NATIONAL ASSEMBLY
FOR ORAL REPLY
QUESTION NO. 166 (written 1042 transferred)
DATE OF PUBLICATION IN INTERNAL QUESTION PAPER: 04 SEPTEMBER 2009
(INTERNAL QUESTION PAPER NO. 14)
Questions Day: 21 October 2009
Mr M Waters (DA) to ask the Minister of Health:
Whether any medicines were destroyed in the past three years up to the latest specified date for
which information is available; if so, (a)(i) in which provinces and (ii) at which hospitals and (b) in
each case, (i) what type of medicine was destroyed, (ii) what were the quantities destroyed, (iii)
what was the monetary value and (iv) what were the reasons for the medicines being destroyed?
NW1209E
REPLY:
EASTERN CAPE
Yes
(a) (i) and (ii) In the Eastern Cape, at both the pharmaceutical depots and at all facilities
(b) (i) and (ii) All expired medicines are destroyed as per medicines controls regulations.
This is across the full range of medicines. In addition, the following items
were destroyed during this period due to changes in policy: Tetanus-
Diphtheria vaccine (full strength) was replaced by Tetanus-Diphtheria (½ st)
– the immunisation schedule had been changed and all available supplies of
the former needed to be removed in order to avoid (dangerous) incorrect
dosing. A total of 6,025 vials to a value of R137, 129-00 were destroyed.
(iii) the following table reflects the monetary value
2006/7 R 572,669.18
2007/8 R 837,010.93
2008/9 R 425,598.13
2009 to date R 214,089.87
R 2,049,368.10
(iv) As above – mostly date-expiry.
FREE STATE
(a) Yes, there was medication destroyed/disposed in the past 3 years in the Free State
Province.
(i) and (ii) The following table reflects the situation
INSTITUTION / OFFICE 2004/05 2006/07 2008/09
Boitumelo Hosp - 2,648.53 36,618.81
Botshabelo Hosp 115,173.81
Bongani Hospital
23,821.17 121,027.09 1,114,835.03
Diamant Hosp 8,273.69 23,192.31 55,861.84
Dihlabeng Hosp - 509.44 357,401.95
Elizabeth Ross Hosp - 70,446.23 24,245.16
Embekweni Hospital 258.30 7,834.06 39,411.03
Harrismith Clinics - 64,428.17
Itemoheng Hosp - 30,547.12 89,631.14
Jd Newsberry Hosp - 31,100.74 66,698.22
Katleho Hospital - 22,208.19 120,378.45
Lejweleputswa District Office - - 5,870,737.28
Mafube Hospital - 880.40 5,165.64
Mantsopa Hosp - 13,401.99 43,042.96
Medical Depot - 285,391.94 3,909,090.94
Metsimaholo - 47,846.08 270,263.73
Mmm 541,200.92
Mohau Hosp - 419,382.30
Moroka Hosp - 62,975.29 66,296.37
Motheo District Office - - 1,923,822.63
Nala Hosp - 114,121.23
National Hosp - 2,978.86
Northern Fs (Fezile Dabi) 158,276.79 133,588.55 229,700.69
Parys Hosp 200,766.44 305,846.64 165,350.88
Pelonomi Hosp - R 305,846.64 1,253,361.62
Phekolong Hospital 10,645.64 25,107.23
Phumelela Hospital (Cold Chain Broken) 14,805.77 R 10,645.64
Phumelela Hospital (Expired) - R 20,871.12 70,606.28
Phuthuloa Hosp - 41,633.37 311,493.24
Psychiatric Complex 16,683.67 5,300.95 39,571.30
Stoffel Coetzee Hospital 82,086.65 180,764.60 14,806.47
Thabo Mofutsanyana District - R 64,428.17 4,233,926.05
Thebe Hospital R 180,764.60 148,768.25
Thusanong Hosp - 11,317.12 44,001.12
Tokollo Hospital - 131,141.04 17,025.11
Universitas Hosp R 131,141.04 38,493.73 2,171,119.93
Winburg Hosp 5,104.80 R 38,493.73
Xhariep District Office R 5,104.80 R - 463,828.79
641,218.32 2,800,701.51 23,838,542.87
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2004/05 2006/07 2008/09
R R R
District Offices 163,381.59 198,016.72 12,722,015.44
R R R
Regional Hospitals 171,645.88 473,826.38 5,514,109.56
R R R
District Hospitals 311,295.65 1,913,195.59 1,693,326.93
R R
Medical Depot R - 285,391.94 3,909,090.94
R R R
646,323.12 2,870,430.63 23,838,542.87
Summary
Name Of District Office / Hospitals Value Of Exp Medication
District Offices
Thabo Mofutsanyana District R 4,233,926.05
Motheo District R 1,923,822.63
Fezile Dabi District R 229,700.69
Lejweleputswa District R 687,709.78
Xhariep District To Be Confirmed
Total District Offices R 7,075,159.15
Regional Hospitals
Dihlabeng Regional Hosp R 357,401.95
Mmm R 541,200.92
Bongani Hospital R 1,114,835.03
Boitumelo Hosp R 36,618.81
Psychiatric Hosp - Not Done
Total Regional Hospitals R 2,050,056.71
District Hospitals
Name Of Hospital Total Value
Newsberry Hospital R 66,698.22
Phuthuloha Hosp R 311,493.24
Itemoheng Hospital R 89,631.14
Phekolong District Hosp R 10,353.69
Phekolong Art R 14,753.54
Thebe Hospital R 148,768.25
Phumelela Hosp R 70,606.28
District Hospitals
Elizabeth Ross Hosp R24,245.16
Mantsopa Hospital R43,042.96
Botshabelo Hospital R115,173.81
Dr J.S. Moroka Hospital R66,296.37
Nala/Mohau/Thusanong R44,001.12
Katleho /Winburg R120,378.45
Metsimaholo Hospital R270,263.73
Mafube Hosp R5,165.64
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Tokollo Hosp R17,025.11
Parys District Hospital R165,350.88
Total District Hospitals R1,583,247.59
Total Exp Medication To Date R 10,708,463.45
Thabo Mofutsanyana
Expired Medication Disposed 08/09 Fin Year
Thabo Mofutsanyana District
Name Of Clinic Total
Bluegumbush R 47,763.22
Boiketlo R 41,370.30
Bolata R 34,830.21
Dinkweng R 11,522.43
Eva Mota R 63,060.94
Kopanong R 83,135.63
Makhalaneng R 62,640.82
Mahaig R 54,555.14
Makeneng R 36,263.67
Makoane R -
Malesoane R 61,432.63
Marakong R 55,677.17
Matsieng R 34,670.00
Monontsha R 34,618.37
Mphalatsane R 21,493.88
Namahadi R 39,760.15
Nthabiseng R 7,865.10
Paballong R 3,528.83
Phutaditjaba R 4,841.67
Qholaqwe R 44,015.49
Riverside R 15,889.18
Seka Mota R 30,678.90
Tebang R 15,061.25
Thabo Mofutsanyana District
Name Of Clinic Total
Thaba Bosiu R 19,259.73
Thabang R 7,078.08
Tina Moloi R 13,795.09
Tseki R 59,087.17
Tshirela R 45,410.83
Senekal Clinic R 36,861.26
Soetwater Clinic R 26,676.89
Marquard Mamelo Clinic R 246,703.93
Masebabatso Clinic R 248,393.51
Boitumelo Clinic R 32,850.62
Hlohlowane Clinic R 8,593.10
Meqheleng Clinic R 1,881,874.01
Ficksburg Store R 36,067.38
Phomolong Clinic R 4,116.33
Mphohadi Clinic R 645.17
Petsana Clinic R 8,223.77
Lindley R 306.15
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Bakenpark R 7,736.39
Dihlabeng Local Area R 9,117.71
Nketoana Hosp R 26,040.40
Rearabetswe Clinic R 28.18
Rosendal Clinic R 15,770.48
Bethlehem Clinic R 50,377.89
Arlington Clinic R 61,217.83
Clarens Clinic R 5,173.16
Bohlokong Clinic R 7,811.57
Reitumetse Clinic R 6,982.40
Bophelong Clinic R 130,564.07
Lesedi Clinic R 77,026.66
Warden Clinic R 32,806.82
Memel Clinic R 11,132.25
Vrede Clinic R 207,589.80
Vrede Ems R 1,953.68
Tsiame Clinic R 26,472.85
Manapo Mohau Clinic R 37,010.94
Harrismith Clinic R 38,494.97
Total Of Clinics Thabo
Mofutsanyana District R 4,233,926.05
Regional Hospitals
Name Of Hospital Total Value
Dihlabeng Regional Hosp R 357,401.95
Mmm R 541,200.92
Totals R 898,602.87
District Hospitals
Name Of Hospital Total Value
Newsberry Hospital R 66,698.22
Phuthuloha Hosp R 311,493.24
Itemoheng Hospital R 89,631.14
Phekolong District Hosp R 10,353.69
Phekolong Art R 14,753.54
Thebe Hospital R 148,768.25
Phumelela Hosp R 70,606.28
Elizabeth Ross Hosp R 24,245.16
Totals R 736,549.52
Grand Total R 5,869,078.44
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Motheo
Motheo District
Mantsopa Phc R 1,934.82
Mauersnek Clinic R 771.62
Boroa Clinic R 101,641.03
Manyatseng Clinic R 26,891.48
Houbhouse Clinic R 4,050.64
Ikaheng Clinic R 41,575.10
Excelsior Clinic R 31,968.70
Thaba Patswa Clinic R 14,655.51
Dewetsdorp 2,265.38
Qibing Clinic 2,515.25
Mafane Clinic R 22,325.27
Sediba Clinic R 555.57
Seadimo Clinic R 4,953.56
T/N Primary Health R 92,874.41
T/N Clinic R 20,302.40
Motheo District
Kgalala Clinic R 1,450.70
Tigeriver Clinic R 29,955.78
Tweefontein Clinic R 21,786.37
Gaongalelwe Clinic R 108,179.08
Phetogo Clinic R 6,292.97
Botshabelo Clinics R 1,154,469.87
Gateway Clinic R 11,967.70
Poly Clinic R 128,825.77
Linolia Old Age Home R 99.71
Kagisanong Clinic R 3,383.39
Langenhovenpark R 11,412.92
Bloemspruit R 3,038.02
Batho Clinic R 4,936.12
Freedom Square R 9,531.62
Tlc R 944.50
Opkoms Clinic R 3,774.79
Bainsvlei Clinic R 3,785.09
Thusong Clinic R 29,869.18
Mmabana Clinic R 809.49
Bayswater Clinic R 2,598.95
Chris De Wet Clinic R 5,088.32
Westden Clinic R 7,783.38
Fichartpark Clinic R 2,575.79
Mcdc R 1,982.38
Total R 1,923,822.63
Mantsopa Hospital R 43,042.96
Botshabelo Hospital R115,173.81
Dr J.S. Moroka Hospital R 66,296.37
Total R224,513.14
Universitas Not Done
Peolonom Not Done
Psychiatric Not Done
Total R 2,148,335.77
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Fezile Dabi
Name Of Clinic R-Value Of Expired Medication Clinics –Ombudsman
Pax Chc Viljoenskroon R 64,911.19
Kananelo Chc R 7,788.78
Tumahole Clinic R 4,924.41
Najaasrus Oah R 88.92
Kroonstad Laundry Clinic R 627.84
Parys Town Clinic R 2,336.73
Lesedi Clinic R 104,781.22
Fezile Dabi D/Office R 22,244.44
Kganya Clinic R 3,551.22
Saundersville Clinic R 180.00
Sizabanthu Clinic R 553.90
Philane Clinic R 17,712.04
Total R 229,700.69
Metsimaholo Hospital R 270,263.73
Boitumelo Hosp R36618.81
Mafube Hosp R5165.64
Tokollo Hosp R17025.11
Parys District Hospital R 165,350.88
Total R 494,424.17
Total R 724,124.86
Lejweleputswa
R-Value Of
Expired
Medication Clinics
Name Of Clinic -Ombudsman
Bongani Hospital R1114835.03
Nala/Mohau/Thusanong R44001.12
Total R1158836.15
Kopano Building (District Office) R687709.78 A Lot To Be Finalized In New Fin Year
KWAZULU/NATAL
A survey was carried out in October 2008 to try to get a picture of what was happening. It was
merely a snapshot, but with sufficient responders to get a fairly good idea of the situation. The
answers below are taken from the survey.
Yes, Medicines Are Destroyed From Time To Time In Most Institutions In The Province.
(a) (i) In KwaZulu/Natal
(ii) From a total of 31 of the 44 institutions from which a response was obtained in the
survey.
(b) No detail is available, but from past experience, it covers a wide range of medicines and is
not limited to any specific type of medicine.
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These are mainly items that have past their expiry date
A portion of the items are those returned by patients/families of deceased patients – none
of this can be re-used.
Occasionally Thermo Labile items will be exposed to high temperature, example if a
refrigerator fails or there is a prolonged power outage.
(ii) details of the quantities destroyed is not readily available.
(iii) the monetary value is R 1 249 581.54 (Over 12 Months) – this equates to 0.27% of
the annual medicine expenditure for the institutions involved.
(iv) the reasons for destroying the medicines include the following:
Poor Stock Management, usually due to:
- Inadequately Trained Staff Especially Where There Is A High Staff
Turnover (Especially At Phc Clinics)
- Inadequate Supervision Mainly Due To Severe Staff Shortages And
Inexperienced Supervisors
Low use of vital items that have to be kept for emergencies. These are often
expensive but rarely get used
NORTHERN CAPE
Yes
(a) (i) and (ii) In the Northern Cape, at all health facilities
(b) (i) and (ii) All expired medicines are destroyed as per Medicines Controls Regulations.
This is across the full range of medicines.
(iii) The following table reflects the monetary Value
2007/8 R120 482.27
2008/9 R201 022.31
2009 To Date R 85 929.44
R407 434.02
(iv) As above – mostly date-expiry.
WESTERN CAPE
(a) (i) Western Cape
1. Only values captured on Sinjani (Provincial Information Management
System) are reported on. Monetary values below does not Include:
City of Cape Town Municipality Clinics and
Cape Medical Depot
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2. Sinjani was introduced in 2006 and is still being rolled out to all facilities.
(ii) A list of Hospitals where medicines were written off is available on Sinjani. All
hospitals have expired medicines or medicines returned by patients.
(b) (i) The medicines destroyed are usually expired medicines. This may include any type
of medicines. Usually medicines provided with short-dated expiry dates; or
medicines not frequently used, but essential to keep stock.
(ii) Quantities and cost per item may vary significantly from hospital to hospital.
hospitals are supposed to record all medicine and quantities for audit purposes, as
well as for destruction purposes.
(iii) See tables below. Central hospitals stock more expensive medicines that may
expire e.g. Immuno-Suppressants or Oncology medicines. Certain hospitals also
carry very expensive life saving medicines that are used seldomly and often expire
e.g.
dantrolene injection (r1700 per vial. minimum stock is 5 to 10 vials – most
vials usually expire);
snake antivenom: require 10 vials;
poison antidotes
(iv) Main reasons for destroying medicines:
Expired medicines
Damaged medicines / containers
Medicines that may have been damaged due to malfunctioning equipment
e.g. refrigerators.
medicines brought back by patients or returned from wards are destroyed by
the hospital (this is not included in the monetary value).
Redundant medicines e.g. flu vaccine
National / provincial policy changes (e.g. new evidence suggests a medicine
may be unsuitable)
Financial Year Value In Rands Comment
2006/2007 R 474 712 2006 / 2007 = implementation of electronic system
for capturing of data
2007/2008 R 4 182 409 More than R3 million of this value was due to
malfunctioning of refrigerator at Tygerberg Hospital
bulk store. More sophisticated equipment has been
installed.
2008/2009 R 587 160
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Level Of Hospital Value In Rands Per Financial Year Comment
2006/2007 2007/2008 2008/2009
Central Hospitals (L3) 201 945 4 036 401* 331 397 * malfunctioning of
Gsh, Tbh & Rxh tbh refrigerator in
bulk store
Secondary Level 20 468 70 488 51 144
Hospitals (L2)
District Hospitals (L1) 30 687 40 481 93 238
Specialised Hospitals 1 657 5 045 3 298
Community Health --------- 5 739 67 120 *** ***Improved
Centres reporting
Community Day 12 306 553** 24 462 **Restructuring of
Centres chc’s to cdc’s
Clinics 4 738 5 396 12 558*** ***Improved
reporting
Provincial Chronic 202 910 18 306 3 943 Includes uplifted
Dispensing Unit stock from hospitals
END.
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