Speech by James Ngculu on the Department of Health Budget Vote Debate

7 June 2007

I would like to firstly acknowledge the Acting Minister of Health, The honourable Jeff Radebe and express the view of the ANC Study Group that we all appreciate and appreciated the role he played during the long absence of the Minister of Health.

We would like therefore to take this opportunity to welcome the minister of health, Dr Manto Tshabalala_Msimang back to the crucible of work she left when she took ill. We, however, would like to express our view that she should take it easy but have no hesitation of her commitment to serve and the energy she continues to dedicate to the people o South Africa.

In the State of the Nation address in 2006, the President highlighted the following areas as the key areas of focus on health:-

  • Continue the expansion of health infrastructure
  • Continue the refurbishment of existing clinics and hospitals
  • Re-open nursing colleges with the aim to increase the number of nurses
  • By September 2006, the authority and accountability for hospitals is delegated to hospital managers

In the 2007 State of the Nation Address, he raised the following:-

  • Expanding training and employment of nurses…
  • Continuing with the implementation of the remuneration dispensation for medical professionals
  • Ensuring the implementation , without further delay, of measures to reduce the cost of medicines
  • In this regard, government commits itself to intensify the campaign against HIV and AIDS…and partnerships built over years are strengthened and that improved national comprehensive strategy against Aids and STI is finalized as soon as possible.

We have highlighted the above issues so as to use them as the benchmark as to whether we are making progress or not. As I stand on this podium I can raise my fist and shout Amandla for as the ANC we have remained true to the issues we have raised and that the problems we have faced in the implementation have not been because of subjective obfuscation or hesitancy but objective problems which in them main are not of our own making. We have not deviated from what the minister of finance said when he delivered his budget - That human life has equal worth… All the things done in the department under discussion today, these words remain true. The CEOs at our hospitals have been put in place and the department of health conducted an audit and found out that in the main the programme is in place. There were questions that emerged especially on issues of Procurement delegation or human resource delegation. This is an issue that we will to further look at as if not properly handled may lead to unintended consequences.

On the issue of infrastructure and refurbishment of clinics and hospitals, though the programme is proceeding well, it is our view that much better can still be done. However, the view that in general the health sector is significantly under-funded has sympathy from us. We have observed as my colleague will elaborate on hospital revitalization that this project is not moving with the pace required and the main reason for this is that financial resources allocated for this are significantly inadequate and results in some areas on unfinished projects.

The programme to re-open nursing colleges is continuing though we think more paces can be gained to accelerate this programme but what gratifies us it that most provinces are addressing this issue.

Perhaps the most dramatic and imaginative programme that has captured the discourse of the country has been the finalization of the National Strategic Plan. We would like to recognize the sterling leadership role our deputy president played in driving this project. She managed under the most extreme conditions of unnecessary brinkmanship from some quarters to mobilize diverse people from across the board to agree on a common programme that must make South Africa turn the corner in the fight against HIV and AIDS. Special mention should be made of the role of Dr Nomonde Xundu played in this process. Her energy and zeal helped to ensure that coordination towards the finalization of the National Strategic Plan is done in such a manner that all those who took part felt part of the process. We hope that they will remain part of the process even when problems arise and not eschew themselves and accuse the government.

We are still in the grip of the MDR-TB and in particular XDR-TB. The problem is that so long we have defaulters in our TB treatment programme, so long we will have MDR. The key problem faced around TB in general is treatment adherence. We are happy to hear that a TB Cluster is being created at the Department of Health and we hope this will help is coordinating our campaign against TB. One of the areas of our emphasis in our fight against TB in general should be to stress on our DOTS which should have community health workers visiting people to ensure that they adhere to their treatment regimen. These people should be incentivised so that we do not lose them. If we are able to build on this, we may reduce the opportunities for XDR-TB. Whilst they may be no disagreement on the question of isolation of people suffering XDR, we, however, need to ensure that we do in a humane manner and people should still feel their respect and their being.

The challenge with regards to the price of medicine still confronts us. We are happy that some pharmacies by and large are sticking to the prices previously gazetted. We hope this litigation issue will be resolved and those people wanting to further engage the department of health on their litigation process, we would like to encourage the department that such people should be given a platform and where they would like to review their strategy, an avenue be created for that.

As we were trying to outline above, the commitment of our government to a better life for all cannot be questioned by any honest South African. This does not mean that in the course of doing so there are no ups and downs or in general mistakes that are not made. It is precisely because of such mistakes that we measure our progress and learn new ways of moving forward to better delivery.

For instance, the challenge that we faced with regards to the situation at Groote Schuur in as far as what some doctors complained that the budget problems have had negative effects on their work as doctors need not just be dismissed. Objectively the problem may be there but sometimes we need to get out of our boxes and see the whole. Whilst there is a need to ensure that our tertiary services are not undermined or compromised, so we should ensure also that the primary health system is equally nurtured. It is this dialectic that we should master without pitting one against another. We may have to review how our tertiary hospitals are allocated their budgets and thus where they are situated in our health system.

The problem that such a critical resource should rely on the slice of a province, whose priorities may not necessarily be in line with the broader priorities of national, may need review. At any rate, tertiary hospitals by their definition should be a national competence and in this way perhaps the allocation may be budgeted differently rather than just either a conditional grant(tertiary services grant) or equitable share. In other words, the problems facing Groote Schuur Hospital will need to be listened to and the Portfolio Committee should do that.

What we have said proves what our President has stated when he said that South Africa has entered its age hope.

In State of the Nation address in 2006, the President said:

"It is up to all of us, through our national effort, to build a winning nation, to do all the things that will ensure that the mountains and the hills of our country break forth into singing before all our people, and the trees of the field clap their hands to applaud the people's season of joy."

In closing allow me to thank the DG, Mr Thami Mseleku and his team for his cordial working relationship with the portfolio committee and the way they were always at hand when ever the call came from us. Also to thank the deputy minister of health. Once again, welcome back comrade Minister!

We support this support.