Questions and Replies

Reply:

a) The Health Professions Council of South Africa (HPCSA)’s Registrar has informed the Minister that –

(i) 382 foreign-qualified persons applied for registration as medical practitioners;

(ii) 5 foreign-qualified persons’ applications were rejected during the period 2020, 2021 and 2022.

As per table below:

Year	Number applied and accepted	Number applied and rejected	Total
2020	116	0	116
2021	83	5	88
2022	178	0	178
Total	377	5	382

(b) (i) In 2020 – None were rejected;

(ii) In 2021 – 5 were rejected, because upon assessment, it was found that the universities where the 5 applicants studied did not meet the standard to be either equivalent or satisfactory compared to the South African standard for registrability;

(iii) 2022 – None were rejected.

END.

Reply:

(a) The estimated number of doses of vaccine that may go for waste is:

• Janssen® COVID-19 vaccine (Janssen vaccine) is 20 780 450.
• Comirnaty® vaccine (mRNA COVID-19 vaccine) (Pfizer vaccine) is 7 479 930

(b) Monetary value of these vaccines is:

• Janssen vaccine = R 2 677 716 836
• Pfizer vaccine = R 1 208 569 690

END.

Reply:

The breakdown of the procurement allocation submitted by health public entities in terms of the percentages allocated to the indicated enterprises (i-iv) is provided in the table below, per the (aa) 2021-22 financial year and (bb) since 1 April 2023:

Enterprises Categories b (i-iv)	(aa) 2021/22	2022/23	(bb) Since 1 April 2023
	Percentage of allocation	Percentage of allocation	Percentage of allocation
South African of Medical Research Council
(i) Small, medium and macro enterprises	1%	1%	1%
(ii) Cooperatives	0%	0%	0%
(iii) Township enterprises	0%	0%	0%
(iv) Rural enterprises	0%	0%	0%
Council for Medical Schemes
(i) Small, medium and macro enterprises	63.13%	50.07%	48.45%
(ii) Cooperatives	0%	0%	0%
(iii) Township enterprises	0%	0%	0%
(iv) Rural enterprises	0.28%	1.10%	0%
South African Health Products Regulatory Authority
(i) Small, medium and macro enterprises	66%	84%	100%
(ii) Cooperatives	0%	0%	0%
(iii) Township enterprises	5%	1%	0%
(iv) Rural enterprises	0%	0%	0%
National Health Laboratory Service
For Requests for Quotations (RFQ) of less than R1m
(i) Small, medium and macro enterprises	37.9%	61.5%	71.7%
(ii) Cooperatives	0.0%	0.0%	0.0%
(iii) Township enterprises	1.1%	0.4%	2.3%
(iv) Rural enterprises	0.7%	0.1%	0.2%
For Requests for Bids (RFB) with a value of over R1m
(i) Small, medium and macro enterprises	6%	21%	0%
(ii) Cooperatives	0%	0%	0%
(iii) Township enterprises	0%	2%	0%
(iv) Rural enterprises	0%	5%	0%
Office of Health Standards Compliance
(i) Small, medium and macro enterprises	29.02%	29.23%	38.09%
(ii) Cooperatives	0.03%	0%	0%
(iii) Township enterprises	2.87%	0.01%	13.73%
(iv) Rural enterprises	0%	95.31%	0

END

Reply:

The Compensation of Employees (COE) when compared to the allocated budget for 2021/22 financial year has shown a decrease of 0.3% (R458.4 million) in 2022/23 and a further additional 4.0% (R6.1 billion) decrease in 2023/2024 baseline.

This has negatively affected Human Resources Capacity in the Public Health Sector, and has forced Provinces to freeze/cut posts funded through the Equitable Share to avoid overspending in Compensation of Employees (COE). The situation was further aggravated by the cessation of the Covid-19 Grant budget as on 31 March 2023, which resulted in termination of employment contracts for employees employed through the Grant.

Currently, Provinces are unable to fill existing vacant posts, despite service delivery needs/demands. Instead, they (Provinces) are required to prioritize filling of posts across all levels of care within the available budget.

In order to mitigate the above, the Provincial Department of Health have introduced several interventions to address the shortage of health workers (i.e. amongst others doctors, nurses and general workers) in healthcare facilities, which amongst includes:

• Prioritisation of the posts in the Annual Recruitment Plan – where funding permits
• Prioritisation of the posts for conditional grant funding
• Filling of replacement posts considered and approved through Annual Recruitment Plan
• Provision of internship and community service programmes

a) In accordance with the PERSAL report below, extracted on 30 April 2023, the overall vacancy posts are 45 072 (i.e. 35 462 health related posts and 9 610 administration and support related posts) in the public health sector.

1.1 Health-Related vacant post (Occupational Groups) per provincial departments as at April 2023
	EC	FS	GP	KZN	LP	MPU	NDoH	NW	NC	WC	Grand Total
DEVELOPMENTAL PROGRAMMES	0	0	0	101	0	8	0	23	0	568	700
EMERGENCY SERVICE AND RELATED PERSONNEL	270	576	574	191	69	21	0	112	134	124	2071
ENGINEERING RELATED AND SUPPORT PERSONNEL	4	22	19	17	3	4	1	13	5	28	116
HEALTH ASSOCIATED SCIENCES AND SUPPORT PERSONNEL	575	1454	1769	1133	272	136	47	474	355	524	6739
MEDICAL SCIENCES AND SUPPORT PERSONNEL	421	719	1166	1077	678	152	10	197	111	341	4872
MEDICAL TECHNOLOGY AND SUPPORT PERSONNEL	15	324	44	38	5	2	0	6	1	11	446
NATURAL SCIENCES RELATED AND SUPPORT PERSONNEL	0	6	1	0	0	0	1	0	0	0	8
NURSING AND SUPPORT PERSONNEL	4		1264	107	20	8	0	0	0	0	1403
NURSING ASSISTANT	255	718	368	513	101	143	0	320	122	213	2753
PROFESSIONAL NURSE	2033	1616	3753	2832	731	506	1	710	325	561	13068
SOCIAL SERVICES AND SUPPORT PERSONNEL	1	44	26	35	2	4	0	13	6	33	164
STAFF NURSE	303	533	484	1014	186	246	0	142	57	157	3122
Grand Total	3881	6012	9468	7058	2067	1230	60	2010	1116	2560	35462

 

1.2 Admin Related vacant posts (Occupational Groups) per provincial departments as at April 2023
	EC	FS	GP	KZN	LP	MPU	NDoH	NW	NC	WC	Grand Total
ADMINISTRATIVE LINE FUNCTION AND SUPPORT PERSONNEL	191	443	882	739	44	163	60	300	195	339	3356
AGRICULTURAL RELATED AND SUPPORT PERSONNEL	6	28	72	34	26	18	0	57	1	0	242
ARTISAN AND SUPPORT PERSONNEL	53	225	3	251	48	3	0	19	19	101	722
COMMUNICATION AND INFORMATION RELATED PERSONNEL	16	5	18	8	0	0	3	16	0	19	85
ECONOMIC ADVISORY AND SUPPORT PERSONNEL	2	75	18	0	0	18	0	0	198	311
HUMAN RESOURCE AND SUPPORT PERSONNEL	1	14	124	212	0	1	9	52	1	102	516
INFORMATION TECHNOLOGY AND RELATED PERSONNEL	9	33	19	8	0	0	7	8	5	35	124
LEGAL AND SUPPORT PERSONNEL	1	1	2	1		0	3	1	2	0	11
MANAGEMENT AND GENERAL SUPPORT PERSONNEL	365	1060	662	893	311	481	86	264	74	40	4236
REGULATORY AND SUPPORT PERSONNEL	7	0	0	0	0	0	0	0	0	7
Grand Total	642	1818	1857	2164	429	666	186	717	297	834	9610

b) Even-though, the is a systematic process of approving funding and advertisements of posts by Accounting Officers (through the Annual Recruitment Plan) a further consultation with the Provincial Treasuries supersedes filling of vacant posts to avoid exceeding Cost of Employment (COE) budgets. It therefore not possible to mention a specific date but to alert that the filling of posts is prioritized across the Public Health Sector.

Reply:

1. The Clinical Associates matters raised in the Task Team report as well as the proposals for addressing some of the concerns raised in the report were presented to the National Health Council Technical Advisory Committee (NHC Tech) which is a forum that consist of the NDoH’s Executive Committee with Provincial Heads of Health Departments on 18 November 2021.

NHC Tech accepted the proposal to undertake a comprehensive review of the Clinical Associates programme.

2. The Department engaged with the HPCSA on the matter of prescribing rights

for Clinical Associates and was appraised about the application made by the Council to the South African Health Products Regulatory Authority (SAHPRA) in terms of the provisions of Section 22A of the Medicines and Related Substances Act, 1965 (Act 101 of 1965) to add Clinical Associates to the list of authorized prescribers.

3. The National Department of Health has held meeting(s) with the Department of Public Service and Administration to table issues pertaining to the conditions of service for the Clinical Associates as raised in the Public Protector’s report. The issue of Occupational Specific Dispensation (OSD) is being dealt with through a process lead by the Department of Public Service and Administration (DPSA). DPSA has commissioned Price Waterhouse Coopers (PWC) to conduct a Personnel Expenditure Review (PER), that includes the review of OSDs in the public sector.

4. The Department has commenced with the process of conducting the review of the Clinical Associates programme performance. The Terms of Reference and data collection tools for the review have been drafted and a process is underway to get them approved. It is therefore envisaged that the review will have been conducted by 30 November 2023. However, finalization of the review and recommendations thereof will be subject to various approval processes of the Department that may extend beyond 30 November 2023

END.

Reply:

a) Section 17 of the Health Professions Act (Act no.56 of 1974) makes registration with the Council a prerequisite to practice any health professions registrable in terms of the Act and practicing while not registered amounts to a criminal offence.

According to the Health Professions Council of South Africa (HPCSA/Council), 124 persons have been arrested for practicing medicine without registration with the HPCSA.

b) In 2014 Council established an Inspectorate Office as a compliance enforcement unit to enforce compliance through conducting inspections of the registered practitioners, suspected/erased practitioners, and to attend to complaints of illegal practice by unregistered persons (bogus practitioners). The office works closely with other regulatory bodies and law enforcement agencies to protect the public against illegal practices by unregistered persons (bogus practitioners). The Council also conducts awareness campaigns to educate the members of the public on how to identify and report bogus practitioners.

In the public healthcare system, one of the requirements for employment is verification of registration with the Health Professions Council before a person can be employed as a doctor. This verification prevents an unregistered person from practicing in the public healthcare system.

In the private healthcare sector, medical schemes also have a verification system in place before doctors can be reimbursed for services rendered.

Unregistered persons evade these systems by working in the private sector where they either only accept cash payment or work in the practice of a registered doctor.

Reply:

1. During the COVID-19 pandemic, there were no backlogs in the distribution of medication. Additionally, there have been no major supply chain challenges related to the essential medicines during the pandemic period.

2. During the pandemic period, patients on chronic therapy, including patients on antiretorvirals, received at least two months’ supply of the medication in an effort to reduce pressure on facilities. Additionally, patients received medicines via the CCMDD programme.

END.

Reply:

National Health Insurance (NHI) describes a totally reformed health system that strives to achieve equity in provision of services. The objective it to achieve Universal Health Coverage where every person gets the health care that they need, when they need it, where they need it and without incurring any financial hardship. NHI is designed to redress some of the worst inequities that characterize the South African health system. These inequities continue to significantly affect the most vulnerable, poor sections of our society, especially those that reside in rural, far-flung areas that continue to struggle to access and utilize needed health services.

It is because many communities, both remote areas and those who live in townships and informal settlements of urban areas, have poor access to health services that we need the NHI.

As the Bill provides for the NHI Fund will be mandated to use strategic purchasing to develop healthcare coverage and access that is equitable. This includes purchasing services from private providers whose facilities are in close proximity to communities that can presently not use those services. It also means changing the way that services are paid for so that providers find it more attractive to move to areas that are presently inhospitable to them because there is no advantage over working in an established urban community.

The introduction of capitation payments and contracting units for PHC will systematically shift resources to communities where resources are presently well below average and are unacceptable. Using a single set of benefits and common formulary the system will reduce overheads and duplications and make more of the existing funds available for services rather than administration and profit-taking.

These provisions are clear in the NHI Bill which has reached the point of the vote in the National Assembly.

The National and Provincial Departments of Health continue to implement a number of interventions directed at maintaining existing infrastructure (clinics, hospitals, CHCs, etc.); refurbishments as well as the commissioning of new ones to address quality and related challenges, with a strong focus on facilities located in mainly rural and disadvantaged areas.

The National Department of Health embarked on the development of a Health Integrated Portfolio System (HIPS) or previously known as the Ten-Year Infrastructure Plan. The system utilised Geographic Information System (GIS), topographical data, locations of current and future planned facilities, demographics and the road networks, to determine accessibility gaps. Projects identified via the gaps will be prioritised and executed as per the normal health infrastructure planning and delivery cycles. This will provide an objective tool to prioritise investments in Health Infrastructure. The first draft of the tool is already expected within the 2023/2024 financial year and will be utilised to guide allocation of funds hence forth. Further to the above the Department is focusing on addressing maintenance, refurbishment, upgrades, and/or replacements as well as new infrastructure in remote rural areas and informal settlements in preparation for the implementation of NHI.

END.

Reply:

a) The names of the mines that have been inconsistent over the past three years and/or not paid levies to the CCOD, either indefinitely or on time are:

1. Wearne Aggregate Quarries
2. Rhino Minerals
3. Manhattan Corporation Pty Ltd - Gravellotte Mine

b) Inspections are undertaken by the finance inspectors of the CCOD to assess the mines and works on accuracy of risk shifts and levy payments; the Deputy Director (Revenue) has written to the above mines and works requesting payment of the levies. Meetings are being set up with the Compensation Commissioner and the Chief Executive Officer of the above mines and works. As a last resort, the legal section of the department will be consulted to assist through the state attorney’s office to begin legal proceedings against the defaulting mines and works.

END.

Reply:

a) Yes, Mpumalanga has post level 1 healthcare facilities as follows:

• 2 x Tertiary Hospital offering level 3 &2 services namely Rob Ferreira and Witbank tertiary hospitals.
• 3 x Regional Hospitals offering level 2 &1 services namely Ermelo, Mapulaneng and Themba regional hospitals.

b) The National Department of Health in collaboration with the Mpumalanga department of health are working on the improvement of some key services as indicated in response(c) below.

The Mpumalanga department of health is only referring level 3 cases to Steve Biko and George Mukhari Academic hospitals for services that the province doesn’t have, for example Cardiology Services and Oncology Radiation Services.

Patients who are going to Mamelodi hospital are going there on their own accord and they are not being referred by the province because those services are available and accessible to the Mpumalanga communities.

c) The Mpumalanga Department of Health has already established the Chemotherapy services at the Witbank and Rob Ferreira hospitals. Patients in need of this service are no longer being taken to Gauteng.

The province is currently processing the establishment of Nephrology Service to have the in-house dialysis services for patients. The province has started with phase 1 planning for the upgrading the Maternity and Mental health Units at the Kwa Mhlanga hospital. The plan is to expand more services until all domains are covered however this depends on the availability of funds.

END.

Reply:

The two officials referred to in the Parliamentary Question were criminally charged by the National Prosecuting Authority (NPA) based on the referral from the Special Investigating Unit (SIU). They were then suspended based on these criminal charges. We have since been informed by the Director-General of the Northern Cape Province that these officials were reinstated after the criminal charges were withdrawn on the 8th December 2022.

END.

Reply:

It is not correct to conclude that majority of pharmacy dispensary duties at clinics, are carried out by nurses. These functions may also be performed by a pharmacist’s assistant (post basic) functioning under the indirect supervision of a pharmacist. Only professional nurses who have been authorised in terms of Section 56(6) of the Nursing Act 53 of 2005, are allowed to dispense medicines up to schedule 4. In some clinics, pharmacist assistants have been appointed to perform duties related to managing medicines in the facility. The process of task sharing is meant to optimise the utilisation of different categories of staff in the team to alleviate bottlenecks that may hamper the dispensing of medicine at a clinic and it does not affect nurses focusing on delivering health services within their scope

a)(i) The tables below provide a Persal breakdown of filled and vacant posts per provinces as of February 2023, which actually shows that vacant posts are minimal and does not impact negatively on service delivery.

Summary of filled and vacant Pharmacy post per province as at April 2023
	EC	ECP Total	FS	FS Total	GP	GP Total	KZN	KZN Total	LP	LP Total
Title	Filled	Vacant		Filled	Vacant		Filled	Vacant		Filled	Vacant		Filled	Vacant
CLINICAL PHARMACIST	3	1	4	0	1	1	-	--	-	-	-	--	-	--	-
PHARMACIST	319	18	337	83	38	121	364	20	384	499	15	514	389	26	415
PHARMACIST (COMMUNITY SERVICE)	61	14	75	34	14	48	88	32	120	139	11	150	60	22	82
PHARMACIST (INTERN)	48	0	48	1	13	14	71	4	75	170	66	236	154	83	237
PHARMACIST ASSISTANT	141	15	156		3	3	86	13	99	210	50	260	25	4	29
PHARMACIST ASSISTANT (POST-BASIC)	456	49	505	343	99	442	636	20	656	1077	78	1155	325	35	360
Grand Total	1028	97	1125	461	168	629	1245	89	1334	2095	220	2315	953	170	1123

Summary of filled and vacant Pharmacy post per province as at April 2023
	MPU	MPU Total	NW	NW Total	NC	NC Total	WC	WC Total
Titel	Filled	Vacant		Filled	Vacant		Filled	Vacant		Filled	Vacant
CLINICAL PHARMACIST	-	-	-	-	-	-	-	-	-	-	-	-
PHARMACIST	250	12	262	209	17	226	68	3	71	246	16	262
PHARMACIST (COMMUNITY SERVICE)	52	4	56	80	0	80	39	1	40	39	6	45
PHARMACIST (INTERN)	11	2	13	16	0	16	8	2	10	22	1	23
PHARMACIST ASSISTANT	23	5	28	41	14	55	12	8	20	24	2	26
PHARMACIST ASSISTANT (POST-BASIC)	207	9	216	139	13	152	158	15	173	576	22	598
Grand Total	543	32	575	485	44	529	285	29	314	907	47	954

(b) Provinces have established recruitment Task Team that prioritises the filling of positions in line with service delivery needs. To ensure that their expenditure on recruitments does not exceed the allocated Cost of Employment (CoE) Budgets. Where there are records of shortages of health care workers (including Pharmacists), the department mitigates by appointing contract employees to address shortages. To ensure further continuity of services, the department offers permanent employment where funding permits.

END.

Reply:

The National Department of Health is determined to implement National Health Insurance (NHI) as the only viable and sustainable intervention to effectively transform the South African health system into one that offers equitable, accessible, affordable and quality health care to all irrespective of their social or economic status. A tiered approach to the provision and access of needed health services is contrary to the values of the Constitution, specifically the rights of every South African as enshrined in the Bill of Rights.  

Concerning developments around the Low Cost Benefit Options (LCBOs), the Council for Medical Schemes (CMS), the statutory body responsible for regulatory oversight of all duly registered medical schemes, issued Circular 13 of 2023: Update on the status of the Development of LCBO Guidelines dated 28 March 2023. This Circular provides an industry update. In this Circular, it was indicated that through a series of industry consultative meetings initiated in 2015 with key government departments, regulatory entities and industry stakeholders, three Advisory Committees supported by technical work-streams were established by the CMS to work on developing draft LCBOs guidelines. The Committees produced the LCBOs Framework Report and Risk Assessment & Roadmap, together with the proposed LCBO guidelines, which were published in Circular 53 of 2022 for public comments and inputs.

Subsequently, at the request of stakeholders and other interested parties, Circular 57 of 2022 was issued, notifying the public of an extension for submitting comments. At the end of the public comments period, 44 submissions had been made to the CMS. The comments and inputs primarily covered three core areas, namely (i) legal and compliance matters; (ii) benefits and pricing issues; and (iii) the market and affordability of products.

The CMS is at the tail-end of thoroughly evaluating all comments so as to finalise the LCBO guidelines and recommendations. It is also crucial that appropriate policy options presented to the Ministry of Health are adequately evaluated and assessed to ensure they do not conflict with the purport, object and intent of the Medical Schemes Act, Act 131 of 1998 and the Department’s policy priorities, especially in relation to the phased implementation of NHI. To this effect, the CMS established an Internal Working Committee consisting of key business functions to provide further inputs on the recommendations of the Advisory Committee.

The purpose of the Internal Working Committee was to provide an independent and informed view on industry issues to the Minister of Health as per Section 7 of the Medical Schemes Act, Act 131 of 1998.

It must be noted that there is no intention for LCBO to be integrated into the NHI environment. Instead, the intention is to create an integrated health financing system that prioritises the health of all South Africans through ensuring access to a comprehensive set of personal health services. Within such a system, medical schemes would only play a complementary role as suggested in Clause 33 of the NHI Bill that is currently serving in Parliament. 

END.

Reply:

The Department is required to pay invoices within 30 days (not within 21 days) in terms of Treasury regulations 8.2.3 which states “Unless determined otherwise in a contract or other agreement, all payments due to creditors must be settled within 30 days from receipt of an invoice or, in the case of civil claims, the date of settlement or court judgement”

National Department of Health

a) The department pays majority of its invoices within 30 days upon receipt of a valid invoice. The delays were due to budgetary constraints within some programmes and some suppliers changing their banking details after the invoice is submitted for payment or in some cases the suppliers ‘s bank details are inactive. Suppliers fails to submit proof of delivery even when they were requested to do so.

b) The department reprioritise within the programmes and economic classification where possible for payment of service providers and constantly engage with the National Treasury to increase the earmarked funds particularly for the CCMDD programme. The department continuously engage with service providers to address challenges that causes the delays on payments of invoices.

Eastern Cape

a) The EC Department of Health has been and is still experiencing challenges on paying creditors within 21 days. This is due to Accruals and Payables, which are reflected below:

• 2019/20 = R3,808 billion,
• 2020/21 = R4,433 billion,
• 2021/22 = R4,659 billion and
• 2022/23 = R4,202 billion (draft stage because of verification and validation processes, which will lead to the inclusion of the final figure of the Accrual and Payables on the 2022/23 Annual Financial Statements to be submitted to AGSA on 31 May 2023). Cumulatively, these Accruals and Payables amount to R17,102 billion. They are not budgeted for instead they consume the budgetary allocation given in a particular financial year. In other words, the department with its limited equitable share allocation attempts to prioritise the payment of SMMEs, which are the priority of the present administration and partially pay the major suppliers, which supply medication for the patients. The department negotiates with the major service providers for medicines to continue rendering services to the department for the sake of our patients. If patients cannot get the medication the department can and is exposing its self to be sued by the health services consumers.
• The cycle of non-payment of creditors within 21 is repetitive in nature due to these Accruals and Payables and inadequate allocation on the Equitable Share. There are no challenges on Conditional Grants payments because they are ring-fenced and are timeously transferred to the EC Province.

b) The Eastern Cape Department is doing the following:

• Negotiating with the EC Provincial Treasury to finance the Accruals and Payables
• Increased its legal capacity to fight the medico legal cases – The Noyila case, which was decided in favour of the department will go a long way in averting the lump sum payments not only for the EC Department of Health but for entire Health Sector in the public administration. This case is at the Supreme Court of Appeal and the EC Department is vigorously defending it. The medico legal court orders have been major contributors to the high value of the Accruals and Payables.
• Negotiating with National Department of Health to share substantially NHLS, SANBS and AFROX costs because of the dual and implicit nature of transactions related to the services rendered by these creditors.
• Developed cost saving projects to deal with the major cost drivers in the department.

Free State

a) Free State Department of Health had cash flow challenge in the last quarter of 2022/23 Financial Year which resulted in supplier invoices not being paid within the prescribed period.

b) Free State Department is currently prioritising invoices aging 30 days and older to reduce payables.

KwaZulu-Natal

a) The Department has always endeavoured to process all invoices received within the prescribed 30-day period by Treasury Regulation paragraph 8.2.3 and to this effect, achieved the following outcomes during 2022/23:

NUMERATOR	DENOMINATOR	PERCENTAGE
13699	15483	88.48%
27005	28471	94.85%
26561	27563	96.36%
25091	26234	95.64%
27871	28905	96.42%
31169	31954	97.54%
35810	36874	97.11%
26880	27905	96.33%
22246	23428	94.95%
29508	30824	95.73%
29340	30226	97.07%
31714	33008	96.08%
326894	340875	95.90%

As can be seen from the table above, the Department’s overall compliance level is quite substantial. The Department is acutely aware of the impact that non-compliance has on its suppliers and is constantly striving to improve its performance in this regard. However, it should be noted that the Department does face the following constraints on a daily basis and it is highly unlikely that the Department will be able to substantially improve on its current 95.90% performance to achieve the ultimate goal of 100% payments processed within 30 days:

• The sheer size of the Department results in enormous volumes of payments being processed on a monthly basis. This is hampered by critical skills and staff shortages at many of the institutions due to limited financial resources and the inability to fill posts.
• The decentralised nature of the Department makes it vulnerable to factors outside of its control. Such factors would include problems with the system downtime, slow processing power, IT connectivity issues, stolen copper lines, load shedding etc.
• Problems being experienced with suppliers, i.e., partial delivery of goods, erroneous and/or incorrect invoices, outstanding credit notes, delays being experienced with suppliers registering/verifying their details on National Treasury’s Central Suppliers Database and closed/inactive supplier bank accounts has resulted in payments being rejected by the banks.
• The challenges experienced with the network by various institutions also cause delays in processing of payments.

b) The Department has implemented LOGIS which is a computerized Logistical system, at Head Office, Umgungundlovu District Office and Greys Hospital Office which will provide warning of invoices that are about to reach 30 days on the system. Further to that the Department has engaged with Telkom SA who is currently implementing the alternative connectivity strategy through the existing DOH/Telkom Master Service Agreement (MSA) LAN Connectivity – The one site network was completed at 42 hospitals on the 28th April 2023. The WAN/ Internet connectivity – This has been delayed pending the exemption from Honourable Minister of Communications and Digital Technologies.

Limpopo

a) Limpopo Department of Health has paid 99% of valid invoice received as at 31 March 2023. However, the non-compliance is due to slowness//non availability of the payments systems and negligence on part of officials.

b) Timeous notify the system controller on the performance of the system-by-system users (Hospitals, Districts and vertical programmes). Corrective action has been taken against responsible officials.

Mpumalanga

a) The Department pays most of its service providers within 10 days as per provincial policy, however, some invoices are disputed due to incorrectness. This causes delaysin the finalization of payments within the PFMA payment period or agreed period.

b) The Department continuously engages service providers and in cases where such challenges are experienced, requests speedily redress.

Northern Cape

a) The Northern Cape Department of Health is currently unable to pay all its invoices as and when they become due and payable. While the Department is doing everything possible and committed to comply with the 30-day payment instruction, the current demand on services and the inadequate budget allocation makes it a challenge to meet this obligation.

Below is our performance in the past two financial years:

b) The Department is strengthening its financial control environment to ensure prudent budget allocation and implementation.

• The roles and responsibilities of programme managers are clearly defined and are gatekeepers to ensuring that the budget of the Department is not overloaded.
• Strict monitoring of financial outcomes and adequate funding of new projects before implementation.
• Strict accountability and consequence management on financial transgressions.

North West

a) The North West Department of Health could not pay all its invoices for goods and services for the 2021/2022 financial year, starting from the third quarter. In the main, the challenge has been inadequate budget allocation over the years as opposed to the ever-increasing burden of diseases and price escalation on non-negotiable items such as medicine supplies, laboratory services, security services, patient catering, etc.

This was confirmed by the consultants appointed by the National Treasury in a project to review the public finance management practice in the health sector in North West Province. According to their diagnostic report, it appears that in terms of the comparisons made, the North West Department of Health in terms of a fair budget allocation can argue that it is indeed underfunded by R1,1 billion, R2 billion and R2,6 billion over the MTEF up to 2023/2024 financial year. In light of the above, accruals amounting to R1,3 billion had to be settled in 2022/2023 financial year which then negatively affected the current year budget allocation for goods and services. 

b) The Department had to prioritize the contractual obligations payments from the third quarter to ensure that accruals which will be carried over to the 2023/2024 financial year are reduced. As a result, the department is projecting accruals percentage reduction of more than 50% from the previous year. The Provincial Treasury has since injected an amount of R200 million into the departmental budget over the MTEF period effective from 2022/2023 financial year and this is a positive move towards ultimately dealing with the accruals. Over and above the contribution by the Provincial Treasury, the Department has reprioritized an amount of R150 million from compensation of employees to goods and services and this is bearing desired results considering the projections.

Western Cape

a) The department strives to pay its service providers within 30 days of receipt of the invoice and in terms of Treasury Regulation 8.2.3. Treasury Regulation 8.2.3 states that: “Unless determined otherwise in a contract or other agreement, all payments due to creditors must be settled within 30 days from receipt of an invoice or, in the case of civil claims, the date of settlement or court judgement”.

b) The department continues to monitor internal controls to track the movement of invoices from the date of receipt to the date of payment. The department will upskill staff to ensure that strengthened internal controls are adhered to and tracking of goods delivered or services rendered against correct orders and ensuring that the quantity and quality of goods and services to be received and received are in line with ordered goods/ services and ensure that payment of supplier’s invoices are made timeously.

END.

Reply:

The World Directory of Medical Schools is a product of partnerships between the World Federation for Medical Education (WFME) and the Foundation for Advancement of International Medical Education and Research (FAIMER) a member of Intealth. These organizations do not control nor monitor training at medical schools.

The WFME is a global organization concerned with education and training of medical practitioners. It is a private non-profit organization developed to share ideas on education and training of medical doctors among between institutions, who wish to do so. It does not regulate the standards of education and training of practitioners across the world. The listing of qualifications in the World Directory of Medical Schools does not imply that the standard of training is assessed for comparability; neither does it confer portability of a qualification across international borders for the purposes of practicing medicine.

The Health Professions Council of South Africa (HPCSA) is a regulatory body, which has a mandate of protecting the interests of the public in the Republic of South Africa. The HPCSA, is empowered by section 15B (c ) of the Health Professions Act to: “upon application by any person, recognize any qualification held by him or her (whether such qualification has been obtained in the Republic or elsewhere) as being equal, either wholly or in part, to any prescribed qualification, where upon such a person shall, to the extent to which the qualification has been recognized, be deemed to halt such prescribed qualification’’.

The HPCSA through its relevant board (The Medical and Dental Professions Board) controls the entry into the labour market of all who wish to practice medicine and related disciplines in the country (South Africa). When the HPCSA grants a license for an individual to practice medicine under its jurisdiction, it implies that such an individual is deemed competent to enter the profession.

The challenge arises when a prospective registrant presents a qualification obtained from a foreign country. The HPCSA has no mechanism of quality assuring medical training in foreign jurisdictions. The only means and process which comes close to evaluating the training environment and the standard of a qualification is to scrutinize the documents submitted by a potential registrant.

This provides limited information about the standard of training obtained in foreign countries. The evaluators can only attempt to infer from the limited information they have at their disposal as to what level of competency the qualification confers on the holder. It can be expected that other regulators around the world face similar challenges when they are presented with similar situations.

To get around these problems, the South African Qualification Authorities (SAQA) and quality assurance bodies have developed an outcomes-based approach in describing abilities conferred by qualifications on the holders. There are other countries around the world such as the United Kingdom, Australia, New Zealand, the United States, and many other European Union countries, which have adopted the same system of describing their programmes, degrees, and qualifications. “Learning outcomes are statements of what a student is expected to know, understand and/or be able to demonstrate after completion of a process of learning” (ECTS Users Guide, p 47).

1. The current implemented systems and/or processes of streamline the process to ensure smooth transition for foreign graduates/ graduates trained outside the republic of South Africa is working well and is not being changed nor replaced.
2. The HPCSA is committed to a turnaround time of 90 days to finalise an evaluation of each programme received. Where the need arises, additional meetings by the Programme Evaluation Team can be arranged to avoid unwanted delays.

END.

Reply:

(1) No. The draft Regulations published on 15 March 2022 will not be withdrawn. These draft Regulations do not deal only with Covid-19 but also with other notifiable medical conditions. The comments from the public are still being processed and will be considered for any decision/amendments to be made regarding the published draft Regulations. The draft Regulations also mean to address pandemic situations as the 2017 Regulations do not address the outbreak of pandemics.

(2) Notifiable Medical Conditions are diseases that are of public health importance because they pose significant public health risks that can result in disease outbreaks or epidemics with high case fatality rates both nationally and internationally. Covid-19 is such a condition and will therefore remain a NMC. COVID-19 is not listed specifically as it resorts amongst the respiratory diseases caused by a novel respiratory pathogen - NMC 20).

(3) The National Department of Health still believes contraventions of these Regulations has serious health implications and as such must remain an offence.

END.

Reply:

The Department has published the draft Regulations relating to the Labelling and Advertising of Foodstuffs for public comments in April 2023. These regulations include mandatory Front of Pack Labelling (FOPL) on the main panel of any foodstuff that has high levels of sugar, saturated fats and salt or contain artificial sweeteners. The closing date for public comments is Thursday, 20 July 2023.

Furthermore, the Department has updated the Strategy for the Prevention and Management of Obesity in South Africa 2023 – 2028. The sixth strategic objective intends to create an enabling policy and legislative environment to prevent and manage obesity. The activities include the extension of the Health Promotion Levy (HPL) to other unhealthy foods and developing a regulatory framework/instrument that restricts the marketing of unhealthy foods to children in South Africa.

END.

Reply:

(a) Limpopo, Free State, Western Cape, and Mpumalanga Provinces do not have irregular expenditure associated with provision of security services. Mpumalanga Department of Health does not have the budget nor expenditure incurred, the security contracts are centralised at Mpumalanga Department of Safety and security in the province.

Eastern Cape incurred R34.9 million irregular expenditure in 2019/20 Financial year (FY), R108.5 million in 2020/21 FY and in 2021/22 FY an amount of R76.1 million. In total for the past three years the Department incurred R219.6 million irregular expenditure on security contracts. There were delays in the appointment of a new service provider as were investigations for the previous contract, however, a new contract has been appointed in 2022/2023 financial year.

The Northern Cape committed R28.4 million irregular on security service in 2020/21 FY, R191.5 million in 2021/22 FY and R208 million in 2022/23 FY. The total expenditure incurred amount to R427.9 million for the past three years on security services due to month-to-month contracts and exceeded the allowed threshold for variation. The procurement process was interrupted by local business forum in several attempts to source new contractor.

North West spent R524.1 million in 2021/22 FY and R583.7 million in 2022/23 FY. The total irregular expenditure incurred on security services amount to R1.1 billion for the past two years, the irregular expenditure is in the process of condonations.

Kwazulu Natal Department of Health incurred R1.377 billion irregular expenditure on average on security services due to month to month contracts after the contracts expiry dates. There were appeals by the bidders hence the Department had to continue with month to month with service providers those contracts have expired.

(b) The National Department of Health has considered insourcing of cleaning and security services in health facilities through National Health Council however it remains the competency of Provincial Health Department to implement the operational services.

The Free State, Limpopo, and Mpumalanga insourced the cleaning services. Eastern Cape, and North West partially outsourced the cleaning services in some areas where there are budget pressures to insource.

The Eastern Cape has partially implemented insourcing as the feasibility of insourcing security services, is unaffordable in some areas. Once the financial position improves it will be reconsidered. The Limpopo, Northern Cape and North West outsourced the security services due budget constraints. The security contract in Mpumalanga Department of Health is centralised at the Mpumalanga Department of Safety and security in the province hence contracts are managed at that level.

KwaZulu-Natal outsourced the security and cleaning services, the insourcing of all services for the department is part of the strategic and operational plan, the implemantation is delayed by budget cuts by impacting negatively on compensation of employees economic classification. However, the provinces opted to implement insourcing in phases for various services.

END.

Reply:

The Provincial Departments of Health are required to phase out or terminate contracts of the temporarily employed nurses in clinics and hospitals funded through the Covid-19 Grant. National Treasury has since terminated the Covid-19 Grant with effect from 1 April 2023 amounting to R1.9 Billion. The National Department of Health is continuously engaging National Treasury to consider the prolongation of funding some or all of these terminated contracted employees (including the nurses) during this current financial year (i.e. 2023/2024). The discussions are continuing in this regard.

The Provincial Departments of Health are the employers of nurses’ categories and continuation of employment of permanent or temporary is based on service delivery needs. Due to budget constraints, Provincial Departments of Health had opted to continue to maintain and fund temporary employment of nurses who manage periodical campaigns (e.g. Immunization campaigns amongst others) through voted funds in the provinces.

END.

Reply:

a) The National Department of Health is still waiting for the data from other provincial health departments. However, the Department has been informed by the Gauteng Department of Health about the stolen cables at Charlotte Maxeke, Steve Biko and Chris Hani Baragwanath Academic Hospitals. To date, only 9 Hospitals were reported for cable theft in the Free State Province.

b) Hospitals that have been reported for cable theft are listed below:

1. Bongani hospital (Welkom)
2. Boitumelo hospital (Kroonstad)
3. Thebe hospital (Harrismith)
4. Mohumadi Manapo hospital (Qwa Qwa)
5. Elizabeth Ross hospital (Qwa Qwa)
6. National hospital (Bloemfontein)
7. Universitas hospital (Bloemfontein)
8. JS Maroka hospital (Thaba Nchu)
9. Mohau hospital (Hoopstad)

c) All the cable theft incidents were reported to the nearest police stations and case numbers were issued accordingly. Mast lights have been installed at various facilities; Manned security was instructed to patrol areas that were identified as high-risk areas for cable theft.

d) All the affected facilities were attended to by replacing the stolen cables during 2022/23 financial year.

e) The Free State Department of Health is planning to employ more security personnel to facilities that are high risk areas. Key interventions also include installations of Clearview fencing and CCTV at health facilities.

END.

Reply:

a) The Minster of Health has appointed a Ministerial Task Team for safety and security in all public health facilities. The purpose of the task team was to assess the effectiveness of security measures and make recommendations. The task team has conducted security assessments at all public health facilities. Subsequently reports were drafted with the following recommendations:

• Improve security infrastructure like perimeter fencing and security guard rooms.
• Installation of security technology like CCTV cameras system, access control and alarm systems.
• Development of standardised security framework.
• 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, memorandum of understanding was entered into between SAPS and NDoH to ensure regular patrols and deployment of police reservists.

Ministerial task team meet on regular basis to monitor the implementations of the recommendations and to assist provinces with any required security intervention.

b) St Georges Hospital is a private hospital under Life Healthcare group at Gqeberha in the Eastern Cape. The matter has not been reported to the National Department of Health for intervention. However, the National Department of Health keeps advising hospitals to improve security measures and to report the matter to their local police.

END.

Reply:

a) The Chief Executive Officer of Rahima Moosa hospital Dr Mkabayi has been transferred to the Provincial Department of Health for the duration of her contract. Dr Mkabayi is receiving professional support and training required and she is adapting very well in the new environment and her performance is good. There are no challenges experienced thus far as she has knowledge, skills and abilities required to execute her responsibilities at this office. She has also subjected herself to the Health Professions Council of South Africa(HPCSA) processes and the outcome of which is now the mandate of the HPCSA.

In a letter received on 15 May 2023 the Office of the Premier has advised that they have requested the SIU to conduct the respective investigations relating to some of the matters raised by the Ombuds.

The above encompass nine (9) of the Ombud’s recommendations specific to Dr Mkabayi.

b) (i)-(ii) Table 1 below represents a list of the other recommendations from the Ombudsman report and the status to date.

Table 1: (i) Ombudsman recommendation and status to date

	RECOMMENDATION	STATUS	ACHIEVED
	Human Resources Related
1	Appointment of the new CEO for RMMCH is identified and appointed within 3 Months	In progress	Post was advertised in the Sunday Times Newspaper of 23 April 2023 with a closing date of 5 May 2023. The Selection Committee has been appointed. Shortlisting will be conducted on 30 May 2023
2	The advertisement for the CEO position should be in line with standardised requirements for CEOs of regional and tertiary level hospitals to ensure any potential candidates meet all relevant criteria and are 'fit for purpose'	Completed	Post was advertised in the Sunday Times Newspaper of 23 April 2023 with a closing date of 5 May 2023. Post was also placed on the GPG Jobs Portal
3	GDOH to consider using recommended CEO advert as outlined in the Ombuds report (pg 16 & 17)	Completed	Post was advertised in the Sunday Times Newspaper of 23 April 2023 with a closing date of 5 May 2023. The advert for the CEO is in line with the recommended KPAs.
4	Only candidates with relevant and proven expertise and experience should be shortlisted with detailed records indicating the reasons for shortlisting or rejecting each candidate	Not yet started	Shortlisting will be conducted on 30 May 2023
5	An experienced CEO knowledgeable in management of regional level hospitals should be appointed. It would be critical that the new CEO is viewed as a leader who would have the ability to unite the health workforce with RMMCH	Not yet started	Advert closed on 5 May 2023 Shortlisting will be conducted on 30 May 2023
6	To ensure success, the GDOH should provide ongoing regular support to the new CEO, which should be documented on a monthly basis	Ongoing	The Acting Chief Director Hospital Services is receiving reports from the ACEO. The Acting Chief Director: Hospital Services has conducted multiple visits to the institution
7	The Gauteng HoD for Health and DDG: Corporate Services must urgently review the Provincial HR processes for the appointment of CEOs and other senior staff within six (6) months. The review should evaluate provincial HR processes with regards to the advertised requirements and competencies required for the position, pre-employment reference checks and vetting for senior positions, especially those of hospital CEOs	In progress	The HR processes have been reviewed for the appointment of CEOs . An Supply Chain Management (SCM) process is underway to appoint a service provider to vet staff including CEOs in the Department
8	During the period of the investigation, it was noted that at least 2 Tertiary Hospital CEOs in Gauteng were suspended for maladministration and misappropriation of Funds (Tembisa & Kalafong Hospitals) raising questions about the calibre of individuals hired for these positions as well as HR processes followed	N/A	The CEO of Tembisa has been charged. The CEO of Kalafong was never suspended.
9	The Gauteng MEC of Health must urgently appoint an independent forensic and audit firm within two (2) months to conduct a competency, ‘fit for purpose’ assessment of the leadership and management staff at RMMCH	In progress	In a letter received on 15 May 2023 the Office of the Premier has advised that they have requested the SIU to conduct the respective investigations
10	The Gauteng MEC of Health must urgently appoint an independent forensic and audit firm within two (2) months to assess the need to upskill all RMMCH managers / EXCO members to ensure they are able to perform their functions in line with the expectations of RMMCH service delivery.	In progress	In a letter received on 15 May 2023 the Office of the Premier has advised that they have requested the SIU to conduct the respective investigations
11.	The GDoH should prioritise the review of the RMMCH staff establishment and appoint staff in line with their skill sets in all departments to ensure compliance with Regulation 19 (2) (a) of the Norms and Standards Regulations.	In progress	This process forms part of the GDoH organizational structure review
12	A review of the utilisation of nurses from Nursing Agencies is also recommended to reduce the strain on the goods and services budget.	In progress	R 48 million has been allocated to permanently appoint nurses to complement services that are normally provided for by nursing agencies. Nurses appointed under COVID-19 grant contracts have currently been prioritised.
13	A report detailing progress on recommendations regarding the review of the RMMCH staff establishment should be sent to the Ombud within six (6) months.	In progress	The process of reviewing the organogram is at an advanced stage. The HR capacity challenges have been addressed in the new organogram; Over 800 new permanent posts will be created and filled in the current financial year. Rahima Moosa has been allocated 58 posts
14	The staff allocated to the MoUs should include Advanced Midwives to ensure support	Done	Hillbrow CHC = 5 advanced midwives (one per shift and the 5th one is the manager responsible for maternity) Discoverers CHC also has 5 advanced midwives. (two are managers)
15	The GDoH is to fast-track the establishment of a fully functional adult ICU at RMMCH within six (6) months. The ICU will ensure that patients are treated in a manner consistent with the nature and severity of their health condition as provided for in Regulation 5 (1) of the Norms and Standards Regulations and allow scheduled surgical procedures within the theatres to continue in an uninterrupted manner	In progress	Discussion initiated. Propose a phased approach - convert an existing H/C bed to an ICU bed with the added nursing and medical resources required
16	The Gauteng Department of Health and RMMCH should institute a disciplinary inquiry within one (1) month following prevailing policy and compatible with the Labour Relations Act 66 of 1995 against the following personnel: 4.1.1. Sr T Goduka for using an unauthorized self-concocted solution in the maternity operating theatres during August and September 2022 by doing so she put the lives of patients at risk and the reputation of GDoH at stake. Her actions led to several adverse events (post-operative wound sepsis) which necessitated eleven 'relook' surgeries in theatre in August and September 2022; Done RMMCH initiated a disciplinary process for Sr T Goduka.		An independent advisory team completed and submitted recommendations to the Acting CEO. Progressive discipline was undertaken Disciplinary action taken and matter concluded - Official has been issued with a written warning
	Infrastructure related recommendations
14	The Premier should ensure that RMMCH is one of the first hospitals to be refurbished, within six (6) months	In progress	Project plan completed with input from GDID & RMMCH Management. A detailed Request for Service (RFS) was sent to GDID. GDID has responded and the GDoH is addressing the issues raised by them as per readiness matrix provided by GDID It should be noted that the 6 months’ timeframe will not be met as all capex works are expected to take no longer than 608 days or 21 months at best.
15	Consideration should be given based on the collapsing sewage system, leaking steam pipes, dilapidated buildings and unkept surrounding areas within the hospital perimeter	In progress	Project plan completed with input from GDID & RMMCH Management. Maintenance division of GDID has scoped some of the work that needs to be undertaken and which doesn't fall under capex. The work of maintenance is being coordinated with that of capex to prioritise urgent works whilst the capex works is taken through the FIDPM stages. The sewer system is planned for medium term redirection to an alternative area until the final design of the sewer is designed and implemented.
16.	The GDoH should provide additional maternity capacity within the district, including but not limited to the construction / refurbishment / repurposing of buildings suitable for a Maternity Obstetric Unit (MOU) to cater for the delivery of low-risk maternity cases within the region, within twelve (12) months. This will further alleviate the overcrowding experienced at RMMCH.	In progress	Management has planned the following to increase the maternity beds in the JHB District: 1. Operationalization of Florida Clinic and convert into a CHC by 2023/24. 2. Conversion of Westbury Clinic into a CHC by 2024/25. The above plans however require availability of posts
	A suitable HR Plan that meets the needs of the health establishment in line with Regulation 19(1) and (2) (a) of the Norms and Standards Regulations must eb developed and implemented within one (1) month	In progress	Draft HR Plan completed by RMMCH. Central Office to take over this task - it is linked to the finalisation of other processes such as the Dept organogram, and the Tertiary Services status of the hospital.
	The HR department should be upskilled and capacitated to carry out the mandate of RMMCH within three (3) months	In progress	Audit completed. Initial training by GCRA commenced 8 May. GCRA committed to further analysis of HR skills.
	Finance and Audit Related
	GDoH should prioritise and fast-track the gazetting of RMMCH as a Tertiary hospital which would ensure that RMMCH receives a tertiary grant, within eight (8) months.	In progress	The National Department of Health in collaboration with the Gauteng Department have started the review The process of classification of all hospitals is in progress.
	In the interim, within two (2) months) GDoH should apply short-term interventions including the application of PFMA section 16A to ensure allocation of additional funds for RMMCH.
	The Gauteng MEC of Health must urgently appoint an independent forensic and audit firm within two (2) months to review corporate governance at the hospital in line with appropriate and applicable King IV corporate governance principles to promote and improve a culture of good corporate governance	In progress	In a letter received on 15 May 2023 the Office of the Premier has advised that they have requested the SIU to conduct the respective investigations
	In the interim, within one (1) month, a larger “Smart Fridge” should be procured to ensure the storage of adequate quantities of emergency blood at RMMCH.	Completed	Fridge procured, delivered and in use
	2017 Rahima Moosa Maternal Child Hospital Coovadia report related
	The MEC and HoD for Health should revisit the 2017 RMMCH report with a view to implementing the recommendations as a matter of urgency. A comprehensive implementation plan is to be submitted to the Ombud within six (6) months including detailed realistic strategies, time frames, and names, designations and contact details of persons responsible for implementation.	In progress	2017 Report and recommendations are being reviewed by the Acting Chief Director Hospital Services in preparation for the development of a feasible implementation plan
	Hospital Administration , Management and Governance related specific to RMMCH
17	The HoD’s office should be sufficiently strengthened to conduct comprehensive oversight of hospitals in Gauteng. A detailed implementation plan is to be shared with the Ombud within one (1) month.	In progress	It is proposed that the HOD establish a multidisciplinary Head of Department Advisory Committee (HODAC) tasked with oversight of hospitals
18	GDoH is to prioritise the reclassification of Discoverers CHC to a district hospital within six (6) months, to alleviate the patient load within the region. It will also ensure compliance with Regulations 5(1) and 8(1) of the Norms and Standards Regulations	In progress	The National Department of Health in collaboration with the Gauteng Department have started the review The process of classification of health facilities and all hospitals is in progress.
19	The GDoH should ensure that RMMCH, a specialist hospital, has Laboratory Services and Blood Bank Services available 24 hours a day, within two (2) months.	In progress	NHLS lab open on site during the day. After hours proposal to improve bloods turnaround time to be discussed. Blood bank obtained 2nd smart fridge for afterhours blood availability.
	The Gauteng MEC of Health is to diligently monitor that the appointed Hospital Board is adequately trained and able to discharge their functions to ensure compliance with Regulation 18 of the Norms and Standards Regulations. 12.2 This should be implemented with immediate effect.	Done	Board has been appointed and given training on their functions and responsibilities.
	The Acting CEO of RMMCH must ensure that the Hospital has a system in place to manage healthcare personnel in line with relevant legislation, policies and guidelines within one (1) month	Carried out on an ongoing basis	Policy updating and distribution to staff is ongoing. Staff also now requesting policy changes which are being considered. Registers in place and checked by HR personnel for compliance Ongoing rollout of policies - PMDS, Records, Absenteeism, Incapacity and Leave Management, R&S done.
	The Acting CEO of RMMCH should identify a suitable area to create a Discharge Lounge, within one (1) month. This will cater for discharged patients who are waiting to return to their homes.	Completed	Completed
	The Discharge Lounge should be allocated dedicated staff to ensure that patients are monitored until they leave the hospital premises	Completed	Completed
	The Acting of RMMCH and HoD must within one (1) month submit to the Ombud a security plan to protect users, health care personnel, and hospital property from security threats and risks and ensure that security staff is capacitated to deal with security incidents, threats and risks	In progress	Security cameras all upgraded and functional. SLA between facility and security company has been reviewed and given to company, which has failed to respond. The on-site security manager has implemented SLA and is monitoring compliance. Weekly reports will be sent to Central Office Security unit on their performance. Security plan has been finalised
	A clear plan is to be developed within one (1) month regarding the safety of healthcare staff over 24 hours, both within the hospital premises as well as within the immediate areas of the hospital periphery to ensure RMMCH complies with Regulation 17 (1) and (2) of the Norms and Standards Regulations	In progress	Security cameras all upgraded and functional. SLA between facility and security company has been reviewed and given to company, which has failed to respond. The on-site security manager has implemented SLA and is monitoring compliance. Weekly reports will be sent to Central Office Security unit on their performance. Security plan has been finalised

(c ) The recommendations from the Ombudsman range from immediate to twelve(12) months.

END.

Reply:

(1) (a)-(b) Existing facilities with Green Rating Cards

Capital Projects in the pipeline for the Green Rating Cards:

(2) Aging public health facilities remains a challenge and growing concern for the Department of Health. The short-, medium- and long-term focus is thus more on restoring many of these facilities to an acceptable state of operability. This does not imply that the Department is not considering environmental sustainability. To the contrary, challenges with electricity and water supply at many of our facilities calls for a more concerted effort towards greater sustainability with less carbon footprint and such thus come into play in the design and refurbishment of these projects. The National Department of Health with the CSIR is currently busy with an investigation into how to become more green in future and will include the outcome of the study into our Infrastructure Strategy.

END.

Reply:

(a) According to the Eastern Cape province this issue was experienced in August 2021 and is attributable to a tender process that made it impossible to have the necessary range of products to choose from.

The key challenge with implants at Livingstone hospital and the whole EC province is the absence of a comprehensive transversal contract and gross budget limitations within the province. The hospital is the only referral hospital for implants in the Western area of the Eastern Cape resulting in massive backlogs.

(b) We are not aware nor informed of any other hospitals experiencing this issue;

(c) (i) To address the budgetary limits, there is a plan to source additional funding that can only be sourced from the Eastern Cape Provincial Treasury. Where possible, the National Department of Health may assist the province, however, it also depends on the availability of additional funding from the National Treasury.

To address the orthopaedic surgery problem that have an impact on Livingstone hospital the following interventions have been proposed to the Eastern Cape Province:

• Strengthening the General Surgical service provision to Uitenhage Provincial Hospital with the allocation of a designated theatre with needed staff support
• Increase Level 1 and 2 beds through the reclassification of PE Provincial Hospital (hybrid) to provide additional theatre access for general surgery.
• Fully establish the surgical disciplines at Dora Nginza Hospital.
• Establish the out-reach and in-reach (Cataract Surgery and General Surgery).These are both underway for Humansdorp and Settlers Hospitals.
• The above-mentioned measures will help address the backlog issues, theatre inefficiencies, remove level 1 cases from regional and tertiary hospitals.

(ii) To deal with the issue of the provision of adequate suppliers, there is also a plan to develop a transversal contract at National level that will also enhance services across other provinces facing similar challenges.

There has also been a discussion that the Eastern Cape should participate in the Western Cape contract to fast track the provision of surgical implants as an immediate intervention.

END.

Reply:

The Western Cape Department of Health reports that it only has one visit card for all patients in all facilities. The information on the visit card will be the name, surname, contact number and address and the date of next appointment. No diagnosis is written on the visit card. Confidentiality is a priority to ensure person-centred care.

The only other card that patients carry with them is the card for TB patients enrolled in directly observed treatment short course (DOTS) and who receive medication at the facility. These patients do not queue at registration but report directly to the consulting room as a measure to fast-track their visit.

END.

Reply:

1. (a) (i) and (ii)

The Ideal Health Facility Framework measures the average time that a patient spends in a Primary Health Care (PHC) facility. It is recommended that patients should not wait longer than 3 hours in the 8-hour facilities. The table below shows percentages for the provinces in terms of PHC facilities that have waiting times less than 3 hours.

PROVINCE	CLINICS	COMMUNITY HEALTH CENTRES
Eastern Cape	75%	74%
Free State	82%	70%
Gauteng	99%	95%
KwaZulu-Natal	94%	80%
Limpopo	91%	96%
Mpumalanga	94%	86%
Northern Cape	78%	75%
Northwest	69%	68%
Western Cape	88%	77%
National Average	86%	80%

The average for PHC facilities (Clinics and Community Health Centers) and hospitals for the country:

• An average of eighty six percent (86%) of all clinics have an average waiting time not longer than 3 hours, ranging from 69% in the Northwest Province to 99% in Gauteng.
• Eighty percent (80%) of all CHC’s have an average waiting time not longer than 3 hours, ranging from 68% in Northwest to 96% in Limpopo province.

(b) The average waiting time for all District and Regional hospitals in all the nine (9) Provinces ranges between 60 to 120 minutes.

(2) The information on the average waiting time for surgeries at public healthcare facilities in the Republic (a) nationally and (b) in each province changes daily as new cases arise. Provincial departments of health continuously strive to reduce surgical backlogs.

(3) The information on current backlogs and procedures with backlogs is not readily available. Provinces have been requested for an update and this will be provided on receipt.

Table 2 below provides information received as at end of October 2022 and the situation may be different currently.

Table 2: information on surgical backlogs provided by provinces as of 15 September and end of October 2022.

Province	Total number of backlogs on surgeries July to September as reported on the 15 September 2022 (PQ 2474)	Total number of backlogs on surgeries as at end of October 2022
Eastern Cape	5373	Information not submitted
Free State	2947	6885
Gauteng	13433	32017
KwaZulu Natal	17906	18906
Limpopo	45690	12373
Mpumalanga	3005	4286
Northwest	5531	7922
Northern Cape	4000	3937
Western Cape	77139	77139 (Same figure submitted as at July 2022 -Not updated)

Table 3 below provides information received from provinces regarding steps taken to address specified surgical backlogs as of October 2022.

Table:3 Steps have been taken to address the specific backlogs as at end of December 2022

Province	What steps have been taken to address the specified backlog
Eastern Cape	Information not provided
Free State	Increased number of days for Elective slates: from 2 days (2021) to 4 days (2022) theatre allocation. Prioritized emergency surgery within first 6 to 12 hours. Developed quality improvement plan to monitor theatre utilization and efficiency via Theatre User Committee Meeting. Expedite appointment and transfer of two (2) Theatre trained nurses form KZN and other areas in October 2022. The utilization of four (4) agency nurses from 1 November 2022. Appoint one medical officers by 01 January 2023. All the backlog patients have elective dates for surgery. Emergencies done daily. Gynecology electives are seven (7) operations weekly. Obstetric electives are ten (10) operations weekly. Electives will stop on 31 December 2022, and resume 2nd week of January 2023.
Gauteng	Procurement of Brachytherapy machines and rental of mobile units as an interim measure. Filling of critical posts at institutional level. Setting up surgical camps within clusters. Extending sessional work to private sector staff to assist to reduce surgical backlogs at public hospitals. Utilising the Public Private Partnerships to address the backlogs, depending on the budget. Working with Eskom to exempt most facilities from load shedding schedules. Working with Johannesburg water to exempt facilities from water shedding. Maximise the referral pathways and channel the patients to the appropriate level of care for surgical procedures by down referring and up referring patients. Working with Department of infrastructure to strengthen maintenance issues at facility level.
KwaZulu Natal	Catch-up has been done by increasing theatre times. Elective slates done over the weekend to catch up. Camps have also been planned. Using after-hours to reduce backlog. Elective theatre slates run after hours. Maximum utilization of theatres with added slates on weekends. An elective marathon is planned to further reduce the backlogs. Cataract camps are regularly conducted. All slates have re-commenced with increased theatre times and using after-hours to reduce backlogs.
Limpopo	The Outreach Surgical Services occur monthly rotating in the five districts to ensure that specialised clinical and surgical operations are conducted at district hospitals. Teams of specialists allocate each other for seven days a month to conduct these surgeries, thus address the backlog. Limpopo Department of Health has a Public Private Partnership with three private hospitals, wherein some of the elective surgery like hysterectomies, hip replacements, urology and general surgery cases are conducted for an agreed fee
Mpumalanga	Rob Ferreira Hospital: A sessional Orthopaedic Surgeon was appointed during the second quarter of 2022 and operating days has been increased to four days in a week. Additionally, the orthopaedic team also operates in Barberton District Hospital four days in a week. Witbank Hospital: Expanded outreach to Ermelo, Evander, Middelburg, and Kwa Mhlanga. Increased operating times for orthopaedics from office hours to after hours and weekends. Improved efficiencies in orthopaedics by streamlining its functions into responsible units. Theatre time during office hours, was increased. Ermelo Hospital: Appointed fulltime orthopaedic surgeon with effect from 01 October 2022. Mapulaneng Hospital: Appointed fulltime orthopaedic surgeon who conduct surgeries and does outreach to surrounding district hospitals.
	Themba Hospital: Increased theatre time by opening the 4th theatre.
Northern Cape	Information not provided
Northwest	At present Klerksdorp/Tshepong theatres are undergoing revitalisation and multiple theatres are being renovated. Most of the theatres are likely to be handed over back by the end of the year. However, all efforts are made to make theatres functioning efficiently to reduce backlog. Weekend blitz is planned next year once theatre renovations are completed. Outreach to Moses Kotane Hospital. First round started 13 October 2022. General surgery recruited a surgeon on 01 October 2022 In Ophthalmology weekend blitz was started on 22nd October 2022 Urology specialist employed and planned outreach to start as soon as new ordered equipment is delivered. In Gynaecology number of theatre days have been increased Ear, Nose and Throat specialist recruited and started on 01 November 2022 Daily optimization of operations thus increasing output during working hours. Doctors on call to perform minor procedures whilst on call. Every weekend, 2 doctors on call with an intern to continue with some cases from the backlog. First part of the recruitment of additional nursing staff required for maximum theatre utilization has been completed, and the process of other staff member is underway. Utilization of other facilities for referring minor cases such as cataracts. Planned weekend marathons have been started particularly in orthopaedic Cases. Procurement of autoclave and sterilising machines underway.
Western Cape	Operations increased by dedicated budget increase and efficiency gains. Operations increased by outreach support and efficiency gains.

END.

Reply:

1. The following grants have been established:

(i) NHI Schedule 5 Direct Grant

(ii) NHI Schedule 6 Indirect Grant which consists of:

• Health Facility Revitalisation Component (In Kind Grant)
• Personal services component
• Non-personal services component

(a)-(b) The overall budget and expenditure of the NHI Grant has been as follows:

For the 2017/18 and 2018/19 financial years, it was only the NHI Indirect grant allocation and from 2019/20 it was funded from both direct and indirect grant allocations as follows:

(c) The items that the specified amount were spent on and (d) the amount returned to the National Treasury are as follows:

2. (a) NHI Pilot Projects were conducted from 2012/13 to 2015/16. The breakdown of the amounts that were budget for during this period are outlined in the Table below:

National Health Insurance Direct Grant
	2012/13	2013/14	2014/15	2015/16	2016/17	Total
NHI Direct Grant	150000,000	48000,000	72000,000	72000,000		342000
Eastern Cape	11,500	4,850	7,000	7,204		30,554
Free State	11,500	4,850	7,000	7,204		30,554
Gauteng	31,500	4,850	7,000	7,204		50,554
KwaZulu-Natal	33,000	9,700	14,000	14,408		71,108
Limpopo	11,500	4,850	7,000	7,204		30,554
Mpumalanga	11,500	4,850	7,000	7,204		30,554
Northern Cape	11,500	4,850	7,000	7,204		30,554
North West	11,500	4,850	7,000	7,204		30,554
Western Cape	11,500	4,850	7,000	7,204		30,554

(b) The breakdown of the projects that were funded through the direct NHI Conditional Grant were as follows:

The NHI project was undertaken in 11 pilot districts across the country namely:

1. OR Tambo (Eastern Cape)
2. Thabo Mofutsanyana (Free State)
3. City of Tshwane (Gauteng)
4. Amajuba District (KwaZulu-Natal)
5. Umzinyathi (KwaZulu-Natal)
6. uMgungundlovu (KwaZulu-Natal)
7. Vhembe (Limpopo)
8. Gert Sibande (Mpumalanga)
9. Dr Kenneth Kaunda (North West)
10. Pixley ka Seme (Northern Cape)
11. Eden (Western Cape)

The following interventions were undertaken in the aforesaid pilot districts:

1. Ward-based Primary Healthcare Outreach Teams (WBPHCOTs), which were responsible for the provision of promotive and preventative healthcare to households;
2. the Integrated School Health Programme (ISHP), which aimed to provide a range of health promotion and preventive services to school-going children at their places of learning;
3. General Practitioner (GP) contracting, which aimed to increase the number of GPs at PHC facilities to improve the quality and acceptability of care;
4. the Ideal Clinic Realisation and Maintenance (ICRM) model, which aimed to increase the quality of services through the establishment of minimum standards;
5. District Clinical Specialist Teams (DCSTs), which were responsible for supporting clinical governance and undertaking clinical work, research and training;
6. The Centralised Chronic Medicine Dispensing and Distribution (CCMDD) system, which aimed to improve the distribution of medicines to patients through the provision of chronic medication at designated pick-up points (PUPs) closer to the communities in the pilot districts;
7. The Health Patient Registration System (HPRS), which has the ultimate goal of a fully electronic patient record-keeping system but commenced with the capturing of patient data and the generation of electronic files;
8. The Stock Visibility System (SVS), which aimed to improve the oversight of stock through an electronic stock monitoring system, thereby reducing stockouts by allowing for appropriate and timely ordering;
9. Infrastructure projects, which were implemented to improve health infrastructure and thereby ensure increased access and quality of care;
10. Workload Indicator for Staffing Need (WISN), which are a World Health Organization (WHO) planning tool implemented to help facility managers make more efficient staffing decisions.

(3) (a) Some of the core outcomes of the project are outlined below per district:

Amajuba (KwaZulu-Natal): This district recorded a mixed set of results when it comes to key indicators that were being tracked as part of the NHI interventions – antenatal first visit before 20 weeks and HIV positive on IPT. There was a noticeable improvement in 2015, then followed by a decrease in both indictors over 2016 and 2017.

uMzinyathi (KwaZulu-Natal): There was a marked improvement in the immunization rate for children under the age of one, with a further indication that directed efforts needed to be implemented to prioritize mother and child health interventions;

uMgungundlovu (KwaZulu-Natal): The district has recorded an improvement in the immunization rate, specifically for the uptake of the measles second dose. However, indicators also pointed to the need to improve the roll-out and capacity of the Ward-Based Outreach Teams.

OR Tambo (Eastern Cape): As a result of various interventions, the district recorded a year-on-year improvement in cervical cancer screening for women over 30. This improvement also showed a marked increase in the ranking of the district as compared to other pilot and non-pilot districts. The same can be reported Diarrhea with dehydration under five.

Gert Sibande (Mpumalanga): This district recorded the highest rate of improvement in immunization uptake for those under five for all the pilot districts. This was specifically for the 2016 to 2017 period. The main challenge they experienced was around having well-capacitated Ward-Based Outreach Teams, and the ability to recruit and retain adequately skilled team members.

Vhembe (Limpopo): The district recorded an improvement in the reported number of cases with diarrhea and dehydration under five. Vhembe showed a sharp decrease in performance for this indicator. The qualitative information revealed a lack of functional DCSTs, with speculation that they need to be dismantled and a new solution found. This is potentially problematic because, with poor immunization coverage, there is a higher risk for poor child health. The DCSTs will then be critical to ensuring that child mortality does not increase.

Dr Kenneth Kaunda (North West): The district also recorded a year-on-year improvement in cervical cancer screening for women over 30. This improvement also showed a marked increase in the ranking of the district as compared to other pilot and non-pilot districts. It ranked second only to OR Tambo District.

Eden (Western Cape): A key achievement for the district was that it consistently reported the lowest levels of drug stock-outs amongst all the pilot districts.

Thabo Mofutsanyana (Free State): The district recorded a significant improvement in the number of diarrheal cases with dehydration over the period 2013 to 2017. They also achieved significant improvements in the number of school learners screened for eyesight, hearing and related conditions.

Pixley ka Seme (Northern Cape): The district recorded significant improvements and was consistently the lowest performer among the NHI pilot districts for the HIV positive with IPT and the BCG dose coverage indicators respectively.

City of Tshwane (Gauteng): This district was amongst the lowest performers of the districts included in the NHI project for the indicator on Antenatal visit before 20 weeks. However, it still recorded significant improvements in the indicator on diarrheal cases with dehydration over the period 2013 to 2017.

More generally, it must be noted that majority of the NHI districts recorded significant achievements in the establishment and roll-out of the Ward-Based Primary Health Care Outreach Teams (WBPHCOTs). The WBPHCOT intervention is currently underpinned by the Policy Framework and Strategy for Ward-based Primary Healthcare Outreach Teams 2018/2019 – 2023/2024 and aims to ensure the successful implementation of the teams and the overall success of NHI implementation in South Africa. As far back as September 2017, a reported 3,519 WBPHCOTs were covering 12 816 152 households. At the end of 2017/2018 financial year, there were a total of 3,323 WBPHCOTs providing basic health services to children and adults across the country, not just in the NHI districts.

(4) (a)-(b) The evaluation of the various interventions implemented as part of NHI is based on a number of interrelated processes, including regular monitoring and evaluation of progress through the Annual Performance Plans at the National and Provincial Departments of Health. It also included undertaking a rigorous evaluation exercises and the prepartion of technical reports detailing the various interventions implemented over time and the impact that these selected interventions have had on key indicators such as antenatal visits, incidence of diarrhea cases as well as establsihment of key teams such as PHC outreach teams. The Evaluation Report is attached as Annexure 1. The implementation of various interventions resulted in a number of interellated achievements, some of which include:

1. The successful roll-out of the Ward-Based Primary Health Care Outreach Teams (WBPHCOTs) intervention aimed at ensuring the successful implementation of the PHC teams and the overall success of NHI implementation in South Africa. As far back as September 2017, a reported 3,519 WBPHCOTs were covering 12 816 152 households. At the end of 2017/2018 financial year, there were a total of 3,323 WBPHCOTs providing basic health services to children and adults across the country, not just in the NHI districts.

2. The rollout of the Integrated School Health Programme (ISHP). The aim of the ISHP intervention is to provide a range of health promotion and preventive services to school-going children with a particular focus on the screening of health-related barriers to learning such as vision, hearing, cognitive and related developmental impairments (National Department of Health, 2017). The programme is underpinned by the Integrated School Health Policy, which outlines the complementary roles of each government department responsible for addressing the needs of learners with the aim of ensuring that strong school health services operate according to clear and uniform standards across the country (National Department of Health, 2013). This intervention was implemented by the NDoH in collaboration with the DBE and holds important lessons with regard to inter-departmental collaboration and coordination during implementation. National stakeholders expressed the belief that, overall, there was good collaboration between the national departments in implementing ISHP.

3. Contracting of Health Practitioners (“GP Contracting”): Recognising that Human Resources for Health (HRH) are a key component of a well-functioning health system, and that the inequitable distribution of human resources within the dual health system in South Africa has been an ongoing challenge. Historically, GPs have not been part of the staffing composition at public PHC facilities. Furthermore, the lack of GPs in the public sector has impacted the system in a number of ways. Notably, this has impacted patients’ perceptions of the quality of care received at PHC facilities. This intervention was implemented to improve quality of care and access to needed health care services at the local facility level, especially in targeted clinics through the introduction of different contracting mechanisms with the aim of improving access and quality services to vulnerable communities.

The contracting of GPs was introduced in 2012 as part of NHI Phase 1 implementation, and at the end of 2017/2018, 330 GPs had been contracted. GP contracting was identified by stakeholders as one of the most important interventions to ensure health system strengthening (HSS). The intended aims and objectives of contracting GPs are evidently clear and well understood among stakeholders. The key objectives of GP contracting were to reduce the over-utilisation of hospitals and to improve quality of care (and perceptions thereof) of public healthcare facilities.

4. Ideal Clinic Realisation and Maintenace (ICRM): ICRM was introduced in response to existing insufficiencies in the quality of PHC services and to lay the foundation for NHI implementation. This intervention was introduced in South African facilities in July 2013 with the aim of improving quality of care after a baseline audit commissioned by the NDoH in 2011 discovered that only one facility in the country met the required standards of a health facility. An ideal clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicine and supplies, good administrative processes and sufficient adequate bulk supplies. It uses appropriate clinical policies, protocols and guidelines, and it harnesses partner and stakeholder support to ensure the provision of quality health services at PHC level to communities. There are 10 components of the ICRM programme, all of which contain subcomponents that specify the initiatives under each component.

The evaluation findings suggest that ICRM is an intervention that achieved considerable scale and reach during NHI Phase 1. At the end of 2017/2018, 3 434 facilities had been assessed, and of these, 1 507 had attained ideal clinic status. Of the facility managers surveyed, 51 of 60 (86%) reported that ICRM was being implemented in their facility.

Moreover, the intervention is commonly understood to have significantly contributed to HSS over the previous five years of implementation as a result of its initial large scale-up across the country.

5. Establishment of District Clinical Specialist Teams (DCSTs): The DCSTs were envisioned to comprise highly specialised HCPs, including an obstetrician and gynaecologist, a paediatrician, a family physician, an anaesthetist, a midwife and a professional nurse, and it was expected that they would spend 70% of their time supporting clinical governance, 20% on clinical work and 10% on research and training. Clinical governance encompasses the maintenance and improvement of standards for patient care at facilities. The various activities of clinical governance have been implemented to different extents in PHC facilities. The four major components of clinical governance are role identification, improving care, improving patients’ experiences and identifying good practice. The DCSTs are responsible for driving these components of clinical governance at district level and are an extension of the district management team and report directly to the district manager as well as the provincial DCST coordinator.

6. Centralised Chronic Medication Dispensing and Distribution (CCMDD): This is a unique model of medicine dispensing and distribution that has been adopted in South, which is led and implemented by the NDoH. CCMDD was introduced in 2012 to improve the successful distribution of medication to patients. This intervention is made up of two components: CCMDD and Pick-Up Points (PUPs); These two components were envisioned (a) to improve the quality of care of patients as chronic patients will be accessing their medication from a private service provider rather than going into facilities, thus decreasing congestion at facilities, making more staff time available and improving the staff’s ability to provide quality services and (b) to increase access for patients and decrease patient waiting times as there will be no need for patients to go to pick up their medication at congested facilities. During the implementation of NHI Phase 1, CCMDD was heavily focused on the provision of antiretrovirals, fixed-dose combinations in particular, to stable HIV patients receiving antiretroviral treatment (ART).

The evaluation findings suggest that CCMDD is overwhelmingly believed to be the NDoH’s most successful intervention implemented during NHI Phase 1. This has been identified as a flagship programme, and for this reason, there are numerous valuable lessons to be learned from its implementation. These lessons will only apply to the continuation of the CCMDD programme but can be useful for the continued implementation of other interventions.

Specifically, lessons around the issues of contracting private service providers, which has been communicated by the NDoH to be a key component of NHI Phase 2. At the end of 2017/2018, there were 2 182 422 patients enrolled in the CCMDD programme who were collecting their medicines from over 855 PUPs across the country (National Department of Health, 2018). On balance, it is evident that CCMDD has indeed achieved its immediate aims of decongesting facilities, which helps improve the availability of HCPs’ time and, as a result, improve health outcomes. The success is largely reflected in the successful scale-up of the programme beyond the pilot districts and beyond the expectations of NHI Phase 1 implementation plans.

7. e-Health interventions: e-Health interventions are those that employ digital solutions to assist health workers and PHC facilities to operate more efficiently, with the ultimate aim of contributing to improved access to and improved quality healthcare.

a) As part of the preparatory work for the phased implementation of NHI, the Department has successfully rolled-out the Health Patient Registration System (HPRS). The HPRS serves as an online registry of all patients using healthcare services in South Africa that can be accessed at any facility to provide health workers with patients’ demographic information and their most up-to-date health records. Patients are registered with a unique identification number (for example, their national identity number or passport number) and assigned to a host facility, which is the facility that they attend most frequently. The HPRS is thus the entry point for patients into the formal health system. The HPRS is expected to lead to more efficient patient registration and record-keeping, which is in turn expected to contribute to better decision-making, to facilitate easier access to patient data and to lead to a better referral system. Overall, the implementation of the HPRS during NHI Phase 1 can be understood to have presented both successes and challenges. At the end of 2017/2018, 2968 PHC facilities were using the HPRS, and there were 20 million people registered on the system (National Department of Health, 2018). Moreover, IT hardware for an additional 918 PHC facilities in 13 health districts was purchased, totalling 4862 computers in total (National Department of Health, 2018). However, challenges have hindered the intervention’s ability to contribute to improved decision-making and referrals thus far. It should be noted, however, that the first stage of implementation was focused largely on setting up user profiles and is not expected to contribute greatly to decision-making as yet. As the implementation of NHI continues and the HPRS becomes more widely used, it will need to be further populated with routine and referral information to improve patient tracking and, in turn, contribute to improved decision-making.

b) Another intervention in the e-Health space is MomConnect. MomConnect is an SMS-based initiative that “aims to support maternal health through the use of cell phone-based technologies integrated into maternal and child health services” (National Department of Health, 2018). The purpose of MomConnect is ultimately to prevent maternal and child deaths through targeted health promotion messages to pregnant women to improve their health and that of their infants (National Department of Health, 2018). At the end of 2017/2018, the number of pregnant women and mothers registered on MomConnect was 1 888 918, which had doubled from the previous financial year. Moreover, a total of 818 688 pregnant women and mothers were receiving health-promotion messages at the end of 2017/2018.

c) There is also the Stock Visibility System (SVS) which is an application designed to address the challenge of drug and related stock-outs and ensure that all South Africans have access to the medicines they need. It is a mobile application used in PHC clinics to monitor and report on stock availability levels for essential medicines like anti-retrovirals, TB medication and vaccines. The purpose of the SVS is to enable more informed decision-making and proactive stock management at PHC facility level. Using the SVS application, clinic staff are able to capture information on the availability of essential medicines at PHC facilities, which is then uploaded to a central online repository. The data from this repository is consolidated in real time to improve oversight of stock availability and, consequently, improve the accuracy and efficiency of stock distribution based on demand.

The SVS is able to detect reported stock-outs at clinic level and automatically send early warning alerts to managers at each point in the supply chain when stock-outs are predicted, from clinic through to national level. In a similar vein, the system also alerts managers to over-stocking, which is necessary to avoid situations where stock is lost due to expiry. These types of alerts thus enable managers to more proactively manage stock levels and avoid stock-outs as well as stock losses. At the end of 2017/2018, the SVS was being implemented in 3167 clinics and CHCs, which equated to 92% coverage (National Department of Health, 2018). The findings of the evaluation indicate that, where it has been implemented as planned, the implementation of the SVS has largely been a success, leading to a reduction in stock-outs and pressure at facilities where it was being implemented.

Over and above all these targeted interventions, the National and Provincial Departments of Health continue to implement a number of interventions directed at maintaining existing infrastructure (clinics, hospitals, CHCs, etc.); refurbishments as well as the commissioning of new ones to address quality and related challenges. Poor infrastructure limits the extent of health services that can be provided to communities. Therefore, since the 2013/14 financial year, more than R1.9 billion has been spent on infrastructure projects in the NHI pilot districts.

END.

Reply:

a) During the 2022/2023 financial year 100% of the total allocation was assigned to health awareness and education on common risk factors as well as access to screening and linkage to care. However only 51.7% of the budget was spent due to lack of human resources. The Department plans to put out a call for proposals to NGOs in the health promotion and non-communicable diseases areas to scale up the health promotion and disease prevention activities.

b) The chronic disease prevention and health promotion levy (sugar tax) is presently allocated toward addressing non-communicable diseases including hypertension, diabetes, cancer, obesity, and mental health.

END.

Reply:

1. Table 1 below indicates (a) total number of ambulances in each province based on the ratio of 1 ambulance per 10 000 people, (b) short fall and (c) number available for a buffer is as follows:

Table 1:

Province	(a) Total of No. ambulances	(b) Short fall	(c) Buffer
Eastern Cape	448	222	30
Free State	138	152	42
Gauteng	1 600	942	60
KwaZulu-Natal	432	742	0
Limpopo	262	348	0
Mpumalanga	168	230	70
Northwest	72	298	0
Northern Cape	110	40	0
Western Cape	120	460	0

2.The number of ambulances not in use, those due to accidents and those due repairs and maintenance per province as at week starting 24 April 2023 are as per table below. These numbers fluctuate daily. 

Province	(a) No. not in use due to accidents	(b)(i) No. not in use due to repairs	(b)(ii) No. not in use due to maintenance
Eastern Cape	15	136	52
Free State	9	43	38
Gauteng	12	64	89
KwaZulu-Natal	15	10	25
Limpopo	15	102	31
Mpumalanga	12	25	24
Northwest	8	57	42
Northern Cape	5	35	61
Western Cape	24	13	22

3. The average waiting time for ambulances to transport patients in each province assuming an immediate scene turnaround time is as follows:

PROVINCE	AVERAGE WAITING TIME
	URBAN < 30 MINUTES	RURAL < 60 MINUTES
Eastern Cape	41%	69%
Free State	47%	81%
Gauteng	55%	85%
KwaZulu-Natal	43%	52%
Limpopo	49%	39%
Mpumalanga	65%	69%
North West	81%	73%
Northern Cape	78%	74%
Western Cape	53%	77%
National Average	56%	67%

(4) The ratio is currently being used (a) nationally and (b) in all provinces is 1 ambulance per 10 000 people.

END.

Reply:

1. (a) All mortuaries, Forensic and hospitals are adequately equipped to deal with loadshedding to prevent bodies from decomposing.

b) All Forensic mortuaries have a backup generator capacity and hospital mortuaries are linked also to the generator capacity of the hospital.

(2) Yes all bodies at both mortuaries are refrigerated.

(3) Table 1 below responds to Forensic pathology mortuaries with space and/or refrigeration challenges.

 

Table 1:

(i) Province	(3)(a) Names of mortuaries that have specific issues with space and/or refrigeration facilities	(2)(b)(ii) In which town/city
Eastern Cape	7 Mortuaries; Mthatha, Lusikisiki, Mount Frere, Bizana, New Brighton, Mount Road and Gelvandale potential to experience space issues related to unclaimed bodies.	Mthatha FPS is in Mthata Lusikisiki is in Lusikisiki Mount Frere is in Mount Frere Bizana is in Bizana New Brighton is in Port Elizabeth Mount Road is in Port Elizabeth Gelvandale is in Port Elizabeth
Free State	None	Not applicable
KwaZulu-Natal	10 Mortuaries: Port Shepstone, Harding, Estcourt, Newcastle, Madadeni, Nongoma, Vryheid, New Hanover, Richmond and Ladysmith have potential refrigerator challenges related to unclaimed bodies. Ladysmith has also space challenge	Port Shepstone FPS is in Port Shepstone Harding FPS is in Harding New Hanover FPS is in New Hanover Vryheid FPS is in Vryheid Richmond FPS is in Richmond Ladysmith FPS is in Ladysmith Madadeni FPS is in Madadeni Nongoma FPS is in Nongoma Estcourt FPS is in Estcourt
Gauteng	3 Mortuaries: Roodepoort, Diepkloof and Johannesburg and have a potential space challenge due to increased intake. 4 Mortuaries: Heidelberg, Sebokeng, Springs and Pretoria have a potential refrigerator challenge due to increased intake.	Roodepoort FPS is in Roodepoort Diepkloof FPS is in Diepkloof Johannesburg FPS is in Hillbrow. Heidelberg FPs is in Heidelberg Sebokeng FPS is in Sebokeng Springs FPS is in Springs Pretoria FPS is in Pretoria.
Limpopo	2 Mortuaries: Tshilidzini and Mokopane have space challenge due to unclaimed bodies.	Tshilidzi FPS is in Thohoyandou. Mokopane FPS is in Mokopane
Mpumalanga	5 Mortuaries: Themba, Ermelo, Kwa Mhlanga, Lydenburg and Tintswalo have refrigerator challenges.	Themba FPS is in Nelspruit Ermelo FPS is in Ermelo Kwa Mhlanga FPS is in Kwa Mhlanga Lydenburg FPS is in Lydenburg Tintswalo is in Acornhoek
Northern Cape	4 Mortuaries: De Aar, Portmansburg, Hartswater, Douglas FPS have challenges with refrigerators due to loadshedding surges. This led to Kimberley FPS reaching its maximum capacity in terms of storage space	De Aar FPS is in De Aar Hartswater FPS is in Hartswater Douglas FPS is in Douglas Postmansburg FPS is in Postmansburg Kimberley FPS is in Kimberley
Northwest	2 Mortuaries: Mafikeng and Lichtenburg have space challenge due to inadequate infrastructure.	Mafikeng FPS is in Mafikeng Lichtenburg FPS is in Lichtenburg
Western Cape	2 Mortuaries: Laingsburg has a space challenge. Ceres has a refrigerator challenge	Laingsburg FPS is in Laingsburg Ceres FPS is in Ceres town

(4) Table 2 below responds to Forensic pathology mortuaries with generators and fuel supply challenges.

(i) Province	(4)(a)(i)(ii) names of the mortuaries that have generators, and fuel supply	(4)(b)(ii) in which town and/or city and province is each specified mortuary located?
Eastern Cape	None	Not applicable
Free State	Phuthaditjhaba FPS Mortuary problems with electricity supply and vandalisms, using adjacent hospitals (Phekolong and Dihlabeng) for storage	Phuthaditjhaba FPS is in Phuthaditjhaba
KwaZulu Natal	Pinetown FPS needs generator that will supply power to the whole facility. Phoenix, Port Shepstone, Pietermaritzburg, Ladysmith, Dundee and Kokstad facilities experience fuel shortages sometime	Pinetown FPS is in Pinetown Phoenix FPS is in Phoenix Port Shepstone FPS is in Port Shepstone Pietermaritzburg FPS is in Pietermaritzburg Ladysmith FPS is in Ladysmith Dundee FPS is in Dundee Kokstad FPS is in Kokstad
Gauteng	None	Not applicable
Limpopo	None	Not applicable
Mpumalanga	None	Not applicable
Northern Cape	None	Not applicable
Northwest	None	Not applicable
Western Cape	None	Not applicable

END.

Reply:

1. (a) Yes, such a plan and policy statement exists as part of departmental policy framework in instances of fraud and corruption which remain a constant threat to public trust and confidence;

(b) The policy plan and whistle-blowing statement are indeed part of the policy implementation process wherein once developed, they get reviewed to keep with developments in government programmes and legislation from time to time. Dates of adoption and endorsement vary at operational level, for instance endorsement at the National Department was approved on 11 February 2022.

2. Each province has its own policies based on national policy statements as adopted, and vary on dates as developed, reviewed and adopted, according to the existing risk management and prevention as an integral part of strategic management of each province, and are available for scrutiny when so needed.

3. The National Department of Health is currently working with other stakeholders to conduct risk assessment that will determine whether there is need for whistle-blower protection or to strengthen the current exiting measures and mechanisms in Government. Thereafter the outcome will determine the way forward.

4. There are a number of strategies that exist based on national laws and policy frameworks, which get considered when policies are developed and reviewed when necessary and such will vary from time to time, such as the current collaboration the National Department of Health is involved in to enhance the current processes through assessment of risk.

5. It is common practice that upon finalizing any collaborative assignment, it is incumbent and becomes essential that the National Department of Health and its stakeholders share the good practice through available mechanisms by adopting a comprehensive approach to benefit the public and interested parties.

END.

Reply:

a) The allocated amount was R48 366 000 in 2022/23

b) R24 437 000 was spent in 2022/23.

c) (i)&(ii) The programme named Chronic Diseases Disabilities & Geriatrics spent R24 437 million on health promotion activities which aim to promote wellness, reduce the common risk factors underlying the priority Non-Communicable Diseases as well as to screen for these NCDs and link persons to care.

(iii) The following strides are made:

• In 2021 PRICELESS reported evidence-based gains from the Health Promotion Levy (HPL), including
  • The national urban household purchases of taxable beverages by volume fell by 51% (Kantar) with a 29 % decrease in sugar intake.

• • In a self-reported Langa survey of young adults ( 18- 39 y), on taxable beverages showed a 37% reduction by volume and 31% decrease in sugar intake.
• • In a Soweto Study of teenagers, young adults, and older adults, the frequency of Sugar Sweetened Beverages intake amongst heavy consumers fell from 10 beverages per week pre HPL to 4 beverages per week one year post HPL.
• In 2022, the Department approved the National Strategic Plan for the Prevention and Control of Non-Communicable Diseases 2022 – 2027 (NSP NCDs) which adopts an integrated person centered approach and is inclusive of population level interventions.

The NSP NCDs aims to promote wellness, reduce modifiable risk behaviour, enhance management and control of non-communicable diseases in particular hypertension and diabetes and empower communities, patients and their families.

• The 2022/23 Annual Performance Quarter 1 to Quarter 4 Reports confirm increased health seeking behaviour as the total screened for diabetes for Q1 was 2 550 479 which increased to 18 838 794 in Q4. Total screened for hypertension for Q1 was 2 654 572 which increased to 19 270 634 in Q4.
• The Health Promotion Levy was implemented in 2018. Strides in terms of health outcomes manifests in the long-term (at least 10 years), since long established behavioural practices that contribute to ill-health, takes time to reverse.

END.

Reply:

a) (i) Causes of death are statistically derived from death certificates. Obesity will be one of the underlying causes of a health condition that does not appear on the death certificate and therefore a distinct number of deaths caused by obesity is not available. It was observed during the COVID-19 surges that there was link between obesity and deaths.

(ii) Obesity is one of the risk factors for diabetes and hypertension and statistics for these two conditions are provided below.

b) According to the DHIS report, the total number of persons who have been diagnosed with diabetes since 1 January to 28 February 2023 is 46 330.

c) Statistics for hypertension is not collected routinely. We make use of surveys to guide planning and decision making in this regard. According to the SA Demographic and Health Survey 2016, the prevalence for males 15 years and above is 44% and for females of the same age category is 46%.

END.

Reply:

(a)(b)(i)(ii) Public health facilities have not been routinely collecting data classified as crush injury and crush syndrome. However, the National Indicator Datasets(NIDS) started collecting information in 2020 on trauma. This data is classified as Accident and Emergency (Casualty) and Trauma unit headcount – Emergency; and Accident and Emergency (Casualty) unit headcount - non-Emergency.

Table1 below indicate overall data on Accidents and Emergency and Trauma Unit headcount for both -Emergency and Non-Emergency by Province

Table 1: Accident and Emergency (Casualty)and Trauma Unit headcount for both emergency and non-emergency from April 2020 to March 2023.

Province	Item	April 2020 to March 2021	April 2021 to March 2022	April 2022 to March 2023
Eastern Cape	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	268 810	305 553	299 033
Eastern Cape	Accident and Emergency (Casualty) unit headcount - non-Emergency	241 718	972 401	263 069
Free State	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	108 553	125 891	125 269
Free State	Accident and Emergency (Casualty) unit headcount - non-Emergency	207 144	211 880	200 482
Gauteng	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	512 255	610 102	583 984
Gauteng	Accident and Emergency (Casualty) unit headcount - non-Emergency	252 813	343 101	421 900
KwaZulu-Natal	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	381 960	405 307	409 092
KwaZulu-Natal	Accident and Emergency (Casualty) unit headcount - non-Emergency	492 142	607 715	637 989
Limpopo	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	244 131	291 818	280 911
Limpopo e	Accident and Emergency (Casualty) unit headcount - non-Emergency	241 488	277 484	235 426
Mpumalanga	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	211 346	244 998	243 611
Mpumalanga	Accident and Emergency (Casualty) unit headcount - non-Emergency	121 188	173 050	146 162
Northern Cape	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	65 657	69 208	65 665
Northern Cape	Accident and Emergency (Casualty) unit headcount - non-Emergency	102 883	111 587	115 623
Northwest	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	110 555	123 935	113 856
Northwest	Accident and Emergency (Casualty) unit headcount - non-Emergency	137 592	152 883	125 648
Western Cape	Accident and Emergency (Casualty) and Trauma unit headcount - Emergency	736 083	885 693	906 388
Western Cape	Accident and Emergency (Casualty) unit headcount - non-Emergency
National Total		4 436 318	5 912 606	5 174 108

Note: data for Western Cape for non -emergency not available

(a)(b)(i)(ii) Data has been requested from the private health care facilities and is not readily available. This will be made available to the honourable upon receipt.

The NIDS has been reviewed to start collecting data from 2023 classified as:

1. Sport related trauma – new
2. Pedestrian vehicle accident – new
3. Motor vehicle accident – new

However, the crush syndrome medically defined as “the systemic manifestations” resulting from crush injury, which can result in organ dysfunction (predominantly acute kidney injury, but multisystem organ injury can also occur), or death is not included in the NIDS.

END.

Reply:

In terms of the National Indicator Dataset, the hospital beds are classified according to disciplines in which patients are admitted. The Department of Health does not have record of beds that were taken up by cases relating to vigilantism, mob and/or community justice in all provinces.

END.

Reply:

a) Total number of children (0 – 59 months ) who died in public health facilities in each province since 1 January 2013 to December 2022 (ten years period)

Table1: Children who died in public health facilities by province since 1 January 2013 to December 2022 (ten years period)

Organisation unit name	Value
Eastern Cape	25 189
Free State	10 189
Gauteng	38 243
KwaZulu-Natal	38 711
Limpopo	24 744
Mpumalanga	14 226
Northern Cape	5 107
North West	10 300
Western Cape	11 736

Source DHIS

(b) Detailed breakdown of the reasons for each death

Provision of individual cause of children’s death to the house contravenes section35 of the Protection of personal information Act (POPIA), aggregated data on common causes of deaths in children are diarrhoea and pneumonia, including the underlying causes such as severe and moderate acute malnutrition, are collected routinely through the district health information system.

Table 2: Causes and underlying causes of deaths from 1st January 2013 to 31st December 2022

Data name	TOTAL
Pneumonia death under 5 years	10,216
Diarrhoea death under 5 years	9491
Moderate acute malnutrition death under 5 years	1410
Severe acute malnutrition death under 5 years	11172

Source DHIS

(c) Number of deaths that were due to unnatural causes?

Number of child deaths due to unnatural causes in public health facilities may not project accurate picture across the country as final causes are documented following the forensic report analysis. Statistics South Africa, Home Affairs and South African Police Service provides accurate information as shown in the table below.

Table 7: Non-natural deaths from 2013 to 2018

Year	Non-natural deaths	% under-5 deaths
2013	2 452	7.0
2014	2 496	7.3
2015	2 509	7.9
2016	2 364	8.3
2017	2 0 4	7.9
2018	2 199	8.4

  Source: StatsSA

 

END.

Reply:

The report titled, The Mental State of the World in 2022 (third report), from Sapiens Labs, is based on responses from 407,959 across 64 countries. The second report of 2021 has an equally small sample size of 223,087 respondents across 34 countries. The reports do not indicate how many persons responded per country, however, the sample size of these reports represent a very small fraction of the population of the countries from which respondents were sourced. Even if the total number of respondents were from South Africa only, the sample size is still too small and the results of the reports can therefore not be generalized to the entire population of South Africa. We nevertheless provide a response to the honourable member’s questions.

a) The Department has prioritised mental health in view of the burden of diseases associated with mental illnesses. The upstream determinants of mental health cut across responsibilities and mandates of a number of sectors and the NDoH collaborates with other Departments in Government and NGOs such as Higher Health and the SA Federation for Mental Health on a number of aspects related to promoting mental health including activities aimed at combating stigma.

b) Future plans are aimed at expanding prevention, advocacy and stigma combating activities. This will entail working with a wider range of partners in line with the strategies articulated in the National Strategic Plan for Non-Communicable Diseases 2022-2027 and the Mental Health Policy Framework and Strategy 2023-2030.

END.

Reply:

The process in the recruitment of Chief Executive Officers (CEOs) is not different between Provinces. As all appointments of CEOs across provinces are guided by the Policy on the Management of Public Hospitals that amongst others, makes provision for the criteria pertaining to minimum qualifications, relevant experience and generic qualities required for appointment to the position of hospital CEO (at all levels). This was introduced by Minister of Health in terms of sections 3(1)(c) and 23(1) of National Health Act, 2003, (Act No. 61 of 2003), after consultation with the National Health Council in August 2011.

In line with the above Policy, the Gauteng Provincial Department of Health has informed the Minister that the Chief Executive Officer positions in the Province, are advertised in the National Media (newspaper) and the e-Recruitment platform (Gauteng professional job centre)

The selection process entails the interviews, presentation on the technical exercise prepared by the Selection Committee. Recommended candidates are subjected to the Senior Management Service competency assessment or developmental assessment and vetting processes depending on the level of the position. The department conducts reference checks from the referees provided and conduct suitability checks with the current and previous employers. The recommended candidates are also required to complete Security Vetting Forms, a process facilitated by the State Security Agency.6 The outcome of the above processes is considered by the Executive Authority (EA) in appointing Chief Executive Officers (CEO).

END.

Reply:

The NHLS has confirmed that all four positions are filled with the following specific positions details:

a) The Chief Financial Officer was appointed on a five-year contract: The appointment was effective from 01 January 2023.

b) A permanent Head of Supply Chain was appointed: The appointment was effective from 01 August 2022.

c) A permanent Facilities Manager was appointed: The appointment was effective from 01 August 2018.

d) The Chief Information Officer was appointed on a five-year contract: The appointment was effective from 01 January 2020.

END.

Reply:

(a)-(b) All health facilities have been affected by the load-shedding across the country and some core services, especially surgical interventions often have to be rescheduled. Fortunately, all hospitals have two back-up suppliers (e.g. generators and Uninterrupted Power Suppliers for theatres and ICU’s) and most of the Community Health Centres have one back-up supplier (e.g. generators). These back-up suppliers have assisted in reducing the impact of load-shedding and preventing untold harm to the patients. All health facilities are continuously adapting to ensure that they function optimally.

END.

Reply:

(1) My Department has appointed CSIR to conduct a due diligence exercise regarding the roll-out of solar energy to all health facilities across the country. (a) The proposed solar energy programme is going to cover the roll-out of the solar energy + battery storage as back-up supply to all the clinics, CHC’s, hospitals, EMS centres including the forensic laboratories. The objective of the exercise by CSIR is to identify the required critical consumption for critical areas of each health facility so that the department can be able:

- To compile a comprehensive business case that will assist the Department in justifying for the required budget;

- To identify critical areas within a “health facility” that requires a back-up service from the solar energy. CSIR is going to quantify the required size of solar energy for those critical areas;

- CSIR is going to consider different kits of inverters with batteries for the Clinics and CHC’s. Unlike solar panels, these kits are not easy to steal. They can be stored in a lockable room with burglar bars and with strict access control;

- To map out the roll-out implementation program for the required solar energy solution for each health facility;

- The study will also identify areas that can be funded by other donors like USAID including others that are interested to partner with the National Department of Health; and

- The exercise/study is expected to be completed at the end of April 2023.

(b) The expected start date of the roll-out of the solar energy programme is June 2023 depending on the availability of funding from the National State of Disaster Centre.

(c) The envisage completion date is going to be informed by the detailed analysis by CSIR.

(2) No.

END.

Reply:

1. (a) See below the breakdown on the expenditure for the diesel consumption by the generators in each province:

Annexure A is attached and it covers a breakdown expenditure for diesel usage by generators for each hospital in the Republic.

b) Yes, the generators are in a workable condition.

2. I will not be making a statement on this matter.

END.

Reply:

Yes, I have been informed that Warmsand in the Northern Cape is a farmstead located approximately 20 kilometres from Keimoes and is therefore serviced from Keimoes when required. Patients from all surrounding areas including Eenduin, Friersdale and Warmsand are being served from Keimoes and not Upington as mentioned in the report. There is an Emergency Medical Services (EMS) station in Keimoes that services Warmsand area.

Due to shortage of staff, the service regressed because of the national measles campaign conducted throughout the province. The mobile clinic with the support from Keimoes Community Health Centre (CHC) staff will resume the services with effect from the 1st week of April 2023 in Warmsand and the surrounding areas.

END.

Reply:

1. I have directed the Director General of Health to meet with ESKOM to jointly seek interventions to mitigate against loadshedding. The first engagement took place on 22 September 2022. The meetings with Eskom are happening on a regular basis to seek for more exemptions of healthcare facilities. There are further ongoing engagements with both COGTA and various municipalities regarding additional exemptions for both private and public health care facilities from the grid.

2. No.

END.

Reply:

1. The department is not aware of “historical concerns with regard to the influence of Mr Bill Gates over the South African healthcare system”. The Bill & Melinda Gates Foundation is one of many philanthropic organisations that contribute to healthcare across the globe. The Foundation “provides funding to organizations to achieve measurable impact in the fight against poverty, disease, and inequity around the world”, and “funds entrepreneurs, companies, and other organizations to create incentives that harness the power of private enterprise to create change for those who need it most.”

The Gates Foundation supports several programs in South Africa with its major focus on health. During the period 2009-2022, the Gates Foundation invested approximately $907 million dollars in South Africa to some 764 grantees and vendors (which include NGOs, universities, science councils, implementing partners, and manufacturers).

With specific reference to the vaccine programmes during COVID-19, departments and/or entities to which funds and/or donations were sent and/or directed by, include only one government entity, the SAMRC for the Sisonke healthcare worker COVID 19 vaccination programme, plus several private and non-government organisations.

With specific reference to SAHPRA since 1 January 2009 the Gates Foundation direct support to SAHPRA is $7.6million to date.

2. The Foundation has provided no direct funding to the NDoH since 1 January 2009 to date. The focus of the Foundation’s health investments is related to TB and HIV response and span the spectrum from discovery, translation science, product development and delivery of new interventions.

https://www.gatesfoundation.org/about/committed-grants?country=South%20Africa&region=AFRICA]

According to the Foundation the programmes and/or associations envisaged through the funding of the Foundation, include:

(i) in the current year:

• Technical Support to the TB Programme
• Technical Support on HIV quality improvement and HIV Prevention
• Technical support to the DDG NHI
• Catalytic support for scale up evidence-based TB and HIV interventions in South Africa
• SAHPRA was supported with paying for external reviewers (both South Africa and non-South African) selected by SAHPRA to address the large backlog (+/- 16000 applications) inherited from the MCC at the request of the SAHPRA Board. This included all products as the Gates Foundation support of external reviewers was not product specific
• Africa Resource Centre to provide technical assistance on Supply Chain management

(ii) envisaged for a later period:

• Provision of catalytic support to implement evidence-based TB and HIV interventions in South Africa

• Support to SAHPRA for digitisation of clinical trials records

END.

Reply:

Yes, I have been informed that there is one ambulance based in Keimoes, however, an ambulance that is based in Kakamas also responds to Keimoes when needed. It must be noted that these are remote areas with low population density and low call out rates.

END.

Reply:

1. The Tembisa Hospital matter is still under investigation by the Special Investigating Unit (SIU). Once the investigation has been finalized, the Department will comply with any directives issued by the SIU. If such directives includes the blacklisting of the companies referred to, the Department will implement the recommendation.

2. (a) and (b) - No Department within the Public Health Sector have blacklisted any company since 01 January 2020 to date.

END.

Reply:

1. Leave of absence in the Public Service is regulated in accordance with the Directive on Leave of Absence as published by the Department of Public Service and Administration in August 2021.

In accordance with the information as extracted from the PERSAL data set-

a) (i) The data as provided gives overall number of days counts that Nurses (in all categories as employed in the Public Health Sector) took in different leave categories during the financial years 2021/2022 and 2002/2023 is as per the table below:

The tables below provide a breakdown of the various categories of absenteeism per provinces.

NUMBER OF DAYS ABSENT BY NURSES (IN ALL CATEGORIES)
	EC	FS	GAU	KZN	LP	MPU	NW	NC	WC	Overall Total
Adoption (Workdays)	2	44	0	4	6	0	0	0	0	56
Discounting (Workdays)	102	1964	102	791	238	148	136	33	852	4366
Family Responsibility (Workdays)	7403	1542	2147	20103	14428	3755	2776	384	11203	63741
Gratuity (Workdays)	239	131	34	713	531	199	82	26	265	2220
Leave Without Pay (Calendar Days)	1540	269	359	3409	595	291	183	130	1421	8197
Maternity	576	163	217	1290	742	362	184	22	524	4080
Occupational Injuries/Diseases (Workdays)	185	41	67	833	1735	988	151	9	158	4167
Paternity (Workdays)	54	12	16	105	100	27	24	1	48	387
Permanent Incapacity Leave	7	1	121	13	598	3	155	9	7	914
Pre-Natal (Workdays)	308	161	154	1376	350	194	77	13	861	3494
Shop Steward/Office Bearer (Workdays)	663	183	87	1024	1052	258	183	78	595	4123
Sick-Full Pay (Workdays)	53276	19217	11953	145227	57858	17671	14473	2504	59599	381778
Special (Workdays)	1893	536	459	10173	3249	601	778	104	10795	28588
Temporary Incapacity Leave	1011	773	583	3358	872	431	343	37	1507	8915
Vacation - Full Pay (Workdays)	103013	37979	17654	214258	91977	38302	25891	4459	75251	608784

(ii) The Public Health Services does not make provision for a Job title of Operational Staff. It is requested that clear indication be provided on what is the meaning of Operational Staff.

(iii) The data as provided gives overall number of days counted that Clinicians (Medical Officers/ Specialist and Registrar’s) took in different leave categories during the financial years 2021/2022 and 2002/2023 is as per the table below.

The tables below provide a breakdown of the various categories of absenteeism per provinces.

NUMBER OF DAYS ABSENT BY CLINITIANS MEDICAL OFFICER / SPECIALIST / REGISTRARS
	EC	FS	GAU	KZN	LP	MPU	NW	NC	WC	Overall Total
Adoption (Workdays)	1	0	0	0	0	2	0	0	1	4
Discounting (Workdays)	14	49	35	206	157	36	69	5	317	888
Family Responsibility (Workdays)	265	174	146	1491	906	284	146	37	726	4175
Gratuity (Workdays)	17	1	0	19	19	10	2	0	16	84
Leave Without Pay (Calendar Days)	20	19	38	261	262	29	18	0	163	810
Maternity	58	40	51	239	161	78	46	3	158	834
Occupational Injuries/Diseases (Workdays)	13	2	16	99	173	107	12	0	11	433
Paternity (Workdays)	20	17	14	99	77	20	15	5	74	341
Permanent Incapacity Leave	0	0	0	0	0	0	0	0	1	1
Pre-Natal (Workdays)	51	15	27	407	118	28	15	1	112	774
Shop Steward/Office Bearer (Workdays)	3	0	2	17	37	15	0	0	118	192
Sick-Full Pay (Workdays)	2011	962	1293	17565	4604	1862	928	184	6852	36261
Special (Workdays)	572	801	263	3440	1328	409	226	33	4505	11577
Temporary Incapacity Leave	19	33	16	140	18	9	10	2	95	342
Vacation - Full Pay (Workdays)	7990	5993	4328	34780	13685	6903	4198	651	23370	101898

2. The National Department of Health is consulting with the Provincial Departments of Health to collate the full details in this regard.

END.

Reply:

a) The total number of-

(i) As per the HPCSA register, a total of 16 964 doctors have been trained in the Republic since 01 January 2013.

(ii) As per the SA Nursing Council register, a total of 181 277 Nurses (all categories) have been trained in the Republic since 1 January 2013.

(iii) A total of 5 877 specialists have registered with the Health Professions Council of South Africa (HPCSA) after training in different fields of Specialty in the Republic since 1 January 2013.

b) Of the above trained numbers, the following have been absorbed in the Public Health Sector

(i) Doctors appointed since January 2013 in Public Health Sector is 15 606,

(ii) Nurses (all categories) appointed since January 2013 in Public Health Sector is 52 542 and

(iii) Medical Specialist appointed since January 2013 in the Public Health Sector is 4 293.

 

END.

Reply:

(1) The list of contacted suppliers is available on the National Department of Health’s website, at the following url: https://www.health.gov.za/tenders/

Click on the tab: Master Health Product List.

1. See attached document with list of essential medicines where contracts were awarded to one supplier only on pages 1–21;
2. See attached document with list of essential medicines where contracts were awarded to more than supplier only from page 22 onwards.

(2) The decision to award a contract to one supplier only is informed by a number of factors including the following:

• The product is only available from one supplier registered with SAHPRA (i.e. sole supplier);
• During the contracting process, a bid was only received from one registered supplier even if there are other suppliers in the market;
• The estimated tender volumes are too low to justify award to more than one supplier as this decreases the benefits derived from economies of scale.

(3) It is the standard practice of the Department of Health to award more than one supplier in to manage risks related to supply challenges for certain strategic products that are important for successful implementation of public health programmes.

The decision to award contracts to more than one supplier depends on factors such as the following:

• The estimated tender volumes are high because of high disease burden, as in the case of first line antiretrovirals used in the management of HIV;
• The highest scoring bidder does not have the capacity to meet estimated tender volumes and their inability to meet demand during a contract period would result in a supply challenge;
• There is a risk to public health if the medicine is not available.

END.

Annexure 1

Medicine Description (More than one contracted supplier)

• Abacavir; 20mg/ml; Solution; 240 ml
• Allopurinol; 300mg; Tablet; 30 Tablets
• Amitriptyline; 25mg; Tablet; 28 Tablets
• Amlodipine; 10mg; Tablet; 28 Tablets
• Amlodipine; 5mg; Tablet; 28 Tablets
• Amoxicillin, Clavulanic Acid; 125mg/5ml, 31.25mg/5ml; Suspension; 100 ml
• Amoxicillin, Clavulanic Acid; 250mg, 125mg; Tablet; 15 Tablets
• Amoxicillin, Clavulanic Acid; 250mg/5ml, 62.5mg/5ml; Suspension; 100 ml
• Amoxicillin, Clavulanic Acid; 875mg, 125mg; Tablet; 10 Tablets
• Amoxicillin; 125mg/5ml; Suspension; 100 ml
• Amoxicillin; 250mg/5ml; Suspension; 100 ml
• Amoxicillin; 250mg; Capsule; 15 Capsules
• Amoxicillin; 500mg; Capsule; 15 Capsules
• Ampicillin; 250mg; injection; 1 Injection
• Ampicillin; 500mg; injection; 1 Injection
• Aspirin; 300mg; tablet, scored; 14 Tablets
• Atenolol; 50mg; Tablet; 30 Tablets
• Atorvastatin; 10mg; Tablet; 28 Tablets
• Atropine; 1mg/ml; injection; 1 ml
• Atropine; 500mcg/ml; injection; 1 ml
• Azithromycin; 500mg; Tablet; 2 Tablets
• Azithromycin; 500mg; Tablet; 3 Tablets
• Calcium Carbonate, Glycine; 420mg, 180mg; Tablet; 168 Tablets
• Calcium Carbonate; 500mg; Tablet; 10 Tablets
• Calcium Carbonate; 500mg; Tablet; 30 Tablets
• Carbamazepine; 200mg; Tablet; 56 Tablets
• Carbamazepine; 200mg; Tablet; 84 Tablets
• Cefazolin; 1g; injection; 1 Injection
• Cefazolin; 500mg; injection; 1 Injection
• Ceftriaxone; 1g; injection; 1 Injection
• Ceftriaxone; 250mg; injection; 1 Injection
• Ceftriaxone; 500mg; injection; 1 Injection
• Cetirizine; 10mg; Tablet; 28 Tablets
• Chlorphenamine; 2mg/5ml; Syrup; 50 ml
• Ciprofloxacin; 500mg; Tablet; 10 Tablets
• Citalopram; 20mg; Tablet; 28 Tablets
• Clotrimazole; 1%; Cream; 20 g
• Clotrimazole; 500mg/50g; cream, vaginal; 50 g
• Dexamethasone; 4mg/ml; injection; 1 ml
• Diclofenac; 75mg/3ml; Injection; 3 ml
• Dolutegravir; 50mg; Tablet; 30 Tablets
• Doxazosin; 4mg; Tablet; 30 Tablets
• Doxycycline; 100mg; Tablet; 14 Tablets
• Efavirenz; 200mg; Tablet; 84 Tablets
• Efavirenz; 600mg; Tablet; 28 Tablets
• Enalapril; 10mg; Tablet; 28 Tablets
• Enalapril; 20mg; Tablet; 30 Tablets
• Enalapril; 5mg; Tablet; 28 Tablets
• Epinephrine (Adrenaline); 1mg/ml; injection; 1 ml
• Fentanyl; 100mcg/2ml; injection; 2 ml
• Ferrous Sulfate Co; 170mg; Tablet; 28 Tablets
• Flucloxacillin; 250mg; Capsule; 20 Capsules
• Flucloxacillin; 250mg; Capsule; 40 Capsules
• Fluoxetine; 20mg; Capsule; 28 Capsules
• Folic Acid; 5mg; Tablet; 28 Tablets
• Furosemide; 40mg; Tablet; 28 Tablets
• Furosemide; 40mg; Tablet; 56 Tablets
• Furosemide; 40mg; Tablet; 84 Tablets
• Glibenclamide; 5mg; Tablet; 28 Tablets
• Glibenclamide; 5mg; Tablet; 56 Tablets
• Glimepiride; 1mg; Tablet; 28 Tablets
• Glimepiride; 2mg; Tablet; 28 Tablets
• Glimepiride; 4mg; Tablet; 28 Tablets
• Hydrochlorothiazide; 25mg; Tablet; 28 Tablets
• Hydrocortisone; 100mg/2ml; injection; 2 ml
• Ibuprofen; 200mg; Tablet; 15 Tablets
• Ibuprofen; 200mg; Tablet; 42 Tablets
• Ibuprofen; 200mg; Tablet; 84 Tablets
• Ibuprofen; 400mg; Tablet; 15 Tablets
• Isoniazid; 100mg; Tablet; 28 Tablets
• Isoniazid; 300mg; Tablet; 28 Tablets
• Lamivudine, Abacavir, Dolutegravir; 300mg, 600mg, 50mg; Tablet; 28 Tablets
• Lamivudine, Abacavir; 300mg, 600mg; Tablet; 28 Tablets
• Lamivudine, Abacavir; 60mg, 120mg; Tablet; 28 Tablets
• Lamivudine; 10mg/ml; Solution; 240 ml
• Lamivudine; 150mg; Tablet; 56 Tablets
• Lansoprazole; 30mg; Capsule; 28 Capsules
• Loperamide; 2mg; Tablet; 6 Tablets
• Lopinavir, Ritonavir; 200mg, 50mg; Tablet; 112 Tablets
• Metformin; 500mg; Tablet; 56 Tablets
• Metformin; 500mg; Tablet; 84 Tablets
• Metformin; 850mg; Tablet; 28 Tablets
• Metformin; 850mg; Tablet; 56 Tablets
• Metformin; 850mg; Tablet; 84 Tablets
• Metoclopramide; 10mg; Tablet; 10 Tablets
• Metronidazole; 400mg; Tablet; 14 Tablets
• Metronidazole; 400mg; Tablet; 5 Tablets
• Metronidazole; 500mg/100ml; injection; 100 ml
• Midazolam; 15mg/3ml; injection; 3 ml
• Midazolam; 5mg/5ml; injection; 5 ml
• Morphine; 10mg/ml; injection; 1 ml
• Morphine; 15mg/ml; injection; 1 ml
• Omeprazole; 20mg; Capsule; 14 Capsules
• Oxytocin; 10IU/ml; injection; 1 ml
• Pantoprazole; 20mg; Tablet; 30 Tablets
• Paracetamol; 500mg; Tablet; 100 Tablets
• Paracetamol; 500mg; Tablet; 20 Tablets
• Pethidine; 100mg/2ml; injection; 2 ml
• Pethidine; 50mg/ml; injection; 1 ml
• Prednisone; 5mg; Tablet; 28 Tablets
• Rifampicin, Isoniazid; 150mg, 75mg; Tablet; 56 Tablets
• Rifampicin, Isoniazid; 150mg, 75mg; Tablet; 84 Tablets
• Rifampicin, Isoniazid; 300mg, 150mg; Tablet; 56 Tablets
• Rifampicin, Pyrazinamide, Ethambutol, Isoniazid; 150mg, 400mg, 275mg, 75mg; Tablet; 112 Tablets
• Rifampicin, Pyrazinamide, Ethambutol, Isoniazid; 150mg, 400mg, 275mg, 75mg; Tablet; 56 Tablets
• Rifampicin, Pyrazinamide, Ethambutol, Isoniazid; 150mg, 400mg, 275mg, 75mg; Tablet; 84 Tablets
• Salbutamol; 100mcg; Inhaler; 200 Doses
• Simvastatin; 10mg; Tablet; 28 Tablets
• Simvastatin; 20mg; Tablet; 28 Tablets
• Sodium Chloride; 0.9%; injection; 10 ml
• Spironolactone; 25mg; Tablet; 28 Tablets
• Sulfamethoxazole, Trimethoprim; 200mg/5ml, 40mg/5ml; Suspension; 100 ml
• Sulfamethoxazole, Trimethoprim; 400mg, 80mg; Tablet (Co-trimoxazole); 28 Tablets
• Sulfamethoxazole, Trimethoprim; 400mg, 80mg; Tablet (Co-trimoxazole); 56 Tablets
• Tenofovir, Emtricitabine, Efavirenz; 300mg, 200mg, 600mg; Tablet; 28 Tablets
• Tenofovir, Emtricitabine, Efavirenz; 300mg, 200mg, 600mg; Tablet; 84 Tablets
• Tenofovir, Emtricitabine; 300mg, 200mg; Tablet; 28 Tablets
• Tenofovir, Lamivudine, Dolutegravir; 300mg, 300mg, 50mg; Tablet; 84 Tablets
• Tenofovir, Lamivudine, Dolutegravir; 300mg, 300mg, 50mg; Tablet; 28 Tablets
• Tramadol; 50mg; Capsule; 100 Capsules
• Tramadol; 50mg; Capsule; 20 Capsules
• Vitamin B1 (Thiamine); 100mg; Tablet; 28 Tablets
• Vitamin B6 (Pyridoxine); 25mg; Tablet; 28 Tablets

Annexure 2

Medicine Description (One contracted supplier)

• Abacavir; 300mg; Tablet; 56 Tablets
• Abacavir; 60mg; Tablet, dispersible; 56 Tablets
• Acetazolamide; 250mg; Tablet; 100 Tablets
• Acetazolamide; 250mg; Tablet; 30 Tablets
• Acetic Acid; Liquid; 500 ml
• Acetylcysteine; 200mg/ml; injection; 10 ml
• Acetylcysteine; 200mg; Tablet; 20 Tablets
• Aciclovir; 200mg; Tablet, dispersible; 25 Tablets
• Aciclovir; 250mg; injection; 1 Injection
• Aciclovir; 400mg; Tablet, dispersible; 70 Tablets
• Adenosine; 6mg/2ml; injection; 2 ml
• Albendazole; 400mg; Tablet; 1 Tablet
• Albumin, Human, Normal; 20%; Infusion (parenteral); 100 ml
• Albumin, Human, Normal; 20%; Infusion (parenteral); 50 ml
• Alfentanil; 1mg/2ml; injection; 2 ml
• Allopurinol; 100mg; Tablet; 100 Tablets
• Allopurinol; 100mg; Tablet; 28 Tablets
• Allopurinol; 100mg; Tablet; 56 Tablets
• Alprazolam; 0.5mg; Tablet; 30 Tablets
• Alprostadil; 500mcg/ml; injection; 1 ml
• Alteplase; 50mg; injection; 1 Injection
• Aluminium hydroxide; 300mg/5ml; Suspension; 500 ml
• Amikacin Sulph; 100mg/2ml; injection; 2 ml
• Amikacin Sulph; 250mg/2ml; injection; 2 ml
• Amikacin Sulph; 500mg/2ml; injection; 2 ml
• Aminophylline; 250mg/10ml; injection; 10 ml
• Amiodarone; 150mg/3ml; injection; 3 ml
• Amiodarone; 200mg; Tablet; 30 Tablets
• Amisulpride; 200mg; Tablet; 30 Tablets
• Amisulpride; 50mg; Tablet; 30 Tablets
• Amitriptyline; 10mg; Tablet; 100 Tablets
• Amitriptyline; 10mg; Tablet; 28 Tablets
• Amitriptyline; 25mg; Tablet; 100 Tablets
• Amitriptyline; 25mg; Tablet; 168 Tablets
• Amitriptyline; 25mg; Tablet; 500 Tablets
• Amitriptyline; 25mg; Tablet; 56 Tablets
• Amitriptyline; 25mg; Tablet; 84 Tablets
• Amoxicillin, Clavulanic Acid; 1,000mg, 200mg; injection; 1 Injection
• Amoxicillin, Clavulanic Acid; 500mg, 100mg; injection; 1 Injection
• Amoxicillin/Clavulanic Acid; 600mg/42.9mg; Suspension; 100 ml
• Amoxicillin; 250mg; Capsule; 100 Capsules
• Amoxicillin; 500mg; Capsule; 100 Capsules
• Anastrozole; 1mg; Tablet; 28 Tablets
• Aqueous; Cream; 100 g
• Aqueous; Cream; 500 g
• Aripiprazole; 10mg; Tablet; 30 Tablets
• Aripiprazole; 15mg; Tablet; 30 Tablets
• Aripiprazole; 5mg; Tablet; 30 Tablets
• Artemether, Lumefantrine; 20mg, 120mg; Tablet; 24 Tablets
• Artesunate; 60mg; injection; 1 Injection
• Aspirin; 300mg; Tablet; 96 Tablets
• Atazanavir, Ritonavir; 300mg, 100mg; Tablet; 28 Tablets
• Atazanavir; 200mg; Capsule; 60 Capsules
• Atazanavir; 300mg; Capsule; 30 Capsules
• Atenolol; 100mg; Tablet; 28 Tablets
• Atenolol; 25mg; Tablet; 28 Tablets
• Atorvastatin; 20mg; Tablet; 30 Tablets
• Atorvastatin; 40mg; Tablet; 30 Tablets
• Atracurium; 25mg/2.5ml; injection; 2.5 ml
• Atracurium; 50mg/5ml; injection; 5 ml
• Atropine; 1%; Drop, Eye; 5 ml
• Azathioprine; 50mg; Tablet; 100 Tablets
• Balanced Salt; solution, ophthalmic; 15 ml
• Balanced Salt; solution, ophthalmic; 500 ml
• Barium Sulfate With Suspending Agent; 4.6%; Suspension; 225 ml
• Barium Sulfate With Suspending Agent; 98g/100g; Powder; 340 g
• Barium Sulfate; BP; Suspension; 1 Kit
• Beclometasone; 100mcg; Inhaler; 200 Doses
• Beclometasone; 100mcg; Inhaler; SERIES; 200 Doses
• Beclometasone; 200mcg; Inhaler; 200 Doses
• Beclometasone; 50mcg; Inhaler; 200 Doses
• Beclometasone; 50mcg; Inhaler; SERIES; 200 Doses
• Beclometasone; 50mcg; Spray, Nasal; 150 Doses
• Benzoin Co; Tincture; 100 ml
• Benzoin Co; Tincture; 20 ml
• Benzydamine, Chlorhexidine; 22.5mg/15ml, 18mg/15ml; Mouthwash; 200 ml
• Benzyl Benzoate; 25%; Liquid; 100 ml
• Betamethasone Disodium Phosphate; 4mg/ml; injection; 1 ml
• Betamethasone Valerate; 0.1%; Cream; 15 g
• Betamethasone Valerate; 0.1%; Cream; 50 g
• Betamethasone Valerate; 0.1%; Cream; 500 g
• Betamethasone; 500mcg; Tablet; 100 Tablets
• Betamethasone; 500mcg; Tablet; 20 Tablets
• Betaxolol; 2.5mg/ml; Drop, Eye; 5 ml
• Betaxolol; 5mg/ml; Drop, Eye; 5 ml
• Bevacizumab; 100mg/4ml; injection; 4 ml
• Bezafibrate; 400mg; Tablet; 30 Tablets
• Bimatoprost; 0.3mg/ml; Drop, Eye; 3 ml
• Biperiden; 2mg; Tablet; 100 Tablets
• Biperiden; 5mg/ml; injection; 1 ml
• Bisacodyl; 10mg; Suppository; 10 Suppositories
• Bleomycin; 15IU; injection; 1 Injection
• Bortezomib; 3.5mg; injection; 10 ml
• Botulinum Toxin, Type A, Lyophilised; 100IU; injection; 1 Injection
• Brimonidine; 1.5mg/ml; Drop, Eye; 5 ml
• Brimonidine; 2mg/ml; Drop, Eye; 5 ml
• Bromocriptine; 2.5mg; Tablet; 30 Tablets
• Budesonide, Formoterol; 160mcg, 4.5mcg; Inhaler; 60 Doses
• Budesonide, Formoterol; 320mcg, 9mcg; Inhaler; 60 Doses
• Bupivacaine, Adrenaline; 5mg/ml, 5mcg/ml; injection; 20 ml
• Bupivacaine, Dextrose; 5mg, 72.7mg; injection; 4 ml
• Bupivacaine; 5mg/ml; injection (Spinal); 10 ml
• Bupivacaine; 5mg/ml; injection (Spinal); 4 ml
• Busulfan; 2mg; Tablet; 100 Tablets
• Caffeine; 20mg/ml; injection; 1 ml
• Calamine; Lotion; 100 ml
• Calcium Folinate; 100mg; injection; 1 Injection
• Calcium Folinate; 15mg; Tablet; 10 Tablets
• Calcium Folinate; 300mg; injection; 1 Injection
• Calcium Gluconate; 10%; injection; 10 ml
• Capecitabine; 150mg; Tablet; 60 Tablets
• Capecitabine; 500mg; Tablet; 120 Tablets
• Captopril; 25mg; Tablet; 60 Tablets
• Carbamazepine; 100mg/5ml; Suspension; 250 ml
• Carbamazepine; 200mg; Tablet; 100 Tablets
• Carbamazepine; 200mg; Tablet; 28 Tablets
• Carbimazole; 5mg; Tablet; 100 Tablets
• Carboplatin; 150mg/15ml; injection; 15 ml
• Carboplatin; 450mg/45ml; injection; 45 ml
• Carvedilol; 12.5mg; Tablet; 28 Tablets
• Carvedilol; 25mg; Tablet; 30 Tablets
• Cefalexin; 125mg/5ml; Suspension; 100 ml
• Cefalexin; 250mg/5ml; Suspension; 100 ml
• Cefalexin; 250mg; Capsule; 20 Capsules
• Cefalexin; 500mg; Capsule; 20 Capsules
• Cefepime; 1g; injection; 1 Injection
• Cefepime; 2g; injection; 1 Injection
• Cefotaxime; 1g; injection; 1 Injection
• Cefotaxime; 500mg; injection; 1 Injection
• Ceftazidime; 1g; injection; 1 Injection
• Ceftazidime; 2g; injection; 1 Injection
• Cetirizine; 1mg/ml; Syrup; 150 ml
• Chlorambucil; 2mg; Tablet; 25 Tablets
• Chloramphenicol; 0.5%; Drop, Eye; 10 ml
• Chloramphenicol; 1%; ointment, eye; 3.5 g
• Chlorhexidine, Alcohol; 0.5%, 70%; Solution (without emolient); 500 ml
• Chlorhexidine, Alcohol; 0.5%, 70%; Solution; 50 ml
• Chlorhexidine; 0.2%; Mouthwash; 200 ml
• Chlorhexidine; 4%; Solution (Hibiscrub); 500 ml
• Chlorphenamine; 4mg; Tablet; 10 Tablets
• Chlorphenamine; 4mg; Tablet; 30 Tablets
• Chlorpromazine; 100mg; Tablet; 56 Tablets
• Chlorpromazine; 25mg; Tablet; 56 Tablets
• Ciclosporin; 100mg/ml; Solution; 50 ml
• Ciclosporin; 100mg; Capsule; 50 Capsules
• Ciclosporin; 25mg; Capsule; 50 Capsules
• Ciclosporin; 50mg; injection; 1 Injection
• Ciprofloxacin; 100mg/50ml; injection; 100 ml
• Ciprofloxacin; 250mg/5ml; Suspension; 100 ml
• Ciprofloxacin; 250mg; Tablet; 10 Tablets
• Ciprofloxacin; 3mg/ml; Drop, Eye; 5 ml
• Ciprofloxacin; 400mg/200ml; Infusion (parenteral); 200 ml
• Cisatracurium; 10mg/5ml; injection; 5 ml
• Cisatracurium; 5mg/2.5ml; injection; 2.5 ml
• Cisplatin; 10mg/10ml; injection; 10 ml
• Cisplatin; 50mg/50ml; injection; 50 ml
• Citalopram; 10mg; Tablet; 30 Tablets
• Clarithromycin; 125mg/5ml; Suspension; 60 ml
• Clarithromycin; 250mg/5ml; Suspension; 60 ml
• Clarithromycin; 500mg; Tablet; 14 Tablets
• Clindamycin; 150mg; Capsule; 100 Capsules
• Clindamycin; 150mg; Capsule; 20 Capsules
• Clindamycin; 600mg/4ml; injection; 4 ml
• Clobetasol; 0.05%; Cream; 25 g
• Clobetasol; 0.05%; Ointment; 25 g
• Clomifene; 50mg; Tablet; 10 Tablets
• Clomipramine; 25mg; Tablet; 50 Tablets
• Clonazepam; 0.5mg; Tablet; 84 Tablets
• Clonazepam; 2mg; Tablet; 84 Tablets
• Clopidogrel; 75mg; Tablet; 30 Tablets
• Clotiapine; 40mg/4ml; injection; 4 ml
• Clotrimazole; 500mg; Pessary; 1 Pessary
• Cloxacillin; 250mg; injection; 1 Injection
• Cloxacillin; 500mg; injection; 1 Injection
• Clozapine; 100mg; Tablet; 100 Tablets
• Clozapine; 25mg; Tablet; 100 Tablets
• Coal Tar; BP; Solution; 500 ml
• Codeine Phosphate; 30mg; Tablet; 100 Tablets
• Colchicine; 500mcg; Tablet; 12 Tablets
• Cyclopentolate, Phenylephrine; 0.2%, 1%; Drop, Eye; 5 ml
• Cyclopentolate; 1%; Drop, Eye; 15 ml
• Cyclophosphamide; 1g; injection; 1 Injection
• Cyclophosphamide; 500mg; injection; 1 Injection
• Cyclophosphamide; 50mg; Tablet; 50 Tablets
• Cyproterone, Ethinylestradiol; 2mg, 0.035mg; Tablet; 28 Tablets
• Cyproterone; 10mg; Tablet; 15 Tablets
• Cyproterone; 50mg; Tablet; 20 Tablets
• Dacarbazine; 200mg; injection; 1 Injection
• Dapsone; 100mg; Tablet; 100 Tablets
• Darunavir, Ritonavir; 400mg, 50mg; Tablet; 56 Tablets
• Deferasirox; 250mg; Tablet; 28 Tablets
• Deferasirox; 500mg; Tablet; 28 Tablets
• Deferoxamine; 500mg; injection; 1 Injection
• Desmopressin; 0.1mg; Tablet; 30 Tablets
• Desmopressin; 0.2mg; Tablet; 30 Tablets
• Desmopressin; 100mcg/ml; Spray, Nasal; 5 ml
• Desmopressin; 4mcg/ml; injection; 1 Injection
• Dexamethasone; 0.1%; Drop, Eye; 5 ml
• Dextrose In Water; 50%; injection; 20 ml
• Dextrose In Water; 50%; injection; 50 ml
• Dextrose Monohydrate; BP; Powder; 500 g
• Dextrose Monohydrate; BP; Powder; 75 g
• Dextrose, Electrolyte; 5%; Infusion (parenteral); 1 L
• Dextrose, Maintelyte; 10%; Infusion (parenteral); 1 L
• Dextrose, Maintelyte; 5%; Infusion (parenteral); 1 L
• Dextrose; 10%; Infusion (parenteral); 1 L
• Dextrose; 5%; Infusion (parenteral); 1 L
• Dextrose; 5%; Infusion (parenteral); 100 ml
• Dextrose; 5%; Infusion (parenteral); 200 ml
• Dextrose; 5%; Infusion (parenteral); 50 ml
• Dextrose; 50%; Infusion (parenteral); 500 ml
• Diazepam; 10mg/2ml; injection; 2 ml
• Diazepam; 5mg; Tablet; 100 Tablets
• Diazepam; 5mg; Tablet; 14 Tablets
• Diazoxide; 20mg; Capsule; 100 Capsules
• Digoxin; 250mcg; Tablet; 30 Tablets
• Digoxin; 62.5mcg; Tablet; 100 Tablets
• Dinoprostone; 0.5mg; Tablet; 10 Tablets
• Dinoprostone; 1mg/3g; Syringe, Prefilled; 3 g
• Dobutamine; 250mg/20ml; injection; 20 ml
• Docetaxel; 20mg/ml; injection; 1 ml
• Docetaxel; 80mg/4ml; injection; 4 ml
• Dolutegravir; 50mg; tablet, scored; 30 Tablets
• Dopamine; 200mg/5ml; injection; 5 ml
• Doxorubicin; 10mg/5ml; injection; 5 ml
• Doxorubicin; 50mg/25ml; injection; 25 ml
• Doxycycline; 100mg; Tablet; 100 Tablets
• Efavirenz; 50mg; Capsule; 28 Capsules
• Electrolyte No 2 Solution: Na, K, Cl, Mg, Hpo4, Dextrose; injection; 1 L
• Emulsifying; BP; Ointment; 500 g
• Enoxaparin; 40mg/0.4ml; Syringe, Prefilled; 0.4 ml
• Enoxaparin; 60mg/0.6ml; Syringe, Prefilled; 0.6 ml
• Enoxaparin; 80mg/0.8ml; Syringe, Prefilled; 0.8 ml
• Epinephrine (Adrenaline); 0.15mg/0.3ml; auto-pen; 0.3 ml
• Epinephrine (Adrenaline); 0.3mg/0.3ml; auto-pen; 0.3 ml
• Epirubicin; 10mg/5ml; injection; 5 ml
• Epirubicin; 50mg/25ml; injection; 25 ml
• Ergometrine, Oxytocin; 500mcg, 5IU; injection; 1 ml
• Ertapenem; 1g; injection; 1 Injection
• Erythropoietin; 10000IU; injection; 1 ml
• Erythropoietin; 2000IU/0.3ml; Syringe, Prefilled; 1 Syringe, Pre-filled
• Erythropoietin; 30000IU/0.6ml; Syringe, Prefilled; 1 Syringe, Pre-filled
• Erythropoietin; 4000IU; injection; 1 ml
• Erythropoietin; 6000IU; injection; 1 ml
• Estradiol, Norethisterone Acetate; 1mg, 0.5mg; Tablet; 28 Tablets
• Estradiol, Norethisterone Acetate; 2mg, 1mg; Tablet; 28 Tablets
• Estradiol; 1mg; Tablet; 28 Tablets
• Estradiol; 2mg; Tablet; 28 Tablets
• Estrogen, Conjugated ; 0.3mg; Tablet; 28 Tablets
• Ethambutol; 400mg; Tablet; 100 Tablets
• Ethambutol; 400mg; Tablet; 56 Tablets
• Ethambutol; 400mg; Tablet; 84 Tablets
• Ethionamide; 250mg; Tablet; 250 Tablets
• Ethionamide; 250mg; Tablet; 28 Tablets
• Ethionamide; 250mg; Tablet; 56 Tablets
• Ethionamide; 250mg; Tablet; 84 Tablets
• Etomidate; 20mg/10ml; injection; 10 ml
• Etonogestrel; 68mg; Implant; 1 Device
• Etoposide; 100mg; injection (Section 21); 1 Injection
• Exemestane; 25mg; Tablet; 28 Tablets
• Fenoterol; 1.25mg/2ml; solution, inhalation; 60 UDVs (2ml)
• Fentanyl; 500mcg/10ml; injection; 10 ml
• Ferrous Gluconate; 350mg/5ml; Syrup; 100 ml
• Ferrous Sulfate Co; 170mg; Tablet; 100 Tablets
• Ferrous Sulfate Co; 170mg; Tablet; 56 Tablets
• Ferrous Sulfate Co; 170mg; Tablet; 84 Tablets
• Filgrastim; 30MU; Syringe, Prefilled; 1 Syringe, Pre-filled
• Filgrastim; 48MU; Syringe, Prefilled; 1 Syringe, Pre-filled
• Flucloxacillin; 250mg; Capsule; 100 Capsules
• Fluconazole; 200mg/100ml; Infusion (parenteral); 100 ml
• Fluconazole; 200mg; Tablet; 28 Tablets
• Fluconazole; 50mg/5ml; Suspension; 35 ml
• Fluconazole; 50mg; Tablet; 14 Tablets
• Fludarabine; 10mg; Tablet; 20 Tablets
• Fludarabine; 50mg; injection; 1 Injection
• Fluocinolone Acetonide; 0.025%; Ointment; 15 g
• Fluorouracil; 5%; Ointment; 20 g
• Fluoxetine; 20mg; Capsule; 100 Capsules
• Flupentixol; 20mg/ml; injection; 1 ml
• Fluticasone Propionate; 50mcg; Spray, Nasal; 120 Doses
• Folic Acid; 5mg; Tablet; 100 Tablets
• Formoterol; 12mcg; Inhaler; 120 Doses
• Fosfomycin; Granules; 1 Sachet (3g)
• Furosemide; 10mg/ml; Solution; 100 ml
• Furosemide; 20mg/2ml; injection; 2 ml
• Furosemide; 250mg/25ml; injection; 25 ml
• Furosemide; 40mg; Tablet; 112 Tablets
• Furosemide; 40mg; Tablet; 250 Tablets
• Furosemide; 500mg; Tablet; 100 Tablets
• Furosemide; 50mg/5ml; injection; 5 ml
• Ganciclovir; 500mg; injection; 1 Injection
• Gemcitabine; 1g; injection; 1 Injection
• Gemcitabine; 200mg; injection; 1 Injection
• Gentamicin; 20mg/2ml; injection; 2 ml
• Gentamicin; 80mg/2ml; injection; 2 ml
• Glibenclamide; 5mg; Tablet; 100 Tablets
• Glibenclamide; 5mg; Tablet; 84 Tablets
• Glucagon; 1mg; injection; 1 ml
• Glucometer; Medical device; 1 Device
• Glycerol; BP; Liquid; 500 ml
• Glycerol; 0.891ml; Suppository; 12 Suppositories
• Glycerol; 1.698ml; Suppository; 12 Suppositories
• Glyco Thymol Co; Mouthwash; 100 ml
• Glycopyrronium Bromide; 400mcg/2ml; injection; 2 ml
• Glycopyrronium Bromide; 50mcg; Inhaler; 30 Doses
• Goserelin; 10.8mg; Syringe, Prefilled; 1 Syringe, Pre-filled
• Goserelin; 3.6mg; Syringe, Prefilled; 1 Syringe, Pre-filled
• Granisetron; 1mg; injection; 1 Injection
• Granisetron; 3mg/3ml; injection; 3 ml
• Half Darrow With Glucose; 5%; Infusion (parenteral); 200 ml
• Half Darrow With Glucose; 5%; Infusion (parenteral); 500 ml
• Haloperidol; 1.5mg; Tablet; 100 Tablets
• Haloperidol; 5mg; Tablet; 100 Tablets
• Haloperidol; 5mg; Tablet; 28 Tablets
• Haloperidol; 5mg; Tablet; 56 Tablets
• Halothane; Liquid; 250 ml
• Heparin; 25000IU/5ml; injection; 5 ml
• Heparin; 5000IU/5ml; injection; 5 ml
• HUMAN COAGULATION CONCENTRATE COMPLEX: FACTOR VIII COMPLEX 1 000 IU INJECTION, UNIT CONTAINING - A HIGH SPECIFIC FACTOR VIII (FACTOR VIII: C) ACTIVITY - VON WILLEBRAND FACTOR (FACTOR
• HUMAN COAGULATION CONCENTRATE COMPLEX: FACTOR VIII COMPLEX 500 IU INJECTION, UNIT CONTAINING - A HIGH SPECIFIC FACTOR VIII (FACTOR VIII: C) ACTIVITY - VON WILLEBRAND FACTOR (FACTOR
• Human Coagulation Factor Concentrate: Activated Prothrombin Complex; 500IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Activated Prothrombin Complex; 1,000IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Ix Complex; 500IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viia Complex; 100,000IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viia Complex; 250,000IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viia Complex; 50,000IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viii Complex; 1,000IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viii Complex; 300IU; injection; 1 Injection
• Human Coagulation Factor Concentrate: Factor Viii Complex; 500IU; injection; 1 Injection
• Hyaluronic Acid; 10mg/ml; Syringe, Prefilled; 0.4 ml
• Hyaluronic Acid; 10mg/ml; Syringe, Prefilled; 0.55 ml
• Hydralazine; 25mg; Tablet; 56 Tablets
• Hydralazine; 25mg; Tablet; 84 Tablets
• Hydrochlorothiazide; 12.5mg; Tablet; 28 Tablets
• Hydrocortisone; 1%; Cream; 20 g
• Hydrocortisone; 1%; Ointment; 25 g
• Hydrocortisone; 10mg; Tablet; 100 Tablets
• Hydroxypropylmethylcellulose; 3mg/ml; Drop, Eye; 20 ml
• Hydroxyurea; 500mg; Capsule; 100 Capsules
• Hyoscine butylbromide; 10mg; Tablet; 10 Tablets
• Hyoscine butylbromide; 20mg/ml; injection; 1 ml
• Hyoscine butylbromide; 5mg/5ml; Syrup; 100 ml
• Ibandronic acid; 6mg; injection; 6 ml
• Ibuprofen; 100mg/5ml; Suspension; 100 ml
• Ibuprofen; 400mg; Tablet; 100 Tablets
• Ibuprofen; 400mg; Tablet; 84 Tablets
• Ifosfamide; 1g; injection; 1 Injection
• Ifosfamide; 2g; injection; 1 Injection
• Ifosfamide; 500mg; injection; 1 Injection
• Imatinib; 100mg; Capsule; 60 Capsules
• Imatinib; 400mg; Capsule; 30 Capsules
• Imipenem, Cilastatin; 500mg, 500mg; injection; 1 Injection
• Immunoglobulin, Anti-D; 100mcg; injection; 2 ml
• Immunoglobulin, Hepatitis B; 100IU/2ml; injection; 1 Injection
• Immunoglobulin, Human, Normal; 12g; Infusion (parenteral); 1 Injection
• Immunoglobulin, Human, Normal; 16%; injection; 2 ml
• Immunoglobulin, Human, Normal; 16%; injection; 5 ml
• Immunoglobulin, Human, Normal; 1g; Infusion (parenteral); 1 Injection
• Immunoglobulin, Human, Normal; 3g; Infusion (parenteral); 1 Injection
• Immunoglobulin, Human, Normal; 6g; Infusion (parenteral); 1 Injection
• Immunoglobulin, Rabies; 150IU/ml; injection; 2 ml
• Indometacin; 25mg; Capsule; 100 Capsules
• Insulin, Biosynthetic, Human, Isophane; 100IU/ml; injection; 10 ml
• Insulin, Biosynthetic, Human, Isophane; 100IU/ml; pen, prefilled; 3 ml
• Insulin, Biosynthetic, Human, Biphasic 30/70; 100IU/ml; injection; 10 ml
• Insulin, Biosynthetic, Human, Biphasic 30/70; 100IU/ml; pen, prefilled; 3 ml
• Insulin, Biosynthetic, Human, Soluble; 100IU/ml; injection; 10 ml
• Insulin, Biosynthetic, Human, Soluble; 100IU/ml; pen, prefilled; 3 ml
• Interferon Beta-1a; 6MIU; injection; 1 Injection
• Interferon Beta-1b; 8MIU; injection; 1 Injection
• Iohexol; 300mg/ml; injection; 100 ml
• Iohexol; 300mg/ml; injection; 20 ml
• Iohexol; 300mg/ml; injection; 50 ml
• Iohexol; 350mg/ml; injection; 100 ml
• Iohexol; 350mg/ml; injection; 50 ml
• Iomeprol; 400mg/ml; injection; 100 ml
• Iopamidol; 370mg/ml; injection; 100 ml
• Iopamidol; 370mg/ml; injection; 50 ml
• Iopromide; 300mg/ml; injection; 50 ml
• Iopromide; 370mg/ml; injection; 100 ml
• Ipratropium Bromide; 20mcg; Inhaler; 200 Doses
• Ipratropium Bromide; 250mcg/2ml; solution, inhalation; 60 UDVs (2ml)
• Ipratropium Bromide; 500mcg/2ml; solution, inhalation; 60 UDVs (2ml)
• Irinotecan; 100mg/5ml; injection; 5 ml
• Irinotecan; 40mg/2ml; injection; 2 ml
• Iron (III) Hydroxide Dextran Complex; 100mg/2ml; injection; 2 ml
• Iron (III) Hydroxide Dextran Complex; 500mg/10ml; injection; 10 ml
• Iron Sucrose Co; 100mg/5ml; injection; 5 ml
• Isoflurane; Liquid; 250 ml
• Isosorbide Dinitrate; 10mg; Tablet; 84 Tablets
• Isosorbide Dinitrate; 5mg; Tablet; 50 Tablets
• Isosorbide mononitrate; 20mg; Tablet; 56 Tablets
• IUD, Copper; Implant; 1 Device
• IUD, Levonorgestrel; 52mg; Implant; 1 Device
• Ketamine; 1000mg/10ml; injection; 10 ml
• Ketamine; 200mg/20ml; injection; 20 ml
• Ketamine; 500mg/10ml; injection; 10 ml
• Ketoconazole; 200mg; Tablet; 30 Tablets
• Lactulose; 3.35g/5ml; Syrup; 150 ml
• Lactulose; 3.35g/5ml; Syrup; 500 ml
• Lamotrigine; 100mg; Tablet; 56 Tablets
• Lamotrigine; 200mg; Tablet; 56 Tablets
• Lamotrigine; 25mg; Tablet; 56 Tablets
• Lamotrigine; 50mg; Tablet; 56 Tablets
• Lanolin; 3%; ointment, eye; 3.5 g
• Leflunomide; 10mg; Tablet; 30 Tablets
• Leflunomide; 20mg; Tablet; 30 Tablets
• Letrozole; 2.5mg; Tablet; 28 Tablets
• Levodopa, Carbidopa; 100mg, 25mg; Tablet; 100 Tablets
• Levodopa, Carbidopa; 250mg, 25mg; Tablet; 100 Tablets
• Levofloxacin; 250mg; Tablet; 28 Tablets
• Levofloxacin; 500mg; Tablet; 28 Tablets
• Levonorgestrel, Ethinylestradiol, Triphasic; Tablet; 28 Tablets
• Levonorgestrel, Ethinylestradiol; 0.15mg, 0.03mg; Tablet (Monophasic); 28 Tablets
• Levonorgestrel; 0.03mg; Tablet; 28 Tablets
• Levonorgestrel; 1.5mg; Tablet; 1 Tablet
• Levothyroxine Sodium; 100mcg; Tablet; 30 Tablets
• Levothyroxine Sodium; 25mcg; Tablet; 28 Tablets
• Levothyroxine Sodium; 50mcg; Tablet; 100 Tablets
• Levothyroxine Sodium; 50mcg; Tablet; 30 Tablets
• Lidocaine, Epinephrine (Adrenaline); 2%, 12.5mg; dental cartridge; 1.8 ml
• Lidocaine; 1%; injection (not for iv use); 20 ml
• Lidocaine; 10%; injection; 5 ml
• Lidocaine; 2%; dental cartridge; 1.8 ml
• Lidocaine; 2%; injection (not for iv use); 20 ml
• Lidocaine; 2%; injection (not for iv use); 5 ml
• Linezolid; 100mg/5ml; Suspension; 150 ml
• Linezolid; 600mg/300ml; Infusion (parenteral); 300 ml
• Linezolid; 600mg; Tablet; 10 Tablets
• Liquid Paraffin; BP; Liquid; 200 ml
• Lopinavir, Ritonavir; 100mg, 25mg; Tablet; 60 Tablets
• Lopinavir, Ritonavir; 40mg, 10mg; Capsule; 120 Capsules
• Lopinavir, Ritonavir; 80mg/ml, 20mg/ml; Solution; 60 ml
• Lorazepam; 1mg; Tablet; 100 Tablets
• Lorazepam; 2.5mg; Tablet; 100 Tablets
• Losartan; 100mg; Tablet; 28 Tablets
• Losartan; 50mg; Tablet; 30 Tablets
• Lubricant, Jelly; Gel; 1 sachet (2.5g)
• Lubricant, Jelly; Gel; 50 g
• Lyophilised Plasma; Infusion (parenteral); 200 ml
• Lyophilised Plasma; Infusion (parenteral); 50 ml
• Magnesium Sulfate; 50%; injection; 2 ml
• Mannitol; 25%; injection; 50 ml
• Mannitol; 5%; Infusion (parenteral); 3 L
• Mebendazole; 100mg/5ml; Suspension; 30 ml
• Mebendazole; 100mg; Tablet; 6 Tablets
• Mebendazole; 500mg; Tablet; 1 Tablet
• Medroxyprogesterone; 10mg; Tablet; 30 Tablets
• Medroxyprogesterone; 150mg; injection; 1 Injection
• Medroxyprogesterone; 5mg; Tablet; 30 Tablets
• Melphalan; 2mg; Tablet; 25 Tablets
• Melphalan; 50mg; injection; 1 Injection
• Mercaptopurine; 50mg; Tablet; 25 Tablets
• Meropenem; 1g; injection; 30 ml
• Meropenem; 500mg; injection; 20 ml
• Mesalazine; 400mg; Tablet; 90 Tablets
• Mesna; 400mg; injection; 1 Injection
• Metformin; 500mg; Tablet; 112 Tablets
• Methadone; 2mg; Solution; 60 ml
• Methotrexate; 1g/10ml; injection; 10 ml
• Methotrexate; 2.5mg; Tablet; 100 Tablets
• Methotrexate; 50mg/2ml; injection; 2 ml
• Methotrexate; 5g/50ml; injection; 50 ml
• Methyl Salicylate; 10%; Ointment; 25 g
• Methyl Salicylate; 10%; Ointment; 25 g
• Methyldopa; 250mg; Tablet; 56 Tablets
• Methyldopa; 250mg; Tablet; 84 Tablets
• Methylphenidate; 10mg; Tablet; 30 Tablets
• Methylprednisolone Acetate; 40mg/ml; injection; 2 ml
• Methylprednisolone Acetate; 40mg/ml; injection; 5 ml
• Methylprednisolone Sodium Succinate; 500mg/8ml; injection; 8 ml
• Methylprednisolone; 40mg; injection; 1 Injection
• Metoclopramide; 10mg/2ml; injection; 2 ml
• Metoclopramide; 10mg; Tablet; 100 Tablets
• Metoclopramide; 5mg/5ml; Syrup; 100 ml
• Metronidazole; 200mg/5ml; Suspension; 100 ml
• Metronidazole; 200mg; Tablet; 21 Tablets
• Metronidazole; 200mg; Tablet; 21 Tablets
• Metronidazole; 200mg; Tablet; 250 Tablets
• Metronidazole; 200mg; Tablet; 28 Tablets
• Metronidazole; 400mg; Tablet; 100 Tablets
• Metronidazole; 400mg; Tablet; 21 Tablets
• Micafungin; 100mg; injection; 1 Injection
• Micafungin; 50mg; injection; 1 Injection
• Miconazole; 2%; Gel, Oral; 30 g
• Midazolam; 15mg; Tablet; 20 Tablets
• Midazolam; 50mg/10ml; injection; 10 ml
• Midazolam; 7.5mg; Tablet; 20 Tablets
• Mifepristone; 200mg; Tablet; 3 Tablets
• Minoxidil; 10mg; Tablet; 100 Tablets
• Minoxidil; 5mg; Tablet; 100 Tablets
• Misoprostol; 200mcg; Tablet; 60 Tablets
• Montelukast; 10mg; Tablet; 30 Tablets
• Montelukast; 4mg; Tablet, chew; 30 Tablets
• Montelukast; 5mg; Tablet; 30 Tablets
• Morphine; BP; Powder; 10 g
• Morphine; 10mg; Tablet, MR; 60 Tablets
• Morphine; 30mg; Tablet, MR; 60 Tablets
• Morphine; 60mg; Tablet, MR; 60 Tablets
• Moxifloxacin; 400mg/250ml; injection; 250 ml
• Moxifloxacin; 400mg; Tablet; 10 Tablets
• Moxifloxacin; 400mg; Tablet; 28 Tablets
• Moxifloxacin; 400mg; Tablet; 5 Tablets
• Multichamber TPN for Adults: High volume bag with electrolytes, Very high protein, Very high calorie for central line; Infusion (parenteral); 2 L
• Multichamber TPN for Adults: High volume bag with electrolytes: high protein, very high calorie for central line; Infusion (parenteral); 2 L
• Multichamber TPN for Adults: High volume bag with electrolytes: Moderate protein, high calorie through central line; Infusion (parenteral); 2 L
• Multichamber TPN for Adults: Low volume bag with electrolytes: low protein, moderate calorie through central line; Infusion (parenteral); 1.5 L
• Multichamber TPN for Adults: Moderate volume bag with electrolytes: Moderate protein, high calorie through central line; Infusion (parenteral); 1.5 L
• Multichamber TPN for Adults: Moderate volume bag without electrolytes: Moderate protein, high calorie through central line; Infusion (parenteral); 1 L
• Multichamber TPN for Adults: Very low volume weaning bag with electrolytes: very low protein, low calorie for central line; Infusion (parenteral); 1 L
• Mycophenolate Mofetil; 200mg/ml; Suspension; 175 ml
• Mycophenolate Mofetil; 250mg; Capsule; 100 Capsules
• Mycophenolate Mofetil; 500mg; Tablet; 50 Tablets
• Mycophenolic Acid; 180mg; Tablet; 120 Tablets
• Mycophenolic Acid; 360mg; Tablet; 120 Tablets
• Naloxone; 400mcg/ml; injection; 1 ml
• Naloxone; 40mcg/2ml; injection; 2 ml
• Neonatal Maintenance, Dextrose (Potassium Free); 33,5,33,100mmol; Infusion (parenteral); 200 ml
• Neonatal Maintenance, Dextrose; 20,15,2.5,0.5,21,2mmol, 10%; Infusion (parenteral); 200 ml
• Neostigmine; 2.5mg/ml; injection; 1 ml
• Nevirapine; 200mg; Tablet; 56 Tablets
• Nevirapine; 50mg/5ml; Suspension; 100 ml
• Nevirapine; 50mg/5ml; Suspension; 240 ml
• Nifedipine; 10mg; Capsule; 100 Capsules
• Nifedipine; 5mg; Capsule; 100 Capsules
• Nilotinib; 150mg; Capsule; 112 Capsules
• Nilotinib; 200mg; Capsule; 112 Capsules
• Nitrofurantoin; 100mg; Capsule; 50 Capsules
• Norethisterone Acetate; 5mg; Tablet; 30 Tablets
• Norethisterone Enanthate; 200mg/ml; injection; 1 ml
• Norgestrel, Ethinylestradiol; 0.5mg, 0.05mg; Tablet; 28 Tablets
• Nystatin; 100000IU/ml; Drop, Oral; 20 ml
• Octreotide; 0.05mg/ml; injection; 1 Injection
• Octreotide; 0.1mg/ml; injection; 1 Injection
• Olanzapine; 10mg; Tablet; 28 Tablets
• Olanzapine; 2.5mg; Tablet; 28 Tablets
• Olanzapine; 5mg; Tablet; 28 Tablets
• Olopatadine; 1mg/ml; Drop, Eye; 5 ml
• Ondansetron; 4mg/2ml; injection; 2 ml
• Ondansetron; 4mg; Tablet, dispersible; 10 Tablets
• Ondansetron; 8mg/4ml; injection; 4 ml
• Ondansetron; 8mg; Tablet; 10 Tablets
• Oral Rehydration; Powder; 1 Sachet
• Orphenadrine; 50mg; Tablet; 28 Tablets
• Orphenadrine; 50mg; Tablet; 56 Tablets
• Orphenadrine; 50mg; Tablet; 84 Tablets
• Oxaliplatin; 100mg; injection; 1 Injection
• Oxaliplatin; 50mg; injection; 1 Injection
• Oxazepam; 10mg; Tablet; 100 Tablets
• Oxazepam; 30mg; Tablet; 100 Tablets
• Oxybuprocaine; 0.4%; Drop, Eye; 3 ml
• Oxybutynin; 5mg; Tablet; 84 Tablets
• Oxymetazoline; 0.025%; Drop, Eye; 15 ml
• Oxymetazoline; 0.025%; Drop, Nasal; 10 ml
• Oxymetazoline; 0.05%; Drop, Nasal; 10 ml
• Oxymetazoline; 0.05%; Spray, Nasal; 15 ml
• Oxytocin; 5IU/ml; injection; 1 ml
• Paclitaxel; 100mg/16.7ml; injection; 16.7 ml
• Paclitaxel; 30mg/5ml; injection; 5 ml
• Pancreatin: Lipase, Amylase, Protease; 150mg; Capsule; 100 Capsules
• Pancreatin: Lipase, Amylase, Protease; 300mg; Capsule; 100 Capsules
• Pantoprazole; 40mg; injection; 1 Injection
• Paracetamol; 120mg/5ml; Syrup; 100 ml
• Paracetamol; 120mg/5ml; Syrup; 50 ml
• Paracetamol; 120mg/5ml; Syrup; 500 ml
• Pethidine; 25mg/ml; injection; 1 ml
• Phenobarbital, Vitamin B3 (Nicotinamide), Vitamin B6 (Pyridoxine), Vitamin B2 (Riboflavin), Vitamin B1 (Thiamine); 16mg/5ml, 10mg/5ml, 0.25mg/5ml, 1mg/5ml, 3mg/5ml; Syrup; 100 ml
• Phenobarbital; 30mg; Tablet; 28 Tablets
• Phenobarbital; 30mg; Tablet; 56 Tablets
• Phenobarbital; 30mg; Tablet; 84 Tablets
• Phenoxymethylpenicillin; 125mg/5ml; Suspension; 100 ml
• Phenoxymethylpenicillin; 250mg/5ml; Suspension; 100 ml
• Phenoxymethylpenicillin; 250mg; Tablet; 100 Tablets
• Phenoxymethylpenicillin; 250mg; Tablet; 40 Tablets
• Phenylephrine; 10mg/ml; injection; 1 ml
• Phenytoin; 100mg; Capsule; 100 Capsules
• Phenytoin; 100mg; Capsule; 84 Capsules
• Phenytoin; 250mg/5ml; injection; 5 ml
• Phospholipids, Total; 100mg/4ml; injection; 4 ml
• Phospholipids, Total; 200mg/8ml; injection; 8 ml
• Pilocarpine; 1%; Drop, Eye; 15 ml
• Piperacillin, Tazobactam; 4g, 500mg; injection; 30 ml
• Polystyrene Sulfonate; Powder; 454 g
• Potassium Chloride; BP; Powder; 500 g
• Potassium Chloride; 15%; injection; 10 ml
• Potassium Chloride; 600mg; Tablet; 100 Tablets
• Potassium Citrate; BP; Suspension; 200 ml
• Povidone Iodine; 1%; Liquid; 100 ml
• Povidone Iodine; 10%; Liquid; 1 L
• Povidone Iodine; 10%; Ointment; 25 g
• Povidone Iodine; 10%; Ointment; 500 g
• Povidone Iodine; 5%; Cream; 25 g
• Povidone Iodine; 5%; Cream; 500 g
• Pramipexole; 0.125mg; Tablet; 100 Tablets
• Pramipexole; 0.25mg; Tablet; 100 Tablets
• Pramipexole; 1mg; Tablet; 100 Tablets
• Praziquantel; 500mg; Tablet; 100 Tablets
• Prednisolone; 1%; Drop, Eye; 5 ml
• Prednisone; 5mg; Tablet; 100 Tablets
• Prednisone; 5mg; Tablet; 40 Tablets
• Prednisone; 5mg; Tablet; 56 Tablets
• Promethazine; 25mg/ml; injection; 1 ml
• Promethazine; 25mg; Tablet; 100 Tablets
• Promethazine; 50mg/2ml; injection; 2 ml
• Promethazine; 5mg/5ml; Elixir; 100 ml
• Propofol; 10mg/ml; injection; 20 ml
• Propofol; 10mg/ml; injection; 50 ml
• Propranolol; 10mg; Tablet; 250 Tablets
• Propranolol; 10mg; Tablet; 28 Tablets
• Propranolol; 10mg; Tablet; 50 Tablets
• Propranolol; 10mg; Tablet; 84 Tablets
• Propranolol; 40mg; Tablet; 250 Tablets
• Propranolol; 40mg; Tablet; 56 Tablets
• Propranolol; 40mg; Tablet; 84 Tablets
• Propylene Glycol; BP; Liquid; 2.5 L
• Pyrazinamide; 500mg; Tablet; 28 Tablets
• Pyrazinamide; 500mg; Tablet; 56 Tablets
• Pyrazinamide; 500mg; Tablet; 84 Tablets
• Pyridostigmine; 10mg; Tablet; 50 Tablets
• Pyridostigmine; 60mg; Tablet; 150 Tablets
• Quetiapine; 100mg; Tablet; 90 Tablets
• Quetiapine; 200mg; Tablet; 60 Tablets
• Quetiapine; 25mg; Tablet; 100 Tablets
• Quetiapine; 300mg; Tablet; 60 Tablets
• Quinine; 300mg/ml; injection; 1 ml
• Raltegravir; 100mg; Tablet; 56 Tablets
• Raltegravir; 25mg; Tablet; 56 Tablets
• Raltegravir; 400mg; Tablet; 56 Tablets
• Ranitidine; 50mg/2ml; injection; 2 ml
• Recombinant Anthihaemophilic Factor VIII; 1000IU; injection; 1 Dose
• Recombinant Anthihaemophilic Factor VIII; 250IU; injection; 1 Dose
• Recombinant Anthihaemophilic Factor VIII; 500IU; injection; 1 Dose
• Rifampicin, Isoniazid; 60mg, 60mg; Tablet; 28 Tablets
• Rifampicin, Isoniazid; 60mg, 60mg; Tablet; 56 Tablets
• Rifampicin, Isoniazid; 75mg, 50mg; Tablet; 84 Tablets
• Rifampicin, Pyrazinamide, Ethambutol, Isoniazid; 150mg, 400mg, 275mg, 75mg; Tablet; 28 Tablets
• Rifampicin, Pyrazinamide, Isoniazid; 75mg, 150mg, 50mg; Tablet; 84 Tablets
• Rifampicin; 150mg; Capsule; 100 Capsules
• Rifapentine; 150mg; Tablet; 24 Tablets
• Ringer Lactate; Infusion (parenteral); 1 L
• Ringer Lactate; Infusion (parenteral); 200 ml
• Risedronic Acid; 35mg; Tablet; 4 Tablets
• Risperidone; 0.5mg; Tablet; 30 Tablets
• Risperidone; 1mg/ml; Solution; 30 ml
• Risperidone; 1mg; Tablet; 30 Tablets
• Risperidone; 2mg; Tablet; 30 Tablets
• Risperidone; 3mg; Tablet; 30 Tablets
• Ritonavir; 100mg; Suspension; 30 Sachets
• Ritonavir; 100mg; Tablet; 56 Tablets
• Rituximab; 100mg/10ml; injection; 10 ml
• Rituximab; 500mg/50ml; injection; 50 ml
• Rocuronium Bromide; 50mg/5ml; injection; 5 ml
• Rosuvastatin; 10mg; Tablet; 30 Tablets
• Salbutamol, Ipratropium Bromide; 2.5mg/2.5ml, 0.5mg/2.5ml; solution, inhalation; 60 UDVs (2.5ml)
• Salmeterol, Fluticasone; 25mcg, 250mcg; Inhaler; 120 Doses
• Salmeterol, Fluticasone; 25mcg, 50mcg; Inhaler; 120 Doses
• Selenium Sulfide; 2.5%; Suspension; 50 ml
• Senna Glycosides; 13.5mg; Tablet; 20 Tablets
• Sevoflurane; BP; Liquid; 250 ml
• Silver Sulfadiazine; 1%; Cream; 250 g
• Silver Sulfadiazine; 1%; Cream; 50 g
• Silver Sulfadiazine; 1%; Cream; 500 g
• Sirolimus; 1mg; Tablet; 30 Tablets
• Sodium Bicarbonate; 4%; injection; 50 ml
• Sodium Bicarbonate; 4.2%; Infusion (parenteral); 200 ml
• Sodium Bicarbonate; 8.5%; injection; 50 ml
• Sodium Chloride, Dextrose; 0.2%, 5%; Infusion (parenteral); 200 ml
• Sodium Chloride, Dextrose; 0.45%, 5%; Infusion (parenteral); 1 L
• Sodium Chloride, Dextrose; 0.9%, 5%; Infusion (parenteral); 1 L
• Sodium Chloride, Dextrose; 0.9%, 5%; Infusion (parenteral); 200 ml
• Sodium Chloride; BP; Powder; 500 g
• Sodium Chloride; 0.45%; Infusion (parenteral); 1 L
• Sodium Chloride; 0.9%; Infusion (parenteral); 1 L
• Sodium Chloride; 0.9%; Infusion (parenteral); 100 ml
• Sodium Chloride; 0.9%; Infusion (parenteral); 200 ml
• Sodium Chloride; 0.9%; Infusion (parenteral); 200 ml
• Sodium Chloride; 0.9%; Infusion (parenteral); 50 ml
• Sodium Chloride; 0.9%; solution, irrigation, bag; 1 L
• Sodium Chloride; 0.9%; solution, irrigation, bag; 3 L
• Sodium Chloride; 0.9%; solution, irrigation, bottle; 1 L
• Sodium Chloride; 0.9%; solution, irrigation; 30 ml
• Sodium Chloride; 5%; Infusion (parenteral); 200 ml
• Sodium Phosphate, Sodium Acid Phosphate; Enema; 135 ml
• Sodium, Potassium, Calcium, Lactate; 131mmol, 5mmol, 108mmol, 29mmol; Infusion (parenteral) (Plasmalyte L); 1 L
• Sodium, Potassium, Calcium, Lactate; 35mmol/L, 12mmol/L, 47mmol/L, 50g/L; Infusion (parenteral) (Paediatric Maintenance); 500 ml
• Sodium, Potassium, Calcium, Lactate; 35mmol/L, 12mmol/L, 47mmol/L, 50g/L; Infusion (parenteral) (Paediatric Maintenance); 200 ml
• Soft Paraffin, White; BP; Ointment; 500 g
• Somatropin; 10mg/1.5ml; cartridge; 1.5 ml
• Somatropin; 5mg/1.5ml; cartridge; 1.5 ml
• Sorbitol; 70%; Solution; 500 ml
• Spacer With Mask For Adults; Medical device; 1 Device
• Spacer With Mask For Children; Medical device; 1 Device
• Spacer With Mask For Infants; Medical device; 1 Device
• Spironolactone; 100mg; Tablet; 60 Tablets
• Spironolactone; 25mg; Tablet; 200 Tablets
• Spironolactone; 25mg; Tablet; 56 Tablets
• Spironolactone; 25mg; Tablet; 84 Tablets
• Streptokinase; 1.5MIU; injection; 1 Injection
• Sulfamethoxazole, Trimethoprim; 400mg, 80mg; Tablet (Co-trimoxazole); 100 Tablets
• Sulfamethoxazole, Trimethoprim; 400mg/5ml, 80mg/5ml; injection; 5 ml
• Sulfasalazine; 500mg; Tablet; 100 Tablets
• Sunscreen; 30SPF; Cream; 150 ml
• Suxamethonium; 100mg/2ml; injection; 2 ml
• Syrup, Simplex; BP; Syrup; 2.5 L
• Tacrolimus; 0.5mg; Capsule; 30 Capsules
• Tacrolimus; 1mg; Capsule; 30 Capsules
• Tacrolimus; 5mg; Capsule; 30 Capsules
• Tamoxifen; 20mg; Tablet; 28 Tablets
• Tenofovir; 300mg; Tablet; 28 Tablets
• Teriflunomide; 14mg; Tablet; 28 Tablets
• Terizidone; 250mg; Capsule; 100 Capsules
• Test: Blood Glucose; test strip; 50 Test Strips
• Test: TB LAM AG; test kit; 25 Test Strips
• Test: Urine, Gluc., Prot., Bl., pH, Ket., Leuc., Nit., Bilir., Urob.; test kit; 100 Test Strips
• Tetracaine, Arnica, Salvia, Aluminium; Ointment; 10 g
• Thalidomide; 50mg; Capsule; 28 Capsules
• Theophylline; 200mg; Tablet, MR; 60 Tablets
• Theophylline; 300mg; Tablet, MR; 60 Tablets
• Timolol, Bimatoprost; 5mg/ml, 0.3mg/ml; Drop, Eye; 3 ml
• Timolol, Brimonidine; 5mg/ml, 2mg/ml; Drop, Eye; 5 ml
• Timolol, Travoprost; 5mg/ml, 40mcg/ml; Drop, Eye; 2.5 ml
• Tioguanine; 40mg; Tablet; 25 Tablets
• Topiramate; 100mg; Tablet; 60 Tablets
• Topiramate; 15mg; Capsule, Sprinkle; 60 Capsules
• Topiramate; 25mg; Tablet; 60 Tablets
• Topiramate; 50mg; Tablet; 60 Tablets
• TPN for Adults: High volume bag with electrolytes: high protein, high calorie for central line; Infusion (parenteral); 2 L
• TPN for Adults: Moderate volume bag without electrolytes: Moderate protein, high calorie For IV infusion through central line. Multichamber bag containing: Amino Acids: a minimum of histidine,
• TPN for Adults: Very low volume weaning bag with electrolytes: very low protein, low calorie for peripheral line; Infusion (parenteral); 1 L
• Trace Elements; injection; 10 ml
• Tramadol; 100mg/2ml; injection; 2 ml
• Tramadol; 100mg; Tablet, MR; 60 Tablets
• Tranexamic Acid; 500mg/5ml; injection; 5 ml
• Tranexamic Acid; 500mg; Tablet; 30 Tablets
• Trastuzumab; 440mg; injection; 1 Injection
• Tretinoin; 0.025%; Gel; 20 g
• Tretinoin; 10mg; Capsule; 100 Capsules
• Tropicamide; 1%; Drop, Eye; 15 ml
• Vaccine: BCG; Injection; 20 Doses
• Vaccine: Diphtheria, Tetanus; 2IU/20IU; injection; 10 Doses
• Vaccine: Diptheria, Haemophilus Influenzae B, Pertussis, Polio, Tetanus, Hepatitis B; Syringe, Prefilled; 1 Dose
• Vaccine: Hepatitis B Adult; 20mcg/ml; injection; 1 Dose
• Vaccine: Hepatitis B Peadiatric; 10mcg/0.5ml; injection; 10 Doses
• Vaccine: Human Papillomavirus, Bivalent; injection; 2 Doses
• Vaccine: Influenza; Syringe, Prefilled; 1 Dose
• Vaccine: Measles; injection; 10 Doses
• Vaccine: Meningococcal Polysaccharide Diphtheria Toxoid Conjugate; injection; 1 Dose
• Vaccine: Pneumococcal, 23-Valent Polysaccharide; injection; 1 Dose
• Vaccine: Pneumococcal, Conjugated; Syringe, Prefilled; 1 Dose
• Vaccine: Rabies; injection; 1 Dose
• Vaccine: Rotavirus; Drop, Oral; 1 Dose
• Vaccine: Tetanus Toxoid; injection; 10 Doses
• Vaccine: Yellow Fever; injection; 1 Dose
• Valganciclovir; 450mg; Tablet; 60 Tablets
• Valproate Sodium; 100mg; Tablet, dispersible; 100 Tablets
• Valproic Acid, Valproate Sodium; 145mg, 333mg; Tablet, MR; 100 Tablets
• Valproic Acid, Valproate Sodium; 145mg, 333mg; Tablet, MR; 56 Tablets
• Valproic Acid, Valproate Sodium; 58mg, 133.2mg; Tablet, MR; 100 Tablets
• Valproic Acid, Valproate Sodium; 58mg, 133.2mg; Tablet, MR; 56 Tablets
• Valproic Acid, Valproate Sodium; 87mg, 199.8mg; Tablet, MR; 100 Tablets
• Valproic Acid, Valproate Sodium; 87mg, 199.8mg; Tablet, MR; 56 Tablets
• Valproic Acid; 200mg/5ml; Syrup; 300 ml
• Valproic Acid; 250mg/5ml; Syrup; 100 ml
• Vancomycin; 1g; injection; 1 Injection
• Vancomycin; 500mg; injection; 1 Injection
• Vecuronium; 4mg/2ml; injection; 2 ml
• Venlafaxine; 150mg; Tablet, MR; 30 Tablets
• Venlafaxine; 37.5mg; Tablet; 30 Tablets
• Venlafaxine; 75mg; Tablet; 30 Tablets
• Verapamil; 240mg; Tablet, MR; 30 Tablets
• Verapamil; 40mg; Tablet; 84 Tablets
• Vinblastine; 10mg/10ml; injection; 1 Injection
• Vincristine; 2mg/2ml; injection; 2 ml
• Vitamin A (Retinol); 100,000IU; Capsule; 50 Capsules
• Vitamin A (Retinol); 200,000IU; Capsule; 50 Capsules
• Vitamin A (Retinol); 50,000IU; Capsule; 50 Capsules
• Vitamin B1 (Thiamine); 100mg/ml; injection; 10 ml
• Vitamin B1 (Thiamine); 100mg; Tablet; 84 Tablets
• Vitamin B12 (Cyanocobalamin); 1mg/ml; injection; 1 ml
• Vitamin B3 (Nicotinamide); 100mg; Tablet; 28 Tablets
• Vitamin B3 (Nicotinamide); 100mg; Tablet; 84 Tablets
• Vitamin B6 (Pyridoxine); 25mg; Tablet; 100 Tablets
• Vitamin D (Alfacalcidol); 0.25mcg; Capsule; 30 Capsules
• Vitamin D (Alfacalcidol); 1mcg; Capsule; 30 Capsules
• Vitamin D2 (Ergocalciferol); 5,000IU/ml; Drop, Oral; 15 ml
• Vitamin D2 (Ergocalciferol); 50,000IU; Tablet; 100 Tablets
• Vitamin D3 (Calcitriol); 0.25mcg; Capsule; 30 Capsules
• Vitamin K1 (Phytomenadione); 10mg; injection; 1 ml
• Vitamin K1 (Phytomenadione); 2mg; injection; 0.2 ml
• Vitamin, Fat Soluble, Vitamin E; injection; 10 ml
• Vitamin, Multi; Drop, Oral; 25 ml
• Vitamin, Multi; injection; 10 ml
• Vitamin, Multi; Syrup; 100 ml
• Vitamin, Water Soluble; injection (for intravenous use in adults); 10 ml
• Warfarin; 5mg; Tablet; 100 Tablets
• Water For Injection; injection; 10 ml
• Water For Injection; injection; 20 ml
• Water For Irrigation; Liquid (Pour Water); 1 L
• Water For Irrigation; Liquid; 1 L
• Water For Irrigation; Liquid; 3 L
• Zidovudine, Lamivudine; 300mg, 150mg; Tablet; 56 Tablets
• Zidovudine, Lamivudine; 300mg, 150mg; Tablet; 56 Tablets
• Zidovudine; 100mg; Capsule; 100 Capsules
• Zidovudine; 300mg; Capsule; 56 Capsules
• Zidovudine; 50mg/5ml; Syrup; 200 ml
• Zinc Oxide, Castor Oil; Ointment; 25 g
• Zinc Sulfate; 10mg/5ml; Syrup; 150 ml
• Zinc Sulfate; 20mg; Tablet; 10 Tablets
• Zinc Sulfate; 20mg; Tablet; 100 Tablets
• Zuclopentixol Acetate; 50mg/ml; injection; 1 ml
• Zuclopentixol Decanoate; 200mg/ml; injection; 1 ml

END.