Integration and Transformation in the South African Military Health Service: briefing

Meeting report

DEFENCE PORTFOLIO COMMITTEE
18 March 2003
INTEGRATION AND TRANSFORMATION IN THE SOUTH AFRICAN MILITARY HEALTH SERVICE: BRIEFING

Acting Chairperson: Mr D M Dlali (ANC)

Relevant documents
Presentation by SAMHS
Report on Integration and Transformation in the SAMHS [restricted]

SUMMARY
The South African Military Health Services addressed the Committee on the progress of integration and transformation in the service. The function and context of the SAMHS was outlined to the Committee. SAMHS presented the figures and graphs to show the progress of the integration process and the process of transformation. They concluded that SAMHS was now more reflective of the demographics of the country.

MINUTES
Briefing by South African Military Health Services
Lieutenant-General J van Rensburg: Surgeon General, South African Military Health Services, outlined the function of the SAMHS.

The Surgeon General and staff ensure the provision of combat ready medical forces and operationally ready infrastructure, as well as the provision of health maintenance services for the DOD. It furthermore develops and updates health policy for the DOD and participates in developing the overall DOD policy. It also participates in the formulation of national health policy as the DOD representative on various statutory and national bodies.

As budgeting authority the Surgeon General and staff distribute the allocated budget to the medical spending agencies on the basis of business plans provided by them. The SG and staff then monitor the output of its spending agencies according to approved business plans and report to the accounting officer and the Chief of Policy and Planning on a regular basis on the performance of spending agencies according to plan. They also report to statutory bodies on adherence to statutory regulations.

Lt General noted that, as a result of political and societal changes, the DOD had to undergo similar fundamental transformation. Transformation covers all aspects required to normalise the DOD to society's new requirements. A key aspect enabling the DOD to achieve transformation is re-engineering. The specific aim of the re-engineering effort is to improve DOD process efficiency in order to sustainable and effectively deliver required outputs within available budget and other policy constraints.

He concluded his presentation by saying that the SAMHS was now more reflective of the demographics of the country and was ready to serve. (Please see presentation attached)

Discussion
Adv H Smidt (DP) thanked Lt Gen van Rensburg for mentioning the reserve forces in his presentation as he felt that they were important. He also referred to the fact that there is approximately 5000 staff in the SAMHS. Was this figure correct? He felt that the establishment was 8000. He asked how the brain drain was affecting the SAMHS.

Lt Gen van Rensburg said that the SAMHS relied on the increased budget allocation. However, the reserve forces were important and more people were needed. He also said that the establishment is 8000, but that they needed to deliver a more economic service which meant that 5000 was uniformed staff while 1700 was Public Service Act staff (PSAP), that is, civilians. There were therefore approximately 400 vacancies which were not filled. Referring to the brain drain, Lt Gen van Rensburg said that many young people use the military as a stepping stone to other careers. This was not unique to South Africa. He did not have a figure for the Committee in this regard.

Mr Z Madasa (ACDP) asked if the SAMHS national policy does not come in conflict with its international policy sometimes. He also felt that the SAMHS should go further in its social responsibility and suggested that they embark on an awareness campaign. He referred to the psychological health of the SAMHS and asked what the latest developments were in this area.

He referred to a remark made by Lt Gen van Rensburg about some members having criminal records and asked how this impacted on promotions and what criteria was used. Referring to the bursaries offered, he said that it was still biased towards whites. In referring to transformation, he said that the figures show that the number of whites had declined as the number of blacks had increased. He said he would have preferred the number of whites to stabilise while the number of Africans increased.

He asked what percentage of the SAMHS was HIV positive as Lt Gen van Rensburg had mentioned that they had a figure.

Lt Gen van Rensburg said that they adapted their policy to fit with international policy, but stuck to the national principles as well. He agreed that there needed to be more awareness of the service. With respect to psychological health he said that a study of suicides in 1995 to 1996 had showed that the Defence Force had the highest figures, but these had declined and was now less that the general population. He pointed out that some were coupled to disease profiles. He added that there was some vacant psychologist posts as there was not enough people of colour to fill these posts.

General Mari: Director General, Human Resources, said that criminal records were considered when promotions were considered, but the seriousness was important. She said that the education of previously disadvantaged people was considered when selection processes were done. The bursary figures were not yet representative as medical studies took six years and it therefore took time to show in the figures. Out of the twenty bursaries offered, fourteen were for Africans, two for coloureds and four for whites.

Lt Gen van Rensburg referred to the number of whites that had declined and said that while that the SAMHS had targets that they were working towards, they were not neglecting standards. These figures were planned.

He hesitated to give the HIV percentages as it could cause confusion if different figures were given by different people. However the figure of 21% mentioned by Minister Lekota on another occasion was the correct one.

Mr N Fihla (ANC) asked whether the SAMHS trained its own doctors or if they recruited doctors. He asked about the contracts which employees signed and whether this could not help stop the brain drain. He asked how SAMHS marketed itself at schools, hospitals and so forth. He wanted to know what the short and long term goals were for closing the gap that existed because of the past.

Lt Gen van Rensburg said that they did not train doctors. They gave bursaries and then they were trained at the University of Pretoria and MEDUNSA. He said that they do try to market themselves but need to do more. He pointed out that that the marketing was done centrally by the Department of Defence.

He said that some of the figures were six years old and that they were moving towards their targets for equality. He felt that in two years time the figures would be very different.

Mr A Blaas (NNP) asked what the SAMHS link was with the commandos. He also wanted to know what the acronyms 'BARTS' and 'BATLS' were, as mentioned in the presentation. He also wanted to know who had access to the tertiary institutions which SAMHS administered and whether there was a return on the investment in the development of staff.

Lt Gen van Rensburg said that they had no control over the commandos. He explained that 'BATLS' meant Battlefield Advance Training for Life Support and 'BARTS' was Battlefield Advancement in Resuscitation and Trauma Support. He explained that the BATLS training was for a doctor only while BARTS was for all medical personnel. He noted that members of the Department of Defence had access to the tertiary institution's facilities.

Mr N Mthethwa (ANC) said that he understood the SAMHS mission but felt that the vision was not very clear. He also felt that they needed to link with the Human Resource 2010 plan of the Department of Defence. He asked when a member of the SANDF would be boarded from duty. He asked whether there was any attempt to learn from other Military Health Services elsewhere. He also suggested that the processes of the SAMHS should be aimed at achieving the aims of Batho Pele. Lastly, he felt that processes must be put in place, such as affirmative action, to achieve the transformation goals.

Lt Gen van Rensburg replied that the vision and mission fitted into the broader picture of the Department of Defence, but he undertook to examine it further. The HR plan was part of a total process and they were moving in this direction. He explained that a member could be boarded from duty if the supervisor recommended it, the medical officer recommended it or if the member requested it. He pointed out that they do draw on the experience of other countries. They had received input from Cuba and Russia. He had just been to China to benchmark the service.

He said that he visited members regularly to see that they were performing and achieving the goals set out in Batho Pele. Referring to affirmative action, he said that this was practiced and imperative and that recruitment was ongoing

The Chairperson referred to the civic education programme and wanted to know more about the component on cultural diversity.

Lt Gen van Rensburg replied that the training of instructors was evaluated by the Chief of Joint Training. Cultural diversity was very sensitive and this component was therefore centralised.

Mr Radebe: Chief Military Health Forces Preparation, added that the Director of Social Work had seen the need for gender equality training and this training was happening with outside institutions.

General Mari said that members signed contracts to be employed for a certain length of time. They did, however, have the option to buy themselves out of these contracts.

Mr S Ntuli (ANC) requested that the SAMHS submit its plan for civic education to the Committee.

Mr N Diale (ANC) asked whether the Military Police were involved in the SAMHS.

Lt Gen van Rensburg said that they were a separate entity and only used if the SAMHS needed them.

The meeting was adjourned.