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Parliamentary Overview 12 June 2019….

 

Changing the guard…  

Plenty of note for business has happened legislatively during the parliamentary recess but perhaps none so important as the re-structuring of Cabinet. As a result  there will be a change in the appropriate portfolio committees to reflect any changes and a consequent shift in portfolio responsibility for various Bills held over from the previous Parliament.    In the areas of energy, trade and industry and communications this will be particularly interesting of who gets to be the chairperson in the light of differences emerging within ANC structures.

Parliament will choose its portfolio committee chairpersons for the National Assembly and select committee chairpersons for the National Council of Provinces on 27th June, two days after the State of Nation Address ANC party chairpersons.  These appointments reflect how a government governs on policy and legislation. Through the chairpersons.

Read more..Parliamentary overview 12 June 2019

Posted in Agriculture, cabinet, Cabinet,Presidential, Energy, Fuel,oil,renewables, Health, Home Page Slider, Justice, constitutional, Land,Agriculture, Trade & Industry, Transport0 Comments

Official recognition to come for living wills

Living wills to be recognised by National Health Act

A private member’s Bill has finally been tabled in Parliament amending the National Health Act which, if passed, will bring about more certainty on the legal status of living wills. It will provide health professionals, when presented with a living will representing the wishes of a patient under their care “with the threat of fear of litigation removed” when making decisions to comply with such requests……..   

Read more……Living wills

 

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NHI to focus on better nursing, says DoH

Pilot NHI facilities to get IT systems

amotsoalediAn impassioned plea in Parliament by minister of health, Aaron Motsoaledi, when presenting the strategy and annual performance plan of the department health (DoH), that nursing in South Africa should return to “the old days” was received well across party lines during a meeting of the portfolio committee on health.

He said he did not like the current system whereby nurses were trained at university, gaining all their four coloured bars in one learning process before gaining practical experience in the various disciplines. What is going to happen he said, is to encourage a heightened understanding of patient care with more bedside experience during training, This led to a round of vocal support from all parliamentarians in the newly elected committee.

Practical qualifications

Dr Motsoaledi said that many nurses with four bars on their shoulder-tabs often had less practical nursing experience than some who only had one bar, meaning that less experience in the real basics of proper nursing care was becoming prevalent.

Change was now being instituted whereby each specialist phase in knowledge attainment would be coupled with a period of field training experience to gain a bar in order to return nursing to proper holistic care principles. Nursing training was to be returned to a seven year period to incorporate periods of field experience, rather than the current crash course system of four years.

He said to MPs that it was “very difficult to send a new highly qualified nurse on bedpan duties for her first duty.”   He received a strong endorsement of the new approach from a cross spectrum of all members. He told parliamentarians that five public nursing colleges would be accredited to offer nursing qualifications under a new system in 2014/5.

NHI will meet world standards

heathpatientDr Motsoaledi detailed all eight strategic goals of DoH and referred immediately to the national health scheme, the implementation of which he said was not “if” but “when”. South Africa’s NHI would meet international standards and use internationally accepted regulations, he said, but he did not answer directly a member’s question on a date when the pilot would end.

However, he expanded on the fact that the current NHI project, a project which involves 700 public health facilities, would be the subject of new patient registration systems with IT backup and electronic health care data collection.   The revised administration systems would reduce patient waiting time, he said, and in addition a mobile phone data collection and communication system was to be introduced.

He also said it was the intention of DoH to have a functional national pricing commission in place by 2017 in order to regulate health care in the private sector.   DoH would again revise methodology and also legislate for the determination of pharmaceutical dispensing fees.

Dr Motsoaledi told the committee that an Institute of Regulatory Sciences was to be introduced and regulations for the function of an Office of Health Standards Compliance to prescribe norms and standards brought into being.

He was adamant that nearly 4,000 primary health care facilities with functional committees and district hospital boards would be in place by 2018/9 and said that 75% of all primary health care clinics in the 52 health districts would qualify for the international terminology of “ideal” by the same date.

Standards

This involved a clinic or facility passing a test based on a regimen of some 180 standards, from infection control to waiting room facilities.   He was candid enough to say that a major issue was now to control a leaning by both municipalities and local government to build new infrastructure to meet patient demand and NDP targets, rather than maintain and improve existing services which had exactly the same result.

He also wanted to see standards developed countrywide on building costs per square metre since, he complained, a building going up in one province can vary by 100% from another province.   He said DoH had little power to influence the activities of health MECs and wanted to see a list created of “non negotiable items” so that some DoH control could be exercised over municipal budgets and spend.

Overview

His discussion with parliamentarians and his briefing for new MPs roamed over a wide range of health subjects, from female contraception and cancer screening to child health and on the issue of HIV/AIDS, he focused on the need to encourage breast feeding at the expense of formula feeding.    He complained that breast feeding was as low as 8% nationally and wanted to see more, even amongst HIV positive mothers.  He gave outcome figures to support his view.

Dr Motsoaledi spent some time detailing the moves by DoH to introduce more emphasis on preventative health care and education by going to the root of the problem rather than chasing curative health targets, stating that education towards better diets had to become a part of an SA way of life.

He said that for each person who died in South Africa, eight were in hospital and that preventive health care education starting nationally at school age was the only way in his view to reduce poor health in a substantial manner.    A post of an advisor to the deputy minister of health was to be established on this subject and a White Paper on affordable heath care produced.

HIV/AIDS

red_aids_ribbon_hi-resOn the subject of HIV/AIDS, he repeated the statement which he said he had made on a number of occasions to the effect that children born to HIV positive mothers should, by law, be tested for mother-to-child transfer of the disease.   This should happen if child mortality in South Africa was to be tackled successfully, he added.   He did not discuss the constitutional issues involved.

He said the total number of people remaining on ARVs was targeted by DoH at 5.1m for the end of 2018/9, the current figure for 2014/5 being 3m. He added that some 2.4m were currently on the regimen.    DoH targets for HIV tests among the population aged between 15-19 years are targeted at 10m annually, he advised.

TB

On TB control programmes, Dr Motsoaledi said a 79% treatment would be reached for 2014/5 and this was to be targeted at 85% by 2018/9.   The TB defaulter rate was 6% presently and this was to be reduced to 5% over the same period.    He advised that there were over 400,000 TB cases recorded in correctional service facilities and a focus was now to give inmates the correct kind of increased TB and HIV diagnosis and better treatment services.

He emphasised that DoH had to ensure regular TB prevention, screening and treatment carried out by mines by enforcement of compliance regulations for approximately 600,000 miners and employees of associated industries.    He said that DoH was to “heighten” diagnosis and treatment of TB in peri-mining communities “in six districts with a high concentration of mines using DoH TB and HIV mobile units”.

Dr Motsoaledi continued that life expectancy of South Africans had to be raised by 2030 to 70 years, at present being dragged down by HIV/AIDS and TB into the ‘fifties, after having reached 60% at one point recently.

In general, however, there were more people living as well as more people living longer.   The cure rate in Western Cape and Gauteng had now reached 81% but it was slower in other areas, averaging at 74% for the country.    The national target was an 85% cure rate.

Preventable health care

However, on non-communicable diseases, Dr Motsoaledi said that the rise in hypertension numbers was “explosive” and high blood pressure problems were therefore very much part of the preventative health care plan.    5m people were targeted for counsel and screening for high blood pressure in the next four years and a further 5m for raised glucose levels.

Obesity was also a major problem and this was targeted to be reduced by 55% for women and 21% for men in the next four years. This was currently being started with school programmes. There was also a DoH programme in place reduce injury through, accidents and violence by 50% from the high levels of 2010.

Other articles in this category or as background
//parlyreportsa.co.za//health/health-dept-winning-on-hiv-aids-therapy-and-tb/
//parlyreportsa.co.za//uncategorized/competition-commission-promises-health-care-inquiry/
//parlyreportsa.co.za//uncategorized/state-acknowledges-responsibility-to-increase-health-staff/

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SA to get coastal management underway

Coastal management includes cities and rural areas …

South Africa’s National Coastal Management Programme (NCMP) is now underway with the publication of working proposals by the department of environmental affairs (DEA) which was accompanied by a call for public comment.

The estimated contribution of coastal resources to the South African economy is in the order of some R5bn and coastal zones, the document says, are estimated to provide approximately 35% of the country’s GDP.   The major coastal cities of Cape Town, Port Elizabeth, East London, Durban, and Richards Bay are affected, all four having experienced the fastest economic growth of all cities in the country.

Preservation and good management of the national coastal areas, says DEAT, is therefore essential if South Africa is to continue to provide the roots for economic development, expansion of the tourism industry and the continued provision of recreational needs.   All these factors are created in areas with a very delicate balance of biodiversity, says DEAT.

Economic reasons

Maintaining this balance into future generations is seen by DEAT as one of its major challenges, not only for environmental reasons but for economic reasons as well. A further important objective of the NCMP is to maintain the coastal environment to the benefit of threatened poorer communities and to protect their livelihoods.
DEAT says in its forward to the NCMP that South Africa has chosen to embrace a holistic approach, known as integrated coastal management (ICM), which sets out objectives, management procedures and contains the kind of definitions, norms and standards that enable a basic environmental regulatory process to happen.

The purpose of the anchor ICM Act is to maximize on the eco-benefits provided by coastal zones and to minimize the conflicts and harmful effects of human activities upon each other, both in terms of resources that could be lost and any surrounding environmental damage.

Pointers only

The NCMP, DEAT says, is a working document to assist in implementing ICM objectives and lays out in its 106 pages a deliberate programme of national management actions. It is not regulatory but a working guide.

First, it contains a detailed situation analysis related to coastal management in South Africa across the full spectrum of zones within the country’s 3,000 kms of coastline. Then the document looks at the current threats to ecosystems followed by a study of existing localised and national environmental management programmes.

In providing a “national vision”, the NCMP provides a structured approach to engage with the stakeholders, DEAT says, and “a template for future cooperative governance”.   It also suggests ways to integrate ICM programmes with localised government, the NCMP therefore expanding with practical programmes based on the ICM Act.

However, DEAT makes it clear in a disclaimer that what is published is neither an amending Bill nor a legal or regulatory process but a guide to programmes which are seen by DEAT as the route to take and which can be necessary in the common interest.

Complimentary to NEMA

To emphasise the co-operative nature of what is put forward, DEAT says in the frontispiece to the NCMP, “This document does not in any way have legal authority or take precedence over the National Environmental Management: Integrated Coastal Management Act but rather serves as a guideline to the development of coastal management programmes, expanding on the provisions of the Act”.

Public input on this plan is therefore called for by DEAT. Comment can be made until the end of June.

Concurrently, DEAT has also published its White Paper on National Management of the Ocean, the acronym for which is appropriately NEMO.

This, DEAT says, aims to promote the protection and conservation of South Africa’s ocean environment, as well as promoting sustainable development for present and future generations. It refers in its pages to the extent of South Africa’s ocean environment and deals with issues concerning protection and conservation of the ocean environment and resources of the sea.

The White Paper says the department’s approach to the subject will promote and expand sustainable development and optimise investment in managing the large ocean space which is accessible to the country.
Other articles in this category or as background
//parlyreportsa.co.za//energy/fueloilrenewables/coastal-management-bill-stirs-waters/
//parlyreportsa.co.za//health/coastal-environment-proposals-getting-clearer/

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