"Health Warriors Serving the Brave" PROGRESS REPORT ON THE MINISTERIAL MEDICAL TASK TEAM Presented to Portfolio Committee on Defence – 16 March 2016 2019/04/04 1 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" AIM To update the Portfolio committee on Defence on the progress made on the implementation of the recommendations made by the Ministerial Medical Task Team 2019/04/04 "Health Warriors Serving the Brave" 2 2

"Health Warriors Serving the Brave" SCOPE Background Phase 1 HR Subcommittee Infrastructure Subcommittee Health Care Service Subcommittee Phase 2 Military Medicine. Research. SAMHS Military Support Doctrine. Discussions/Comments 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" BACKGROUND 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" BACKGROUND During 2013 complaints were received from HCPs. These complaints were followed by newspaper articles/reports. On 9 March 2014 the MOD&MV appointed a MMTT (Ministerial Medical Task Team) consisting of 9 independent HCP’s to conduct an investigation of complaints received from the HCP’s working in the SAMHS & came up with recommendations. The MOD&MV required the MMTT to investigate “Factors that influence the optimal functioning of the Three Military Hospitals”. The MMTT came with 7 (seven) broad recommendations and 10 (ten) specific recommendations. 2019/04/04 "Health Warriors Serving the Brave"

BACKGROUND cont.. This investigation was scheduled from 10 March to 21 April 2014, however the MOD&MV decided to expand the terms of reference to include “An assessment on the Military Medical Support provided to SANDF Forces at training formations and during deployments”. A DOD implementation committee divided the recommendations into Phase 1 and Phase 2. The MMTT submitted its final report to MOD&MV on 16 October 2014. 2019/04/04

"Health Warriors Serving the Brave" Phase 1 HR SUBCOMMITTEE Phase 1 Recommendations.docx 2019/04/04 "Health Warriors Serving the Brave"

AUDIT STATISTICS: TOTAL IN OSD POSTS AS FROM 2014 SANDF Members PSAP TOTAL Total in OSD Posts Medical Officers and Specialists 226 64 290 Nursing Personnel 767 34 801 Psychologists 88 12 100 Dentists 62 11 73 Pharmacists 69 17 86 Ancillary Health Personnel 457 30 487 Social Workers 144 3 147 1984 TOTAL IN OSD POSTS AS FROM 2014.pptx 2019/04/04

AUDITS COMPLETED: FEBRUARY 2016 SANDF Members PSAP TOTAL Audits Completed Medical Officers and Specialists 226 64 290 Nursing Personnel 639 34 673 Psychologists 72 12 84 Dentists 62 11 73 Pharmacists 63 17 80 Ancillary Health Personnel 370 30 400 Social Workers 141 3 144 1744 (88%) AUDITS COMPLETED FEB 2016.pptx 2019/04/04

FILES NOT YET AUDITED SANDF Members PSAP TOTAL Files not yet audited Medical Officers and Specialists Nursing Personnel 128 Psychologists 16 Dentists Pharmacists 6 Ancillary Health Personnel 87 Social Workers 3 240 FILES NOT YET AUDITED.pptx 2019/04/04

INFRASTRUCTURE SUBCOMMITTEE 2019/04/04 "Health Warriors Serving the Brave"

CONDITION ASSESSMENTS 1 Military Hospital was opened during 1982. The design of the 1st floor based on the 1977 design was absolute and did not comply to best practices applied in theatres, intensive care, casualties, X-rays and the sterilizing unit. Realizing potential challenges regarding the mechanical and electrical systems at 1 Military Hospital, condition assessments were done on all mechanical-, electrical-, wet services, lifts and electronic systems. Repair work needs to be done on all these systems for the whole hospital in order to prevent systems shutdown and to address functionality and to comply with safe working conditions. 2019/04/04 "Health Warriors Serving the Brave"

DEPLOYMENT OF THE DEFENCE WORKS FORMATION TO 1 MILITARY HOSPITAL Carpentry, plumbing, electricians and bricklayer teams were deployed to 1 Military hospital and all took part in demolishing tasks on both the 1st and 2nd floors. Demolishing work on the 2nd floor was completed during October 2015, while demolishing work on the 1st floor will be completed during April 2016. Cost savings to the DOD: Demolishing work completed R2 500 779-00. Management of the project R5 536 443-00/annum. Photos.ppt 2019/04/04 "Health Warriors Serving the Brave"

HEALTHCARE SERVICE SUBCOMMITTEE 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" Ensure training, development and supervision of Interns and Community Service HCPs according to HPCSA requirements, ie clinical meetings – (1) Clinical meetings have been established in the 3 military hospitals. Morbidity and Mortality meetings have been established in the 3 military hospitals. Dir. Medicine and CD MHFP continuously monitoring supervision of interns and community service doctors (i.e. mentoring). 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" Determine whether the three military hospitals meet the provincial benchmarks to be accredited for NHI – (2) Communication has been made with the chairperson of the OHSC (Office of Health Standards Compliance) and a meeting has been set up with the Vice-Chairperson to discuss the way forward. This office is going to do the rollout of the requirements for compliance. The Vice-Chairperson of OHSC has established criteria for assessment of hospitals. 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" Recommendation that delegation for grade and salary progression be given to SG – (3) Delegation for grade and salary progression has been given to the SG and the auditing of HCPs files will help SAMHS HR functionaries to manage the OSD. 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" Develop military skills for the deployment of HCPs ie manual with protocols, BATLS and BARTS courses – (4) The Military Health Training Formation is conducting training for members. Curriculum has been revised to meet international standards. Handbook with protocols for deployment has been updated. The SAMHS now has qualified instructors who can facilitate BLS, ATLS, ACLS, BATLS & BARTS at 1Mil Hospital and School for Military Health Training. More instructors are in the processes of qualifying for 2 & 3 Military Hospitals. 2019/04/04 "Health Warriors Serving the Brave"

"Health Warriors Serving the Brave" Phase 2 LEADERSHIP "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" LEADERSHIP RECOMMENDATION ACTION TARGET REMARKS 1.The SAMHS structure should support the DR and structures of SAA, SAAF, and SAN. Restructuring of the SAMHS according to DRIPT. Promulgation of the Defence Review. Mid-term objective. 2. The SAMHS structure should mirror the supported combat and divisional structures. Consultation with other services and mirroring this with the final input from the DRIPT. Implementation of the Defence Review. 3. Conversion of the clinical reserve posts into permanent posts. Consultation with CHR about the feasibility of such. Ongoing process. Recognized difficulty in recruiting clinical reserves due to competition for HCP. "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" LEADERSHIP - 2 RECOMMENDATION ACTION TARGET REMARKS 4. Broader participation of the members in the restructuring of the SAMHS. Force Preparation and the GOC’s consulted for the restructuring process of the organization. Ongoing. Participation of the HCP’s and the command element. 5. OSD should not be linked to posts but to qualifications of the members. HR function to be communicated with CHR. Immediate implementation. Members promoted into command or staff posts not to lose their OSD. 6. Develop a Military Health Command Post(Ops Room) to provide seamless support to deployed clinical entities. An ops directorate has been established in the SAMHS with personnel identified to actuate this activity. The Ops room is now operational. This was the responsibility of the Mobile Military Health Formation and the ops function has been elevated to the HQ. "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" MILITARY MEDICINE "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" MILITARY MEDICINE RECOMMENDATIONS ACTION TARGET REMARKS 1. Establishment of a military academy. Initial steps taken to establish the faculty of Military Medicine with the University of Pretoria. Medium to long term objective. CD MHFP to focus on defining Military War Medicine and the training of members in BATLS, BARTS, ACLS and ATLS. Review of all military Health Training Schools for the future strategic direction of the SANDF. "Health Warriors Serving the Brave" 2019/04/04

MILITARY HEALTH SUPPORT DOCTRINE "Health Warriors Serving the Brave" 2019/04/04

MILITARY HEALTH SUPPORT DOCTRINE RECOMMENDATIONS ACTION TARGET REMARKS 1. The SAMHS military heath doctrine should be in line with the Defence review. This will be part of the DRIPT restructuring process. Ongoing. The doctrine will be aligned with the DR. "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" RESEARCH "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" RESEARCH RECOMMENDATIONS ACTION TARGET REMARKS 1. Establishment of a SAMHS Research Entity. 1, 2 and 3 Military hospitals, MPI, MVI, D HIV/AIDS, to utilize the Phidisa Structures as a basis for the formation of a research unit in the SAMHS. Ergotech and Protechnik are strategic entities of ARMSCOR utilzed by the SAMHS. Ongoing. This initiative has already been started. "Health Warriors Serving the Brave" 2019/04/04

"Health Warriors Serving the Brave" GENERAL OBSERVATIONS The morale of the deployed soldiers and their loyalty towards the SANDF remains commendable. The creativity of the deployed soldier is commendable because they are living proof of the slogans “make do with what you have” and “do more with less”. 2019/04/04 "Health Warriors Serving the Brave"

DISCUSSION AND COMMENTS 2019/04/04 "Health Warriors Serving the Brave"