1. Click to edit Master subtitle style 8/19/11 REPORT ON SAFETY AND SECURITY Portfolio Committee on Health 17 August 2011

2. 8/19/11 Presentation Outline Background Progress to Date Provincial security audits/assessments Recommendations 22

3. 8/19/11 Background The Department has conducted safety assessment as part of the Core Standards This assessment has demonstrated weaknesses in safety and security of health facilities There have also been a number of incidents where staff or patients have been injured or killed due to poor security provided in health facilities 33

4. 8/19/11 Progress to Date (1) The Minister invited SAMA to present to the National Health Council on safety and security issues affecting their members The findings concurred with the Department’s audit findings NHC deliberated and recommended that steps be taken to address safety at public health facilities 44

5. 8/19/11 Progress to Date (2) Short term : appoint a task team, improve physical security incl CCTV, conduct an audit on status of facilities to develop an action plan Medium term: develop norms and standards, enforce contracts, upgrade security officer’s positions to appropriate levels Long term view: develop a career path for security personnel, new health establishments to be designed with safety in mind 55

6. 8/19/11 Progress to Date (3) As per NHC resolution the task team was convened in July 2011 Most provinces represented except: WC, LP and GP An external security expert invited from PRASA NIA, SAPS and SANDF also part of the task team A follow up meeting is scheduled in August 66

7. 8/19/11 PROVINCIAL assessments 77

8. 8/19/11 Provincial Reports –Short term A number of provinces have conducted audits/assessments on safety and security – Mpumalanga (focused on hospitals) – KwaZulu Natal (detailed and followed by operational plans) – Free State (targeted hotspots and improvement plans are based on just the hotspots) – North West (focused on certain facilities) 88

9. 8/19/11 Provincial Reports –Short term Security measures implemented are reactive to incidents Master keys of institutions are still being kept by unknown individuals CCTV cameras are not strategically placed 99

10. Click to edit the outline text format Second Outline Level  Third Outline Level Fourth Outline Level  Fifth Outline Level  Sixth Outline Level  Seventh Outline Level  Eighth Outline Level Ninth Outline LevelClick to edit Master text styles – Second level Third level – Fourth level » Fifth level 8/19/11 Provincial Reports –Short term Cameras only play live footage with no playback for later viewing No clocking points to prove that indeed patrols did take place as planned Proper fencing is required and tree and grass cutting needed to enable clear view of the premises 1010

11. Click to edit the outline text format Second Outline Level  Third Outline Level Fourth Outline Level  Fifth Outline Level  Sixth Outline Level  Seventh Outline Level  Eighth Outline Level Ninth Outline LevelClick to edit Master text styles – Second level Third level – Fourth level » Fifth level 8/19/11 Provincial Reports –Short term Peculiar to XDR/MDR hospitals, patients have a tendency to cough-up sputum and threaten to spit in security personnel’s faces when they wish to abscond. The guards will either run away in fear of being infected or use batons to subdue the patients 1111

12. 8/19/11 Provincial Reports –Medium Term Security function not seen as core business and not on Annual Performance Plans There is no line function or security cluster at provincial level Some provinces do not have provincial security managers Security officers doing similar work in provinces appointed at different levels 1212

13. 8/19/11 Provincial Reports –Medium Term There are areas of good practice that have to be shared across all provinces For example, there is success from KZN on enforcing a service level agreement Have tight SLA and penalties for poor performance Most provinces cited poor contract management and enforcement 1313

14. 8/19/11 Provincial Reports –Medium Term Lack of uniformity on : – where security function is located at provincial level i.e. where they report how security contracts are awarded and monitored – For example, in some provinces contracts are centralised at the department of safety. PDOH gets informed on which security company has been appointed and have little input 1414

15. 8/19/11 Provincial Reports –Medium Term In other province the reverse is true, the awarding of contracts is decentralised to district level. Provincial officials are not involved in the entire process but have to supervise the district officials There is sometimes lack of skill on safety and security at district level and contracts are not enforced 1515

16. 8/19/11 Provincial Reports –Medium Term Sometimes the security guards are requested to play the role of porters meaning they have to leave their station unmanned when responding to such requests. Late payment or non-payment of security guards by service provider puts the security personnel in a vulnerable position and makes them easily susceptible to bribery. 1616

17. 8/19/11 Recommendations (1) At a recent NHC it was agreed that the KZN SLA and penalty clauses would be shared with all HODs as an example Example of KZN penalty clause... 1717

18. 8/19/11 DeficiencyPenalty Security officer(s) not postedR1000 No radio/unserviceable radioR250 Drunk/under the influenceRemove from site R 1000 Use of security officers not registered with SIRA R1000/ removal from site Provide security officers of grades other than those called for in the contract R1000 per shift/removal from site Supervisors failing to visit premisesR 500 per event Repeated occurrences or failure to comply to any of the above may result in the cancellation of the agreement and/ or service for a specific site or property Dealing with Poor Performance 1818

19. 8/19/11 Recommendations (2) A security audit be conducted across all provinces using a standardised approach and methodology – Use the available provincial reports as a basis to develop a process of a systematic and structured security audit directed at national level – Terms of reference for the consultant/s or team to conduct the audit will be developed and the DG will sign off 1919

20. 8/19/11 Recommendations (3) – Develop an action plan and interventions to address the gaps – Map out clear timelines and milestones in the work plan – Focus on physical infrastructure, systems and procedures, management and access control – Ensure compliance with security legislation in terms of authorised entities to audit state facilities Follow up on other NHC resolutions through the work of the task team 2020

21. 8/19/11 Thank You 2121