Mr. Chairman, I move the amendment which appears in my name on the Order Paper, as follows—

Clause 3 deals with the functions of the Health Matters Advisory Committee which is established in terms of clause two of this legislation. The function of the Health Matters Advisory Committee is to bring together senior professional people in this field in order to investigate, discuss and make recommendations in respect of a large range of health matters. It can, in fact, make use of a large number of sub-committees to deal with the various aspects of health, and in respect of any aspect of health which is not provided for, it can create a sub-committee to investigate such matter. Basically the function of the Health Matters Advisory Committee is to examine in detail all aspects or any aspect of health which come to its attention, to discuss these matters and to make recommendations.

It also provides that before these recommendations are sent to the Minister for further action, those recommendations must be submitted to the Administrators of the four provinces, in order to obtain their comments on the recommendations. Because the recommendations of this committee are so important and will affect the health services provided by the provinces as well as by the local authorities, because these recommendations will affect many other persons and organizations which operate in the field of health services, and because these recommendations are likely to form the substance of regulations, policies and procedures which will emanate from the central health department and from the provinces, I feel that before the Minister acts on these recommendations, it will be only fair to everybody concerned and in the interests of the health services themselves if these recommendations are subject to scrutiny and comment by a much larger body of persons and organizations. For that reason I feel that before the recommendations go to the Minister, they should be submitted to local authorities in particular. As I said previously, the local authorities are the organizations which will carry out in the field the provisions and purposes of this legislation. They are in fact the people who are in close contact with the communities concerned, the people who will in the final analysis be called upon to carry out these provisions, and on whom the success of this legislation is going to depend. I believe that they should have an opportunity to examine and comment upon these recommendations.

I feel too that the homeland authorities, the CRC and the S.A. Indian Council should have an opportunity of commenting on these recommendations, for obvious reasons which I should like to state once again. Health services are needed for 22 million South Africans and I believe that the non-White South Africans, the Coloureds, the Indians and the Blacks in South Africa, can play a very valuable part in contributing to the building up of effective health services. I believe that the time to consult them is the time when the regulations and the policies are made. They should be consulted at the time when procedures are being designed. The time to consult them is not after these have been decided upon by an exclusively White body. So, Mr. Chairman, I feel that the bodies representative of the Blacks, the Coloureds and the Indians in South Africa, should have an opportunity of examining the recommendations, of making their point of view known and of actually participating in the decisions which are taken. I believe therefore that these recommendations should go to them as well for their comment.

Furthermore, I believe that all other interested persons, bodies or authorities should have these recommendations circulated to them. I am thinking for example of bodies like the Medical Association and other related professional organizations. No provision is made in this legislation for close collaboration with these bodies in respect of the work which this committee will do. I would like to recommend to the Minister that these bodies too should be circularized as far as these recommendations are concerned.

The overall purpose is this: If the government wants to build up an effective and comprehensive health service covering all the people of the country in all aspects at all levels, they must in the first place consult with them when the system is being created. In the second place the government must obtain their co-operation, and in fact their enthusiasm, in carrying out these provisions. In the third place, the government must establish the closest liaison with them right from the beginning. This cannot be done if all the decisions are to be made and all the work done by a committee which is not representative of the vast majority of the people who are going to be affected by these provisions or by those who are going to have the responsibility of carrying them out. I should therefore like to make an appeal to the Minister to include in this clause the amendment which I have proposed.

Mr. Chairman, I think that if one wants to provide a proper health service, one must first of all know how things fit together and how they work and not stand up and talk nonsense like the hon. member who has just resumed his seat. Let us take a look at what he proposes. In terms of the Bill, before they pass on information to the Minister and the House, the advisory committee that has to advise the House, must inform the administrators so that the administrators can look at the recommendations or regulations. In the first place this means that if one sends it to the administrators in fact, it automatically goes to the local authorities too. The local authorities are under the control of the provincial administrations. Therefore the hon. member’s first recommendation, concerning those to whom it should be sent, falls away. If the administrator deems it necessary to consult local authorities or to refer matters to them, then he does so.

As regards the second matter, these people with their race-obsessed brains do not realize that health in this country knows no colour.

Precisely!

This Bill does not contain a single reference to colour of any kind, except for what the hon. member wants to include here now.

The committee is exclusively White!

Mr. Chairman, may I please carry on with my speech now?

[Inaudible.]

Order!

Mr. Chairman, that hon. member does not realize or know that the health services of the homeland authorities are not managed by us, but by themselves. When the homeland authorities eventually become independent, does the hon. member still expect us to submit this legislation and advice to them? In other words he is asking them to give advice to an independent White South Africa. That is what the hon. member is proposing.

He asks that it be submitted to the CRC and the Indian Council. If the hon. member knew what was going on, he would have realized that the CRC and the Indian Council have nothing to do with health affairs.

It does not matter.

It does not matter? The hon. member simply wants to ask them. It is actually so amusing that it cannot be true. According to the hon. member, recommendations must be presented to every interested person, body or authority that may be interested in it or affected by it. When one drafts health legislation or regulations, it affects every person in this country. Does the hon. member now want a referendum to be held first in order to be determine what every person’s opinion is whenever advice is dispensed to this advisory committee? This is a recommendation which is really too ridiculous to allow. It is a pity that one cannot debate with people on the other side who know something about health matters. The hon. member comes up with a speech which someone wrote for him and with a lot of recommendations which someone submitted to him. One cannot say who it is, but it sounds almost as if these are Dr. Selma Browde’s stories. I really think that it is a ridiculous amendment and one which does not belong in this House.

Mr. Chairman, I should like the hon. member for Bryanston to point out where in this Bill it is stated that this Bill and the committees to be established in terms of it are exclusively for the Whites of South Africa. I do not know where he got this impression. I felt that throughout the deliberations which there have been, in bringing the Bill before the House, we tried to avoid labelling groups and that health is a matter concerning all our people. We specifically did not divide this up into separate legislation for each ethnic group. I hope this will continue to be the case, and consequently I cannot support the submissions of the hon. member for Bryanston.

Mr. Chairman, the hon. member on the Government’s side who spoke last, made a number of statements which I should like to reply to. In the first place he said that, if he sees fit to do so, the Administrator of a province will inform the local authorities in terms of these recommendations. It is for the very reason that this is the case that I moved this amendment. I moved it precisely because the Administrators do not always see fit to inform ail the local authorities under their control or in their area of these matters. If this legislation is to be effective, then in the first place, not only the provinces must be consulted and informed in this case, but also the local authorities who are going to perform the primary task of applying this legislation.

Who says so?

The local authorities and people who speak from experience say so.

In other words, not you!

The hon. member said that my speech was written by someone else. This is not true. However, I asked the advice of many people, people who know much more about health matters than all the members on that side of the House. The Government maintains that they are going to give the Coloureds and Indians in South Africa sovereign independence within South Africa.

Order! The hon. member must confine himself to the clause.

Yes, Sir, I shall do so with pleasure. The point that I want to make is that, whilst the Government wants to give independence and sovereignty to those people, they do not even want to take the step now of consulting them on something which is of fundamental importance to them.

The hon. member said that the question of colour was not brought into the Bill by the Government. However, what is happening— and this is what I object to—is that the Government is forming a committee which will consist exclusively of Whites. No provision is made for representation for the Black people, the Indians or the Coloureds.

Mr. Chairman, may I ask the hon. member why a Black man cannot become a director of a hospital in any place according to his policy? If he could do so, he would be able to serve on the committee.

If we were in control of affairs, this could happen in the normal course of events and then there would not have been any great fuss about it. But in terms of the NP policy the Whites have to decide everything. In this connection I want to ask whether one of the hon. Deputy Ministers did not say that, regarding services provided to the Blacks, Coloureds and Indians, it is the policy of the Government that the White man plays the piper and therefore that the White man calls the tune. Is this clause in line with the attitude of the Government? Since the Government is going to pay for the health services, the Government says that the Whites alone are going to determine what those services will be and how they will be provided. A fine piece of legislation which could mean a great deal for South Africa and could provide services to all the citizens of the country, is now being transformed into an abhorrent piece of apartheid legislation by the Government’s refusal to consult the other racial groups in South Africa. The hon. member went on to ask why other persons and bodies should be consulted. After all, it is obvious that organizations like the Medical Society and other allied organizations have a primary interest in health services in South Africa and can make an important and valuable contribution. Why then was provision not made for these people also to be consulted in the development of the services? Why is it that the Government wants to do everything on its own and does not want to consult any other organization or person in carrying out the task?

Because it is the Government.

I want to make the statement that the reason why the Government so often fails in attempting to provide effective services, is that it is not prepared to consult others in providing those services. What we have here once again is an example of the attitude of the Government. At the outset of a new era in our health services, when new health services are going to be provided to the people of South Africa, the National Government deals a blow to this legislation by being insistent on making it an apartheid measure and not a measure to the advantage of and in the interests of all South Africans.

Mr. Chairman, it is deplorable that an hon. member of this House wants to launch legislation of this nature on this note. We on this side of the House are always being accused of being racialistic. I have never seen a better illustration of blatant racism than the one which we have just heard. This Bill has absolutely nothing at all to do with colour or colour groups. Actually, if we take a close look at this matter for whom is this legislation chiefly being created? Is it not for the lesser privileged people of our country? Is it not the Black people and Coloured people who will derive the greatest benefit from this? It is clear to me, after what the hon. member for Fauresmith said, viz. that this speech and these ideas were impressed upon the hon. member by an outsider, and that he apparently did not read the legislation. If the hon. member looks at the composition of the committee in terms of clause 4 of the Bill, he will see that all of them are official bodies. There is not yet any Coloured person in an official capacity who can fill this post. Now he makes the ridiculous suggestion that every local authority in the country should first be consulted before the hon. the Minister can accept a recommendation of this committee. Apart from the fact that he knows nothing about health, the hon. member apparently knows much less about public administration. If we look at the composition of this committee, we see that it will consist of the Secretary for Health, the various directors of hospital services and two medical practitioners employed by local authorities. Now the hon. member wants to allege that those two medical practitioners are not competent or able to convey the standpoint of the local authority. There is another medical practitioner who serves on that committee and who is attached to a local authority in the rural area. Is he not able to convey the standpoint of the local authorities? The PRP is so full of the Johannesburg city council. If they were in power now, they could have appointed a Black medical health officer. Then he would automatically have been given representation on this committee. The hon. member must do his homework much better. I deplore the fact that he began the debate on this note.

Mr. Chairman, I am quite sympathetically inclined towards the hon. member’s motivation for the amendment which he has placed on the Order Paper. He is motivated by his concern that the public as such must be involved in decisions of this nature. This is quite in order. The public of South Africa represents a kaleidoscope of race and colour—Black, Coloured and White. This is recognized in this Bill. But the hon. member must also bear in mind that we have now entered a new era. He must please not cause us to upset this new era from the very beginning by introducing this type of thing, which is merely the result of a failure to understand what is going on here. The hon. member for Bryanston must please understand that we base our actions on existing conditions. If one’s premise is to base one’s actions on existing conditions, one must also take into account the effective machinery at one’s disposal. That machinery is available. However, when it is not stated anywhere in the legislation that those who at the moment are not yet competent to do all these things at a high level, will be able to do so in time—after all, nothing prevents them from doing so—the hon. member must please not try to put them at the very top right at the outset and give them a position which in any event, they are not yet capable of occupying. He must not try to do this, for the simple reason that changes must take place in an orderly way and that grievances must be settled satisfactorily.

I accept that the hon. member believes that the NP will always be in power. Therefore I can also assure him that his justified grievances will also be eliminated in an orderly way. However, there is one thing which the hon. member must understand. It is not only because the Whites are paying that they are all placed in leading positions. It is simply because this happens to be the existing position. In terms of the existing position in South Africa there are three authorities that provide health services. These are the central Government, the provincial administrations and the local authorities. The CRC and the Indian Council have no share in providing health services at this stage. The only other bodies at the disposal of these people at the moment are certain boards in rural areas, as well as one or two local authorities. It is hoped that they can eventually be represented on the advisory committee by means of their local authorities. This is not impossible. The local authorities are controlled by the provinces. Hon. members gave a very good exposition of this and I do not want to go into it in greater detail. The matter at issue here is not mere contact or liaison between local authorities and the Administrator. On the contrary, the Minister and his department liaise directly with local authorities in many respects.

If hon. members take a look at clause 16(f), clause 17(3), clause 20(2) and clause 20(3)—and clause 26 for the financial aspect—they will notice that provision is made for all these things. However, as regards the homeland authorities, I am quite unable to understand why the hon. member broached the subject. At this stage most of the homeland governments are already taking over their own health services. We liaise with those of them who have already taken over their own health services. We also have certain agreements with them. Therefore I cannot understand why homeland governments should also have a say in our territory. Those who are not yet independent, liaise with my department through the Department of Bantu Administration in other respects.

The section of the hon. member’s amendment which reads “all other interested persons”, etc., is an aspect which has been fully replied to by the hon. member for Fauresmith. However, there is one other thing which I want to mention to the hon. member, which may set his mind at rest. It will be seen from clause 6(4) that the machinery has been established in such a way that sub-committees can be appointed to advise the advisory committee at this stage. In any event, the bodies which are nominated cannot nominate anyone to the advisory committee even if they have health functions. However, the subcommittees do not exclude the public. Therefore, in due course, after a gradual evolution, these people will in fact have their share. I think the hon. member must look at it as three levels of governments which render services according to the existing legislation and set-up in South Africa, and the hon. member cannot use Parliament by way of this Bill to try and change the existing political dispensation. We should not play politics with health legislation. I think that the hon. member must try and see it as follows: preventive, curative, promotive and rehabilitation centres are divided in a certain way without compartmentalizing them. The services are allocated to the various levels of government and there is continual liaison. As regards the public, including those about whom the hon. member is concerned, they will have the opportunity to make themselves felt and possibly have even more influence at the lowest level of the pyramid. As far as I am concerned, health services in South Africa are not divisible. Therefore I cannot accept the hon. member’s amendment.

Mr. Chairman, I am very grateful for the hon. the Minister’s calm approach to the amendment. It is quite unlike the approach of his colleagues on the other side who, obviously, are in serious need of health services themselves. If we take what the hon. the Minister has said, the first half of his reply was a very good support and motivation for the amendment before the House. It may well be that the amendment can be regarded as too wide when it refers to “other interested persons”, because it is very difficult to know where to draw the line. However, in terms of clause 4 of chapter 1, the hon. the Minister himself has made it clear to the House that the positions referred to are occupied by one particular group. This is inevitable at this stage, and we accept that. I submit that that is one of the main reasons why the amendment which is before us ought to be accepted. Therefore I would like to support the amendment as moved by the hon. member for Bryanston. The very fact that there are positions which are now in a sense limited through an accident of history and the situation in our own country by Whites, means that it will lend itself and all that the amendment calls for is for “information and comments”. In other words, this is an attempt to assist towards the establishment of a better, more comprehensive health service than ever before. Immediately one begins to consult with people and make it clear that comments are welcome, immediately when information is laid before them, the matter will become the responsibility of the country. I cannot understand why there should be such a hysterical response from the hon. member for Fauresmith and from the hon. member for Cradock. This is not a question of introducing a blatant racism into the Health Bill—not at all.

It is!

There we go again. Hon. members should try and keep calm. The main thing is … [Interjections.] Mr. Chairman, if I had a tranquillizer I would have offered it to the hon. member. The major object is comment, response and information. What is wrong with giving people information? After all, it is quite clear that any health service that is going to operate in South Africa, irrespective of the fact that the homeland Governments are now beginning to set up their own health services and irrespective of the fact that at the moment the CRC and the Indian Council do not have this facility, the very best way to introduce it is to make it clear that certain recommendations are going to be made for their comment and, particularly, for their information.

Lastly: The hon. member for Fauresmith is absolutely right when he says that health knows no colour whatsoever. Because of that it is the responsibility of those who are in a position to do so and who have gained from the health services the knowledge, the experience and the skills they have at their disposal, to disperse this as widely as possible in order to build up our health services, services which are going to affect every single person in South Africa, including those who are represented directly by the Coloured Representative Council and by the Indian Council and those in the homelands.

Mr. Chairman, I think I owe the hon. member for Pinelands an explanation. Seeing that he is concerned about consultation at a lower level—I have already indicated that we cannot accommodate these people at levels where they are not legally represented in terms of the existing Act—I want to say that what he has said applies equally well to the stages of initiation of policy and of legislation. That is why I specifically mentioned the subcommittees. That is where these people will come in. I foresee that. They may even come in at a higher level later on. It all depends. Some of the local authorities may eventually deem it appropriate to appoint not necessarily a White person, but a Coloured or Indian person according to the geographical distribution, of people. He may come from Natal or from the western Cape. So as far as those arguments are concerned, I think that to a certain extent he is corroborating what I have already said about consultation at a level where consultation is possible as far as the public is concerned.

Amendment negatived (Progressive Reform Party dissenting).

Clause agreed to.

Clause 4:

Mr. Chairman, many of the arguments advanced under the previous clause apply equally well to my amendments in regard to clause 4. Amendments (1) and (2) are self-explanatory. It is merely a suggestion, because I believe that urban local authorities are entitled to slightly larger representation than is provided for in the Bill. The suggestion is that they should have three representatives who should be selected from six persons nominated by the United Municipal Executive.

I want to emphasize what I have said previously. The local authorities are responsible for large urban populations. These communities often live in very closely-packed conditions, particularly the Black, Coloured and Indian communities. As a result of housing problems, socio-economic considerations, sanitation services not having reached the standards they should and because under these circumstances these people are particularly subject to infection, there is particular need for health services amongst these communities. Because it is in the areas of responsibility of these local authorities that these problems arise to the largest extent and because they are particularly suited to offer the services that are required, I believe they should have greater representation on the advisory committee. Therefore that is simply a technical proposal that the representation should be increased.

The suggested paragraphs (g), (h), (i) and (j) in amendment No. (3) are in line with my amendment to clause 3, and irrespective of what the hon. the Minister has said and irrespective of what hon. members on the other side of the House have said, I think it is vitally important that the Bantu homeland authorities, in spite of the fact that they have their own health systems, should have the closest co-operation with the central authority in South Africa. The health programme that has been designed for the Bantu homeland authorities in its structure is as good, if not better, than the structure which we are designing today. The simple reason for this is that it was possible to design a health programme and a health policy from scratch for the homeland authorities. In other words, it was virgin territory and the people who designed the policy had the opportunity of designing something from nothing which did not have to contend with old, established and traditional structures and prejudices. Therefore, they were able to produce something that is very good indeed. I believe that it is vital that the closest co-operation should exist between homeland authorities and the central authority in South Africa, because the people of the homelands are part and parcel of the larger South African community. These people come into contact with the other communities of South Africa and by way of the migrant labour system many hundreds and thousands of them operate daily in close contact with the other communities of South Africa. The diseases and the health problems which they have to deal with are equally the diseases and the health problems which South Africa has to deal with.

In order that there be a combined and united effort in contending with these problems, it is essential that the various authorities that are going to be called upon to contend with these problems, have an opportunity of operating in very close co-operation with one another. Unless one has this co-operation at all levels, in particular at that level where policy is established and where procedures are decided upon, one cannot have effective co-operation and effective combined action between these authorities. Under those circumstances it is vital that these bodies are all represented. The suggestion has been made that this is not necessary because some of them, such as the Indian Council and the Coloured Council, do not have control over health matters. It has also been suggested that possibly these bodies do not have personnel that have reached the level of development and the capability to serve on such a committee. I should like to ask anybody in this House whether a start has been made in local authorities or in any other multiracial or White authorities in South Africa to give opportunities to Coloureds, Indians and Blacks to advance within the health services. There is not a single local authority in South Africa which has senior Coloured, Indian or Black staff in their health services. Therefore I think it is hypocrisy to say that the time will arrive when Blacks, Coloureds and Indians will be in positions of authority and that they will reach the top level in the structure of these bodies. It will never happen in a hundred years as long as the NP is in power, because it is contrary to their philosophy and their policy …

Order! I think the hon. member is going too far. He should rather confine himself to the contents of the clause.

Because it is impossible, in terms of Government policy, for Blacks, Coloureds and Indians to fill these positions, it is outrageous to suggest that they will eventually have the opportunity to serve on that committee as representatives. However, I shall leave the matter there. I want to emphasize once again that the fact that no provision is being made for the representation of all the groups and communities in South Africa on the committee will inevitably mean that this legislation will not be as successful as it would otherwise have been. There will not be the same co-operation and there will not be the same obligation on all the groups to work together to the same extent in order to make a success of the legislation.

†I now come to my fourth amendment, which relates to the appointment of a vice-chairman. Bearing in mind that this committee is a committee of professionals, having many important functions, I believe it is correct that the Secretary of the department should be the chairman of the committee. He, after all, will be the person who will motivate the committee and see to it that the committee operates effectively. He therefore has to be the man at the top who is in close liaison with the Minister of Health. I believe that when the Secretary is not available to serve as chairman of that committee, the second most senior official in that department should carry out those tasks. In other words, I believe that the vice-chairman should be appointed in the same way as is the chairman, and that he should not be elected by the committee. I make this proposal simply to ensure that the person who heads the committee is the most senior official as far as the Department of Health is concerned. He should be the person who is in the closest contact with the Minister and the department at all times. I accordingly move the amendments printed in my name on the Order Paper, as follows—

1. (1) On page 10, in line 9, to omit “two” and to substitute “three”;
2. (2) on page 10, in line 14, to omit “four” and to substitute “six”;
3. (3) on page 10, after line 27, to insert:
   1. (g) one medical practitioner nominated by the South African Indian Council;
   2. (h) one medical practitioner nominated by the Coloured Representative Council;
   3. (i) one medical practitioner nominated by each Bantu homeland authority; and
   4. (j) two medical practitioners who shall represent the urban Black community, nominated by the Minister;
4. (4) on page 10, in lines 44 to 48, to omit subsection (4) and to substitute:
   1. (4) The most senior of the three persons designated by the Minister in terms of subsection (1)(b) shall be vice-chairman of the committee.

Mr. Chairman, I do not want to waste the Committee’s time by repeating all the hon. member’s arguments. As far as the hon. member’s first two amendments are concerned, I just want to point out that where we say “two” he says “three” and where we say “four” he says “six”. I shall leave it at that. We cannot carry on in that way. I actually want to plead with that hon. member and that party not to spoil a fine piece of legislation by dragging in a lot of unnecessary petty racist politics. It is a pity that one should reach the stage when, as the hon. member for Rosettenville says, one is ashamed of being White. I think the hon. member and the members of that party owe us an apology. I remember that when I was a student, the following Latin idiom was inscribed above the laboratory door: “Sanis aegroti suprema lex”—“The welfare of the sick is the sovereign law”. This is all we are dealing with here. That is why the hon. member should not spoil a good law with unnecessary petty politics.

Mr. Chairman, I should like to say that we in these benches agree with the hon. member for Fauresmith when he says that racism in any form should not appear in legislation of this nature. Consequently I do not want to argue along those lines. However, I want to put one or two questions to the hon. the Minister in connection with this clause. Provision is made in this clause for the advisory committee to be composed of people with technical training who, as one would expect, ought to know best how to promote the health of the nation. We have no fault to find with that. What I do find strange, is that there is no provision enabling the committee to co-opt additional members in time. Sir, I want to tell you why we think that it would be a good thing to have a provision like this under the circumstances. It is pointless to say that a body like the CRC will not be given power and responsibility in the course of time as regards health for their own people in the rural areas as well as in the large complexes which will be created for the Coloured people. After all, the way is open for whatever type of responsibility the CRC and the Indian Council may be able to acquire in the course of time. That is why I think it would be a good thing to provide—not on the basis of a racial group—for the committee to be able to nominate additional members of the committee in consultation with the Minister. In this way one makes provision and also leaves the way open for these people to be able to serve on the committee in the course of time. I do not think that the argument of racism could then be raised and if the responsibility of the CRC and the Indian Council is widened in this respect, it will not be necessary for the hon. the Minister perhaps to change the legislation at a later stage. I therefore ask him: Is it not possible, for example, for him to add a paragraph in the region of lines 25 to 27 on page 10 which will make it possible for the committee to have the right to co-opt?

Mr. Chairman, I am dealing with the three amendments moved by the hon. member for Bryanston. He mentioned that the local authorities which are actually the primary bodies that provide health services, should have greater representation since there are more than 1 000 of them in the country. I quite understand this, but as he will note from the provisions of the Bill, it is actually a committee of knowledgeable people drawn from the authorities that render health services. We are concerned with health now, and irrespective of their size and what they control in the country, the only health functions of local authorities are the prevention of communicable diseases, the promotion of the health of persons and the rehabilitation in the community of persons cured of any medical condition. They have been cured already and return to the community. Apart from these normal functions, some functions can be delegated to them by the central Government in terms of clause 20(2). However, the idea of this committee is to obtain a diversity of interests from people with administrative and technical skills and I think that the committee is just the right size and sufficiently well-balanced to provide us with those skills. If we start arguing about numbers now, we will never stop. I think that it is sufficiently well balanced. I want to tell the hon. member that it was never our idea to accommodate the various bodies of the specific groups according to numbers. Once we start thinking along those lines, we will be faced with the old idea and the old problem we had in 1972 once again, viz. that one party in the committee wants to overshadow the next by weight of numbers. These are the reasons why I cannot accept the first part of the amendment.

On page 10, after line 27, he moved more or less the same type of amendment as the one we have just discussed, and that is the representation of what we might call the “non-White groups in South Africa”. I really wish that the hon. member would get rid of his obsession with colour and race. It is impossible in terms of the Act, but according to the present policy of the NP it is not impossible for these people eventually to be given representation. However, let us be fair towards one another. We are always so fond of saying that it is merit that should count, and that race should not come into it. For the non-Whites I have made provision for other bodies rendering services at the lower level. If the political set-up changes and we can therefore advance the argument that there are now authorities that must be represented on the grounds of knowledge and on the grounds of their function of rendering services, I would place this first. Merit should come second. Those authorities could even choose a White man, although this does not necessarily have to be the case. The hon. member did not say whether it should be a White man or a Black man. However, he is bringing in the concept of race. Should the position change, then in terms of this party’s policy it is not impossible for this to happen. Indeed, I have said so. Why is the hon. member forever coming back to it? The groups which the hon. member referred to and is concerned about, do not yet have medical practitioners who can be nominated at these levels. I am not insulting them when I say this. After all, we all know what the position is. They do not have any medical practitioners in their employ whom they can appoint and this is exactly why they do not have a function here. To me this is important.

I do not want to stretch the argument any further. Simply allow me to say that there is excellent liaison and co-ordination with the Bantu homelands. We have fixed methods of co-ordinating and liaising with these people when they are not yet independent. Most of them are not yet independent. Nevertheless many of them already have their own health functions. The Bantu Homelands Constitution Act, 1971, provides that laws concerning certain matters, including health, have no application whatsoever to citizens of those countries. In other words, this Bill does not have to apply to their own people. Should they have a right as regards laws in our area while we do not have a similar right in their areas? This is the point; this is what is important. I think that the hon. member must see it in this light. That is why I cannot accept this amendment.

Then the hon. member moved a third amendment. In it he asks that the most senior of the three persons whom the hon. the Minister can appoint in terms of subsection (1)(b), shall be vice-chairman of the committee. Of course these are officials of the department, that is, the head of the department and three of his deputy directors. I sympathize with the hon. member’s point of view. Of course one wants continuity. One would like the policy-making group to know what could happen in future and, if the chairman is not present, the best man must be able to take his place. However, I want to tell the hon. member that the next man on the list may be the senior director of hospital services of a province. In that case the hon. member’s argument falls away once again, because, like us, he wants to have the best man in that position. Now one has the colleagues there. One of them may say that as far as he is concerned, a junior employed by the central Government should act as chairman. Another may feel that there are men in the provinces who have, much more experience and who should therefore serve as vice-chairman. It is not fair for those people to be put in an embarrassing position. That is not all. In this way one is limiting the usefulness of a person who may be more capable of acting as chairman. Therefore I believe that the hon. member will understand why I cannot accept his amendment.

Amendments (1), (2) and (3) negatived (Progressive Reform Party dissenting).

Amendment (4) negatived.

Clause agreed to.

Clause 5:

Mr. Chairman, I move the amendment printed in my name on the Order Paper, as follows—

There is no indication as to what transgressions by a member of this committee will lead to his dismissal from the committee by the Minister. I feel that it would be better if my amendment were to be accepted, which would make it necessary to obtain the recommendation of the committee for such a dismissal. The hon. the Minister has just said that those who serve on this committee are among the most senior executives in the health services of South Africa, representing local authorities and the provinces, and I believe that if such a person needs to be dismissed, it should not be the exclusive decision of the Minister. It should be the decision of the Minister after the matter was referred to the committee for their recommendation as well.

Mr. Chairman, I would like to support this particular amendment because I believe it will be an improvement if the committee has an opportunity to express an opinion in regard to the vacation of office of one of its members. At the moment I think the clause is very broad. The Minister is not circumscribed in any way at all. I would therefore like to draw the attention of the Committee to the fact that in certain legislation specific conditions are laid down under which it is considered desirable or necessary that a member may vacate office. While I do not think that it is necessary in this particular Bill to lay down such conditions, I am strongly of the opinion that the committee itself should have some liaison with the Minister when the decision is made. Let me quote one statutory body in respect of which it is stated specifically that a member of the board shall vacate his office if his estate is sequestrated, if he becomes disqualified under this Act for practising his profession, or he becomes a patient as defined in terms of the Mental Health Act, if he is convicted of an offence in respect of which he is sentenced to imprisonment without the option of a fine, if he ceases to be a South African citizen, if he has been absent for more than two consecutive ordinary meetings, or being an elected member he tenders his resignation, or if the State President in the public interest terminates his membership.

Mr. Chairman, here specific circumstances are stipulated. I reiterate that I believe that it is not necessary to detail the conditions under this clause. However, I think it is strongly desirable that there should be some coordination, consultation and liaison between the Minister and the committee if such an occasion should arise.

Mr. Chairman, I just want to draw the Committee attention to the fact that in terms of the previous clause, the members are appointed on the recommendation of the United Municipal Executive of South Africa or of the Association of Divisional Councils of the Cape Province. The committee therefore has no jurisdiction in this matter. The implication of the hon. member’s amendment is that if one of these two bodies or the Minister wishes to relieve a person of his post, this should be submitted for consideration by the committee. If the committee refuses to endorse the bodies’ action, then this would be a slight to the Minister or the other two bodies. On the other hand, this would also mean that the colleagues of such a person—with whom he is on an equal footing in this committee— would have to decide on the termination of his service. This would be humiliating for all the parties concerned. I therefore think the amendment is totally ill-considered and that for this reason, we cannot support it.

Mr. Chairman, I think the hon. member for Pietersburg has quite adequately replied to the amendment, and I think the hon. member for Bryanston will now realize why we cannot accept it. The hon. member for Berea did mention something about a liaison between this committee and the Minister. I just want to point out to him that these people are public officials and as such fall under their specific authorities. Where they are not public officials in the strict sense of the word, their conditions of service fall under the Industrial Conciliation Act. I therefore feel that we have amply provided for everything here. The hon. member need not worry about that.

Amendment negatived (Progressive Reform Party dissenting).

Clause agreed to.

Clause 6:

Mr. Chairman, the hon. the Minister referred earlier this afternoon to the question of the appointment of subcommittees. I want to draw his attention to a particular instance which has been brought to my notice in regard to the appointment of these subcommittees. That is in connection with representations received from the Hotels and Accommodation Establishments Association (non-Liquor) of Natal. That is a constituent body of the National Federation of Hotel and Accommodation Associations. I realize that the regulations clause is not under discussion at the present moment, but this particular constituent body of the federation is particularly concerned about regulations which may subsequently be promulgated regarding specifications and requirements in connection with private establishments, particularly old establishments which, up to the present, have received the approval of various local authorities with whose bye-laws and regulations they have had to comply. Their suggestion is that, before such regulations are even published for information, it would be desirable in terms of this clause for a committee to be appointed, a committee on which will be represented these particular people who claim that they have a specific and specialized knowledge. I want to draw the attention of the House to clause 6(2), which says—

My request to the hon. the Minister is that he should bear this particular aspect in mind. If he feels that it has some merit, I ask him to indicate in due course that a subcommittee including members of the Federation could be appointed to deal specifically with a problem of this nature, should it arise.

I conclude by referring to a portion of a letter received from the chairman of the Natal Association, a letter in which he says—

I am sure that the hon. the Minister will agree with me that many of these private establishments, which offer accommodation, are serving a very useful purpose, particularly in regard to the aged, to pensioners and to people in the lower-income groups. Although they may never be able to comply with more modern conditions that may be laid down, it would be, I believe, a hardship if the situation would ever arise in which they will be unable to continue to give what I consider to be a necessary service.

Mr. Chairman, the hon. member for Berea has raised a matter which I briefly referred to during Second Reading. He has, obviously, different experiences to mine in this particular connection. I do not wish to repeat my same arguments of yesterday. I want to refer them again to the hon. the Minister. There are some old buildings which were previously hotels or residential hotels, or even old houses. Those old buildings have succeeded in obtaining a registration from the department, and are now operating as old-age homes. My argument against them is that they are very often inadequate, particularly because of their antiquity and because of the purposes to which they are being put.

My second argument has been consistent throughout, viz. that they are homes that are located in areas which were previously residential areas, and that they are changing the character of those areas. It has an accumulative effect on the residential character of the area. Very often the homes are not suitable for the purposes for which they are being used. A lot of servants are brought onto the premises and social problems arise from that, because very often there is not adequate accommodation for the servants and the servants have friends. Whereas before the house to which I am referring, which is an old house, had a family, large grounds and a couple of servants, they now perhaps have 15 to 20 patients accommodated—whereas before only 10 people lived in the house—with five to six servants, whereas there were only two before. There are all sorts of ancillary problems that arise from these circumstances. It is not so easy as the hon. member would suggest when he spoke earlier on. I want to ask the hon. the Minister to look into the matter to see whether it is not possible, before registration is given to any applicant for an old-age home or hospital, to take very careful consideration of the surrounding circumstances, the surrounding character of the area and the social consequences of creating an institution like this in a residential area.

Mr. Chairman, as far as the hon. member for Simonstown is concerned, I can only say that we have taken cognizance of his problems in this regard. As far as the hon. member for Berea is concerned, I do think that apart from taking cognizance of it, it is a function of the advisory committee to advise, and this includes advice on subcommittees. They are appointed by the Minister for that purpose. These matters, including those concerning the hotel association of Natal, will be duly considered on merit. One of the objectives of the Bill is to save manpower, facilities, money and a host of other things. Consequently, after one has thoroughly examined a building, as the hon. member would have it, and it is found to be still serviceable, one could most certainly present a report to the effect that a building which would otherwise stand in disuse, could be used after all. That is all I can say at this stage.

Clause agreed to.

Clause 11:

Mr. Chairman, I wish to move the amendment printed in my name on the Order Paper, as follows—

At the present moment the clause reads as follows—

1. (1) The council shall consist of the following members namely—
   1. (a) The Minister who shall be chairman of the council;
   2. (b) the member of the Executive Committee of each Province who is charged with Hospital Services.

I want to point out to the hon. the Minister that my amendment contains a principle which was accepted when the commission deliberated, and when the commission prepared the draft Bill it made it quite clear that in the type of council which the commission put forward as a recommendation, there should be provision for an alternate, because specifically in the type of council the commission recommended, it was felt that the council should include the surgeon-general or his representative, the member of the South African Medical Council or his secundus and the secretary of the Public Service Commission or his nominee. That is a principle which the commission after due deliberation felt was desirable to embody in the Bill. I believe that in drafting the Bill before the House the same principle has been accepted in regard to the Health Matters Advisory Committee. We have here a 12 member committee, and in clause 4(2) it is laid down that—

However, in clause 11, constituting the National Health Policy Council—a small committee consisting of the Minister plus four members, plus the Secretary of Health as the secretary—no provision is made for alternate members. I believe this is an undesirable position because one can well, at one time or another reach the situation where the member of the executive responsible for health matters is unable to attend a meeting which has been duly called. Under those circumstances it could mean that a province is completely unrepresented. I do not believe that is a good policy at all. It should be embodied in the Bill that where such a position may arise, that member should be in a position to designate one of his peers, one of the other members of the executive committee, to attend a specific meeting which this member is unable to attend. I can visualize circumstances under which this may be necessary. The member of Exco who is responsible for the health matters of the province may be invited overseas on special business in connection with his post, he may fall ill or he may find that at the last minute he is unable to attend an important and vital meeting. I think it is absolutely essential that there should be provision made for the province, through the executive committee, to designate someone to take the member’s place under those circumstances.

Mr. Chairman, we support the amendment moved by the hon. member for Berea. It is a reasonable amendment in view of the fact that if one representative on that small body cannot be present at deliberations, the corresponding province is unrepresented at those important deliberations. The only question I have is whether the substitute to be designated should be another member of the executive committee or whether he should be the next most senior person in the provincial council team dealing with health matters. It is an open question, but sometimes one will find that another member of the executive committee may not be sufficiently informed or capable of effectively representing his province on the Council with regard to health matters and that there may well be another member of the provincial council who could stand in more effectively for the member of the executive committee in charge of health matters.

Mr. Chairman, I must admit that this is the type of stipulation one often finds in legislation. This point, however, was raised with the Administrators and they did not accept it. That was when the draft Bill was published. We received no representations from the provinces in this regard. At that time it was unanimously decided that the different viewpoints of the executive as such should be brought to the notice of the council, and that after that had been done, the specific member could express his own viewpoint and vote as he liked. That was decided upon in a session I had with the Administrators. One must realize and appreciate that anybody who serves on a council like this will eventually develop a fairly intimate knowledge of health matters. One must not allow things to develop to a stage where the Administrator can just appoint anybody as a substitute. The fact is however, that it will not be impossible for him to appoint someone else from amongst the members of the executive. Such a person will not be a substitute as such, but will be able to take part and vote in the proceedings in the event of a member being ill or absent from the country. I do not, however, what this to become a general rule and that is why I shall leave it at what is possible under the present conditions. The Administrator can appoint someone else at the moment. I may say that we usually arrange dates for the getting together of these members long beforehand. In addition, this council is not going to sit every month or so; it is a policy council and it may sit once every six months or only once a year. Therefore I do not think it is really necessary to make a general rule to provide for a substitute in a case like this, especially since I do not want this to become a general way of doing things, where anybody who is available for the time being is appointed. I want this council to be taken very seriously. The Administrators agreed with me in this respect and there were no more representations from the provinces in this regard. Therefore I cannot accept this amendment.

Mr. Chairman, I understand the hon. the Minister’s argument, but to me it is quite straightforward. It is happening at present that if there is a person who is unable to attend, someone else is designated or nominated, and I cannot see, for the life of me, why this cannot be embodied in the Bill. I cannot agree with the hon. member for Bryanston, because he suggests that perhaps a member of the provincial council could stand in as an extra member. I do not believe that the status of this council should be lowered in any way and that is why the amendment which I moved specified the designation of a member of the executive committee. I am sorry that the hon. the Minister is reluctant to accept the amendment. I should like to give him a few examples where, in statutes, this principle has been embodied. As far as I know these statutes have been operating for a long time, and they have created no difficulties. The hon. the Minister has not been able to convince me that there would be any difficulty whatsoever if he were to agree to a small amendment which would make legal what is happening now, and if he were to include it in the Bill. I am only asking that in the event of the member specified not being available, he should be able to designate a peer to be present for one meeting. I quote the Unemployment Insurance Act, No. 30 of 1966, to the hon. the Minister. It refers to “not fewer than eight and not more than 16 members” whom the Minister “may” appoint. It is therefore permissive. In the Architects Act of 1970 it is provided that—

The Wine, Other Fermented Beverages and Spirits Act provides that in respect of the Government Brandy Board, consisting of five members, the Minister “may” … That, too, is permissive. It is also the case in regard to the Bantu Administration Act, which functions specifically with alternates whose names are gazetted—

The Stock Exchanges Control Act was amended specifically to provide for the hon. the Minister to have power to appoint an alternate member in respect of any member so appointed by him. The Fuel Research Institute and Coal Act deals with the appointment of alternates to a six-member body, and it is obligatory. The Universities Act also deals with this matter. In front of me I have the Professional Engineers Amendment Act of which a portion of the long title reads as follows—

This had to be embodied in an Amendment Act and I should like to know why, when we are discussing one of the best Acts of all time concerning health, we cannot embody something which will only ensure smoother working and which will clarify the position beyond doubt. I ask the hon. the minister sincerely to reconsider his decision in the light of the evidence I have put before him.

Mr. Chairman, I am extremely disappointed that the hon. the Minister is unwilling to accept the amendment of the hon. member for Berea. I think the hon. member is making a very reasonable proposal and he has quoted precedents where this does, in fact, happen. One can nevertheless come across the situation in which a member serving on the executive committee of the Health Policy Council, finds he cannot be present. Who is to take his place then? Once can understand that when a member of the executive committee responsible for hospital services is sick for a long time, the administrator will fill his post, but what would be the position if a man was suddenly prevented from attending a council meeting? There is the possibility that his replacement would not be there. Then the situation arises that the executive committee of the provincial administration concerned, has no representation. In my opinion, the hon. the Minister’s argument as to why under the circumstances, he does not want to accept the amendment, is unfair. We shall therefore support the hon. member for Berea in his representations.

Mr. Chairman, I think the hon. the Minister has taken the wrong decision. He said in his reply to the hon. member for Berea that there was consultation, firstly at executive level in the provinces. A decision is then taken and that decision is forwarded to this council. In the next part of his speech he said something which makes me think that it is absolutely essential for him to accept the amendment moved by the hon. member for Berea. He said that when they come together and after they have discussed a matter, they take a vote. If they take a vote it me is that that province is deprived of a vote because they have no alternate. For that reason alone I think it becomes absolutely essential for the alternate to be present. I am not interested in how often these meetings take place. If this Bill is going to work properly, they will have to meet more than every six months, because if one is going to get something off the ground, it will require frequent meetings on account of the new things that are going to happen as a result of this Bill. For that reason it should be enshrined in the Bill that every province shall also have an alternate member who will be entitled to vote if its nominee cannot attend the meetings.

Mr. Chairman, I said—this was my most important argument; why do we now have to speak at cross purposes?—that it is now possible for an Administrator to appoint someone to an active capacity within a day to take someone else’s place. This is now possible, if such a thing were to happen. In the period of just under five years during which I have acted as chairman of the Hospitals and Health Coordinating Council, this has never been necessary. During this period of just under five years, we have never voted. I told hon. members that I did not want to allow it to become a habit by inserting it into the legislation, because whatever is included in it, quickly becomes a habit. They can simply nominate someone and he may go. Anyone can go. They can simply decide among themselves.

†I do not appoint these people. But if any of the provinces feel that they want to be present during a discussion of health matters, then the Administrator can appoint someone to sit there and, if necessary, vote for the province. They will never be deprived of this opportunity.

*I do not know why we are taking up our time with trifles. Considering the friendly spirit here—it seems to me that it is now breaking out everywhere—I should very much have liked to accept it, but if we accept something, we accept something that is worth the trouble and we do not take up our time with a matter that I think I have motivated well enough.

Mr. Chairman, I have been pondering the argument of the hon. the Minister. He has said that at the present moment an Administrator can arrange for somebody else to attend the meeting of the existing co-ordinating council. The Bill before us is, however, entirely new. The representatives on this council shall be the member of the Executive Committee of each province charged with hospital services. That is a specific member of the Executive Committee. In the absence of that gentleman through illness or anything else, there is nobody able to attend in the capacity as the person in charge of hospital services in that province. There is only one member of the Executive Committee who has that function. Nobody else can be sent in his place unless we put a provision in this Bill for an alternate to attend in his place. The hon. the Minister shakes his head, but he cannot make laws except by regulation under this Act.

The Act will say, if this Bill is passed in its present form, that the council shall consist of the Minister and the member of the Executive Committee of each province who is charged with the responsibility for hospital services. That is an identifiable member of the Executive. It is his portfolio responsibility. In the same way the hon. the Minister would be identifiable if the Bill said that the person who could attend was the Minister in charge of health in this Parliament. Only that Minister himself would then be able to attend, unless the Act specifically stated that an alternate or somebody designated in his place could attend. I presume that at one stage or another it may be necessary to test the validity of a decision of this committee, and if a person attended after being sent by the Administration because the incumbent, the MEC in charge of hospitals, was ill, the Minister’s whole procedure in respect of the council could then be challenged as irregular because a person who was not in terms of the law entitled to attend, attended that meeting and participated in the proceedings. I think that the Minister is being unnecessarily difficult in not accepting this amendment because he himself admits that in practice it will be done. He has already said that in practice it will be done. We only wish to see that it is done legally, and in terms of the law and not as a concession to be challenged at a later stage. I think that the hon. the Minister should think again about this and decide to accept the amendment moved by the hon. member for Berea.

Mr. Chairman, I want to say again to the hon. the Minister that if he intends to do what he has been doing, under the new Bill, he will be acting ultra vires. He cannot do what he says because he is not allowed to do it. There is nothing in this Bill that will give him the power to say to an Executive Committee, “If John James cannot come, send somebody else.” He cannot do that. The only person he can send is the member in charge of hospital services on the Executive Committee, and nobody else. All we wish to do is to make it easier for the Minister. All we are saying to him is that if John James cannot come, let the Administrator appoint an alternative. That is the beginning and the end of it. If he does not do that, there can be no meeting as all four members are not present.

Mr. Chairman, this legislation came about after consultation between me, the Administrators and the Executive Committees. We were ad idem on these matters. This point was specifically put and they did not want me to write such a provision into the clause. If I cannot find enough reason for it, why should I agree to an amendment like this?

*Mr. Chairman, I should like this board to be an important one that takes its work seriously. If I incorporate something in the Bill that is not related to the intimate knowledge people have acquired in regard to these matters, and which therefore cannot make a contribution, it could happen that the member of the executive committee in question decides that because he has other matters he wants to deal with, someone will have take his place. This would mean that the council would reach the point at which the best people were not always present. I think they all realized this. They want the best people. If it happens that someone is ill or that someone is abroad or that extraordinary circumstances have arisen, it only takes a day for the Administrator to appoint an acting member. The hon. member for Green Point must not come and tell me now that this is not possible. I do not appoint the people. In accordance with the Administrator’s ordinances, he may appoint such a person if he deems it important enough for his man to be there. In that case, his man would really only come and sit there in in order to hear them put their case. He would hardly be able to make a contribution. I do not want this to happen at every second or third meeting, however. I think I have now given sufficient reasons as to why I cannot accept this amendment.

Mr. Chairman, I should like to make a friendly suggestion to the hon. the Minister. He has indicated that the provinces themselves have not shown any particular desire for the provision of an alternate, and I accept that. However, I made it my business to discuss this with two MEC’s in Natal and both of them felt that the provision of a designated alternate was desirable. Sir, it is extremely unlikely that this Bill will reach the Other Place before the Easter recess. Therefore I want to suggest to the hon. the Minister that he consult with the respective provinces and ask them whether they would rather have a clause like this in the Bill or not. If, after receiving the answers of the provinces, he feels that the provinces would like to have such a clause in the Bill, he could discuss it with his staff and his legal advisers and then introduce such an amendment in the Other Place. I believe it would still make for a more satisfactory piece of legislation.

Mr. Chairman, if Mr. Martin, who is a highly esteemed member of the Executive Committee of Natal and whom I greatly respect, had gone through the right channels, I should have been able to take cognizance of their point of view in that regard. He did not do so this time, however, if what the hon. member referred to, is true. After all, I cannot check on what is said in private conversations. For that very reason, too, I do not think I can

Can we not talk to people about a Bill which is before the House?

The hon. members opposite are raising the matter now, but let us understand each other very well: The fact is that we reached unanimity in our discussions. We were in agreement.

Was this specific point discussed?

Yes, it was discussed. Was the hon. member not listening, then? I specifically read it out here. Mr. Chairman, I think we may as well call a halt to these arguments. The hon. members could still keep on for a long time but I think I have given the reasons why I cannot accept the amendment. The hon. members must not think I do not want to help them. It is just that in all honesty, I do not feel this matter is worth the trouble.

Amendment negatived (Official Opposition and Independent United Party dissenting).

Clause agreed to.

Clause 12:

Mr. Chairman, in clause 12 the functions of the National Health Policy Council are set out. One of those functions, as set out in paragraph (a), is—

Note that the local authorities are included. Paragraph (b) reads—

A list of general health services then follows. In this regard I move the amendment printed in my name on the Order Paper, as follows—

Paragraph (b) will accordingly read—

I also move the second amendment printed in my name on the Order Paper, as follows—

“needy” to insert “and aged”.

If this amendment is accepted, paragraph (b)(iv) will read—

In respect of the first amendment, I have addressed the House on this subject this afternoon and I am not going to repeat what I said with regard to the importance of local authorities. However, because of their importance, I believe that it is essential that the words “local authorities” be included in this particular clause in order to make it clear that local authorities will be considered, involved and included in carrying out the provisions of this particular clause.

The next amendment deals with health services that apply to the aged. It is important that this amendment be included since it is becoming more and more essential that health services should be provided for aged people and it is a responsibility that can be carried out particularly effectively by local authorities. It will be found that there are local authorities such as Johannesburg and Germiston which run health centres for the aged where the full spectrum of health services and other services are rendered for aged people when they visit those centres. It is a very useful service from the point of view that aged people who have limited mobility— persons who find it difficult and costly to move around—can, as far as these centres for the aged are concerned, by making one call benefit from a spectrum of health services which would otherwise have required their calling on different addresses in the town or city in which they live. I believe that it is essential that, as far as aged people are concerned, we make it clear that we take health services for the aged very seriously and that the provision of such services will be included in the aims of this Bill. That can best be done by including the words “and aged” after the word “needy”.

Mr. Chairman, if the hon. member who has just resumed his seat had read clause 12(d) he would have seen that we are not dealing with local authorities now. The issue is specifically that of the co-ordination of the State and the province as regards the division of functions. The local authorities are not concerned here. If we were to involve the local authorities in this regard as well, how would we achieve co-ordination at the levels below the local authorities? It is not a question of local authorities being left out, but these functions specifically concern the co-ordination of functions between the central Government and the provincial administrations. The local authorities do come into the picture later by way of delegation after the central Government and the province have found that certain functions must be delegated to the local authority.

As far as the second amendment is concerned, I do not know whether the hon. member’s argument was a little confused, because the word “needy” has never in any legislation excluded the aged. Indeed, there are needy young people and needy old people, and consequently there is no question of the aged, to whom the hon. member referred, being excluded. I want to ask the hon. member whether he is in favour of State medical services and the socialization of medical services for all. After all, we cannot include Harry Oppenheimer’s grandmother here in the sense that she would be a needy person who was also entitled to free medical services simply because she was elderly.

Mr. Chairman, the hon. member who has just resumed his seat made a statement which, in my opinion, was not consistent. Clause 12(a) reads as follows—

In other words, in clause 12(a), definite mention is made of local authorities. However, clause 12(b) is more important; it reads as follows—

I want to stress once again that in terms of clause 12(b)(i) it is specifically and primarily the local authorities who have a responsibility in that regard. It is primarily the local authorities that are able to carry out that responsibility effectively because they are in close contact with the community. A sense of community responsibility must be developed at that level. Indeed, clause 12(b)(ii) reads as follows—

Once again, many of the local authorities already carry out some of those functions very effectively.

On the strength of what the hon. the Minister said, this is a responsibility which will be allocated specifically to local authorities. I am therefore of the opinion that the words “local authorities” should be inserted just after “provincial administration” in line 22.

I have asked that the words “and aged” be inserted there. Once again it is clear why I should like to have this done. It is because it is becoming a greater responsibility for local authorities and for the Government to provide health services to the elderly as well. I believe that this should accordingly be inserted in the Bill in order that it may be clearly stated that this is in fact the case.

Mr. Chairman, I feel that I also want to take issue with the hon. member for Bryanston, who blithely wants the words “and aged” added. I feel that it is extremely dangerous merely to incorporate the terminology “and aged” in such a broad sense, because we could have an aged millionaire drawing the benefits of these health services. Surely he would be better advised if he were to speak of the “needy aged” or “the aged in need” or the “aged pensioner”. To say merely “the aged person”, I believe is giving this a tremendous scope. The present wording is: “the application of measures to provide health services to the needy”. This encompasses everybody; this encompasses all those people who are in need. This would obviously encompass people who are aged, as well. As a matter of fact, the first group of people one would look at as possibly being needy, would be the aged. I submit that the hon. member for Bryanston is completely off the rails by wanting to add the word “aged” as it is quite unnecessary.

Mr. Chairman, in the first place I want to reply to the first part of the amendment moved by the hon. member for Bryanston. I want to draw the hon. member’s attention to the fact that whereas he moves that “local authorities” be inserted in clause 12(b), the fact is that the functions to which reference is made in the subsection in question, only relate to the Department of Health and to the provincial administrations in their capacity as umbrella bodies. The allocation of those functions to local authorities is not envisaged. However, where the hon. member refers to clause 20(1)(d)(ii), this can relate to a specific directive from the Minister to a specific local management. This, therefore, has nothing to do with the aspect of co-ordination to which reference is made in clause 12(b). It only concerns the two main authorities. However, where the hon. member refers to the coordination of health services in which local authorities are involved, he should rather look at clause 12(c). In clause 12(c) the local authorities get their opportunity. Of course, certain specific services can be allocated to them under clause 17(3), clause 20(2) and clause 20(3). I therefore think that it would be in conflict with our whole structure if we were to accept the hon. member’s amendment with regard to functions that belong with the overall control of the two authorities. That is why I cannot accept the amendment.

The hon. member also asked that the words “and aged” be inserted after the word “needy”.

†I think the hon. member for Umhlanga replied to this aspect quite effectively. We cannot resort to that kind of socialism where we will be responsible for the health of old millionaires.

*Whatever the case may be, I do not think that we in South Africa can afford to introduce a health service for all aged persons. There is already a health service for needy aged persons in South Africa. The Department of Health, the Department of Social Welfare and Pensions and the hospitals make arrangements at various levels and the services do therefore exist. Due to the expansion of medical schemes, many of our aged people remain members of medical schemes and are covered, even though perhaps not in full. From the viewpoint of principle I cannot agree that we must introduce health services for all aged people, and I think that I have furnished sound reasons as to why I am not able to accept this amendment either.

Mr. Chairman, if we have to adopt the amendment moved by the hon. member for Bryanston it will mean that a lot of the intent of the Bill will be destroyed because what we have tried to do right through the Bill is to avoid duplication, overlapping and an ill definition of what the functions of the various tiers of government are. If local government is brought in here, it will ruin the whole primary set-up of the Bill. I think it is unnecessary in any case because the local authorities will, following this, know exactly what their duties are. There will as a result be no more overlapping, duplication and confusion.

Amendment (1) negatived (Progressive Reform Party dissenting).

Amendment (2) negatived.

Clause agreed to.

Clause 13:

Mr. Chairman, I move the amendment as printed in my name on the Order Paper, as follows—

Clause 13(2) states that—

If my amendment is accepted the clause will read—

I believe one has to give the Minister broad powers of discretion here because in certain matters which the Minister may wish to make known are of sufficient importance to be published in the Government Gazette. There could be other matters, matters which affect provinces, which should be published in the provincial gazettes whilst in matters affecting local authorities the Minister in his wisdom would decide on the best manner in which such information should be given to such local authorities. When the commission submitted its report it did indicate a certain direction in this respect. In the draft Bill which was published it was suggested, on page 6, under the heading “constitution of council” in subsection (6)—

That was a principle that we accepted in regard to the personnel of the council. In view of the importance of this Bill, I believe it is desirable that whenever the hon. the Minister considers it necessary, these matters should be published in the Gazette. He would be allowed full discretion, in other respects, to have them published in the manner he sees fit.

Mr. Chairman, clause 13 of the Bill provides that any decision made by the Minister shall be made known in such manner as he may determine. I fail to see any substantial difference contained in the amendment and I think there is really no sense in accepting it. The Minister has the discretion to decide what to do. Many Ministers’ and important councils’ decisions are not made public. They might be made known. The Bill does not stipulate that it be made public, but merely that it “shall be made known”. Many decisions by Ministers and councils at that level are not made public and are not gazetted. As a matter of policy, I might just in my discretion decide never to publish in the Gazette. So the hon. member will appreciate it that I do not really see any point in accepting this amendment.

Mr. Chairman, we support the amendment of the hon. member for Berea. I think it is a reasonable amendment. It will in fact improve the communication between the hon. the Minister and those authorities and persons with whom he has to communicate with regard to his decisions. The amendment of the hon. member for Berea reads as follows—

I think the second part of the amendment meets the objection the hon. the Minister has in respect of not making all his decisions public. In other words, the hon. the Minister can, in respect of decisions he does not wish to make public, use any other method of communication he deems to be expedient under the circumstances.

Amendment negatived (Official Opposition dissenting).

Clause agreed to.

Clause 14:

Mr. Chairman, I have a number of amendments pertaining to clause 14 on the Order Paper. When interpreted, these amendments are all the same. Here again it relates to the position of the local authorities. The clause reads—

Subsection (1)(a) reads as follows—

The services mentioned in the last three lines of subsection (1)(a) are in particular the sort of services that can most effectively be rendered by local authorities. Therefore I believe that the words “excluding any function referred to in subsection (1)(a)” should be removed in order to allow local authorities to have the opportunity by way of delegation, from the Department of Health or from the provinces, to be given the responsibility of carrying out the health services that are required to meet the “comprehensive health service” requirement for the population of South Africa. Further down in subsection (2) wherever the expression “provincial administration” is used, I ask that after the word “administration” the words “local authority” should be inserted. It once again has the same purpose, viz. that the local authority, in the first place, be recognized in terms of the provision of health services and, in the second place, that it be made possible for health services to be delegated to them so that they can carry these out effectively as far as their communities are concerned.

In the circumstances I move the amendments printed in my name on the Order Paper, as follows—

1. (1) On page 16, in lines 22 and 23, to omit “, excluding any function referred to in subsection (1)(a),”;
2. (2) on page 16, in line 24, after “administration” to insert “or local authority”;
3. (3) on page 16, in line 28, after “administration” to insert “or local authority”;
4. (4) on page 16, in line 30, after “administration” to insert “or local authority”

I regret that I am unable to accept amendments (2), (3) and (4) as they require the State President’s recommendation.

Mr. Chairman, with respect to the hon. member’s first amendment, I just want to point out that clause 14(1)(a) specifically gives substance to the key principle of the legislation, i.e. the overlapping and co-ordinating function of the Department of Health. The implication of the amendment of the hon. member is that the hon. the Minister can delegate the coordinating function to the provinces and the local authorities. In other words, a local authority or a province can be authorized to co-ordinate the services the department furnishes with the services which the authority furnishes and can therefore exercise control over such services. In our political set-up it is absolutely unacceptable that a junior government body should be authorized to exercise control over a senior government body. The powers are merely granted to the Department of Health, the powers to provide additional services with a view to ensuring a comprehensive service, and not to any other body. This is to prevent absolute chaos developing amongst government bodies. If the function were to be delegated to the province and to local authorities, this would mean that any authority could then carry out any function, while the Bill specifically aims at introducing realism and co-ordination into the services to ensure the optimum utilization of our resources. If the hon. member’s amendment were therefore accepted, it would definitely be a step backwards. I therefore feel that the Committee should not accept the hon. member’s amendment.

Mr. Chairman, I agree with the hon. member for Pietersburg that we cannot accept the amendment because what it would amount to in reality would be that bodies such as local authorities would have to carry out the co-ordination of comprehensive health services, something which is actually the chief task of the Department of Health. After all, it is not their function and not even the function of the provincial administration either. If it should happen that anyone is allowed to do anything he wants to, we would have chaos. I therefore find it unacceptable that a junior government body should co-ordinate the task of a senior government body. Co-ordination also presupposes a measure of control, but control must take place from above. That is the only way in which it can really be done efficiently. Also bearing in mind our resources and the whole approach of the Bill, i.e. the saving of our resources, work and even manpower, I cannot accept the amendment.

Amendment (1) negatived (Progressive Reform Party dissenting).

Clause agreed to.

Clause 15:

Mr. Chairman, I move the amendment printed in my name on the Order Paper, as follows—

The amendment asks for the word “audited” to be included as far as a certificate issued by the secretary of the local authority is concerned. I move this amendment as a result of representations made to me by a local authority.

Mr. Chairman, I regret that I heard virtually nothing the hon. member said because I could not get to the earphone in time. I therefore tender my apologies. I have, however, looked at his amendment, but I do not actually know what he means by an audited certificate. One can make a sworn statement and one can probably also speak of a sworn certificate, but I do not know what an audited certificate is. What is being used here is a legal terminology, as in the case of sections 10(4) and 11(1)(c) of the old Public Health Act. This is therefore the accepted practice, and the hon. member will therefore understand that I cannot introduce a term here which is not acceptable to the legal advisers. I therefore regret that I cannot accept it.

Amendment negatived.

Clause agreed to.

Clause 16:

Mr. Chairman, clause 16 deals with the functions to be exercised by the provinces in the field of health services, and I would like to move the amendment printed in my name on the Order Paper as follows—

Once again I believe that it is better in respect of virtually any primary health service, e.g. family planning, pre-natal and post-natal services, promotive health services, preventive health services, minor curative health services, rehabilitative services, health services for the aged, mental health services and so on, that where a local authority exists—thus practically in respect of all large local authorities—and where they have the capability to provide these services, they should be given the opportunity to do so. They can provide better services because they are in constant communication with the communities they serve; they are in close contact with the problems that exist and with the people who need health services. In many ways they are directly responsible to those people and also accountable to them. In other words, a local authority can develop a much closer accountability and responsibility to a community than for instance a province. I believe that wherever it is possible and feasible for health services to be delegated to local authorities, those health services should be so delegated. Therefore I believe that provision should be made in the Bill for the provinces, when they have satisfied themselves that a local authority can render a health service and after consultation with the Minister—in other words, subject to investigation and subject to satisfaction being obtained that the local authority is capable of providing the services—to encourage the delegation of health services and to be given the means by which it can be done. In order to have that means it is necessary for an amendment such as the one I have moved.

Mr. Chairman, in every clause the hon. member for Bryanston wants to give the local authorities powers and a statutory status that they do not have at present. The matter has been clarified so many times by the hon. the Minister and other hon. speakers. It is clear that the hon. member thinks that the PRP is going to take over the Johannesburg City Council and even now wants to dig himself in there. With that in mind, he cannot want us to insert things into the legislation which are illogical and do not make any sense either.

Mr. Chairman, the way I feel now, perhaps I should simply accept one of these amendments by way of a gesture. I cannot, however, Mr. Chairman. Apart from the initial barrage, when a little politics crept into the debate, I must say that the hon. member for Bryanston did do a tremendous amount of work, even if only in reading and studying what others had perhaps drawn up for him. I accept the fact that he had to do some study. I therefore appreciate the fact that he wants to do his bit, but unfortunately I cannot accept these amendments. This Bill is the result of many long negotiations and the thorough correcting of both the legal terms and the language. In terms of his amendment a province simply has to consult with the Minister and then it can do what it wants to. This would emasculate the whole object of the legislation and of the principle of the central determination of policy. There has been a 60-year-long struggle to reach eventual agreement between the three levels. However, that is not all. In terms of his amendment a province would be able to delegate certain tasks to local authorities, but there is not even provision for them to compensate for that. The province, therefore, has no actual safeguard in this respect. The local authorities themselves objected vehemently when that was initially contemplated in the draft Bill. We therefore know of their views in this matter. I feel that within the financial capabilities of the country we must take the central Government’s approach into consideration. We cannot allow everyone to do what he wants to. There is provision for local authorities to carry out certain functions. I refer again to clause 16(f) and clause 17(b). There is also provision for compensation. There the local authorities at least have a means of bargaining, and they are also protected by the arbitration right of the Minister who can finally decide the issue. We would therefore actually be exposing the local authorities to some or other form of abuse and, what is more, if we accepted the hon. member’s amendment things could go completely haywire as far as the provinces are concerned. Since the hon. member is specifically concerned about local authorities, and takes up their cause at every turn, I think he will understand why I cannot accept this amendment either.

Amendment negatived (Progressive Reform Party dissenting).

Clause agreed to.

Clause 18:

Mr. Chairman, in view of the explanation of the Minister in rejecting my previous amendment, I shall not move an amendment standing in my name on the Order Paper in respect of clause 18.

Clause agreed to.

Clause 20:

Mr. Chairman, clause 20 deals with the functions of local authorities. Although it appears from the attitude of the speakers on the Government side that they wish to reduce the importance of the functions of local authorities and to emphasize the function of the provinces and the central authorities, if one looks at the Bill itself, one sees that there are many pages which deal with the responsibilities of local authorities as far as the provision of health services is concerned. Most of those pages deal, generally speaking, with environmental health services. What I want to suggest is that local authorities should be given the right, by way of my amendment, to deal with curative treatment of minor ailments in health service centres staffed by nurse practitioners, who are nurses, who are given additional training. They can identify and diagnose many minor ailments and prescribe treatment. People who are so treated in these health centres might as a result not have to go to hospitals in order to get more advanced treatment. In other words, what I believe the situation should be is that through the local authorities a system should be developed of health centres which would be widely dispersed throughout the communities in the country and that those health centres should have the equipment and staff necessary to deal with a large range of health services. They should, inter alia, be in a position to diagnose and treat minor ailments in order primarily to avoid the necessity of the people concerned having to go to hospital to receive treatment. I believe that that would be an improvement. I want to admit immediately that the majority of local authorities are not in a position at this stage to provide such health services on a large scale. But it is something which I believe should be an aim of this legislation. I believe that the local authorities should be given the means and the guidance to work towards this end. Therefore I move the amendment printed in my name on the Order Paper, as follows—

In addition, I move the second amendment printed in my name on the Order Paper, as follows—

This amendment is the same as a previous one.

Mr. Chairman, with respect to the first amendment moved by the hon. member for Bryanston, I think one should just draw attention to the fact that the legislation we have before us is not in competition with private practice in South Africa. The private practitioner in this country is a very important component of a comprehensive health service and it was certainly not the intention, with this legislation, either to compete with or to replace the private practitioner. There is yet another very important principle which the hon. member loses sight of, and here I am referring, in particular, to the definition of “minor ailments”. In the motivation of his amendment the hon. member gave us no idea whatsoever about what he meant by “minor ailments”.

The other very important principle at stake here is that in medical practice use is not made of semi-qualified people to handle diagnosis and treatment. Diagnosis can only be done by a trained medical practitioner, and to give legal substance, in this legislation, to the employment of semi-skilled medical practitioners would be completely at odds with the principles underlying medicine in this country. Therefore I cannot accept the hon. member’s first amendment.

Mr. Chairman, let me simply draw the hon. member’s attention once again to clauses 16(f) and 17(3), in terms of which local authorities are covered financially when certain curative services are delegated to them subject to control. They are consequently not totally excluded. Although the hon. member wants us to include this in the Bill, he must realize that the provinces are the bodies responsible for curative services.

†The hon. member’s amendment will change this because the concept of “minor ailments” has a different meaning from person to person, from authority to authority. Local authorities may be able to render sophisticated out-patient services and this is contrary to what the Bill envisages for them.

*I therefore think that in this instance it can also be understood that the gist of the legislation determines a central policy and that we cannot defuse it in this respect. I therefore cannot accept the amendment.

The second point the hon. member raised is in connection with the deletion of the phrase: “excluding any function referred to in subsection (1)(a)”. This deals with the coordination of the comprehensive health services by the central Government. In that case the same arguments apply as were applicable to the previous amendment he moved, and I therefore do not want to deal with that in any greater detail. The hon. member will understand why I cannot accept the amendment.

Mr. Chairman, I would like to reply to what the hon. member for Cradock and the hon. the Minister have said in this connection. It is not a question of asking for something new; it is already the practice in respect of a number of local authorities in South Africa, local authorities which have established health centres where a wide range of health services are rendered by qualified nurses, nurses who have been given additional training. They are called “nurse practitioners”. They are provided with the equipment and the opportunity needed to provide health services that include curative treatment. This is the case in a number of local authorities in South Africa. But, South Africa aside, also in a large number of countries throughout the world it has been found that this is the only way in which health services, including curative health services, can be made available to millions of people. The choice is either for health services to be provided on this basis, or the people do not receive the services they need. We have a rapidly expanding South African population, particularly with regard to those groups and sections of the population who are socio-economically deprived and who do not have the financial means to go to the hon. member for Cradock for medical attention. South Africa has millions of people who fall into that group, the majority of whom do not receive adequate medical services. I am talking particularly about the rural areas of South Africa, including the existing homelands. The only way in which effective health services can be made available is to change the whole concept of health services and to encourage the provision of dispersed health centres, in which although it will not be practically possible to have doctors to serve the people, medical personnel with the necessary training and the necessary equipment will be able to deal with those aspects of curative services which do not need more advanced attention. Of course they will be in a position to refer to doctors or to hospitals any cases which need more advanced attention. I am saying that it is a new system which is being used and applied throughout the world, a system which we in South Africa in particular will have to accept in view of the composition of our population and in view of the fact that large numbers of our population are socio-economically deprived and cannot be treated effectively in the traditional way.

Mr. Chairman, clause 20 provides that each local authority may do certain things. We regard these as the primary tasks of local authorities. Since the hon. member has spoken of the curative treatment of what he calls minor ailments, let me just say that this is not what we regard as a primary task. If the whole clause is read, it is very clear that if the Minister thinks that the local authorities can carry out these primary tasks, he can require them to do so. In other words, what it amounts to is an obligation. In clause 20(3) mention is made of delegated powers, i.e. there is nothing in the legislation preventing a large local authority from carrying out more extensive functions. This is already the case, as the hon. member has said, in a large local authority like Johannesburg. It can, in fact, happen; there is nothing in the legislation preventing it. However, this is not regarded as a primary obligation. The present situation can continue. My contention is that it will happen more frequently in future. There is nothing in this Bill preventing it. What this amounts to, however, as we see it, is merely that it is not a primary function or an obligation. It will not happen on a large scale throughout the entire country. I just want to add—the hon. member for Fauresmith also mentioned this during the Second Reading debate—that one must guard against loading people with too many duties and obligations to the detriment of private medical practitioners. This could also cause problems. As the hon. member for Cradock rightly remarked, this is a very important component. I cannot accept, however, that this is meant to rest as an obligation on the shoulders of local authorities. As the Bill reads at present, it is not an obligation, but it is not prohibited either. After all, it is quite in accordance with what happens in practice and also with what is practicable. That is how we want it.

Amendments negatived.

Clause agreed to.

Clause 23:

Mr. Chairman, clause 23 deals with the functions and the responsibilities of medical officers of health of local authorities. Since the new philosophy that applies to health takes a much wider look at health and all the factors affecting health, such as environment, nutrition, employment, housing, and the like, I should like to move the amendment printed in my name on the Order Paper, as follows—

The motivation for this amendment is that it is particularly, the circumstances in which housing is provided, and housing conditions which have a marked effect on the health of the community, particularly in the urban areas with large populations where high-density occupation is experienced. In those circumstances the housing of the people has a very significant influence on the health of the community. I believe it should be a specific requirement that in all decisions and actions of local authorities which have any connection whatsoever with housing, the medical officer of health should play a very important part. In order to ensure that this will be the case, I believe there should be a provision in the Bill which stipulates that medical officers of health should play an important part as far as housing is concerned.

Mr. Chairman, in the first place I should like to draw the hon. member’s attention to clause 23(d). In that clause provision is already made for the fact that such an officer of health can be invested with functions of this nature. However, with respect to housing vis-a-vis health—and now I am speaking in general terms—there is already provision for the making of regulations. If the hon. member also looks at clause 33(q)—he will find the same thing in clause 33(d), (h), (i) and (m)—he will note that sufficient provision is, in point of fact, made for that, in my estimation at least. If an officer of health therefore has to implement the regulations— and they are comprehensive regulations— with respect to housing, overcrowding and conditions which could influence people’s health, there is adequate provision made for the officer of health to take action. In terms of clause 24(3) the medical officer of health must exercise control over the health personnel and supervise their activities. The local authority determines the functions which the official must carry out. I took note of the question in connection with defined functions. Defined functions are detailed in the regulations and not in the Act. The hon. member did not say what defined functions he had in mind …

That can, in any event, be done in terms of clause 23(a).

Yes, there is that provision and that can be done. There is adequate provision in the regulations for the definition of all the things the hon. member envisages, and the addition of any further items would be superfluous. As far as I am concerned, the hon. member should also abandon the amendment.

Amendment negatived.

Clause agreed to.

Clause 24:

Mr. Chairman, there are a few things in respect of the responsibilities of local authorities that I should like to see included in the Bill. One that I should like to have included is set out in my amendment to add the following subsection—

The position is that institutions of this nature—i.e. nursing homes, old age homes and all other similar institutions—in any particular community, which is the responsibility of a local authority, are very closely linked to that community. These services are often provided by a local authority, but also by the community by a charitable organization or by some free enterprise organization. I believe one should develop, wherever one possibly can, a close community responsibility for these institutions and a close interest by the community in the welfare and activities of these institutions.

One of the ways in which that responsibility and interest can be developed is to give the authority concerned responsibilities as far as the institutions are concerned. I believe that as far as the maintenance—i.e. high standards of sanitation and appearance—and services rendered are concerned, if the local authority is made responsible for the inspection of the institution, high standards will be maintained. I therefore move the amendment printed in my name on the Order Paper, as follows—

Mr. Chairman, I am afraid the hon. member for Bryanston is now also reading other legislation into the Bill. The Bill before the House is the Health Bill, but the hon. member speaks about old age homes. Old-age homes have nothing to do with the Bill as such and with the functions of the Department of Health. They fall under another department. What is more, the hon. member wants “and all other similar institutions” inserted. That is a very vague statement. What other “similar institutions” are there? Perhaps there is such an institution for his party, but I do not know of similar institutions. It is a vague statement which is not relevant to the Bill. As far as nursing homes are concerned, surely the hon. member knows that when it comes to health aspects, specific regulations have to be complied with. There are specific regulations in terms of which inspections have to be carried out.

Mr. Chairman, I want to point out to the hon. member that the functions of local authorities are actually set out in clause 20(1) of the Bill. He should actually have broached this matter when that clause was under discussion. Nevertheless, for the sake of clarification I want to explain that a decision was taken on nursing homes and the control of nursing homes last year. This issue comes up again in clause 44 of the Bill. In terms of clause 44(1)(a)(iii) regulations will be made in connection with the inspection of the institutions. In no way does this mean that local authorities are excluded.

He has already heard that old age homes are the responsibility of the Department of Social Welfare and Pensions. The Department of Health can therefore not introduce legislation covering that aspect. That could only be done by way of an agreement. In any event, that is not relevant here. However, if the hon. member is concerned about the rights that local authorities have to inspect buildings in their respective districts, let me assure him that those rights are already contained in local by-laws. They will still be able to exercise those rights in terms of this legislation. The hon. member does not have to worry about that. The particulars will be looked after by way of regulations. For that reason I cannot accept the amendment. I do not think it is necessary for us to have it placed on the Statute Book either.

Mr. Chairman, may I ask the hon. the Minister whether the officers of health of local authorities firstly have the right, and secondly whether it is their responsibility, to inspect institutions of this nature with a view to ensuring that the required health standards are maintained there?

Mr. Chairman, regulations exist to cover that aspect. This right must be given to the people; otherwise there is a great vacuum. They already have the right.

Amendment negatived.

Clause agreed to.

Clause 26:

Mr. Chairman, I move the amendment printed in my name on the Order Paper, as follows—

The background to and reason for this amendment is that the United Municipal Executive sent a memorandum to me in which they stated that they believed that clause 26(4)(b) could be interpreted as if the partial refunding of salaries and allowances in terms of clause 26(4)(a) is limited exclusively to health officers who have performed duties which are not ordinarily related to health services. It would be an anomaly if this were the case. Of course this interpretation does not reflect the intention of the Bill, but nevertheless this provision may perhaps result in confusion. Therefore the intention of this provision must be spelled out a little more clearly. This can be done by determining that when the health officer performs additional services, over and above his health services, the Minister may sanction this, but when the Minister has to pay a subsidy on that portion of his services pertaining to health, it is, of course, paid on that portion only, because it may happen that a health officer may sometimes even act as a traffic officer. I am moving the amendment for the sole purpose of stating the matter in clearer terms.

Amendment agreed to.

Clause, as amended, agreed to.

Clause 38:

Mr. Chairman, I move the amendments which appear in my name on the Order Paper, as follows—

Actually, the two amendments are related. The Minister of Water Affairs is in fact concerned with the regulations which the Minister of Health is going to enact in regard to water. According to the provisions of the Water Act, the Minister of Water Affairs has certain obligations in regard to the prevention of water pollution, and that is why the Department of Water Affairs has requested that they should also be consulted in this regard and that the necessary provision should be included in the legislation. This takes place in the same way as in clause 37 where provision is made for consultation with the Minister of Water Affairs.

Mr. Chairman, I move as an amendment to the Minister’s first amendment, the amendment which appears in my name on the Order Paper as follows—

At the moment a lot of pollution of water takes place as a result of uranium mining. There is also a seepage of cyanide products after the extraction of gold and we are having trouble with the disposal of the effluent from certain mines which are particularly mining uranium. For these two reasons alone I think it is essential for us to consult with the hon. the Minister of Mines whenever it might be necessary. I think the hon. the Minister will realize what the problem is and how great it can become in future if we do not provide for the proper disposal of water that has been used on the mines, and has become polluted.

Mr. Chairman, this clause deals with the promulgation of regulations about rubbish, night-soil, sludge, sewage, etc. These regulations shall, however, not apply, in terms of subsection (3), to—

1. (a) the disposal of sludge, waste or trailings;
2. (b) the utilization of land for the purposes of such disposal; or
3. (c) the conferring of surface rights to land for the purposes of such disposal or the withdrawal of such rights.

This is according to the Mines and Works Act, the Precious Stones Act, and the Mining Rights Act. Therefore, consultation with the hon. the Minister of Mines is not necessary in this instance. If that were not the case, I would gladly have accepted the amendment. The only other aspect which the hon. member mentioned, which I consider to be a cogent argument, is in respect of the disposal of radio-active material. That is a very important matter, but as the hon. member very well knows—he should know because he took part in the discussion of the legislation last year—that is covered adequately by the Hazardous Substances Act of last year. I think the hon. member will agree with me that his amendment is therefore not necessary.

Amendment moved by Dr. E. L. Fisher negatived.

Amendments moved by the Minister of Health agreed to.

Clause, as amended, agreed to.

Clause 53:

Mr. Chairman, I move the amendment printed in my name on the Order Paper, as follows—

This particular clause deals with the powers of officers, inspectors and authorized persons. As subsection (4) of the clause stands at the moment it indicates that where an officer, inspector or person referred to in subsection (3) makes an inspection or performs any duty that is provided for in this Bill he shall at the request of any person affected thereby produce the document which authorizes him to act in such a manner. The object of the amendment is to make it obligatory for the inspector to show his certificate to the person being inspected prior to taking action in terms of the powers granted by the Bill. I do not think it is necessary for me to motivate in detail the reasons for this particular amendment being moved except to say that I am sure the hon. the Minister is fully aware of the motivation. I believe that the amendment will help to create a better relationship between the inspector and the inspected because the inspected will be fully aware of the identity of the person and will be satisfied as to his genuineness. It also eliminates any possibility of fraudulent inspectors. I want to point out to the hon. the Minister that the principle was unanimously accepted by the commission on page 14 of its report, where it is quite clear that the intention of the legislation produced by the commission was that the inspector shall exhibit the identification document referred to in subsection (3) to any person affected by the exercise or the performance of any power. I would also like to point out to the hon. the Minister that both he and his predecessors have accepted this principle from as far back as 1964 and that in many of the Acts which fall under the hon. the Minister’s department, wherein powers of inspectors are defined, it has already been accepted in principle that those inspectors shall exhibit their authority prior to conducting any functions under the requirements of the Act.

Mr. Chairman, I think it would be grossly unfair of me not to accept this very reasonable amendment. I accept the amendment.

Amendment agreed to.

Clause, as amended, agreed to.

Schedule 1:

Mr. Chairman, I move the amendment printed in my name on the Order Paper, as follows—

Section 12 of the Finance Act, No. 47 of 1949, which is being repealed in this schedule has been incorporated in the Finance and Financial Adjustments Consolidation Act in 1977. Therefore it is a change which has already been incorporated in another Act. Of course, the provision cannot be left out of the Act concerned, when it is consolidated, since the Health Bill has not yet been passed. Therefore I move the amendment as an inevitable consequential amendment.

Amendment agreed to.

Schedule, as amended, agreed to.

House Resumed:

Bill reported with amendments.

Third Reading

Mr. Speaker, I move, subject to Standing Order No. 56—

Mr. Speaker, today we are going to put the seal of approval on a Bill which has been brought before this House after a long and thorough investigation. This Bill replaces the 1919 Health Act. That Act was brought before this House 58 years ago and has since stood the test of time. Many of the aspects of that Act have been incorporated in this Bill. If the 1919 Act can serve as an example of how legislation can last if it is done thoroughly, this Bill, which we regard as a much better piece of legislation than the 1919 Act, should do the same.

The 1919 Act was introduced almost immediately after the Spanish ’flu epidemic, as it was called, which swept the country at the time. That terrible scourge swept across the country, especially across the Western Province. Reading about what happened at the time, I was amazed to find that out of a population which was then estimated at 6 million, 2 million were stricken with the disease. Of this 2 million, over 159 000 died. In Maitland, Cape Town, alone, over 200 people a day were buried. The 1919 Act then came into being, and it was amazing how quickly infectious diseases were restricted, and not only contagious and infectious diseases, because at the same time a preventive scheme was brought into being. With that we saw the beginning of mass vaccination and the use of new drugs, new methods of isolation and new methods of treatment.

Today scarlet and other fevers have almost been wiped out. When we have to isolate people today, we no longer talk about the scarlet fever, chicken pox and mumps; we talk about new and far more virulent diseases, for instance Marburg disease. For this type of disease isolation has to be expertly carried out, because if it is not, the disease can spread like wild fire and can cause death and destruction wherever it strikes. I shall come presently to what we are going to be faced with in the future. I was pleased to be able to serve on the Select Committee and on the commission, which played its special part in the bringing into being of this Bill.

At this stage I think that it will be only right for me to add my congratulations to those of the Minister for all the co-ordinating work that has been done so as to be able to have the Bill here this evening. I also wish to take the opportunity to pay tribute to the Secretary of Health, to his deputies and in particular to Mr. Gert Pieterse, who was our law adviser and did so much to help this Bill into being. These people have done a tremendous amount of work. Why we on this side of the House are so appreciative of what they have done, is because their doors have always been open. On countless occasions we discussed various aspects, not only of this Bill, but all matters in respect of health. I wish to thank them most sincerely. I also take this opportunity of congratulating the hon. member for Fauresmith, Dr. Van Der Merwe, who was Chairman of both the Select Committee and the Commission. He carried out his difficult and onerous task in a most able, diligent and tactful manner.

Referring again to preventative medicine: As a result of what has been done in the past, we find today that fever hospitals have got empty beds. Where before the hospitals were overcrowded and tents had to be erected alongside them, today there are empty beds. As regards all kinds of infectious diseases we find that, irrespective of the population growth, there is a drop in the number of people suffering from infectious and contagious diseases. I hope that in the very near future we shall see that the number of people and particularly the number of Black people in our country who are suffering from tuberculosis will also drop rapidly. I should like to say the same about bilharzia and other diseases. These are vast projects the Government has in hand. It requires a great deal of work, money and personnel to deal with these things. This Bill gives those projects a chance to succeed.

The rapid changes taking place in the world today mean that the Government, through the Minister, will not only have to keep pace with what is needed now, but will also have to make provision for the future when even more rapid changes are going to take place. In the future changes will be far more rapid than they have been in the past. New diseases—I have just mentioned one— are coming into being. The drugs we are using today are producing bacteria that are far more resistant to drugs than they were previously. We have to combat this. The man in the street is going to be faced with health changes, which are going to cost an awful lot to meet.

Look what has happened just recently in the field of surgery. I refer to the transplants, the spectacular exchanges between one part of a body and another. Pacemakers are put into the body to keep the heart going. Arms are being transplanted, fingers are being transplanted, toes are being exchanged for thumbs. All this is going on and it is spectacular stuff.

But the UP cannot be saved.

All this costs a tremendous amount of money. The news media, the Press, radio and TV, highlight this. It is glamorous: it is something the people want to see. However, nothing is heard of the other side of the picture. Nothing is heard of the people who help to prevent diseases. Nothing is heard of the men in the laboratories who work day and night. All these aspects must be highlighted as well.

If we want to become a healthy country and meet the future confidently, we have got to spend an awful lot of money on the prevention of diseases. Together with that, we have to make sure that our population growth is kept in check. We have to make sure that our food supplies are sufficient. An end must come to the destruction of food. New methods must be found to preserve it. When I hear that food cannot be given to the needy, the poor, to those suffering from malnutrition because we do not have transport to take it to them, I blush for shame, because we have got the food, and a lot goes to waste. How much does it cost to keep a child suffering from malnutrition in a bed in a hospital? I would say that I would be underestimating if I said that it would cost at least R20 a day to keep a child suffering from malnutrition in hospital yet we cannot even find the money to hire a truck to take the food which is going to waste to these people. What is wrong with us? Where is the co-operation with other departments? What is happening to us that we can allow these things to occur in our country? Why should skimmed milk be poured down the drain? Why should eggs be sold at a loss when we need them for our own people? It is the food of the people that keeps the people healthy. This Minister has got a big job. Fortunately he has a lot of help and we on this side of the House will give all the assistance he needs in these matters. He need not be afraid to introduce legislation in this House if it is going to help the people. We will see to it that it goes through. We shall even improve on the legislation which he introduces.

Something that we will have to cope with in the future is that every day of our lives we are being subjected to new stresses and strains. Our whole environment is changing. When I first came to this House I came down from Johannesburg to Cape Town in a Viking aircraft and we travelled for three and a half hours.

Were you pedalling?

We were going very quickly. Today when we do the trip in one hour and 50 minutes, we ask: “Why so slow? Cannot we go a bit faster?’ ’ The stresses and strains that are occurring in that aeroplane we will know about later. Aviation medicine is only starting; it is still in its infancy.

When one thinks of the mining industry, some time ago 6 000 ft. was considered to be deep. Today the mines go down 13 000 ft. Today miners are subjected to new stresses and strains of heat, pressure and new dusts. This is a problem with which the hon. the Minister will have to deal. It is his job.

The hon. the Minister said that he would deal separately with occupational diseases. They cannot be divorced from the health structure of our country. Look at what is happening in our industries today. New chemicals are being used. There are the new plastics, the new fibres, the new clothing which we wear, new utensils, new machines, all of which have an effect on man. Changes can happen so quickly that we do not have a chance of adapting ourselves properly to the change. When things happened at a slow pace, we had time to adapt; that is not so today. Things are happening overnight and man must adapt himself to all these changes which are occurring. If we do not have legislation to look after the people disaster is going to occur. Look how near we were to disaster when dealing with asbestos. As soon as asbestos was introduced into industry, we found new diseases occurring and it affected not only the people in the industry, but it affected the people living in the surrounding areas as well who had never even been in a factory which was working with asbestos. Some of the people who were affected were farmers who were living tens of miles away from the factories. I could go on and on in this vein.

What of the future? Are we going to be able to meet it? How are we going to make it work? Today the hon. the Minister has given us his plan. He said that he would separate the curative aspects from the prevention of disease. He also said that he would give duties to each of the three tiers of government. He said that these duties would be allocated not by a sudden edict; he would not do it himself, but would consult with the people. He would consult with the people from the bottom to the top. He will start with sub-committees, with groups, he will find out what they require. These sub-committees will come to a higher committee and the higher committee will eventually come to the council. If he does that and he is successful, he will solve a lot of problems. However, one can do all this if one has the hands to do it. That is one thing that we in South Africa do not have. We do not have the hands to do the job. We have the brains and the ability but we do not have enough people to do the job. It is quite strange that here—even in our country with its fast growing population—we cannot keep pace with the wants of the people because we do not have enough trained people.

Here I want to stop for one moment and to say to the people who are contemplating leaving this country, and particularly to members of my own profession: This country has given you a fair deal. This country has provided you with your profession. You only paid a fraction of what it cost to train you. Do not run away. This is the place to be. If you think things are wrong, help to make them right, but do not leave it to the few to do the job while you criticize them, even if they are trying to do the job properly. I can tell them that the grass is not greener on the other side of the fence. I also want to say to others who are not in my profession, to do the same. I want to say to them: Stay. Be part of us. If we are in trouble, help us to overcome it.

Mr. Speaker, the hon. the Minister must realize that we have to have experts in all health fields. We have to have research workers. We have to have a stream of people going into research and finding out what diseases are all about. Without them the health services are lost. Those people have to tell the practitioners what to do. The practitioners have to serve both in preventative and curative medicine. The hon. member for Bryanston touched on the curative diseases. He spoke about local authorities taking over. The job is far bigger than that. Where a local authority can be established in a town or in a city the troubles are not so big, because there are lots of hospitals available where people can be served. There are many hospitals with out-patient departments. We should be concerned about places where there is not a hospital nearby and where there are many people who need help, where populations are either overcrowding the area or where the area is under-populated. We should think about doctors who cannot practise in such areas because they cannot make a living there. Nevertheless, there are people living there, people who need help. Then there are the over-populated areas, areas where doctors will go, but where they cannot render good service because there are too few of them for too many sick. These are the problems that we have to meet.

I agree that if the doctors cannot do it, and if there are not enough doctors to do the job, whether they be White or Coloured or Black, we will have to make use of the hands available. Those who are not doctors, but are in the nursing profession, must be trained to become specialist nursing staff.

From what my own experience has taught me, we have a group of women in this country of ours who are dedicated, able and willing to do the job if we allow them to do it. Every university must have a faculty where a nurse can become specialized. She must become specialized in those things which she will need when she goes to help to man a clinic in the country or a clinic in an overcrowded area. If she is trained she will know when to refer the case to the doctor and when she can deal with it herself. Although she is not an expert in disease, she will be able to recognize disease and will be able to direct where that case should go to. These are things that we have to plan for now. Some of it has been done. I have seen it being done and done very, very well indeed. Because we already have a basis for this type of work we must take every opportunity we possibly can to improve it and to swell the numbers of people who are willing to do the work.

What else is there? The cost of illness? I cannot go into that today. It is astronomical and I do not know where it is going to stop. I do not know when the doctors are going to stop putting up their fees. I do not mind people making a good living. Why should they not? Able businessmen take pride in the amount of money they make. Doctors can do the same, but the difference is that doctors are dealing with people who need them. This is not business speculation, but it is for the needy and for the preservation of life. Doctors must please help to put a brake on these soaring costs. However there are many, many doctors, thousands of them, who do a job of work and who are paid a very, very low salary but who are willing to carry on.

Medical aid came into being because people could not pay the doctors’ fees. But, what do we find now? We find that the people are not earning enough to subscribe to medical aid. The end result will be that more and more people will have to go to provincial hospitals and will have to be accommodated there because people cannot afford to go to private hospitals. That is for sure. Due to the rapid development of medicine, heart pacemakers are today put in by surgeons as a matter of course. However, do hon. members know how much it costs to have a pacemaker put in? R2 000 is nothing. The other day I was told by one of my colleagues that a woman had a pacemaker put in and was in the nursing home for five days. The account came to over R5 000. It was one of my colleagues here who told me. The operation was done on a member of his family. At the same time, I can tell the House that one of my family went to the General Hospital in Johannesburg and had a pacemaker put in. Do hon. members know what it cost her? It cost her the cost of the stay in the hospital; virtually nothing. This shows one the imbalances prevalent in our country. On the one hand it cost nothing, while on the other hand it cost thousands for the same job.

I hope we will have another opportunity to discuss these things again. I see that my time has now come to an end. I want to say again to the hon. the Minister that we give our blessing to the Bill and we hope that through it the people of our country, whatever colour they are, whether they are rich or poor, can expect a good deal and that the road for better health is now open.

Mr. Speaker, I have listened with special interest to the chronology of health legislation since the influenza epidemic of 1918. I also listened with special interest of the health philosophy of my hon. friend on the other side of the House as he elaborated on the special enthusiasm he has for those matters he expounded on, for instance the cost of treatment of diseases, doctors’ costs and the possibility of embracing our nurses in professions in time to come, professions in which they are not embraced at the moment. We foresee that nurses can be put to much better use in future. I agree with the hon. member there. I also agree with many other things he dwelt upon.

This Bill is the culmination of many years of dedicated and very hard work by many people, e.g. the hon. member over there. I already said that I had great appreciation for the work done by the members of the commission and I repeat it now. I think, however, that it is perhaps fitting that I read a telegram I received from a very revered old gentleman who is now in his ripe old age. He is one of the foundation fathers of health legislation in South Africa. Because of the completely nonpartisan nature of this Bill, I think it is appropriate that I read this telegram. I think it will be appreciated. I received the telegram about two weeks ago. It reads—

He still remains a politician!—

I am not going to waste any more of the time of this House by saying anything further about this Bill, except just to thank everyone for their contributions and to express my appreciation for the fact that there were no divisions, although we have been discussing amendments the whole afternoon, amendments on which we differed greatly, at the beginning of the debate in particular. Therefore the differences are not profound. We have the correct attitude. I cannot but thank the officials who have worked hard at this legislation over the past years once again. We must not forget that the attitude of the people outside, the provinces and even the local authorities and the way in which they approached differences of opinion when they had to consult us on certain aspects of this legislation. The way in which they approached this and consulted us, ultimately made it possible for us to bring this legislation to full maturity.

Question agreed to.

Bill read a Third Time.

Mr. Speaker, when the House adjourned last night, I was arguing that the Opposition was opposed to the Second Reading of the Bill mainly because of two definitions. The definitions are contained in clause 2 which defines the concepts “Bantu employee” and “employer”. I have advanced detailed arguments as to why it is necessary that the clause should be given statutory effect. I have indicated that if the clause is not included in the principal Act, this renders the Environment Planning Act completely powerless.

It is for that reason that I cannot for the life of me understand the argument and the amendment of the hon. member for King William’s Town. In his speech, the hon. member for King William’s Town made a heart-rending plea for decentralization. The legislation envisages decentralization, but the IUP moves an amendment and says that it is going to vote against the legislation.

Some of the most important provisions of the Amendment Bill are contained in clauses 6(2) and (3) which amend section 12 of the principal Act. Briefly, the gist of the clause is that it enables the State or any authority to freeze the number of Bantu employees at a given time. The clause also provides for the establishment of certain presumptions in court; firstly as regards the number of Bantu workers in service at a given time, and secondly, that a Bantu worker is in fact a Bantu.

One can best discuss the clause against the background of a practical situation and in that regard, we can only take into consideration the labour situation in the Western Cape. We must do this, however, while bearing in mind that it is stated policy that the Western Cape and specifically the Cape Peninsula, are preferential labour areas for Coloureds and Whites. What happens in practice? Practical experience shows us that the labour market is being flooded by Bantu workers. If we consult the statistics in this regard, we see that the number of Bantu workers in the Peninsula increased by 43% during the period 1960 to 1970, whilst the increase in the number of Bantu in South Africa as a whole, amounted to 37,6%. In practice, this means that the number of Bantu workers in the Cape Peninsula has increased more rapidly than the total population increase of the Bantu in the country as a whole. Further statistics indicate that the number of contract workers in the Western Cape during 1965, amounted to 35 000. The number of contract workers increased to 120 000 in 1975.

That state of affairs cannot be allowed to persist indefinitely. It is precisely due to the provisions of clause 6(2) and (3) that this matter will now be regulated a little and that the uncontrolled increase of Black workers in the Cape Peninsula will be limited. Because the authorities did not have the necessary statutory powers that they are, in fact, now obtaining in terms of clause 6(2), the private sector exploited the surplus of Black labour for the sake of short-sighted economic gains. It was argued that the surplus of Black workers on the labour market in the Cape Peninsula, has occurred mainly for three reasons, namely that it is cheap labour, that the employer did not have to pay the levy that has to be paid for Bantu labour, and that the employer worries very little about how his workers are housed and he worries very little

Order! The hon. member is not to make matters too difficult for me. He should not go too deeply into aspects that have already been dealt with in the principal Act. The hon. member may proceed.

I accept your ruling, Mr. Speaker. I should like to argue, however, that the statutory provision made under clause 6(2) and (3) of the Bill before the House, will freeze the state of affairs as I have just sketched it.

In my opinion, the provisions contained in clause 6(2) and (3) herald a new dispensation as far as labour relations in the Western Cape are concerned. They also contain new principles that could be valid in respect of the employment of Bantu workers in the Western Cape. The principles are chiefly the following. We must accept that as far as the labour situation in the Western Cape is concerned, it is firstly a preferential area for Whites and Coloureds. Secondly, the local labour market must be fully exploited before any other labour can be used. Thirdly—this, in my opinion, is a very important provision—a premium must be placed on Bantu labour. There must be involvement on the part of the employer with his Bantu labour so that it does not result in what is being experienced at the present stage, namely that trade and industry are flourishing on cheap labour whilst the authorities have to provide expensive facilities such as housing, hospitalization, schools and roads.

In conclusion, I want to argue that for technical and administrative reasons, no responsible authority could permit the provisions contained in the principal Act—which I do not want to go into now—as far as decentralization, the maximum utilization of our natural resources and the drawing up of guide plans are concerned, to be rendered powerless. Furthermore, I want to argue that from an economic, planning, as well as a strategic point of view, it is absolutely vital that we cannot have a policy that gives preference to Coloured labour in the Western Cape, when the labour market is being flooded with Black labour. These provisions are chiefly aimed at protecting the Black labour that is employed here lawfully. This is the chief objective of this provision, because the available facilities cannot be inundated by labour without there being any control. For that reason, these provisions will, to some extent, correct the imbalance in the labour structure; and because it will, to a certain extent, remedy the existing disequilibrium, it is a privilege for me to support the Second Reading.

Mr. Speaker, the hon. member for Bellville made much of the fact that, while the hon. member for King William’s Town had talked about decentralization, he moved an amendment last night that the House decline to pass the Second Reading of the Bill because it will have a restrictive effect on the development of the existing metropolitan industrial areas, a development that is absolutely essential for the advancement of the whole of South Africa. That is good stuff and I want to point out to the hon. member for Bellville that there are two points in that that need to be considered. One concerns the existing industrial or metropolitan complexes and the other is that the hon. member for King William’s Town talked about the whole of South Africa. His was not the voice of fragmentation. I should like to point out to the hon. member for Bellville that decentralization and centralization cannot actually be seen in isolation. When one talks of decentralization in terms of the policy of this Government, one is talking about separate development and the development of the homelands. Mr. Speaker, those two developments, viz. the development of the homelands and the development of the existing industrial growth complexes, are interdependent. One cannot see one without seeing the other. If I could get one fact across to the hon. member for Bellville, who may then see the connection of what the hon. member for King William’s Town said, it is that the economic development of the homelands and the policy of decentralization can only be seen as a consequence of, must be seen as a consequence of, the development of the established growth complexes. It is in no sense an alternative.

The hon. member for Bellville yesterday also attacked the hon. member for Bryanston and he did so on two grounds. Let me say, before I get to the point and just to get the record straight, that we on these benches have got nothing against the policy of decentralization per se when the economics matrix warrants and attracts it. However, we have nothing good to say about the policy of decentralization when it is done for ideological purposes.

I have never argued the point.

When the hon. member for Bellville came to the hon. member for Bryanston, he attacked him on two grounds. I appreciate that he was under some difficulty because there was nobody else to come up to bat. Despite that he said that the hon. member for Bryanston was opposing this measure because it would do nothing to improve the growth, overall, of South Africa, but rather pull it back. I hope the hon. the Deputy Minister, when he comes to reply to the Second Reading debate, will tell us how, in any way, this measure is going to improve the overall wealth of South Africa and how, in any way, it can be said that as a result of this the 2616 million people who live in this country are going to be better off. I am quite frank and I am looking forward to hearing it from him. By all means, if he can give us examples of how, overall, this measure improves the wealth of South Africa, then we will be the first to stand up and say that he has convinced us.

The second thing the hon. member for Bellville said yesterday was that the hon. member for Bryanston had taken this line because thereby it would give grounds to attack South Africa and to attack this Government overseas.

That is so.

The thrust of that is, firstly, that whenever one disagrees with the Government, that is what one is doing. In reply to that I want to say two things: firstly, there is not one good thing to be said about this measure, and therefore the Opposition is placed in an extraordinary position in relation to that criterion; and secondly, those who sit on those benches seem to have the absurd belief that people outside South Africa do not know what is going on inside South Africa.

Mr. Speaker, when the hon. the Deputy Minister introduced his Second Reading speech, he talked about administrative difficulties. He said that this legislation had been brought to do certain things: to define “Bantu employee”, to define “employer”, to close certain provisions which had applied to the contracting industry before this time and, finally, to introduce the presumption which is contained in the proposed new section 12(3) on page 6. We all know what we are dealing with here, viz. with the ratio of Black employees in certain areas. The hon. member for Pretoria East came with some confusion about Coloureds and Indians. As I understand it, and I hope the hon. the Minister will confirm it, they are excluded from this ratio any way and that it does not take account either of certain industries which are classified as locally bound. When one looks at this legislation and at this clause one sees that it mentions specifically 18 January 1968 as the date. It is interesting to note that a persistent strain has been placed on business ever since that period of time, and now the hon. the Deputy Minister is coming with this legislation to try to shut loopholes, loopholes in the sense that when court cases have been held the judges have not produced satisfactory convictions.

Mr. Speaker, we have done an estimate, using figures from the Department of Statistics and adjusting them for the population split as between homelands and urban areas of Prof. P. J. v.d. Merwe of the University of Pretoria and also of one of the researchers of the Prime Minister’s Economic Advisory Council. To get some idea of the number of people involved by this particular clause, one can estimate that since 1968, roughly 1 782 000 new economically active people have come on to the market, of whom 837 000 are in the urban areas. These will of course be affected by this legislation. It seems absolutely extraordinary that at this time, with a reasonably official estimate of 1 million to 1,8 million unemployed, the hon. the Deputy Minister comes with this legislation.

I think we are entitled to ask which hand of the Government we are dealing with here, because at the time when this hon. the Deputy Minister comes with this piece of legislation to tighten it up, we had his colleague, the Minister of Economic Affairs, on 22 February the following in reply to a question (Questions and Replies, col. 423)—

He then goes on to say—

There we have the hon. the Minister of Economic Affairs saying that one of the major problems we face in South Africa is the level of capital intensity, and the obvious inference to be drawn from that is that he wants more people used as opposed to machines; and then we have this hon. Minister coming with this legislation.

In conclusion may I simply say to the hon. the Deputy Minister that he is strangely miscast in the role in which he now finds himself in having to come with this measure. He is rather like King Canute trying to get the sea to roll back. We support the amendment moved by the hon. member for Hillbrow, and let me simply say, in conclusion, that we honestly cannot find one good word to say about this legislation.

Mr. Speaker, at the outset I want to indicate that I support very strongly the amendment moved by the hon. member for Hillbrow. I do so for very real and very urgent reasons. The original Act passed through the House and the amending Bill we are now considering, and especially clauses 3 and 6 which give the original Act a great deal more teeth, affect different areas and different communities in different ways. Some areas will be affected more severely than others. The application of the Act and the amendments to it which we are now considering have a very serious detrimental effect on the industrial development of the area which I represent, namely the Port Elizabeth-Uitenhage industrial complex. One never likes to be parochial in this House by raising the problems of a particular area, but in the light of the provisions of the original Act and of the amending Bill we are now dealing with, I feel duty bound to do so.

Bearing in mind the effect of the amendments we are considering, there are certain aspects to which I very urgently want to draw the attention of the hon. the Deputy Minister. Firstly, he must bear in mind that in the Port Elizabeth-Uitenhage industrial complex there is a permanently resident Bantu population of a quarter of a million people. They are not there on a temporary basis like the hon. members opposite are here temporarily: the people living in the Port Elizabeth-Uitenhage complex are as permanent as can be. There is no hope, there can be no pipe dreams that at some future time they may disappear or move to the homelands. They are permanently resident in that area.

They are even more permanent than you are.

Very shortly, Sir, I shall be permanently on the other side. That is the prospect I have. Sir, in a population of this kind there are 32 000 Bantu children at present attending school in this area. If I must make a rough guess—let it be a guesstimate—there are something like 3 000 children leaving school each year in that area, i.e. 3 000 new work-seekers on the labour market. Then I am ignoring the labour seekers who come from other quarters. If any steps are taken at this stage by the Government through its legislative programme to control the industrial expansion of this particular area, steps which in any way curtail the creation of extra job opportunities, a very serious unemployment situation simply must arise there. I am raising this matter with the hon. the Deputy Minister because I think that as a result of tightening up and applying more rigorously the provisions of the original Act we are going to have that very situation arising in Port Elizabeth. In fact, the position there has become aggravated in recent months. I think the hon. the Deputy Minister must take my word for it that the effect of this Bill and the tightening up of the Act will aggravate a situation that is already serious; so much so, that I take the liberty here this evening of asking the hon. the Deputy Minister to visit the area and to study for himself the implications of the application of the proposed amendments and of the Act itself. I think that, if he comes there, he will find that I am in no way exaggerating the situation.

The hon. the Deputy Minister knows that in terms of the Government’s decentralization policy Port Elizabeth falls within a White/Coloured labour preference area. This fact, the effect of which will be heightened by the proposed amendment to Section 3 of the original Act, is causing a degree of industrial stagnation in the area and this is a most serious matter when it is so important that a programme of industrial diversification should be in progress in an area which is at present largely dependent on one industry, namely, the motor industry. For that reason I hope the hon. the Deputy Minister will visit the area to study the problem I am now outlining to him. It is for this reason and others why I feel so strongly about the application of the Act and the amendments we are considering. I am quite convinced that the best interests of the area can only be served by ensuring that there are more job opportunities provided, whether they be for Black people, Coloured people or White people. The way we are setting about it, with special reference to the area I represent, we are not going to achieve that effect. In so far as the other clauses are concerned, those dealing with the question of quarries and allied subjects, we find that section 6B of the principal Act is now being substituted by a new provision and I fully endorse what the hon. the Minister is doing in this respect. In the past, when it came to a railway and road construction, the country-side was certainly despoiled by the reckless excavating of gravel and other mineral elements from the country-side. I welcome the fact that the hon. the Minister is now going to take powers in terms of this new provision to control vigorously the indiscriminate excavating of mineral materials for the construction of roads, railways, etc. I hope the hon. the Minister, although he is now giving these powers to the National Transport Commission, to the Railways Administration and to provincial authorities, will keep a watchful eye to see that these authorities will carry out his wishes as contained in this legislation. There are many instances throughout the country of ill-considered and reckless work done by contractors and others, thereby leaving scars along the main routes of the country. I therefore believe that the hon. the Minister should take steps now and give instructions to these authorities to see that something is done to try to improve these ugly scars that are seen all over the country. I believe that if he does this, he will be acting in the best interests of the environment and scenery of our beautiful country.

Mr. Speaker, the hon. member for Johannesburg North, followed by the hon. member for Port Elizabeth Central, clearly showed the dividing line, the distinct schism, between this side of the House and the hon. members opposite. I believe that hon. members on this side of the House are people who believe in the future of South Africa. They are people who believe in long-term planning and in the development of South Africa, in contrast to those people who have a short-term approach—let us be very honest—Macmillian’s concept “the White man is expendable”. I am convinced that the hon. member for Johannesburg North is interested in one thing only, namely, material goods.

†He is the typical paternal liberalist. He loves to propagate and try to give the impression that he would do things for the Black man and for the Coloureds, but when it comes to actually touching his own pocket, his whole inside revolts and he revolts against that which is fair to the other colours in this country. That is what worries me.

*This is what worries me. Today we have to contend with an official Opposition and with a party that sits in the middle and which consists of people who do not want to act with an absolute loyalty towards South Africa. [Interjections.] The hon. member for Yeoville must please not try to make interjections. It is not my fault that he is so thin-skinned. [Interjections.] I want to emphasize the point that hon. members on this side of the House believe in the future of South Africa. Hon. members on that side of the House do not have the same concept of loyalty as far as South Africa is concerned. There are people who believe that South Africa is already an industrial country. I differ with them in that respect. I say that South Africa has the potential to become an industrial giant and I believe we have the natural resources, the human material and the will to develop this country into an industrial giant. I believe that. But if this does not take place on an orderly basis, if we do not do it on the basis of confidence and vision, then it cannot happen at all. I find it tragic that the hon. member for Port Elizabeth Central is pleading for only a few industrialists. It is not for the Blacks in Port Elizabeth that he is making a plea. His first duty ought to be the Brown people in Port Elizabeth. This is a Brown man’s land …

There ought to be job opportunities for everyone.

Exactly: job opportunities for everyone. The possibilities exist in South Africa for giving everyone job opportunities. I believe that under the present economic system, since problems do in fact exist internationally, we ought to set it as a prerequisite that one should encourage labour-intensive industrialists and afford them the opportunities to develop. But what did the hon. member for Benoni do yesterday afternoon? That hon. member very clearly allowed some doubt to glimmer through in respect of the present-day industrial development in the decentralized areas. He spoke of bankruptcy and the tremendous sacrifices which are allegedly unfair towards these people. What is the hon. member doing? There are a few industrialists who have complained to the hon. member for Benoni and said that they want to employ more Blacks and now he is kicking up a fuss. He does not look at the long term; he does not look at South Africa’s future and say that we have to develop South Africa in the long term in the interests of all our people. I am going to prove that the statement he made, that things are not going well for the border industries, was a very unfair and irresponsible statement. The contrary is true. He made the statement that industrialists supposedly accept Brits and Rosslyn but then he spoke of Rustenburg, Newcastle and Ladysmith which were not acceptable. Some years ago, it was the same hon. members who said that Brits and Rosslyn had no future. But look at the position today.

Order! Before I adjourn the House, and since this debate will continue tomorrow, hon. members must remember that the principle of centralization or decentralization has already been thrashed out in the principal Act. Under section 3 of the Act, it has also been decided whether the Minister ought to have the authority to approve the establishment of factories and what conditions ought to be attached to Black labour. These are matters that are cut and dried and all that must happen now, is that hon. members must discuss the content of the Bill; in other words, whether it is in fact necessary; its effect, if it is accepted; as well as the “timing” of the Bill, if I may put it that way. That is all that is at issue now.