1

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1MH/R/95096202PR

Telephone: 0824946013

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1 Military Hospital

Private Bag x 1026
Thaba Tshwane
0143
27 February, 2013

SUBMISSION: WRITTEN AND ORAL ON THE MENTAL HEALTH CARE AMENDMENT BILL [ B39-2012 ] TO PARLIAMENTARY PORTFOLIO COMMITTEE ON HEALTH.

INTRODUCTION

  1. The Parliamentary Portfolio Committee on Health (National Assembly) invited interested individuals and organisations to submit written comments on the Mental Health Care Amendment Bill [B39-2012], and invited the public to make submissions on 27 February, 2013.
  1. The bill seeks to amend the Mental Health Care Act, 2002 so as to insert a new section;
  1. To provide for the delegation of powers by the head of the national department to officials in the national department;
  1. To repeal the Mental Health Act, 1973; and
  1. To provide for matters connected therewith.
  1. The advertisement was issued by DrMB Goqwana, MP, Chairperson of the Portfolio Committee on Health.
  1. Tertiary Military Health Formation document TMHF HQ/R/104/10 of 29 June 2006 refers. In it Gen LJ Smith required from the General Officers Commanding 1 Military Hospital, 2 Military Hospital and 3 Military Hospital to provide a report from their Psychiatry Service Unit Managers as well as a concept standing operational procedure for their institutions to the GOC TMHF before or on 31 Jul 2006.
  1. Gen LJ Smith wanted to be assured that the 3 military hospitals complied with the regulations of the Mental Health Care Act, 2002
  1. In spite of the presentations received by the Surgeon General of the South African Military health Services from General LJ Smith, uncertainty remains regarding the following matters:
  1. Are SAMHSHospitals and clinicsSTATE health services like, under or parallel to the Department of Health services?
  1. Do SAMHS hospitals have to be designated facilities as envisaged in Section 5(1) of the Mental Health Care Act 17 of 2002?
  1. ADV P G SELEKA on behalf of the Pretoria State Attorney on 9 July 2007 gave a legal opinion to the Department of Health Cluster manager: Non-Communicable Diseases. The legal opinion was shared with the Surgeon General of the SAMHS. The following facts came to light:
  1. The Defence Act 42 of 2002 provides for the establishment of a Military Health Service (SAMHS)for the South African National Defence Force (SANDF). The SAMHS is not mentioned by the national Health Act, 61 of 2003. It seems to exist parallel to the National Health Service run by the Department of Health.
  1. Regulation 13(1) provides that the SAMHS must at all times be structured and funded at State cost to provide an all-inclusive multi-disciplinary health capability to the SANDF and its members.
  1. Regulation 7(1)(a) of the defence act provides that:
  1. The Chief of the Defence Force may issue orders in terms of these regulations relating to –
  1. The provision, management and control of medical, dental, hospital, psychiatric and rehabilitative services, assistance and support to serving members of the SANDF and authorised patients.
  1. In terms of Regulation 11(1), the Surgeon General is obliged to make arrangements for, and exercise professional, executive and administrative control over the provision and administration of any treatment authorised in terms of Regulation 7.
  1. Therefore the mental health units operating within the respective Military Hospitals are not governed by the Mental Health care Act 17 of 2002 which came into operation on 15 December 2004, but by the Defence Act and the regulations published there-under.
  1. The designation envisaged in Section 5(1) of the Mental Health Care Act is not applicable to the Military Hospitals.
  1. At a practical level there has to be collaboration between the Surgeon General of the SAMHS on the one hand, and the head of the national department and heads of the relevant provincial heads on the other hand, regarding the nature of the health care, treatment and rehabilitation services to be provided by the Military Hospitals and their specialised units.
  1. The MENTAL HEALTH CARE ACT, 2002 (Act No.17, 2002) in the definitions Chapter I, section 1, mentions the Correctional Services Act 1998 but makes no mention of the Defence Act. This may have been an omission that must be addressed in the Amendment Bill.
  1. Section 40 (1) and (8) deals with the duties and responsibilities of the South African Police Service, but does not mention the Military Police Services of the SANDF. This must also be addressed by the Amendment Bill.
  1. The Bill must be clear in talking about Implementation of Policies and measures by State, that the South African Military Health Services (SAMHS) of the Department of Defence (DOD) is included as an organ of the state responsible for military health services.
  1. The Bill must specify that Military Hospitals (currently 1Mil in Pretoria, 2 Mil in Cape Town and 3 Mil in Bloemfontein) are State Hospitals and thus automatically Designated to serve as Psychiatric Hospitals and or care and rehabilitation centres.
  1. Section 5 (1), “The head of national department, with concurrence of the head of the relevant provincial departments” must specify that the Surgeon General of the SAMHS is included as equivalent to head of national department of health.

REQUEST TO THE PORTFOLIO COMMITTEE ON HEALTH

  1. We, the consultant psychiatrists working at the 1 Military Hospital, Pretoria, would like the Bill: Mental Health Care Amendment Bill [B39-2012 to clearly state the position of South African Military Health Services as regards being State Hospitals and thus needing no designation by the Department of Health head of national department.
  1. The responsibility and duty of South African Police Services must be extended to the Military Police Services of the SANDF.
  1. Explicit naming of the Surgeon General of the SANHS and of the SANDF Military Police Services will reduce uncertainty in the relationship of the Department of Health, the National Health Act, the Mental Health Care Act on the one hand and the Department of Defence, the Defence Act and the South African Military Health Services on the other hand.

(T.E.RANGAKA)

PRINCIPAL PSYCHIATRIST: 1 MILITARY HOSPITAL: LT COL

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