanding electricity accounts:

FACILITY NAME	MUN CODE	TOWN	SUBURB	VERIFIED OUTSTANDING ELECTRICITY
DIAMOND HOSPITAL	FS162	JAGERSFONTEIN	JAGERSFONTEIN	R356 083,95
TROMSBURG - ALBERT NZULA HOSPITAL	FS162	TROMPSBURG Farm	TROMPSBURG Farm	R905 032,78
SMITHFIELD HOSPITAL	FS163	SMITHFIELD	SMITHFIELD	R273 713,70
EMBEKWENI HOSPITAL	FS163	ZASTRON RD	ZASTRON RD	R322 470,39
WINBURG HOSPITAL	FS181	WINBURG RD	WINBURG RD	R548 546,84
THUSANONG DISTRICT HOSPITAL	FS184	ODENDAALSRUS	ODENDAALSRUS	R1 039 539,70
KATLEHO HOSPITAL	FS184	VIRGINIA	VIRGINIA	R1 098 783,50
BONGANI REGIONAL HOSPITAL	FS184	WELKOM RD	WELKOM RD	R6 456 031,14
NALA HOSPITAL	FS185	BOTHAVILLE	BOTHAVILLE	R235 524,37
MOHAU HOSPITAL	FS185	HOOPSTAD	HOOPSTAD	R771 548,09
JOHN DANIEL NEWBERRY HOSPITAL / CLINIC	FS191	CLOCOLAN	CLOCOLAN	R168 413,33
PHUTHULOHA DISTRICT HOSPITAL	FS191	FICKSBURG	FICKSBURG	R164 537,07
ITEMOHENG HOSPITAL - SENEKAL	FS191	SENEKAL	SENEKAL	R225 643,91
PHEKOLONG HOSPITAL	FS192	BETHLEHEM	BETHLEHEM	R10 854 908,76
DIHLABENG HOSPITAL	FS192	BETHLEHEM	BETHLEHEM	R5 061 231,19
NKETOANA HOSPITAL	FS193	REITZ RD	REITZ RD	R334 285,13
THEBE DISTRICT HOSPITAL	FS194	HARRISMITH	HARRISMITH	R0,00
ELIZABETH ROSS HOSPITAL	FS194	HARRISMITH RD	HARRISMITH RD	R0,00
MOFUMAHADI MANAPO MOPELI HOSPITAL	FS194	QWA-QWA	PHUTHADITJHABA-A	R0,00
PHUMELELA HOSPITAL/VREDE CLINIC	FS195	VREDE	VREDE	R0,00
SENORITA NHLABATHI HOSPITAL	FS196	LADYBRAND	LADYBRAND	R857 455,55
BOITUMELO HOSPITAL	FS201	KROONSTAD RD	KROONSTAD RD	R3 915 423,49
TOKOLLO HOSPITAL	FS203	HEILBRON	HEILBRON	R1 594 812,28
PARYS HOSPITAL	FS203	PARYS	PARYS	R1 131 364,09
Fezi Ngumbentombi Hospital	FS204	PARYS RD	PARYS RD	R12 565 856,06
MAFUBE HOSPITAL	FS205	FRANKFORT	FRANKFORT	R0,00
NATIONAL DISTRICT HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R20 785 268,98
PSYCHIATRIC COMPLEX	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R31 590 119,88
PELONOMI HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R43 334 465,10
UNIVERSITAS ACADEMIC HOSPITAL	MAN	BLOEMFONTEIN	BLOEMFONTEIN	R66 108 250,22
BOTSHABELO HOSPITAL	MAN	BOTSHABELO	BOTSHABELO-BA	R18 733 852,05
DR J S MOROKA HOSPITAL	MAN	THABA `NCHU	THABA 'NCHU	R0,00

b) The Free State Department of Public Works & Infrastructure continue to negotiate with service providers not to disconnect the electricity supply as it will hamper service delivery and may cause loss of lives if a hospital electricity is disconnected. The Province is continuously assisting the department in identifying savings which are then re-directed to augment the budget pressure in this regard.

GAUTENG

a) The total amount in outstanding electricity bills at each hospital in each province amount to R285,357,103.13, from the amount R102,478,398.20 already processed on the system for payments. The total outstanding electricity bill amount to R182, 878, 704.93 of which the institutions to conduct verification for payment.

Refer to the table as below mentioned:

Vendor details	Institution	Awaiting Payment Run	Institution to approve, before payment is done
City of Johannesburg Municipality	Charlotte Maxeke	-	114 174 074,96
City of Johannesburg Municipality	Chris Hani Baragwanath Hospital	19 202 124,74	966 713,30
City of Johannesburg Municipality	Edenvale Hosp	2 205 293,14	-
City of Johannesburg Municipality	Health Head Office	-	593,14
City of Johannesburg Municipality	Helen Joseph	7 329 585,56	12 245 916,03
City of Johannesburg Municipality	Johannesburg Metro District Health	-	176 929,11
City of Johannesburg Municipality	Rahima Moosa Hosp (Coronation Hosp)	1 812 301,43	17 542 309,44
City of Johannesburg Municipality	South Rand Hosp	-	6 896 388,53
City of Johannesburg Municipality	Tara Hosp	207 047,83	523 177,46
City of Tshwane	Forensic Pathology Services	-	342 328,32
City of Tshwane	Jubilee District Hosp	-	3 286 238,53
City of Tshwane	Kalafong Hosp	1 589 028,09	-
City of Tshwane	Lebone College of Emergency	-	448 876,27
City of Tshwane	Mamelodi Hosp	589 336,07	-
City of Tshwane	Masakhane Cookfreeze	49 675,80	-
City of Tshwane	ODI District Hospital	-	399 425,03
City of Tshwane	Pretoria West	-	2 497 959,24
City of Tshwane	Steve Biko Hosp (PTA Academic Hosp)	-	96 503,47
City of Tshwane	Tshwane District Health	229 719,49	19 406,52
City of Tshwane	Tshwane District Hosp	-	-
City of Tshwane	Tshwane Rehab	-	501 685,89
City of Tshwane	Weskoppies	-	1 797 203,68
Ekurhuleni Metropolitan Municipality	Dunswart Hosp	884 844,00	-
Ekurhuleni Metropolitan Municipality	Ekurhuleni District Health	53 751 000,00	-
Ekurhuleni Metropolitan Municipality	Far East Rand Hospital	-	2 002 165,09
Ekurhuleni Metropolitan Municipality	Tambo Memorial Hosp	6 126 127,08	45 473,62
Ekurhuleni Metropolitan Municipality	Tembisa Hosp	-	3 268 538,16
Ekurhuleni Metropolitan Municipality	Thelle Mogoerane	-	220 000,04
Emfuleni - GP Local Municipality	Kopanong Hosp	7 094,31	521 335,48
Emfuleni - GP Local Municipality	Sebokeng Hosp	62 501,63	2 831 029,82
Emfuleni - GP Local Municipality	Sedibeng District Health	-	-
Lesedi - GP Local Municipality	Forensic Pathology Services	-	47 196,14
Lesedi - GP Local Municipality	Heidelburg	73 551,13	733 037,29
Merafong City - GP Local Municipality	Carlton Vill Clinic	-	8 815,87
Mogale City - GP Local Municipality	Dr Yusuf Dadoo	-	809 736,78
Mogale City - GP Local Municipality	Leratong Hosp	3 022 440,53	-
Mogale City - GP Local Municipality	Sterkfontein Hosp	2 251 647,14	-
Mogale City - GP Local Municipality	West Rand District Office	168 332,38	-
Rand West City - GP Local Municipality	West Rand District Office	402 852,88	21 284,42
ESKOM	Charlotte Maxeke	-	97 313,13
ESKOM	Ekurhuleni District Health	4 348,81	-
ESKOM	EMS	-	13 876,81
ESKOM	Johannesburg Metro District Health	1 224 494,37	409 322,98
ESKOM	Jubilee District Hosp	-	7 298 418,97
ESKOM	ODI District Hospital	-	265 607,22
ESKOM	Pholosong Hosp	-	397 829,63
ESKOM	Sedibeng District Health	117 874,95	75 465,31
ESKOM	Tara Hosp	497 564,22	-
ESKOM	Thelle Mogoerane	-	1 607 620,72
ESKOM	Tshwane District Health	469 739,63	138 186,88
ESKOM	West Rand District Office	199 872,99	150 721,65
Grand Total		102 478 398,20	182 878 704,93

b) The department conduct weekly meetings with Eskom and bilateral meetings with Municipalities, which are arranged and attended to by Representatives from Gauteng Treasury, COGTA, Department of Health: Head Office and Health Institutions (Hospitals & Entities).

KWAZULU-NATAL

a) The Department’s electricity bill across the province is all current, sitting at just over R31million.

b) The Department prioritise the water and electricity on a month-to-month basis resulting to the total debt owed being current.

LIMPOPO

a) Yes, The department has as at 31 August 2023 municipal bills of hospitals amounting to R8 590 999,33, of which the balances were within 30 Days.

The breakdown of the total bills as per the tables below:

Capricorn district

Mopani district

Sekhukhune District

Vhembe District

Waterberg District

b) All bills listed above were settled during the month of September 2023. The department is paying the municipalities monthly, hence all transactions reported are within 30 days. The department will continue reconciling the accounts and settle the debts accordingly.

MPUMALANGA

a) The hospitals will be able to process the electricity bills soon as the outstanding invoices are received and when the system is back. Attached hereunder, please find table detailing the outstanding electricity bill per hospital and payment status.

Name of Facilities	Status	Amount in Arrears	Comments
GERT SIBANDE DISTRICT
Bethal Hospital	Paid until September	604 953,00	Emzinoni Clinic billing from 2018, new matter still under investigation. A meeting schedule for tomorrow with CFO Govan Mbeki
Evander Hospital	Paid until September	300 000,00	A shortfall on the committed order, a new order to be generated
Carolina Hospital	Paid until July	-	waiting for August and September invoices. The municipal has implemented a new system which causes the delay.
Embhuleni Hospital	Paid until August	-	Invoice received after the cut-off date, yet to be processed
Ermelo Hospital	Paid until August	-	Awaiting for September invoice, a dispute was lodged on the initial invoice.
Msukalingwa Clinic	Paid until August	-	Invoice received after the cut-off date, yet to be processed
Total		904 953,00
EHLANZENI DISTRICT
Tintswalo Hospital	Paid until August	234 770,70	Invoice received after cut-off date
Themba Hospital	Paid until August	-	Waiting for invoice
Barberton TB Hospital	Paid until August	300 980,00	Invoice received after cut-off date.
Barberton Hospital	Paid until August	-	Waiting for invoice
Sabie Hospital	Paid until August	219 970,43	Invoice received after the cut-off date.
Total		755 721,13
NKANGALA DISTRICT
Kwamhlanga Hospital	Paid until 31st August 2023	37 450,00	September invoice received in process
Benice Samuel Hospital	Paid until 31st August 2023		September invoice not yet received
Middleburg Hospital	Paid until 31st August 2023	650 323,18	September invoice received in process
Mmamethlake Hospital	Paid until 31st July 2023		August and September invoice not yet received
Impungwe Hospital	Paid until 31st August 2023	253 361,19	September invoice received in process
Waterval boven	Paid until 31st August 2023		September invoice not yet received
HA Grove Hospital	Paid until 31st August 2023		September invoice not yet received
TB Hospital	Paid until 31st August 2023	192 141,36	September invoice received in process
PHC Facilities	Paid until 31st August 2023		September invoice not yet received
Total		1 133 275,73
Grand Total		2 793 949,86

b) Outstanding invoices will be processed upon receipts and captured invoices will be paid soon as the system is back.

NORTHERN CAPE

No response, after several engagement and follow ups with the province.

NORTH WEST

a) The department owes electricity bills of R5 017 155,17 outstanding as of September 2023, However, the R631 134.69 is in dispute with ESKOM.

Name of the Hospital	Total outstanding electricity bills
Ventersdorp CHC (Hospital)	352 035.81
Mafikeng Provincial Hospital	631 134.69
JST Hospital	2 879 515.91
Taung Hospital	1 154 468.76
	1 506 504.57

b) The outstanding bills are current. The department conduct regular reconciliation of the accounts with facilities when a need arises for settlement.

WESTERN CAPE

a) As of 31 August 2023, 99% of our outstanding balances are current. Some have been settled and reflect as 0 and some in credit reflected in brackets:

Hospital	Current electricity bill
Alexandra Hospital	(R1 023,27) in credit
Beaufort West Hospital	R 406 456,64
Brewelskloof Hospital	R 380 534,96
Caledon Hospital	R 365 431,18
Ceres Hospital	R 287 907,87
Citrusdal Hospital	R 421 045,97
DP Marais Hospital (vacant land)	0
Eerste River Hospital	0
False Bay Hospital	0
George Hospital	R 1 219 583,28
Groote Schuur Hospital	R 5 986,75
Harry Comay	R 166 705,81
Helderberg Hospital	0
Hermanus Hospital	R 35 710,22
Karl Bremer Hospital	0
Khayelitsha Hospital	0
Knysna Hospital	R 391 993,44
Ladismith Hospital	R 78 459,00
Laingsburg Hospital	R 75 264,00
Lapa Munnik Hospital	R 150 800,53
Lentegeur Hospital	0
Metro TB Hospital	0
Mitchells Plain Hospital	0
Montagu Hospital	0
Mosselbay Hospital	R 151 655,87
Mowbray Hospital	0
Murraysburg Hospital	R 45 654,65
Nelspoort Hospital	R 12 777,66
Oudtshoorn Hospital	0
Paarl Hospital	R 1 107 137,61
Prince Albert Hospital	R 135 198,70
Radie Kotze Hospital	R 68 478,58
Red Cross Childrens Hospital	R 2 994 987,92
Riversdale Hospital	R 210 159,68
Robertson Hospital	0
Somerset Hospital	R 805 743,74
Stellenbosch Hospital	R 270 917,51
Stikland Hospital	R 6 822,08
Swartland Hospital	R 2 582,18
Swellendam Hospital	R 168 770,49
Tygerberg Hospital	0
Valkenberg Hospital	0
Victoria Hospital	(R 400,00) in credit
Vredenburg Hospital	R 418 976,96
Vredendal Hospital	R 170 159,95
Wesfleur Hospital	R 227 512,42
Worcester Hospital	0

b) Measures in place:

• Monthly reporting to Provincial Treasury (PT) Local Government Directorate on Rural debt, which manages outstanding Provincial municipal debt, based on identifying long outstanding debt. PT will engage with the said municipality and the Department to address the debt and identifying and resolving disputes,
• Receipt of month-end outstanding billing from the City of Cape Town (Metro) to ensure all payments processed in that month are allocated to the correct accounts and all Metro accounts are reflected as current.
• BAS reports are monitored monthly.

 

END.

Reply:

1. Applicants are required to submit safety data on vaccines before they are registered by regulatory authorities (SAHPRA in the case of South Africa). Once registered manufacturers and regulatory authorities are required by law to conduct post-marketing surveillance of adverse events following immunisation, and to update or amend registration and product information based on this surveillance.

In addition, health care workers and the public are encouraged to report adverse effects following immunization to SAHPRA. After notification, provincial authorities investigate each case in a systematic manner and provide results to the National Immunisation Safety Expert Committee (NISEC). Experts on this committee evaluate each case to determine causal associations with vaccines. Results of these case evaluations are reported on the SAHPRA website https://aefi-reporting.sahpra.org.za/.

2. No. There is no scientific reason nor evidence to support the notion that exposure to COVID vaccine through a blood transfusion can cause harm to the person who receives the blood. As a result, donated blood is not routinely tested to determine whether it contains COVID vaccine.

3. There are no reported cases of patients reacting negatively to blood as a result of the donor having received a COVID vaccine. Blood donated by vaccinated and unvaccinated persons is processed and made available to potential recipients using the same standardised safety and other procedures.

END.

Reply:

1. Most Provincial Departments have conducted the National Health Facilities Baseline Audits. Some were conducted within the last five years and some are in the process of being reviewed. The table below indicates the last dates of the audits that were conducted/performed by the provincial health departments:

Province	Last date of conditional assessment
EC	June 2013
FS	June 2018
GP	Aug 2017
KZN	Nov 2022
LP	Sep 2023
MP	June 2011
NC	June 2016
NW	April 2015
WC	Sep 2017

2. Yes, all reports will be furnished to Mr G R Krumbock

END.

Reply:

In response to the question, all health facilities in both public and private sector were included. The total number of facilities was divided by population using the 2022 Mid-Year Population Estimates by Statistics South Africa. The South African Health Facilities are classified into three categories, Peri-urban, Rural and Urban.

The total number of health facilities that serve a population of 100 000:

 

(i) Province	Peri-Urban	(a) Rural	(b) Urban
Eastern Cape	2,10	9,95	14,75
Free State	1,81	8,35	24,64
Gauteng	0,35	0,16	15,05
KwaZulu-Natal	1,53	7,60	16,47
Limpopo	1,53	14,78	5,44
Mpumalanga	1,02	6,08	10,19
Northern Cape	4,66	17,57	28,73
North West	1,39	8,07	8,77
Western Cape	1,77	7,57	24,61
National	1,34	6,75	15,43

The Urban category has a higher facility density per 100 000 population followed by the Rural with Peri-Urban having the lowest density. This is comparable to the WHO density assessment which had the hospital density for South Africa per 100 000 population at 0,67 in 2013, Malasia at 0,47 and Sri Lanka at 0,099.

END.

Reply:

1. (a)(i) is indicated in Table 1 below as received from Provincial Departments of Health.

Table 1: (i)Number of Forensic Mortuaries including holding Facilities.

Province	Number
Eastern Cape	22
Free State	11
KwaZulu Natal	33
Gauteng	11
Limpopo	12
Mpumalanga	21
Northern Cape	11
Northwest	7
Western Cape	16
Total	145

 

(1)(a)(ii)(iii) and (b) is indicated Table 3 below as received from the provincial departments of Health.

Table 2(ii): Number of Forensic Pathologists per Province

Province	Number
Eastern Cape	2
Free State	7
KwaZulu Natal	2
Gauteng
Limpopo	7
Mpumalanga	2
Northern Cape	1
Northwest	2
Western Cape	16

Tables below indicate (ii) Number of medical officers(iii) Bodies examined, (b) Backlog per facility.

EASTERN CAPE

	Facility	(ii)Number of Medical officers including pathologists	(iii)Bodies examined for month of August 2023	(b) Backlog as of 31 August 2023
1	Adelaide		Holding Facility	Not applicable
2	Aliwal North	1	25	None
3	Bizana	1	45	None
4	Butterworth	2	70	None
5	Bhisho	1	80	None
6	Dutywa		Holding Facility	Not applicable
7	Gelvandale	2	45	None
8	Grahamstown	1	35	None
9	Graaff-Reinet	1	15	None
10	Joubertina		Holding Facility	None
11	Lusikisiki	1	45	None
12	Mdantsane	1	70	None
13	Mount Fletcher	1	45	None
14	Mount Frere	1	45	None
15	Mount Road	3	35	None
16	Molteno		Holding Facility	Not applicable
17	Mthatha	4	200	None
18	New Brighton	2	65	None
19	Port Alfred		Holding Facility	Not applicable
20	Queenstown	2	80	None
21	Uitenhage	0	40	None
22	Woodbrook	1	80	20

 

FREE STATE PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Bethlehem	1	25	None
2	Bloemfontein	7	95	None
3	Botshabelo	1	26	Not applicable
4	Ficksburg	0	Holding facility	Not applicable
5	Jagersfontein	0	Holding facility	Not applicable
6	Harrismith	0	Holding facility	Not applicable
7	Kroonstad	1	30	None
8	Phuthaditjhaba	1	50	None
9	Sasolburg	1	20	None
10	Smithfield	1	Holding facility	Not applicable
11	Welkom	2	55	None

GAUTENG PROVINCE

No	Facility	(ii)Number of medical officers including pathologist	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Bronkhorspruit	01	29	None
2	Carletonville	02	46	None
3	Diepkloof	06	256	None
4	Ga-Rankuwa	08	121	None
5	Germiston	11	400	None
6	Heidelberg	01	27	None
7	Johannesburg	12	410	None
8	Pretoria	12	219	None
9	Roodepoort	04	161	None
10	Sebokeng	04	230	None
11	Springs	04	164	None

KWAZULU NATAL PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined Jan to Dec 2022 monthly average
1	Bulwer	Shares with Ixopo	Holding Facility
2	Dannhauser	Shares with Newcastle	Holding Facility
3	Dundee	1	20
4	Estcourt	Shares with Ladysmith	32
5	Eshowe	Shares with Richards Bay	26
6	Greytown	2	37
7	Harding	1	19
8	Howick	1	19
9	Ixopo	1	30
10	KwaDukuza	2	73
11	Kokstad	Shares with Ixopo	10
12	Ladysmith	1	60
13	Madadeni	1	44
14	Manguzi	Shares with Richards Bay	Holding Facility
15	Mkhuze	Shares with Richards Bay	Holding Facility
16	Mtubatuba	Shares with Richards Bay	Holding Facility
17	Mosvold	Shares with Richards Bay	Holding Facility
18	Newcastle	3	17
19	New Hanover	Shares with Greytown	10
20	Nkandla	Shares with Richards Bay	Holding Facility
21	Nongoma	1	43
22	Park Rynie	4	141
23	Paulpietersburg	Shares with Vryheid	Holding Facility
24	Pietermaritzburg	4	166
25	Pinetown	8	216
26	Phoenix	3	321
27	Pongola	Shares with Nongoma	Holding Facility
28	Port Shepstone	3	67
29	Richards Bay	3	141
30	Richmond	Shares with Pietermaritzburg	Holding Facility
31	Ulundi	Shares with Nongoma	Holding Facility
32	Umzimkulu	Shares with Ixopo	14
33	Vryheid	1	26

(b) The KwaZulu Department of Health indicates that there is a backlog of 52 bodies as of 31 August 2023.

LIMPOPO PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Polokwane	8	148	None
2	Lebokwakgomo	1	42	None
3	Bela Bela	1	45	None
4	Elim	1	38	None
5	Maphutha Malatjie, Phalaborwa	0	30	None
6	Nkhensani, Giyani	1 for Phutha Malatjie and Nkhensani	40	None
7	Kgapane, Tzaneen	1	35	None
8	Tshilidzini	2	21	None
9	Letaba, Tzaneen	2	24	None
10	St Ritas	1 for both St Ritas and Groblersdal	12	None
11	Mokopane	2	21	None
12	Groblersdal	0	17	None

MPUMALANGA PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Balfour	1	6	None
2	Barberton	1	12	None
3	Belfast	0	11	None
4	Bethal	1 for Bethal and Standerton	21	None
5	Carolina	1 for Carolina and Embhuleni	8	None
6	Delmas	1	8	None
7	Embhuleni	0	13	None
8	Ermelo	1	27	None
9	Evander	1	31	None
10	KwaMhlanga	2 for KwaMhlanga and Mmamethlake	36	None
11	Lydenburg	1 for Lydenburg and Mapulaneng	10	None
12	Mmamethlake	0	0	None
13	Mapulaneng	0	43	None
14	Middelburg	1 for Middleburg and Belfast	30	None
15	Piet Retief	1	14	None
16	Themba	2	65	None
17	Tintswalo	1	23	None
18	Tonga	1	26	None
19	Standerton	0	16	None
20	Volksrust	1	11	None
21	Witbank	2	56	None

 

Mpumalanga Department of Health has additional:

• Forensic Pathologist responsible for the whole province
• 1 Forensic Pathologist responsible for Nkangala District
• 1 Senior Medical officer responsible for Ehlanzeni District
• 1 Senior Medical office responsible for the Gert Sibande District.

NORTHERN CAPE PROVINCE

No	Facility	(ii)Number of medical officers including a pathologist	(iii)Bodies examined for the month of August 2023	(b) Backlog as of 31 August 2023
1	Kimberley	2	50	None
2	Upington	1	33	None
3	De Aar	1	20	None
4	Kuruman	1	30	None
5	Calvinia	1	5	None
6	Springbok	1	15	None
7	Postmasburg		Holding facility	Not applicable
8	Hartswater		Holding facility	Not applicable
9	Douglas		Holding facility	Not applicable
10	Prieska		Holding facility	Not applicable
11	Victoria West		Holding facility	Not applicable

NORTHWEST PROVINCE

No	Facility	(ii)Number of medical officers including pathologists	(iii)Bodies examined on the month of August 2023	(b) Backlog as of 31 August 2023
1	Phokeng	2	82	None
2	Vryburg	1	26	None
3	Klerksdorp	1	23	None
4	Lichtenburg	1	11	None
5	Brits	3	54	None
6	Potchefstroom	2	13	None
7	Mafikeng	1	17	None

WESTERN CAPE PROVINCE

No	Facility	(ii)Number medical officers including Pathologists	(iii)Average Bodies examined for the period April 2022/2023 financial year monthly average
Garden Route / Central Karoo	3
1	Beaufort West		7
2	George		24
3	Knysna		12
4	Laingsburg Mossel		2
5	Mossel Bay		10
6	Oudtshoorn		10
7	Riversdale		5
City of Cape Town
8	Salt River	15	355
9	Tygerberg	15	318
Westcoast/Cape Winelands	4(2 vacant)
10	Malmesbury		14
11	Vredenburg		11
12	Vredendal		16
13	Paarl		40
Winelands/Overberg	4
14	Hermanus		26
15	Ceres		17
16	Worcester		44

(b) The Western Cape Department of Health indicates that the number of outstanding postmortems as of 2023/09/28 is 202 with no mortuaries indicated.

(2) Tables below indicate Forensic pathology mortuary by name and location.

EASTERN CAPE

	Facility	Location
1	New Brighton	New Brighton
2	Mount Road	Mount Road
3	Gelvandale	Gelvandale
4	Grahamstown	Grahamstown
5	Graaff-Reinet	Graaff -Reinet
6	Woodbrook	Woodbrook
7	Mdantsane	Mdantsane
8	Bizana	Bizana
9	Butterworth	Butterworth
10	Bhisho	Bhisho
11	Queenstown	Queenstown
12	Adelaide	Adelaide
13	Aliwal North	Aliwal North
14	Middelburg	Middelburg
15	Mthatha	Mthatha
16	Mount Fletcher	Mount Fletcher
17	Mount Frere	Mount Frere
18	Molteno	Molteno
19	Lusikisiki	Lusikisiki
20	Port Alfred	Port Alfred
21	Uitenhage	Uitenhage
22	Joubertina	Joubertina

FREE STATE PROVINCE

No	Facility	Location
1	Bethlehem	Bethlehem
2	Bloemfontein	Bloemfontein
3	Botshabelo	Botshabelo
4	Ficksburg	Ficksburg
5	Jagersfontein	Jagersfontein
6	Harrismith	Harrismith
7	Kroonstad	Kroonstad
8	Phuthaditjhaba	Phuthaditjhaba
9	Sasolburg	Sasolburg
10	Smithfield	Smithfield
11	Welkom	Welkom

GAUTENG PROVINCE

No	Facility	Location
1	Johannesburg	Hillbrow Johannesburg
2	Roodepoort	Roodepoort
3	Germiston	Germiston
4	Carletonville	Carletonville
5	Springs	Springs
6	Heidelburg	Heidelburg
7	Diepkloof	Diepkloof, Soweto
8	Sebokeng	Sebokeng
9	Pretoria	Pretoria
10	Bronkhorspruit	Bronkhorspruit
11	Garankuwa	Ga- Rankuwa

 

KWAZULU NATAL PROVINCE

No	Facility	Location
1	Phoenix	Phoenix
2	Pinetown	Pinetown
3	Park Rynie	Park Rynie
4	Port Shepstone	Port Shepstone
5	Harding	Harding
6	KwaDukuza	KwaDukuza
7	Pietermaritzburg	Pietermaritzburg
8	New Hanover	New Hanover
9	Howick	Howick
10	Richmond	Richmond
11	Ladysmith	Ladysmith
12	Estcourt	Estcourt
13	Dundee	Dundee
14	Greytown	Greytown
15	Newcastle	Newcastle
16	Madadeni	Madadeni
17	Dannhauser	Dannhauser
18	Kokstad	Kokstad
19	Ixopo	Ixopo
20	Umzimkulu	Umzimkulu
21	Bulwer	Bulwer
22	Nongoma	Nongoma
23	Paulpietersburg	Paulpietersburg
24	Vryheid	Vryheid
25	Pongola	Pongola
26	Richards Bay	Richards Bay
27	Eshowe	Eshowe
28	Richards Bay	Richards Bay
29	Mkhuze	Mkhuze
30	Mosvold	Mosvold
31	Manguzi	Manguzi
32	Nkandla	Nkandla
33	Ulundi	Ulundi

LIMPOPO PROVINCE

No	Facility	Location
1	Polokwane	Polokwane Hospital
2	Lebokwakgomo	Lebowakgomo
3	Bela Bela	Bela Bela Hospital
4	Elim	Elim Hospital
5	Maphutha Malatjie	Maphutha Malatjie Hospital
6	Nkhensani	Nkhensani Hospital
7	Kgapane, Tzaneen	Kgapane Hospital
8	Tshilidzini	Tshilidzini Hospital
9	Letaba, Tzaneen	Letaba Hospital, Tzaneen
10	St Ritas	St Ritas Hospital
11	Mokopane	Mokopane Hospital
12	Groblersdal	Groblersdal Hospital

MPUMALANGA PROVINCE

No	Facility	Location
1	Balfour	Balfour Community Health Centre
2	Barberton	Barberton Hospital
3	Belfast	HA Grove Hospital
4	Bethal	Bethal SAPS
5	Carolina	Carolina Hospital
6	Delmas	Bernice Samuel Hospital
7	Embhuleni	Embhuleni Hospital
8	Ermelo	Ermelo Hospital
9	Evander	Evander Hospital
10	KwaMhlanga	KwaMhlanga Hospital
11	Lydenburg	Lydenburg Hospital
12	Mmamethlake	Mmametlhake Hospital
13	Mapulaneng	Mapulaneng Hospital
14	Middelburg	Middleburg Hospital
15	Piet Retief	Piet Retief Hospital
16	Themba	Themba Hospital
17	Tintswalo	Tintswalo Hospital
18	Tonga	Tonga Hospital
19	Standerton	Standerton Hospital
20	Volksrust	Amajuba Hospital
21	Witbank	Witbank SAPS

NORTHERN CAPE PROVINCE

No	Facility	Location
1	Kimberley	Kimberly
2	Upington	Upington
3	De Aar	De Aar
4	Kuruman	Kuruman
5	Calvinia	Calvinia
6	Springbok	Springbok
7	Postmasburg	Postmansburg
8	Hartswater	Hartswater
9	Douglas	Douglas
10	Prieska	Prieska
11	Victoria West	Victoria West

NORTHWEST PROVINCE

No	Facility	Location
1	Phokeng	Doves Private Mortuary, Rustenburg
2	Vryburg	Joe Morolong Memorial Hospital, Vryburg
3	Klerksdorp	Tshepong Hospital Complex, Joubert on, Klerksdorp
4	Lichtenburg	Lichtenburg SAPS Station Lichtenburg
5	Brits	427 Crocodile St, Primindia, Brits
6	Potchefstroom	25 OR Tambo Street, Potchefstroom
7	Mahikeng	Mahikeng Provincial Hospital

WESTERN CAPE PROVINCE

No	Facility	Location
1	Salt River	Salt River
2	Tygerberg	Tygerberg
3	Paarl	Paarl
4	Vredendal	Vredendal
5	Malmesbury	Malmesbury
6	Vredenburg	Vredenburg
7	Worcester	Worcester
8	Wolseley	Wolseley
9	Hermanus	Hermanus
10	George	George
11	Laingsburg	Laingsburg
12	Mossel Bay	Mossel Bay
13	Knysna	Knysna
14	Oudtshoorn	Oudtshoorn
15	Beaufort West	Beaufort West
16	Riversdale	Riversdale

3. (a) There are no specific regulations in place that regulate the period for post-mortems. The regulations regarding the rendering of Forensic Pathology Service (R359; 23 March 2018) in terms of section 90(1) of the National Health Act does not specifically state any such timelines.

The Forensic Pathology Service in each province does however set targets and measure the turn-around time of post-mortem examinations and most provinces set the 3 to 7 days turnaround time. This also is depended on the number of bodies received and capacity that is available to conduct post-mortems. However, most postmortems are conducted between (1) to (3) days in majority of facilities.

(b) There are regulations that govern mortuaries in terms of the National Health Act (Chapter 8). These are R363; 22 May 2013; Regulations regarding the management of human remains.

The National Code of Guidelines for Forensic Pathology Practice in South Africa, issued in relation to the Regulations of the National Health Act 61 of 2003 provide guidance on period for postmortem examinations and body storage temperatures. The Code of Guidelines stipulate only that postmortem examinations must be conducted as soon as possible. These Code of Guidelines and are currently being revised.

END.

Reply:

1. (a) Bodies were taken to both Hillbrow (Johannesburg) and Diepkloof Forensic mortuaries.

• The Diepkloof Forensic Mortuary was used for postmortem examination, but also as a central storage for bodies so that families can access one central point for identification of family members.
• The Hillbrow (Johannesburg) was also used to conduct advanced scientific investigation such as DNA harvesting, Fingerprint taking and use of the LODOX/ X-Ray services.

(b) All mortuaries in Gauteng province operate with back-up/emergency generators.

(2) The Gauteng Department Health indicates that there were 21 fingerprints taken from the bodies using Forensic Pathology Digital Fingerprint system, 12 bodies were verified of which four (4) bodies were that of immigrants with valid Republic of South Africa permit.

(3) Currently, Gauteng Department of Health Forensic Pathology Service offers a no-fee for the investigation service. The said allegations were investigated by means of CCTV footages, security access control register and media announcements with no success in identifying the complainant.

In addition, Department of Health in Gauteng held a live TV interview session with Newsroom Africa on 07 September 2023 to create public awareness regarding free investigative services provided by Gauteng Forensic Pathology service.

END.

Reply:

There is no obligation on the Provincial Departments of Health to report to the National Department of Health matters that relate to discipline, fraud and/or corruption committed by the provincial staff members. The National Department of Health is not privy to any matter that relates to Mr Ntshane Lephoto as that matter has not been reported to the National Department of Health.

END.

Reply:

According to Limpopo Department of Health;

Cats in Siloam District Hospital, in Vhembe, Limpopo come from nearby households for the purpose of food. The cats increase in numbers due to reproduction. The hospital has an informal agreement with farmers from the area to periodically collect cats to assist them with rodents on their farms. The first collection already happened in September 2023. The NDoH is advising the Limpopo Department of Health to consult the Society for Prevention of Cruelty to Animals (SPCA) to arrive at a good solution to this problem.

END.

Reply:

a) To date from January 2023, a total of 3 974 posts of medical doctors were advertised and filled as compared to 2 053 medical doctors’ posts of the previous year (2022) for the same periods of employment. This means that an additional 1 921 posts for medical doctors were funded to accommodate unemployed medical doctors.

It is also acknowledged that not all unemployed medical doctors after completing community service, applied for these positions due to their different personal interests (e.g., Preference of urban areas rather than rural).

It remains the obligation for the Department of Health to ensure that sufficient platform is available for all eligible South African Citizens and Permanent Residents for medical internship and community service and after qualifying for independent practice, doctors are allowed to seek employment either in public or private sector.

The National Department of Health remains accessible/open to refer unemployed medical doctors, either individually or through their Associations, to Provinces for recruitment to available funded posts.

b) The National Department of Health has been working with the HPCSA throughout the process to ensure that all South African Citizens who studied abroad are eligible and given a fair opportunity to sit for the Medical Board examinations.

Following engagements with HPCSA, the Department can now confirm that the next schedule of exams will be held as follows:

• Theory Medical Board examinations: 25 October 2023.
• Practical/OSCE Medical Board examinations: Planned between 05 and 08 December 2023.
• HPCSA has since invited applicants who meet the requirements for these examinations.

END.

Reply:

The information provided below was accessed the National Health Information System (DHIS)

	Psychiatric hospitals	Provincial hospital	Regional hospital
	Total number of patients treated for mental health related illness in psychiatric hospitals (outpatients departments)	Total number of patients treated for mental health related illness in emergency and outpatients’ departments (ambulatory services)	Total number of patients treated for mental health related illness in emergency and outpatients’ departments (ambulatory services)
2019	209396	47860	152340
2020	110982	57467	140785
2021	75284	57763	152147
2022	81568	67271	167223
2023 (January-July)	45486	46207	99627

NB:

• Specialised psychiatric hospitals do not have emergency departments
• The statistics for emergency and outpatients departments in provincial and regional hospitals are not separated in the DHIS.

END.

Reply:

(1) All investigations emanating due to incidents that happen at provincial level are handled by the specific province. However, there are instances where the Ministry gets informed about some of them.

a) The KwaZulu-Natal Department of Health indicates that the hearing for the two (2) emergency care personnel that were involved in this incident is scheduled to take place on 28 September 2023.

b) All cases, such as this one, follow departmental policy where incidents are investigated. If misconduct is evidently found, then the prescribed disciplinary procedures are followed, and sanctions may be instituted where warranted. In addition, all emergency personnel are registered with the Health Professions Council of South Africa: Professional Board for Emergency Care and are required to abide by the Ethical Code of Practice. Such incidents will also be subjected to the HPCSA processes for managing all formal complaints against practitioners.

c) All complaints are managed directly by health facilities within Provinces. As the National Department of Health, some of the complaints are sent through the office of the Director-General, sometimes through the office of the Minister. For the last financial year we received five (5) complains and two (2) in 2023 regarding Emergency Medical Services. All of the complaints are related to response times and not negligence. According to the information we received from provinces, there are no negligent misconduct cases reported in Emergency Medical Services except the KwaZulu-Natal province.

(2) The matter of the two (2) emergency care personnel leaving a patient is still under investigation. We will await the outcome of investigation. However, it must be noted that there is no excuse for any case of negligence whether related to staff shortage or any other service related challenges.

END.

Reply:

Yes the National Department of Health is informed by all provinces on many issues, including matters related to misconduct.

(a) According to the KZN Department of Health, the case against Sibongile Zungu, the former Head of Kwazulu-Natal is being handled by the law enforcement agencies and they have not been updated on the matter.

(b) In response to the prevalence of fraud, corruption and mismanagement of financial resources, the Department has sought a number of remedies to curb these anomalies by reviewing its policies, embarking on proper management of records and developing Standard Operating Procedures (SOPs). The Department has developed and adopted a Fraud Prevention Plan, Fraud Prevention Strategy and a Whistleblowing Policy which is widely circulated within the Department.

The Department continues to conduct Fraud and Anti-Corruption Awareness to all employees.

 

END.

Reply:

(a) Measures taken and directives issued to hospitals and clinics in protecting and/or highlighting sexual crimes (child pregnancies) in KwaZulu-Natal and throughout the Republic and,

• Maternity Care Guidelines (2023) stipulate that:

• • During the Ante Natal Care visit, every pregnant woman irrespective of age must be screened for possible intimate partner violence.
  • Every pregnant woman must be screened for mental health problems and
  • It is mandatory that health care providers report any cases of every pregnant woman below the age of 18 that point adverse incidents to social services for further management.
• Pre-Exposure Prophylaxis guidelines (2017) stipulate that health care professionals must:

• • follow algorithm of managing women exposed to sexual assault or rape cases which includes ensuring privacy and confidentiality, proper history taking, examination, counselling, medical management, and completion of J88.
  • report (mandatory) through completion of specific form (Form 22 attached as annexure of the Children’s Act) in cases of children, persons with disabilities and the elderly.
  • Refer the affected person (10-14 year old) to the nearest Thuthuzela Centre (TTC) for management of sexual abuse in conjunction with forensic nurses, and other government agencies.

• Termination of pregnancy guidelines(2017) stipulates that:

• • Every pregnant woman has the right to request termination of pregnancy irrespective of age of the woman.

(b) Role of the Department of Health in highlighting the dangers of child pregnancies emanating from sexual abuse being categorized as ordinary teen pregnancies

• Conducts quarterly capacity building workshop for Health Care Workers on mandatory reporting of child abuse and neglect including the completion of a specific form (Form 22, as an annexure to Children’s Act No.38 of 2005) through the support of Department of Social Development who are the custodians of the Children’s Act No.38 of 2005. Over 800 Health Care Workers (HCW) are reached in one session, and four (4) sessions are held in a year since 2020 at the national level.

• Awareness campaigns are held for the children in schools and clinics on the scourge including availability of comprehensive Sexual and Reproductive Health (SRH) services in the health care facilities. The department make use of the Online platforms such as B-Wise. Safe space for adolescents in health care facilities (Youth Zones) have been created to strengthen awareness about the dangers of teenage pregnancies. Awareness campaigns are augmented by provision of SRH services during outreach to avoid missed opportunity to prevent unwanted pregnancies.

END.

Reply:

The Minister is aware of the requirements for hospitals to function optimally.

(a) In relation to SS Gida Hospital, a small district hospital with number of 122 usable beds, the staff establishment as per approved posts on the PERSAL system is 459. The Minister is also aware that the bed occupancy rate is at 42.5%, which necessitates a review of the staff complement appropriate to render the quality of care (does not require the full staff complement).

(b) Included in the table below, are 38 appointments effected between April and September 2023 of which 11 are clinical and 27 are non-clinical.

CATEGORY	TOTAL FILLED
Chief Executive Officer L11	1
Clinical Manager Grd 01	1
Middle Manager Admin L10	1
Assistant Manager Quality L9	1
Medical Practitioners Grd 01-3	6
Dentists Grd 01	1
Information Officer L7	1
Radiographer Grd 01	2
Clinical Associate L7	1
Dentists Grd 01	1
Dental Assistants Grd 01	3
Social Worker (Supervisor) Grd 01	1
Occupational Therapist Grd 01	1
Pharmacist Grd 01-3	1
Pharmacist Ass (post basic)	1
Pharmacy Ass (Learner Basic)	1
Physiotherapist comm serve	1
Radiographer Grd 01	3
State Accountant L6	1
Accounting Clerk L5	1
Registry Clerk L4	1
Driver L3	2
Admin Officer L7	1
Admin Clerks L4	5
Admin Clerks L5	14
Mortuary Attendant L4	1
Porter L2	12
Client Information Clerk L5 (Switchboard)	1
Cleaner L2	32
Laundry Supervisor L4	1
Laundry Worker L2	4
Food Service Supervisor L4	1
Food Service Aid L2	5
Artisan Foremen Grd 2	1
Deputy Manager Nursing	1
Area Manager General In-patient Care Services	1
Operational Manager Speciality	1
OPD/Casualty Services
Operational Manager Speciality	1
Theatre/ CSSD
Operational Manager Speciality Maternity (Antenatal, Post Natal, Labour Ward, Neonatal)	1
Operational Manager Speciality	1
Paediatrics
Operational Manager General	1
Female Medical
Operational Manager General	1
Male Medical
Prof/Nurse Speciality OPD/Casualty	1
Prof/Nurse Speciality Maternity: Antenatal	1
Prof/Nurse Speciality Paediatrics	2
Prof/Nurse General	44
Staff Nurse	15
Nursing Assistant	23

(c) Interviews for 8 Professional Nurses General Grade 1 were conducted and are awaiting confirmation of appointment. Interviews for one Pharmacy post will be conducted on the 5th of October 2023. A further 12 non-clinical posts were approved for next advertisement. As a result, filling of the above posts, will ensure acceptable staffing to render quality care at the facility.

END.

Reply:

(a) The Mpumalanga Department of Health indicates that an enquiry was opened with the Directorate for Priority Crime Investigation in Middelburg on 07 October 2021. This was followed by an internal Department of Health investigation which is about to be concluded. In addition, a case of theft has been opened at Kwa Mhlanga Police Station, CAS number 357/08/2023.

(b) The department is constantly in consultation with the family on this matter. The family will receive an official report once the Department has received feedback from the South African Police Service (SAPS) & Directorate for Priority Crime Investigation.

 

END.

Reply:

The Department has developed the National Policy Framework and Strategy on the Prevention and Control of Cancer. This policy informs implementation of services, starting with prevention and awareness through to management and treatment and concluding with palliative care.

The Department is also administering Human Papilloma (HPV) vaccine to grade 5 girls aged 9 years and older for cancer prevention, since 2014. Other education measures include utilization of different media platforms in collaboration with provinces and non-governmental organisations and patient advocacy groups. These organisations work together with Provinces in conducting screening activities as well as providing education on cancer awareness.

(a) According to KwaZulu-Natal Health Department, specific programmes targeting cancer prevention and education in KwaZulu Natal include PhilaMa Campaign, UuMdlavuza Pap Smear Drive, and Large Loop Excision of the Tranformation Zone (LLETZ) Drive.

Public Awareness on cancer is done through health education sessions, MEC Community Outreach events such as Isibhedlela kubantu; Weekly MEC Live Lunch Time Chat in selected Radio Stations, Health Community Engagements and Community Radio Stations health slots to address various health topics.

The following prevention and education activities are ongoing:-

• Staff capacity building and training
• Facility based health awareness and Health Education,
• Provision of posters and pamphlets,
• Partnership with Cancer Association,
• Cancer screening during outreach programmes

(b) The KwaZulu-Natal Health Department indicated that they reach the most remote areas through:

• Services in health facilities in rural areas
• Cancer screening that is conducted during outreach programmes,
• Use of mobile vehicles of the Department and of partners
• MEC Community Outreach events such as Isibhedlela kubantu; Weekly MEC Live Lunch Time Chat in selected Radio Stations and Health Community Outreach Engagements.

END.

Reply:

Yes, Emergency Medical Services is provided on a 24 hour, 7 days a week basis in all 52 health districts by approximately 3000 ambulances operational from 483 EMS stations located strategically throughout South Africa, in both, rural and urban settings.

a) Ambulances are further strategically assigned within the districts into municipal areas based on community needs, that is, the population density, location of district health services, accessibility to public transport and related socioeconomic factors taking into consideration budget availability. These ambulances are dispatched from our Emergency Communication Centres within the respective districts when requested upon by the callers/patients via our toll-free emergency number - 112.

b) The following measures are in place to complement numbers of ambulances we have:

• In planning the EMS footprint, provinces consider rural settings, and the most marginalized citizens are taken into account.
• Our public EMS in all provinces have service level agreements with private EMS providers for urgent calls and interfacility transfers.
• Prioritized recruitment of EMS personnel for rural districts.
• Use of vehicles with 4 x 4 capabilities are sourced in rural areas for ease of access in the tough terrain of the province. It must be noted that road infrastructure in rural areas is poor and distances to be travelled between health facilities and communities is longer which results in longer response times to emergencies.
• Air ambulance service is used to access some of the hard-to-reach rural settings for life threatening cases.
• Implementation of Planned Patient Transport to reduce usage of ambulances for patients needing transportation only between health facilities.
• EMS plays an integral role in the District Health System, as is the case in any geographical area, therefore, works collaboratively with Primary Health Services and District Hospitals to ensure access and continuity of health care.
• Notwithstanding these measures, we acknowledge that there are service-related challenges, like ambulance shortages, high number of ambulance breakdowns exacerbated by long turnaround times by repair service providers, etc and are cognisant of the variance in service, especially on our rural communities.

END.

Reply:

(1) The Department of Health can confirm that the Oracle tender in Ekurhuleni, does not relate to processes undertaken by the Department hence we are unable to clarify the involvement of the specified person and the outcome of that tender process.

(2) (a) The Gupta-linked Mediosa contract has been thoroughly investigated by the Klerksdorp Serious Commercial Crimes Unit (SCCU) and the person implicated is currently on trial before the Mahikeng High Court. The SCCU investigation did not implicate Dr Masike.

(b) The contract that North West Department of Health entered into with Mediosa was terminated in February 2018.

 

END.

Reply:

1. The information on the tables below was obtained from provinces. Western Cape Province data includes all violent incidents by patients towards staff and not just mental health care users.

(a)(i); (b)(i); (c)(i)

	(a)(i)				(b)(i)	(c)(i)
Province	2019	2020	2021	2022
Eastern Cape	11	4	3	7	Staff physically assaulted or manhandled (kicked, punched, bitten, slapped, pulled) by mental health care users	Elizabeth Donkin and Fort England Specialised Psychiatric Hospitals
Free State	1	1	1	7	Four (4) staff members reported being physically assaulted or manhandled by mental health care users. One (1) got injured whilst separating mental health care users that were fighting and the other five(5) got accidentally injured whilst giving an injection or handling an aggressive user.	Free State Psychiatric Complex, Phumelela hospital, Thebe and National hospitals
KZN	5	3	11	10	Staff physically assaulted or manhandled (kicked, punched, bitten, slapped, pushed, hit with an object) by mental health care users	Madadeni, Town Hill, Ekuhlengeni, Umzimkhulu specialised psychiatric hospitals as well as at King Dinuzulu Complex
Mpumalanga	2	7	33	12	Staff physically assaulted or manhandled by mental health care users	Mental health units/wards at Witbank, Rob Ferreira, KwaMhlanga, Mmametlhake, Embhuleni, Barberton Shongwe and Piet Retief Hospitals
North West	2	6	14	5	Staff physically assaulted or manhandled (stabbed with a pair of scissors, clapped, punched, attempted strangling, scratched, kicked, hit with objects by mental health care users	Witrand, Potchefstroom, Job Shimankana Tabane, Klerksdorp/Tshepong Complex, and Moses Kotane Hospitals
Western Cape	No data	16	20	74	Staff physical assaults by patients. (Data include all incidents and not limited to incidents of mental health care users in psychiatric hospitals)	Psychiatric facilities and general facilities

(a)(ii); (b)(ii); (c)(ii)

	(a)(ii)	(b)(ii)	(c)(ii)
Province	Since 1 January 2023
Eastern Cape	6	Staff physically assaulted or manhandled (shoved, beaten) by mental health care users	Elizabeth Donkin and Fort England Specialised Psychiatric Hospitals
Free State	8	Staff physically assaulted or manhandled (pushed, punched) by mental health care users	National and Thebe Hospitals
KZN	27	Twenty-two staff members were physically assaulted or manhandled (pushed, punched, kicked, clapped) by mental health care users. Two were held hostage whilst three fell and got injured whilst handling aggressive mental health care users	Madadeni, Town Hill, Fort Napier, Ekuhlengeni specialised psychiatric hospitals as well as at King Dinuzulu Complex
Mpumalanga	6	Staff physically assaulted by mental health care users	Witbank Hospital and Mammetlhake Hospital
North West	10	Staff physically assaulted or manhandled (hit with an object, head-butted, clapped, punched) by mental health care users	Job Shimankana, Moses Kotane, Klerksdorp/Tshepong Complex
Western Cape	123	Staff physical assaults by patients. (Data include all incidents and not limited to incidents of mental health care users in psychiatric hospitals)	Psychiatric facilities and general facilities

We still await information from Gauteng, Limpopo and Northern Cape Provinces.

(d) Section 16 of the Occupational Health and Safety Act, 1993 (Act No 85 of 1993) requires the Chief Executive Officer to have safety protocols and procedures in place. Information received from provinces indicates that various mechanisms and procedures are implemented to protect healthcare workers at psychiatric facilities and these include:

• Appointment of Hospital CEOs and District Managers according to Section 16(2 of the Occupational Health and Safety Act)
• Health and Safety Representatives and Committees are nominated and trained
• Conducting continuous risk assessments of mental health care users
• Searching of staff, patients and visitors for any dangerous weapons and illegal substances
• In-service training of staff on management of aggressive mental health care users
• Standard operating procedures for restraints and seclusion of mental health care users

2. The provinces and health facilities in terms of Section 16 of the Occupational Health and Safety Act, No. 85 of 1993 designates that the ‘Chief Executive Officer’ - (Head of Department of the provincial department of Health or the Head of the health facility) - should have safety protocols and procedures in place.

3. While this is a function which is managed by health facility management in every health facility and supervised by provincial health departments, the NDoH, liaises with provincial occupational health units to provide support where required.

4. Please find attached, the occupational health and safety policy for the NDoH. NDoH is awaiting the health facility copies from the provinces.

END.

Reply:

a) According to the response received from the Health Professions Council of South Africa (HPCSA), registration with the HPCSA for foreign qualified applicants is not guaranteed. The relevant Board must satisfy itself that, the curriculum and/or training received is equivalent to that offered in South African institutions, or at least, satisfactory. For the relevant Board to make the necessary determination, it relies on the submission of documentary proof by the applicants for review. Such documents must respond to requirements as set by the relevant Board, including hours of training received domains and evidence of satisfactory clinical exposure during training. The documents usually written in foreign languages may also need to be translated into English and notarised.

A Task Team of the relevant Board will review the submissions and may decide to either reject the application or subject the applicant to a Board examination. Once the Board has approved the application for a Board exam, the applicant may need to wait until a Board examination is available according to set schedules (exams are available frequently set and sometimes may happen only twice in a year).

These processes are lengthy and may sometimes take several months especially as applicants sometimes do not provide all the documentary evidence as required timeously (a non-compliant application will not be processed).

Internship placements is the responsibility of the National Department of Health. Applicants for internship registrations must submit proof of placement to perform internship in an accredited facility. This requirement is in terms of the regulations relating to registration of interns. Those who are waiting placement are therefore not registrable until such time that they have been placed.

b) Based on the above it is evident that there are a number of factors that an applicant must comply with before an application can be processed. If applicants fail to comply with these requirements, then they will unfortunately be delayed. Thus the only way these issues would be permanently resolved is when applicants are in full compliance of the HPCSA requirements.

END.

Reply:

a) According to the Western Cape Department of Health and Wellness, the following factors and occurrences have caused delays on the project:

• Construction Tender delays.
• COVID-19 pandemic delayed the commencement of construction.
• An Implementer (in terms of the IDMS) was appointed in 2023 to manage the implementation of the projects.
• Professional Service Providers (PSP) Contracts came to an end and new PSP’s had to be appointed who need to familiarise themselves with the project documentation.

b) Provision of access to healthcare to the affected community:

• The Pacaltsdorp Clinic is a fixed facility operating from Monday to Friday (07h30 to 16h00), providing comprehensive health including acute, mother and child and chronic diseases management including HAST, with full doctor and pharmacy services daily. The facility is congested, and an appointment system is being implemented to try and relieve this.

In addition

• A dentist and oral hygienist visit the facility once a month, patients are pre-booked for these services. Emergency cases are referred to the Regional Hospital.
• A Mental Health nurses visits the facility twice a week to see booked cases and uncontrolled mental health clients.
• There are three external pick-up points located within the facility catchment area where stable chronic patients collect their medication.
• Mobile outreach services providing comprehensive PHC are provided at 4 sites (one site per week) in 4 different areas furthest away from the clinic in Pacaltsdorp.
• Health promotion outreach is done twice a month where preventive services are provided (family planning, immunisations, screening for HIV and TB, health promotion talks, etc.). The outreach is done to different sites on a rotational basis throughout the suburb so as to reach as many people as possible.
• Where specific health related concerns are identified, ad-hoc outreach is done to address the specific concern and to conduct surveillance as part of our outbreak response.
• Schools and creches are visited quarterly according to a roster for health promotion and dental outreach.
• Psychiatry outreach to the facility is provided by George Regional Hospital, twice a month. Patients requiring urgent specialist psychiatry consultations or urgent and routine specialist services by other medical disciplines, are referred to the Regional Hospital.
• Our partner, SAHARA, does substance rehabilitation on an outpatient basis at the facility, once a week.
• Allied health services are provided on a rotational basis i.e. Occupational Therapy, Speech Therapy, Physiotherapy visits the facility once a week, one speciality per week on a rotational basis. Patients are booked to see these specialists in advance. Patients requiring emergency consults with Allied Health Specialists are discussed with the specialist and seen on special outreaches (additional to planned visits) or refereed to the Regional Hospital Allied Health services.
• Social Work services are provided by DSD and instances where the DSD Social Worker is not available, the Sub-district Social Worker will attend to the case on an urgent basis.
• SASSA Dr does remote file assessment and so doing considers approximately 40 client applications per week.

To increase space in the limited size-facility, space has been extended with standalone containers wherein some of these services are delivered. until the facility is upgraded

Once the building is upgraded and there is a full-time security, we will explore extended hours at the facility and flexible hours for staff to decrease pressure on the facility.

END.

Reply:

According to the Northern Cape Provincial Department of Health, the Frank Smith Diamond Mine is situated 65 km northwest of Kimberley on the farm Frank Smith No HV37, in Dikgatlong Local Municipality (Barkly West area). The population for Smith’s Mine is approximately ±200-300 residents.

These residents are serviced by a mobile clinic from Dikgatlong.

Due to the population size the area will continue to be serviced by a mobile clinic as it does not qualify for a fixed health facility.

The department is engaging on infrastructure improvement on a continuous basis, however not all areas will get a fixed facility for now but will be continuously serviced by the mobile unit. It should be noted that services rendered at mobile unit are same services rendered at fixed clinics.

END.

Reply:

The approach to improving safety and security in all public health facilities is to ensure provision of adequate security infrastructure. Security assessments were previously conducted by the Ministerial Task Team at all public health facilities and the following recommendations were made:

• Improve security infrastructure like perimeter fencing and security guard rooms.
• Installation of security technology like CCTV cameras system, access control and alarm systems at hotspot facilities.
• Effective security contract management to hold Service Providers accountable.
• Regular security patrols at public health facilities by SAPS especially in hotspot facilities.
• Deployment of police reservists at hotspot public health facilities.
• Implementation of intelligence driven security measures at hotspot facilities
• Escort of EMS by SAPS to hotspot communities.

In this regard, a Memorandum of Agreement was entered into between SAPS and NDoH to ensure regular patrols and deployment of Police Reservists. The local hospital management take primary responsibility to provide patients and health care users as safe environment.

END.

Reply:

The following table reflects the details in this regard:

Table 1.

NAME OF THE PROVINCES	HEALTH FACILITIES HAS HE FOUND ACCOUNT FOR THE MOST MEDICO-LEGAL CLAIMS IN EACH PROVINCE?
Eastern Cape	1. Livingstone Hospital
	2. Frere Hospital
	3. Mthatha Regional Hospital
Free State	1. Pelonomi Regional Hospital
	2. Mofumahadi Manapo Mopeli Regional Hospital
	3. Bongani Regional Hospital
Gauteng	1. Chris Hani Baragwanath Academic Hospital
	2. Thelle Mogoerane Regional Hospital
	3. Tembisa Hospital
Kwazulu-Natal	1. Prince Mishyeni Memorial Hospital
	2. King Edward the 8th Hospital
	3. RK Kahn Hospital
Limpopo	1. Tshilidzini Hospital 2. Pietersburg Hospital 3. Mankweng Hospital
Mpumalanga	1. Rob Ferreira Hospital
	2. Themba Hospital
	3. Witbank Hospital
Northern Cape	1. Robert Mangaliso Sobukwe Hospital
	2. Kuruman Hospital
	3. Dr Harry Surtie Hospital
NorthWest	1. Mahikeng Provincial Hospital
	2. Klerksdorp Hospital
	3. Job Morolong Memorial Hospital
Western Cape[1]	1. Tygerberg Hospital
	2. Groote Schuur Hospital
	3. Mowbray Maternity Hospital

END.

1. According to Western Cape’s response: The Department has not identified any specific facility with any disproportionate number of claims, compared to other facilities. Tygerberg, Groote Schuur and Mowbray Maternity Hospitals together account for 31.15% of active claims. ↑

Reply:

The Honourable Member is kindly referred to the attached Annexure 1, containing the response to the same question asked by Honourable Christians of the DA.

END.

Annexure 1

NCOP

QUESTION: 187

FOR ORAL REPLY

DATE: 06 SEPTEMBER 2023

DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 25 AUGUST 2023

(INTERNAL QUESTION PAPER NO. 30)

Ms D C Christians (Northern Cape: DA) to ask the Minister of Health:

(a) What is the current surgery backlog at Robert Mangaliso Sobukwe Hospital in Kimberley and (b) to what extent are elective surgeries taking place as opposed to emergency operations? CO724E

REPLY:

a) According to the Northern Cape Department of Health, the current surgical backlog at Robert Mangaliso Sobukwe Hospital in Kimberley is standing at 6000 cases as at 31 August 2023. This backlog was accumulated during the Covid-19 period. The following table shows the breakdown per specialty field:

Area	Surgery backlog	Type	Waiting time
Urology	471	Multiple type of operations	20 months
General surgery	201	Multiple type of operations	4-5 months
Orthopaedics	Emergency – 41 Elective – 481 Arthroplasty – 509 Hands – 131 Wards – 59 Total = 1221	Multiple type of operations	2-3 months
Ear-Nose-Throat (ENT)	977	Multiple types of operations	6 months
Ophthalmology	Cataract – 2060 Other – 634 Total 2694	Blind patients Partially sighted Pterygium Oculoplastic and strabismus Children with squint	2-3 months
Plastic Surgery	52 electives	Multiple type of operations	No waiting time
Oral and Maxillo-Facial	65 patients	Multiple type of operations	No waiting time
Obstetrics and Gyneacology	250 patients	Multiple type of operations	Gynae 6 months

b) Robert Mangaliso Sobukwe Hospital has the possibility to operate in 8 theatres, but due to severe speciality nursing staff shortage the hospital can only operate in 3 theatres on a daily basis Monday to Friday. One operating theatre is reserved for elective surgeries which are performed daily from 08h00 - 16h00 Monday to Friday.

Emergency surgeries are done daily on a 24/7 surgical list basis. During weekends the hospital only performs emergency cases. The average number of emergencies per week is 105 cases.

 

END.

Reply:

Yes, unused Pfizer and Johnson & Johnson COVID-19 vaccines have been destroyed. Doses of vaccine doses that are yet to expire will also be destroyed.

A total of 70 573 820 does of COVID-19 vaccines were acquired, either as a donation or purchased in line with the bilateral agreement.

• For Johnson & Johnson COVID-19 vaccine, 453 600 doses were received as a donation and 30 848 000 doses were purchased.
• Similarly, for Pfizer COVID-19 vaccines, 7 877 610 doses were received as donation and 31 million doses were purchased.
• 76 800 doses of Paediatric Pfizer vaccine were received as a donation.

To date, 27 536 318 doses have been destroyed, i.e. 20 643 322 doses of Johnson & Johnson COVID-19 vaccine and 6 892 996 doses of Pfizer vaccine.

This is 39% of all doses that were acquired and includes both donated and purchased doses.

a) The estimated monetary value of vaccines to be written off:

• Jannsen vaccine = R 2 501 583 564
• Pfizer vaccine = R 1 328 606 043 (value of donated vaccine written off)

b) Steps to avert such waste

• There is no possibility of any further extension of shelf life of the vaccines from manufacturers and SAHPRA.

• Covid-19 vaccination has been integrated into routine health services.

• The NDoH continues to promote vaccinations to the public until the last dose expires. Various demand creation strategies including vaccinating hard to reach communities through outreach services have been implemented to increase uptake of the vaccine.

END.

Reply:

(1) (a) and (b) In response to the meeting to be held in Panama, the Department has not yet decided on the size of the Delegation (no decision has been taken about a delegation due to cost containment). South Africa has not rectified the Illicit trade protocol and therefore does not participate in MOP.

(i) The Department is not aware of a meeting taking place in Rwanda.

(ii) There is no public sector entities reporting to Minister that will be attending as part of the delegation.

(2) (a),(b) and (c) There is no planned research, training, or policy formulation budget for the anticipated delegation.

(d) and (e) Travel, and substance will be determined once the delegation is approved.

(3) (a) In previous meetings one delegate was funded by WHO and one by the DOH.

 

END.

Reply:

(1) (a) The Department has not yet finalised its position on the various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions

(2) (a) The Department has not yet finalised its position on various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions.

(3) (a) The Department has not yet finalised its position on the various agenda items.

(b) The country’s mandate is based on the latest scientific evidence and country policy decisions.

(4) (a) The Department has not yet finalised its position on various agenda items.

(b) The countries mandate is based on the latest scientific evidence and country policy decisions.

END.

Reply:

According to the Eastern Cape Provincial Department of Health, the

a) On or about the 11th day of June 2013, the Eastern Cape Department of health made a conditional offer of R 500 000. 00 as a full and final settlement without admission of liability. The offer was made purely on humanitarian grounds. The following factors have been advanced:

• The stipulated time on the offer lapsed, and the department deemed that the plaintiff had rejected the offer.
• On or about the 17th day of June 2011 the plaintiff submitted an Actuarial Report demanding a payment of R 4 355 307. 00 (Four million three hundred and fifty thousand three hundred and seven rand).
• The matter has been set down on several dates and we are not aware about any outcomes.
• There is no Court order and essentially the matter is considered dormant.
• The plaintiff has been engaging outside the Court processes and pressurising the Department to pay her R 4 355 307. 00.
• The Department has one medical report dated 1st June 2005 which is inconclusive and does not make any recommendations.
• The Department is of the opinion that there is no offer, and the Department should not revise or entertain plaintiff's demands.
• The Department is advised that there was no nexus or causal link between tooth extraction and the disability that she suffers from.

b) Attempts will be made to advise the plaintiff that she has no claim against the Department but that the Department would still be prepared to make good on its humanitarian offer.

c) (i) The attempts referred to in (b) above will be acted upon on or before 30th September 2023,

(ii) It is hoped that the matter could be finalised before the end of October 2023.

END.

Reply:

According to Mpumalanga Department of Health patients were never turned away. H A Grove Hospital is one of the two district hospitals servicing patients from Emakhazeni sub-district in Nkangala district, as direct patients or referrals from the local clinics both as emergencies and outpatients. The outpatient department has a booking system to avoid long queues and long waiting times. Patients are booked according to the different outpatient clinics.

END.

Reply:

The Department regularly engages with the Health Professions Council of South Africa (HPCSA) on matters pertaining to functions and functioning of the HPCSA, including challenges experienced relating to finalisation of the service level agreement with the service provider to conduct the board examination.

According to the response received from the HPCSA, registration with the HPCSA for foreign qualified applicants is only approved after assessment of the training. The relevant board must satisfy itself that, the curriculum and/or training received is equivalent to that offered in South African institutions, or at least, satisfactory. For the relevant board to make the necessary determination, it relies on the submission of documentary evidence by the applicants for review.

Such documents must respond to requirements as set by the relevant board, including hours of training received, domains and evidence of satisfactory clinical exposure during training. The documents, usually written in foreign languages, may also need to be translated into English and notarised. A Task Team of the relevant board will review the submissions and may decide to either reject the application or subject the applicant to a board examination. Once the board has approved the application for a board exam, the applicant may need to wait until a board examination is available according to set schedules (exams are available frequently set, and sometimes, may happen only twice in a year). These processes are lengthy, and may sometimes take several months, especially as applicants sometimes do not provide all the documentary evidence as required timeously (a non-compliant application will not be processed).

Medical Board examinations are managed on behalf of the Medical and Dental Board (MDB) by an appointed service provider. Previously, this was the Sefako Makgatho University (SMU) whose contract expired, following extensions, in March 2023. The HPCSA had already started a supply chain management process to seek a replacement service provider, with initial bids advertised in March 2022. There was only one bidder that responded, which sadly did not meet the requirements. A closed bid was subsequently advertised in July 2022 to all universities with medical schools.

The same institution again was the sole respondent, still not meeting requirements. Management resultantly sought deviation from Council to enable negotiations with the same institution to provide guidance to ensure that requirements are met. The process took a long time, and it is only being concluded now, with a draft contract negotiated, and will soon be ready for signing.

The HPCSA is still planning to have a round of theory and practical examinations before the end of this year, followed by another round as early as possible next year to address the current backlog of applications received.

 

END.

Reply:

To date from January 2023, a total of 3 974 posts of medical doctors were advertised and filled as compared to 2 053 medical doctors posts of the previous year (2022) for the same periods of employment. This means that an additional 1 921 posts for medical doctors were funded to accommodate unemployed medical doctors.

It is also acknowledged that not all unemployed medical doctors after completing community service, applied for these positions due to their different personal interests (e.g. Preference of urban areas rather than rural).

It remains the obligation for the Department of Health to ensure that sufficient employment is available for all eligible South African Citizens and Permanent Residents for medical internship and community service. This is to enable them to fulfil the legal requirements to qualify for independent practice, after which they can to seek employment either in public or private sector.

The National Department of Health remains accessible/open to refer unemployed medical doctors, either individually or through their Associations, to Provinces for recruitment to available funded posts.

 

END.

Reply:

According to the South African Nursing Council (SANC), the case was reported to them in February 2022, however the Council experienced difficulty accessing the records from the Hospital. The matter was discussed at the Preliminary Investigating Committee in terms of section 47(3) of the Nursing Act, 2005 (Act No. 33 of 2005), which found that there was a case to be answered and in terms of section 47(3)(b) of the Act. The matter was therefore referred to the Professional Conduct Committee for hearing (PCC). The matter has been set down to be heard at the next PCC.

 

END.

Reply:

The following table reflects the details in this regard.

Province	(a) total number of hospitals in each province is experiencing food shortages	(b) are the specified shortages	(c) are the reasons that the specified hospitals are experiencing such shortages?
Free State	11	Fruits Vegetables Meat and dairy products Bread Meat	Budget constrains Unreliable Suppliers and accruals, however, fund shifts have been done to provide more funds on the items. Delays in terms of delivery by suppliers due to late/non-payment - payment will be authorised on time but disbursed late or supplier refusing to deliver meat because of outstanding payment of bread Prolonged Supply Chain processes but is in the process of generating a new order. Suppliers don’t always have the capacity to deliver food items, delivering only partially and then cancelling the remainder of order. Late payment of suppliers.
Kwa Zulu Natal	The Kwa Zulu Natal health facilities have not experienced any food shortage	N/A	N/A
Mpumalanga	There is currently no hospital in Mpumalanga that experience any shortage of food.	N/A	N/A
Western Cape	The Western Cape health facilities have not experienced any food shortages.	N/A	N/A

Inputs are still awaited from Eastern Cape, Gauteng, Limpopo, North West and Northern Cape Provinces. This information will be submitted to Parliament as soon as it is received from these provinces.

 

END.

Reply:

Yes, the National Department of Health had an exhibition area at the 11th SA AIDS Conference. This was in collaboration with the South African National AIDS Council (SANAC).

(a) The total cost breakdown for the exhibition stand is as follows:

Element/s	Costs
1. Booking of exhibition space at the Durban ICC exhibition Hall	R 46 956.54
2. Conceptualization, design, production and dismantling of an exhibition stand frame, panels and related items Audio-visual materials showcasing during the exhibition Sound, information, technical and communication components of the exhibition stand Promotional items and collaterals to be used during the exhibition	R 725,050,00
3. Recording, production, editing of videography and photography of HIV/AIDS, STIs and TB interventions/programmes that were showcased during the exhibition. Lay-out, design and production of Information, Education and Communication (IEC) promotional items that captured HIV/AIDS, STIs policies, guidelines and key documents: lay-out, design and production of IEC materials, lay-out, design and produce memo sticks with key multi-sectoral policies and documents.	R 283,944,20
GRAND TOTAL	R1,055,951

b) The exhibition stand was manned by officials from the National Department of Health and the South African National AIDS Council (SANAC) throughout the conference.

END.

Reply:

(1) The delegates would agree with mandates that are in-line with the country’s goals, existing and planned regulatory frameworks to control the use of Tobacco and related products.

(2) The current Tobacco Products and Electronic Delivery Systems Control Bill has not been passed yet, if during the consultative process there individual or stakeholders that would propose amendments that can advance public health without compromising the health of vulnerable groups they may be considered.

(3) The mandate of the delegation is to engage on matters that will advance public health, as indicated in earlier responses, the country position on various agenda items has not been finalised.

(4) South Africa follows its own legislative process as mandated by Parliament.

 

END.

Reply:

(i) National Department of Health

(aa) The National Department of Health annual report was not printed in the 2020/2021 financial year due to the COVID-19 pandemic. Electronic copies were circulated to the stakeholders and uploaded on the departmental website.

(bb) For the 2021-2022 Annual Report –

(a) R279,900 was paid for printing

(b) Ribola Holdings

(c) 500 copies

(cc) The procurement process of printing of the 2022-2023 annual report is underway and the appointment of the successful service provider is expected to be finalised before the end of September 2023.

(ii) Public Entities

Council for Medical Schemes

Financial Years	(a)(ii) Total amount spent on printing	(b) who were the suppliers	(c)(ii)(i) Total number of copies printed in each specified year
(aa) 2020-21	R109 940.00	Kashan Advertising	300
(bb) 2021-22	R336 974.70	Shereno Printers	500
(cc) 2022-23	R 42 535.57	Lebone Litho Printers	150

Office of Health Standards Compliances

Financial Years	(a)(ii) Total amount spent on printing	(b) who were the suppliers	(c)(ii)(i) Total number of copies printed in each specified year
(aa) 2020-21	R138 600	The Link Institute	200
(bb) 2021-22	R29 900	Creative Boost	200
(cc) 2022-23	R166 310	Rebuild Group	200

National Health Laboratory Service

Financial Years	(a)(ii) Total amount spent on printing	(b) who were the suppliers	(c)(ii)(i) Total number of copies printed in each specified year
(aa) 2020-21	R88 456	Milk Brown Design and Communications	150
(bb) 2021-22	R82 245.70	45TH Media (Pty) Ltd	200
(cc) 2022-23	R37 600.40	Litha Communications (Pty) Ltd	200

South African Health Products Regulatory Authority

Financial Years	(a)(ii) Total amount spent on printing	(b) who were the suppliers	(c)(ii)(i) Total number of copies printed in each specified year
(aa) 2020-21	R159 988	45th Media	500
(bb) 2021-22	R192 860	Shereno Printers CC	500
(cc) 2022-23	R156 319.50	Shereno Printers	300

South African Medical Research Council

Financial Years	(a)(ii) Total amount spent on printing	(b) who were the suppliers	(c)(ii)(i) Total number of copies printed in each specified year
(aa) 2020-21	R83 288.75	Blackburn Solutions	100
(bb) 2021-22	R55 549.60	Lebonelitho Printers	100
(cc) 2022-23	R87 429.90	Blackmoon Advertising	100

END.

Reply:

(a) (i) and (ii) The following table reflects the details in this regard

a) What is the current waiting list of
Hospital	(i) Surgeries	(ii) backlog in the hospitals in Mpumalanga
	General Surgery	Gynae	Cataract	Paediatric	Orthopaedic
Rob Ferreira	170	0	1900	110	0	2180
Witbank	204	0	1710	0	54	1968
Mapulaneng	70	0	63	0	13	146
Themba	180	32	225	0	12	449
Ermelo	50	0	410	0	72	532
Total	674	32	4308	110	151	5275

(b) The department is running a Registrar Training Programme, which is a programme that offers bursaries to Mpumalanga Medical Officers to train as specialists in the different disciplines. The Medical Officers sign a contract with a work-back obligation to ensure they serve the province after completion of training. The period of the work-back obligation is equivalent to the time the registrar spent in training. The department continues to headhunt surgeons and other specialists to increase the pool.

The department is running synchronised marathons in the regional- and tertiary hospitals (namely Rob Ferreira and Witbank Provincial Tertiary hospitals and Mapulaneng, Temba and Ermelo regional hospitals) to reduce the backlogs of patients waiting for operations and this is beginning to bear fruits. The following can be reported:

• Orthopaedic marathon was conducted from the 8-31 May 2023. A total of 427 patients were operated in the two tertiary and three regional hospitals. Some of the operations conducted include Open reduction and internal fixation (ORIF), Femur nailing, K-Wire removals, debridements, tendon repairs etc.
• For General Surgery, 19 patients were operated in July 2023 at Ermelo regional hospital in one day to reduce backlog because Ermelo hospital does not have surgeons. The team that worked there included three surgeons, two anaesthetists from tertiary and other regional hospitals, as well as Ermelo hospital medical officers. The operations conducted included Myomectomies, Skin graft, Inguinal hernia repair, Laparotomy (complex), Mastectomy (complex). The plan is to provide outreach to Ermelo until they have at least one surgeon. This approach is meant to support any hospital that doesn’t not have a specific specialty.
• Women’s Health Gynae Operations were done throughout the month of August 2023 from 3rd to the 31st in all the two tertiary and three regional hospitals. A total of 259 women were operated. Operations conducted include total abdominal hysterectomies, vaginal Hysterectomies, Myomectomies, Bilateral Tubal Ligations, Rectovaginal Fistula Repairs and Laparoscopy.

The department continues to work on interventions to manage the waiting list of patients waiting for surgeries. The department also works with Tshemba Foundation NPO for cataract surgeries

It is worth noting that the recruitment of specialists in rural provinces remains a major problem and the affected provinces continue to look for innovative ways to recruit and retain specialists.

END.

Reply:

According to Mpumalanga provincial department of health:

(a) There are 62 clinics out of 294 clinics in Mpumalanga that do not have visiting doctors because of difficulty to recruit and retain doctors.

(b) Patients who use the specified health facilities and those who needs to be seen by the doctors are referred to the nearest referral hospital, since the Primary Health Care services are nurse managed with doctor support.

(c) The department is contracting GPs to increase support to PHC facilities and is currently in the process of contracting a total of 69 general medical practitioners to increase support to PHC facilities.

(d) It is not possible to provide this date because it is uncertain what the recruitment/contracting process will yield for 62 clinics that do not have visiting doctors.

(e) and (f) PHC Facilities that do not have visiting doctors and the wards in which they are located are in the tables below:

District	Sub-district	(e) what are the names of the clinics in Mpumalanga that do not have visiting doctors and	(f) in which wards are they located?
Ehlanzeni	City of Mbombela North	Clau-Clau	10
Ehlanzeni	City of Mbombela North	Khumbula	34
Ehlanzeni	City of Mbombela North	Manzini	7
Ehlanzeni	City of Mbombela North	Zwelisha
Ehlanzeni	City of Mbombela South	Glenthorpe clinic	45
Ehlanzeni	City of Mbombela South	Kaapsehoop clinic	30
Ehlanzeni	City of Mbombela South	Boulders clinic	30A
Ehlanzeni	City of Mbombela South	Low’s Creek clinic	43
Ehlanzeni	City of Mbombela South	Louieville clinic	30B
Ehlanzeni	Nkomazi	Masibekela	14
Ehlanzeni	Nkomazi	Figtree	11
Ehlanzeni	Nkomazi	Mbangwane	12
Ehlanzeni	Nkomazi	Mbuzini	13
Ehlanzeni	Nkomazi	Ndindindi	13
Ehlanzeni	Nkomazi	Strydomblok (Municipality)	6b
Ehlanzeni	Nkomazi	Mananga	12
Ehlanzeni	Nkomazi	Dludluma	6
Ehlanzeni	Nkomazi	Jeppes Reef	32
Ehlanzeni	Nkomazi	Driekoppies	26
Ehlanzeni	Nkomazi	Middelplaas	31
Ehlanzeni	Nkomazi	Jeppes Rust	18
Ehlanzeni	Nkomazi	Mgobodzi	15
Ehlanzeni	Nkomazi	Sihlangu	16
Ehlanzeni	Nkomazi	Sikhwahlane	19
Ehlanzeni	Nkomazi	Phiva	10
Ehlanzeni	Nkomazi	Boschfontein	23
Ehlanzeni	Nkomazi	Sibange	16
Ehlanzeni	Nkomazi	Ritchershoek	29
Ehlanzeni	Nkomazi	Buffelspruit	29
Ehlanzeni	Nkomazi	Schoemansdal	28
Ehlanzeni	Nkomazi	Ntunda	19
Ehlanzeni	Nkomazi	Schulzendal	31
Ehlanzeni	Nkomazi	KaMdladla	07
Ehlanzeni	Thaba Chweu	Brondal	11
Ehlanzeni	Thaba Chweu	Simile	06
Ehlanzeni	Thaba Chweu	Kiwi Clinic	05
Ehlanzeni	Bushbuckridge	Calcutta Clinic	03
Ehlanzeni	Bushbuckridge	Mkhuhlu Clinic	01
Ehlanzeni	Bushbuckridge	Oaklely Clinic	24
Ehlanzeni	Bushbuckridge	Jim-brown Clinic	06
Ehlanzeni	Bushbuckridge	Thokozani Clinic	06
Ehlanzeni	Bushbuckridge	Madras Clinic	02
Ehlanzeni	Bushbuckridge	Cottondale Clinic	20
Ehlanzeni	Bushbuckridge	Moreipuso Clinic	32
Ehlanzeni	Bushbuckridge	Orinocco Clinic	12
Ehlanzeni	Bushbuckridge	Arthurseat Clinic	10
Ehlanzeni	Bushbuckridge	Xanthia Clinic	37
Ehlanzeni	Bushbuckridge	Zoeknog Clinic	32
Ehlanzeni	Bushbuckridge	Cork Clinic	23
Ehlanzeni	Bushbuckridge	Belfast Clinic	23
Ehlanzeni	Bushbuckridge	Goromane clinic	01
Ehlanzeni	Bushbuckridge	Skukuza Clinic	38
Total PHC facilities not supported by a doctor in Ehlanzeni: 52

District	Sub district	(e) what are the names of the clinics in Mpumalanga that do not have visiting doctors and	(f) in which wards are they located?
Gert Sibande	Chief Albert Luthuli	Diepdale Clinic	01
	Chief Albert Luthuli	Glenmore Clinic	11
	Chief Albert Luthuli	Swallowsnest Clinic	06
	Chief Albert Luthuli	Bettysgoed Clinic	06
	Chief Albert Luthuli	Kroomdraai Clinic	12
	Chief Albert Luthuli	Vlakplaas Clinic	19
	Chief Albert Luthuli	Arhmberg Clinic	10
	Chief Albert Luthuli	Mbejeka Clinic	18
	Chief Albert Luthuli	Carolina Clinic	15
	Chief Albert Luthuli	Silobela Clinic	22
Total PHC facilities not supported by a doctor in Gert Sibande: 10

 

Grand total for Ehlanzeni and Gert Sibande= 62 PHC facilities not supported by the doctors but refers patients to the nearest hospitals.

END.