The administration of social grants for adult persons with disabilities in the Northern Cape
Du Toit, Mangalane Maggy
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Orientation: Section 195(1)(b) of the Constitution (1996), the White Paper on Transforming Service Delivery (1997), and the Public Finance Management Act, 1999 (Act 1 of 1999), call for an efficient (doing things the right way), effective (doing the right things) and economical (at the lowest possible cost) administration of social services. In line with the progressive legislative prescripts, several improvements were made in the social grants administration arena since the merging of the different administrations (made up of the four provinces and the ten Bantustans) post 1994 and making social grants the responsibility of the national government. These improvements included the establishment in 2006 of the South African Social Security Agency (SASSA) as an entity of the Department of Social Development (DoSD), tasked with administration and payment of social grants, and the introduction of the 2011 Social Grants Disability Management Model (SGDMM) to deal specifically with challenges relating to social grants for adult persons with disabilities (PWDs). Among other things, the 2011 SGDMM identifies several stakeholders critical to the efficient administration of social grants for adult PWDs, namely applicants of social grants for adult PWDs, SASSA officials and contracted medical doctors. Research purpose: The purpose of the study is to assess efficiency in the administration of social grants for adult PWDs in the Northern Cape (provincial sphere of government) and South Africa (national sphere of government), using the 2011 SGDMM as a point of departure. The study aims, in particular, to explain why, despite the gatekeeping element of the 2011 SGDMM, adult PWDs presenting with the same medical condition, with mild or no verifiable impairment whatsoever, keep returning and are allowed through the system, only to be rejected again, citing the same reasons as before. The motivation for the study: Whereas many studies about social grants for adult PWDs have been conducted, the majority were about the impact of those social grants on the lives of the recipients and their families. Few have considered the administration thereof or have looked specifically at the Northern Cape Region (NCR). The only studies relating to the administration of social grants for adult PWDs that could be identified from the literature search were conducted in 1994 and 2008, focusing on KwaZulu Natal and Limpopo respectively. These studies focused on administration from the perspective of a medical doctor conducting assessments, not the process that applicants of social grants for adult PWDs must go through to have social grants awarded. However, despite social grants for adult PWDs becoming a national competency and the establishment of SASSA in 2006 for administration thereof, the statistical analysis of grants in payment from the 2012/13 to the 2017/18 financial years shows that despite the introduction of screening and gatekeeping elements of the 2011 SGDMM, the number of applications and rejections for social grants for adult PWDs is increasing every financial year, instead of decreasing. Secondly, despite SASSA advocating for one-day turnaround times in the application of social grants, in terms of the current administration process, it takes at least three visits to a SASSA office before a social grant for adult PWDs can be captured and verified on the system, and an outcome communicated. The study focuses on the NCR, which had the largest percentage, at 12.85%, of social grants for adult PWDs in proportion to all social grants in payment as at 31 March 2018 (SASSA, 2018d). This number is 5.69% higher than the national average of 7.16%. The efficiency in the administration of social grants for adult PWDs, rather than the effectiveness of the grants themselves, is what motivated the study. Research paradigm, design, methods of data collection and sampling: An interpretivist paradigm is where the researcher interprets results and details the meaning to people, rather than just understanding what he or she has researched (Maree et al., 2020). In this study, structured interviews (telephonic and face-to-face), focus group discussions as well as semi- structured face-to-face, associated with the interpretivist paradigm, and concurrent triangulation were employed as methods of data collection (Van Thiel, 2014: 32–36). For this study, the researcher followed the phenomenological research approach, which coincides with the interpretivist paradigm. The phenomenological approach is based on a paradigm of personal knowledge and subjectivity and emphasises the importance of personal perspective and interpretation of the situation. As such it is a powerful approach for understanding the research questions: (i) why, despite the gatekeeping element of the 2011 SGDMM, do adult PWDs presenting with the same medical or mental condition keep returning, and why are they allowed through the system, only to be rejected again, citing the same reasons as before? and (ii) how are the two stakeholders (i.e. SASSA officials and contracted medical doctors) organised and managed to achieve the common purpose, which is the administration of social grants for adult PWDs? The primary data, collected by applying the concurrent triangulation approach, consist of responses from structured telephonic interviews and structured face-to-face interviews with applicants of social grants for adult PWDs, semi-structured focus group discussions with SASSA officials, and semi-structured face-to-face interviews with contracted medical doctors. Data were collected from four population groups (successful and unsuccessful applicants of social grants for adult PWDs, SASSA officials and contracted medical doctors) in overlapping phases. Structured telephonic interviews and structured face-to-face interviews were conducted with 276 applicants of social grants for adult PWDs (successful and unsuccessful). In addition, four semi-structured focus group discussions were conducted with 34 SASSA officials and, lastly, semi-structured face-to-face interviews were conducted with 10 contracted medical doctors. All four data collection methods explored the knowledge, experiences and attitudes of the applicants regarding the administration of social grants for adult PWDs. The secondary data consist of international and national literature, existing Internal Reconsideration Mechanism records (2011–2018) and existing statistics about social grants for adult PWDs (2012–2018). The responses were organised according to the three sections in the structured and semi- structured interview schedules. Snowball sampling was used to select respondents for the structured telephonic interviews and structured face-to-face interviews with applicants of social grants for adult PWDs (successful and unsuccessful), while non-probability, purposive sampling was used to select respondents for the semi-structured focus group discussions with the SASSA officials and for the semi-structured face-to-face interviews with the contracted medical doctors. Main findings: During the literature review, it was discovered that numerous studies have been conducted relating to social grants in general and social grants for adult PWDs in particular, but only two relating to the administration of social grants for adult PWDs were found. These studies were conducted in 1994 (Mhlambi) and 2008 (Tumbo) before the 2011 SGDMM was introduced. Most of the previously conducted studies focus on the impact of social grants, rather than the process of their administration. Existing research also focuses on the inclusion of HIV/AIDS as a criterion for awarding social grants for adult PWDs to address the plight of those unable to be self-supporting due to opportunistic diseases related to the human immunodeficiency virus (HIV). From the literature review and results of the different interviews, it was evident that if there are no social assistance measures or programmes in place to address a lack of income for the population group aged 19–59 years, the revolving door on applications of social grants for adult PWDs will continue. Extending social grants for adult PWDs to people living with HIV/AIDS and other chronic illnesses, while commendable, poses a dilemma – a complexity that was not anticipated by either the Department of Health (DoH) and/or the DoSD. Knowledge of the qualifying criteria for social grants and the reason the government provides them, without the aforementioned social assistance measures or programmes in place, will not address the problem of repeated applications by applicants of social grants for adult PWDs. Practical/managerial implications: The different organs of state (i.e. national and provincial departments) and other critical stakeholders should enter into implementation protocols that clearly describes the role and responsibility of each organ of state; outlines priorities and desired outcomes; and provide for monitoring, evaluation, resource allocation and dispute settlement procedures. Regular interaction is necessary to ensure that development pertaining to policy is coordinated and fast-tracked, and that obstacles are removed where they impede service delivery. Moreover, both the DoH and DoSD should develop policies that are complementary rather than contradictory when it comes to addressing the issue of HIV/AIDS and other chronic illnesses related to social grants for adult PWDs. Contribution/value-add: The recommendations generated in this study will, inter alia, attempt to improve efficiency in the administration of social grants for adult PWDs in two spheres. In the national sphere, the recommendations will assist policymakers in developing clear, integrated policy guidelines on the administration of social grants for adult PWDs. The recommendations of this study will be captured in the accompanying Regulations to the Social Assistance Act, 2004 (Act 13 of 2004 as amended). In the provincial sphere (SASSA NC), on the one hand, the results of the study will inform uniform processes and structures to improve efficiency in the administration of social grants for adult PWDs as well as future concept documents or standard operating procedure manuals for the NCR. On the other hand, participation in the study will create a platform for stakeholders (applicants of social grants for adult PWDs, SASSA officials and contracted medical doctors) to provide input to the administration process and practices governing social grants for adult PWDs in the NCR.