COMMITTEE ROOM M46, MARKS BUILDING CAPE TOWN RESPONSE TO FINDINGS AND RECOMMENDATIONS BY THE PORTFOLIO COMMITTEE DURING ITS OVERSIGHT VISIT : JUNE 2015 17 AUGUST 2016 COMMITTEE ROOM M46, MARKS BUILDING CAPE TOWN

In June 2015, the committee visited the following facilities in the Free State: - Ikgomotseng Clinic in Soutpan, Lejweleputswa District. Medical Depot and Pelonomi Hospital.

Progress on Findings & Recommendations Ikgomotseng Clinic, Soutpan Recommendations Progress Priorities the issue of infrastructure and staff shortages Recently the clinic was painted, ceiling repaired, security doors and shelves installed in the pharmacy. The water tank is to be replaced and connected to the clinic, roof is being sealed, fence replaced and front area paved. Office furniture was procured for the clinic; 6 L shaped desks,10 four drawer filling cabinets,1 set patient aluminium chairs, 9 dust bins, four cupboards, still to be delivered is 6 personnel chairs, 2 visitors chairs, patient chairs, canteen chairs and tables for the kitchen. This clinic has been prioritised for infrastructure improvement through massification program for scheduled maintenance and upgrade within the MTEF period.

Progress on Findings & Recommendations Ikgomotseng Clinic, Soutpan Recommendations Progress Priorities the issue of infrastructure and staff shortages According to WISN the clinic only requires one professional nurse which the district has not been able to fill due to financial constraints and projection of over expenditure. The post is prioritised in the district critical list of posts to be filled within this financial year. Ikgomotseng Clinic, Soutpan Recommendations Progress Referred patients have to wait outside the facility in the early hours of the morning to be transported. Improve ambulance response time The pick up point and time for EMS was reviewed to 07:00 at the clinic. No patients are expected to queue from 04:00 EMS satellite station will be operational from the 01 September 2016. The clinic is too small and congested EMS moved out of the park home to create additional space for consulting rooms.

Progress on Findings & Recommendations Ikgomotseng Clinic, Soutpan Recommendations Progress Address the challenges of payment and training of community health workers, this will ensure that they render effective services The payment for community care givers was resolved, payment is done consistently through NGO; Life Line Free State. The care givers are paid monthly stipend of R1850. The care givers will be considered for community health worker phase 1 training in the last quarter of this financial. That the community is made aware of the MomConnect and registration of expectant mothers. As at end of June 2016, Masilonyana sub district which includes Ikgomotseng clinic has registered on mom connect 1097 out of the 1344 (81.6%) targeted pregnant women. Urgently address the boarder administrative failures in the Lejweleputswa District The district management team was stabilized by appointment of an acting district manager, Mr Nkala who is supported by other managers.

Progress on Findings & Recommendations Medical Depot Recommendations Progress Address staff shortages at the Medical Depot 23 posts to the tune of R7 674 350 were prioritised for filling through headhunting, internal and external recruitment process in this financial year. The following posts will be filled: 5 Pharmacists, 4 pharmacy assistants, 5 SCM clerks, 2 HR practitioners, 2 cleaners, 3 security officers and 1 SCM practitioner.

Progress on Findings & Recommendations Medical Depot Recommendations Progress Address system bottlenecks hindering procurement and supply of medicine Inventory Management system The system in use, MEDSAS, is an old system which does not allow batch tracking. However the Pharmacist Assistants in the warehouse are responsible for ensuring stock rotation in terms of First Expiry First Out principle. National Department of Health is currently investigating a uniform system that will be used by all provinces. Review of Levy charged For 2016/17 financial year the Capital Augmentation has been revised from R2m to R40m in order to aid with the operational costs of the Trading Account, however the levy charged has not been revised.

Progress on Findings & Recommendations Medical Depot Recommendations Progress Address system bottlenecks hindering procurement and supply of medicine Funding Model of the Trading Account The task team comprising of members of both the Department and Treasury were assigned to investigate a sustainable funding model for the Trading Account, benchmarking was done in Western Cape Province and the draft report is available. The report recommends that the medical depot should be incorporated into the department as a directorate pharmaceutical services

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