House Chairperson (hon Frolick), Minister, Deputy Minister respectively, hon members, guests and fellow people of South Africa as whole, good morning. As members of Parliament
of the Republic of South Africa, we are delighted and we welcome the cabinet approval on National Health Insurance, NHI, Bill, which will be tabled here at this august house as practical and urgent as possible. Now that we have been little bit attacked, I thinks it's important that we go out and address those issues. Accordingly, we believe that that the department will develop a systemic improvement programme within the national framework of annual performance plan. We have absolutely no doubt that the department need to strengthen, the systems and processes environment that will help to sustain improvement and quality of service.
His Excellency, The President Xi Jinping of the People's Republic China said: "The growing gap between the rich and the poor is both unfair and sustainable...". he goes on to say "...the development is meaningful only when its inclusive and sustainable" I will talk to
it later on the context of NHI. I think what we have seen from the left, from the DA, it's important that we reflect what Maxim Gorky says "Truth doesn't heal the wounded soul" the DA is heavily wounded, and it doesn't matter what progress the peoples glorious movement the ANC led-government can do, they will continue to be forces opposed to progressive change and development towards national democratic society.
It is within this context that the ideas or ideologies, flawed right wing ideology that seeks to advance subjective factors rather than the objective reality. I know they have mastered now, the left views of Lenin "A lie often told enough becomes the truth" The use the media for fourth estate herein referred as the media, unelected media to confuse society and project the ANC and its members as corrupt. This is untrue. Where this confusion does rises from? Right wing ideology neoliberal agenda subjective of reality.
For the past 25 years it remains a fact that the ANC led-government has been building clinics and hospital, going forward we are much concerned about the building the quality of health care [applause], to this end we expect our hon Minister to come up with scientific mega or bold infrastructure expansion proposal; how to build a new smart hospitals and clinics to accommodate NHI services, this will
be aligned with the population growth which will be fundamental necessity consistent with our 2030 vision.
More South Africans are living longer, the average life expectancy increasing to 64 years in 2018 from a low of 53 years in 2005. Progress in life expectancy reflects improvements in the quality and availability of health care, our massive campaign to turn the tide against HIV and Aids and our efforts to meet basic needs like access to clean water, electricity and adequate housing.
More than 4,5 million South Africans living with human immunodeficiency virus, HIV and Acquired immunodeficiency syndrome, AIDS, receive antiretroviral treatment, up from 2,4 million in 2014, making it the biggest antiretroviral treatment programme in the world. We have made dramatic progress in the prevention of mother- to-child transmission of HIV. In 2004, over 70,000 of babies born to HIV positive mothers became infected. By 2018 this figure had plummeted to 4,500, saving tens of thousands of new born babies per year. New HIV infections have decreased but our collective fight continues for an AIDS-free generation.
In 2009, there were 69,000 Tuberculosis, TB, related deaths, and by 2016 these had dropped to 29,000. Access to free primary health care
has been expanded from pregnant women and children less than six years of age in 1994 to free primary health care for all today. Despite all the achievements, the struggle for good quality health for all will continue.
President and Minister collectively demonstrated leadership on the NHI which demonstrate political commitment to this bold 54th National Conference of the ANC decision As President Cyril Ramaphosa said:
NHI is fundamentally about social justice. NHI will ensure that all our people, whether you are black or white, rich or poor, you will be able to access a comprehensive range of health care services.
This one - we agree! Today we spend -as a country, not as government- over 8% of the gross domestic product on health care - this spend is far higher than many countries of our economic size and more in line with advanced economies. According to many studies, this is more than enough to provide everyone to good health care.
Going forward despite high spending as a country and despite progress made, many of health outcomes remain stubbornly
disappointing. We know that despite such huge health care resources, the country has, good health care is not for everyone - they are many who do not get good health care when they need it. We must respond to this important question -As to why? As the ANC led- government the root courses of problem can be found in our two- tiered health system we inherited from the apartheid era, which reproduces the systematic inequalities in access and good quality care. It is a system made of huge medical aid funded and highly resourced private health care herein referred as "the first tier", designed primarily for the rich elite and the publicly under-funded public health care for the poor majority for our people, as referred in as a "the second tier".
Despite 25 years of major interventions to transform our health system and many achievements recorded - the two-tiered unequal system remains stubbornly high. We in the ANC have declared that the answer to our two tiered health care system is not an incremental, market forces driven solutions as suggested by the DA in the left, to problems of health coverage and quality health care. All DA what seeks to do is to main the central role of private health insurance in our national health system, thereby reproducing the inequalities, which is not sustainable in health care and this will be rejected by out Sixth Parliament.
What needs to be done to change the two tiered health system itself. Only the ANC have solution to all our people. To this end we have proposed a publicly financed national health insurance programme that would fully cover health care for all South Africans. NHI is therefore universal, comprehensive, and affordable and will be provide free health care at the point of use. We will eliminate the need for two tiered health care system dominated by private health insurance and we will be putting forward progressive a single, unified national health system. As the NHI White Paper notes:
NHI represents a substantial policy shift that will necessitate massive reorganisation of the current health care system, to address structural changes that exist in both the public and private sectors. It reflects the kind of society we wish to live in, one based on the values of justice, fairness and social solidarity. Implementation of NHI is consistent with the global vision that health care should be a social investment.
The White Paper also notes that:
The implementation of NHI is underpinned by vision 2030 of the National Development Plan, which envisions that by 2030, everyone must have access to an equal standard of care, regardless of their
income, and that a common fund should enable equitable access to health care, regardless of what people can afford or how frequently they need to use a service.
As the ANC, we have a clear electoral mandate to ensure that we do achieve this by end 2025-26. This is our target year, in which NHI fund will be fully functional, with access to all revenue collections; covering majority or entire population; with purchasing capacity to pay accredited health providers who meet quality standards. Therefore, one of the immediate priorities of the Sixth Parliament is to ensure the tabling of the NHI Bill that will set foundation for the roll-out of the NHI implementation.
It is part and parcel of NHI implementation to ensure that we strengthen the provision of health services, particularly in the public sector, with strong emphasis on primary health care. This could entail the building of the primary health care network, that includes school health services, and radical improvements in the performance and quality services of primary health facilities. NHI implementation will require adequate planning for that production and distribution of human resources for health, including absorption of tens of thousands of community health workers, who the Minister talked about earlier, who are paid above national minimum wage. We
also need to strengthen nursing colleges and medical schools - this the Deputy Minister has talked about-while building on the successful partnership on medical training programme with Fidel Castro- Dr Nelson Mandela Programme - Cuba a country renowned for its best health care system in the world.
The cost of medicines and drugs has been major concern of ANC-led government and we played an important role in reducing the cost of some of the essential drugs and will continue to do so. However, as part of our efforts we need to build domestic capacity to produce our own medicines by similars and medical equipment through creation of state-owned pharmaceutical enterprise, this is in consistent with our own both 53rd and 54th National Conference, within the Department of Health, we need to have capacity to meet the needs of our national health system.
This intervention must be understood within the context of our drive to industrialisation through localisation and leveraging the political economy of health care through its huge public procurement spend. Health is global business, international relations and political economy related international trade.
South Africa must reject- and I think it's important we indicate that Prof Woods from Oxford University analysis and accept that there is a global economic shift (in the globe), that the shift is the developing nations, so therefore the developing nations led by China have the capacity to acquire strategic asset which can benefit developing nations as a whole. It is important that we must reject unilateralism of Trump and remain solid and unshakable on the multilateral system. We must make sure that World Health Organisation must be able to spend of most of its capacity and work within the developing nations.
The country is not an importer not exporter that is linked to hard currency serious dollar in Europe. I mean of this era of drugs and medicine. So it is the currency volatility which will continue to affect the pricing and import of drugs, because they shift in large volume, the additional cost of logistic and warehousing, will definitely impact on the higher cost of procurement on medicine which will be borne by the patients.
It is within this context that the 53rd and 4th Conference Resolution, I repeat again, resolved on the establishment of the establishment of the pharmaceutical state-owned company, we can no longer postpone this issue Minister. The health care sector is not
blind to digital revolution. Especially on artificial intelligence, could unleash huge potential in digital health care technologies. Ensuring enhanced access for good quality care, especially our people in rural, remote area and part of our country. We therefore a looking forward to the contributions of the Department of Health to invest in digital health care services, including smart health facility, within the context of NHI implementation.
Consistent with the Department of Health annual performance plan on the strategic approach on National Strategic Framework 2014-19:
The era of digitalisation technology will be extensively used to leapfrog health system to implement NHI policy. In taking forward this decision our portfolio committee also resolve that the ministry need to have inter-ministerial engagement within Department of Communication and Digitalisation to secure telecommunication spectrum dedicated for e- governance with the key focus on healthcare technology to reduce the cost of services.
We are very clear that the spectrum would also be utilised to make sure that artificial intelligence or technology would be able to provide surveillance and face recognition technology, scan platform that would be able to ensure that safe and secure hospitals and
clinics and combat theft of medical drugs such as Antiretrovirals, ARVs. The health workers are also given [Interjection] [Inaudible] ... we support the Budget.