Chairperson, colleagues, MECs of Health from different provinces, hon members of the House, distinguished guests, and ladies and gentlemen.
I am presenting this budget under circumstances of serious challenges in health care in our country and around the world; namely, the H1N1 influenza and the global economic crisis. During economic crises, social outcomes are usually the first to suffer and the last to recover. Health is usually on the forefront of the social outcomes to suffer, because countries may be tempted to cut all social spending when faced with financial crises.
Let me start this presentation by reminding this House what His Excellency, President Jacob Zuma, said concerning health during the state of the nation address:
Fellow South Africans, we are seriously concerned about the degeneration of the quality of health care, aggravated by the steady increase in the burden of disease, in the past decade and a half.
This statement by the President is a clarion call to the Minister of Health and the MECs of Health in the provinces to put their heads together and decisively deal with the state of affairs. I'm therefore calling on my colleagues - the MECs from different provinces - to help me to deal with these issues without fear or favour.
In order to make a good start, we need to accept and acknowledge upfront that among the myriad of factors the following played a significant role and need to be carefully and urgently looked into: First, lack of managerial skills within health institutions; second, failure to act on identified deficiencies; third, delayed response to quality improvement requirements; fourth, unsatisfactory maintenance and repair services of our institutions; fifth, poor technological management; sixth, poor supply chain management; seventh, inability of individuals to take responsibility for their actions; eighth, poor disciplinary procedures and corruption; ninth, significant problems in clinical areas related to training and poor attitude of staff; and last, inadequate staffing levels in all areas.
I call upon provinces to note that, while some of these problems need a systemic approach, others are quite urgent and can be partially solved. That is, some problem areas need urgent impromptu solutions.
Let me take this opportunity to commend the Gauteng province on launching Operation Kuyasheshwa La. [Applause.] I wish to see such operations in all the provinces. At the same time, I want to share with the House our 10- point plan, which has been translated into our programme of action. The ruling party noted that there are problems within the health and education systems during their watershed conference in December 2007 and, hence, adopted and passed far-reaching resolutions. The binding resolution passed expected us to prioritise the health and education systems of the country in the next five years and beyond. The resolution was not just rhetoric, but a realisation of problems that we are faced with.
Since then, the ruling party came up with the 10-point programme, which has been officially adopted by the Department of Health as a programme of action. First is the strategic leadership and the creation of a social compact to better health outcomes. It is self-evident that if we don't provide leadership at all levels, including in the society, our health outcomes will never improve.
Second is the implementation of the National Health Insurance, NHI, which, unfortunately, has already been debated in the media even before the document was tabled.
Third is the accelerated implementation of the HIV and Aids Plan and the increased focus on tuberculosis, TB, and other communicable diseases.
I attended a session two weeks ago at the United Nations called by the Secretary-General of the United Nations and the Director-General of the World Health Organisation, Dr Margaret Chan. It was called because they worry about what governments around the world may do to health budgets when they are beaten by this global crisis, and they wanted to stop that. It was during that session that I was told, especially by leaders within the United Nations, that if South Africa failed to take the lead on the issue of HIV and Aids, the continent wouldn't be able to move. They were saying that, as the continental power house, South Africa needs to take the lead in the fight against HIV and Aids. For that reason, we need to be equal to the task and know that whatever leadership role and programme we take on HIV and Aids, it's not only for our country, but for the whole continent.
Fourth is the overhauling of the whole health care system and the improvement of its management. In this case, we will need to evaluate all hospitals' chief executive officers, CEOs, to ensure that they meet the minimum requirements for effective management of the set facility when instituting corrective measures where indicated that may include retraining and or redeployment of people. We are also doing a feasibility study for the establishment of a leadership academy of health managers.
In further overhauling the system, we'll evaluate and strengthen the district health care system and primary health care, which is not doing as well as expected. I want to remind the House that when we took over in 1994, the hallmark of the whole health care system and the central issue in our strategy was primary health care, which means the improvement of health right where the people are, in their homes and at clinics. At the moment, I think we are relying too much on hospitals, which is why there is so much overcrowding. So, we are going to have to look into that.
Fifth is the improvement of human resource planning, development and management. In this case, as I spoke about the shortage of staff, it is quite evident that when it comes to doctors, nurses, pharmacists and other related health workers, we are one team as a country. One of the most urgent things we are going to do is to open all the nursing training colleges to make sure that as many nurses as possible are trained. Presently, the training of nurses takes place at universities only. That is wrong and will not take us anywhere because it's like training an army with generals and no foot soldiers, and that needs to be changed as soon as possible. We also need to speak with our vice-chancellors from medical schools. The fact that only 1 200 doctors are produced by our eight medical schools, yearly, for the past eight years, needs to come to an end because we won't be able to move as a country if that doesn't change.
The sixth factor is to improve the quality of health care services.
The seventh factor is the revitalisation of the health care infrastructure.
The eighth is mass mobilisation for better health for the population.
The ninth will be the reviewing of the drug policy, which has been causing running battles between government, the pharmaceutical companies, pharmacists, etc. In this case, the fact that we have been able to bring drug prices down is a good starting point, but the whole policy on drugs in our country needs to be reviewed.
Last is to strengthen research and development in our country.
Let me indicate that by implementing this 10-point programme we will pay keen interest to the following four issues: Firstly, on the whole issue of financial management, whether at institutional, provincial or national government level, we are going to pay urgent and immediate attention to it.
Secondly, there is the issue of infrastructure or engineering services, including maintenance of health facilities, rather than to continue building new ones.
Thirdly is the issue of human resources for both the management and its development is something that we will keenly look into, because, as a country, I don't think we are doing very well in that regard.
Last is the issue of information communications technology, ICT, because in this modern world you cannot run a sophisticated department like the Department of Health unless the IT and ICT systems are up to standard.
These are the four main causes of the failures within the public health care system and there's no way we can implement the 10-point plan without looking at them. Our programmes of accelerating HIV/Aids are well catered for in our 10-point plan and when we get an opportunity we would like to expatiate on it. To conclude, if enough time was available, one would have liked to appraise the House about the present contemporary issues of the occupation-specific dispensation, OSD, because I'm sure that at some stage this House will need to know and understand what is happening. It doesn't help to get issues from the media because most of them have been distorted, misquoted and misdirected. It's puzzling because one won't exactly know what is happening in our country. I thank you. [Applause.]