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PRESENTATION TO THEPARLIAMENTARY PORTFOLIO COMMITTEE ON DEFENCE ON INTEGRATION AND TRANSFORMATION IN THE SAMHS. AIM The aim of this presentation is to brief the members present on Integration and transformation in the SAMHS in terms of the White Paper on Transformation of the Public Service.

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    1. PRESENTATION TO THEPARLIAMENTARY PORTFOLIO COMMITTEE ON DEFENCE ON INTEGRATION AND TRANSFORMATION IN THE SAMHS

    2. AIM The aim of this presentation is to brief the members present on Integration and transformation in the SAMHS in terms of the White Paper on Transformation of the Public Service

    3. SCOPE The Health Context Restructuring the SAMHS Representivity and Affirmative Action Integration in the SAMHS Human Resource Development The SAMHS Reserve Promotion of a professional Ethos Conclusion

    4. SA Military Health Service Internationally it is a standard principle that members of a defence force who risk physical, psychological and social exposure, injuries, disablement or death in service of their country, can depend on a dedicated health service that is guaranteed, comprehensive, available anywhere at all times, and thus supportive.This international norm places a normal obligation on a country to guarantee provision in its defence force for a military health service that renders continuous operational health support. Thus the SANDF needs a health capability that is trained in and interlinked with the doctrine of combatant forces. Infrastructure Static and Mobile (RSA Health Reserve Capacity) Unique Capabilities and Experience The Health Context National Health(Public Health Care) National Legislation,Policy and Regulations National Infrastructure Level 1,2,3 and 4 Hospitals NH Clinics Provides health care to National Population Private Health Care Private practices Private Hospitals Health Care Groups Medical Schemes General and Specialised Hospitals Private Clinics Provides health care to private funded patients

    5. Part of National Health System SAMHS Represented on: Health Professions Council Health MinMec PHRC close co-operation in: combating of disease outbreaks immunisation campaigns support to summits support during disasters support during labour unrest

    6. Restructuring the SAMHS Transformation Context Strategic Objectives Structural Concept Involvement and Buy in System and Responsibility Descriptions Operationalisation of Scenarios The Structures enabling Military Health Care Service

    7. TRANSFORMATION CONTEXT As a result of political and societal changes the DOD had to undergo similar fundamental transformation. Transformation covers all aspects required to normalised the DOD’ to society’s new requirements. A key aspect enabling the DOD to achieve transformation is re-engineering. The specific aim of the re-engineering effort is to improve DOD process efficiency in order to sustainable and effectively deliver required outputs within available budget and other policy constraints.

    8. STRUCTURAL CONCEPT The MoD is an integrated organisation comprising all the elements that together form the departmental head office and highest military headquarters. Task Forces are force employment structures under task force commanders (TFC’s) as intermediate level commanders. A Type Formation is a structure composed such that it can execute an approved business plan to ensure the development of, and preparation of a specific “Type” grouping of combat ready user systems. As such a type formation includes, as far as is practicable, all units and support elements relating to a specific user system type. (The adopted principle includes a dedicated school and depot to each TF). Support Formations are intermediate level force support structures under (support) formation commanders, but similar to type and all other system structures. Units are combat units (such as artillery regiments, squadrons, ship or medical battalion groups) or support units (such as depots and schools)

    9. The SAMHS - Fully participated in the re-engineering of the process and Contributed to the Design Workshop Report to couple structures to processes

    10. SG and STAFF Main Responsibilities The Surgeon General and staff ensure the provision of combat ready medical forces and operationally ready infrastructure, as well as the provision of health maintenance services for the DOD. It does this through developing a sound business plan and monitoring the performance of type formations. It furthermore develops and updates health policy for the DOD and participates in developing the overall DOD policy. Participate in formulation of national health policy as DOD representative on various statutory and national bodies. It ensures adherence to material and professional statutory health regulations on behalf of the DOD The Surgeon General is also the government’s specialist advisor wrt international conventions

    11. SG and STAFF System Description The SG and staff system makes available the medical service’s business plan to the policy and planning and finance divisions. The business plan is approved and an appropriate budget allocation is made. Guides all subordinate elements in developing and preparing Military Health Service, combat ready user systems and combat ready higher order user systems. As budgeting authority SG and staff distribute the allocated budget to the medical spending agencies on a basis of business plans provided by them. SG and staff then monitor the output of its spending agencies according to approved business plans and report to the accounting officer and the Chief of Policy and Planning on a regular basis on the performance of spending agencies according to plan. They also report to statutory bodies on adherence to statutory regulations.

    12. SG and STAFF System Description Surgeon General also has the responsibility to report to Cabinet on the health status of the President.

    13. TERTIARY HEALTH TYPE FORMATION Responsibilities Responsible for the development and maintenance of specialised medical and related services and professional staff. These services are provided to the DOD as a whole, as tertiary medical consultation services. During wartime Tertiary Health Type Formation Institutions could be turned into operational support centres (4th line). This formation provides hospitalisation services and offers all medical and related specialities in consultation. Deploy specialist services and advisory teams in combat through the specialist units. It carries a further responsibility of collateral application of facilities and services to approved beneficiaries in support of National or DOD strategy

    14. AREA MILITARY HEALTH SERVICES TYPE FORMATION Responsibilities The co-ordination of the delivery of health services in specific regions of the country. It ensures the availability of quality medical support to area defence formations, common support bases and all other formations in peacetime mode. This formation is only responsible for the professional aspects of health services provision. It thus ensures service provision through centralisation / decentralisation decisions, manages linkages between service delivery points and between those points and tertiary health formations.

    15. AREA MILITARY HEALTH SERVICES TYPE FORMATION Responsibilities It will furthermore manage the availability of professional personnel and specific medical / health facilities in support of the common support base. On request of J Ops Provide elements to support forces deployed in borderline protection and assistance to SAPS Provide operationally ready infrastructure user systems

    16. MOBILE MEDICAL TYPE FORMATION Responsibilities The mobile type formation prepares and provides combat applicable medical forces for use in defence operations. It draws up business plans and determines readiness levels according to the force design and Government objectives. It reports to SG on readiness levels of medical forces It groups together statutory disciplines in medical battalion groups It evaluates operational doctrine and advises on required adaptations. It plans and provides for operational exercises It develops user systems by integrating personnel with mobile medical facilities It ensures, develops and sustains chemical warfare countermeasures

    17. OPERATIONALISATION OF SCENARIOS The DOD should contribute to internal security, peace, stability and development. This should happen inter-actively with other state departments. Health support to internal peace and stability operations Active participation during natural disasters (Floods) Active participation during disease outbreaks (Cholera) Support to National Hospitals during upgrading (Theatres to Chris Hani Baragwanath)

    18. Support to SAPS - internal deployments Health care President, Deputy President, former President Foreign Dignitaries, Officials of State (as required) i.e. Late Min Steve Tshwete AU and WSSD - Trauma centers Medical posts at hotels and airports

    19. OPERATIONALISATION OF SCENARIOS • International and global opportunities must be utilised by the DOD to improve relations with other states • All Africa Conference. • ISDSC Military Health Services Workgroup. • ICMM. • RSA/USA Defcom: • Medflag hosted in 2004 Exercise with 3rd Air Force Funding Masibambisane. • Telemedicine equipment. • Disaster Management. • Weatherhaven • BATLS and BARTS - UK and Netherlands. • * • Invited to co-operation, exchanges and conferences to the extent that is impossible to credit all

    20. OPERATIONALISATION OF SCENARIOS • The DOD should play a participative leadership role, supporting the establishment of political democracy through peace support operations and missions. The DOD must support Foreign Affairs in their initiatives through participation in the ISDC by contributing to combined military capability development. The DOD must also participate in confidence building and security measures • DRC. • Burundi Mil Base Hospital and deployed support • Dr Halle (senior medical advisor Dept Peace Keeping Operations) visited SA Military Health Service. • Two UN Staff Officers MONUC HQ. • 1 X UN Staff Officer at DPKO New York. • SAMHS to train SADC Staff. • 1 Mil Level 4 Medical Facility for MONUC

    21. AMED - Airfield crash and rescue Phase III support own Bn and Eng Coy support UN deployment Level 2 Medical facility Disaster Relief Ferry disaster in Tanzania Bombs at US Embassies Flood Mozambique Flood Limpopo flood plain Cholera outbreak KZN Foot and Mouth disease outbreak

    22. OPERATIONALISATION OF SCENARIOS Other reasons for the contribution in the Southern African region is to interact in and with the region to be able to promote the African Renaissance [Nepad] and to generate stability through the DOD being part of a larger Southern African capability. Involvement in the Health Workgroup of ISDSC Establishment of a Regional Health Training Center Medical co-operation and hospitalisation of all ISDSC Defence Forces

    23. OPERATIONAL SCENARIOS The DOD should contribute to internal security, peace, stability and development. This should happen inter-actively with other state departments. International and global opportunities must be utilised by the DOD to improve relations with other states The DOD should play a participative leadership role, supporting the establishment of political democracy through peace support operations and missions. The DOD must support Foreign Affairs in their initiatives through participation in the ISDC by contributing to combined military capability development. The DOD must also participate in confidence building and security measures Other reasons for the contribution in the Southern African region is to interact in and with the region to be able to promote the African Renaissance [Nepad] and to generate stability through the DOD being part of a larger Southern African capability.

    24. Planned UN Field Hospital stationed in RSA to train SADC countries members through SAMHS Special Forces members from Botswana assessed at IAM

    25. STRUCTURE SA MILITARY HEALTH SERVICE Surgeon General Permanent Force Medical Continuation Fund IG Medical CBD Reserve C MHS WO SAMHS Legal Advisor Force Plan of SAMHS Advisor CD MH Force Preparation CD MH Force Support D Nurse D Social D Animal D Psych D Med D Oral D OHS C MHS Budget SSO D MHHR Work Health Health Log Management Corp Comm D Ancilliary D Envrn SSO Med SSO D Pharm Foreign Patient HIS Health Int CI Health Health Supp Ops Pastoral Relations Admin Service

    26. STRUCTURE SA MILITARY HEALTH SERVICE SG and Staff Mobile MH Fmn Tertiary MH Fmn Area MH Fmn MH Trg Fmn MH Supp Fmn Thaba Tshwane General Support Base 1 Med Bn Gp 1 Mil Hosp S MH Trg MHBD Area MH U WC 3 Med Bn Gp 2 Mil Hosp S Mil Trg MH Proc Unit Area MH U EC 6 Med Bn Gp 3 Mil Hosp SAMHS Nurs Col Area MH U NC 7 Med Bn Gp IAM SAMHS Band Area MH U NW 8 Med Bn Gp IMM MCP CTC Area MH U FS MPI J PTSR Trg Cen Area MH U KZN MVI Area MH U GT Area MH U MP Area MH U NP Regional OHS Centres NOTE IAM - Institute for Aviation Medicine IMM - Institute for Maritime Medicine MPI - Military Psychological Institute Area MH U - Area Military Health Unit MCP ABS - Medical Command Combat Training Center MVI - Military Veterinary Institute

    27. Integration in the SAMHS Commenced on 27 April 1994 Amalgamation of health elements of Non Statutory Forces SADF TBVC Part of forming SANDF

    28. Integration is: The forming of a new union SAMHS replaced the SAMS Organisational renewal - structural and human resources Integration is not: Mentorship, Fast Tracking, Affirmative Action, Equal Opportunities, Racism or Reverse Racism

    29. 842 Former MK 4109 Former SAMS 521 Former APLA 66 Former Transkei SANDF JMCC SAMHS 86 Former Bophutatswana 61 Former Venda New Recruits 1614 41 Former Ciskei No former force described 57 Total 7397 on 21 Nov 2002 Figures reflect current employment background

    30. JMCC AGREED CRITERIA Selection Process Medical evaluation Psychological evaluation Required qualifications Applicable experience Current Professional Registration Personnel Maintenance Phase 1 Post and Personnel Audit Phase 2 Placement of Personnel in approved posts Phase 3 Maintenance

    31. JMCC AGREED CRITERIA Training Principles Induction Orientation Training Bridging Training Supplementary Training Adult Education Evaluation Academic Support Emergency Care Training Standards

    32. INTEGRATION PROCESS Phase 1 TBVC MK 300 2000 40 7000 APLA SAMS Force Composition Dictates Capabilities of Medical Services

    33. INTEGRATION PROCESS Phase 2 Pre Integration Evaluation Process All members will be evaluated according to the relevant process Of the approximately 83 occupational groups in the Defence community the Military Health manages 52 per individual Pers Admin Standard Occupational standards determined as by occupational councils - basis for evaluation and mediation

    34. Phase Integration Placement Interview Placement of personnel Rank determination Letter indicating placement and rank and bridging training requirements Accept / Reject Appeal Board Final offer with BMATT input / arbitration

    35. SAMHS UNIFORM MEMBERS PER RANK, GENDER AND RACE

    36. SAMHS UNIFORM MEMBERS PER GENDER

    37. TOTAL SAMHS UNIFORM MEMBERS PER EX FORCE

    38. UNIFORM MEMBERS STAFFED PER RANK & MUSTERING

    39. UNIFORM MEMBERS STAFFED

    40. UNSTAFFED UNIFORM MEMBERS

    41. UNSTAFFED UNIFORM MEMBERS

    42. PSAP STAFFING/PLACEMENT SITUATION AS ON 20 FEBRUARY 2003 • TOTAL PSAP: 1707 • TOTAL STAFFED AS ON 20/02/2003: 1037 • STAFFING IN PROCESS: 437 • TOTAL NOT STAFFED/PLACED: 233

    43. SAMHS PROMOTIONS PER RACE 01 JANUARY 2002 - 07 MARCH 2003

    44. SAMHS PROMOTIONS PER RANK 01 JANUARY 2002 - 07 MARCH 2003

    45. BRIDGING TRAINING • FUNCTIONAL TRG: 69 OUTSTANDING • DEVELOPMENT TRG: 26 OUTSTANDING • BASIC TRG: 16 OUTSTANDING • TOTAL OUTSTANDING: 112

    46. CIVIC EDUCATION • PRESENTED AS PART OF ALL MILITARY DEVELOPMENTAL COURSES • CHAPTERS 1 - 4 & 6 PRESENTED BY SAMHS INSTRUCTORS • CHAPTER 5 (CULTURAL DIVERSITY) PRESENTED BY TRAINED FACILITATORS FROM J TRG DIV • NEW INSTRUCTORS IN PROCESS OF BEING TRAINED

    47. STUDIES AT STATE EXPENCE • SAMHS OFFER THE FOLLOWING STUDY OPPORTUNITIES: • FULL-TIME STUDIES • PART-TIME STUDIES • BURSARIES FOR FULL-TIME STUDENTS

    48. FULL-TIME STUDIES • MEDICAL AT UNIVERSITY OF PRETORIA AND MEDUNSA • TOTAL STUDENTS: • MALE - 27, FEMALE - 28 • AF - 13 , C - 2, AS - 2, W - 38 • DENTAL - 5 WHITE MALES AT STELLENBOSCH AND PRETORIA • FINAL YEAR STUDENTS SCHEME NOT UTILISED SINCE 1995 • TECHNICON: • MALE - 6, FEMALE - 21 • AF - 5, C - 0, AS - 1, W - 21

    49. BURSARIES • BURSARIES ARE ALLOCATED TO MEDICAL & DENTAL STUDENTSWHO HAS SUCCESSFULLY COMPLETED THEIR THIRD ACADEMIC YEAR • ON COMPLETION OF THEIR STUDIES THEY SERVE ONE YEAR FOR EVERY YEAR THEY RECEIVED A BURSARY • MALE - 33, FEMALE - 29 • AF - 34, C - 2, AS - 2, W - 24 • BURSARY HOLDERS PRESENTLY SERVING AS INTERNS AND COMMUNITY SERVICE: • MALE - 23, FEMALE - 19 • AF - 11, C - 5, AS - 3, W - 23