House Chair, hon members, the establishment of the Office of Health Standards Compliance is a welcome move. There are many complaints relating to the service that citizens receive, particularly from public health facilities, and the treatment they get.
In the absence of prescribed norms and standards, it is difficult to hold people accountable. The saying is true: If there are no rules, there can be no violations. Azapo will therefore support the Bill, with the understanding that there will be no interference with the independence and integrity of the office, particularly when it comes to the ombudsman. We believe that with the passing of this Bill, our people will at least have recourse, rather than complaining in the corners. Like I said, we support the Bill.
Hon House Chairperson, hon Ministers and Deputy Ministers, hon Members of Parliament, my neighbour went to the clinic in my local village. When she returned, at about 16h00, she informed me that the nurse was rude to her. I went to the clinic and as I got out of my car at the clinic gate, one teenager, with a baby on her back, told me that she had been told that the medication for her child had not been delivered because it was out of stock at the provincial depot. In one corner there was a hawker who sells fruit at the clinic. She joined in the conversation and told me that she had overheard the nurses telling each other that they had run out of gloves and were forced to improvise when treating patients.
My illustration is an example of what many South Africans go through every day when they visit the health facilities. In turn, nursing staff members face similar problems when treating patients. This means that there is a vicious cycle of "each one blames one". We cannot sit and watch this situation happen before us, just hoping that, between the patient and the nurse, one of them must be rational and understand and accept the situation as it is.
As the hon members would know, in the vicious cycle that I am talking about it is only the poor who are given the short end of the stick. They are given a raw deal because they do not have as many options as you and I who are sitting here today. They are stuck with the situation. This may not be the case in this country today.
When I was going through that mental and emotional exercise, I was reminded that the National Health Amendment Bill was in circulation for public comment and would be debated soon. That gave me hope. This Bill is a window of opportunity for us to invest our energies in ensuring that it is passed into law so that things can change.
We must accelerate this Bill so that future generations can inherit a health service that is under scrutiny and constant assessment for quality compliance. We cannot afford to hand over a badly run and badly maintained health service to our children.
As I say this, I am reminded of a song that I heard being played by some boys in our township. It goes, "Every generation blames the one before." When I remember this song - I do not even know the singer - I say that I certainly do not want to be part of the generation that will be blamed by the coming generation. That is why I am excited to be part of this debate, which will establish the Office of Health Standards Compliance.
The Bill has indeed come at the right time because through it our people will be able to enjoy the full rights of access to health services, as enshrined in the Constitution. They will enjoy the benefits of this hard- earned democracy, for which millions of our people were tortured and some even killed.
When I went through the Bill, I was struck by a few points that I would like to highlight in this House. I was struck by the fact that the department is serious about improving the lives of the people by improving the manner in which they are cared for when they visit the health centres. The Bill will establish the Office of Health Standards Compliance, which will be the custodian of quality health care. This office will surely go a long way towards ensuring that the public health facilities are compliant with the norms and standards. It is my belief that the OHSC will be central in ensuring that the dignity of our people is restored.
It is my wish that this office must indeed live up to the expectation of many South Africans because it holds the key to hope for the people who lost it during the unacceptable conditions under which they were treated. We cannot afford to have a situation where everyone is a law unto themselves.
Nako ya kwa ga Mmapereko; kwa go ikapeelwang ka moteme teng, e tla fela. [The time for selfishness where everyone is a law unto themselves will come to an end.]
The fact that this office will be outside the influence of the department is reassuring. I know for sure that the office shall not be seen to be in conflict with itself because it will be free from undue influence and pressure. It is my wish that the board that will be appointed should be independent - the Minister should not be called in every now and then to come to the rescue of a CEO who is under fire from the board. We need a board that knows what to do; that does not only do what the CEO says. And we need a CEO who does not only do what the board says.
I want to believe that the appointment of the health officers and inspectors will be yet another guarantee that the work of the Office of Health Standards Compliance will be carried out by professionals who have been trained in the field. I am certain that we have many people who have graduated from universities and will be able to do a professional job.
In order to strengthen the situation, the department should ensure the following: the appointment of competent hospital and district managers; the training of those managers that need further capacity to deliver; the revitalisation of health structures, with specific focus on primary health care facilities, which is where patients will be expected to start; the improvement of the drug supply to the facilities, especially those in far- flung parts of the country; the prioritisation of primary health care facilities when employing doctors and nurses; that all health facilities have essential equipment; the appointment of infection-control nurses for all facilities, especially the primary health care facilities; and that all facilities have maintenance officers, cleaners and admin clerks.
We are confident that the Bill will be one of the best pieces of legislation that we have had in this House. It will be the best in terms of its purpose and the many potential benefits of its implementation, as well as the manner in which it will accelerate the department's successful implementation of the National Health Insurance. The ANC supports the Bill.
Hon House Chair, I wish to thank members for unanimously supporting this Bill. It certainly holds out the hope of quality affordable health care for our people. I am sure that even in this House there are members who might have forgotten that public health facilities, clinics, hospitals and health care centres can be innovative and work and function very well.
I am saddened when I recall that the very first successful heart transplant, not only in South Africa but in the whole world, was conducted in a public hospital. I have met a number of people who have forgotten that. We want to bring back those days, when even people like you, hon members, will find it possible to utilise public hospitals.
I want to share a painful experience about our country. The Quality Care Commission in Britain helped us to put together this Bill. The CEO of the National Health System in Britain was central in workshopping various structures in our country while dealing with this Bill. One day he said, "Minister, let me ask you a question. What are you South Africans trying to do? Because I do not understand what you are all doing." He went on and said, "Everybody in your country who has a name, a title and a salary believes that when they get sick they should use only private hospitals and nothing else." He further said, "Minister, come to Britain - the rich, the powerful and the mighty utilise public hospitals. You cannot afford to destroy public hospitals in your country." We have been working with those words at the back of our minds. That is why this Bill is so important and that is why I am happy that it is supported.
I want to deal with two issues that were raised by hon members. The first is the issue of independence. Ever since we started discussions on this Bill, this issue cropped up time and time again. We believe there are enough mechanisms in the Bill to assure professional independence. That is why, after inspection, whatever comes out of the report will not be hidden. It will be made public. Because we deal with issues of public interest, hon members should not play politics, but must work in the public's interest.
What do we actually mean by independence? While I was listening, it seemed to me that in this country when we say a structure is independent, we mean that it is another opposition party. Opposition parties are here in Parliament and are elected to do the work of opposition parties. But we are called upon to create structures that must work as opposition parties. I think that is unfair. We give adequate independence to our structures.
Let me give an example. We have the Health Professions Council of SA, which was called the SA Medical and Dental Council. We gave it independence. You will never have heard reports of the Health Professions Council taking a doctor through a disciplinary hearing and striking the doctor off the roll only for the doctor to appeal to the Minister and the Minister reversing that decision. That has never happened.
There was a situation that nearly made me cry: the Health Professions Council condoned a doctor who had raped, saying that because there were so very few doctors they could not strike that doctor from the roll. I nearly cried, but because they are an independent structure I could not go against them and say, "Please, expel this one." I actually wanted that doctor to be expelled, but because of the independence we gave them, I could not do that.
However, whenever this body commits an error, people call on the Minister - even from within the opposition parties, I will remind you, especially the DA, the official opposition. Whenever a foreign doctor wants to get into South Africa and the Health Professions Council has a problem with registering them, remember that it is an independent body. It can decide against registering someone. The first thing the public says is, "Where is the Minister? Why can't the Minister intervene?" And this is the very structure to which they say the Minister must give independence!
I am sure you listen to the news. The Health Professions Council has just come up with tariffs - the so-called ethical tariffs - which doctors will charge or, if they do not follow those tariffs, be taken to the disciplinary committee. It is their decision and I was never involved. I was listening the whole morning, and people were saying, "Where is the Minister? What did the Minister do? Why all those tariffs?" But this was done by an independent structure to which I gave independence.
Whenever that structure makes what people perceive as a mistake, they call for the Minister. When there is no problem, they say, "Independence!" I want hon members to be careful about this issue and to tell us exactly what they are talking about. However, I am sure that the structure we are forming through this Bill will be given enough independence to do its work.
The last issue I want to deal with is that of appointing qualified managers. We will definitely do that. We have been talking about this matter in Parliament for a long time, Mrs Segale-Diswai, and I can promise you that advertisements have been placed and we want all our hospitals to have CEOs with a health background as their initial qualification. [Applause.] We have actually advertised and the short-listing process is taking place.
We are going to establish a Public Health Management Institute, which will be run by Harvard University, the University of Pretoria and the University of Fort Hare. These three universities are going to run a health management institute. The preparation is far advanced.
After interviewing individuals who applied for the jobs of CEOs of our hospitals, we will not allow them to go to work immediately. They will have to go through this institution for training. It is not going to be a physical institution, but Harvard, Pretoria and Fort Hare universities will set up a curriculum and a training programme. Only after going through that programme will we allow them to take up jobs as CEOs of hospitals.
In future, anyone who will manage a health care system will have to get qualifications from this institution. We will later bring information about this but I thought I should take this opportunity to inform the House. Thank you. [Applause.]
Debate concluded.
Bill read a second time (Democratic Alliance dissenting).