1. MUNICIPAL HEALTH SERVICES
(MHS)
STATUS QUO REPORT 2016

2. PRESENTATION OVERVIEW
BACKGROUND
KEY CHALLENGES
DEVOLUTION
EQUITABLE SHARE
COMMUNITY SERVICES FOR EHP’s
STAFFING NEEDS
TRAINING AND DEVELOPMENT OF EHP’s
RESOURCES AND TOOLS OF TRADE
NATIONAL AND PROVINCIAL GOVT. INTERVENTION
LEGISLATION
RECOMMENDATIONS
CONCLUSION

3. BACKGROUND
MHS QUESTIONAIRE
PROJECT PLAN
DATA COLLECTION

4. KEY CHALLENGES
DEVOLUTION

5. KEY CHALLENGES
DEVOLUTION

6. KEY CHALLENGES
EQUITABLE SHARE

7. CHALLENGES COSTING OF MHS PRIORITISING MHS
ROLE OF SECTOR DEPTS – ASSISTANCE
EQUITABLE SHARE – MORE TRANSPARENT
SALGA ENGAGEMENT/DISCUSSION WITH MUNICIPAL FINANCIAL OFFICERS – RELOOK –ALLOCATION OF MHS BUDGETS

8. COMMUNITY SERVICES PROVINCE MUNICIPALITY 2012 2013 2014 2015 2016
KWA-ZULU NATAL
ETHEKWINI METRO 15
UMKHANYAKUDE 5
HARRY GWALA (SISONKE) 2
UTHUKELA 3
UMZINYATHI
UMGUNGUNDLOVU 7
AMAJUBA
ZULULAND
LIMPOPO
WATERBERG 1
MOPANI
VHEMBE
GAUTENG
CITY OF TSHWANE 4
WESTERN CAPE
CITY OF CAPE TOWN 8
CENTRAL KAROO
WEST COAST
EDEN
CAPE WINELANDS
EASTERN CAPE
JOE GQABI
CHRIS HANI
O.R. TAMBO 18
ALFRED NZO 35
NORTHERN CAPE
PIXLEY SEME DISTRICT
JOHN TAOLO GAETSEWE
NAMAKWA
MPUMALANGA
GERT SIBANDE
NKANGALA
ehlanzeni
FREE STATE
FEZILE DABI
LEJWELEPUTSWA
XHARIEP
NORTH WEST
DR. RUTH SEGOMOTSI MOMPATI
TOTAL 33 63 59 76
117
COMMUNITY
SERVICES

9. CHALLENGES COMMUNITY SERVICE EHP’s – MUNICIPALITIES ORGANOGRAMS
LACK OF FUNDING
NEED FOR A CLEAR STATEMENT – LEGALLY WHO IS RESPONSIBLE TO PAY AND PLACE CSEHP’s
RELOOK AT CSEHP ROLLOUT STRATEGIES
PRIVATE SECTOR
OTHER GOVT. DEPT’s
INTERNS

10. STAFFING NEEDS ADDITIONAL WORKLOAD – LIMITED STAFF FACTORS
INCREASE IN POPULATION
MIGRATION
EMERGENCE OF NEW DISEASES
CLIMATE CHANGE
LEGISLATION
PLANNING TO MEET THE STAFFING
NORMS

11. TRAINING AND DEVELOPMENT
ONGOING TRAINING
CPD’s
IMPLICATIONS FOR MUNICIPALITIES (EMPLOYERS)

12. NATIONAL AND PROVINCIAL GOVT. INTERVENTION
RESOURCES AND TOOLS OF TRADE
OFFICE ACCOMMODATION
TRANSPORT
MHS MANAGERS MUST FULLY PARTICIPATE IN THE BUDGETING PROCESSES
NATIONAL AND PROVINCIAL GOVT. INTERVENTION
SUPPORT
PROPER COMMUNICATION
CO-OPERATIVE GOVERNANCE
3 SPHERES OF GOVT. TO APPOINT MHS CHAMPIONS
TO RETHINK RENDERING MHS/EHS

13. LEGISLATION DEVELOP A POLICY/LEGISLATION ON MHS FINANCING OF MHS
ROLES AND RESPONSIBILITIES OF COGTA, DM’s AND METROS
COMMUNITY SERVICES FOR EHP’s INCLUDING FUNDING
AUDITING AND MONITORING OF MHS, INCLUDING EQUITABLE SHARE ALLOCATIONS
INCLUSION OF THE REPORTING BY MUNICIPALITIES ON MHS TO THE AUDITOR GENERALS REPORT
PRIORITIZING OF MHS IN THE MUNICIPAL BUDGETS AND SERVICE DELIVERY PACKAGE/PLATFORM

14. RECOMMENDATIONS
The following recommendations and matters need to be addressed urgently so that the issues raised in this survey can be addressed in a planned approach. The Summit needs to consider these recommendations seriously. 
A target date needs to be set by the delegates for the finalisation of the devolution process both from the LMs and Province to the DMs and Metros. Those LMs and Provinces that are delivering MHS in the Districts and Metros without SLAs or MOUs must be finalised so as to legitimise the process. Special attention needs to be given to this process to be finalized by SALGA
SALGA and the SAIEH to finalize the development of a costing model for MHS
The need to capacitate Politicians and Financial Officers of the Municipalities on MHS. SALGA to facilitate this process.

15. RECOMMENDATIONS
SALGA needs to intervene to ensure that EHPs receive necessary training, by being given access to CPD opportunities, which is necessary for them to practice competently and to comply with the HPCSA requirements and legislation. Municipalities need to allow EHPs to attend these training and CPD activities.
SALGA needs to advise the Municipalities that they need to be more transparent about the equitable share for MHS and ensure that the Managers of these services are kept informed.
SALGA needs to continue to pursue with the National Treasury the issue of funding CSEHP posts at municipal level provided the Municipalities have made allowance for these posts in their organisational structures as they have done for financial and engineering interns. The SAIEH to submit a proposal to NDOH on the placement of CSEHPs.

16. RECOMMENDATIONS
Due to the serious consequences of not having a fully functional MHS, Municipalities are called upon to prioritise MHS and ensure that they have plans in place to address the key challenges that MHS Manager are facing on a daily basis e.g. office accommodation, motor transport, office furniture and computers.
The PDOH and NDOH to become involved with the key challenges at local government level and to intervene and give proper guidance to Municipalities.

17. RECOMMENDATIONS
The issue of staffing is a serious problem in every Municipality in the country. There has to be a serious discussion at a National level between NDOH, SALGA, COGTA and National Treasury to find a way forward to address this crisis. Let us not wait for an outbreak of disease and deaths before we act as this will be too late. The approved norm of 1 EHP per 10, 000 population as per the National Environmental Policy must be implemented.
COGTA needs to get involved together with SALGA on discussions concerning MHS and the funding model for this service.

18. CONCLUSION
THANK YOU