ENVIRONMENTAL HEALTH SERVICES DELIVERY REVIEW DN Nkuna Commemoration of World Environmental Health Day – September 2016

OUTLINE OF THE PRESENTATION 2 The presentation will cover the following:  Background  Purpose of the Review  Establishment of the Task Team  Role of the Task Team  Key Questions to be answered  Legislative Implications  Acknowledgements  Process followed to date  Status of the Report

BACKGROUND 3  Minister’s directive during the strategic planning meeting of the Department held on the January 2016  Cluster Environmental Health and Port Health to review provision of Environmental Health in the Country.  To respond to the concerns raised by politicians and the public about non visibility of EHPs  To engage Environmental Health Fraternity in responding to the public query  To come up with ways of improving service delivery

PURPOSE OF THE REVIEW 4  To provide technical advice to the Chief Directorate regarding the status of Environmental Health Services delivery since the enactment of the National Health Act  To Review Environmental Health Services Delivery in the Country  To Identify benefits and challenges experienced  To explore all available options of rendering EHS in the country  Document inputs from engagements and formulating a report to the Minister.

ESTABLISHMENT OF TECHNICAL TASK TEAM 5  Task Team has been established by the DG  Members of the TT include the following:  three provincial representatives,  three District Municipality representatives,  three Metropolitan representatives,  four National Department of Health Representatives  SALGA, GOGTA, SAIEH, HPCSA and Institute of Higher learning.

ROLE OF TECHNICAL TASK TEAM 6  Work with the Chief Directorate to respond to the Minister’s call to review Environmental Health Services provision.  Consult broadly in all provinces to source inputs for the review  To provide progress report on benefits and challenges experienced in EH since the enactment of the National Health Act 2003, (Act No 61 of 2003).  Considering the subsequent devolution of Environmental Health Services to District and Metropolitan Municipalities, and  Transfer of Port Health Services from Provincial Departments of Health to National Department of Health.

KEY QUESTIONS TO BE ANSWERED 7 The Task team had to respond to the following questions: Environmental Health Services  What is Environmental Health Services?  What is Municipal Health Services?  What is the difference between the two?  What are the highlights or achievements that can be said about Environmental Health Services since the enactment of the National Health Act 2003, (Act No 61 of 2003).  What challenges are facing Environmental Health Services in the Country?  Why are Municipalities not meeting the Norm for Human Resource Allocation of 1: ?  Why are EHPs not Visible in the Country?  What must be done to change the situation?  Is Environmental Health Services properly Placed?  Where can they be suitably placed for optimal output?  Why do you think so?

KEY QUESTIONS TO BE ANSWERED CONT 8 Transfer of EHS(Devolution of MHS and Transfer of Port Health Services)  What is the status of Devolution in the Municipality/ Province?  What is the status of transfer of PHS in the country?  What Benefits came with devolution and/or transfer of port health services?  How can they be improved?  What challenges came with devolution and transfer of PHS?  What must be done to address the challenges?  Politicians & members of the public are dissatisfied with the level of services rendered, where services are placed and visibility of EHPs on the ground  What went or where are we wrong?  How did it go wrong and Why did it go wrong?  What must be done to remedy the situation?

KEY QUESTIONS TO BE ANSWERED CONT 9 Community Service  What is the understanding of Community Service EHP?  Are there any Community Service EHPs in your Metro or District Municipality, Province and/or PHS?  If No, why?  If Yes, how did you go about getting them in place?  Are Community Service EHPs budgeted for Annually in your Municipality?  If No, why?  If Yes, how did you go about getting the budget approved?  What lessons have been learned in the process?  These questions were meant to trigger discussion  Inputs were not limited to the highlighted questions  Inputs were received from various stakeholders

LEGISLATIVE IMPLICATIONS 10 Some of the Legislations and research documents that have an impact on Environmental Health Services delivery  Constitution of the Republic of South Africa, Act 108 of 1996  White paper on transformation of Health Services in South Africa  National Environmental Health Policy,  National Health Act, Act 61 of 2003  Health Professions Council Act, Act 56 of 1974  Foodstuffs, Cosmetics and Disinfectants Act, Act 54 of 1972  Municipal Systems Act, Act 32 of 2000  Municipal Structures Act, Act 117 of 1998  Division of Revenue Act, Act 1 of 2015, (seem to change annually)  Other Relevant Documents, (Not limited to these)  Audit Reports by SALGA  Municipal health services in south Africa, opportunities and challenges by Thuthula Balfour, Health Policy Analyst, DBSA

ACKNOWLEDGEMENTS 11 The following stakeholders were key in the development discussion document and ultimately the report:  National Department of Health: A.P.R Cele; M.A.M Ramathuba; D.N Nkuna; S.M. Mdlalose; B. Makhafola, P. Masilela; F. Makobe; A. Ramatswi; R. Loykisoonlal; M. Mainganye; N. Mbele and S. Tshelane, D. Matlala; C. Thabethe, P. Campbell and P. Moonasaar  Health Professions Council of South Africa: D. Sebidi  South African Local Government Association: M. Mallane  South African Institute for Environmental Health: S. Moodley  Department of Cooperative Governance and Traditional Affairs: L. Moseki  National Treasury: S. Kenyon  South African Institutions of Higher Learning: C. Qoto and M. Agenbag  District Municipalities: A. Van Zyl; Z. Van Zyl; D. Hlanyane, N. Masekwane and M. Mukwevho  Metropolitan Municipalities: J. Chaka; A. Falati and C. Hugo  Provincial Departments of Health: D. Stander; J. Mokgatle and B. Mhlongo  All stakeholders who participated in the consultation sessions and who inputted to the discussion document

PROCESS FOLLOWED TO DATE 12 DATEACTIVITY March 2016Presentation at InterProv Meeting 08 March 2016Drafting of Concept/ Discussion document 09 March 2016Internal Meeting to finalise draft Discussion Document 10 March 2016Submission for the appointment of a Task Team 4 and 5 April 2016Invitations of the Task Team 12 April 2016First Task Team Meeting 26 April 2016Submission of contributions by Sub Task Teams 06 May 2016Circulation of Discussion Document 10 May 2016Second Task Team Meeting 11 and 12 May 2016Two Days National Workshop 12 May 2016EHSDRTT consolidation of report 17 June 2016Final Report to Minister

STATUS OF THE REPORT 13  The report is following internal processes  Not yet available for publication and communication  Decision to be taken after the Minister has considered the report  The outcome to be communicated to all once finalised  Further actions will follow from there  Everyone to think about the following: EHP visibility How to improve service delivery National Identity for Environmental Health

Thank you 14