Questions and Replies

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:

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) Not all hospitals have been exempted from the load-shedding. However, the National Department of Health has provided Eskom with a total of 213 hospitals to be considered for possible exclusion from loadshedding. About 67% of these hospitals are supplied by municipalities while Eskom supplies about 33% of the identified hospitals. Out of the 213 hospitals, 76 hospitals have been exempted of which 26 are directly supplied by Eskom and 50 by Municipalities. The number of hospitals exempted to date have doubled since the meeting held on 22 September 2022 between Eskom and National Department of Health. To date, there are 7 hospitals exempted in Eastern Cape, 9 in Limpopo, 15 in KZN, 4 in Mpumalanga, 4 in Western Cape, 2 in Northern Cape, 3 in North West, 14 in Free State, and 18 in Gauteng provinces. Should there be a need of hospitals names per province, a breakdown list of hospitals is available on request.

b) Load-shedding has a negative impact to the provision of health services at primary health facilities, hospitals, community health centres, clinics, EMS centres including the forensic laboratories. In order to reduce the impact of load-shedding, the National Department of Health is seeking for the financial support to assist with the effective delivery of the following areas:

(i) Additional funding support for fuel, oil including the servicing of generators. The hospitals have been forced to use its budget on fuel, oil and medical gas just to keep healthcare facilities running. With persistent stage 6 load-shedding, greater energy demand is placed on generator capability which requires increased fuel consumption and vast expenditure.

(ii) Additional funding support for the installation of dedicated lines for certain key hospitals that are deeply embedded within the Eskom’s or Municipal networks rendering exclusion impossible in their current state as bigger loads are to be exempted.

(iii) Additional funding support for 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.

END.

Reply:

1. The Health Sector Anti-Corruption Forum (HSACF) has convened its meetings on Nine (09) occasions since 2018, below is the details of the meetings:

#	Date of Meeting
1.	23 August 2018
2.	20 November 2018
3.	27 November 2019
4.	21 May 2019
5.	30 June 2020
6.	02 December 2020
7.	29 June 2021
8.	30 March 2022
9.	21 September 2022

 

In addition, the HSACF has established the Steering Committee that has been mandated to assess all health-related corruption allegations that have been reported. The Steering Committee serves as an operational structure of HSACF and meets more frequently or as and when there are new allegations that has been reported, which requires to go through assessment process.

2. (a) Number of allegations of corruption have (i) been referred to the forum and (ii) resulted in investigations by the HSACF in each year since 2018.

• A total number of eleven (11) allegations were reported to the HSACF in 2018/19/20. All allegations were referred to the relevant entities who are part of the HSACF for formal investigations as per their legislative mandate.

• A total number of twelve (12) allegations were reported to the HSACF in 2020/21. All allegations were referred to the relevant entities who are part of the HSACF for formal investigations as per their legislative mandate.

• A total number of five (05) allegations were reported to the HSACF in 2021/22. All allegations were referred to the relevant entities who are part of the HSACF for formal investigations as per their legislative mandate.

• One (01) allegation was reported to the HSACF in 2022/23. The allegation was referred to the relevant entity who is part of the HSACF for formal investigations as per their legislative mandate.

3. The HSACF has registered quite a significant investigations outcomes or successes in twelve (12) matters that were reported to the Forum and formally investigated by member entities. The below table highlight some of the successes in terms of criminal prosecution, civil recoveries, and medical aid sanctions:

#	Entity Investigated	Investigation Outcomes
1	Health Professional Council of South Africa	Presidential report submitted in May 2022 DC referrals 19 NPA referrals 21 SARS referrals 2 OHSC referral 1
2	Provision of Aero Medical & Patient Transport – NW	Freezing order of former HOD pension to the value of R2 125 113,58 R30 000 000 civil proceeding have been instituted. HOD has been referred for disciplinary and has been dismissed on 13 January 2020 NPA criminal referral for 2 officials (Thapelo Buthelezi & CFO Mr Lekalakala) Disciplinary referral made for CFO who facilitated the irregular payments to Buthelezi EMS Civil proceedings underway to the value of R204 million are being instituted against Buthelezi EMS
3	Provision of Aero Medical & Patient Transport – FS	10 disciplinary referrals. 8 referrals for administrative action. 5 referrals to the NPA
4	National Health Laboratory Services	8x Disciplinary Referrals 11x NPA Referrals 8x finalised investigations 1 x Civil referral: Review application against 8 companies: R172 million. Preservation order obtained
5	Council for Medical Schemes	13 x disciplinary referrals relating to 2 individuals. 1 x criminal referral relating to 18 individuals. 4 x systemic recommendations 53 x investigations concluded (lifestyles, complaints, procurement, regulatory reviews)
6	Office of the State Attorney	Focus Area 1: Maladministration in connection with the affairs of the office of the State Attorney in relation to― (a) legal services that were provided, or procured, by the office of the State Attorney in the performance of its functions as contemplated in section 3 of the State Attorney Act, 1957 (Act No. 56 of 1957), on behalf of― (i) the Gauteng Department of Health and the Eastern Cape Department of Health in respect of claims based on medical negligence; Legal Practitioners Civil litigation instituted to the value of R82 994 347 for potential cash and/or assets recovered. R 217 000 Acknowledgement of Debt - AoD signed 8x disciplinary referrals 15x administration actions referrals 12x criminal referrals Medical negligence cases in Court. Civil litigation instituted to the value of R412 549 298 for potential cash and/or assets recovered. Rand value of potential loss prevented to the amount of R412 549 298 14x disciplinary referrals made. 13x administrative action referrals 7x criminal prosecution referrals Rand value of matters in respect of which evidence was referred for the institution or defence/opposition of civil proceedings to the value of R412 549 298 Focus Area 2: Maladministration in connection with the affairs of the office of the State Attorney in relation to ― the South African Police Service in respect of claims based on wrongful arrest or detention, assault, or malicious prosecution. Rand value of potential cash and/or assets to be recovered to the value of R1 600 000.00 Rand value of potential loss prevented to the amount of R25 747 581 1x disciplinary referral made. Focus Area 3: The procurement of legal services, as contemplated in paragraph 2(a) of this Schedule, by the office of the State Attorney, or payments which were made in respect thereof, in a manner that was― (a) not fair, competitive, transparent, equitable or cost-effective; or (b) contrary to manuals, policies, procedures, prescripts, instructions or practices of, or applicable to the office of the State Attorney, and any related unauthorised, irregular or fruitless and wasteful expenditure which the Department or the State incurred as a result thereof. Rand value of potential cash and/or assets to be recovered to the value of R4 146 476 079. Rand value of actual cash and/or assets recovered to the value of R2 228 773.44 2x disciplinary referrals 5x criminal prosecution referrals Focus Area 4: Irregular conduct by— (a) employees or officials of the office of the State Attorney; or (b) any other person or entity, relating to the allegations referred to in paragraphs 2 or 3 of this Schedule." 27 criminal prosecution referrals 33 Administrative action referrals 28 disciplinary referrals 1x SARS referral 12x systemic recommendations made.
7	South African Health Product Regulatory Authority	5x criminal referral letters have been for referred to NPA to institute criminal prosecutions for fraud in respect of 5 officials who caused the issuing of irregular licenses. 5x disciplinary action referral letters (DCs) have been referred to the South African Products Regulatory Authority (SAHPRA) so that they can be disciplined in line with their policies and the Public Service Act. The investigating team is busy drafting the Final Presidential Report.
8	National Department of Health Medico Legal Claims	18 legal practitioners are being investigated by the Special Investigating Unit (SIU) that assisted the Office of the State Attorney in rendering legal services in respect of medical negligence claims on the Gauteng Department of Health and the Eastern Cape Department of Health. 17 claims of legal practitioners still need to be verified by Legal Tax Bill Consultants. The SIU is also busy litigating cases involving Hypoxic Ischemic Encephalopathy (HIE) with acute profound & partially prolonged in courts costing more than R203 549 298. Hypoxic Ischemic Encephalopathy (HIE) with acute profound & partially prolonged. Hypoxic Ischemic Encephalopathy (HIE) with acute profound & partially prolonged. The SIU has investigated Janilite (PTY) Ltd which acted as intermediary in both ECDH & GDH and a settlement of R2 228 773.44 was agreed by the departments with the assistance of the SIU.
9	National Department of Health	The docket has been submitted to the State Prosecutor for decision, this matter relate to senior officials who defrauded the Department of Health millions in subsistence and travel irregularities.
10	Government Employee Medical Scheme (GEMS)	The docket is almost complete, the Investigator is working on concluding financial report based on financial statements. The docket will soon be submitted to State Prosecutor for decision
11	COVID-19 National Proclamation	The final report was submitted to the President in June 2022. The legal outcomes have been presented to Parliament oversight Committees
12	Pretoria Eye Institute	Acknowledgements of debts was signed on this matter with some of the medical schemes that are affected who were involved in claim irregularities.

4. Specified preventative and/or risk-management measures were implemented by the HSACF

1. A series of webinars were successfully rolled out in 2020/21FY under the banner of HSACF Corruption Prevention Program with the following objectives:

• To create public awareness about corruption in the health sector
• To profile the Health Sector Anti-Corruption Forum (HSACF)
• To raise awareness about whistleblowing and witness protection

Amongst the thematic areas in relation to health sector corruption that were discussed include the following:

• The corruption pandemic in South Africa’s health sector
• National Health Insurance (NHI) and its vulnerability to corruption
• Combatting corruption in the private health sector
• When corruption and Covid-19 intersect
• Unpacking whistleblowing protection in South Africa

2. Collaboration with UNODC to implement corruption prevention programs in South Africa’s health sector.

• The HSACF is collaborating with the UNODC to implement corruption prevention initiatives in the health sector, which include strengthening whistleblowing/reporting mechanism and corruption risk assessments. Two (2) health sector entities were identified to implement these projects.

• These entities include HPCSA where a pilot project will be implemented on strengthening their internal whistleblowing/reporting channels and National Department of Health where corruption risk assessments will be implemented in particular around procurement.

3. Corruption Risk Mitigation Plan for COVID-19 Vaccine Roll-Out

• The COVID-19 Corruption Risk Mitigation Plan (CRIMP) was initiated to supports the National Covid-19 Vaccine Roll-Out Plan, led by the Inter-Ministerial Committee, chaired by the Deputy President
• The key objective of CRIMP was to develop and implement a specific anti-corruption lens on the roll-out of the vaccine taking lessons from the PPE investigations.
• The development of the CRIMP was led by DPME, working closely Health Sector Anti-Corruption Forum, convened by the SIU under the ACTT Prog 4.

The specific purpose of CRIMP was to enhance and complement existing efforts by providing:

• Framework and template to assess COVID-19 Vaccine corruption risks.
• Consolidate and Assess (“hack”/stress test) the workstream plans into a single, living anti-corruption risk mitigation plan.
• Act as coordination interface between the IMC work streams and specialist anti-corruption capacity (such as ACTT and its Fusion Centre) where required.
• Act as coordination interface with civil society, business, and labour; and optimise the existing mechanisms (e.g., with the SIU led Health Sector Anti-Corruption Forum) on broadening the anti-corruption response.

END.

Reply:

1. The Pandemic Treaty deliberation are still in the conceptualisation of a Zero Draft framework and negotiations have not yet commenced. South Africa participated in discussions focussing on the development of the Conceptual Draft Document which is a framework and outline of the envisaged pandemic instrument that looks at background, methodology and approach to be used during the development of the negotiation tool. South Africa was represented by our Health Attache to Geneva and the United Nations, Ms Lebogang Lebese, who is based in the South African Mission in Geneva.

2. South Africa is championing the cause of access and equity in pandemic preparedness and response. Therefore, the technical input to the Conceptual Zero draft referred to above, was centred around strengthening of the framework in the areas of “operationalisation of the instrument and on achieving equity” with emphasis on seven types of equitable access on Tools; Essential Supplies (strengthening supply chains and shortening supply lines); Financing; Vaccines; Health Workforce; Disease Surveillance and detection of zoonotic and environmental risks; and Equitable ramping up and diversification of manufacturing.

3. The Pandemic instrument discussions have not yet reached the stage of discussing a second draft. South Africa participated in further discussion on developing the Conceptual Zero Draft framework and was represented by our Health Attache, who was also joined by our Ambassador Mr Mxolisi Nkosi, the South African Permanent Representative to the United Nations office in Geneva and other international organisations in Switzerland.

END.

Reply:

1. The response to parliamentary question 2091 that which was provided on 17 June 2022 indicated a total vacancy posts of 27 137 for doctors, nurses and emergency medical services personnel in the Republic. As of 28 February 2023, there were 18 804 vacant posts of doctors, nurses and medical care personnel. This demonstrates a 31% achievement rate in the filling of vacant posts.

a) The main reason for the recorded vacant posts is general budget cuts introduced by National Treasury. These cuts also affect Compensation of Employment (CoE) negatively resulting in not all posts being filled simultaneously.

b) As demonstrated above in order to reduce the vacancy rate by 31%, the Department introduced several interventions which amongst others, include:

• (i) Prioritisation of the posts in the Annual Recruitment Plan – where funding permits;
• (ii) Prioritisation of the posts for conditional grant funding;
• (iii) Filling of replacement posts considered and approved weekly;
• (v) Advertisements published National wide through print media.

c) Filling of these vacant posts will be prioritised in all provinces as per above method to ensure that there is no over expenditure of Compensation of Employment (CoE).

d) Posts are prioritised according to the availability of funding and the Annual Recruitment Plan as informed by the service delivery model.

2. (a) The Department working together with Provincial Departments of Health and National Treasury has put in place mechanisms to ensure that all eligible South African Citizens and Permanent Residents are allocated to accredited medical internship positions within the Cycle that applicants qualify for. This is evident by the conclusion of allocating 2 505 medical interns applicants in the January Annual Cycle 2023.

Only 55 applicants are still to be allocated as they were not eligible due to various reasons e.g., applicants declining the posts and preferring to wait for the next cycle.

(b) All eligible applicants will again be given an opportunity during the Midyear Cycle which will start on the 1 July 2023.  

3. (a) The Department working together with Provincial Departments of Health and National Treasury has put in place methods to ensure that all eligible South African Citizens and Permanent Residents are allocated to medical community service positions within the Cycle applicants qualify in. This is evident by the conclusion of allocating 2 509 medical community service applicants in the January Annual Cycle 2023.

(b) All other eligible applicants, who met the allocation requirements later, will again be given an opportunity during the Midyear Cycle which will start on the 1 July 2023.  

(4)   Registration of foreign qualified medical applicants with the Health Professions Council of South Africa (HPCSA) is a multi-layered process. The HPCSA has to satisfy itself that applicants studied in legally recognized Institutions, by both the health and regulatory authorities of the countries of training. Applicants are required to submit several documents that will assist the HPCSA to establish their competency, including the hours that they would have spent in training and the domain training completed. As most of them study in non-English speaking countries, for example China, Russia and Turkey, documents have to be translated into English and notarized before the HPCSA  can submit them to relevant committees of the board to make a determination about the equivalence of their training to that provided in South Africa. Any delays in one of the steps in this process ordinarily lengths the processing of applications.

END.

Reply:

1. The honourable member should note that nurses do not register with the Health Professions Council of South Africa (HPCSA), but with the South African Nursing Council (SANC).

(a)-(b) As per the information received from the SANC, the total number of nurses whose membership was terminated or their names removed due to their registration lapsing is 21 332 over the period of 2021 to 2022, as per the table below. The reasons are also reflected in the very table below.

Table 1.

	Reason for removal
Province	Deceased	Removed - Administratively	Removed - At own request	Removed - Disciplinary	Removed - Non-payment of annual fee	Grand Total
Eastern Cape	14	2	8	1	3020	3045
Free State			3		1086	1089
Gauteng	24	3	32	5	5257	5321
KwaZulu-Natal	39	5	27	0	4708	4779
Limpopo	16		2	3	1622	1643
Mpumalanga	2	2	1	0	929	934
North-West	8		5		1362	1375
Northern Cape	1		0	1	343	345
Outside RSA			4		84	88
Western Cape	7	6	21	0	2679	2713
Grand Total	111	18	103	10	21090	21332

2. In order to assist nurses with their lapsed registration, the Department has successfully signed Resolution 3 of 2019 at the Public Health and Social Development Sectoral Bargaining Council (PHSDSBC) which is an agreement on payment of annual statutory registration fees in respect of health and social development professionals (including Nurses)

The objective of the Resolution amongst others is to:

- Introduce mandatory deductions of professional registration fees from salary of employees by PERSAL as required by the respective statutory professional bodies in the Health and Social Development Departments.

- Assist in the monitoring of potential risks and compliance with registration requirement for appointment and practice as stipulated in the respective Statutory Professional bodies in the departments

END.

Reply:

Steps the department has taken to raise awareness amongst the public about the prevention and management of cholera.

After the WHO reported that the cholera outbreak had occurred in Malawi and Mozambique, and other countries in the SADC regions, the National Department of Health alerted all the provinces about the cholera outbreak. The provinces were requested to use the risk assessment and contingency plan tools to assess their capacity for preparedness and readiness for cholera outbreak. The National Department of Health met with the provinces to discuss the plans and actions required in preventing and controlling the spread of cholera. Steps that were taken to raise awareness amongst the public about the prevention and management of cholera are outlined below as follows:

a) Prevention and Control

The National Department of Health has activated the Multisectoral National Outbreak Response Teams (MNORT), which includes members from the National Department of Health, National Institute for Communicable Diseases (NICD), provinces and the World Health Organization (WHO). The focus areas include surveillance; water, sanitation and hygiene; social mobilisation; Risk Communication and Community Engagement. The MNORT meetings are held on weekly basis (Fridays) to discuss the ongoing cholera outbreak in the country.

• A public announcement was made to inform and alert the public about the outbreak of cholera.
• All provinces received cholera guidelines and case investigation forms.

b) Surveillance

Disease surveillance, preparedness and outbreak response activities to detect outbreaks rapidly are ongoing in the provinces and at national level.

c) Water and sanitation interventions

The long-term solution for cholera control lies in access to safe drinking water and adequate sanitation. Actions targeting environmental conditions including the implementation of water, sanitation and hygiene (WASH) solutions to ensure use of safe water, basic sanitation and good hygiene practices in cholera hotspots are being addressed. 

d) Community Engagement

Community engagements were conducted in all provinces, and distribution of Information, Education, and Communication (IEC) pamphlets and posters to teach the public about potential risks, symptoms of cholera, precautions to take to avoid cholera, when and where to report cases and to seek immediate treatment when symptoms appear continues to take place.

Awareness was raised about prevention through:

• Development and distribution of posters and flyers
• Giving health talks on community radio stations
• Cholera prevention and management messages were shared using departmental social media.
• Continuous health education is conducted in health facilities.

END.

Reply:

(1) The Department is taking the following epidemiological responses to contain measles outbreak:

a) Measles campaign vaccination

Nationwide mass measles vaccination campaign is conducted in all 52 districts to contain outbreak by administering additional measles dose to all children from 6 months to 15 years regardless of their previous history of measles vaccination.

b) Epidemiological and clinical management of cases and contacts.

• All confirmed measles outbreak cases are epidemiologically investigated through field visits, and support to the affected areas are provided by both provincial and national teams.
• All suspected measles outbreaks are confirmed by the National Institute of Communicable Diseases (NICD) to be due to measles virus infection.
• There is clinical management of cases including isolation, administration of Vitamin A, management of complications and follow-up of close contacts.

c) Intensified Measles surveillance

• Measles surveillance is intensified to actively seek additional cases both in public and private health facilities.
• Health workers are urged to be on the alert to detect, investigate and appropriately manage cases.
• There is an ongoing full investigations of possible outbreaks in non-affected districts and urgent measures to strengthen surveillance are implemented.

d) Enhanced communication

Various Risk Communication and Community Engagement platforms are used to raise awareness in the communities about the disease and its prevention - and alerted to report people with measles symptoms and to ensure that children are fully vaccinated according to the national schedule.

e) Establishment of Outbreak Response teams

Outbreak teams have been established at district, provincial and national levels. The following work streams have been established within the national outbreak response team:

• Case management (including contact tracing)
• Surveillance and reporting
• Risk Communication and Community Engagement
• Supplementary vaccination campaign planning and execution – includes vaccine procurement and data management sub-streams.

(b) Children from 6 months to 15 years are given an additional measles dose at Early Development Centres, Primary schools and High schools.

END.

Reply:

According to the information received from our Provincial Departments of Health, the table below reflects the details in this regard:

PROVINCE	Number of medico-legal claims filed	Number of claims paid out	Number claims paid by way of settlements	Number of claims been paid by way of court order	Number of claims awarded based on lost patient files	Number of duplicate claims filed	Total (b) amount spent on legal cost
Eastern Cape	1714	331	0	331	0	0	R 281 368 162
Free State	345	25	25	0	0	0	R 31 619 758.74
Gauteng	384	-	0	0	0	0	R 996 278 397.03
KwaZulu- Natal	833	148	0	148	0	0	R 417 603 116.00
Limpopo	1147	41	4	37	0	0	-
Mpumalanga	756	79	30	49	27	0	R 358 971 364, 00
Northern Cape	83	25	25	0	7	0	R 37 921 415.00
North West	351		16	10	0	0	R112 273 309.00
Western Cape	273	137	137	0	0	0	R71 161 000.00

Table 1.

END.

Reply:

1. (a) In 2019, the National Department of Health appointed Service Providers to conduct forensic investigations. One of the responsibilities has been to identify any fraudulent claims. The reports of these investigations are the basis of the current SIU investigations in all the Provinces in line with the Proclamation.

The following table reflects the details in this regard:

Province	Number of fraudulent claims paid out	Amount of money recouped	Top causes and/or reasons for medico-legal claims	Total number in each case
Eastern Cape	Nil	Nil	Obstetrics & Gynae related	1135
			Orthopaedic,	92
			Surgical	42
			ICU related	46
			Other	399
Free State	Nill	Nill	Cerebral Palsy	132
			Surgical complications	53
			Gynae & Obstetrics	84
			Wrong diagnosis/ medication	63
Gauteng	Nill	Nill	Prolonged labour	18
			Brain damage	93
			Genetics	2
			Injury or impairment	66
			Multiple prior pregnancies	18
			Unwanted pregnancy	5
			Respiratory distress syndrome	1
			Prior damage to uterus	25
			Foreign object found in birth canal	9
			Bacterial infection	26
Limpopo	Nill	Nill	-	-
Kwazulu-Natal			-	-
Mpumalanga	Nill	Nill	Cerebral Palsy	613
			Orthopaedics	391
North West	-	-	-	-
Northern Cape	Nil	Nil	Cerebral Palsy	33
			Surgery	9
Western Cape	Nill	Nill	Obstetric other mishaps	20%
			General surgical	10%
			Trauma	5%
			Neurosurgery	5%
			Orthopaedics	5%
			Ophthalmology	5%
			Paediatrics	5%
			Anaesthetics	5%
			Other	10%

2. According to Provinces, they use both manual and electronic tracking systems. Most of the Provinces have their inhouse electronic system.

3. According to the Provinces, there are those that are using their own electronic system. These include Eastern Cape Mpumalanga, Limpopo and Western Cape. Kwazulu-Natal, Free State, Gauteng, Northern Cape and North West are using the Case Management System.

END.

Reply:

The Republic has participated in several multilateral platforms dealing with Pandemic Preparedness, Prevention and Response (PPPR). These platforms include the Access to COVID-19 Tools Accelerator (ACT-A) Facilitation Council, the World Health Organisation-led International Health Regulations (IHR)(2005) review processes, and the World Health Organisation-led Intergovernmental Negotiating Body (INB) that will consider the envisaged international pandemic treaty that is still to be negotiated. The ACT-A Facilitation Council (FC) was launched in April 2020 and established in September 2020 to facilitate the work of the ACT-A partnership and was Co-Chaired by South Africa and Norway are the Co-Chairs of the FC. The ACT-A was established
to enable an effective and equitable global response to the COVID-19 pandemic and was established at a time of urgency and uncertainty – less than three months after the World Health Organisation (WHO) determined that the outbreak of the 2019 novel coronavirus (2019-nCoV) was a Public Health Emergency of International Concern on January 30, 2020. It brought together governments, scientists, businesses, civil society, and philanthropists and global health organizations such as the World Health Organisation (WHO), the World Bank, the Global Fund, the Bill & Melinda Gates Foundation, CEPI, FIND, Gavi, Unitaid, and Wellcome.

The ACT-A was responsible for mobilising Medical Countermeasures (MCMs) as tools that were deployed for interventions and treatments used to prevent or mitigate the effects of a pandemic or other public health emergency of international concern such as vaccines, therapies, medical devices, tests and other diagnostic tools, and personal protective equipment. The ACT-A Facilitation Council commissioned an independent external evaluation. The evaluation Report assessed 24 evaluation questions across six areas namely: 1. Mandate; 2. Set-up and structure; 3. Resource mobilization and
financing; 4. Achievements; 5. Gaps and missed opportunities; and 6. Way forward. The evaluation Report was published on 10 October 2022.

https://www.who.int/publications/m/item/external-evaluation-of-the-access-to-covid-19-tools-accelerator-%28act-a%29.

South Africa is also participating in the IHR-2005 review process through the Bureauof the Working Group on Amendments to the International Health Regulations (2005) coordinated by the WHO. The review process is still in the early stages. Member States and relevant stakeholders have been invited to express their general views on the proposed amendments, including on Article 2 “Purpose and scope” and Article 3 “Principles” of the IHR. Member states will in future be invited to identify areas where there may be convergence and also the opposite, and to identify any priorities for addressing the amendments including on areas of potential overlap with the work of the Intergovernmental Negotiating Body (INB). The Director-General of the WHO will
communicate the package of targeted amendments before the opening of the Seventy-seventh World Health Assembly as per Article 55(2) of the IHR.
In addition, South Africa is participating in the intergovernmental negotiating body (INB) consists of WHO Member States and which is Co-Chaired by South Africa and Netherlands. The INB is involved in the discussion of the Pandemic Instrument. The deliberations are currently still at the stage of the conceptualisation of a Zero Draft framework. The Zero Draft document is a framework and outline of the envisaged pandemic instrument that looks at background, methodology and approach to be used during the development of the negotiation tool. The negotiations have not yet commenced but South Africa is participated in discussions focussing on the development of the Conceptual Draft Document. The proposed accord would take the lessons learned from the COVID-19 pandemic and use them to prepare better in the areas of Pandemic Preparedness, Prevention and Response (PPPR). The issue of equity has been identified as one of the key principles that must be considered in future deliberations of the new accord. Negotiations on the instrument will only commence in the latter part of 2023.

END.

Reply:

The Electronic Vaccination Data System (EVDS) does not make provision for the classification of an individual as a matriculant, teacher or any other occupation.  We are therefore unable to provide the requested data.

As at 13 March 2023 a total of 2 186 819 people between 12 and 17 years of age had been vaccinated (primary schedule) out of a total of 6 239 794 minors in this age bracket (35,04%).

During the essential service vaccination period personnel of the public and private basic education sector were vaccinated but it was made clear that that time that no differentiation was made in data collection that would make it possible to identify teachers separately.

END.

Reply:

1. I am pleased to inform honourable member that the Department developed and published (in February 2021), a 2030 Human Resources for Health Strategy that serves as a guideline of the Human Resources Agenda for the Public Health sector at various levels of care.

2. The modelling undertaken in the development of the 2030 HRH Strategy, indicates a current shortfall of skilled health professionals in South Africa hence the strategy makes a call for investing in the health workforce to address human resources deficits and inequalities across provinces and between private and public health sectors. However, its implementation has been a challenge due to stringent budgets.

3. To date, with the acknowledgement of the available limited resources in the public service generally, the Department has managed to close the vacancy-rate gap for healthcare related posts to 12.4% and administration positions to 11.80%, respectively, as at the 30 September 2022, across all provinces.

4. The Department further managed to allocate guaranteed funding/budget for the statutory positions of medical internship and community service personnel through the equitable-share and the Human Resources Training Grant (HRTG).

5. Further to the above developments, to address shortages and to ensure the provision of optimal healthcare services, Provincial Departments of Health are implementing plans that amongst others include:

• 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 weekly
• Employment of health professionals on contract bases to strengthen capacity
• Prioritization of these contract employees for permanent employment where funding permits at the end of their contracts
• Awarding of bursaries yearly to internal and external candidates to study further in various disciplines where there are shortages
• A dedicated Registrar Programme to train and produce specialists
• Provision of the internship and community service programme.

END.

Reply:

My office was informed by the Board of the Office of Health Standards Compliance (OHSC) of the various allegations against the Chief Executive Officer (CEO) in August 2022, which contained inter alia allegations as set out in the Honourable Member’s.

2. The functions of the OHSC are under the control of the Board, and the Board is the Accounting Authority of the Office. I am informed by the OHSC that the allegations were investigated by the Human Resources and Remuneration Committee; Audit, Risk and Finance Committee and the Executive Committee of the OHSC Board in terms of the applicable Grievance and other policy prescripts, following which the Board considered the reports.

Following the above investigation, the Board did not find substance in the allegations against the CEO, relating to (a) the misuse of State funds, (b) the contravention of procurement and tender procedures, (c) threatening behavior towards staff and (d) the misuse of office vehicles.

Based on the investigation and findings of the Board I do not see the need for the Minister to repeat such an investigation which would come with an additional cost.

END.

Reply:

a) The waiting list of wheelchairs in each province is as follows:

Province	Wheelchair waiting list
Eastern Cape	5140
Free State	0
Gauteng	181
KwaZulu-Natal	166
Limpopo	789
Mpumalanga	67
North-West	244
Northern Cape	166
Western Cape	0

b) Steps taken to address the waiting list.

According to the Provincial Departments of Health –

• Eastern Cape has placed orders and are awaiting delivery. They will also manage wheelchair supply as a project to reduce this waiting list.

• KwaZulu-Natal has placed orders and is awaiting delivery which will clear the waiting list.

• Limpopo will arrange that deliveries to take place at district offices for hospitals to collect nearby, thereby reducing the turnaround time.

• Mpumalanga will prioritize procurement early in the beginning of the financial year. The waiting list developed because of expiry of relevant transversal contract.

• North West will increase the budget in the 2023/24 financial year.

• Northern Cape commits to place orders by end April 2023.

• Gauteng is yet to advise

c) We are informed by the provinces that the backlog will be reduced by the end of July 2023.

END.

Reply:

According to the South African Health Products Regulatory Authority (SAHPRA), the importation of Meloxicam was not blocked. Meloxicam is a scheduled substance, and the importer of these substances requires an importation licence as per Section 22C (1) (b) of the Medicines Act and the related regulations.

The SAHPRA processes all applications in accordance with the legislation indicated above and has presence at the regulated ports of entry in line with Regulation 6 of the Regulations, to ensure that the importers of scheduled substances comply with the law. As per the table below there is no Meloxicam detained as per the list of importers provided in the question:

TABLE 1: IMPORT LICENCE APPLICATION STATUS OF FURNISHED COMPANIES

No	Company	Import Licence Application Status	Currently Detained API	Expected Outcome date
1	DB Fine Chem/ Spec	Application finalised recently Licence to Import/distribute scheduled substances as per approved list and pharmacies offering compounding services may access via this or similarly licenced facility.	None	N/A
2	Marsing	Licence being finalised, due to name change and organisational ownership changes over the past few years, they were delaying on application processes. This has now been resolved.	None	N/A
3	Idexis	No application received	Under review Vitamin K2 (ORTIA)	Before 9/03/2023
4	Compounding Pharmacy of SA	No application received	None	N/A
5	Fagron	No application received	None	N/A
6	Rowan Management	No application received	None	N/A
7	V Tech	Licence application under process due to other considerations and an inspection to take place	Under review prednisolone (ORTIA)	Before 9/03/2023
8	Acupharm	No application received	Under review Famotidine (ORTIA)	Before 9/03/2023
9	Lycoderm	No application received	Under review Vit K1(through Multichem Sourcing ORTIA)	Before 9/03/2023
10	Lenbury	No application received	None	N/A
11	Kyron	No application received	Under review Petcam (ORTIA)	Before 9/03/2023
12	Avanti	No application received	None	N/A
13	Vets Focus	No application received	None	N/A

END.

Reply:

(a) Based on response received from the South African Health Products Regulatory Authority (SAHPRA), the importation of Meloxicam is allowed as a substance by companies that are licenced to (a) import as per Section 22C (1)(b) of the Medicines Act and Regulation 6 of the regulations published in terms of the Medicines Act.

There are requirements in terms of the possession, manufacture or selling of a scheduled substance. Section 22A (1) of the Medicines Act, states that no person shall sell, have in his or her possession or manufacture any medicine, Scheduled substance, medical device or IVD, except in accordance with prescribed conditions. Section 22A(5) further provides conditions regarding the sale of schedule 3 and mentions the persons that may sell these substances. Persons allowed to sell Schedule 3 substances include registered pharmacy personnel, manufacturers, wholesalers and other health care professionals that are adequately licensed in terms of Section 22C(1)(a) of the Medicines Act.

SAHPRA requires substances to be sold according to the requirements of the Medicines Act and its regulations. It should be noted that Meloxicam is not subject to the requirements of Schedule 3 when it is specifically packed, labelled or sold for industrial purposes including the manufacture or compounding of consumer products which have no pharmacological action or medicinal purpose, or if used for analytical laboratory purposes.

(b) SAHPRA regulates persons who are licensed to import scheduled substances and its mandate includes enforcing the requirements of the Medicines Act in terms of control of scheduled substances for medical use. SAHPRA does not regulate companies involved in the use of meloxicam for industrial purposes including the manufacture or compounding of consumer products which have no pharmacological action or medicinal purpose, or if used for analytical laboratory purposes.

END.

Reply:

Various scientific institutions and groups have been involved in the collaborative work on the cure for the Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS). All scientists agree that finding a cure is far more complex because no one has ever been cured of HIV and AIDS and as such correlates of protection are not known. There is some other work towards a cure that include people who go on structured treatment interruption after receiving some intervention and South Africa is involved in these studies. There is also an investigation of the use of Indigenous Knowledge System (IKS) or products derived from indigenous plants that have antiviral activities and claims to cure HIV. There is, further, an on-going work that is designing appropriate studies to investigate many claims of cure for HIV and AIDS, which will probably be structured treatment interruption based.

In the meantime, South Africa has participated in various HIV vaccine efficacy studies such as Phambili, Uhambo, Imbokodo, and Antibody Mediated Prevention (AMP). The outcomes of these studies have found that the vaccines that were tried are not effective against the virus. These trials were critical to our endeavor to find an effective HIV vaccine, hence their findings have led us to pursue two alternative pathways:

• A programme of experimental HIV vaccine trials to improve immunogenicity using an approach to iteratively develop and improve both bnAb and T-cell targeting vaccines and that.
• The next (5) five years the country will be assessing the role of utilizing broadly neutralizing monoclonal antibodies as part of HIV prevention strategy.

We are also evaluating these vaccine approached in HIV exposed uninfected infants to try and prevent breastmilk transmission.

It is critical to collaborate with international partners because the costs of these trials are prohibitive.

While these efforts are ongoing, everyone must be mobilized to support the Antiretroviral programme which has demonstrated achievement in viral suppression when and where there is a strong adherence to treatment.

END.

Reply:

(a) According to the KZN Province, Dr Shaheem Seedat who was employed at Mahatma Gandhi Memorial Hospital in eThekwini, KZN, was suspended and charged for allegedly negligence (causing the death of a motor vehicle accident patient).

On 18 March 2016 he was then charged and subsequently found not guilty.

On 25 February 2019, Dr Seedat issued summons (claim) against the Department of Health, KZN for reputational damage in the sum of R20 650 000.00. In his summons he alleged that during 2016 the MEC for Health made a statement to various media /news that he was suspended and being investigated for the charge of misconduct. According to him such newspaper or social media statements were wrongful and defamatory, causing reputational damage.

The Provincial Department of Health defended the case through the office of the state attorney. The Parties have exchange pleadings. The state attorney reports that the Plaintiff (Dr Seedat’s attorneys) wanted to amend their summons.

At this stage there is no date for the trial yet. The Plaintiff (Dr Seedat) will have to apply for it. The notice to amend is still awaited.

(b) The Department of Health, KZN (the employer) is obliged to investigate any alleged misconduct by its employees. The acquittal does not mean that misconduct did not occur. According to the Department of Health, KZN, the claim for damage in the sum of R20 650 000.00 by Dr Seedat is not justified and as such must be defended.

END.

Reply:

I would first like to set the record straight that as much as there are challenges in Health sector, it should be noted that the health sector has not collapsed.

a) I have been informed by the Gauteng Department of Health that it is unable to place junior doctors who are bursary holders due to budget constraints. However, there is a process underway to prioritize the human resources needs to place them in institutions across Gauteng.

b) Due to general budget cuts that affects the Cost of Employment (CoE) in the public health sector, there is a systematic process of approving funding and advertisements of posts by Accounting Officers in consultation with Provincial Treasuries supersedes filling of vacant posts to avoid exceeding Cost of Employment (COE) budgets. Therefore, the Department prioritised the filling of the critical and scarce skills within the available budget.

Across all provinces, both clinical and non-clinical posts are continuously identified and vacancies are filled through block adverts and recruitment throughout the year in response to the service demands.

END.

Reply:

(a)-(b) At Primary Health Care level, the department has an Ideal Health Facility tool that is used to determine the number of health facilities that have functional piped water and the number of health facilities that have emergency water supply.

Each health facility is required to have both functional piped water and emergency water supply kept in water tanks connected to the water reticulation system in the health facility. There is also further arrangement with municipalities that in case of the emergency water tankers running empty during drought seasons, the municipality brings water by means of water tanker trucks to fill up emergency water tanks at the health facility.

END.

Reply:

No, I was not aware of any refusal by the Witbank TB Specialised Hospital to treat newly diagnosed TB patients and directing them to Bongani Regional Hospital.

The Mpumalanga Province has been reorganising the service platform, due to demands in the Province. This has resulted in the repurposing of Witbank TB Specialised Hospital to be the internal medicine unit to support Witbank Provincial hospital. The repurposing of the hospitals means that Bongani Hospital is the new DR-TB referral site to take over the clinical management of complicated DR-TB patients for the entire province. All district hospitals are still responsible for the management of the DS-TB patients.

END.

Reply:

Adverse Events Following Immunisation (AEFI) and safety concerns in terms of contraindications, special precautions and warnings are reviewed and included in the product Information leaflet. All potential risk factors are outlined in the product information leaflet and the clinician/health care provider prescribing the vaccine is thereby informed. If there are critical concerns/risks, the product will not be registered and will not be made available to public.

The responsibility for pharmacovigilance and surveillance is ultimately with the regulator, SAHPRA. All clinicians and the public themselves have been encouraged to report both side effects and adverse events. There is ongoing assessment of safety of all medicines and vaccines. This information is shared globally so that all countries can combine their experiences and determine actions where appropriate.

In the case of the Covid-19 vaccines in use in the country there is a great deal of information available, it is included in the product information. There are known rare adverse events, just as rare side effects are known for all medicines. The evidence is that no elements of the two Covid-19 vaccines may put the lives of persons at risk any more that another medicine. There is however evidence that the vaccines improve immunity and protect the vaccinees from severe infection.

END.

Reply:

a) The National Department of Health has conducted few studies focusing on the condition assessments of the health facilities in line with the requirements of the Government Immovable Asset Management Act. The studies also covered few recommendations. Firstly, the study recommended that a certain portion of the capital budget for be hospitals must be set aside for the routine maintenance. Secondly, the study recommended that a certain portion of the capital budget for the hospitals should be set aside for the urgent redress of the major (and often dangerous) poor conditions of the identified hospitals. Thirdly, the study recommended that a certain portion of the capital budget should be set aside for the new infrastructure for the Primary Health Care; Level 1; Level 2 and Level 3 capacity and infrastructure for specialities.

b) Based on the recommendations mentioned above, a ten-year infrastructure plan of the health facilities for 2015 – 2025 was developed and signed off at the beginning of 2015 by the National Department of Health. The ten-year infrastructure plan covers the following areas:

1. priority sites that requires the access improvement;
2. condition of existing infrastructure;
3. illustrate relative capital (replacement) value;
4. maintenance estimate;
5. refurbishment estimate;
6. technology value estimate; and
7. timelines for the maintenance activities and refurbishment work.

The total budget implication over ten years was estimated to be in the order of R31bn. The breakdown of the recommended projects for hospital bed capacity improvement:

• Build Value R23,86bn
• Refurbish Value R2,57bn
• Technology Estimate R4,6bn
• Total R31bn

END.

Reply:

a) The development of an integrated portable Electronic Health Record (EHR) for Public Health Facilities will cost an estimate of R300 million per annum over the next five years. This solution will be available to all public and private health establishments and will result in a common portable health record for all users of the entire health system. The costs associated with the roll-out and implementation at scale inclusive of the ICT Infrastructure and change management for the users of the solution still need to be costed with the required detail. Based on industry practices it can be estimated that roll-out and implementation at scale, bare similar costs as the development of the HER software solution.

b) It will take approximate 5 years to develop the full solution and phased implementation, pending funding availability. The process will be governed through the National Health Information Systems Committee which is a multistakeholder sub-committee of the National Health Council.

END.

Reply:

An evaluation was conducted and finalised in August 2019, just prior to COVID-19.

The report found that:

“The evaluation findings suggest that the Central Chronic Medicines Dispensing and Distribution (CCMDD) is overwhelmingly believed to be the National Department of Health’s (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.”

“On balance, it is evident that CCMDD has indeed achieved its immediate aims of decongesting facilities, which helps improve the availability of Health Care Practitioners’ 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.”

“Stakeholders also observed this intervention was well integrated with other interventions, and this integration was evidenced by information sharing between the CCMDD programme and the WBPHCOTs.”

Like any other programme, funding is critical to the success of CCMDD. While the programme had limited donor funding initially it is now funded mostly from a portion of the NHI conditional grant.

During COVID-19 patients were able to collect their chronic medication from CCMDD Pick-up-Points (PUPs) outside of health facilities without undue exposure to the virus. During that time script periods were extended and patients were required to return less frequently to collect their medicines. This lesson has been adopted as current practice to extend the capacity of the CCMDD and to improve access to medicines for patients.

END.

Reply:

The shortages of human resources for health are a global phenomenon and South Africa has not been spared from this challenge. The human resources challenge was particularly glaring as the country grappled to manage and contain the Covid-19 pandemic.

The human resource for health shortfall is well recognized by the country’s 2030 Human Resources for Health (HRH) Strategy which makes a strong case for significant additional investment in the health workforce to improve health services access, quality, and equity.

In increasing the pool, the HRH Strategy provides some insights into the additional numbers of health workers needed Hence a case is also made for aligning health workforce education and training with the health system’s needs.

Specific to a pool of nurses, a baseline audit to quantify gaps between existing supply and existing needs for all categories of nurses including nurse specialists has been concluded. This will guide areas of training required to increase the pool.

In order to enhance services in the overstretched public health sector, particularly with regard to South Africa’s response to the Covid-19 Pandemic, the department appreciated the introduction of the Covid-19 Grant and was able to inject an additional 6 688 health care workers (that included 3 460 nurses and 409 doctors) into the System on a contract basis

A further 7 583 (with 2 605 Nurses and 2060 Doctors) health professionals were allocated to do community service in health facilities to commence duty from 1 January 2023.

END.

Reply:

a) There has been minimal disruption to the delivery of health care services in all flood affected provinces within the public sector. However one private hospital in Komani, Eastern Cape was severely affected by flooding where our public sector Emergency Medical Services assisted with transferring of in-patients to nearby healthcare facilities.

The rendering of Primary Health Care services continued unaffected and assistance was also provided to the displaced community members in temporary shelters where necessary. Temporary shelters were inspected daily to monitor for water-borne diseases. No outbreaks or cases of food borne illness directly attributable to the floods were reported. Medication distribution was also not affected.

b) The Department of Cooperative Governance and Traditional Affairs (COGTA) through the Disaster Management Act of 2002 is responsible for disaster management however the Department of Health has also put several health measures in place at national, provincial and district levels to mitigate for the impact of floods as follows:

i) Governance

• The National Department of Health(NDOH) participates in the inter-sectoral national structures, the National Disaster Management Centres (NDMC); linking with the provincial Departments of Health for national oversight and support.

• The provincial Departments of Health are represented at Provincial Joint Operation Centres (ProvJOC), Provincial Disaster Management Centres (PDMC) and/or local Disaster Management Centres, as activated within the respective provinces for effective and efficient response.

• EMS is placed on high alert to provide emergency response as and when required. EMS from unaffected provinces gets mobilized to assist affected provinces when needed and this is facilitated by NDOH.
• Urban search and rescue teams are on standby to assist affected provinces with rescue and medical personnel.

ii) Hospital Services

iii) Both public and private hospitals are alerted to receive patients in all affected areas in case of diversions as and when needed. If necessary, inpatients will be transferred to unaffected hospitals.

iv) Primary Health Care(PHC) Services If a PHC facility is affected, patients will be directed to an unaffected PHC facility, or mobile clinics will be utilized. PHC services may also be provided in temporary shelters.

v) Environmental Health Services (EHS)

National and Provincial EHS officials provide oversight and support. The respective local government EHS will undertake water quality monitoring and ensure appropriate sanitation measures are adhered to. Temporary shelters, if established, will be inspected by teams from the Environmental Health Units daily.

vi) Communicable Disease Control, COVID-19, Malaria and Zoonotic Diseases

• The respective Outbreak Response Teams at district, provincial and national, are placed on high alert to monitor affected areas and are on standby to respond to any water borne / communicable disease that may arise.

• The National Institute for Communicable Diseases (NICD) heightens surveillance for COVID-19, malaria and zoonotic diseases in the affected areas.

vii) Health Promotion & Nutrition

Awareness on water safety and communicable diseases is initiated within the communities as needed. Small scale water purification, safe food handling and keeping and monitoring of food is also done to ensure prevention of food poisoning and communicable diseases.

viii) Food Control

• Food Control makes food safety Information Education and Communication(IEC) material available to respective EHS and Health Promotion teams to create awareness as needed.

• EHS gets also support in terms of inspection of donated foodstuffs to ensure safety, and record keeping as and when required.

ix) Forensic Pathology Services (FPS)

FPS function is to remove bodies of flood victims in close collaboration with SAPS in affected areas.

x) Pharmaceuticals

Medication distribution will be monitored for disruptions and alternate distribution methods are applied.

xi) Risk Communication and Community Engagement

Media releases are undertaken on all platforms as and when required. Monitoring of local media clips, news and social platforms is also ongoing.

Additional technical expertise is also available and gets deployed where needed.

END.

Reply:

1. According to the information received from our Provincial Departments of Health, no medico-legal cases have been referred to the Health Sector Anti-Corruption Forum (HSACF) since it was established in 2018.

2. Not applicable.

END.

Reply:

I am aware that there were concerns raised by communities regarding provision of ambulances services around Botshabelo and Mangaung in 2022 in Free State. I am also aware that the MEC of Health in the Free State has also responded to some of the communities and have acceded to some of these challenges in this regard.

Pertaining to this particular incident in the Mangaung Metropolitan Municipality where an ambulance did not arrive to collect a patient when an emergency call was made to the Emergency Communication Centre, I was not informed of this. The lack of details on this particular matter makes it difficult to make an enquiry.

I have however been informed by the province that the Public Emergency Medical Services in Mangaung Metropolitan Municipality currently operates with 26 ambulances distributed as follow:

• Bloemfontein 11
• Botshabelo 6
• Thaba Nchu 5
• Wepener 1
• Dewetsdorp 2
• Soutpan 1

The public also has an opportunity to report the matter through the Free State Department of Health’s complaints system.

END.

Reply:

Steps the department has taken to raise awareness amongst the public about the prevention and management of cholera.

After the WHO reported that the cholera outbreak had occurred in Malawi and Mozambique, and other countries in the SADC regions, the National Department of Health alerted all the provinces about the cholera outbreak. The provinces were requested to use the risk assessment and contingency plan tools to assess their capacity for preparedness and readiness for cholera outbreak. The National Department of Health met with the provinces to discuss the plans and actions required in preventing and controlling the spread of cholera. Steps that were taken to raise awareness amongst the public about the prevention and management of cholera are outlined below as follows:

a) Prevention and Control

The National Department of Health has activated the Multisectoral National Outbreak Response Teams (MNORT), which includes members from the National Department of Health, National Institute for Communicable Diseases (NICD), provinces and the World Health Organization (WHO). The focus areas include surveillance; water, sanitation and hygiene; social mobilisation; Risk Communication and Community Engagement. The MNORT meetings are held on weekly basis (Fridays) to discuss the ongoing cholera outbreak in the country.

• A public announcement was made to inform and alert the public about the outbreak of cholera.
• All provinces received cholera guidelines and case investigation forms.

b) Community Engagement

Community engagements were conducted in all provinces, and distribution of Information, Education, and Communication (IEC) pamphlets and posters to teach the public about potential risks, symptoms of cholera, precautions to take to avoid cholera, when and where to report cases and to seek immediate treatment when symptoms appear continues to take place.

Awareness was raised about prevention through:

• Development and distribution of posters and flyers
• Giving health talks on community radio stations
• Cholera prevention and management messages were shared using departmental social media.
• Continuous health education is conducted in health facilities.

END.

Reply:

(1) According to the KwaZulu Natal Department of Health, Wentworth Hospital Gateway clinic has a backlog on issuing of spectacles to 300 patients. The reason for the backlog is that the institution exhausted the budget for spectacles in October 2022.

(2) There is no optometrist employed at Wentworth Hospital Gateway Clinic. However, the facility receives support from a visiting optometrist who visits the hospital once a week. There is one ophthalmic nurse employed at the clinic.

(3) The hospital has no budget to fill optometrist posts, however, the Department continues to advocate for enough funds to address this problem. The budget allocated to the hospital over the past years was insufficient to create new posts.

(4) The hospital has included the filling of the optometrist post in the budget bid for 2023/24. Additional funds for spectacles have also been requested.

Further information is awaited from the Province.

END.

Reply:

We are not aware of any deaths associated with the crisis of loadshedding as the question alleges. With regard to the details furnished by the Honourable Member, I am assured by the Gauteng Provincial Department of Health that there is no reported incident in Radiology relating to any death in CT/MRI due to loadshedding at the Chris Hani Baragwanath Hospital, as alleged. The Gauteng Provincial Department further confirms that the CT and MRI machines of the Hospital have uninterrupted power supply (UPS) and generators, which ensures the continuity of service during black-outs. It could be of great assistance if details of the abovementioned case can be made available to us for detailed investigation and response.

END.

Reply:

a) Infant Mortality Rate

Chris Hani Baragwanath Hospital -All Data	2020	2021	2022	Total
Death in facility 0-6 days	359	403	325	1087	59,6%
Death in facility 7-28 days	162	162	191	515	28,2%
Death in facility 29 days - 11 months	43	95	84	222	12,2%
Total infant deaths	564	660	600	1824	100,0%
DHIS data extracted 20th February 2022

(b)-(c) Chris Hani Baragwanath Academic Hospital (CHBAH) does not procure ambulances. Provision of ambulances is the responsibility of Gauteng EMS. Gauteng EMS does not have dedicated obstetric ambulances as all ambulances are equipped to treat and transport all emergencies including obstetric cases.

Gauteng EMS is piloting the Gauteng Scheduled Emergency Transport (G-SET) which is a scheduled transport system between high call volume facilities like CHBAH. We are encouraged by the improved response times and plan to expand G-SET during the new financial year subject to recruitment of additional staff.

(d) (i) Action plans to reduce avoidable mortality

• All Health care facilities should have monitoring and evaluation team that monitors perinatal mortality data using the Perinatal Problem Identification Program (PPIP) to exclude avoidable deaths.
• Integrate PPIP programme into M & E teams at all levels of care.
• Facility management should develop quality improvement plan focussing on avoidable factors of death and address them.
• Facility Management must ensure that all delivering institution discuss every death within 7 days, report on PPIP, develop and follow up on implementation of Quality Improvement Plans (QIP)
• Senior management must ensure that junior staff is provided technical support on the job and onsite corrective measures.
• Provincial Management to submit and verify their PPIP data to NDoH establish Provincial Perinatal Mortality Meetings Committee, NDOH, Provinces, MNCH cluster.

(ii) Promote the prevention, early identification, and comprehensive management of the stabilisation phase of children with Severe Acute Malnutrition (SAM)

• Strengthen the capacity of hospitals to identify and care for acutely sick children not limited to the following:

• Equitable allocation and non-rotation of staff
• Ensure effective triage system in hospitals.
• Strengthen daily ward rounds including on weekends.
• Sustain Outreach support to District Hospitals

• Empower households and strengthen community services to promote early entry into the health service and reduce barriers.

• Create a safe home and social environments for children to reduce non-natural deaths, such as burns prevention and road traffic accidents.

• Strengthen the capacity of community and primary health care services to address common childhood illnesses.

(e) The Department of Health reached the sustainable development goal set target of <12/1 000live births by 2030 for newborn nationally which is part of the infant mortality rate. The Department is therefore striving to sustain the performance not to regress below the current achievement, however.

The Infant Mortality Rate sustainable development goal which is also the Departmental goal is set at 20/1 000 live births by 2030.

(f) The Department of Health reached the sustainable development goal set target of <12/1 000live births by 2030 for newborn nationally and the infant mortality rate l recorded in 2020 was 23.6.

END.

Reply:

I was made aware of Operation Dudula protesting outside public health facilities around Gauteng province including Johannesburg and Kalafong Hospital.

a) In Kalafong Hospital, Operation Dudula protest caused an obstruction of free access to the facility, hence the need to intervene, which was done in collaboration with the Gauteng Provincial Department of Health and Kalafong Hospital management.

b) (i) Gauteng Provincial Department of Health applied for an urgent court interdict against Operation Dudula. Subsequently, the Court order preventing disruption to free access to the hospital was granted. Over and above working with the Gauteng Provincial Department of Health, we prevailed with the South African Police Service to be more decisive in implementing the interdict, thus ensuring the protection and safety of all healthcare users, including foreign nationals. The court was applied mainly to prevent obstruction of healthcare facilities from being accessible to all users, including foreign nationals.

(ii) I, together with the Director-General gave the leadership of Operation Dudula an audience, who by the way also had other allegations against the Kalafong Hospital management. Operation Dudula leadership was informed that there are other ways of addressing their allegations against the hospital management. Having visited the Kalafong Hospital and assisting the Gauteng Provincial Department of Health and subsequently meeting with Operation Dudula leadership, was done as an attempt to open the lines of communication so that Operation Dudula are free to talk to us about specific matters they might have.

END.

Reply:

1. In accordance with information extracted from the PERSAL Data Set of 28 February 2023, a total of 8 employees are occupying positions in acting capacity on senior and/or executive positions in public hospitals in the Republic with no permanent contract on salary level six and higher.

The table below is the data as extracted from PERSAL and its accuracy is being verified with Provincial Departments of Health:

ACTING PERSONNEL WITHOUT PERMANENT CONTRACTS AS Feb 2023
POST CLASS DESC	ACTING PERSONNEL	EC	FS	GAU	KZN	LP	MPU	NC	NW	WC	Grand Total
DEP MAN NURS(LEV1&2)	ASSIST MANAGER NURSI	0	0	1	0	0	0	0	0	0	1
HEAD CLIN DPT MED	HEAD CLIN UNIT MED	0	0	0	1	0	0	0	0	0	1
HEAD CLIN DPT MED	MEDICAL SPECIALIST	0	0	1	0	0	0	0	0	0	1
HUMAN+SUPPORT SR10	HUMAN+SUPPORT SR8	0	0	0	1	0	0	0	0	0	1
LINE FUNC + SUP SR11	LINE FUNC + SUPP SR9	0	0	0	0	0	0	0	0	1	1
LINE FUNC + SUPP SR9	HEALTH AND SUPP SR8	0	0	0	0	0	0	0	0	1	1
MANAGE+SUPPORT SR10	MANAGE+SUPPORT SR9	0	0	0	0	0	1	0	0	0	1
MANAGE+SUPPORT SR13	LINE FUNC + SUP SR11	0	0	0	1	0	0	0	0	0	1
Grand Total		0	0	2	3	0	1	0	0	2	8

2. The table below indicates total number of senior staff in the employ of his department with a level 6 remuneration package or higher who have a disciplinary process and/or cases pending against them.

(2)(a)(i) total number	(ii)details of cases
Level 6=1	Theft
Level 8=1	Gross Absenteeism
Level 8=1	Corruption and maladministration
(b)disciplinary measures	Yes

END.

Reply:

(1) (a) No specific research has been conducted on the effect of Health Promotion Levy (HPL) on obesity, however, studies have been conducted on the effects of HPL on the consumption of Sugar Sweetened Beverages.

(b)-(c) Scientists have shown that the HPL is working, for example, evidence shows that in the first year after the introduction of the HPL, urban household purchases of sugary beverages fell by 51% (Stacey et al, 2021). Similar results were shown in young adults in Langa Cape Town (Essman et al, 2022) where a 37% in volume and 31% in sugar intake was demonstrated. In Soweto, the frequency of Sugar Sweetened Beverages (SSB) intake amongst heavy consumers fell from 10 beverages per week before the tax to 4 beverages per week one year later (Wrottesley et al 2020).

(d) The results on the effectiveness of SSBs on consumption are published papers that are accessible to the public.

(e) Not Applicable

(2) Yes, the research has been shared with National Treasury by the researchers.

(3) There has not been any discussion between the DOH and National Treasury on above mentioned studies by the Department since the researchers shared the results directly with National Treasury.

(4) There is currently no planned research focussing only on the impact of HPL on obesity. The Department is finalising the Dietary intake study which will reveal other foods including those with sugar that are consumed by South Africans. The information will assist the Department to identify additional interventions that should be taken to control obesity and reduce the risks of NCDs. Considering that Obesity is caused by multiple factors, with sugar being the major contributor.

END.

Reply:

It is our considered view that visitations to healthcare facilities, especially hospitals, are properly arranged ahead of time, with the relevant authorities, for visitors to be accommodated in the schedule and operations of the facility. This is so because all staff in our healthcare facilities are extremely busy all the time and if the visitation is not pre-arranged or arranged in an orderly manner, the operations of the facility will be negatively affected. Honourable Members are very well aware that our facilities are overburdened with demand for healthcare services, while at the same time experiencing shortages of staff of various sorts. We therefore do not want the staff in these facilities to operate in an unplanned and uncoordinated manner as this could even result in the Honourable Members ending up not receiving proper attention being taken on walk-abouts or being attended to by staff during such visits. The risk is therefore that the same Honourable Members will as a result complain that they went on a visit and they were not attended to and that no one was available to answer their questions. Also, the Honourable Member will wonder around in the facility and have a risk of causing even more disruption. It is our considered view therefore that visits by everyone to our healthcare facilities, including public representatives, are pre-arranged, but that in the case of Members of Parliament, such visits are further coordinated under the auspices of the relevant Parliamentary Committee. In this way, the Honourable Members will make a positive contribution in improving the quality of healthcare service delivery in our healthcare facilities in particular, and in the entire healthcare system in general.

The Honourable Member is well aware that a healthcare facility is a very sensitive area and allowing uncontrolled access to any healthcare facility poses risks to staff and patients both in terms of security as well as infection control.

END.

Reply:

It is important to remind Honourable Members that all these trips are in fulfillment of the obligations for the Portfolio for various representations of the country in various fora in the world, and further, that the international ones are strictly approved by the Head of State before they can be undertaken.

1. The details of the destination, total costs for accommodation, travelling and any other costs incurred for international trips for each Minister and Deputy Minister since 01 June 2019 are as follows:

• Minister R3 712 892.05
• Deputy Minister R1 919 384.33

(aa) The former Minster

The Current Minister

(bb) Former Deputy Minister

Current Deputy Minister

2. The total costs incurred for domestic air travel for each Minister and Deputy Minster since 01 June 2019 were as follows:

a) The total cost for domestic air travel incurred for Minister, Dr. ZL. Mkhize was R1 343 877.00 up to the year 2021, and cost incurred for the current Minister, MP Dr. MJ Phaahla amount to R310 271.79 to date.

b) Costs incurred for former Deputy Minister, Dr. MJ Phaahla since 01 June 2019 until 2021 amount to R616 929,28 and current Deputy Minister, MP Dr. S Dhlomo with effect from 2021 to date sits at R718 054.54.

END.

Reply:

There are no state owned entities reporting to the Minister of Health. There are five public entities (Section 3A) reporting to the Minister of Health. (a) The table below depicts the salary of each (i) chief executive officer and (ii) top executive position in each public entity reporting to the Minister of Health

Name of Entity	(a) (i) the salary of each chief executive officer	(a) (ii) the salary of each top executive position in each public entity reporting to the Minister of Health
Council for Medical Schemes	R 2 736 815	Executive Manager: Office of CEO - R1 849 744 Chief Financial Officer - R1 881 000 Chief Information Officer (Vacant) - R1 881 000 Executive: Corporate Services - R1 881 000 Executive: Regulation - R1 881 000 Executive: Policy, Research & Monitoring - R1 849 744 Executive: Member Protection (Vacant) - R1 881 000
National Health Laboratory Service	R2 792 380	Chief Operations Officer: Strategic Initiatives - R2 117 754 Chief Financial Officer - R2 117 754 Executive Manager: Human Resources - R2 328 376 Executive Manager: Information Technology - R2 117 754 Executive Manager: Academic Affairs, Research; Quality Assurance – R2 703 158 Executive Director -NICD - R2 521 313 Executive Director -NIOH - R2 398 227
Office of Health Standards Compliance	R2 368 024	Chief Financial Officer - R1 431 623 Chief Operations Officer – R 1 814 443 Executive Manager: HSDAS - R1 370 070 Executive Manager: Compliance Inspectorate - R1 540 533 Executive Manager: Complaints Management - R1 586 413 Health Ombud - R2 354 061
South African Health Products Regulatory Authority	R3 005 567.25	Chief Operations Officer - R2 247 799.61 Chief Financial Officer - R1 898 253 Chief Regulatory Officer - R1 604 650.30 Executive Manager: HR - R1 394 372.70 Company Secretary - R1 196 010.90
South African Medical Research Council	R3 280 727	Chief Financial Officer - R3 149 585 Vice President: Extramural Research Units - R2 730 269 Chief Research & Operations Officer - R2 594 400 Executive Director: Grants, Innovations & Product Development - R2 153 086 General Counsel - R2 102 207 Executive Director: Human Resources - R2 050 558 Executive Director (part-time): Transformation - R1 107 064

(b) Executives of Section 3A public entities do not receive remuneration for the attendance of meetings of their organization.

END.

Reply:

The Honourable Member is referred to the response to Question 283 asked on the 17 February 2023.

END.

Reply:

(1) Yes the adjudication committee has been appointed, trained and the 1st meeting was held on the 14 December 2022. The appeal committee is in the process of appointment 

(a)  82 cases have been linked to the use of the vaccine, and claims are being processed

(b) 3 claims have been approved for payment

  (c) 0

(2) No.

END.

Reply:

(1) (a) Total backlog for FCLs is 35 776 tests (CPT, JHB and PTA labs

(b) Outstanding reports:

(i) 1-5 years = 11 948

(ii) 5-8 years=3 391

(iii) 8-9 years= 2 158

(iv) 9-10 years = 1 749

(v) more than 10 years = 2555

(c) Backlogs were cause by, amongst others:

● old laboratory equipment that constantly broke down.

● Insufficient goods and services

● Delays in procurement

● Shortage of skilled staff

The nature of the samples that must be tested, and the volume of new samples and a high incidence of urgent requests. There normally are multiple samples per case, thus one case can consist of blood, urine, stomach content, liver, bile and a drug which all linked to one body.

Additionally the import of Certified Reference Materials to confirm and quantify controlled substances, is a very lengthy process which delays laboratory testing.

(d) The NHLS is streamlining activities in this discipline and the focus is on improving productivity to reduce the backlog.

(2) The backlog developed since the National Department of Health did not have the expertise and resources to effectively address the backlog. The laboratories have now been transferred from the NDOH to the NHLS given the efficiency of the NHLS as a specialised laboratory service. NHLS is leveraging its resources and expertise to turn things around and strives to address the backlog.

Public private partnership is a legislated process which requires a defined procurement approach which requires Treasury approval. The NHLS will explore amongst others the possibility of a public private partnership.

END.

Reply:

The Patient Information System implemented in OR Tambo Memorial Hospitals is owned and implemented by the Gauteng Department of Health. The Gauteng Provinces adopted the Modernisation Strategy aimed at improving the overall public services. “Gauteng health services will be modernized through effective management of information systems and the development and implementation of e-health strategies towards creating a paperless environment. The implementation of the new Patient Information Systems was to replace the two legacy systems used in the Gauteng facilities, being Medicom 2X and PAAB, the two systems were implemented in early 2000 and were no longer supported by their Original Software Manufacture (OSM).

The implementation of the system was expected to create queues only in the first two weeks of transitioning from the old system to the new system. This was due to data being migrated (data clean-up, data verification, data crossmatch, and data validation) from the old systems to the newly implemented system. To mitigate this expected issue, a change and adoption team was made available to the hospital to interact with patients while waiting in the queues and provided details on the new system and its benefits. The above intervention allowed the hospital to stabilise the system and transition from the old to the new system.

The hospital has a complaint and complement system in place which are monitored regularly. Based on the records for this system such complaints as per the question has not been recorded. The hospital also monitor patient waiting time for retrieval of files and this waiting time is within the benchmark waiting time of 30 minutes

Elderly patients have their own queues and should they come for a follow-up visit with a booking at the hospital, the files are retrieved the day before the booking. This significantly decrease waiting time for the retrieval of files at the administration.

END.

Reply:

a) The Thaba Tshwane building had enough space to accommodate the staff of the National Department of Health. And it was complying to all requirements of the Occupational Health and Safety Act.

b) The location of the building is not affecting the mission of the National Department of Health. The compliance of the building to OHS Act brings back the focus of the health staff, it is assisting the National Department of Health to put more focus on measures that can assist the provincial health departments to improve the health status through the prevention of illness, disease and the promotion of healthy lifestyles, and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.

END.

Reply:

The procurement of the seven-year lease building was done by the Department of Public Works and Infrastructure. However, the National Department of Health has four times the staff compared to those of the Department of Cooperative Governance and Traditional Affairs. The square meterage that was required by the Department of Cooperate Governance and Traditional Affairs was far less compared to the one that was required by the National Department of Health due to the size of the Department. The rental price of the building is based on the required size of the square meterage.

END.

Reply:

1. (a-b) Not all government facilities have been exempted from the load-shedding. However, the National Department of Health has provided Eskom with a total of 213 hospitals to be considered for possible exclusion from loadshedding. About 67% of these hospitals are supplied by municipalities while Eskom supplies about 33% of the identified hospitals. Out of the 213 hospitals, 76 hospitals have been exempted of which 26 are directly supplied by Eskom and 50 by Municipalities. The number of hospitals exempted to date have doubled since the meeting held on 22 September 2022 between Eskom and National Department of Health.

1. (aa) See below the number of hospitals that are exempted to date across the country:

i. (bb) Clinics and Community Health Centres are going to be covered within the solar energy roll-out programme.

ii. The National Department of Health in partnership with CSIR (Council for Scientific & Industrial Research) is currently conducting a due diligent exercise for the installation of solar panels at all our health facilities

END.

Reply:

The measles outbreak was in five of the nine provinces namely Limpopo, Mpumalanga, Gauteng, Free State in Thabo Mofutsanyane district only, and Northwest.

1. Yes.

(a) In response to the current outbreak and seeing that there is a need to increase the age group from 6 to 15 year, the department worked with the relevant role players to get enough vaccines for the purposes of interrupting transmission.

(b) There is enough stock to conduct a supplementary immunisation campaign for children aged 6 months to 15 years in all provinces. The number of doses procured by provinces for outbreak/campaign is 10 123 300 for the target population of 16,3 million. The doses referred to here above exclude the stock on hand in the province before the campaign and outbreak.

2. In provinces where there is Public Private Partnerships (PPP) exists, with Service Level Agreement, for private sector, their facilities are supplied with vaccines and trained to manage data and submit to the local sub-district for capturing, however PPP is not in all provinces.

3. No.

END.