Mr Chairman, during the debate yesterday, various speakers pointed out the importance of job creation in South Africa. Together with that the importance of productivity was also emphasised. In fact, it is of no use creating job opportunities if those job opportunities are not also perpetuated. That is why it is necessary for productivity to be considered a constant top priority.

The principal objective of the policy of industrial decentralisation is surely to create job opportunities in those areas of the country where development is slow and has lagged behind the rest of South Africa.

However, it would serve no purpose to create job opportunities in a regional context if those job opportunities are not also permanent—or at least as permanent as they can possibly be in an uncertain economic climate. An argument which is frequently advanced by critics of the Government’s policy of industrial decentralisation is that the job opportunities which are created are purely cosmetic because those opportunities will disappear as soon as the concession expires, particularly the short-term concessions. That is why it is important for the job Opportunities that are created to be created by viable industries which will be able to keep on providing employment after the short-term industrial concessions have expired.

In order to attain this object it is a pleasure for me to announce that a scheme has been introduced for promoting the productivity of decentralised industries. In consultation with the TBVC states it has been decided to add a new element to the scheme, which is aimed at the monitoring of productivity with the object of increasing the productivity of regional industrialists. By means of this scheme regional industrialists are encouraged, during the period in which they receive short-term concessions, to increase their productivity to such an extent that they will be able, after the concessions have expired, not only to keep on being competitive, but also to be so competitive, we hope, that they will grow and expand after having been established on this basis.

In consultation with the NPI, the National Productivity Institute, it was decided, as a first step, to ask the NPI to devise a productivity monitoring system by means of which the regional industrialists can gauge their productivity and determine in this way whether they are satisfying the norms that have been laid down. Officials of the Decentralisation Board will also be trained by the NPI to undertake this monitoring with a view to supporting industrialists in improving their productivity. What is being envisaged as a second leg of the system is to support industrialists financially to make use in this way of the services of the NPI and of other approved institutes or organisations in order to increase their productivity. The financial support entails a subsidisation of 50% of the costs of such inspections, subject to specific conditions. I think this is a great step forward to consolidate those industrialists who establish undertakings in a regional context in such a way that they can provide employment in those regions on a permanent basis.

Mr Chairman, may I ask the hon the Minister why they are being paid 50% of the cost if decentralisation is to their advantage? Surely the industry must want to actually improve its productivity. Why are they now being paid 50% of the cost as a subsidy?

Certainly the Government also makes a great investment in these industries. We subsidise them by means of short-term and long-term incentives and it is in the Government’s interests as well that permanent industries should be established in these areas. However, instead of only requesting the industries to engage in investigations into their productivity we believe it is a responsibility of both the Government which makes an investment as well as the industrialist to engage in these productivity investigations.

Would not a penalty be better if they do not…

Well, once a scheme has been launched one can always look at the conditions and change those conditions if necessary. If it appears that amendments must be made to the present scheme one can consider those amendments but for the time being I believe it is a major step forward to engage all these industrialists in productivity investigations which will in the long term be beneficial not only to the industrialist but also to the country at large.

*Unfortunately my limited time does not allow me to react in detail to all the other speakers, but I should like to come back to the hon member for Uitenhage. He made a very responsible speech on a very important problem in the Eastern Cape. The problems of the Eastern Cape are well known, as the hon member pointed out. In particular I appreciate the constructive suggestions the hon member made. It is easy to criticise and point out problems, but it is not so easy to find solutions to them.

The hon member was right to point out that the Eastern Cape’s problems were complicated because they were caused by various factors. He was correct when he said that there were no simple and easy solutions to the problems.

In a previous debate in this House the hon member for Walmer said that all we needed to do was improve the incentives for Port Elizabeth and the solution would be in sight. I just want to emphasise the fact again that although Port Elizabeth-Uitenhage is classified as a metropolitan area, that area received incentives from the very outset.

Yes, the hon member for Walmer is pulling a face now, but those incentives were upgraded in November 1985. [Interjections.] I should like the hon member to take note that the improved incentives led to the applications for industrial establishment in Port Elizabeth-Uitenhage increasing considerably from 21 approved applications in 1984-85 to 75 approved applications in 1985-86. These 75 applications put Port Elizabeth third on the list of approved applications at identified industrial development points anywhere in South Africa.

What value does that have?

The projects approved in 1985-86 involved a planned investment of R101 million. If they were all to be established job opportunities for 2 077 workers would be created.

There are further problems however. In the light of the prevailing conditions and the urgent need for job creation in that area the position is presently again being reviewed with a view to possible improvements of the incentive package. Negotiations in this regard are presently being conducted by the Regional Development Advisory Committee for region D, and we are awaiting its recommendations. The moment we receive those recommendations the Government will act expeditiously and sympathetically.

*The hon member for Uitenhage also referred to the motor industry and to the need for rationalisation. It is desirable that there should be rationalisation, but as the hon member himself also indicated, it is not desirable that this rationalisation be brought about by direct State intervention. Several motor industry leaders have already made it clear, in fact, that they did not think it would be desirable for the Government to intervene directly in this connection.

My standpoint is that the rationalisation process in the motor industry should be encouraged instead by giving the manufacturers who comply with specific set targets incentives and credit to enable them to run their industries in a more viable way. In this connection the hon member referred to exports. I think that is an important aspect for which manufacturers ought to receive credit so as to enable them to develop a more vital domestic industry. With a view to this I have instructed the Board of Trade and Industries to revise the phase 5-programme in an effort to solve the various problems to which the hon member also referred.

†I have directed the Board of Trade and Industries to investigate and report on, firstly, the impact of the present measures to promote the local manufacturing of motorcars such as commercial vehicles and components thereof; and secondly, the extent to which the development of the industry was economically sound. In the light of its findings the board is to make recommendations on any new measures or amendments to existing measures to ensure the sound development of the industry from the viewpoint of the country’s interests with special reference to exports. I think this is the appropriate way to deal with this matter.

*The hon member for Pretoria East once again addressed a very important aspect, something to which he has referred several times. We have great appreciation for the second episode, and I should probably expect a third one as well. It is a relevant and important subject. The development of technology for the RSA is particularly important in the present climate of sanctions and disinvestment, and that is why the matters to which the hon member referred are being accorded a high priority.

The debate between basic science or research and more applied research in the form of technology and the transfer of technology is certainly of cardinal importance at this stage. I can just reassure the hon member that since the tabling last year of the White Paper on the Promotion of Industrial Development as an Element of a Cohesive Regional Development Strategy for Southern Africa, and in view of the emphasis technology received in that White Paper, various steps have already been taken to advance this matter.

It also entails fundamental course adjustments in the activities of the CSIR. The process of re-organisation, re-orientation and re-arrangement with a view to greater involvement of the CSIR in industries, has not yet been completed. It is still in progress, and various possibilities in this connection are being considered. The possibility of making a larger portion of the income of the CSIR and its institutes directly dependent upon the technology which is developed for the consumers, that is to say the market, is at present receiving attention. The end consumer, the private sector or whoever the end consumer may be, should be more directly involved in this research and the related costs. In this way I think the market will also to a large extent determine what type of supporting science is necessary to enable it to develop the technology which is required in our particular situation at this stage of South Africa’s history. If the time at my disposal had allowed, I would also have been able to inform the hon member and the committee about the various steps that are being planned, but I should like to do this in another way and on another occasion.

In the final minute at my disposal I should like to conclude by emphasising once again that the policy of decentralisation is not only aimed at establishing factories in various parts of our country. It is a development policy and as such it is primarily directed at people. It is not concerned with factories, but with people and the circumstances of their lives. It is concerned with the quality and calibre of their lives. We want to provide people with work so that they can make a decent livelihood in their respective environments. In that way South Africa will develop economic equilibrium.

In this connection the figures and the statistics which we release from time to time do not tell the full tale. The statistics must also be interpreted further. I want to draw something to the attention of hon members. According to calculations one can accept that for every permanent job opportunity created through decentralisation at least 2 to 2,4 additional job opportunities are created.

I admit that these are rather rough calculations and that one must take into consideration a certain degree of leakage in these figures, but one can make a rough estimate. It means that the approximately 300 000 job opportunities that have potentially been created during the first four years since the new scheme was put into operation amount in reality to approximately 750 000 job opportunities in the informal and semi-formal sectors. If one also takes into consideration that each worker supports an additional four to six people, we are referring here to figures of between three million and five million people who may eventually be benefited if all these schemes become a reality. We are therefore referring to a vast number of people who could be positively affected by the Government’s policy of decentralisation.

Therefore I want to invite hon members of the Opposition if they are able to do so, please to make constructive contributions to the improvement of this scheme. But it is not a scheme aimed exclusively at attaining political objectives. It is a scheme which is directed at giving the people of South Africa, all the people of South Africa, an opportunity to live better lives in their regions and environments.

I want to conclude by thanking my hon Deputy Minister, in addition to all the hon members who participated in the debate. Not only is the Deputy Minister a very pleasant person to work with, he also takes a great load off my shoulders and is a person who thinks and works innovatively. It is a very pleasant privilege for me to be able to work with him in this department.

I wish to convey a further word of thanks to our top management, an excellent team of officials who work with great dedication, and in particular to the Director-General. I want to tell hon members that in Mr du Plessis and his top management we have an excellent team, which is of great value to this country in difficult times. They are people with vision and dedication, and I should like to thank them for that.

Vote agreed to.

Vote No 31—“National Health and Population Development”:

Mr Chairman, allow me on this occasion to pay tribute once again to my predecessors in this portfolio, the late Dr Nak van der Merwe, and the hon the Minister of Communication and Public Works. Many important people have managed this portfolio in the past and it could be important for hon members of the Committee to know that no less a person than that colossus in South African politics, Dr D F Malan, was Minister of Health and, in fact, on 26 October 1928, officiated at the inauguration of the Medical Council.

The appropriation for the 1986-87 financial year amounts to R1,8 billion, which is R484 million, or 36,24%, more than the allocation for the previous financial year. I should imagine the Committee would like to know why this is the case. I must point out that no important policy changes are being envisaged, and these additional funds are required mainly to make provision for the Government’s contributions to the pension funds of personnel attached to White education. Previously the provincial administrations made provision for this to the amount of R243 million. Furthermore, financial provision is being made for normal cost increases, improved service benefits in respect of several professional groups, a limited expansion of the existing services and for the introduction of new services.

I have emphasised the real importance of population development before in this House. As far as the Population Development Programme is concerned, I want to point out to hon members that family planning is an integral part of that programme and that at present we have 55 000 visiting points in the work places and residential areas of the communities of South Africa. More than 1 500 nurses are involved in this programme. The high fertility rate among teenagers in this country is a source of concern to my department and consequently we have launched an active adolescent programme.

When we consider the use of family planning methods, I can inform the Committee that 1,5 million Black, Coloured and Indian women are at present being protected against pregnancy in this way. When we examine these statistics, we find that 44% of the Black, 60% of the Coloured, 66% of the Indian and 83% of the White fertile women in our country are using some form of family planning method or other. The figure in the self-governing national states is not very clear. The abovementioned statistic which I have quoted was ascertained by the HSRC, and not by my department. It is probable that approximately 22% of the women in self-governing national states are using family planning methods, while it is a matter of only 10% in the rest of Africa.

Africa is facing a tremendous problem because the population growth in Africa is far in excess of its economic growth rate, in other words Africa is not producing enough food for its people.

With the Population Development Programme this department is endeavouring to achieve a total of 2,1 children per woman by the beginning of the next century. This will mean that at that stage we shall have to protect 6,8 million people against unwanted pregnancies.

It is a pleasure for me to announce that the Cabinet has decided to establish a Population Development Council. This council will consist of people from various interested organisations such as the AHI, Assocom, the Federated Chamber of Industries, the SA Agricultural Union, the SA Women’s Agricultural Union and prominent Black women in order to involve the private sector. In addition people from the Rural Foundation, demographers and other experts from our universities will serve on this council. Ucasa will be represented there, as well as other members of the self-governing national states.

It is now my privilege to announce that the chairman of this very important Population Development Council will be Mr A L Schlebusch. He is the former Vice-State President, the former Chairman of the President’s Council and the present chancellor of Unisa. He is a person who has already initiated the Population Development Programme in the President’s Council and who has a thorough knowledge of the matter. I am pleased to be able to announce that Mr Schlebusch has consented to taking this important task upon himself. As soon as the other members who have been invited to serve on the council have received the invitation, I shall make a further announcement in this regard.

†I should now like to turn to certain aspects of the economics of health services. The total expenditure on health and health services in the 1984-85 financial year is estimated to have been R5,4 billion, R2,1 billion having been spent by the private sector and R3,3 billion by the public sector. I think these are important figures. This amounts to roughly 5,4% of the GNP of that particular year. First World countries find themselves spending 5% to 9% of their Gross National Product on health services, while Third World countries usually cannot manage to spend more than 2% to 3% of their GNP on health services. Hon members will therefore notice that South Africa comes closer to the First World figure, spending 5,4% of its GNP on health services.

I would like to draw hon members’ attention to the fact that the World Bank recently reported that in developing countries 70% to 80% of the total expenditure on health care is on curative services. Patient-related preventative services such as maternal and child health care and community health programmes receive only 10% to 20% of the total. This is also the situation in South Africa. The preventative services which are non-patient related, such as disease control programmes, sanitation, irrigation and the promotion of health and hygiene, as well as controls of pests and the monitoring of disease patterns, only received 3%.

For this reason, I have formally requested the Medical Research Council to conduct research into primary health care, especially as far as services in the rural Black areas are concerned.

Well done!

Thank you very much. It is of the utmost importance that our emphasis should be on primary health care in the years to come. South Africa has to provide health services in a First World environment, as well as to those who are still developing from a Third World environment.

Those in the lower socio-economic groups are prone to infectious and communicable diseases which take a disproportionately high toll especially among the young and the very young. Thus the infant mortality rates in these communities once again reflect the development gradient, but are also affected to a large degree by the discrepancy that exists in the provision of services in urban vis-a-vis rural settings.

I would like to sound a word of warning in analysing infant mortality. As hon members know, the infant mortality rate pertains to the number of deaths in relation to the number of live births in a particular area or country. The problem we are facing in South Africa is that live births are not always registered, especially in the rural areas. In other words, the figure is not always correct, because deaths are registered whereas births are not always registered. In my own department I have sometimes witnessed a situation in which, just before school starts, we have had to register more than a 100 children in a day. I would like to warn hon members about the discrepancies in the figures in this respect.

As far as curative services are concerned, there are approximately 700 hospitals in this country with a total of approximately 150 000 beds. Some 3,5 million people are admitted to hospitals annually, while between 25 and 30 million are attended to at casualty and other out-patient departments every year. The overall bed occupancy is somewhat over 70% with an average patient stay of 11 days, which I feel is too long. Hospitalisation and the cost of medicine are still the two most important aspects of total health expenditure.

When analysing the annual rate of health care costs, it should be noted that the changes in costs can relate to price changes or to volume changes, or to a combination of these, as well as to usage changes.

In a recent publication by Scott and Reecky—Prof Reecky is the Professor of Economics at the University of the Witwatersrand—they examined these aspects. They showed that the changes in the medical component of the consumer’s price index in relation to the overall consumer price index, have in fact occurred at a lower rate than the consumer price index over the past few years. The point here is that it is not true to say that there has been a tremendous escalation as far as overall health expenditure is concerned in this country. The high level of medicine costs increased at a rate greater than inflation and has not only—and this is very important—resulted from price increases of this magnitude. It could therefore have been produced by price increases together with one or more of the following factors, namely increased usage of drugs, the use of new and expensive drugs, or a higher proportion of ailments requiring more sophisticated and hence more expensive drugs. Our problem in this regard can be summarised as follows, and I quote from the work of these authors:

I think more people should be covered by health insurance and a more flexible user-oriented health insurance should be encouraged in South Africa.

Mr Chairman, may I ask the hon the Minister whether the some R2,5 billion spent by the private sector included medical aid schemes or whether it was only for private hospitalisation?

That includes the total expenditure in the private sector. In other words, it does include medical aid schemes and private hospitalisation.

So it is what the public pays.

In the private sector, yes.

That is thus what the public itself pays.

No, I am referring to the total cost of the service; not to what the public pays.

Well, if the private sector is paying it then the public are paying it.

Well, yes, in the final analysis.

When one looks at the manpower situation in South Africa, one notices that there are at the present moment 18 109 registered medical practitioners in this country of whom 4 350 are on the specialist register. The number of registered nurses and nursing assistants amounts to 101 039, with approximately 20 000 paramedical staff, health inspectors and health-related professional people who add their important contribution to the health services as a whole.

It is important to note that figures during 1980 show that the doctor:population ratio in South Africa at that stage was 1:2 125. In the USA it is 1:750 and in the United Kingdom 1:1 100. However, the figure in Zimbabwe is 1:4 800; that in Zambia, 1:8 000; in Nigeria, 1:43 000; and, as we can expect, in Ethiopia it is 1:180 000. These figures are in comparison with the figure in South Africa of 1:2 125.

Many hospitals in our country are equipped with high-technology facilities so that a very high standard of curative medical care can be guaranteed. Sophisticated expertise and equipment are available, for instance, to deal with highly infectious diseases such as the viral haemorrhagic diseases and fevers, and assistance in this respect has been rendered in the past year to various other countries such as Kenya, Zaire, and Malawi.

At an international meeting on the ebulla virus infection and other haemorrhagic fevers held in Antwerp, Belgium, Dr D P Frances from the Centre of Disease Control in Atlanta, Georgia, made the following remark:

I think this is remarkable, and a very good testimonial to our hospitals.

As far as health team professionals are concerned, South Africa has an intermediate position between those countries of the First World and the Third World communities. The ratio of nurses and nursing assistants is 459:100 000 of the population in developed countries. In South Africa the total is 473 and in developing countries it is 65. It is 459 in developed countries, in South Africa the figure is 473 and in developing countries it is 65. As far as dentists are concerned the different figures are: 42 per 100 000 in developed countries, 10 in South Africa and 6 in developing countries.

At this stage I should like to thank all those health manpower members—nurses, doctors and health inspectors—who have rendered services to the communities under very difficult conditions over the past year. I should like to pay tribute to them. I must also make mention of the fact that the large number of people here from outside South Africa places an additional financial burden on South Africa and also present a considerable health risk. It has already been established that refugees from Mozambique are highly infected with malaria which in itself involves a considerable amount of additional fieldwork, materials and medicines.

Of 8 249 cases notified in the Eastern Transvaal area 3 020—that is 36,6%—were cases from outside South Africa. For the corresponding period, 35,5% of malaria cases in Northern Natal were refugees from Mozambique. Surveys have shown that approximately 10% of these Mozambique refugees do suffer from malaria, compared with a figure of 0,08% of our own population.

*The total number of malaria cases during 1985 was 11 332. This represents a considerable increase, which could be attributable to one of the following factors: Firstly the fugitives from Mozambique, and secondly an entomological change. We have discovered that Anopheles Gambiae has been replaced by Anopheles Arabiensis. The latter has a completely different biting pattern. It is far more noxious and bites more frequently.

Almost like the AWB. [Interjections.]

I want to tell hon members that it is also perhaps attributable to the high rainfall figure in those areas.

On the other hand cholera reached a peak during the summer months of 1982-83, but I am pleased to be able to say that during the past summer season only 94 cases were reported—the smallest figure since 1980.

Hon members will therefore see that when we are discussing the health scene in South Africa we have a problem with the highly specialised technological services, but we also have a problem with the Third World services, such as those dealing with cholera.

I now wish to make an important announcement and say that there is a product which, over a period of a year, is literally eaten by the ton, also by hon members in this Committee … [Interjections.] … and I am not referring to peppermints. I shall come back to the occupational disease problems of the hon members. Last year—that is to say from August 1984 to August 1985— the department caused a total of 115 samples of boerewors to be examined. That examination was undertaken by the University of Pretoria and by Onderstepoort. The findings were illuminating, but worrying. Only 40% of that boerewors was free of impermissible fibre, while soya protein, either as textured plant albumen or as soya bean flour was found in 33% of the boerewors samples. Other impermissible fibre was for example cartilage, bone particles, salivary glands, spleen, liver, kidneys, lungs …

Whoa! Whoa!

… and cow udders. [Interjections.] I think hon members will agree with me that it has become essential for regulations to be made in regard to the labelling and composition of meat products.

Hear, hear!

It is therefore a pleasure for me to announce that such regulations will appear in the Gazette soon.

As far as boerewors is concerned, it will in future have to be made from minced beef, mutton or pork, or from any mixture of these. It will have to consist of at least 65% lean meat and not more than 30% fat, which may be cut up into blocks, or of at least 95% meat containing fat. In addition it may contain only the following additional ingredients: Grain, salt, vinegar, spices and other harmless flavourings and preservatives, of which benzoic acid, butyric acid and sulphur dioxide are permitted.

Similar regulations will also appear in regard to mincemeat, beef sausage, pork sausage and mutton sausage. It will be very clearly indicated what parts of the beef animal or sheep may not be used. These include the lungs, the oesaphagus, the marrow, the rectum, and so on. [Interjections.] Now I want to tell hon members that someone may still use lungs for the manufacture of sausage, but then it may only be called sausage. In future, if someone labels sausage as “boerewors” we know it consists of 60% lean meat, not more than 30% fat, or 95% meat containing fat. In other words, that national product of my people, my culture, can now be protected. That is why we are now going to eat boerewors that we can trust. [Interjections.]

Mr Chairman, may I ask the hon the Minister whether, seeing he is going to ban the use of certain internal organs in the making of boerewors, he is going to consider banning the national delicacy of another group, a delicacy known as haggis? The delicacy is sometimes known as “kop-en-pootjies” in another tribal group.

Mr Chairman, I will gladly receive a written, detailed and duly motivated recommendation from the hon member for Pietermaritzburg North. However, I want him first to circulate his suggestion among the hon members of this House. [Interjections.]

*In the time left to me, I want to deal with two matters that were termed important in the Press. The one matter deals with the health of detainees. Hon members all know that people are being detained in terms of section 29(1) and section 31 of the Internal Security Act, 1982 as well as regulation 3(1), promulgated in terms of the Public Safety Act, 1953. I want to tell hon members that a detainee has to be examined by a district surgeon as soon as possible—these are the rules of the department—after detention, after which a health form is filled in. After that the detainee must be examined at least once every 14 days. In section 39(1) cases, copies of this form must be sent to the following people: The Regional Director of the Department of National Health and Population Development, the Chief Director of Community Services and the Director of Security Legislation.

In section 31 and regulation 3(1) cases it is not necessary for the district surgeon to submit reports of a routine nature, but a record must be kept in the detainee’s file. If it is found, however, that there are signs of illness of mental abberation, that injuries have been incurred, that injuries have been incurred as a result of assault or if the detainnees were under the influence of alcohol or drugs, a report must be made to the magistrate. The latter will then in turn report to the Attorney General.

When detainees have gone on a hunger strike, their physical and mental condition must be monitored on a daily basis and a report made to the department. The dangers of a hunger strike must be explained to the detainee.

As far as psychiatrical services are concerned, detainees who are depressed or who display suicidal tendencies, must receive special attention. If the district surgeon has any doubts about how to handle a case, a psychiatrist must be consulted. A professor in psychiatry or a person nominated by him is used for this purpose.

Detainees may also, with the consent of the district surgeon, make use of the services of a private medical practitioner as long as it does not cost the State anything. In 1985 State physicians examined 2 378 detainees and submitted reports as specified. Only 15 cases of hunger strikes were dealt with. Thirty cases of depression and five cases of light injuries were dealt with.

On this occasion I should like to pay tribute to a deputy director general, Dr Igna van Rooyen, who has been employed in this department for 16 years and is going to retire at the end of the month. He rendered excellent services, for which I want to thank him very sincerely. I am certain I am speaking on behalf of all of us when I tell him that I hope his retirement will be very pleasant and very beneficial and that Providence will smile on him.

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

This is the sixth time that I am participating in the discussion on this Vote and it is already the third Minister and the third Deputy Minister involved in it. I understand that three Ministers for “racialistic” health affairs have been appointed, the three hon Ministers of Health Services and Welfare who have been discredited from the outset because of the kind of portfolios they hold. [Interjections.] Therefore I was very interested in the hon the Minister’s speech.

I welcome him here, but I shall have to listen to him a bit more before I can congratulate him on his appointment to this portfolio. I think I am being honourable and not false and I wonder if one can congratulate him on his appointment to a portfolio in which he has to apply a policy of racial discrimination. [Interjections.]

I also requested the hon Whip to ask the hon the Deputy Minister of Population Development to attend. I understand that he will be here later. I hope that the questions I put to the hon the Minister will also be replied to by the hon the Deputy Minister as they have a direct bearing on him.

†We are often asked what the policy of the PFP is. We have a policy as far as health is concerned. Our policy is an immediate policy and a long-term policy. I would like the hon the Minister and the hon the Deputy Minister to listen to our policy and to reply, and if I find any hope in their replies I am prepared later today to congratulate the hon the Minister and the hon the Deputy Minister on their appointments.

How is health and welfare possible when there is discrimination in health and discrimination in welfare? The hon the Minister who was a very successful doctor must know and agree with me that the definition of health is not simply the absence of disease but that it is a state of mental and physical wellbeing.

I listened to the hon the Minister’s speech on detainees. I must admit that I cannot accept that we live in the same country when I compare what the hon the Minister says about health to what I can see for myself. Today in South Africa there is burning, shooting, killing and developing hatred.

For what reason?

For the reason that there is discrimination in this country. People are reacting to the discriminatory laws started by the colossus that the hon the Minister mentioned, namely Dr D F Malan.

You do not know what you are talking about!

I would like to ask the hon the Minister and the hon the Deputy Minister if they would agree with me that the most important task in the health affairs of South Africa today is to abolish all forms of discrimination in health and welfare matters. The hon the Minister of Justice said in one of the other Houses this week that he was prepared to abolish discrimination in the administration of justice. Where are compassion, devotion and sacrifice of more importance than in health and welfare matters in South Africa? Cannot the hon the Minister start to work together with us for the abolition of discrimination in our health services?

In abolishing this discrimination we of the PFP believe firstly that there should be no discriminatory departments of health. I want to ask the hon the Minister if he agrees with that. There are many authorities that agree that discrimination in a health department is totally wrong. I have already challenged the hon the Minister of Health Services and Welfare and the hon the Minister of the Budget to tell me who in the health and welfare services of South Africa except for the NP, the CP, the HNP and other right-wing groups supports the issue of own affairs.

I want to quote from an article from The Argus of 12 April:

If the hon the Minister is looking for authorities he need only turn to the people working in Government departments.

I would like to ask the hon the Minister and the hon the Deputy Minister in this House today to give me their justification for a racialistic health service and a racialistic welfare service in South Africa. They must try to prove to me that all the other experts are wrong.

Secondly, we would like to have all discrimination removed in the training of medical personnel. In South Africa Black nurses still have to be trained in Black hospitals and White nurses in White hospitals. There is even an attempt by the Government to have doctors trained separately in Black, Coloured and Asian hospitals. I have been told that apartheid is outdated but apartheid is alive and well in the health department of this hon the Minister. I therefore want to ask the hon the Minister and the hon Deputy Minister for their justification for racial separation in the training of doctors in South Africa.

I want to get back to the question of nurses. I cannot understand how the hon the Minister can say in his department’s annual report that 40 000 Blacks applied to be trained as nurses but that only 4 000 of them were accepted. The hon the Minister speaks about the development of primary health services but who is going to undertake this? Will it be the White nurses? Today they cannot even enter Black areas any more because they are not safe there. It is the Black nurses who will have to be trained.

Why are they not accepted for training? I can accept that not all of the 40 000 applicants were suitable for training. However, the hon the Minister must remember that we are losing a wealth of nursing ability and experience due to the inability of his department to train Black nurses.

Our third request is that all discrimination in health facilities should be abolished. By this we mean that every hospital, clinic and other health facility should provide one service for all.

I would like to give hon members a few examples of the problems and hardships which have been caused by discrimination in health services. The hon the Minister will be aware that the cardiac units of the Baragwanath and J G Strijdom hospitals were moved to the Johannesburg Hospital to be combined as one unit. Black nurses and patients were therefore moved into a White hospital in the process of pooling personnel and facilities. A certain gentleman whom we all know, namely Mr Daan Kirstein, Director of Transvaal Hospital Services, entered the picture. Do you know what he did, Sir? He ordered separate wards for Black and White patients in the restructured heart unit. Separate wards for the two races! I would like to quote his reason for doing this as reported by The Star.

Just like that, he “formed the opinion”!—

I wonder if he was able to speak the language of these Black people, which would of course mean being able to speak four or five languages, and was thus able immediately to come to the conclusion that Black patients were more comfortable in their own wards and White patients in theirs.

He went on to say the following:

I want the hon the Minister and his Deputy to give me their opinion of that statement today. I would like to know if Mr Kirstein was expressing his own opinion or whether this is the policy of the NP Government and of the hon the Minister’s department.

This kind of immoral racial discrimination has existed in our health services for far too long. I have grown up with it. The hon the Minister will remember the days when all the Coloured and Asian doctors and medical students would have to leave a lecture room when a White patient was brought in. We set ourselves apart in lily-white wards where White nurses attended to White patients, while Black nurses attended to Black patients in their wards.

The previous Minister of Health and Welfare, now the hon the Minister of Communications, said in this House that the policy of the Government was to ensure that each race was nursed by its own members. The hon the Minister will no doubt say that the policy has now changed, but I feel that the changes are cosmetic or are changes of convenience. Why are Black nurses now working at White hospitals? The reason is simply that there are not enough White nurses, not that there has been any change in the Government’s policy. Black nurses are brought in and facilities made available only for the convenience of this Government, not as a result of any real desire on the part of the Government to change the laws of this country.

I would also like the hon the Minister or his deputy to tell me what is happening in the Cape Province, for instance at the Tygerberg and Worcester hospitals where there are White and non-White wards. Do not the Coloureds lying next to Asians and Blacks also feel uncomfortable? Would they not be better off in their own wards? Is their only concern to draw a distinction between Whites and Blacks in this country? What is this Government’s policy regarding health facilities, the nursing of patients and the training of nurses and doctors?

We are developing an own affairs system in health. We have to assume this means the provision of health services on racial lines. The hon the Minister owes it to this Committee to inform us of his views and those of his department on the further development of that department.

I would like to offer another example of the harm which is done by racialism in the context of health. I must tell the hon the Minister that I was working at my practice in Johannesburg yesterday. I think that fewer than 10% of our staff of Black nurses who comprise about 70% of the total staff of that private hospital came to work. Those who came to work told me the previous day that they wanted to come. If the hon the Minister’s Government did not have a Group Areas Act yesterday that strike would not have been successful, because they would have been living with us. May a Black nurse in Johannesburg live in the grounds of the hospital where she works? Do hon members know at what time in the morning she has to start to get to work? At 4 o’clock or half past four in the mornings she has to take a bus and a train and then walk some distance to take another bus to get to hospital. She leaves the hospital at seven at night and gets home at 10 o’clock.

Then the hon the Minister comes here today and he talks about family planning and about “boerewors”! I could actually not believe that the contents of “boerewors” could be an issue in the first speech of this hon the Minister in this Committee in South Africa today on 2 May 1986. Therefore, I am going to sit down and ask the hon the Minister and the hon the Deputy Minister to reply to these questions I have asked today, because the future of health services in South Africa depends on that. In the course of his speech the hon the Minister said there were doctors in South Africa who were working for a revolution. I should like him to give us more details about these people. I think he must come out with the truth and tell us who they are. I think he was referring to Namda. He must tell us who they are. If the hon the Minister is aware of doctors who are working for revolution, he should report them to the hon the Minister of Law and Order who will only be too happy to get hold of them. The Medical Council will also be only too happy to punish them. However, he cannot come to this House with vague statements.

I demand that the hon the Minister reply here today, because the future of health in South Africa and the future of South Africa depends on some of the replies he is going to give us.

Mr Chairman, it is a great privilege for me to take part here today, particularly since we have a new face in the Chair. It is one of the most open faces I have yet seen in that chair. [Interjections.]

I am surprised about the degree of aggressiveness in the hon member for Parktown who has just resumed his seat. If one thinks back on the past six years during which the hon member has been the main speaker on health on that side of the Committee—as he rightly said, this is the sixth Vote discussion which he has taken part in— there has been no change in this hon member’s style and method during the six years in which I have been here as well, and have acted in the same capacity on our side.

What do we basically expect of an opposition member when he rises to take part in a non-political debate such as this one? If I were in his place, I would have told the hon the Minister, as a loyal opposition member, that I understood his policy, but did not think it worked and therefore proposed that he make certain changes concerning this or that.

†I do not want to pick a quarrel with that hon member, because he is a fine gentleman. He is a very good doctor, but when it comes to his political views, I am afraid that he has quite a lot to learn, not only today but also in the future.

*I have a document in my hand which he probably has too. It concerns health services in Natal and is a very good memorandum. It is, in fact, about the basis of our health services as structured by the new Constitution. I think that is the focal point around which our discussion should revolve today if we want to talk about national health and the population development programmes as well as about health, welfare and pensions. It says clearly here—and I should like to relay it to the hon member for Parktown:

He is leaving.

That is typical. When one speaks to that hon member and confronts him on a certain point, he leaves, but I am pleased he heard me speaking and that he is coming back, because I should like to speak to him frankly. I want him to listen to what I am saying. I quote:

Someone in Natal said that. One can have positive discussions about the memorandum of these people and the ideas they submit in it. Many of the things mentioned by the hon member are matters on which the hon the Minister will reply to him, because there are answers to them. We ask the hon member to make a more positive contribution, rather than simply to level negative criticism from the beginning of his speech to the end.

I want to broach a number of matters this morning, but first of all I want to state from this side of the Committee that our point of departure is that the discussion of this Vote should take place on the basis of the new constitutional dispensation. We adhere to that, but at the same time I must add that if other hon members of the Committee have worries and fears, they must realise that we too are worried and afraid concerning certain matters.

An example of this is the socialising in health services. We have been talking about this for a long time and we want to inquire into a way in which it can be prevented.

We very definitely question the possibility of fragmentation of health services, but we are addressing the matter and inquiring into it.

The possible decline in the quality of and standards in the health services is receiving our attention too. Other hon members on this side are going to speak about that later, and I do not want to anticipate them.

I want to thank the Director-General very much for an excellent annual report which he and his department compiled this year. We have some of the country’s best brainpower at our disposal in the top structure of Government departments and the national economy. I want to convey our sincere thanks to the Director-General and his colleagues who render service even in the remotest corners of the country, for what they do, the energy they put into it and the quality of work they render across the total spectrum of health, population development, welfare, pensions, etc. It is greatly appreciated by the hon members in this Committee.

A second annual report was made available to us recently. I think it is of cardinal importance this morning, viz the annual report of the Medical Research Council here in Bellville. Wonderful work is done at this research centre. I pay tribute this morning to Prof Andries Brink who does a great deal, not only in our country but also outside our borders, to prevent South Africa from being isolated from the international medical community. Our researchers in South Africa make one breakthrough after another, also as far as medical services abroad are concerned, in that we are taking the lead in various areas.

I shall not go into this matter any further except to say I want to ask the hon the Minister one question about it. I see this matter, viz that there is an immense lack of funds, also emerges very strongly in the annual report. If we neglect our research centres, our medical services cannot progress. I plead with the hon the Minister to see whether more funds cannot be allocated to the Medical Research Council of South Africa, from the private sector as well.

I want to emphasise a matter mentioned by the hon the Minister in his speech in respect of the detention of prisoners, viz that a board has been appointed to enquire into it. Some members of this Committee went along when we visited the prisoners. I would be neglecting my duty shamefully if I did not have it put on record here this morning that the medical services of those detained in the prisons in terms of emergency regulations are not of the highest quality in South Africa. We were able to speak to those people and examine their registers. We were able to put questions and return to the hospitals upon special request by the relevant Minister, and evaluate the services. We were able to do just as we pleased. I do not think what is done in respect of the medical aspect in our prisons is equalled anywhere in the world, and I am sure hon members will speak about that in a moment and endorse what I have said. [Interjections.]

The hon the Minister made the important announcement that the Council for Population Development Programmes had been appointed. He also mentioned a few names and I want to join him by congratulating the Hon A L Schlebusch who has been appointed chairman of that council. He knows how to deal with these matters. He has acted as the chairman of very important councils in the past, and I am pleased we have such a capable person to take the lead on this level. I am sure that what will emerge from this will be very positive, and therefore I wish him and his council every success.

Congratulations also go to the hon the Minister and the hon the Deputy Minister on their appointment to their posts. I think the State President should get the credit for having seen, in connection with general and own affairs, that we needed a broadening of the Department of Health as far as the total health spectrum was concerned, and that as a result he entrusted the hon the Minister with the post of National Health and Population Development, and gave him a Deputy Minister to assist him, particularly as far as Population Development is concerned. I want to tell hon members we can equal the best with our research programmes and do well in every other sphere in this country, but if the Government, every population group and everyone in this country who is involved in this matter, do not make their contribution as well, and we fail in our Population Development Programme, we can pack up and leave, because within a few years we in this country will devour one another like a pack of rats in a cupboard, because there will not be enough room for everyone. I therefore appeal to everyone involved really to knuckle down as far as the support of this programme is concerned. [Time expired.]

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

Mr Chairman, that is one of the nicest proposals that hon member has ever made. [Interjections.] I thank him very much.

We congratulate the hon the Minister and the hon the Deputy Minister as well as their heads of department, and wish them every success on the road ahead.

It was said this morning that the hon the Deputy Minister will appear in this Committee in a little while, and that is why I want to congratulate him and wish him luck on behalf of this side of the Committee now. I wish him luck in particular in his involvement in population development among the Coloured population. I know of a great deal of success that has already been attained and I believe he will mention this in his speech.

I want to come to a point which worries me a great deal, and that is the friction among the pharmacists, the manufacturers, or even better, the manufacturing industry, and the doctors, which is dragging on in such a way that it looks as if it will never end. I am sorry about that, because each of these three facets of the health services render excellent work and provide indispensable services.

The doctors are accused of prescribing medicines which are too expensive. The pharmacists are accused of encouraging the expensive medicines because this increases their profits. The manufacturers are also accused of making exceptionally high profits. Nor can one get away from the result, which is that the private hospitals and other bodies have to charge unheard-of prices for their beds and the medicine they sell, with the result that in the end the man in the street has to pay for this, and he cannot afford to.

My great fear, therefore, is that our health services in general are going to become too expensive for the man in the street, that the medical schemes will succumb at one stage or another because they cannot afford this, and that we will have an associated drop in the quality of our health services.

I have here the speech the hon the Minister made to a group of pharmacists a while ago. The statement made by the hon the Minister on that occasion has my wholehearted support. It concerned the role of the pharmacist in the health team. He said:

The hon the Minister then furnished figures about the number of pharmacists in the country, the number of students studying pharmacy at the universities and technikons, as well as the number of pharmacists in the private and public sectors respectively. There are approximately 7 000 pharmacists in the country, and at present there are approximately 1 200 students at four technikons and 11 universities, that is if the figure I remember is correct.

People in the pharmaceutical profession tell us—the newspapers write about it too; it is there for everyone to read—that they would like to practise their profession, that they merely want to be pharmacists and that as professional people, they want to do their best in their position after five years of intensive study. They ask only to be given that opportunity, in such a way that economically speaking they will be able to maintain a reasonable standard of living.

On the other hand, it is said that the doctors dispense medicine, and take the bread out of the pharmacists’ mouths. I think this reaction is exaggerated in that there are areas in the country in which the population is absolutely dependent upon the dispensing doctor. It is also true, however, that there are doctors who abuse their intrinsic right to dispense. I think this is a matter which should be researched thoroughly. I believe the pharmacist and the doctor can come to a mutual agreement so that each of them will be able to lead a decent life and to enjoy career satisfaction.

When I look at the pharmaceutical manufacturing industry—most of the companies in this industry are multi-national—it is clear to me that such companies’ greatest investments are abroad, while South Africa is also an excellent market for their products. No figures are available in respect of the percentage of their profits that remains in South Africa and the percentage that returns to the country in which the company’s headquarters are. I should like to know what that ratio is.

When the then Minister of Health and Welfare submitted his programme of substitutive medicines in February 1984, a great row was kicked up, especially by those multinational companies, against the companies in South Africa which produce those products and distribute them here. I should like us to consider that urgently.

I think we must say in the same breath, if we do not want to socialise and do not want to get an imbalance in the situation of the pharmacist, the doctor and the manufacturer, that the share of the government in respect of medicines—I am referring now to the SA Transport Services, the SA Defence Force, and the provinces—should not be out of proportion to the private sector’s share in the dispensing of medicines.

I want to conclude by making a few remarks about the Year of the Handicapped. In my own district there is an institution, called PWV 3, which does extremely good work. Other hon members will probably speak about this too. It is the Year of the Handicapped this year, and I think it was one of the finest decisions made by the Cabinet to consider the welfare of these people in depth. We support it wholeheartedly. This programme is not restricted only to South Africa; the TBVC countries and the self-governing states are taking part in it too. It is a large-project which deserves all our support.

Mr Chairman, in opening, permit me to tell the hon member for Brits that he appears to me to have become very sensitive about politics since last Thursday. One is not allowed to talk politics at all now but I wish to tell the hon member immediately that health also forms part of the total national economy. The hon member for Parktown probably has the fullest right to mention his philosophy as a standpoint to be stated here from his point of view.

We are not ashamed of it—as you are. [Interjections.]

Similarly it is our right and I shall get to this in the course of my speech. Before closing that subject, however, I wish to say to the hon member I saw a columnist’s comment that the hon member had suddenly developed a sense of reasonableness on the expression of opinion because he was on the receiving end now.

That must be an English newspaper.

It is definitely a fact that his support base in Brits is sliding out from under him.

In opening, I also want to congratulate the hon the Minister and wish him everything of the best in his great task. I want to assure him that I have great respect and regard for him as a person; in the past he was always friendly and considerate toward everyone. The hon the Minister and I have known each other for many years—actually since our high school days. We matriculated at the same high school but obviously he did so a few years later than I. We subsequently graduated from the same university with a corresponding period of time separating us; in other words, we both fared well at university—academically speaking.

Oh, you did not fail together.

I followed the hon the Minister’s subsequent career with interest. His postgraduate academic achievements were outstanding—here and in the USA—and in 1970 he became a professor and head of the Department of Obstetrics and Gynaecology at the University of Stellenbosch.

He has published a wide variety of medical literature, especially in the field of cytology. When the hon the Minister went to South West Africa in 1983 to become the Administrator-General there, I honestly thought it was a pity viewed purely from the angle of medical science in South Africa.

Now the hon the Minister is sitting in the House and we are ranged opposite each other as political opponents—in two parties between which a deep ideological difference exists. In fact, if we cast a look over this Committee, we see that ideological division between the rightist parties—the CP and the HNP on one hand—and all the variations of leftist politics in South Africa—like the extreme leftist NP, the PFP and the NRP—on the other. That is the actual political division in South Africa today.

The leftists and the new leftists.

I think the hon the Minister must have become only too aware of this during his short period in the House.

Nevertheless I wish to assure the hon the Minister that, regarding his department, we on this side of the Committee shall attempt not to involve this department unnecessarily in the political arena. I actually have great regard and respect for the Director-General and the officials of that department as well and, if possible, it should not come into the political arena at all.

The hon the Minister is the political head of a department and that is why what I have just said is not always possible because the Government’s constitutional policy of reform affects every facet of society and the existing order—as regards health care in this country as well—as I shall indicate in the course of my speech. I am going to differ with him there; I shall even cross swords with him there if I must but I shall still attempt to do so without personal disparagement.

Have you requested the privilege of the second half-hour?

I apologise, Mr Chairman; I should like to request the privilege of the second half-hour.

A bit late, but there it is.

Order! Is there any objection? Since there is no objection, the hon member may proceed.

In other words, Mr Chairman, I shall not fight the hon the Minister unnecessarily because I am convinced that deep in his heart he knows just as well as I and perhaps the rightist wing of that party that our people—let me add here that I am pleased the hon the Minister still uses the term “our people” as he did this morning in speaking about the “boerewors”—and their current supporters out there will ultimately reject the Government’s way of integration. [Interjections.] This will certainly happen; the writing is on the wall. When that happens, we shall perhaps again travel the road together in future and there must be no bad blood between us. [Interjections.]

I wish to get to a few financial aspects of the hon the Minister’s Vote. Earlier this year in the Additional Appropriation for the 1985-86 financial year the hon the Minister under a Programme 2—“Infectious, communicable and other diseases”—appropriated an additional amount of almost R3,6 million—and now I am using the exact words as given in the explanatory memorandum— “to make good shortfalls in their funds caused by the suspension of ex gratia payments by administration boards to White local authorities in respect of health services rendered in Black communities”.

In the same way a certain amount is appropriated for Programme 3—“Mental health”; R6,8 million for Programme 4— “Medical care”; R2,2 million for Programme 5—“Health protection and occupational diseases in mines and works”; R600 000 for Programme 7—“Population development”. The total amount is approximately R13 million. In the 1986-87 Budget, appropriation takes place in the same way. For example, R4,1 million is appropriated for Programme 2; R310 000 for Programme 3; R7,8 million for Programme 4; R2,2 million for Programme 5 and R692 000 for Programme 7. The total runs to R15,2 million. I want to ask the hon the Minister whether this will remain a responsibility of this department in future or whether it may become the responsibility of regional services councils. One notes that regional services councils are to furnish a service in the field of health. We should like the hon the Minister to clarify this for us.

Obviously this question is related to the entire matter of the restructuring of the administration of health services in South Africa. As early as 13 February I put a question on this to the hon the Minister of Health Services and Welfare. He replied:

That was two months ago and there is still great uncertainty on how the health services of South Africa are to be further fragmented between the Departments of Health Services and Welfare of the three Chambers of Parliament, the Department of National Health and Population Development and possibly regional services councils and local authorities.

The problem is that we have large regional hospitals providing for Whites, Coloureds, Asians and Black people in one hospital. I can see that it could cause a problem on how to apportion the administration of such an institution to various controlling bodies. There are people who say that emergency services—in other words ambulance and fire prevention services—should possibly fall under the Department of Constitutional Development and Planning because fire prevention services are a local authority matter and in particular one of the activities of the regional services councils which have to fall under the Department of Constitutional Development and Planning. On the other hand one knows there is a close connection between fire prevention and ambulance services. I therefore wish to ask the hon the Minister what his standpoint is on this.

I also wish to express the hope that the apalling variation in the standard of ambulance and rescue services will come to an end. This came to light in the report of the research unit of the Automobile Association which appeared in November last year. The South African Medical Journal also devoted a leading article to this and, as my time is somewhat limited, I cannot quote the entire passage:

That is certainly so. I think there are places such as Cape Town where rescue services are excellent but there are others where they certainly leave much to be desired. I wish to tell the hon the Minister that if he found it necessary to promulgate regulations on “boerewors”, I think it is certainly far more necessary to issue definitive, standardised rules and regulations in this sphere.

He must remove the hon member.

As the hon member for Parktown has made that interjection, I must say that pressure is being exerted on the Government from all directions to cease the fragmentation of health control in South Africa. I think the hon member devoted almost his entire speech to that. Many well-founded scientific and practical arguments have been put forward but I wish to emphasise that many of the arguments are also politically inspired. The gap is taken here to appeal for one health department, one education department and one for each of the other Government departments in the unitary state which has to come into being.

One Black President.

I cannot understand why many hon members over there object so strongly to the unitary situation. In addition I have good reason for reservations on whether the Government will be able to resist that pressure in the long term.

Hon members can now ask me with justification what the CP standpoint is on this. I wish to put our standpoint clearly and unequivocally this morning that this House of Assembly ought to be the sovereign legislative authority in an area of jurisdiction in Southern Africa and that we shall have one Government Department of Health as every independent state has which previously formed part of the territory of the Republic. Of course, there can be a Southern African health organisation to deliberate on health matters of fundamental importance to the member states of such an organisation.

The CP has a clear ethnic policy for the ethnic diversity of South Africa which will be in the best interests of all in the field of national health in the long run. The CP standpoint is—and I am mentioning it to the hon member for Parktown too—that if we find ourselves in a unitary state in which there is differentiation between various peoples, we will never get away from racial discrimination. We can forget about it; it just does not work like that.

A further reason why I feel there should be clarification from the side of the Government on the furnishing of health services is that I have been informed that there is no uniformity in the handling of various population groups in provincial hospitals. The hon member for Parktown also referred to this.

I have been informed for instance that in the Transvaal Asians—but not Coloureds— are dealt with in White casualty and outpatient departments in some hospitals. Now the aged or pensioners come to us with complaints because one should not lose sight of the fact that the waiting room for outpatients comprises a large part of the living space occupied by an aged person or pensioner. He or she spends many hours in such a waiting room; under the circumstances those people feel they are being crowded out of their own living space.

In the Cape Province there is apparently a totally integrated hospital policy in operation, for instance at a provincial hospital like Groote Schuur. The MEC responsible for hospital services reacted in a very interesting manner to a query from the hon member for Sasolburg and it is staggering. I shall read a paragraph from his letter to the hon member for Sasolburg:

The MEC continues by saying:

He concludes with the following paragraph:

[Interjections.] It therefore appears that the MEC in the Cape Provincial Council still comes from the ranks of NP old timers.

I wish to get to one of the fundamental problems of medical services at this juncture and that is their enormous cost escalation. If one looks at the sharp escalation of costs it is disturbing. I was amazed to hear that the learned people the hon the Minister quoted here had said that cost increases for medical services were lower than the tempo of the increase in the general cost of living.

One can conjure marvellously with statistics but I recently acquired statistics at a meeting of the Health Strategy Association where it came to light that a basic manufacturing price of medicine of R382,8 million rose to the astronomical amount of R957,3 million through all the various stages including the addition of GST. That represents a total increase of 250%. Those are figures as I obtained them and I should like to hear what the hon the Minister has to say on this.

Perhaps he can also tell us what the influence of the Government tendering system is on these exceptionally high costs of medicine. It is certainly true, as emerges clearly from every medical aid scheme and also the annual report, that medicine forms the very highest component of medical costs.

The influence on costs of promotional campaigns by various manufacturers of medicine is a further factor. I do not have time to go into all the factors but the fact remains that, to my mind, medicine costs have increased out of proportion to the costs of other disciplines in the furnishing of medical services. I honestly think that, even as regards GST on medicine, we should seriously consider adopting all means of keeping this sector of medical services within the reach of the broad public of South Africa.

Mr Chairman, both the hon members for Parktown and Pietersburg commented on ideology and to my mind with complete justification because there is an ideology and a policy concerning this. We do not want to conduct party politics as regards this department but one cannot escape the ideology. Unfortunately I do not have time today to go into this and in any case I think the hon the Minister will answer the hon members well but I wish to make two comments.

The first is that the day when apartheid no longer exists both the PFP and the CP are going to be in great trouble. The Progs blame apartheid for all that is wrong whereas the CP on the other hand thinks apartheid holds everything together. They are both absolutely wrong. Apartheid will not exist much longer and that is the day the PFP and the CP will both be in trouble.

You are going to be in trouble!

That is the UDF man talking!

Now for my second comment. Much is said about the ideology of power-sharing and so on and this is quite right. I wish to make one statement on this which I shall be prepared to debate on a more fitting occasion. The Whites of this country have freedom and we do not wish to share only power but also freedom with all the people of South Africa. This is an important statement but I shall argue it on an occasion other than this debate. [Interjections.]

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

No, I have only ten minutes and I cannot make a late request for the privilege of the half-hour. My time is therefore unfortunately very limited. I shall conduct a political debate with the hon member on another occasion.

Did Leon Wessels give you permission to speak?

The hon member for Pietersburg and the hon the Minister are both called Willie. I am rather tempted to compare the two Willies with each other. Both studied at the University of Pretoria as I did but the similarity seems to start running out there.

They were both good chaps! [Interjections.]

The hon the Minister and I were friends at university and we often walked down South Street to classes of a morning. Subsequently this Willie became a professor …

You said you had only ten minutes!

So I asked my daughter: “That Professor Willie van Niekerk— what type of chap is he?” She then told me as honestly as a young nurse would: “He is very cantankerous but at least he is bright!” I agree with the hon member for Pietersburg that it is quite a shame that he was lost to that research work.

The hon the Minister then went to the President’s Council where his subject was human relations. Afterwards he went to South West Africa where I was born and grew up. There he also played a great part in international relations. If time permits, I shall revert later to the role of medical practitioners on the international level.

In contrast to the hon member for Pietersburg, the hon the Minister and I are still travelling the same road.

Surely that is not really true!

We on this side of the Committee, and I am reasonably sure all hon members from all three Houses, will assist him in carrying out his great task however we may differ on minor ideological aspects. [Interjections.]

There is a matter I wanted to discuss later but I shall mention it now in case I run out of time. I should like the hon the Minister to tell us something about the atomic disaster in Russia. How does it affect us and, regarding medical aspects, how does Koeberg affect us?

I also wish to devote a little attention to ambulance services and in conclusion, if there is any time left, I wish to speak briefly on the role of the medical practitioner, the medics and the paramedics in the international and national states.

On the subject of ambulance services I should like to pay tribute from the bottom of my heart on behalf of millions of people to ambulance crews for the great, selfless service they render. They carry out this work 24 hours a day, seven days a week, 12 months a year, year in and year out, decade after decade. We wish to thank them for this.

I want to refer in passing to the AA report. At the moment I am a first-year student at Unisa and I am expected to do assignments in my work. I am also set certain norms and standards to make these assignments slightly scientific. The AA is a large organisation which has done very good work in South Africa but I think this little report does not redound to its credit. It is not scientific at all. Much is said but hardly any of it is proved; even the vein in which it is written is not worthy of the AA. A great deal has been said and the Press reported it very dramatically under headlines such as “Dooie Koos” ry die ambulans”. The drama is based on this report and I wish to quote a few statements made in it.

†It so happened that I opened the English version of this report and only noticed the Afrikaans version of it on the other side later on. I want to quote the following from page 13 of the report:

*Then this statement follows:

Surely that is absolute twaddle. I think this type of statement is typical of this report. Even the Afrikaans and the English versions differ in meaning.

I wish to cite a few cases arising from my own experience in Krugersdorp. On 22 June 1982 I had to write a report on the Krugersdorp ambulance service. Incidentally, it is said in the Afrikaans version of the AA report that they visited 116 towns and cities but according to the English version it is 116 towns and villages. With the English version in mind, I wondered why cities were not visited at all. If one therefore says one visited Cape Town, Durban, Johannesburg and Port Elizabeth but one had also been to Koekenaap, Gatsrand, Putsonderwater and Loeriesfontein and one then says it was going well at four places but there was not good service at four others, this is so unscientific and senseless that it is just not true.

Consequently I wish to mention the example of Krugersdorp. We have built up an ambulance service there and the men are well qualified. If I were involved in an accident, I would far rather have those ambulance men treat me than doctors—for the simple reason that they are versed in that exercise. Those men can administer intravenous feeding and give injections. They are in radio contact with the medical practitioner 24 hours a day and we stand by. When an ambulance goes out, the doctor is informed where it is heading. Those men have built up a very good reputation in this way. If someone has had a heart attack, for instance, the ambulance crew is in close contact with the doctor and reports on the patient’s blood pressure, pulse rate and general condition.

The public develops enormous confidence in those people. If a paramedic is well trained professionally, he instils confidence and creates calmness in a patient. Time and again patients are delivered to hospital in a better condition than that in which they were picked up in the veld or at home. In 1981 and 1982 over a period of more than two years approximately 10 000 patients were conveyed in Krugersdorp and not a single patient died in the ambulance. Later it went so well—I do not wish to name the people— that after a patient had died of a malignancy of the lung and the ambulance staff came to fetch the deceased, the lady was standing at the gate and told them they were not to enter that place because they would resuscitate him and he had suffered enough. [Interjections.] That actually happened.

That is what the ambulance crews of this country do; they instil enormous confidence. On another occasion a patient suffering from acute asthma had an attack when he had to go down the mine. He was blue in the face. They contacted me by radio and I told them to give the man a slow intravenous injection of Theophyllin. Five minutes later that patient refused to go to hospital; he was going down the mine to work. He said he was all right; he had had his treatment. Such is the service ambulance personnel furnish in South Africa.

The AA report has the advantage that, where certain problem areas remain, they have now been indicated. Obviously there will not be an intensive care centre in Loeriesfontein; one cannot have the best ambulance services everywhere. Ambulance services in the vast majority of centres in South Africa furnish an excellent service. Long before this report appeared, the hon the Minister called for reports on this. I thank ambulance crews for what they are doing for us. [Time expired.]

Mr Chairman, I would like firstly to congratulate the hon the Minister on his appointment and wish him the best in his new task.

I think he is going to have a problem with one of his duties. Under Programme 6 I see that one of his duties entails “The examination of Ministers, Deputy Ministers, Administrators and Senior Officials, on a voluntary basis with a view to determining health anomalies and to promote efficient service.” I am afraid the “efficient service” part is going to be beyond the hon the Minister and his department, and I would be interested to know how many volunteers there have been for that particular service which he renders! [Interjections.]

I want to start my speech by discussing the title of this department. It is a piece of typical Nationalese—that queer language that they develop to call things by funny names that do not describe them. This is the Department of National Health and Population Development. One will find in the dictionary that the word “develop” has four connotations, namely to increase, produce, expand and evolve. This is the Department of Population Development. To develop means to increase, produce, expand or evolve. Those are the four connotations of the word “develop.” Yet R59 million has been allocated to family planning, which aims at reducing the population, not expanding, increasing or developing it, while R6,2 million has been allocated to the development aspect. This money comes out of a total Budget of R1,8 billion. They plan to reduce the number of children per family by the end of this century by means of a programme of family planning, and they call it “Population Development.” It beats me! Welfare services are not included whereas pensions make up R1,28 billion of the R1,82 billion that is to be appropriated for this Vote.

I do not have the time to deal with pensions adequately, but I would make a plea to the hon the Minister. I refer to the Civil Pensioners’ Association of South Africa, or “die Siviele Pensioentrekkersvereniging van Suid-Afrika.” The hon the Minister has all the relevant documentation and I am not going to quote from it. This association has put up a well-motivated unarguable case for the civil pensioner who has been on pension for a long time. They have calculated and shown unquestionably that the civil pensioner who has been on pension for more than 10 years, is getting a raw deal and a very raw deal indeed. I would plead with the hon the Minister to study the memorandum himself and ascertain whether they do not make out a justifiable case for that group of pensioners.

I want to deal now with the question of fragmentation. In this regard, the hon member for Brits did something unforgivable. [Interjections.] He quoted from a confidential document which reads as follows:

The hon member stopped there, but the very next words are:

[Interjections.] On the next page we find the conclusion which the hon member also did not quote, and which reads as follows:

Why did the hon member not quote that? [Interjections.] He quoted from this memorandum in an effort to show that Natal is satisfied with the fragmentation that is being proposed. However, the memorandum then goes on to make a practical proposal for unifying all the services, even including a schematic diagram to show how this can be done within the bounds of an own affairs system.

Among these documents, there is another one from a different health authority, and this one says the following:

In other words, the medical people are circumventing the legislation in order to provide services. I could go on to quote more and more of these examples, but these are confidential documents in the first place and, if one quotes from them, one should quote accurately and fully and not try to create the wrong impression. [Interjections.]

Let me refer to Natal which the hon member for Brits made mention of. In Natal, an excellent system of co-operation was built up with the hospitals. In Pietermaritzburg, for example, there are two hospitals, one dealing basically with Coloureds and Indians and the other dealing mainly with Whites.

What about Edendale?

I shall come to that. Those hospitals have joint specialist services which service both hospitals. They attract young, able registrars and juniors who enjoy working with these top specialists, and who want to gain experience from them. If one splits those two services, however, one is not going to get the same quality of specialist service dealing with half the number of people and simply duplicate this in the other hospital.

Edendale hospital is another example of this. It was taken away from the province and handed over to kwaZulu. It became shambolic because it was not getting the specialist services. Since then a new system of co-operation has been developed and the situation is improving. However, what I have said, applies to all the hospitals. All the country hospitals in Natal deal with all races—White, Coloured, Indian and Black. One cannot divide a little country hospital up. It must be dealt with as one entity. I therefore want to plead with the hon the Minister, as I do not have the time to develop my argument fully, to look at the realities of the situation and to listen to such experts in the field as Masa and to officials who have to say that they accept the law simply because they are officials of the State. They could not say that they rejected the law of the land. Nevertheless, their advice and their recommendations are not to fragment.

The situation becomes even worse when it comes to the distinction between preventative and curative medicine. That field is creating problems. Do we have to have an Indian spraying in Chatsworth to kill mosquitoes, and a Black spraying in Umlazi, while a White man sprays in the centre of Durban or Berea and a Coloured sprays in Sparks Estate, each eliminating his own racial strain of mosquito? It does not make sense! These are services which must be coordinated. I think we should think of another name for this department. I think it should be called the “Department of Health, Duplication, Wastage, Disaster and Shuttle Services”! [Interjections.]

I want to quote an example of the department’s “shuttle service”. I wrote to the hon the Minister about World War I pensioners. He shuttled it to the own affairs department of the hon the Minister of Health Services and Welfare. He sat on it for a few months and shuttled it back to that hon Minister. I wrote the letter in August, and they only dealt with it towards the end of October, having shuttled it from one department to the other. [Interjections.] Sir, can you imagine the cost involved because of the duplication of aspects of this department? Under the system of own affairs each of the race groups has its own directors and directors-general. This whole thing is not going to work. It has to be co-ordinated, and we must cut out the duplication. [Time expired.]

Mr Chairman, the hon member for Durban Point spoke inter alia on fragmentation. I wish to tell him we shall probably debate that far more in the discussion on the Own Affairs Vote which is still to come. The propaganda story that health services have been unfragmented up to the present is totally wrong, however, because we are actually faced with a very seriously fragmented situation at present. We shall continue debating this.

The hon member for Parktown in effect made an appeal in his speech for Black people. His speech was so riddled with negativism that no word of thanks was uttered to the Government which has accomplished so much for Black people in the field of health over the years that we have an exceptional situation here compared with that in the rest of Africa. We never hear a word of thanks from that side of the Committee for what is done for other people in this respect.

In his introductory speech the hon the Minister said he would return to hon members’ problems concerning occupational diseases. I do not know what he had in mind but I merely wish to warn members of Opposition parties that the politics they are conducting are showing signs of their very serious contamination by the ANC, the UDF, the “Kappiekommando”, the AWB, etc to the extent that the hon member for Pietersburg for instance is having hallucinations already about what could possibly happen in the NP in future! [Interjections.]

In the limited time at my disposal I should like to express a few thoughts on those very occupational diseases. I want to refer more particularly to the problem in mining. [Interjections.] The work in mines is classified and may be classified as risk work for very good reasons.

In opening, I wish to say that to my mind we have reason to lift our hats to every miner going down a mine in the morning and moving and crawling about those passages to earn his daily bread.

It is not only dangerous simply because it is dangerous to move about underground where blasting is done for instance. Nor is it risk work merely because people working there are exposed to external factors such as shaky economies and political problems in the form of strikes and so on which can influence their daily work.

Exposure to elements deep in the mine which cause occupational diseases and affect the lungs in particular certainly make this work one of risk. No wonder that safety measures in mines receive the highest priority and that we are not only leaders in the field of mining technique but also in that of the prevention of occupational diseases.

In spite of all these preventive measures a certain percentage of workers unfortunately still suffer from the after-effects or side-effects of exposure to those elements. This has resulted in our having to pursue a policy of compensation. This brings me to the Nieuwenhuizen Report, the Government White Paper which succeeded it and the legislation which will arise from it. Time has passed since the Nieuwenhuizen Commission was appointed and published its report and the White Paper came from the side of the Government but one is nevertheless delighted to hear that amendments to legislation are ultimately coming. I hope the hon the Minister will be able to confirm our surmises in this respect.

Apparently the interdepartmental work team composed of experts from the Department of Mineral and Energy Affairs, the health disciplines and the Department of Manpower is experiencing problems in its task of coming up with legislation. The Cabinet revised the White Paper and it appears that the matter was reviewed and that it was decided that the administration as regards the compensation for permanent, irreversible and incurable occupational diseases in terms of the Occupational Diseases in Mines and Works Act should preferably be incorporated with the workmen’s compensation system of the Department of Manpower. I think this was a wise decision because the Workmen’s Compensation Commissioner already has a suitable staffing structure and effective recovery mechanisms at his disposal.

The hon the Minister is aware of how strongly the NP study group on health and that on mineral and energy affairs feel about the rights of the miner and, I almost want to say, the privileged position in which they find themselves. I therefore sincerely hope the hon the Minister will be able to tell us that the principles and rights, as embodied in the Occupational Diseases in Mines and Works Act, 1973, will continue to be regarded as a point of departure and as such will be incorporated into the modified legislation.

In addition I sincerely hope the standing committee will have had the opportunity before the short session of examining this legislative amendment and that we shall also possibly be able to conclude it during the short session after the winter holiday.

If I am granted the time, I should like to add something about the Medical Bureau for Occupational Diseases. It is common knowledge that many of the workers in the mining industry regularly doubt the integrity of this bureau if it does not want to certify them as sufferers from an occupational disease or from a more advanced stage of it if they have previously been certified as sufferers from a grade 1 occupational disease. They query the integrity of the bureau because the Compensation Commissioner has up to the present always formed part of the same medical-diagnostic compensation mechanism. Consequently when we have the legislative amendment and consideration of it in terms of a Cabinet decision on where the compensation aspect will now be handled, we shall have more to say on this. We nevertheless believe that we shall ultimately be able to institute an improved dispensation.

On behalf of the Medical Bureau I appeal to miners not only for understanding but also patience. I appeal for understanding because the employee making use of the services of these bureaux should not forget that the bureau and the people working there have to operate within the parameters of an Act. They have to furnish their services within the parameters of an Act of this Parliament. In addition the staff work load does not become lighter; on the contrary, the statement is made in the first paragraph of the report of the Medical Bureau for Occupational Diseases that the total number of men turning up at the bureau increased over the past year as the economic recession made it difficult for them to obtain work outside the mining industry.

I further argue for patience from the side of miners. In terms of an agreement among mineworkers, a mineworker may take a day’s leave when he has an appointment to visit the bureau to make use of its services there. I have been informed that these employees traditionally report to the bureau very early in the morning although the bureau starts furnishing services as early as six o’clock. Miners report there very early for assistance. It is a fact, of course, that the earlier one reaches the place, the earlier one wants to be attended to. If one is not attended to, one becomes impatient. A miner is no different from ordinary people; he also becomes impatient. I therefore appeal to them seriously to be patient with the bureau during the time they spend there. [Time expired.]

Mr Chairman, I take pleasure in following the hon member for Rustenburg; I regard him as one of our best members of Parliament. I do not wish to praise him but I heard him say one day that the moderate use of alcohol was the best possible medicine. [Interjections.] I therefore take pleasure in associating myself with what he said about the good effects of the moderate use of alcohol.

I have actually myself found how good they can be. I told a very old man who had never taken alcohol but who was very ill that he should take a little. Mr Chairman, if he has not died already, he is still alive. [Interjections.]

In 1950 the Press informed us that a cure had been found for one of the most dreaded of diseases—tuberculosis. This was certainly wonderful news way back in 1950. This disease, which had previously terrorised Europe, was beaten by means of vaccination and administering medicine. In America today one seldom if ever hears of cases of tuberculosis. I suspect this disease has also been totally eliminated in Europe but what is the situation like among us in the Republic?

Hopeless!

What I am about to say has not been sucked out of my thumb. I am quoting from the annual report of the Department of National Health and Population Development for 1985. From this it appears to what extent the incidence of tuberculosis in South Africa is increasing. In 1980 the number of cases reported totalled 48 000. In each succeeding year that number rose and in 1984 55 000 cases were reported. Consequently the number of reported cases of tuberculosis is continually increasing in South Africa.

It is interesting, Mr Chairman, that it emerges from statistics on diseases in South Africa that there are some diseases which have already been totally wiped out. We no longer have anthrax here, smallpox is no longer found and bubonic plague has also disappeared entirely. I note that cases of sleeping sickness no longer occur in South Africa either.

What about Tom Langley? [Interjections.]

Mr Chairman, my hon benchmate has just drawn my attention to the fact that there is still a case or two of sleeping sickness in this House. [Interjections.]

The number of deaths owing to tuberculosis is not declining in South Africa either. We are simply not gaining the upper hand over this disease. Two hundred people out of every 100 000 of the population of the Republic of South Africa have latent tuberculosis. The tuberculosis death rate also appears to remain constant; in 1980 2 000 people died of tuberculosis in the country and in 1984 this figure was still in excess of 2 000.

Mr Chairman, why is this disease such a scourge in our country? Are we so different from the people in America and Europe?

Oh yes!

This is a disease which occurs chiefly among poor communities. It thrives in poorly lit, overpopulated slum neighbourhoods and flourishes where a family has to live on only one bag of mealie meal—something which still occurs in our country.

The consequences are devastating. Last year 3 000 children contracted an exceptionally dangerous form of TB; many of them have already gone blind, deaf or even seriously retarded mentally. This is in addition to the cases I have already mentioned, that is that there were 55 000 new cases of TB in 1984 and 62 000 in 1985. Then there are an additional 60 000 people who are not even aware that they have latent tuberculosis.

Tuberculosis is a disturbing threat to our society. It recognises no class, race or colour. The problem is too vast for one person to tackle and also too overwhelming to be stemmed by individuals. Each of us in this Chamber as well as everyone in the country should do his share if we wish to curb this avalanche of deaths and deal TB a mortal blow in this country. It can be done.

Tuberculosis is the commonest disease in our country. The strategy on tuberculosis is directed at all groups of the population and curative as well as preventive strategies are included in the programme. The policy followed in the RSA is basically the same as the recommendation made by the world organisation as well as various world-renowned experts. As I have said, this disease can be arrested.

We at Worcester had an institution furnishing after-care services. Owing to the decline in tuberculosis cases there, this institution has now been converted into a rehabilitation centre for alcoholics. I have been there—but just to see it! [Interjections.]

A hospital with almost 500 beds was established there through the good work of a Dr Wilson because of the healthy climate there and the extent of the disease in the years 1948-50. In the interim this has borne fruit and this hospital is almost empty—in spite of the fact that the provincial hospital has insufficient beds! Many other institutions would like to use it, for example the schools for the handicapped, deaf and blind as well as the technical institute. It is situated very strategically and I therefore wish to request the hon the Minister to consider the request sympathetically that the Brewelskloof Hospital may now serve another purpose. Without attempting to bribe the hon the Minister, I promise him a bottle as well if he assists me with this confounded business. [Interjections.]

Mr Chairman, as usual the hon member for Worcester made an interesting speech with a few jokes into the bargain. However, for the most part he spoke about his own constituency and therefore I shall not react to his speech. I am sure the hon the Minister will pay attention to those problems.

†I think, Sir, that we were all disappointed that the hon the Minister did not give us some indication of how he is going to resolve this problem of a subdivided and racialist constitution in relation to health. After all, this hon Minister has just come from a territory, namely South West Africa/Namibia, which has had the greatest problems and has now finally had to scrap the amazing structure which was created. The hon the Minister is familiar with the difficulties, purely in terms of functional efficiency, of running a health department which is fragmented into many parts. [Interjections.] The hon member for Brits suggested that the Medical Association of Natal had a proposal which could be applied. All of us have received the Medical Association’s reports on this and also reports from all parts of South Africa from non-political groups who are desperately worried about the effects. I believe the hon the Minister should explain to us when he replies to this debate why he could not make a statement now or, if he is not going to make a statement today, when is he going to give some clarity on this matter.

He is also ashamed of it.

Let me also say the hon member for Durban Point who is not in the House now made as though the NRP was so keen on not fragmenting health. Yet when we wanted to use the old Grey’s Hospital, and the Pietermaritzburg Chamber of Industries suggested that the old Grey’s Hospital and its facilities be used as an in-patients’ facility to relieve the pressure on Edendale Hospital, we found out how verkramp those chaps really are. [Interjections.] That approach was non-political and it was supported by the doctors in Pietermaritzburg but the NRP showed its true colours. These chaps are not worth anything at all yet they hold themselves out as enlightened non-racialists.

Who are these “chaps?”

Order! When the hon member referred to “chaps”, was he referring to hon members of this House?

No, Sir, I was referring to the NRP members in general. There are many of them in Natal who are not in this House but fortunately their numbers are diminishing every day. [Interjections.]

I want to speak to the hon the Minister about the urbanisation strategy. The Government has come forward with what I believe is a critical document for the future of South Africa. [Interjections.] The White Paper on Urbanisation has got one paragraph, paragraph 11.4, on the health problems of urbanisation but a good deal of its motivation for the urbanisation strategy’s being applied is the recognition of the fact that as soon as there is urbanisation there is development and a dramatic drop in the rate of population growth. Furthermore, infant mortality drops, and that is an indication of development. We know that for example in Soweto the infant mortality rate is almost a third of what it is among Blacks in the rural areas. While I am on the subject I want to ask the hon the Minister why he does not give us statistics on infant mortality. He could always add a footnote explaining that because all births are not recorded the figures in some of our rural areas are not as reliable as we would like them to be. Why then does the hon the Minister not arrange to have a process for the recording of births? Surely that is not beyond the capability of our Government. I am pleased that the hon the Minister and the Government have realised that the most potent way of reducing our birthrate is to develop and urbanise our society.

The White Paper asks the hon the Minister to assist local authorities and I believe he should give us some indication as to how the Department of National Health is going to deal with this urbanising problem. We have seen how in Crossroads the local divisional council has done a superb job in providing good health care—admittedly with the backup of an enormously sophisticated health service in the Western Cape.

I want to deal with the question of health standards for Third World societies at affordable levels. We welcome the fact that the hon the Minister is going to seek to apply standards and branding, as it were, to a product such as “boerewors”. However, it concerns me that he seems to regard the consumption of good protein food like spleen, lung, liver etcetera as undesirable. Any full-blooded Englishman enjoys tripe and onions and any decent man from the Karroo enjoys “kop-en-pootjies.” In this country offal as it is called in other parts of the world is a desirable and inexpensive form of protein for a very large number of our people. I believe that the hon the Minister should appreciate that our health laws must be adjusted to meet affordable levels.

You are talking tripe.

I like to eat it but I very seldom talk it. [Interjections.]

The point is that we are going to have to, I believe, revise our health laws to prevent our food costs rising unreasonably. Take for example the issue of milk. The Black market likes curds and whey as Miss Muffet did when she sat on her tuffet. They like natural or raw milk as it is called. Why cannot the department introduce health regulations which are appropriate to those people rather than health regulations which are developed by some health inspector who has been imported from Germany or England and comes here with non-African standards.

They should fortify maize!

If necessary, we can have two different kinds of health standards or else we should mark all products with two different kinds of health standards.

You are calling for inferior standards for Blacks!

Those of us who do not mind consuming a little bit of salmonella in our rooibosch tea can take the risk as we have done for the past 50 years and survive.

Now we see your true colours! [Interjections.]

I want to deal with something that the hon the Minister has hinted at. I want to welcome the fact that he is asking the Medical Research Council to look into the financing structure of curative as opposed to preventative health care. I believe the hon the Minister should explain to us how he will be financing health in the future. I would appreciate it if he would tell us when he replies. Is he going to have a two-tier system of private and public medicine? Will some of the public medicine carry a charge—even if it is a small one?

The World Bank undertook a study in 1985 called “Paying for Health Services in Developing Countries”. It concludes that curative health normally consumes anything from 70% to 87% of one’s budget in a healthily balanced society. The hon the Minister is obviously familiar with this kind of thinking. In this country, however, as he himself has mentioned, we are only spending 4% of our health budget on preventative health.

This is because we have distorted priorities. We tend to run this country from this White House as though it is a First World country, and we look to Europe for our standards. It is precisely this kind of budget which explains why there are enormous discrepancies in infant mortality rates between urban areas and rural areas and between the different racial groups.

It is because the rural areas are neglected. They do not get the money and the resources that they should get in terms of preventative care although they will often have a good modern hospital nearby.

I want to tell the hon the Minister that we on this side of the House shall watch very carefully the proportion of money that he spends on curative and preventative health. For example, some of the curative costs could be reduced immediately by privatisation. As the Whites get richer why does the hon the Minister not sell or lease out the Karel Bremer Hospital, the J G Strijdom Hospital and the Pretoria West Hospital? They are all half empty, they cannot find staff and they do not have the patients. Let Rembrandt, Afrox or any hon members of this House who want to go into the private hospital business lease those hospitals. [Time expired.]

Mr Chairman, the hon member for Pietermaritzburg North must excuse me if I do not react to what he said.

Today I should like to say one or two things about the debilitated aged. I should like to bring it to the hon the Minister’s attention that in our country there is, in particular, an urgent need for accommodation for the debilitated aged, also bearing in mind those who are ageing. On a previous occasion I also touched upon this aspect, but I have found it necessary to bring this to the attention of this hon Minister too because it is such an urgent matter.

In all four provinces I have made inquiries about bed occupancy. I have found that the bed occupancy of hospitals in Natal averaged 54% over the past 12 months. In the Cape provincial hospitals, which have approximately 6 000 beds, the occupancy was 58,5%. As far as the Orange Free State is concerned, we had a bed occupancy of 54,7%. For the Transvaal I specifically want to refer to the J G Strijdom Hospital where there are 629 beds, only 482 of which are in use and where there is a bed occupancy of 56,1%. The bed occupancy figure for the Johannesburg Hospital, where 1 052 of the 1 887 beds are in use, is 34,8%. In the B category hospital on the Far East Rand there is a bed occupancy of 49,5%. At the Rob Ferreira Hospital in Nelspruit the figure is 48,5%.

My friendly request to the hon the Minister is that serious consideration be given, if this is at all practicable, to making those beds available to our debilitated aged.

The hon the Minister referred to medicine, and here too I am concerned about our debilitated aged. I took a sample of the increase in the prices of medicines, particularly the medicines used by our older people. If one looks at the blood pressure pills that they have to use so often, one sees that in the past year the prices increased by 42%. The price of the water pills has increased by 66% and heart pills by 56%. I think that is a matter that should receive very urgent attention. [Interjections.]

Order! I want to appeal to hon members not to converse so loudly. The hon member for Witbank may proceed.

I should now like to come to the Year of the Handicapped. The State President has announced that 1986 will be the Year of the Handicapped. Today, on behalf of the handicapped working in the Parliamentary building, and also those throughout the length and breadth of our fatherland, I should like to thank the State President and the Cabinet for having thought of that, so that we can, as a result, examine at all aspects involving the handicapped in South Africa.

The aims have been drawn up, and I would not like to elaborate on that, but what is important to me is the main theme which concerns the involvement of the handicapped in the community. I have also had a look at the involvement of the handicapped in our legislative assemblies, and firstly I want to refer to Parliament. There has been a handicapped person in this House, and here I am referring to Robert Walter Bowen who represented the Cape Town Central and Green Point constituencies from 13 June 1929 until his death on 27 June 1948. Let me also refer to William Morris Hall Campbell who, as a handicapped person, had a seat in this House from 1942 to 1960. He was one of the last Whites to represent Black people in this Parliament. I can also refer to Hendrik Belsazer Klopper who had a seat in both the Senate and the House of Assembly and who is at present a member of the President’s Council. Matthys Johannes van Lingen has been a member of the President’s Council from 1 January 1981. Many hon members perhaps do not know of Mr Richard John Lackay of the House of Representatives who is taken into that House each day in a wheelchair.

As far as I am concerned, it is important for us to have a look at the involvement of our handicapped in the community. The lives of all individuals in our country are regulated by laws, from the cradle to the grave. In looking at the laws governing the lives of the handicapped in South Africa, I must say that I am concerned. I want to make a serious appeal to the hon the Minister about this.

Without discussing the matter in detail, I just want to say that we should have only one overall law relating to the handicapped throughout the country. If one were to inquire about measures affecting the handicapped, whether about a law, a regulation, an ordinance, a by-law or a circular, one would see that the handicapped are never taken into consideration.

If one looks at the speeches made by the handicapped in this House, one sees that there have already been references to this on the relevant occasions. The erstwhile MP for Green Point, to whom I referred, mentioned the inequality in the payment of pensions, particularly those of war veterans. He referred to this problem on 23 July 1929, and today we still have the problem.

If a school-leaver, owing to his training, eventually becomes a military pensioner, his pension is fixed by the Department of National Health and Population Development, whilst someone in the service of the State has his pension fixed by the Workmen’s Compensation Commissioner. What is important, as far as I am concerned, is the great difference between the pensions that are payable. It gives one cause for concern.

I want to point out another inequality to hon members. A quadriplegic who is totally paralysed and a blind person get exactly the same pension. We must have a look at that. It is not fair, it is not right.

We all took note of the Church Street disaster, and let me tell hon members what happened there. Two people emerged from the building and were injured. The one makes use of a transport system provided by the State to transport him to and from his home. He receives benefits, but the other one, making use of his own transport, is not entitled to any compensation. I do not think that is right, and we should have a look at these matters. As far as I am concerned, this is a very serious matter.

The needs of the handicapped can basically be divided up into six categories, ie housing and daily care, work and recreational activities, income, rehabilitation, integration into the community, emotional needs and relationships with others, including the fulfilment of the basic needs of life such as parenthood and their sexual life. The aforementioned needs, however, embrace far more than is merely tangible. It is vital for attention to be given to these needs with a view to enabling the physically handicapped to lead full-fledged lives in our community.

As far as the extent of handicaps are concerned, according to the latest statistics available to us there are 75 208 handicapped Whites in our country. As far as the causes of handicaps are concerned, I am of the opinion that an in-depth study ought to be made of all factors contributing to handicaps. I am saying this because there was no source available to me from which I could ascertain what all the contributing factors are and what percentage of accidents contribute to handicaps. I personally greatly value each and every person and body involved in ensuring that the handicapped get the necessary attention in our country.

As a non-handicapped person living and working in an environment where all the planning is done to cater for the needs of the non-handicapped, one is inclined to forget, in the process, that provision should also be made for the needs of the handicapped.

I want to conclude by saying that I appreciate the State President’s announcement and, in particular, the positive reaction, from the country as a whole, to this extremely deserving cause that should be brought to the attention of our people.

Business suspended at 12h45 and resumed at 14h15.

Afternoon Sitting

Mr Chairman, there is an old Afrikaans proverb that states: “Bitter in die mond maak die maag gesond”, which could be changed today into: “Medisyne in die mond, platsak die beursie terstond.” Hon members have referred to the astronomical increase in the cost of medicines, and this afternoon I should specifically like to link up with that.

The extent to which the cost of medicines has increased in the past two years gives cause for concern. Regular as clockwork we are informed by medical aid schemes that their fees are being increased, amongst other things because of the increase in the cost of medicine. Since I wanted to make very sure about whether this statement was really true, I asked a few of my friends in the medical aid schemes to quote me a few statistics about medicines that are fairly regularly prescribed. The statistics are actually amazing. Here before me I have a relatively long list of such medicines, but I just want to mention a few of the preparations by name to indicate that we know what we are talking about. I shall give the percentage increases in the prices of each of them over the past two years. Over the past two years, for example, the price of Feldene increased by 68%, preparations such as Helseen became 58% more expensive, the price of Keflex increased by 64%, Voltarin SR became 92% more expensive and Zandtek is 85% more expensive than it was two years ago. And I could go on in this vein. Amongst others, there is a preparation which is used fairly frequently and which has become 146% more expensive over the past three years.

Those are absolutely astronomical increases! On several occasions we have discussed the financial benefits of generic substitutes, but I do not think we have really given this matter enough emphasis. From the manufacturers of patent medicines we also hear, as regular as clockwork, that there are reasons why generic equivalents are not acceptable. I think that some hon members agree with this argument of theirs. We hear that some of these generic preparations do not have a sufficiently long self-life and that they are not all that effective either. I have ascertained, however, on good authority, that Iscor’s medical aid fund, for example, which relies heavily on generic equivalents, states that the average cost per prescription is considerably less than that for other medical aid funds. In my view their members are as well cared for, if not better, than those of the other funds. If there is one fund that has really shown us the financial benefits of generic substitution, it is specifically that fund.

I can, however, mention another example. Another medical aid fund, which basically has approximately 13 000 members, made use of generic substitution when it was able to do so, that is until quite recently, and do hon members know what? Within a few months they evidenced a saving of quite a few hundred thousand rand. They are prepared to make these statistics available to us in order to illustrate this fact.

They did not even make use of the full spectrum of generic preparations available to them. Let me tell hon members today that not one of their members has died.

What worries me is that there are bodies which are using generic equivalents but which are preventing others from doing so as a result of certain court judgments that have been handed down. The man in the street, particularly the less well-to-do, is asked to pay more and more simply because we are not permitted to make use of generic substitution. People must not tell us that only a small percentage of medicine is involved. I myself was involved in an investigation and study of this aspect, and I want to assure hon members that the percentage of medicines is quite a bit higher than the figure presented to us by manufacturers. Hon members need only ascertain, from Iscor or an organisation such as the Klerksdorp Mine Benefit Society, what the true benefits and financial value of substitution are.

We are living in a Third-World country and we simply cannot afford not to have recourse to generic substitution. I want to go further, however. Many manufacturers of patent medicines were immediately prepared to give our medical aid funds substantial discounts or rebates on their preparations the moment generic substitution could take place without any obstacles. Some of them— so I have heard on very good authority—are still prepared to do so at present, merely because they are afraid that generic substitution will again be sanctioned. One argument we often hear when we talk to manufacturers is that the State is driving up the price that private patients have to pay for medicines. According to the manufacturers, the State—the largest consumer of medicines in the country—purchases all its supplies, or the major portion of such supplies, on tender.

In order to obtain the tender, the manufacturers virtually have to furnish the medicines to the State at cost price—and frequently, they say, even at a loss. According to them, those losses then have to be recovered by way of the commodities they make available to private concerns. According to them this results in private individuals and pharmacists having to pay more, pro rata, than they would have paid if the State were not such a large consumer purchasing at such low prices.

As far as I am concerned that is a specious argument. Surely no company would market the major portion of its products at a loss and then, what is more, tender for further and greater losses. I cannot accept that. If we look at the financial results of pharmaceutical undertakings, and accept their statement about the State supposedly being the cause of such great losses, it is clear that the man in the street has to ensure such tremendous profits.

We ask our people to make increasing use of self-medication. What we are telling them is that because of the cost involved they should try to make use of more and more self-medication. I think that is going to mean that pharmacists are going to make more use of generic equivalents, specifically to reduce costs. What I am therefore asking is why we cannot again permit generic substitution. There is no doubt that in the future we shall have to resort to generic substitution, particularly with a view to the Third World, which goes to make up a large portion of our country’s population, and also the future increase in the price of patent medicines. The quicker we establish watertight regulations and legislation, the more slowly will the cost of our medicines increase. I am convinced of that.

I want to ask the hon the Minister to give serious attention to this matter so that the patients themselves can decide whether or not they want generic equivalents, just as they can decide whether they want to consult a doctor who is contracted in or contracted out. [Interjections.] I shall reply to that hon member in a moment. The fact that a patient wants to do so, does not make the treatment he is getting any worse, even though he is paying less in the case of a doctor who is contracted in. The same applies to generic equivalents. Cheaper generic equivalents do not necessarily mean inferior medicines, and I think doctors would do well to spell this out to their patients. They can, after all, tell their patients that a certain type of medicine is a generic equivalent that will have the same effect. There are numerous generic equivalents available in our country and I really think we should have another look at whether we should not permit generic substitution.

In the short time I have left, I should today like to pay tribute to a portion of the medical profession which, in my opinion, lags far behind and is actually the stepchild of the profession. I am now speaking of our nurses. I really do not believe that we can lavish enough praise on our nursing corps. They are people who work for long hours on end, and when one looks at the hours they have to work, one sees that those hours exceed the hours worked by probably 90% of the other workers in the country. They are prepared to do their job right throughout the night, a job which in my view is a labour of love, judging by the salaries they actually earn. I think we really owe them a great deal of praise and thanks for what they are doing under very difficult circumstances; sometimes amongst people who do not appreciate it. We do, and we commend them for it.

Mr Chairman, on 1 July 1985 the hon the Minister and the hon the Deputy Minister took over their positions in this department. On that same date that department took over the Directorate of Social Planning from the Department of Constitutional Development and Planning. Along with that take-over they took over the report of an investigation into the present welfare policy of the Republic of South Africa.

Where is the hon the Deputy Minister?

This report has been distributed to national welfare bodies for their comment. At the same time the 1985 departmental report states:

Now, Sir, what exactly is contained in this 144 page report of which the hon the Minister will be well aware? I should like to point out what certain key recommendations are.

It is the ideal that separate welfare organisations should be established and maintained for the various population groups on the national, regional and local level. In matters of common interest umbrella bodies can be created on an ad hoc basis. The report refers to these as “multinational” bodies. Furthermore, registration of welfare organisations should be done by the various administrations for own affairs. The existing South African Welfare Council should be replaced by individual advisory councils for White, Coloured, Indian and Black communities. [Interjections.] A permanent coordinating committee for welfare matters consisting only of officials of the central Government should be created.

There is another magnificent recommendation which ought to be framed: A publicity campaign should be brought into existence to foster a change in attitude toward the policy of differentiation! [Interjections.] The NP has to sell apartheid! Furthermore, national bodies for welfare organisations should be bodies for own affairs. Social welfare services should increasingly be transferred to the private sector. A substantial reduction-note that—of the State’s financial responsibility for and contribution towards the country’s social welfare services should take place. Certain functions in social welfare should be transferred from the central Government to local authorities, including inspection of registered institutions, the screening of the aged before admission to homes for the aged and also the acceptance of applications for pensions and social relief. [Interjections.] The last point, of the many in this report, is that in social security the Government’s responsibility for individuals and families in need occurs only when contributions from the individual family and the community are insufficient.

These then are some of the key recommendations in that report and I should like to discuss them under three main headings: Racial differentiation, privatisation and funding.

Whether the hon the Minister likes it or not, differentiation means “to be different”, to be separate, racially separate—it means apartheid. It is worth nothing that there is a constant repetition of the need to racially separate all welfare services. I find it very ironic that, at the same time, rationalisation is said to be needed to eliminate the overlapping and duplication of services. This obsession with racial separation is driven to quite incredible lengths.

We already have many voluntary welfare bodies in this country—the hon the Minister is aware of that—in which two or more population groups work quite happily and successfully in one voluntary welfare organisation. This report proposes that these bodies be forcibly divided. We already have the crazy situation in regard to at least one welfare body of which I know—there may be more—servicing the poor, the needy and the unemployed of all races, in that it has to maintain four separate sets of accounts and draft four annual reports to the four different racial Government welfare departments which provide funding to it. What insanity is this? Why is this Government so drawn to racial separation?

Apartheid is not dead! This report shows it to be alive and well. I should like to know what the hon the Minister thinks of this report. [Interjections.] The hon the Deputy Minister is not here, even though we asked him to be here, but I should also like to know what he thinks of this report. Does he support racial welfare services?

Where is the hon the Deputy Minister?

We need to be quite clear that the Government’s duty is to serve all of South Africa’s people. That is the Government’s duty. To divide them one from another besides entrenching the race ethic also cause the resources of all people to be tightly confined in one community. The wealthy do not see their talents spread to the poor and the poor get caught up in their own ghettoed needs. We find it totally incomprehensible that this report seeks to ensure that all voluntary welfare bodies follow the Government’s policy of social apartheid.

Let us be in no doubt that the majority of South Africa’s people and the world outside will never understand how, in a time of reform, this extremely retrogressive report could come to be circulated among the country’s welfare organisations. It is incumbent on the hon the Minister to agree immediately that all those recommendations in the report which further seek to divide South Africans one from another, be rejected.

Hear, hear!

We recognise, and this party has said so before, that church and community groups which are of one race do exist and carry out excellent and meaningful work. I have no problems with that; they are voluntary groups. What we plead for is for the hon the Minister to agree not to categorically enforce racial division in social welfare. Many churches today in South Africa are non-racial, many social groups are non-racial. Would the hon the Minister kill them?

The second area is that of the privatisation. I acknowledge the major and significant role played by private bodies and individuals in our social welfare structure. What we cannot agree with are the absolutes portrayed in this report of either having a total welfare state or having almost total state withdrawal, which is what this report almost advocates.

I do not believe the USA is a welfare state. Even where a social welfare policy exists which encompasses the concept of a safety net, the State must assume final responsibility for caring for those not significantly cared for by family or community. In America today they have food stamps, family allowances and medicare. They are all aspects of this policy.

We do not believe that the increased transfer of social welfare services to the private sector is a wise move. We do not have the kind of general welfare net which effectively covers all South Africans. The very high figures for infant mortality and infant malnutrition, which were mentioned today, are clear signs of this lack of a safety net now. So is the racial difference between life expectancy for the racial groups. We do not have that safety net. We also have an imbalance between resources. When one combines privatisation with racial separation the mixture becomes explosive.

We cannot accept that there should be a progressive withdrawal of the State’s financial responsibility for social welfare; on the contrary, we believe that there must be a progressive, non-racial expansion of those State services to ensure that no child dies from malnutrition and no old person dies cold, lonely and abandoned. We, as legislators, do have a role to play in ensuring that far more funds are allocated to aid social services. In this connection the increases in the sums for social relief, for the feeding programme for schoolchildren and for work programmes are all welcome.

Finally, the inclusion of references to local authority participation cannot be accepted orwelcomed without question. Whilst not wishing at this stage to enter into a full debate about third-tier government, we wish to point out that this devolution of functions holds major difficulties. We support the devolution of functions, but to non-racial local authorities which will have the expertise to carry out certain social welfare functions.

I earlier challenged the hon the Minister and the hon the Deputy Minister to state their views on this report. I now call on them to reject it as it stands and to appoint a non-racial body of experts, drawn from all South Africa’s welfare persons to draft a new report for a truly non-racial and effective social welfare service.

Mr Chairman, with the hon member for Pinetown’s permission I shall not be reacting to what he said, because I should like to get round to a quite different subject under this Vote. I want to say a few things about pensions.

One of the points of discussion yesterday, at quite a few of the May Day meetings in the Cape Peninsula, specifically involved the question of parity in pensions. This was discussed on a few occasions, in the course of the year, in the other two Houses of Parliament by members who broached the subject, requesting parity in pensions. From the relevant Hansard reports it also appears that the hon the Minister of National Health and Population Development—at least I think so—dealt with this subject very effectively and realistically.

It is true, Mr Chairman, that at present, on the instructions of the hon the Minister, a joint committee is, amongst other things, devoting attention to the way in which satisfactory pension arrangements can be made with a view to making provision for people from that section of the population who cannot, in truth, look after themselves in their old age. That is specifically the great cause for concern. Unless we give attention to this matter now, this is eventually going to place such a heavy burden on the Government that the Government will not be able to shoulder it. I do not want to say much about what the committee has thus far discussed, nor do I want to anticipate its report, except perhaps to say that we have already made fair progress with our discussions. I should also like to add—in the presence of a few hon members who are now sitting here and who are members of that committee—that these discussions are taking place in a unique spirit of co-operation amongst all the members of the respective Houses of Parliament.

I also want to point out that the said committee is well aware of the practical problems we are faced with. We are also well aware of the eventual stumbling-block, and that is the problem of how we are going to implement our ideas in practice and, moreover, sell them to the masses.

Arising out of the discussions at yesterday’s May Day meetings, and those in the other two Houses, I would just like to exchange a few ideas about the question of parity in pensions. Let me then say at once that the Government has, on several occasions, expressed itself in favour of the principle of parity. So as far back as 1985 a start was made on equal pension adjustments being introduced each year. This means that the percentage adjustment for the respective races is not the same, though the amount is the same. This also means, of course, that the percentage differences between the respective pensions do not increase. The question is however—and this is the point I should like to deal with—what it would cost this country if we were to introduce parity in pensions today. What would it cost the country on the other hand if, for example, we were to reach parity in 15 years’ time? At present approximately 240 000 Whites receive different forms of social pensions. There are, for example, old-age pensions, war veterans pensions, pensions for the blind, disability pensions and also maintenance and family allowances for 240 000 Whites, 400 000 Coloureds and Indians and approximately 700 000 Blacks.

It is, of course, interesting to note what this really costs the State at present. The total expenditure for the three own affairs administrations is at present—ie in May of this year—R150 million. That is for only one month. This means that for a period of 12 months the cost would be R1,8 billion. When the R500 million paid out in Black social pensions is added, the total cost to South Africa is R2,3 billion per annum. That is as far as social pensions are concerned.

I did an interesting projection. If we were to introduce parity to the four separate groups—the Whites, the Coloureds, the Indians and the Blacks—at present it would immediately cost the State an additional R1,5 billion per annum. What this means is that the State would be paying a total of R3,7 billion per annum on social pensions. In other words, the additional amount of R1,5 billion is approximately 5% of our total annual budget. That is what parity would cost us. I am afraid it simply cannot be done. Where must we get that extra money from today? The idea has been raised about the possibility of pension funds, which have investments totalling R40 billion at present, being taxed on the income derived from those investments. I think that would be counter-productive because we are specifically trying to ensure, as far as possible, that people are to provide for their own needs when they reach pensionable age. So immediate parity cannot be achieved.

What, then, is the alternative? The problem we have—I think the hon member for Edenvale has already pointed this out to us in the past, but I just quickly want to mention it again—is that in this country these days our people live longer as a result of improved medical services and increased living standards. So our people progressively have a longer lifespan.

Secondly it should be borne in mind that our people are urbanising. It is calculated that by the year 2000 there will be 36 million people living in the cities, 26 million of whom are going to be Blacks. Those people break their family ties. Whilst in the old days they depended on their families for their care, they now have to look after themselves, and eventually the State will have to take care of them.

A third aspect is that our numbers are increasing, both our older and our younger people, particularly amongst the non-Whites. The problem is that the middle group is the only economically productive group. That small group must now take care of all the old people, on the one hand, whilst on the other it has to take care of all the young people who have to be educated.

Now I just want to give hon members my quick projection of what is going to happen in the year 2000. As I now see things, the numbers of people who will have to receive social pensions will be as follows: 260 000 Whites, 600 000 Coloureds and Indians and 1,2 million Blacks—by comparison with the present 700 000. If we wanted to apply parity to all those people, it could cost us R8,6 billion. That is a quarter of our present budget.

In conclusion I just want to issue a word of warning in regard to the question of parity. In referring to parity, must we think of optimum parity? Or must we think of parity as an average figure so that if a specific group wants to do better—for example the Whites—they have to find other methods or other levies to pay for their additional amounts in regard to the aged in the specific group concerned. The problem is that if we are going to take the top figure as the norm, many people today would be tempted to stop working immediately so as to receive an old-age pension. I would therefore very much like to issue that warning.

If I could exchange one final idea, let me say that as a committee we should also look at the means tests applicable to the respective groups.

Mr Chairman, with reference to what the hon member for Paarl said about pensions, I want to say that every right-minded person who leads a planned life, makes provision from day to day for a decent livelihood by qualifying himself or herself academically or technically, or in whatever way. In addition that person will save, make provision for suitable life insurance, and also, as regards accepting employment, make a point of seeing to it that one of the conditions of employment is suitable pension scheme.

In terms of the Constitution social pensions are treated as own affairs, and fall under the hon the Minister of Health Services and Welfare. But civil pensions fall under the Department of National Health and Population Development. That is what I should like to talk about this afternoon. When we look at the latest information in the department’s annual report, we find that there is an encouraging growth in participation in pensions schemes. Of course this deals only with schemes to which employees of State institutions belong, membership of which is usually compulsory. This nevertheless give an idea of what is going on in the RSA with regard to pension schemes.

In the annual report we find that the department administers 19 funds, with a membership of 900 000. This is an increase of 50 000 members compared with the previous year. As becomes apparent from the report, during the year under review 8 000 new pensions were allocated, totalling R84,7 million. This means that a further 8 000 officials retired and were well provided for by means of a pension scheme. Another splendid figure which indicates that officials make a point of providing for their old age, is a total of 27 927 applications from members of various pensions funds to back-date their pensionable service. These applications have been disposed of.

What rather upsets one in the annual report is a table dealing with the number of resignations. There were a total of 39 149 resignations during the 1985 financial year. I suppose it is normal for people to resign when they get married—but there were only 133 such cases. One assumes that many of those people—perhaps most of them—were incorporated in their husband’s scheme after the marriage.

There were also 5 146 absconders. I suppose one cannot do anything about that because there will always be such people. [Interjections.] There were also 38 870 resignations, and this figure looks a little high to me. There can be many reasons for this, but in most cases it is probably people who change their jobs and possibly join other firms with a similar or a different pension scheme as a condition of employment. It can also be in the private sector.

It is nevertheless gratifying to note that the number of resignations has decreased consistently since 1981. In 1981 there were 93 985 resignations; the figure for 1982 was 94 620, a little higher. Then the amount began to decrease. In 1983 it was 68 161; in 1984, 65 011; and in 1985, 38 149. This possibly indicates that owing to the poor economic conditions the officials hung on to their jobs and did not resign so readily.

What does worry me about the resignations, is that people’s pension benefits end and paid-up amounts are paid out. This means that people terminate their membership of schemes and must join a new scheme at an advanced age and start from scratch again. This can only have one consequence namely that when they reach pensionable age they have earned a smaller pension.

Notwithstanding the fact that in general pension schemes are good nowadays and furnish a good income on retirement, it is an irrefutable fact that if that pensioner lives 20 years or longer after retirement, inflation eats up the buying power of good assets. If a pensioner retires with a backlog, there are usually soon problems.

I do not want to ask for consideration to be given to a national pension scheme today. In my opinion this is not possible owing to our population structure. It will also be difficult to administer and there are many insurmountable problems. But we must now reach finality once and for all that pension contributions must not be paid out when a person resigns, but must be transferable to other funds. This will encourage people to join another fund immediately and make further provision. This will contribute towards relieving the burden on social pensions, which the Treasury cannot carry indefinitely, in future and assure many people of a better old age.

I now want to talk about military pensions to which reference is also made in the annual report. The people who receive these pensions are a group of pensioners who because of their particular contribution to the security of the country receive pensions. When one thinks of a pensioner, one usually thinks of a person who has reached an advanced age. Today I want to look at this from another angle for a change.

The Republic has for many years now been involved in a war and we hear about pitched battles and young men who were killed. But we hear very little about the wonderful young men who are maimed on the battlefield or who are involved in an accident and are dogged by misfortune for the rest of their lives. Many of them are now pensioners. A sum of money or a pension cannot compensate for their loss of enjoyment of life. The State does a great deal for them as regards medical care and pensions, but I want to ask the hon the Minister also to look at other aspects which affect their lives.

Some of them have to be looked after 24 hours a day. Insufficient is being done to compensate for their nursing which in many cases must take place at home. I know of cases where the mother as the breadwinner must see to the patient in the morning, then go out to work all day, and when she arrives home, she must prepare supper and see to the patient, and then she can go and sleep. The next day she must follow the same routine.

The compensation for this nursing is meagre and absolutely inadequate. I want to appeal to the hon the Minister to look into this aspect of pensions too.

Mr Chairman, I should just like to tell the hon member for Middelburg that I have no quarrel with him about pensions. When I look at the benches on that side of the House and even on this side, I think there are quite a number of us who are longing to go on pension at the moment.

That is Stoffies!

That is including the hon member for Sasolburg! [Interjections.]

This new department has a new hon Minister. We have almost reached the end of today’s debate and I would take it amiss of myself if I did not talk today about the role of women in this department. No one has actually done so yet and there is not always someone to side with women, although they are an indispensable element in the department of this hon Minister. She is the one who enters many spheres of this department.

She is not only involved in physical health, but also in mental health. Then we are not even mentioning infant care, family care, the care of the aged, the care of the handicapped and the care of ill-treated and neglected children. Who can do these things better than women can?

I find her in many spheres, and now the men must listen attentively. The attractive typist, secretaries and receptionists in all their offices are women who see to it that they do their work. [Interjections.] There are the helping hands of the nurses and doctors in their white uniforms who take such excellent care of those people. I think it is appropriate to mention here that we also have a nurse in an attractive blue uniform who is always waiting in her duty room to see to the needs of the people in Parliament. I think many of the men have developed more ailments than were really necessary. [Interjections.]

The social and welfare workers are another group of women who must instil self-confidence and sympathy in people who are in great distress. The responsibility of wives and mothers as regards the physical health of their families is very important, but the spiritual care of their families is also very important. The woman is responsible for giving her husband and children security at home so that they can carry out their duties in the outside world effectively. I want to say that it is the woman who can probably also give her family LSD; not the LSD which dulls their senses and to which they can become addicted, but the LSD of love, security and discipline.

The woman also plays a big role in community services. Just think of all the charitable organisations we have in this country, which look after people from the cradle to the grave. This is a service rendered by women, for which they are not paid, but which they render free of charge with great love in their hearts and very willing hands. It is an act of charity which is unselfish, particularly when they also have many duties at home and are in many cases also working women.

I want to say something about the care of the aged. The aged do not only need physical care; we must really understand this. It is very important for them never to feel lonely, cast aside or in the way. After all these people played a very big role in building up and developing this country in their years of service. They worked hard in difficult times and in every sphere. They made sacrifices to acquire a better land for all of us.

Now that they have retired they must look on while others continue to do that work, and it is only human for those people to develop a feeling of “I am no longer needed”. In my opinion it is the responsibility of society and of every one of us to ensure that these people never get that feeling.

It is also necessary for us to endeavour to allow these people to remain actively involved in the system. We can use the man and woman power of the aged very effectively, and this gives them self-confidence and also develops their self-image so that they will never feel lonely. I think loneliness is the worst disease afflicting the aged.

We come across men who have retired after many years of fruitful service and who are still active, and in this connection I want to make special mention of our service officers who work on every floor of this building, for every political party and in every office making the task and the carrying out of their duties easier for hon members. We could not manage without these men in their uniforms. They deserve our sincere thanks and appreciation. We want to tell them: Thank you very much!

Because this is a co-ordinating department for health and welfare, the hon the Minister also determines the policy in respect of welfare. I should like to know what the policy with regard to a number of welfare matters is. I have just talked about the aged, but I also want to say something about old age homes. There are many aged people living in old age homes, but we do not have enough old age homes. In the future plans of the hon the Minister is there not perhaps a subsidy for aged people who are living in their own homes in their own communities, and who are also trying to render a service in those communities?

Furthermore, what is the standpoint of the hon the Minister with regard to child care, foster care and institutional care? Can financial assistance be given to foster parents who in these difficult times sometimes also find it very difficult to care for their families?

As far as population development is concerned, the objective is 2,1% children per woman. Measured against the numerical strength of the various population groups this is not beneficial to the numerical ratio. Judging by the present numerical strengths, the Whites will be totally destroyed by this objective. Even the Coloureds and the Asians will not be able to keep pace with the numerical strengths of the Black people.

The same average number of children cannot apply to the entire population. A separate average figure should be determined for each population group to get a real balance. It will be fatal for the Republic of South Africa if the Whites disappear here. Then the same chaos would prevail which prevails in all the other African states from which the Whites have disappeared, because the Whites are and remain the only factor assuring continuity in any country. We see this in our country, but we see it specifically in the African countries to the north of us where Whites no longer live and where the people are murdering each other, and there is famine, misery and deterioration. [Interjections.]

Mr Chairman, I am on record as having said that I like a woman who can stand up for herself, but I like a woman who can stand up for herself like a woman.

Hear, hear!

For that reason I should like to start at once by reacting and saying that it is a pity that the concept “differentiation” has now been politicised and that the concept “apartheid” has been linked to it. An analysis of the welfare services is going to convince the authority, or the expert, that the problems or the deficiencies with which we are at present battling in the sphere of welfare, must in fact be linked to one very important shortcoming, namely a First World approach to the development of welfare services.

Welfare organisations are inclined to act reactively. They wait for the client who applies or who is sent in for services. As a result of this approach a sophisticated clinical therapeutic assistance programme has developed, but a serious shortcoming has arisen in the development of a preventive-orientated approach.

If we look at the concept “differentiation”, and we look at what some of the learned people who have researched this matter have said—I am referring now to the theories of Maslow which are accepted throughout the world and in which the existence of the requirement levels of people are recognised—we find that it has also become essential for welfare organisations to begin planning their services on the basis of the requirement levels of people. This is in fact one of the big shortcomings which has not yet been overcome.

Consequently I want to arrive at a national welfare strategy this afternoon, because I think that it has now become necessary to address this problem in an effective way. The welfare requirements can be addressed affectively, if a national assistance programme is developed which will in fact make provision for the differentiated nature of the various social welfare requirements we identify at present. This will in fact require that the various requirements of the various communities be identified in a very effective way. The point of departure in the development of the service must in fact be the identifying of the requirement in the community and not the applying of the individual client to the welfare organisation.

Mr Chairman, the hon member spoke about groups. Does she want the differentiation to be on the basis of race or on the basis of regional groups? Is she in favour of racial differentiation?

I am talking about welfare requirements which have nothing to do with race requirements. [Interjections.] I think it is a pity that the hon member for Parktown is trying to politicise this matter and to attach a racial connotation to it.

In principle this concerns the welfare requirements of the different groups of people. It is necessary for us to develop an effective programme which is going to address the requirements at the various levels. We need various structures for this which can address the requirements of the people in a differentiated way.

How do hon members explain the fact that some of the regional welfare boards have now indicated that they prefer to continue functioning as separate boards? It is because they understand the nature of the people’s requirements and because they understand that these requirements can be satisfied in the most effective way by people who understand them.

We now have a need for a national strategy. The requirement levels as they occur in the various communities must be made clear. We need a planning programme which will approach the various requirement levels in an effective way. But the professional social worker must be involved in this planning programme. This has become necessary because the social worker is the expert who can awaken an awareness of the need for self-participation in the various communities. It is necessary for the community to become involved in the welfare programme which must be planned. It is essential for the expert, the professional social worker, when the needs become apparent, to awaken the motivation in the community in order to involve people in finding the unique solutions that have to be found for their own affairs.

Today I am proud to say in this Committee that the programme among the Afrikaner people was launched by the Afrikaner woman. Fundamentally it is a programme involving the awakening of the self-awareness of the people and awakening a motivation to do something about their own circumstances of life. Consequently the potential must be awakened and utilised.

I am also asking that attention be given at national level to the training of volunteers so that greater use can be made of the available potential in the community. In the Coloured and Black communities this is in fact one of the matters which needs serious attention, so that the resources and the available competent people can be used in a counteraction to launch the social upgrading of those communities. Training has consequently become essential.

Attention must also be given to ensuring that the mistakes made in the past are not repeated. One such mistake was that the different requirements of people were considered on a general basis. The differentiated nature of the requirements must in fact be considered. This requires structures which will have to give individual attention to the various requirement levels. I can go into details, but I do not think this is relevant now. At the appropriate time I can discuss the matter further with the hon the Minister.

Another matter I want to mention here, is that it has become necessary to launch a strong co-ordinating programme, in spite of the differentiated programmes for different requirements. We need a co-ordinated policy, as well as the co-ordinated utilisation of resources and a co-ordinated approach to the planning of subsidisation.

I want to make one more statement. In his speech on 26 March 1986 the hon member for Parktown remarked that business undertakings no longer wanted to support welfare services because, so he alleged, services were not being rendered to Black people (Hansard, House of Assembly, col 2545). That is not quite what is happening in practice. I am speaking as a person who every year had to help collect R3 million for an organisation. We received the most support from business communities.

It does not matter to whom the service is rendered. What does matter is what the relevant organisation achieves, and the reason why the business community is asking that something be done for Black people is because they know that as a result of the structures effective attention is in fact not being given to the development of services in the Black communities. For this reason the business communities are now insisting that the welfare community must move away from its clinical therapeutic programme to a preventive-orientated programme.

In conclusion I just want to say that I think the time has come for us to focus more on a prevention-orientated programme in the overall planning of the national welfare assistance programme.

Mr Chairman, it is always interesting to listen to the hon member Dr Venter speak on welfare matters. I can agree with her when she says that one must differentiate on welfare needs. In reality, however—to take one very simple welfare need in South Africa, namely that of the social old age pension—what one gets does not depend upon what one’s need is, but upon the colour of one’s skin and no one other factor at all. [Interjections.]

I should like to say to the hon the Minister, who is new to this portfolio, that he will have learnt that one of the things we have referred to on the pension issue is the need to market a national pension dispensation for South Africa, particularly after what happened to the 1980 proposals. I also want to say, however, that we must be very sure that we know what we mean by the term “marketing”. Do we mean that we must take the existing Western system and go and sell it to the Black community or to the Coloured and Indian communities? I think if we were to do that, we would heading for disaster in South Africa.

In his speech earlier today, he referred to the need for a user-oriented approach, and I think that what we must ask ourselves …

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

Not now; I do not have the time. [Interjections.] In considering the present situation in South Africa, we have to ask ourselves the question as to how the existing system meets those needs.

For example, if one looks at the all-media products survey of 1983, one sees that it shows that 11% of families in South Africa had a household income in excess of R1 200 per month; 33% earned between R250 and R1 200 per month; and 56% earned less than R250 per month. I ask myself how relevant it is to talk to a man about providing for his future when he cannot even provide for the present.

To take a second factor, that of life expectancy, we know from the demographic report of the Science Committee of the President’s Council that the life expectancy for a Black male in South Africa in 1980, was 55. I ask myself how that life expectancy impacts upon his thinking about pension, because if one is a White male, then one’s life expectancy is 67. It is then reasonable to talk to a person about providing for his retirement. However, if my life expectancy is 55 how relevant is that, particularly if I am battling just to meet my present needs and the needs of my family? [Interjections.]

We can argue that life expectancies are increasing; and that is a good thing. However, it is still very difficult to motivate a person to provide for an event which, according to the law of averages, is never going to occur. I should just like to ask the hon members present how excited they feel about paying life insurance premiums so that others can benefit from their deaths. [Interjections.] The fact that so many people take out life insurance gives us hope.

The third reality in South Africa is that, officially, there are approximately three quarters of a million people unemployed in this country. The unofficial figures are much higher. Either way, that is a large number of unemployed. For many inhabitants of our country, job security is something they only hear about; not something they experience. When they are unemployed, they have few savings upon which to draw. The Unemployment Insurance Fund is slow to pay out and it does not provide for chronic unemployment. For those who are fortunate enough to belong to a pension fund, a refund of their pension contributions may be the only savings they can draw upon to meet life’s crises.

I ask myself whether we can reasonably tell a man not to worry about today and tomorrow but that he should worry about what he is going to do in 20 years’ time when he retires. I think we have to ask ourselves some very fundamental questions. Are we going to take our First World pension instruments and attempt selling them to the Third World, or are we going to design instruments which are relevant to the needs of those people? After all, there is no particular value in a pension fund. What is important is the objective, namely how we can help people to provide for their retirement. That is what is important.

I believe we have to look at this whole question of the various instruments we have. I think we have to adopt a very flexible approach. The report of the interdepartmental pension committee of 1980 recommended three instruments, namely pension funds, retirement annuity funds and special frozen accounts. In fact, they said that the provident fund was not a legitimate pension provision instrument. I must admit that I was inclined to agree with them but I now wonder about it. I notice that countries like Malaya provide for their pension requirements by provident funds. Large segments of the South African population belong to provident funds, and I do not think we should tamper with them. I think we have to look at creating new instruments for helping people to provide for their welfare needs.

When we talk about the problems of welfare provision for the majority of the population, there are a number of issues which are interrelated. One cannot separate the question of providing for retirement while one is employed, from the problem of providing for living when one is unemployed. We either have to improve the Unemployment Insurance Fund dramatically with regard to benefits and efficiency for the Third World inhabitants of our country, or we have to accept that retirement funding vehicles should be flexible to meet these emergencies.

In Brazil, for example, there is no unemployment insurance fund but an employer pays a contribution of 8% of an employee’s salary into a special fund and, in the event of unemployment, his former employee can draw upon that.

In South Africa it is often said that employees see a pension fund as a form of compulsory saving. Perhaps that is what they are looking for. Perhaps, instead of telling them that it is not what they should be doing, we should design instruments which will meet those needs. We may find that by offering them a benefit now out of a particular investment, we shall, in fact, be helping them to provide for their retirement.

We have to look at the question of how we are going to use these retirement funding instruments in a Third World situation. In the near future we shall discuss a Bill which will permit of the amount that one can obtain out of a pension fund for housing to be increased from 75% to 90%. If we are having difficulty in convincing people that they have to provide for their retirement, perhaps what we can do is to suggest to them that they belong to that fund because it is not going to help them only when they retire; it can also help them while they are still working. To me it is far more beneficial to use pension fund money to provide for housing than to use pension fund money to chase up shares on the Johannesburg Stock Exchange or to build glorious buildings which do not add one cent to the productive capacity of South Africa. I think we need to introduce a whole new flexibility into the debate on welfare provision in South Africa. I hope that these few thoughts will help to stimulate that debate in this Committee.

I am pleased that the hon the Deputy Minister of Population Development is here. I must say that I am sorry he was not here a little earlier.

Mr Chairman, the hon member for Edenvale is an expert on the topic of pensions, and I would rather not cross swords with him about the remarks which he made this afternoon.

I would like to exchange ideas on the subject of population development, but before I do so, you will probably permit me to welcome the hon the Deputy Minister of Population Development to the House of Assembly on this occasion. We are looking forward to what he has to say to us this afternoon and we also want to wish him everything of the best with the important matter he is dealing with.

Someone once said that philosophy was the queen of the sciences, meaning that philosophy was the most important science and I wholly endorse that. On the analogy of that, I now want to make the remark that I think population development is the queen of the government departments, meaning that population development in my view—and I do not want to exaggerate—is probably the most important state department at the moment, and I want to tell hon members why I say this.

If the population development programme does not succeed, we shall not be in a position in this country to provide sufficient job opportunities for all South Africa’s people.

If the population development programme does not go off successfully, we in South Africa shall not be able—and this includes the public and private sectors—to provide adequate housing for all South Africa’s people. If the population development programme does not succeed, we shall not be able to give equal education opportunities of a high standard to all South Africa’s inhabitants. If the population development programme does not succeed—so I understand—we shall not even be able to provide all South Africa’s people with water. It is said that the carrying capacity of South Africa, with regard to water consumption, is 80 million people. I do not think that I have to continue to enlarge on the point that the population development programme is of vital importance to all planning in South Africa and I think the hon member for Brits also made this point this morning.

The broad aim of the population development programme is, expressed briefly, to improve the quality of life of all South Africa’s inhabitants. This can be done—and reference was also made to this fact today—if the increase per family is 2,1 and not 2,3 as is the case at present. This applies to all population groups.

Allow me just to point out that there are certain factors that adversely affect the population development programme—or let me put it in this way—the population growth in South Africa. One of the factors adversely influencing the population growth in South Africa, is the fact that numbers have actually been politicised by an important part of the population and are actually being used as an instrument to attain political participation.

In this connection I just want to refer to an article which appeared under the heading “Family Planning in South Africa: A kind of genocide”, which appeared in 1982 in the African Communist. I quote the following observation from it:

Because the perception exists amongst Blacks that the population development programme is really aimed at reducing numbers and precisely because their numbers are regarded as an instrument for obtaining political power, it seems to me as if this is a factor which could handicap this programme. That is why I want to express the view that when the constitutional process in South Africa has run its full course and there is in fact meaningful political participation, a different attitude—I think—would possibly also exist amongst Blacks.

But there are also factors which have a positive influence on population growth. Let me refer to two of these. One is specifically urbanisation. It is a world-wide phenomenon that urbanisation causes a drop in the birthrate. In South Africa too, we have a situation where in urban areas even the family growth amongst Blacks is much lower than in the rural areas. That is why I think that whereas in the past we sometimes adopted a negative position towards the process of urbanisation, this whole counteracting aspect of orderly urbanisation is also a sound instrument to lend support to the process of population development.

I now want to refer to a second aspect. I also think that the abolition of influx control could have a positive effect on the population development programme. In an article which appeared in the Financial Mail, it is mentioned that hospital staff in the rural areas refer to September as the baby month. That is because it can be traced back to the migrant labourers who come home over the Christmas vacation. With influx control we therefore also often achieved just the opposite to what we were originally aiming for. And so I think that abolishing it as well would likewise stabilise this situation.

In conclusion, Mr Chairman, I just want to make one further remark. I think the stated policy on the population development programme, that of raising the standard of living in general, will also serve as an incentive and will accordingly give the population development programme the necessary impetus. I think it is generally known—and everyone freely agrees with this—that when one increases the quality of life of people, numbers decrease and South Africa would consequently also become a more habitable country for everyone.

Mr Chairman, it is for me an honour, and indeed a privilege, to be in this House today together with you and hon members of this House. It is also a pleasure for me to share in this debate with my colleague the hon the Minister of National Health and Population Development. I should also like to express my appreciation to the State President for the opportunity he has afforded me of taking up the challenge which this particular portfolio offers.

I believe it was Joseph Conrad, in his book Heart of Darkness who said, and I quote:

Somebody also recently said that a hungry stomach had no conscience. It is this particular issue which is of paramount importance to me, as well as, I am sure, to hon members of this House.

*The Population Development Programme which was launched in 1983 is probably one of the most important initiatives we are involved in today. It is important in this respect that the future of the country and its people is going to depend largely on the success that may or may not be attained by this programme. The respective communities throughout the country are displaying increasing needs for an improvement in their quality of life. These needs are sometimes fraught with emotion, and in other respects are very objective and concrete. The fact of the matter is, however, that this desire for an improved standard of living is actively present in communities, and as a result can no longer be ignored.

If a country gives the rightful attention to these desires and needs, the effect on the country and its inhabitants in general will be a stabilising one. Should these needs be regarded as of lesser importance, however, or ignored, the consequences for the future can be serious.

The Population Development Programme is directed at development, by means of which efforts are being made on all levels of development in the community and in society to improve people’s quality of life. The improvement in people’s quality of life is an important aspect for the RSA as well as the rest of Southern Africa, because we are dealing here with communities that differ from one another in terms of culture, background, development opportunities and present levels of development.

It is important for the Population Development Programme to regard Southern Africa’s population in the light of the position of the respective communities in the so-called democratic stages or development phases. In the first place we have the traditional phase of development which is characterised by high birth and death rates, resulting in a relatively low population growth. Basically the RSA population has moved through this phase of development already.

Secondly there is the pre-modern phase of development, which is characterised mainly by a high birth rate, as well as a sharp decrease in the death rate as a result of better health, education, housing, and even the part played by the Church. The latter phase results in a high population growth. Seen as a whole, the Black population in particular was in this development phase, with a percentage population growth of as high as 2,8% per annum. The so-called Coloureds, and the Asians in particular, are quickly moving on to the modern stage of development. The characteristics of the pre-modern stage of development are the following: A strong need for basic means of subsistence such as food, water, housing, clothing and so on. In this phase a community is not really geared yet to the so-called great need for self-realisation. A further characteristic of this basic phase of satisfying needs is that there is a vicious circle of a high birth rate and poverty, which results in a declining quality of life.

With reference to the latter, such communities normally experience an inability to break this vicious circle themselves. External assistance, combined with the community’s self-help and own responsibility, is necessary to break this poverty spiral. Seen as a whole, the Whites are the only population group in the RSA who are in the modern stage of development. This phase is characterised in particular by a low birth rate, a low death rate, an attendant low population growth and a high quality of life in which the greater requirements of self-realisation and future expectations make up an important part.

And higher cholesterol.

It is a fact, however, that a greater and greater percentage of the population of the other population groups in South Africa is moving into this modern phase of development.

†It is not easy for communities to break out of the vicious circle of high fertility, poverty and deterioration, and further high fertility, poverty and deterioration without external help. In view of this fact it is of cardinal importance that the Whites of this country continue in their earnestness to promote the development and prosperity of all population groups. There should therefore especially be an attitude of acceptance and of co-responsibility in supporting our Third World communities in their progress towards reaching the modern phase of development as soon as possible.

If we can succeed in this, all our descendants will inherit a population of manageable size in terms of available resources. We will also leave them a country in which they can live in peace and stability and where there will be a quality of life which will ensure everyone’s future. A low quality of life places great stress on a community as well as on its neighbouring communities. Because of this the Population Development Programme is aimed at negotiating and working with the TBVC countries as well as the self-governing national states. The aim is to motivate countries to run similar population development programmes which will benefit the whole of Southern Africa. Southern Africa, and more specifically the Republic itself, will have to make every attempt to ensure a manageable population for the future as it becomes clearer daily throughout the world that countries develop an inability to satisfy the needs of their surviving communities.

The call on communities in our country is thus to help and support one another in actually reaching a state of self-help, personal initiative and total acceptance of responsibility. At this stage we can indeed ask the question whether the Population Development Programme has had any success yet and whether there are any positive prospects for the future. Without hesitation this answer is yes. I would very much like to expand on this “yes” and would therefore appreciate your bearing with me a moment longer.

In the past two years the Population Development Programme has especially endeavoured to establish attitudes within communities and organisations to focus attention on preventive and development programmes. Good progress has been made with programmes which have been implemented by, inter alia, mining groups, farmers on their farms, industries, churches and commerce institutions. Approximately 175 development societies or committees have been established throughout the country which are committed to the aims and objectives of the Population Development Programme. By implementing a community development model, the Population Development Programme is helping in the development of people who are capable of defining their own realities, of identifying their own problems and needs, of determining their own priorities and planning the necessary action in connection with those priorities and, ultimately, who are capable of determining their own future.

The interdepartmental committees for the Population Development Programme on national and regional level have already succeeded well in co-ordinating public-sector actions on regional and local levels and in joining forces to reach common goals. The Population Development Programme has also made good progress in initiating in communities programmes which are aimed at churches, the economic sector, the status of women, training—especially for women in the labour force—and programmes aimed at the farm labourers. The Population Development Programme has had a positive success rate in obtaining the acceptance and cooperation at top levels of both the private and the public sectors. It is interesting to note that this is one of the prerequisites for the successful implementation of a population development programme.

The Population Development Programme has also established measuring instruments to evaluate the progress of the programme on a regular basis. The quality of life in each regional development association region is quantified according to objective quality-of-life indicators. The quality of life in the RDA region is compared with the national index, and the progress of the PDP objectives is measured against time scales.

The Population Development Programme is also negotiating with top level tertiary organisations in planning curriculae for training students in the philosophy and practice of community development. Emphasis is being placed especially on the manner in which the programme’s objectives can be meaningfully reached within a community context. There is a growing need in communities to learn more about the practical applications of community development.

At this stage I think it is worth asking what community development is. Community development can best be defined as a process by which a community is assisted in identifying its needs and objectives. It helps develop confidence and the will to work at those needs and objectives in finding the resources to deal with those needs and to take action in respect of them.

In so doing the community develops cooperative and responsible attitudes. In this process the efforts of the community are united in improving its own socio-economic conditions. The Population Development Programme receives continuous requests from institutions and organisations for help in training and equipping personnel in the theory and practice of community development. Such requests are avidly met.

*As far as the future is concerned, the Population Development Programme sees the following in particular as important components which should receive attention. The substance and modus operandi of population development must be established more strongly in Southern Africa. Attitudes in communities must be developed so as to assist other communities in the pre-modern phase and to accept responsibility towards them. Communities must be informed about the danger of a too rapid population growth and particularly about the catastrophic results that will entail for the next century. Communities must be persuaded to accept the rationale of smaller families, and at the same time, to strive for a higher quality of life as a point of departure for Southern Africa. Communities must realise their mutual interdependence as far as development is concerned, and must continue to accept joint responsibility for one another’s standards of living. The Population Development Programme will have to be publicised more intensively and comprehensively, and special attention will have to be given to the practical implementation of programmes and projects to improve the quality of life of communities on the local level. By co-operation between the authorities and the private sector, efforts will have to be made to achieve the Population Development Programme’s objectives up to the local level.

The importance of the Population Development Programme is emphasised in particular by the fact that if its objectives are not attained, we are in danger that the country as a whole will degenerate into a Third World situation.

As a result, the call to us as residents of the RSA is clearly and unequivocally to give our positive co-operation to the Population Development Programme for the sake of our own future. What is even more important, however, is that hon members in this House can still make a great contribution in the community by helping to create the correct attitude towards and perspective regarding the importance of the improvement of the quality of life of people in the RSA and also in Southern Africa.

†I believe that in my absence from this House the hon member for Pinetown asked a question regarding welfare which he expects me to answer. There seems to be some confusion as to exactly what my role in this particular department should be. The truth of the matter is that this department is called the Department of National Health and Population Development, and the Population Development division has absolutely nothing to do with Welfare. [Interjections.]

Tell us what it does!

It has its own directorate and its own officials.

In closing, I would like to express my appreciation and thanks to the Director-General of our department, the Chief Director and all the officials under their supervision for their co-operation and help in the short time that I have been in office.

Mr Chairman, allow me to congratulate the hon the Deputy Minister on his appearance today in this Chamber. I wish also to congratulate him on the philosophies he expressed. On behalf of the hon members on this side of the House, I wish him well with the tremendous task which is his responsibility.

*I wish him the best of luck for the future.

I should also like to associate myself with what the hon the Deputy Minister said in respect of population development. At the risk of becoming like a cicada which sings only one note, or my old “ramkietjie” which has only one string, I want to refer once again to what I referred to last year, viz the Foundation for Rural Community Development or in short, the Rural Foundation. Hon members will forgive me if I speak about this every now and again, and am a little possessive about it, but it was my privilege to have a share in the establishment of the Rural Foundation.

The hon member for Randfontein referred to this as well. The late Dr Nak van der Merwe, the hon the Minister’s predecessor, said on more than one occasion as the Minister of Health that we in South Africa and in this Parliament could make as many laws and constitutions as we pleased, but if we did not pay attention to the growth of the unsophisticated section of our population, and could not wrench these people out of a culture of poverty in this way, none of this legislation would serve any purpose. This soul-destroying condition can be ascribed mainly to having too many children per family. Let us be frank about that. That is why I am especially grateful to hear from the hon the Minister about the establishment of this new council for population development.

It is true that having many children per family is part of the tradition of our Black population groups. It is part of their background and their way of life, since they measure their wealth by the number of children they have because their children are their means of providing for a pension, and care in their old age. Fortunately this view is becoming obsolete, particularly in the urban complexes, where the Blacks are beginning to realise that the fewer children one has per family, the better off one is materially. Unfortunately it is true that this view has not yet taken root in the rural areas at all. That is where it is most necessary, seen against the background of the terrible poverty conditions.

This is where the Rural Foundation comes into the picture and where they do more and more valuable work every year, along with what is done by the department itself. The Urban Foundation was established on 23 December 1982, and was initially launched here in the Western Cape. The objective in the beginning was to launch 20 projects per year, but the need for this kind of development quickly caused the demand to be much greater than had been projected. As early as 31 March 1985—a year ago—49 areas had been affiliated country-wide. It is interesting to look at only a few areas. I want to mention a few names, such as the Bo-Gamtoos, Ficksburg, Koppies, Koster, Kroonstad, Letsitele, Lichtenburg, Middelburg, Patensie, Prieska, Reitz, Tsitsikamma, etc. There are 999 farmers involved in this, with 14 143 families representing 86 640 people. This was in March last year, when 33 negotiations and inquiries were in progress. At present that figure has increased to 70.

It is very clear that the Rural Foundation is achieving a great deal of success. But how is this Foundation financed? There are three partners, the farmers, who definitely make their contribution financially, the private sector and the department. I want to say immediately that the department in particular makes its contribution, but unfortunately the private sector does not. If one thinks of the contributions that flow from the private sector to all kinds of projects, of which some— let us be frank—are of lesser value, it has become imperative for us in South Africa to exhort the private sector to accept this social responsibility of theirs. When we look at trade and industry, and particularly at insurance, this is a sphere in which they can invest, not only for their own good, but for that of our country as a whole.

Initially our department guaranteed three years’ financing of these projects, and this period expired in March this year. In view of the Rural Foundation’s success, it is a privilege for me to plead with the department to continue their support, and even to increase it. In the Budget approximately R66 million in total is allocated to the department for population development. Of course, one would have liked to have had much more. If we are serious about this aspect of our population and our development, the State has an obligation to make more money available to the department so that it can support the Foundation on a larger scale. The Foundation envisages a growth of 18% in their budget. The present objective is to reach 20% of the farmers. They represent 80% of the labour force in agriculture. The first priority at present is the development in the Orange Free State where most of the Blacks live and where the greatest population growth in the rural areas takes place. The Foundation has the necessary machinery at its disposal to be able to do this work. They make a rand go a long way. In the development of a particular area, for example, they start with highly qualified staff. When things are going well there, they withdraw those people to start developing another place. They are then replaced by staff with lower qualifications, who fall under the central authority and continue the work.

The Rural Foundation’s management consists of inspired people, people who make it their business to do something about this immense problem in our country. Hon members will agree that the work done by them is extremely valuable, in the first place to the individual as such, but also to our country. This work can be continued only with continued support, that of the Government in particular. That is why I plead with the hon the Minister, the hon the Deputy Minister and the Government to support the Foundation properly, financially and otherwise. On behalf of the Rural Foundation, we convey our sincere thanks for what has been done already.

Mr Chairman, I listened with great interest to all the speakers during this debate. I must admit, to repeat what I said this morning, that the Government and we in the Official Opposition do not view health and welfare in South Africa in 1986 in the same way. Not one of the hon members of the NP has referred to the state the country is in as far as the revolution, the bloodshed, the shootings, the killings and the burnings are concerned. If one reads the report of the department, one finds that not a word is said about that there. At the beginning of my speech this morning I said that I would not congratulate the hon the Minister or his deputy until I had listened to their speeches. I welcomed them and respect them as people. Unfortunately I have not yet heard the hon the Minister’s reply to me, but he will reply to me later.

I should like to tell the hon the Deputy Minister that I cannot congratulate him. The hon the Deputy Minister said he was responsible for the population development division in the department, and that therefore he had nothing to do with welfare. Therefore, he said, he could not reply to the speech of the hon member for Pinetown and reply to his questions concerning welfare. If we are wrong in our approach, the hon the Deputy Minister must blame his department. I should like to refer the hon the Deputy Minister to chapter 8 of the annual report of the Department of National Health and Population Development. Chapter 8 is headed “Population Development and Social Planning”. May I ask the hon the Deputy Minister if he has only to do with population development, and nothing with social planning? Does the hon the Deputy Minister also have something to do with social planning? May I ask him that across the floor? If this is wrong, is this not the department that he represents here? In chapter 8, dealing with population development and social planning, the following matters are discussed: The Population Development Programme, the Council for Population Development, social planning, social welfare, the National Advisory Council on Rehabilitation Matters which concerns welfare, the South African Welfare Council, and general welfare education, amongst others. I should like to ask the hon the Deputy Minister in what capacity he is a member of this department. If the hon the Deputy Minister says he has nothing to do with welfare, I should like to tell him that, if he claims that the main object of national health and population development is to improve the quality of life of people, one cannot improve the quality of life of people without improving the welfare of the people. Therefore I do not know what the hon the Deputy Minister represents here today. I hope he will forgive me for this, but he reminds me of the time when we fought the referendum on the new Constitution. Does he know what his leader said then? He said that they were going to use this system to destroy apartheid. He said that he would tell the White man to hand over the goodies! [Interjections.] If he does not look after the welfare of his people, I do not know what he wants to do about the “goodies” or why he is asking for them. [Interjections.] I should like to tell the hon the Deputy Minister that I also asked him many questions. I do not know whether or not his officials have told him about those questions, but I am very disappointed that he did not take this opportunity to reply to the questions I asked him. I therefore want to ask him some questions across the floor. With reference to your department, for which you cannot escape responsibility as you are a Deputy Minister in the Nationalist Government and therefore the political head of Population Development, and as you are involved in welfare, I want to ask you whether there is any racial discrimination in respect of welfare. Secondly, if so, do you support it? That is all I want to ask you. I would like you to join us here in fighting this, because fighting racial discrimination in welfare is to the benefit not only of your people, but of our people and the people of South Africa as well. [Interjections.]

Order! I should like to point out to the hon member that all remarks must be addressed to the Chair.

Mr Chairman, I apologise if I have insulted you. That was not my intention. I tend to get worked-up because this is something which I believe is very important. [Interjections.]

*I should like to tell the hon the Minister that I think that the new pseudonym for apartheid is “differentiation”. That is the new word that has been coined. “Apartheid” is now passé; it is out-moded. “Differentiation” is now the in word.

I want to tell the hon member Dr Venter a story. It is the true story of a woman who was involved in a car accident. Her neck was broken and she was totally paralysed.

†She had a fracture at C4 and C5 which resulted in paralysis of her entire body, including all her limbs, and she had no control over her bowel and bladder action.

Her need was to be admitted to a spinal unit. However, in the city in which she lived there was only one spinal unit and that was in the White section of Verwoerd Hospital. Differentiation resulted in her being admitted to the so-called Coloured section of the Black wing of the hospital—can you believe that there is a White section and a separate so-called Coloured section of the Black wing at the hospital?—where she was nursed without there being the facilities for spinal cases.

That was not what she was talking about.

Of course she did not talk about it. I am talking about differentiation. Perhaps if I call it apartheid, you would understand it. I will call it apartheid and then you will be happy. However, it is now differentiation.

When she was eventually seen by a medico-legal expert—a neurologist—in what condition do hon members think he found this woman? The woman was lying in a pool of pus on a bedsore the size of a saucer. The bed she was lying in was not a spinal bed. There was no spinal care for her under those conditions. I should have liked to have put a question to the hon member Dr Venter who, I am pleased to see, has left, presumably because she cannot understand and because she is ashamed of what she said earlier. In any event, I shall ask the hon the Minister and the hon the Deputy Minister: Would this have happened to that woman if she had been White? [Interjections.] Would it have happened?

Yes!

The hon member says yes. I think he is a doctor. Is that what he thinks of the medical profession in South Africa? [Interjections.] Of course, she would have been admitted to the White spinal unit at the Verwoerd Hospital where she would have received proper spinal care.

I should now like to come back to the hon the Minister. He is a doctor and I would like him to tell me whether he believes that he can justify that type of differentiation, after having taken the Hippocratic oath and having declared his devotion to his patients. I should like to ask him what he and his department are going to do to get rid of this differentiation, so that all South Africans may be treated equally, in equal facilities, under the same doctors and staff.

Mr Chairman, firstly I should like to avail myself of this opportunity to thank the hon the Deputy Minister of Population Development for his excellent contribution in the Committee.

Hear, hear!

I have come to know him as someone who acquits himself of his task in the department with great enthusiasm, and I am also very glad to be able to say that he recovered well from his injuries after he was nearly killed when a hand-grenade was thrown through his window. I am very glad that he is here, and that he survived that terrorist attack.

I should now like to deal with the hon member for Parktown. [Interjections.] He is an excellent cardiothoracic surgeon. [Interjections.] I should now like to tell hon members that the quality of his contribution to this debate today bears no comparison with the quality of his surgery; to be honest, it was extremely feeble. [Interjections.] He did not welcome me to the position which I now hold, but that does not bother me at all. The hon member’s leader welcomed me in a very nice way, which I appreciate very much. [Interjections.]

The hon member for Parktown said:

Yes, and so it is.

And what about Black-on-Black violence? What about the necklace murders? What about those 500 who are already dead? Tell me about them!

I did mention them! [Interjections.]

Is that also as a result of discrimination?

Yes! [Interjections.]

Are Blacks killing one another as a result of discrimination? [Interjections.] That is rubbish!

Violence breeds violence!

That is utter rubbish! [Interjections.]

Order!

It is probably because of frustration. It is simply not logical to think so. Is it as a result of apartheid that one Black kills another?

Under these circumstances, yes. [Interjections.]

No, that is really absolute nonsense! I cannot understand how the mind of the hon member for Parktown works! [Interjections.]

The hon member speaks about discrimination, but he has not trained one Black cardiothoracic surgeon. Has he?

How could we? [Interjections.]

Now suddenly he could never do it. [Interjections.]

He told us here that the medical students of the University of Witwatersrand were unable to get into the hospital. Do hon members know what happened? The hon member for Parktown knows it himself—the patients come first, and it was their wish that the students examine them, except in gynaecology, obstetrics and pediatrics. What did the Black students then say? Radicals? No, they were not satisfied with that. I should now like to tell the hon member that he should go back to Johannesburg and speak to those students. He should tell them that the State pays for a large part of their training, and that it is time they dedicated themselves to their studies and stayed in the country; not run away!

And their fathers pay tax.

They should not run away, because the State pays more than their fathers. The contribution of the State is far bigger.

The worst remark that the hon member made is to be found in his opening words.

†He started off by saying:

He went on by saying:

*That was all he had to say about it then. Has any other hon member heard anything further about their policy? That was all he said. I am waiting until next year to hear what their policy is! [Interjections.]

Then you are hard of hearing! [Interjections.]

†We have a policy and you can read my Hansard to see what it is. I challenge you to do that!

The hon member speaks of a short- and long-term policy. [Interjections.]

†Right. Discrimination. Does he know that there are White sisters working in Black hospitals?

Of course! [Interjections.]

Right. Now does the hon member know that there are Black sisters working in White hospitals?

Is that your policy?

Sir, that hon member did not have the decency to say thank you for the fact that the salaries are now on par. Is that not true? He knows about it!

What about the junior staff? [Interjections.]

That is typical of the hon member. He has no policy; he just wants to fight! He might as well forget about it, because he simply has no policy as far as health matters are concerned. [Interjections.] The hon member is really ludicrous. [Interjections.] He has no policy. No policy whatsoever! Then he wants to know from me which doctors are participating in the revolutionary organisations—he and his party who are friends of the ANC. I shall not tell him but I am very observant. I am glad the hon member asked us for our opinion of Black nurses who live on hospital premises. Does the hon member know that Black nurses have been living on the premises of the H F Verwoerd Hospital since 1948?

Is that your policy?

Of course. They stay there because there is a Black hospital as well. [Interjections.] I should like to tell the hon member something, although he and I both know it. The hon member quoted the Hippocratic Oath, and he knows the patient comes first. The patients prefer to be together. When I was guest professor in New York the patients of ethnic origin preferred to be together—those of Polish origin, those of Italian origin, etc.

Today the policy of the provinces, and one which I agree with entirely, is that patients who want to be together must be put together. They asked with whom they wanted to be, the Xhosas with the Xhosas, and so on. It is especially very important that language groups be kept together. Only in the observation unit are they mixed, and the hon member should himself know that it is cost effective having one cardiothoracic surgical unit, and not one at Baragwanath in Johannesburg, and one at the J G Strijdom Hospital. [Interjections.]

With that I have disposed of the argument of the hon member for Parktown, but since I am on this subject, I should also like to deal with all those other hon members. Let me just say that although Welfare and Population Development are two completely different things they are dealt with by the same Deputy Director-General and that is why they both fall under the same department. [Interjections.]

They are not the same systems.

That has nothing to do with it.

Population development is a completely new discipline, and is also a new academic discipline. I should prefer to give the hon member a private lecture on the subject later. He may as well come for a few classes.

†I should like to refer to the hon member for Pinetown. He referred to a document, but unfortunately misinterpreted this welfare policy report. I wish to stress that this document is neither an expression of Government policy nor a statement of a new welfare dispensation. It is merely a working document aimed at eliciting views and comments from a wide variety of bodies in the welfare field. In other words, it is a starting point for discussion, not an expression of policy. [Interjections.]

It is a bad start!

To date we have already received many replies with a variety of views and comments, and after these have been processed, the matter of a new policy and structure will be fully discussed with all major welfare organisations.

I should honestly like to thank the hon member for Pietermaritzburg North for his contribution. [Interjections.]

Haas Das.

That is not the constituency.

I should honestly like to thank him, because he really made a good contribution, and repeated a part of my speech. [Interjections.]

You pinched part of mine!

He used exactly the same words out of the report of the World Bank. I think it was a good part, and I think it was a good thing to do in order to reinforce it. It was exactly the same part of it. I think it was very good.

I never said one cannot eat haggis, lungs or tripe. I did not say that. I only said that, if the label says pork sausage or beef sausage or boerewors, then the ingredients must be of a certain kind. The hon member may eat it day and night. He is quite welcome to do so. It is all up to him. [Interjections.] I must say though, Mr Chairman, that he looks very healthy to me. [Interjections.] I believe he is doing very well indeed.

The hon member for Edenvale made some very good points. That I must admit. There is at present an interdepartmental committee, established in collaboration with private welfare bodies, and we are at the present moment investigating all facets in relation to the preparation for retirement by people of all population groups. That is the one important point.

Secondly, I should like to point out that we will have the welfare pensioners for ever. We do try, nevertheless, to get them to be economically active, as the hon member for Paarl also said. This is an aspect to which we will be paying constant attention in future. I am sure the hon member for Edenvale will be very delighted to hear that we are actually dealing with that very problem at the present moment.

That then, Sir, I believe, takes care of the health policy of the PFP. Let us leave it at that.

*That brings me now to the hon member for Pietersburg. Firstly, I should like to thank him very sincerely for his kind words to me. It was really kind of him, and I certainly have a great appreciation for it. It is true that we have known each other for a very long time. It is also true that he was an excellent student in his day. His contribution was very good as well.

Next, I should like to refer quickly to a few points which I believe will also be of use to the hon member. He referred to the case of the outpatients in the Pietersburg Hospital. I have been informed that it is a matter of one or two cases a week, and that the province for that reason cannot add on a separate facility in these times. The hon member also mentioned the ex gratia payments that were being made to the Black areas. That money was previously paid by the administration boards, but because they are no longer there it now has to be done by someone else. That is why we are doing it at the moment. I think that answers the inquiry made by the hon member for Pietersburg.

He also spoke about the high cost of medicines. Other hon members also referred to that. I said—and I think the hon member may have misunderstood me in that regard— that the costs of medicines were high, but that they were not as high as the costs of inflation. Furthermore I said that the cost of medicines was high for several reasons. This also has a bearing on the argument which the hon member for Stilfontein raised. One of the reasons why the cost of medicines is so high is because the basic components have to be imported. Because of the low value of the rand it has of course become considerably more expensive to import those components. In fact we have to pay for them in American dollars. A second reason for medicines being so expensive—and this is a reason which is causing a great deal of concern—is that the American companies who have subsidiaries here in South Africa, pay their workers tremendously high wages because they do not want to unleash a dispute with their workers. This is of course a major problem. The wages which those companies pay, are unrealistically high. Our internal companies are suffering as a result.

A further important statement I want to make is that I have already given the Pharmacy Board official instructions to investigate the high cost of medicines. I believe that that should satisfy the hon member for Pietersburg. Furthermore I should like to refer him to the Press statement I made on 24 March this year in connection with ambulances. In that statement I said that we had the previous year already given the advisory committee on health matters instructions to look into the question of ambulances, and, if necessary, to draw up regulations pertaining to it. I am very pleased that the hon member Dr Vilonel pointed out that our country also had very good ambulance services—not only bad ones. I believe that that takes care of the matters which I had to discuss with the hon member for Pietersburg. Of course the matter concerning the regional services councils has not been disposed of yet.

Since I am discussing this matter now, Mr Chairman, I might as well say right now that the problem of the classification of the work of this department into own affairs and is something we are working on. However it falls under the jurisdiction of the hon the Minister of Constitutional Development and Planning. [Interjections.] Yes, that is the case, since it is of course a provincial matter. Therefore I do not want to say now that I have no interest in the matter. I am intensely interested in it. I also have a great interest regarding it. I should just point out however that hon members cannot get angry with me about a portfolio which is not mine. Another hon Minister must be upbraided about it. A decision in this regard will be taken shortly. Hon members will understand of course that it is a decision which has to be taken very circumspectly.

The hon member for Germiston District spoke very well about the role women play. I have very great appreciation for it. She also spoke about the problem of the elderly.

I want to associate myself with that because I think we must indeed look after the elderly people in our society. Our present policy as regards care of the aged has already been laid down. It is to keep the elderly in society for as long as it is practicable. There are already many auxiliary shemes in existence in order to promote this policy, and further subsidies do not appear to us to be necessary at this stage. Foster parents receive allowances to ensure the care of foster children. If the allowances are insufficient, the foster parents can always make representations.

I should now like to come to the hon member for Durban Point. The hon member is a very seasoned politician. In fact he is so seasoned that he thought he was going to get away with something here today. [Interjections.] Hon members will remember that he said that he was angry with me concerning certain letters which had apparently been passed on.

Yes.

As a matter of fact, what did the hon member actually call it? I know he called it something. [Interjections.]

Shuttles.

Yes, that is right. Now I ask the hon member for Durban Point whether that particular letter was not about the means test.

It concerned World War I veterans.

Right.

*The point was that one of those letters dealt with the means test for war veterans, and it had been sent back and forth so that we could change the test. It was in fact changed this year, and the hon Minister of Finance announced it. It was also indicated in his letter.

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

No, I have no time now. The hon member had his turn. [Interjections.]

Your letter refused him. [Interjections.]

Yet the matter was subsequently cleared up. How could we tell him in advance what we were going to do in Parliament? [Interjections.] After all who could expect that?

Of course, you made use of…

Yes of course. The hon member would have done the same. The fact of the matter is that we now have all the veterans’ votes. [Interjections.] Now we have the votes, whereas the hon member’s party would have had them.

*I now want to make an important announcement concerning military pensions. The military pension scheme has been reviewed in its entirety and now makes provision for the following: The replacement of the existing two-tier pension structure by a three-tier structure, based on academic qualifications, ie: Those with a degree, R1 000 per month; those with Std 10 R750 per month; and those with a lower qualification than Std 10, R600 per month. As a result all existing military pensions will therefore be increased by between 11,59% and 19,5%.

To bring about parity, there is a difference in the benefits payable to the separate population groups. A new allowance for serious disability is payable where the degree of pensionable disability is 80% or more, and a pensioner is then dependent mainly or entirely upon the help of a second person. The aforementioned benefits are being introduced from 1 October 1986. The total cost of these improvements in military pensions will amount to R3,9 million for the 1986-87 financial year.

I think everyone will be glad to hear about these new improvements. I am especially grateful that we could do it in these times, when one cannot be extravagent with money.

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

No, Mr Chairman, I do not have any time for that. The hon member can write to me. [Interjections.] I have already spoken to the PFP. I am not speaking to them any more. [Interjections.] I have finished speaking to them. The hon member can now write to me.

I should now like to turn to the hon member for Brits. I think he made an excellent contribution and I should like to congratulate him. The hon member spoke about health. [Interjections.] Mr Chairman, there is someone on the opposite side who is speaking incessantly. I do not know who he is, but would you please deal with him? [Interjections.]

The point that I want to make is, that when we discuss medical practitioners who do their own dispensing, I want to tell this Committee so that everyone will know about it… [Interjections.]

Order!

Thank you, Mr Chairman, that is appreciably better. [Interjections.]

The Competition Board is looking into the situation of dispensing by doctors and pharmacists, and I expect their report within the next few months. [Interjections.] I think this is a very important aspect, which has to be looked into. [Interjections.]

The hon member for Middelburg made a very solid contribution on pensions. It is very clear to me that he knows all about pensions, and he made it obvious. [Interjections.] There are a few points to which I should like to react. [Interjections.] Since 1978 public pensions have been increased every year to the tune of … [Interjections.]

Order! I want to ask the hon members of the PFP to please speak more quietly. [Interjections.] Order! I want to ask the hon members of the PFP to please make less noise!

There is a constant muttering here. [Interjections.]

Order! Would the hon member for Berea please stop arguing!

Mr Chairman, I am arguing with the hon the Minister, and interjecting, and I am entitled to do that. [Interjections.]

Order! When I ask the hon member for Berea to please stop making interjections …

Mr Chairman, on a point of order: Is there a new rule that one cannot make interjections in this House?

Order! If the Chairman of the House orders that no interjections be made either from the whole House or from a certain section of the House from which continual interruptions are coming, then that order applies!

Mr Chairman, is that now your ruling?

Order! Of course it is the ruling! [Interjections.] The hon the Minister may proceed.

As I was trying to say, public pensions, bearing in mind the availability of money, have been increased every year since 1978 in order to try to compensate for the dwindling purchasing power of money. However, it is not linked to the rate of inflation. We shall never be able to afford pensions that will satisfy everybody.

The second point I want to make with reference to the speech made by the hon member for Middelburg is that the resignation figures to which he referred, were for the public service as a whole and were not confined to this department alone. I just wanted to make these few points clear to the hon member.

The hon member for Rustenburg made a valuable contribution concerning the question of the occupational hazards Whites in the mining industry have to contend with. We must realise, though, that those workers are in a privileged position. I think it was a good decision of the Cabinet to entrust the inquiries into the dangers to this department and that—as the hon member correctly indicated—the Workmen’s Compensation Commissioner has to deal with the administration of the payments as the Nieuwenhuizen Report recommended. I am very glad that we have someone such as the hon member for Rustenburg, who is an expert in the sphere of occupational diseases.

I want to refer to the hon member for Worcester—he is not here at present. He is probably administering medicines. [Interjections.] I shall therefore reply to his speech later.

The hon member for Wellington made a wonderful contribution on the rural foundation, and I am very grateful for it.

A few hon members spoke with appreciation about the nursing profession, and I want to corroborate this. We have a shortage of nurses, but I think that the new salary structure and adjustments and the parity differences which are going to be abolished, will do a lot to eradicate the shortage.

The hon member for Germiston District thanked Sister Van Coller for her work in Parliament. I think it is fitting that we all express our appreciation for this sister of the Clinic Service. [Interjections.]

It is with great gratitude that I think of the other health professions. On this occasion I want it placed on record that there are many statutory boards associated with this department, and I do not think they always receive our gratitude. I should therefore like to say that the National Health Policy Council functions very well. The hon Ministers of the Ministers’ Councils and the MECs of the various provinces have representation on this National Health Policy Council and I thank them for their work. There is also the Health Matters Advisory Committee, the Afrikaanse Geneeskundige en Tandheelkundige Raad, the South African Nursing Council and the South African Pharmaceutical Council as well as the Council for Social and Associated Workers, the Dental Mechanicians Board, the South African Associated Health Services Professions Board, the South African Welfare Council, the South African Medical Research Council, the Central Council for Medical Schemes, the Medicines Control Council, the National Advisory Board on Rehabilitation Matters, the National Air Pollution Advisory Committee and various disaster funds such as the Disaster Relief Fund and the South African Defence Force Fund. I should like to extend my heartfelt thanks to them all. This list represents 560 people, who do their work without receiving any salary for it.

I want to get back to the hon member for Stilfontein concerning the question of generic dispensing. I should tell the hon member that generic dispensing and generic subsitution are not all that simple. It is a matter of therapeutic equivalence and not generic equivalence as such. There are only two countries in the world who practice generic substitution, and they are the USA and Canada. It is true that money can be saved in that way, but then it must have a therapeutic equivalence. If we were to apply generic substitution to all medicines we would save a maximum of R19,9 million.

The Medicines Control Council is at present compiling a list of therapeutic equivalences among generic medicines. Once we have this list we shall look into the matter again. It is true that we have to examine the cost of medicines, but I have already told the Committee that I have officially instructed the South African Pharmaceutical Council to look into the cost of medicines in its entirety, and we expect their report soon.

I should like to thank hon members on this side of the House for their sturdy contributions. I should now like to refer specifically to the speech made by the hon member for Witbank. I think that the hon member made a very important point when he said that we would need the empty hospital wards one day because the people of South Africa were getting older and older. One of these days we are going to have a very large number of infirm aged and then we are going to need those beds. Furthermore I am glad that the hon member referred to the Year for the Disabled and I am also glad that he spoke about it very positively. I shall follow up the other points that he mentioned with him personally.

It is a great pleasure for me to be able to say, moreover, that we are very thankful for the improvement in State pensions announced by the hon the Minister of Finance, which I shall not repeat now. What is very important is that a sliding scale has been built in—I think the hon member for Durban Point will like it—which I think is very good. I think the increased State pensions is going to bring about a great improvement for many people.

Then, too, I should like to thank the hon member for Randfontein for his excellent contribution in the sphere of population development. He summarised it very well, and the hon the Deputy Minister also followed it up very well.

I think that I have referred to all the hon members now; I do not know if I have left out an hon member. If I have omitted to mention an hon member it does not mean that I did not think that he had made a good contribution; on the contrary, I think that except for a few who made very weak contributions, everyone made a good contribution. [Interjections.]

I have thanked the hon member for Pinetown. I have not thanked the hon member for Paarl yet.

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

I shall reply to the question as soon as I have thanked the hon member for Paarl, if there is any time left.

I turn to the hon member for Paarl. He is the very important chairman of the Joint Committee on Pension Benefits. I am very thankful that he has shouldered that burden. They have already made a great deal of progress in their task, and the hon member gave us some very important new information here today. I should like to thank him and the members of his committee and tell them that I hope that we shall receive their report soon, and that we shall be able to implement it to the advantage of all the people of South Africa. I like the principles which they stated; they are sound principles. One of those principles is to allow as many people as possible to earn their own pensions. The hon member knows as well as I do that there are many people whom we shall always have with us, and I am referring to the social pensioner. We shall consider the matter of parity, but again it is a question of the availability of funds and, as the hon member for Paarl pointed out, it will require enormous contributions from the State to attain that parity quickly.

The hon member for Worcester spoke about a hospital. [Interjections.] At the moment we are taking a look at that hospital, and we shall put it to other uses as soon as it has been restored and we have completed the investigations. I must admit that it is not quite finished at this stage.

I shall now answer the question of the hon member for Hillbrow.

Mr Chairman, may I ask the hon the Minister to clarify his department’s policy with regard to what appears to be a dispute between doctors and pharmacists concerning the doctor’s right to dispense medicine?

The hon member for Hillbrow’s question is a very good one. We are disturbed by the growing feeling of animosity between pharmacists and doctors. I have frequent discussions with both groups. At the moment, the Competition Board is looking at the whole problem because, as the hon member will appreciate, the question which needs to be looked at here is the lack of competition in the whole system. We are awaiting their reply. Following upon that—I want to stress this again—the South African Pharmacy Board is looking at the overall cost of medicines in South Africa. I think the hon member asked a very good question, and we will keep him posted.

Mr Chairman, may I ask the hon the Minister whether he wanted to tell us anything further in connection with the explosion at a Russian nuclear power plant, the nuclear problem and so on?

I am very glad that the hon member asked that, but before replying to him, I should very much like to thank the hon member Dr Venter here for her contribution. It is always interesting and instructive to listen when an hon member is discussing his or her field. She speaks like a professional. I enjoyed listening to her, and I know that she is going to make a great contribution to the new welfare strategy of the Republic of South Africa.

The leak at the Russian nuclear reactor was cause for concern for all of us who know about the possible effects of radiation. I have worked in that field myself. The question therefore is: What is the present situation in South Africa?

Besides the critical risk analyses concerning the design, construction, running and maintenance of a nuclear power station, the Atomic Energy Corporation requires an emergency plan from the respective licencee in South Africa, which will become operational with any excessive release of radio-activity during a radiation accident. The emergency plan must be practised regularly and must be demonstrated to the Atomic Energy Commission by means of an imaginative accident scenario at least once a year.

Environmental monitoring of any possible release of radio-active material is constantly done by Escom and the Atomic Energy Corporation, so that no release however small, can occur unnoticed.

Another important aspect for this department is that the functional rationalisation of radiation control has now progressed to such an extent that I can make this announcement, which was also singled out to a certain extent in our annual report.

Some far-ranging attempts have been applied over a very long period of time to transfer the control over radio-active nuclides from the Atomic Energy Corporation to the Department of National Health and Population Development. With such functional rationalisation it has in fact been envisaged to bring together all the multi-disciplinary facets of radiation protection, concerning both the electromagnetic and the acoustic spectra and radio-active nuclides under one roof. The elimination of duplication and the attendant saving as far as expert manpower, expenditure and sophisticated apparatus is concerned, as well as the promotion of a more effective controlling function which will arise from the effective coordination of the functions and legislation has been emphasised on various occasions.

A lack of manpower and facilities has always handicapped the department in bringing about the functional rationalisation concerned. More recently the department has attained remarkable success in this regard and the necessary expert personnel has been recruited for this purpose.

Section 50(2) of the Nuclear Energy Act, 1982 states that the State President may by means of a proclamation in the Gazette,transfer control over radio-active nuclides, which presently falls under the AEC, to a Minister. Two days ago, on 30 April 1986, the said proclamation was signed by the State President, in terms of which control over radio-active nuclides in South Africa was transferred to this department.

The expansion of the Radiation Control Division’s activities has now been combined in a National Radiation Control Unit by means of integration of the control on electronic radio-active products which on the one hand produce ionising and non-ionising radiation, and—this is important—radio-active nuclides on the other and in so doing a new era in radiation control with new responsibilities and other priorities is being ushered in.

In conclusion I should like very much to express my gratitude to the Director-General, Dr Retief. This morning I have already mentioned the Deputy Director-General, Dr Van Rooyen, who will be retiring one of these days, and the very good work which he did. I also mentioned the other Deputy Director-Generals who were present there. With such a team in the top management and with the worthwhile contributions which have been made in this debate today, I look forward to a good year for this department and for welfare, health and the population development of all members of our population in South Africa.

Vote agreed to.

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

House Resumed:

Progress reported and leave granted to sit again.

Mr Speaker, I move:

The Bill contains amendments to the following Acts, ie the Insurance Act, 1943, the Pension Funds Act, 1956, and the Stock Exchanges Control Act, 1985.

The first of the proposed amendments to the Insurance Act provides for an extension of the Registrar’s powers to cancel the registration of an insurer. Existing powers authorise the cancellation in the event of an insurer having ceased to carry on insurance business or having failed to start doing business within a reasonable period after registration. They do not, however, authorise the Registrar to cancel a registration if an insurer, after registration, deviates from the basis on which he indicated, prior to registration, he would be conducting his business. Nor do they authorise him to initiate deregistration measures in the event of an insurer deciding not to carry on actively doing insurance business. In the latter case the owners of the insurance company would normally want to retain the registration because the right to carry on insurance business has commercial value, adding to the sale value of the company. The registration acquires commercial value as a result of the circumspect screening which precedes the granting of registration. Purchasers are prepared to pay for this because it provides back-door access to the industry in a manner which side-steps the preregistration screening. Trading in registration in this manner, however, is seen as undesirable and not in the interests of the public.

The proposed extension of the Registrar’s powers will enable him, in both the cases I have mentioned, to prohibit the insurer from issuing new policies and, when liability under existing policies has expired, to cancel the registration.

The second of the proposed amendments to the Insurance Act provides for more stringent conditions for the recognition of outsiding premiums as an insurance asset. In the case of short-term and compulsory third-party insurance, a premium outstanding for six months can still qualify as an insurance asset. The proposed amendment will reduce this period to two months.

The third of the proposed amendments to the Insurance Act provides for more stringent requirements in regard to the transmission, to insurers, of short-term insurance premiums collected by intermediaries. The existing requirements for transmission of the premiums are determined by section 20bis of the Insurance Act and boil down to the fact that the intermediary (a) must transmit the premium to the insurer within 14 days of receipt or (b) must pay the premium forthwith into a separate trust account and have it transmitted to the insurer not later than 60 days after the end of the month in which the due date of the premium falls or (c) secure the premiums owing to insurers in the form of a banker’s guarantee and transmit that premium to the insurer not later than 60 days from the end of the month in which the due date of a premium falls.

Initially the amending Bill provided for the total abolition of the control measures, but the Standing Committee on Finance decided against it. Instead, the committee proposes that (a) in the case of trust account and banker’s guarantee procedures, the period granted to the intermediary for the transmission of the premium be reduced by 30 days and (b) the transmission within 14 days of receipt by the intermediary be abolished.

Since the insurers and intermediaries support the standing committee’s proposed amendments, I am prepared to accept them. If it should become evident in practice, however, that they do not furnish the necessary solutions, attention will again have to be given to the matter.

A new basis for the determination of the amount of the banker’s guarantee is also being introduced, thus more adequately securing the intermediary’s debt to the insurer.

The fourth proposed amendment to the Insurance Act makes provision for the greater protection of debtors against exploitation under so-called conditional transactions. A conditional transaction is one in which it is a condition that an insurance policy be taken out. A money loan would, for example, be a conditional transaction if the money lender were to make it a condition that the debtor should take out a life policy in order to secure the debt.

At present conditional transactions are prohibited, but exceptions are made in cases where it is reasonable, for securing the debt, to require a policy and the nature of the policy and the insured amount are reasonable for such purpose. Where a new life or home service policy is required, the proposed amendment aims at making it clear that it is unreasonable to require the insured sum to be larger than the amount of the debt, or for the scope of the risk to extend beyond the risk of death or disability of the debtor.

The fifth proposed amendment to the Insurance Act aims at enabling the Registrar to exercise more effective control over access to the insurance industry. Where access to the industry is obtained by the purchase of an existing insurer, or of a significant interest in such an insurer, at present the parties to the transaction need only report the transaction to the Registrar. The proposed amendment will now compel them to obtain his prior approval for the transaction.

The sixth amendment relates to the distinction that may be drawn between one life policy and another in regard to the provisions and conditions of the policies. An insurer may, with the Registrar’s consent, draw such a distinction, and the Registrar would grant approval if the distinction could be justified on actuarial grounds. The proposed amendment will abolish the need to obtain the Registrar’s approval, but the insurer would only be able to draw such a distinction if his valuator has satisfied himself that it is justified on actuarial grounds.

Without lowering standards, the proposed amendment will simplify and facilitate the administration of the relevant legal provisions.

The remaining amendments to the Insurance Act are of a regulatory nature and do not involve any important changes in principle.

†I now come to the amendments to the Pension Funds Act. The first of these amendments relates to the valuator’s triennial report on the financial condition of a registered pension fund. The proposed amendment will appreciably expand the scope of the matters which the valuator has to cover in his report. However, he will no longer be required to give his opinion on the question of whether the Fund is in a sound financial condition. Instead, he will have to furnish a comparison of the actuarial value of the Fund’s assets with accrued liabilities and, in the event of a deficiency in assets, report on its causes or probable causes and the steps taken or recommended to eliminate it.

The second amendment relates to a pension fund which has furnished the Registrar with a return which discloses a deficiency in assets. The proposed amendment requires such a Fund to submit, within a period of three months, a scheme for approval by the Registrar, setting out the arrangements made for eliminating the deficiency. The scheme must be accompanied by a valuator’s report on the scheme. The new requirement will enable the Registrar to exercise more effectively his supervision of the financial condition of pension funds.

The third of the proposed amendments relates to loans granted by a registered pension fund to its members. Such loans are presently restricted to housing loans which are secured by a first mortgage over fixed property, or a pledge of the member’s pension benefits, or by both mortgage and pledge.

The amount secured by the mortgage may not exceed 75% of the market value of the property. The proposed amendment will increase this percentage to 90%, which may be further increased to 100% if the amount above 90% is covered by an irrevocable guarantee given by the member’s employer. The increase to 100% was proposed by the Standing Committee on Finance. I find it acceptable because new loans to members will have to be of the decreasing kind and redeemable in equal payments over a period not exceeding thirty years. This relaxation of the present restrictions should make a significant contribution towards the financing of the housing needs of the lower income groups of our population.

The proposed amendment also requires that new loans be granted at interest rates which are not lower than those prescribed by regulation. The prescribed rates will be market related thereby ensuring that the yield on the Fund’s investments in mortgages will, to the benefit of all the Fund’s members, be kept at a market related level.

The fourth amendment empowers the Registrar of Pension Funds to declare, with the Minister’s consent, a specific practice or method of conducting business as “irregular” or “undesirable”. This power corresponds to that which the Insurance Act confers upon the Registrar of Insurance.

The last amendment to the Pension Funds Act provides for a doubling of the fines for contraventions of the Act. The amendment was proposed by the Standing Committee on Finance. I have no objection to it. The proposed amendments to the Stock Exchanges Control Act are of a regulatory nature and do not involve any changes in principle.

Second Reading resumed

Mr Chairman, what we have here is an omnibus Bill which, in fact, covers three different institutions. It is a Bill which was passed through the standing committee with amendments.

There are a number of important points in connection with this Bill which I should like to discuss with the hon the Minister of Finance. The first one is that this Bill shows how difficult it is actually to implement philosophical concepts like those of the free market system, free enterprise, and so forth in practice. These are the things we are dealing with in this Bill. One of the problems is that we sometimes get confused between those terms. We have, for example, in this Bill the question as to what kind of access one should allow people to have to a market. We have had a situation in South Africa where an insurance company was licensed as an insurer but did not want to use it, but at the same time they did not want to get out of the insurance market because that registration actually has value. For that reason we have had in the past this trading in things like bank licences and insurances licences. In terms of this Bill, the Registrar now has the right to deregister an insurer under certain circumstances, and I think that is a good thing.

What is also important is that clause 5 of the Bill specifically prevents people coming in by the back door. What one sometimes finds is that, if people cannot meet the requirements that are laid down by the Registrar to start a new company, they try to buy a licence which is not being used at the moment and so come in by the back door. That problem is also covered by this Bill.

One of the things we have to ask ourselves is whether we can leave it to the market only to organise financial institutions and financial transactions. Here I am specifically thinking of the question of premium payments to insurance companies. The hon the Minister will recall that in the original Bill, clause 3 sought to scrap a certain provision in order to speed up by legislation the intermediary getting the premium to the insurance company. I think the hon the Minister will agree that that did not work too well. The original idea was to leave it to the companies and to the intermediaries. The question that we as legislators have to face, however, is whether one can in fact do that. What happens is that the broker takes the money and begins to use it almost like overdraft finance. From the point of view of the person who is paying the insurance premium, this premium is paid in order to reduce risk. He does not actually pay it to an intermediary so that he can have risk …

What is so funny?

What is so funny is that I know what sometimes happens, namely that people sometimes use this money instead of overdraft finance. We experienced exactly the same thing in the travel industry as the hon the Minister in charge of Land Affairs will remember as he sat on that committee. The travel agents were actually using their clients’ funds to help finance their businesses rather than using overdraft finance. [Interjections.]

We must ask: Do we just leave it to the intermediaries and the insurance companies. One cannot. In this particular Bill we lay down regulations that have to be complied with. One might say that this is impinging on the free market system, but that illustrates that one has to have a balance between protecting consumer interests and allowing the market to find its own solution.

We have a similar situation with conditional transactions, which is covered by clause 4 of the Bill. We would all agree that conditional selling is a bad thing, but if one looks at what happens in practice, one finds that there are situations when it is in fact justified. I think of participation mortgage bonds in this regard where one grants a man a bond and one then makes it obligatory for him to take out insurance to cover that property. It is not to protect one’s own interests but to protect one’s client’s interests, because he is investing money in that property and one obviously wants to make sure that the right insurance cover has been obtained. The key question in this regard is whether the cost of the insurance is reasonable, because this is something that can be exploited. Here we leave it to the discretion of the Registrar to determine what a reasonable cost and reasonable conditions are. I think that that is fair.

What I am trying to point out is that it is easy to talk in terms of principles, but when one actually has to implement them in the day-to-day running of the financial affairs of South Africa, it becomes very difficult.

Clause 9 of this Bill deals with pensions. It is not often I get the opportunity to talk on pensions twice in one day, and I therefore welcome it. What we have here, is a clause which extends the financial conditions which have to be reported on by a valuator. I think that is very, very important because there has been a tendency in the past not to watch pension funds perhaps so closely as we should have done. After all, when it comes to pension funds, it is easy to promise a man something 20 years hence without really having to worry about funding it now. Then one worries about what is going to happen in 20 years’ time. We saw this particularly in the United States in such companies as Lockheed Chrysler. At one stage, Chrysler’s unfunded pension liabilities were greater than the total assets which the company in fact had.

The end result in respect of a pension fund really depends upon a number of assumptions, the most important of these being the contribution level and the salary level, particularly because we tend to use final-salary pension schemes; no one can really judge what the inflation rate is going to be. Then, of course, there are one’s investment returns. Those assumptions are very important.

Prof Harold Winkelvoss of the Wharton School, who is a pensions expert in the United States, once estimated that a change of 1% in one’s wage assumption changes one’s cost and liability structure by 13%. A change of 1% in one’s investment return assumption can actually change one’s costing and liabilities by up to 25%. Therefore it is very important that the pension fund valuators should not only value it, but that they should also spell out what the assumptions are. I am very pleased to see in this Bill that they are in fact forced to spell out what their assumptions are. Obviously, if one has spelt it out and certain things are wrong, then they have to be corrected, and I believe the Bill actually gives the Registrar sufficient teeth, where a pension fund is not in a sound position, to take steps in order to put it on a sound footing. They have to tell him what they are going to do. They have to spell it out and if he is not satisfied with it, he can amend it. I think that that is a particularly good provision.

In fact, I should like to see us go even further. I believe we should consider that a company—particularly quoted companies— should have to append a copy of the actuarial valuation of its pension fund to its accounts. I think this is something which is of interest to the public because it obviously affects the future viability of the company.

In clause 11 we are allowing pension funds to advance up to 90% of the value of a house to members of the pension fund or their dependants. Previously the figure was 75%. Under certain circumstances, it may in fact be increased to 100% provided that the employer will guarantee the additional 10%. I think this is a particularly good measure, although it did exist previously. One finds that other Third World countries also tend to do this. I am thinking of Brazil, Malaysia and Singapore. I should just like to make the point with regard to pension funds that, particularly as we are trying to encourage people to belong to pension schemes, it will be useful if we can actually show people that when they contribute their money they will now be deriving some benefit from it in the form of money advanced on housing. This is particularly useful in a country like South Africa which has a large Third World element. In fact, from the economic point of view, I would suggest that it is far more useful than chasing up Stock Exchange share prices or building large buildings which look very nice but which in fact do not add all that much to the productive capacity of our economy.

The problem is, of course, that if one lends out money on housing, then the rate must be market-related, otherwise one is going to prejudice those people who do not borrow. In this Bill we provide for a prescribed rate of interest which, I assume, will be market-related.

Mr Chairman, there is one thing relating to pensions which does not appear in this Bill, and which I should like to raise with the hon the Minister of Finance. We merely look upon three particular types of pension instruments. We look upon a pension fund. We look upon a retirement annuity. We look upon provident funds. If the hon the Minister should refer back to the 1980 interdepartmental report he will notice they thought then that provident funds were not a legitimate retirement providing instrument, and they suggested that we look at what they called special frozen accounts. What I want to ask the hon the Minister of Finance in relation to this aspect is the following. Has the time not come in South Africa that we take a more flexible approach towards funding one’s retirement?

What I am thinking of is the following. Let us take those special frozen accounts and widen them a little bit. Say someone wants to provide for his retirement, let him then do so by way of a number of instruments. Whether he invests his money with the Post Office or in any other way he gets the same tax consessions. What I like about that, however, is that that man has a greater flexibility. While he keeps his money sheltered wherever it is invested he enjoys the tax advantages that go with it. It has the problem, however, that it stops the accumulation of interests of wealth in a few financial institutions. If he withdraws his investment—something he could do in the event of unemployment or for some other reason—he loses the tax advantages. Then his money in fact becomes taxable.

Mr Chairman, when one thinks about it, it seems ridiculous that we give people money, that we grant them tax concessions in order for them to contribute to a pension fund to meet a particular contingency, and then, when they withdraw the money, we allow the first R1 800 to be free of tax. I must tell the hon the Minister that I do not quite understand why we do that. We might do it for an administrative purpose. I think though that when it comes to the question of encouraging people to contribute to pension funds and to keep their money in those pension funds, something like that becomes counterproductive.

Mr Chairman, I take it the hon member for Edenvale supports the legislation under discussion. He did not make that clear. If that is so, I thank him very sincerely for doing so. He nevertheless made a very substantial contribution here.

As usual!

Yes, that is how we have come to know him.

Mr Chairman, the Bill under discussion embodies amendments to the Pensions Funds Act, 1956, the Insurance Act, 1943, and the Stock Exchanges Control Act, 1985. I chiefly want to coniine myself to certain amendments to the Insurance Act.

The Registrar’s powers of cancelling an insurer’s registration in respect of a particular class of insurance undertaking are at present restricted to those cases in which an insurer has ceased to carry on with, or within a reasonable period after registration has failed to commence with that class of insurance undertaking. The present powers do not enable the Registrar to cancel a registration if an insurer fails to utilise the registration to carry on insurance actively. It does happen, for example, that the owner of an insurance company loses interest in actively carrying on with an insurance undertaking but, with a view to the commercial value of the right to carry on with the insurance undertaking, is not prepared to surrender the registration voluntarily. Therefore the registration acquires a commercial value as a result of the strict screening preceding the granting of registrations. It is in conflict with public interest for registrations to be traded in this manner, thus affording the purchasers backdoor access with a view to circumventing the strict screening for registration. The proposed amendment in this connection enables the Registrar to cancel a registration in such an instance.

The existing provisions for the remittance of premiums are regulated by section 20bisof the Insurance Act, and what this amounts to is that firstly within 14 days of receipt the intermediary must remit the premium to the insurer or—secondly—pay the premium into a separate trust account, and not later than 60 days after the end of the month in which the premium’s due date falls, remit the said premium to the insurer. Thirdly it can be done in the form of a bank guarantee, whereby it can be ensured that the premiums owing to the insurer are remitted to him not later than 60 days after the end of the month in which the payment of the premium falls due.

Initially, in clause 3, the amending Bill made provision for the total abolition of the control measures. After the Standing Committee on Finance had taken evidence, on the strength of the evidence obtained from the insurance brokers’ associations, including SAIBA and SAIA, the committee decided against that. Instead of section 20bis being repealed, it is to be retained, and amended in certain respects. In the case of the trust account and bank guarantee procedures the period granted to the intermediary for the remittance of premiums is being reduced by 30 days. The provision about the remittance within 14 days after receipt by the intermediary is also being abolished.

A new basis for the determination of the amount of the bank guarantee is now also being introduced, which will prove a better safeguard in regard to the intermediary’s debt to the insurer. Here I am referring to clause 3(c)(ii), which makes provision for such a guarantee to be equal to at least 20% of the premiums owed by such an intermediary to registered insurers in the past financial year, with a minimum of R100 000 instead of the present maximal amount of R250 000.

Certain objections and doubts were expressed by SAIBA, and I quote:

Unfortunately these alternatives were not acceptable to the standing committee. The reasons were, amongst other things, that I firstly could not understand why the increase in the amount of the guarantee should be regarded by SAIBA as clumsy legislation and as being in conflict with the idea of deregulation. SAIBA and SAIA made forceful and meaningful representations to the standing committee, specifically to convince it to retain section 20bis. Upon analysis of the data furnished by SAIBA, I find the tremendous power and concentration of the larger intermediaries to be really alarming. I find it even more alarming, and even strange, that financial institutions would not be prepared to issue guarantees in favour of intermediaries in whom they have the biggest possible interest. When banks are not prepared to issue guarantees, how can SAIBA expect these risks to be carried by the insured and by the insurers? The practice of intermediaries who make use of guarantee options on premiums of the insured who have not yet paid, thus financing the premiums of late payers, brings the question of the safeguarding of premiums to the fore.

The granting of credit by intermediaries via money they hold in trust is even more serious, particularly in present economic circumstances, in which many banks are concerned about the creditworthiness of their clients. I have no fault to find with intermediaries being prepared to pay the premiums of their insured, but then they must do so from their own funds, and not from the trust funds of the insurers.

During 1985 the office of the Registrar of Financial Institutions experienced problems with six insurers, problems relating to statutory solvability requirements. At present there are also further comments about certain of the larger insurers experiencing problems in meeting these requirements. I therefore cannot but come to the conclusion that SAIBA is trying to protect the interests of its larger members and that the real reason for this is, as they stated in their telex message, and I quote:

Here it is therefore chiefly a matter of the additional costs involved in obtaining a larger guarantee. The interests of the general public, and of the insurance industry in particular, should be taken into account here and should also have precedence.

In accordance with the shortened period of payment, which is now being proposed, at a given time intermediaries will have two months’ premiums in their possession. This consequently means 16,7% of the total annual premiums. I am therefore convinced that this new basis of 20% for the determination of the amount of the bank guarantee instituted for the better safeguarding of the intermediary’s debt to the insurer is the correct approach. That is why I also gladly support the legislation under discussion.

Mr Chairman, I do not want to elaborate at any length on the Bill under discussion. We support it. The hon member for Smithfield mentioned most of the things I also wanted to say.

I do, however, think it is fitting for me to point out at this stage what the director of financial institutions, Dr Burton, and his staff did in preparing this Bill for us and in supplying us with all the relevant information. I therefore feel I am quite correct in asking that the thanks of this House as a whole be conveyed to them. One finds great satisfaction in officials furnishing a service of this quality.

As far as the insurance aspects of the measure under discussion are concerned, I do just want to mention, in addition, certain of the submissions we received, amongst others from the Life Officers’ Association of South Africa, the South African Insurance Brokers’ Association, the South African Insurance Association, the South African Association of Consulting Actuaries, and also Legal and General, Volkskas and the Clearing Bankers’ Association of South Africa. It is really gratifying to receive so many memorandums from so many interested parties when certain pieces of legislation are being dealt with in the standing committee. Whether those submitting a particular memorandum are in favour of or opposed to the relevant legislation is, of course, neither here nor there. It merely affords those dealing with the legislation a better opportunity. For all the submissions we received—in regard to other legislation as well—we extend our sincere thanks to the Directors-General of the relevant departments and their staff for the extensive and important role they have played in this and for the exceptional way they have acquitted themselves of their task as far as this is concerned.

I also want to raise one important aspect, and this relates to the pension funds. The Bill under discussion amends three Acts; amongst others the Pension Funds Act, 1956. When a specific, registered pension fund’s financial position is not quite sound, the truth is that the Registrar has to be notified of the fact. In the memorandum to the Bill I have read a passage that really is gratifying, and I quote:

There is nothing as important as the fact that all financial institutions should be financially sound. This applies, of course, to pension funds in particular. I also want to emphasise strongly that the department and the hon the Minister must, under all circumstances, ensure that pension funds consistently remain on a sound financial footing.

There is the possibility that one may work one’s whole life long, throughout the years making pension contributions in conjunction with one’s employer, only to find when one retires, at the end of one’s career, that the company is bankrupt. It is good money that one has paid in, merely to discover that one is not going to get anything. That really is a catastrophe! A pension fund could rather be too strong and have too much credit than become insolvent. I therefore want to emphasise, on behalf of the CP, that one should always ensure that pension funds are strong and sound. We support the Bill.

Mr Chairman, like the hon member for Sunnyside I take pleasure in supporting this measure especially as some of the clauses contained therein—the hon member for Sunnyside also referred to this—concern the protection of the public whether in regard to their pension fund or their insurance. I was pleased to hear the hon member say that he welcomed the interest which companies in the insurance industry and others had in this particular measure. As the hon member listed them one realised that many institutions and associations appeared before the Standing Committee on Finance to discuss this particular problem. I think the hon member has confirmed what I have discussed with him on previous occasions, namely that the new system of legislation is far better than the old system.

The previous speakers have covered the Bill very adequately. However, there is one subject that I would like to raise in this connection and that is the whole purpose of insurance.

I would say insurance is really there to give protection to the person who is taking it out. As such it is extremely desirable that the premiums that such a person has to pay should be kept as low as possible. Unfortunately we find that there are many people who like to get in on the act and who try to bleed the system. There is one measure in this Bill—I think it is clause 1 or 2—which introduces greater control over the handling of the premium income between the customer and the insurer. As has been said, the intermediary could utilise this money to his own benefit if he could hold on to it for a while. The amended Act will give greater control over that money because, after all, insurance premiums have been arrived at by actuaries who consider the risk they are taking on the assumption that the premium is paid to the insurer as soon as possible. If someone along the line takes an unfair cut of it by holding onto and investing it for a while for his own benefit, it only follows logically that the premium should be higher. For that reason I am pleased that we have this measure before us.

We are living in a time where insurance premiums have increased considerably, and I know that the public is concerned about this. Any person with house or car insurance is very concerned about the high premiums and their increases. I would therefore like to spend just two minutes discussing this matter.

I believe there are too many people manipulating the system. Let us take motorcar insurance for example. Last year somebody ran into the back of my car and I had to have repairs done to it. I was told that I need three quotes. Believe it or not, but in this city a person from a panel-beating shop came around to my flat, looked at the damaged car—I must admit that he did a very thorough job in examining the damage—and then took out three different quote forms, filled them out for three different companies and stamped them individually. It was clear that there was a ring of panel-beaters involved and one of them got my job.

Why did you allow him to do it?

That hon member is quite right—perhaps I should have done something about it. I thank the hon member for pricking my conscience. However, I do believe that that was wrong.

A few weeks ago Time Magazine had this front page statement: “Sorry America, your insurance has been cancelled”. The article dealt with how people are exploiting the insurance system in the USA—especially public liability insurance. This has resulted in the average annual premium of an obstetrician in Los Angeles being as much as $45 000 per year. That of a neurosurgeon in Long Island, New York is about $83 000 per year. This article shows that the system is being exploited by all sorts of people, from the legal profession to panel beaters.

Mr Chairman, our time for this debate is very limited, so I will conclude by saying that I believe it is our job as legislators to make sure that the laws which we pass protect the public where they need to be protected. As this is the purpose of this particular measure, I welcome it.

Mr Chairman, to do justice to this Bill would, of course, take a considerable amount of time. I would need at least 20 to 25 minutes, but fortunately I do not have to do it justice because the hon members for Edenvale and Smithfield in particular have already gone through it in some detail. There are, however, a couple of points I would like to raise in passing.

The hon member for Amanzimtoti made the comment that insurance is there to protect the person who has to pay the premiums. I would suggest that the intention of this Bill is to protect the insured from the insurance companies. Considering what is going on these days in many insurance companies—not all of them—this is a very necessary measure. There is no doubt that the insurance business today should have a good look at its ethics. I was in the insurance business 30 odd years ago, and it seems that moral standards in this field are lower today than they were then. Of course, this could be because I left the business!

There are only two points I would like to comment upon. Firstly, I consider clause 1 to be very important in that it shuts the back door through which certain people register as insurance companies without undergoing stringent investigation and regulation. This excellent clause will stop a lot of shysters getting in on the business.

I think clause 11, which deals with pension funds, will be of considerable importance to the public. It allows the granting of bonds of up to 100% when suitable guarantees are provided by employers. I believe this will give certain employees who might otherwise not have been able to do so the opportunity to buy houses. In this day and age, I believe it to be vitally important that every avenue should be opened to those who are in any way able to buy homes.

This party supports the Bill.

Mr Chairman, I should like to thank the hon member for Edenvale and other hon members for their support for this Bill. The hon member for Edenvale made a very valuable and constructive contribution. We have come to expect this of him when he talks on finance and steers clear of politics. What could otherwise have been a very dry debate turned into something worth listening to.

One point I found particularly interesting was the hon member for Edenvale’s reference to the clash which obviously takes place sometimes between the market system and direct measures which are taken to protect the consumer. This Bill provides a very good example of what can happen in these circumstances. We thought the insurance industry would welcome it if we left the transaction between the insurer and the broker entirely to the market itself. As hon members pointed out, we subsequently found out that the industry would like to be disciplined and that they found security in the existing legislation. We therefore had to put the relevant clause back into the revised form of this Bill.

I think we should all take note of the message the hon member tried to give us. The South African economy which is peculiar in so many respects does not need an ideology as far as market systems or control systems are concerned. It needs a balanced approach to apply the right kind of tool for each problem. I therefore do not think we should ever try to box the people who play an important role in the economy as far as policies concerned, into any of these watertight schools of thought. I welcome the support of hon members with regard to this particular aspect of the Bill where we wished to achieve a proper balance.

However, I wish to point out once more that a very positive aspect of the parliamentary system that we use at present, was stressed by the way in which we were able to solve the problems that we were faced with concerning this Bill. This is particularly illustrated by the way the Standing Committee on Finance operates. I say this in spite of the fact that the hon member for Sunnyside opposes the new Constitution as well as the parliamentary system we use at present. The fact that we have this Bill before us, proves my standpoint.

*In particular I want to thank those hon members who are members of the Standing Committee on Finance and especially the hon member for Smithfield, who is the chairman, and the hon member for Yeoville, who is the vice-chairman, very sincerely for the trouble that they go to and the depth that they give to the debate when highly technical matters are discussed, such as those covered by this Bill. With all due respect to Parliament, I do not think it was possible in the past to give such depth to the investigations into such technical legislation as is now the case with this standing committee system. It is not possible to do so in an assembly like this. For that reason one can accept legislation like this far more confidently and implement it in practice.

†The hon member for Edenvale referred to a very important principle incorporated in this Bill, namely that the valuator of a pension fund will now, inter alia, have to report on what measures are to be taken to rectify a certain inadequacy he identified in the process of valuation. Not only is it an important principle as far as the pension fund is concerned, but I think it is also an important principle in management in South Africa, managing the affairs of South Africa from the level of authority. That principle is that we should place control and creative responsibilities on the shoulders of professionals to a much greater degree than ever before. In terms of the laws in this land they have to busy themselves with the soundness of the administration of funds etcetera.

*By that I mean that professional people in South Africa should play a far greater role in the control of funds. I hasten to add, however, that we shall then have to enter into discussions with the professions on a continual basis not only to have a shake-up of the ethical codes but also to make sure that the people who are involved in evaluating and supervising funds or whatever other function they perform will be properly qualified to do so.

Because of the confidentiality of certain aspects I cannot elaborate on them but I can assure hon members that it is not all that easy to attain this ideal in respect of certain individual cases. But in principle we would do well to take this matter further in a spectacular way.

†The hon member for Umbilo also referred to the fact that it is now possible for a member of a pension fund to obtain a 100% mortgage loan, if his employer guarantees 10% of it. This fact has, in my opinion, not received in the media the publicity or the recognition of the role this arrangement can play in South Africa that it really deserves. In this regard I want to refer to two points only. Firstly, hon members will remember that we had some problems in the past when there was a movement afoot to make membership of pension funds compulsory. We had to face strikes etcetera because it was difficult for those people who were not used to that kind of system to envisage getting their money back one day. If, however, it is possible for them to look forward not to getting their money back but to deriving some benefit from it in a shorter period of time, then in the first place it will not only help them to accept the system of a pension fund and to provide for their old age themselves, but it will also help them to achieve home-ownership as soon as possible. It need not be debated how stabilising a factor that would be in our society particularly.

As the Bible says, however, if one does the one thing, one must not neglect the other thing. That is the most important factor. We must promote housing and home-ownership through financing it by way of pension funds, but on the other hand we must not neglect the protection of the contributors to that pension fund in the sense that they may lose some of their assets. It is therefore important for us to achieve this balance and a fine degree of control over the funds.

The case the hon member made out for other instruments also to be used is fundamentally a good one. I think it is a good idea as long as we can resolve it in such a way that we do not open further loopholes for tax evasion. It certainly is something that we can take seriously, and we have taken note of the hon member’s point.

*I want to express my sincere gratitude to the hon member for Smithfield, and not only for his exposition of this particular Bill either, because it must have been clear to all interested parties that the hon member paid personal attention to this matter. Furthermore it must really be an indication to us that he and his committee went out of their way to achieve fairness in this matter.

It is not easy to reach consensus if one is going to deprive people of the right to lay their hands on a little more cashflow. It is not easy but I think we are being fair by requiring those amounts on their way from the insured to the insurer to be properly dealt with. I thank the hon member for his efforts in this regard which enabled us to deal with this matter in such a way today.

I should also like to thank the hon member for Sunnyside for his contribution and for the fact that he supports this Bill as well as for the fact that he showed courtesy to the Registrar of Financial Institutions and his staff. This is a well-deserved word of thanks and I am sure other hon members who were involved support the case which the hon member made out. I agree that pension funds should be strong. We need not debate that any further because we are unanimous on that score.

†I think we have taken note with a great degree of concern of the point that the hon member for Amanzimtoti made, namely that there are always people who take advantage of any system. I think we must strive to close as many loopholes as we possibly can. I do not have the time to devote to all the suggestions than we already have, but I have already requested the Registrar of Financial Institutions to go into further details, particularly as far as the coercive selling of policies is concerned in order to restrict that further. The hon member made an important point that we must take note of. I thank him for his support, and I also wish to thank the hon member for Umbilo again for his support.

Question agreed to.

Bill read a second time.

In accordance with Standing Order No 19, the House adjourned at 17h30.