as Chairman, presented the Third Report of the Standing Select Committee on Trade and Industry, dated 19 August 1987, as follows:

Bill to be read a second time.

Mr Chairman, I move:

Agreed to.

Mr Chairman, the Ministers’ Council of the Administration: House of Assembly has the responsibility, as provided by the Constitution Act of the Republic of South Africa, to render inter alia health services to a specific section of the population. That section of the population includes the voters of each of us in this House. This afternoon’s debate therefore concerns health services rendered to that group of voters, their children and grandchildren, who are represented in this House by us.

The establishment of departments responsible for health services in the respective Ministers’ Councils provided the opportunity for the restructuring of health administration as a whole in South Africa. The result of this was the new health plan which was announced on 14 August 1986. This new National Health Plan also provided an opportunity for a more dynamic development of the health facilities plan which was accepted by the Cabinet in 1982. The National Health Facilities Plan is classified into six levels. The first level deals with the basic needs of sewerage, drinking water, waste removal and food supplementation. The second level is that of health education, which includes training, education and counselling as important components. The third level is that of primary health care, which centres mainly around self-care, community nursing services, community health centres, as well as community health organisations. Levels four to six are concerned with hospitalisation. Level four comprises community hospitals, level five regional hospitals and level six academic hospitals.

Health services of the Administration: House of Assembly has the full responsibility for levels one to three, viz the provision of basic subsistence requirements, the health education element and the primary health care of the White population.

†Primary health care is a wide-ranging concept. Services rendered as part of primary health care are, at present, the following: Antenatal care; children’s clinics; the control of infectious diseases; school health services; geriatric services; family planning; immunisation; caring for the aged; and especially health guidance, among others. These services can be rendered in a community health centre, a mobile clinic or even at home by visiting community health nursing personnel.

*As far as hospitalisation is concerned, the Administration: House of Assembly has power of disposal over 44 hospitals countrywide. A list of these hospitals can be found in Annexure 1 of the annual report. Because of factors of cost-effectiveness, the Administration: House of Assembly delegates powers to the various provincial administrations with regard to the management of these hospitals.

It is important to realise that this department is responsible for the appointment of the medical superintendents of these hospitals, although the superintendent will remain on the provincial administration’s establishment. This also applies to the chief nursing officer and the secretary of the hospital. The ministerial representative of the Administration: House of Assembly will play an important part in this connection.

The various provincial administrations will make an estimate of the operating costs of these hospitals and submit this to the Ministers’ Council of the House of Assembly. The Ministers’ Council will budget for the financing of these hospitals. The provincial administrations will make a comprehensive report to the Administration: House of Assembly on the expenditure in respect of these hospitals on an annual basis in terms of the provisions of the Exchequer and Audit Act, Act 66 of 1975. The Commission for Administration and the implementation committee have completed their work in respect of clinics, community health centres and school health services, and the transfer of these functions takes place on 1 October this year.

The Department of Health Services of the Administration: House of Assembly is represented on the Advisory Committee for Health Affairs by its Chief Executive Director. Allow me to avail myself of the opportunity to thank the Chief Executive Director, Dr Slabbert, for his services in this and in other connections. This Advisory Committee for Health Affairs is served by various subcommittees, which make important inputs that are conveyed to the National Health Policy Council. There is a subcommittee on staff matters, mental health matters, dentistry, nursing, the promotion of health, health statistics and epidemiology, ambulance services, nutritional services, health services for the aged, academic hospitals, privatisation and financial matters and health legislation.

The National Health Policy Council consists of the various Ministers of Health Services and Welfare in the Ministers’ Councils with is the Minister of National Health and Population Development as its chairman. The National Health Policy Council co-ordinates and formulates those aspects of health which affect all population groups. It follows, therefore, that the National Health Plan ensures the rendering of a co-ordinated and balanced health service. Those health services which are most closely concerned with community life are the responsibility of the various Ministers’ Councils.

Allow me to dwell for a moment on an important facet of this service, viz health care for White scholars. The school health services render what is primarily a screening service. In this way children’s health problems are spotted at an early stage and health factors which may have a detrimental effect on their education process are diagnosed and dealt with.

An important facet of the service consists of a health education campaign which encourages a healthy lifestyle. The eventual goal is a more comprehensive service in which all facets of living and health will receive attention. Through this kind of approach it will be possible for the essence of health, viz physical, mental and social welfare, will be able to receive attention as a whole and to be furthered among the children in our schools.

At present the service is rendered by the provincial administrations of the Orange Free State and the Transvaal. In the other provinces the service is rendered by the Department of Education and Culture. There is an agreement with the Transvaal and the Orange Free State that the service will formally be transferred to the Administration: House of Assembly on 1 September 1987 and 1 October 1987, respectively.

The service is rendered by a team of doctors and nurses and there is a programme according to which schools are visited. The total number of pupils in the schools in the respective provinces who are involved in this programme is 100 095 000. This is a very important preventive health service which is being rendered to White scholars.

I want to pay tribute today to those men and women who rendered this important service in the past and are still doing so.

When we look at the cost of the health services of the population group the Administration: House of Assembly is responsible for, we are struck by the fact that when the public has a case in connection with the cost of a doctor, a dentist or paramedic services, this member of the public can make representations to the SA Medical and Dental Council. When a member of the public is concerned about his chemist account, he can make representations to the Pharmacy Board; when a member of the public is concerned about the account of a chiropractor or homeopath, he can make his representations to that statutory board, but when a member of the public is in a private hospital, he has no body to turn to. We have 113 private institutions, with 8 441 beds today. For that reason I want to make an announcement which I consider to be an important one.

The Department of Health Services and Welfare of the Administration: House of Assembly, as the registering authority for private hospitals, is aware of complaints about the fees charged and the service rendered by certain private hospitals. In talks with the society which represents three quarters of all private hospitals, it was clear that this association was also concerned about excessive fees and problems with the rendering of service by certain private hospitals. In fact, this association—as I said, it represents three quarters of all private hospitals—has already established a disciplinary committee which is investigating complaints in this connection.

I want to point out to hon members that the Browne Commission recommended that the Department of National Health and Population Development should have a statutory responsibility to investigate complaints about the rendering of service and excessive fees charged by private hospitals. It appears from talks between officials of the Department of Health Services and Welfare of the Administration: House of Assembly and officials of the Department of National Health and Population Development that a supervisory and controlling body, which may even be a statutory board, could be established in terms of section 44 (1) of the Health Act, Act 63 of 1977, to deal with this matter. It is envisaged that interested parties could be represented on this body either directly or on a co-opted basis. The composition, functions, procedure and so on of this envisaged body will be discussed with the existing advisory committee for private hospitals, but I have no doubt that this body should be established as soon as possible to remedy this important deficiency. This will give the public the opportunity, if they feel that the rendering of service in a specific private hospital is not as one would wish or that levying of fees by private hospitals is exorbitant, to make representations to a body which can take the matter further.

I give hon members the assurance that this body will be operational before the end of the year, because this is a very important matter which must receive attention. I have no doubt that the private hospitals in South Africa render a very important service; in fact, in general they compare well with the best in the world. There are always those, however, that exceed their bounds, and that is why we need this body to which representations can be made and which will deal with matters.

Hon members could ask me what a body of this kind could do. If there were a case of repeated exorbitant levying of fees, the registration of such a private hospital could be cancelled.

†I have no doubt in my mind that we owe this to the public, because the society which handles and represents more than 75% of the private hospitals in this country feels that this is an important issue that must be dealt with forthwith.

*I want to conclude at this stage by expressing my thanks and appreciation to the Director-General of the Administration: House of Assembly, Dr Jooste, who retires at the end of November. Dr Jooste filled this post with great distinction. I want to convey my personal thanks to him as well as the thanks of the Department of Health Services and Welfare, for what he has achieved. He had a great burden to bear, but he did so very diligently. I also have great appreciation for his capacity for work.

In the same breath I want to welcome the newly appointed Director-General, Mr Wessel Meyer, who will fill the position from 1 December. I believe he will follow the tradition of the previous two Directors-General with the same distinction.

I have great appreciation for the contribution of the hon the Deputy Minister to solving the problems in respect of the registration of private hospitals, but I want to congratulate him in particular on this occasion on the fact that he became a grandfather last night. [Interjections.]

I shall conclude for the moment on that high note.

Mr Chairman, I request the privilege of the first half-hour.

We on this side of the Committee also want to wish Dr Jooste, who is retiring, continued success and good fortune in the future, and we also wish the new Director-General, Mr Meyer, everything of the best in his task.

I think the hon the Minister has made a very important announcement about something of great importance to the general public, namely a proposed body to which complaints relating to private hospitalisation may be directed, and which could also quite possibly even have the power to suspend the registration of a private institution. It is a simple fact that in all sectors of society there is that sector or branch of a profession which oversteps the mark and in relation to which there definitely should be some disciplinary powers.

The task of this hon Minister’s department relates to a specific segment of our society, namely the Whites. It is nonetheless clear from the hon the Minister’s speech that a restructuring process is still under way. Apart from the announcement in August last year, we find, for example, that the school health services in all four provinces have remained unchanged and that 44 hospitals still fall under the department, although their administration has been transferred to the provinces. As far as I am concerned, and in terms of the Constitution, hospitalisation is in any event pre-eminently an own affair. I shall come to that at a later stage.

It is sometimes difficult to keep track of the names and the responsibilities of State departments, which are changing so rapidly that one does not always know whether a particular health function is in the province of the department entrusted with own affairs or in that of the department in charge of general affairs. For example, only last year, during this debate on own affairs, we discussed health and welfare, which at that time incorporated social pensions. Now social pensions are under the auspices of the hon the Minister of the Budget and Welfare, and the Chief Executive Director of the Department of Health Services and Welfare submits his annual report to two Ministers of the Ministers’ Council in the House of Assembly.

A further aspect that is illustrated by the function and the responsibilities of this department is in fact the diminishing importance of the so-called own affairs health services as opposed to the increasing importance of the general affairs health services. We read the following definition of own affairs in section 14 of the Constitution:

When we look at Schedule 1 of the Constitution, we see that health matters comprise the following: “Hospitals, clinics and similar or related institutions”. These are pre-eminently regarded as own affairs, and hospitals in particular are own affairs. Initially it was also the case that if a hospital provided for the needs of 95% of a particular population group, that hospital would fall under the administration of the population group concerned.

This proposed arrangement was short-lived because hospitals—this was the aspect of health services that was indicated in the Constitution as being notably an own affair—are now in fact a general affair falling under the provincial administrations and therefore under the jurisdiction of a multiracial second tier of government. As the hon the Minister has indicated, there are other hospitals which still fall under this administration, but the provincial hospitals do in fact fall under the second tier of government.

Because some hospitals do in fact fall under this department, it is important that we should take a look at a certain bone of contention in regard to hospitalisation in particular. I think this was illustrated by a question the hon member for Parktown asked on 23 June. He asked whether any facilities or hospitals administered by the State were integrated. He asked, if this was not so, what the reason for this was, and if so, which of the facilities mentioned were integrated, and in which hospitals. The hon the Minister replied that certain facilities were integrated, and he mentioned a long list of facilities. According to the hon the Minister’s reply, that differs from one province to the next.

The hon the Minister said that those sectors that were integrated consisted of special units such as intensive care units and radio-therapy units. This applied, secondly, to clinical support services and, thirdly, to administrative and support services. I am afraid we were actually told a half-truth in this regard, because in the Cape, for example, numerous other hospital services such as out-patient services, casualty sections and even normal wards, are totally integrated. Surely the hon the Minister does not wish to deny that. He cannot, because the factual situation is there for everyone who visits such a hospital or who is admitted to one, to see. The July edition of the journal Medical News Tribune quotes the hon the Minister. I want to ask him whether it is correct that he reportedly said:

That is what is stated here; the hon the Minister may simply tell me whether it is correct.

He is shaking his head.

In other words, if this is correct, we must accept that it is the policy of the hon the Minister, and therefore of the Government as well, ultimately to have health services, and hospitalisation in particular, fully integrated. That is a situation which is totally unacceptable to our people. I want to illustrate this by quoting from a letter we received recently and referring to “forced racial integration at the Red Cross Hospital”, as the writer calls it. I quote from this letter:

These people were then referred to the non-White department. The letter goes on to state:

We have also received other correspondence in this regard, from the Cape too. For example, someone wrote to us regarding the position at Victoria Hospital. I quote from that letter:

The writer of the letter went on to refer to the incidents of friction which could inevitably arise. He enclosed, with his letter, a cutting from Die Burger in which it was reported that the MEC in charge of hospital services had said the following in reaction to a question contained in a letter from the executive committee of the University of Cape Town’s medical faculty, which was reportedly published in the latest edition of the S A Medical Journal:

It would appear, therefore, that some confusion exists in relation to the specific policy of the Government in this regard. According to this MEC, the Government has a specific policy in regard to the care of patients at all provincial hospitals. I think the hon the Minister should spell out clearly to us what the Government’s policy is in this regard.

The CP’s policy in this regard is very clear. We say that if there is one domain which ought to be reserved for an individual population group, it is that of the sick who need the nursing and the care of their own people the most. From every vantage point, this is the best option. It is the most acceptable option, because this does in fact form part of a group’s own way of life and customs, and it is precisely this terminology that is used in section 14 of the Constitution.

I want to ask a second question, and this pertains to the medical care of our aged. In recent times quite a number of changes have been introduced in relation to certain services which have traditionally been directed at the underprivileged, the pensioners and other aged persons. The annual report also refers to the services of the district surgeons and the posts that are open to them.

The first problem I want to highlight is that of the dispensing of district surgeons’ prescriptions. We have received various complaints in this regard, particularly from pharmacists. Let me quote, for example, from a letter a physician wrote to a pharmacist:

I made some enquiries at the Pharmaceutical Society, which informed me as follows:

Needless to say, the pharmacists are quite rightly very upset about this. I quote, for example, from a letter from a pharmacist:

I want to ask the hon the Minister what the specific arrangement is and how this can be reconciled with the privatisation policy of the Government. I want to know how, from an ethical point of view, the hon the Minister views the R35 per case payable to the physician and whether he is satisfied with such an arrangement.

A second matter I want to refer to, concerning the services of district surgeons render to the aged and the needy, is the fact that certain traditional tasks which were performed by the district surgeon, have been transferred and now fall under the Administration: House of Assembly. This now affects all social pensioners, the recipients of social allowances, those civil pensioners who have been declared indigent by a magistrate and other indigent persons or persons with chronic illnesses such as diabetes or epilepsy, with extensive long-term financial burdens, whose treatment has been duly authorised by the magistrate.

What is happening in practice? The hon the Minister’s department, for example, now provides a part-time physician at an old-age home at a certain time. Very often this is situated far from the city centre. Alternatively, these people have to go to the provincial hospital which is situated in another part of town, because only so-called general affairs patients may be examined at the traditional, central district surgeon’s clinic. General affairs patients, at this specific stage of our dispensation, are Black patients.

The district surgeon may therefore only see Black patients in those places.

What is even more disturbing is the fact that this district surgeon still makes his calls to remote little places, and here, too, he is not entitled to render his services or to provide indispensable medicines or prescriptions to White patients. Here, too, he may only see the so-called general affairs patients. These people generally live far away from the towns. Sometimes they live on a farm some 60 km to 70 km away. These people have become totally impoverished during the droughts of the past five to six years and literally have to count every cent of their money. Some of them have no transport whatsoever and must rely on a lift into town every now and again.

For instance, a case recently came to my attention of an elderly person who suffered from hypertension and who, as a result of this situation, saw fit rather to halve the dosage of his medicine in the hope that it would last until he was one day able to get to town again. Needless to say, Sir, that particular patient died of a stroke.

I want to appeal to the hon the Minister to ensure that at least an equivalent service is rendered to this sector of our White community, as was done previously. Even if these people are elderly, and even if they are poor, we still want to keep them on their farms for as long as possible. Therefore, if this situation is not rectified, it will prove to be an important factor in the further depopulation of our rural areas.

A further consequence of this is that, particularly in the smaller rural towns, there is an increasing concentration of White elderly persons. This is giving rise to an acute shortage of service centres and housing schemes for the aged. For instance, it has recently come to our attention that at Paul Roux in the Free State, where the local community has been battling since 1977 to have centres established for the aged, the membership of a service centre, which is being run from a private home, having been launched by the synod commission for poor relief of the Ned Geref Kerk, already amounts to 80. Now I know that the actual provision of these facilities is not the responsibility of this hon Minister’s department. The hon the Minister may nevertheless impress upon his colleagues that adequate facilities must be established in this regard. I have only referred to one isolated case. There are, however, many more places where these acute shortages exist.

Our White community is a rapidly aging community which is going to make increasingly heavier demands on this hon Minister and the Department of Health Services. That challenge simply must be faced because we may not neglect this responsibility. After all, these were the people who built up this country. We simply have to take care of them. It is our bounden duty to do so.

Finally, I just want to refer to a recent newspaper report. In this article the assertion is made that the State’s medical service is in a state of decline. I quote from a newspaper report of 15 August this year:

This is a warning issued by the Medical Association of South Africa. It goes on to speculate on the reasons for this. The report goes on to state:

I think this is a disturbing state of affairs, Mr Chairman, and I should like to hear the hon the Minister’s comments on this.

Mr Chairman, the hon member for Pietersburg has had a great deal to say about health and medical services being own affairs. That is true, of course. To a great extent this does fall under own affairs. One cannot compartmentalise these matters absolutely, however.

One must be frank and honest, though. While I am standing here, a by-election is taking place in hospital district 25 in Johannesburg. This election is being conducted on a party-political basis. There is a man—I shall mention his name—Mr Jack Dormehl, who was the CP’s candidate in Rosettenville during the recent general election. That former CP candidate is handing out rosettes and assisting the candidate who is representing his party in that hospital district at the moment. He is doing this with Blacks and people of other races. They are participating politics together there, Sir.

My argument is merely the following. The CP contends that health services is own affairs and should be compartmentalised. Why then are they—CP supporters—conducting a party-political by-election with Blacks and people of other races at this very moment? Surely that does not make sense.

What does the Government say? Must we integrate?

One of the hon members in the CP benches referred to the hon the State President and asked what about moral reasons. Those hon members must not talk about morality. They must not think it is possible …

What is the point?

The point is that someone who was a CP candidate is openly participating in mixed politics in this way. [Interjections.] He does not regard it as being an own affair, however. Is that not own affairs? That is my question.

Do you simply want to disregard own affairs?

Now that is an example of double standards!

Order!

If I am correct, it is that very hon member who spoke about morality, and by way of an interjection I said: “You people should not talk about morality. ” I can give a few other examples as well, but I think Sir, that you would rule me out of order.

It is an exceptional honour and a privilege for me to take part in the debate on this Vote for the first time as the NP’s main spokesman and as chairman of the NP study group today. It is also an exceptional honour to be able to work with the hon the Minister, who is a Minister of high repute. He has attained great heights in his professional capacity, is a very well-known gynaecologist and is world renowned for his research. He was also involved in South West Africa, where he was the Administrator-General, and he did good work in the sphere of human relations, from which the CP could learn a great deal. In addition it is an honour for me to work with officials such as Dr Slabber. He has also become well known in his field.

The motto of the Department of Health Services and Welfare is to promote the best possible overall health to the benefit of the whole population. I see that in the newspaper of 15 August, Prof Piet Cillié of Nasionale Pers suggested the following winning recipe to Nasionale Pers: It should be the first with the most of the best. Our motto is to provide the greatest possible number of people with the best possible medical care as quickly as possible, and, of course, the greatest possible number of people includes everyone. As far as this Vote is concerned, it is the White population.

The public can help us a great deal in this. One often gets the impression that people think only the doctors, the nurses or only paramedics are involved in health. The general public can play an enormous part, however. Members of Parliament can play an enormous part. I want to give only two examples. I am not going to elaborate on the one; at the beginning of the year we had the private member’s motion on population development, in which we emphasised the enormous part that members of Parliament could play in this extremely critical and important aspect of health. I can also refer to the 1985 annual report in connection with the very important part that this own affairs department has to play in population development. In other words, we do not only need specialists to do each of these things.

†I should also like to mention another example. Scientific breakthroughs during the past 3 ½ decades have uncovered much of the mystery that surrounded mental illness. We are now able not only to treat many of these illnesses effectively but also for the first time to prevent mental disorders and promote mental health. In other words, we can prevent and treat mental illness.

This modern approach applies to schizophrenia, depression and anxiety, Down's Syndrome, child psychiatry etc. Unfortunately, however, there is still a stigma attached to these conditions. Schizophrenia affects approximately one in a hundred of the population, but what makes it so tragic is that it occurs for the first time primarily in otherwise healthy adolescence and that without treatment most of its victims never recover. All too often the poor prognosis of schizophrenia is due to a delay in diagnosing and treating the condition.

*I must say here that I am not referring to schizophrenia, the political disease; I do not think one can do anything about that as far as certain gentlemen I know here are concerned.

You are talking about the PFP.

This is where the layman can help us to pass this necessary information on to the public and do away with this stigma that attaches to being treated for this sort of condition. The same sort of thing happened with cancer. If someone suspected that he had cancer he just did not want to go to the doctor whereas so many people could be cured.

*People are realising more and more that it can sometimes be cured and are going to the doctor in time. When someone realises that a member of his family is developing a psychiatric condition, he is often too shy to go to a doctor. I see, however, that people in America are proud to say who their psychiatrist is. I want to ask the general public to help us in this connection.

Another aspect that I want to refer to briefly is the Medical Association of South Africa. As hon members know, this association is a member of the World Medical Association. It is one of the few scientific bodies in our country which still has good contact with the world organisations. I see in a report in Die Vaderland of 6 August of this year that a delegation from the Medical Association of South Africa is going to a World Medical Association congress, in which the subject under discussion is the finalisation of and international guidelines on the ethical aspects in respect of in vitro fertilisation and embryo transplants. What is so pleasing is that the chairman of the Medical Association of South Africa, Dr Marais Viljoen, is also the chairman of the World Medical Association’s Committee on Social-Medical Affairs and is also a member of the Medical Ethical Committee. The point I want to make is that we can be proud of this association. I have said this before, but let me repeat that as a doctor with more than 25 years’ experience, I know a great deal about this country’s doctors and medical associations and I take my hat off to them. Just as the farmers in this House fight for the farmers’ interests, I shall—I know the country’s interests come first—do my best for the interests of the doctors.

In addition to the Medical Association of South Africa there is an association with the acronym Namda.

†Namda is much more of a political organisation than a medical association. In a publication on a certain congress held in Amsterdam in 1986—this was also publicised by the ANC—Namda said the following:

[Time expired.]

Mr Chairman, I request the privilege of the second half-hour.

I should like to congratulate the hon member for Langlaagte on his appointment. I hope he will still have that honour when I have finished my speech.

†I want the hon member for Langlaagte to listen very carefully to my opening statement and to tell me whether he agrees with it. I believe in racially integrated health care and sound national medical economics. I am committed to a totally apolitical national health profession. There is no doubt about it because if one analyses it, what is political about medicine? The basic decision any country has to make is whether it is going into a socialistic or a capitalistic medical dispensation. We shall always have a socialistic element in this country but every year we must try to make health care as cost effective as we can and that is a question of good, capitalistic, racially integrated management. Does the hon member agree with me?

I only have a problem with the first sentence and the last few words.

Does the hon the Minister agree with me?

I will answer you.

I quoted word for word what the hon the Minister said in an article in The Medical News.

[Inaudible.]

I saw no statement by the hon the Minister that he did not agree with the article. He need not feel too badly about it. I also contributed an article to this journal and the hon the Minister can look at my photograph if he wants to and read what I said. I stand by what I said. [Interjections.]

I should also like to define the word “hermaphrodite”. It means: A human being combining characteristics of both sexes; one person with both male and female sexual organs. It is derived from the Greek myth of Hermaphroditus who became one with the nymph Samalcis. It is well known that hermaphroditism is a lifelong hobby of the hon the Minister. He has published a book on the subject and I will not discuss with him his theories about the Wolffian and Müllerian ducts. He knows much more about it than I.

I wish to state that the hon the Minister is a hermaphrodite Minister of health because he combines characteristics of both general and own affairs health matters. He is therefore a hermaphrodite Minister. Today this hon Minister of National Health and Population Development becomes one with the nymph of own affairs—Whites only “nogal”!

The hon the Minister must know all the problems of true hermaphroditism, such as the psychological, mental, identity crisis and health problems and many more. He is treated very sympathetically. The hon the Minister also knows that surgery is possible to establish the appropriate sexual characteristics. It is known as a sex-change operation. To prove this, we all know the story of the little boy who told his friends that his Aunt Cissie went to Johannesburg to see the doctor and came back as his Uncle Charlie.

When we read the numerous reports on the many problems in our health services, it becomes more and more obvious—and we have heard this from the hon the Minister and the chief spokesmen for the CP and the NP—that the Government needs to perform this political change operation on the hon the Minister as a matter of urgency, so that our Aunt Cissie of own affairs can become our Uncle Charlie of general affairs. [Interjections.]

The hon the Minister is also economically a hermaphrodite Minister. He is the head of a socialistic and a capitalistic department of health. I would like to refer again to the same article I mentioned before. He seems to be really in favour of a greater privatisation of health services making them more capitalistic, although he admits—I grant him that—the need for a social system in South Africa as well. He has stressed that whenever possible he has endeavoured to involve the private sector in health care development and the decision-making process.

My question to the hon the Minister is whether this is the Government’s policy. A few weeks ago I was astounded to hear the hon member for Bezuidenhout making what I considered to be an ill-advised attack on our private providers of health services. I will not repeat everything he said, because I think he should be given an opportunity in today’s debate to repeat his accusations. However, it was obvious that he blamed some sections of the private sector if not the private sector as a whole for the escalating costs of health care, and was’ adamant that the private sector should not be allowed to dictate to the Government on health policy.

I repeat that I hope the hon member will take part in this debate so that he can state his views and give the hon the Minister in this House the opportunity to discuss his views on the input of the private sector providing health services in South Africa. I think he owes it to this House.

We take serious note of the recent statements by the Medical Association of South Africa. The hon members for Pietersburg and Langlaagte referred to this matter. In this report Masa stated that medical services were deteriorating rapidly because of unsatisfactory service conditions. They warned that the standard of patient care and the training of medical practitioners would decline to the detriment of the population as a whole. This is a serious warning, and the hon the Minister and his department must view it in a very serious light.

According to yesterday’s Business Day the hon the Minister responded by saying that he was concerned about the number of vacancies for medical officers in many hospitals. Hon members will agree that this is not good enough. The hon the Minister must tell us today what he plans to do about it.

I want to ask him what he is going to do about the frightening increase in the costs of health care. Every day we read about escalations in the costs of health services; increases in the price of medicine; increases in hospital fees. There are increases in every sector, and these escalating costs are causing concern. What does the hon the Minister plan to do about this?

Secondly, I want to know what he is going to do about the concern among medical personnel regarding their conditions of service. He knows their problems. He knows that they are concerned about their salaries; about research facilities; about the difficulty of going to other countries to attend congresses. The hon the Minister knows as well as I do that medical standards in South Africa will decrease if a free flow of information is not available from one country to another. He knows the pressure on South Africa and how difficult it is for us to get visitors from overseas. The Government, instead of encouraging overseas contacts is creating tax conditions which make it financially almost impossible for the medical profession of South Africa to attend congresses overseas.

Thirdly, the hon the Minister must tell us whether there is a shortage of nurses, doctors and other medical personnel in South Africa. This morning we heard statements by the department that there is no shortage of nurses in one place, while another place has 70% of the required number. Where in South Africa is there a shortage of nurses, and what is he going to do about it?

Fourthly, I believe that the hon the Minister must do something to stop the constant mud-slinging and finger-pointing among the various representatives of the health services who blame each other for the increasing costs of health care—doctors against dentists, dentists against pharmacists, pharmacists against medical schemes, medical schemes against private hospitals etc. The hon the Minister must do something to stop this. I know that the profession itself should also do something about it, but I think the hon the Minister and his department should take the lead. The department of the hon the Minister, I must say, also does not hesitate to point a finger at other members of the health services provision system.

I should like to suggest another operation to the hon the Minister to cure South Africa in this economic hermaphroditism. I submit to the hon the Minister that he excise the sharp division between the private and public health sectors in our country. I repeat that there is a sharp division between the private and the public health sectors in South Africa.

It is well known that the public sector in South Africa plays an absolutely vital role in South African health care. They train our doctors, our nurses and other medical personnel; they provide and do the research which is so vital to our country; they are responsible for prevention, promotion and rehabilitation and they also provide health care to the indigent and the old. They provide these vital needs in the South African health care system and, as the hon the Minister and the hon member for Langlaagte have said, they have been doing so to the highest standard possible.

The problem is—we hear this everywhere—that this standard is being threatened. They are being paid a pittance for this total devotion to duty and are facing deteriorating conditions of service and a lack of money for research facilities and visits to congresses being held overseas.

The hon the Minister knows that I have worked behind the Iron Curtain. Why has the standard of medicine there decreased so much? It has happened because of their total lack of contact with other countries and their medical practices and the difficulties encountered in the fertilization of medical minds through the cross-pollination of medical knowledge. It is essential that this is continued and the Government must encourage it and provide financial assistance.

The private sector, on the other hand, provides none of these services, but mostly concentrates on the provision of hospital facilities for expensive, high technology, First World medical care. We believe this is essential and is a need they must provide. They work in the private sector to enable them to do this and on the whole they are financially better off than their full-time brothers. Yet they have very few facilities for research, training, teaching and improving their knowledge.

Basically they are barred from participating in the education and other facilities in the public sector. As I have said, there seems to be a kind of medical wall between these two groups in South Africa, and the hon the Minister knows it as well as I do. I know about it because I have worked in both of these worlds. They are suspicious and wary of each other and, in fact, they resent each other. The hon the Minister knows it.

The answer to this problem must therefore be simple. Open both worlds so that there can be free movement between the private and the public sector in all the facilities of health services.

Why should there be such a difference between the two sectors? The hon the Minister has visited America. I worked at the medical school in Houston, Texas. Dr Debakey, under whom I trained, was the professor of surgery of the Baylor University. He also had a private practice. In America the training and teaching facilities are available to all; in fact, there is one system only. In South Africa we have this unbelievable need to differentiate, to cut up politically, economically the private, public and provincial health services—the list is never ending. Why cannot we have one system?

I would therefore like to suggest to the hon the Minister a few things that may be achieved by creating one system, as well as the advantages of such a unified system. I would like the hon the Minister to consider my suggestions carefully.

I would suggest therefore that we should attempt to open medical facilities to both the private and the public sectors. Both sectors must be allowed to use private as well as public facilities. I believe that is essential in South Africa.

I have said so already.

All right. The hon the Minister must be learning from me. He must have read my previous speeches, and I am grateful for that.

If we do this, it will result in more facilities becoming available and there will be a reduction in expensive duplication. The hon the Minister knows this.

Secondly, training facilities and material will be increased, and the hon the Minister knows about our problem in South Africa concerning training facilities and material. We have been warned of the growing scarcity of training material in many of our teaching hospitals, especially in White hospitals, whereas private hospitals can supply abundant material which is totally unutilised. There is no teaching taking place in that private domain. Students do not go there.

More than 90% of nurses are trained in State hospitals whereas training facilities for nurses in private hospitals are hardly utilised. Make these available to the training of nurses in general, and immediately facilities will be available to train enough nurses for the needs of South Africa. We should also make training of nurses totally interracial, in spite of what the hon spokesman for the Official Opposition said here today.

The conditions of service of the medical personnel will improve immediately. Allow the public sector personnel to have private patients and a private income, and allow the private personnel to have access to research and training facilities. Immediately most of the problems Masa mentions will be solved.

The private sector must be encouraged to contribute more health rand, so that the State’s health rand will be free to provide basic health facilities where needed. The Medical Schemes Act must be amended as a matter of urgency, so that the private sector can present various health care packages and have more freedom to provide medical cover for various groups according to their needs.

I believe an urgent meeting between the hon the Minister and the private and public health care sectors is necessary—and I again quote the hon the Minister—“to establish good, capitalistic, racially integrated health management in South Africa”.

I therefore appeal firstly to the hon the Minister and the Government to make the necessary policy changes to make this type of system possible. Secondly, I appeal to the medical profession and all health service providers to forget the past and to act in unison for the benefit of all our patients. Thirdly, I appeal to the public to ensure that they make provision for the necessary finances in order to provide for their own health needs, and not to abuse health care systems by making unnecessary demands. Fourthly, I would like Government to make it their policy that nobody is denied health care for any reason, whether it be financial, racial, or whatever.

Health care is expensive. It will become more expensive as modern health technology develops. Our patients not only deserve this health care, but they also must have it.

For these reasons I think the hon the Minister must effect the necessary changes.

Mr Chairman, the hon member for Parktown must forgive me if I do not deal with all the aspects he put to the hon the Minister here this afternoon. I have a high regard for the hon member’s skill as a medical man and I wonder whether our country could not do with more such competent people, particularly in the medical world. [Interjections.]

The quality of the health services rendered in this country is among the best in the world. I am honest and sincere in saying this, and I should like to associate myself with what the hon the Minister said in this regard as well. The demands being made on the Government, and the challenge of providing all the developing peoples in our country with adequate health services, are tremendous. The overall amount budgeted for 1987-88 in respect of health services is R2,2 billion. That sounds astronomical, but when one considers the tremendous need for health services, one realises that corners will have to be cut in order to make provision for everything. Two amounts, in particular, have come to my attention, namely the R32 million budgeted for research and the R46 million for laboratory services.

It is becoming ever more important, particularly in view of constantly rising medical costs, for increasing attention to be paid to prevention rather than cure. That is why it is so important for research to be done on an on-going basis in order to keep abreast of things, and for particular attention continuously to be paid to the development of effective preventive as well as curative medicines.

When one looks back over the past 50 years, one becomes aware of the fact that the dreaded children’s diseases such as polio, diphtheria and particularly whooping cough, have steadily disappeared from the scene. This has only happened as a result of the development of specific vaccines.

I should like to dwell briefly this afternoon on the dreaded children’s disease of whooping cough. It is highly contagious and was once highly prevalent, particularly before the Second World War. It was recorded in the old medical journals, and reference was made to it as early as 1578. It was particularly among children who were subjected to a poor medical, health and nutritional environment that this disease reached epidemic proportions and that death occurred on a large scale.

The illness is caused by the bacillus pertassus, which attacks the mucous membrane of the respiratory organs. It is accompanied by violent bouts of coughing, fever, vomiting and consequent exhaustion. Because no vaccine was available before the last World War, many children, particularly those in their first year, died as a result of this disease. It was only in the late forties that the so-called cellular or single-cell serum was developed.

This is manufactured from the dead cells of the bacillus pertassus. As is always the case with any foreign substance that is injected, a reaction takes place to a lesser or greater extent. In contrast to what happens in the case of certain children’s diseases, the mother does not pass her immunity to whooping cough on to her baby, and that is why it is very important for the baby to be immunised within its first year of life. In our country a baby is given a combined injection against diphtheria, tetanus and whooping cough at the age of three months. In South Africa the vaccine is manufactured by the SA Institute for Medical Research and complies with all the safety standards laid down by the World Health Organisation.

It was interesting to read that in 1970 certain cases occurred, particularly in Britain and the USA, in which one child in 100 000 developed the so-called “West Syndrome” after being inoculated with a whooping cough serum. This is a type of epileptic attack which manifests itself in a characteristic fashion. The head, neck and limbs bend forward in the so-called “salaam-position”. The child who develops this syndrome also suffers brain damage. Many of the vaccines were taken off the market, particularly in Britain, Sweden and Japan, and were not generally administered. This was done because the public had begun to build up a resistance to this cellular vaccine.

It was a Japanese man by the name of Yogi Satu who began to research the development of a safer vaccine. He developed the so-called “acellular” vaccine by isolating and detoxifying the antigens. This vaccine was introduced in Japan as far back as 1981 and to date 2 million doses have been administered to children, at the age of two years or older, without any detrimental affects. The costs are high because this is a new vaccine, and for this reason some people are not willing to use it on a large scale.

With the support of the World Health Organisation the Swedes also began to develop their own acellular vaccine. They have just begun to use their vaccine as well.

Britain still uses the cellular vaccine, but this is available only on demand. I find it interesting to note the influence the British Royal family has on the entire way of life of the British people. I was also touched when I read recently that Prince Charles and his wife Diana had had their children inoculated against whooping cough in order to show the British people what confidence they had in the whooping cough vaccine.

We are still using that vaccine in our country. The question now is whether we should not also take a closer look at the development of an acellular vaccine against whooping cough. However, it is better to have a vaccine for general use, so that whooping cough will not occur on an epidemic scale in our country, than to protect one out of 100 000 children by not using the vaccine. Health, and particularly that of our children, is the most precious thing one can have in life. If one is not healthy, there is not much sense in living.

The reason why I have shown such an interest in all this is because I have a case of West’s Syndrome in my constituency. For that reason I simply felt that I should like our Government, and particularly our health departments—for which we have the highest regard—to pay constant attention to the development of this latest vaccine.

I should like to close by quoting what Isaac Walton said in 1653:

Mr Chairman, it is a particular privilege for me to take part in this debate for the first time. What is more, it is a great privilege for me to follow upon what was said by the beautiful hon member for Edenvale. I think she made a very substantial contribution and made a very interesting speech on the whooping cough virus and vaccine. I want to congratulate her on her contribution.

In the present economic climate there is a definite need for us to make a sustained effort to effect savings in all areas. There is also a constant need to guard against excessive cost increases, including hospital costs—since we are discussing them today. We must at all times provide the general public with hospitalisation at the lowest possible cost, without the quality of the service rendered suffering in any way as a result. I am only too aware of the fact that the provincial authorities, as well as the hon the Minister and his National Health Policy Council, are doing everything in their power to effect savings in order to continue rendering this indispensable service. In spite of this, it recently became necessary again to increase hospital fees quite considerably. In some instances they were increased by as much as 100%.

There is a certain matter which, in my view, should receive the urgent attention of the authorities. I am convinced that it could result in large savings for the State. I first want to make it very clear, however, that the matter to which I am referring only applies to White hospitals, because the discussion of this Vote is an own affairs matter. I shall therefore not refer to other hospitals.

I should like to refer to the under-utilisation of beds in the White hospitals. It appears from statistics that the bed occupancy rate in both regional and community hospitals varies between as much as 97% and as little as 23%. It is also evident from the statistics that the bed occupancy rate in community hospitals, in particular, is extremely low.

According to the 1986 census there were 365 000 White aged over the age of 65 in the Republic at that time. In 1985 the relevant figure was 388 000. This figure will, in all probability, double within the next 10 to 15 years. Apparently this also applies to the health service needs of the aged.

There are very limited funds available at the moment for the building of new old-age homes and hospitals for chronic cases, in which the frail aged may be cared for. I see that Sanca announced in the Press last week that at present there are 353 000 alcoholics in South Africa. This figure is steadily increasing. There is also a great need for institutions in which these people can be treated.

Furthermore, trained nursing staff countrywide are overburdened. The upshot of this has been that the chronically infirm aged, who in actual fact only need good care and not specialised nursing, can no longer be treated in the normal medical wards, particularly in the regional hospitals. This kind of care could just as well be given by assistant nurses.

When one takes all these factors into account, as well as the fact that some of the community hospitals have an adequate infrastructure and are sufficiently well equipped, and in some instances also have enough nursing staff, I want to make an earnest appeal to the hon the Minister today to launch an investigation into the possibility of using some of those unoccupied beds for the care of the frail aged and possibly also for alcoholics. I want to appeal to him to instruct his department to search for a workable formula to facilitate the co-operation of the provincial authorities and the Department of Health Services and Welfare so that those smaller hospitals may be used for more than one purpose.

There is also the constantly rising number of drug addicts, whose needs will have to be catered for to an increasing extent in future. This brings me to a matter I raised in my maiden speech, namely the excessive use of medication. As I said, the general practitioner is today being swamped with requests for prescriptions for medicines, because, today after all, there is a pill for everything. There is a pill for those who want children and a pill for those who do not want children. There is a pill for those who want to eat and one for those who do not want to eat any more. [Interjections.] There is a pill for those who want more energy, and there is a pill for those who want less energy. [Interjections.] There is a pill for those who want to sleep, but there is also a pill for those who want to stay awake. There is a pill for those who want to calm down and one for those who think they may be too listless. It is specifically the excessive use of the drugs in the latter two categories, namely sleeping pills and sedatives, the so-called “tranquillisers”, that I am particularly worried about. You will note, Sir, that I have said that there is a pill for those who want to slim and for those who want to sleep more soundly. In other words, these are drugs which the patient usually asks for because he wants them, and not so much because the doctor thinks he needs them.

According to MIMS—that is the index of ethical medicines for prescription, compiled for physicians—there are at the moment 32 different sleeping tablets, 64 different sedatives, 50 different anti-depressants and 96 different combinations of analgesics and sedatives on the market which may be obtained on prescription. There are also many others which may be freely purchased over the counter. In other words, literally millions of these dangerous drugs are being used monthly.

These drugs are just as dangerous as the vile smoking habit and the excessive use of alcohol. [Interjections.] This scourge normally begins very innocently, but because most of the drugs are highly addictive, they are used in ever-increasing doses over increasingly longer periods.

I greatly appreciate the SABC’s sound policy of not advertising cigarettes or tobacco, but I now see that another bugbear is raising its ugly head. I am referring to the advertisements for sleeping draughts and sedatives on television. I should like to issue a friendly request to the hon the Minister concerned to ban these advertisements too if possible.

In conclusion, I should like to quote from an article which appeared in Die Burger of Saturday, 15 August 1987. It deals with the drug aid centre in Observatory, and reads as follows:

I believe this proves that my statement was correct.

Mr Chairman, I have been listening carefully now to the hon member for Welkom. I appreciate his having had to say so much about pills. I know that we are still searching for one pill, and that is the pill we want to give the NP so that they can return to partition. [Interjections.]

This afternoon I want to talk about the wealth of our people, wealth far greater than the value of gold and diamonds. I want to talk about the wealth of children. A person and a people can get along without gold, but never without children. Without children we are on our way out. Fortunately there are many happy families in South Africa. We know that the family is the soul of a people. We also know that there is a tremendous onslaught on the family today, particularly from the communist world. Break the family, they say, and you break the people, because if one breaks the family the child has no safe place in which he can be nurtured.

Fortunately the State and the Church have never failed to do their duty. We think of the many children’s homes, which were formerly called orphanages. In the past the churches in particular devoted special attention to the children who no longer had a parental home. In particular we think of the Abraham Kriel Children’s Home, in regard to which the late Rev Abraham Kriel performed an act of faith after the Anglo-Boer War when under very difficult circumstances, he gave the orphans whose parents had died in that war a future.

For that we as a people, and particularly as Afrikaners, pay tribute to him this afternoon. We also think of the great ’flu epidemic of 1918, during which many children ended up in children’s homes because their parents had died. So successful were these children’s homes that there are even hon members sitting in this House of Assembly today who grew up in children’s homes. The department wishes to stimulate child and family care in order to enhance the quality of life of families, and that is why we are grateful that constant attention is being given to the preventive services offered by the department to keep families healthy.

Auxiliary measures are being introduced in many spheres to serve as a support for the family. In this the department is not alone; there are many welfare organisations, church societies and other organisations that cooperate to enhance the quality of life of the family and to cause it to flourish. Nevertheless we still have the tragic circumstances which compelled the department, during the past year, to order 2 834 juvenile court enquiries, and in the process 1 986 children were removed from their family context. Fortunately these figures show a decrease compared with the figure for 1984.

Some of these children were placed in foster care. At present there are approximately 7 500 children in foster care. Consequently I want to break a lance this afternoon for every family that provides foster care services. Personally I have frequently seen with what love and patience foster parents treat these children. I myself have seen how a family took in homeless children, virtually picking them up out of the ashes; how these people are building the nation of tomorrow. One is truly grateful to know that there are still many families with open doors and open hearts for these children.

Mr Chairman, I have also seen what sadness can prevail when a foster child has to return to his own home after a few years, or when he has to take leave of his foster parents. The ties which were so close are then severed. A mother who was like his own mother to that child must then tear herself loose. I wonder whether the hon the Minister would not, at some stage or another, institute a committee of enquiry into the circumstances which sometimes arise when a family has to be torn away from the foster child it has looked after for so many years. One of the most heartrending moments I have ever personally experienced was when I had to witness such ties being broken. That is why I welcome the appointment of a foster care committee, which is being established by the hon the Minister to investigate all aspects of foster care, for example the recruitment and selection of foster parents, as well as the placing of children in foster care.

I also want to say a few words about our children’s homes this afternoon, which were formerly known as orphanages. Nevertheless there are very few children who are true orphans in the sense that both their parents have died. The statistics on true orphans at two large children’s homes at which I made enquiries, reflect a total of approximately 2% or 3%. There are 74 children's homes that are being run by churches and organisations, in very close co-operation with the department. The number of children at these children’s homes is approximately 5 600. I am now referring to the children who are resident in these children’s homes.

Lately the emphasis has moved from the large diningroom and the large living area to the so-called home atmosphere. This afternoon I want to request the hon the Minister to please try to develop and improve this system of a home atmosphere, in which 10 to 15 children are placed in the care of house parents. The house father works during the day, as all fathers elsewhere also have to do, while the house mother holds the fort at home. In the evenings parents and children are together around the so-called family table, facing life’s vicissitudes together.

One of the best children’s homes is that of the AFM in Johannesburg. The inhabitants of each home consists of the house parents and approximately 10 children. Life simply goes on as if it was a normal family. What a splendid example of therapy! What a fine example of healing the frequently deep wounds inflicted on children’s hearts in the conditions from which they were removed, and moulding them into something splendid and noble!

It costs anything up to approximately R500 per month to accommodate a child in such a parental home atmosphere. The State subsidy is R344,50 per child per month in these, one could almost say, parental home clinics. This afternoon I want to make an appeal to the State to do everything in its power to render assistance for structural purposes at the older children’s homes such as the Abraham Kriel Children’s Home in Langlaagte, and also to pay attention to the increased tariff brought about by family care. Perhaps the subsidy will have to be available the moment a position of house parent is filled.

It is a fact that these organisations do not have a great deal of money; sometimes they exist on donations they receive from generous persons and organisations. Consequently they do not have the funds available to fill these posts immediately, and hon members know that the State requires posts to be put into operation first, as it were, before paying out any subsidies. This afternoon I want to ask the hon the Minister please to re-examine this position of house parent, and in particular give attention to the question of the older institutions that have to undergo structural alterations which entail heavy expenditure.

We also know that the State, for example, makes funds available for a period of up to 40 years at 1% interest, and we think it is a fine gesture on the part of the State to help these children, and also to help the organisation to continue with their work. Consequently we want to ask the State to take an in-depth look at the position in regard to the funds that have to be appropriated for these parental organisations, so that every day there can be more joy in the hearts of children who sometimes had to endure bitterness and sorrow in their lives.

What has been said about agriculture remains true: A people that looks after its agriculture, looks after its own future. Nevertheless I think there is another great truth, perhaps even greater than the one that applies to agriculture: A people that looks after its children, looks after its future. I hope that this department together with the parents and the organisations that perform this labour of love will build for the future for our children’s sake.

Mr Chairman, the hon member for Welkom intimated here this afternoon that he knew all about pills—all kinds of pills. Now I just want to tell that hon member—I do not know whether he knows it—that a doctor may not advertise in that way. Fortunately it is Wednesday afternoon, and the doctors do not have consulting hours on a Wednesday afternoon; otherwise he would probably have been inundated by hon members asking him to fetch them the pills they were seeking. [Interjections.]

I have no fault at all to find with the matters which the hon member, who has just resumed his seat, touched upon; on the contrary, I am ad idem with him about everything he said. I want to congratulate him on his speech. He began with a bit of a detour when he spoke about the pills which the Nationalists should drink. What worries me is that the pill the hon member for Pietersburg is prescribing for the CP is a pill which makes them so confused that they do not know whether they are coming or going. [Interjections.]

I should like to express my sincere thanks to the hon the Minister, also for his words of congratulation. I just want to add that if one reaches the stage in which one is a member of the red carnation club, it means that one has nine grandchildren. I just wanted to correct that for the record.

I want to tell the hon the Minister again that it is a privilege for me to work with him. He is literally and figuratively a man of stature. He is a professional—as has already been said here—and an administrator par excellence, and it is a pleasure for me to work with him.

I also want to refer to the officials. A finger is so often pointed at public servants, but when one has the privilege of working with them, as I do now, one is not only impressed by their administrative expertise and the fact that they are equal to their task in the true sense of the word, but also by the goodwill and helpfulness among them, for which I am truly indebted to them. One can learn a great deal from books, but goodwill, helpfulness and the ability to co-operate and to want to cooperate, comes from the heart. I have very great appreciation for that, and I thank them very sincerely. I also want to convey what I have just said to my personal staff, who mean so much to me and with whom it is such a pleasure to co-operate.

I am not going to reply to all the hon members, because the hon the Minister has more time than Deputy Ministers do, and will probably reply to each hon member individually. What the hon member for Pietersburg said, ie that we are engaged in restructuring the department, is true. It is also true that we are experiencing problems. We also stated in last year’s debate that we were experiencing problems with the practical implementation of the new system. We are going to prove to the hon member, and keep on doing so year after year, that we want to, and are able to, give substance to the own affairs concept in terms of the Constitution. I want to agree with the hon member for Langlaagte that absolute compartmentalisation is simply not possible. We know that very well.

As regard the hon member for Parktown, I do not want to become personal. There are always so many questions in his speeches that it is not possible to give attention to all of them. Then, too, there is a touch of arrogance which is not hidden away at all. The biggest problem I have with the hon member for Parktown, however, is that he suffers from an extremely malignant ailment, viz negativism. Never in all the time I have been listening to him speak in this House, has he ever mentioned anything good that we have achieved with health services.

Like what?

He has never mentioned the reduction of the death rate among newly-born babies in our country as proof of the great work that is being done in this connection. Of course we have many problems, but we shall get round to them. The hon member said virtually the same thing a former member of this House, Mr McIntosh, said. In the past, during a discussion in a debate on own affairs health services, he said that the Whites would have to accept hospitalisation that was not organised on a racial basis. I want to ask the hon member for Parktown whether he agrees with such a statement.

Yes, it is already the case in private hospitals. That is right; that is how it ought to be.

In other words, it must apply throughout?

Yes.

In other words, it is in line with the open society policy of the PFP. What happened? How does one assess whether the policy one has stated is acceptable? One does so by means of the voters. What did the voters say when the PFP put forward the open society policy? The voters rejected the PFP, and did so in no uncertain terms. [Interjections.]

In practical politics one must come back to the reality. The PFP will know nothing about that in any case, because they have never been in the seat of government, nor will they ever be. In practical politics one must take historical group formation into consideration, and we cannot get away from that, because from that a need develops among people to live their lives in their own context. When they fall ill, they want to be nursed in their own context. [Interjections.]

I want to add that the condition for the rendering of service must be acceptable to the community. This has nothing to do with apartheid, superiority or discrimination. I therefore suggest that the medical care system, which we should like to expand as much as possible, should be directed at the needs of the population group we want to serve. If one takes an honest look at the needs of the various groups and communities, and analyses them carefully, it becomes clear to one that through the application of differentiation it is possible to create an own administration covering the entire health spectrum of prevention, cure and rehabilitation, and which can in this way serve the specific communities. [Interjections.]

In respect of the services rendered to all the population groups, I want to tell the hon member for Parktown that the Government accepts that a large sector of the population will not, for the foreseeable future, make provision for possible medical expenses. These persons will remain the responsibility of the State. I want to repeat what my colleague, the hon the Minister of Health Services, has said repeatedly in this House and elsewhere, viz that no one—this is the fear he expressed—will be denied medical care because he cannot afford it. There is no doubt about that.

I want to congratulate the hon member for Langlaagte sincerely on the position he occupies as chief spokesman, and on the contribution he made this afternoon. I shall let that suffice, and raise another matter.

The debate we are conducting this afternoon happens to coincide with the National Dental Health Week. I think it is fitting that we also divided attention this afternoon to preventive health services.

†In the final report of the Commission of Enquiry into Health Services it is stated that the commission’s enquiry revealed the following as a practical shortcoming:

In its response in the White Paper the Government agrees with this view and it reiterates its commitment to the National Plan for Health Service Facilities. The plan contains several very important principles which can be summarised as follows: A shift of emphasis from the sick person to the healthy person; regard should be had to the total need of the human being; services should be increasingly community-oriented; and a shift of emphasis from curative to promotive and preventive care.

These principles, if applied, have the basic ingredients for meeting our fundamental objective of health care, and that is the striving for the psychological and physical well-being of all the inhabitants of the Republic of South Africa.

The imbalance in and the shortcomings of our system of health care are, however, still apparent from the fact that of the total budget for health services, only 4,7% is devoted to preventive services. The Government has therefore decided to take steps to ensure a balance between curative and preventative services; between hospital-centred services and community-centred services; and between facilities for the provision of primary, secondary and tertiary care.

To achieve these health care objectives the Government has decided to follow a standard procedure for obtaining funds to finance all Government health services in South Africa. All Government health authorities will negotiate funds for specific objectives on the basis of the national health policy and priorities set by the National Health Policy Council. In future all budgets of health authorities will be channelled through the Health Matters Advisory Committee to the National Health Policy Council for consideration.

*It is clear that the Government is in earnest about health services developing in a well-balanced way. Thorough planning, coordination and constant evaluation of services rendered are of cardinal importance. I want to repeat that we will constantly keep on taking a fresh look at our list of priorities. Everyone who is in need of funds from the Government, must know that the allocation of funds is a matter which receives responsible consideration.

The funding of preventive services is a long-term investment in the interests of health, and consequently the positive results of preventive services are frequently only noticeable over a period of years and are not as dramatic as the frequently life-saving effect of curative services. However, we can already see positive results in the sphere of preventive services. I want to refer to two areas of priority in the department, namely nutritional guidance and dental preventive services.

Nutritional guidance is one of the tasks assigned to the department in terms of the provisions of Schedule 1 of the Constitution. I do not want to refer to the daily activities of the department in this connection, but I would like to refer to two long-term projects, namely the coronary risk factor study, known as the Coris Project, and the Vanderbijlpark information project in regard to health, obesity and coronary risk factors, otherwise known as the Vighor Project.

The Coris Project in the South-western Cape is specifically aimed at developing a guidance programme in order to counteract the high death-rate associated with coronary heart diseases. The area was specifically chosen owing to the high incidence of known risk factors in the Afrikaans-speaking rural community. At the first survey there was already a significant decrease in the incidence of high blood pressure and hyper-cholestrolomy. The Vighor Project, on the other hand, is being carried out in an industrial area in which other factors, for example tension, play a more prominent role. The first survey in this connection is being envisaged for 1988.

What are we trying to achieve with these two projects? Together with the SA Medical Research Council and the HSRC, our partners in this project, we are trying to establish blueprints that are acceptable to the community. In both studies the professional inputs are progressively being reduced, and it is in fact becoming a community project. We hope that these communities will encourage other communities to launch similar projects. In this way it might be possible to reduce the incidence of the dreaded coronary heart disease. The provisional results in this connection have in fact been encouraging.

In respect of dental preventive services, the department has chosen the younger child as target group and is therefore concentrating in particular on primary and pre-primary schools. During the Year of the Handicapped, in 1986, particular attention was given to schools and institutions for the handicapped. Mouth hygienists play a key role in this preventative programme. They have become an indispensable link in this dental team and fortunately we see an increasing interest in training in this professional sphere.

I want to come back to preventive actions. Remarkable results have already been achieved. In 1976 25% of five-year-old White children were free of caries. It increased to 40% in 1980, and 55,9% in 1986.

†As I have already mentioned, this debate coincides with the 15th National Dental Health Week. This week has become an annual institution organised by the Dental Association of South Africa and, during the third week of August, the importance of oral health is propagated throughout the country by means of lectures, posters and interviews on the media. This year the slogan is “Oral Health the Nation’s Wealth” or in Afrikaans “’n Nasie is ryk met monde wat pryk”.

In trying to propagate the importance of oral health, may I also plead with our dental colleagues in private practice to offer their services at branch level. They should carry the message to every school in their community that “Oral Health the Nation’s Wealth” is an attainable goal and not an idealistic dream.

*Unfortunately my information is that there are students at certain faculties that are not being allowed to participate in the National Dental Health Week. I cannot find words strong enough to express my displeasure at this behaviour.

†Political motives must never be allowed to persuade our students that they have no duty to the people. Service above self must be the motivating force behind every professional man. We as professional men owe it to the community at large. This commendable initiative by the private sector emphasises the fact that the private sector can and should become involved with preventive health, and the success of this week can largely be attributed to the close co-operation between the private and public sectors.

I have mentioned this week because I want to emphasise two very important principles that will certainly contribute to the success of this commendable initiative in particular and to the national health plan in general. This national plan is the formula for achieving the ideal of a comprehensive health service for South Africa. The two principles I should like to emphasise are that no health plan in South Africa can succeed without close cooperation between the public and the private sector; and that no comprehensive health service is possible in South Africa unless the private sector is also willing to become involved in rehabilitative, preventative and environmental matters.

Nobody underestimates the importance of curative health care, but we need a balanced, comprehensive approach to health matters if we want to succeed. We hope to report back in a positive way during the debate on this Vote next year.

Mr Chairman, I have neither the time, the knowledge nor the inclination to reply in any detail to what the hon the Deputy Minister has been saying this afternoon.

He said nothing.

I want to say only one thing to him, and that is that regardless of what the election revealed, I tell him that sheer necessity is going to make it necessary for the Government to change its health policy as far as integrated services are concerned. Not too long ago it was unheard of to have a Black patient admitted to a White hospital—private or otherwise—or to have Black nurses nursing White patients in private hospitals. Now they are nursing patients in State hospitals as well. All this is happening against the Government’s policy of separation of the races and of the services provided for those races. Let us therefore not be too dogmatic about the policies we are going to follow in this country.

I want to say one thing to the hon member for Langlaagte who had some very disparaging things to say about Namda. I want to tell him that if it were not for Namda the disgraceful behaviour of the two doctors who failed to treat Steve Biko in a proper manner would never have been brought to light by the Medical Council itself, neither would they have been punished. It was entirely due to the efforts of Namda that this did happen, and the hon member can label it political or whatever he likes—I call it justice, long delayed justice. [Interjections.]

I want to raise very briefly an important issue I have raised before without success with the hon the Minister and with his predecessor, and that is the need for the urgent review of the working and efficacy of the Abortion and Sterilization Act of 1975.

I wish to emphasize at once that when I give my views on abortion I speak in my personal capacity and not on behalf of the PFP, because this party has decided that the question of abortion should be left to a free vote. It is a highly emotive issue and it has some strong religious undertones. Our members vote as they wish to on the issue of abortion. I would hope that hon members on the other side of the House, as well as in the CP, for there might be one or two enlightened hon members there on this particular subject, would also be allowed a free vote on the question of abortion.

Secondly, I must point out that my views on abortion are well known, and that I believe the Act is badly in need of amendment and liberalisation, especially regarding pregnancy as a result of rape where there are ponderous procedures required, despite the hon the Minister’s reply to the deputation that saw him last year; regarding pregnancy in girls of 16 years and younger, something I am very much concerned about; as well as pregnancy in women with already large families, women who, to their dismay, find themselves having yet another pregnancy.

What is your definition of a large family?

I would say any woman who does not want another child is entitled to say so. That is my private view, and I have made it clear. Let us, however, say that any woman who has four children and does not want any more should be allowed to have an abortion without having to go through all these difficult procedures.

This is what I want—a judicial commission of inquiry to examine this question. Let them decide on the norm for a large family. I want an independent judicial commission of inquiry to go into the workings and efficacy of an Act which has been on the Statute Book for more than 13 years. Nobody has examined it in any detail in that period. I might add that I would obviously like to see a preponderance of women on this commission, unlike the case of the select committee on whose recommendations the Act was framed and passed. There was not a single woman on the committee. Can you believe that Sir? It was a select committee examining the question of abortion, and there was not a single woman serving on that committee! I think there should be a commission of inquiry headed by a judge, with the majority of members being women of all races, from the legal and medical professions, and social workers—people who work in this particular field all the time.

I think it is downright insulting that the Population Council which consists of 27 people has only two women serving on it. There is not a single representative of the Family Planning Association on it and, needless to say, there are no representatives of any organisation in favour of the liberalisation of abortion.

In May last year the hon the Minister received a high-powered deputation of women headed by Mrs Margaret Lessing, the director of the Women’s Bureau. It represented all the women’s organisations which the bureau encompasses, except the Catholic Women’s League—obviously for religious reasons—the Women’s Christian Temperance Union and the ACVV. These organisations were not represented, although the ACVV put in a memorandum the year before favouring a commission. They have changed their minds since because this new hon Minister with his overbearing manner has no doubt used his influence on them.

This hon Minister appears to be singularly lacking in insight because he actually informed me last year when I raised this matter with him by way of a question that the women went away very satisfied with the reception they had received.

That was not very nice!

On the contrary, they were deeply offended by the manner in which he received them—by the brush-off, in fact, which he gave them. They were furious with him.

I have no time to comment on the 17 paragraphs contained in the hon the Minister’s response to the extremely well-reasoned memo put to him by the deputation, but of course we all agree that raising standards of living is the major way in which to control population growth. That goes without saying—it is universally accepted. However, family-planning campaigns—this has been found in every country in the world which has gone into this sort of control—must be backed by a modern approach to abortion onrequest—notabortionondemand, mayIadd.

The hon the Minister’s memo also questions the veracity of the deputation’s submission concerning the alarming increase in the number of back-street abortions. He claims that hospital reports do not support the conclusions reached in the bureau’s memo that cases of removal of residues of pregnancy are in the main due to back-street abortions. There has been a steady increase in the number of such cases of removal of residues of pregnancy, from 28 500 cases in 1984 to 32 500 cases in 1985 to 36 000 cases in 1986—I give round figures.

More than half of these cases, according to the annual report of the department, relate to widows, divorcees and single women, and I would like to put it to the hon the Minister that such women are very “lucky” if indeed they have natural miscarriages. Over 50% of those cases refer to widows, divorcees and single women. Of the 1 282 septic abortions 67% were recorded for widows, divorcees and single women. Surely the hon the Minister will concede the strong probability that these are cases of induced abortion, and that the cost of treatment—antibiotics, blood transfusions, operations and post-operative care—is much higher than a more liberal legalized abortion policy would be. I should add that all these statistics are underestimates, because many of the disastrous aftermaths of back-street abortions never come to hospital, are never seen by doctors and are certainly not reported because of the illegality involved in self-induced abortions.

I hope the hon the Minister will give consideration to my request.

Mr Chairman, it is said that there is always a first time for everything, and today it is the first time I have had the honour—I am saying it is an honour—of following up on what the hon member for Houghton said. I must at least give her credit for the fact that her standpoint—I repeat that she said it was her own standpoint and not that of the party—on abortion on demand and “not on demand”, as she put it, is still precisely the same. There is, of course, a difference. I do not want to elaborate on that any further. In a previous debate, when I spoke about this matter, I put forward my view.

I want to come back to the question of private hospitals and the fact that, according to the announcement, a certain degree of control is now being envisaged, because I think that this announcement made by the hon the Minister has simply passed unnoticed. What surprises me is that the PFP, by way of its chief spokesman, did not say a word about this announcement. The hon member—I want to cross swords with him for a moment—said a few things to the hon the Minister which, in my view, were a bit extreme.

He said a few things to the hon the Minister about hermaphroditic phenomena, etc, which were not quite …

It is his Vote.

I know, but one does, after all, associate a good Minister with a good Vote. It is such an impressive Vote that one really does not want to raise petty political issues. It is really one of the outstanding Votes we have the chance of discussing here.

Apparently the hon the Minister’s announcement has completely passed hon members of the opposition by. When one looks at the question of private hospitals, one notices that there are two divergent views. On the one hand we have the patients, the medical aid funds and the SA Medical Journal with the following attitude to private hospitals, and I quote from Beeld of 21 July and Die Burger of 28 July:

Another important instance is that which is reflected in an interview Dr Retief himself had with Die Burger. I quote:

That is one view of the matter. The National Association of Private Hospitals, on the other hand, feels differently about this. I quote from The Natal Mercury of 9 December 1986:

I quote further from The Star of 3 June 1987:

I do not want to cross swords with the private hospitals this afternoon, because I regard them as a very important link in the whole chain of national health care.

But?

But they are not being quite honest when they say they cannot make ends meet. Permit me to motivate what I am saying.

Very well!

I have personal experience of this. In May 1981 we purchased a private hospital. We did so because we felt that as a medical aid fund private hospitals were exploiting us. I am specifically using these words. As far as possible we sent the majority of our patients to that institution of ours. By the way, it is an institution with 46 beds; in other words a reasonably large one.

What facilities does it have?

All the facilities except an intensive-care unit.

Is it a specialised facility?

I am coming to that.

We then made a few calculations about what it would cost us over a certain period if we took the patients we were treating in our own hospital—that is why I am excluding specialist care—and sent them to a private hospital. We calculated what the cost would be as against our actual costs. Over a period of five and a half years our savings paid for the capital costs involved in purchasing the hospital and for the equipment. We are as subject to departmental control as any private hospital. I do want to add that we did not include medicines in our calculations at the same tariffs as those applicable to the normal private hospitals, because then we would have been able to make our repayments over an even shorter period. We calculated them at cost price.

I just want to mention one further example. Hon members could possibly accuse me of trying to use one example to establish a rule, but I merely want to indicate what sometimes happens in private hospitals. A year ago we sent a patient, who was a member of the same fund I have just spoken about, to Johannesburg. He was treated in a private hospital over a period of 21 days, and I can furnish the hon the Minister with the names of both the patient and the hospital.

He was not in an intensive-care unit, but under ward care, because they had to prepare him for an operation and see that his condition improved before he went in for the operation. The patient died after 21 days. The account we received was for R13 074. The most significant aspect is that R9 000 of that amount was for medicines. Within 21 days a man who was ill used medicine costing R9 000. [Interjections.]

We, of course, queried this, and were subsequently given a credit of R1 500. One of the major reasons they advanced for the amount we were credited with, was that there were supposedly unused bottles of medicine left in the man’s bedside cabinet.

I am merely asking how a private hospital is run when those running it only discover, two months after a patient has died, that there is still some unused medicine in his bedside cabinet. This is merely to give the Committee some idea of what is happening and to motivate my contention that private hospitals are not being quite honest when they say that they cannot make ends meet.

The representative of private hospitals then goes further and says even more about the comparison with private hospitals. I am sure the hon member for Parktown is going to agree with me about this. It is stated:

I agree with that, and I am saying that before the hon member asks me whether I agree. What I have just quoted comes from Die Burger of Tuesday, 28 July, and the headline reads: “Koste van hospitale nie vergelykbaar nie. ” The report goes on to state:

That is true. He does not go on to state, however, that provincial hospitals have to make provision for costs such as ambulance services and training facilities, or that they have to provide for such facilities as staff housing and casualty wards. [Time expired.]

Mr Chairman, it is a pleasure for me to participate in this debate in the interests of the Ventersdorp constituency. In the first place, I should like to thank the Director-general and his officials for the annual report which they have prepared and made available to us.

Since elderly White persons are primarily reliant on district surgeons for medical assistance, it is a pity to see in the annual report that vacancies exist for district surgeons. Consequently I want to appeal to the hon the Minister to take positive steps to get those vacancies filled so that only the highest standard of medical services can be rendered to our elderly people.

There is another matter in this connection which I should like to bring to the attention of the hon the Minister. It is a matter to which the hon member for Pietersburg has already referred in passing, and which affects both elderly persons and pharmacists in the rural areas intensely. As hon members know, the TPHS is at present engaged in negotiations which boil down to district surgeons making medicines available to less affluent and aged patients. This system has already come into operation in Witbank, Middelburg and Lydenburg without pharmacists officially having been consulted in the matter. The same is now happening in the Western Transvaal.

According to the pharmacists in the Western Transvaal, and in particular in the Ventersdorp constituency, such a system is not to the advantage of the patient, and for the following reasons. In the first place the treatment of most patients who are at present receiving treatment, particularly the chronic cases, will have to be curtailed or drastically changed to fall within the limits of the permissible minimum costs. In that way the principle of value for services falls away.

Secondly, because the medicines are going to be provided by district surgeons, the patients are being deprived of the basic services provided during the making-up of the prescription by pharmacists. The pharmacist examines every prescription for irreconcilable aspects of medication and correct doses. In respect of each prescription the pharmacists informs the patient about the nature of the medication, medication-interactions, medication/food-interactions, the correct use of the medication and any possible side-effects.

Thirdly, the pharmacist keeps a whole spectrum of medicines in stock at great expense, to the benefit of the patient. Fourthly, the pharmacist stores and provides medicines in a professional, pharmaceutically correct way.

A very important service which the pharmacist also performs in the interests of the elderly patient is that he fetches the prescription from the patient, and delivers the medicine. This is done because most district surgeon patients are unable to get to the pharmacist, either for financial reasons or because of physical disability.

It is also important to note that the contemplated system of the TPHS is diametrically opposed to the findings of the Brown Commission and the Competition Board, in that services that have at present been privatised are, according to the new TPHS system, returning to the State. This is not a matter that can be ignored. It is a very serious matter, because if the envisaged system is put into operation in the Ventersdorp constituency, for example, it is going to have a direct effect on the pharmacists, the aged in particular, and the public in general.

The seriousness of the matter is apparent from the percentage of district surgeon prescriptions as a percentage of the total number of prescriptions in the Ventersdorp constituency. For the information of the hon the Minister I shall present him with the information briefly. Firstly, in the case of the Ventersdorp Pharmacy, it is 35%; of the Rhona Pharmacy, 32%; of the Hartbeesfontein Pharmacy, 44%; of the Jiggs Pharmacy, 30%; and of the Swartruggens Pharmacy, as much as 70%. It is clear from this that the viability of certain pharmacists in the rural areas will be jeopardised.

Together with the drought and the poor economic conditions this system could deal some pharmacies in the rural areas a final death-blow, and that could have far-reaching consequences for the rural communities. It will mean, among other things, that towns such as Swartruggens and Hartbeesfontein will no longer have certain professional services.

In order to support this statement, cognisance must be taken of the fact that approximately 300 Blacks per month consult pharmacists about less serious ailments. After the disappearance of this function of pharmacies, they will go to district surgeons. Pharmacists are consulted monthly by approximately 200 Whites, and approximately 800 purchase unprescribed medicines from the pharmacy. If the rural pharmacies are to disappear, it will contribute further to the depopulation of the rural areas, which will result in the security situation deteriorating, particularly in a town such as Swartruggens, which is situated in a border area.

Finally, if this system is put into operation, it could also lead to relations between the pharmacists and medical practitioners being marred. It is therefore an urgent matter, and I request the hon the Minister, in the interests of those patients and of the communities in their entirety, to give attention to it.

Another matter I should like to discuss is the position of the infirm aged. There are many infirm aged who, owing to their advanced age and the condition of their health, have to be taken up in institutions because their children or family members are no longer able to care for them. However, it is an impossible task to find such an infirm aged person accommodation in an institution for the infirm aged, because all institutions of this nature are full. Recently I tried to find accommodation for an infirm aged person in such an institution, without any success. All I could accomplish was to be informed that the name of the woman in question would be placed on a waiting list, and that she would be helped if someone died.

That is why I want to make a courteous appeal to the hon the Minister to put White hospital wards that are empty at present and are not being used at this stage—in this respect I have in mind a hospital of which I have specific knowledge, the Sybrand van Niekerk Hospital in Carletonville—at the disposal of the infirm aged, so that they can be accommodated and cared for there.

Another matter I am worried about is the fact that the Commission of Inquiry into Health Services found in its final report that many trained nurses are no longer active in their profession, and that the number of nurses entering the profession is increasing too slowly.

I want to make an appeal to the hon the Minister to give attention to the salaries of White nurses, because if the salaries of White nurses are made more attractive, trained staff that have left the profession might be persuaded to come back, and could easily lead to young White women entering the profession again. It would also prevent large numbers of trained White nurses being lured away to private hospitals with higher salaries.

Mr Chairman, I support this Health Services Vote which will go a long way towards streamlining our health and welfare services. I feel confident that under the capable direction of the hon the Minister of National Health and Population Development, the existing high standard of health care will be enhanced by the provision of a crisis intervention and suicide prevention service that will be able to meet the increasing demand for such a service.

In recent years the fastest-growing cause of death in South Africa has been suicide, especially the suicide of young people. I should like to thank the hon the Minister and his department for kindly agreeing to continue the services provided by the SA Suicide Prevention Centre, better known as Suicides Anonymous, which over the past 28 years has helped to prevent tens of thousands of suicides. This crisis intervention service should become a model for other organisations in other areas to emulate. At the same time, however, I should like to make an earnest appeal for the establishment of crisis intervention clinics—intensive care psychological counselling units—at major urban hospitals, and for the role of these clinics to be bolstered in the community.

Having been engaged for many years in suicide prevention and crisis intervention, I know what is needed, especially in the case of those suffering as a result of a serious disappointment in life or from a depressive illness. What is needed is timeous intervention. If people are helped in time they recover and do not necessarily ever have a recurrence of suicidal or homicidal impulses.

There has recently been a spate of suicides by schoolchildren who shoot themselves, and familial killings, a horrifying almost daily event. This gives cause for concern and we must act swiftly to remedy the situation, help to calm a person’s fears and provide realistic facilities where people will be able to seek help.

South Africa has a high murder rate, and all too often there is a link between murder and suicide. This is creating a mental health crisis in this country. Among the White population it is estimated that one in three people who commit murder go on to commit suicide, and half of all suicides have thought of committing murder.

*In 1982 the National Health Policy Council, the NHPC, took the following very important decision regarding the establishment of crisis services. The NHPC’s resolution No 60 of 1982 stipulates that wherever possible, services should be introduced in the casualty wards of provincial and departmental hospitals, where emotional crisis situations of a social or psychiatric nature may be dealt with.

†I was a founder member of the Crisis Liaison Committee which was established at Tara Hospital on 16 January 1985. This committee recommended the establishment of crisis clinics as part of hospital services.

A general hospital is geared to the preservation of human life. To this end, general hospitals have casualty sections which deal with medical emergencies and accident injuries. However, with few exceptions, special facilities do not exist in the casualty section of a hospital for the emotionally ill patient. This situation therefore perhaps contributes, unknown to the hospital authorities, to further attempts at self-destruction.

To help solve this problem the need for crisis intervention clinics arises—a walk-in centre offering a 24 hour service, with the facilities for short-term admission for persons who have feelings of despair and need help. The provinces were required, in accordance with the 1982 NHPC decision, and also in terms of the health legislation, specifically section 16 (c) of the Health Act, to provide services for acute psychiatric and crisis care. However, they have only done so halfheartedly. Some years ago a prominent psychiatrist of a large South African hospital wrote to a former director of hospital services telling him of the magnitude of the problem of suicide and emotionally troubled people in his hospital. I quote what he said:

A former director of hospital services replied as follows:

I can only describe this response as anachronistic and irresponsible.

Do we not sometimes hide behind red tape and ordinances instead of facing up to the urgent needs of the very people we serve? Health and welfare services cannot remain static. We must either adopt a dynamic, responsive and active preventive health system, or gradually sink into a drug-like stupor. Crisis services is the change that is required, and it costs money. Under the previous divided system of health services, where central Government and provincial hospital services were separated, these services were, for a variety of reasons, not implemented. In the new health dispensation provincial services fall under the central Government. We now have the opportunity to look at all South Africa’s health services together to set the matter right and to bring about the best level of services for this country.

One of the most difficult problems confronting people in what I call the helping professions—and that includes the police—is where to accommodate high-risk, temporarily emotionally emergency crisis cases—people who are in need of protection, observation and care until they can be admitted to an institution or return to their homes when they can once again cope sensibly.

At the same time, the cornerstone of crisis services today is the volunteer and voluntary organizations like Suicides Anonymous, Life Line or the few private crisis organizations. They have become the most important members of the team. Yet South Africa’s hospitals have not yet recognized a single volunteer involved in suicide prevention and crisis intervention.

Most South African hospitals do not yet have a crisis service of any form. We take it for granted that the physical crisis will be treated in the casualty department, but we remain relatively oblivious of the emotional crises of those undergoing stress that is usually the result of overwhelming emotional reactions to life events.

Depressive illness is now assuming alarming proportions in this country, yet millions of rand worth of tranquilizers and sleeping tablets are used instead of the correct treatment. A new phenomenon is the ready availability of a prescription for tranquilizers and pills with a drug effect. What effect this inappropriate use of drugs has on productivity has yet to be quantified, but it must surely run into many millions of rand.

I believe the crisis clinic concept will be a vital component that will take the load off hospitals and fill some of the gaps but, more importantly, serve as early-warning stations for psychologically troubled people. It must be borne in mind that suicide crises and psychological ailments have no respect for sex or age. The lonely housewife who goes to hospital with a physical complaint may in fact be suffering from the effects of stress due to the inability to cope with her home and her life’s problems. Many aged persons, especially pensioners, suffer from depression and are subjected to an additional burden by an uncaring society by now having to pay R2 for every hospital visit. I believe that this should be reviewed.

Whilst it is impossible to estimate how many people might have been turned away from suicide, homicide or crisis problems by hospitals which did not recognize the early-warning signs, I believe that crisis intervention clinics would help to fill a vital gap in our health defences. Although I see this type of crisis clinic as having a primary role to fulfil in hospital services, it can in fact meet a much greater need, namely serving as a safety valve to identify potential suicides or family crises and emotional distress thus showing that perhaps the vast majority of people go to a doctor or hospital just to have someone to talk to about their problems.

In other words, they may have an illness, but this illness is psychosomatic. Furthermore, an urbanised and industrialised society carries within itself the seeds of frustration and stress. The crisis clinics, to my mind, should be staffed by auxiliary health-service personnel and selected volunteers. Working together they need to be trained to recognise and interpret early-warning signs. Whether these have to do with potential suicide, child abuse, drug-taking, alcoholism, emotional problems or depression, counselling should be done on the spot and appropriate follow-through action be taken immediately.

It is my experience that the suicidal or emotional phase is usually of short duration, and most episodes could last from a few minutes to a few hours. Depression and suicide and human crises can strike at any hour. This needs a 24-hour service. I have known of many people who have taken their own lives because there was no one to talk to, no one to encourage them to go on, and nowhere to go to.

Just one final word to the hon member for Parktown, Mr Chairman, because my time is running out very fast. I put it to the hon member that he is putting my views completely out of perspective. I will talk about this matter where this should be done, viz on the standing committee. [Time expired.]

Mr Chairman, I gladly follow the hon member for Bezuidenhout. He is a man, I believe, who is well known throughout South-Africa as someone who has been very intimately involved in crisis care and crisis prevention. Since this is one of the three topics I want to touch on, I follow in fact upon what he has been talking about.

I believe we should all be tremendously concerned about the extent to which familial killings have occurred in South Africa since the final months of last year and throughout the course of this year. These family killings, characterised by one member of the family murdering the other members of the family and then committing suicide have, I believe, all the characteristics of what the hon member for Bezuidenhout will well know as the copycat syndrome. I am very concerned about this indeed, Mr Chairman. I believe that, following along the line which the hon member for Bezuidenhout has stressed and looking at hospitals as crisis-care centres, it well behoves this hon Minister to consider the role of his department in a tonal change. I think we are looking here at a need to get to the roots of society’s problems, or particular aspects of society’s problems, that bring about a situation in which family killings proliferate.

Unless we prevent this copycat syndrome things are in fact going to get worse. Every time we pick up a newspaper and we see that a father has killed his children and then his wife because of an impending divorce, it puts the idea into the minds of more people. This is a very worrying situation indeed, Mr Chairman. We actually have to address the root cause of the proliferation to which I have referred. I believe that in the case of this hon Minister—I am not dumping it entirely in his hands—there is an interrelationship between that and various other departmental concerns.

I should like to link that to another crisis area—that of child battering. I believe the whole child-battering syndrome in South Africa again has to be addressed on an interdepartmental basis. We cannot just leave it to Justice or Law and Order or Health and Welfare. It has to be viewed in its totality, and I suspect that we are actually going to have to look at a number of departments, including the departments of education, linking together to bring to an end this syndrome of child battering. When I speak of a tonal change in our society, I think this hon Minister could in fact give a clear indication to his colleagues and to South Africa of an area which can be addressed.

The second point I want to address is that of private hospitals. I am delighted with the hon the Minister’s announcement that a body will be established before the end of the year which will address or consider the matter of private hospitals. There is a particular aspect I want to address today which is that of the legal control of private hospitals. As I understand it, Sir, the legal control of private hospitals does fall under this hon Minister.

I want to obtain an answer here, through him, on the whole question of negligence. I have been involved in making certain inquiries on behalf of a particular case, which naturally I am not going to produce today. However, a particular legal precedent set in the Durban and Coast Local Division of the Supreme Court in 1974—the case of St Augustine’s Hospital (Pty) Ltd vs Le Breton - has led to a situation where cases of negligence cannot in fact be brought against the hospital perse, but have to be brought against the professional staff. If I may just quote from that finding, the judge, Mr Justice Fannin found that—

I am legally advised that the position arising from that situation is that if a patient wishes to proceed on a charge of negligence, he can in fact only bring it against the professional staff—the doctor or the nurse. He cannot bring it against the hospital. That may be a blockage that is peculiar only to Natal, since this precedent is from the Natal Division, but in my opinion it is one that should be addressed, since it does create a particular problem.

The third point I want to make is one that has recently been touched on in the Press. In the August 13 edition of the Natal newspaper, The Daily News, there is an article entitled “Big health care crisis looms”. This involves the whole question of the setting of the tariff of fees for consultations. Rams has set the rate for a consultation fee at R13,60, whereas Masa has recently recommended that this be raised to R27,00. Here again, all we are looking for is a clear indication from the hon the Minister to the public as to the progress that is being made in settling the whole dispute relating to medical schemes and matters such as consultation fees.

Mr Chairman, I shall not react to the previous speaker; I hope to follow him one day in the education debate.

*I should like to start by saying that I am participating in this debate as a consumer and not as a person who belongs to the medical profession or who has ever participated in it, except on those occasions when my title had been mentioned, and people immediately asked me for free medical assistance or advice.

I should like to talk about privatisation in the medical profession. There is a perception that privatisation, in whatever sector, will solve all our problems in this country as regards the economy. This also applies to certain expectations our medical practitioners themselves have. In order to look at the profession, it is in the first place necessary for us to consider the facts in this connection, and as I have said before people only take 25% of all the facts into consideration. Hopefully one can change certain perceptions a little so that they are in line with the realities of the situation.

Privatisation is not a new concept. In actual fact it is something we have looked at before and which has been applied in practice. Recently, however, it has again been deemed necessary to consider what aspects can be privatised in our country. It is also necessary for one to say at this stage that the increasing role of the public sector in the economy is not restricted to the RSA, but is in actual fact a phenomenon occuring in most other countries since the Second World War.

†The Government has no illusions regarding the fact that its share in the economic activities of this country needs to be curtailed in order to expand the activities of the private sector. This will in turn lead to greater discipline in market and price mechanisms, greater efficiency in the economy and a high economic growth rate. Every country has its own unique circumstances and it is therefore necessary to take into consideration the particular problems of South Africa.

In terms of privatisation in the medical field due consideration should be given to the large section of the population, estimated at about 75%, who are unable to pay for medical services. At the same time there is a large group of people who prefer to go to private agencies and have the ability to pay. Why not allow private enterprise to cater for these needs and lighten the burden of the State?

At this stage it is perhaps necessary to look briefly at what privatisation is and what is to be achieved by it. According to the White Paper on Privatisation and Deregulation it is the systematic transfer of appropriate functions, activities or property from the public to the private sector where services, production and consumption can be regulated more efficiently by the market and price mechanisms. The purpose of privatisation is to improve the performance of the economy through the more effective use of production factors, the optimum functioning of market forces and an increase in the percentage of net fixed investment in the private sector.

*Privatisation in the RSA cannot be compared with the privatisation of previously nationalised assets in other countries. The Government is inter alia not in favour of the sale of assets simply to obtain a non-recurrent income in this way. One of the most important prerequisites is that the strategy will be in the long-term interests of the inhabitants of the RSA. As regards medical services, it is particularly important to consider the underprivileged sector of our population. This also means inter alia that monopolies, which can so easily develop in the private sector, cannot be countenanced at all.

The leasing of underutilised facilities is a matter which can be considered. Another possibility is the farming out on contract where the private sector can render the service or perform the activity as well, more effectively or more economically.

One of the most important criteria for privatisation is that it must be to the longterm benefit of the taxpayer and the community as a whole. There are however also invalid criteria for privatisation, eg because of cross-subsidisation some profitable activities must be retained to carry other less profitable activities. This is unacceptable. An activity which has to be run at a loss in the public interest, should be handled in such a way that the consumer contributes the maximum amount to the costs, and only the loss which is then still suffered must be borne by the Treasury. I should like to refer to such a practical situation which can be looked into.

I am really speaking as a layman when I say that a prosthesis takes place when some substance or other is left behind in the patient. In practice it is provided that when such a prosthesis takes place, at this stage the patient will bear the costs when the costs exceed R100. Consumable items which are only used by one patient and which are not classified as a prosthesis are not specified. They are disposable, but in one specific kind of examination for example apparatus is used which costs R1 300. In a private institution fees are levied for every one of these disposable items. The profession should therefore also make provision for this and in this way save a considerable amount in respect of those sectors which cannot be privatised.

The second invalid criterion is that a service will be more expensive after privatisation. This argument is frequently based on the comparison of two entities which cannot be compared. In the case of public institutions such as hospitals—a previous speaker referred to this—services are frequently supplied at a price far below the actual cost. The large amounts which cover the fixed costs, such as the creation of the total infrastructure, are not taken into account. Only the calculating of total costs will make it possible to arrive at a scientific and responsible conclusion.

The basis of the department’s policy on privatisation is that the State will not build any more hospitals when there is insufficient proof of a particular need which the private sector cannot or does not want to meet. In addition the State, in co-operation with the private sector, wants to accept responsibility for the privatisation of health services. Cooperation and communication are the key words to implement this aspect successfully.

My personal research among medical practitioners has indicated to me that these people are very enthusiastic about privatisation. Nevertheless these medical practitioners are aware that they do not always have the expertise needed to establish a successful development and to run it successfully as a business undertaking. At the same time they also fear monopolies in the hospital services, particularly because they are also concerned about their underprivileged patients.

This again indicates to me that we must establish better channels of communication between the policy-makers and the medical practitioners. These people who are in the profession can probably point out certain things to us which can make a big contribution when we consider which sectors can be privatised and whether, more importantly, existing facilities and practices can be made more viable.

In the short time at my disposal I should like to refer to a few other practical situations. First of all I want to refer to the creation of day-hospitals. They need not necessarily be privatised. In some cities there are already private day-hospitals where treatment is given. These are cases where the patient is admitted at 7 a m and he regains consciousness so quickly … [Time expired.]

Mr Chairman, when an hon member speaks after the hon member for Kempton Park he must actually straighten his tie and see to it that he looks neat. If I had known that I would have to speak after the hon member for Kempton Park, I would have spoken off the cuff, because then I would have had time to look around me. I am sorry that I am sitting so far away from her, because now I can stand and look at her properly for the first time. She not only speaks well; she is also attractive. [Interjections.] I want to congratulate the hon member, because she really spoke very well and I invite her to visit me in my office after this. [Interjections.]

I also want to take this opportunity to congratulate the new hon Deputy Minister, who has recently been appointed to this position. He is also a member of our 1977 group. I think at the moment he is the one who has fared best. I wish him everything of the best, and I want to tell him that a flower does wonders even for an ugly person. [Interjections.] I want to tell him that he is looking “grand” this afternoon. [Interjections.]

I had better stick closely to my notes from now on, because I am afraid I shall become confused, particularly as we have just listened to such a fine speech. I have just returned from my constituency, which is as attractive as the hon member for Kempton Park. Very fine work is being done there for the deaf and the blind of our country. I want to tell hon members that, as is the case in all fields, there are normal children among the deaf and the blind who do very well and are or become an asset to the country.

There is a deaf and blind boy there—he is both deaf and blind—who speaks English better than I do. That is not saying much, but it still goes to show what can be done. Regarding those of us who do not speak English very well, Van der Merwe said that we should go to England, because even little children speak English there! [Interjections.] Now we have a big problem, because among the deaf and blind we also have multiple handicapped persons who cannot earn a livelihood anywhere, and must of necessity remain in homes for the blind and the deaf. That is where our big problem lies. They must engage in sheltered employment there, and the place is very small.

The department and the State are very sympathetic towards these people and the church plays a major role. However, expansions are absolutely essential at the moment, and today I should like to make an appeal for the expansion at these two institutions for multiple handicapped persons to be placed very high on the list of priorities. I want to assure hon members that the dam wall is about to burst; we cannot wait much longer. That is all I have to say about Worcester.

The matter I am talking about this afternoon is actually not very pleasant. In the entire debate on after-care and welfare services one is only involved with misery. [Interjections.] I want to thank the hon the Minister and his department for all the work they are doing for the health and welfare of our people, particularly when it comes to the provision of services to the severely mentally handicapped and mentally ill. Here too it is a partnership between the private sector and the State.

Every individual is as far as possible responsible for his own welfare, and the family and the community have a responsibility to support the individual to achieve his full potential in his circumstances. The private voluntary organisations play a big role in the provision of services to the severely handicapped as well as the mentally ill. The latter hospital represent one of the best examples of successful privatisation. The hon member for Kempton Park also referred to this. This is then the private sector.

Speaking of privatisation, in my part of the world the chemists are also kicking up a fuss about privatisation. The other day I heard what privatisation is. Privatisation is when the private sector can do something more cheaply and better than the State. This is now privatisation. The severely mentally handicapped person with an IQ below 30, does not benefit from an education even in special schools or from training such as that offered in sheltered workshops. However, through intensive stimulation or rehabilitation programmes it is possible to increase the degree of self-sufficiency of these people to an amazing extent.

The State has a responsibility to assist parents in the provision of special services which can improve the quality of life of the handicapped person considerably. The department pays allowances to parents who are caring for these children, and we are very grateful for this. Transport allowances are paid so that the children can be transported to these centres. Almost 700 severely mentally handicapped persons attend these centres every day. At present there are 4 300 severely mentally handicapped persons accommodated in State hospitals and licenced homes.

The State accommodates by far the majority of the patients, because the homes for the severely mentally handicapped do not receive the same subsidies as the homes for moderately handicapped persons. I am appealing to the department to introduce uniform subsidisation in order to help these people. We are very grateful that the department accepts full responsibility for severely mentally handicapped persons, because such persons cannot easily be cared for outside a hospital.

As regards the treatment of the mentally ill, the private sector is playing an increasingly big role in the provision of acute voluntary services in particular. Recently this has expanded tremendously, but does not anywhere near meet the requirements. There is a shortage of 700 beds, and this includes 400 beds in the Transvaal alone.

Every cloud has a silver lining, however. The need for beds for chronic mentally ill patients, ie those persons who do not react to acute treatment, is decreasing annually. The present patients are getting older and the number of long-term patients is declining rapidly as a result of more successful treatment.

The private sector should make provision for so-called half-way houses or group houses for 3 000 long-term chronic patients. At present fewer than 200 patients are accommodated in group houses. There is an increasing interest in this field, and I hear that nine of these houses are in the process of being built. If the State and the private sector can co-operate in all fields in the same way that they do as regards the provision of services to the severely mentally handicapped, I would say things are looking up. It, however, remains a fact that it is the responsibility of the department to care for these long-term patients, because the mental state of the vast majority of these patients makes their transfer to a hostel impossible.

I want to thank the department for what they have done for these extremely unfortunate Whites. I hope that what I asked for at the beginning of my speech, namely homes for the severely handicapped blind and deaf people at Worcester, did not fall on deaf ears.

Mr Chairman, this afternoon I want to touch very briefly on the whole issue of own affairs health as it has affected all the provinces and in particular Natal. I want to look at practical rather than medical issues.

May I say at the outset that I am deeply concerned about own affairs health on both moral and practical grounds. I totally support this party’s attitude to it as made clear in this House during the debate on this particular Vote last year and by our chief spokesman on health, the hon member for Parktown, today.

The moral issue is obvious and I simply want to repeat what many speakers in this party have said before and that is that own affairs health is unethical and immoral and that it is wrong that health matters are divided on the basis of race.

On the practical side I want to say that the whole system is proving to be as clumsy, impractical and expensive as was predicted when it was first introduced. I want to draw the hon the Minister’s attention to some points that are relevant in Natal and probably in other provinces as well.

I believe the hon the Minister will appreciate that Natal has always had a particularly efficient and capable hospital and health service. It is a fairly small province and therefore it was possible, before the introduction of own affairs, to share staff, equipment and services among all the hospitals that fell under the control of the provincial administration. A single controlling body existed for all the hospitals. However, with the introduction of own affairs we now find that various departments must exist for various groups and thus the control of health services has been fragmented. Consequently the system of sharing of services has come under scrutiny and changes have had to be made.

Dr Fred Clarke, former Natal Provincial Council member and member of the Executive Committee in charge of hospitals, recently wrote an article on health services in Natal. I believe we all accept that Dr Clarke is a man held in particularly high regard in medical circles in Natal. He wrote:

He went on to say:

Own affairs health care has created problems in Natal. I want to give one or two examples, although my time is unfortunately short.

Let us take, for example, the matter of the single orthopaedic workshop which under the former provincial administration control catered for the needs of all the hospitals. It serviced them all. No special control structures for this was required, no special invoicing system was needed and no bureaucratic structure existed, because all the hospitals fell under a single controlling body. Now we find that the same workshop still caters for the needs of all hospitals, but unfortunately a strict system of control of invoicing now has to exist because hospitals now fall under various own affairs departments, and these various departments have to be invoiced for the services rendered by the workshop. [Interjections.] Consequently, more red tape is involved, and more red tape means that more people need to be employed and thus more money has to be spent. It cannot be a more efficient system; it is simply a more cumbersome system.

The same applies to the movement of staff. Previously it was easy to move doctors, nurses and surgeons from one hospital to another as and when this was required. I would refer in particular to moments of necessity. The moves were made simply and easily, but now this ease of movement is no longer possible because the services rendered have to be charged against the various own affairs departments under which the hospitals fall. An invoicing system for time and services, which again is clumsy, time-consuming and has added to the overall expense has had to be implemented.

The same also applies to the loan of equipment from one hospital to another. Generally, own affairs health care has greatly complicated a system that used to work extremely well. [Interjections.]

There is one other matter I would like to raise with the hon the Minister today which is on a different tack altogether. When the Government introduced own affairs matters it said that in these areas there would be a devolution of power and control to the local authorities—that there would be a minimum of control from the central departments. I wish to ask the hon the Minister whether this is still the intention with regard to health services. I am told that there are approximately 45 posts at the level of director within the central department where a staff complement of approximately 18 000 people exists. In Natal, however, where a staff complement of 20 000 exists, there are only 4 posts at the level of director. If a policy of devolution does exist, is it likely that we will see some of these 45 central posts given to the provincial departments? That is a question I wish to ask the hon the Minister. I believe that this is absolutely essential. Real promotion and career opportunities must exist in the provincial departments so that top personnel will not be forced to leave them by moving to the central office in order to seek job satisfaction and fulfilment.

In conclusion I wish to say that I sincerely hope that what has happened in education where the number of deputy-director posts is being reduced in the provinces and given to the central office, will not in turn happen to health services.

Mr Chairman, the hon member will excuse me if, owing to lack of time, I cannot follow him in his argument or reply to him.

When my time expired just now when I last took part in this debate, I was quoting from a paper which was delivered by Namda in Amsterdam towards the end of 1986. It is also a paper which has been used extensively by the ANC itself as recently as March 1987. I quoted a passage where Namda said that they were not primarily concerned with doctors. The Medical Association of South Africa is, of course, also not only concerned with doctors but with medical care itself and the patients primarily.

Namda said that they were not primarily concerned with doctors, but with broader socio-political issues in health care, issues which ranged from community issues and trade union work up to direct political work.

I must tell the hon member for Houghton I have no argument with people who tried to solve the problems concerning the Biko affair.

I think the Biko case was one of the most tragic things to have happened in this country and I hope such a thing will never occur again.

I happened to be a member of the Federal Council of the Medical Association albeit not for a very long period. I know that the Medical Association worked very hard—I myself worked very hard—to see what we can do to rectify matters. [Interjections.] I think it is incorrect for the hon member for Houghton to say that if Namda had not done something about it nothing would have been done. I do not agree with that. More or less every medical practitioner in this country, including lecturers and academics at Wits, UCT etc, are members—maybe even members of the hon member’s family or mine—of the Medical Association. Therefore, if we say it was Namda that did the job, as if the Medical Association did not do its job, it is a reflection on the Medical Association and doctors as such. I do not agree with that.

[Inaudible.]

I say that the Medical Association is quite capable of doing its job for the doctors and patients in this country, and if one does not agree with what it is doing and one is a member, then one should do something in that association, and not what Namda does. Namda tries to break up the Medical Association and does us irreparable harm in the outside world.

Let me quote another example. In the Chicago Sun-Times of 24 May of this year Dr Diliza Mji, president of the National Medical and Dental Association—that is Namda—said: “Masa is an integral part of apartheid”. Of course, that is not true. He was answered by the Medical Association in the following terms, and I quote from the most recent Medical Journal'.

Another case in point is the following statement of Namda in that same newspaper:

This is not true in the first instance. In the second instance they have never once deplored necklacing and that type of murder. What is more, when they were asked why they did not produce the evidence they said the following, and I quote the Medical Association again:

Contrary to that, the Medical Association says that it is its moral and ethical duty to report those cases so that something can be done about it.

Therefore, I think we can really be proud of the Medical Association of South Africa in contrast to Namda, which is a self-acknowledged political organisation.

[Inaudible.]

Is the hon member of Parktown a member of Namda?

I am not a member of Namda or of the Medical Association.

Well, that is a disgrace in one case and a good thing in the other case! [Interjections.]

I am a little worried sometimes because I can quote numerous misrepresentations by Namda. Namda says for instance—and as I said, this is a paper of March 1987:

That, of course, is not true. For instance, they quote figures to show that there is a higher incidence of tuberculosis etc in the so-called Bantustans and then they say this is because of apartheid. That worries me. There are people in this country and abroad who claim that apartheid is the cause of everything that is wrong here. On the other hand there are also Whites that say that everything that is good is thanks to apartheid. They say there must be a law for this and a law for that but that is also wrong. Even when there is not one iota of apartheid left in this country there will still be a First World and a Third World here. What is happening today is that the gap between the First World and the Third World is growing.

*People of the First World are capable of developing things more quickly as a result of computers and so on. Our children who also enjoy those benefits, are developing more quickly. That worries me, because when we blame everything that is wrong on apartheid, we are harming this country for it is not true. Apartheid is on its way out; if no one else sees to it, then I shall! The point is that when apartheid no longer exists, we shall still have to deal with these tremendous problems.

Mr Chairman, will the hon member take a question?

No, unfortunately my time has nearly expired. We can discuss this afterwards. [Interjections.]

The hon member for Stilfontein referred to certain medical and hospital costs. Unfortunately time is catching up on me. He referred to the article in the medical journal in which mention was made of the large account of R433 received by the patient, who is a doctor himself, for a small operation. I am in complete agreement with the medical journal. It is a disgrace.

We must also investigate the regulation of our financial affairs in the provincial hospitals, however.

†How we run our financial affairs should also be fully investigated. I have a paper here written by a certain Mr P J Strachan. It was delivered at the Medical and Status Group Congress and the title is “The Relevance of Cost Containment in Medical Management”. He states that a hospital is no different from a commercial business enterprise. The shareholders are ultimately the taxpayers and the management teams of the hospitals have as much accountability to the taxpayers as a board of directors has to the shareholders. He talks about spending other people’s millions as though they were our own millions.

*I note that the University of Stellenbosch offers an MBA degree in Health Management. That is the direction in which we should be taking.

The hon member for Stilfontein also quoted figures such as R333 per day at the Universitas Hospital and R180 per day at the Groote Schuur Hospital. I think that if one were really to calculate the cost of the Groote Schuur Hospital, one would find that it amounted to far more. Managing a hospital has in fact become a specialised field and a doctor is no longer capable of running a hospital economically.

I want to convey a last thought. There are certain matters which we have to rethink very seriously. When I am told that a hospital is to be built in Pretoria at a cost of more than R300 million with operating costs amounting to R190 million per annum, while only 50% to 52% of the existing hospital in Pretoria is being utilised, I have serious misgivings. When it is said in the Free State that hospitals in various towns are being closed down because they are no longer being used, and yet Reitz is getting a new hospital, I simply do not understand it. [Interjections.] I think we should look at these things anew. I fully agree with the announcement the hon the Minister made about private hospitals. [Time expired.]

Mr Chairman, it is a great pleasure to speak after the hon member for Langlaagte. The hon member for Witbank referred to the influenza epidemic.

†Judging by the way I feel today and listening to the sneezing and coughing around me, I think the “groot griep” has invaded this Chamber! [Interjections.] Perhaps we need compulsory inoculation.

Maybe they are allergic to you!

We could be selective, however! [Interjections.]

In considering the subject of the standard of health care in South Africa and in particular in the Natal Midlands I confess that I speak as a layman, but I do have some experience having been on the Greys Hospital Board for a number of years.

Currently, there is a great deal of criticism in regard to the declining standards of health care, brought about by the so-called “fragmentation” of health services and a shortage of qualified staff as a result of the cut-back in posts because of financial constraints. There are also shorter working hours for the nursing staff, because of the cut-back on ward time through an increase in the time spent on their training. These problems will have to be addressed.

I do believe that we can be justifiably proud of the health services provided in South Africa for all our race groups. While it is true that in the urban areas we are more generously endowed with health facilities than in the rural areas, I do not think this is a problem peculiar to South Africa alone. In Venda, for instance, the infant mortality rate is 36 per 1 000 and in Gelukspan, an area in Bophuthatswana, the rate is 14 per 1 000. This rate cannot be achieved in any other country in Africa.

The South African Government’s commitment to improving health care is convincingly illustrated by the allocation of 5,4% of the GNP for this purpose. Few, if any, developing countries use more than 2% or 3% of their GNP for health care. Even in highly developed countries which are industrialized, it varies from 6% to 10%.

The question of Namda was mentioned in earlier speeches. I want to refer to a recent visit of Dr Diliza Mji, the President of Namda, to the United States where he made certain accusations which were answered in the supplement to the South African Medical Journal of 18 July of this year. Most of these utterances, according to Masa, can be regarded as deliberate attempts to mislead in order to influence world opinion against South Africa. The facts published by the Medical Association are that the average infant mortality rate in South Africa is 55 per 1 000. The Black infant mortality rate is difficult to estimate, because of the many unregistered births and deaths. It is estimated to vary between 80 and 90 per 1 000 as compared to world estimates in Africa of 116 per 1 000. Although this figure is higher than that for other population groups, it is still 37% better than in the rest of Africa.

Dr Mji stated further that our segregated society has one White physician for every 300 White citizens compared to one Black physician for every 91 000 Blacks. However, Masa states that the fact of the matter is that by far the greater part of the medical attention received by Black, Coloured or Asian patients is provided by White doctors. The standard of medical care is of the same high standard for Black as well as White patients. Statistics provided show that in 1986 there were approximately 20 000 doctors in South Africa or one for every 1 500 of the total population. This is more than six times better than the figure for all of Africa. For every 100 000 of our population there are 295 nurses. This is by far the highest ratio in the developing world. For every 1 000 of Blacks, Coloureds and Asians there are 5,2 State and private hospital beds, compared to the figures for similar regions in the world such as South East Asia with 1,7, the Eastern Mediterranean with 1,2, Africa with 2 and the Western Pacific with 2,9. I think the Masa publication is most revealing and the facts contained therein deserve wider publicity in order for the real truth to be known.

I would like to sketch very briefly the scenario of health services in the Province of Natal and in particular in the Pietermaritzburg region. Health care in Natal is currently administered by several different authorities. Firstly, there is the Natal Provincial Administration which oversees provincial hospitals that care for Whites, Coloured and Asians, as well as Blacks who do not fall into the KwaZulu area. Many of these Blacks come from outside the province and they are a severe financial drain on the provincial budget. This aspect should receive special attention from the hon the Minister of Finance. Secondly, there is the KwaZulu Legislative Assembly which administers health services to KwaZulu. Thirdly, the State Health Department carries the responsibility for preventative health and psychiatric hospitals. It is also responsible for providing White doctors at certain major KwaZulu hospitals.

Sir, it is considered by many—the medical profession in particular is of this opinion—that with three separate authorities responsible for administration and health care, it is difficult to formulate a comprehensive policy that meets the requirements of all the population groups. However, I think it is pleasing that the control of White hospitals such as Grey’s Hospital in Pietermaritzburg will continue to fall under the tried and trusted umbrella of the provincial hospital services.

It should be emphasised that the medical profession in Pietermaritzburg does not query the own affairs basis of health care, as this should lead to improvement in the standards at non-White hospitals because of direct representation of their interests by their own members of Parliament.

However, the deleterious effects of fragmentation, particularly in the field of specialist services and facilities, must be carefully considered. I refer in particular to the use of expensive equipment such as a CAT-scanner, which is situated in Grey’s Hospital and is available to other groups and hospitals in the area. I refer also to the sharing of facilities such as the world famous cranio-facial unit under Dr Wolfgang Losken and the renowned neurosurgical facilities. Sharing in this way obviates needless duplication and consequent wasteful expenditure. I could elaborate further but time does not permit.

I should like to draw the hon the Minister’s attention to one last point—I think also of that of the hon the Minister of Finance—which concerns the high cost of health services today, and a possible source of funds to assist hospital boards and hospitals to maintain the high standards that we have come to expect. I ask that consideration be given to expanding the taxation relief for donations to educational funds in terms of section 18 (a) of the Income Tax Act, and also section 56 (1), paragraphs (i) and (j) which relate to donations, so as to provide for deductible donations to teaching and training hospitals, provided that the money is spent on specific projects to be determined by the Department of Inland Revenue.

Many advantages will accrue from this extension. Donations will be encouraged; hospital boards will acquire real teeth in having funds available to improve the standards of hospital equipment and the continuing education of hospital personnel; and the State could well experience substantial savings in expenditure.

Mr Chairman, it is a privilege for me to reply to the debate this afternoon. I shall revert to what the hon member for Pietermaritzburg South said but I should like to start with the Official Opposition’s chief spokesman on Health, the hon member for Pietersburg. I congratulated him on this position on a previous occasion.

The hon member for Pietersburg remarked with justification that hospitalisation was an own affair. I agree; in fact, hon members will recall and can look it up in Hansard, that I said that in the case of those 44 hospitals the right of disposal was vested in the Ministers’ Council. What does this mean? It means that the Ministers’ Council granted delegated powers to the respective provinces in respect of certain functions which the latter carry out for the Ministers’ Council. As I said, the reason for this is cost-effectiveness. Hon members will appreciate that, if we wished to establish separate organisations for all those hospitals, it would be very expensive.

We could continue to maintain the same principle, however, as I agree with the hon member that it is very important to our people when they are in wards during the recovery phase. In fact I told the hon member for Parktown last year that I had seen both Negroes as well as Spanish-speaking and Caucasian Americans occupying wards when I was a visiting professor at the University of New York. This is nothing strange and it is the policy of the Government.

What is more, I want to tell the hon member for Pietersburg that a few days before the election the Director of Hospital Services in the Cape Province spelt out Government policy on the Groote Schuur and Red Cross Hospitals very clearly. It was on the front page of The Argus. The electorate was left in no doubt as to the Government's position. What was the outcome? The poorest showing the PFP had ever made in the Peninsula. Those are the hard facts. The hon member referred to the article in Medical News which I must say is embarrassing in quite a few respects, such as their reference to a comparison by a certain American Secretary of State and so on. What he regarded as the “integrated medical service” or “management” is the NHPC on which the Ministers of the Ministers’ Councils—I stated this very clearly in my opening address—decide on those matters which are not own affairs in respect of health. “Racially integrated management” was his term and this answers the hon member for Parktown’s question as well. It is therefore his terminology for the NHPC which I regard as an important functioning body.

Where hon members have problems—the letter from the Red Cross and so on—they do not affect policy. They may be sent directly to the Director of Hospital Services, Cape Province, or to the MEC, Mr Theron. I am in full agreement with him that the living space of a sick person is important. We have experience of this, we know this and we realise it.

The medical care of the aged is of the greatest importance to health services in the Ministers’ Council. The hon member for Ventersdorp also referred to this. As regards the infirm aged in South Africa, we have facilities for 23 000 White infirm aged, but there are an additional 8 000 of the non-infirm aged in those facilities. I want to say at once I tackled these matters last year. We examined all vacant space in White hospitals. We shall probably convert the Sybrand van Niekerk Hospital into a hospital for the infirm aged soon, and it will cater inter alia for training—the hon member will be very pleased to hear this—in the care and nursing of the infirm aged because this is a specialised discipline, which we can develop further in this way.

I am very concerned about the shortage of district surgeons in South Africa. The reason for this shortage is remuneration; I think the hon member will agree with me that salaries are not all they should be and this can once more be attributed to a shortage of funds. Our doctors’ salaries are not what they should be and I want to tell hon members that we shall have to remedy this before the end of the year. Are hon members aware that a district surgeon receives R5 for a night call to a free patient? I do not consider that practical; we should improve it. In addition we should grant cessions to district surgeons in remote rural areas—from this Ministers’ Council and from provincial authorities—to enable the district surgeon to deal with everyone in that remote area on his journey. It is certainly not feasible to send four or five district surgeons to a small place. I think the hon members for Pietersburg and Ventersdorp will agree.

I want to talk to the hon member personally about the situation in Pietersburg, which he mentioned earlier. I wish to inform hon members that Dr Slabbert and Mrs Coleman are doing very good work there. I have verified this. They have 20 service points where they visit the aged and I consider that good. I want to tell hon members, however, that we as well as the AC should pay more attention to our district surgeons nationwide. The Health Matters Advisory Committee is working on this at the moment and I shall keep the hon member informed. When we consider vacant posts, I have to say that funds are the problem but I believe we shall fill those vacant posts before the end of the year. I have already informed hon members of our concern about the infirm aged.

I also wish to address the hon member for Ventersdorp because he referred to the infirm aged, and to the Sybrand van Niekerk Hospital.

The Sybrand van Niekerk Hospital at Carletonville has 140 beds, of which 61 are occupied at present. Only 12% of these are State patients, so the majority of them are private. This is one of the hospitals I am investigating with a view to a possible utilisation of that space for the infirm aged. We are also examining other hospitals such as the Volkshospitaal. In addition we are in the process of a possible sale to Iscor of the Pretoria West Hospital, since large areas of this hospital are empty. I think this should satisfy the hon member for Kempton Park on the subject of privatisation.

I wish to thank the hon member for Langlaagte and congratulate him on his chairmanship of the study group and also on his important contribution in the standing committee.

And on his good English.

As the main speaker on this side of the House he has repeatedly shown himself to be a formidable debater—as he did this afternoon. He made a few points of major importance, which I endorse strongly, especially when he linked Namda to the ANC. I think it is time this Committee was informed of what Namda is.

I now want to react to the hon member’s request on hospitalisation. The Productivity Institute investigated all Transvaal hospitals in 1985. We held an in-depth brainstorming session on this matter, and many of the proposals have already been implemented.

Furthermore there are many of our superintendents in South Africa who already hold the MBA degree in Health Management, not only from the University of Stellenbosch but also from Unisa. I want to point out to him, however, that the H F Verwoerd Hospital will have 50% non-Whites. I also want to draw his attention to the fact—I have said this before and am repeating it this afternoon—that our academic staff will have to treat private patients. For that reason the rest of that hospital can be used, and the same applies to the Johannesburg Hospital.

This is also a reply the hon member for Parktown because I agree with him that we should provide our full-time academic staff with the opportunity to treat private patients—for two reasons. One of these is the broad spectrum of patients for training and the other is that this represents improved incomes to them. I think this is no more than right. So much for that point then.

I wish to thank the hon member for Langlaagte once again for his very good contribution.

†As far as the hon member for Parktown is concerned, I think I have dealt with the situation as far as his “integrated Health” in The Medical News is concerned. He understands it now, I hope.

No.

Try! [Interjections.] He must try his utmost; if he really tries hard I am sure it will get through. [Interjections.]

I have no doubt that the private health sector is important, and I have often said so. We must make the private health sector larger and the socialistic sector smaller. He has also said so. I think all of us here are in agreement as far as that is concerned.

There is no doubt about it that we are worried—as I have said—about the vacant posts in our hospitals. I have said that I am sure that before the end of the year we will have an improved salary structure as far as our doctors are concerned.

Rising costs are something we are all worried about. We will again address this matter, the hon member and I, when we discuss my other Budget Vote in a couple of weeks’ time.

As far as medicines are concerned, there are a couple of things which we will discuss then such as transfer pricing, customs duty on raw materials, especially active ingredients, the 10% surcharge on raw materials, general sales tax, lack of control over price increases in the pharmaceutical industry, and wasteful promotional practices. We will discuss these matters because they are important. We must remember, however, that R10 in 1980 is R4,40 today.

I wonder why!

Inflation is an important factor here. [Interjections.]

There is no doubt in respect of chemists and doctors as far as the Competition Board is concerned. We will, however, deal much more fully with this aspect in the discussion of my general affairs Vote. That, I believe, will settle once and for all this discrepancy between those doctors who are prescribing medicine and those chemists who are encountering problems as a result. I will come back later to the question of chemists in the rural areas.

There is a division between the public and private sectors. I agree with that. Allowing private patients into academic hospitals, however, will also improve that situation. There is also good co-operation in this field, however, because there are many private facilities which are used by our provincial hospitals. To the hon member for Pietermaritzburg-South I should like to say that there is no reason why other patients cannot use his facilities. There is no reason why. This is done in other provinces.

The hon member for Parktown referred to the lack of contact with foreign doctors. This is very true. It is, however, not quite as bad as the hon member thinks it is. He said I should let him know whether we were experiencing a shortage of doctors. I think that is what the hon member said. Is that correct?

I referred to the statement by Masa.

Yes, there are vacancies, but when we look at the situation in relation to immigrants, it appears that during the past five years we have had a net gain of 450 doctors and 60 dentists. I have the figures here in front of me. We have also experienced a loss, however. The greatest loss has been in respect of the University of Cape Town. During the period 1970 to 1975 altogether 52% of people in the medical profession who left the country were from the University of Cape Town, 38% from the University of the Witwatersrand, 5% from the University of Natal, 4% from the University of Pretoria and 0,9% from the University of Stellenbosch. I believe it is important to take note of these figures. The fact of the matter is that we must do our utmost to foster foreign co-operation, and I am sure, too, that we will have to bring back the system of tax deductions in respect of professional visits abroad by medical doctors.

Yes, I hope that will be done.

We will talk about the Medical Schemes Act when my other Vote is debated here in the House. Under the present Act, however, there is no reason why they cannot insure themselves against any catastrophic eventualities. There is absolutely no reason why they cannot do this.

*I agree with the hon member for Edenvale on the importance of research. She made a good speech on the problem of whooping cough and I congratulate her on it. The hon member for Welkom is an absolute expert in the field of pills; there is no doubt about this. [Interjections.] He made a very competent speech.

The hon member for Witbank spoke with great passion. It was commendable. I am in full agreement with everything he said except that I am convinced that the pill to bring about total partition is not going to be discovered. [Interjections.] Nevertheless the rest of his speech was excellent. I agree with it completely. The family is the foundation of the people. It is also the reason which prompted us to work out our family policy which will be announced within the next few months. I agree with the hon member when he says that we should place greater emphasis on creating the atmosphere of the family circle. This is a fundamental problem; the hon member is quite right. Problems as regards foster parents were dealt with by the hon the Minister of the Budget and Welfare. I also agree with the hon member for Witbank’s statement that we should pay further attention to the problems of foster parents. I agree that the situation of house-parents should be examined. I think the hon member for Witbank made a very useful contribution.

The hon the Deputy Minister of Health Services made a very good contribution on dentistry. He explained the Coris and Vighor projects very well to us.

†I have great pleasure now in dealing with the speech made by the hon member for Houghton.

Hear, hear! [Interjections.]

The hon member for Houghton went out of her way, of course, to make complimentary remarks about Namda and the Biko affair—and especially about Namda. Of course, Mr Chairman, that does not surprise anyone. It surprises nobody, because we are all familiar with the hon member for Houghton and her propinquity to the ANC. And that is a fact, Sir.

Now what do you mean by that? [Interjections.] What has Namda got to do with Biko? Biko was concerned with Black Consciousness. Do you not know that?

I am not going to teach the hon member English. I am coming back to her speech of 19 June.

With a lot of smears.

No, I do not think so.

Of course!

Does the hon member know what it means?

Yes.

What does it mean?

Smears.

No. Propinquity means “akin”, “nearness”. You will find it on page 1818 of Webster’s International Dictionary. [Interjections.]

Did you find that out today?

Let me come back to the speech made on 16 June by the hon member for Houghton—I have the hon member’s Hansard here—in which she said: “There are many detainees presently under psychiatric treatment. ” Those were the hon member’s words.

That’s right.

Immediately afterwards I said that I would like to know where and how many. I am still waiting for a reply.

Can’t you find out? Ask the department; they will tell you.

I am waiting for a reply, because the hon member for Houghton made that statement. She does not have the facts, but she wants the overseas Press to know. It is again one of those …

Are you denying that there are detainees …

I ask her how many. I am not aware of any. [Interjections.]

It does not matter how many there are, …

The next time the hon member makes statements like that, she must just remember that I will again ask her to come forward with the facts.

You don’t scare me at all!

The hon member also made her traditional plea concerning abortion. We have improved the procedures tremendously as far as the situation pertaining to rape is concerned. I would like to make it quite clear that the figures the hon member gave concerned spontaneous abortions.

They did not. They …

The most common causes of spontaneous abortions are chromosomal defects, especially in older women; I wrote a paper on that. What is interesting is that the hon member had our report.

Yes, I read it.

She knows that an induced abortion, a criminal abortion, must, by law, be reported. However, she said nothing about the fact that as far as criminal abortions are concerned, according to our report there was a total of 18 cases in 1985. In 1986 there were 16.

But they are not reported.

Who reports crimes? [Interjections.]

That, however, she will never mention. The reply to the hon member for Houghton is therefore that we will not change the Abortion and Sterilization Act.

That is ridiculous. [Interjections.]

I now turn to the hon member for Stilfontein. [Interjections.]

*Mr Chairman, would you quieten this commotion a little?

Order! The hon member for Houghton must restrain herself.

The hon member for Stilfontein made a splendid contribution on privatisation. He is knowledgeable on private hospitals and I am very grateful for his reference to the body we are now going to establish and to which, as he so aptly said, matters would be referred so that they can be investigated and so that action can be taken against such hospitals. It was a very good contribution and I want to congratulate him on it.

I have the greatest appreciation for what the hon member for Ventersdorp said. Regarding vacancies for district surgeons, we should remember that the R35 limit is rather low. This is a limit fixed by the province of the Transvaal.

I want to tell hon members that I discussed the entire problem of pharmacies in rural areas with the MECs of all the provinces last Friday. This has already been rectified in the Free State and to such an extent that pharmacists are to receive the same benefits as doctors. We are examining the situation in the Transvaal now because I am also truly concerned that this will put the pharmacist at such a disadvantage that we shall have a massive exodus of pharmacists from the rural areas. I want to point out to hon members, however, that our provinces have to economise because we have no money; that is why this is an economy measure. Nevertheless the Government feels very strongly that doctors should not benefit more than pharmacists in terms of the same economy measures.

I think hon members would agree with this. We should also remember that country districts are losing their White component so the district surgeon’s work is increasing.

With reference to the Sybrand van Niekerk Hospital, I wish to tell the hon member that the salaries of White nurses were increased last year and are higher than those in the private sector at the moment. We do not have adequate funds to fill all the vacant nursing posts at all hospitals, but the notch is not the problem here.

†It is quite evident that the hon member for Bezuidenhout is an expert on crisis intervention. He mentioned a very important thing, viz the necessity to accommodate those special cases. We will have to look into that and then I shall come back to the hon member.

The hon member for Pinetown mentioned familial killings. I fully agree with him. I think this is something which concerns all of us and we have asked our psychologists and psychiatrists to go into the matter. I am also worried about the fact that this sort of thing is shown night after night on television which may trigger it off. We know that we have manic-depressive cases here and we know that it is sometimes triggered by the economic situation in South Africa. The biggest problem is to try to identify these cases before tragedies happen. I think the hon member will agree with me there.

Child-battering is no doubt one of the most alarming aspects as far as paediatrics is concerned. I must tell the hon member that a meeting of the various organisations involved as well as the departments will be held on 24 August and I hope to report back on this matter next year. It is a very good point which the hon member raised.

I thank the hon member for supporting this body which will be able to monitor private hospitals. As far as his problem in regard to negligence is concerned, I may say that in my association with hospitals I have found that if a certain kind of instrument, for example the Boyle’s anaesthetic machine, is not properly serviced, that would be negligence as far as the hospital is concerned. We shall go into this matter although it is really a legal one and advise the hon member on our findings.

On the determining of current fees for consultations and the disputes about the medical schemes, I want to say that we are going to have a roundtable discussion and that I shall report fully when my other Vote comes up for discussion.

*The hon member for Kempton Park made a very good contribution on privatisation. I think we should all read the hon member’s speech in Hansard because she raised a few very important points. I should like to add as a summary of privatisation in the field of health that anything the State does that can be done to the same standard but more cost-effectively by the private sector can be privatised. Nevertheless privatisation does not mean that the private sector is then to do it at a higher cost while the State pays for it. Unfortunately this is a perception which has taken root. In other words, people say pharmacists can handle medicine and therefore they should do so. It is only in the Free State, however, that R5 million is being saved by the new initiative. The Pharmaceutical Society agrees with this.

The hon member may also be interested to hear that the Health Matters Advisory Committee has a subcommittee for privatisation on which people from the private sector serve.

I thought the hon member for Worcester would have spoken about self-medication and dealing with private pharmacies. [Interjections.] He made a very good, competent speech on a subject of great importance. I should like to tell him that the expansion of those two institutions for the handicapped tops the list of priorities and that it is merely a question of funds. This will be tackled as soon as funds are available. I can also announce that the Treasury recently accepted in principle that licensed homes for persons who are severely retarded mentally can be subsidised on the same basis as those for other handicapped persons. Steps are therefore being taken to make up this financial leeway over a certain period; of course, it again depends on the availability of funds.

†I must tell the hon member for Durban North quite frankly that I do not think that he has the right information. It is simply not possible for everybody to have an orthopaedic workshop. It is simply not possible. The same with a mortuary.

But everybody will have it.

No, they will not.

He said there was one. That is not what he said.

That is the point. But the hon member said they would be duplicated. I say they will not.

He said they were billed separately.

Do you not understand English? [Interjections.]

Let us move on to another point. With regard to time and services, I want to mention the R K Khan Hospital as an example. The only thing that is going to happen there is that at the end of the year the Ministers’ Council in the House of Delegates will supply the financial assistance to run the R K Khan Hospital. That is the situation. The Ministers’ Council in the House of Delegates will appoint the superintendent, the secretary and the chief nursing sister. That is what will happen. So I do not think the hon member really understands what is going to happen.

As far as the devolution of power is concerned, we have done a lot in this regard which I shall address again during the discussion of my next Vote. [Interjections.]

The hon member for Pietermaritzburg South referred to fragmentation. I must tell the hon member quite frankly that we have dealt with fragmentation to a large extent. We have cut our fragmentation to a large extent, because, as I said—the hon member was not in the House at that stage—the first three phases of the National Health Facility Plan are going to be run by the various Ministers’ Councils. That is important because that is community based. I explained fully how the hospitals are going to work. We avoided fragmentation because we want these services to be cost-effective.

The National Health Policy Council laid down policies for the whole of South Africa. This also applies to the hospital services in Natal. We have streamlined that. I also want to add that there is no reason why facilities cannot be shared. They are shared all over South Africa—between the private and public sectors and the public sector and the various hospitals. I think this is a sound situation.

*I listened to the debate with great pleasure. I believe we had excellent contributions here and I thank all hon members for their contributions. In conclusion I wish to say that the Health Services of the Administration: House of Assembly from the outset regarded that important instruction to see to the health of those we represent here, the electorate, their children and grandchildren, as a very important one. The health of man as a whole is one of a people’s most important assets. We shall see to this and are sincere in our intent.

Vote agreed to.

Chairman directed to report progress and ask leave to sit again.

House Resumed:

Progress directed and leave granted to sit again.

Mr Chairman, I move:

Mr Chairman, apart from certain aspects which I shall be indicating, we cannot support this report. I want to state very clearly and unequivocally that in principle we support consolidation which is meaningful and essential in practice. That is part of our policy. We support this, in particular, when it is essential for rounding matters off properly. As far as this report is concerned, with the exception of the proposal contained in schedule A (c) (ii) the proposals meet the requirements we have laid down.

As far as we are concerned, in terms of the Development Trust and Land Act, 1936, the quota for the Transvaal has been fully met and additional land cannot simply be acquired and provided. Our standpoint is that such land can, in fact, be employed for consolidation, but then it should be purchased or exchanged.

With money belonging to Whites or Blacks?

I shall come to that. It should either be purchased by the state for whose consolidation the land is needed, or by a citizen or private body of that state. We specifically think that such land could, in particular, be employed for the purposes of private ownership in those states in which there is a problem. If the committee were therefore to recommend that, in a process of consolidation with the relevant state, this land be purchased by certain bodies or exchanged, we would grant the report our full support.

There is, however, an additional reason why we cannot support the release of the land described in schedule A (c) (ii). This land was contained in the 1983 proposals. It is that narrow corridor to which reference was made in the 1983 proposals. The Government, however, did not accept those proposals in 1984 and did not come to any decision. It consequently maintained the status quo. In other words, the area remained White. The reasons are obvious.

Those farms, which are now being acquired, close that corridor, cutting the northern and southern parts of the Transvaal off from each other. As a result, if those living to the north of that corridor want to travel through South Africa, for example to Pretoria, they have to go via Northam, and if they want to travel through South Africa to Zeerust, they virtually have to go via Pretoria to get back there.

There is also another obvious reason, and that is that it actually makes a peninsula of the remaining portion of that corridor—a small South African peninsula in Bophuthatswana. I predict that that land will eventually suffer the same fate as the farms now being used to close the corridor.

The most important reason for our opposition is one relating to security. Those farms which are now being included lie on a terrorist or a potential terrorist route to Pretoria and Johannesburg. Whilst that land was South African territory, it was less attractive or accessible to terrorists, because there were Whites on those farms and therefore a local observation post. One could therefore very quickly obtain news about any strange movements there, but one could also patrol that area or have it patrolled by one’s security forces. If this did not completely stop the terrorists from gaining access via that route, at least it was a deterrent to those terrorists wanting to use it. As far as we are concerned, those are three important reasons, but as far as this specific area is concerned, there is another important aspect. In a debate on the State President’s Vote last week, the hon member for Vasco said that the CP’s policy in regard to consolidation was that land could be purchased or exchanged. The hon member then discovered that he would probably wake up one morning to find the whole of South Africa had been sold or exchanged.

I now want to speak to him about that. The hon member was talking nonsense and had obviously not studied the CP’s policy, because our policy states unequivocally that we basically adhere to the 1936 quota. If, however, for some practical or essential reason, additional land has to be obtained, this can be done by way of purchase or exchange. [Interjections.] This can only take place, however, with the permission of the Parliament of the RSA. Surely the hon member knew that. Surely we are not the ones who give away land like Father Christmas. The case we are now discussing is a specific example, not of what we are doing, but of what that hon member’s Government is doing.

In 1985 the Presidents of the RSA and Bophuthatswana held discussions, and arising from those discussions the South African State President decided that those farms should be given to Bophuthatswana. I take it there was no further consultation involved. Without any further decisions being taken by anyone else, he decided that that land was to be given to Bophuthatswana. The South African Parliament is now being asked ex post facto to release those areas because the South African State President has, like Father Christmas, given land away.

The hon member for Vasco must not say such things about the CP, because it is his party which is dishing out land so liberally. [Interjections.] It was the hon the State President, after all, who said that as far as he was concerned the quota was not a sacred cow. I regret having to tell the hon member this, but I think the quota is even less of a sacred cow when the Transvaal is involved, and the hon the Minister of National Education, the Transvaal leader of the NP, is doing nothing about that. [Interjections.] For that reason we are specifically opposing this.

Notwithstanding the fact that the land defined in schedule A (d) is being acquired and given away, we support the release of that land because it is very clear, from practical considerations, that that land should actually have been included from the start, and I say this on the strength of the fact that the hon member for Brits specifically submitted relevant documents and on the strength of the fact that in this case there are old people who could be hard hit and it is therefore necessary, on humanitarian grounds, to afford them relief as quickly as possible. We also support the release of the area near Ciskei, defined in schedule B, because this is a meaningful and practical step, but also specifically because it is taking place by way of exchange and there is consequently a quid pro quo in this instance. It is true that this is not taking place in a specifically prescribed manner, but it does meet the basic requirements we have laid down.

We merely wanted our standpoints in regard to these proposals on record.

Mr Chairman, before I react to the hon member for Soutpansberg, I should just like to express my thanks to the members of the standing committee, members from all three Houses, who were very helpful and sympathetic in having this report dealt with as a matter of priority. I also want to express my thanks to the chairman of the commission, my colleague the hon member for Vryheid, for his particular contribution and for his assistance in this regard. I also want to thank the officials, the Director General, Mr Gilles van de Wall, and Messrs Pine Pienaar and Mac van der Merwe, for the assistance they granted us as far as information was concerned. This is perhaps not always done, but I should also like to express my thanks to the Whips for having helped us deal with this as a matter of priority.

Land remains a problematic issue. When it is decided that land should be alienated, it is always an emotional issue. As soon as that decision has been taken, however, it is always a good thing to deal with the matter and have it settled as quickly as possible.

Even at this stage I should like to express my thanks to hon members of the PFP for their proposed support of this measure. I know there are certain aspects they would perhaps want to raise with the hon the Minister, matters he himself will probably discuss with them.

Before I come to the merits involved in the transfer of the land, it is unfortunately necessary to dwell on the question of the principle raised by the hon member for Soutpansberg on behalf of the CP. I think the time has come, on an occasion such as this when we are dealing with a very important matter such as the transfer of land to Black people, for us to obtain greater clarity from the CP about what precisely they mean when they use certain words. Words do, after all, mean something to each and every person. When one listens to the standpoints and policy statements of the CP and reads about its policy, one finds it to be fairly obscure, and I say this with all due respect to hon members of the CP. I think there is utter confusion when it comes to the actual standpoint of the CP about how much land should be given to certain people in this country and to whom it should be given. The hon member for Soutpansberg said he supported the principle of meaningful, practical consolidation. We find no fault with that and we do appreciate the fact. We also try, wherever possible—I am now speaking as a member of the commission—to round off consolidation in this country as meaningfully and practically as possible. The hon member for Soutpansberg’s remark about this Government simply giving away or dishing out land left, right and centre is really not fair, in my opinion, and not true either.

The third point he made—I want to speak about that—is that the 1936 quota has now been dealt with. They are now saying: “That’s that as far as the rest is concerned. No more land should be given to Black people.” Let me say at once—we have already begun to debate this issue with hon members to a certain extent—that we accept the CP’s bona fides with regard to their Programme of Principles and Policy. For Hansard purposes I should like to reiterate this. I quote from paragraph 2. 3. 9 of the section involving their policy:

It is quite interesting that they also qualify this:

The truth of the matter is unfortunately—hon members of the CP do not reply to this—that there are conflicting standpoints within the CP on this specific aspect of their policy. I do not know whether they decided the matter at their congress yesterday. We do not, however, have any clarity on this issue.

Mention the points which are not clear.

I shall do so in a minute. I have mentioned them on three occasions and my colleague, the hon member for Springs, mentioned the differences the other afternoon. Hon members, however, do not say a word about that, not telling us what policy they advocate. [Interjections.]

Before coming to that, I just want to explain one point and refer to the hon the State President’s speech of 7 February 1979 when the hon members of the CP—I am referring, in particular, to the hon member for Soutpansberg—were still members of the NP. I do not have the relevant Hansard here, but hon members may look it up in columns 241 and 243 of Volume 79. I just want to speak about a principle and, owing to a lack of time am not going to quote. On that occasion the hon the State President said that he would launch an extensive investigation into the whole question of consolidation. Certain very clear guidelines were laid down. Mr Chairman, you will remember those guidelines much better than I do, because at that time you yourself were involved in the activities of the commission. One of the things the hon the State President said was that we would not feel ourselves bound by the 1936 quota.

The sacred cow.

Let us rather not make snide remarks about sacred cows or whatever.

Those were his words.

It makes no difference. The hon the State President said that he would not unnecessarily exceed the 1936 quota; nor would he be bound by it, however, because if it were necessary, and if the investigations made it apparent that more land had to be given than was provided for in the 1936 legislation, the Government would be prepared to consider this. Those were the guidelines governing the commission’s activities. At that time those hon members were still members of the NP and, in my humble opinion, up to 1982 they accepted those guidelines and had no objection whatsoever to them. After all, once one has started doing something, one must take the consequences, not try to escape them. Surely hon members were jointly responsible for that decision which was submitted to the NP caucus and which the hon the State President, then still the Prime Minister, submitted to this House. I want to ask when the hon member for Soutpansberg and the hon member for Barberton deviated from that point of view clearly held by the NP. From 1979 to 1982 the CP went along with the guidelines of the commission.

The hon the State President gave very good reasons why the 1936 quota should not unnecessarily be exceeded. The hon member would do well to reread that speech by the hon the State President. That is only the first problem.

Secondly I want to ask what the CP’s standpoint really is. I quoted its objects and principles to hon members. I know that at that stage the hon members for Ermelo and Bethal were not members of the CP; I do not know where they were—they have a strange past. Those two hon members, however, adopted a very clear standpoint; they put pen to paper and wrote a book. Together with Dr Willie Lubbe, they were co-authors of a book. I am now asking the hon members whether that book was the secret plan to which the hon member for Ermelo referred when he wrote in The Argus of 15 June: “We do have a plan, but we cannot divulge it now. ” What is that hidden plan which we do not know of and which the electorate would also like to know about?

I said a moment ago that on two previous occasions that aspect was raised with hon members. My colleague, the hon member for Springs, repeated that statement. The hon members for Ermelo and Bethal are as silent as the grave; they do not speak about that. After all, that book contains very clear views. Those two hon members are not here today, and I do not know whether, in their absence, the hon the Leader of the Official Opposition would have the courage to repudiate them and say that that is not CP policy.

In that book mention is made of a White homeland. There are also suggestions of the Whites seceding from the rest of the RSA. They say that separate development should be reversed. That is the standpoint presented in that book. Mention is made of majority occupation.

When you joined the NP, what did it stand for?

The hon member for Soutpansberg asks what the NP stood for when I joined the party. In other words, the hon member wants to tell me that the NP has now deviated from its previous standpoints. [Interjections.] We concede as much; I am not arguing about that. We concede that we have deviated from many standpoints, but I am asking whether the hon member for Ermelo and the hon member for Bethal have relinquished this standpoint of theirs.

Do you trust the State President now?

Those two hon members must tell us. That is what the hon member for Soutpansberg was suggesting. The two hon members who wrote that book, who held those views, repudiated themselves the day they joined the CP.

Order! The hon member should rather devote less time to the book and more time to the report.

Business suspended at 18h30 and resumed at 20h00.

Evening Sitting

Mr Chairman, I gladly comply with your request that we pay a little more attention to the report, but unfortunately a few political matters of principle were raised which we could not allow to go unanswered.

In regard to the reasons for these specific cases, I think we have met the requirement laid down by the hon member for Soutpansberg himself when he said that a case should have merit. I think that if one looks at these consolidation proposals, one sees that they really do have merit. The first case is that of the area known in the report as Vryburg 1. Seventy five percent of the land of those farmers is surrounded by the existing Bophuthatswana, and there were representations from the relevant owners asking to have their land bought up. Although that land was not part of the 1984 proposals, agreement was reached about it by our hon State President and President Mangope. The hon member for Soutpansberg also objects to the fact that the hon the State President has entered into an agreement.

Those hon members always quote history. Let me tell them—perhaps there were some of them, during the deliberations of the commission, who came across the fact that if there was one person who dished out land by way of agreement, it was the esteemed President Paul Kruger. We said, during the deliberations of the commission, that if it had not been for President Paul Kruger and Queen Victoria we would not have had so many problems to solve in certain quarters. The principle of heads of state dealing with these matters on an ad hoc basis, as situations present themselves, is not a principle new to the South African situation.

As far as the area Vryburg 2 is concerned, there was also a request from the owners for their land to be bought. This was, in fact, part of the proposals, and there was overwhelming evidence in support of the fact that that land should go.

The Marico area was divided in two. The hon member for Soutpansberg supports the first area. That is the area around Braklaagte and Leeuwfontein, but not the farms themselves. The area about which the hon member has objections is that of Marico North. The hon member for Soutpansberg again made the same point, ie that that was not part of the 1984 proposals. What the hon member must accept, however, is that it was part of the 1983 proposals investigated by the commission, and it was only the Government which did not include those farms in 1984. After hearing evidence, and again obtaining a request from the local inhabitants, the standpoint was changed and those areas have now been included.

It is specifically a matter of these farms in regard to which the situation is really critical. It is in this specific connection that I want to thank members of the standing select committee for the fact that we have been able to expedite matters to such an extent. The majority of those farmers want to sell. They actually blame the Government for the fact that the matter has not yet been finalised. I think that those people, in particular, will be grateful for the fact that we are accommodating them. Let me urge hon members of the CP to accept that situation. It is a bona fide situation. The farmers want to sell, they have already taken up options on other land and there is an urgency involved in the situation. I think the hon CP members should help us with that. [Interjections.]

I just want to make one final remark about the principle of negotiation. Did the hon the Leader of the Official Opposition, in Leadership SA, not say what we have so frequently quoted, but which hon members of the CP do not want to react to, and I quote:

What the hon member for Soutpansberg says, ie that they stop short at the 1936 proposals, does not accord with this standpoint adopted by the hon the Leader of the Official Opposition when, in an interview, he said he was prepared to negotiate for more land.

I did not say that we stopped short at the 1936 proposals. You people do not listen.

The hon member is now saying that they do not stop short at the 1936 proposals. [Interjections.] The hon member must make that very clear to us, because that is the view they hold. They said that no more land should be purchased than that contained in the 1936 quota. It is a generally accepted fact that we have already gone beyond 1936. If one looks at the amount of land involved in the present negotiation process, one sees that we have reached the 1936 quota and that in certain instances we have gone beyond it.

[Inaudible.]

The hon member himself says that they do not stop short at the 1936 quota. He must now decide for himself whether they stop short at the 1936 quota or whether they would be prepared to negotiate further.

Let me conclude by saying that I think hon members should take the opportunity to state clearly where they stand, particularly in regard to the views of the hon members for Ermelo and Bethal.

The last point I want to mention involves the question of security. Countries such as Bophuthatswana and Venda—what are involved here are those Northern Transvaal areas about which the hon member is so concerned—are as anti-communist and antiterrorist as South Africa could ever be. That is a fact, after all, and to question that, since certain areas are going to be incorporated, by saying that they will not implement the law strictly enough to ensure that terrorists do not cross their territory is a little unfair. Those hon members are questioning the bona fides of those people and I think they should reconsider their standpoint. We should like to support this report and we trust that it will enable the hon the Minister to solve this long-standing problem quickly and effectively.

Mr Chairman, to begin with I would like to congratulate the hon member for Turffontein on being elected Chairman of the Standing Committee on Foreign Affairs and Development Aid. We appreciate the way in which he has handled the affairs of the committee during the course of this session.

We shall be supporting this report, because it is largely of a technical nature and, as it stands in the Minutes, is not of a contentious nature. We shall also support it, because paragraph (c) (i) excludes the farms Braklaagte and Leeuwfontein which are situated in the Marico area.

I want to give hon members some background to explain what happened with regard to this report. It is very difficult for a layman to handle matters of this nature competently because the information is of a highly technical nature and one has to be intimately involved with surveyors’ jargon and the areas concerned to readily understand what is going on. For instance, one of the descriptions of the areas reads:

If one is not aware of maps and plans of these areas and surveyors’ jargon, it is very difficult to understand exactly what is meant in the memorandum. When the memorandum arrived during the recess I made some enquiries from various individuals, including I might say the chairman of the standing committee, and I was told it was a technical matter and not of a contentious nature. I am not suggesting that the chairman was misleading me. I am sure he was not aware of what was contained in the memorandum and had not been fully briefed. However, because of my cautious nature—which others might call suspicious—I approached a firm of attorneys in Johannesburg who normally deal with issues of this nature. They told me that the incorporation into Bophuthatswana of the farms Braklaagte and Leeuwfontein was highly contentious indeed. I was advised that almost 14 000 people were living on the farms and that they were vigorously opposing the incorporation of those areas into Bophuthatswana.The farms had apparently been acquired by the tribes involved in 1906. When they became aware of the intention of the Government to incorporate them into Bophuthatswana they wrote to the hon the State President pleading with him not to proceed with this matter. I have a copy of this letter and it contains a very heartrending appeal that they made to the hon the State President in 1986.

I should like to quote a paragraph or two, if I may. They say:

But now this incorporation will destroy everything. Our children will be locked into unemployment in the homeland of Bophuthatswana. We will be punished by President Mangope for resisting incorporation and applying for South African citizenship, because he rejects dual citizenship. He has already tried to depose our Chief, who has ruled us since 1949. The peace in our village will be totally destroyed. At a time of unrest in our country, we feel it is criminal for the Government to create more problems as we have never had any quarrel with it, except when it has tried to take our land, which we purchased legally.

Please reconsider this terrible situation. We know you have it in your power to leave us alone, and that we can stay in peace in South Africa.

That is the heartrending appeal from these people who felt that they were to be deprived of their land. They highlighted the central issue of citizenship, an issue which is a matter of dispute between South Africa and Bophuthatswana.

What reply did they get?

Sir, to the best of my knowledge they did not receive a reply from the hon the State President. [Interjections.] However, what they did was to engage the services of an attorney. He has been in correspondence with the hon the Minister, asking for this decision to be reversed. I have copies of the correspondence with me, and I have a copy of a letter from the hon the Minister’s office replying that the matter was receiving urgent attention.

However, what happened? I want to ask why the Standing Committee on Foreign Affairs and Development Aid was misled into believing that this matter was non-contentious. Only when it was brought to the attention of the committee that the matter was indeed contentious were the names of the two farms removed from the memorandum.

I wish to place on record that I am appreciative of the sympathetic attitude of the chairman and of the members of the committee and for their support when we raised the problem. I say this, because to have approved the original memorandum would have amounted to a forced removal, and there is no way in which the PFP could be party to that. [Interjections.]

But what happens now, Sir, to the people of Braklaagte and Leeuwfontein? I hope, when the hon the Minister replies to this debate, that he will advise us as to why these farms were included in the original memorandum, when he or his department must have known that an urgent appeal was being made for this matter to be reconsidered by him and the department. Why was it put into the memorandum and not made clear to the members of the standing committee that that was a matter in contention?

I hope the hon the Minister will also tell us what he intends doing about the plight of these people. I hope he will reassure this House that he will consult with the people concerned. I hope too that arrangements will be made for their leaders and their representatives to appear before the standing committee. With those few remarks, Sir, we will support the adoption of the report. [Interjections.]

Mr Chairman, I should like to thank the hon member for Johannesburg North for their support for the memorandum before us. I also want to extend my congratulations to my colleague, the chairman of the standing committee, for the way in which he has dealt with this matter. We are more than satisfied with the way in which he has allowed us all to make a contribution.

The hon member for Johannesburg North raised a few problems here. We are very glad that he supports the adoption of the report; they can see that what we are dealing with here is merely a question of smoothing out a few of the snags in the consolidation of Bophuthatswana. The only objection, on the part of hon members of the PFP, related to the question of Braklaagte and Leeuwfontein. The hon member for Johannesburg North asked why we had included Braklaagte and Leeuwfontein in the first memorandum and then deleted them. Unfortunately that was a mistake that was made, because it was not necessary for us to obtain permission in the memorandum for the release of Braklaagte and Leeuwfontein, since Braklaagte and Leeuwfontein are owned by the State. It is State land. The land was obtained years ago by the State when the original objective was to move the people concerned. Hon members must bear in mind that 15 000 people live on that land. The Government has its stated policy in regard to the removal of people, a policy which we said we changed because we realised that the forced removal of such large numbers of people was simply not viable. It is not Government policy. That is why those people will no longer be moved; they will remain where they are. It is perhaps CP policy to move people, but it is not NP policy. I want to give the hon member the assurance that the people will remain where they are.

Apart from their unwillingness to move, one must also take the cost factor into account. To move one family costs at least R10 000 these days, and it would cost us many millions of rand to move 15 000 people. When we do have people removed, it is merely to improve their living conditions, or only where squatting takes place. This land belongs to the State. The hon member need not be concerned about that. There is no forced removal involved. The people will remain where they are.

As far as their inclusion in Bophuthatswana is concerned, I think the hon member is making a mistake. There are 15 000 people living there. Then one single person writes a letter to an hon member of the CP, or to that hon member’s party, stating his dissatisfaction. Meanwhile the people living there are ordinary citizens and, from a linguistic point of view, compatriots of the Tswana-speaking people in that area.

I just do not want the hon member to run riot on the strength of one individual case, because one cannot, after all, obtain complete unanimity among 15 000 people. The feelings of the people will be conveyed to the Government in an orderly fashion and the Government will determine the best course of action under the circumstances. We shall deal with this matter in consultation with the independent state of Bophuthatswana. We are very grateful for the support we have had as far as this matter is concerned.

I should just like to reply to one or two statements made by hon members of the CP. We have the same objective as hon members of the CP, and that is to bring about meaningful consolidation. The ideal would be to have the 10 existing states, national and independent states, each in one solid block. At present there are approximately 60 separate blocks. Let us take the 28 different blocks of kwaZulu, the 11 blocks of Lebowa and the seven independent blocks of Bophuthatswana which we are now discussing. The ideal would be to have Bophuthatswana in one solid block. Hon members of the CP ought to support us in this, because we have managed to link up two blocks, the result being that after this is approved, Bophuthatswana will no longer consist of seven blocks, but only of six. I think that hon members of the CP ought to be glad about that.

I already spoke about people being moved. Hon members of the CP, with the hon member for Barberton as their spokesman, said they would not send the bulldozers in there either. They did not want to move people by force. They would also negotiate. We are glad to hear that.

As far as the exchange of land is concerned, hon members of the CP say they would stick to the 1936 Act. They would not purchase any more land, but would, in fact, exchange land with a view to linking up the separate blocks. Hon members of the CP must just realise that this is a very difficult exercise. Firstly it is expensive and, secondly, virtually impossible. How can one exchange fully occupied land, land occupied by thousands upon thousands of Black people, for unoccupied high-potential agricultural land? How would one do that and who would be willing to make the exchange?

What I find interesting about hon members of the CP—and we must obtain clarity about this—is that they say they are going to stick to the 1936 Act, but are nevertheless going to allow Black people to purchase land. If I understand the matter correctly, they are saying that they are going to allow Black people to purchase land. In other words, Black people can exchange their land or link up their areas—we also call it consolidation—by way of purchase. I now want to know from hon members of the Does that apply only to the states, or will they also allow individual Black people to purchase land in the RSA, and will they allow the Black people to buy land only on the borders, or will those Black people also be allowed to purchase land in the detached areas in the RSA? I should like hon members of the CP to clear this matter up for us.

In regard to the aspect of willingness, let me say that we are dealing with these few areas on request in order to eliminate the drawbacks and deal with problem cases, for example in the Vryburg district where people fell under Mafikeng as a result of changes to provincial boundaries. People who fell under Mafikeng will now fall under Vryburg. That is why we had that addition there. Hon members will also find the other additions to be essential.

The CP’s only major objection involved the further addition of the northern Marico link. I have told them, however, that this link ought to fit in with their ideal of contiguity.

Mr Chairman, with these words I gladly support the report.

Mr Chairman …

Koos, tell us a little about …

Order! No, Mr Speaker has ruled that we are not permitted to address one another by our Christian names.

Mr Chairman, I should also like to associate myself with the congratulations extended to the hon member for Turffontein on his election as chairman of the committee. I also want to wish him well, but he made a rather poor start this evening. [Interjections.] Instead of replying to the CP’s questions, what he did, in effect, was precisely what has been done by hon members of the NP since the beginning of the year, and that was to attack CP policy whenever the NP was cornered and could not answer one’s questions.

Answer his questions.

An hon member has just said that I should answer that hon member’s questions. It is not my report that has been tabled here; it is surely the Government’s report, and we are the ones who must then weigh up that report. In doing so we see there, in bold letters: “Mené, mené, tekél, ufarsin”. What we have here is the fact that the CP’s questions go unanswered. We are being inundated with a lot of questions and accusations. The hon member for Vryheid furnishes a good example of this. This evening he emphasised once again that forced removal was not his party’s policy. The other day I asked the hon the Deputy Minister of Development Planning a question about Wheeler’s Farm, for example, where more than 7 000 Black people are squatting. I now want to ask: If those people do not want to move, what is the Government going to do? Is the Government never going to move them by some means or other? Are people entitled to come along from every part of the country?

No!

The hon member says no. But they are coming, Sir! Let me tell you, Sir, that on the Witwatersrand there are at present between 80 000 and 100 000 squatter-shacks. From Randfontein down through the Vaal Triangle alone there are hundreds of thousands of Blacks who are squatting illegally.

And you are squatting in Overvaal! [Interjections.]

Order! The hon member for Overvaal must confine himself a little more specifically to the report.

Very well, Mr Chairman. Let me now turn my attention from the subject of forced removals by saying that the Government owes us an explanation about how it is going to move people if it is reluctant to do so by means of force. That has got the Government in a corner.

The hon member for Vryheid said that the CP’s objective was the same as that of the NP, ie meaningful consolidation. Well, then I really do not know why he subsequently attacked us. Our methods are also, to a large extent, the same, and passages to that effect have been quoted from the CP’s constitution. In that constitution we clearly state that the 1936 legislation is final, but that we would promote consolidation by way of exchange rather than by way of donation. Let me just say that our constitution has been amended. Hon members may obtain our new booklet in due course. In that new booklet we state that the purchase of land is also included. So we are still prepared to negotiate with a view to meaningful consolidation. All we are saying, however, is that we will not give land away for nothing. We are prepared to negotiate with Blacks by saying that they can purchase or exchange land. And when it comes to the purchasing of land, I think the hon member for Vryheid was being mischievous when he tried to create the impression that we were prepared to sell Blacks land in White areas. That is not, after all, our policy, Sir. The purchase of that land is purely for the purposes of meaningful consolidation.

To link up all the people?

To bring about meaningful consolidation. [Interjections.] To bring about meaningful consolidation as far as possible.

In White areas!

How can the hon the Deputy Minister now say they are White areas? He should rather worry about the fact that he said we would be getting a Black President within three to five years. [Interjections.] He should be more concerned about that and preferably request a turn to speak so that he can sensibly tell us what he is talking about instead of consistently making a fool of himself. [Interjections.]

Mr Chairman, I now just want to ask the hon member for Vryheid whether he realises that we are dealing with partition here. In discussing these matters, surely we are talking about partition.

Yes!

The truth of the matter is that the hon the State President said the other day that it was secession and emancipation. In essence it is nevertheless partition. The hon the State President also conceded as much. So we are talking here about partition. That is what the discussion is all about. The NP, however, no longer believes in partition. [Interjections.]

Mr Chairman, I now want to come back to the hon member for Turffontein. I put it to the hon member for Turffontein—and here I also request the hon the Minister’s attention—that the real questions the hon member for Soutpansberg asked here concern the crux of our objection to the one piece of land mentioned in paragraph (c) (ii). That is what it is all about.

Just wake Tom up over there! [Interjections.]

What happened there was that a piece of land was consolidated. Our objection in this instance relates to the way in which it took place. I shall inform hon members of the way in which it happened. After a decision was taken in 1985 to maintain the status quo, the hon member for Soutpansberg levelled the accusation …

Just wake him up please! [Interjections.]

He asked … Sir, you should rather wake up the hon Chief Whip of Parliament from time to time. You should see how he sits here fast asleep at times. There are many other hon members who sit here fast asleep. So it is very dangerous to refer to hon members who sit here fast asleep. [Interjections.]

Now you have at least woken him up, haven’t you? [Interjections.]

Mr Chairman, the hon member for Soutpansberg made the statement that this … [Interjections.] Mr Chairman, I cannot hear myself speaking.

Order! There are a few hon members who would do well to restrain themselves. I am watching them and I ask them please to make fewer interjections. The hon member for Overvaal may continue.

Thank you, Sir. The crux of the hon member for Soutpansberg’s objection was the following: After it was decided, in regard to the relevant piece of land mentioned in paragraph (c) (ii) of the report—this involves approximately 70 000 hectares—that the status quo should be maintained, the following happened. This decision was taken in 1985.

1984.

Yes, in 1984. We alleged that in negotiations with President Mangope the hon the State President simply offered him that piece of land without any consultation having taken place. I am referring to the piece of land between Nietverdiend and Dwaalboom. An hon member of my party claimed, in his speech a while ago, that the hon the State President had given away that piece of land without consultation. He merely spoke to President Mangope and said: “Lucas, you can have that land. ” [Interjections.] The hon the State President is shaking his head, but then the hon the State President must get himself some other speakers, because the hon members for Turffontein and Vryheid did not refute that statement. I must therefore surely accept that that is true and, if he does not refute that statement, that the hon the State President simply gave away that land without consulting the local inhabitants. Nor did he consult Parliament on that issue. After all, it is a matter of record. No one has disputed it; surely I can now argue the point.

If that is to be the position, the hon the State President is riding roughshod over the rights of the farmers in the area and disregarding their wishes. That means that a tremendous number of people now have to travel very long distances to visit one another, that their wishes have not been taken into account and that Parliament is becoming a rubber-stamp. The hon the State President simply comes along here and says that he has decided to give away that land and that we should simply endorse his decision.

We object most strongly to this type of action; it is, in effect, contempt for Parliament, which should be consulted in such matters. [Interjections.] We also said that it was a poor attempt at consolidation. We said that making that land designated land was a poor form of consolidation, because in that specific spot there is no corridor for the people of White South Africa to traverse. The hon member did not reply to that.

I do not think the hon member for Turffontein knew that the hon the State President was going to be here.

Mr Chairman, may I ask the hon member whether he could tell us whether they are going to implement consolidation in such a way that there will be corridors all over the country?

That is a good question. In certain spots one cannot allow for corridors, but in strategic areas allowance must be made for corridors. [Interjections.] Looking at this map, I ask whether the Defence Force was consulted. [Interjections.]

Of course!

Someone is saying: “Of course!” I do not think he was even a member of that commission. I want to ask the hon member for Turffontein what the Defence Force said.

[Inaudible.]

You see, now he does not know. If the Defence Force had been consulted, there is a ten to one chance that the Defence Force would have stated, as the hon member for Soutpansberg said, that that was possibly an ideal terrorist route and that from a strategic and military point of view it would have been a good thing to have had a corridor at that specific spot. [Interjections.] What happened here is that the hon members for Turffontein and Vryheid did not do their homework. They cannot answer our questions, but they simply want the report to be adopted. I do hope that the hon the Minister will be able to give us these answers, because at this stage we are opposing the adoption of this report for specific reasons. Surely it is easy for the hon the Minister to prove to us that our arguments and our fears are possibly unfounded. Then we would possibly be able to support the report.

The hon the Minister must tell us whether the hon the State President simply gave that land to President Mangope unilaterally or whether there was proper liaison before the time. He must also explain to us what the situation is from a strategic and military point of view, and whether this is meaningful consolidation, because we support consolidation in principle. Our policy is based on the fact that consolidation should, in effect, take place because we specifically need Blacks in those areas; that is our policy. The hon chief spokesman of the NP could not answer the question—they sat here like children who had not done their homework—and we now want to see whether the hon the Minister can give us an answer. If he cannot do so, we shall unfortunately not be able to support the adoption of the report.

Mr Chairman, the hon member must simply start preparing himself for the abandonment of his party’s initial resistance to the adoption of this report, because there are satisfactory answers to all the questions he posed, and if he keeps his word, he will have to support the motion.

In the first place—initially I want to confine my attention to the question of the so-called Marico corridor—it is not true that the hon the State President simply offered this area to President Mangope unilaterally, without consultation. Even prior to 1984, when the proposals were published in which this specific case was not included, the Commission for Co-operation and Development held exhaustive consultations in that area. Several representations, for and against consolidation, were received from the farmers in that corridor. After the decision had been made that that corridor would not be included, there were again several representations from farmers from both the southern and the northern parts of the corridor. The Deputy Minister who was responsible for that at the time, Mr Wilkens, held discussions on several occasions with individual farmers and the official farmers’ association. So there can be no doubt that before the hon the State President held discussions with President Mangope, repeated discussions were held, in two distinct phases and at the insistence of the inhabitants, between the representatives of the Government, the commission and the farmers of that area. Let me make it very clear that the inhabitants to the north of the Dwarsberg, the northern portion of the corridor which is, in fact, being included, made representations to the effect that their section should please be included, in spite of the fact that the southern portion was not being included.

What do you say now, Koos?

Virtually all of them made strong representations. There was one person who did not react, but when we carried out investigations, it appeared that his farm was, in any case, uninhabited and that he preferred to live somewhere in Johannesburg or Pretoria.

Secondly, the hon member for Overvaal said that the hon the State President had treated Parliament with contempt. Surely the hon member has been a member of Parliament for quite a few years now and ought to know the procedure in regard to consolidation'. The Government first announces its proposals for initial comment and reaction on the part of the community, and after that reaction has been obtained, the Government announces its final decisions, but before it can take a single step towards purchasing a single piece of land, the proposal is submitted to the select committee via Parliament. That is precisely what is happening now. I cannot understand how the hon member can be so confused that he does not understand that the hon the State President’s proposals and decisions, which were announced, are specifically being submitted to Parliament for ratification and that, in terms of the law, the executive authority cannot do anything before this Parliament has approved the release. [Interjections.]

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

I first wish to conclude this argument, Sir.

Thirdly, the hon member for Overvaal said that we had ridden rough-shod over the wishes of the farmers. I think I have clearly indicated the reversing of an initial decision not to include any farms in the corridor specifically as a result of the representations from farmers from the northern portion of the corridor to the north of the Dwarsberg.

Fourthly, there was the question about whether those involved in security had in any way been consulted on the issue. They are an important component of the overall mechanism involved in the consideration of consolidation proposals. They gave due consideration to this matter and furnished a clearly motivated report which indicated that they had no problems with the Government’s decision. So the Government duly consulted them too, as it always does.

I also want to point out that the southern portion of this area at Braklaagte and Leeuwfontein, which was also brought up for discussion, is specifically needed for irrigation purposes, together with the area to the north of the Dwarsberg. That is an important matter which both the farmers and the government of Bophuthatswana brought to our attention, ie that the optimal utilisation of the new irrigation works which Bophuthatswana is establishing there specifically necessitates the purchasing and incorporation in the consolidation of that land. The irrigation works are specifically aimed at establishing individual farmers on a commercial footing. That is specifically what the hon member for Overvaal and his party have advocated on several occasions.

The hon member for Soutpansberg again raised the fundamental question which his colleague, the hon member for Overvaal, also mentioned, and that is that they were, in fact, in favour of consolidation, but that they wanted to limit this to the 1936 quota.

You must listen now, Koos.

He also said that if there was to be any deviation from that quota, this should only happen by way of purchase or exchange. In 1979—the hon member for Turffontein has already referred to that—the hon the State President made an historically important speech here in Parliament when he again focused on the question of consolidation, which had apparently been finalised at that stage. At that time I was not directly involved in politics, but my judgment of the situation at the time was that it took great courage to focus once more on the extremely delicate question of consolidation which, with the decisions taken in 1975, was generally regarded as having been finalised. The then Prime Minister said that he was specifically focusing on this issue once more so that we could ensure that the decisions we had taken about consolidation were in accordance with our constitutional objectives of achieving freedom for the various Black peoples. Hon members will recall that there was a whole edifice of consultation involving four regional committees, an overall central consolidation committee and ultimately the Commission for Co-operation and Development which again examined the whole question of the feasibility of existing consolidation decisions in depth. In 1979 the hon the State President expressly said in that connection (Hansard: House of Assembly, vol 79, col 242):

That was when hon members opposite still occupied benches on the Government side. In other words, the hon the State President was being quite frank when he called it a new approach, different to that of his predecessor. Under certain specific circumstances he was prepared to deviate from the 1936 quota if this was essential for the achievement of our aims. He also said that where necessary this would be done by way of exchange, but that in principle it could also take place in terms of the normal process of consolidation. [Interjections.]

At the time this was, therefore, a very clear statement of policy on the basis of which a complete re-examination of consolidation was initiated, a process which has taken quite a few years and which is now on the point of assuming its final shape. It is not simply a random decision; it is not something that simply remained at a superficial level. It was a far-reaching decision which was tackled very comprehensively, and no one had any illusions on this score. So if hon members have to come to light with a new policy now, they must know full well that it is a new policy. It is not the policy which they, as a team, promised to join the hon the State President, the Prime Minister at the time, in promising to implement.

The hon member Vryheid said it was the same as ours.

It is therefore very clear that there can be no real grounds in principle for those hon members now suddenly to say that any deviation from the 1936 quota may only take place on the basis of purchase and exchange.

If, in releasing further land for acquisition with a view to its utilisation by Black people and its inclusion in Black areas, that released land can only be obtained by the Black people by way of purchase, I want to know whether the hon members for Overvaal and Soutpansberg can imagine what absolute uncertainty and suspense this would create. The farmers would have to wait until some individual Black purchaser or a Black state with the necessary funds came to light to make such a purchase.

This is already causing the affected farmers to grow impatient at the Government not purchasing the land quickly enough after a decision has been taken. How much longer would there not be this uncertainty, and how protracted would it not be, if the conditions set by those hon members were the only ones applicable when it came to using land to augment Black areas, ie those of purchase and exchange?

It is therefore a completely impractical and unworkable approach which would place the affected land-owners in a completely inequitable position. This would also be in total conflict with the undertaking given by the hon the State President at the time in the speech to which I referred. He said that the interests of those persons and areas which might possibly be involved in such a new and extensive investigation into consolidation would have to be regarded as a matter of top priority and that people would not be expected to relinquish any assets or interests without adequate compensation.

In a subsequent speech he also joined the then hon Minister of Co-operation and Development in emphasising that there would be the utmost possible speed in implementing that policy in regard to proposals which had been announced for consolidation and release.

The hon member Johannesburg North referred to the cases of Braklaagte and Leeuwfontein.

†I think there is a misunderstanding which the hon member for Vryheid has already touched upon, namely that this report does not deal with the incorporation of land in national or independent states. This report deals with the release of land for purchase by the Trust with a view to ultimate incorporation in or consolidation with either a national or an independent state. The issue of incorporation in Bophuthatswana was dealt with last year in terms of Act No 112 of 1986 which amended the Borders of Particular States Extension Act.

However, I would like to give the assurance that although there was ample opportunity for everyone concerned to address the Commission for Co-operation and Development and to address Parliament at the time when proper notice was given, there was no reaction whatsoever from the residents of those two areas.

Nevertheless, I have indicated my willingness to discuss with them any problems which they might have, so as to see whether we cannot solve them—especially in conjunction with and with the co-operation of President Mangope. We are not going to ride roughshod over the objections of these people, but we are also aware that there are various views and various groups there. Apparently those who have the support of the Black Sash and similar organisations and access to certain legal organisations are always immediately ready, when a decision has been taken by this Government, to see whether they cannot upset it by organising opposition or a divergent movement not going along with the decision of the majority. [Interjections.]

Even so, I would like to give the assurance—as I have done in correspondence with the attorneys referred to—that we are prepared to discuss this matter with the people who did not avail themselves of the opportunity to submit their objections and their petitions at the time. Nevertheless, we shall give them another opportunity.

*I want to conclude by extending my sincere thanks to my colleagues on this side of the House. The hon member for Turffontein, as chairman of this committee, gave evidence of exceptional leadership and persuasive ability in obtaining the support of the standing select committee for this report. In my view he and the hon member for Vryheid also dealt very effectively with the unfounded objections put forward by the spokesmen of the Official Opposition.

With the use of concrete examples, the hon member for Turffontein very neatly pointed out how the statements about consolidation in the CP’s policy document were contradicted by the various statements of the hon members for Ermelo and Bethal, and also by those of the hon the Leader of the Official Opposition. [Interjections.] The hon member for Turffontein also pointed out that their policy was actually in conflict with the standpoint they held in 1979 when the then Prime Minister adopted this new approach.

But that is not true.

I also want to thank the hon member for Vryheid very sincerely for the way in which he indicated that the proposals contained in these documents were virtually, in all cases, based on representations from the inhabitants concerned and that they were aimed at overcoming obstacles and problems existing in the relevant area. I therefore feel myself at liberty to ask the House to adopt this report. [Interjections.]

Order! Is the hon the Minister prepared to take a question now?

Yes, very well, Sir.

Mr Chairman, there is a conventional method of consultation, and I just want to hear from the hon the Minister whether consultation about that land again took place by conventional means after 1984, when the Government did not accept those initial proposals and during the period prior to the hon the State President and President Mangope entering into that agreement?

I know that the former Deputy Minister definitely did hold discussions in that area with those who had objections and had made representations and with people who also had objections to the representations which the others made. He held discussions there on more than one occasion with people in both the southern and northern parts of the corridor. [Interjections.]

Question agreed to (Official Opposition dissenting).

Mr Chairman, I move:

It sometimes occurs that a person who has committed a crime in one state, finds himself in another state or country. In terms of the principles and mutual arrangements of extradition, such a person is then handed over by the one state to the other to be tried there. Extradition may also take place in cases where a person, already convicted and sentenced, has fled to another state in order to escape serving his sentence.

The Extradition Act, 67 of 1962, contains the necessary legal provisions in terms of which the extradition of offenders to and from South Africa is dealt with. In terms of this Act, extradition may take place with or without an existing agreement between South Africa and the other states involved.

The extradition procedure provided for in the various extradition agreements between the SATBVC states, gave rise, among other things, to delays in the extradition of persons between and amongst us. As a replacement for separate agreements with each state, South Africa signed a convention relating to extradition on 20 November 1986 with the Republics of Bophuthatswana, Venda and Ciskei then being the other signatories. An agreement along similar lines was also later concluded with the Republic of Transkei. This development originates from negotiations between said states and the Republic and has the effect that certain amendments to the Act have to be brought about. In this connection, I wish to commend the Director-General and his staff for having brought the negotiations to a successful conclusion.

In the convention a simplified extradition procedure was agreed upon, which is based mainly on the endorsement of warrants of arrest issued in associated states, without diplomatic intervention, for which we already have a provision in the Act. The convention, however, also makes provision for the possibility of a request for extradition by an associated state through the diplomatic channel to be retained as an alternative to the new, simplified procedure.

The compulsory use of the diplomatic channel contributed to considerable delays. Although it is appreciated that diplomatic involvement may be expedient or even essential in some extradition procedures, a real need exist for a more direct channel of communication. Provision was therefore made in the new convention and agreement, not only for extradition by way of the diplomatic channel procedure, but also for the reciprocal endorsement of warrants of arrest issued in the SATBVC states, which in terms of the definition section are associated states. This provision has the effect that section 9 (4) of the Extradition Act will have to be adjusted accordingly. That is the business upon which we are embarked today.

This section provides that an enquiry with a view to the extradition of someone who has allegedly committed an offence in an associated state must be conducted according to the provisions of section 12, while the enquiry regarding someone who has committed an offence in a foreign state other than an associated state, must be conducted according to the provisions of section 10. Where the alleged offence has therefore been committed in an associated state, the magistrate may, without intervention by the Minister of Justice as contemplated in section 10, issue an order for surrender under section 12. This is done regardless of whether extradition has been requested under section 4 (1) through the diplomatic channel or whether the person concerned has been detained under a warrant of arrest as contemplated in section 5(1) (a), 5 (1) (b), 6 or 7. In clause 2 (b) it is now prescribed that if the surrender has been requested through the diplomatic channel in terms of section 4 (1), enquiries with a view to the surrender of persons who have allegedly committed an offence in an associated state must also be conducted according to the provisions of section 10.

Under section 9 (3) of the Extradition Act, 1962, certain documents may be received in evidence at a hearing regarding extradition, if they are authenticated in the prescribed manner. It was found that the requirement for the authentication of documents was the cause of much confusion and delay while it in fact has very little practical value.

Provision is now being made in clause 2 (a) that in the case of an enquiry with a view to the surrender of a person to an associated state, such documents may also be received if they are certified by a judge or magistrate of that state or by an officer authorised by one of them as original documents or as true copies or translations thereof.

In terms of section 19 of the Act, a person surrendered shall not “be detained or tried in the Republic for any offence committed prior to his surrender, other than the offence in respect of which the extradition was sought, unless such foreign state consents thereto. ” Although a person who has been surrendered and charged, for instance with robbery, may, under the Criminal Procedure Act, 1977, be convicted of certain lesser offences which have been proved, for instance theft, it is doubtful whether, in terms of the existing wording of section 19, he may be detained and tried for such a lesser offence. Since provision is now expressly being made for such detention and trial in the agreements, it is recommended in clause 3 that a person may also be detained or tried for such lesser offences and that the person concerned may consent to being detained or tried for other offences. Section 2 (3) (c) is amended accordingly by clause 1.

Second Reading resumed

Mr Chairman, the CP will support this Bill.

The Bill amends sections 2 (3) (c), 9 (3) and (4) and 19 of the Extradition Act, Act 67 of 1962. The provisions of this Bill are aimed at improving the system of extradition. This brings more legal certainty and is better legislation. We are satisfied that the matter of extradition is summed up far better in this Bill.

In the circumstances we therefore support it.

Mr Chairman, on behalf of this side of the House I should like to thank the hon member for Overvaal and the CP most sincerely for their support for this legislation. In his Second Reading speech the hon the Minister clearly set out the merits of this amending Bill and I do not intend to repeat the details given by him in the House. However, in support of this Bill I should like, on behalf of this side of the House, to single out a few points in this Bill and emphasise them again.

The first of these is that it is absolutely essential that in its legislation, and in particularly in its criminal law and criminal procedure every state should have an extradition procedure which can be applied effectively and is feasible in practice. The objective of this amending Bill is to make the existing Extradition Act, No 67 of 1962, more streamlined and particularly to eliminate unnecessary delays in the extradition of accused persons or persons who have already been sentenced. I want to emphasise that the Extradition Act should not be subject to other provisions and convention, which can hamper the implementation of the Act and in this connection I am referring in particular to the diplomatic sphere, where unnecessary delays can occur in the extradition of criminals and suspected criminals.

This legislation is not controversial and only three new clauses are being incorporated in the amending Bill, which does not change the nature of the existing Act at all, but merely improves it. Clause 2 of the amending Bill, which amends the existing section 9 of the Principal Act, introduces the principle of certification of original documents. It is an accepted fact that copies of legal documents authenticated by the relevant officials in the various countries, are accepted as true copies by our legal system in civil cases, subject to certain rules. It will therefore also be correct for documents certified by the relevant officials to be acceptable in constitutional law as well, without recourse to diplomatic channels.

This amendment does not introduce a new principle either. On pg 23 of their book Extradition—The Law and Practical the brothers Stanbrooke and Stanbrooke wrote the following:

They go on to say:

Another very important amendment in this measure is the amendment to the existing section 19 of the Principal Act. As the Act at present reads, no extradited person can be detained or tried in the Republic for a crime committed prior to his extradition, except for the crime in respect of which the extradition was requested, unless the foreign state agrees thereto. Clause 3 of the amending Bill introduces a change here, namely that the accused himself can now agree to be detained or tried for other offences, and this makes the implementation of the legal process more effective.

On pg 21 of his book Extradition in International Law, Shearer wrote:

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

Order! Is the hon member prepared to take a question?

I do not have the time now, Mr Chairman, but I can tell the hon member for Greytown that we do not have an extradition agreement with Dakar. [Interjections.]

Mr Chairman, may I ask the hon member another question?

Order! No, but the hon member for Greytown may resume his seat. The hon member may proceed.

In conclusion I want to state that this legislation is in line with legal reform and will serve as a deterrent to prospective criminals who flee to countries and want to have recourse to and hide behind the fact that they can only be extradited through diplomatic channels. This legislation can only be to the benefit of the administration of justice in South Africa and we on this side of the House support it.

Mr Chairman, it is the intention of the PFP to support the Bill—I think in far fewer words than the hon member Mr Van Gend did.

He spoke on behalf of the whole family! [Interjections.]

Well, hon members have possibly heard enough Van Gends tonight.

Be that as it may, there is one reservation I have about the Bill. It is not that I think it needs amendment but I do believe that one important aspect needs monitoring. When we look at the proposed new section 9 (3) (b) as contained in clause 2 of the Bill, we will see that we are allowing documentation to be admitted in evidence—obviously not for the truth of the content of the documents but for the documents themselves to be admitted in evidence—if it is certified by a judge, magistrate or some officer appointed by them. This would be a judge, magistrate or officer in some foreign country. Obviously we would have no control over who or what category of officers are appointed by this particular individual judge or magistrate.

The reason for designating judges and magistrates is clear. It is because of their high office that we in this country are prepared to accept their certificates as sufficient proof as to the authenticity of the document which we are going to pay attention to in our courts. I think we will just have to be very careful where we accept certificates from other countries to make sure that the practice of appointing officers is not delegated to some lowly clerk. We do not want someone like that to be responsible for this very onerous job of deciding whether a document is in fact authentic so as to be acceptable in our courts. I just want to make this one point that I think in the application of this law there should be very careful monitoring to ensure that the people who certify these documents in foreign countries, people appointed by judges and magistrates elsewhere, are in fact competent to perform that particular function. With these words we support this Bill.

Mr Chairman, while we are all in a good mood and congratulating one another, I want to congratulate the hon member for Overvaal. He is not in the House at the moment …

Here I am! [Interjections.]

I think he deserves our congratulations because he enjoys so much confidence in his party that they have allowed him to remain a leader here in the House. They are sure that he will not lead a coup d’état, and that he has enough weight to handle debates. However, it is quite clear to me that he has lost his self-confidence in the interim, because he called in his hon leader. We are very sorry about that, because up to that point it was clear to us that the hon member for Overvaal was rising in stature, position and status in his party. We think it is well-earned. He is an interesting debater and supports our Bills briefly and to the point. For that reason I think he deserves our appreciation.

The hon member Mr van Gend raised two points. I want to tell him that we have indeed introduced quite a number of interesting amendments, all of them aimed at making the Bill more streamlined. We are refining the documentation which must be authenticated in respect of the specific procedure which is adopted, as prescribed in section 9 (3), in the sense that we need not battle through diplomatic channels or with authentication and so on, with which we have been familiar up to now. This will at least allow the communications between ourselves and other countries in Southern Africa to proceed far more smoothly.

The hon member for Groote Schuur said we must make sure of the persons appointed by way of delegation. In addition to a judge or a magistrate, an official may also be appointed to undertake the certification now. I want to give the assurance that we are in fact extremely scrupulous in ensuring that there is no lowering of standards with regard to one another’s legal qualifications. In order to ensure that standards are not lowered I want it placed on record that these states with whom we have agreements are just as scrupulous about their legal qualifications. I want it placed on record that we appreciate this and that we are co-operating very closely with them in this connection.

As regards recognition of one another’s legal qualifications, I want it placed on record that increasing emphasis is being placed on legal training, so much so that it has even silenced the critics. Of course we expected this. I want to give the assurance that this matter, particularly the states with which we have links, is very important to us. I have no doubt that they are constantly striving for quality.

With these few words, and with the emphasis on co-operation, I am saying this evening, in this brief time at my disposal, that we can continue to extradite one another’s criminals.

Question agreed to.

Bill read a second time.

Mr Chairman, when we discussed this Bill on 26 June and I was speaking, I asked that everyone should contribute towards the success of the establishment of the Transport Advisory Council. Since then a few things have happened which have made that appeal of mine more important.

In the few minutes at my disposal I want to say that various people in the business have come forward since that date and have alleged that the Government was not sincere as regards deregulation and the White Paper on this matter. I have considerable documentation in this regard in the form of cuttings. However, I do not want to deal with it this evening; I feel we should deal with it tomorrow, when we discuss the Department of Transport in the debate on the Appropriation Bill. I think it is essential that we refer to this and that we emphasise the bona fides of the Government in this regard.

I want to mention one example in particular, and this was when the hon the Minister of Transport made a major announcement on further deregulation yesterday, by means of which these insinuations and certain statements on the White Paper and deregulation and on the intentions of the Government in the Press can be rejected with the contempt they deserve. I think the time has come for the Department of Transport to consider gradually getting rid of all its consultants. They have done wonderful work, and we are very grateful for this, but in future the work must be passed on to the Transport Advisory Council. I feel it is essential that the people who are eventually going to be affected, who are going to participate, who are going to spend money and try to make a profit, the people with vested interests and those who want vested interests, should make their voices heard on the Transport Advisory Council so that we can also hear from them how deregulation and the new transport policy should be applied in South Africa.

In conclusion I want to say that in my opinion it is essential that the Transport Advisory Council should be established as soon as possible. I also want to ask the hon the Minister to see to it that the legislation which is still going to be introduced—and there is quite a lot of it—to create this new transport policy in South Africa, is not delayed. I feel we are all in a hurry to see the new measures, to pilot them through Parliament and to apply them. It will be a good thing if this legislation can be submitted to the Transport Advisory Council first so that the council can make its contribution before the Bills are referred to the standing committee, without delaying the measures unnecessarily. I want to ask that if a period of time is going to elapse before the appointment and establishment of the Transport Advisory Council, we should get the legislation from the Cabinet and Mr Speaker, so that the standing committee can give attention to it and set the ball rolling.

The Transport Advisory Council will, for example, have to give attention to and reach a decision on an aspect such as whether—I am only mentioning one example because my time is limited—it is essential for the envisaged tribunal to fall under the Department of Transport Affairs or whether there is merit in its being transferred to the Department of Justice.

It gives me pleasure to support the Second Reading of this Bill.

Mr Chairman, the hon member for Primrose has made some interesting comments here this evening. I think it is a worthwhile thought to consider that the tribunal should form part of the Department of Justice rather than the Department of Transport because, after all, the tribunal will have to some extent to sit in judgment which is more a judicial function than a transport function in the first place. Secondly, if the tribunal is part of the Department of Transport we will have a tribunal that is part of what probably will be one party to the case. In other words, if there is a case to be heard by a tribunal one of the parties will probably be the Department of Transport itself. It would therefore probably hold merit to have an outside or third party involved in these decisions.

The hon member also spoke about the comments made and queries that have been raised on the commitment of the Government to the new transport policy system. While I can understand why the hon member said this I want to point out to him that the delays that have been caused in the implementation of this system give rise to the very comments that have been made. There have been inordinate delays in the implementation of the national transport policy system recommendations and there were delays with the White Paper but, as the hon member himself said, we will discuss this perhaps more fruitfully in the debate tomorrow.

I want to start by quoting from the précis of a book by Dr Wassenaar entitled Assault on Private Enterprise. He starts his comment by talking about the Marxian philosophy. He says in this comment that the Manifesto of the Communist Party was drawn up by Karl Marx and Friedrich Engels and published in London in 1848. One of the principles was the abolition of private property. To accomplish this aim various methods were advocated and one of those methods was the centralization of the means of communication and transport in the hands of the state.

That communistic practice has been the case in South Africa for some considerable time. The Government has finally grasped that nettle and in its White Paper it has made a commitment to move away from that Marxian theory and philosophy. This Bill now before the House is the first indication of that and the first putting into practice of the move away from Marxian theory.

I find it astonishing therefore that the hon members on my right are opposing this Bill. [Interjections.] They want to retain the present philosophy and the present situation within the transport community. They do not want to move towards the free enterprise system.

Nonsense!

The hon member for Primrose in his speech on 26 June said the following, and I quote from Hansard, 26 June, col 2373:

They have done it again on this Bill. Now it is all very well to stand up and shake one’s fist in the air and say: “We must get rid of communism” etcetera and then turn around and support theories, philosophies and policies that are in fact communistic in origin.

We support the principle in the Act!

It is not enough simply to rant and rave and shout and scream in a mindless manner against communists. One must also reject their economic theory and their economic practice. [Interjections.] Why is the CP not supporting this Bill?

We told you why.

The answer is very simple. They are not supporting it because the council will be a multiracial body. Apparently they believe in total self-determination. I now want to ask the hon member for Roodepoort, who spoke in this debate, some questions. Does the CP believe that there should be a national transport advisory body for each race group? The hon member does not answer me.

Each nation should have its advisory body.

Each race group should have its own advisory body nationally. [Interjections.]

In the first place, I want to ask if this will not be very expensive. Instead of having one body there will be any number of them—probably one for each Black tribe, one for Indians, one for Coloureds and one for Whites. Secondly, if one adopts this philosophy, how does one provide for self-determination on national roads? It is ludicrous to suggest that there should be an advisory body for each race group. Surely there has to be an overall controlling body on which all groups have representation. One has to end up with a national transport policy. There cannot be a whole series of little policies for the various race groups. It is quite ridiculous! Or—and I think that is probably what they believe—every group should have its own national advisory body, but at the end of the day the “Wit Baas” is going to make the decision despite what the other advisory bodies have to say. That party wants the Whites to make the ultimate decision. [Interjections.] One can see that that is what their whole philosophy is about. Therefore, the national advisory bodies for the other race groups that they so glibly talk about are nothing but a cover-up and a curtain drawn over the reality of the situation.

I want those hon members to answer a very simple question. Let us assume that there are various advisory bodies: How does one decide on which side of the road to drive?

In the middle!

Are the Coloureds going to drive on the left and the Whites on the right or vice versa? No, I regret that the solutions to South Africa’s problems offered by the CP are expensive and impractical and will create rather than resolve conflict. [Interjections.]

We got more votes than you did!

The CP in fact believes that everything washes whiter when the electorate has spoken. The NP makes that same mistake. The fact that a party gets more or fewer votes actually does not mean that it is more right or wrong. It just means that it had been able to fool more of the people more often.

That is loser’s talk.

As to the Bill itself, we in this party welcome it as the first move away from a most undesirable and expensive transport policy which has operated to the economic disadvantage of South Africa for some considerable time. The change away from this system cannot come about quickly enough for the hon members on this side of the House. This does not necessarily mean to say that, as far as the Bill itself is concerned, we are totally happy. We would, for example, prefer there to have been more private sector members on the advisory council. When one actually looks at the recommendations of the National Transport Policy Study, one realises that they recommended that the council should consist of 15 private sector members and 7 public sector members. I acknowledge that the main objective has been met in this Bill in that there is still to be a private sector majority on this advisory council.

I welcome that. However, after R7 million had been spent on the National Transport Policy Study—that was what it cost the Government and the taxpayer of this country to have that study—and after considerable discussion and after a considerable amount of evidence had been heard, a certain recommendation was made which has not been proceeded with. I am certainly happy to go along with the advisory council as it is constituted in this Bill. However, I think it would have been better if there had been a heavier weighting in favour of the private sector.

I want to refer hon members to some of the representations which the standing committee received, for instance, from the Federated Chamber of Industries. I quote from their letter of 14 August 1986:

We also had a telex from Assocom, in which they say:

In addition, it is recommended that 15 members be appointed by the Minister from the private sector and eight further members from the public sector. Therefore, one can see the thread that runs through these representations. As I say, we are happy with the composition of the advisory council. It represents a very considerable improvement and, as such, we welcome the Bill.

I just want to refer to one of the final representations that was made in regard to this Bill which I believe has some merit. It has to do with the subsidiary committees which are to be part of the transport committee. This is a representation from the Commercial Aviation Association of Southern Africa. They say:

I should like to recommend to the incoming chairman of the advisory council that when they appoint a subcommittee to deal with a specific subject, they should call it an aviation committee or a shipping committee or something of this nature. I do not think it needs to be embodied in this legislation but I really do think it would be sensible if, in practice, this is what occurred.

Finally, Sir, I have placed some amendments on the Order Paper which I shall move at the Committee Stage. As the hon the Deputy Minister also has amendments, we will presumably be having a Committee Stage which, obviously, I am quite happy to take immediately.

One of the amendments relates purely to a textual misprint which I picked up and am seeking to alter; the other is perhaps somewhat more interesting. In the original standing committee it was moved by the former hon member for Bezuidenhout. It has to do with the fact that the Minister should be given certain powers to appoint members. We are always chary of powers being given to Ministers to appoint under certain circumstances. [Interjections.] I accordingly moved an amendment to that clause. Subsequently, I decided that I would not be putting the amendment to this House at the Committee Stage because of the reasons behind that amendment. By and large those reasons relate to the fact that it became apparent that there was concern that population groups other than White might not have proper representation on this committee.

This power was being given to the Minister to enable him to overcome that particular problem. I want to have that placed on record in this House because these powers can be abused and have in the past been abused. We shall therefore not be opposing that particular provision but I should like to make it quite clear—I hope the hon the Deputy Minister will comment on this—that we want that power to be used to ensure proper representation of all population groups on the Transport Advisory Council.

With those words we support the Bill.

Mr Chairman, at the outset I should like to thank the hon member for Port Elizabeth Central for his support of the Bill, even though with several ifs and buts. I think he himself will concede that the standing committee did in fact make several changes to what was originally suggested. I think the hon member should accept that fact.

Yes, of course.

I should like to have that placed on record, but I shall deal with the matter a little later.

In my opinion the legislation before us did not have an easy passage through the standing committee. This was, firstly, because it was something completely new—a departure, as it were, from the past, and the first step towards a more modern and market-related transport system. Then, to compound the problem, I believe there was also an attempt to secure personal interests as against group interests on the council.

We, the committee, had the additional task of ensuring that all population groups were represented on the council. This was a difficult task in the sense that the accommodation of all interest groups was absolutely essential if the proposed council was going to be effective and successful in its deliberations and decision-making in order to advise the Minister. Furthermore, it was imperative for the proposed council to have the necessary status and respect in the eyes of the entire transport community.

Although the NTPS group made the majority of recommendations, there were in fact some very valid reasons for deviating from some of these recommendations. The NTPS recommended that the Transport Advisory Committee comprises the following 25 members: A chairman and vice-chairman from the private sector 15 members from the private sector from bodies not specified by the NTPS; and 8 members selected from departments in the Public Service identified by the NTPS. The NTPS further recommended that the 15 members be appointed by the Minister from a list of 15 organisations selected by him, which could nominate a total of 30 persons. It was apparent from this recommendation not only that the Minister would have to make decisions on an arbitrary basis, but also that he would be placed in the invidious position of having to select suitable organisations from the transport sector without the advice or assistance of the standing committee. In fact, the standing committee would have had no discretion if these proposals had been accepted.

After hearing much evidence from various bodies involved in transport, the standing committee, with good reason, came to the conclusion that groups other than the 15 originally envisaged by the NTPS had equal if not better cause to be nominated to the council. It was realised that numerous divergent groups had an interest in decision-making with regard to transport, for example, agriculture, mining, aviation, commerce and industry, road transportation—both passenger and goods—shipping, employer organisations and tourism, to name but a few.

The evidence presented to the committee was comprehensive and varied and led us to believe that what we as a committee had to ensure was that the proposed legislation made provision for representation over the broadest possible spectrum.

What I want to stress is that interest groups and not individuals must in all instances be represented on the Transport Advisory Council. This Bill makes provision for such representation, and because of the divergent nature of the representation on the council, the formation of pressure groups should be eliminated. It is in this regard that I believe the contribution by the Department of Transport was extremely useful. It helped the committee to crystallise its thoughts with regard to certain decisions embodied in the Bill before us. Equally, representations from outside bodies were favourably considered. As an example I quote from a representation made by one of these bodies, viz Assocom.

We received a telex from Assocom—I think the hon member for Port Elizabeth Central referred to it—and I would like to quote from it as follows:

I think the hon member for Port Elizabeth Central will concede that we did make allowances for that particular representation.

In their representation, Napto says the following:

Secondly, this submission aims to appeal to the standing committee to assign appropriate prestige to the proposed Transport Advisory Council.

I think we have complied with that. We have made provision for these people in clauses 3 (k) (v) and (vi).

The Department of Manpower also made a very valid comment, and I quote them as follows:

We have accommodated them in clause 3 (k) (viii).

In retrospect, with thanks to all the various bodies that presented evidence and with the consensus reached on the standing committee, the Bill before us lays a firm foundation for positive future change in transport legislation.

I sincerely believe that change is inevitable and the sooner we get on with it the better. The private sector has requested the Government to speed up the pace of deregulation and privatisation in the transport industry for good reason.

Since the inception of the National Transport Policy Study in 1981, Government has created expectations for both the user and the suppliers of transport in this country. What we have to do, is to define the objectives of deregulation and the mechanisms to achieve the stated policy goals and, with respect, find a way to put the theory of the White Paper into practical terms for implementation with far more clarity than exists at the moment. There are many of us—I certainly am one of them—who believe the current Road Transportation Act is too restrictive in limiting the operational flexibility and efficiency needed to meet the modern-day requirements of the marketplace. Unless we are paying lip service to the free market concept then one can only agree that the present Act is unfair and, with respect, cuts right across the principle of the free market concept, a position, I believe, we can no longer afford if we are to survive the outside pressures against us.

The economic control of transport is costing the country not less than R60 million per annum in direct costs. The indirect costs run into hundreds of millions of rand, and I want to quote one or two examples. I have here an example of a certain company whose costs for permits, consultants and legal fees in the year 1986 amounted to R326 000. Administrative costs on permits amounted to R81 000 and the total amount was R407 000. That is a lot of money in anybody’s language.

One wonders why, in view of the Government’s acceptance of the NTPS study, there still appears to be harassment on the roads from the inspectors.

I want to refer to another company. Since 1983 they have had 126 cases against them of which 111 have been withdrawn. There have been 19 court appearances and two losses. One of the cases was won on appeal at Bloemfontein. Six appeals are pending and there are 14 impoundings. The legal costs have amounted to R100 000.

I have another case here of litigation involving another company. From 1977 to 1983 legal costs amounted to R29 000, travelling costs to R14 000, and down time R63 000. From 1983 to 1986 legal costs amounted to R185 000, travelling costs to R51 000, and down time to R116 000. I could quote many more examples.

I want to ask the question: Can we as a developing country continue along this road of stonewalling of certain organisations and in overcoming technical problems in implementing what has already been agreed to? In this regard I want to quote from the White Paper on National Transport Policy.

I quote from paragraph 3. 2. 2:

Therefore, in supporting this Bill before us, I earnestly appeal to the hon the Deputy Minister to use his influence to see to it that there are no unnecessary delays in the implementation of the proposals in the White Paper. I say this because in certain transport circles the impression is gaining ground that the Government is not serious about the White Paper on National Transport Policy. This is so notwithstanding the fact—it is important to note this—that the hon the Minister has committed himself to the spirit of this Bill.

Furthermore, in a news release by Dr D J de Villiers on 2 May 1986, the following was said:

Mr Chairman, in supporting this Bill I say to the hon the Minister once again that I think that there is a lot of confusion in the marketplace. I hope that this can be cleared up to remove the uncertainty that still prevails.

Mr Chairman, allow me to make a few remarks in consequence of what the hon member for Port Elizabeth Central said. It seems to me he does not understand the CP’s principles at all. He says that we are opposed to the Council, and he asks who is going to decide whether we are going to drive on the left or the right hand side of the road.

I want to ask him this evening whether he has noticed someone from Zimbabwe among the various members appointed to serve on this council. Yet we transport many of our goods to Zimbabwe via South Africa, and we do not share an advisory council with them. None of their members are here. We do not care which side of the road the people in Zimbabwe drive on either; they can drive where they like and we will drive where we like. It does not bother us. [Interjections.] The error in reasoning of the PFP is that they think there are only borders between Zimbabwe and South Africa or between Swaziland and South Africa and forget that we are also going to lay down certain boundaries in consequence of our racial policy.

This evening I want to talk about a transport advisory council as such. We have no objection to a transport advisory council as such; as a matter of fact we think it is important for there to be such a transport advisory council, because the SATS is a large organisation. It was established in 1910 and has four divisions, viz, rail, road, air and sea, with the three pipelines for petroleum products. The organisation provides employment for virtually a quarter of a million people.

A start was made with the building of the first railway line in South Africa, the line from Cape Town to Wellington, in 1859. Since then a tremendous rail network which is divided into ten geographic areas has been laid down. Every area has its own regional manager. We think, for example, of the era of the steam locomotives and later the oil locomotives which were gradually replaced by electric locomotives so that soon approximately 80% of all traction will be electrical.

We also think of Sentrarand to the east of Benoni which was completed in 1982 at a cost of R700 million, where block freights to their destinations facilitate traffic. We also think of the transport capability of the industry. The locomotives in use at present total 4 724, goods wagons total 181 000 and the carrying capacity is more than 6 million tons.

What has this got to do with the Bill?

Then there are also the harbours such as Durban, which covers 892 hectares, Table Bay with its extensive facilities for repairs to ships and Port Elizabeth, East London, Saldanha and Richards Bay.

Sir, may I put a question to the hon member?

No, I do not have time to reply to questions.

Order! The hon member may proceed.

These harbours handle millions of tons of freight annually. I have not even mention shipbuilding, which is also one of the important subdivision of the Transport Services.

Nevertheless, we cannot support the Transport Advisory Council. It is a multiracial Transport Advisory Council. One can ask directly who should serve on the Advisory Council, and when it is spelt out who these people are, it is across the race and colour bar. One can go and read in the White Paper on the National Transport policy what they must do. The reply to what they are going to do, is given in this White Paper. On page 1 of the relevant White Paper it is stated inter alia that it is a—

On page 3 in the pre-condition for the implementation of these recommendations it is said, inter alia, that the measures are designed to—

The present transport policy is therefore not in line with the present national policy which has to be implemented by the present NP. The transport policy must be brought into line with “the process of political and social changes”, as is stated on page 5 of the White Paper.

On page 37 of the White Paper the recommendations are set out and a Transport Advisory Council is recommended, inter alia. This Council must also be composed of members of all population groups. The Government’s standpoint is set out as follows on page 38:

Chapter 7, on page 50, reads inter alia:

Apparently the Government can no longer govern if another population group is not involved. [Interjections.]

On page 50 of the White Paper it is mentioned that the Transport Advisory Council is to be established but that the local Road Transport Boards are to be phased out and this is a pity. I foresee problems and not always solutions.

Furthermore, the hon member for Roodepoort has pointed out a few mistakes, for example the wording “an office of profit under the Republic” instead of “an office of profit in the service of the State”. There are also a few words which have not been spelt correctly, and the word “van” appears twice in succession in the Afrikaans text. Reference is made to the “majority of persons”, but also to the“ single representative”.

We on this side of the House do not consider a Transport Advisory Council across the race and colour bar to be necessary. We do not want to tell the other population groups whether they should have a Transport Advisory Commission, but in our opinion there must only be a White Transport Advisory Council in our country.

Mr Chairman, in my reply I hope to refer to what all the hon members said about this measure.

The last time we conducted this debate was in June, as the hon member for Primrose pointed out, and a long time has elapsed since then. I shall have to refer in some detail to the hon member for Roodepoort, who introduced the debate on behalf of the Official Opposition, although the hon member spoke quite a long time ago.

I first want to take this opportunity, though, to convey my sincere thanks to the hon members who served on the standing committee, and who are still members of the existing standing committee now, but particularly those who were involved in the legislation before us, for the work they did.

The hon member for South Coast pointed out that many hours were spent on this legislation. The meetings of the standing committee were almost always fully attended, because there were very few members absent. I want to add that the evidence given was given well, and that the Department of Transport was very helpful and accommodating. The outcome of the national transport policy study is that the department—I think—is as eager to establish this body as we are.

I also want to avail myself of this opportunity, since the hon members for South Coast, Primrose and Port Elizabeth Central referred to the doubt some people had as to whether the Government was in earnest about implementing this new transport policy and the White Paper, to try to satisfy those people and to try to calm down the feelings that have been aroused by saying that the Government is very much in earnest about implementing the findings of this White Paper and about proceeding with its policy of deregulation and privatisation, particularly as far as the transport industry in South Africa is concerned.

We are not dragging out feet and we are not backing away, but I want to point out to hon members that we had hoped we would be able to place the legislation on the establishment of this Transport Advisory Council on the Statute Book last year. However, we did not succeed. This year an election intervened, but we are now going to place it on the Statute Book.

Mr Hendrik Schoeman, the former Minister of Transport Affairs, made the promise some time ago that the Government hoped to complete the implementation of this White Paper by 1991. I am almost certain that, if we get a move on, we shall have done so by 1991. I trust that this will reassure hon members and members of the public who had doubts—it is understandable that they felt that way.

†Interested parties have had this doubt but I would like to put their minds at rest. We will try our level best to stick to this programme and to see to it that this White Paper is implemented by 1991.

*This legislation forms the most important component for launching a new transport policy. It was the first difficulty that had to be overcome. On occasion and at intervals all the hon members who participated in this debate acted very positively. In particular I want to thank the hon members on our side of the House very sincerely for the support they gave. Even the hon member for Roodepoort was very positive at the beginning of his speech. Subsequently, however, just like the hon member for Witbank, he became confused between sound common sense on the one hand, and wishful thinking, on the other, that people of colour did not form part of the South African pattern of co-existence. [Interjections.] They became confused between those two points.

I want to ask the hon members of the CP a few questions. I am pleased the hon member for Port Elizabeth Central also put those questions to them.

It just goes to show how close you are to one another.

No, I think it was sheer common sense that applied in this respect.

You are blood brothers.

I want to ask what danger can lurk in an advisory body on transportation. Could it perhaps lead to power-sharing and/or being engulfed or overwhelmed, or could it perhaps endanger White self-determination?

What danger is there …

Nowhere do the dangers and spectres those hon members conjure up lurk in this legislation before this House. [Interjections.] At the same time the hon member for Roodepoort, as well as the hon member for Witbank, did not make it clear how they envisaged consulting with people of colour about transportation matters. Surely the hon members on that side of the House cannot ignore the transportation requirements of the other groups in South Africa, or do they intend to do so? If that is the case, those two hon members are not as sensible as I thought they were.

That hon member said at the outset:

That hon member displayed sound common sense.

He went further, however, and maintained that such an advisory body could produce long-term as well as short-term plans relatively more quickly and more ingeniously, which could lead to cost-effectiveness in transportation. He also asked why there were pre-eminently various factors in South Africa which necessitated an advisory body of some kind or another in the transportation industry. The hon member then mentioned the factors which play a role from day to change the circumstances, and which necessitated adjustments in the transportation policy. What did he say those factors were? He said they were township development, urbanisation, depopulation and the establishment of industries. This is only a few examples the hon member mentioned. These are all practical phenomenae which the authorities in South Africa, in the same way as that hon member, cannot disregard. These are the facts facing us. They affect all population groups intensely, and call for a policy, guidance and a solution. However, the CP refuses its co-operation because other groups will also be serving in this council. Not only are they leaving the transportation industry in the lurch, but also the true interests of all South Africans.

However, I appreciate the fact that the hon member, who was the first speaker on this subject, studied the legislation well. I thank him for that, just as I do the hon member for Port Elizabeth Central. He spotted certain minor errors in clauses 3 and 15. As regards the errors in clause 3, we and the department also spotted them, and changes will be effected. This will, as the hon member knows, be done during the Committee Stage.

The hon member also referred to the expression “office of profit under the Republic” in clause 5 (1) (e). According to the hon member’s view, it would be preferable to use the expression “office of profit in the service of the State”. The hon member asked for that. The words “office of profit under the Republic” are part of our Constitution and are contained in section 54. What is good for our Constitution, cannot be harmful to this legislation. The old wording is part of our tradition and has withstood the test of time. [Interjections.] The legal draughtsmen allow themselves to be led by existing and proven legislation. [Interjections.]

That is my reply to that hon member. The hon member and his colleagues also said they did not like the present provincial system in which members of the Council were nominated by the Administrators. They want the provinces to have elected representatives in this Council. It is impossible to do something like that. All the other hon members are nominated in this way. Why should we therefore curtail the powers of the Administrator in this way? The views of the hon members of the Official Opposition are inexplicable and I think they are merely looking for arguments to oppose this legislation. However, that hon member and the hon member for Witbank stated the standpoint of their party. According to them the legislation cannot be agreed to—whatever advantages may be attached to it—because in the Advisory Council recognition is being given to all groups. With that the hon member for Witbank closed his argument.

†We on this side of the House do not apologise for giving recognition to the other groups on this body. It is essential that the advisory council should be representative of all racial groups in South Africa. Members of groups other than the White group form the majority of our passengers. As transport entrepreneurs they are growing in numbers and it is the policy of this side of the House to give the small entrepreneur a chance to compete in a growing market. Let us just look at some of the figures that I have available.

*The number of registered motor-vehicle owners among groups other than the Whites in 1984 was 900 000. By now it is probably more than a million. Daily more than 4 million non-White commuters are conveyed by bus. This was a figure furnished by Saboa. Every day 1,6 million non-Whites are conveyed by train. I found this figure in the 1986 Transport Services’ annual report. There are more than 23 000 legal non-White taxi owners. A further 5 000 kombis and microbuses, which are probably being used for taxi activities, are not included in this figure.

It is therefore clear that people of colour comprise the largest percentage of our passengers. They are the people who have to commute the most. It would therefore be a terrible mistake, under our South African circumstances, to ignore them. Consequently we make no apology whatsoever for wishing to include them in this body.

†I know that this body of 40 members is a large advisory body. I think it was the hon members for South Coast and Primrose who pointed out why this had to be a large advisory body. It has to be representative of all interested parties. That should be so because we have sea, land and air modes of transport.

Sir, I must say, it is difficult to single out any sector or any interested party that we have left out. Hon members need only look at clause 3 of the Bill; they are all mentioned there. I think the only group in South Africa we have left out are the undertakers and nobody, as a passenger, is going to worry very much about how the last journey will progress!

This body, its management committee and also the various committees which it has the power to co-opt will serve as instruments to programme the implementation of the national transport policy.

It will be able to advise the Minister in order to enable him to identify and avoid pitfalls in the implementation programme. Above all, we shall ensure through their representation that the interests of the various economic sectors are catered for. An important function will be to ensure that South Africa remains in the running with regard to modern transportation development, if not at the forefront.

I should like to remind the hon member for Port Elizabeth Central, who clearly felt that the private sector was not adequately represented on the advisory council, that 57,5% of the representatives will be from the private sector, and 42,5% from the public sector. I therefore believe that the private sector is well represented on the advisory council.

The hon member also asked, if we establish these subcommittees, whether we should not give attention to specific industries, for example, the aviation industry. I agree with the hon member but this is something for the new chairman of this body and the advisory council to decide. It will depend on whether they would like to go back to the old system of having such bodies as, for example, the maritime council or the aviation council. I would not like to commit myself on this particular issue at the moment. I think we should leave it to them.

The hon member for Primrose, as our official spokesman, and also as chairman of the standing committee, proved once again by his contribution that he clearly understood what transport in general and this Bill in particular were all about. He advocated, inter alia, that we should have a division of information within the department. He did not say so today, but he did say so previously.

The advantage of such a division must be obvious, but clause 12 empowers the Director-General to appoint such officers and personnel as may be necessary. He will do this in conjunction with the Commission for Administration. I believe that the hon member’s suggestion should receive attention.

Other related matters like the appropriate accommodation for staff can also be dealt with in terms of the clause I have just quoted, and also—as I have indicated—by the Director-General in conjunction with the Commission for Administration. I hope that answers the hon member’s questions.

*In conclusion I just want to thank hon members who participated in this debate for their contributions. In general there is absolute unanimity on this legislation, and we should all like to see it being implemented as soon as possible because we know the cost involved in permits for South Africa. We are also, as I have already said, committed to privatisation and deregulation. I hope that I have replied to most of the questions put by hon members.

Question agreed to (Official Opposition dissenting).

Bill read a second time.

Mr Chairman, I move:

Agreed to.

Committee Stage

Clause 3:

Mr Chairman, I move amendments (1) and (2) printed in my name on the Order Paper, as follows:

1. 1. On page 6, in line 17, to omit “(1)(j)” and to substitute “(1)(k)”.
2. 2. On page 6, in line 25, to omit “(1)0)” and to substitute “(1)(k)”.

Mr Chairman, I accept the hon member’s amendments and I appreciate the proposals he made.

Amendments agreed.

Clause, as amended, agreed to.

Clause 15:

Mr Chairman, I should like to move the amendment printed in my name on the Order Paper, as follows:

1. 1. On page 12, from line 26, to omit paragraph (b) and to substitute:
   1. (b) by the deletion in subsection (8) of the words “the National Marine Advisory Council, and”; and
   2. (c) by the deletion in subsection (9) of the words “of the National Marine Advisory Council, and”.

Let me just explain that if the relevant clause were not amended in this way, the word “of” would appear twice, and that would make no sense. I therefore think it is absolutely necessary for this matter to be rectified, from a linguistic point of view too.

Amendment agreed to.

Clause, as amended, agreed to.

House Resumed:

Bill, as amended, reported.

Bill read a third time.

Mr Chairman, I move:

The Gold Mines Assistance Act, 1968, originated from the report of the Steenkamp Committee in 1967. The Committee found that assistance to marginal gold mines could be justified only if a substantial rise in the price of gold within the decade after the completion of its report were to be assumed.

The Committee also stated specifically that only mines likely to close within eight to ten years if not assisted were to be included in the assistance scheme. The measure of 1968 aimed at instituting a new scheme of assistance for gold mines instead of the previously unsuccessful scheme whereby loans were granted.

†Hon members will recall that the gold price was then fixed at $35 an ounce and not related to market values. Since the date of commencement of the Act, until March 1987, assistance has been given to approximately 14 marginal gold mines. The State has received during the same period, in the form of direct taxation and mining lease rental, an income of almost R611 million from mines classified as assisted gold mines against an amount of approximately R385 million in the form of paid-out assistance.

Mines receiving assistance have over the years produced on average 9% of the total gold production. During the past five years gold mines were assisted as follows: R39,788 million to seven mines during 1983; R28,012 million to five mines during 1984; R46,110 million to four mines during 1985; R27,410 million to four mines during 1986; and R23,244 million to three mines during 1987.

*Sir, I accept that since the aim of this Bill is to abolish an established statutory assistance scheme, certain interest groups may object. There is no getting away from it that an established scheme, irrelevant of the sector involved, is apathetically withdrawn from, even in the absence of the original reasons for the move.

The Franzsen Committee which was appointed in the early eighties specifically to investigate and report on the continued right of existence of the Act or the possible amendment thereof against the backdrop of the prevailing circumstances recommended in its report of 3 February 1983 that the Act should be repealed in its entirety. This recommendation was based on the fact that all the reasons for a Treasury assistance scheme, amongst others a gold price of $35 an ounce, had disappeared.

The Committee also showed that it was never the intention to protect the gold mining industry against a fluctuation of prices. Hon members will realise that, despite substantial increases in working costs, the gold mining industry today, thanks to a firmer gold price than at that time, is in a far better position to survive without direct State assistance.

Within a free enterprise system the State cannot be expected to be held responsible for the usual risks involved in undertaking private enterprise. Therefore the Franzsen Committee also came to the conclusion that the State ought not to accept that responsibility.

†The Government realises that there may be meritorious cases where assistance should be provided on the grounds of exceptional social or socio-political considerations. Not only do gold mines alone qualify for assistance; it is well known that the Government, as far as this matter is concerned, is not neglecting its duty, despite its drive to reduce State spending. Hence the Government considers aid and assistance from time to time on an ad hoc basis and offers assistance only where this is vital to the national interest.

The Government does also not intend to withdraw assistance from gold mines. In future, however, assistance will not be given according to a fixed statutory formula, but strictly in accordance with merit, the means available to the Treasury and other national priorities.

* Against this background the Government considers the repeal of the Gold Mines Assistance Act of 1968 as desirable and sees the mining industry under the prevailing circumstances in a favourable position to survive without direct State subsidisation.

Sir, the legislation will now be dealt with by my colleague, the hon the Deputy Minister.

Second Reading resumed

Mr Chairman, the CP supported this amending Bill on the standing committee and we should also like to support it at this stage.

Initially the position was such that when the profit margins of mines decreased to below a certain level, the mines qualified for State assistance as a matter of course. The object of the amendment is merely to ensure that State assistance is no longer granted as a matter of course, but rather on merit. Therefore the Minister can now exercise his discretion, as in the granting of a Land Bank loan, for example.

As far as we are concerned, this is sound legislation. Assistance is no longer granted as a matter of course, but rather on merit. Therefore—and with an eye on the minute-hand of the clock—let me say that I support the Bill on behalf of my party.

Mr Chairman, we are grateful for the support granted to this Bill by the CP. We should very much like to have this dealt with as quickly as possible, and I shall therefore content myself with saying that the original legislation was aimed at assisting the gold mines when the gold price was $35 per ounce. With the passage of time the price has of course, to the satisfaction of all of us, increased tremendously. This has resulted in the Act becoming superfluous for all but three mines. On close inspection the position of the three remaining mines is in effect such that they could continue without financial assistance.

It is important to state that this legislation does not block all channels if the gold mines were to require further support. They are still able to approach the State, whereupon the case would be dealt with on merit. We would, of course, then have to take into account how much money was available for such assistance. This side of the House also supports the Bill.

Mr Chairman, we also support this Bill in the interests of free enterprise, and we recognise that discretion is available where assistance is necessary. We support the Bill.

Mr Chairman, I rise merely to thank the hon members for supporting this measure and also for doing so in such an efficient manner.

Question agreed to.

Bill read a second time.

Mr Chairman, I move:

During the previous century and the earlier part of this century, the State transferred large areas of land gratis or at a nominal price to local authorities. A condition to the effect that the State may at any time resume possession of any portion of such land for public purposes was embodied in the deeds of grant. As such rights are vested in the State, they may only be exercised by the State President.

*It is established practice to resume land only if the relevant local authority consents thereto. To obtain this consent is usually a mere formality since the land is nearly always required for the erection of a public building or other construction or to provide a service to the local community or the region which has the support of the local authority.

It is unnecessary to involve the State President in these matters, especially where agreement regarding resumption has already been reached, and the object of the Bill is therefore to enable the State President to assign his power in this regard to the Minister of Public Works.

†To this effect it is necessary to extend section 2A of the principal Act by making provision for the State President to exercise a right of resumption reserved in respect of land. The proposed insertion of section 2A(1)(b) then makes it possible for the power to be assigned to the Minister, in terms of section 6 of the principal Act.

The other amendment which is proposed is merely aimed at changing the designation of the Minister of Community Development to that of Minister of Public Works.

Second Reading resumed

Mr Chairman, it is interesting to examine the Acts relating to State land, for example the State Land Disposal Act, Act No 48 of 1961, in terms of which prescription is prohibited. This 1961 Act repealed many other Acts. No fewer than 31 Acts were appealed in toto. In our younger days we frequently heard the older people speak of “crown lands”. We also remember the outspans with signposts clearly indicating that one could rest there. There we frequently gave our oxen or horses a chance to rest on long journeys, or let the cattle or sheep rest overnight when trekking to the Bushveld or the Highveld.

This legislation is composed of two parts. It deals with local authorities and with land obtained from the State. Clause 1 merely deals with an amendment to the designation “Minister of Community Development” and that of “Minister of Public Works”. Clause 2 makes it possible for the State President to delegate his powers to the relevant Minister. This, too, affects only State land and local authorities.

With the repossession of land from local authorities, it is in the interests of the local authority concerned, because normally the State wishes to recover the land for the purposes of erecting some structure or other which would be of benefit to the community.

If the principal Act as a whole, and in particular section 6, is not read in conjunction with the Bill, the individual clauses seem to be incomplete, but as a whole the intention of the legislation is clear. This side of the House would like to support the Bill.

Mr Chairman, we on this side of the House thank the hon member for the Official Opposition’s support for this measure.

I do not want to repeat what he said. This is an administrative measure aimed at lightening the State President’s administrative burden. Both this Bill and the next one were dealt with by a standing committee that no longer exists, but I am thankful to be able to say that the Bill was unanimously approved by the then standing committee.

We on this side of the House should therefore like to support the Bill.

Mr Chairman, the PFP will likewise support the Bill. It is clearly designed to lessen the burden on the hon the State President and will hopefully provide for better administration.

One thing that bothers me slightly about this piece of legislation is that if it were not for the explanatory notes one would certainly not be able to perceive from the amending legislation any clause let alone any wording which sets out to achieve the objective as stated in the memorandum. The memorandum states that the power may now be assigned to the hon the Minister instead of the hon the State President exercising this particular function.

If we look at the amending legislation there is, in fact, only one little paragraph which amends existing legislation and that is the wording: “The State President may … at any time exercise any such right”. One then has to look at section 6 of the existing legislation to find out where the function of delegating power in fact lies. I merely wish to say that where one is passing amending legislation with a specific purpose, it should, if possible, be apparent from that legislation what the purpose is, and one should not have to employ the expertise of legal analysts to try to find out what the legislation is all about.

In essence the legislation in its amended form, however contorted, does achieve its objective and we on this side of the House support it.

Mr Chairman, I simply want to content myself with thanking the hon members for Witbank, Umlazi and Groote Schuur for their support.

Question agreed to.

Bill read a second time.

Mr Chairman, I move:

The Committee of the President's Council for Economic Affairs in its report “A Strategy for Small Business Development and Deregulation”, gave attention to the matter of restrictions on professions and drew attention to the need for deregulation. As a result the Competition Board has been instructed to investigate and to make recommendations on meaningful deregulation in regard to professions. The reservation of work for a specific profession and a prescribed tariff of fees to which a member of a profession is entitled for professional services rendered by him, are two of the most common kinds of restrictions.

Order! Hon members must please not talk so loudly.

The statutory reservation of work for members of a specific profession is in fact nothing less than a statutory monopoly which could be detrimental to the public interest. Injudicious reservation of work can also be inflationary and it has been argued that it only serves the interests of the relevant profession. The Government is blamed for unfair intervention in the choice consumers or employers have by prescribing to them whom they may employ for a certain purpose. It would, however, be incorrect to regard reservation of work as undesirable in all cases. In certain circumstances the reservation of work may serve to protect the public. Any application for the reservation of work should therefore be decided on its own merits. The Competition Board gave the matter considerable attention and also had negotiations with the statutory boards of several professions. The Amendment Bill now under consideration provides that the reservation of work for town and regional planners may only be done with the concurrence of the Competition Board.

Another restriction found in practice concerns the prescription of a tariff of fees for professional services. It has been argued in favour of this practice that price competition will lower professional standards. According to the Competition Board this point of view has no merit because a minimum tariff of fees can never serve as a guarantee for high professional standards. Professions overseas have already done away with fixed tariffs without the resultant lowering of standards, while important benefits such as efficiency, cost-awareness and also lower tariffs were brought about. The Bill therefore provides that a town and regional planner and his client may negotiate the tariff payable for professional services. Only in cases where the parties did not negotiate a tariff of fees or do not reach agreement in that regard a prescribed maximum tariff of fees will apply. The client will thus be in a position to negotiate an acceptable tariff while the practitioner will be able to offer his services at a competitive tariff.

In closing I would like to mention that the other professional legislation administered by the Department of Public Works and Land Affairs, namely the legislation pertaining to valuers, land surveyors, quantity surveyors, architects and engineers, will also be dealt with in a similar manner.

Second Reading resumed

Mr Chairman, as far as town and regional planning and town and regional planners in training are concerned, the object of this Bill, as set out in the memorandum, is that in future certain kinds of work, whose reservation may be considered a restrictive practice, may only be reserved with the concurrence of the Competition Board. A further object is to provide that the parties may, by agreement, deviate from the prescribed tariff for services rendered, which may also be considered to be a restrictive practice.

The proposed amendments achieve these goals. The Official Opposition supports this Bill because it is both in the public interest and in the interests of the town and regional planners’ profession.

Mr Chairman, we are also grateful to the Official Opposition for their support of this Bill. This Bill was also unanimously agreed to by the former Standing Committee on Communications and Public Works. This standing committee, of course, is no longer in existence.

This is perhaps a fitting time to express my sincere thanks to the hon members of this House and the other Houses who served on that standing committee. I think that in the main we did a good job and that we really had very little cause for serious disagreement with one another.

We should like to support this Bill.

Mr Chairman, all I wish to say is that the PFP supports this amending legislation.

Mr Chairman, I should like to content myself with thanking the hon members for Potgietersrus, Umlazi and Groote Schuur for their support of the legislation.

Now the hon the Minister can make himself popular!

Order! I just want to point out that it is very disruptive if remarks are made when the Chairman is speaking or the secretary is reading a Bill. I am asking hon members please not to do so. In regard to those aspects of the matter, let us conduct ourselves properly.

Question agreed to.

Bill read a second time.

Mr Chairman, I move:

Agreed to.