1. PRESENTATION: PORTFOLIO COMMITTEES ON CORRECTIONAL SERVICES AND HEALTH PROVISION OF HEALTH CARE WITHIN CORRECTIONAL CENTRES 1

2. CONTENT 1.Introduction 2.Background 3.Discussion 4.Areas of assistance 5.Way forward 6.Conclusion 2

3. INTRODUCTION The Department of Correctional Services (DCS) has been faced with numerous challenges in the provision of health care services to the inmates and several meetings have been held with the Department of Health (DoH) at various levels and National Treasury to try and resolve this issues. Several presentations were made to the different Parliamentary structures in the past years and the challenges remain the same. 3

4. BACKGROUND During the last presentation on the health care delivery in DCS to the Portfolio Committee on Correctional Services the following summary of major challenges were highlighted:  Legislation impact on DCS;  The delivery of programmes and services;  Health human resources;  Infrastructure;  Target population;  Health information system;  Transport. 4

5. BACKGROUND Subsequent to the presentation, the Portfolio Committee on Correctional Services requested that the Department of Correctional Services and Department of Health should meet and discuss the financial responsibility for the provision of health care services to the inmate population A meeting was thereafter held between the Acting Commissioner and the Acting DG of Health The basis of the discussion was on the challenges the DCS is faced with in the provision of health care services to the inmates and the following identified areas of assistance required from the DoH 5

6. AREAS OF ASSISTANCE AREA / ISSUESUPPORT REQUIRED Legislation issuesRole of the Provinces in terms of the White Paper on the Transformation of Health Services and the National Health Act to be clarified. Explore possibility of amending the Correctional Services Act in conjunction with the DoH Representation of DCS in identified structures DCS to be permitted participation or representation in some of the Strategic structures where decisions affecting health care delivery in the department are taken, or informed of such decisions and related processes 6

7. AREAS OF ASSISTANCE AREA / ISSUESUPPORT REQUIRED Incorporation of DCS health facilities into the District Health System Formalize the incorporation of departmental health facilities into the respective Districts for :  The provision of policies and guidelines  Improved management of diseases, and  training, mentoring, guidance, support, monitoring and evaluation in the management of diseases 7

8. AREAS OF ASSISTANCE AREA / ISSUESUPPORT REQUIRED Reporting structureHealth care professionals to account to and be supervised by health professionals to ensure professional independence Management of specific diseases and patients Admission of identified patients in the designated health facilities, e.g. mental health care users, forensic patients and drug resistant patients Service Level Agreements The provinces to determine capacity of entering into SLAs with the relevant Regions for the provision of identified services and programmes 8

9. AREAS OF ASSISTANCE AREA / ISSUESUPPORT REQUIRED Referral systems Formalize and strengthen referral systems for the provision of some primary and secondary as well as tertiary levels of care including relationships with the National Health Laboratory Services Payment medication e.g. TB and ART Provinces to review decisions that the department should pay for these medication Payment of private tariffs Review of tariffs paid by the department for patients’ consultation and treatment Implementation of PHC Assist in the development of guidelines for the licensing of PHC nurses in DCS 9

10. AREAS OF ASSISTANCE AREA / ISSUESUPPORT REQUIRED Support in the provision of services and programmes Provinces to support in the management of diseases especially MDR and XDR –TB and provision of drugs (e.g. acute medication, TB drugs and ART) where the department does not have services of departmental pharmacists Health Information System Permission for access or linkages to the DHIS to improve on data management and enable monitoring as well as evaluation of performance of the various health programmes 10

11. WAY FORWARD The meeting concluded by coming with the following recommendations: Establishment of a task team comprising of DCS, DoH and South African Military Health Services to conduct an audit of the current status of health services in DCS and identify challenges per province Options that may be looked at are: Whether current health care system in DCS could be strengthened with support of DoH Take over of health care delivery in DCS by DoH South African Military Health Services could be contracted by DCS to render health care services Contracting delivery of health care services to private sector 11

12. CONCLUSION To improve the quality and outcome of health care delivery in the DCS, there is a need for a high level decision making at political level with regard to the roles and responsibilities of the Department of Health at all levels on Correctional Health Services 12

13. 13 Together doing more & better to break the cycle of crime