Chairperson, with regard to cash payment contracts, beneficiaries of social grants may choose to cash their grants at private businesses. The SA Social Security Agency, Sassa, is aware that beneficiaries are receiving their grants at private businesses, which have been subcontracted by cash payment contractors in terms of the current payment contracts.
Private businesses cannot impose conditions on the paying out of grants as beneficiaries are entitled to receiving their full grant amount. The outstanding service level agreements signed between Sassa and service providers explicitly state that beneficiaries should be paid the full grant amount they are entitled to. The service level agreements do, however, permit service providers to introduce alternative payment channels that are meant to improve access to social grants by beneficiaries through the provisions of the service level agreement and legislation.
In terms of these alternative payment channels that the service providers enter into with private businesses, there is also a new service level agreement that we have entered into which looks into improving the quality of service we deliver to our people. Maybe we should specify that it's not all the provinces that have contracts with private businesses. This service is rendered throughout the provinces of KwaZulu-Natal and the Northern Cape. In the Western Cape, it is rendered only in rural areas, and in Mpumalanga it is rendered in some parts of the province. Thank you, Chairperson.
House Chair, Madame Minister, thank you very much for that reply, and I do appreciate it. But given the reply that there should be no conditions imposed on the paying out of social grants, there appears to be conditions that are being imposed. Is your department not aware of this happening? If it is aware of this happening, is any action being taken where cash payment contracts are being abused or not adhered to by the service provider?
Chairperson, there are instances where the department, working together with Sassa, has intervened. This is where you will find that businesses are forcing especially the aged to take groceries instead of their money. Where this has happened, we have cancelled the contract. It's actually not us but the service providers that cancel the contracts because people don't meet the standards.
I also think it is important for us to say that, with regard to service level agreements, service providers and private businesses have to consult with Sassa before entering into the contract. What is also important is that people are not forced to get their grants from private businesses. They can go back to where they received their pensions before going to private businesses. Thank you.
House Chair, Deputy Minister, I think you will agree with me that this issue of outsourcing is a serious problem in the country, and this is an example of outsourcing. If it is found that these people are outsourcing, what are you going to do with such people? Thank you.
Chairperson, I think we have already dealt with the issue that when people do not meet standards the service provider cancels the contract.
Chair, I just want to ask the Deputy Minister what the department and Sassa can do about the loan sharks that enter the halls were people are getting paid in the Western Cape. Is there any way we can just restrict them to maybe 2km away from the halls so as to protect our vulnerable people, because these guys sometimes keep their cards and Ids? They go in with the people to the vending machines to collect the money. While they collect the money on the one hand, they give the money over to these sharks on the other hand. Thank you.
Chairperson, what we all know is that there is an agreement that no one should be around the area where pensioners receive their grants. The department is in the process of dealing with this matter, working together with the special investigation units.
As to how we are going to deal with the matter, we are not going to say it here. But we are trying to ensure that none of the cases we have lodged is dropped. This is because, for instance, here in the Western Cape there is a case that was reported and then dropped during the process. So, we are trying to strengthen our cases so that we can deal with the matter once and for all.
Chairperson, hon Deputy Minister, is there any service fee payable to these service providers? If so, what are the relevant details? Thank you.
Chairperson, if we are actually talking about private businesses, they have this contract because they want to attract more people to their businesses. They are the ones who hire gadgets from service providers for paying out pensions. So, the service providers don't get a cent out of this because we don't pay businesses. They only pay for the gadgets they hire. That is why we see no reason why they should force people to get groceries instead of their pension grants.
Mechanisms to monitor and evaluate quality of services at state clinics and hospitals
8. Prince M M M Zulu (IFP) asked the Minister of Health:
Whether his department has any mechanisms in place to monitor and evaluate the quality of services that the various state clinics and hospitals provide to the public; if not, why not; if so, what are the relevant details? CO74E
Chairperson, in reply to the question, I wish to refer the hon member to our government's new programme of action for the next five years, which clearly reflects that we put a big premium on the issue of improving the quality of health care services. Point no 3 of our programme of action, or our 10-point plan, is about improving the quality of health care services. This means refining and scaling up a detailed plan on the improvement of quality of services, and directing its immediate implementation.
But, already, a set of national core standards for health facilities was released as early as 2008 and was used to benchmark an initial set of hospitals and health care centres. These standards are being extensively revised currently through a process of wide consultation and technical review. The organisational standards reflect existing national policies and guidelines and are organised in a number of domains in which quality or safety could be at risk, namely patient rights, patient safety, clinical governance and care, public health, strategic leadership and corporate governance, operational management and facilities management.
The revised standards will be piloted shortly in all provinces, prior to widespread use, to improve quality, to monitor and benchmark compliance and to accredit facilities. These standards will be expanded over time to become more complete and include other systems.
The department is planning and supporting a project for improving the quality of services in four specific identified problem areas within these domains. These are patient safety, infection prevention and control, waiting times and cleanliness in about 1 000 health care centres - that means both hospitals and clinics. The facilities and projects within them will provide detailed monitoring information as implementation proceeds.
Supervision is an integral function of managers at all levels - as a process to improve the quality of services on an ongoing basis. In the case of clinics, it is supported through a structured tool which we call a supervisory manual that guides the monitoring of services and the process towards improvement.
The District Health Information System, or DHIS, is a national system that collates data collected at all the clinics and hospitals in the country on a regular basis. This monitors both detailed programme plans as well as strategic objectives set for the department. Quality of services is monitored through measuring coverage of specific services or activities. The analysis of these, which forms a specific quality perspective, is being strengthened and gaps in indicators identified to be able to produce a customised response by the end of this financial year.
Complaints from patients constitute an important monitoring system for quality, and the existing call centres in some provinces and the national department will be integrated and their capacity to analyse complaints as a monitoring mechanism strengthened, ensuring co-ordination with similar centres, for instance the call centre in the Presidency.
Patient satisfaction surveys are carried out on a regular basis by external teams. The national protocol is several years old and is being revised to ensure standardisation. Patient satisfaction also forms part of several other surveys carried out over the past few years, for example, the evaluation of the national comprehensive Aids treatment plan. Thank you.
UMntwana M M M ZULU: Mphathisihlalo, ngiyabonga. Phini likaMongameli wezwe, oNgqongqoshe abakhona, maLungu ahloniphekile ale Ndlu. Ngqongqoshe ngikhuluma njengendoda yasemakhaya kwaNongoma, yikho ngithi endabeni yokuqapha ingabe ikhona yini into obusuyicabangile, noma-ke mhlonishwa Ngqongqoshe kuzofuneka ukuthi uke ugcizelele ezintweni ezithile.
Kukhona into ekade yenzeka, ngisho nayizolo lokhu mhla ziyi-12, ingane yaphathwa yikhanda kodwa kwathi uma sifika kwaNongoma esibhedlela basitshela ukuthi umbhede awukho, kwaze kwazanywa ezinye izindlela zokuthi ize isiwe kwesinye isibhedlela Enkonjeni lapho eyafika yashonela khona.
Bese kuba khona le mitholampilo yasemakhaya, njengoba ngikhuluma njengendoda yasemakhaya elusa izinkomo, le mitholampilo yasemakhaya iyavalwa ebusuku. Ngakho-ke uma ugula ufuna ukushayela inqola yeziguli, kufanele ushayele eHhovisi Lesifunda eliseMgungundlovu ukuze ukwazi ukuthola inqola yeziguli ezosuka Olundi ihambe iye KwaNongoma izokwazi ukuhambisa umuntu esibhedlela. Zonke lezi zinto mhlonishwa - njengoba ninegunya elininikwe ngabantu bakuleli lizwe bethi bafuna impilo engcono - kuzodingeka ukuthi ukubheke lokho ngoba angikwazi ukukubeka icala ngalezo zinto ngoba yizinto ekufuneka zilungiswe lezo ngoba sikhonela khona ukulungisa izinto la emhlabeni. (Translation of isiZulu paragraphs follows.)
[Prince M M M ZULU: Thank you, Chairperson. Deputy President, hon Ministers who are present here, hon members of this House and Minister, I am speaking as a rural man from Nongoma, which is why I am asking whether you managed to come up with something with regard to monitoring. Otherwise, hon Minister, you will have to emphasise certain issues.
Something has been happening for a long time. Yesterday, the 12th,a child had a headache but when we arrived at Nongoma Hospital we were told that there was no bed available. We used other means to take the child to Enkonjeni, where the child died.
Then there are these rural clinics - I am a rural man who herds cattle - which are closed at night. Therefore, if you are ill and you need an ambulance, you have to phone the district office, which is in Pietermaritzburg. The ambulance will then be dispatched from Ulundi to Nongoma so that you can take someone to the hospital.
Since you have the authority given to you by the people of this country who say that they want better health care, you need to look into all these issues. I cannot blame you with regard to these issues because these are the things which need to be corrected because we are here to make sure that such things are corrected here on earth.]
Chairperson, I have just outlined a plan to do exactly what the hon member is asking me to do. That is exactly why I read such a long statement. I was not saying that we've eliminated all the problems mentioned, but that we have a plan to make sure that we resolve them. Thank you.
Mr Chair, on the question the hon Prince asked, I saw that in the 2008-09 budget, which we went through the other day in the workshop, the department in the Northern Cape underspent on their budget. But if you look at the clinics, there isn't enough medicine, cleaning materials, and so on. We saw some clinics in a very bad state. Then, a big worry to me is the new hospital in Barkly West in the Northern Cape, which is a state-of- the-art hospital, but I think it's called the "hospital of death" as two or three people have died because there weren't any doctors on duty. In terms of the monitoring process, I'd just like to know why our clinics and our hospitals don't have staff or don't have sufficient materials. What is the position and how are you monitoring it if we don't spend our budgets correctly? Thank you.
Chairperson, I also wish to say to hon members that when they meet specific problems, as I have just said, in terms of monitoring, they have the right to inform us on an individual basis, to phone us - in the same way that there is a hotline in the President's Office - and tell us what they are experiencing.
But I have just said that in recognition of this problem, the department has come up with a 10-point programme of action. If you go through it, it outlines the steps that we are going to be taking to eliminate some of those problems. I am quite aware of the problem of underspending, and of the problem of overspending in some areas in provincial departments. We have sat down with the Auditor-General and gone through that. We have instructed the CFO in the department to call the CFOs of all the provinces to sit down to develop a policy so that such things don't happen again. Such a meeting took place about two weeks ago, and we are waiting for the report of what all the CFOs said. There is overspending on personnel but underspending on service delivery and we are worried about that because that is very abnormal.
Hon Chairperson, thank you very much. My question to the hon Minister is about the participation of the community at the service delivery points of government. What responsibilities are there and also what opportunities are there to make use of the community in the councils of hospitals and clinics so that we can monitor from the community's side service delivery from the hospitals and the clinics? Thank you very much.
Chairperson, they do play a very important part. That's why, in this programme of action, the very same point which we put down, which we are working on, is to provide strategic leadership and create a social compact for better health outcomes. "Social compact" means exactly that: that the department must provide leadership and go to all the stakeholders and have a social compact with them, and find a role for each and every one of them for better health outcomes, because better health outcomes cannot be achieved by the department alone. Thank you.
Measures to enable persons without electricity and/or access to a TV set to watch 2010 World Cup matches
9. Prince M M M Zulu (IFP) asked the Minister of Sport and Recreation:
Whether, in light of the fact that many persons living in the rural areas do not have electricity and/or access to a television set, his department has any measures in place to ensure that these persons also watch various matches on television and experience the excitement and the atmosphere during the 2010 World Cup Tournament; if not, why not; if so, what are the relevant details?