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5 May 2008

Questions

Chairperson: Thank you very much, Minister. Now the floor is open for questions. We'll take questions. Please indicate which media house you are from and who you're directing the question, to which department. The panel is all yours. First and then you're noted.

Journalist: Minister I don't know whether it falls within the portfolio of this cluster, but with regard to the food security and the plan to assist the poor with rising food prices, what is the… how far is that programme? What can we expect in terms of a strategy document or what thinking of government is? Thank you.

Chairperson: Let's take them one by one.

Minister Manto Tshabalala-Msimang: I can see the two Directors-General this side are nudging. They are itching to answer that question. They say they specifically came for that particular question, they anticipated it.

Vusimuzi Madonsela, Director-General (DG) Social Development: Thank you. With regard to the food security and the food parcels, as you know very well that for the previous years the Department of Social Development distributed food parcels, what we've recommended to Cabinet is reconsider because of the challenges which were encountered, but look into other mechanisms which can be really, you know, targeted to the vulnerable, which is either (unclear) transfers or vouchers.

Journalist: This is for the Department of Agriculture. Now the Health Ministry has been leading the pack in sort of market intervention for… to sort of cap high prices and the effect on the poor. Is this something that the Department of Agriculture is considering? I mean, would you be making sort of submissions to the retailers, to move beyond just an appeal sort of thing, to say listen here we do not want you to go beyond X, Y. Are you considering that?

Chairperson: Okay, Linda has got another follow-up.

Journalists: Yes, thank you. Is there money for a food security program and what do you anticipate it will cost, and is it going to be focused on either food parcels or food vouchers? If you could just clarify that, thanks.

Chairperson: Director General

Vusimuzi Madonsela, DG Social Development: Thank you. We're looking at a range of options. As my colleague has already pointed out in the past we have ventured into food parcel distribution to poor households that are negatively affected by food insecurity. That program was riddled with a number of challenges. At this point in time we're looking at an option that would present us with fewer problems. You would be aware of the fact that we've used… we've in-sourced the services of companies to procure food and distribute, and in several provinces we've had difficulties with tender battles in courts which have delayed the delivery of food to the people that need it on an urgent basis. So we are looking to find a solution that would enable us to meet our obligation to the poor with any… with minimal kind of disruption.

So we are looking at options such as food vouchers, to look at whether in fact that could be distributed speedily without as many hassles as we've had with food parcels. The other option of course is to look at increasing cash transfers that would only be able to reach people who are already on your social assistance programme. But there would be poor people who fall outside it, who need assistance. So that is part of what we're looking to fund.
It may well be that in the end it will be a combination of increased cash transfers for those who are on that program, together with food parcels for those who… sorry, food vouchers for those who are not on your cash transfer programs. But we are moving speedily towards refining exactly what the strategy is going to be, we appreciate the urgency of the matter and the impact that the… you know, the spiralling food prices has on the poor, so we're moving speedily with that, and we will be going back to Cabinet with detailed analysis that we've been asked to do on it, and in… we won't wait for another press briefing of this nature to give you details but we will communicate to the nation on what strategy we're going to employ going forward. Thank you.

Chairperson: Okay.

Dr Tozi Gwanya, DG for Land Affairs: Okay, perhaps maybe I need to clarify that this is not just an initiative of agriculture, it's an inter-ministerial committee consisting about eight departments, and all the programs which are existing currently in various department are currently being reviewed and strengthened to ensure that we really reach the vulnerable. I think my colleague here mentioned some of the difficulties encountered with the food parcels, but with regard to what we intend doing, yes, we are not only looking it as to what government can do, we're also looking into mechanisms which we can engage the sector in partnership to look into other programs which can be introduced and strengthened. Thank you.

Journalist: Could you elaborate? My question was very specific, the Department of Health has for example made a proposal, it is moving towards legislation looking at capping high medicine prices as an example. Are you guys looking at it to… engaging in the sector in such a way that it would cap high food prices for your essential foods?

Dr Tozi Gwanya, DG for Land Affairs Yes, it covers a whole range of initiatives short term which will impact directly on household food security, and the long term kind of ventures which focuses precisely on production. And I would like to emphasise that because when you look into the agriculture sector as a whole you realise that, you know, investment in agriculture has been declining over years, and even some of the farmers moving away from the farming and going out of farming for various reasons.

Now some of the things which we have recommended regarding the long term measures to just touch on those cuts across issues along the reconsidering zero rating on some of the basic foods which are there. Particularly those who have not been zero rated. We are not only looking into the starch because sometimes when we talk about shortage of food we normally focus on maize, and this will go along together with the campaign of the Department of Health with regard to healthy lifestyles, because in South Africa basically when we talk about a shortage of food we only look at maize. We don't look into broadening some of the starch base which is there, and this will go hand in hand with the promotion of indigenous food and also coming and promoting technology development on some of the basic foodstuffs which are starch based liker amadumbe which is well grown in KwaZulu-Natal. So we'll be focusing on those broad ranges.

Minister Manto Tshabalala-Msimang: I'd just like to add to what the DG has said, and I'm grateful you've mentioned amadumbe. Because to my pleasure, greatest pleasure in KwaZulu-Natal they cook amadumbe in garlic and it's quite tasty, and of course they put a little bit of beetroot on the side as well. So that makes it a real delicious meal. But you ask specifically whether we are considering legislation or regulation like the Department of Health has done with regards to the retailers. If you draw that parallel I think you should also learn lessons from the Department of Health. We didn't just straight away go for legislation and regulation.

We really appealed to the conscience of the citizens of this country. Equally so, even with the tobacco control bill. People used to say it won't work, you don't have enough police, but I think the citizens of this country have proven to us that they do have a conscience, where of course it fails like we you know, it took us a long time before we met with the pharmaceutical companies and the private sector, the hospitals, and then we engaged with them. It came from them when they said look we have tried, we have failed, please assist us. And I think that's the way to follow, because then you give space to people to also [unclear their own consciences and say what we do. Yesterday I was watching on television somebody in Thailand whose selling rice, I'm sure you saw it, rice and rice [unclear].

And he was saying I am not going to increase the price of rice in this country. Even though the price of rice is increasing, my conscience says to me I can afford and still make a little bit of profit. And I think primarily that is the approach one would look for but of course if everything else fails then we should begin to prepare legislation of some sort. But if you can see even in the whole world, I don't think everybody's jumped to legislation and regulation, I think everybody is trying everything else possible so that we can address this crisis that is facing the world at the present moment. And as you've heard from the Director General Agriculture, we have put in place quite an elaborate program, the DG of Social Development also has elaborated further on some of the measures that were put before Cabinet last week to indicate what the thinking of the inter-ministerial committee is in this regard. Thank you.

Chairperson: Thank you, Minister.

Journalist: Before I go on, can I ask more than one question or should I ask them one at a time?

Chairperson: One question per person.

Journalist: I see that with the Tobacco Control Act there are stricter measures to… in terms of making life difficult for smokers or… I just wanted to find out as you've seen in the recent past with youth formations particularly the ANC Youth coming out strongly against the use of alcohol and the abuse thereof. If we can expect the same moves from the department, thanks.

Chairperson: Minister?

Dr Tozi Gwanya, DG for Land Affairs: If you persuade us to do that we'll do it. I think in the interests of the lives of the… particularly the youth in this country, it might be the correct way to go. But having said so I am sure you will recall that the first step that we've taken as the Department of Health is first of all to label the bottles that contain alcohol, and we think this should come into effect by the beginning of 2009. Because we are giving the industry 18 months so that they could change the labelling and put the warnings about the dangers of alcohol so that is in the pipeline. But as I said obviously you do take things step by step, because I think it is important for the consumer also to understand why certain measures are being taken. It is in the interests of the health of the citizens of this country that if everything else fails and try to persuade then for Christ's sake let us have regulations and legislation in place.

Chairperson: Thank you, Minister. Sue, Deon, you're noted.

Journalist: The photograph incident in the bin, Dr. Mark Blaylock says he threw the photograph of Peggy Nkonyeni in the bin because she said rural doctors are only interested in politics and not caring about people. Do you feel the incident at the Manguzi Hospital over the photograph in the bin justified Dr. Blaylock's suspension? Is there anything that your department is doing to improve the morale of rural doctors?

Thami Mseleku, DG for Health: Thank you. First of all, any disciplinary process that takes place in an employment context is very difficult to actually comment on because you haven't seen actually what the charge is, you know the media can easily isolate that incident of the bin, but there are many other incidents. So let's allow for the processes that are actually taking place in terms of disciplinary measures to actually unfold and we feel that it's important for any organisation to have some form of discipline, and I'm sure the Natal Witness has the same form of discipline and would actually discipline its members if they actually didn't go according to the code of discipline of that organisation, so let's allow for that and if the doctor is innocent then he'll be found innocent. Let's not prejudge the issue, that's the first thing that we would want to say, but when it comes to the general morale of doctors, first of all I don't believe that we should generalise and say there is something wrong about the morale of rural doctors, in fact the morale of those doctors is very, very high and in many instances working under very difficult conditions. So I don't think we should be saying what you are doing to boost the morale of rural doctors. We should be saying what we are doing in actual fact to ensure that these health professionals that are so committed are supported and they've our support. And we're doing all sorts of measures.

We can start from the measures of improving the conditions, including their living conditions, including their salary conditions, to ensuring that we give them more support in terms of staff, in terms of other doctors and recruitment processes that we are taking… that we are undertaking in the country. So there's a whole range of things that we are doing to support our health professionals, and we'd hope that rather than us saying the morale of doctors is low and generalise about it we should be saying what are we doing to support these doctors that are actually committing themselves in those rural areas. But it doesn't mean that if they are if an individual is alleged to have actually done something wrong they shouldn't be disciplined simply because they are rural doctors. Thank you very much.

Chairperson: Thanks.

Minister Manto Tshabalala-Msimang: Can I just add one more thing. And I think we must be very frank with each other here. I think it is absolutely incorrect to take an MEC's photograph and throw it into a dustbin. I think in other countries you'd have a terminology for that, but I dare not mention it here right now, but you would have a terminology for that kind of act. It's not correct. Because in these countries there are lots and lots of channels, forums, meetings where you can articulate you know, unhindered, whatever your dissatisfaction are, whatever your concerns are, it's possible to do that. Even to phone the MEC herself. But to pick up a picture of a political elected person and throw it into a dustbin, I don't think that is correct. It smells anarchy, thank you.

Chairperson: Thanks, Minister.

Journalist: Just so that the Department of Housing doesn't feel too left out, could we have a… I notice that the report or your statement here today doesn't mention anything about the investigation into the abuse of the housing subsidy scheme. If you can perhaps give us an update of where we stand with that, specifically if a decision is being taken about a general amnesty. I know that that has been discussed for a while, can you tell us if a decision has been taken about that. If I can just slip in another one, this voucher system for building materials in the rural areas, if you can give us a bit more detail on that, what does that involve? Thank you.

Itumeleng Kotsoane, DG for Housing: Thank you very much, Deon. Well, there are two questions that you raised, the first one relates to the investigations. You'll recall that last year the President signed a proclamation allowing SIU to work with the department to investigate those cases where subsidy amount or subsidy money was you know abused or disappear or whatever in all of our provinces. We have received a report a week or so ago from Special Investigation Unit (SIU) in terms of work that has been done.

There have been several cases that have been opened in provinces across the country, obviously there are instances where you know people particularly public servants who did not qualify at the time, they got those houses, some have subsequently paid back the money. So there is some progress and I think in a very… in a week or so we'll be able to give a comprehensive report as to… or release a statement as to what is it that has been achieved, and obviously the challenges that are still needs to be attended.

General amnesty matter hasn't been resolved or concluded. We are waiting for the MinMec to consider the matter and I think they will do so in June this year. There were many challenges that arose which are part of this and of course I can't… I won't bore you with those, but there are certain considerations that we were raised, but the decision still has to be taken by the MinMec in June. The voucher system for rural areas, you know currently we do have one of the housing departments company's, state company, which is providing loan to rural people in rural areas, and they are doing very well. They submitted a report to the MinMec recently where they asked that this be extended. You know they can only provide a loan of up to 1 200 for instance. So they asked that it be extended to include purchasing of materials, not only giving money to potential beneficiaries but purchasing of materials a team has been established to work together with this company to look at the possibilities of doing that, so a voucher comes in the sense that the money for that, you know, for the material will come directly from the housing subsidy, part of it, and part of it of course were repaid by the beneficiaries. So, again as we are saying in the statement we are busy investigating, obviously we hope to implement this project this year, as soon as, you know, our investigations are concluded.

Journalist: This is a question for the minister please. The Sunday Independent carried a front page story yesterday citing a Development Bank report which found that 7,6 million South Africans are infected with HIV. That figure is 40% higher than government's own figures, and if correct has quite serious implications I would imagine for planning the country's response to the epidemic. Do you think the figures are correct?

Minister Manto Tshabalala-Msimang: You know this country has a serious problem with regards to statistics, I'll cite a few examples. There was a countdown 2015 conference held here in Cape Town and we were given figures particularly about South Africa. I've just come back from Ouagadougou, Burkina Faso. Where we listened to a presentation and of course I was all ears to say, oh, I wonder what they are going to say about South Africa today. Figures were completely different. Absolutely different.

In fact we didn't feature this time, and so you see the figures as indeed as presented in the Sunday Independent do seem to be significantly different but as I say I'm locating it within the context and I'm not trying to deny anything, just within the context of how South Africa is operating. You see even with regards to the babies' deaths in Ukhahlamba you got this figure, you got another figure, and you are sitting in Pretoria, by the way. You get 25, you get 80, you get 15 and so you say what is the real figure here? And so what do I do? I then send the committee that I just established to go and find facts for me, and bring them of course I'm still waiting for the final report but I now have a draft report.

So I think really there needs to be some engagement amongst researchers to guide us on this and ensure peer review of the outcomes. You will recall also even about the clinical trials, there's been serious engagement lately because the different results that are coming out conflicting each other, and so we need really to sit down and as South Africans and map a way forward for ourselves. And so I would think it's going to be very important for an engagement amongst researchers so that they can guide us on this matter. But of course we will continue as the Department of Health to do all those things that are in the comprehensive plan, to do all those things that we started during this one way develop the strategic plan, which amongst others is ABC, you know, management of opportunistic infections, the research that is required, and all those things. We won't be stopped just because there are new figures that are coming now. I think we must continue to do those things that we've always wanted to do, in the meantime have the researchers sit together and really guide us on these matters, if I may.

Journalist: Quickly follow-up. With that particular point in mind, I take your point that you need guidance from the research community as to the voracity of these figures. Is the Health Department going to meet with the Development Bank or engage with their staff to try and get to the bottom of the discrepancy?

Minister Manto Tshabalala-Msimang: That is in the culture of the Department of Health.

Journalist: Also for the Minister of Health or the DG, could you just give us an update please on the progress in the roll-out of dual therapy for the prevention of mother to child transmission? Have all provinces now started with the roll-out and have you encountered any particular problems or is everything going smoothly?

Minister Manto Tshabalala-Msimang: Before I allow the DG to tell you about the progress, I always want to remind ourselves so that we don't forget these things; we locate them and contextualise them. When we as this department and government ask questions about mono therapy it was this collective that was up in arms. Mono therapy is the best. Go ahead, do it, do it, do it. And so we did it. We had to have some time to prepare to do it under very difficult circumstances we did. Roll it out, roll it out. You're very slow absolutely slow. So I will now give over to the DG to tell you about the dual therapy, but I thought it was important for me to remind yourselves that even as you ask these questions you remember what the role of the media was, when in fact we were querying the use of mono therapy as a country. But the media with some other people outside of this collective were absolutely toy-toying up and down the streets of South Africa, push, push, push, Uganda is right, Uganda is right.

Not soon thereafter it came up that the data that was in Uganda was not quite correct. So we were correct and because it did [unclear] that the data was not correct we were then being asked to go and evaluate the data. I said over the dead body of this country we will not go and evaluate the data of another country. Those who trusted that country that it produced the correct result it was their business to mobilise resources to go and dig through all the data that was available. I just thought I must locate this and remind ourselves how sometimes we behave. We don't want to sit back and reflect, I give you over to the DG.

Thami Mseleku, DG for Health: Ja, why can't I [unclear]. The process of implementation as we said in our statement was actually… according to various phases. For example, there was the issue… there is the issue of accreditation of sides, of specific sides, because it's not automatic that the sides that had been previously operating would actually be accredited for this much more complex matter. And that related to ensuring that there are trained health personnel, a doctor or a trained nurse that would actually be able to administer dual therapy under those circumstances. And so provinces that actually had started on the training of health personnel such as Gauteng, for example, and KwaZulu-Natal, parts of KwaZulu-Natal actually would have started with the program.

The other provinces are still finalising the training of the health personnel. This is in general. Of course there are specific sides that would actually have been accredited already in those provinces. So what one can say is this is not a matter of saying all provinces are implementing this because it's not like a boom, once-off situation, you're talking about like the other implementation of the comprehensive plan and its accreditation processes, depending on the pace at which the sides are able to meet the criteria that is actually set. So some provinces are much more advanced than others depending on the availability of the resources that are necessary. But all of them have started somewhere. Others are in training processes, others have accredited a few sides, and others have accredited more sides than others. So that's the situation with regard to implementation of that.

Minister Manto Tshabalala-Msimang: Sorry, just so that there's no misunderstanding also. It doesn't mean that because we updated the Prevention of mother to child transmission (PMTC) programme we therefore stopped using mono therapy, after all the country had demanded the use of mono therapy. So if those sites are not accredited, mono therapy as per the decision and the demands of this country, mono therapy will continue to be given, so that nobody thinks (unclear) any women were excluded.

Chairperson: It looks like we've run out of the last bit of questions.

Journalist: Can I just have a follow-up to that, sorry. My understanding when I read the roll-out plan from KwaZulu-Natal was they were saying because of the shortage of positions in the province they were also looking at training non-positions in providing the dual therapy, and if I remember the Health Minister from the previous briefing you were actually quite against non-physicians doing this, so where do we stand on that?

Thami Mseleku, DG for Health: I think if you go back to that presentation you will find… you will find that what was said was that we are talking about trained health personnel in accordance with the legislation of this country. And that legislation, for example the Nursing Act, which actually was the specific thing that would enable other people other than non-physicians to be able to administer dual therapy, it actually explains very, very seriously that nurses under certain circumstances can administer schedule four medicines, but those will have to have… to undergo thorough training and be thoroughly monitored by physicians from time to time, so that's what KwaZulu-Natal is talking about.

They're actually not deviating from the legal position as it were, and I don't… I think the minister in speaking about it was emphasising that we'll face in actually putting dual therapy into operation because of the schedule four natures and in particular the side effects of the medicines involved, AZT in particular, with its anaemic implications. And therefore the emphasis was on ensuring that if there are non-physicians that are involved it must be done (unclear) and strictly in accordance with the law, because then you are able to make certain defences if there is a comeback. Because remember people will always claim against the state for whatever negligence or whatever impact a certain programme is actually having on them. So you can't just negligently be saying anybody who is a non-physician simply because you have a number, you have a demand situation. It must be in accordance with the law and the law is very clear about the training required. And that's what KwaZulu-Natal I think is talking about.

Chairperson: Okay, is that a follow-up? Or is this new question? Okay, I take Donald and then come to you.

Journalist: Minister and DGs, going back to the question of food support, do we have an idea of the budget, I think that question wasn't answered, the budget available for food vouchers, and how many people have you got figures, the number of people who fall outside of the security blanket at the moment who would need this sort of aid?

Minister Manto Tshabalala-Msimang: Can I start perhaps so that you can hear a different voice on the matter. I think we should understand first of all that if you remember the Cabinet statement of 16 April which is about two weeks ago, Cabinet said we are concerned about this situation of rising food prices in the country and we have asked an inter-ministerial committee to work on the matter. And the inter-ministerial committee worked on the matter immediately and reported to Cabinet on the 30 April, about the various measures that would need to be taken, and that was a preliminary report to say we are looking at these options, and Cabinet said okay now delve deeply into them in order to actually work out what the implications are. So there's not yet a very specific budget that says we're now going to actually use this budget to do ABC.

Because now we are actually zooming into the issues that are actually identified and agreed upon as possible ways of intervening, and therefore there's not yet a particular budget that has been set aside. As the DG said earlier on, when we go back to Cabinet we'll be able to say on the issue of zero rating this will be the implications for zero rating the following food substance and this is the budget implications, and then Cabinet will take those decisions. Now with regard to the issue of the numbers that we're talking about, I think again we must remind colleagues that the government had started a program already of looking at how we can implement our anti-poverty strategy while focusing broadly on anti-poverty in general, but also begin the process of identifying households that are actually the most vulnerable.

And that process is part of the project that we are undertaking. So that we do not have at the moment a comprehensive number of people who fall outside the safety nets that are there in South Africa. But even those that fall within those safety nets, whether they are adequate enough for them to actually be supported etcetera we're still working on those figures and so we wouldn't be able to say this will impact on so many households in the country, it would impact differently on different people depending on the measures that are being taken. For example, if you take the measure to adjust the cash transfers in order to actually meet that gap, we can give you figures for that particular impact, we can be able to say if you adjust the child support grant there are so many people that are in the child support grant and this is how it's going to impact.

But the different measures will impact on different numbers of people. If you take the school nutrition program it actually impacts on more than four million children at the moment, and so if you adjust that like extend it for example to your early childhood development centres then you'll be able again to give a figure. So there will be different figures for different schemes that we are actually going to be undertaking. Thank you.

Journalist: Given the increase in prices already, 20, 25%, this government having to adjust existing programs, increase the budgetary allocations for existing programs in order to accommodate the rising food prices, and what's that going to cost, have you got any figure on that perhaps?

Unidentified Speaker: I thought as I said, if I give an example, one of the measures that was being looked at was whether it was necessary for us to look at adjusting as we did last time, some of the social assistance programs such as the cash transfers that we have, child support grants, pensions etcetera. Now that's one of the considerations. What we are doing now is to do the actual counting so that we can be able to say if you do that it will impact on so many people and this will be what it will cost. That's the next stage of the work that we are doing.

First we had to actually reflect on what measures can be taken, short term, medium term to long term. And then outlined those at the Cabinet of the 30th, and Cabinet selected some of those and said these, can you actually work faster and in more detail on, and part of that is to look at exi9sting programs to see whether we need actually to adjust them, what impact it will have, and then look at some new programs, and I've outlined some of them. For example, if we further zero rate some other footsteps, other than the ones that are 15 or 17 items that are already zero rated in this country, and in fact one of the questions that arises is we've got those zero rated, who's benefiting? And we need to do a little bit of analysis as to whether for example brown bread is actually cheaper than white bread, or it's still the same thing. Because brown bread is actually zero rated in the country. So you have that kind of work that we're still going to do in the next week or so.

Journalist: Saying it's like… like say for example the school nutrition program you've allocated 300 million. Now that will… given rising food prices that 300 million is not going to buy you a same amount of product, so you're going to have to actually maybe increase is that what you're talking about? Okay.

Chairperson: Okay, thanks. Next time we need to be recognised, okay? Can I just indicate that the promotion of national identity and social cohesion, if you have any questions we've been joined by the Director General of Arts and Culture as well who's sitting in the audience. So if there are any other questions please let's do that.

Journalist: My question is directed to the Health Minister. Minister, just two issues. The situation in the Eastern Cape with the babies that died there, apparently from infected water, could you just elaborate a little more on what the national department is doing to intervene there, and just on the issue of TB, these tracer teams, it's all very well to have these tracer teams to track down extremely-drug resistant (XDR) and multi-drug-resistant (MDR) patients, but we're seeing… have you noticed an increase in your department having to go to the courts or having to use more stringent action to force people back into treatment?

Minister Manto Tshabalala-Msimang: About being forceful I will ask the DG, I'm sure as you can see he's able to use the force. I'm very (unclear) to use any force. So he will answer about the stringent measures. DG, if you'll do that for me please. Now with regards to the babies in the Eastern Cape, the first report I got… in fact I was in Lusaka attending a meeting of the SADC ministers of health. Of course we considered this as a very serious matter but as I say there were different figures, some figures were saying 25, 80, 85, 20, and then at that moment it sounded like it had just happened right there, at that particular point in time.

And so we thought it was actually a very serious matter. We then immediately sent a team from the Department of Health to go and find out what was happening. They gave me the initial report and soon thereafter, after reading the report, we then decided to send the newly created ministerial committee on the under five mortality to also go and investigate, and as I said they've given me an initial report but I'm sure by tomorrow I should be getting the final report from them, we've been talking to each other over the weekend. But you see, when it comes to deaths of this nature, of course we have to locate it within an understanding of the primary healthcare approach of this country. And if you look at the primary healthcare approach you cannot but also focus on the social determinants of health. Which are not the core businesses of the Department of Health? You know, for example nutrition, food security, yes, we participate. Water supply, quality, yes we participate, we have our own team also that does analysis from the Department of Health, they did a bit of an analysis of the quality of water there. Yes, there are issues of sanitation, our role there will be public awareness.

Wash your hands after before you touch your food, after you've been to the toilet, if you've been outside, you've been shaking too many hands, please wash your hands. You know gender relations. It's all these matters which are really not the core business of the department of… of the Department of Health. And so we participate with everybody else to ensure that we try and address these matters, and in this regard we agree I think two weeks back, DG that we are going to have a meeting with South African Local Government Association (SALGA).

Because it did seem over and above everything else that perhaps we need to zero in on these other social determinants of health which are really as I say not the core business of the Department of Health. But on our side we've taken some action to strengthen surveillance for example, increase public awareness, and ensure the readiness of the health facilities to deal with higher numbers of cases of diarrhoea during diarrhoeal season, and you must remember that really the diarrhoeal season is around November to March, but the peak season is around February. So we don't want the same thing to happen next year. So we are doing rigorous health promotion campaigns focusing on water purification, hygiene practises, and as I say we are going to have a meeting with SALGA where we will work out an extensive programme.

Because as you recall it's not just the Eastern Cape who had the same outbreak of diarrhoea. Delmas region, in Standerton, but as I say some of the issues are really not if I may the core business of the Department of Health, but we cannot abdicate that responsibility ourselves because we work as a team. If something doesn't work properly in one sector as a social sector we always consult and say what we do collectively in order to improve whatever circumstances that might court that particular condition. And so the stringent measures, the DG.

Thami Mseleku, DG for Health: The answer is no. We haven't seen any increase in the number of cases that we have to take to court in order to get people into treatment. In fact, it's only limited to certain areas and certain hospitals. In other hospitals we are seeing a lot of cooperation especially with our tracer teams being involved because they're also finding other alternative ways of dealing with the matter. But of course there are hotspots for the kind of action that we need to take to keep people in hospitals. The answer is no.

Chairperson: Okay, I'm going to recognise last two hands. One and you'll have the last word.

Journalist: My question is for the Department of Housing and regards specifically the recent intervention, the team sent to the Eastern Cape because of a drop in the number of housing delivery. What has the department found to be the cause, the structural failure in housing delivery in the Eastern Cape, and what is the delegated team meant to do over the next 12 months before the national department takes over? Thanks.

Itumeleng Kotsoane, DG for Housing: Well, there're a number of factors that impacts negatively to the delivery of housing in the Eastern Cape. But you know in the recent past in the last financial year we realised that to transport materials in the Eastern Cape in particular is more expensive than [unclear] for instance in the Free State or in Gauteng. Now the Eastern Cape does not attract skilled, well organised contractors to help with the delivery of housing, precisely because of the cost factor. And secondly, the prices there are much higher not only of transporting of materials but for house… to build houses. They are much higher than anywhere, I mean, than some parts of the country. Again you know that also affect negatively the delivery of housing in that province. So, obviously some of the challenges there were structural issues really. The Department of Housing in the Eastern Cape they are busy recruiting you know staff, because they've had some difficulties with personnel particularly inspectors. So our team is intending to work with the department to identify major projects and of course to interact with the, you know, other developers, established developers, who are willing to come in and work with the local contractors and in big projects, not small projects of 150 houses here, 20 houses there, because surely they don't make sense, you know, to developers. But we're trying to package sizeable projects which will attract you know established contractors to come into the province. Obviously we are also having discussions with the material suppliers; trying to see whether you know can't we come into a particular agreement in terms of the costs, because surely they are quite exorbitant in that part of the country. We hope to work with the province for the next 12 months after which we think that the province will be able at that time to take forward the housing delivery programme on their own. Thank you.

Journalist: Minister, there've been a lot of reports about the flight of doctors and nurses more exacerbated in the recent months apparently, I don't know whether this is something that the department has renewed its attention to, what the shortfall of doctors and nurses in the country are, and what kind of programs you've launched to retain and attract staff.

Journalist: I'm looking puzzled by the flight of doctors and nurses.

Minister Manto Tshabalala-Msimang: You can see I'm very puzzled too, you know this exacerbated… this exacerbation. I don't know, I don't have that exacerbation reported to me. Maybe DG you can respond.

Thami Mseleku: No, no, why I'm looking puzzled, first let me start with the nurses. In fact I would have thought that after the introduction of you're… of our occupation specific dispensation you would say we are seeing more nurses coming back into the country and into the profession. We are seeing actually the effects of that on for example hospitals, because more nurses are moving from hospitals to primary healthcare and those are the issues that we are examining. We are not examining issues of shortage now. Of course we still need more nurses.

But we're also looking at issues of deployment of these nurses that are coming and are willing to come. Some of them are actually now we're here, but we're seeing our response time in the provinces for… to actually absorb them is actually not up to scratch. So we're not seeing a situation where people are leaving, but we are seeing them coming. Even with doctors, there's nothing that has actually suggested that there's a sudden upsurge, in fact we wouldn't see it that way. So maybe you have facts that we are not aware of. But our facts tell us that with our nurses we're getting more nurses coming back from wherever they were, and in fact we are urging our provinces to be much more responsive because the numbers are really growing, even from the private sector for that matter. We're seeing more nurses, actually even stopping these practises that they used to have of moonlighting because they now are finding their fit in the system, and we're going to pursue those measures and other measures that are related to that. So I'm not sure about the's why we look puzzled.

Chairperson: Thanks DG, on that positive note of health professionals returning into the profession. Thank you very much Minister and the DGs. We'll see you tomorrow with the governance and administration cluster briefing at one. Thanks.

Issued by: Government Communications (GCIS)
5 May 2008