Committee Report on Parmed

Ad Hoc Committee on Parliament and Provincial Medical Aid Scheme

14 November 2018
Chairperson: Ms L Maseko (ANC), Mr P Parkies (ANC, Free State)
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Meeting Summary

The Chairpersons opened the meeting and asked members if they would like to discuss the report on PARMED or if they wanted to dismiss the meeting as quorum was not met. The purpose of the meeting was to adopt the report but due to quorum not being met this could not be done.

Some Members advocated for the dismissal of the meeting due to time constraints but also questioned the legality of the meeting. Some Members also suggested the meeting be dismissed as there were differing perspectives on the drafted document thus the meeting should occur when the Committee is fully fledged.

Other Members advocated for the meeting to be used to discuss the report, any additions members would like to make and get everyone on the same page.

The Chairpersons then went through the document page by page providing a summary for members (see document). Issues were raised regarding PARMED restricting the number of dependents one can have on the medical aid scheme. The perception that PARMED is being protected was also discussed as well as the exclusion of options from the draft of the document.

The Committee decided to reconvene on Monday, 26th of November 2018, not only to deliberate on the changes made to the document, but also adopt it. Thereafter the document will be taken it to National Assembly and the National Council of Provinces.

Meeting report

Chairperson Parkies’ opening remarks
Chairperson Parkies opened the meeting. He hoped that members of the Committee had gone through the draft report, studied it and looked at the submissions made and so forth whilst taking notes on areas that needed to be changed. The Committee could not take any decisions as there was a shortage of members therefore the Committee had to decide on whether to discuss the report and get inputs from members who are currently present at the meeting or cancel the meeting.

Discussion
Mr S Marais (DA) said that all members had the opportunity to read the report, so they could either make contributions at the meeting or via email. If a resolution could not be taken, then there was little purpose in dragging the meeting out as the Committee needed a resolution. Members should be instructed to send in contributions by a specific time if they had any. The Committee can then reconvene at lunch time on a given day for the purpose of adoption only and not for discussions or deliberations as there had been many opportunities for that, there even was a report compiled already. Nothing was stopping the Committee from sending in feedback on the report, because should it be discussed then members who are not in the meeting would want to open up discussions again. Members not being present at the meeting means that they had forfeited that privilege.

Ms T Mokwele (EFF) said that Members must not be tempted to follow the incorrect procedures. The report on its own was a subject of the work of the Sub-Committee, who should brief the broader Committee so that everyone could be on board and answer any outstanding questions. Not all Members of the Committee were part of the Sub-Committee hence they would like to know how the Sub-Committee came to certain conclusions. For example, the first two recommendations in the report, which all Members had made. If the report was debated, on which grounds would the debate happen and by whom? In the next constitutional meeting, Members would be tempted to discuss and deliberate on the same issues that were dealt with in an illegal meeting. She then called for a cancelation of the meeting as quorum was not met and time was not on their side. If political parties wanted to contact their administration in order to add anything to the report, then recommendations and observations should be sent to the administration of the Committee so that everyone’s inputs will be considered in the next meeting. She noted that it was late at this point and thus they cannot be in a meeting which is almost like a caucus.

Chairperson Maseko welcomed members to the meeting and mentioned that two members of the National Council of Provinces (NCOP) were on their way to the meeting. She stated that the report was given to everyone to read as the Members were the ones who mandated the Sub-Committee to compile the report. She then articulated that she will be going through the report page by page so that if there were any questions Members could raise them.. She continued to mention that item number 12 on page 29 was not supposed to be added to the report. It was supposed to end with options (see document), the Members would then make recommendations.

Ms M Chueu (ANC) agreed with the Members in that the Chairperson should talk through document because she was concerned that some things written in the report was not an accurate account of what the story was. The Members would prefer if the Chairperson would speak to the document then they could ask questions when they were so inclined in relation to specific pages.

Mr S Tleane (ANC) asked whether the Committee would still be able to meet quorom with the two members of NCOP still to arrive. If the two members coming would satisfy quorum, then the Committee should consider whether to break-away or to continue with some form of discussion. Since everyone was already together, he suggested that they should use the time optimally to see if there was a convergence of ideas at least in terms of the general understanding of the issues even if they do not adopt the report. The Committee should utilize this time to check if there is a collective understanding of the key principles with regards to the report. Then in a full-fledged meeting they can adopt the report. He added that they had the draft report which it was their document thus they cannot turn their backs on it. What was the deadline for the Committee to give feedback on the report to Parliament if they are to postpone this meeting? Other Committees are busy with the budgetary review and recommendations reports and some of the Members of their Committee are part of those hence their unavailability. He noted that everyone was a family in the Committee irrespective of their political party affiliations.

Chairperson Maseko said that they were short of one person to make quorum, meaning that they could discuss this document, but they could not take a decision upon it. Tomorrow then they would meet just to adopt a decision, as Mr Marais suggested.

Ms Mokwele said that she did not want to sound like she is against the views of the Members of the Committee, but realistically speaking the Committee did not have to do things just for the sake of doing them. She had gone through this document herself and found that there were so many wrong things in it, but the Committee was sitting with the document in an informal meeting. Should a member of NCOP come to the meeting the Committee still would not have quorum. The rules state that for a meeting to reach quorum if it is a joint meeting between National Assembly and National Council of Provinces, there must be five provinces present of the NCOP, but with an arrival of the member it would only constitute four. Therefore, whatever Members suggest in relation to additions to the document, on which platform will they be rectified? As the EFF there were suggestions that they needed to put in the document in a constitutional meeting therefore should the Committee deliberate on the document, any suggestion tabled by the EFF would not matter. Therefore, the meeting should be rescheduled with the administration of the Committee by checking dates and times when all Members are available, as Members have other engagements to attend to. She added that some submissions were tabled and others not, and she did not know why this was the case. Recommendations that are present in the document were not informed by anything therefore they should not rush this document and should deliberate on it thoroughly.

Chairperson Maseko said the meeting was not illegal as rule 27 of the Joint Committee stated that a joint Committee may proceed irrespective of the number of members present but when they have to decide on something and the number of Members present is insufficient for the decision to be taken, the presiding members can either decide to suspend the decision until a sufficient number of Members if present or adjourn the meeting. Therefore, the meeting is not illegal, the Committee is just short of one member to establish quorum, which did not mean there should be no deliberation on the document at hand. Members were also given another package with all submissions made that they had to go through. Those submissions were to inform what was in the document.

Mr Marais said that for those who had been attending meetings including the staff, this document reflected all that was discussed and contributed by the Committee in meetings and not just drawn up by staff members. In his view, the document was a result of deliberations by the Members of the Committee.

Chairperson Maseko added that in the coming week (19-23 November 2018) the NCOP would not be in Cape Town, they would be in Gauteng, therefore the Committee would not be able to sit during that week. This Document must be tabled to Parliament in the week after that, on Tuesday, 27 November 2018.

Dr S Thembekwayo (EFF) said that this coming Friday, 16 November 2018, would be an alternative option for a meeting day. She responded to Mr Marais’ comment and stated that she agreed with the sentiments expressed by Ms Mokwele regarding the recommendations. On page 29 (see document) on point 11.3, which was option three on the repeal PARMED Act, should not be part of this document.

Chairperson Maseko responded that she had mentioned earlier that option 3 on page 29 (see document) would not be part of the final document as it was just an oversight. In the Committee there were no minority views but rather everyone was equal. Everyone in the Committee was affected by PARMED Act thus they all want to fix it and make recommendations to be adopted by both houses.

Chairperson Parkies said the Committee had already requested two extensions for submission of the adopted document, hence the Committee could not ask for another extension. He also said he would not accept any person who was going to undermine the contents of the document as if political parties were not represented. If the EFF felt that the input that they had made had been undercut, there was a proposal that stated that anybody who was a Member of the Committee was free to make submissions. Therefore, the EFF should have said that their submission was not explicit in the document. It was unfair of the EFF to engage and speak about the document whilst they were still discussing the formality and legality of the meeting. The Committee either takes a decision and postpones the meeting or takes submissions and then convene on Friday or Monday. However, it must be considered that the NCOP would not be available in the coming week. He added that flights coming back to Cape Town at the moment are disrupted which made traveling difficult to plan. He reiterated that there are no minority views in the Committee as they were all affected by the PARMED Act.

Mr Tleane said that the Committee was beginning to make some progress as most of the members had been working together and had no problems or tensions with one another. Therefore, they should try and maintain the good working relationship so that cooperation can be facilitated. The Committee should then agree on moving forward to discussions in the next hour just to check that everyone has a collective understanding of what was in the document. Given the time constraints, going through the document page by page would not be feasible. Therefore, they should study the options and what it took to get to the options rather than the recommendations; as the options told a story about the various issues that the Committee had with the Act. The Committee should proceed and use the time optimally by zooming into the options and discuss them as a Committee, then decide when the adoption of the document would occur whilst taking into consideration the time constraints.

Chairperson Maseko then spoke to the document reiterating that item 12 (see document) should be removed. She then summarised each page of the document (see document).

Mr Tleane said that it was an excellent idea for Chairperson Maseko to summarise the document for the Committee so that everyone could understand the discussions and processes that has unfolded. As Chairperson Maseko was going through the document, it was very coherent, and each page built upon the last, even with the addition of other public office bearers who should also be part of the PARMED Act, as their exclusion might catch up with Parliament.

Mr M Kalako (ANC) apologised for being late and asked for clarity on what the mandate of the meeting was. Whether it was to present the document, go through it and amend where needs be and after that, does it need to be adopted? There was already a lot of work done on the document and in his opinion all that was left was for the Members to take this document to their respective parties with the amendments made in the meeting.

Mr Marias thanked Chairperson Maseko for a beautiful summary of the document and commented that most Members at the table are those who might not come back or had one term left. Therefore, PARMED’s benefit was also post their occupation of being Members of Parliament. If PARMED is disbanded then everyone would be on their own at the end of their term, whereas for the rest of a Member’s life still under PARMED they would only have to contribute one third of the total cost of the scheme and that would not be part of a Member’s package but rather additional as government and Treasury would bear the cost. Hence he agreed that the Committee should assess what went wrong with PARMED then see how then they could fix it as they have had various submissions from different stakeholders. He was confident that this approach would be beneficial for all Parliamentarians.

Ms Chueu commented that the restriction that PARMED has by only allowing Members to add two children to the scheme was unfair due to the fact that African families usually have an extended number of dependents, some of which might even be older than 18 and unemployed. Regarding the options (see document), she added that she had been a Member of Parliament for many years and has never once used the medical aid except to get spectacles. Therefore, Members should have the option to leave the medical aid if they wanted to as the amount she has paid over the years to PARMED is exorbitant. With regard to option three (see document), she stated that Members still wanted the benefits of private hospitals, but when and how will Members ensure that public hospitals in South Africa are up to par if they themselves did not want to use them? She added that any law can be repealed. Some Members are older and therefore have older kids which they take care of. These types of conditions and circumstances should be considered in the options so that Members have access to and know that there are such avenues.

Dr Thembekwayo said the Committee must not create a precedence where people are incited to recognize a certain option as their best option. In her understanding, the manner in which option one is written and stated to the Members was made as if it supersedes all other options. Option two was started off with all the negatives in the first sentence, which negatively connotes it and makes it undesirable.

Chairperson Maseko responded that the options were not in any favorable sequence but rather in the manner that they were discussed in. The Sub-Committee did not take any formal decisions as the Committee was the forum that finalizes the document with recommendations to be taken to the House. The mandate of the meeting was to amend and adopt but it was clear that this would not be the case. Furthermore, the issue of family members was not forced but it was just based on there being two dependents. PARMED was affordable during the 1990s and it got messed up with the Moseneke Commission of 2008. What was missing in the document was to show the comparison of a current remuneration package to that from the years prior to 2008. This would help illustrate that PARMED was affordable then but now it was not.

Mr Tleane apologised to Ms Chueu for his comment earlier then noted the importance of indicating the marriage between the scenarios as they are related, but also option one and two as well. Once implementation occurs, the membership grows due to councilors, traditional leaders and other public office holders who are added to PARMED, which creates a space for those who would like to leave the scheme. He agrees that Africans have extended families but because PARMED was so restrictive there is no space for the creation of such options. If increments from PARMED and the remuneration packages are also adjusted and in line, then that would balance things out. The principle of understanding the interconnectedness of options and why option three seems so unfavorable would require the Committee to start afresh, which would be a challenging task. Even if the Committee did not adopt today, but in principle agree with the spirit of the document then they should find a date to adopt.

Chairperson Maseko said it is up to Treasury to contribute the resources in the salary package to try and balance the present shortfall. It must also go to the Commission itself so that their recommendations would be taken up by the President.

Mr N Singh (IFP) apologizes for being late. He said that the Committee should not be focused on the timeframe as there were so many other issues that are involved in it. The issue was not only about quorum but other differing views regarding the document as well. The Committee’s terms of reference were to look at the tariffs and according to his observation, they are unaffordable to single, young, new Parliamentarians, which also relates to the remuneration packages. These packages should be relooked at, which must be included in the recommendations. Furthermore, the Committee could not accept option one as the only option. PARMED benefits some and is favorable but there are other options.

Amendments to legislation has to be done but the assessment of the impact on retired Members is another factor. In his opinion, the Committee and Treasury should interact with other legislatures to carry the cost of continuation Members.

This document will be a continued work in progress and in his opinion, this fifth Parliament will not be able to deal with it adequately. On the family side of things, the number of dependents has increased so PARMED must provide the options, so that Members with more than two dependents would possibly pay a higher premium than those with just two. PARMED needs to tell them how they would encourage people to come on board. PARMED should not be protected, as that is the impression he is getting. A holistic decision needs to be made in order to move forward.

Chairperson Maseko said PARMED used to be affordable before but now it is not, so the Committee is not protecting it. She asked if Members could meet on the Monday, 26 November.

Members agreed on the date for the next meeting.

The meeting was adjourned.

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