Education, Health, Science & Technology: ANC discussion document 2017

Draft legislation for NHI Fund is ready to be released together with the White Paper



Discussion document



ABET: Adult Basic Education and Training ANA: Annual National Assessments

CAPS: Curriculum and Assessment Policy Statements CEM: Council of Education Ministers

DBE: Department of Basic Education

DHET: Department of Higher Education and Training DoH: Department of Health

DST: Department of Science and Technology DTI: Department of Trade and Industry ECD: Early Childhood Development

ELRC: Education Labour Relations Council EPWP: Expanded Public Works Program FET: Further Education and Training

HEI: Higher Education Institution

IQMS: Integrated Qualifications Management System LTSM: Learning and Teaching Support Material

NEEDU: National Education Evaluation and Development Unit

NHI: National Health Insurance NHIF: National Health Insurance Fund

OHSC: Office of Health Standards and Compliance

PSETA: Public Sector Education and Training Authority

QLTC: Quality of Learning and Teaching Campaign SETA: Sector Education and Training Authority

TVET: Technical and Vocational Education and Training


1.1 This document is an account of the performance of the sectors of the ANC NEC Subcommittee on Education and Health, namely Basic Education; Higher Education & Training; Health; Science, Technology and Innovation. It is also a tool aimed

at stimulating debates in the ANC, in communities and amongst stakeholders on issues that are relevant to the sector including proposals on how to serve South Africa best through programmes mentioned herein or proposed.

1.2 The African National Congress (ANC) is trusted by the membership and supporters of the ANC and the masses of South Africans as the organisation that provided leadership in the struggle against apartheid and colonialism. From the time of its founding in 1912, until the democratic breakthrough of 1994, the ANC was the only hope for the majority of our people as it was always in the forefront as a liberation movement.

1.3 The ANC is the most popular party in South Africa. It has been governing the country since 1994. It has performed well in transforming South Africa.

1.4 The mission of the ANC is to construct a united, non-racial, non-sexist, democratic and prosperous South Africa. Its main goals are expressed in strategic documents such as the Freedom Charter, Ready to Govern, Reconstruction and Development Programme (RDP) and various election manifestos, especially those that form the basis of election manifestos of the last two elections, namely the 2014 National Elections and the 2016 Local Government elections.

1.5 All programmes implemented and pursued by the education, health, science and technology sectors are derived from the 2012 Strategy and Tactics of the African National Congress; all relevant resolutions of the last National Conference; responses to key findings of the 20 Year Review, the National Development Plan (NDP) 2030; and decisions of the 2015 National General Council (NGC).

1.6 As stated in its pronouncements towards the 2012 National Policy Conference, discussions of policy are aimed at stimulating debates in the ANC and in communities. Discussions on Basic Education; Higher Education & Training; Health; Science, Technology and Innovation matters are at best objective assessments of achievements by the ANC and exercises in identifying challenges experienced in the implementation of policies and programs.

1.7 Constructive discourse of the performance of the ANC in communities and in government should also assist the movement and country to assess the impact of the work of the ANC since the dawn of democracy.

1.8 The ANC has adopted policies and programmes primarily designed to transform South Africa into a united, non-racial, non-sexist, democratic and prosperous country in line with the aspirations of our people as eloquently expressed in the Freedom Charter.

1.9 The ANC presented these policies and programmes to the masses of our people at every election. It always received an overwhelming support for their implementation. These policies and programmes have been translated into government policy, thereby ensuring that our country decisively eradicates the legacy of apartheid.


The following are questions that are recommended for use as a guide for discussions by all stakeholders, especially members of the ANC at branch level:

- What progress has been made in the education; health; science, technology and innovation sectors in your community and province since the 2012 Mangaung National Conference?

- What is your experience and those of your community about whether schools, colleges, clinics and hospitals are accessible and serve your community?

- Have you found that ANC policies in these sectors support efficient and speedy delivery of services?

- Are there any policy gaps in these sectors that you have identified and policies that you would propose for adoption by the ANC?

- What should the ANC, government and communities do to improve and strengthen all our sectors to implement policies and programmes effectively?

- As a member of the ANC, are you playing a role in the implementation of programmes in these sectors?

- Please propose one action or policy change that the ANC should do or adopt in each sector, namely education; health; science, technology and innovation, to get the country closer to radical socio- economic transformation?


3.1 This discussion paper of the 5th National Policy Conference covers sectors already mentioned, which constitute the focus of the ANC NEC Subcommittee on Education and Health.

3.2 Whilst providing an assessment of the performance of the ANC as the governing party, this discussion paper also aims to enable the ANC, as the undisputed leader of the revolution in South Africa, to emerge from the 5th National Policy Conference and the 54th National Conference with a renewed revolutionary edge and vigour to continue its service to the masses of our people.

3.3 This paper has ensured that there is continuity of political thought and analysis between discussions of the 4th and those of the 5th National Policy Conference.

3.4 It also responds to all directives of the National Executive Committee (NEC) that policy papers must be guided by and focus mainly on the critical issues identified. These include:

3.4.1 A review of decisions that have been taken since the 53rd National Conference, including relevant decisions of all NEC meetings, Alliance Summits, resolutions of the ANC Leagues and recommendations of the 2015 NGC.

3.4.2 An assessment of implementation of ANC resolutions and decisions, including integration of these into the implementation of the NDP Vision 2030 as our national plan for eradicating poverty, unemployment and inequality.

3.4.3 An assessment of the adequacy of current ANC policies per sector.

3.4.4 Clear identification of policy gaps and proposals to remedy these in each of the sectors.

3.4.5 Conscious focus on sharpening policy and programmes for the ANC to retain its position as the leader of society and leader in each sector.

3.4.6 Recommendations from the sectors and proposals from each for the 5th National Policy Conference to set the tone for a watershed 54th National Conference in December 2017.

3.4.7 Proposed steps to close identified policy gaps and weaknesses of programmes are presented below as recommendations to the 2017 National Policy Conference.


The report of each sector will be structured as follows:

- ANC Policy context.

- Government policy context.

- Key decisions made between conferences.

- Reports on the implementation of specific projects and programmes.

- Reports on the impact on society of implementation of ANC policies and programmes.

- Policy gaps.


4.1.1 All sectors of the Subcommittee have heeded the call for urgency of implementation that was made at the close of the 53rd National Conference.

4.1.2 ANC branch activism, leadership and campaigns in communities on issues of education; health; science, technology and innovation are issues that still need strengthening.

4.1.3 There is a need for the ANC to rekindle the spirit and practice of accountability in members and leaders of the ANC, Alliance and in deployees and implementers of programmes of the ANC in the organisation, in legislatures, and in the public service. It is very important that this spirit be infused by the ANC into local communities.

4.1.4 Levels of monitoring and evaluation of implementation of conference resolutions are still inadequate.

4.1.5 The Subcommittee convened meetings, as directed by the resolution of conference, to deal with a number of issues, especially the NHI and programs to address challenges facing the health sector.

4.1.6 The Subcommittee dealt continuously and decisively with the main and important causes of failure of delivery in government; namely finance, procurement and infrastructure planning, delivery and maintenance; and provision of human resources for education, health, science, technology and innovation.

4.1.7 All sectors of the Subcommittee mobilised all necessary resources to achieve the goals and priorities set out in the National Development Plan (NDP) 2030. ANC directives and resolutions were translated into government plans and aligned to the NDP 2030. However, sectors did not continuously identify gaps in the NDP for purposes of policy and planning.

4.1.8 The Science and Technology sector intensified its work and collaboration with relevant stakeholders to ensure that Science, Technology and Innovation are put on the agenda of the ANC in all Subcommittees across the board and in government and business.

4.1.9 The Subcommittee regularly communicated its achievements through appropriate structures of the ANC.

4.1.10 The Subcommittee ensured that the ANC adopts programmes to commit local government to play a critical role of supporting education; health; science, technology and innovation, including Information and Communication Technology (ICT).

4.1.11 The structures of the movement are encouraged to actively participate in the activities of the Subcommittee. This entails, amongst others, attending meetings of the subcommittee. Most provinces were regularly represented by members of their PEC Subcommittees at meetings of the subcommittee.


4.2.1 Provincial Subcommittees have been established and are active at provincial and regional levels in the Eastern Cape, Free State, Gauteng, KwaZulu-Natal, Limpopo, Mpumalanga and North West. These provincial structures are represented in meetings of the Subcommittee. Northern Cape and Western Cape PEC Subcommittees need to be formed.

4.2.2 Representatives of the ANC’s Leagues, Alliance Partners and the Progressive Youth Alliance, namely COSAS, ANCYL and Young Communist League attend meetings of the Subcommittee on invitation. Some of the leagues do not attend regularly.

4.2.3 The resolution directing that, at a provincial level, a PEC member who is not the political head of Education or Health shall serve as a Chair of the Subcommittee on Education and Health was implemented as directed. The same was also done at local government level.

4.2.4 Chairpersons and Whips of relevant Parliamentary Portfolio Committees and Study Groups and MECs of Education and MECs of Health participate regularly in the work and meetings of the Subcommittee.

4.2.5 The ANC NEC Subcommittee has not completed the consolidation of policy of each of its sectors, as directed by resolutions of the 53rd National Conference. The deadline of 30 June 2013 was not met.

4.2.6 The Subcommittee noted that the ANC invests lots of time and resources in policy work, and agreed to recommend that the policy cycle be reviewed.


4.3.1 ANC Policy context In line with the NDP, science and technology will play an increasing role in skills development, job creation and economic growth. The ANC and Mass Democratic Movement (MDM) commitment towards transformative STI policy predates the historic 1994 democratic breakthrough. This is evident in the 1993 IDRC commissioned report entitled “Towards a science and technology policy for a democratic South Africa”, in which the ANC and MDM argued that the apartheid legacy had seen the evolution of a research system whose principal characteristics included: An orientation towards protecting racial and economic privileges. An emphasis on t e c h n o l o g i c a l development to serve the needs of state security, and the suppression of the majority of the population, as evidenced by the high share of resources allocated to defence and nuclear programmes; An imposition of secrecy as an imperative value in the workings of government, and the shifting of debate, through media control even among the white population, on major issues of public policy; An approach to t e c h n o l o g i c a l development dominated for many years by presumed interests of state security rather than economic efficiency or social equity; and A rationalisation within the scientific community that scientific and technological develop- ments were, in some sense, apolitical. In addition to these legacy issues, the ANC and MDM, were grappling with three broad sets of policy objectives namely, those of promoting international competitiveness for enterprises; social equity for all members of society; and sustainability of interactions with the environment. These three broad sets of policy objectives became key objectives of the post-apartheid 1996 White Paper on Science and Technology (S&T). Resolutions on STI were adopted at different national and policy conferences of the ANC and the 2015 NGC. For instance, at the 2012 Policy Conference the Economic Transformation and Rural Development and Land Reform commission resolved the following: “There is a need to develop mineral knowledge linkages by encouraging youth to study science and engineering, and providing incentives for this including free education up to first degree (university level) for these subjects”. “We must also expand investment in research and development that contributes to innovation that supports beneficiation”. Science and technology reports on its work in the Subcommittee on Education and Health.

4.3.2 Government policy context Since the dawn of freedom after South Africa’s first democratic election, the Science and Technology sector has translated ANC policy into government policy at a national level through resolutions of Cabinet, departmental policy, the adoption of the 1996 White Paper on Science and Technology and various Mid- Term Expenditure Frameworks (MTSFs), especially the 2009-2014 and 2014-2019, which are relevant for this reporting period. Strategic Plans and Annual Performance Plans are concrete plans and programmes that give effect to the said MTSFs. The NDP 2030 identifies areas to be pursued jointly by the Department of Science and Technology and other government departments. The first category focuses on research and development (R&D) in existing areas of competitive advantage, where global markets are set to grow. The second category focuses on dedicated programmes in water, power, marine, space and software engineering, in which South Africa has both comparative and competitive advantages. The NDP vision and aspirations resonate with the post-apartheid STI policy, namely the 1996 White Paper on Science and Technology, introduced by the ANC-led democratic government. The preface of the 1996 White Paper on Science and Technology makes reference to the authoritative pronouncements of President Mandela, who emphasised the Government’s commitment to the creation of a ‘people-centred

society’ in which liberty, the goals of freedom from want, hunger, deprivation, ignorance, fear and suppression were to be regarded as binding covenants on the government as guarantees of ‘human dignity.’ The White Paper also introduced the National System of Innovation (NSI) as a framework to implement its vision and to ensure that science technology and innovation (STI) benefit everybody, not a minority as it was during apartheid regime. The NDP 2030 calls for the expansion of the NSI so that it becomes larger, more effective and closely aligned with firms that operate in sectors consistent with the growth strategy; and the realisation of a NSI that links universities, science councils, and other R&D role players with priority areas of the economy. It insists that South Africa’s competitiveness will rely on the NSI, permeating the culture of business and society. In implementing the NDP’s objectives, the STI sector has proposed a phased-in approach that includes the use of knowledge to increase economic efficiency, to enhance industrialisation and to build a knowledge-based economy. Some of the NDP objectives related to STI were translated into concrete deliverable targets in the 2014-2019 Medium-Term Strategic Framework (MTSF) and Departmental Strategic Plan have continuously been monitored through different outcome delivery forums. It is within this context that discussions of proposals and recommendations on STI are made and should be understood.

4.3.3 Key decisions made between conferences: The ANC NEC took various decisions and resolutions from January 2013 immediately after the 53rd National Conference to date. Many of the decisions that emanated from meetings of the NEC were   informed by deliberations and recommendations of ANC NEC Makgotla and the 2015 NGC.

4.3.4 Reports on the implementation of policy and specific projects and programmes: The 53rd National Conference Strategy and Tactics makes reference to the critical role of the National System of Innovation in building the knowledge-based economy. The ANC prioritises development of policy, implementation and monitoring of progress of its work in science, technology and innovation. The principle of mainstreaming Science, Technology and Innovation in the ANC, government and the private sector has been adopted. The Ministry of Science and Technology provides strategic leadership and coordination of the National System of Innovation. Despite efforts of the STI sector to get adequate finance and increase the capacity of the National System of Innovation with the aim of reaching the target of 1,5% expenditure of Gross Domestic Product (GDP) or at least the investment equivalent to African Peers by 2017, this has not been attained. The Gross Expenditure on Research and Development (GERD) to GDP ratio has remained stagnant at 0.73% for past two assessments periods of the national R & D Survey. The DST is exploring innovative ways of resolving this. It proposes that funds be earmarked at all levels of government, especially provincial and local government levels, to fund research on technology-based solutions and to improve service delivery through STI. In its quest to support the objectives of diversifying and transforming South Africa’s economy, Science, Technology and Innovation shares its reports with the ANC NEC Economic Transformation Committee (ETC)

for incorporation into the strategies of the ETC. Programmes and plans on strategic projects such as mineral beneficiation are regarded as key initiatives in economic transformation. These include projects such as Hydrogen South Africa (HySA Fuel Cells), Titanium Beneficiation, Manganese Precursor Development and the Fluorochemicals Expansion Initiative. The process of fast-tracking the finalization of a Research and Innovation Vote to ensure that Science councils across government are properly and consistently funded is at the level of consultation. It has not been finalised. The focus is on the finalisation of processes on the research and innovation vote or budget coordination to enhance the efficiency of the allocation of resources to publicly funded STI institutions. The STI sector has, through the Meraka Institute at CSIR, piloted the Wireless Mesh Network to provide much needed connectivity to rural schools. This has provided

210 wireless mesh nodes at schools and other facilities in the Nkangala and Sekhukhune area. More recently, connectivity has been provided to 54 schools in the Northern Cape. This is one of the ways that the STI and Basic Education sectors draw on their work and experiences to providing and improve connectivity to schools across the country. To ensure that there is research on education issues to inform policy, thirteen (13) research chairs have been established through the South African Research Chairs Initiative (SARChI). These are focusing on mathematics education, numeracy education; integrated studies of learning languages, mathematics and science; teacher education, higher education and human development, and work-integrated learning. Science education is an integral component in encouraging the exploration of science, technology, engineering, mathematics and innovation (STEMI) as a career. Focussed initiatives cater for teacher training and learner engagement opportunities; The STI sector has prioritised the process of evaluating the remuneration of academics to attract younger people into academia.

4.3.5 Reports on the impact on society of ANC policies and programme. The sector has, in the course of executing its mandate based on policies and programmes of the ANC, positively influenced society to appreciate the central role of science, technology and innovation. Many marginalised communities in rural villages have benefitted immensely from innovative programmes such as the Cofimvaba pilot project. This project is used to assess the extent to which quality educational outcomes can be achieved by the introduction of a range of innovative technologies such as ICT in schools, alternative energy supply, sustainable sanitation options, e-Health in clinics and hospitals, nutrition through local supply of ingredients by small scale agricultural developments and a combined Science Centre and Teacher Resource Centre in rural communities. The decision to prioritise astroscience and energy as key studies at the Sol Plaatje University in the Northern Cape; and agroscience as a key focus of the University of Mpumalanga has changed the lives of the people of these two provinces. This has also given our country valuable national resources that will advance the lives of our people.

4.3.6 Policy gaps: Uptake of locally produced technologies by government and private firms. Coordination between government departments and harmonisation of policies and incentives. Improve use of STI within and across the public sector and as an enabler of service delivery. The ANC should consider adopting policies that promote innovation to be a daily local norm and activity that will encourage learners in schools, students at colleges and universities, and workers in every sector to attempt to invent new technologies and products by analysing and learning from those imported and used daily in their lives.


4.4.1 ANC Policy context Education remains an apex priority for the African National Congress. This position and policies of the ANC are informed by the ANC’s vision enshrined in the Freedom Charter that the Doors of Learning and Culture shall be opened! It is also in line with the vision of the ANC of People’s Education for People’s Power. The 1994 Policy Framework for Education and Training and the Reconstruction and Development Programme and policy positions contained in the document Ready to Govern remain key anchors of ANC education policy. These are foundations on which the resolutions of various conferences rest, including those of the 52nd and 53rd National Conferences, which inform policies, and programmes of the ANC and government in the period 2012 to 2017. It is important that the ANC intensifies programmes to ensure ongoing improvement in the quality of education, especially basic education.

4.4.2 Government policy context

Government has declared education its apex priority. The 1995 White Paper on Education and Training provided a solid foundation for the new and democratic national education system. This was followed by a number of legislative frameworks and national policies that shaped the country’s education system from 1994 to date. Government has adopted its Mid-Term Strategic Framework (MTSF) 2009-2014 and 2014-2019, which are translations of ANC Policy into government policy and programmes. It has incorporated into its plans and programmes the NDP vision and aspirations.

4.4.3 Key decisions made between conferences

The ANC NEC took various decisions and resolutions from January 2013 immediately after the 53rd National Conference to date. Many of the decisions emanated from the meetings of the NEC, in some cases informed by deliberations and recommendations of ANC NEC Makgotla and the 2015 National General Council.

4.4.4 Report on the implementation of policy and specific projects and programmes The ANC-led government has made considerable progress in the last twenty two years in providing schooling and basic education to young people and recorded tangible progress in the areas of policy formulation; the development and the implementation of strategic programmes; the alignment of the sector programmes with the National Development Plan (NDP); the implementation of legislation and national policies; the improvement of the performance of the system in general; and in particular at school level as shown through the national, intercontinental and international assessment programmes. The Annual National Assessment (ANA), the National Senior Certificate (NSC), the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ), and the Trends in International Mathematics and Science Study (TIMSS), all provide substantive evidence of an improving learner and system performance in the Foundation, Intermediate and Senior Phases, as well as in the FET Band in partnership with business and civil society through the National Education Collaboration Trust (NECT) and through interactions with communities through the Quality Learning and Teaching Campaign (QLTC). The sector has continued to improve access and inclusivity; has more people leaving school with a National Senior Certificate entering colleges and universities. Other programmes implemented successfully include Early Childhood Development (ECD); strengthening of the curriculum; the introduction of Information Communication Technologies (ICTs) in schools through Operation Phakisa; the introduction of the three- stream curriculum model of academic, technical-vocation and vocational-occupational streams; the introduction of ICT-resourced teacher development centres; the roll-out of the learner improvement and attainment strategy; addressing inappropriate school infrastructure; the provision of water, sanitation and electricity to schools; the provision of a national school nutrition programme (NSNP) in schools and the strategic funding of schools; the provision of LTSMs, particularly stationery, textbooks and workbooks to schools; the provision of health and social programmes, including psycho-social services, deworming, and HPV Vaccination against cervical cancer; the steady increase of learners who register and actually write the National Senior Certificate examinations, signifying an improved internal efficiency or retention of the system; the improvement in the number of learners who pass their NSC examination and qualify to register for college and university studies; the continued provision of bursaries through Funza Lushaka, thus increasing the number of adequately qualified teachers, especially in gateway and scarce subjects. The Trends in International Mathematics and Science Study (TIMSS) results show that South Africa has shown the largest improvement in learning outcomes between 2002 and 2015 in Mathematics, and Science though from a low base, which is the best improvement among all countries that were assessed in 2015. Despite the great progress recorded in the Basic Education sector, there are challenges that require attention, which include lower than expected quality of educational outputs and outcomes and the efficiency of the system in general; the drop-out and repetition rates, particularly in Grades 9-12; social challenges such as teenage pregnancy; bullying in schools; drug and substance abuse; violence, corporal punishment and health-related challenges such as TB and HIV and AIDS; the provision of quality Early Childhood Development (ECD) and its resourcing; procurement challenges related to LTSMs, infrastructure and school furniture; the mergers and closures of small unviable schools, and the eradication or phasing out of multi-grade schools; strategic, administrative as well as professional and governance leadership and management in the different layers of the sector; continuing with the programmes to strengthen literacy and numeracy levels, especially in the lower Grades; and management and administrative lapses. In terms of access, South African schools have become more inclusive since the advent of democracy, and more equitable in terms of staffing, teacher provisioning, and resourcing. Following the 53rd National Conference of the ANC, progress and challenges have been recorded on the Conference resolutions on basic education, particularly in the following areas:

Improving the working conditions, performance and the remuneration structure of teachers The finalisation of recommendations by the Presidential Review Commission appointed in 2012 to review conditions of service and remuneration of education professionals was delayed. The DBE has completed its work of matching teaching skills, qualifications and competencies with the positions to which teachers are appointed. New teachers are appointed after having been matched with the vacant positions. Terms of reference for research on post provisioning have been finalised. The outcome of the research will be used as a basis for the amendments to the post provision norms and resulting funding requirements, including the staffing needs for the three-stream curriculum model. This has not been concluded. A comprehensive human resource plan to enable the system to contribute significantly to the overall national transformation agenda is still under discussion. The Collective Agreement for the redeployment of educators in excess to the declared school establishments was signed in 2016. It is not being implemented as yet awaiting ratification by some stakeholders.

Resourcing education and Procurement The National Treasury has developed an Integrated Development

Management System (IDMS) to be used in all infrastructure planning, management, delivery and oversight to make infrastructure delivery uniform and integrated in the country. The sector is working to refine a strategy to retain specialised professionals in the build-industry. Scientific methods, such as geospatial analysis, to determine population dynamics versus the need to provide school infrastructure, are being conducted in the Eastern Cape and Limpopo, and will be rolled-out in other provinces as well. On LTSMs, the sector has developed the National Catalogue, which standardises the selection of textbooks and workbooks. The Office of the Chief Procurement Officer (CPO) and the National Treasury advertised a transversal tender on central procurement of stationery to be used by Provincial Education Departments (PEDs) at the expiry of their contracts. The DBE owns the copyright on all workbooks produced and delivered to Grades R-9 in public ordinary schools. A system is being put in place to make school principals responsible and accountable for the receipt and retrieval of textbooks, which is a challenge at the end of each school calendar year.

Monitoring and evaluation of performance In ensuring successful monitoring and evaluation of performance, the sector has promulgated the South African Standard for Principalship and is developing the Advanced Diploma in Leadership and Management, as an entry qualification for principals. The DBE is working with the Department of Public Service and Administration (DPSA) to develop competency assessment tools for school principal The Integrated Qualifications Management System (IQMS) has been refined, and is now called the Quality Management System (QMS). A Collective Agreement in the Education Labour

Relations Council (ELRC) was signed by the DBE and the Combined Teacher Unions – Autonomous Teacher Union (CTU- ATU) in November 2014. Engagements on the implementation of the Collective Agreement are still underway.

Review of funding model for schools and review of the Quintile Model The sector has reviewed the funding model for schools and the Quintile Model, with quintiles 1 to 3 classified as “no fee” schools and Quintiles 4 and 5 schools classified as fee paying schools.

The appointment of school principals Consultations on draft amendments to the South African Schools Act, 1996 the focusing on the powers and roles of SGBs in the appointment of school principals are ongoing.

The capacity of government The sector is implementing programmes to build capacity through constant training and development in accountability measures, internal controls and consequence manage- ment.

Mismanagement, corruption, incompetence and ill-discipline Applicable sections of the Public Service Act (Act No. 105) of 1994 as amended, and the Labour Relations Act (Act No.

66) of 1995 as amended, are invoked when dealing with unethical, unlawful and corrupt practices by public servants.

Poor education outcome As poor education outcomes are largely a reflection of poor leadership at various levels in the system, the sector has instituted programmes to strengthen leadership and monitors these interventions regularly.

Language and cultural education The sector has strengthened the teaching of African languages through the Incremental Introduction of African Languages (IIAL) Strategy. It has also developed the Foundation Phase Second Additional Language (SAL) Toolkit and distributed to all schools that are implementing the IIAL. Provincial IIAL teacher orientation workshops are held regularly.

Curriculum A Task Team has been appointed to develop a framework for the compulsory offering of History in the Further Education and Training (FET) Band, in addition to History provision in the General Education and Training (GET) Band. Also of importance to report is that the sector introduced a three-stream curriculum model, instead of the two-stream model as earlier envisaged. This comprises of the academic, technical-vocational and vocational-occupational streams.

Credibility and image of the sector The sector has improved its communication. The work done with strategic partners, and in particular the NECT and the QLTC, is beginning to show positive outcomes.

School Governing Bodies The power of school governing bodies with regard to of the locus of authority in terms of language, the capacity of schools and curriculum choices has been reviewed, and appropriate legislative amendments are proposed in the draft Basic Education Laws Amendment (BELA) Bill. The department conti- nues to develop the capacity of SGBs in rural and township schools through the funding that has been made available. The department, through the consultations with the national SGBs association, the NECT and the QLTC, has launched an advocacy campaign to support and empower SGBs including co-opting members with appropriate technical skills to assist school governing bodies.

Section 100 (1)(b) interventions Legislation to guide interventions in terms of section 100 of the Constitution has not been promulgated as yet.

Employment of educators and other civil servants as local government councillors While a resolution that government should prioritise passing a law that bars civil servants from taking up employment or positions as local government councillors whilst still employed in government posts, was passed, such a law has not yet been promulgated. However, most of the teachers who were elected as councilors resigned. The new challenge is that of their re-employment as teachers.

Multi-grade schools The Council of Edu- cation (CEM) noted in July 2016 that, since 2015, 2 677 schools were earmarked for rationalisation in all nine provinces. The majority of these schools, were not multi-grade schools per se, but were schools that were declared as small and unviable. A total of 663 of these schools, have since been rationalised; and the remaining 2 043 schools, will either be rationalised, or will be retained and be refurbished. Provinces continue to provide support to these schools in the form of teacher training, as well as monitoring of LTSM usage and curriculum coverage.

Retention and drop-out rates Measures taken to strengthen the basic education sector to provide more opportunities for young people, as well as increasing retention, progression, and completion rates in the basic education sector, include focused programmes to address drop-out rates, especially at high school and the negative effects of teenage pregnancy, gangsterism, and vulnerability, including bullying. The introduction of the three-stream curriculum model in the Basic Education sector is one of the sector responses to increase post-school options, including the strengthening of the collaboration between DBE and DHET to improve articulation between basic and post- school education, in order to expand the effectiveness of credible post-school education and training options. In promoting inclusive education, learning programmes linked to the National Senior Certificate and the National Curriculum Statement have been developedand advocated. The Basic Education sector introduced critical developments aimed at promoting inclusive education since 2014. These include the introduction of the South African Sign Language (SASL) Curriculum, and Assessment Policy Statement (CAPS) for Deaf learners, completed in 2014 and introduced in Schools for the Deaf in 2015; the institutionalisation of the Policy on Screening, Identification, Assessment and Support (SIAS) as well as Curriculum Differentiation; the development of a Policy for access to quality education and support for children with profound intellectual disability.

Early Childhood Development, including Grade R The sector hopes to finalise the National Policy for Grade R in order to make Grade R compulsory. This will be done through the process of finalising the Basic Education Laws Amendment (BELA) Bill by end of March 2017. The Professionalisation of all Grade R practitioners will not be achieved by 2018 as per resolution, but will depend on the change of policy to include Grade R as formal schooling. The Post Provisioning Norms and Standards will determine the number of teachers which will be required and assess the supply available.

Areas for consideration by conference The following are areas that the sector is submitting for consideration by the Conference: On children: Conference should devise better ways of determining areas of support of educational and development needs of young children which must be developed and normed for African Languages in the early childhood years. On youth: Conference should ensure a youth development focus for post-school opportunities that must be established with a focus on rural spaces in order to eliminate the scourge of poverty and its effect on young people. On curriculum enrichment, arts, culture, indigenous games and heritage: Conference could ensure that the African languages are reflected and used in all schools, and will leverage the opportunities to develop materials in African Languages within broader society. This means that communities must ensure that curriculum enrichment; arts, culture, indigenous games and heritage events are attended and used to enable social cohesion and a sense of national identity among young people. On economic transformation : Conference could recommend that an updated Science

Technology Engineering and Mathematics (STEM) strategy to develop be developed and implemented in order to feed national human resource development goals. Conference should undertakea radical review and transformation of the means of assessing what learners can and should do and know at national and provincial levels, and ensure that this is integrated with classroom- and school-level systems for improving feedback and teaching for better learning outcomes. On informationand communication technologies (ICTs): The Conference should ensure that ICT is established and felt in teaching and learning in our schools and educational institutions. Teacher development and learner understanding will be deepened through the use of ICTs in preparing young people to radically improve their post-school and life opportunities in a diverse context. On the safety and stability of schools as well as the protection of education from disruptions: Conference could recommend that parents and communities be mobilised and pressured to secure schools as essential service points, in support of education and service to our nation. All monitoring activities and efforts should be improved especially at the level  of the classroom and the school, whether it is in terms of schooling ethos, values, resources and functionality. Ensure that all schools provide psycho-social support to learners. Ensure that education is regarded as a continuum both in structure and articulation. Ensure that the sector is able to sustain the momentum of the infrastructure programme, with particular reference to the provision of basic services, safe and conducive environment. Ensure that the Ministry of Telecommunications and Postal Services continue to work closely and collaboratively with the Departments of Basic Education as well as Science and Technology to provide rapid universal connectivity for ICTs as enablers for quality education. Ensure that the Departments of Higher Education and Training as well as Science and Technology work collaboratively, cohesively and in an integrated manner in the promotion of Science, Maths and Technology (SMT) to support the Department of Basic Education’s newly established Maths, Science and Technology unit. Explore ways in which schools with amenities share their resources with historically disadvantaged schools, given the disparities in resources because of the legacy of apartheid. Swiftly move to a quality management system to enable the DBE to assess the competencies of educators for development purposes and to encourage self- assessment by educators. Discourage frequent curriculum changes, in order to avoid change fatigue. Fast track the implementation of the Learner Unit Records Information Tracking System (LURITS) to enable the education sector to track learners from basic to higher education, and make this system live and web- based. Intervene in the Intermediate and Senior Phases of schooling, especially in the area of Mathematics. Provide support to Learner Representative Councils (LRCs) to better understand their roles in the governance of schools. Mobilise communities to oppose tendencies that target schools as part of civil disobedience. Improve the efficiency of scholar transport provision. Further embed our constitutional values and principles as well as those of the Freedom Charter in the Curriculum. Improve efficiency in the roll-out of the National School Nutrition Programme (NSNP).

4.4.5 Report of the impact on society of implementation of ANC policies and programmes:

Encourage and promote problem-solving and analytical skills among learners and use ICT as enabler for learners and teachers.

 4.4.6 Policy gaps: The existing resolution of the ANC on making education an essential service must be reviewed, as it has the potential to derail existing cooperation in the sector. Taking active steps to prevent vandalism at schools, and to protect all public property. Building and renovating boarding schools to reduce many unviable schools; removing the need for scholar transport in some rural areas; and providing a safety-net, especially for children from poor families, the orphaned, and other disadvantaged children. Promoting and strengthening technical schools as centres of excellence focusing on specific disciplines and skill sets. Developing policy on schools that will provide a focus on talent development, e.g., development or establishment of public schools for talented or specially gifted learners. Reviewing the education landscape, particularly preparation for post- school education. Review the approach to education, from high stakes tests to formative education and assessment. Early Childhood Development (ECD) and pre-school must in time, be moved from the Department of Social Development (DSD) to the Department of Basic Education (DBE), and further work to continue to provide quality provisions in this area should be considered. Promote and expand the second (vocational) and third (occupational) stream in the public schooling system. Strengthen continuous professional development and utilise Teacher Resource Centres optimally.


4.5.1 ANC Policy context: Education remains an apex priority for the movement and this includes higher education and training. The ANC policy position is as described above under the section on Basic Education.

4.5.2 Government policy context: The vision of an integrated education and training system was articulated in the African National Congress (ANC) Policy Framework on Education and Training in 1994. This was translated into government policy through resolutions of Cabinet and various instruments such as the MTSF. The establishment of the Department of Higher Education and Training in 2009 added a new dimension to the transformative possibilities in higher education, which is the provision of a single, seamless post-school education and training system that meets the aspirations of young people and adults. A plethora of new policy and legislation has come into effect since 2009. These have been introduced to facilitate the transition from a disjointed post- school education and training system to an integrated system. These are designed to take forward policy imperatives of government. The Department’s focus and priorities are informed by the vision espoused in the National Development Plan, the 2009-2014 and 2014-2019 Medium Term Strategic Frameworks (MTSF) and the imperatives of the 2013 White Paper for Post-School Education and Training which are translations of ANC policy into government policy, plans and programmes.

4.5.3 Key decisions made between conferences:

The NEC, as the key policy-making body between conferences, took a number of decisions that were implemented by the higher education and training sector. Those are reflected in the body of the report.

4.5.4 Report on the implementation of policy and specific projects and programmes: The following is a summary of the work of the higher education and training sector.

Implementing free higher education for the poor in South Africa The report on the extension of the provision of free education for the poor was submitted to the Subcommittee in November 2015. It was neither adopted nor sent to the NEC for adoption. The adoption of such a policy is necessary to guide government. The policy on free higher education for all poor undergraduate level students was not finalized for adoption before the end of 2013 as directed. The ANC resolved after the 2015 NGC that uncontrolled fee increases should be curbed in colleges and universities and directed government to put in place regulations to implement those throughout the higher education and training sector.

The National Student Financial Aid Scheme A newly structured national student financial aid system has been introduced to enable fee-free education from 2014 onwards, as directed by conference. The National Student Financial Aid Scheme (NSFAS) has started implementing its new student centric model. The policy dialogue was initiated in July 2014 and is being utilised. It was replaced by reference group, which has been used to develop a fully-fledged funding model for students from poor families and for those described as “the missing middle”. This model is currently being tested. The sector is currently considering a graduate tax for all who graduated from higher education and training institutions. It is expected that the Presidential Commission of Inquiry into Higher Education and Training, including TVET colleges and universities, will consider this in their work.

Community service for graduates from higher education institutions A report on the feasibility of community service for all graduates has been developed. It recommends the strengthening of existing similar programmes. The policy on Community Service for all students was due by July 2016 and implementation was scheduled to begin by December 2017. This has not been finalised.

Infrastructure for post-school education and training system The Department of Higher Education and Training has consolidated the infrastructure requirements with estimated costs to expand the post school education and training system. This is linked to and coordinated by the Presidential Infrastructure Coordination Council (PICC).

On Higher Education Colleges Due diligence is being undertaken on Agricultural Colleges by a Technical Task Team and a report with recommendations will be ready by March 2017. All public Colleges, specifically Agricultural and Nursing Colleges, currently under provincial authority are to be moved to a national competence in line with the constitution to be managed under the relevant Higher Education and Training legislation. The sector has not concluded the work of shifting Nursing and Agricultural Colleges to a national competency by March 2017. Feasibility studies have been conductedandaprocess isunderway to enable all nursing colleges to be transferred to the National Department of Health and to operate under the requirements of the Higher Education Act of 1997 as amended, fully incorporated into the post-school system in terms of articulation, governance, information systems and skills planning.

On former Teacher Education Colleges A survey of former College of Education sites was done and a report compiled towards a full audit of all former College of Education infrastructure to identify those Colleges which are not being utilised for educational purposes or are underutilised and could be productively used to expand post school education and training opportunities.

Other matters in the mandate of the Higher Education and Training sector A special committee on the transformation of Higher Education Institutions (HEIs) has been established by the Minister. A funding model informed by the report of the Ramaphosa Commission is biased in favour of the Historically Disadvantaged Institutions of Higher Learning. Bogus colleges that have not been registered have been criminalized. A review process of the curriculum content of the National Certificate- Vocational (NCV) has been initiated. A policy document seeking to align FET Academic schools, Technical Schools and FET Colleges is being developed. An initiative has been launched to attract better qualified TVET lecturers and staff. There are discussions between the Department of Higher Education and Training and Higher Education South Africa (HESA), now known as Universities South Africa (USAf), in relation to standardization of points or scores for purposes of admission to universities or universities of technology. The Minister of Higher Education and Training in his capacity as a convener of the Human Resource Development Inter-Ministerial Task Team has approached State Owned Enterprises (SOEs), sister departments and the private sector to provide opportunities for practical training of graduates. Eskom has already taken about

8 000 learners as interns and apprentices. Back to school campaign has been extended to include Higher Education Institutions. All stakeholders in the higher education and training sector have been engaged and are regularly consulted to ensure that disagreements at HEIs are dealt with in a disciplined manner without resorting to vandalism and destruction of property or acts of intimidation. The Revised Higher Education and Training funding model and framework was approved in November 2016 against the deadline of March 2015. Implementation is taking place as directed. The Central Application Service (CAS) is being fast-tracked for implementation by March 2018. Full implementation of the CAS across the PSET system is scheduled for 2022. Finalise Policy and Procedures for Measurement of Research Output of public HEIs by March 2015. This was completed and implementation is taking place as directed. Implementation of forensic audit of NSFAS at institutions by March 2015. This was completed and a report will be submitted. The implementation of first phase of Staffing South African Universities Framework was completed by 01 July 2015 and Phase 2 has been implemented. The Education Alliance has met to consider issues at hand. It should have a programme to support PSET system. Monitor HEIs toensure they are not using the national benchmark test as a hindrance to transformation.

4.5.5 Report of the impact on society of implementation of ANC policies and programmes:

The implementation of ANC policies and programmes is ensuring a socially just and more responsive post-school system by improving access to a more diverse set of education and training opportunities for the youth and adults from very different educational backgrounds, with a bias towards the most marginalised. The post-school system is therefore being strengthened to become more responsive to the needs of its citizens and ensure the social and economic development of the country.

4.5.6 Policy gaps: The ANC must develop policies to clarify the nature and role of the entire college sector that comprises Community Education and Training (CET) colleges, Technical and Vocational Education and Training (TVET) colleges and other colleges for specialised purposes such as agriculture, nursing, emergency care, policing and teaching. There must be clarity on programmes offered by all colleges, especially TVET and nursing colleges. Technical and vocational training must be marketed as the first choice leading to attractive career options for the majority of learners ahead of university education. Research must be undertaken into the cost effectiveness of training students at university in mid-level courses such as Primary Health Care (PHC) and health promotion to determine where such courses would best be delivered. Note must be taken of the possible resistance offered to a changed approach from universities and organisations such as the South African Nursing Council (SANC) and the Democratic Nurses Organisation of South Africa (DENOSA). Universities must also focus on education and training in the social sciences. Retirement age of professionals and academics must be increased. The ANC must consider policy changes that will make it compulsory for colleges and universities to obtain concurrence and approval to offer a course from relevant ministries, especially in the health sector. This should aim at improving the alignment between college and university programmes to the requirements for employment in different sectors under the governance of relevant ministries. Post-school education and training is being made more accessible; and this must be accompanied by convergence in the funding of higher education and training.


4.6.1 ANC Policy context: Health is a priority for the ANC and country. The Freedom Charter under the Clause “There shall be houses, security and comfort!” states that “… a preventive health scheme shall be run by the state; free medical care and hospitalisation shall be provided for all, with special care for mothers and young children …” The 1994 ANC National Health Plan and the Reconstruction and Development Programme (RDP) and policy positions contained in the document Ready to Govern remain key anchors of ANC health policy. These are foundations on which resolutions of various conferences rest, including those of the 52nd and 53rd National Conferences, ANC election manifestos and decisions of the 3rd and 4th National General Councils, and programmes of the ANC and government in the period under review.

4.6.2 Government policy context: The vision of an integrated and unitary National Health System was articulated in the 1994 ANC National Health Plan. This was translated into government policy through resolutions of Cabinet, various instruments such as the MTSF and the 1996 White Paper for the Transformation of the Health System in South Africa. The National Development Plan (NDP) 2030 provides a vision for strengthening the health system to ensure that it is efficient and responsive and offers financial risk protection.

4.6.3 Key decisions made between conferences: The performance of the health sector is measured against the resolutions of the 52nd and 53rd National Conference Resolutions, including the 2009 ANC Ten Point Plan for Health. The NEC took various decision between conferences, and those are ANC policy directives that emanated from NEC meetings assisted by various forums such as Makgotla and the NGCs. ANC policies and programmes were translated to the government Programmes of Action for implementation as the mandate that was obtained from the South African electorate, especially commitments contained in the various national and local government election manifestos.

4.6.4 Reports on the implementation of policy and specific projects and programmes:

National Health Insurance (NHI) Work on the establishment of the NHI Fund has been progressing steadily and the White Paper on NHI has been finalised waiting for endorsement by Cabinet. The draft legislation is ready to be released together with the White Paper. The NHI Fund should have been set up using state revenue by 2014 as per national conference resolution. The ANC and government have embarked on activities to mobilise broad social support for the roll out of the NHI. Road shows have been conducted; and stakeholders consulted. Social mobilisation continues to take place at national and provincial levels. The ANC Subcommittee has provided guidance and oversight over the processes leading to the approval of the draft White Paper on NHI in March 2015 and its publication for public comments in December 2015 against the timeline of 2013. The NEC has received and discussed regular reports on programmes that were implemented through the NHI Pilot sites to prepare the health system for implementation of NHI. Conference resolved that this process be finalised by 2013.

Central hospitals, namely academic hospitals directly attached to medical schools In moving Central Hospitals to become the responsibility of national government including its overall management, legal opinion was sought. The sector was advised and agreed to stop the move as there was a possibility of litigation against the national government using the current National Health Act. The solution was to bring this resolution into the NHI White Paper as a proposal of a new policy initiative that would emerge in the NHI legislation and amendments of the National Health Act. National Health is implementing programmes to ensure improved management and related capacity of central hospitals to deliver services efficiently and effectively. Full delegations have been developed for all managers in Tertiary and Central Hospitals. The implementation of operational management structures and processes for public hospitals has been formally adopted and facilitated.

Security and efficiency of supply of critical services The process of in-sourcing of critical services such as cleaning services, security, food and laundry services and linen supply is currently underway in varying stages of implementation. Its progress differs from province to province. The areas that are advanced are laundry services, food services and cleaning services. Security services are lagging behind because of their complexity. The department introduced direct delivery of pharmaceuticals, dry dispensary and related supplies to facilities by suppliers to ensure improved turnaround times and prompt payment of suppliers through the Direct Delivery Strategy (DDS), Central Chronic Medicine Dispensing and Distribution Programme (CCMDD), the operationalization of the Control

Tower and Provincial Medicine Procurement Units (PMPU). End- to-end visibility in the supply chain and electronic data interchanges and Direct Purchasing have been implemented. The department has extended the central procurement mechanism to all pharmaceuticals, dry dispensary and medical equipment and devices. The framework of non-negotiables has been adopted by the sector. It has been successfully implemented for the past five (5) financial years (2011-2016). Government is aware of the resolution that the state must have majority shareholding in the state owned pharmaceutical company, Ketlaphela.

Human Resources Development The National Human Resource Strategy for Health was endorsed by Conference in 2012. Good progress has been made in ensuring that the primary training platform for nurses is located at nursing colleges inside the hospitals. Ten (10) nursing colleges are already in various stages of refurbishment to meet the goals of this resolution. There are ninety-five (95) public nursing colleges in operation in all 9 provinces, excluding private nursing colleges. Not all these colleges are attached directly to hospitals. In implementing the resolution, the Ministers of Health and Higher Education and Training are due to sign an agreement and release a public statement soon on this matter. The NDoH and DHET have initiated a process in partnership with DHET and South African Nursing Council (SANC) to review relevant legislation and regulations governing the nursing and education sectors. All eight (8) medical schools have expanded their training platform for medical students thereby increasing their total intake per annum. A ninth medical school was established at the University of Limpopo. It had its first intake in 2016. The training of doctors in Cuba through the Mandela- Castro Health Collaboration was expanded from 2010 from an intake of 80 to 1000 by 2011. The ANC has directed that this programme and Health Collaboration be intensified. An agreement has been arrived at in the health sector that this number is too high for the Cuban Programme to be undertaken annually and therefore the intake must be done in three year cycles. The health sector, together with Higher Education and Training, has no national and comprehensive programme to extend training to outside the borders of our country. However, some provinces have done so as individual provinces and are now faced with a serious challenge of non-recognition of qualifications by the Health Professions Council of South Africa (HPCSA).

Healthy lifestyles Government has conducted successful campaigns promoting healthy lifestyle. Most ANC branches do not have programmes that promote at no costs healthy lifestyle of members, their families and communities in wards where the ANC operates. The proposal that a day, e.g. Wednesday afternoon, be adopted in communities and schools as a common day for health promotion, including health education and healthy lifestyle was not put into operation. Various pieces of regulations to mitigate risk factors to diseases have been passed such as Regulation on Salt Intake. The Strategy on Non- Communicable Diseases is being implemented. The Obesity Sugar Tax is being debated. Fast tracking legislation and regulations to deal with the risk factors of diseases and injury has been slow due to disagreements amongst various stakeholder groups in government, industry, labour and society at large. The operating framework for the establishment of a multi-sectoral

 Health Commission, whose function is to promote healthy lifestyles, encourages prevention of diseases and promotes health care by enforcing health regulations, has been developed; but the said commission has not been created in 2013 as directed. The ANC and government have embarked on national and provincial campaigns and hosted events and activities to promote healthy lifestyles through mobilization of individuals and communities to engage in physical activities, good dietary practices and reduction of harmful use of alcohol, tobacco and the control of substance abuse. The sector has published the National Mental Health Policy Framework and Strategic Plan 2013-2020; is implementing the Policy Framework and Strategy for Rehabilitation and Disability; put into operation the Sexual Assault Policy and Implementation Guidelines; and launched the She Conquers as some of concrete actions to strengthen the capacity of rehabilitation services in the public sector with a focus on mental health, physical disability, gender-based violence, childhood trauma and substance abuse.

Infrastructure The health sector has concluded a comprehensive audit of all facilities under the auspices of the PICC, to ensure that substandard infrastructure is revitalized and refurbished by 2025 using the public fiscus and public-private partnerships where appropriate. The extent of backlog maintenance in each facility has been quantified in both monetary and physical terms. The actual replacement and maintenance programme has commenced in more than 50% of the facilities. New Clinics and Community Health Centres (CHCs) are being built. A draft framework for maintenance strategy to improve preventative and reactive maintenance was developed. Government has not reported on whether it established teams of engineers and other professionals in built industry from, e.g., the CSIR, DBSA, Transnet, Eskom, to provide health infrastructure on a massive scale in the pilot districts in order to shorten the pilot period. KwaZulu Natal, Gauteng, Western Cape, and Eastern Cape provincial health departments have made reasonable progress in establishing effective project managementteams led by technical professionals such as engineers by filling the 44 core infrastructure posts in compliance with the law. However the Free State, North West, Northern Cape, and Mpumalanga have not made any significant progress in establishing project management teams for health infrastructure. No progress has been made to establish workshops in health facilities for maintenance of infrastructure and medical equipment.

Quality of Health Care The DoH established the OHSC nationally by the inauguration of the National Board of the OHSC in January 2014 against the deadline of 2013. The Interim CEO for the National OHSC was appointed on 01 April 2014 and legislation has been written in such a manner as not to have OHSC established in all nine provinces. The Health Ombudsman has been appointed with effect from 1 June 2016 against the deadline of 2013. In accelerating the establishment of facility improvements teams for each district, these were established in NHI pilot sites or districts but not in all health districts. The concept of facility improvement teams has been overtaken by the launch by the President of Operation Phakisa-Ideal Clinic Model in all the districts. The sector has adopted non- negotiables for health, e.g. pharmaceuticals, security, vaccines, food, dry dispensary, as a policy and good practice for hospitals and clinics. It has been successfully implemented for the past five (5) financial years (2011-2016). The sector is considering the proposal that it performs lifestyle audits of staff in procurement where indicated; and also that staff in procurement at all levels of government must be rotated regularly to minimise corruption. The sector is attending to boilers in health facilities, as part of its infrastructure maintenance programme.

Re-engineering of primary health care A massive family planning programme under the theme Dual Protection was launched in 2014 with introduction of new family planning method, i.e. the trans- dermal implant against the deadline of 2013. To date approximately 800 000 women received implants. A public consultation process has been concluded on school health programme in relation to reproductive health rights, HIV counselling & testing and prevention of Sexually Transmitted Infections (STIs) and has been gazetted and is waiting for an implementation plan developed together with school governing bodies. In 2013 South Africa was the first country to sign the WHO Framework Convention on Tobacco Control Protocol to eliminate Illicit Trade in Tobacco Products. The protocol has gone through Cabinet. It will be presented to Parliament for ratification. A draft Liquor Bill was developed by the DoH and Department of Social Development. Subsequent to that, a more comprehensive Liquor Bill that includes trading hours, distance from schools and churches, and advertisements of alcohol products was developed by the Department of Trade and Industry. It was agreed that relevant

information from the draft Liquor Bill will be incorporated into the DTI Bill. This Bill is currently in the public comments phase. This process means that the law to abolish marketing of alcohol products was not passed by 2013 as directed. To accelerate the contracting of General practitioners to work in government clinics, a total of

335 GPs and 329 Pharmacist Assistants have been contracted. This programme has not met its year-on-year targets. The sector has prioritised and intensified the roll out the programme of the Ideal Clinic Model using the Operation Phakisa Delivery Model. The sector has not formally adopted the model of Operation Sukuma Sakhe and the War Room Implementation Programme (WRIP) in all provinces to be the method of delivery of community programme and creative use of auxiliary workers, such as Community Health Workers, Lay Counsellors, AIDS Councillors, Community Liaison Officers and Community Development workers. The sector has reactivated programme to ensure that the District Health System (DHS) is functional in all provinces, as a practical step of strengthening Primary Health Care (PHC). Community Health Workers (CHW) have not been absorbed into formal government employ as directed by resolutions. This is mainly due to budgetary constraints.

Cost of Health Care The establishment of the National Pricing Commission was halted pending the outcome of the Health Market Inquiry into the cost of health care. The deadline for its establishment was 2013. The Alliance has been engaged to publicly support the proposal on the reduction of the cost of the private health care.

Other programmes HIV and Maternal and Child Health: Innovative programme, e.g. bringing mothers and fathers of board on issues such as exclusive breastfeeding, have been embarked upon to keep the momentum of the HIV campaign. Our communities are involved in campaigns against advertisements such as those that promote illegal abortions and other unethical practices that endanger lives of our people. Tuberculosis (TB): According to the 2016 WHO global TB Report, South Africa has done well, accounting for the largest share (45%) of people living with HIV who have received TB preventive treatment for latent TB infection (LTBI) in 2015, followed by Malawi, Mozambique and Kenya. However, South Africa has the highest estimate of incidence of Tuberculosis in the world at 834 per 100

000 population, as compared to Lesotho (788), Swaziland (565), Democratic Republic of Congo (561), Namibia (489), Zambia (391), Botswana (356) and Zimbabwe (242). The country’s incidence and prevalence remain unacceptably high and TB remains the number one underlying cause of death in South Africa despite the institution of game changing interventions such as GeneXpert testing, assertions of the TB disease burden as declining in absolute numbers and proportionally. The number of MDR-TB and XDR- TB patients remains high in South Africa. Recent data suggests that 4737 MDR-TB and 389 XDR-TB were initiated on treatment in 2009 as compared to 10,735 MDR-TB and 603 XDR-TB in 2016.

This high number is identified as a result of the use of GeneXpert in the management of patients with MDR-TB and XDR-TB and in the population, (technology which has markedly improved the rate of detection of TB). These numbers might also suggest an increase in the spread of MDR-TB and XDR-TB amongst communities, despite increased efforts of initiating treatment in Centres of Excellence and decentralized treatment sites. A huge programme was launched to screen for TB amongst all correctional services inmates, mineworkers and people in peri- mining communities especially in the top 6 prevalent districts. As part of efforts to improve access to treatment and treatment outcomes for MDR/ XDR-TB, South Africa is now at the forefront of TB treatment and research using newer and innovative drugs. The sector has intensified programmes against Tuberculosis at Primary Care level, and is fostering greater collaboration with relevant government departments such as the Departments of Correctional Services and Mines as well as with research institutions to pursue programs of research and development of new approaches and innovative drugs against priority illnesses and diseases as referred to in the preceding paragraph. Many ANC Branches do not have health portfolios as directed by conference, to deal with TB and other health issues. Progress has been made in dealing with challenges related to National Forensic Chemistry Laboratory, especially the state’s ability to provide the Justice System with blood alcohol results needed as evidence of drunken driving.

4.6.5 Reports of the impact on society of implementation of ANC policies and programmes: The impact of implementation of ANC policies, such as the positive impact anti-HIV and AIDS programme which resulted in less deaths and increased life expectancy, reduced overall mortality in the country, dramatic reduction of maternal mortality, dramatic drop in mother to child transmission and reduction in child and infant mortality and drop in TB mortality due to successful ARV treatment.

4.6.6 Policy gaps. The ANC is highly committed to good quality health care in the public and private sector. However, having noted with great concerns the high costs of medical insurance and litigation against medical malpractice, policies have to be developed to deal with these concerns. The health sector has a duty of promoting good health and preventing and treating diseases. One critical method used to prevent communicable diseases is to eliminate all vaccine-preventable diseases which have existing vaccines with proven efficacy on or before 2037 in the same way as Cuba did. Focus on this would change the current course and approach that is disease-focused thereby resulting in the population of our country becoming relatively healthier. This proposal has the potential to result in massive programmes of health promotion and prevention of disease at Primary Care level. It has a huge potential for generating research and development; new developments in vaccinology, economic gains, effective enforcement of the Immigration Act and orderly urbanisation. Strengthening military health and fostering cooperation between military and civilian health services: The 4th National Policy Conference discussed the relationship between military and civilian health. Its recommendations were not presented to the 53rd National Conference. To restate the discussion, the policy of the ANC as stated in the 1994 National Health Plan for South Africa is that “A single comprehensive, equitable and integrated National Health System (NHS) must be created.… It will coordinate all aspects of both public and private health care delivery, and will be accountable to the people of South Africa through democratic structures. All existing public sector departments including local authority, homeland, military and prison services will be integrated into the NHS”. The 50th National Conference held in Mafikeng noted “the under‐ utilization of valuable resources of the South African Military Health Services” and resolved “to look into the integration of the South African Military Health Services into the public health services for the benefit of the public at large”.

Facilities used by the SAMHS should be prioritised for revitalization in line with the infrastructure program pursued in the context of the NHI. Our main military hospitals must be prioritized for optimization of management, human resources and equipment to always be our pride. The ANC should advocate for the integration of military and civilian health services without compromising the combatreadiness of the SAMHS. Cooperation between the public and private health sector serving primarily the civilian population, and the SAMHS serving mainly the military community and our top leaders, must neither interfere with service delivery in military facilities nor hinder the exercise of authority by a properly designated commander over assigned and attached members of the SAMHS.


As we discuss the work and the future of the ANC, let us ensure that new policy proposals and resolutions are not a repetition of any work that was done in the organisation in the past. Proposals of new policies must not be a rehash of old resolutions, especially those taken by past conferences and by the NEC between conferences. Proposed policy and programme changes must focus mainly on injecting more energy into implementation in the ANC and in government, where government serves as the ANC delivery tool or mechanism.

Members of the ANC must focus on having the ANC and ANC-led government emerging out of the Policy Conference confident that its capacity to implement is strengthened substantially. Towards that goal, the National Policy Conference must be persuaded to agree that there should be minimal changes to policy.

Further, it is recommended that the ANC policy review cycle should be increased from five (5) years to at least ten (10) years. This will allow the ANC enough time to implement and also relieve the ANC of the burden of unnecessary and frequent policy changes.

Policy and programme proposals in the form of discussions and resolutions


5.1.1 The ANC policy review cycle should be increased from five (5) years to at least ten (10) years.


5.2.1 On the use and increase of uptake of locally produced technologies Noting that technological innovations developed in South Africa have difficulty in becoming recognised and commercially viable due to limited visibility and support from public and private procurement; Therefore recommends that government and private firms be encouraged or compelled to use and increase their uptake of locally produced technologies.

5.2.2 On the coordination and harmonisation of policies and incentives related to STII Noting that there are a range of policies, incentives, and initiatives sponsored by various Departments in support of STI and that these are not always well coordinated, resulting in these achieving less impact than desired; Therefore recommends that a focused process be set up to coordinate and harmonise policies and incentives, especially those related to STI.

5.2.3 On the use of STI within and across the public sector as an enabler of service delivery Noting that the take up and utilisation of STI by the public sector is not always recognised as providing possible solutions to improved delivery of services to communities by provinces and local government; Therefore recommends that a coordinating mechanism be considered and implemented to improve the use of STI within and across the public sector and as an enabler of service delivery.

5.2.4 On the promotion of new innovations and invention of new technologies Noting that, although our people experience and make use of STI in their daily lives, this wide spread acceptance and usage of STI is often not realised by our communities, sometimes as a result by a historical deprivation from access to the sciences; Therefore recommends that policies be adopted to promote the recognition of the prevalence of STI in daily life and that these serve to encourage learners in schools, students at colleges and universities and workers in every sector to attempt to invent new technologies and products by analysing and learning from those imported and used daily in their lives.


5.3.1 The existing resolution of the ANC on making education an essential service should be reviewed, as it has the potential to derail existing cooperation in the sector.

5.3.2 Active steps to prevent of vandalism at schools and to protect all public property.

5.3.3 Boarding schools can be an important social net, especially for children from poor families, as well as orphaned and other disadvantaged children.

5.3.4 Reviewing the education landscape, particularly preparation for post-school education.

5.3.5 Review the approach to education, from high stakes tests to formative education and assessment.

5.3.6 Technical schools must be made schools of excellence focusing on specific disciplines and skill sets.

5.3.7 That the ANC should develop policy on schools that will provide for a focus on talent development, e.g. development or establishment of public schools for talented or specially gifted learners.

5.3.8 Early Childhood Development (ECD) and pre-schools must be moved from the Department of Social Development (DSD) to the Department of Basic Education (DBE).


5.4.1 The College sector in the Post-School Education and Training System The Post-School Education and Training (PSET) system is currently skewed towards university education, and will not self-correct. It requires a massive focus on Technical and Vocational Education and Training (TVET) and Community Education and Training (CET) in order to develop the system, change perceptions and culture and make TVET colleges attractive institutions of choice as envisaged in the White Paper on PSET. The ANC must develop policies to clarify the nature and role of the entire college sector that comprises Community Education and Training (CET) colleges, Technical and Vocational Education and Training (TVET) colleges and other colleges for specialised purposes such as agriculture, nursing, emergency care, policing and teaching. There must be clarity on programmes offered by all colleges, especially TVET and nursing colleges. Research must be undertaken into the cost effectiveness of training students at university in mid-level courses such as Primary Health Care (PHC) and health promotion to determine where such courses would best be delivered. Note must be taken of the possible resistance offered to a changed approach from universities and organisations such as the South African Nursing Council (SANC) and the Democratic Nurses Organisation of South Africa (DENOSA). Marketing technical and vocational education and training as the first choice Noting that:

1. Progress has been made in the PSET system, especially with regards to the migration of the full college functions to the Department of Higher Education and Training from 1 April 2015


 2. Technical and Vocational Education and training is important for skills development towards an inclusive economy; Therefore recommend that:

1. Technical and voca- tional training should be marketed as the first choice leading to attractive career options for the majority of learners ahead of university education;

2. The entire college sector has to be re- imagined in terms of the White Paper on PSET;

3. Sufficient resources be made available for increasing access, inf ras t r u c t u re , lecturer in service training bursaries

and curriculum transformation;

4. Higher Education and Training, and Basic Education sectors are called upon to align technical and vocational offerings in schools and colleges; and

5. TVET colleges needs to progressively offer qualifications for Grade 12 entrants on Levels 5 and 6.

5.4.2 Focus on education and training in social sciences Colleges and universities must continue prioritising mathematics, science and technology, but also focus on education and training in the social sciences.

5.4.3 Free higher education and training for the poor and subsidised higher education for the working class and lower middle strata in South Africa Noting that: Higher Education and Training in South Africa has become unaffordable for many poor, working class and middle class families The ANC has made huge strides towards providing fee free higher education to all undergraduate level students from poor families through massive increases in funding; A newly structured student centred model and central applications process to access financial aid has been implemented across the university and TVET college systems; A full review of the NSFAS Act and regulations is underway; A proposed model has been developed and is being tested to enable free higher education for the poor and subsidised higher education for the working class and middle strata; Recommend that: A new financial support model to ensure that academically capable poor, working class and middle strata students are supported to access higher education must be finalised and fully implemented by 2020; Sufficient funding to ensure the success of the model must be drawn from both government and the private sector; Consideration should be given to various taxation options to address funding needs; Fully subsidised grants should be provided to academically qualifying students from poor families in university education programmes. Poor families are defined as those who earn a gross family income within the lowest SARS tax bracket – currently below R75000 per annum; Academically capable students from lower working class families should not be expected to pay any up-front fees in order to access higher education and should be subsidised through a combination of grants and affordable loans. These families are defined as those earning family incomes within the second SARS tax bracket currently R75000 to R150 000 per annum; Academically capable students from working class and middle strata families, currently defined as earning from R150 000 up to R600 000 per annum, should be subsidised through a combination of grants and affordable loans, with their families providing a household contribution to their studies in proportion to their ability to pay; The fees that should be covered include tuition, accommodation, books, other essential study materials or learning resources, and a stipend to cover meals and other essential living needs - that is the full cost of study fees; All students receiving grants and loans from the state to access higher education, should receive additional academic and psycho-social support to increase their chances of success; SARS processes should be implemented to recover the loan portion of funding provided to working class and middle strata students by 2023;

5.4.4 Fast track Central Application Service (CAS) for implementation by March 2018 and full implementation across the PSET system by 2022.

5.4.5 Retirement age of professionals and academics should be increased.

5.4.6 The ANC must consider policy changes that will make it compulsory for colleges and universities to obtain concurrence and approval to offer a course from relevant ministries, especially in the health sector. This should aim at improving the alignment between college and university programmes to the requirements for employment in different sectors under the governance of relevant ministries, especially in the health sector.


5.5.1 The health sector must continuously strengthen measures to improve the quality of care delivered by health practitioners in the public and private sector plus draft a policy to curb high costs of medical insurance and litigation against medical malpractice.

5.5.2 The health sector should adopt a policy for the country to eliminate on or before 2027 all vaccine-preventable diseases which have existing vaccines with proven efficacy.

5.5.3 Facilities used by the South African Military Health Services (SAMHS) should be prioritised for revitalization in line with the infrastructure program pursued in the context of the NHI. South Africa’s main military hospitals should be prioritized for optimization of management, human resources and equipment. Military and civilian health services must be well- coordinated without compromising the combat-readiness of the SAMHS.


6.1 Report of the 2012 ANC NEC 53rd National Conference: Resolutions of the Education and Health sector.

6.2 Education, Health, Science and Technology discussion paper of the 4th National Policy Conference held in 2012.

6.3 Report of the ANC National General Council (NGC), 2015.

6.4 ANC Constitution, 2012.

6.5 Strategy and Tactics of the African National Congress, 2012.

6.6 The Freedom Charter.

6.7 Mafikeng Conference resolutions.

6.8 20 Year Review, Republic of South Africa.

6.9 The National Development Plan (NDP) 2030;

6.10 ANC Local Government elections, 2016.

6.11 ANC National Election manifesto, 2014.

6.12 Annual reports of government departments.

6.13 1996 White Paper on Science and Technology.

6.14 1995 White Paper on Education and Training.

6.15 1996 White Paper on Transformation of the Health System.

6.16 1994 ANC National Health Plan.

6.17 1994 Policy Framework for Education and Training.

6.18 Ready to Govern.

6.19 Reconstruction and Development Programme (RDP).

6.20 A report of the ANC National Conference, 1994 Bloemfontein.

Issued by the African National Congress, 12 March 2017