Honourable Chairperson
Honourable Minister of Health , Dr Aaron Motsoaledi
Honourable Ministers and Deputy Ministers present
Honourable MEC's
Honourable Chairperson and members of Select Committee on Social Services
Honourable Members of the NCOP
Distinguished guests
Ladies and gentleman
Good Afternoon
Hon Chairperson I am very pleased to get this opportunity to participate in the 2015/2016 Budget Vote of the Department of Health.This month of June is an important one in the calendar of the struggle for freedom in our country. Yesterday we marked the anniversary of the watershed June 16 Soweto uprising when young people took to the forefront of the liberation struggle. In 9 days time we will celebrate the 60th anniversary of the adoption of the Freedom Charter. These two are amongst some of the significant landmarks which remind us where we come from and the obligations we carry in ensuring that every day we lay a brick in the wall of building a democratic non-racial non-sexist and prosperous South Africa.
The mandate of the Department of Health arising from the Freedom Charter is simple and straightforward, viz the creation of a preventive health scheme and free health service for all at the point of delivery. Our strategic plan, our annual performance plans and our outcome of "A long and healthy life for all South Africans" are all derived from the vision of the Freedom Charter.
Hon Chairperson it is for this reason that our plans are anchored on the following priorities:
i) Promotion of health and prevention of disease.
ii) Acceleration of progress towards Universal Health Coverage by implementing the National Health Insurance and thereby ensure free health service at point of delivery.
iii) Reengineering of primary health care.
iv) Improving health facility planning, improved maintenance of existing infrastructure and effective delivery of new infrastructure.
v) Improving management capacity at all levels with focus on human resources management, financial management, supply chain and infrastructure development and maintenance.
Honourable Chairperson let me take this opportunity to again remind honourable members that while infectious diseases such as HIV/AIDS and TB remain a challenge we must not lose focus on the silent killers known as non-communicable diseases. We must do everything possible to highlight the dangers of these category of our burden of disease because they are largely preventable.
The broad categories of these diseases are:
i) Hypertension and cardiovascular diseases
ii) Chronic kidney diseases
iii) Diabetese Mellitus
iv) Cancer
v) Mental diseases
To differing extents the common causative or contributory factors to these diseases are:
a) Poor or inappropriate diet.
b) Tobacco smoking
c) Excessive use and abuse of alcohol
d) Lack of adequate and regular exercise
Hon Chairperson and members we utilise various tools in helping and galvanising our nation to avoid the NCDS:
a) Education and mobilisation
We work with various partners in government at various spheres, non-governmental organisations, civil society groups and even some business entities in educating our people about NCDS. Our education and mobilisation campaigns are either focussed on one particular disease such as diabetese or broad awareness on healthy living. I want to again take this opportunity to thank all the organisations, business and individuals who have put a lot of energy in the promotion of healthy living.
Amongst those we have worked well within the last financial year I can mention Pink Drive whose focus is on cancer especially breast and cervix cancers for women and prostate and testicular cancer for men. We also appreciate the contribution of the Proteas National Cricket Team early this year during the West Indies Tour. We also recognise the efforts of the first lady MaNgema-Zuma who is championing diabetese awareness while also appreciating the work of first Lady Thobeka Madiba-Zuma for working with Pink Drive in cancer awareness.
b) Legislation and regulation
A lot of work has been done with regard to regulation of smoking and advertisement of cigarettes and the benefits can be seen through a research by Human Science Research Council which shows that between 1993 and 2012, smoking has reduced by 50%.Regulatory work to protect the public has also been done to reduce the content of salt and trans-fatty acids in our retailed food or food products .The major challenge still facing our nation is the excessive consumption of alcohol in our society. The multiple negative impact of alcohol on the health of individuals and society are well known. We should reach finality this year on the legal instruments we can apply to help reduce the damage of alcohol abuse.
C) The third and the fourth areas of intervention are early detection of disease and the necessary intervention which is either just advice on Lifestyle change or initiation of medical treatments or both. We have various primary health screening programmes for this purpose based in our facilities but also through outreach programs. In order to maximise on resources we are now encouraging combined screening for infectious diseases such as HIV/AIDS and TB together with NCDS.
Honourable members our overriding message is that we must do everything in our power to prevent disease and promote healthy lifestyles. We are looking forward to working with our presiding officers to make sure that members of parliament are themselves living healthily with regular exercise.
Honourable chairperson we managed to progressively increase the number of designated high risk individuals protected through seasonal influenza vaccination. In 2014 a total of 818908 people were vaccinated as compared to 706374 in 2012 and we are targeting a million recipients of the vaccine in 2015.
Malaria is a vector transmissible disease in which we are doing very well with our focus still on elimination. We have seen a decline with 13986 cases in 2014 and 175 deaths compared to 64 622 cases and 459 deaths in year 2000. We continue to work with neighbouring countries especially Mozambique and also the Elimination 8 initiative involving 8 Southern African Development Community (SADC) countries to move towards a complete Malaria elimination. We are strengthening malaria surveillance systems, tracking drug and insecticides resistance, increasing community awareness and increasing human resource capacity
Honourable Chairperson, in terms of strengthening health services delivery systems we have developed a plan to improve quality of care in our central, tertiary, regional and specialised hospitals. While we are quite clear that the rock on which an effective health systems should be built is the primary health service we have no illusion about the importance of strengthening our hospital services as well.
In order to achieve a good quality hospital services we have a plan to radically reform central hospitals management and governance .Our intention is that at the level of central hospitals the boards and management should be given the maximum possible delegations, to manage the resources of the institutions. We envisage a situation where central hospitals will operate as Cost Centre or Business Units with the boards and management being held fully accountable for the use of resources and revenue collection. A model which will be compliant with our legal prescripts is being investigated in this regard
All our hospitals from central, tertiary , regional and specialised should adhere to national core standards established by the Office of the Health Standards Compliance. Five central hospitals were targeted for measurement of compliance. The outcome was that three of the five central hospitals ie. Steve Biko Hospital at 96% , Inkosi Albert Luthuli at 89% and Groote Schuur at 88%, were fully compliant with the national core standards and only Steve Biko was adherent to extreme measures at 100% and vital measures at 96%.
We still face challenges at tertiary, regional and specialised hospitals of the centralisation of operational decisions and non-functional governance structures but now, the policy is addressing this challenges
We have however made progress in that in 2014/2015 we had targeted two tertiary hospitals to have full packages of tertiary one services but we have been able to gazzette four instead. In the 2015 /2016 financial year we plan to have all ten central hospital with the full delegated authority, four additional tertiary hospitals with full tertiary 1 package and also to have more central and tertiary hospitals fully compliant with the national core standards.
Honourable Chairperson we have published regulations governing the promotion of emergency medical services in the 2014/2015 financial year. This regulations will enhance the importance of EMS by setting norms and standards of key service provision elements. We will now start inspection of ambulances and assess competencies of personnel. We have finalised policy on emergency care and education to improve the skills of EMS personnel; so that they are competent to deal with pre-hospitalisation of the ill and injured. We will fast track the process of establishing a national dedicated toll free emergency services.
Honourable Chairperson and members, in the area of forensic pathology services we have seen improvement in the turnaround time for performance of autopsies. We have appointed a national forensic pathology committee to ensure that services are up to acceptable standards. The new forensic laboratory in Durban is now functional and will eliminate the need for blood samples in KZN and the Eastern Cape to be transported over a long distance to Cape Town and Pretoria
Honourable Chairperson and members, the Department of Health has oversight over a number of schedule 3 public entities which we will briefly reflect on:
One of the most critical entities under the Department of Health is the National Health Laboratory Services.
The national health laboratory services is an important institution for providing diagnostic laboratory services to our health facilities. It also provides training , education and supports health research. In order to address financial challenges in the NHLS, the budget council has endorsed a reform which will now see the national institute for communicable diseases, national institute for occupational health and the teaching, training and research function receive funding through a transfer from the department from 2015/2016 financial year .This will result in the shift of funds from the HIV/ AIDDS conditional grant and equitable share back to department of health for the transfer to the above mentioned entities of the NHLS directly .
To even-out matters the tariff schedules will be reduced since these functions were previously cross-subsidised through laboratory tests. The NHLS is also taking various measures to improve efficiency, cut duplication , wastage and improved performance.
Amongst the six statutory health professional councils we can only mention that we are in the process of addressing governance and management challenges being experienced by the HPCSA. A ministerial task team chaired by Professor Mayosi of UCT is investigating various allegations and will report back to the Ministry in due course.
Cuban students programme
The Mandela Castro Bilateral Agreement has ensured that South Africa has Cuban trained specialists in remote, rural and undeserved areas of our country. In many instances, in some of these areas, our hospitals were totally dependent on Cuban doctors.
Since the inception of this agreement , South Africa has had the benefit of over 600 doctors from Cuba serving in South Africa. There are currently 196 Cuban doctors in South Africa mostly in rural areas.
The Cuban student training programme has already delivered 415 doctors to our country, a further 26 will graduate next month. In total there are currently close to 3 000 South African students studying to become doctors in Cuba. We are concerned in that many provinces are starting to reduce the numbers of students they are funding on this programme due to financial constraints.
We move South Africa forward.
Thank you.
