presentation of the 2006/07 Budget Vote
5 June 2006
Mr Speaker,
Honourable Premier,
Esteemed members of the House,
Distinguished guests;
Shortly after my appointment by the Premier of Gauteng as MEC for Health, I
publicly stated that I donât believe in âa business as usual approachâ to
health issues in the province.
My remarks were intended not as a negative reflection on the many
achievements and successes achieved by my predecessors in this portfolio, but
as an expression of my hopes that we can look at health services in Gauteng
with fresh eyes and new perspectives.
One of the most obvious changes that are there for all to see is that I am
not a medical practitioner nor did I come to this job with any specific
background in the medical field. It might pose some challenges for me when I am
confronted with medical jargon and scientific research but it also does give me
the ability to look at the health services provided by the province through the
eyes of an ordinary consumer.
If there is one over riding principle that I want to establish from the
outset in the Gauteng Health Department from top management right through
district level to every hospital and clinic, to doctors and nurses and
administrative staff, it is that the needs of the public our patients and our
clients must come first.
We have to evaluate and critique our services constantly from the
perspective of the elderly gentleman waiting patiently in the queue to receive
his medicine from the victim of a shooting incident about to receive emergency
attention; from the expectant mother preparing for the birth of an infant and
through the eyes of a young child about to be immunised.
I am convinced, Mr Speaker, that when we apply these yardsticks we will find
that there are many things to praise and to applaud within the Gauteng health
system. Every day, every hour, every minute a medical doctor, a nurse or a
community health worker in this province perform minor miracles. They save
lives, they comfort the afflicted, they prevent the spread of disease and they
influence the risky lifestyles of individuals.
More often than not, the many dedicated professionals in our health system
do not receive the recognition they deserve for doing extra ordinary things
under very ordinary circumstances. And I believe it is time that we recognise
and acknowledge this.
But at the same time, honourable members, I think that we must also admit
that there are many things that can be improved in our system and many drastic
changes that need to be made to ensure that we have a people centred health
system operating in Gauteng. I spent the first few weeks since my appointment
visiting health facilities throughout the province speaking to managers,
medical staff, nurses and other health professionals as well as patients about
their experiences but also about their expectations.
I came away from most encounters with an overwhelming sense that we are
indeed making progress but that there is also significant room for improvement
across the entire spectrum of services that we deliver.
In many instances we can make profound changes by merely modifying existing
practices and procedures.
I donât believe in throwing money and budgets at issues that can be resolved
through simple common sense, commitment to duty and decency.
I donât need a medical degree to know that it is unacceptable for sick
patients to wait in long queues before being attended to. I donât have to be a
health expert to understand that patients must wear clean pyjamas that their
linen must be changed regularly and the floors of hospitals must be cleaned. We
donât need extra budgets to ensure that patients are treated with respect and
adequately informed about the nature of their ailments and the treatment that
is prescribed. These are basic, non-negotiable elements of any health care
facility.
I donât need a management consultant to tell me that professionals at our
hospitals should spend less time in staff meetings and symbolic gatherings and
more time in the wards looking after the welfare of their patients. I donât
need a three-month investigation to tell me it is unacceptable that in the age
of technology we still have to capture patient information manually and open
new files every time they are transferred from clinic to hospital. The good
work performed by dedicated health professionals is often undone by our weak
information systems resulting in long waiting times.
I donât need a professor in psychology to tell me that the most basic
expectation of any patient at a Gauteng health facility is to be treated with
dignity. It is the first principle of the ethical code in the medical
professions âthe welfare of the patient is the highest law.â
My concern is that if we lose this focus we are soon going to get lost in a
forest of secondary issues. If there is one thing that I want to commit myself
at the start of my tenure as MEC, it is that this Department will follow a
people centred and a patient centred approach. And once we have defined our
core business, all the peripheral issues will eventually fall in place and all
the concerns and challenges will be resolved.
As I present this R10,4 billion budget of the Gauteng Health Department I
would also like to recommit myself to the ideals espoused in the African
National Congress (ANC) health plan of 1994 which required us to change focus
from hospi-centric to primary health care. It also committed us to improving
the quality of healthcare, thereby ensuring access to health services to
communities on the ground. These ideals are now reflected in the way we
allocate resources.
Mr Speaker,
This is an important symbolic year in our countryâs history. In less than
two weekâs time we will celebrate the 30th anniversary of a seminal event
namely the Soweto Uprising. Many of us politically came of age at that time and
the events of 16 June shaped our private views and convictions and altered the
course of South African history.
In August we will commemorate that day in 1956 when South African women
stood up to confront the evils of apartheid and to tell the rulers of the time
sitting inside the Union Buildings that they will no longer be silenced or
oppressed into submission.
With the benefit of hindsight I believe that there is more than a casual
link between these two important events. In both instances the people who took
the initiative emerged from marginalised communities from within broader
society in August 1956 from women who have been shunted to the sidelines and
suffered a double dose of discrimination based on both race and gender.
And in June 1976 it was the youth of our country who rose up against a
political and education system that forever confined them to second-class
citizenship and humiliation inside the county of their birth.
Mr Speaker,
When we look at the importance of these events and we relate it to the
challenges facing South Africa in 2006 and especially those relating to health
issues there are clear parallels to be drawn. Some of the most pressing matters
that we need to address today are in the fields of womenâs health, reproductive
health, child health and gender issues.
I believe that we have a duty towards the past generations who pioneered the
democratic transition in this country who were arrested, imprisoned, tortured
and sometimes killed in the struggle for human rights and equality to ensure
that their sacrifices were not in vain.
And one of the best ways we as democratically elected representatives of the
people and as servants of the public within this administration can achieve
this is to ensure that women and children do not remain marginalised within our
democratic society.
This means that we will have to redouble our efforts to strengthen the
health status of women and to improve our capacity to deal with issues of
gender violence, physical abuse and sexual assault. I have no doubt that
improvements in the health status of women, children and the elderly will have
a ripple effect throughout the entire health system.
Child and youth health
We have been able to implement successful health strategies such as the
Integrated Management of Childhood Illnesses (IMCI) to improve the survival of
infants and children in 84 percent of our primary health care facilities.
Through the training of senior and middle managers we will continue to provide
support and advocacy that will enable us to increase coverage to 90
percent.
The Perinatal Problem Identification (PPI) programme has been implemented in
20 hospitals and 22 Midwife Obstetric Units. This is a strategy aimed at
reducing avoidable causes of neonatal and perinatal deaths. I am happy to
report that perinatal deaths have been significantly reduced from 37 per 1000
to 30 per 1000 and that our objective is to reduce this further.
The Kangaroo Mother Care (KMC) programme has been an important part of our
strategy to reduce deaths in premature babies and has proven to be cost
effective. This programme will be implemented in all hospitals providing
maternity and neonatal services in Gauteng this financial year.
Our immunisation coverage currently stands at 83 percent. Honourable members
will know that together with nutrition this programme is the single most
important intervention we are making to save the lives of children. Last year,
we launched every day an âimmunisation dayâ and Gauteng was named by the
national Department of Health as the province with the best immunisation
coverage. In 2006/07, we will ensure that we reach 90 percent immunisation
coverage for children under the age of one year, which will bring us in line
with the World Health Organisationâs (WHO) goal for global polio eradication by
2008.
Mr Speaker, we have seen a significant decrease in the number of children
under the age of five years who are experiencing severe malnutrition in our
province from 0,5 percent in 2004/05, to 0,34 percent in 2005/06. Last year a
total of 1 784 crèches were funded to provide nutrition to children and 53 216
young people were fed through the school nutrition programme. We also supported
30 soup kitchens benefiting people with chronic diseases attending our primary
health care facilities. A significant number of children and adults received
nutrition supplementation as part of the comprehensive care plan for HIV and
AIDS and tuberculosis (TB). The Vitamin A supplement was given to more than 150
000 children improving the coverage to 86 percent for children under one-year.
This year we aim to raise this coverage towards the 90 percent mark.
We have achieved the 100 percent target in the implementation of the
prevention of mother to child transmission of HIV and AIDS programme in the
hospitals and community health centres. We will expand the programme to 75
percent of the PHC clinics that provide antenatal care services in the
province.
In 2005/06 financial year the Department screened 117 228 learners for
learning obstacles. Over 16 000 of these learners were referred for appropriate
assistance. More than 1 000 learners with impaired vision were provided with
spectacles and 38 learners received hearing aids.
The youth friendly services have been expanded from 38 in 2004/05 to 52 in
2005/06, covering all our districts. A total of thirty new beds for child and
adolescent mental health services were opened at Chris Hani Baragwanath, Tara
and Sterkfontein Hospitals. The Sterkfontein programme focuses on adolescent
forensic services.
The Department launched the âclassroom health guide for teachersâ as part of
the Bana Pele programme last year. This guide aims to assist teachers in their
role as guardians of children by providing basic knowledge about common health
conditions. President Mbeki recently said that our country has entered its âage
of hope.â We believe that the Bana Pele programme supports this vision to
ensure that Gauteng becomes a province where the health needs of our youth are
valued and their future is secured.
Sexual, reproductive and womenâs health
Mr Speaker, as we prepare to celebrate the 50th anniversary of the march to
the Union Buildings by South African women we also have to evaluate the
progress we have made in improving the health status of women.
Our health professionals in hospitals and clinics still see far too many
women survivors of sexual assault and physical abuse. Our women also carry a
disproportionate burden of HIV and AIDS because of the violence that they have
to endure in relationships, within marriage and in society generally. This is
not an issue that can be solved at the level of health services alone. It
requires a concerted effort from the entire community including government, the
private sector, community and faith-based organisations and civil society to
ensure that we turn this tide around.
The post exposure prophylaxis for sexual assault survivors is now available
at 55 facilities of which 56 percent are open 24 hours of the day. In the past
year it has benefited 36,000 people. Five additional facilities will be
established at Chiawelo, Mofolo, Itereleng, Esangweni and Randfontein during
2006/07. To ensure holistic management of sexual assault survivors, 79 health
professionals were trained in medical forensic examination last year.
To further improve the health of women in our province, the Department
together with other stakeholders undertook successful campaigns to raise
awareness of cervical and breast cancer.
Last year 77 603 women which is an increase of 27 000 were screened for
cervical cancer and 7 649 for breast cancer.
A project has been introduced to improve the management of patients
diagnosed with breast cancer at Chris Hani Baragwanath, Johannesburg and Helen
Joseph Hospitals. This project will ensure that there is a reduction of
avoidable deaths amongst affected patients. A breast cancer clinic has been
established as a centre of excellence at Helen Joseph Hospital and will be
officially opened in the next quarter.
TB, HIV and AIDS
Mr Speaker, tuberculosis (TB) continues to affect our people. It also poses
a burden to our health system. The low cure rate remains a challenge, given
that TB can be cured with the correct treatment and compliance of patients and
with the support of communities.
Together with our partners we will be implementing the tuberculosis Crisis
Plan this year. The initial focus will be on Johannesburg Metro with a view to
improving the cure rate and we will gradually expand it to other districts in
the province.
We will continue to implement strategies to improve training of Directly
Observed Treatment Strategy (DOTS) supporters through the TB free centre.
With effect from 1 April this year, we have taken over the TB in patient
treatment programme from Non-Governmental Organisations (NGOs) and integrated
it into our district hospitals across the province. The Department now directly
manages the 820 TB beds previously managed by SANTA and Life Esidimeni.
A TB and HIV collaborative programme will be implemented in all
sub-districts this year and we will train 1 000 health care professionals on
comprehensive HIV and AIDS and TB clinical management and care.
The report of the United Nations Task Team (UNTT) on HIV/Aids released in
New York (NY) last week again highlighted the impact that this pandemic is
having on health systems and resources throughout the world. And although the
report notes that the global rates of infection and fatalities seem to have
reached a plateau, it is less optimistic about the situation in sub-Saharan
Africa.
A recurring theme throughout the report is the high incidence of HIV
infection amongst women and children more than half of the worldâs estimated
24,5 million people who are HIV positive are women from Africa and there are
two million children younger than 15 on our continent who are affected.
Since the inception of the Comprehensive Care Management (CCM) and treatment
programme including antiretroviral treatment, more than 350 000 patients have
been assessed and over 41 000 of which 6 000 are children have commenced
treatment.
In this financial year the HIV and AIDS CCM and treatment programme
including antiretroviral treatment will be expanded to hospitals, community
health centres and all sub-districts. By the end of this year there will be 54
operational sites with an estimated 60 000 patients receiving antiretroviral
therapy.
I am pleased to announce that our total budget for HIV and AIDS is increased
by 47,8 percent to R515,4 million. This confirms our unwavering commitment to
ensure that we bring this epidemic under control.
In Partnership with the South African Medical Association (SAMA) additional
general practitioners are provided to assist in managing our HIV and AIDS
clinics. This partnership will ensure a reduction in waiting times.
Mental health
Mr Speaker, one of the key areas that we must strengthen urgently is the
treatment of mentally ill patients. Again we are talking of a community that
has been marginalised in the past. This requires the urgent attention of a
people centred health care system.
Recent media reports about conditions at Dr George Mukhari and Tara
hospitals indicate the kind of challenges that we face. To ensure public trust
a comprehensive audit was carried out in all our mental health institutions to
review the patient care safety and infrastructural needs. In particular Dr
George Mukhari Hospital infrastructure was upgraded as a matter of urgency.
Furthermore, resources are allocated in this financial year to upgrade other
facilities.
I am pleased to announce that the budget for psychiatric hospitals is
increased from R465,2 million to R488 million which is an increase of
4,9percent.
And we have already appointed two mental health review boards as required by
the Mental Health Care Act and two more will be appointed in the next
quarter.
Chronic diseases
The burden of disease from chronic illnesses such as diabetes and
hypertension is on the increase in our province and our country. In 2005/06 we
had more than five million visits for chronic non-communicable diseases in our
primary health care facilities in the province.
Alcohol abuse, smoking, poor dietary intake and lack of exercise are among
the risk factors that are responsible for the increase in diseases of life
style.
A study conducted by the Foundation for Alcohol Related Research in 2000
revealed a disturbing finding that Foetal Alcohol Syndrome was unexpectedly
high among grade one school children in our province. This was found to be a
big problem especially in Lenasia South, Soweto and Westbury.
Clearly these findings should be of great concern to all of us and society
at large. Again we will need the concerted effort from across the spectrum of
society to address this and other social issues in our province.
We have implemented a âmove for health strategyâ aimed at educating
communities and all public employees in preventing and managing diseases of
lifestyle, through appropriate wellness programmes. Support groups have been
established in all sub-districts for chronic non-communicable diseases.
Flu vaccines were made available to all old age home residents to senior
citizens who attend our health care facilities and to other vulnerable sections
of our communities.
Strengthen primary health care
Mr Speaker,
The cornerstone of the national health system (the ANC Health Plan) is the
district health system which is a vehicle for the delivery of primary health
care services to our communities.
We continue to strengthen the primary health care services through better
access to health facilities in 291 fixed clinics (as well as satellite and
mobile units) and 28 community health centres.
Most of these facilities are situated close to the most disadvantaged
communities to ensure access to health care services and also to decrease the
burden on our hospitals of treating ambulatory patients who only require
primary health care.
The ANC policy of free primary health care services has improved access to
health care and patient visits have increased from 10,4 million in 2002 to 14,1
million in 2005/06. Utilisation figures are on the increase with visits per
capita in the province rising from 1,5 in 2004 to one and nine in 2005/6.
Many primary health care facilities have extended their service hours and
now provide after hour services to ensure improved accessibility to care
including emergencies. After hour services are now available in 75 percent of
sub districts. The target for the current financial year is 80 percent. The
Refiloe and Zithobeni clinics in Kungwini will start operating on Saturdays
this financial year.
Additional staff will be employed and medication and equipment purchased for
the purpose of further extending our after hour services.
We place great value on our partnerships with the universities to ensure the
appointment of family physicians as a medical specialty which will improve
quality of care.
New primary health care facilities will soon be opened at Boikhutsong in
Soshanguve, Bophelong in Atteridgeville, Eersterus, Bekkersdal, Hillbrow CHC,
Eldorado Park, Cullinan Community Health Centre and the Johan Deo clinic in
Sebokeng as well as the Mamelodi District Hospital.
Mr Speaker, our Community Health Workers (CHW) programme has already proved
its value to the people of Gauteng. Already more than 2000 community members
have been trained to provide community based health programmes. This programme
will further be supported by the additional R22 million from the Expanded
Public Works Programme (EPWP) within the social cluster. The programme is
geared towards alleviating poverty and developing skills in our disadvantaged
communities up to National Qualification Framework (NQF) level four.
Through our initiative of ward based health subcommittees, community
participation in primary health care has improved significantly from 61 percent
in 2004 to 75 percent in 2005.
In alignment with the National Health Act of 2005, the Provincial Health
Council has been established and quarterly meetings take place between the
Department and municipalities to ensure co-operative governance and integrated
health services.
The Department is working through the Department of Local Government towards
the transfer of primary health care services in accordance with the Act. In
line with National Health Act, the Gauteng Department of Health will
provincialise the provision of PHC services in district councils during 2006/7.
Joint district health service plans for 2006/7 have been completed.
Emergency medical services
An amount of R362 million is allocated towards emergency medical service for
this financial year. In line with national policy decisions Gauteng will take
over the responsibility for provincial emergency services.
At present emergency medical services are still rendered by local
authorities on an agency basis for the Department.
An interim memorandum of agreement has been concluded with local
authorities, to continue providing the service up to the 30 June 2006. A due
diligence study is currently being undertaken by the Department to ascertain
details of the costs and other risk factors for this move.
An amount of R22,29 million has been budgeted for Emergency Medical Service
(EMS) vehicles and equipment replacement.
A dedicated Obstetric EMS has been implemented in the Sedibeng area as a
pilot project, with great success. This vehicle transported 2 628 maternity
patients during the past year and waiting time for this service was reduced
significantly. The system will be expanded to the other districts within this
financial year.
21 vehicles for planned patient transport system have already been purchased
and are undergoing conversion. They will be delivered and distributed to
hospitals and clinics.
Hospital service delivery system and revitalisation
Mr Speaker, honourable members, in the few weeks since my appointment as
Health MEC, I have taken time to visit some of our hospitals. I have seen the
kind of pressure that they are under because of an increase in patient
loads.
I have seen how our health professionals are trying to do their best in what
sometimes are challenging conditions. But I have also spoken to many patients
and consumers of our services to determine their evaluation of the services we
render.
My view is that our Chief Executive Officers should be appointed on the
basis of leadership qualities and management skills. As a Department we have to
provide the required support and training to ensure that they are competent and
empowered to do their job effectively.
Our hospitals will only be able to render the services expected by our
people if they are managed by competent and responsible men and women. The
delegations of CEOs are being reviewed in order to empower and enable them to
manage hospitals effectively and efficiently. Full support shall be given to
them by senior management.
I am convinced that we have to implement our revitalisation programme with
greater speed and urgency. There are ample opportunities for collaboration with
the private sector and I am pleased to announce that the Chris Hani Baragwanath
Hospital revitalisation programme has now been registered as a Public Private
Partnership (PPP) by the National Treasury. To achieve this we will soon
appoint a Transaction Advisor to initiate the planning and implementation of
the PPP.
Through a partnership with the private sector we have been able to complete
the construction of a hand unit at this hospital. Discussions have also been
held with the Nelson Mandela Childrenâs Fund to establish a childrenâs unit,
while the Jewish Board of Deputies has indicated its interest to collaborate
with the Department to ensure an improvement in nursing care at this renowned
hospital.
Mr Speaker, these are but some of the examples of the excellent
relationships that are currently growing between the Department, the private
sector and civil society.
I am convinced that we must pursue this approach with increased vigour in
the coming years and so mobilise all possible resources and expertise in a
joint effort to raise the quality of health services in Gauteng.
Other projects included under our revitalisation programme are the
construction of the new Natalspruit, Lillian Ngoyi, Zola/Jabulani and Lenasia
hospitals and the upgrading of the Germiston, Mamelodi and Tshwane district
hospitals.
A new mortuary is being built at Dr George Mukhari Hospital as part of the
revitalisation programme. A second Computerised Tomography (CT) scanner is
being installed at the same hospital. A new Magnetic Resonance Imaging (MRI)
scanner will be purchased for Dr George Mukhari Hospital. This brings to 12 the
total of Gauteng Hospitals that now have CT scanners.
We have made significant progress to improve the capital expenditure on our
projects. An amount of R944 million has been allocated towards capital projects
including machinery and equipment.
The new Pretoria Academic Hospital has been commissioned and will be
officially opened during the second quarter of this financial year.
The modernisation of the Johannesburg Hospital pharmacy is on going. A new
oncology unit is being constructed and equipped at a cost of R178 million at
the Johannesburg Hospital. This provincial centre of excellence will provide
cancer treatment for the population of Gauteng, as well as surrounding
provinces and will also be officially opened during the next quarter.
The quality of the service rendered by our health professionals and support
staff at our hospitals continues to give us hope. Despite the heavy work load
and pressures on our health professionals in the tertiary institutions, we have
succeeded to significantly reduce the surgical backlog.
Human resources
The World Health Organisation (WHO) has declared 2006 the year where special
attention will be given to the global crisis in the health workforce.
According to the most recent WHO survey there is an estimated world wide
shortage of 4,3 million doctors, nurses, midwives and other health support
workers. We in Gauteng have not escaped this global trend.
In his introduction to the report, the Director-General of the WHO, Dr Lee
Jong-wook notes that âpeople are a vital ingredient in the strengthening of
health systems. But it takes a considerable investment of time and money to
train health workers. Countries need their skilled workforce to stay so that
their professional expertise can benefit the population. When health workers
leave to work elsewhere, there is a loss of hope and a loss of years of
investment.â
In Gauteng we have to implement a human resource strategy against the
backdrop of a sharp rise in demands for our services. The number of people
visiting our primary healthcare facilities has risen from a mere one million in
1994 to the current figure of 12 million. This rise can directly be attributed
to the success of this government and this administration to make health care
facilities accessible to the entire population.
Mr Speaker,
It is thus patently clear that we in South Africa must have the strategies
and the programmes that will not only enable us to recruit and train health
professionals to meet our growing needs but also to retain their services in a
global environment where the skills and knowledge of our professionals are in
great demand.
In line with the WHO focus for 2006 we had already in our province set a
strategic objective to be a leader in human resource management and development
for health.
The Bill of Rights puts the right to access to basic health care and
emergency services as a primary mandate. To deliver on this mandate, we have
set ourselves a target of increasing the number of nurses produced by our
colleges by 20 percent annually. In the last financial year we admitted 3651
student nurses of all categories into the education programme which is exceeds
our target by 600.
In addition 1 249 new graduates were employed in different hospitals and
clinics. This year we will reopen one nursing college and our objective is to
double the number of nurses we are producing by 2009.
This will necessitate that we appoint 50 more tutors to meet the teaching
needs of the increased production of nurses.
The Department has also embarked on strategic partnerships with the private
sector and an agreement has been reached with Life Health Care to train nursing
students. This training commenced in January 2006 and these students are funded
by Life Health Care.
We are working with our partners, organised labour and professional
associations to retain our existing nursing staff and improve the quality of
their work environment. This takes place through projects such as the âCaring
for the Carersâ programme, led by DENOSA and other partnership programmes with
the International Labour Organisation, the International Council of Nurses, the
WHO and Public Service International.
The Departmentâs drive to recruit and retain health professionals is
yielding positive results in that 2 900 professionals joined the Department in
the previous year. This drive will continue in the coming months with the
target to recruit 2300 health professionals by the end of the financial
year.
I am pleased to report that we have been able to retain critical staff
through a number of important interventions. This includes the revision of
remuneration structures through notch and level increments that were
implemented for targeted health professionals. We are also improving the
quality of the work environment for professionals through the increase in the
number of trained nurses, procurement of state of the art equipment, the
payment of recognition awards to deserving employees and the improved positive
profile of the Department as a preferred employer.
I have no doubt that an important element of the solution to our human
resources concerns is to raise the status of the nursing profession and to
improve the quality and the skills base of the nurses that we produce.
However, I want to state clearly that the status of a profession is not
conferred or trusted upon from the outside. Status is something you have to
earn. From our side we must look at remuneration and working conditions of
health professionals but there has to be an equal response in terms of
professionalism, commitment to service, ethics and innovation.
This year we will launch an Employee Charter which we believe will
drastically change the culture of caring.
As we make inroads in our recruitment and retention strategies we also have
to pay attention to changing the attitudes of our staff.
It is our fervent hope that the efforts that we are putting in improving the
working environment of our staff will have a direct positive influence on the
relationship between health professionals and our patients. We are also
computerising our facilities to improve patient record-keeping and strengthen
the administration.
While our patients have become more informed about their rights they are
still vulnerable because of the burden of disease. It is upon us to give them a
new experience show them we care treat them with compassion and dignity, to
demonstrate that we are indeed living in the age of hope.
We strive to provide excellent health services in our hospitals and
community health centres. Within this environment, we require the services of
more empowered leaders and managers with the necessary authority to take
decisions. We are currently reviewing the delegations and expect to complete
this process in the next quarter.
Mr Speaker as part of our service revolution drive, we know that this will
not be possible without a proper performance management system. We have,
therefore, presented a customised performance management contract to our CEOs
at the Imbizo and we are consulting our clinicians on their customised
version.
Conclusion
Mr Speaker and honourable members,
I think it should be clear that we have made significant progress in the
provision of quality health services in Gauteng but that we are also facing
numerous challenges. According to a recent report by Niel Steyn, the Executive
Officer for Research and Development at Hospital Association of South Africa
(HASA), 82,4 percent of people who used public hospitals and clinics were
satisfied with the service offered by these institutions.
Although this is still lower than the score achieved by the private sector,
it still provides us with an indication that we have made a good start and are
making progress.
Let me remind you of the words of the late Oliver Tambo who said; âThe
challenges we face are ones that arise out of success. They impose on us the
obligation to succeed even more, to succeed better and more quickly and to
succeed to achieve victory.â
In conclusion, I would like to thank my predecessor Dr Gwen Ramokgopa, for
laying a strong foundation on which we can continue to build the public health
system in the province. I would also like to thank the Premier for the
confidence he has shown in me. My word of gratitude also goes to my family,
colleagues in the ANC and this government for their support.
I intend to spend a lot of my early time in this portfolio listening to
people who have ample experience in the medical field both in the professions
and the administrations. It is important to listen to their concerns and the
challenges that they face. I have no doubt that we must address issues such as
the administrative burden on health professionals and the lack of resources as
matters of urgency.
But I also believe that we should not only complain and moan but also find
solutions together. We are living in a country where there are competing
demands for limited budgets. Obviously health is at the top of the list of
priorities but issues such as education, welfare, job creation, crime
prevention, infrastructure and small business development are as important for
balanced and sustainable growth in our society.
I want to call on people to make positive contributions to the health
debates in our country and our province. The easy answers are just to say âmore
moneyâ and âbigger budgetsâ or to âfire those that donât deliver.â But these
responses do not address the root of the problems.
As South Africans we often boast about our abilities to adapt to situations
or to find innovative solutions to complex problems. We talk about our âcan do
attitudeâ and of South Africa as a country that is âalive with possibility.â I
believe it is time that we apply these perceptions of ourselves to the harsh
realities of our health challenges.
I thank you!
Issued by: Department of Health, Gauteng Provincial Government
5 June 2006
