The Status of Older Persons in South Africa

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The Status of Older Persons in South Africa
Presented to the Portfolio Committee on Social
Development by Roedolf Kay National
Coordinator SAOPF
2
Our Ageing Population

• South Africas population is ageing. The birth
  rate is falling and more people are living to a
  greater age. The HIV/AIDS pandemic is broadening
  the gap between the youngest and the oldest,
  placing new burdens on the older population and
  reducing their family support structures.
• The 2009 mid-year population estimate of persons
  over 60 is 3.7 million this amounts to 7.55 of
  the total population 58 of the 3.7 million are
  women.
• In most provinces the population of older persons
  is 6 8 of the total population.
• In the 2001 census the number of people aged 60
  ranged from 95,000 in the Northern Cape to over
  700,000 in the Eastern Cape and KwaZulu Natal.

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Our Ageing Population
Older Persons aged 60 85 per Gender per
Province
All information contained in the Tables has
been extracted from information obtained during
the Community Survey conducted by Statistics SA
in 2007.
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Our Ageing Population
Older Persons aged 60 85 per Race per Gender
per Province
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RECOGNITION OF THE NEED FOR A UNITED VOICE FOR
OLDER PERSONS IN SA
Organizations and individuals working with older
persons and older persons themselves recognized
the need for a coordinated body. International
experience has shown that in societies where
older persons lack coordinated, institutional
representation, age discrimination is common.
While gathering submissions on the draft Older
Persons Bill via provincial workshops in 2004,
the SAHRC realized this to be true of the sector
in South Africa. As a result, in May 2005 the SA
Human Rights Commission funded and appointed a
coordinator to work for one year towards forming
a national forum for older persons. The
co-ordinator was based in the SAHRC offices in
Johannesburg but the establishment of the
national forum only constituted a portion of her
duties.   In August 2005 the SA Human Rights
Commission and the National Department of Social
Development jointly called and funded a national
convention to consider the establishment of a
national forum for older persons. More than 200
delegates from 150 organizations (CBOs, NPOs,
FBOs, Government Departments and individual older
persons) attended this convention and unanimously
approved the establishment of the SAOPF and an
interim committee elected. The task of the
Interim Committee was to establish the SAOPF as a
legal entity and to bring the forum to its first
AGM or inaugural meeting. Directors were elected
to the Interim Committee according to sectors
this was to ensure that all sectors would be
represented. The sectors were weighted to ensure
that there would not be domination by one sector.
However, there was a general consensus among
members that this system would eventually need to
be replaced with a more representative and
workable system.   At this convention, the
former minister of Social Development, Dr. Zola
Skweyiya, gave his assurance that thee Department
would commit themselves to the establishment of
the national forum for older persons.
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The Sectoral Representation System

• Individual older persons, defined as men and
  women 60 years of age and older
• Non-governmental organizations (NGOs), Community
  Based organizations (CBOs) and Faith Based
  organizations (FBOs)
• Academia
• The private sector , persons who have an
  interests in older persons
• Networks and Forums promoting the interests of
  older persons
• Individuals and organizations from rural
  communities
• Individual war veterans and organizations
  representing their interests.

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SAOPF VISION

• A society for all ages in which
• the contribution of older persons is
  acknowledged
• older persons can experience security and
  personal fulfillment
• the right and dignity of older persons is
  respected
• and older persons have a role to play in
  development.

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SAOPF Mission statement
The mission of the South African Older Persons
Forum (SAOPF) is to identify and articulate the
concerns and needs of older persons, as voiced by
them, and, in consultation with Government and
other role players, to ensure that these needs
are addressed in legislation, services and
programs.
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The Integrated Forum Structure
After the launch of the SAOPF in 2005, forums
were established on provincial, regional and
district levels in South Africa. There is no
one size fits all structure for municipal,
district, regional or provincial forums as each
province has different challenges. While forums
at municipal, district and regional levels
function as an informal open platform for older
persons, forums on provincial levels are formal
and registered structures. It is the
responsibility of provincial forums to see to it
that forums are established at all levels in the
province taking into account the unique
geographical layout of their province to ensure
maximum participation of all in the sector,
especially older persons, extending to grassroots
level.
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HOME BASED CARE

• Keeping older persons in their communities as
  long as is possible means that they are able to
  continue with their roles of advising, educating
  and transferring skills to their children and
  grandchildren through story telling, passing on
  cultural values and religious believes
• Caring for older persons has become everyone's
  responsibility but in reality these services
  mostly provided by NGOs, FBOs and CBOs
• Despite the emphasis on home-based and community
  based care and the recognition of the importance
  of the family unit these services are largely
  underfunded
• In rural areas home based care services are
  almost non existent an those that do exist are
  generally underfunded
• In a meeting with the SAOPF the national DSD
  reported that although a set of guidelines for
  Home Based Care is desperately needed, no money
  for this will be available in the foreseeable
  future.

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FRAIL CARE

• There is a substantial difference in the costing
  models used by provinces for Frail Care as no
  standard currently exists
• Costing models should be in line with the
  Regulations (Norms and Standards)
• Proportionally the biggest line item contributing
  to the cost of Frail Care is salaries of care
  staff. NGOs are losing nursing personnel who opt
  for career paths that offer better remuneration
• Frail care comprises mainly health care. The
  department of Health lays down requirements but
  does not fund the DSD subsidises Frail Care
• Payments of subsidies are frequently delayed and
  in some cases paid retrospectively which
  adversely affects service delivery and places
  unnecessary strain on facilities and staff
• Suitable turn-around times for payments should be
  standardized and processes are to be streamlined
• The exclusion of Geriatric Nursing science from
  the training curriculum of nurses will negatively
  impact on the quality of care for older persons
  which is especially detrimental to frail care.

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Health Care

• A countrywide survey of medical practitioners
  attitudes to Geriatric Medicine and older
  patients conducted in 2004 showed high levels of
  disinterest in the sub-specialty by doctors and
  negativity towards aged patients (Ferreira, M
  Kalula S 2006, 'SA Fam Practice', CPD Editorial,
  8pp)
• The investigators concluded that South African
  medical practitioners attitudes towards older
  patients are ageist and based on negative
  stereotypes. However, it is encouraging that
  younger doctors are more positive about GM and
  older patients than their older colleagues
• Due to the fact that Geriatric Medicine is hardly
  included in the undergraduate training of Health
  professionals many doctors are ill-equipped to
  manage older patients at a primary care level
  (all family doctors and general practitioners are
  at a primary care level)
• The South African Nursing Council informed
  training colleges that new qualifications
  registered with the National Qualification
  Framework no longer includes courses in
  gerontological nursing science or gerontology
  (including geriatrics) the SAOPF and other
  organisations have appealed to the Nursing
  Council to have this decision reversed
• At public hearings conducted by the South African
  Human Rights Commission into the public health
  care system in 2007, older persons expressed
  extreme dissatisfaction with the service. Their
  complaints included inefficient appointment
  systems, long waiting times, client overloads,
  understaffed facilities, shortages of medication,
  unavailability of assistive devices, and health
  personnel perceived as not doing thorough
  examinations, not explaining older persons health
  problems to them and not treating them with
  respect.

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In 2007 the Minister of Social Development at the
time, Dr Zola Skeweyiya, announced the following
in his Budget Vote in the NCOPWe will
recommend that the means test for old age pension
be removed as soon as possible and that all
people meeting the qualifying age receive the old
age pension. To ensure sustainability of our
pension system, all employed South Africans must
save for retirement. The new pension system must
reflect the system of solidarity, which is the
South African cultural thrust of the spirit of
Ubuntu. Our proposals will ensure that the cost
of saving for retirement be reduced
significantly.
In 2007 the Minister of Social Development at the
time, Dr Zola Skeweyiya, announced the following
in his Budget Vote in the NCOP We will
recommend that the means test for old age pension
be removed as soon as possible and that all
people meeting the qualifying age receive the old
age pension. To ensure sustainability of our
pension system, all employed South Africans must
save for retirement. The new pension system must
reflect the system of solidarity, which is the
South African cultural thrust of the spirit of
Ubuntu. Our proposals will ensure that the cost
of saving for retirement be reduced
significantly.
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Social Security
At the 3rd Annual General Meeting of the SAOPF it
was resolved that the forum should negotiate with
the Department of Social Development in working
towards the abolition of the Means Test for
social pension as it applies to old-age grants.
The SAOPF formally requested that a committee be
appointed to investigate the cost of implementing
the Means Test for old age grants as opposed to
abolishing it and using the money saved to
extend the grant to all older persons.
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The SAOPF as well as The Black Sash, has
monitored SASSA application points and found that
the elderly are standing in queues from early in
the morning waiting to apply for a grant. The
Black Sash Community Monitoring and Advocacy
Project monitoring an application point in
Belhar, Western Cape, found for example that the
longest waiting time was 13 hours (a male aged
61) . The earliest that an applicant arrived at
the application point was 115am (female aged 60).
Application points
The SAOPF as well as The Black Sash, has
monitored SASSA application points and found that
the elderly are standing in queues from early in
the morning waiting to apply for a grant. The
Black Sash Community Monitoring and Advocacy
Project monitoring an application point in
Belhar, Western Cape, found for example that the
longest waiting time was 13 hours (a male aged
61) . The earliest that an applicant arrived at
the application point was 115am (female aged 60).
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SASSA contracts 3 major service providers namely
Cash Paymaster Services (CPS), All Pay and
EmpilweniTrade Union NEHAWU accused SASSA of
being enemies of the People following a report
that SASSA was paying R1bn to outside contactors
for poor and inexcusable service and accused
the organisation of gross misappropriation of
public moneyThe service provider CPS is
responsible for paying out 65 of the countrys
social grants and pays grants in KwaZulu-Natal,
Limpopo, North West, the Eastern Cape and the
Northern Cape, paying 4.5 million people a
monthAllegations of blatant violations of
service level agreements and human rights in
regard to the payment of pensions abound At an
SAOPF workshop in the Northern Cape an allegation
was made that CPS provides loans to grant
recipients and charging them as much as 50
interest
Pay points

• SASSA contracts 3 major service providers namely
  Cash Paymaster Services (CPS), All Pay and
  Empilweni
• Trade Union NEHAWU accused SASSA of being
  enemies of the People following a report that
  SASSA was paying R1bn to outside contactors for
  poor and inexcusable service and accused the
  organisation of gross misappropriation of public
  money
• The service provider CPS is responsible for
  paying out 65 of the countrys social grants
  and pays grants in KwaZulu-Natal, Limpopo, North
  West, the Eastern Cape and the Northern Cape,
  paying 4.5 million people a month
• Allegations of blatant violations of service
  level agreements and human rights in regard to
  the payment of pensions abound
• At an SAOPF workshop in the Northern Cape an
  allegation was made that CPS provides loans to
  grant recipients and charging them as much as 50
  interest

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The SAOPF and SASSA conducts quarterly meetings
in which problems affecting older persons are
discussed a MOA between SASSA and the SAOPF has
been drafted and is currently awaiting the
signature of the Acting CEO.The SAOPF has
highlighted the following problems in
meetingsThere are still pay points lacking
water, toilets, seating, shelter or fencesIn
Limpopo, Mpumalanga, Eastern Cape, North West and
KZN long queues prevail, with some pensioners
spending up to 8 hours in a queueMany
pensioners travel long distances to pay points
which is costlyHelp desks are not always
available at some paypointsAt some paypoints no
medical assistance for those who take ill while
queuingFaulty machines and incorrect payments
are common complaints in some provincesIn some
areas pensions are paid through local shops and
grant recipients forced to buy their
goodsAbusive behaviour by staff at paypoints is
commonIn many areas hawkers and loan sharks
continue to harass and exploit pensioners.

• The SAOPF and SASSA conducts quarterly meetings
  in which problems affecting older persons are
  discussed a MOA between SASSA and the SAOPF has
  been drafted and is currently awaiting the
  signature of the Acting CEO.
• The SAOPF has highlighted the following problems
  in meetings
• There are still pay points lacking water,
  toilets, seating, shelter or fences
• In Limpopo, Mpumalanga, Eastern Cape, North West
  and KZN long queues prevail, with some pensioners
  spending up to 8 hours in a queue
• Many pensioners travel long distances to pay
  points which is costly
• Help desks are not always available at some
  paypoints
• At some paypoints no medical assistance for those
  who take ill while queuing
• Faulty machines and incorrect payments are common
  complaints in some provinces
• In some areas pensions are paid through local
  shops and grant recipients forced to buy their
  goods
• Abusive behaviour by staff at paypoints is
  common
• In many areas hawkers and loan sharks continue to
  harass and exploit pensioners.

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SASSAPaypoints
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Abuse

• Abuse of older persons is rife in all provinces.
  There has been an increase in the reporting of
  abuse as a result of increased, ongoing
  awareness. World Elder Abuse Awareness Day
  (WEAAD), an international day, observed on 15th
  June each year, has contributed to this. The
  national DoSD has distributed (metal) purple
  ribbons to sustain the awareness created by
  WEAAD.
• It is a false perception that elder abuse only
  occurs in care or residential facilities. The
  majority of older persons live in communities
  where elder abuse is more difficult to expose and
  investigate, especially in the rural areas.
• The focus of the Older Persons Act no. 13 of
  2006 is broader than that of the previous Act
  aims to protect older persons living in
  communities as well as in care and residential
  facilities. Implementation of the Act will
  require intersectoral collaboration amongst
  government departments and between these
  departments and their civil society partners.
  Increased budgets for services to older persons
  will be required if the Act is to be properly
  implemented.
• Anyone who is aware of or suspects that an older
  person is being abused must report this to either
  the DoSD or the SA Police Force. In addition
  there is a 24 hour, tollfree helpline HEAL (Halt
  Elder Abuse Line) for anyone to report elder
  abuse.

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Our Ageing Population
HIV /AIDS

• The HSRC report in 2009 on HIV prevalence rates
  found that men over the age of 50 are an HIV/AIDS
  priority risk group.
• The HSRC study also showed that communication
  programmes aimed at educating older persons about
  the pandemic had failed them- 37.8 of people in
  the 50 years and older age group are not getting
  the message.
• The Muthande Society for the Aged in KZN claims
  Older persons face discrimination around HIV
  services because of wrongly held assumptions
  about their sexuality, including the belief that
  the disease only affects younger people.
• Older woman are in many instances the primary
  care givers of children and grand children
  orphaned by HIV / AIDS.
• The lack of reach into the older age groups has
  been raised repeatedly in previous studies, yet
  nearly four out of ten people aged 50 years and
  older are not reached by any programme. - (Dr
  Warren Parker, Former Executive Director - Centre
  for AIDS Development, Research and Evaluation
  (CADRE))

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Our Ageing Population
Housing

• In a study done by Community Agency for Social
  Enquiry (C A S E) DSD on the Status of Older
  Persons in South Africa in 2009 showed that only
  about 17 received houses.
• The study also shows that many older persons have
  never applied for an RDP house despite them
  needing one. Limpopo and Eastern Cape provinces
  recorded the lowest proportions of respondents
  who received an municipal/RDP/government
  subsidized house.
• According to the study very few older persons
  benefited from the government subsidized housing
  program even though the policy stipulates that
  recipients of the old age grant are eligible for
  the housing subsidy scheme.

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Our Ageing Population
Housing
The Status of Older Persons in South Africa C A
S E DSD 2009
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The Older Persons Act (ACT 13 OF 2006)

• The first draft of the Bill appeared over 10
  years ago yet it was finally signed into
  legislation in December 2006
• Since 2006 the SAOPF has fought hard for the
  regulations to the Act to be finalized
• Draft Regulations appeared in 2007 and again
  after extensive consultation were finalized and
  gazetted on the 1st April 2010
• A draft implementation plan for the Act has been
  finalized but no time frames are attached to
  implementation.

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IMPLEMENTATION OF ACT 13 OF 2006 BY PROVINCES

• Since the Older Persons Act came into effect on
  the 1st April 2010 information re the progress of
  provinces relating to the implementation of the
  act is not always accessible
• The implementation of the Act and Regulations by
  provinces is of crucial importance as this
  relates directly to the services older persons
  can expect and how the rights and dignity of
  vulnerable older persons, especially in rural
  areas will be observed and protected.
• The SAOPF requested an update from all provincial
  departments re the progress of implementation
  plans for the Act but response seems to be
  delayed.
• Very little information is available re the time
  frames for the provincial implementation of the
  Act, the SAOPF has requested updates from all
  provincial DSD offices re the implementation of
  the Act, we are currently awaiting their
  response
• Provincial Coordinators tasked with the Portfolio
  of Older Persons only It is our experience when
  provincial coordinators portfolios include
  children, people with disabilities and older
  persons the latter seem to get the shortest
  stick. Coordinators that have the three
  portfolios cannot cope with their work load. The
  evidence of this is clear in provinces in which
  the coordinators administer three portfolios
  older persons forums are not getting off the
  ground, service delivery is negatively affected
  and on the whole older persons feel that they are
  being sidelined and neglected by the DoSD.

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DSD DRAFT IMPLEMENTATION STRATEGY
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The Older Persons Act (ACT 13 OF 2006)
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The Older Persons Act (ACT 13 OF 2006)
DIRECTORATE CARE AND SERVICES TO OLDER PERSONS

• For the act to be effectively implemented by the
  DSD a substantial increase in the budget for the
  Directorate for Care and Services to Older
  Persons is required the budget for this
  Directorate is exceptionally small in comparison
  to that of other sections/directorates within the
  DSD
• Partnerships between government and civil society
  have been formed so that services may be provided
  to older persons however adequate funding of
  these services is an issue
• The budget allocated to Care and Services to
  older persons both at national and provincial
  levels is inadequate to ensure the implementation
  of the Act, the rollout of services and effective
  advocacy.

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The Older Persons Act (ACT 13 OF 2006)
NGOs

• Non-governmental organizations (NGOs) offer a
  range of services to older persons. The services
  they offer include social support groups,
  training and education, income generating
  projects, frail care services, transport to
  health facilities and luncheon clubs and Home
  Based Care.
• NGOs remain largely underfunded despite
  delivering services to older persons which the
  DSD is responsible for providing in terms of
  legislation.
• This situation violates the rights of older
  persons as laid down in the Constitution and
  Older Persons Act.
• Services to older persons especially those in
  formally disadvantaged areas needs to be brought
  in line with current similar services to older
  persons in more affluent areas.
• Delays in payment of subsidies and the lack of
  consultation with the DSD results in frustration
  on the side of the NGOs and ultimately inadequate
  service delivery and lack of compliance with the
  requirements of the new Act
• NPOs report delays in transfers of funding that
  has already been allocated causes disruption of
  services to older persons.

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Impact of the Judgment of the Free State High
Court

• Three NPOs brought this court application against
  the DSD after several years of serious
  frustration about the way in which the Department
  dealt with transfers (or subsidies) to NPOs.
• The judgment of the Free State High Court (2010)
  instructs the Free State government to come up
  with a better policy in respect of funding of
  non-profit organisations (NPOs).
• This judgment is relevant for NPOs and provincial
  departments of social development in other
  provinces as well because the Free State policy
  on funding of NPOs is almost identical to the
  national policy which covers all provinces.
• The judgment notes that 1 400 NPOs are currently
  funded by the Free State Department of Social
  Development, and that the Department is dependent
  on the NPOs for delivering services which the
  Department is responsible for providing in terms
  of various laws, in particular the Childrens
  Act, and the Older Persons Act.
• The judge ordered the Free State Department of
  Social Development to revise its policy on
  financial awards to NPOs.
• Because the Department had failed even to pay the
  already allocated subsidies, and because there
  were other indications that the department lacks
  leadership and/or capacity the judge decided to
  impose a structural interdict which means that
  the Court will supervise the implantation of the
  court order by the Department.
• While the judgment is against the Free State
  Department of Social Development, it is relevant
  to all provincial departments of social
  development because the Free States NPO funding
  policy is the same as the national policy.

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The Older Persons Act (ACT 13 OF 2006)
PROVINCIAL OLDER PERSONS FORUMS

• While some provincial forums are well on their
  way to representing the voice of older persons in
  their respective provinces other provincial
  forums are struggling.
• Free State OPF The Free State Forum is up and
  running and recently elected its first board of
  directors, Ms Ivy Kgetse was elected as chair.
  The FSOPF is still awaiting approval of its NPO
  registration from the DSD. The Office of the
  Premier in the province has taken an interest in
  the forum and seems to providing it with some
  assistance.
• Gauteng OPF The Gauteng forum was previously
  chaired by a DSD official that has since
  resigned. Indications are that the structure of
  this forum does not allow for inclusion of all
  districts municipal forums. The transformation
  of the Gauteng forum will be one of the focal
  points of the SAOPF strategy plan for 2011/12.
• Eastern Cape OPF The forum in the Eastern Cape
  was recently registered as a NPO and is still
  struggling to get of the ground. The Office of
  the Premier in the province has taken an interest
  in the forum and seems to providing it with some
  assistance.
• KZN OPF This forum functions not as an NPO but
  forms part of and is supported by the Office on
  the Rights of Senior Citizens in the Office of
  the Premier. The KZN forum has established
  district and municipal forums in almost every
  district in the province and plays an active role
  in the advancement of the rights of older persons
  in the province.
• Limpopo OPF The Limpopo Older Persons Forum is
  a registered NPO but currently has to operate
  without any financial assistance from the DSD.
  The Office of the Premier in the Province
  previously provided the forum with some
  assistance but less support seems to be
  forthcoming from the current administration.
• Mpumalanga OPF This forum has an Interim
  Committee in place and is in the process of
  applying to be registered as a NPO. There is a
  very positive relationship between the department
  and the forum in this province.
• North West OPF Although an interim committee
  exists in this province this forum has not really
  progressed much. Providing assistance to the
  North West forum will be one of the focal points
  of the SAOPF strategy plan for 2011/12.
• Northern Cape OPF This forum forms part of the
  overall Victim Empowerment Programme in the
  province the DSD in the province is of the
  opinion that this is the only way that the forum
  in the province will get off the ground. This
  issue will be debated by the newly elected board
  of the SAOPF.
• Western Cape OPF At the AGM of the WCOPF the
  interim committee was replaced by directors
  elected by members of the WCOPF. The WCOPF is a
  registered NPO and receives funding through a
  conduit NGO called Zela Social Development from
  the DSD in the Western Cape. The WCOPF have now
  set up an office, employed a full time
  coordinator and involved established district
  forums. The DSD has indicated that the forum
  would enjoy future support and funding by the DSD.

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The SAOPF has the mammoth task of representing
the voice of a very vulnerable and fragmented
sector but in partnership with government and
other stakeholders this voice can be augmented
into a united front. Given the number of
successes in the SAOPFs short lifespan, there
can be no doubt that challenges still to be faced
will be overcome, and that older persons in South
Africa will be recognized as the valuable and
unique resource that they are.
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