Mr. Chairman, I ask for the privilege of the half-hour.

At the outset I should like to thank the hon. the Minister and his department for the comprehensive annual report of the department for 1981. I should also like to convey my thanks to the staff of the department, the Director-General and other officials, for their kind and willing assistance during the past year. In the course of my speech I shall make further reference to the report and mention what it does contain and what it does not contain.

During the discussion of the Vote of the hon. the Prime Minister, the hon. the Leader of the official Opposition made an important statement. He said that each Prime Minister left his own imprint on things during his term of office and would be remembered on account of certain policies. I should like to express the hope that the hon. the Minister of Health and Welfare will grant me the privilege of making certain statements, statements on which we shall be able, I hope, to conduct fruitful discussions during the debate on his Vote. I also believe that the hon. the Minister will agree with me when I say that I hope we shall remember him one day on account of an important change in policy which occurred during his term of office. I hope that what that policy will amount to is that in future we shall bring health to the people and not the other way round. I believe that if we regard this department in that light we shall be able to make a contribution which will be really worth-while.

If we look at the future of health in South Africa, there are a few aspects which are evident. The first of these is that medical services in South Africa, and the work being done by this department and all other health organizations in South Africa, are costing more and more. Medical services, too, cannot be detached from the increase in the cost of living. In this regard I want to refer to Annexure 10 in the annual report of the department. From that it is evident that there has been a constant increase in the expenditure of the department during the past three years. On closer examination it is evident, however, that the increase in expenditure does not differ much from the increase in the cost of medical products, etc. It seems that the ratio is remaining fairly constant.

The first question I should like to put to the hon. the Minister is the following. Is he of the opinion that, as the need for medical services increases, the money that is being appropriated for medical services in South Africa is sufficient? Does he foresee that medical costs will continue to rise in the future and that the money will always be available to meet such costs? I regard these as two very important questions, as aspects definitely deserving of attention. As the costs of medical services increase we shall have to take a very close look at hospitals, medical institutions, etc.

As far as I am concerned, we find excellent examples of the recognition of this aspect in the department’s annual report. We on this side of the House can but support the emphasis placed on this aspect. We can no longer afford to build such expensive hospitals as those built in the past. In saying this I do not want to maintain that we do not need those hospitals any longer. We do need them of course, for example, as training hospitals for medical faculties. This is very important. This brings me back to what I said earlier on, and that is that we should bring health to people. In speaking of expensive hospitals, I have in mind the new Johannesburg General Hospital, for example, a hospital which is accessible to the ordinary people but the situation of which is such that it is within walking distance only from Mr. Harry Oppenheimer’s home. It is impractical to build that kind of hospital.

In the annual report reference is made to the community health centres. I want to dwell for a moment on this subject. In future these centres are going to be of the utmost importance to us. We shall be able to bring medicine to the people only if we make full-scale use of centres of this nature. As is evident from the report, the object of community health centres is to provide education in connection with family planning, as well as to make provision for pre and post-natal care, for certain tests for cancer, for immunization, and for the daily treatment of sick patients The centres are also utilized in combating tuberculosis, venereal disease and other illnesses, as well as for child care, geriatric services, health education—especially with regard to nutrition—and, in addition, for the accommodation of voluntary service organizations. With planning of this nature we cannot go wrong. It remains true to the theme, viz. to bring health to the people.

Over the weekend I paid a visit of observation to one of the day hospitals in Port Elizabeth. I think it is important that these hospitals should not be too large. They should be kept small in size. Moreover, they should be spread over as wide an area as possible so as to be close to the public. Nor should the staff of these centres be concentrated only in their own centres. They should spread their work in order to bring health to the people and should concentrate on health education in particular. I do not believe that our country can afford, in the first place, the public not receiving health education, and, in the second place, as many illnesses as possible, including chronic cases, not being referred to these centres.

From the report it is also evident that this department and the Department of National Education seek to co-operate with each other precisely in order to achieve this. I am in full agreement with this. It is a very good thing.

Next I should like to refer to another aspect of the Department of Health and Welfare. I am referring to the question of staff. In this regard I refer to page 11 of the annual report. In the process of bringing health to the people we should not loose sight of the fact that at present there are 27,6 million people in this country, of whom 17% are Whites, 71% are Blacks, 3% are Asians and 19% are Coloureds. Therefore, to provide health services to all these people, we need staff. We cannot get away from that. There must be adequate numbers of well-trained staff. In this regard I want to express my concern. I quote from page 11 of the report, as follows—

The report goes on to say the following—

Then it is said—

I hope the hon. the Minister will tell us and this House honestly and sincerely how he sees this problem and how he is trying to solve the problem. We cannot try to conceal the problem. The shortages exist. I do not want to become hysterical and say that they are critical, but we shall have to admit that those shortages do exist and that something will have to be done to reduce them. The problem will only become worse in the future.

On the same page under the heading “Investigation of Salary and Post Structures” we find the following—

The first category of health personnel mentioned in the nursing and auxiliary nursing personnel; the second is medical and related personnel; the third is pharmaceutical and auxiliary personnel, followed by paramedical personnel, psychology personnel and the chemical, laboratory and related personnel. Again, I should like to enquire from the hon. the Minister how he sees this problem and how this problem, in his opinion, can be solved.

I want to dwell for a moment on the question of the availability of certain medical officers. In this regard I refer to Annexure 40—“Nurses registered with the S.A. Nursing Council on the 31st December from 1971 to 1980“ and Annexure 41—“Doctors, Dentists and Pharmacists registered with the S.A. Medical and Dental Council and Pharmacy Council on the 31st December 1960, 1965 and 1970 to 1980”. In this country we have 27,6 million people of whom 17% are Whites and 71% are Blacks. From the figures for nurses for 1980 we see that the numbers are as follows: Whites 28 630, Blacks 21 318, Asians 931 and Coloureds 4 143. With reference to these figures I should like to enquire from the hon. the Minister whether he is in fact able to hold out the prospect of any improvement in the quality of nursing for these 26 million people unless we utilize the services of Black nurses to a larger extent. The hon. the Minister will probably agree with me that there are many Blacks applying to be trained as nurses, and it is very clear to me that there are not an adequate number of places at which they can be trained. I want to ask the hon. the Minister whether this is in fact correct and whether he is able to tell us how the position may be improved. If one investigates the department—and I conducted an investigation over the weekend—one comes to the conclusion that there are a sufficient number of Black nurses. I was told at a certain institution that it had 30 posts for pupil nurses but that it would have been able to accommodate 120 if it had the necessary facilities. To me this is an important fact. If we are unable to recruit nursing personnel in any other way, we must train the Black people to become nurses. I think their conditions of service must be improved and other shortcomings must be eleminated.

Let us now deal with the question of doctors. What are the prospects for the future as far as doctors are concerned? In this regard I refer once more to Annexure 41 and the figures for 1980. In that year we had 15 663 doctors in this country. Separate figures for the various race groups are not furnished, but I understand that there are 200 Black doctors in South Africa, 350 Coloured doctors and 1 200 Asian doctors. In reply to a question I put this session in respect of the number of first-year Black medical students, I was told that the number was 48. I want to make the statement that if we do not train more Blacks as doctors, we are going to experience many problems in the future.

Now I want to refer to Annexure 7—“Appointments and losses of permanent and fulltime temporary White staff”. I am sure the hon. the Minister will agree with me that these figures are very alarming. According to the figures furnished in this Annexure, 1 375 men and 1 961 women were appointed. We get the almost unbelievable figure of there being virtually more losses than posts. This is a problem. In the report it is said that this is something which is giving rise to problems, but it is not only a shortage of personnel; it is also a lack of dedication, training and willingness as far as part-time personnel are concerned.

Annexure 8 of the annual report deals with vacancies in representative White entry posts. In the short time I have at my disposal I am unable to refer to all the various categories, but there is a shortage in all categories. The Annexure contains columns under the heading “Authorized number of posts”; “Posts filled permanently”; “posts filled part-time”; and “Number of actual vacancies”. Out of the total number of 6 882 posts there are 1 831 which are not filled. Let us look at certain ramifications of the department. I shall deal with the district surgeons first. The hon. the Minister will have to admit that if we want to realize planning envisaged for the future, district surgeons are very important. There are 121 posts of which 91 are in fact filled. I do not think that this is really satisfactory. Let us look at occupational therapists. For them there are 81 posts of which 44 are filled permanently. As far as radiographers are concerned, there are 14 posts of which only two are filled permanently. For male nurses there are 1 252 posts of which only 606 are filled permanently. I think this is a state of affairs which is a major cause for concern. The hon. the Minister must tell me how, in his opinion, we shall be able to provide medical treatment for our people if we do not have the necessary staff.

I want to remind the hon. the Minister of a speech he made last year during the discussion of his Vote. He referred to everything that was being done so as to eliminate the shortage of nurses and the dissatisfaction amongst nurses. In column 81, Debates of the Standing Committees, 1981, he, after we had moved an amendment, that his salary be reduced, made the following statement—

I should now like to know from the hon. the Minister …

Are you going to move an amendment to that effect today?

No.

As far as I am aware, there has not been any major improvement as yet. I want to know from the hon. the Minister where this is leading to.

When we look at the White population, we find that it is a population whose numbers will increase very little over the next 20 years. But there is no doubt about it that the numbers of aged will increase very rapidly. For that reason we say that we on this side support the proposal that this year be the Year of the Aged. We say it is a good thing, because our aged need this. I wonder whether the hon. the Minister, having regard to the shortages, cannot have a Year of the Personnel. I should like to propose, if finality has not yet been reached in this regard, that next year or the year after be the Year of the Nurse. Next we can have a Year of the Physiotherapist, etc. Personally I am of the opinion that such programmes can in fact have a beneficial effect. We shall then be able to concentrate for one year on our shortage of nurses.

†I should like to refer briefly to the Black population. The Black population increases very rapidly. In addition there is a rapid urbanization of the Blacks. In planning the future, the hon. the Minister will have to recognize these two facts. These facts are recognized in the annual report and I believe that the community centres will be of great assistance. They could also play an important role in so far as family planning is concerned. This is a very delicate subject, but I believe that family planning must be brought to the population. It must be brought to them in a very sensitive and correct way. Each population group must be involved to its own satisfaction that its involvement does not constitute a threat to it in one way or another. I want to leave it there because I do not have enough time available to take it further. However, family planning is essential for future healthy medical development in our country.

I now want to deal with the question of mental health and to thank the hon. the Minister for allowing me to visit the Eastern Province area. I am a little bit concerned about an area such as Port Elizabeth, where there is only one bed for acute mental illness amongst the Black population. These people have to be transported to a mental home two and a half hours away by car and 12 hours by train. I visited the Tower Hospital at Fort Beaufort and I can only speak with the highest admiration of the personnel involved. I wish I had time to speak more about that.

I should also like to speak about the Komani Hospital in Queenstown which I visited. Again the staff are of the highest standard. However, there are shortcomings. In spite of the hard work the facilities are inadequate. But, I must be honest, it is recognized. New hospitals are being built for Blacks at the Tower and at Komani. However, there is a danger that as long as socio-economic conditions do not improve amongst the Black population, the kind of treatment and the bringing in of a community service will not be successful unless there is a tremendous socio-economic upliftment in areas such as housing, education, food, etc. All these things are very important for the future planning of health in South Africa.

We have heard a lot about “healthy” power-sharing, but I should like to ask the hon. the Minister: What is his opinion about healthy health-sharing? How does he see future health services among the various population groups? Is it going to be a rigid Whites for Whites, Coloureds for Coloureds and Blacks for Blacks system, or is the hon. the Minister going to try to alleviate the future problem by recognizing that we are all human beings, all subject to ill-health and enable everybody to share medical treatment to the benefit of all population groups?

Mr. Chairman, it is a privilege for me to speak after the hon. member for Parktown. This afternoon there was a noticeable difference in the hon. member’s debating method. I do not know if this should be ascribed to the wisdom which comes with age, or whether it should perhaps be ascribed to the fact that this year is the international Year of the Aged. I have here a little gift for the hon. member for Parktown. I tried to identify the oldest member on that side of the House. I have here one of the T-shirts the National Council for the Care of the Aged is presenting to senior citizens. In view of the hon. member’s grey hair and creaking joints, I feel we should give this shirt to the hon. member for Park-town this afternoon. The hon. member may come and collect it from me just now.

Kowie would prefer to have it! [Interjections.]

I should have liked to have given it to the hon. member for Johannesburg North, but the tunnels in which the hon. member is so regularly to be found digging away, would soil such a white shirt too much!

Joking aside, I listened attentively to the few remarks the hon. member for Parktown made a moment ago and I can assure him that it is in fact the policy of the Government—this is quite clear from the annual report of the department—to bring health services to the public, instead of the other way around. Hon. members will note that there has been a tremendous change in the formulation of policy and that it was a very positive adjustment. So this is in fact Government policy.

In the second place, it is true that health services have become more expensive. However, what has not become more expensive in these times in which we are living? It is an open question whether there will ever be sufficient money available for health services. Under a capitalistic system in which the individual is basically responsible for his own health services, I do not think there can ever be enough money and because we in South Africa have a tremendous disadvantage caused by our not yet having introduced a compulsory pension-system, and things of that nature which make it possible for everyone to be self-sufficient, There can never be sufficient money for health services in their fullest extent. As far as community health centres are concerned, if the hon. member were to go to the rural areas he would see that this is exactly what we are doing. As far as the staff shortage is concerned, this is not unique to South Africa. I was privileged to be in West Germany three weeks ago, and I want to assure the hon. member that when we discussed immigration there—they have an unemployment figure of 10%—and asked them to send trained people to South Africa, they replied that they were also faced with the problem of having an insufficient number of trained people. Those people in Europe and in West Germany who are unemployed are untrained people.

But surely we can train them here.

It is a universal problem. It is therefore not a problem in South Africa only. It is an acute problem in all developed countries.

But it is a problem.

It is a problem and we are working on it. The Manpower 2000 program and the Government’s entire policy of training, in-service training and retraining is being accorded the highest priority, for our growth depends on this. I think it is extremely important. It does not matter whether it is at the health level, or whether it concerns our scientists; training must be accorded the highest priority in South Africa.

As far as staff is concerned, I want to repeat what I said last year. It is not money in the first place that makes people happy. The highest suicide rate among prominent people in New York occurs among millionaires. It is therefore not money which makes people happy. We must try, and the department is doing just this, to see whether we cannot ensure job satisfaction for all workers in South Africa, whether it is in the health services or in whichever service it may be. We must not only ensure job satisfaction but, also security, a guaranteed livelihood and future prospects. I think this is terribly important. This does not only apply to Whites, but also to people of colour. If one has a positive outlook on the future and there are future possibilities for one in one’s profession, one gives of one’s very best. Then one will also have the right priorities. In the planned constitutional dispensation, when there will be differentiation there will, also as far as health services are concerned, be separate services for people of colour, coupled with decision-making of its own for every group. That is what I anticipate, at any rate. We shall then be capable of achieving greater success—I am now referring to the Whites, Coloureds and Asians together—if each group decides in conjunction with and for its own people. There are so many political barbs which our enemies use when, for example, we want to initiate certain programmes. They may say a programme is politically instigated, whereas it really concerns the good of the individual. I am referring here to the tremendous progress that has been made as far as family planning is concerned, and the tremendous decline that has come about as a result of improved medical services amongst the Coloureds and the Blacks. This is a brief reply to what the hon. member for Parktown said.

I also want to take this opportunity to congratulate the department, the Director-General and his staff, most sincerely on the excellent annual report they have presented us with this year. It covers health, welfare as well as pensions. We have been examining the activities of the department for a number of years now, and since the two departments have now been rationalized, viz. Health with Welfare and Pensions, and this is the first year this has been in full swing now, we see that it was a wise step which the Government took and we also see that it has been applied in practice in a positive way. It is not only the preparation and the contents which are good, but the overall picture of the health, welfare and pension services in our country is presented to us in a very positive light. This is also supported by the enlightening annexures at the back of the report.

In my opinion there is also a very good balance between health and welfare services within the same department. I repeat: All the reports are supported by excellent annexures. Hon. members should take note of the attention given to the cholera epidemic which prevailed during 1981 and 1982. It was an epidemic in every sense of the word, but as a result of the tireless efforts of the hon. the Minister of Health and the staff of his department it was arrested. I feel it is a feather in the cap of our general health services that only 1,2% of all proven cholera cases reported were fatal. The exact figure is only 42 deaths out of 3 950 proven cholera cases.

This disease is causing a problem because it sometimes disappears and then reappears again for no apparent reason. It is therefore a complex problem, but owing to the fact that we are able to identify certain causes, for example poor hygienic conditions, water pollution, etc., outbreaks of cholera can, to a great extent, be eliminated. There is therefore good reason to be enthusiastic about the fact that the serious epidemic was brought under complete control by the department, and I want to thank the department for its share in making additional funds available so as to act quickly and efficiently where necessary.

This afternoon I should like to refer to a second specific matter which appears in the report and which, in addition to cholera, also came to our attention last year. I am referring to what was certainly one of the greatest natural disasters which has ever occurred in South Africa, namely the flood disaster which occured on 25 January last year. Only, a year after the event, do we realize its exact magnitude. Because the State President made use of section 26 of Act No. 78, which pertains to fund-raising, for the first time in our history to declare a state of emergency and to declare the affected districts to be a disaster area, the Government was able to give immediate aid to 21 districts.

Order! The hon. member’s time has expired.

Mr. Chairman, I am merely rising to give the hon. member an opportunity to complete his speech.

Thank you very much. I also want to thank the hon. member for Hillbrow in advance because he is not going to discuss the Smoking Bill this afternoon!

The day after the tremendous rains fell in the 21 districts, 162 properly equipped units were erected at Laingsburg at a cost of R3,5 million for those who had suffered major losses. After those events something unique occurred, in the sense that the Government presented awards to people in the private sector and also to certain bodies for the outstanding services they had rendered. Some of us were present this morning when the Salus award was handed to two members of the community, namely Rev. April of George and Mr. Van der Merwe of Laingsburg. These two gentlemen each received a silver medal, and medals were also awarded a short while ago to a number of scientists, who had rendered specific services in respect of international activities. We on this side of the House would therefore like to congratulate the department most sincerely on the introduction of these awards, and we also want to convey our congratulations to those persons—and their families—who received those awards this morning.

Now that I have said all these positive things, I must also add, however, that there are other things which I am concerned about. I want to associate myself with those persons who referred to these matters, not only with the hon. member for Parktown who discussed one of these matters today, but also with other hon. members who mentioned it in the past. Of course it is much easier to speak than to act. There are reasons for the high cost structure in the health services. One thing countries abroad have shown us quite clearly is that we must take care not to make the infrastructures we erect, the buildings or complexes, so luxurious or expensive that there is not enough money left over to provide the necessary services. Sometimes the location of buildings also causes problems, because they are not situated in exactly the right place. Generally speaking it cannot however be said that this was done deliberately. Frequently it also transpired later that they were built in the wrong place.

We shall have more to say on the welfare aspect of this Vote later. A highly developed State like West Germany spends one-tenth of every German mark on health. This means that it spends one-third of its total budget on health and welfare services. Hon. members can therefore see how far behind we are in this regard, but we must remember that Germany is a federal socialistic State. It is not a purely capitalistic State like South Africa. We must bear this in mind, particularly since the private sector is now beginning to declare itself willing to meet the State half way. The private sector is willing to help, not only in creating the infrastructure for health service facilities, but also in certain programmes. We are looking forward to positive co-operation, and I should like to emphasize this today. We need only consider the programmes now being developed. There is for example the programmes of Syncom, which has already held three symposiums. The planned goals are excellent and their planning and intentions are good. I am saying exactly what I said when we discussed the legislation on chiropractors and the establishment of a council for them. I also want to tell these people that we have the necessary channels. There is the Medical Council and the departmental committee which evaluates the projects. We must work through the department instead of making use of extra-parliamentary programmes. I want to conclude by saying that we have great sympathy for the pharmaceutical industry as a whole. The retail chemists are struggling to keep their heads above water because certain things went wrong.

They are annoyed with you.

On the other hand the manufacturers are also struggling because the cost structure is high and there is not much money for research. I could say many things to prove that it is not the fault of one of the parties, but that it is in fact a complex problem. Although I could give examples, I do not want to do so now. I just want to say that we have great sympathy for these people. The Browne Commission is investigating this matter, and if some of those people still feel that there are matters which warrant attention from the Government, they are welcome to approach the Browne Commission and make their submissions.

I should like to conclude with these few remarks. Later this evening I hope to say a few words on the Government’s welfare services in general and in particular.

Mr. Chairman, to my mind it is very important—I am saying this on behalf of the CP—that medical and health services rendered in South Africa should be of the very best, both as regards the comprehensive nature of the service to every sector of the community as well as the quality of the service rendered. They should cover the entire spectrum of health care from comprehensive primary care in isolated areas to the highly specialized and sophisticated service rendered at training hospitals and research units. They should also actively promote and protect our population’s mental and physical welfare. This should be done by maintaining a sound balance between private enterprise and the essential social medical service which have to be provided to the underprivileged sector of the population. The role the Department of Health and Welfare should play, particularly as regards preventative medicine, which is gaining in importance in the total health set-up, cannot be underestimated. I also do not hesitate to say that the department is doing invaluable work. The annual report proves this.

However, I want to raise one point of criticism. In Annexure 13 statistics are given regarding the Abortion and Sterilization Act. As regards section 3(1)(b) we read the following in the annexure—

If we look at the figures we see that of the 381 abortions legalized, in this way, 265 pertained to the White group. To my mind that is not realistic. As far as I am concerned the Act is being misused to legalize abortions in South Africa. I think we shall have to look into this.

Let us for a moment consider the private sector as far as medical practitioners in South Africa are concerned, i.e. the approximately 10 000 medical practitioners of the 15 000 medical practitioners who are registered with the S.A. Medical Council. What is the quality of the approximately 600 medical practitioners who are trained annually in South Africa? I believe it is among the best in the world. It is true that cases of unethical behaviour or misconduct occur, as in any other profession, and that tremendous publicity is usually given to these cases, but any member of the public has the statutory right to submit a complaint to the Medical Council and it will be investigated thoroughly, after which the necessary disciplinary steps will be taken without exception if they are justified. However, if we take into consideration and assume that those 10 000 private medical practitioners see an average of 20 patients a day, this means that about 40 million consultations take place annually. In 1980 only 195 complaints were lodged against medical practitioners, of which only 29 led to an actual disciplinary investigation. I think this speaks volumes for the ethical standards which are being maintained by the South African medical practitioners. On the other hand it is certainly a great comfort to the public that a statutory body like the Medical Council guards rigorously against malpractices and unethical behaviour and that it ensures that proper training standards are maintained at all times.

Nowadays the development and progress in medical science is so rapid that bodies like the Medical Council and training hospitals must take constant care to ensure that the required standards are maintained. On the other hand the medical community itself must also guard against the medical practitioner becoming a cold impersonal scientist. Warm, personal interest, honest concern and affection between doctor and patient must not be lost in the process. For this reason I want to warn against too much State intervention. We had legal commissions to lay down tariffs and this caused discord between the medical profession and the Government which still exists today. It also marred the relationship between doctor and patient. We must guard against this.

The ideal situation and balance which does in fact exist to a great extent between medical ethics and the standard of training in South Africa is largely owing to the control which the Medical and Dental Council exerts as an umbrella statutory body covering the entire spectrum of health services. For this reason I still think it is a pity that the hon. Minister recently piloted the Associated Health Services Professions Bill through Parliament, in terms of which measure a second statutory body will now come into existence which also has to exercise control in the field of primary health care in South Africa, independently of the Medical Council. I do not want to repeat arguments which were raised during that debate this afternoon. However, I am still convinced that the S.A. Medical Council, particularly since the matter was only rejected by a majority of one vote, would have reconsidered its decision after a thorough investigation by a Select Committee. Control over these so-called associated health services professions by the S.A. Medical Council would undoubtedly have been in the best interests of all the parties.

In his reply to the debate on that legislation the hon. the Minister stated that he would like to pursue the matter further when his Vote was discussed. I should therefore like to place the matter on record here, to the best of my knowledge, in chronological sequence, according to the facts at my disposal. Professor Guy De Klerk, the president of the S.A. Medical Association, approached me in December last year with a view to being granted an opportunity to address the caucus group of the NP. I informed the hon. the Minister that we had received such a request from Professor De Klerk. I am now trying to reconstruct our conversation. The hon. the Minister asked me what the subject of the communication by Professor De Klerk would be, and added that it would be a shame if he were to go into too much detail concerning the specific legislation because the legislation had not been discussed by our group. The meeting was then arranged for Tuesday, 9 March 1982, because the caucus room would not be available for some time, but would not be in use at 11h00 on that specific morning. The group’s secretary notified the hon. the Minister of the meeting.

At that meeting an apology was made on behalf of the hon. the Minister because he was in a Cabinet meeting. I did this myself. The meeting then took place and Prof. De Klerk did not attack either the hon. the Minister or the department.

In the mean time the events had taken place which led to the establishment of the CP of South Africa, and I could therefore not participate further in the final decision with regard to this specific legislation. These are the facts as I have them.

The next day, 17 March, Die Transvaler tried to make political capital out of this situation. Without quoting from Die Transvaler, I want to say that the newspaper made more or less the following allegations. In the first place it was alleged that I had approached the president of the S.A. Medical Association of my own accord. This is not true. That I did so without the knowledge of the hon. Minister is not true either.

I then had an interview with the editor-in-chief of Die Transvaler and made the necessary corrections. I rectified the inaccuracies in Die Transvaler. The correction, published on 18 March, annoyed the hon. the Minister so much that he stood up in this House and said the following.

Mr. Chairman, may I put a question to the hon. member?

No, I am not replying to any questions now. I stated here in this House that I had notified the hon. the Minister personally of the fact that Prof. De Klerk would address the meeting. However, the hon. the Minister said here in this House that this is not true, and that the secretary of the group notified him telephonically. He alleged that I had not discussed this matter with him. As far as the time at which the meeting would take place is concerned, this is true.

The hon. the Minister raised a point of order here in this House and said he objected to the fact that I was trying to imply here that I had informed him that Prof. De Klerk would be at the caucus group meeting that specific Tuesday morning. I concede that I did not discuss the time at which the meeting would take place with the hon. the Minister. However, I did notify him of the fact that the meeting would be held.

The hon. the Minister then said that there would be plenty of time to discuss this matter again when his Vote was being discussed. Unfortunately I do not have plenty of time to do so. This afternoon, however, I want to know from the hon. the Minister if he would have refused the request by Prof. De Klerk to address the caucus if I had asked him to accede to this request. If so, why would he have refused? Does he not want the organized medical profession to address the NP caucus? I sincerely regret that this situation was exploited for political gain by the newspapers. The report was misplaced and riddled with inaccuracies. [Time expired.]

Mr. Chairman, I shall not make any contribution now to the hon. member for Pieterburg’s argument regarding the visit by Prof. De Klerk. The hon. member for Pietersburg asked specific questions and I am sure the hon. the Minister will reply to them adequately.

It is significant that at this moment—at the same time as this debate—a debate on manpower is taking place in the Senate Chamber. This emphasizes the fact that even if we have the best manpower available in our labour set-up, it will be of no avail to us if that manpower is not healthy. In the same way we can have the best health services in the world, but if we do not have trained people to do the work we cannot not prosper either. The co-ordinated regional development of our health services and a central responsible body and the closest co-operation with and between all interested bodies, including those beyond our borders, can make a success of the planning of the health service facilities for the Republic which was announced in 1980. This is a plan we must present and sell as widely as possible, so that it will not be necessary for a committee of the Northern Transvaal branch of the Medical Association of South Africa, which drew up a memorandum on hospital facilities in Pretoria, to ask: What is the policy of the State in respect of health services? This proposed plan must be explained and if problems arise, even in the planning stage, all those involved must be given the opportunity to help iron out those problems. The State cum provincial authorities do not want to evade their responsibilities in this connection. However, they have spelt out quite clearly that they cannot take sole responsibility for the planning and implementation of a health service. This is not a good practice and we cannot afford it either. Incidentally, the annual operating costs of a large hospital at present amount to one-third of its erection costs. I reiterate that we cannot afford it. The private sector will have to make its contribution; as a matter of fact, it will be made easier for the private sector to participate, in whatever manner, in providing a health service and creating facilities. With the Department of Health and Welfare as co-ordinator, the provinces as traditional providers of the infrastructure and the private sector as an increasingly important partner, the local authorities, the medical funds, the Medical Association of South Africa, the Dental Association, the Pharmaceutical Association and the Nursing Association must work together as one to invest in health and not in sickness. This plan in fact lends itself to the achievement of this goal.

Let us consider a few of the components of the plan in the few minutes at our disposal. One central body ought to be responsible for the planning of health services, the formulation of policy and for determining the strategy. We can find no fault with this. This plan will have to take the health services in the neighbouring States into account. A strong case is also being made out for absolute co-ordination between the Department of Health and Welfare and all service rendering bodies in order to evaluate any matter which may have an effect on the rendering of a service as quickly as possible. In addition, there is the idea that a health authority can share existing and future well-planned and well-located facilities, and that this will result in a more comprehensive service being available without any appreciable increase in capital expenditure.

In connection with this health plan I want to refer more specifically to primary health care and also to hospitalization. Primary health care is in essence health care based on practical, scientifically based and socially acceptable methods, which is available to the entire population at a price they can afford, bearing in mind the problems of our population structure. It will therefore have to be health care which is available as close as possible to where people live and work. It will have to be a service catering for the masses and of a preventative nature, with the following as its eventual goal: To increase the life expectancy of people, to reduce the hospital population, particularly among the aged, and to try to keep and utilize more people in the work situation for longer periods.

This will mean that the accent must fall on preventative instead of curative health services, which will also, inter alia, mean that the medical practitioner’s training will have to be adjusted accordingly, in order to make him more community-orientated. If we want this plan to succeed, we shall have to emphasize the need for a team effort with the medical practitioner as the team leader. I want to go further and say that the medical practitioner must also take part in providing this service in a general practice context, therefore as a private medical practitioner. It is gratifying that at the community hospitals and at the proposed regional hospitals ample provision will be made for facilities for general practitioners and specialist services. It is equally important that the services provided at the community health centres, will not be in opposition to the general practitioner, but that the one will help the other.

If we read and study the Governments regional development plans for industrial development, which were published a short while ago, we cannot but bring the community centres we have just referred to and overall family planning into the picture as well, and in this way we emphasize the uniqueness and the complexity of our problem. We need the help of the Opposition parties as well if we are to succeed.

I want to say a few words about hospitalization. As far as this is concerned, we can no longer afford to build curative palaces. I hope the plan we are now drawing up will finally put a stop to this fad. There is not really a shortage of hospital beds, but there is a shortage of hospital facilities, because the facilities are becoming unusable as a result, inter alia, of a shortage of nurses. Specifically, there is a lack of facilities for private White patients, particularly in the larger cities.

It is not necessary for us to build our hospitals in the wrong place; we have all the means at our disposal to be able to make the correct decision.

I also want to say that the private entrepreneur should not be impeded in his attempts to provide health facilities, because we must admit that they have in the past and still do provide an effective service of a high standard. The hospital authories should certainly not see these undertakings as their competitors but rather as their co-workers in one vast health service programme.

The more one thinks of the spectrum through which this department operates, the more respect and appreciation one has for the work of a formidable work force, and we want to say to them, and to the hon. Minister who is leading them: Thank you, carry on the good work!

Mr. Chairman, firstly I should like to congratulate the department on yet another informative and well prepared annual report. Secondly I should also like to place on record my appreciation to the staff of the department. Their courtesy and willingness to discuss various matters which arise from time to time is very much appreciated.

I want to refer specifically to page 41 of the annual report where there is a heading “environmental health”. I am amazed to read—

This raises two queries: Firstly, is the department expecting too high a standard which is beyond the financial capability of the local authority, or is it the laxity of the local authority concerned? If it is the latter, and bearing in mind that these local authorities employ health inspectors who are subsidized by the department, these local authorities, particularly the health inspectors, should be taken to task in no uncertain manner. If in fact it is due to financial problems, then I submit that the only way to overcome this is that the payment presently being made by Treasury in lieu of rates, should be conditional, viz. that these funds should be made available only to improve facilities for the upgrading of health services where local authorities are at fault.

This brings me to the second point. If this state of affairs exists within local authorities, what are the conditions within squatter camps and densely populated rural areas not falling within a local authority’s jurisdiction? The hon. the Minister will recall that during the debate on the Health Amendment Bill in February this year, I was on the point of raising this question when the debate ran out of time. Unfortunately I must come back to it. If one reads page 1, par. 6, of the annual report of the department I must ask the hon. the Minister to inform us what exactly is happening in respect of improving the infrastructure, and how much money has been spent to improve services such as water and sewerage. The reason I raised this is quite obvious. An epidemic has occurred, and its origin—the hon. member for Brits confirmed this—is obviously from the lack of basic necessities, such as safe drinking water, basic sewage and waste removal and reasonable housing. If we are to eradicate cholera and diseases associated with underdevelopment, I believe we have to make radical changes in our national health spending. We are going to have to obtain more money from Treasury for health services than we do at present. Added to that, we must co-ordinate those who are responsible for the minimum health services, or alternatively, the department must take full responsibility, provided the finances are forthcoming.

What is the position today? Look what happened at Bathurst. Ultimately the department had to move in. Let us look at Inanda. I accept that part of Inanda is in KwaZulu, but parts are not. No-one really seems to be prepared to accept responsibility for Inanda. In fact, the area has no status, because it has no local authority. There is also no townplanning, in fact no control whatsoever. Squatter camps are a reality, a fact of life, be they controlled or not. We must accept responsibility, especially health responsibility, for them. It is in areas such as these that cholera, typhoid and tuberculosis find a hold and from where they spread. We must also accept that with the breakdown of health services in our northern neighbouring territories the situation has been compounded. Disease knows no colour and is no respector of class, creed or culture. I believe the time has come for the hon. the Minister of Health and the hon. the Minister of Environmental Affairs to put their heads together and to give urgent attention to this alarming situation that has developed. Basic sewerage, refuse removal, as well as the supply of safe drinking water are absolute essentials. Prevention is after all, better than cure, and ultimately if we have further outbreaks of epidemics, it will cost us dearly in health, life and finance.

The next aspect which I want to raise is the position of occupational health. Quite obviously there is disagreement between two departments as to who should have overall control of this very important factor of our daily lives. In many factories disablement and death may result from occupational diseases which manifest themselves only after many years. Let me quote only two examples, i.e. silicosis and brown lung. In this country, from which many migrant workers return to their homes after completing their contracts, delayed effects of toxic substances can go unnoticed by employers and governmental authorities. I should like to refer here to the Erasmus Commission of Inquiry into Occupational Health, 1976. It complained then and said—

It found that 5,78 million, 71,9% of the 8 million economically active people in South Africa, were not covered by occupational disease legislation. The commission pointed out that South Africa was one of the few industrially developed countries without a comprehensive health system for the protection of all industrial workers and the prevention of occupational disease. It also found that there was a critical shortage of factory inspectors, a point I shall come back to a little later. Six years have passed and still there is no clarity as to what the Government is going to do. Again I refer to the disagreement between the Department of Manpower and the Department of Health and Welfare, which is common cause, I believe, why we have no legislation today.

There are no statutory standards for lead exposure and standards employed by the State are permissible. Three times the amount allowed in United States’ plants and one and a half times the amount allowed in West Germany are allowed in South Africa. Surveys conducted in recent years have indicated that many employers in South Africa are failing adequately to protect employees working with lead. The National Council for Occupational Health has found that 20% of workers in some mercury amalgamation plants were exposed to potentially disabling amounts of mercury.

Then we come to the asbestos industry. Approximately 40 000 people are involved in mining asbestos or manufacturing products therefrom in South Africa. Again, there are no statutory limits to levels of asbestos exposure in mines, factories or the local environment. May I quote Dr. Myers, author of Asbestos and Asbestos-related Diseases, who says—

It is also interesting to note that studies made by the Americal National Cancer Institute and the National Institute of Environmental Health Services claim that 20% to 25% of people who are heavily exposed to asbestos die from lung cancer. While these two departments are wrangling over who should control what and who, our workers are suffering.

I should now like to come to the Erasmus Commission and their findings, which show that there was a critical shortage of factory inspectors. In fact, one occupational safety expert estimated that there was only one inspector for every 1 250 factories. This is an unsatisfactory state of affairs. I believe the hon. the Minister should now put his foot down in his dealings with the hon. the Minister of Manpower. I say this for two reasons, and I see the hon. the Minister of Health and Welfare is smiling: Firstly, because this is a serious health matter and, secondly, in every area where there are factories there are already health inspectors and it would be no extra problem to take over this important facet of our national health. After all, the health inspectors are already trained; they have the expertise and in most cases they are on the spot to ensure that legislation is complied with when brought into effect. Hopefully this will be soon. For practical purposes it is obvious that the Department of Health and Welfare should control this important facet of our society.

Mr. Chairman, I shall refer to and comment on some of the statements made by the hon. member for South Coast during the course of my speech.

*Water is the carrier and distributor of such a wide variety of organisms and viruses which are fatal to man, for instance cholera and gastric fever, to name only two, that control over the pollution of water for human consumption should obviously be of extreme importance. When one speaks of the control over pollution, one should firstly take note of the different sources, of drinking water. For instance, one thinks of boreholes, wells and underground water, which should on the face of it be very pure, but which are nevertheless subject to pollution by, firstly, seepage from contaminated sources, for instance, from a pit latrine near the water source, or even a rat or mouse which has accidentaly drowned in the source of the drinking water, and a person only discovers this when the hair from the decomposed body is found in a glass or mug. Secondly, there are pans in the veld which are normally the resting place or abode of animals during the dry season and which could then become sources of drinking-water during the rainy season. Thirdly, there are gravel pits along the roads or in the veld which often serve as latrines for passing travellers or hikers. Fourthly, there are rivers and streams which could be polluted by the waste matter flowing in from the many tributeries over a very wide area. In the fifth instance, there are dams and pools of stagnant water which are accessible to man, animals and birds. Sixthly, swimming pools can convey infection from pathogenic organisms which could affect the nose, ears and throat.

There are many sources of drinking-water, and an even greater number of possible ways in which pollution could occur in these sources. Add to that the choice which someone who is really thirsty has to make. His choice is either to drink the water which appears to be polluted, and perhaps die as a result, or to die of thirst for certain if he does not drink the water. One recalls how many of us, in the days when we still wandered through the veld looking for sheep and cattle, came across a pan in the veld and then strained water from the cattle trails through our teeth, hoping that we would not die as a result. On the other hand, if we had not done this, we would surely have died of thirst.

In view of this, one is aware of how completely impossible it is for any individual, State Department or local authority to exercise absolute control, thereby preventing someone from drinking polluted water and spreading a contagious disease.

It is necessary to take cognizance of the present set-up in respect of preventative measures against the pollution of drinking-water and the sources of drinking-water. By means of rationalization, the provision of water has become the task of the Department of Environmental Affairs, while the purification and distribution of water is the task of the local authorities. The task of laying down standards and norms for healthy and pure water, rests on the shoulders of the Department of Health, and this task is carried out in close co-operation and consultation with the Bureau of Standards. In addition, the Department of Health initiates and finances research with regard to water for human consumption. This research is carried out by the Water Research Institute of the CSIR, and particular emphasis is given to the health aspect.

It is very clear that in view of the way in which control is being exercised in the RSA today, the Department of Health can in no way be blamed for ineffective control when pollution of water sources occurs. On the contrary, they should be praised for the services which are being rendered through the establishment of norms and standards which have to be applied by those who distribute the water. Here I am referring to what the hon. member for South Coast said about the fact that a certain percentage of the water which is distributed by local authorities, does not comply with health standards. However, it is not the task of the Department of Health to deal with this. It is the task of the local authorities, and the Department of Health has in its report rightly put its finger on the sore spot and indicated that they are the people who should be held responsible. However, the problem areas are those in which there are no local authorities to control distribution and in which control is then the responsibility of the Directorate of Health. In view of the pollution of drinking-water in these areas—I reiterate that these are areas which are not controlled by local authorities—something which could be fatal, it is absolutely essential that the hon. the Minister of Health should utilize the powers entrusted to him in terms of section 37 and 38 to issue regulations to exercise control, in the interests of our country and all its people, since it is at these very points, the origin of contamination, where no supervision or control is exercised by local authorities, that the Directorate is then called upon to maintain supervision. The hon. the Minister should therefore be able to use his power in terms of those sections to promulgate regulations for proper supervision and control.

I wish to conclude with a word of sincere thanks to the Department for its excellent information and guidance services with regard to the drinking of pure and clean water, and its sustained campaign against the pollution of our sources of drinking-water by means of information and guidance pamphlets.

Mr. Chairman, it is a pleasure to participate in this debate after the hon. member who has just resumed his seat. I should very much like to speak at length on the same subject of pollution, because it is of particular concern to the constituency I represent, in view of the coal mines there.

However, I would be remiss in my duty this afternoon if I did not, on behalf of all the pensioners in my constituency, convey my special thanks, at the outset of the discussion of the Health and Welfare Vote, to the hon. the Minister and the National Government for the concession that has been made to our old people in this country with regard to pensions. I have a request which I wish to put to the hon. the Minister. I should like him to give his attention to the matter of ensuring that the means test is not applied to pensioners who get married. I am saying this because there are many people in our country today who are living in sin, for if they were to get married they would have to sacrifice a part of their pension.

Furthermore, I wish to ask the Department to give attention to the payment of pensions to our old people. I am aware that it is a function which is carried out by the Department of Posts and Telecommunications. One appreciates that there are thousands of proxies who have taken this responsibility upon themselves, but in spite of this, there are still thousands of our old people who have to go to the post offices themselves to receive their pensions. Congested conditions often occur when the pensions are paid out. The pensioners then have to receive their pensions in the presence of so many people, and because that small sum of money is so important to the pensioners, they often feel that it is necessary to hide the money. Some of the women hide it under their clothes, and I have also seen some men hiding the money in their socks because they are afraid that there are people who will take it away from them when they leave. I am therefore addressing a friendly request to the hon. the Minister to give his attention to the way in which pensions are paid out to our pensioners.

I should like to devote my speech in this debate mainly to atmospheric pollution. In a country such as England attention was drawn to the problem of atmospheric pollution as long ago as the thirteenth century. In 1307, when King Edward II was king of England, a person was punished by being subjected to torture because he had burnt coal and had in that way polluted the atmosphere. This is an indication of how long ago attention was drawn to the problem. In 1930 for the first time, a disaster occurred as a result of atmospheric air pollution. It happened in Belgium. It was from that time onwards that this matter began to receive serious attention throughout the world. Hon. members are perhaps aware of the atmospheric pollution disaster which struck America in 1948. Atmospheric pollution is the largest man-made problem in the entire world. A disaster struck England when 4 000 people died within two weeks as a result of atmospheric pollution. Two months later, a further 8 000 people died in London from the after-effects of the atmospheric pollution disaster. This was followed by further disasters in 1956 and in 1962 when thousands of people died.

Therefore we in the Republic of South Africa should take proper cognizance of this and regard atmospheric pollution as a serious matter. We are aware of the preamble to the atmospheric pollution legislation in the Republic of South Africa, which was passed in 1965. One can only appreciate what has been achieved over the years. It is only when the results of atmospheric pollution affects one’s own family circle, for instance, when someone in the family has a problem with asthma, that one realizes the discomfort and unhappiness which atmospheric pollution causes in the case of people who suffer from asthma, as well as other diseases. One could remain without food and water for five days and longer, but one cannot go without air for five minutes, for one would die. That is why it is so important that we take cognizance of this.

Further disadvantages are, of course, the economic losses which the country suffers. If one considers the various sources pollution, one of which we should take thorough cognizance is the exhaust fumes emitted by motor cars. The problem in this regard was established for the first time in Los Angeles. Let us consider for a moment the position in this regard in our country. Let us assume, for the purpose of our discussion this afternoon, that in a city such as Johannesburg, there will be 409 000 motor cars by 1983. This would then mean that the following volumes of gases would be emitted in that city: 1 260 metric tons of carbon monoxide, 252 metric tons of hydrocarbons and 72 metric tons of nitrogen. We must take cognizance of these things in our country.

There are also various other sources of atmospheric pollution, for example, factories and mines, in other words, industries. We have to accept that the Republic of South Africa is the workshop of Africa.

We also have to accept that the Republic of South Africa is the powerhouse of Africa. However, a price has to be paid for this. The question that now arises is: What is being done? Since Dr. Halliday has already received an award for the service he performed when he acted as chairman of the Advisory Committee, I should also like to express my appreciation on this occasion today, especially since he acted as chairman of NAPAC for 15 years, and made a valuable contribution there.

With reference to my own constituency, I could mention examples of several large sums of money which are being spent to combat atmospheric pollution. For instance, their is a carbide factory, which has spent R3 million during the past year in combating atmospheric pollution. At Trans Aloys, R8,3 million, and at Highveld Steel, almost R30 million, have been spent for the same purpose. Furthermore, problems have arisen with the power stations which are being constructed in the Eastern Transvaal. At one single power station there an amount of R12 million has been spent on combating atmospheric pollution. At three other power stations which are being constructed in the Eastern Transvaal, R20 million will be spent in the next five years on combating atmospheric pollution. The lessons learnt by Sasol at Sasol I have resulted in Sasol 2 and Sasol 3 installing the most modern equipment, at a cost of R700 million.

Then there is also the Sappi paper factory at Richards Bay, and another in the Transvaal Lowveld, where R80 million is being spent to eliminate the unpleasant smell and atmospheric pollution. This serves as proof that our people have the right attitude to the problem of atmospheric pollution.

However, I should like to know from the hon. the Minister whether the department is, in fact, giving attention to this problem and whether bursaries are being made available for further study in this direction. Are universities being approached with a view to offering a full-scale course which will qualify people to combat atmospheric pollution in the Republic of South Africa? I also believe that we should convey the message clearly to our schools, as well as to our Black communities, that are being led by us on the path of full independence. The question of atmospheric pollution should urgently be brought to their attention as well. [Time expired.]

Mr. Chairman, it is a pity that more people are not as conscious of the danger of atmospheric pollution as the hon. member for Witbank is.

†People did not have to concern themselves with anxieties about population growth until quite recently. It was not until the late 19th century that disease and natural disasters became so under control that population growth became extremely rapid. Even today population increases have stabilized in only the most advanced countries in the world—the Western World, and possibly Japan. Recently, however, the public imagination has become so focused on the problem of the population explosion that it has failed to realize the implications resulting from an arrest of this process.

In South Africa, for example, the White population grew very rapidly during the first 25 years of this century. Since then, however, it has become almost static. One can already notice that the Coloured and Asian population reflects quite a sharp decline in the rate of growth, whereas, as in the case of the Black population, the full flood of its population explosion still has to reach us. In this regard the following statistics are very interesting. In 1982 one out of 10 Whites is in the aged category, while only one out of 25 of the other race groups in the country is in the same category. That is considering aged to be 60 years in the case of women and 65 years in the case of men.

In the year 2020 one out of five Whites will be in the aged category, as against one out of 10 in all other race groups. In the following 20 years the numbers of aged people will double again. In the United States, e.g., in 20 years’ time one in three people will be aged.

The implications of such a large proportion of the population being unproductive are obviously immense. It will be impossible for the working section of the population to supply the capital goods in the way of housing, institutional buildings and the necessary infrastructure required by these people unless provision is made progressively and from now. Luckily a small start has already been made with the type of arrangement that permits people to build themselves a cottage in a housing scheme owned and run by organizations like the Red Cross. The terms of these agreements are that the cottage will be bequeathed or sold on an advantageous basis to the controlling organization when it is no longer required by the person who has built it. The South African Government encourages this process of increasing the nation’s housing capital by accepting the fact that a cottage built on this basis represents the alienation of capital. Someone building such a cottage is therefore immediately permitted to value it at the means test value of R9 800 and is also permitted to write off that amount over a period of five years. People who do this sort of thing are normally people who have made a real contribution to the country and its economy during their lifetime and now, in the last years of their lives, they are making a final and vital contribution to the country’s store of fixed assets. Inflationary patterns appear to be a fact of life that we are going to have to live with. This type of project enables older people to finance tomorrow’s houses at today’s prices and, in the process of helping to solve tomorrow’s housing problems, they are also assisted to live out the final years of their lives with pride and in comfort and security. If inflation continues to average about 10% per annum—which is only about two-thirds of the current inflation rate—then a cottage which costs R25 000 today will cost R135 000 in 20 years’ time. This amount will be difficult or impossible to find. I want therefore to ask the hon. the Minister to agree immediately to allow people who build cottages under approved schemes of this nature to remove the total value of the cottage that they erect from their personal schedule of assets. I also want to ask the hon. the Minister to consider further tax benefits or subsidies that will encourage private individuals to make provision for their old age in this manner.

The next suggestion that I wish to make flows directly from the same causes as the first. Not only is the total population of the country getting older, but the total population of these old-age villages is also increasing. Thus the requirement for a hospital facility for these villages is becoming far more urgent. A scheme already exists in terms of which the State assists in the financing of service centres by providing capital at a purely nominal rate. I want to ask the hon. the Minister whether this could not be extended to enable approved bodies to borrow money on the same basis for the extension of hospital facilities in the neighbourhood of these old-age villages. This would create a valuable and badly needed additional facility and would be in conformity with the Government’s policy of encouraging the private sector to make fixed investments to the benefit of the whole country.

I want in conclusion to ask the hon. the Minister to consider the question of the existing discrimination between social old age pensioners and civil and private pensioners. When we consider the aged, we tend to concentrate on the pensioner and on the infirm and pay less attention to those who look after themselves. A private or civil pensioner does not qualify for a social old age pension if his income exceeds R116 per month whereas a person with no income can draw a social old age pension of R138 per month. The anomaly does not stop there; the social old age pensioner has further advantages which the private or civil pensioner does not have, for example free medical attention and he has the ability frequently to buy from certain shops and big organizations at wholesale rates. This is something which does not apply to private or civil pensioners.

I think the hon. the Minister should rectify this obviously inequitable situation and ensure that private pensioners are not placed at a disadvantage in relation to social old age pensioners.

Mr. Chairman, I should like to say a few words on a subject which affects virtually every hon. member of this House. I should like to speak on behalf of the millions of people in South Africa who would like to stop smoking, but are quite unable to do so. I include myself amongst these millions of people, namely the non-smokers of South Africa who are forced to smoke, whether they want to or not, in public places, in aircraft, on trains and in many other places.

Throughout the world very comprehensive research into this problem has been carried out, and I shall try in the few minutes at my disposal to refer to it briefly. The facts in South Africa are very disturbing if we consider that in South Africa 29 500 million cigarettes are smoked every year. We can ask ourselves how many people are adversely affected by every cigarette smoked and how many people must share every cigarette smoked whether they want to or not. If we consider this, we might begin to perceive, in its true perspective, the magnitude of the problem.

There is no doubt that there has been a tremendous increase in the number of cigarette-smokers in South Africa. There has been an increase in the number of women who have acquired the smoking habit. In particular, there has been a tremendous increase in the number of young people who have acquired the smoking habit. It is calculated that this year at least 30 000 schoolchildren in South Africa will start smoking.

I am quite aware that this is a tremendously wide-spread and complex problem. One need only consider the income the State derives from this to realize the size of the industry built up around smoking in South Africa. In the 1981 calendar year the State received R319 million in excise duty from the sale of cigarettes alone. In the 1981 calendar year the State received R16 million in excise duty on pipe tobacco and R265 000 in excise duty on cigars. It is estimated that this year the State will receive R368 million in excise duty on cigarettes and R17 million in excise duty on tobacco and cigars. It is also true that in addition to the income from excise duty the State also earns millions of rand in GST payable on the sale of this commodity. The State also received millions of rands in the form of tax paid by the cigarette companies. Approximately 70 000 cigarette company employees pay millions of rand in income tax every year. It is therefore a fact that we are dealing here with a huge industry. It is not easy simply to say that we must try to ruin this industry completely.

However, the fact remains that if we in South Africa want to look after the interests of our people and more specifically their health interests, we must ask ourselves seriously in this debate which concerns the health of our nation, how we should deal with this problem.

There is no doubt that researchers and research institutes throughout the world have proved indisputedly that lung cancer and other forms of cancer that kill people are directly caused by the smoking of tobacco. I have here an article in which reference is made to the American Department of Health and Human Auxiliary Services. They submitted a report to Congress on the health hazards that are inherent in smoking. The following was said about this report—

What however bothers me tremendously is that this report, and recent research in South Africa, has proved irrefutably that people who do not smoke, but who inhale smoke, do not escape the detrimental consequences of smoking. If one considers the facts in South Africa I want to ask that we not only consider the health of the smoking public of South Africa but also the health of non-smokers. It is alleged that the chances of a woman married to a smoker contracting lung cancer are four times greater than those of a woman married to a non-smoker. It is also alleged that the unborn child of a mother who smokes weighs an average of 500 grams less at birth than the child of a mother who does not. One can quote various scientific and medical research institutes throughout the world that are opposed to smoking. It is also true that the Medical Association of South Africa has declared itself unambiguously and strongly opposed to smoking.

There are many ways of exercising control over smoking. People suggest all manner of methods, but today I want to ask that we impose a total ban on smoking in public places in South Africa. Several municipalities have already done this and I therefore want to ask that a total ban be imposed on smoking in theatres, cinemas, all places where food is served, on aircraft of the S.A. Airways and in the dining-cars of our trains—where a voluntary restriction already exists. Ever since I came to Parliament I have tried to put an end to smoking in the parliamentary milieu. I am not angry with my smoking colleagues—they are all very good people—but sometimes in a meeting one must change seats two or three times to get away from the clouds of smoke. I have nothing personal against people who smoke, but the health of our people is at stake. I therefore want to make an urgent appeal to the hon. the Minister and his department to give serious consideration to introducing such a ban via the provincial administrations and city councils. I do not object to anyone smoking, but there is no doubt in my mind that my rights as an individual who does not smoke, and the rights of the millions of other non-smokers in South Africa, are being infringed by the other people who sit next to us and smoke. Sometimes one even has to have one’s clothes dry-cleaned and there are many other unpleasant aspects.

I think we could go even further in South Africa and launch a comprehensive educational campaign in our schools via the department. I am not suggesting that we kill the entire tobacco industry overnight, because the fact of the matter is that if one were to do that, all the non-smokers will have to pay more tax to make good the tax the State will no longer receive from the tobacco industry. We must launch a comprehensive educational campaign in our schools. Our people must also be prepared to set an example, and here I am thinking particularly of doctors, nurses, teachers, parents, and those of us who are setting our children a bad example with this bad habit. I feel the time has come for us to look into this matter.

Of course we also have all kinds of smokescreens in politics. I hear that the Tobacco Board is going to award special prizes, their Artes award. There is a prize for the most dedicated bout of coughing—the “Every cough is a Masterpiece” trophy. This is to be awarded to the hon. member for Durban Point. There is also a prize for the greatest political dissatisfaction of the year, the “After Action, Dissatisfaction” trophy and this is to be awarded to the hon. member for Rissik. There is also an Artes award for the man who worked hardest behind the scenes. This prize is the “International Passport to Working Pleasure” trophy and is also to be awarded to the hon. member for Rissik. I think there are millions of people in South Africa who will support these few words in a debate on health when I say on their behalf: We, the millions in South Africa who would like to give up smoking, demand our right as individuals not to have to expose our health to what we consider to be the unhealthy habits of other people, and we appeal to the Government, the hon. the Minister, the provincial administrations and other authorities, gradually to introduce a ban on smoking in all public places in South Africa. One need only look at the foyers of theatres. One need only look at aircraft with air conditioning in which the same air is recirculated. Whether we want to or not we all end up with smoke-impregnated clothing, and I do not think it is good for our health. That is all I have to say.

Mr. Chairman, I should like to endorse the argument advanced by the hon. member for Innesdal. I think he made a very good point. He also made a very good contribution on behalf of the non-smokers in this House. I watched all the smokers and they were all staring at him wide-eyed. After this discussion they will probably haul the hon. member over the coals at the coffee table.

We shall corner him in the Lobby.

This afternoon I should like to refer to a subject which is closely related to the subject raised by the hon. member for Innesdal. This subject is drugs and the smoking of dagga, which is becoming increasingly prevalent among the young people in our society. I am referring to this because I believe people cannot be warned too often against the dangers of these drugs, and I also believe that there cannot be too many statutory preventive measures against such dangers either. I was motivated into making this speech by a father who came to talk to me about his son who is a dagga addict. The father told me his story with tears in his eyes and said that they had been a happy family until a drug pedlar had led his son astray. Today that boy is dying a slow death. Various reasons can be advanced to explain why someone starts taking drugs. However, I do not want to concentrate on this aspect this afternoon, but rather on the implications of the abuse of these substances for the community and on the measures to control this evil.

The Abuse of Dependence-producing Substances and Rehabilitation Centres Act, No. 41 of 1971, made provision for the control and elimination of this evil. The introduction of this Act contributed greatly to reducing the magnitude of the problem in our society, yet many offences of this nature are still being committed. During the period 1 July 1980 to 30 July 1981 there were 26 166 offences in respect of dagga alone. I also want to point out that on 10 July 1980 3 222 persons were serving prison sentences for drug offences. Most of them were dagga smokers. In addition to the fact that our legislation is fairly strict, the S.A. Police confiscated and destroyed 275 419 kilograms of dagga between 1 July 1979 and 30 July 1980. This fact emphasizes the necessity for the Act to be made even stricter so that it will be more difficult for the dagga pedlars to dispose of their product.

If one looks at the number of people who were treated for dagga-addiction during 1981, one finds the following: There are 37 State rehabilitation centres which only treat dagga addicts, while 55 State centres concentrate on dagga addicts, alcoholics and other drug addicts. Last year 1 Oil people were treated in these State rehabilitation centres. In addition there are private rehabilitation centres which also make a major contribution. At present 38 of these institutions deal only with dagga cases, while there are 130 other institutions which treat dagga addicts, alcoholics and other drug addicts. During 1981, 8 882 people were treated in these private rehabilitation centres and if one adds this figure to the number of cases treated in State-controlled centres, one finds that over 9 000 people were treated for some or other form of drug addiction, and doctors estimate that only 2% of these people staged complete recoveries.

Although dagga addicts form a small percentage of the total number of patients treated, this still remains the starting point for virtually all forms of drug addiction. The smoking of dagga has far-reaching consequences for the individual and the community. It is well known that dagga is first smoked by young people on an experimental basis. However, it is the first step towards taking stronger drugs and eventual addiction to them. When dagga is smoked and other drugs are taken on a long-term basis, the individual’s physical, mental, emotional and social functioning is impaired. It has been proved that the taking of any drug seriously affects the drive, motivation and interest of the individual. This leads to a loss of manpower and productivity in our economy, and to many sociological problems in our society.

The use of dagga and other drugs is also an evil which plays directly into the hands of our enemies. It is well known that the psychological onslaught on our country is aimed at totally paralysing the spirit of the population. Drug pedlars are therefore deliberately planted in our society to make certain members of our society so dependent on those drugs that this will eventually have an effect on the spiritual and psychological resistance of the nation. That is why it is so essential that this evil be eradicated at its source, namely the drug pedlar. At present Act No. 41 of 1941 makes provision for a minimum sentence of five years and a maximum sentence of 15 years imprisonment for any form of drug peddling. For a second offence the minimum sentence is 10 years and the maximum sentence 25 years’ imprisonment. However, I feel that these sentences do not in any way deter drug pedlars, and of a number of my voters agree with me.

In practice it has been proved that the evil persists, and I therefore want to make a request to the hon. the Minister to re-examine Act No. 41 of 1971. I also want to ask that the sentence for drug pedlars be adjusted in such a way that they will be a greater deterrent. I am even inclined to ask the hon. the Minister not to exclude the death sentence.

However, we shall not be able to solve this problem by means of legislation alone. Intensive education of the population is also necessary. They will have to be kept constantly informed, i.e. at home, at school and at church. In this connection I should like to congratulate the department on the efforts they have thus far made to bring the dangers of the abuse of drugs, inter alia, dagga, to the attention of school children and the community in general.

I also want to ask the hon. the Minister if we could not perhaps make use of the SABC to combat the abuse of drugs. This is a matter of affecting the entire community, and I believe that the SABC could help the Department of Health in carrying out its task in this connection.

I trust that the hon. the Minister will treat this matter I have raised with the necessary compassion.

Mr. Chairman, one basically welcomes a discussion of the subject just dealt with in this House by the hon. member for Schweizer-Reneke, i.e. the question of drugs, and in particular their effects on the youth, but I cannot, with great respect, support heavier penalties in terms of the Abuse of Dependence-producing Substances and Rehabilitation Centres Act of 1971, and I certainly cannot support the death sentence, even for pushers. We have not gone back to the Dark Ages. There are far worse crimes, and we have not yet found ourselves resorting to the types of penalties imposed, for example, in Turkey or Greece.

I think that the penalties we have imposed in terms of this Act are indeed very severe, particularly the minimum penalties. The hon. member has quoted figures to indicate that there has been a drop in the number of cases. This is confirmed by the good report presented to us by the Director-General of the Department. I do not believe that the drop in the number of cases is due to the fact that there is less dagga-smoking or a greater acceptance of drugs. What has happened is that because of these very severe penalties the problem has been driven underground. This being the case, the problem as such is not being exposed and one is not getting the people involved to court. That is the difficulty.

I certainly support the broader aspects of what the hon. member has said. President Nixon voted $1 million for the Schaeffer Commission which he appointed. That commission was here and I gave evidence before it. I read the commission’s report afterwards. There is a domino principle involved, as members of that commission suggest, and I think that our concern in this country is indeed for the youth. When dagga or other drugs are used by school-going children this does, in terms of the domino principle, lead to the use of other drugs. I am sure the hon. the Minister will join me in condemning the use of Mandrax and Welconal which are very widely abused in our society today. The latter drug should be very strictly curtailed. I know that steps have already been taken in regard to Mandrax. So much for the drug problem.

Before I deal with the hon. member for Innesdal, I should like to draw the hon. the Minister’s attention to the important question of social workers in South Africa who play such an important part in so many facets of our life. I am referring to facets such as the prevention of child neglect, ill-treatment, probation, crime prevention, alcoholism, general social work services, medical and psychiatric social work services, family-life education, marriage guidance and divorce councilling. There are three important problems that have arisen with regard to the social workers. Firstly I think it is a little alarming to find that there has been such an increase in the number of vacancies, particularly in State and Provincial administrations, there not being enough social workers to do the jobs that have to be done in South Africa. Secondly the number of students enrolling at the university to be trained as social workers has dropped by 50% over the last year or two. I think that that is a very severe drop that is going to have a marked effect on the entire spectrum of provincial health services and those given by a private institution in this country. Why are the people leaving? It is basically because commerce and industry are offering much better salaries and much better conditions of service than are available in the provincial and State administrations. Because of that I believe that we have to do something positive about salary scales. I accept the fact that 15% may be a fairly good increase, if it is to apply to them as well—but comparing their salary scales—I have them here before me—with the work they have to do and the training they have to undergo, I must say that I do not think that we are going to keep the social workers we have, in the departments in which they are employed at the moment, unless we make their conditions of service and salaries far more attractive. The hon. the Minister knows, in fact, that the Council for Social and Associated Workers has submitted a memorandum. I have seen the Press release submitted by the hon. the Minister on, I think, 8 February. The matter was referred to the Commission for Administration and I hope we can debate the matter in this House today under this hon. the Minister’s Vote. It is an important matter and I trust that we shall be able to bring it to a successful conclusion in order that we may provide this important service in South Africa.

With reference to the speech of the hon. member for Innesdal, may I say how welcome and refreshing it was and how it cleaned the air in the House today. He broached the matter of smoking. The hon. member appealed to the hon. the Minister to impose a ban on smoking in all public places. He said it must be carried out by public administrations and local authorities. We must, however, bear in mind that every local authority fails under a local-government ordinance. The local government ordinance gives every local authority the power to pass by-laws with a view to promoting the comfort and convenience of the public. It is under that aegis that the Johannesburg city council, for example, initiated by-laws over 10 years ago to ban smoking in theatres and cinemas. It was based on that aspect. I think the local authorities have to base it on that.

A Bill under my name has appeared on the Order Paper of the House for the last three years and I want to say that what the hon. member for Innesdal has asked for can in fact be accomplished. It cannot be done now because we cannot direct a local authority to impose a ban, but if the hon. the Minister accepts my Bill, he will have the power to do what the hon. member for Innesdal has asked him to do.

We do not get a chance to consider it. It is at the bottom of the Order Paper.

And that is where it belongs.

Well, let us make an opportunity. As far back as 1964 the Surgeon-General of the USA issued a 150 000-word document as a result of which every packet of cigarettes and every advertisement for cigarettes has to state that smoking is dangerous to one’s health and has to state prominently the nicotine content and the tar content of the cigarettes.

I wonder whether the hon. the Minister is not a little bit embarrassed this afternoon. His own department in 1978 issued a report undertaking to have legislation passed in the House in this regard, but up to now, in 1982, the hon. the Minister has not brought such legislation to Parliament. Why has he not done so? He has been taken in by the tobacco people and he has been persuaded that they themselves will put their house in order. How will they do that? They themselves will publish on every packet of cigarettes the quantity of the condensate and the quantity of nicotine. Most people probably do not understand what is meant by “condensate”.

How many hon. members in the House will, when picking up a packet of cigarettes, look at the back? I have borrowed a packet and I can assure hon. members that it is empty. In the minutest of letters on the back of this box one can read, if one’s eyesight is very good, that the nicotine content amounts to 1,3 mg and the condensate to 1,6 mg. Firstly, one can hardly read it and, secondly, one does not understand what it means.

Mr. Chairman, may I ask the hon. member a question?

I want to tell that hon. member, who represents the tobacco community of Brits, that the hon. member for Innesdal should be the chief spokesman on health matters for the Government side.

Mr. Chairman, I want to ask a question.

You have got your answer already.

Mr. Chairman, I am afraid I do not have the time to answer questions. If that hon. member, as chief Government spokesman on health matters, can, in representing his community, allow his interests to lie more with his voters and his tobacco than with the entire health of South Africa, I think he is morally bound to hand over his post to the hon. member for Innesdal.

To return to what I was saying, no one understands this information on the packet of cigarettes. The warning on the packets should be in terms of low, medium or high content. It should also be printed prominently. Advertising in this regard should be controlled. These are things we ask should be done. I think it is a disgrace that …

Why should your view be the only one that matters? What about the smokers’ rights?

If the hon. member wants to get up and express his views, let him do so. If my Bill is brought before the House and support of it is left to the individual conscience and we have a free vote—I suggest that it be left to the individual conscience and I call for a free vote on this Bill and I call for this Bill to be discussed in Parliament—I venture to suggest, and challenge anyone to gainsay, that the Bill will be passed by the House in its present form because the majority of members on both sides of the House will support it.

Why should you dictate to us. I thought you were against a dictatorship.

It is inconceivable that since 1978 nothing has been done. [Time expired.]

Mr. Chairman, I was momentarily dumbfounded and stunned by the claims the hon. member for Hillbrow made here about tobacco. I felt he should rather have introduced that argument by way of a private members’ motion. He made such a fuss that he has caused the hon. the leader of the NRP to be seized by a fit of coughing. [Interjections.]

We appreciate the fact that the hon. member for Hillbrow is so vehemently opposed to the use of tobacco. However, I should like to point out to him that as far as I am concerned we probably have a far greater problem when we consider the abuse of alcohol.

Yes, it makes you fat and it raises your cholesterol level.

Be that as it may, I should like, in the first place, to compliment the hon. Minister and his department on the wonderful work they have done during the past year. I should also like to associate myself with what the hon. member for Witbank said. There were quite a number of pensioners in my constituency—old people-—who asked that we express our thanks for the increases envisaged for them. What is also very important is that they asked that their gratitude and appreciation be conveyed to the department for the health services made available to them at the provincial hospital. Allow me to add at once that we know that those health services are not perfect. However, we also know that this department is working under tremendous pressure. The department is faced with staff shortages and problems caused by the present economic crisis, etc. All these things lead to great pressure being exerted on the department in the activities which it performs. In spite of this these senior citizens have only the highest praise for the services and the treatment they receive, and for the medicine and preventive treatment provided for them by the various hospitals. We offer our sincerest thanks to the hon. the Minister and his department for this.

Then there are two facets I should like to emphasize briefly today. They concern something which affects us all—the health of the nation—in which drug addiction, to which the hon. member for Schweizer-Reneke has already referred, is very important. There is also a second aspect, which is perhaps less serious, but which also affects many of us. These are the advertisements in connection with obesity.

However, before I discuss obesity I should like to say a few words about drug addiction. We have already heard the figures and statistics from the hon. member for Schweizer-Reneke indicating how drug addiction has increased in our country. It is truly astonishing when one considers to what lengths people will go to get hold of drugs. In this regard one need only think of burglaries at chemists, the theft of prescription forms from the consulting rooms of doctors, etc. Stolen prescription forms are then used to counterfeit prescriptions in order to get hold of drugs. Then there are also young girls who turn to prostitution merely to get hold of drugs. All these aspects are manifestations of the problem we are having to contend with today.

In my opinion it is quite correct for us to introduce heavy penalties for offenders in this connection. I also agree with previous speakers that we should in fact introduce heavy penalties for drug pedlars. As far as I am concerned the problem does not lie with persons who take drugs. As far as I am concerned the problem actually lies with persons who sell these drugs. In regard to the former I feel that the hon. Minister’s department could perhaps make recommendations to the department controlling these matters, and to jurists, in connection with the possibility of imposing lighter sentences in this connection. I shall explain my reasons for this statement in a moment.

I am referring to those persons who are found guilty of drug abuse, provided that they then make themselves available for treatment and also furnish information on the suppliers of the drugs. And therein lies our problem. The supplier is the person who is causing tremendous suffering in this country in view of the number of drug addicts we have in South Africa at the moment.

There is a second possibility we could investigate, and this is for the authorities to establish an institution similar to Alcoholics Anonymous. Today I want to ask that the department consider the possibility of establishing a separate organization, perhaps by means of direct financial assistance, consisting of people who concentrate on the treatment of drug addicts. Nowadays we are trying to treat drug addicts through organization such as private clinics, etc., which in the past concentrated on the treatment of alcoholics. In all sincerity I do not think that these bodies are at this stage quite equal to this self-imposed task. I feel we must put a quick stop to this by establishing an organization and keeping it completely separate from the other organizations which attempt to treat alcoholics. If we consider the misery caused to young people and how they degrade themselves in their efforts to get hold of these drugs, we ought to do everything in our power to try to stamp out this evil, if this is at all possible.

I agree that a great deal can be done by making use of the radio and television networks, but I think we should go even further. I think the Department of Health and Welfare ought to distribute pamphlets, particularly at schools and universities, in connection with the dangers of drugs. This should be undertaken to a greater extent than is at present the case. It is tragic that it is not the older generation which is addicted to drugs but the younger generation.

I should now like to refer very briefly to a problem which I feel is cropping up more frequently, namely those wonderful slimming aids we are always reading about and hearing about. I want to refer specifically to an article which appeared two Sundays ago in Rapport and try to indicate how, as far as I am concerned, people are misleading other people. The article read as follows—

I thought the article was referring to me! In any case, the report went on to state—

The next part of the report is very interesting—

He says all he does is inject a liquid substance, make a tiny incision into which he inserts a “creepy crawly”, and then he sucks out all the fat. [Interjections.] What is important is that friends of mine who are plastic surgeons tell me that according to their information this liquid consists almost exclusively of alcohol. This liquid not only dissolves the fat but also the surrounding tissue. This is where the danger lies. If this man is simply allowed to continue, it could create a health problem. I have learnt there is only one way of getting rid of fat and that is to keep one’s mouth shut and not eat too much. In any case, I should like to know from the hon. Minister if there is any form of control over this sort of treatment. Is the Medical Council keeping an eye on this or is it the task of the department to do so. This man says he can offer this wonderful treatment and no one has told him he may not do so. If this sort of thing continues, it could assume such proportions that it could constitute a danger to a sector of our community. People could eventually develop all manner of maladies which we would not be able to suck out with this kind of scientific “creepy crawly”. If the department does not exercise any control in this connection I should like to ask the hon. Minister whether he would consider taking steps to control this kind of treatment or action and whether he would also include the various types of pills which are being marketed and which in my opinion could also ruin one’s health. These pills are simply intended to make certain people rich.

Mr. Chairman, I do not want to react to the hon. member for Stilfontein’s very interesting speech because there is another subject I want to discuss. It concerns radiological hazards and protection.

We all know that our first atomic power station at Koeberg will, according to reports, come into operation by January 1983. Owing to public interest in the subject I should like to make a few remarks on radiological hazards and protection.

In assessing the safety of a nuclear power station one of the major considerations is the possible exposure of workers in the plant and the population in the vicinity to radiation. Before I discuss the control measures, I should like to say a few words on radiological hazards.

X-rays were discovered in 1895, and by 1896 the first researchers reported skin burns as a result of the primitive X-ray apparatus they were working with. Many of the early researchers suffered tremendous damage to their health and some of them even lost their lives as a result of excessive radiation. By 1922, 100 deaths which could be directly ascribed to excessive radiation had been recorded.

Cognizance was taken of these early health hazards and deaths and in 1928 a group of independent scientists came together and formed the International Commission for Radiological Protection with the object of making recommendations concerning standards in the application of the principles of radiological protection. This commission still exists today and it regularly revises the standards applicable to radiological protection. Its recommendations have been incorporated in the legislation of many countries so that the principles and standards established are in fact applied internationally.

The modern principles of radiological protection were formulated in 1958 on the basis of the experience with radiation in the Second World War and also on the basis of information obtained from research in the Manhattan project, the project which was responsible for the manufacture of the atom bomb. This experience and research yielded information regarding the effects of both high-level and low-level radio-active radiation.

It is of importance to note that the standards drawn up in 1958 are still being used virtually unchanged today and that those standards have ensured the very best safety record in the history of modern industry over a period of 34 years.

In order to see the exposure of workers and the general public to radiation from an atomic power station in the correct perspective, it is necessary to furnish certain general information. In the first place, mankinds natural environment is itself slightly radio-active and our forefathers have been subject to atomic radiation from the earliest times. The sources of radiation are well known. In the first place there is cosmic radiation; in other words, radiation from the stars, etc., from outer space. In the second place there is earth radiation; in other words, radiation from rocks and soil, caused by radio-active elements. In the third place there is also internal radiation to which we are all subject, caused by natural radio-active elements in the composition of our bodies.

To this natural radiation has now been added radiation which man has introduced since the end of the previous century owing to his modern way of life, mainly caused by the use of X-rays in the medical field. In the first place there is the medical use of X-rays for both diagnostic and therapeutic purposes. In the second place there is radiation caused by the fall-out from nuclear weapon tests in the atmosphere. There is also radiation resulting from the use of radio-active materials in industry. There is also radiation caused by the operating of atomic reactors and the recycling of nuclear material. Of course there are also other sources of slight radiation, for example the dial of one’s watch. Calculations have shown that in this century man has increased the natural radiation of his environment through the use of radio-active elements by approximately 50%.

It is true that any activity in which man participates exposes him to dangers. Even people who do absolutely nothing are in fact constantly exposed to the risk of injury or death. The statement that certain activities or installations are absolutely safe is therefore completely untrue.

The task of a licensing authority—the authority which has to issue a licence for the operation of a nuclear plant—is to ensure that the presence of the nuclear power station will not contribute significantly to the normal risks to which people in that vicinity are in any case subject as a result of other industrial applications. This means that the risk in respect of nuclear activities must compare favourably with the risks involved in other industrial undertakings and that allowance must be made for higher standards which the community can set during the operation of that nuclear installation in the future.

I should like to mention a few facts in connection with the operating of nuclear plants.

In almost 25 years of operating commercial nuclear reactors, an average of over 200 reactors a year have been operating for an average period of more than 10 years. We are therefore speaking of over 2 000 reactor years, and in this period no one has been injured or killed as a result of a nuclear accident in any reactor. People are injured and killed as a result of conventional accidents at such plants—a man can slip and break his leg—but these injuries and deaths were not caused by nuclear accidents. Even in the most serious nuclear accident, the Three Mile Island accident in 1979, no one was killed or injured as a result of nuclear radiation and no after-effects are envisaged for the general public as a result of the accident.

Another very important fact is that a nuclear power station cannot explode like a bomb. As a result of the low enrichment of the fuel, such an explosion is quite out of the question.

In general one can say—this comparison is frequently made—that it is more dangerous for one to travel two kilometres a day by motorcar between one’s place of employment and one’s home than to live within two kilometres of a nuclear power station.

I should like to mention a few statistics in respect of occupational hazards in industries to indicate what occupational hazards the nuclear industry constitutes. The figures indicate the number of people per million per year who will probably die. In the chemical industry the figure is 200; in commerce, 160; in agriculture it is fairly high, namely 360; in mining, 785; and in transport, 975, as against the figure for the entire nuclear industry of approximately 200. Actually, this figure is exclusively the result of conventional hazards. The contribution of the possibility of nuclear radiation is only approximately 0,01.

Mr. Chairman, on this Vote, the hon. member who has just resumed his seat has made an interesting contribution on a particularly complicated and specialized subject, one which we in South Africa will have to take into account to an increasing extent in future. I assume that the hon. member’s views will receive the attention of the hon. the Minister and his department.

However, I should like to confine myself to another problem, and that is the problem of housing, particularly the problem of housing for the aged, in as much as it also has an impact on health and health services.

†In raising this subject, I am aware that it to an extent overlaps with the Department of Community Development in that that department provides the capital costs of many subsidized buildings, but the Department of Health and Welfare provides the running costs for such homes occupied by aged people. The Department of Community Development provides assisted housing for certain income groups, but the Department of Health and Welfare is responsible for special accommodation for people in a certain age category. There is therefore an overlapping but also a separation.

I am also aware of the very good work that has already been done by the Department and which is reflected in Annexure No. 61 to the Report of the Department for the past year. I am also glad to see on page 5 that the South African Welfare Council for the Aged has met and has, inter alia, considered the question of the care and need of the aged in the field of housing.

Nevertheless, the fact is that it is becoming an increasing problem which has a very direct bearing on the health and welfare of a growing section of our population. It is becoming a growing problem for a number of reasons. First of all there are an increasing number of senior citizens and especially the frail, weak and less well off are finding themselves in a desperate position as far as accommodation is concerned—especially accommodation where an auxiliary form of medicare is required. This is the area to which I want to direct myself. The reason for the increase in the number of these people is that because of increasing longevity in South Africa there are in fact more aged people in this country. There is less and less dependence on the family for support as urbanization, mobility and costs move children and supporting elements within the family away from the aged members in the family community. Thirdly, there are the rising living costs. No group in this community is feeling the impact in the dramatic rise in living costs more than the aged in South Africa who live on relatively fixed incomes, whether it is for accommodation, medical treatment or for the ordinary needs of survival and maintaining an ordinary standard of living. When one looks at housing, one sees a rise on building costs of over 50% in two years, rentals sky-high, rent-controlled premises becoming fewer and fewer and even where there are rent-controlled premises, they are only available at a premium. As a result we find that more and more elderly people, who a short while ago were in a position to fend for themselves, are now not able to fend for themselves because of rising costs and fixed incomes. Only today I had a meeting with people from social welfare, who described the scene of the elderly person who has to eat into his or her capital in order to provide for the payment of accounts. Such people have to start reducing their standard of living, selling their possessions, and then sliding down the social scale away from the environment which they enjoyed and gradually living in increased isolation and increasing insecurity. This is the pattern which this social worker described by which these people are being relegated to a kind of ghetto existence away from the community in which they lived before. I raise this as a serious social problem for all of us. The homes for the aged are full to over-flowing and welfare organizations—and I speak particularly about the Cape Peninsula—sit with long, long waiting lists. I do not have time to read a letter from the Cape Peninsula Welfare Society for the Aged, which says that for people in the under R250 income group a desperate position has arisen. This is the direct responsibility of the Department of Health and Welfare.

The people who are really caught in this financial squeeze-play are the people in the intermediate income group. Indigent people with an income of less than R200 per month can in fact get subsidized accommodation in old-age homes. The welfare organizations accept people with an income of under R200. They also accept people with an income of over R360 per month because it costs R360 to look after these people, but for old people who earn an income of between R200 and R360, there is no accommodation. There is no accommodation of the ordinary kind and there is particularly no accommodation of the kind which you require when you become ill, for example if you have a stroke and you become paralysed and you need continuing medical care. I raise this as a very, very serious problem. I believe that the hon. the Minister should immediately re-examine this income level. I believe that R200 per month is an unrealistic income level and it should be increased so that many more people who are really in need, can get the benefit of assistance from the State. I believe that in addition the hon. the Minister must do as other hon. Ministers have done and try harder with the hon. the Minister of Finance to get more money for this project because no society can sleep at night if the old people in that society have no accommodation.

Secondly, I want to speak about the specialist accommodation for the frail and the sick among our older people. There is very little accommodation available at prices that people can afford. The sick bays in old-age homes are only available on a temporary basis for people who are already resident in those old-age homes. The beds in provincial hospitals are only available on a temporary basis while an attempt is being made to cure these people. In the main that is the intention although there are certain facilities for the chronically ill. But what about the older person, the person who is not well off, the person who is suffering from a permanent illness or disability? Here I can only call the words of Dr. R. L. M. Kotzé. the Director of Hospital Services in the Cape Provincial Administration. He read—

He added—

So we are not thinking about hospitals in the curative sense but hospitals in the sense that they can sustain, give succour and accommodation to people who need this kind of attention. In the Cape Peninsula area there is the Zerilda Steyn Home in Pinelands with 360 beds, serving not only the suburbs of Cape Town but the whole of the northern areas as well. To a lesser extent there is the Booth Hospital in the Gardens with 70 beds which is run by the Salvation Army. These institutions are concerned at the fact that they are unable to provide accommodation for those frail, elderly people who need assistance in the field of accommodation and simultaneous medical care. In addition to that, on the subsidy formula of R200 a month, these institutions are finding it increasingly difficult to accommodate people and to make ends meet. Both from the capital point of view—and this applies to the hon. the Minister of Community Development—and from the point of view of running costs, the subsidy for the individual inmate of these particular homes and hospitals is the responsibility of this Minister and this is what we are asking him to do.

What are the proposals? We believe that the hon. the Minister, taking into account that the number of old and frail people and people in need is going to grow, should grasp every opportunity to provide suitable premises or facilities for creating this type of institution. May I draw the hon. the Minister’s attention to just one in my constituency? I refer to the Sea Point Clinic, formerly the Monastery, in High Level Road, which is now up for sale. It has the facilities for an old-age home in which people can be given medical care. I believe that once that site is lost, once it is sold to the property developer and once a high-rise building or town houses are erected there, the opportunity of buying the building at relatively low cost on a large piece of land will be lost for all time. The hon. Minister should be looking around for suitable sites for suitable premises in order to provide this facility for the older people in South Africa. Secondly I also wish to mention the question of income level and money from the Treasury and I intend repeating this every time during the discussion of the Votes. Thirdly, it is not only the State and it is not only the Government—we believe that the State should take the initiative in initiating a national campaign to promote such concepts as community involvement and the judicious sharing of existing facilities. Much more can be done with existing facilities if they are shared judiciously by people who need this kind of accommodation. Much more could be done if the State in an active way could inspire and get the co-operation of the community.

Therefore, while we accept the fact that the State has a prime responsibility, we believe that this is the responsibility of society as a whole. All we ask of this hon. Minister is that the Government plays its part in providing the money and the services and that it should also take the initiative in inspiring the South African community to look after the elderly who live in this country.

Mr. Chairman, Edmund Burke once said that no nation could escape its past, and no institution of whatever nature can be understood in the absence of an historic perspective. This also applies to local authorities and health services, to which I am going to refer briefly.

The only reference to health in the original South Africa Act of 1909 was a brief section which provided that the provincial administration would be responsible for hospitals, although local authorities did in fact have health divisions under the old colonial legislation which functioned separately, without any co-ordination. It was only during the ’flu epidemic of 1918 that authorities realized that no co-ordinating organization existed to prevent diseases or fight epidemics. At the national health congress held in that year, not only the central Government and the provincial administrations, but also local authorities were represented. During that congress the matter was put right and a draft Bill on national health was drawn up and passed by Parliament in 1919 as the National Health Act No. 36 of 1919. Section 10 of this Act gave specific directives and responsibilities to the third level of government, namely local authorities, whether city councils, municipalities, health committees, divisional councils or even “any body of persons constituted by the Governor-General”. In the rural areas—excluding the Cape Province—where there was no other body, the magistrate was appointed.

In terms of this Act the primary responsibility was the prevention and control of contagious diseases and the treatment of patients contracting such diseases. Over the years conditions have changed, however, and in course of time, as effective vaccines were developed and antibiotics discovered, health departments had the necessary instruments to control epidemics.

Suddenly the world, including South Africa, was faced with a population explosion. More babies were kept alive and old people lived longer. Family planning and preventative geriatric services became essential. Gradually the emphasis in South Africa shifted from hospital-orientated therapeutic services to a comprehensive preventative and health service.

The new Health Act No. 63 of 1977 was also designed to promote this approach and, on the one hand, to co-ordinate the activities of the three levels of government, and on the other, to differentiate between the potential duties of the main cities on the one hand and those of the smaller towns and rural communities on the other.

The services and responsibilities of local authorities under the new Act are set out in section 20, and may be divided into personal and non-personal (regional services). Personal health services include ante and postnatal clinics, baby clinics, immunization clinics and general clinics, as well as venereal disease clinics, family planning, geriatric and psychiatric clinics, and clinics for the control of contagious diseases. Non-personal health services on the other hand, include the following: The provision and purification of water, sewerage and the removal of sewage, the removal of solid and liquid waste of household, commercial or industrial origin, atmospheric pollution control, food hygiene, economic and sub-economic housing, the control of noise, rats and radiation, town planning, cemeteries, recreational facilities and the prevention of accidents.

From the above it is clear that the health services that local authorities provide are very comprehensive and important. The service is also of such a nature that nothing dramatic happens as long as the service is provided efficiently, and the better the service, the less aware of it the inhabitants are.

We on this side of the House can only express our thanks to the local authorities who provide these health services so purposefully and efficiently to all the inhabitants of the Republic of South Africa. With the increasing urbanization taking place in our country, these responsibilities will become greater.

As far as the optimum use of manpower is concerned, it will at all times be necessary to guard against duplicating health services provided by the various agencies. The communal health centres, to which reference has already been made today, will in my opinion make a tremendous contribution in this connection. It will also have to be seen to that the health services are provided at the lowest possible level, where the necessary infrastructure exists of course. In any future Government set-up it is essential that the greatest degree of decentralization of power should take place. Because local authorities comprise the government level that is closest to the community, in any future dispensation an increasing amount of responsibility will be placed in their hands, which will also call for the greatest degree of community involvement and participation. The municipal government level is therefore the appropriate level for education and training, in regard to health services as well, for the less developed population groups in the RSA.

To understand the magnitude of this challenge better, it will be necessary to take time to consider the potential of these population groups. On the basis of statistics collected by the Browne Committee, it would seem as if as many as 200 autonomous Coloured authorities can be established in the Cape and 60 Asian authorities in Natal. At the time of the investigation there was one in the Cape and two in Natal. It is therefore possible that by about 1990 as many as 300 municipalities or municipal-type authorities could be established for Coloureds and Asians, as against the existing 500 local authorities for Whites. Increasing urbanization, to which I have already referred, has led to 38% of the Black population already being urbanized at the time of the 1980 census. In less than 20 years from now this percentage could double. In other words, the present six million urbanized Blacks could increase to over 20 million by the year 2000. A tremendous education and training task therefore lies ahead for local authorities when it comes to health services. In future the emphasis as regards these services may not be placed so much on the further development of health services, as they are at present organized, but perhaps far more on new methods of identifying basic needs and establishing simple preventive and curative services. The challenge facing local authorities in this connection is no insignificant one, nor is, the contribution they must make to the welfare of our country and all its people.

Mr. Chairman, I should like to react to the speech by the hon. member for Newcastle. It is quite clear that he knows what he is talking about and I want to congratulate him on his contribution.

We cannot allow the health part of this debate, which is almost at an end, to pass without referring to nurses. Any profession which has a spokesman and champion of the calibre of Prof. Charlotte Searle is certainly fortunate. I am therefore gratified that during the past two years she has received various awards, including the D.M.S., as a token of appreciation for the services she has rendered the nursing profession. We are proud of her and want to tell her so in this House.

Before I agree with the fact that we cannot feel happy about the present staff situation in the nursing profession, I just want to mention the fact that there is indeed a sufficient number of trained White nurses in the Republic. However, there are too many inactive nurses who are not in the service for a variety of reasons. What we really have, therefore, is a relative nursing shortage.

Let us consider some possible reasons for this. In the first place, I feel that we are all agreed that inadequate conditions of service, including salaries, are among the important reasons why nurses are either unavailable or seek pastures new. I shall say more about this later. In the second place, a nurse, who some times has to serve people under very trying circumstances, is a person who can also fill a position in a far wider labour field, and after all, the labour market is looking for such people, reliable, energetic, disciplined workers and mature people who have proved that they will not allow even a very difficult academic course to stand between them and success and who are physically and mentally able to face up to the hard world in which a nurse moves. I think that for this reason we lose many more nurses than we realize. In the third place a nurse is and always will be someone who plays a very important role in the family. For reasons I have already mentioned she is frequently not available for nursing duties, even on a limited or part-time basis.

There is another reason too. The hospital where she must work is frequently out of reach for the nurse who is still interested in offering her services. This is true not only in rural areas but also in the cities. It is interesting that an investigation undertaken by the CSIR showed that the greatest percentage of nurses working at provincial hospitals lived in the south-eastern part of Pretoria, according to their residential addresses. In spite of this information the newest and most luxurious of our provincial hospitals has been built in the north-western part. I think it is true to say that no worker wants to travel 10, 15 or 20 kilometres a day through the city traffic to his place of work. Inaccessibility also applies in rural areas. I shall have more to say about this a little later.

These are only some of the many factors which can and do play a role. What is the solution to this problem? There is no instant solution and there is certainly no all-embracing answer. However, I believe that part of the answer lies in the health services facility plan for the RSA. We should note that the success of primary health services as a part of this plan, where the emphasis shifts from the curative to the preventative, will in fact depend on a favourable nurse/population ratio. For this reason, new nurses will have to be recruited and qualified people will have to come back into circulation.

This immediately brings us to conditions of service. This will always remain a ticklish problem, but we must not shy away from the necessity of overcoming this problem as far as possible with the means available at present. We must give the very best attention to this. I believe it is not so much the salary of the pupil nurse or the student nurse that is at issue. While she is undergoing her training and is being paid she has the advantage that she is also being prepared for her life’s task. She is also given a uniform allowance, accomodation arrangements etc. However, the day she completes her training and must take up the highly important position of nurse, she must be properly compensated and she must be handled like a delicate piece of porcelain.

The coming into being of community health centres throughout the Republic of South Africa of necessity gives more nurses, particularly those outside the active profession and those living far from existing hospitals, the opportunity to enter the service. We have organizations like the CSIR, the National Productivity Institute and the HSRC—excellent organizations, which afford us the opportunity to undertake a unique day to day evaluation of the problems involved in supplying health services, and the effect of urbanization or the migration of people. In the department under discussion, too, innumerable and constant investigations are under way. All that remains is to co-ordinate the plans of all interested parties involved in the training of doctors and nurses and other medical staff and in the creating of hospital facilities.

By the way, I should like to know the opinion of the hon. the Minister regarding the idea that the training of nurses, should not only be undertaken by the State, but also by the private sector; it goes without saying that this would be in co-operation with academic institutions and under provincial control.

Is another answer to the shortage not perhaps a less idealistic entrance requirement and more practical training instead of highly academic training taking into account, of course, the maintenance of the high standards in nursing that we are accustomed to and would like to see retained.

In conclusion, a few ideas on the role of the nurse. No one can build up the image and the status of the nurse better than the nurse herself. The nurse must show confidence in herself and in her profession. All outsiders and that includes us, must show confidence in these people, and tell them so as well. Professor Searle has never, in the midst of all the troubles surrounding the nursing profession, threatened that the people she represents would go on strike or act irresponsibly. No. Wherever she goes she always states quite clearly that the people she represents are among the most important professional people in our national economy. In addition, she tells them time and again that they must not be satisfied to provide anything but the very best service. This is the attitude with which we must approach this problem; then we shall really make progress.

Mr. Chairman, it is a pleasure to conclude the debate on the health aspect of the department by conveying my thanks and appreciation, right at the outset, to the hon. members for Parktown, Brits, South Coast, Kimberley North, Witbank, Walmer, Innesdal, Schweizer-Reneke, Hillbrow, Stilfontein, Pretoria East, Sea Point, Newcastle and Rustenburg.

Right at the outset I should like to convey my thanks to the chief spokesman of the official Opposition, the hon. member for Park-town, for the way in which he introduced the debate. I think this contributed a great deal towards placing the debate at the level where it belongs. Last year, unfortunately, we conducted the debate on this Vote against a political background, because the activities of the department were dragged into the political arena. This year, however, things were different. Interesting suggestions have been made here to which I shall react later. However, constructive debate took place. There was criticism as well, but suggestions were made which, I believe are exceptionally important. I believe that the hon. member for Parktown will agree with me when I say that I hope that we shall continue to follow the same pattern in future. After all, one does not launch attacks when it is unnecessary to do so.

I should like to reply to a few of the points which the hon. member for Parktown raised right at the outset. The first question he put to me was whether I was satisfied that enough money was voted. Clearly, as a Minister I can never be satisfied that enough money is voted. However, we must not be greedy either, and have money voted which we cannot use. We are engaged in the restructuring of our entire health service. This started a few years ago when the Health Act, which hon. members have already mentioned, was introduced. From that basis we have moved in very positive new directions. In my period of service we have drawn up the national health facilities plan and it has been accepted by the Cabinet, and I think that the hon. member has now also decided that “if you can’t beat them, join them”. That has been our slogan in the department for years now and over the past 2½ years we have simply been trying to emphasize this more. In my first period of service in medical administration with the Cape Provincial Administration I found that because we lacked the money to build hospitals, we took health to the public. Now we are continuing with this on a far greater and better scale which is far more comprehensive. Health centres offer services by which everyone can benefit. We provide all people’s medical requirements such as family planning and dental care. The latter is a service which was not initially available at the day hospitals. By means of these health centres we are now taking the care to the people. We are getting away from the idea of the building of large hospitals, as the hon. member proposed. There is a Cabinet decision that no hospital can be built without the permission of the Minister of Health and Welfare. We now have co-ordination in this sphere. For example, it has been agreed to that in an area like Soweto, up to 10 of these health centres may be built over the next year or two, and we are at present negotiating with the Transvaal to establish more smaller ones.

In the interim, however, certain hospital improvements have to be effected, and in this regard an amount of more than R40 million is being spent on the Baragwanath Hospital in the Soweto area. This will be done over the next few years. The work has to be doen because one has to keep up to date, and this is a very important hospital. Only time will tell whether anything more than these health centres and the improvement of the Baragwanath Hospital is necessary. It is fixed policy that we must first make an effort to take the health services to the people, as the hon. member said, and that is why we are now building those health centres and trying to get away from the idea that only hospitalization on a large scale and sophisticated services provide the solution in this regard in our country. In this country of ours part of the population are of the so-called First World and another is of the so-called Third World—“developed” and “developing”. We are a mixture of both. Our health services also have to be cast in that mould, but unfortunately the branch which grows towards the sophisticated side has in my opinion grown too large over the years. However, it is pointless complaining about that, and we must simply prune that branch a little or help the other branch to grow bigger so that the tree can be more balanced. The hon. member raised a very interesting point in this connection. I am sure that if we can co-operate and discuss matters in this field and to some extent get away from these great hospital colossi which have been built over the past number of years, we shall be far better off.

The hon. member also raised the issue of staff shortages. I want to say to the hon. member that we are all concerned about the staff shortages, and one annual report after the other indicate to us that there are indeed problems in this connection. There has been an improvement. This is not indicated in the annual report, but after we had launched an intensive campaign in an effort to attract nurses, we received very good reports from all the provinces. There has been a major improvement in the enrolment of nurses; in any event, there is no deterioration of the position. I think that this is largely due to the very sober attitude adopted by the S.A. Nurses Association. They encouraged the nurses to remain in their jobs since the Government was investigating the whole matter. The hon. member for Rustenburg also raised this point. One cannot simply produce nurses from nowhere. There are a number of nurses who have left the service because the grass is greener on the other side of the fence. Whatever we pay, the private sector will continue to attract them away. I am not all that opposed to this, because everyone that goes to the private sector performs a service which our department would otherwise have had to perform. Many of these nurses go to factories. They join communities where they perform certain tasks for which we have trained them. The hon. member put a question to me which has often put to me in the past, and that is whether we should not try to train more Black nurses. I have dealt with this argument on a number of occasions. The ratio of the Black population to Black nurses is getting disproportionately high when compared to the ratio of White nurses to the White population. If, therefore, we wish to do something, we must train more nurses for the Black population. A great deal of training has already been done, of course, but it is pointless coming along with a slogan and saying that Blacks should be trained to nurse Whites. We have Blacks nursing White patients at the moment. One encounters them inter alia in our psychiatric hospitals because we are no longer able to get nursing assistants who want to work in a psychiatric hospital. The atmosphere there tends to be depressing, and it is easier for them to obtain their money at other hospitals, particularly in view of the shortage we are experiencing at present. When bodies even in the private sector want to use Black nurses in White sections of their hospitals they have to obtain approval in advance from the Minister. After all, we have to have order in the overall health set-up.

What has been done recently about the problems surrounding the nursing profession? An investigation into the basic problems has been launched by the Advisory Committee for Health. They have appointed a subcommittee to investigate the training. All this has been done over the past 12 to 18 months. Radical changes will have to be brought about in the training and in the way the nurse is used in the time when she is actually rendering service. She must spend less time with her books and more in practical work. She must also fall under the college and not under the matron who is concerned with illness, viz. under the academic matron. I obtained approval for this the other day and conveyed it to the association. Prof. Searle’s words to me were that this was the greatest step ever taken by nursing since it began. We were given approval by the Minister of National Education for our nursing colleges to link up with the universities in future on the same basis as that in which the teachers’ colleges link up with the universities. Contracts will now be entered into, and with the approval of the Minister of National Education we shall enter a new phase, enabling the nurse to link up with the university academically. To qualify for this the nurse must of course be in possession of a matriculation certificate. If she wishes, she can enter for a degree course at a later stage and then some of the subjects she has completed at the college will be recognized for degree purposes.

After a separate association?

Yes, of course. I shall deal with the hon. member when we resume our discussions on the Bill. The hon. member is always coming up with a silly story when I am talking earnestly about something which is very important.

Your story is silly.

This has nothing to do with associations; it has to do with the training of nurses.

*Having said that to the hon. member I believe he will realize that, as I said in a previous debate, we are trying to deal with the overall situation as regards nursing.

There is something else, too, that is of importance. The Commission for Administration has allocated nine of its staff members to a differentiated investigation because the Government said that there had to be differentiation in various professions. One that is enjoying priority is the nursing profession. This is such a comprehensive investigation that the nine members of the staff have been busy for almost 12 months now. However, this is not in respect of nurses alone; it concerns the entire health service. The information at my disposal is that they have set the target of giving us the recommendations towards the end of this month, but it may take a little longer—until, say, the end of May. I asked them to ensure that we are given an overall picture and that they do not come forward with interim steps. I cannot go to the nurses with an interim solution; we must present a reasonable solution which will have to have been approved by the Cabinet. However, I am convinced that the Cabinet will have no difficulties in this regard, for the very reason that this is such a comprehensive investigation.

The hon. member referred to Black medical practitioners. If, then, we come closer to one another—well, I do not like that idea much; the hon. the Prime Minister also mentioned the fact that we agreed on certain matters—I do want to point out that when we established a Black university like Medunsa, I did not hear a single hon. member of the PFP—that was before the time of the hon. member for Parktown—saying that that was a good idea. Objections were raised. It was said that this was a Black college which would train a Black medical practitioner who would be nothing more than a half-mast practitioner. A few evenings ago I spoke to a dean from Medunsa. He told me that he had worked at three university hospitals and in all those three White institutions he had not encountered such dedicated students as the young Blacks they train at Medunsa. We are training medical practitioners, dental technicians and all the various health service professions at Medunsa. Hon. members must support us in this. These people want to offer training in a milieu where they know one another and form their own groups. They also form their own associations, discuss matters with one another and enjoy themselves there. We need not always be speaking in terms of “throw open the White medical schools”; we should rather afford these people the opportunity to train their own people at Medunsa, as is now the case. We should like to have the support of the PFP in this regard and then it will be possible to train sufficient Black medical practitioners in our country.

The hon. member referred to a shortage of posts for district surgeons. This may not be a true picture—we are encountering problems in this regard—but in future, only the district surgeon who undertakes certain legal work will be employed by my department, while the other district surgeons will be in the employ of the provincial administration. They may be employed on a fulltime basis or work on a session basis. The picture may look uncompromising in this regard, but it is not really so bad.

The hon. member asked that we should consider, as in the case of the Year of the Aged, declaring a staff year or a year of the nurse. I cannot agree with the hon. member, because every year is the year of the nurse. We have to effect improvements to their working conditions and their conditions of service every year and listen to them in an effort to eliminate, over a period of time, those things which are major problems for the nurses.

The hon. member for Parktown and the hon. member for Walmer made mention of the fact that the Black population was increasing so rapidly. I do not want to elaborate at length on family planning, but it is clear from the budget that a larger amount is available for this purpose this year. We already have more than 1 000 workers in the field who speak to people in their own language and try to persuade them, not to have fewer children, but to have children whom they can look after and educate. In every country with a successful family planning programme, one immediately has a drop in the infant mortality rate. The world reproaches us for having a high infant mortality rate, but we cannot be held responsible for that if people do not want to raise families judiciously so that they are able to take good care of their children. If people raise families injudiciously it is their own responsibility if the child dies at an early age. If they plan their family judiciously and have smaller families which they can look after properly, then they can look to the Government and say that we do not provide a decent health service. We cannot carry all health services if the public of the entire country does not want to co-operate in this particular regard.

I think I have more or less replied to what the hon. member said.

†The hon. member for Parktown talked about mental health. I am glad that he did mention that new facilities are being built at Komani Hospital and at the Tower Hospital. It is very important that we get these facilities. I am sure the hon. member saw some of the poor conditions, and I am not hiding it. In fact, I said the hon. member could take more members of Parliament along with him to go and have a look. We have also been negotiating with private enterprise and I believe that private enterprise can play a part, as we have already very good hospitals erected by private enterprise. Private enterprise only wants to know that over a long period of time they will not be ruled out as far as, perhaps, losing their buildings, etc. However, I do not think that there should be any problem in this regard.

*The hon. member also said that “there should be healthy sharing in the finances”. There is no area within the South African structure of expenditure in which such disproportionate expenditure takes place as in health services. However, this does not occur in the direction which hon. members of the PFP think, but the other way around. Of the one billion rand which the department and the four provinces spend on health, only a quarter is spent on the Whites and at least three-quarters, R750 million, on health services for the other population groups. The hon. member for Parktown has himself worked in Groote Schuur hospital and he will know that two-thirds of all patients in the hospital are people of colour. The same happens at the Tygerberg hospital. If one works this out pro rata, it is clear that the State spends at least three times as much on the Black, Brown and Asian population groups of our country. Because the Whites rely on medical funds and private doctors, they have to obtain their services from that source. We are not in the accused bench when it comes to expenditure on people of colour. We could rather be in the accused bench as far as expenditure on the Whites is concerned. Hon. members said earlier that they agreed that we were moving our service towards the public in accordance with our policy. We are indeed doing this, and I hope that in the next year or two, if everything goes well and we can maintain the financial assistance we are receiving from the Government at present, we shall be able to continue along this road. All that will be required is greater co-ordination between our expenditure and that of the provinces. We are conducting negotiations in this regard and I have already met the Administrators. We shall have to ensure that we spend more money on preventive medicine and less money on curative medicine. This does not mean that the people at large must lie down and die. We must turn the wheel so that it will not be necessary for the people to go to hospital.

I should also like to thank the hon. member for Brits for the excellent idea and for the T-shirt he gave the hon. member for Parktown. I think he earned that T-shirt today. He behaved very well. Mr. Chairman, in terms of the Standing Rules and Orders the hon. member will probably not be permitted to wear the T-shirt in this House, but I hope he will keep it in memory of this debate.

I think the hon. member made a very good speech about the national health facility plan. He indicated that this was already our policy. I do not want to go into that. I just want to convey my sincere thanks to him for having put it so clearly. I want to convey my thanks and appreciation to both the hon. members and also to the other hon. members who praised the Department of Health and Welfare and the Director-General for the exceptional report which has been presented. I, too, think that it is a very good report and I think that the fact that we are able to get it ready and make it available for study by the hon. members before this debate, is a feather in the cap of the Director-General and the entire Department of Health and Welfare. The report has been drawn up concisely and it was drawn up with the approval of the Director-General. I did not see the report in advance at all. There was no discussion as to what words should be deleted and what columns inserted. It is his report, and therefore, when it came to me I had to consider what was in order and what could be improved on in the department.

The hon. member put it very clearly that this was only the first year of rationalization, and that the project was already beginning to show signs of success. It is very difficult to marry two departments like Health and Welfare. The services differ and there are differing points of view and approaches in the two departments. It will take another year or two before we can experience the full benefit of this rationalization but I am sure that our officials have performed a Herculean task. Some had to do so under more difficult circumstances, but I am sure that in the time that lies ahead we shall achieve exceptional success with this approach.

The hon. member for Brits also referred to cholera. I do not want to elaborate on this at any great length today. I only want to say two things about it. A major campaign has been launched by a co-ordinated committee working group on which a number of departments were represented. The Director-General of the Department of Health and Welfare was the chairman of the committee working group and the Departments of Co-operation and Development, Environment Affairs, Community Development—a large number of departments took part and managed at least to give a large section of the population in the cholera region clean drinking-water within a very short space of time, on an ad hoc basis. This is not the total solution. We must now proceed to the next step and do our best to make more money available. When I say this to hon. members, it is interesting to know that in fact very large amounts have already been spent on water. The hon. member for South Coast also spoke about this and he asked what we are actually spending. I shall just sum it up for him briefly: The total amount spent in 1981-’82 on the provision of water by the Department of Co-operation and Development in the national States such as Ciskei, Gazankulu, Kangwane, KwaNdebele, KwaZulu, Lebowa and Qwaqwa, is R62 million. A further R17 million has been spent on drainage. Together these two amounts total almost R80 million.

†The amount of R80 million spent on water supply and sewerage in the national States, is a terrific figure. I can give the exact figures, but it will take a lot of time. I can give it to the hon. member later. During the cholera epidemic of 1980, particulars of which is reflected in the 1981-’82 financial year, the department also helped with an amount of R1 000 500 for Kangwane, R750 000 for Ganzankulu and R750 000 for Lebowa. The total amount for the two-year period amounted to over R80 million for water and sanitation. So we are not asleep in the matter. It is nevertheless an enormous project. I can assure the hon. member that it is one of those projects of which one does not seem able to see the end.

*There is just one thing I want to state very clearly today. The Government must not be blamed for all the squatter conditions which have occurred in the cholera areas. I myself went to look in Natal—I am speaking to the hon. members from Natal now—and there are areas which belong to Indians and to Black people who own land there. On a tour of inspection by helicoptor I saw 400 squatter huts without any drainage or water on a farm belonging to an Indian. However, those corrugated iron huts are rented to those squatters and they have to pay rent every month. If the Government were to come along now and say that things cannot continue like this and that we must move the people, who will be the first to kick up a fuss? The hon. member for Houghton and the hon. member for Berea! They would jump up and scream: “Now you are moving these poor Black people”. But we did not put them there. However, this will most definitely have to be looked into. There is at present a Government working committee which is investigating the matter. After my visit there I reported to the Cabinet that no Government would allow this, although it is not really anyone’s responsibility.

†The hon. member also asked whose responsibility it is. In one area it is ours and in other areas it is nobody’s. In still another area it is the local authorities’. Therefore it is a problem.

Mr. Chairman, may I ask the hon. the Minister whether it is not possible, in a case where the land is privately owned and the owner has allowed squatting, for the department to force that owner to put in water reticulation and sewerage?

That is one of the ideas we have in mind. But that does not get rid of the problem. In that particular area, near the one particular KwaZulu clinic I visited, I would say that of the more than 150 to 170 cases of cholera that were being treated every day, more than 100 came out of that particular area. Just over the hill from that clinic there was a beautiful housing scheme with water and sewerage run by one of the local authorities. I went through the records and not one case of cholera came out of that particular area.

*I cannot say to hon. members that the epidemic is over, but we have the cholera situation under control, thanks to the co-operation of all those involved, viz. the KwaZulu government, the local authorities, the Provincial Administration and everyone who made a contribution in the committee we established there to ensure that we would be able to deal effectively with this matter.

†There is one further point I wish to mention, but I shall not labour it. I was very disappointed and upset when I saw a report in one of the Durban newspapers that stated that a member of the Executive Committee of Natal, Dr. Clarke, made a statement in which he said that there were about four times more cases of cholera than had been reported by the department and that there was some sort of a “cover-up”. I feel it is my duty to tell Dr. Clarke and the council that there was no “cover-up” in the Department of Health and Welfare. We announced all the figures. We got the figures from his own hospital. In fact we obtained the figures from the six or seven hospitals that were handling cholera cases. We received these figures on a weekly basis. The discrepancy was partly Dr. Clarke’s own fault because the 4 000 cases had stayed in hospital for three days and that gave him 12 000 patient-days. When I pointed this out to him he found that there was a discrepancy. He then admitted that there had been only 4 000 cases at that particular date.

Did he admit he was wrong?

Not yet. We met and we decided on making a joint statement. I gave him a few days to consider the matter, but I have not heard from him since. The meeting took place about a month ago; so the joint statement will not make any real sense now. I do not want to take the matter further here, but I just want to place it on record that there was no “cover-up” by the Department of Health and Welfare. We gave two sets of figures. The one figure was for all the cases treated and the other one was for cases actually proven as cholera. We could not test every case because our laboratories could not cope, but we did follow a certain pattern, and I presume that we confirmed about one in three or one in four cases that we treated.

But there is also a time lag in getting the confirmation.

That was the actual number of cases that we saw, the overall figure that we gave in every instance. The other figure is more of a statistical and academic figure.

I should, however, like to congratulate all the authorities who took part in this particular effort and who are still at the moment playing a role. I want to thank them for the way in which they treated these people, and in this regard the nursing staff should get a special medal. Most of this treatment was done by nurses. They diagnosed the cases and treated patients immediately.

In this regard I want to come back to the hon. member for Parktown. Once we have moved our services out to the people, we will need fewer nurses. We will not need the intensive type of nursing service that requires a 24 hour service. Most of those clinics in Natal are run from 8 am until 5 pm, and then the staff go to their homes. In the Cape Provincial Administration I used the motto: “The cheapest bed is the patient’s own bed”. It is not necessary to keep a patient in a highly sophisticated hospital bed if he can be treated at home. Our figures showed that 93% of people attending the out-patient departments of hospitals could go home and be treated in their own beds, while only 7% had to be admitted to hospital. If we can therefore get this wheel turning, we will need far fewer nursing assistants, and we will be able to make more efficient use of our nurses by taking the service to the people.

*The hon. member for Brits also spoke about the flood disaster at Laingsburg and the 21 districts that were affected. He attended a very beautiful ceremony this morning at which Mr. Izak van der Merwe and Rev. April were each awarded a Salus award. The Rev. April received the award for the services he rendered the community in the George district, while Mr. Van der Merwe was honoured for services rendered in the Laingsburg district. He was chairman of the Disaster Committee and did outstanding work.

I do not wish to go into detail now, but I just wish to mention that all the Government departments, inter alia, the Department of Environmental Affairs, Agriculture and Health, have to date spent R48 million on the 21 districts affected by the disaster. Almost R8 million has been spent on personal expenses such as household effects, clothes, children’s clothes, school books, radios and university bursaries. The aid fund of Die Burger contributed R10 million, and apart from that there were other contributions which also amounted to R2 million. In the old fund there was still an amount of R2 million and the other R2 million—which brought the total to R8 million—came out of the Government’s pocket. I make mention of this so that the inhabitants of Laingsburg and surrounding districts do not gain the impression that we set aside any of the voluntary contributions in case a similar disaster occurs in the future. In fact, the Government paid more than was contributed by the funds.

I also wish to convey my thanks and appreciation to the Director-General and the department, and indeed, to all the departments that played their part in this great task that was performed at Laingsburg. This was a wonderful example of how people can stand together and help one another under extremely difficult circumstances.

The hon. member provided a few reasons for the high cost structure of medicine and expressed his sympathy towards the retail pharmacists. He said, inter alia, that the manufacturers, too, complained frequently. Perhaps it will be enough to tell him that we are awaiting the Browne Report. The hon. member Mr. Marais is chairman of the pharmaceutical committee and this week he will hear evidence. In the meantime we have been told that an interim report may be issued in May. Although I cannot answer for that at this stage, I trust that we shall be able even at that stage to begin implementing the proposals of this commission.

The hon. member for Pietersburg discussed the issue of sterilization of Whites and referred to Schedule 13 of the annual report. The hon. member complained that there is such a large number of Whites who have undergone abortions during this period. However, we have the Abortion and Sterilization Act, and in the schedule in question, sections 3(1)(a), (b), (c), (d)(aa) and (d)(bb) are quoted. These provisions specify the precise circumstances under which abortion can be carried out. Here of course the hon. member is referring directly to our own colleagues, because they have to examine the people to determine whether they fall into these categories. I have already said in this House that during my period of service only these categories will be allowed to qualify for abortion. I do not intend extending this legislation or tampering with it in any way. Therefore one must be careful not to cast a reflection on the medical practitioners who have examined these people. The figures have nothing to do with the legislation or the Government. It is not we who encourage abortion. It is the medical practitioners who have found that a person’s life is in danger and have accordingly performed their task.

But the legislation allows them a great deal of latitude to be able to do so.

I think one should be careful not to create the impression that we approve of this. We only approve of it in terms of the rules laid down if the medical practitioners agree that it is in fact necessary. I think that the conditions that have been laid down are very conservative, and I think the hon. members will agree with me. [Interjections.] There is nothing radical about these conditions.

The other issue raised by the hon. member relates to the determining of tariffs. However, I do not quite understand the hon. member. When we discussed this legislation in this House the hon. member was the chief spokesman on this side.

[Inaudible.]

I do not want to go into this any further. I just wat to refer to one or two things which the hon. member said about it. He made a very good speech that day, but things do change sometimes! [Interjections.] The hon. member said, inter alia—

[Interjections.] He went on to say that he thought that the commission of enquiry—I am not going to quote what he said verbatim—would investigate this whole aspect and that we should wait until the commission indicated whether it considered that this House should continue to determine these tariffs. Therefore the hon. member agreed with me at the time when we passed the legislation that the Minister should have the final say over the tariffs so that we could protect not only the doctor but also the public.

[Inaudible.]

I am pleased that the hon. member agrees that he still feels that way. The hon. member devoted the remainder of his speech to something I said in a previous debate. I think we should leave this matter at that and I say so for a specific reason. I think that there may have been things printed in the newspaper which were not a precise reflection of what was said. That is the one thing. Secondly, if we are to continue arguing with one another about who said what, we shall not get any further. I can only say that there were indeed certain caucus rules. The hon. member knows that the hon. the Prime Minister referred to them in the caucus. He regarded this as a violation of the rules of the caucus, but in my opinion it would be pointless to discuss the matter further at this stage since the hon. member is no longer in the caucus. I think it would be better to leave it at that.

I did it on your invitation only.

I appreciate what the hon. member did while he was chairman of the group on this side of the House. I only hope that while he is sitting on that side of the House he will debate at the same level as before. Perhaps he will still hold the same points of view as well.

The hon. member for Pietersburg also spoke about the plan for health facilities; I think I have already disposed of that matter.

†The hon. member for South Coast mentioned a very important point, namely the lack of basic facilities in certain areas. There is nothing that worries me more than this lack of basic facilities, but we do have a problem here which I want to touch on again. Every now and again a squatter problem crops up at Crossroads originating from the mounds around Crossroads. There are absolutely no facilities there. There is no water and no sanitation, but every time anybody touches the people in Crossroads, the hon. member for Houghton practically has a fit. She takes the matter to every forum she possibly can and attacks the Government.

Quite right!

For certain reasons, for example, health reasons, we shall in future have to act more determinedly. For those reasons we cannot allow squatting or where it takes place in South Africa.

It is a result of urbanization.

It does not matter whether it is the result of urbanization.

Do you want to let them starve in the homelands?

Why do the members on that side not rather support us in keeping people away from areas where there are no services?

You dump them in the homelands and then you have cholera.

Sir, I have visited a number of those so-called dumping-grounds. They were called dumping-grounds at the outset. One can go and look at Sada. At the outset it was called a hell-hole, but today there are a number of factories there.

Because we complained.

That hon. member’s complaints would not make much difference. One goes by one’s own conscience. My own farm workers now tell me they feel like going back to their own homeland. Two of them have left to go to live in Sada. Is that then a sort of dumping-ground? They are getting a good salary there and there is clean water available.

Go to Onverwacht.

I have visited Onverwacht. There is a water tap at just about everyone’s doorstep and every plot has sanitation.

How many jobs are available there?

Never mind! Now the hon. member is talking about jobs, but she asked me about the health facilities there.

Jobs as well. The people there have to eat.

Onverwacht has a clinic. Mobile clinics provide a health service. There are family-planning facilities and the people there enjoy as good a health service as any of the hon. member’s people have in Houghton.

They have to eat.

The hon. member for South Coast spoke about the various areas and said there should not be fragmentation of services. I think that the hon. member for Newcastle gave a very good dissertation of what local authorities should do. I do not know whether the hon. member for South Coast was in the House at the time. We are looking into this matter, because certain local authorities do try to duck their responsibilities. I must say that, although I shall not mention names. The hon. member for South Coast may assume that I know who they are. We shall have to deal with this matter in the time ahead. On the other hand, one must not classify all the local authorities accordingly because of a few black sheep. There are local authorities providing an excellent service as far as these facilities go, but it is also a matter of finance. We shall, however, egg them on.

Then there is the question of occupational health. This has been a very worrying matter. The hon. member for South Coast very rightly said that there was disagreement between the two departments concerned, i.e. Manpower and Health. So there was, but that was because of the difficult nature of the problem and not because of people being cussed and just not wanting to agree. There are the two facets, occupational health and occupational hygiene. The Department of Health and Welfare feels that the health side should be attended to by itself. A number of discussions have been held on this. We in fact drew up a Bill, after which further discussions took place. Then the Commission for Administration felt there should be only one Bill and not two. So we got together again and had one Bill drawn up with a chapter in respect of the Department of Health and Welfare. There were certain things I did not agree with in this chapter, but the hon. the Minister of Manpower and I decided to publish the Bill, which we did. In this way we obtained a lot of comment on this Bill, also from the Commission for Administration. We should have met again last week, but unfortunately something urgent came up as a result of which the hon. the Minister of Manpower could not attend. We are, however, meeting in the next week or two in order to iron out the difference that still exists. As far as I see it, any differences that remain concern only minor matters. Very definitely the health side of occupational health should fall under the Department of Health and Welfare. That does not mean that the department has to interfere with the process the Department of Manpower deals with, including the trade unions. I do not want to become mixed up with trade unions. We just want to look after the health side because if there are two people dealing with the same trade unions it might easily happen that one gets played off against the other. We do hope, however, that, at least by the next session of Parliament, this Bill will definitely be coming forward. That is if nothing unforeseen happens, which, I do not believe, will happen. We have reached the stage now in which we have a draft Bill before us, which might still be changed in a few minor respects.

The hon. member also referred to environmental health. I believe the department is gradually progressing in the direction of spending more and more on preventive health services. This also applies to environmental health. I believe we should take care that the population itself is given a better chance not only to help itself, but also to obtain facilities necessary for this very purpose. The population should be enabled to live in an environment in which it will have proper water supply, proper hygiene, proper sewage facilities and proper sewage removal. This will be the ideal situation. Even in the rest of the world, with the exception of the highly developed Western world countries, there are very few countries where all this has already been done. The World Health Organization has set the year 2000 as the year in which everybody should be enjoying the convenience of proper water supply and sanitation. I hope we will be able to accomplish that in South Africa before the year 2000.

The hon. member also referred to the question of toxic materials. I think this question will also be dealt with in the proposed Bill on occupational health.

*The hon. member for Kimberley North gave an interesting discussion concerning what can happen with water and who is involved in the provision of water. I think he answered certain questions raised here by hon. members in connection with certain norm and standards. I want to thank him for the way in which he thanked the department. I understand that he is at present participating in the discussion of the Manpower Vote in the Senate Hall. He thanked the department for the information it provides and for its information service by means of which proper information is conveyed.

Our co-operation with the CSIR is very sound at present as regards the effort to find a cheap way to purify water at a low cost and make it available to even the smallest community. We have an indication that many small water purification units are produced overseas. These are units which may be utilized in rural areas, even in communities where conditions may not be ideal, but where pure water is still essential to prevent all kinds of disease and germs being spread through water. I want to thank the hon. member for his contribution. He of course comes from a constituency where water is plentiful.

I am told that the hon. member for Wit-bank is also in the Senate Hall at the moment. He asked that the means test should no longer be made applicable to pensioners who marry. We shall investigate this problem further at a later stage. This is one of the really major problems. Take as an example a male pensioner who marries. The woman with whom he marries may also have an income, with the result that the man suddenly has to forfeit his pension. We shall investigate the matter. This is of course an issue which is investigated on an on-going basis. We regularly receive information, requests and letters from people involved.

As regards the payment of pensions to elderly people I just want to point out the following aspects. Pensioners need only indicate that they want their money paid into a bank, a building society or any savings account. Indeed, we are trying to discourage them from standing and waiting for their money at post-offices. Hon. members will note that nowadays the majority of pensioners have their money paid into their bank account or other savings account.

The hon. member also discussed air pollution. He made a very interesting contribution in this regard. I do believe, of course, that he has every reason to do so, because two or three years ago I was travelling through Witbank on a day when Highveld Steel was evidently busy producing a great deal of steel. Never before have I seen so much red and black smoke belching out of one chimney as I did on that day. I brought the matter to the attention of the department, and since then air purification equipment costing R40 million has been provided there. They are now awaiting test results to see how well it works. The hon. member also referred to other figures. I think he is quite correct when he says that one of the most important things we must consider is air pollution in that specific area which extends to the Lowveld, where one has a certain climatic condition which means that smoke stays at a lower level with the result that people have no choice but to inhale the smoke. The hon. member mentioned training, too, and I am sure that a great deal has already been done in that regard. Nevertheless I believe that we can still do more in an effort to improve this.

†The hon. member for Walmer spoke about family planning. I do not wish to deal with the whole question of family planning now in this House. I think it is a matter which requires a great deal of action and that the less said about it, the better. I say this because there are so many people who see in family planning some sort of nasty political weapon. Because of this, I think that the best thing to do is to get on with the job, obtain the funds and get one’s staff organized as far as possible and then try to achieve a particular goal. We are achieving certain specified goals every year. We have also decided to try to cut down on our 10 year programme and to try to achieve the desired results within five years. Whether or not we shall succeed in doing so, I do not know. However, this is what we hope to achieve and we shall certainly strive to do so to the best of our ability.

The hon. member also mentioned the position of the private and civil pensioner who does not receive free medical services. From this year the civil pensioner’s needs in this regard are being catered for in terms of the current budget. I cannot speak about the private pensioner at the moment but if such a pensioner’s income is very low, he can be treated at a provincial hospital. If the hon. member wishes, he can give me further details in regard to these specific problems that he is experiencing in this regard and we can investigate them.

The hon. member also mentioned the question of housing. The reason why we assess the value of a pensioner’s house at R9 800 is to prevent one house being worth R20 000 and another perhaps R40 000. We are trying to ensure that these pensioners will continue to live in their own houses and that is why we keep the assessed value of such house as low as possible. We may even be able to consider reducing this amount further.

*The hon. member for Innesdal reminds me of the young fellow who went to church. When he came home, his father asked him what the clergyman had spoken about. He replied: “About sin, father”. “What did he say about sin?” “Father”, he said, “it seems to me he is against it”. [Interjections.] Listening to the hon. member, it is clear to me that he is against smoking. [Interjections.] He provided very illuminating statistics. I almost had a fright when he spoke about “AVB” (GST); I thought he meant the AWB! [Interjections.] He referred in lighter vein to the Artes awards, but I think that when one brings in something of the kind in lighter vein, it underscores the seriousness of the matter. He referred to young people and pregnant women who smoke; I think that this is a matter that is given constant attention.

The hon. member for Hillbrow also discussed smoking. However, I do not know why he is less concerned about drug abuse than the smoking habit. He waxed fanatical about the smoking habit, but he lives in a constituency where the level of drug addiction is probably far higher than in any other constituency in the country. When the hon. member for Schweizer-Reneke pleads that we make the laws more stringent, the hon. member for Hillbrow says that he does not believe it will help; it will drive them underground. Well, if I introduce more stringent legislation on smoking, everyone will probably smoke under the blankets and in the basement!

The hon. member spoke in derogatory terms about the small figures on the cigarette packets. Those figures are of the size which is internationally prescribed. If he goes overseas he will find that the figures there are of the same size. This step was taken voluntarily and without having been imposed by legislation. What fool of a Minister would introduce legislation to provide that the figures be printed on the packet, when it is already being done voluntarily? We have established the situation that there is no longer advertising at schools. The Tobacco Board have set up their own advertising code. Some time ago I had another meeting with them, and they know that we also monitor cigarettes through the Bureau of Standards. The figures are submitted to us. Thus far we ourselves have not established a section in the department to carry out the monitoring in regard to the condensate and nicotine content of cigarettes. One reason why we have not done this yet is that we lack the staff. However, this is something that will have to be done. I have also told the Tobacco Board that if they do not co-operate, we shall be compelled to introduce legislation. The hon. member must take it from me that we want to get by without legislation if possible. I shall keep trying. I am not a smoker and I, too, believe that smoking is not good for one. But one should rather try to persuade smokers not to smoke.

May I ask the hon. the Minister whether he does not think that the warning that smoking is dangerous to health is just as important, if not more important, than the …

I shall tell the hon. member what I saw in America in October. Americans do not go for small advertisements. I saw one Advertisement on cigarettes next to a highway about half the length of the wall of this chamber and about twice its height. In the bottom corner of the advertisement there was a red square. I thought it might be a warning, and when one more or less got one’s binoculars out, one could see that it said: “The Surgeon-General says it is dangerous to smoke and it is bad for your health”. That kind of warning does not make much sense. If one had to put it on the packet to try to convince the chap that it is bad for his health, one would be totally wasting one’s time. One must be able to discourage him through the department and the various educational channels. One must reach the schoolchildren. The department has decided to give attention to schoolchildren to see whether we could stop them smoking, because if they can be converted then one would not have a smoker once that child becomes an adult. I do not think putting the warning on the packet is the solution. If it was so successful, smoking would have already been stamped out all over the world. However, if it is a way of doing it, we will do it. But I do not think this is the time to do it or to force it down somebody’s throat. The hon. member often says that we have too many laws and that we want to force everything down everybody’s throat, but when he feels like forcing non-smoking down somebody’s throat, he comes with a Bill every year and every year it bounces.

There is a time and place for everything.

The hon. member for Schweizer-Reneke is a young man who can speak as a young man, and I listened to him very attentively. For example, the hon. member made a study of drug abuse. There are hon. members in this House who still think that dagga is not dangerous. The hon. member made the interesting point that dagga affects one’s drive, motivation and judgment. Surely we do not need such people in this country. We have enough of them; we do not want any more. We should rather try to crack down on this enemy of ours.

The hon. member perhaps put it a little harshly when he called for the death penalty for dagga offenders, although in some other countries the death penalty can be imposed for this, because there, too, it is a major problem. I cannot say that I support the hon. member in that idea, but I interpret it as an intimation of the gravity with which he views this situation. These are the opinions of a young man who knows that his life is still before him and we must accord him the opportunity to air his honest opinion.

The hon. member also asked that we take another look at Act No. 41 of 1974. The departments concerned will certainly do so. I believe that there should be far more stringent penalties for offences in connection with the trade in dagga. Far heavier penalties should be imposed. It is pointless sentencing a man who trades in dagga to a few years in prison and not confiscating his property and the money he has earned. Such a person earns hundreds of thousands of rands in one or two transactions and has enough money to spend hundreds and thousands of rands on advocates if some of them are arrested for peddling activities. We have experience of this and we know it happens. I shall certainly follow up the suggestion and the suggestion that the SABC should help us in this regard. I am sure that some of the programmes that are presented could be set aside so that we could try to help our youth in this way.

Next year a conference on the abuse of dagga is to be held in this country and authorities from throughout the world will be invited here. I met President Reagan’s adviser on liquor and drug abuse, also a young man, in America last year. He is intensely interested in the matter because the biggest drug problem in America today is the simultaneous use of dagga and alcohol. Nevertheless we still have people in our ranks in this House who say that dagga is not dangerous, but merely makes one feel better. Therefore I think that the problem should be investigated, and I hope that the conference will be a great success. The department is already negotiating with the other departments involved.

I have already dealt in part with the speech by the hon. member for Hillbrow as far as smoking and drug sniffing is concerned.

†I do not want to deal with the question of social workers at great length except to say that the associations put their problems to me. Through them I referred it to the council, who drew up a memorandum which they brought to me. After we had further discussions I took the matter to the Minister of State Administration, who submitted it to the Commission for Administration. The Commission for Administration started their investigation on the 25th of last month. Three weeks ago I had a further discussion with the council’s members, with the executive as well as with the Commission for Administration. They were told that the matter was receiving attention and that it needed careful examination in relation to the salary structure of the State. If one approaches the matter in this way, one will find that the problem can be overcome at a certain stage instead of through piecemeal adjustments.

*The hon. member for Stilfontein expressed his thanks for the assistance given to elderly pensioners. He also spoke about the treatment of drug addicts. The rehabilitation to which he referred is of the utmost importance. I gain the impression that if one looks at the board established to combat alcohol and drug abuse, he is right when he says that we must try to separate drugs and alcohol. These are two separate problems which different people are interested in. The other day I conducted discussions with Col. Smit of the Police, who is probably our foremost authority in the field of narcotics in this country. He told me that the board devotes a great deal of attention to liquor and the abuse of liquor, but that the abuse of drugs could perhaps be given a little more attention. He was extremely concerned about this and he is the very person who has to arrest these people. He told me astonishing stories not only about the quantities that are smuggled today, but also about the problems they encounter in getting people before the courts. The hon. member told us about the increase in the number of people who go to rehabilitation centres. This is one of our major problems. I cannot see that we can simply continue to rehabilitate. We are trying to catch the horse once it has already escaped from the stable, and therefore it is very important that we should put our heads together. During the conference which is to take place next year we have an opportunity to make an effort to see whether we cannot keep the people away from these things. Prevention is, after all, better than arresting people. I shall consider the hon. member’s suggestions.

The hon. member also spoke about obesity advertisements. As far as operations and injections are concerned, this is something which the Medical and Dental Council is responsible for. I shall bring the advertisement and the article to the attention of the department. I agree with him, because to me, too, it sounded too good to be true, because one cannot lose weight so rapidly, particularly those who battle with that problem. When the hon. member for Pretoria East stood up to speak it was clear that he is not only an expert, but knows exactly what he is speaking about, due to the training he has received. I do not take it amiss of the hon. member of the Opposition who spoke after him for not quite understanding what that hon. member had to say. The standards laid down by the commission are in fact of the greatest importance. At the moment we have the Atomic Energy Board which is at present known as the Atomic Energy Corporation. That Corporation falls under the Department of Mineral and Energy Affairs. They have a certain degree of control, and our department exercises a certain degree of control, but due to the rationalization, we are at present trying to sort out what must remain with the Department of Mineral and Energy Affairs and what should fall under the control of the Department of Health and Welfare, because we do have a division that deals with radio-active materials, with regard to medicine as well. I think that the hon. member showed very clearly that he is not merely an authority in this field, and I am sure that he will not mind if I ask his advice from time to time about this kind of case because he is acquainted with the dangers and also because he knows exactly how this works. For example, we have difficulties with certain materials and certain industries, and I think that if he were perhaps to have the opportunity to discuss the matter with my department and myself, we should gain more clarity on that matter. To me, of course, this is something which I do not know much about, except what I read about it.

The hon. member for Newcastle made an exceptional contribution and discussed the history of the department. He pointed out how we had shifted the emphasis from hospitals to comprehensive services, and the way in which he thanked the local authorities for their services, clearly indicated that he has a wide knowledge of this matter. He also warned that we should guard against a duplication of services. This is of the utmost importance. We had hoped to eliminate a great deal of this by way of the Health Bill, but we still find that there are problems. I think the suggestion by the hon. member that we should provide the services at the lowest social level is probably one of the most important suggestions made here today. This is in line with the idea that we should take the health service to the people. In point of fact, this will take a great deal of education and training. Ultimately, if we are able to succeed in this, it will require far less money. I am quite sure that the hon. member’s contribution will help us to continue along this road.

The last member who spoke was the hon. member for Rustenburg. I want to associate myself with the tribute he paid to Prof. Charlotte Searle. She is retiring as president of the S.A. Nursing Association on 30 April this year. She and a person like Prof. Harrison of the University of Cape Town, who is also retiring, actually represent the end of an era in nursing. There are other members, too, who are retiring with them, because they feel that they have made their contribution there and at this stage, perhaps, wish to serve on other bodies in lesser capacities. I think that apart from paying tribute to them one must also regard them as a personification of the nursing profession as a whole. They are people who have consistently done their best to achieve the best for the nurses, but by way of negotiating and discussing matters with one and not by seeking confrontation. This may have taken a little longer, but I am sure that when they retire and the new salary structure for nurses is introduced shortly, the nurses will know that it was they who were able to negotiate that for the nurses, plus the fact that they managed to arrange that the nurse may now acquire more status in that the nursing college may link up with a university on a contract basis. The hon. member for Rustenburg made the statement that there was no instant solution for the nursing situation. I do not believe that anyone could dispute that. This is one of the most important things we have to understand: It is a process.

We must simply try to co-operate with all the investigations. The hon. member also spoke about the contribution of the private sector to the training of nurses. This is something which we shall discuss with them. I am sure that they must make a contribution. The private sector must play a far greater role in health service in this country. The Government cannot bear all these burdens alone in the future. The private sector will have to accept both what is good and what is bad. They will not simply be able to take what is good and leave what is bad to the Government. However, a movement is already taking place among them and I spoke today to one of the representatives of the private sector, who wants to conduct a discussion with me shortly in order to submit a plan with regard to how they think the private sector can play a greater role.

The hon. member for Sea Point raised a matter which in my opinion falls under the next part of the discussion, and after I have listened to what other hon. members, too, have to say in that regard, I shall reply in greater detail. It is really a matter of care of the aged and there may still be hon. members who want to say something about that. That, then, disposes of the section dealing with health, and I wish to thank once again all the hon. members who took part.

Mr. Chairman, coming now to welfare and pensions, I should at the onset like to take this opportunity and thank the department for the speed and courtesy with which they have handled the many queries I have sent to them during the past year. I sometimes wonder why it is that the Department of Health and Welfare can reply so quickly to one’s letters when it takes some other departments so long.

The subject that I should like to raise to-night actually concerns a report that never saw the light of day in this House, which is a great pity. I refer to the First Report of the Interdepartmental Committee of Inquiry into Certain Specific Pension Matters.

Which report is that?

The First Report of the Interdepartmental Committee, dated March 1980. I suppose one should not be surprised that this report was never discussed in the House, there seems to be the tendency that we do not get an opportunity to discuss reports about pension matters. I think for instance of the Cilliers Commission of 1964 that reported in 1966. Then, of course, there was the report of the Van der Spuy Committee in, I think, 1976. The point I want to make is that these reports contain a lot of useful information.

I do not agree with everything contained in the First Report of the Interdepartmental Committee, but I agree with about 90% of what was said. Three very important principles were raised. The first related to the preservation of pensions; the second to the transferability of pensions, and the third to the evaluation of the amount that should be paid to a man who has contributed to a pension fund and who leaves the fund after a few years. I am sure that all of us have lived with this problem of paying into a pension fund and then withdraw say after five years. What does one get? One then gets one’s contribution together with a nominal rate of interest, of 2%, 4% or 5%, while all of us know that the interest that had been earned on one’s money is considerably higher than that.

Hon. members might ask why this question of transferability and preservation of pensions is so important. I think there are two reasons. Firstly, if one looks at the 21st annual report of the Registrar of Pension Funds for the year ended 31 December 1979—this is the latest report I could get hold of—one will see that under the heading “Benefits” R217 million was paid out on account of resignations and withdrawals. In other words, this R217 million was most probably wasted. It certainly did not contribute towards providing for a person’s old age.

The second reason why, in my view, the preservation and transferability of pensions are important is that experts in the insurance industry will tell you that somebody who has contributed to a pension fund or a retirement annuity fund, but particularly a pension fund, is retiring on something like 40% of his final income, whereas if there had been transferability and preservation of pensions and if all his contributions had continued to be paid out to him, the figure would have been approximately 70% of his salary over the last three years.

During the debate on health, we spoke about preventative and curative medicines, but in regard to pensions I think the time has come for us to look at it from the point of view of preventing the problem rather than trying to cure the symptoms of the problem. I think there are three dimensions to this problem that should be raised. The first is the actual growth in the number of aged. The hon. member for Walmer mentioned the percentage. In the United States, for example, it is estimated that by the turn of the century one out of three people will be retired people. If one considers that one out of three may be under the age of 20, while one out of three is retired, it means that one-third of the population is going to have to provide for the remaining two-thirds. That is the problem. Let us just look at the figures for South Africa. The HSRC, in its population projections, pointed out that in 1980 there were 1,34 million aged. By the year 2000, however, there will be 2,35 million and by the year 2020 there will be 4,64 million. In other words, over a period of 40 years the number of aged people is going to treble. The point I want to make is that we are not talking about something that still has to happen, because the people who are going to be 60 years of age by the year 2020 have already been born. They are here with us now. That is the first aspect of the problem.

The second aspect of the problem is what sociologists call the breakdown of the extended family unit, something that comes about mainly as a result of urbanization. It means that whereas in the past the family tended to look after its aged people, there is now a tendency to ask other people, the State or society to look after the aged in our community.

The third aspect of the problem is that of cost. Let us just look at the present cost of pension increases, as announced in the budget, including the bonus. I am assuming that the pension increase runs for the full year. The amount involved is more than R200 million; in fact, R201,7 million. I should like hon. members to bear that figure of R200 million in mind in the light of the information in the inter-departmental report. In 1973 the total cost of social old-age pensions paid by the State to Blacks, Whites, Coloureds—in fact, to everybody—was R88 million. In 1977 the amount was R188 million. In 1978 the amount was R237 million. In other words, we have reached the stage when just the cost of the increases is nearly as much as it cost us to run the total social old-age pension system four years ago. Hon. members will remember that the hon. the Minister of Finance mentioned in his budget speech last year that by the year 2000 social old-age pensions could cost us R7 000 million. That is the problem.

How can we solve it? I think that in the past this side of the House and that side of the House have tended to talk past one another because we have tended to talk in terms of a national contributory pension scheme. I think that the fundamental problem is that everybody who works is going to have to contribute to a pension fund. But perhaps the way in which we should look at this problem is not from the point of view of the employee, but rather from the point of view of the employer. Let us, in fact, make it compulsory for the employer to provide a pension fund for his employees. If one looks at the figures of the Registrar of Pension Funds, one sees that we have close on 11 000 pension funds in South Africa. That gives one a variety to choose from, a variety which, I believe, is more than sufficient for anybody. For the small company, or the person who works for himself, there are retirement annuities. I think that the time has come, however, for us really to tackle this problem.

I have tried to work out what each year of delay is costing us because each year approximately 50 000 people apply for social old-age pensions. The cost for one year is approximately R43 million but those people are going to live for eight, nine or ten years. If they live for 10 years, the cost of each year’s delay is something like R430 million.

In the private sector I believe that we do have the necessary infrastructure. What we actually now need to do is to compel employers to provide pension benefits for their employees. If the hon. the Minister were to do that, this side of the House would support him. We have actually stated, on many occasions, that we believe that every worker in South Africa should contribute to a pension fund. I do not think, however, that we need another in-depth commission of inquiry, because I think that the work that has been done in this field is extensive. If the hon. the Minister does not see his way clear to doing that, maybe we can establish something similar to what the hon. the Minister of Finance established in respect of the taxation of fringe benefits, viz. a small parliamentary committee which can look into this problem to determine the nature and the extent of the problem and then to make recommendations with regard to it. [Time expired.]

Mr. Chairman, I should like to associate myself with what the hon. member for Edenvale has just said. What it amounts to, is that he was dealt with the crux of the Government’s economic policy, of which one of the off-shoots is the policy with regard to pensions, civil pensions, social pensions, etc. Just to point out a different figure from those pointed out by the hon. member I can say that the civil pensioners, of whom there are about 80 000, are costing the Government R28 million per month or approximately R360 million per annum. This equals the amount presently required for the administration of South West Africa, and then I am not including the war effort. This shows one what astronomical figures are involved here.

The gist of the matter is that our economy is a free market economy. I am sorry—as the hon. member also mentioned—that we do not have the time to discuss this matter in depth with one another. However, I should like to address a request to the hon. the Minister, a request which sums up the gist of the matter. In the first place, has the time not arrived for us to take a very thorough look—it does not matter whether this is undertaken by a departmental committee or a Select Committee—at the limit of the means test as such? There have been enormous adjustments since this limit has been determined. In the second place, we were very positive and optimistic when debating the Bill concerning the compulsory transfer-ability of pensions and their non-terminatability. Now we know why the Government has not put this into operation yet. The reason is that a large part of the population does not understand what it is all about. However, I want to request that it be introduced for that part of the population which does understand and which realizes that it is absolutely essential. Let us at least introduce it for the Whites, Coloureds and the Asians and give the other nations the opportunity to become involved in it as they mature—and this is happening fast. We cannot wait until we arrive at a situation where we could never escape from this powerful maelstrom which may develop and which could suck us into a socialistic system.

It was not actually my intention to discuss the subject I have just referred to. In the very short time at my disposal I should very much like to briefly refer to four matters. While paging through the reports, what struck me first was that there was an enormous improvement as far as court orders issued by the Juvenile Court in South Africa were concerned. There was a substantial decrease in the number of orders issued. I am speaking of social conditions now. As far as these are concerned the picture is extremely positive. The decrease was dramatic. It amounts, in fact, to the following: In 1963 we needed 115 homes or institutions to accommodate these children, while today only 80 homes are needed to provide for the children who have been allocated to foster parents in terms of court orders issued by the Juvenile Court. This can be attributed solely to improved social work methods, improved knowledge and effective implementation mechanisms, if I may put it that way, for social workers who provide an extremely valuable social service.

Business suspended at 18h30 and resumed at 20h00.

Evening Sitting

Mr. Chairman, in the few minutes at my disposal I should like to make a few comments with regard to the department’s enormous success as far as family planning in society is concerned. I should also like to say something in connection with the package which the department is now offering pensioners, and then I should like to conclude with a single word about the International Year of the Aged, which is being organized by the National Council for the Aged this year.

However, in the very first place I should like to say to the hon. member for Edenvale that I believe that we have reached consensus on one aspect, viz. that we should once again give our attention to legislation concerning compulsory contributions to retirement on pension and the transferability of money from pension funds, and that we must convince the Government that it is of cardinal importance that that legislation be considered once again. However, I should like to ask the hon. member for Edenvale what the attitude of his party will be—what he, as chief spokesman on pension matters will have to say—and whether we will enjoy the full support of the PFP in this connection. The hon. member is indicating with a nod of his head that we have their support. I accept that then. I also thank him for it.

As far as the pension package is concerned, it is now more or less the fifth consecutive year in which this subject is being broached in the discussion of the Health and Welfare Vote. We have very prosperous economic years behind us. 1982 must be one of the most difficult years we have experienced in a long time. In fact, the economic prognosis is not very positive, particularly not in the short-term. In spite of that the Government is now offering the aged one of the very best packages ever. The point at issue is not only the categories of aged people provided for by the State. I shall very briefly refer to the various categories. They are social pensions, settlers’ allowances, parental allowances, maintenance allowances, allowances payable in respect of the children of settlers, family allowances, etc. This means, in a nut-shell, that the department is offering these people a wonderful increase, an increase which will be repeated in May and December by way of a bonus payment. Moreover, for each year since their retirement, in addition to the increase of 10% which they are already receiving, receivers of social pensions are being offered an increase of 1% per year, an increase with retrospective effect for each year prior to 1982, even if it is as far back as 1950. That as far as social pensions are concerned. I believe that this is a phenomenal step, a step for which we wish to thank the Government sincerely. Also, on behalf of all the pensioners in our various constituencies, we should like to express our sincere thanks to the Government.

In conclusion I should just like to say a few words in connection with the International Year of the Aged. In South Africa it is known as the Year of the Aged. I should firstly like to pay great homage to the organizers. They are Mrs. Zerilda Droskie and Mrs. Anna van Dyk, who is assisting her. A special information service has been established by the National Council to inform the aged about every single facet of their existence. What I believe to be the most important aspect here, is that in society we should not regard the aged as a special or sickly old person, but as a useful citizen. Just like other people, older people do not form a homogenous group. The aging process is part of a natural process. Older people should be regarded as a resource rather than a burden to society. Older people also have rights and responsibilities which should in fact be allotted to them. I think if we adopt these four principles we shall be able in future to accomplish a great many things as far as the use of aged people is concerned. In this regard I should like to quote just three examples with which we are quite familiar. These men will say to me: But I am not old yet. In this regard I quote the example of Mr. Louis Rive when he retired. What did he do? I refer to Dr. Brand Fourie. What did he do when he retired? What did Dr. Rautenbach do when he retired? We should follow this example set by the Government to involve useful senior citizens in our society when they retire on pension instead of disregarding them, for our nation desperately needs that valuable manpower.

I want to conclude by saying that at the beginning of my speech I addressed two requests to the hon. the Minister and I now wish to address a third request to all the municipalities in the country. I want to request that every aged person who qualifies for a pension in terms of the means test should be exempted by municipalities from paying rates. [Time expired.]

Mr. Chairman, the hon. member for Brits is an expert in this field. I do not disagree with anything he said. I think he made a very good speech.

Yesterday our church celebrated its Day of Compassion. If I had been a minister of religion yesterday, I could have found a great deal of evidence and many examples—actually too many—in this wonderful report of the department to show the people the wonderful objective and the wonderful ideal of the department as far as compassion is concerned. This annual report gives striking proof of an unstinting service of upliftment and charity. I therefore want to congratulate the hon. the Minister, the head of his department and the entire staff on this fine report. This report gives striking proof of service, loyalty and compassion towards many people who are less fortunate than we are. If we were to sit down for a moment and consider how dreadful it must be for people who have lost their sight, and cannot see the wonders of the changing seasons, or the colours of flowers and trees, the veld and nature, or for people who have lost their hearing and cannot hear the singing of birds or music, or for those who are unable to speak and cannot communicate with their fellow-man as we do, we would realize on paging through this annual report that all these people and many others are indeed receiving attention. We thank the hon. the Minister and his department most sincerely for this.

I also want it placed on record that I want to express my thanks and appreciation to our local office at Vereeniging which is at all times prepared to help me and my people with any representations we may address or applications we may make. We appreciate this. I can say the same of the head office and its staff in Pretoria because we receive the same treatment there.

Two weeks ago during the budget debate the hon. Minister made a very fiery budget speech. In that speech he turned to my colleagues and I in these benches. He ended that fiery speech with these words. He told us that when Dr. Malan took leave of politics he held his hand up in blessing and said farewell. I then wrote a letter to the hon. the Minister. I told him that from the point of view of the Nationalists he had made a very good speech but I also added that I was sorry he had bade us farewell because I did not want him to leave. I said he had to stay on. He could not resign at this stage or choose another course. He is a good Minister and we should like him to remain here. [Interjections.] I think he is one of the better National Party Ministers. For that reason we would like him to remain here as long as they are here, until the next election. [Interjections.]

Lastly, I should like to express a word of appreciation. Last year during the discussion under this Vote I mentioned that building work on the old-age home at Meyerton was progressing rapidly. This evening I am in the fortunate position of being able to tell the hon. the Minister and his department that the old-age home at Meyerton, which will accommodate 94 senior citizens, is 99% complete and will soon be occupied. Many thanks for this.

Is Lapa going to live there?

We should like to welcome him there in 30 years’ time.

This evening I want to bring a matter I have already raised here in the past, very, very firmly to the attention of the hon. the Minister and his department. I shall bring up this matter every year until I am successful because I believe my representation has merits. There are senior citizens in our country who feel compelled at this late stage of their lives to give up their homes, whether it be their own house or a rented house, as a result of pressing municipal obligations. The hon. member for Brits has also referred to this. I am referring to obligations such as rates, water, electricity and sewerage tariffs, etc., which are constantly increasing. These tariffs are increasing more rapidly than those people’s pensions. From time to time some of these old people come to me, show me their budgets, indicate how much they must pay for their rates, water and electricity, and for meat, milk, vegetables and groceries, tell me that they cannot make ends meet and will be forced to give up their homes and apply for a place in an old-age home.

I refer with gratitude to the fact that in the annual report an amount of almost R22 million is being set aside to subsidise old-age homes. We are grateful for this, but I should like to ask whether the hon. the Minister—we shall try to assist him in this task—cannot address representations for an additional R5 million. This additional amount must be spent on old people living in their own or rented houses, so that they will not be forced to give up their homes and go into an old-age home.

If one works this out one finds that if R500 is made available to every aged couple as a housing subsidy, 10 000 old people who would otherwise have to be accommodated in old-age homes, could remain in the community. R5 million is a very small amount in the national economy. This evening I am making this plea in all earnestness. I realize that there must always be old-age homes. They must be available for old people who have to live there and for others who prefer to live there. However, I want to ask that we make it possible for those people who prefer to stay on in their own homes, to remain in the familiar surroundings where they have become firmly rooted, for the last years of their lives. They must not be uprooted against their will from their immediate environment to which they have become acclimatized over the years. I trust the hon. the Minister will give serious consideration to this representation.

Mr. Chairman, it is a pleasure to participate in this debate in which there is so much unanimity and we cannot find fault with the standpoints of hon. members of other parties.

I should like to associate myself with what the hon. member for Meyerton said regarding charitable services by the churches. I think we could probably hold a very good debate on the charitable services of our churches and the care of our aged, because I think all of us who belong to a church are fully aware of the fact that the church also has a duty and that in general, the church is profoundly aware of that duty. For this reason yesterday was probably a special day in the church of the hon. member, because special emphasis was placed on this and people realized anew what their responsibilities were as regards their duty to be charitable.

As far as social, military and civil pensions are concerned this budget reveals a wonderful spirit of goodwill towards the aged or senior citizens, particularly as this is also the Year of the Aged. I appreciate in particular the significant concessions and improvements announced in the budget for social pensioners and also for military and civil pensioners. It is my firm conviction that it is not the exclusive task of the State to care for the aged, as I tried to indicate a while ago. On the other hand an obligation also rests on children to look after their parents when they are old, sickly and worn with age. As a matter of fact this is what happens in most families where there is a good relationship between parents and children. However, if we look at the history of the Republic during the past 100 years, we find that there are a large number of people in respect of whom, as a result of economic conditions in the past, it was not possible to make provision for their old age. I am particularly sympathetic towards these people. These are people who led an honest life, people with self-respect, people we do not want to see humiliated, nor do we want to see their standard of living lowered as a result of the rise in the cost of living. They are not beggars who must stand hat in hand waiting for a hand-out. In this Year of the Aged we want to pay tribute to these people for the contribution they made to our national life. Perhaps they did not always make a contribution in the economic sense or a contribution which could be measured in terms of money, but frequently they contributed to the building of our nation and the education of our children. These are people who provided the leaders in our national life and very frequently battled to raise large families during the depression. If we consider the men and women in the history of our nation, we see that some of our greatest leaders, academics and people in other fields came from such homes. To sum up, then, I want to say that these were people of steel, courage and determination, with an undaunted faith in their God and in their nation and their culture.

I want to express my thanks for the handsome sum of money which could be set aside in this time of economic pressure to try to improve these people’s pensions. In this way the Government has yet again proved that it is aware of the financial problems which the rising cost of living is causing our senior citizens and other under-privileged people. I feel sure that not only the increase in the monthly amount but also the two bonuses announced will afford great relief to pensioners. I think one should address a word of warning to those people—and here I am referring to people who want to make political capital out of this budget—who constantly, year after year, make a plea here and ask why the aged must wait till October for their bonus. The behaviour of these politicians is despicable. They do this only for political gain, and then they pretend to be the champions of the aged!

They do not do this out of compassion. It is this Government that knows what the needs are. Let us be quite clear about this. An increase can only take place once a year. For many years now the increase in social pensions has occurred on 1 October, and the sooner we have the co-operation of those quasi-champions, the sooner old people will also understand, and they will not have false expectations.

As far as civil pensions are concerned I want to thank the hon. Minister for the fact that a differentiated formula, to which the hon. member for Brits also referred, has now been found to increase civil pensions, namely 10% this year plus 1% for every completed year of retirement. We are all aware that there were pension schemes to which civil pensioners belonged prior to 1973 which were extremely bad. I have in mind in particular pensioners of the late ’fifties and the early ’sixties, people who have been on pension for 20 years and more. In some cases these are people who used to occupy respected positions in their communities. Their pensions are now extremely small, but in view of this differentiated formula some of them will receive an increase of upward of 30%. A better formula could not have been found. I trust that the hon. the Minister will find it possible to apply this formula every year in future, at least, I should say, until such time as we reach the stage where there are no longer pensioners who retired at a time when the pension schemes were so bad.

I should like to touch on another aspect, which is that the hon. the Minister found it possible, in addition to the aforementioned formula, to make adjustments for civil pensioners in respect of a medical scheme, whereas in the past they never had the opportunity to be members of such a scheme. Now they are being helped to become members of one of the official medical funds. From 1 October this year they will be able to share in the benefits of a medical fund. This is a case I have argued in this House in the past. As a matter of fact, only a few months ago I sent written representations in respect of this matter from one of my voters to the hon. the Minister. All our social pensioners have the advantage that they can make use of the services of a district surgeon and have free hospitalization. The group of civil pensioners to whom I referred, however, have never had the opportunity of belonging to a medical scheme. After retiring they had to care for themselves on their pension and with their savings. Over the years the inflation rate ate into their savings. Even if they are healthy they find it difficult to make ends meet. However, they have now reached a time of life where their health is no longer so good. I am therefore particularly grateful that we have now reached a stage where it is possible to help this group of pensioners to become members of such a scheme. The hon. the Minister of Finance voted R5,2 million in the budget for this purpose. I feel that through this gesture the Government has proved that it is concerned about the welfare of pensioners and that it has their interests at heart. In this Year of the Aged this concession will stand as a monument to the Government.

Mr. Chairman, I have pleasure in agreeing with the hon. member for Middelburg on the formula for civil pensioners. The formula will close the existing gap and will wipe out or assist in wiping out the injustice which became aggravated over the years. I believe that it is something which we all welcome and which will certainly be welcomed by civil pensioners.

I also agree with the hon. member for Meyerton with regard to his plea for people who should like to live in their own homes but who are having problems, especially with regard to rates. If the hon. member were to come to Natal, where we have a good provincial government, he would find that we have now amended the ordinance concerned.

This year?

Yes, this year.

In the Cape Province I did that four years ago.

Town councils now have the right to exempt pensioners completely from rates. We therefore do things and do not just talk about them.

The Cape Province has been doing it for a long time!

Yes, I am not arguing about that; the Cape Province also made this concession.

†Mr. Chairman, I want to add my voice to that of hon. members who expressed appreciation to the personnel of the ministerial office, of the head office and of the regional office in Durban for their unfailing courtesy, co-operation and assistance when one raises a problem or takes up a matter with them. [Interjections.] I hope that one of the things the hon. the Minister can do is to make an effort, in co-operation with the Commission for Administration, to try to increase the staff of this department in various sections, but particularly in respect of pensions. Every hon. member knows that an application for a pension can take anything up to three or four months from date of application until it is approved. This is not for want of trying or because of lack of interest or inefficiency on the part of the staff. It is simply because there is not sufficient staff to handle the volume of work that comes in, and this is something that, I believe, the hon. the Minister should look at.

At the risk of disturbing the benign atmosphere that reigns here tonight, I want to look at the position of so-called pensioners. I am not ungrateful. Indeed, nobody could be ungrateful, least of all pensioners themselves, for the increase of R16 and a bonus. I accept that this year’s is the biggest increase that has been granted. But this increase does not solve the crisis or end the despair of tens of thousands of pensioners who are in a desperate situation. The amount of R16 sounds like a lot of money, but it is in fact only 17%. With an inflation rate that was running at 18% and this year is expected to be approximately 15%, this increase does not even make up the inflation backlog. What is more important, however—and this is what I want to bring home to the hon. the Minister and the Government—is that the cost of living index is irrelevant when it comes to pensioners because the index is based on a cross-section, a basket of costs applying to the normal family. The pensioner’s three main cost items are the roof over his head, food and clothing. He has very little for clothing. It is true that he can get medical treatment at provincial hospitals, but basically the two major bites out of his income are rent and food, and both these have moved way above the average for the cost of living index, particularly rentals.

I am glad the hon. the Minister of Community Development is here this evening. Let me just quote from a newspaper report, considered so important as to have banner headlines: “Landlords plan to limit rent increases”. Everybody said: Hurrah, it looks as though this may help! What, however, was that limitation? It was limited to an increase of 20% per year. That is the target those people set themselves, but it is also the target allowed by the hon. the Minister of Community Development’s rent boards. The Minister has appealed to landlords to keep increases down to 10% for two years, but in practice rent boards are granting increases of up to 20% per annum.

What is the interest rate on bonds?

I know. It is not this hon. Minister of Health and Welfare I am getting at. It is that hon. Minister of Community Development I am talking to about the reasons for the problem and possible solutions. That is not this hon. Minister’s problem. His problem is the consequence of the situation. I am not arguing the merits of the issue. I am just stating a fact. That hon. Minister of Community Development has to deal with the problem and this hon. Minister of Health and Welfare has to deal with the consequences. What I am pointing out is that it was once possible to get flats for R50, R60 and R75 per month, but that sort of flat no longer exists today. They are simply not available now. I do not have the time to do so, but I could give the hon. the Minister umpteen examples of rents that have gone up by more than 100% in the last three years. We are talking here about a fact of life. The hon. the Minister of Community Development is nodding his head. He knows that it is true that rentals are going up at that rate. I have a thick file of correspondence with him and the department. What I am stating now is a fact. Over and above that fact, however, there is an additional problem.

Developers are also selling flats. I have a case at the moment in my constituency of a beautiful old building, the Gables, being up for sale. The building contains 122 flats which are now being sold at prices way beyond the means of the tenants. So there is another group of people who are going to be in trouble. How can a person pay rentals of R100 or R120 and still expect to live on the pension of R138 they are going to get? I believe—I have said it before—that in the major urban concentrations, particularly in the flatlands, for example in beach areas like mine and those in Sea Point, a minimum pension should be in the region of R200. [Time expired.]

Mr. Chairman, later in my speech I shall associate myself with the gratitude expressed by the hon. member for Durban Point to the hon. the Minister, the Director-General and the officials for their courteous and obliging attention to representations.

The hon. member for Meyerton has once again pleaded for subsidies for those old people who wish to remain in their own houses, thereby relieving the pressure on old-age homes. Incidentally, this was the theme of both his and my speeches last year. Therefore I wish to support him whole-heartedly in his representations. After that speech, I received a number of letters even from people outside my constituency, all expressing the hope that the Government would consider such a possibility. Therefore I am pleased to support the hon. member.

I represent a large number of senior citizens who have given up their services and their best years to build up this country and its people. Tonight I wish to pay tribute to them. Just as the youth is the hope of our nation, the old people are the pride of our nation. Many of them are the unsung heroes of our nations; unsung, but with an honourable share in what we pride ourselves on, a happy, peaceful and prosperous country. Next to the Strand, where there is a large concentration of pensioners, Parys in the Free State is one of the most well-known and sought-after inland retirement resorts. It is a beautiful town with a pleasant climate, tasty fruit, lush green lawns, colourful flowers …

And a good MP.

… and the leafy banks of the Vaal River.

And a good MP as well.

It is a true delight to see, with a peaceful atmosphere where many a pensioner cheerfully passes his days in happy anticipation.

I am happy to hear various hon. members encouraging me by saying “And a good MP as well”.

Many of these old people have been given assistance with regard to pension problems as a result of my personal representations to the hon. the Minister, and I should like to say to the hon. the Minister tonight: Thank you very much indeed for this; it is highly appreciated.

The Department’s annual report mentions on page 58 under the heading “Liaison with other State Departments regarding Welfare Matters”, that the Interdepartmental Consultative Committee on Professional Welfare Matters met twice during the year and gave attention, inter alia, to the need for an investigation into foster care. In 1978, I made a special plea concerning foster care in the discussion of this same vote. Therefore I wish to do two things this evening. Firstly, I want to ask the hon. the Minister whether the committee has already begun its investigation into foster care, and if so, whether any further announcement can be made in this regard; if not, I should like to ask the hon. the Minister to support such an investigation and actively to promote and encourage it. Secondly, on the basis of the sympathetic standpoint adopted by the then Minister of Welfare and Pensions, Mr. F. W. de Klerk, with regard to my plea concerning foster care, as recorded in columns 737 to 739 in the 1978 Hansard of the Standing Committees, I wish to request the committee to consider, in the course of its investigation into foster care, the plea I made in this regard in this House.

Much is being done by the Government in this country with regard to welfare services and the care of the aged. As far as veterans’ pensions alone are concerned, a total amount of R21 122 000 was paid out at the end of the last financial year to 13 161 veterans. In the past ten years alone there has been an increase of 249% in veterans’ pensions, a proud record for any government. The entire country can be gratified that the Government shows its appreciation in such tangible form for the sacrifices which these people have made in the interests of the country and the nation. How does one adequately compensate the 82 surviving participants in the Anglo-Boer War? Their contribution, their sacrifice and their devotion to South Africa and its people cannot be calculated in terms of money.

I maintain that the Government is doing a great deal for welfare services. The total amount paid out in social pensions alone during 1981, is R269 516 300 in respect of 182 419 people, of whom—and this is interesting—69,61% are women. In this fact, ie. that 69,61% of those who receive welfare pensions, are women, lies a warning to us men, if I may say so in lighter vein. It requires an enormous amount of work and processing to have pensions for that number of people available on time at the various addresses and pay-points every month. The hon. the Minister referred to this earlier today when he was replying to the speech of the hon. member for Witbank in this regard. The position regarding these payments does not remain static, however, and this only makes the task of the department even more complicated.

During the past financial year, literally thousands upon thousands of new applications for pensions were received. They were tested and weighed up against the criteria and legal requirements applicable. Of course, this is in itself an enormous task, and the final result was that 23 787 new and renewed applications for pensions were approved.

Unfortunately, there is also another aspect which is not static, and which increases the workload of the department as well. This is that during 1981, a total of 21 720 welfare pensions and allowances were cancelled, chiefly due to the deaths of elderly pensioners. At this point, on behalf of all the pensioners in my constituency, I should like to convey my wholehearted thanks to the hon. the Minister, the Director-General, Dr. De Beer—who has been an esteemed personal friend for longer than 20 years—as well as the staff of the Department for the mammoth task they perform in the interests of the care of the aged and of welfare services in our country. In this regard, therefore, I wish to associate myself with what the hon. member for Durban Point said earlier. This is a department which does not often receive praise. However, it unobtrusively performs a mammoth task the true extent of which is not often realized. This task is carried out in the interests of the aged, needy children and other unfortunates in our society. On behalf of all of them I wish to thank the hon. the Minister and his department and convey my highest appreciation. The fact that they attend to every problem which is brought to their attention by us as representatives in so courteous and obliging a fashion deserves, I believe, the praise and gratitude, not only of the representatives who deal with this, but also of the pensioners on whose behalf we make representations of this nature.

Mr. Chairman, I should like to associate myself with various hon. members who during the course of this debate thus far have expressed their gratitude to the hon. the Minister and the Department for the fine increased pensions which the aged received recently. I am aware that the hon. the Minister played a very active role in bringing about the considerable increase in pensions. I believe that I am speaking on behalf of approximately 6 000 retired and elderly people in my constituency when I express my gratitude to the hon. the Minister here tonight. Furthermore, I want to place on record that I have received far too many telephone calls and letters of gratitude to deal with individually here this evening. I think that the hon. the Minister has designed an excellent formula whereby our retired people, our senior citizens, may be assisted. I also wish to say that I am aware that this formula is a direct result of the hon. the Minister’s active involvement in this task. Once again, I thank him wholeheartedly.

Furthermore, I know that my predecessor, Mr. J. T. Albertyn, played a very active role in this regard. However, I trust—and I wish to bring this to the attention of the hon. the Minister—that in the years to come, our pensioners, our elderly people, will not be forgotten as far as their pensions, in regard to which they have received such admirable assistance, are concerned.

I also wish to associate myself with everyone who paid tribute in such fine and striking language to our older guard, our older people. This evening, I wish to put a few ideas to the hon. the Minister with regard to our senior citizens. Over the years, much has been done and achieved in respect of the care of our aged. A great deal has been provided, and one realizes this when one pages through the annual report of the Department. I wish to congratulate the hon. the Minister and his department in this regard. Looking at the statistics, it is brought home to one very clearly that the expense and the nature of the services will, in the future, rise to a level never encountered before. This does not apply to the Department alone, but to all institutions dealing with the care of our aged. Since the beginning of this century, the average life expectancy in the developed countries has increased by more than six years, mainly as a result of progress in the medical and scientific fields, as well as the progress in the sphere of living conditions which man has provided for himself. If one takes into account the fact that the number of old people, as a percentage of the population, is increasing continually—in certain countries it is as high as 13%—one realizes afresh that, in the future we shall have to make provision for these people on a much larger scale. There is a tendency today—and it is a distressing tendency—for the care of our aged to be regarded more and more, as our material wealth increases, as the sole responsibility of the State. Ironically enough, the fact is that the basis of the wealth we are experiencing today was laid by those who are regarded as not so young today. They are our retired and elderly people. Certainly it is true that the State has a duty in this regard, and I just wish to place on record this evening that, since the tendency is to believe that this responsibility should be or could be shifted on to the State, we feel at liberty to say that we can leave the bill to be settled by the community.

I believe that the elderly should be regarded as an integral part of the community, and I also believe that we shall be at fault if we wish to treat him as a spare part to be pushed aside just because his age is against him. Therefore I believe that our activities with regard to the care of our aged should be directed in such a way, that he be retained in the community for as long as possible as a happy and fully-fledged member in his own circle of friends and his own environment and, if need be, in his own home where he may keep his own beloved pet to which he has been attached over the years. This is very important, as it contributes towards solving one of the problems of the elderly, viz. the loneliness which accompanies old age. We should also take into account that the numerical ratio of the normal elderly person to the elderly person who needs some form of specialized attention, is only one to six. From this we may infer and state that the building of old age homes as such need not always necessarily be the highest priority in our care of the aged. If we wish to strive for the ideal of retaining the elderly in the community, we shall have to shift the emphasis, as far as care is concerned, from institutionalized care to home care. The question then, arises, and rightly so, as to whether the most important form of service to our elderly should necessarily be the building of old age homes. I believe that the programme for the provision of service centres, facilities for home care, the establishment of recreational and other facilities which the elderly need, will have to be more rapidly extended in the direction of care outside old age homes. I know that excellent work has already been done in this regard by the Department of Health and Welfare. I can bear witness to the fact that in my constituency, means are being supplied at an old age home, for instance, and this is merely a subdivision of the service as a whole. If one studies the figures in the annual report on what is being spent on old age homes, on the one hand, and on the home care of the elderly on the other hand, one wonders whether those amounts are not slightly in favour of the building and subsidizing of old age homes. In countries such as Canada and America, as well as in Europe, much research has been done on this matter and interesting results have emerged concerning the fine achievements attained in this regard. That is why I believe that apart from the considerations which I have mentioned in the short time at my disposal, it is also in the interests of continued economic stability and progress that we should productively utilize the knowledge and experience of our elderly people for much longer than is the case at present. One need only think of our national servicemen who could be replaced by the elderly in the economy. If we can succeed in this, we shall be taking a step in the right direction. We are creating an economic bottleneck for ourselves by allowing people who are, and who often still want to be economically active, to retire at a too early age. I wonder whether the hon. the Minister does not want to take the initiative in this regard by giving his attention to this matter of a too early retirement age.

This would also assist the elderly in overcoming one of the biggest problems of old age, viz. the mental stagnation which follows physical or other forms of inactivity after retirement. The achievement of this goal will require an imaginative adjustment in our approach, and I wish to suggest that we make a special effort to involve the elderly themselves in these efforts. In this Year of the Aged, we could give the aged no greater gift than to make them realize that we have not written them off, but that we need them and would very much like to see them actively involved in society.

Mr. Chairman, I should like to start off by disagreeing with the hon. the Minister about his statements on the year of the nurse. I believe every year should be the year of the aged and every year should be the year of the child. For the same reason—although every year, as the hon. the Minister stated, should be the year of the nurse—I cannot accept that his argument is valid, because it can also be used to highlight the nursing profession, what it provides, its shortcomings and solutions to its problems. I again want to plead with the hon. the Minister to try to arrange a year of the nurse, because I think it would be a very good thing.

I want now to deal with mental health in the Port Elizabeth area. I recently asked the hon. the Minister a question about the number of community psychiatric sisters in Port Elizabeth, and the answer was that 10 positions were available of which only one was permanently filled. This is for a population of approximately 500 000. I should also like to tell him that it has come to my knowledge that the Whites of Port Elizabeth have beds and good facilities for acute mental illness. They have about 110 beds for approximately 130 000 Whites. However, for approximately 350 000 Blacks, Coloureds and Asians there is totally inadequate medical care for those with acute mental illness. Basically the nearest hospital is 12 hours by train and 2½ hours by car. I would be very grateful if the hon. the Minister would look into this matter because I believe that this is a disparity which South Africa at this stage cannot afford.

I have told the hon. the Minister that I will speak in this debate on what is in the annual report. I will support what is good and will criticize what is not so good. However, I would also like to discuss things that is not in this report. I would for instance like to refer to the care of patients in prisons and other places of custody. I would like to point out to the hon. the Minister that nothing of this nature is mentioned in his annual report. I think the subject is very topical and very important and we should get some indication of the duties of his department and some indication of what they are doing. There is a beautiful little book printed by the department of the hon. the Minister which appeared in March 1978 titled The Medical Practitioner in the Health Service. I would like to recommend that any hon. member who is interested in health care in the Government service should read this book because it is a valuable book and can be of great help. There is a code of practice on page 3 where the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the Tokyo Declaration are described. It then goes on to the patients in police custody and I want to mention briefly some points in the Tokyo Declaration. I want the hon. the Minister to tell me whether he, his department and his district surgeons agree with this oath—

Mr. Chairman, I would like to ask the hon. the Minister if he can give us a guarantee tonight that the instructions to his department is to act according to this code. There are many points flowing from this, but I would like to add one more. A doctor must have complete clinical independence in deciding upon the care of a person for whom he or she is medically responsible. A doctor’s fundamental role is to alleviate the distress of his or her fellow-men and no motive, whether personal, collective or political shall prevail against this high purpose. I would again like to ask the hon. the Minister to tell us whether he is confident that this is what is happening and if he can reassure us in this regard.

Time does not allow me to go into more details but I am specially referring to detainees under section 6 of the Terrorism Act. There is a great deal of unhappiness about this in South Africa for example, such as by the Medical Association and many others. Many recommendations have been made. An ad hoc committee of the Medical Association has made recommendations and I would like to ask if the hon. the Minister has taken any notice of these recommendations. However, I would like to suggest something to the hon. the Minister in regard to the medical care of the detainees. I think he will agree with me that there is dissatisfaction about them being seen only once a week at the request of the police by a district surgeon. The Rabie Commission has recommended that such detainees should be seen at least twice a week. I do not think this is enough. I am not satisfied with that. Recommendations have been made and the idea has been put forward that he should be seen by his own medical practitioner. I think this is a good idea, although I think it can lead to abuse. I appeal to the hon. the Minister to ask the Medical Association to appoint a panel of doctors to look at the detainees. They should be able to visit them on a regular basis and at the request of the patient. I think that once an independent group of doctors is brought in, the hon. the Minister will find that this grey area will be eliminated and it will be good not only for the detainees, but also for the public of South Africa and for the medical profession.

In the very short time still available to me I should just like to point out to the hon. the Minister that great concern has been expressed by social welfare workers and social welfare in South Africa. It is stated that there is a crisis of manpower in the social welfare profession, and indeed the figures prove the great shortage of social welfare workers. It is stated by the Council for Social and Associated Workers that in July 1981 there were vacancies for 399 social workers. Taking into account that the norms set by the Department of Health and Welfare for the workload of social workers is 60 clients per families, this could mean that 60 times 399—23 940 person families, are not receiving service. I think this figure proves that there is a severe crisis. There are many reasons for this manpower shortage. The most important reasons include discriminatory salaries, salaries in general, lack of adequate service conditions, particularly in so far as pensions and housing subsidies are concerned, and the method of subsidization of social workers. It is stated in the report of the Human Sciences Research Council of 1979 that male social workers are the lowest paid of the professions with similar educational conditions. It is our belief that one of the main problems in so far as social welfare is concerned is the division of social welfare into three departments. I cannot see that the differentiation between the races of South Africa is big enough to differentiate their social work. I think there is a greater advantage in bringing them all into one department. [Time expired.]

Mr. Chairman, the hon. member for Parktown touched on various matters here tonight to which the hon. the Minister will certainly reply in full. Last year, too, we discussed the question of nurses in a Standing Committee, and on that occasion I told the hon. member about the witch-doctors who, in their time made a hole in the heads of people in order to determine what was wrong with them. I hope that it will not come to that here, but that the hon. the Minister, in the light of the Rabie report on the problems of the social workers and everything which he mentioned here, will furnish him with an adequate answer.

I should very much like to talk about a matter which we encounter continually, particularly those of us who represent constituencies, viz. whether the time has not come for social pensions to be replaced by a Government pension scheme. During the discussion of the hon. the Prime Minister’s Vote the other day, the hon. member for Durban Point pointed out that our elderly people are going through very hard times. That is true, and one accepts that. Very earnest attention is given to the Government’s role, but the Government has to fill up many gaps under difficult circumstances. I consider it the duty of every working person to bear in mind the day when he will no longer have a permanent job. At the same time the question is being asked whether the best human resources are not being lost by premature retirement, in that even at the age of 40 or 50 years productive people are simply closing the door behind them, putting away the trowel and state that they are no longer required on the labour market.

In many cases they themselves have not made provision, and consequently this is a major problem for us.

When the Government pension scheme was proposed in 1977, it was introduced merely as a memorandum to be discussed and not as Government policy, and on that occasion it was made very clear—and I believe that it should be emphasized again on this occasion—that on the adoption of the pension scheme, national savings would have to be changed drastically, and that savings at present deposited in financial institutions such as building societies and banks would be adversely affected. The question now arises as to whether this will not eventually lead to renewed demand inflation if people should all of a sudden receive large amounts of money at or before retirement and to people spending more than they produce.

If such a scheme were to be introduced, it could also result in a laissez-faire attitude, the idea being that the Government would and would have to look after the individual under all circumstances, after all. The pensioner will then be inclined to make constant demands for higher pensions, however little he contributes, because in that way the scheme will be more attractive to him.

In economic circles it was said at the time that a contribution rate of 7% was adequate to ensure that a pension equal of 75% of the final salary could be guaranteed. If the scheme were not to succeed financially, even with such a meagre contribution and such a large payment, viz. 75%, who would then have to pay the piper? The taxpayer? Or will the Government eventually have to carry the risk? And who would eventually benefit?

Those people who, after the fixed date, have reached the pension age will be entitled to the benefits, and they constitute only part of the population. In due course, however, the elderly in the population all become entitled to these benefits, and if the population figure were to rise more rapidly than the resources of the country could manage, an imbalance would be created. The question of the introduction of a compulsory pension scheme for all races has been discussed quite often, and for the above-mentioned reasons we believe that it simply will not pay.

In 1970 it was found that 34% of the population was receiving money from a pension scheme, and that employees resign at an early age in order to obtain money. In 1973, for example, it was found that a sum of R6,5 million was paid out to people who were still alive and who had not yet reached the retirement age.

Germany has one of the best pension contribution schemes in the world. In that country the pension contribution annually is 18% of a person’s salary. However, it proved to be inadequate. As a matter of fact, the German pension scheme has been on the verge of collapse. Moreover, France and Britain also found that their economies were being drained by the national pension schemes.

In my opinion, therefore, it is not the duty or the task of the Government to see to a national pension contribution scheme; individuals and organizations should see to that themselves. We feel sure that under present circumstances the hon. the Minister and the State are doing what is best for our population in that regard.

Mr. Chairman, I am in full agreement with the hon. member for Rosettenville, who spoke before me. What he has just said is absolutely true, and for that reason I want to associate myself with what he said and request that we investigate the possibility of a Government pension scheme for those who do not belong to other pension schemes. I know that such a scheme will require a great deal of study in advance and that it is not a matter on which the hon. the Minister can give us a reply tonight without further ado, but I am sure this is something that could be considered. How feasible it will be in practice, however, is another matter which will have to be studied in depth. Therefore I shall leave the matter as it was so ably stated by the hon. member for Rosettenville.

The case of the elderly person, the pensioner, is something which is very close to all our hearts. Indeed, in my own home, too, we have had a great deal to do with elderly people, because we cared for four elderly people until the last, and I know, therefore, that it is not the easiest of tasks to look after the elderly. However, there is a joy in it to consider that those are the people who would have done everything for you to sustain you through life when you were a helpless child. Thinking of that brings one great joy and happiness. A mother is probably the most wonderful being ever created. One need only consider that she will do everything for her child and would fight for him like a wild animal if need be. A good father will also try to do everything possible to ensure that his family does not lack anything. He will always try to do the best for his family. To their dying day, parents will honour their children, praise them if they deserve it, and entrust them to the grace of God, because to a parent the child remains a child until the day the parent dies. This is my experience in life. Of course, there are always exceptions, but we are not talking about them. Fortunately, there are not so many of those exceptions in our fatherland. We know, too, that all children have a sacred duty towards their parents. Of course there are children who neglect their parents, but that, too, is the exception in our country. Since nowadays both husband and wife have to work to keep the household going, not everybody can look after their elderly people. If both the husband and his good wife have to work, it makes matters very difficult. We all know that there is an acute shortage of old age homes today and that the waiting-lists are extremely long. The reasons for that do not all fall under the portfolio of the hon. the Minister, however, because other Ministers are also involved in this matter. However I should like to put a friendly request to him to use his influence, if possible, to see whether he could not render any assistance.

The hon. member for Middelburg spoke about the depression years. Most of today’s elderly people were children in the years of the depression, victims of that terrible time. They were the people who bore the brunt for us in those years. In the days when our people did not have any standing in their own fatherland, they were the people who saw to it that we were clothed and could go to school. They were the ones who did the best possible for us. Fortunately those days of polarization between the Afrikaners and the English-speaking have gone for ever. The struggle of the past has now moved to another sphere.

Nowadays an elderly person receives a pension of R122 per month. As from October it will be R138 per month. I am very grateful to the hon. the Minister for this increase. When both spouses are still alive they can by careful budgeting, make ends meet if they do not have other expensive financial obligations. If one passes away, however, it is quite a different matter. Moreover, by the law of averages, the husband is the first to go. Statistics indicate that the life expectancy of a man is far shorter than that of a woman, indeed, about seven years shorter. Consequently a widowhood of about seven years awaits a woman, plus the number of years that she was younger than her husband, because usually she is younger than he. She is the one who normally suffers most when her husband passes away, and as a result, is hardest hit by inflation. We know, too, that the economic laws governing people’s needs contain certain irrefutable truths. In terms of those laws, the primary requirement in life is food, the second clothes and the third housing. That is followed by many more, but for the purposes of my argument I shall only discuss these three for the time being. First of all, I should just like to bring something to the attention of the hon. the Minister. I know that this, too, is a matter which does not concern his department only, but because it does concern the position of the elderly, I feel at liberty to bring this to the hon. the Minister’s attention. If there is one person who really looks after the elderly, it is this hon. Minister. He used to live in my constituency and we worked together, consequently I know to what extent he does his duty by those people. The matter that I am referring to, is the tremendous exploitation which is taking place nowadays at certain shops, usually chain stores. I know of one instance where the price of a certain item rose by 8 cents per case. The public had to pay 8 cents more per can. There were 48 cans in that case. I therefore believe that if the hon. the Minister could be instrumental in introducing price control, the fate of the elderly will be faciliated a great deal.

Then we have the rent boards. I know that they do not fall under the department of the hon. the Minister, but they do directly affect the elderly. Now that rent control boards are being phased out, certain people are enriching themselves and poor people are becoming poorer by the day. In this regard I have in mind in particular the widows of pensioners, who constitute the largest number of people receiving pensions today. I know of people in my own constituency who are almost no longer able to make ends meet because rent has risen so sharply. I should just like to bring this to the friendly attention of the hon. the Minister.

There is another request that I want to make to the hon. the Minister. I want to assure the hon. the Minister of my good faith, and he will understand my request because he knows that my attitude towards him is particularly good. He knows, too, that I mean well towards him. I want to ask whether it would not be possible to bring the pension increases into effect simultaneously with the increases granted to the Public Service. Here I am not referring to October this year, but next year. When increases are granted to the Public Service, people who want to exploit it know exactly when those increases come into effect. Then they increase their prices accordingly, and the pensioner is prejudiced because their increases only come into effect months later. I am aware of the hon. the Minister’s problem in this regard, and I also know that he will not be able to rectify it this time, but I merely raise this matter with a view to the future.

I want to conclude by thanking the hon. the Minister very sincerely for what he has done for the elderly in recent times. I want to thank him, too, for paying a visit to two homes for the infirm and the elderly in my constituency, viz. the Tini Vorster Home and the one at Vogelstruisbult. In this way he could see for himself the good work that the staff there is doing, as well as the very good work being done there by the churches and by volunteers who assist in keeping those people there busy. The greatest problem of the elderly today is loneliness. Few people can tolerate loneliness, and it drives the elderly virtually to madness. That is why it is most important to pay visits to those places. People who visit those places confer a benefit upon the elderly people of our nation.

Mr. Chairman, I agree with the hon. member for Nigel that the child has a duty towards his parent. As a matter of fact, this is the theme of my speech. As far as price control and increases are concerned, I cannot agree with him completely. In any event, it does not belong here under this Vote.

Nowadays social pensions are increased annually, linked to the consumer price index. I should like to ask that consideration should again be given to where the real obligation in this regard lies. The hon. member for Edenvale, the hon. member for Brits and other hon. members indicated how this whole matter could develop if we examined what demographers had to say about our future population structure. It would also appear from the report that other agencies are fulfilling their duty, particularly after the Fund-raising Act was passed. During 1980 90 temporary authorizations and 206 permanent authorizations were granted in terms of the Act, while 42 authorizations and 1 582 permanent authorizations for the raising of contributions in terms of the provisions of the Act were issued during 1981.

There is no doubt that the parent who is financially capable should support his child. In fact, there is adequate provision for this in our legislation and in our judicial system. So it can be enforced. Only if the parent cannot meet his obligation does that obligation pass to the State. It is true, however, that according to our common law authors the child has a reciprocal duty to support his parent. This is not only a moral duty; it is a legal duty as well. Writers like Voet and Van Leeuwen provide evidence of this and ever since its inception our judicial system has left no doubt about this. The only aspect that could be doubtful, is the sequence in which this duty presents itself. That aspect, however, is not relevant now. I do believe that it is very clearly laid down in our judicial system. This duty could also rest with a brother, sister and grandchildren. So we could get a situation where a needy parent becomes the dependent of his child. But is is very interesting to note that in our administration of justice I could find no instance of a parent actually enforcing this right upon a child. The cases in which this does occur are usually instances in which the parent maintains that the child has a duty to support him and where the child is dead or injured and, therefore, cannot fulfil that duty. Consequently the parent has no qualms about suing a third party and in so doing making use of that legal obligation I could find no instances, however, of a parent actually taking steps against a child; a reluctance which is of course quite understandable.

Consequently it is alleged that a parent may raise many children but that many children find it difficult to care for a single parent. The question, however, is whether the Government has an obligation in cases where the legal obligation to support their parents, rests upon the children. In the view the reluctance of parents to enforce their right upon the child, it is quite probably a child whose education put the parent in a position of indigence. I want to suggest, therefore, that such a person be assisted by granting him a pension, but that the Government, on behalf of the parent, should then recover that particular amount from the dependents who were responsible for that happening. It is my submission that the duty to support the needy should only be passed on to the State when those who are really liable are not in a position either to discharge the obligation of providing support.

I also want to refer briefly to the Year of the Aged. It is no use our pretending that we have a responsibility towards these people and that we shall discharge that responsibility if, in so many other respects, we foist that responsibility upon the Government. I am fully aware that statutory amendments will probably be required, particularly to facilitate the practical application of this idea, and that that could also result in some measure of additional administrative obligations. However, I do not want to repeat what previous speakers have already said. The situation we are heading for is such that the State alone will not be able to discharge this obligation that ultimately, if this obligation is eventually passed on to those who are legally liable the amounts which are available could mean more than they do at present.

Mr. Chairman, the question is sometimes asked whether, if one wants to solve the problem of the aged, it should not be left to free enterprise. In this House we have sometimes debated the question of whether the State has a responsibility in this respect or whether it should be left to free enterprise. I want to answer this by saying that if we are going to leave it to free enterprise we have to consider the fact that in 1958 one out of five working South Africans contributed to a pension fund. By the year 1978 that figure had grown to roughly 2 out of 5. Roughly 40% of working South Africans contributed to a pension fund. At that rate we are going to have to wait way beyond the year 2000 before we solve this problem. We obviously cannot afford to do so because of the costs involved. Who bears the cost? There is, of course, a cost. One just has to look at the present system. The cost is borne by the taxpayers of South Africa. What we are in effect discussing is the fact that people should be allowed to contribute towards their own retirement because if they do not do so then the burden in this regard is passed on to the taxpayers of the future. One may then experience a situation such as occurred in Los Angeles where half of the amount collected in property taxes was having to be utilized for the payment of retirement benefits to retired municipal employees.

I think we must distinguish very carefully between a national contributory pension scheme and a system in terms of which every working South African belongs to a pension scheme. The two concepts are totally different and we must not confuse them or else we are going to talk past one another. What I am suggesting that we should do—and I think this is also what the hon. member for Brits suggested; I think that if we can find each other on this basis then we will be achieving something—is that every working South African must—the emphasis is on the word “must”—contribute towards a pension scheme. There are a wide variety of pension schemes to which he can contribute. The second fundamental factor is that if he is going to contribute towards a pension scheme he must ultimately derive the benefit of those contributions. What does that mean? This means two things. Firstly, it means that his pension must be preserved. If we are going to preserve pensions there is a third factor that must be taken into account and that is that one must have transferability of pensions. One must be able to transfer a pension benefit from one pension scheme to another pension scheme. I say that if we can find one another in respect of these points then we should put this into operation now. We must take action in this regard now. If we do it in this way we will not be interfering with the private enterprise system at all. We shall not be setting up a State pension scheme. We all know that State pension schemes can go insolvent just as private pension schemes can. It all depends on the way in which such a scheme is funded. I say therefore that we must get moving in this regard now because every year that we delay we place an additional burden on the taxpayers of the future.

Mr. Chairman, I am very grateful for the few minutes which the Whips are allowing me at this late hour in order to complete the speech I was making.

When my time expired, I was saying that I very much regretted the fact that the situation I had discussed had been exploited by newspapers for political gain. Their reports were ill-considered and riddled with inaccuracies. I also bitterly regret the fact that the matter led to a quarrel between the hon. the Minister and myself across the floor of the House. I say this because I really have pleasant memories of friendship and good co-operation with members of the NP’s health group, as well as with the hon. the Minister himself. I say this quite frankly. However, I want to assure the hon. the Minister that we in the CP will continue to be guided by sound judgment and that we shall not oppose him for political reasons when he wishes to pilot measures through this House in the interests of the health and welfare of our people outside.

Finally, I just want to underline what two hon. members have said about welfare. The hon. member for Meyerton spoke about people who own property. He said that they received pensions, but that as a result of municipal rates and the enormous rise in water and electricity tariffs, they could no longer live in those houses. It is a fact that these people are being penalized precisely because they own property and because they wanted to provide for their old age. It is true that some local authorities do grant concessions to the aged, but these are not uniform. I am therefore pleading for them to be granted some form of relief.

I want to make a second point. The hon. member for Middelburg pleaded for civil pensioners who had retired in the early ’sixties. Today these people are 80 years of age and older, and they used to be school principals, inspectors of schools, etc. They used to be respected people in their communities, and today they can no longer make ends meet. These are people whose interests we have at heart, people who worked for our country when our country needed them. I should like the hon. the Minister to reconsider the case of these people.

Mr. Chairman, so far this has been a peaceful debate.

So far, yes, but it is not over yet.

Yes, the debate is not over yet, and I do not know whether there is another Prog speaker on the other side of the House. If any discordant notes were struck in the debat the only one probably came from the hon. member for Parktown, who once again voiced excessive concern about the health care of detainees, especially of people detained in terms of section 6 of the Terrorism Act. I sometimes wonder why this aspect is always so specifically singled out when the PFP discusses these matters. I wonder whether it reflects some distrust in fellow medical practitioners. The hon. member knows as well as I do that these cases are seen to by district surgeons, and district surgeons are, after all, medical practitioners. Is the hon. member alleging that the medical practitioners employed by the State are not doing their job, or are deliberately neglecting to provide proper care in these cases?

What about the Biko case? [Interjections.]

Yes, even in the Biko case. If the hon. member for Park-town, who is a medical practitioner, were to rise and criticize his own profession for not doing their job properly, I might still accept it, but why is it always used as a pretext for raising other matters, and why is it always necessary to create the impression that the Government does not see to the welfare of detainees? Even the welfare of terrorists is seen to. Therefore this is a rhetorical question.

I should like to react to the Vote as such.

This has been a poor show on your part.

When one is dealing with poor people, I suppose one had better give a poor performance as well, otherwise they might not understand what one is saying. One often wonders why there has to be a welfare function in a country, especially in a prosperous country such as South Africa. One asks oneself whether this might not have something to do with the doctrine of evolution. Arising from this, I should like to quote a passage entitled “Man’s Pedigree”, by an unknown author—

The old story that “Your mother caught you in the mountains and chopped off your tail” probably gives rise to indignation among the monkeys.

We are very grateful to the State for the improvement there has been in respect of the pensions and other penefits for our elderly people. Personally I wish in particular to associate myself with the thanks expressed by the hon. member for Middelburg, in connection with medical aid to civil pensioners—the idea that as from 1 October 1982, membership fees will be paid to one of the official medical schemes in respect of the civil pensioners who do not belong to any such scheme at present.

I am actually speaking at the behest of a community which suffered severe losses during the Laingsburg flood. It is gratifying to know that a community in the vicinity of the afflicted people contributed so generously towards helping them in their need. In particular, I want to express gratitude and pay tribute to the committee which handled the affairs of the disaster relief fund and who lightened the burden of so many people who had to start all over again under difficult circumstances. I want to thank the chairman of the committee, the hon. the Minister of Health and Welfare, the Director-General of Health and Welfare and all the officials who worked so loyally to provide relief in this connection. I thank them on behalf of the inhabitants of the disaster-stricken areas.

Mr. Chairman, you know that a great deal of assistance was rendered in the disaster-stricken areas by the Department of Agriculture and Fisheries and by other Government departments. There were cases which those departments were unable to accommodate and where assistance had to be rendered by means of the disaster relief fund. Here I am thinking in particular of farmers with smallholdings of less than 4 ha, who also suffered enormous damage, especially in the Montagu district. They had to turn to the disaster relief fund for assistance. It took quite a while before they could be assisted, but I understand that most of them have now received their cheques. For this I want to convey my very sincere thanks to the hon. the Minister.

Mr. Chairman, we should all welcome the decision to make this year an occasion to honour our aged and senior citizens. There is only one commandment which has a promise attached to it; “Honour thy father and thy mother”. The promise is “that thy days may be long in the land”. This may well be another way of saying “Honour and respect are essential to a stable society”. Today, in our youth-focused society, respect for the aged seems to be one of the discarded virtues. If we want our days to be long in the land, we must see to it that our concentration on youth and the future is not at the expense of our senior citizens. We must also realize that it is only thanks to the past that we can build on the future. Having said that, may I also say to the hon. the Minister that we are extremely grateful for the increases in pensions announced by the hon. the Minister of Finance. However, I think even he will concede in this time of ever-rising inflation that the pensions paid are not adequate in order to maintain a reasonable standard of living. I do not think that there is any hon. member in this House who can argue that fact, especially if one is living only on an old age pension. I also accept that because of financial stringency and policy insufficient funds are available to pay higher allowances. I therefore put it to the hon. the Minister that other ways and means of generating funds to pay higher allowances to our senior citizens must be found.

It was my intention to talk this evening on the possibility of a retirement bond. I thought this could be introduced, but after discussions with some of the officials concerned, it is generally accepted that because of the present financial climate this would not be an appropriate time to launch such a scheme. However, may I just ask the hon. the Minister to note this for future reference because I shall come back to it at some future time. I shall certainly raise this matter again.

Last year, during the discussion of this particular Vote, I touched on the subject of a State lottery and I was given a flat refusal by the hon. the Minister. I now come back to it, for obvious reasons, as a source of funds.

You are a martyr.

That is right.

Dogged does it.

It is time for us to discuss this matter again. It is true that this Government, which professes to regard gambling as immoral, has set its face against casinos in its own territory but has conceded the principle of lotteries by introducing bonus bonds. The Government allows horseracing and accepts the profits in the form of taxes derived from horse-racing. Is there a moral question involved? Surely risking large sums of money on the races, sometimes in the belief that a horse cannot lose, is more immoral than spending R1 on a lottery ticket with which the gambler knows he has little chance of winning? It is presumptious for any Government to impose the ethical standards of a section of the population on the whole population if in fact ethics are the criterion. To digress, I welcome the statement made by the hon. the Prime Minister in so far as Sunday sport is concerned. However, to get back to casinos, the Government is against the establishment of casinos in this country but, on the other hand, is quite prepared to supply transport—at a price, I agree—to convey South Africans to the casinos outside our territory. Is there any conception of how much money is leaving South Africa by way of gambling in the casinos?

May I ask the hon. member how we supply the transport?

Through the S.A. Transport Services. The Government is making money out of it. In other words, what I am saying is that the Government is actually aiding and abetting people to go out of the territory and gamble. [Interjections.] A lottery can support many worthy causes, not least of all our senior citizens of all races plus the coffers of the State. It is common cause that lotteries have financed many worthwhile causes, for example, hospitals, opera houses and institutions. One can go on and on when one thinks of the Irish, the Rhodesian and many other Sweepstakes. When one thinks that 20% goes for administration, 20% for the State—which is sorely in need of money—20% for prizes and that the balance of 40% can go to a worthwhile cause such as our pensioners, what a windfall it would be for them. Let those who object to lotteries keep their money in their pockets, but why should the non-objectors who, after all, are in the majority, be debarred from a harmless pleasure? It would be an interesting exercise to have an honest survey of hon. members in this House to find out in fact how many of them have been to a casino and who have won or lost money in the same casino. I put it to hon. members: Is it a case of do as I say but do not do as I do? I again ask the hon. the Minister to reconsider his position in this regard, especially this year which is the Year of the Aged.

I now wish to come to the position of income limits for residents in homes for the aged. The South African National Council for the Aged has asked the Department of Health and Welfare to increase the income limit in respect of residents in homes for the aged from R200 to R300 per month for subsidy purposes. If, after all, the Department of Community Development can increase the income limit to R300 per month for building loans, why cannot this department do so as well? The department did pay a subsidy for residents with an income not exceeding R200 per month. This included social pensioners who, in addition to the old age pension of R122 per month, had an income from investments that in total could have exceeded the stipulated R200 per capita. As from the first of this month, however, homes for the aged will not receive a subsidy for social pensioners if their total income exceeds R200 per month. Does the hon. the Minister realize what a detrimental effect this has on the income of these homes, because they levy board and lodging according to income and also according to income from investments? Sir, there can be no doubt that the basis upon which subsidies are paid to homes for the aged needs drastic revision, and I should like to know whether this is going to be revised. Some of the homes catering for very frail are finding it extremely difficult to manage on the subsidies payable by the department, because costs differ from city to city, from town to town, and so does the quality of the services rendered.

I now wish to deal with preventative services. A subcommittee on medical services for the aged was appointed by the hon. the Minister in January 1978 under the Health Act of 1977. This committee met regularly until April 1981. I may add that this committee was representative of all race groups. A working group was appointed to study and make recommendations concerning medical services for the aged. These recommendations were submitted to the National Advisory Committee, and there, to my knowledge, the matter rests. Would the hon. the Minister please tell me what has happened to the report and the recommendations, because I believe that emphasis was placed on preventative services to obviate admissions to hospitals and homes. I would appreciate it if the hon. the Minister could tell us what the position is.

Mr. Chairman, we are now coming to the end of the debate on the second part of my Vote, although some hon. members discussed the question of health under both subdivisions. However, I shall try to reply to the questions.

In the first place, I wish to thank all the hon. members who have participated in the debate. Among them were the hon. members for Edenvale, Brits, Meyerton, Middelburg, Durban Point, Parys—or perhaps I should rather say “Paradise” after listening to the hon. member’s speech—Parktown, Rosettenville, Nigel, Nelspruit, Pietersburg, Swellendam and South Coast. Sound contributions were made, and I want to thank hon. members. However, one or two points were raised which had been raised in previous years as well, and which I had already replied to, but I shall repeat the replies in the course of my speech, if my time does not run out.

I told the hon. member for Sea Point earlier that I would reply to his representations when we were discussing pensions, and at the same time I wish to reply to the hon. member for South Coast as well.

†The hon. member for Sea Point spoke about homes for the aged and said that the sick-bays in these homes might possibly be adequate for the inmates, but that patients from outside could not be accommodated. He said further that very little was being done for the frail old aged, but I do not think that that is quite correct. The hon. member referred to the Zerilda Steyn Home and the Booth Hospital. Let us look, however, at what we are spending on homes for the aged and the infirm. During this year we will be spending R27 million for this purpose. The department has four of these homes, namely Sonop at Brits, Tienie Vorster Home at Dunottar, Karatara at George and Silwerkroon at East London, on which we spend nearly R1,6 million. The aged residents of these areas are catered for completely in these homes. There are private homes, as a result of the pressing need for homes for the infirm aged. Four such homes are run by the firm Smith, Mitchell and Company on behalf of the department. These homes are, for all practical purposes, regarded as State homes and the firm is reimbursed on a daily tariff basis. The amount paid out is R2 266 000. There are the ordinary subsidized homes which are subsidized to the tune of R23 500 000. Virtually every one of them has a sick-bay. In these particular homes there are various categories of people, and we pay the homes a subsidy. Special grants are made to the managements of subsidized homes for the aged to cover the more expensive equipment. We have settlements at Sonop, Karatara, Ganspan and Charlesville at Jagersfontein, and the amount involved here is R2 271 000. So I could go on, but I do not think I have to go through the list any further. What I wanted to illustrate to the hon. member for Sea Point, however, is that we do an enormous amount. The frail aged do bother us. We do have a committee, and the hon. member for South Coast asked us about it. I am referring to the Advisory Committee for Health which has dealt with this matter. There has even been a subcommittee working on it. We have a report that has come in from the committee. When I have finished dealing with my Vote and can again get down to some honest, hard work in my office, I shall be giving attention to that report.

The hon. member asked that the sum of R200, which is the limit in some of the homes, be increased. The hon. member for South Coast also mentioned the same amount. At the present stage we are already negotiating with the Treasury to see whether we cannot fix this at a more realistic figure of say R300, but as with everything, there are the financial implications to be considered. We have to see what the actual implications will be before we can get to a final answer.

The care of the aged, especially the frail aged, is to a large extent in the hands of the private sector. We have the organizations for the care of the aged, which do an enormous amount of work. My personal feeling is that the State must see to it that they contribute and help the people concerned to keep the homes running. We must have community involvement, whether we are dealing with the aged, with children, with the sick or whatever. It must be possible for anybody who falls within the ambit of this department to be helped by the community. The community must take an interest.

*The hon. member for Nigel gave a very moving account of how they had cared for four elderly people in his house. It must have been difficult for him and his wife, who also had to make a contribution, but they did it with pleasure, and to me the word “pleasure” is the key word. If we had more people who took pleasure in caring for their elderly relatives, their parents, we would not have such a big problem. There are many thousands who are already doing this, but it is important to state clearly once again what the policy of the department is.

The department will not evade its responsibility. We shall make a contribution, but we must have the assistance our our “voluntary” organizations, if one may call them that. The hon. member Mr. Aronson serves on the management of the Red Cross. They did me the honour of naming a complex which they had built in Port Elizabeth after me. I have been dealing with them for years. They perform an enormous task in caring for the aged and they only ask for the minimum subsidy. They just want their books to balance. We have many similar organizations. We must bring it home to our people that young people must care for their parents. I still say—I have often said so—that young people who do not care for their aged relatives, who do not accept responsibility for the aged, have no future in this confused world. It gives them certain values they can rely on. They still have contact with their parents. They can still have them in their homes. Many of us have had this experience. Eventually, however, the time comes—I say this to the hon. member for Sea Point—where it is no longer humanly possible to care for one’s parents. Therefore we shall examine the whole aspect. I think we shall certainly be able to make considerable progress in this field on the basis of the report still to be submitted by the department.

A number of members spoke about the aged and praised the Year of the Aged. The hon. member for False Bay referred to deputations which had come to me through him. I just want to read some extracts from one or two letters. Receiving this kind of letter really makes one’s work worth while. It actually surprised me that the hon. member for Edenvale, who is the chief spokesman of the official Opposition on pensions, did not say in either of his two speeches tonight that he thought the formulas we had worked out and the amounts we had allocated for pensions this year were really worth while. He did not even comment on this. To me it seems that this was a case where silence about a specific subject actually contained an element of praise. Perhaps he simply could not bring himself to praise the Government for having done something for the aged this year.

The day the budget was introduced, one Mr. Mike Pienaar phoned me. He is a prominent person in the northern suburbs. He used to be mayor of Bellville and one of the most honourable school principals I know. He has reached an advanced age. He is one of those who retired before 1969. He was the leader of a deputation which included Mr. Stimie, secretary of the Committee of Retired Teachers, and Mr. Van der Westhuizen from the False Bay constituency, which came to see me about the problem of the “older generation”, as they call themselves. It was quite an experience to have an interview with four people who were all 80 years old or older and who simply stated the facts concerning one aspect after another. Subsequently I had talks with the private sector. I make no secret of this. I asked them how they would solve the problem. Then a person who lives in my constituency and who occupies a very high position in the private sector told me: “Why do you not try a basic percentage with a percentage for every year of retirement?” The hon. the Minister of Finance and I accepted this.

Mr. Mike Pienaar phoned me at 10 o’clock that night. He was pleased and said that this proved that the Government still cared for the aged. The membership of medical schemes is going to cost a further R10 million a year—R5 million this year, because it is half a year. We must first get the administrative side sorted out. We must negotiate with the funds to ensure that they will be covered by medical schemes. They will be fully covered and will not have to contribute anything. The Government will pay the contributions, and the people will be able to go to private doctors and hospitals, where at the moment they still have to pay their doctors out of their pensions or stand in line at provincial hospitals. We want to give these people back their self-respect and to prove that the Government cares for the elderly people who built up this country.

As I have said, Mr. Pienaar phoned me that night. He asked me to convey his message. He did not want to have a long conversation. He just wanted to express his thanks on behalf of the deputation. In a letter, the secretary of the Committee of Retired Teachers expressed his appreciation for the 10% plus 1% plan. He went on to write—

I have also received a letter in this connection from Lt.-Gen. Fankie Rossouw, national chairman of the League of Ex-Policemen. He corresponds with me regularly. He writes to me and explains his problems. Then I refer them to the commiteee and the department to be dealt with. In this way, there is an exchange of information which can be useful in drawing up the budget. He wrote—

He also wrote—

I want to refer to one more letter, which was also received from a person who had been a member of the deputation. This was Mr. Van der Westhuizen of the Strand. He wrote—

The finest sentiment is conveyed in the following words—

So this elderly person feels that he is now being recognized as an individual, and that he is no longer merely a member of a group for which a flat percentage of 10% or 15% is being provided. He can say that he is getting 10% plus at least another 20% or 30%. I want to have the contents of these few letters recorded, and in addition, I want to make it clear that we are not going to forget about the aged from now on. We have not set aside a year for the aged merely as a gesture. If anyone wants to refer to it as merely a gesture, I want to submit that it is actually no more than right that we should have done it. However, we cannot suddenly say goodbye to the aged now and then sit back, waiting for the next Minister to attend to their problems again.

In co-operation with the S.A. National Council for the Aged, this department has organized a national conference in Johannesburg from 13 to 16 September this year. The theme of the conference will be “the aged in modern society”. It will be known as the Southern African Convention for the Care of the Aged. It will serve no purpose if we neglect these matters in the future. We must continue to give attention to them. At a conference about the aged in modern society, many of the ideas expressed here tonight will be voiced again. All hon. members who are also members of the various discussion groups on health are present here tonight. I therefore want to request them to take the opportunity of participating in the discussions at that conference from 13 to 16 September. It will provide an opportunity for a concerted attempt by all of us to enable elderly people in South Africa to spend their last years free from any political interference—if we want to call it that—and also free from the need to travel by bus to protest meetings, free from anything which could prevent them from enjoying the last years of their lives.

The biggest problem I foresee in the future is the increase in the number of elderly people and the simultaneous decrease in the number of young people. In this respect, the Department of Health and Welfare is setting a very good example. Some time ago I visited the head office of the department. In the section dealing with pensions, some of the staff are pensioners who are experts in this field. The eldest among them, whose name I saw on a list there—unfortunately I did not meet him personally—was 76 years old. He was still doing temporary work because he was still strong and healthy enough. Nonetheless, he is already 76 years old. Perhaps he is an exception. However, there are a great many people between the ages of 65 and 70 years who certainly do not need to sit back. We are setting an example by employing these people.

Helen is 76, after all, and she is still very active! [Interjections.]

What are you saying there?

I say I like your hairstyle. [Interjections.]

Mr. Chairman, I believe it to be the duty of the Government to keep trying to improve the quality of life of these people. Therefore I hope that we shall be able to do so in the future.

There are a few other matters I should like to reply to.

†The hon. member for Edenvale quoted from the report of the inter-departmental committee of 1980, and made the interesting point that we may have talked at cross purposes regarding the question of a national pension fund. I do not believe we have been talking at cross purposes. We have only expressed different opinions. The hon. member stated the case for the PFP saying they were in favour of a national pension fund run by the Government. That has been their policy until now. In all the discussions we have had so far across the floor of this House I have stated that the Government cannot run a national pension fund. I paid a visit to America last year and saw for myself the absolute chaos reigning in the American so called Social Security, which is a government-run pension fund. That fund went completely bankrupt and the President Reagan had to suspend many of the benefits enjoyed by members in order to balance the books. We are not interested in a national pension fund run by the Government. We are interested, however, in a scheme of the nature mentioned by the hon. member for Edenvale. In fact I stated that last year. That is that the private sector should come along with a reasonably simple type of pension; not a complicated pension scheme with numerous variations. They can form a consortium of funds which people can join once they start paying. However, there are other conditions, as the hon. member mentioned. We have first to ensure that we carry out the recommendations of this Interdepartmental report. It was unfortunate that it so happened that the question of transferability of Pension Contributions had to be withdrawn. This was mainly as a result of agitation that was set in motion where our Black population was brought under the impression, especially the workers, that the Government was going to steal their pension contributions. The agitation was successful because we very nearly had strikes on our hands because of it. As I say, this question of transferability was withdrawn but it will be considered again in the near future. I have already indicated to the hon. member for Brits that the PFP will support me if I take this matter back to the Cabinet and ask them to reopen the question of introducing legislation affecting the transferability of pension contributions. The hon. member for Edenvale nods his head so I take it that that is the policy of the PFP in this regard. I undertake to do this in due course in consultation with my colleague, the hon. the Minister of Finance, under whose jurisdiction the bulk of such legislation will fall.

I have already replied to some of the other questions raised by the hon. member for Edenvale such as the position of the aged in the community. The hon. member made the point that he thought the time had come when we should encourage the public to take provision for their old age in this way. The hon. member did not say that the public should be forced to do this but I feel there must be some sort of compulsion. However, one must then have transferability of pension contributions from one scheme to another without making it possible for these large amounts to be withdrawn. I think that that is going to become an important factor in the time that lies ahead.

The hon. member for Brits also referred to the question of transferability and stated his standpoint on the matter. I shall not elaborate on this.

He also mentioned the drop in the number of orders made in the Children’s Court. In his view, progress is being made in the social field, and he is of course an expert on the subject. I have made an announcement concerning the congress on the care of the aged, and I hope this will also tie up with the proposals he made and with his remarks concerning the package for the aged. I think we shall also have to see in the future whether we can influence the municipalities to do something about the payment of municipal rates by the aged. The hon. member for Meyerton also referred to this.

The hon. member for Meyerton and I are now seated on opposite sides of this House. However, I must be very careful, for when he praises me now, I must mind my step, or I might be shown the door as well. In English they say that it might be the kiss of death. I thank the hon. member for the kind sentiments he expressed. I am actually very sorry that we had to part on such a note at one stage.

I hope that our elderly people will experience great joy and happiness in the home for the aged at Meyerton.

Willie will come back to the NP. [Interjections.]

His proposal concerning the appropriation of R5 million as a subsidy for elderly people living in their own homes or in rented homes is interesting. We are looking for solutions, because it is our policy that the aged should be kept in their own homes as long as possible. We must give them the opportunity of doing so. We succeeded last year in obtaining more funds from the hon. the Minister of Finance for the purposes of nursing and social services that are made available to the aged at their own homes. I had long discussions in America with the department in President Reagan’s administration which deals with this matter. It is interesting that in that country they call it a “chore service”. They also have groups in that country like the ACVV and the Women’s Federation in this country, but there, such groups are subsidized to employ people who go to the home of an elderly person to make his bed, to do his dishes and to enquire whether there is anything else which that person requires, as would have been the case if the elderly person had employed a servant. Such tasks are performed for the aged every day. In this way, the care of the aged is taken to the homes of the aged.

If we want to introduce a similar system in this country, we shall have to examine the question of municipal rates and the payment of water, electricity and sanitation tariffs, as was said by the hon. member for Meyerton and by another hon. member I am still coming to. I do not think we shall be able to eliminate the payment of such taxes and tariffs altogether, but we may be able to reduce it. It may have to be done by subsidizing the local authority. I cannot say at this stage what will be done, but I am sure that we shall bear this in mind, and every year, when we deliberate upon these things, we shall see whether we cannot introduce some improvements.

The hon. member for Middelburg and the hon. member for Meyerton praised the role played by the churches in the care of the aged. I believe the hon. member also made it quite clear why the increase in social pensions is not taking effect in April, but in October. There has been representations asking us to change the date from October to April. We could consider this, but there are certain problems. Perhaps we shall just have to push the matter through in a more prosperous year. The only thing that worries me is that once we have changed the date to April, representations may be made for us to put it forward to the previous year. One could go on in this way until eventually one would not know which came first, the chicken or the egg.

The hon. member for Middelburg also spoke about civil pensioners and expressed his thanks and appreciation for what was being done for them. He referred in particular to the medical scheme, and I thank him for his kind words. I think the Government did as much in this case as it was actually capable of doing at this stage.

The hon. member for Durban Point raised a few matters, and complained, among other things, that pensioners were not afforded enough time to keep pace with the rent increases.

†This is very obviously a problem that I very often do not know how to combat. One cannot bind the private sector by telling them that because a certain person is aged, he must be housed at a lower cost.

The hon. member also raised the question of increasing pensions in certain areas to R200 or R300, on a differential basis, but I do not think such a system will be completely acceptable to everybody. We will, however, have to find some way of getting past the problem.

It can be done by way of a housing allowance.

The hon. member say we must give a housing allowance. This is something which we can look into. There are many ways of tackling the problem. We know the problem—we have heard it again from the hon. member this evening—and we will see whether we can possibly do something about it. I do not have the solution to the problem this evening, but we will have a look at the suggestion of the hon. member. The hon. member did mention what Natal is already doing. Some of the other provinces also do that.

The hon. member also expressed his appreciation for the work of the department and raised the issue of taking in more staff. The department has actually devised a system whereby we will shortly be scrutinizing and evaluating all social pensions applications from our various regional offices, from where information will be sent via an on-line computer link to our head office in Pretoria. It will not be necessary any more to transport all the forms to and from the regional offices and the head office in Pretoria. Once the regional office has dealt with the application, the necessary information will be put on the on-line computer, and that is that. We hope thereby to save a lot of staff at head office and make more use of our staff in the particular regional areas. The matter has already been put to Treasury, and as soon as we get the necessary money we will be able to carry on.

The raising of pensions is based on the consumer price index, but that again, as I have said, only solves the problem if everything else stays equal. It does not solve the problem if somebody suddenly increases rent by 50%.

Mr. Chairman, may I ask the hon. the Minister this question: The hon. the Minister mentioned the increasing number of pensioners, but there is one group which is decreasing—1914-18 war veterans. Seeing that this year the youngest of them will be 80 years of age, will the hon. the Minister not consider exempting World War I pensioners from the means test?

Mr. Chairman, I can give the hon. member the undertaking that we will look into the matter. It is a matter of seeing what the figure is and how many there are. We will get the number from the relevant authorities and service leagues and we can then look into the matter. I am quite sure that this is possibly the time that one should attend to that.

It is only their just reward.

Yes, we will look into that.

*The hon. member for Parys paid a moving tribute to the aged, and he also used the beautiful expression “the pride of our people”. I have been to his constituency and I want to tell him that I was impressed by the number and the quality of elderly people living there. There must be something in Parys except, as the hon. member says, that it is a paradise with all those rivers. He waxed lyrical about it, but perhaps they are all moving there because the hon. member must be one of the most active members as far as helping pensioners is concerned. It seems to me that his representations are usually successful.

I also want to refer to the question of foster-care. There is an inquiry being conducted at the moment into the care of children in institutions in terms of the Children’s Act. As soon as this has been completed, I believe we shall be able to appoint a committee to examine the question of foster-care. It is one of the problems which one is always faced with and which is also giving us some headaches at the moment in terms of the new Children’s Act. I shall discuss it with the organizations concerned from time to time. The hon. member furnished some very interesting figures which I do not wish to repeat. However, I want to thank him as well for his kind words to the department and the officials. It is always gratifying to know that there are members in this House who are prepared to rise and to say that they find the officials courteous, obliging and energetic when it comes to handling matters. It makes one feel good to be a Minister with such officials.

I want to thank the hon. member for False Bay for the kind words addressed to me personally, as well as for the pension formula that has been devised. I also want to tell him that the contribution which he made with regard to the aged will certainly not go unnoticed by the aged in False Bay. His contribution with regard to the ideal of home care will be very clearly recorded in Hansard. He referred to a change of emphasis from cold institutions to care within the community. As I said earlier, the hon. member’s speech simply supported our policy. There must be service centres and outside services and the aged must be kept active for a longer period. I think those suggestions will be considered at the conference in September and I hope the hon. member will also have time to attend it. At the end of his speech he said that the aged should not be written off. I hope that during my period of office, and even afterwards, no Government will ever dare to write off the aged. They cannot be written off, for how can one write off one’s past? They are part of our past, even though they are still with us in the present.

†The hon. member for Parktown again raised the point about the year of the nurse. I replied to that a bit earlier when I spoke in the Welfare debate. He also mentioned the problems we have with staff in the mental health services as well as the distances people have to travel to acquire these services. These are matters we are paying attention to at the moment. I personally feel that a large number of our mental health patients who are at present still housed in institutions such as Towers, Komani and Port Alfred could be housed closer to their own homes. We have approached the private sector to see if they will not erect institutions because the price that the Government has to pay to erect institutions is very large and we can only erect a limited number of institutions every year. We are doing this in the area that he actually saw.

The member also mentioned the question of prisoners and detainees and asked whether the department accepts the Tokyo declaration.

*It is included in our guide which we send to the doctors. However, there is a later one. That is the Lisbon Declaration. Every time the World Health Organization meets, they bring it up to date. We subscribe to the code; our medical practitioners subscribe to it and we advise them to subscribe to it.

†The hon. member also referred to section 6 of the Terrorism Act in regard to detainees. I discussed this matter fully in the presence of the hon. the Minister of Justice, the Commissioner of Police and members of the executive of the Medical Association just a few weeks ago. They were satisfied that the department was doing its job correctly. One must realize that the detainee is not detained just because he is found doing something wrong. They are people who are being specially investigated because of the possibility of their being a danger to the State. They have to be examined, questioned, etc., but there are certain regulations that are laid down by the Police. For instance, on arrival they are immediately seen by the district surgeon. After that they are seen at regular intervals at their own request by the district surgeon who is either called by them through the Police or through the inspector of detainees. The district surgeon also makes his regular rounds in order to see that they are all in good health. I think the one problem—and this problem was again illustrated this evening by the hon. member for Houghton—is that over a period of time the district surgeon has been dragged into the political arena and he has actually been discredited.

*The district surgeon who has to see to these people today is regarded as a thug. Either he is ignorant or he is in collusion with the Government or he assaults the prisoners. One would think that this was the task for which the district surgeons were appointed. Hon. members should rather regard the district surgeons as colleagues, as people who have a free hand. If a district surgeon has examined a detainee and he wants to call in a specialist, he has the right to call in a private specialist in terms of the instructions to the Police. This happens every week, every month. Every time one talks about this, the hon. member for Houghton shouts: “What about the Biko case?” One of the doctors in the Biko case was a private specialist. He was not a district surgeon. Why does the hon. member have to revile the district surgeons who were there as though they were a bunch of thugs? I think we should try to let this matter take its course. The executive of the Medical Association, who had come to see me, indicated that they were very pleased with the talks and that they had left with greater clarity in their minds. I think they may have more appreciation in the future for what actually happened.

I have already dealt with the lack of social welfare workers in my reply to one of the other hon. members.

I thank the hon. member for Rosettenville for his contribution. He made it quite clear that a national pension scheme was not a part of our policy. Perhaps he did not spell out the reason for this. The reason is that it tends towards socialism, and it is not working in other parts of the world either. The hon. member spoke about Germany, France and the USA, where it is not working. He made it quite clear that this was not our ideal. We shall not evade our responsibility, but neither do we want duties imposed upon us which in my opinion could not be satisfactorily performed or would just be a millstone around our necks.

I have already referred in part to the hon. member for Nigel. I want to thank him for his kind words, and I am sure that what he said at the end of his speech, namely that one of the problems of the aged was their loneliness, indicated one of the things we must try to combat. Local communities must be involved, and we have even advised local communities and school children to adopt some of the elderly people and to visit them at home every day or every week to talk to them. The friendly face of a child could remind an elderly person of his or her own childhood.

The hon. member for Nelspruit, if I remember correctly, spoke about the moral and legal duty. I fully agree with him that it is the duty of young people to care for their parents, and I immediately want to pay tribute to the thousands of young people who do this. We tend to hear only of those parents who are rejected by their children, but there are many thousands who are cared for by their children, and I know of many children who do this under difficult circumstances. In addition to their own families—which in many cases include small children—they care for their parents as well.

I have already replied to the questions put by the hon. member for Edenvale. The hon. member for Pietersburg had a second turn to speak, and he spoke about support for measures which are in the national interest, and I thank him for his contribution.

The temporary hon. member for Pietersburg.

The hon. member for Swellendam dealt with the hon. member for Park-town in connection with the only discordant note in the debate. However, I do not wish to conclude on a discordant note tonight. The hon. member has the right to ask such questions, and I trust that he accepts my replies. I believe that if a medical practitioner is enabled to do his work properly, and if he does this, there is nothing to prevent the district surgeon from ensuring that the people concerned, the detainees, receive the best treatment. I am personally aware of many cases that have been referred to specialists in recent months. I have seen the list, and I have discussed it with the Medical Association as well. I am now referring to the list of people who have been examined by medical practitioners as well as by specialists, and there is no complaint under the sun which has not been diagnosed in detainees and for which they have not been treated. One is actually surprised at the fact that the patients have received such comprehensive treatment during their detention, for there have been cases where teeth have had to be filled, and many other ailments. I want to emphasize at once that no one in the Government believes that those people should receive poor medical services or that anything should happen to them as a result of poor conditions there. The purpose of their detention is to interrogate them, so this does not mean that they should receive poor medical services under those circumstances.

The hon. member for Swellendam also expressed his thanks for the aid rendered to people in the disaster-stricken area. I want to thank him and all the MPs in the disaster-stricken constituencies, because they played an important role in keeping the people calm and conveying their problems to me.

†The hon. member for South Coast raised the question of a State lottery. Once again the answer is no. [Interjections.] While I hold the portfolio of Health and Welfare there will not be a State lottery, but should the Cabinet hold a different view it is up to them to introduce or sanction such a lottery. One cannot compare a State lottery with casinos or anything of that nature. [Interjections.] I investigated the State lottery system in Ireland, and found that it is not what it is made out to be. Ireland derives very little money from State lotteries for its hospitals. In fact, Ireland has a very poor hospital system. [Interjections.]

The hon. member also asked that the income level for the aged should be raised from R200 to R300. I have already referred to that matter. [Interjections.]

*I want to convey my thanks once again to all the hon. members who have participated in the debate, also for the pleasant atmosphere in which it was conducted in this House. I trust that we shall be able to conduct the debate under similar circumstances next year in the interests of health and welfare, for these are matters to which we all attach great importance.

Vote agreed to.

Business interrupted in accordance with Standing Order No. 22.

House Resumed:

Progress reported and leave granted to sit again.

reported that the Standing Committee on Vote No. 4—“Manpower”, had agreed to the Vote.