Chairperson, hon Ministers, hon members, whilst the national health budget deserves praise for the objectives and priorities, the speech outlines almost no details on the budget allocated to various projects.
In a broad context, and together with a wide range of key stakeholders, we support the 10-point programme, with the exception of the National Health Insurance, because we believe alternative ways and means should be researched to strengthen the delivery of health services throughout the country.
However, the budget speech is severely lacking in details and, more specifically, the tactics that must be implemented to address the estimated shortfall of almost R6 billion, which is more than double that of the previous financial year. In fact, with the gross underestimation of the occupation-specific dispensation, the real health deficit is a guessing game.
Die oorspandering van die ander agt provinsies tot 'n bedrag van ongeveer R7 miljard - met Gauteng op R1,75 miljard; KwaZulu-Natal op R2,3 miljard, en die Oos-Kaap op R1,6 miljard - bewys dat dit 'n standaardprosedure geword het vir die provinsies om nie hul aanwas te betaal nie en dat hulle by hulle krediteure agterstallig is. (Translation of Afrikaans paragraph follows.)
[The overspending by the other eight provinces to the amount of about R7 billion - with Gauteng at R1,75 billion, KwaZulu-Natal at R2,3 billion and the Eastern Cape at R1,6 billion - proves that it has become standard practice for the provinces not to pay their accretion and that they are in arrears with their creditors.]
The goals and objectives set out in this week's budget speech remain only concepts if specific amounts, tight financial control and strict fiscal discipline to manage and pay back these shortfalls are not built into the implementation.
Die verbetering in die kwaliteit van dienslewering as 'n prioriteit word verwelkom.
Die effektiwiteit van dienslewering word onder geweldige druk geplaas deur, onder meer, migrasie en immigrasie. Volgens Demographics Online, word die vloei van mense in Gauteng op 446 900, in KwaZulu-Natal op 12 100 en in die Wes-Kaap op 137 000 bereken.
Die Departement van Binnelandse Sake se sake is so deurmekaar en oneffektief dat die werklike getal immigrante nie geregistreer word nie. Sodoende kan die provinsie nie behoorlik beplan en begroot vir die dienslewering van gesondheidsorg nie.
Verdere probleme kom voor waar migrante van byvoorbeeld die Oos-Kaap meer gebruik maak van dienslewering in die Wes-Kaap. Die Oos-Kaap het 83 staatshospitale teenoor die 55 van die Wes-Kaap. Di in die Oos-Kaap staan leeg of het geen toerusting, personeel of medikasie nie en daarom is daar 'n toestroming na die hospitale in die Wes-Kaap.
Hierdie soort van situasie behoort en moet dringend aangepak te word, hetsy deurdat 'n pro rata-toewysing van meer fondse aan die Wes-Kaap of 'n verbetering in dienste en omstandighede in die Oos-Kaap.
Op 9 Maart verskyn 'n berig in die Cape Argus waarin die Minister van Binnelandse Sake haar kommer uitspreek oor die groot getal kinders onder 15 jaar wat geen amptelike status in Suid-Afrika het nie en nie in 'n inskrywingsboek of die bevolkingsregister voorkom nie. Hulle het ook geen geboortesertifikate nie. Die feit is dat babas nie meer op 'n gereelde basis by hospitale geregistreer word nie. Binnelandse Sake se kantore is nie toeganklik vir mense van verafgele gebiede nie. En, indien wel toeganklik, is die dienslewering so stadig en ondoeltreffend dat ouers net nie daarvoor kans sien nie. (Translation of Afrikaans paragraphs follows.)
[The improvement in the quality of service delivery as a priority is also welcomed.
The effectiveness of service delivery is placed under tremendous pressure by, among others, migration and immigration. According to Demographics Online, the estimated flow of people in Gauteng is at 446 900, in KwaZulu- Natal at 12 100 and in the Western Cape at 137 000.
The affairs of the Department of Home Affairs are so mixed up and ineffective that the true number of immigrants cannot be registered. As such, the province cannot properly plan and budget for health service delivery.
Further problems arise where migrants from for instance, the Eastern Cape are making more use of service delivery in the Western Cape. The Eastern Cape has 83 state hospitals as opposed to 55 in the Western Cape. Those in the Eastern Cape are standing empty or have no equipment, personnel or medication, and therefore there is a convergence on the hospitals in the Western Cape.
This type of situation ought to and must be addressed urgently, either by allocating more funds pro rata to the Western Cape or by improving services and conditions in the Eastern Cape.
On 9 March a report appeared in the Cape Argus in which the Minister of Home Affairs expressed her concern regarding the large number of children under the age of 15 who do not have official status in South Africa and who do not appear in a registration index or in the population register. They also have no birth certificates. It is a fact that babies are no longer being registered hospitals on a regular basis by hospitals. The offices of Home Affairs are not accessible for people from remote areas. And when they are accessible, the service delivery is so slow and ineffective that parents are just not up to it.]
However, I want to congratulate Minister Dlamini-Zuma for all her efforts and what she has achieved so far.
Ontoeganklikheid ten opsigte van primre gesondheidsorg kan bydra tot die swangerskap- en kindersterftesyfers. Die feit dat al drie bogenoemdes prioriteite in die Begroting is, word waardeer, maar daar is geen spesifieke planne om die toepassing daarvan te verseker nie, soos byvoorbeeld deur middle van befondsing, vervoer, die aantal gesondheidswerkers en die toerusting wat benodig word.
Weereens dra Binnelandse Sake se werksetiek by tot die bykans onmoontlike registrasie van opgeleide, vaardige immigrante. Die Cape Argus van November 2009 berig, en ek haal aan:
To aggravate matters, the Department of Home Affairs officials make it virtually impossible for the genuinely skilled among these African migrants to get permits for legal employment; consequently, Nigerian theatre nurses are selling mangoes at the side of the road.
In die Wes-Kaap word kinders uit noodsaaklikheid van geboorte tot vyf jaar teen polio, en van ses maande tot 15 jaar teen masels ingent. Die gesondheidswerkers het vrywillige hulp van ouers en die gemeenskap gekry en oor die afgelope twee dae is 20 000 kinders in Khayelitsha alleen ingent.
'n AGB LID: Baie mooi!
Me A MARAIS (Wes-Kaap): Soos Minister Motsoaledi genoem het, moet 190 000 kinders nog ingent word en 700 000 swanger vroue teen, onder meer , die N1H1 griepvirus gevaksineer word. Dit is voorwaar 'n grootse taak. (Translation of Afrikaans paragraphs follows.)
[A lack of accessibility in respect of primary health care can contribute to the pregnancy and child mortality rates. The fact that all three of the above-mentioned are priorities in the budget is appreciated, but there are no specific plans to ensure implementation, such as for instance by way of funding, transportation, the number of health care workers and the equipment required.
Once again the work ethic of Home Affairs is contributing to the virtually impossible registration of trained, skilled immigrants. The Cape Argus of November 2009 reports, and I quote:]
To aggravate matters, the Department of Home Affairs officials make it virtually impossible for the genuinely skilled among these African migrants to get permits for legal employment; consequently, Nigerian theatre nurses are selling mangoes at the side of the road.
In the Western Cape children are perforce inoculated against polio from birth to five years, and against measles from 6 months to 15 years. The health workers have received voluntary help from parents and the community and in the past two days 20 000 children were inoculated in Khayelitsha alone.