Hon Chair, Ministers that are here, Deputy Ministers, hon members, members of the SA Medical Research Council that I have seen, members of the Health Professions Council of SA, members of the Board of Healthcare Funders, members of the National Health Laboratory Service, members of the Council for Medical Schemes and members of the board of the SA Medicines Control Council, I think we must all congratulate the Department of International Relations and Co-operation for helping so that the paediatric oncologist could be on the plane today, coming back to South Africa. We welcome that. [Applause.]
We always promise a better life for the people of South Africa. Do we ever look back and ascertain whether we have fulfilled that promise? With regard to health, the ANC-led government has achieved what I regard as the most important indicator in South Africa. For the first time in the history of South Africa, life expectancy is prolonged. The people of South Africa now live longer than they used to. Consequently, because of the prolonged life expectancy, South African people will be directly contributing to the economy that supports them for longer periods. People see and experience their legacies whilst they are alive.
Allow me to inform the House how the ANC-led government has kept its word to better the lives of South African people.
Thina nto zaziyo asothukanga nto. Sitsho sisithi bekufanele, sibona kamhlophe sithi bekumele. Awukho umbutho onokwenza njengoKhongolose. [We, the knowledgeable ones, are not surprised. We say it was appropriate, we saw it clearly and said things happened as expected. There is no political party that can do better than the African National Congress.] [Applause.]
Honesty is our value. Humility is our motto. Driven by the people is our mission. [Interjections.] The department we are overseeing is very complex. It is both an entry and an exit of humankind to and from life. The Department of Health has power over the life and death of the people of this country. Health professionals are tasked with prolonging the period between the life entry and the life exit. For the first time, this has been achieved in South Africa. This indicates to us that the Department of Health is on the right course.
Three years ago, on this platform, we said that the passion showed by the Minister gave us hope. It has been proven that passion without resources can work, but resources without passion can be an empty shell. The hopes of the people have been renewed by the successful vaccination of children to reduce pneumonia and diarrhoea, which were the foremost causes of death in the young ones.
The price of antiretroviral drugs has tumbled down to help comply with the taking of the ARVs. Pharmaceuticals have introduced a single-dose drug that will greatly improve compliance and reduce side effects. Consequently, the viral load will drop to zero. What this implies is that the chances of infecting another person will drop to zero when a person is on this therapy. This is also a preventative measure.
CEOs with medical qualifications have been appointed in hospitals. Training has been given to CEOs using funds from both the public and private sector. The SA Medical Research Council has produced a few scientists, who are South Africans, to continue doing research in South Africa. Nothing about us without us.
The public health care sector has been regulated for the first time. Regulating the public health care sector has not happened before. Primary health care has been re-engineered. The School Health Programme, ward-based community involvement, and specialist teams in district services have been set up, and this brings hope. Maternal deaths have been reduced and progress has been made, especially after the launch of Carmma, the Campaign for Accelerated Reduction of Maternal Mortality in Africa, held in Durban. This involved the launch of the programme for obstetric ambulances in the provinces, the ability to diagnose the commonest causes of death in maternal patients, and the fact that the department has set up maternal enquiries. All these have made it possible to reduce the maternal death rate.
We commend the Department of Health for actually budgeting for the shortfall in funding for Pepfar, the US President's Emergency Plan for Aids Relief, that has being reduced. The rate of mother-to-child transmission has dropped. We have seen advances in the health sector, such as the first cloned skin graft, performed by Dr Ridwan Mia and his team. We have heard about antibodies to the HIV virus being discovered by Prof Abdool Karim and his team. All these advances serve to prolong the gap between the entry to and exit from this life.
Does the Department of Health deserve this House's support for this Budget Vote? Obviously, yes, we support this Budget Vote owing to what I have said. The department has implemented the ANC-led government's policies, and I have narrated to the House that when we look back we see that they have done very well.
However, the Department of Health still faces challenges. Statistics SA showed that despite tuberculosis being a treatable condition, it is still a killer. As a country, we are rated low globally because of the rate of infectious conditions compared to that of other countries. Despite the bad association of TB and the HI virus, TB is still the main killer.
I am sure we know that doctors who are saying that TB is a killer are right because there are few conditions in which the HI virus is the actual killer. What is worrisome about the rate of TB is the fact that this indicates to us that there is still a big gap between the rich and the poor, particularly because we have two parallel health structures, which are the public health care sector and the private health sector, and they are failing to reach a rapport on this matter.
As for the Western Cape, the statistics for TB infection are very high, yet the statistics for HIV are very low. This tells you that the gap between the rich and the poor in the province is very high. [Interjections.]
The Department of Health is a divine idea from the mind of God that has been made manifest. The officials and professionals of the department are accountable to the Minister, Parliament and the Auditor-General. Besides these structures, who should call department officials to account? Is the South African public not supposed to call them to account? They are the payers of taxes and it is within their rights to demand accountability.
People think that issues of health are very complex, and hence they shy away from them. It is the responsibility of the department to engage and empower health beneficiaries at all levels in order for people to understand health issues.
Are health professionals not entitled to some accountability by the department? Yes, they are, but owing to the fact that they are speaking in different voices and are not unified, they are making it difficult for the department to respond and account to them. There are many professional voices advocating for health issues, public health care, private health care, clinical care professionals and health administration. I urge health care professionals to speak with one voice so that they can advance further the struggle for health care.
When persons need health care, irrespective of whether they choose the public or the private sector, they will be attended to by a nurse, a doctor, or an auxiliary health professional if necessary. At the core of health services are the health care professionals. Health care professionals should be the ones who drive universal coverage. As custodians of health care, they have the ability to make health services universal.
Private health care should make the department accountable to them too. South Africa needs the private health care sector. When the ANC took over in 1994, the private health care industry was in existence in this country providing services to about 8 million South Africans. We need private health care, but let us agree that it cannot be business as usual. The high cost of private health care is a disservice to the country. Owing to the high cost of private health care, benefits get depleted for a great majority of patients on medical aids before patients are cured of their diseases.
The patient who leaves hospital not having been cured of a disease, such as TB, goes back to his or her family and community and infects more people. This is owing to the high costs. This is what I am alluding to when I say that the high costs of private health care are a disservice to the country.
The worst scenario is that a TB patient, who could not complete his or her treatment owing to high costs, will definitely develop multidrug-resistant or extreme drug-resistant TB. His or her treatment becomes more expensive for the country under these conditions. With situations like this, nobody is safe, even the doctors and nurses looking after the patient. All this is caused by the fact that the private health care industry is not affordable.
When a person falls sick, suffers a cardiovascular incident or a heart attack, it is a matter of life and death and there is no time to shop around for cheaper health care. By the time the sick person gets to another health care provider, the condition has worsened or the person has died. I commend a group called Intercare, which is in the private health care industry. They are investing in primary health care, rehabilitation and day care hospitals. They keep patients for a shorter period to make sure that they go back and contribute to the economy. In fact, it is interesting that the founders of Intercare are health professionals who assisted in actually transforming what we used to call the Medical Association of SA to the SA Medical Association.
South Africa is plagued by a society that is very angry. Whether this anger relates to our past or to mistrust among the different people inhabiting the country is yet to be established.
The country has a number of undiagnosed psychopaths languishing in prison. If we could look at the profile of a typical psychopath, we would see that these people need mental services, especially after serving their prison terms. Mental services need to be integrated with primary health care, and we need health care workers to specialise in mental health care.
Our primary health care plan is very good, but the department needs to make sure that the plan filters down to the rural areas. Irrespective of the good re-engineering of primary health care, we still have challenges in rural areas. I remember that listening recently to a programme on SAfm in which the Deputy Minister was hosted. Two doctors phoned from the rural areas, complaining about services that are not very good in the rural areas. The development of rural health care actually assists in helping the referral system to the big hospitals.
The Public Service is facing a serious challenge of quantity as far as health care workers are concerned. This is not exclusive to South Africa, but is a worldwide problem. The tendency of wanting to produce larger amounts of health care workers compromises the quality. The inadequate number of health care workers has a direct impact on the quality of patient management. The downward spiral of quality in patient management is the reason why lawyers have a free reign in suing the Department of Health.
I am making a serious call on universities, colleges and professional councils to assist and to be sure of the quality of health care professionals that we train in South Africa. I am reminded of the case of a three-month-old baby in hospital: when this baby went to hospital the staff wanted to give intravenous treatment and make sure that the baby was rehydrated. They tried to put a bandage around his head to look for a vein, but couldn't access one. They put a bandage on the leg, but still couldn't get a vein. The staff then tried the arm, but still couldn't find a vein. Three days later, the three-month-old baby was examined by a doctor, only to find that the limb was black and swollen, could not be used any more and had to be amputated.
The question that you ask is: Wasn't this baby crying from the bandage being on for three days? Obviously, this is poor quality service that needs to be considered. That is why we are calling on universities, colleges and professional councils to assist us and make sure that the quality and the attitudes of our health care workers become better.
From the aforementioned, it is evident that the Department of Health has done very well, and they deserve this budget they are calling for. But, I think, there are certain things that we need to consider. We need to look at the private and public health care services, because these services are perpetuating the infectious conditions we have. I also call on all health professionals to know that they should be the leaders in universal coverage. I thank you. [Applause.]