E Selao: Northern Cape Health Prov Budget Vote 2006/07

Northern Cape Department of Health Budget Vote 2006/07
presented by MEC ES Selao

15 June 2006

Introduction

Today, we are pleased to say that we live in an era of growth and
opportunity. Our country has seen unparalleled and consistent growth in the
economy over the last decade. The fruit of this growth has been evident in the
extent to which lives of the poor have been positively affected.
Notwithstanding the above, we have to acknowledge that many people are still
trapped in a cycle of poverty, or live below the breadline. This has enormous
implications for the quality of life of people resulting in a high reliance on
social grants as well as giving rise to a number of socio-economic problems
that are associated with poverty and vulnerability. In any society dependence
for sustenance solely from government is not productive and ultimately negates
growth in the Provincial economy.
Given our acknowledgement of the above, our policies have to be focussed on
promoting self-reliance of vulnerable persons and consciously move away from
perpetuating dependency.

To this end, the Department has commenced an intensive review of its
activities, with a view of moving towards a developmental approach and
providing services to the poor and vulnerable sectors of our society. Through
this new approach we seek to enhance sustainable livelihoods.

The principles that underpin this new methodology are equity, accessibility,
efficiency and participation of people in decisions that affect their lives,
which ultimately must lead to self-reliance. Through this model, we will ensure
that people are involved in determining their own destination and hence move
away from a purely rehabilitative approach to a more preventative one. Given
this new vision, our first task was to ensure the streamlining of the
instrument of delivery of services.

In 2004, we sought to improve on the internal functioning of the Department,
by addressing matters affecting staff morale, team spirit, internal
infrastructure, expenditure control as well as the devolution of
decision-making.

During the course of 2005, we sought to add to this strategy by the
improvement of service delivery and in particular the improvement of support to
our development partners. As a result we attained successes in eradicating the
backlog in social grant applications including the backlog in foster care
applications. Improved financial management systems, had the effect of ensuring
that we came within budget as well as attaining an unqualified report from the
Office of the Auditor-General. In that year we also created an enabling
environment for our social partners in the non-governmental (NGO) sector by
increasing the subsidies to them, in some instances by as much as 50%.

A major review of the Departmental Strategic Plan was undertaken with a
revised vision and mission statement emerging out of this intensive process. In
line with our new focus we developed a new organogram for the Department which
will be regularly reviewed to ensure it remains relevant to achieve our
strategic objectives.

In steering the Department on a developmental trajectory, we are acutely
aware of the need for evidence-based policy making. We need accurate and
reliable information to enable appropriate policy choices. To this end, the
Population Development Unit located in the Department, has concluded numerous
research reports in the last year and will continue to do so this year.

Macro Focus for 2006/07

Today we want to move away from an approach that lists achievements in the
various sectors of the Department for the last financial year, and list plans
for the coming year. Instead, we would like to focus on how policy matters will
find resonance in the 2006/07 financial year.

Key for this year, and in recognition of the significant role played by our
social partners in attaining our developmental objectives, is the improvement
in allocations to NGOs.

Also an important objective for 2006/07 must be to address the social
infrastructure needs that will underpin our new approach. A further area of
focus is to strengthen targeted programmes in support of family preservation,
care of the elderly, disabled and vulnerable children. I will elaborate further
on these matters later.

Target sectors:

I want to caution that although we will deal with each target group and
programmatic intervention separately, these issues are all inter linked and the
manifestations of the malfunction of any one area of society has implications
for another area. For example, malfunctioning families give rise to the
phenomena of children in conflict with the law, or to matters of substance
abuse.

Families

I need not remind members that the family is the basic unit in our society
and is integral to the general well being of individuals be they children,
youth or older members of society. With effective parenting within families,
children are nurtured, supported and provided with opportunities for growth and
development into becoming well-adjusted adults, who in turn contribute
positively towards building a caring and cohesive society.

Having said this, we are painfully aware that the institution of the family
as we know it is under threat, and often no longer serves as the conduit for
norms and values to the younger generation. In the last financial year,
emphasis has been on programmes raising awareness on the Interim National
Family Policy, with community dialogues held in four regions of the
province.

For the coming year, in addition to the programmes targeting vulnerable
children, we will host a Family Life Indaba involving a broad range of
stakeholders to strategise around the disintegration of family life. Campaigns
and Programmes will focus on Family Preservation, which is the essence of the
new policy paradigm. The Adolescent Development Programme and Professional
Foster Care Programme will be rolled out as Family Preservation Programmes in
Pixley ka Seme and Namakwa regions.

The elderly

I cannot over-emphasise the important role played by the elderly in our
society. They are the custodians of our different cultures and are largely
responsible for the continuity of our traditional values and standards. Today
also happens to be the day that we commemorate the International Day against
abuse of Elders. Pending legislation (the Older Persons Bill) recognises these
concerns and makes provision for the protection of the rights of older persons
as well as to make provision for the establishment of community based services.
This approach ensures that we do not place older persons in institutions such
as old age homes except where they are frail and in need have care.

In fact the policy makes provision for home-based care services and the
establishment of Multi Purpose Centres. We are proud to say that in this
Province we have pre-empted the new policy direction and have already
established the Resthaven Facility as a pilot in Kimberley as a multi-purpose
centre for use by the elderly in the community. Construction is already
underway in Groblershoop to establish a second Multi Purpose Centre and a third
will be built in Strydenberg during this financial year. In addition, for this
financial year, provision has been made for 8 additional service centres for
older persons. We will also appoint an additional 27 caregivers to whom
stipends will be paid.

Other interventions include increased support to NGOs in terms of additional
posts to be funded as well as strengthening institutional arrangements to
ensure sustainable programmes. Two of our social partners who are active in
support of the elderly i.e. Age in Action and Older Persons Northern Cape, will
receive additional support from us this year with a view of increasing capacity
in their staffing structure. Whilst subsidies to NGOs and service centres will
be increased by an average of 5 %, allocation to the 27 Old Age Homes will be
increased by 25 % with effect from 1 June 2006.

Children

The majority of children, not only in this province, but in the entire
country, live in conditions of poverty. A recent study conducted by the Centre
for Actuarial Research at the University of Cape Town (UCT) suggests that 66%
of children live in households where the income is less than R1 200.

Unfortunately children are also the first to bear the brunt of substance
abuse, neglect, child abuse as well as HIV/AIDS.

Evidence of the commitment of Government in dealing with issues affecting
children as well as transforming services to children, is witnessed in the
response by Government in various areas.

The most effective response to child income poverty was the introduction of
the Child Support Grant in 1998. In the Northern Cape, 119 366 children benefit
from the Child Support Grant.

In addition, the Children's Bill gives effect to children's constitutional
rights, to social services, to family care, parental care or appropriate
alternative care and protection from neglect and abuse.

Our programmes in the last financial year were focussed on the provision of
awareness campaigns for the protection of vulnerable children, programmes aimed
at equipping children with life skills and encouraging them to participate in
decision making on services and issues that affect children.

In pursuance of our aim to upgrade social infrastructure in support of
children, we improved security at the Molehe Mampe and Lerato Place of Safety
and are looking at further systemic and infrastructural improvements in the
current financial year.

In keeping with our commitment to transform institutions as well as the
effective use of our resources, the Kamieskroon VGK Children's Home and the
Roman Catholic Children's Homes were amalgamated. Focussed interventions for
the benefit of children will include the upgrading of 3 facilities, namely
Kestell Children's Home (in Kimberley), Bright Lights Children's Home (in
Pofadder) and Jannie Roux (in Barkly West) at R150 000 and R200 000 and R100
000, being allocated to each respectively. The Department will also be
embarking on a joint venture with Idwala Mine, Finch Mine, the Kgatelopele
Development Forum as well as NG Welsyn when we launch the Tsholofelo Children's
Home in Daniëlskuil this year. The new established Children's Home will cater
for children in need of care.

Last year saw an increase of 50% in the subsidies to our social partners in
the NGO sector dealing with children. This year we have provided for inflation-
linked increase of 5 % to ensure that we maintain the value of the previous
substantial increase. Furthermore allocations to shelters that cater for
homeless children will also be increased by 16%. Shelters are intended as a
temporary arrangement whilst interventions are also made to reunify children
with their families or alternatively placed appropriately in foster care or
adoption in pursuance of our family preservation mandate.

For this financial year we will strengthen our services for children by
improving allocations to child-focussed services.

Early Childhood Development

This Department is also tasked with the implementation of stimulation
programs for children below 5 years, the registration of facilities in line
with the Child Care Act, as well as the monitoring and evaluation of Early
Childhood Development programs.

Our commitment to enhance the development of our children has resulted in
the funding of 13 Early Childhood Development centres and the registration of
26 additional centres in the past financial year. This year we will be funding
an additional 40 Early Childhood Development centres at a cost of R3,7 m
bringing the total funded centres in the Province to 219. This allocation will
increase to R11,6m in the 2007/08 financial year, enabling the Department to
implement the recently adopted Guidelines for Early Childhood Development
Centres, and provide holistic services in relation to the child's health,
nutrition, development, psychosocial and other needs. As part of our
commitments in terms of Expanded Public Works Programme in the last financial
year 100 social auxiliary workers were trained. Another 100 people were
appointed under the Early Childhood Development Learnership Programme in August
2005, as well as the provision of training to management boards of Early
Childhood Development Centres.

Social Crime Prevention programmes

The Policy on Social Crime Prevention is largely reflected in the Child
Justice Bill, which introduces major changes in the manner in which children in
conflict with the law are managed within the criminal justice system. In
essence the Bill places emphasis on a wider range of diversion programmes and
extends variety of sentencing options for children in conflict with the law. To
this end we have successfully implemented the home-based supervision programme
for youth awaiting trial in the Frances Baard Region, which is an alternative
sentencing option for youth. In addition, probation officers and assistant
probation officers were appointed in various towns in the province rendering a
range of services including prevention services diversion programmes and
statutory services in courts as well as a sexual offence programme with
therapeutic diversion for young sexual offenders.

The Northern Cape Province is also piloting the volunteer assistant
probation officer skills development programme, which forms part of the
national youth services programme in partnership with the Umsobomvu Youth Fund.
For this financial year, we will extend the Home Based Supervision Programme
(HBSP) to Siyanda, Namaqua and Pixley Ka Seme. This will be linked to the
appointment of Assistant Probation Officers who will be tasked with
implementation of the Home Based Supervision Programme. In addition, we will
also host a Probation Services Indaba for all stakeholders to develop an
integrated strategy in line with the Child Justice Bill.

Substance abuse

Linked to the problem of social crimes is the matter of substance abuse
which is becoming increasingly more prevalent and can be directly related to a
number of socio-economic problems. Other than crime these include amongst
others, family disintegration, child neglect and abuse as well as increased
exposure to sexual assault. Research conducted by our Department indicates that
the average person spends a high proportion of their income on liquor (some as
high as R500 pm).
The Departmental response to this attack on our quality of life includes a
focus on awareness campaigns to educate and inform people about the effects of
substance abuse as well as treatment options. The launch last year of the Ke
Moja "No Thanks I'm Fine Without Drugs" Campaign in schools in the Province is
a campaign targeting young people at schools. In addition, we have trained 30
people in substance abuse counselling skills enabling them to do assessments
and provide counselling to persons affected by substance abuse. An outcome of
the Substance Abuse Summit held in October 2005 was the tabling of a clear
intervention strategy for the Province, which requires improved integration of
our efforts, the establishment of drug fora and the focussed implementation of
the Drug Master Plan. For the current financial year, we will continue to
expand our awareness campaigns, our training interventions, as well as
strengthen our institutional mechanisms. We will also register and fund 4
organisations and 8 community based treatment programmes, which we expect to
reach about 1000 targeted individuals.

Abuse of children

Trends indicating high incidences of child abuse and neglect have come to
the fore in the past few years. Members of this house have on numerous
occasions expressed their dismay at this phenomenon. In addition to our
existing programmes this year, we will increase our efforts in protecting our
children through strengthening support networks for children. We recently
launched the community based Safety Networks for Children in the province. The
Northern Cape Province is the first to initiate this programme. The Safety
Networks is made up of prospective foster parents, adoption parents and safety
parents with whom children in need of care can be placed. Other community based
child protection services such as the Isolabantwana programme and the Neighbour
helping Neighbour programme will continue to be strengthened. An amount of R700
000 has been budgeted for the training of 170 volunteers in victim empowerment
and trauma support services. Continued funding to the value of R600 000 has
been allocated for victim empowerment shelters and centres. In addition R500
000 will be spent towards the implementation of a victim empowerment
campaign.

People with disabilities

In line with the developmental paradigm shift, the policy guidelines for
services to people with disabilities have also taken a more developmental
stance. The Integrated National Disability Strategy calls for the realisation
of a variety of services to make it possible for people with disabilities as
well as parents of disabled children to access services that will enhance their
ability to be self-reliant.

The pursuance of self-reliance for people with disabilities has been given a
boost through training for parents to enable them to effectively care for their
children especially those who have multiple disabilities. Secondly we funded
the Disabled Children Action Group (DICAG) and also trained 30 social workers
in Psychiatry and Mental Health to empower them with skills to render
appropriate services to psychiatric patients and their families. For the coming
year we will allocate R138 000 to the Deaf Federation of South Africa (DEAFSA)
to upgrade their facilities in Upington and De Aar whilst an amount of R500 000
will be spent to establish mental health services in the province. An amount of
R285 000 will be spent on the training of an additional 100 parents and
caregivers in order to train them to care for children with multiple
disabilities.

I also wish to announce that homes for the disabled as well as protective
workshops will be receiving a 5% increase in their allocations.

Khomani San

Since the publication of the report of the Human Rights Commission on the
Khomani San, the following interventions have been affected by the Department:
Counselling was given to victims of abuse and learners were involved in
therapeutic sessions. A social worker has been appointed and has involved the
learners and the parents in the following programmes: Back to school projects;
Parental guidance groups; and economic and sustainable projects for women. In
addition, Alcoholics Anonymous groups have been established to address the
problem of substance abuse within households.

We are pleased to announce that the province has developed a comprehensive
plan to address other outstanding matters, which amongst others will include
the operation of a mobile soup kitchen that will service this vast area.
Sustainable livelihoods

The eradication of poverty remains one of Provincial Government's focus
areas and our efforts in this regard are guided by the framework set out in the
Provincial Growth and Development Strategy. In this regard our target group is
the poor and vulnerable in our society and those who unduly rely on social
grants.

Last year we supported a total of 12 projects, mentored by the IDT, at a
cost of R6,9m. We also implemented food security projects, establishing 16 soup
kitchens, 4 food gardens, a women's cooperative as well as four additional
drop-in centres. 4 food and clothing banks were also established.

For this financial year, sustainable projects to be established include 16
additional soup kitchens, seven more food gardens, four drop-in centres, two
women's co-operatives, eight additional food and clothing banks, two small,
medium and micro enterprise (SMME) initiatives, as well as 20 poverty relief
projects. For the implementation of all the above, an amount of R16,598m has
been allocated for this financial year and R57 m over the MTEF period.

Youth development

The Northern Cape can be described as a youthful Province where 57% of the
population is younger than 30 years old and unemployment being high amongst the
youth.

Our focus in this area is out of school youth who are unemployed and are
also considered to be youth at risk. Accordingly, programmes emanating from
this Department are thus focused on skills development and socio economic
projects targeting youth.

For the 2006/07 financial year, an amount of R1,5 m is allocated for a range
of activities ranging from training 250 youth in leadership skills, social
development programmes for youth in conflict with the law, to the funding of
socio-economic programmes, like the youth vegetable garden in Delportshoop.

HIV/AIDS

The impact of HIV/AIDS for the social services sector is made evident by the
increasing number of orphans and vulnerable children, the increase in the
phenomena of child-headed households as well as the emerging trend in
disintegration of families. Our services in this sphere include the current 53
Love Life Sites in the province, Home Community Based Care services, paying
stipends to the 488 care givers with about 10 000 persons benefiting from the
service. Immediate relief to families affected by HIV/AIDS, counselling
services as well as the provision of material assistance in the form of
nutritious food parcels are but some of the activities undertaken by the
Department. The Isibindi Project, which is a community based child and youth
care programme focussed on child headed households, was piloted in Donkerhoek
and rolled out to Lerato Park and Soul City and will be extended to Greenpoint
in this year.

For the current financial year we have sought to expand and deepen our
services, with 300 more child headed households receiving support, the
employment of an additional 30 child and youth care workers, and the funding of
another nine NGOs active in the fight against HIV/AIDS. Our total expenditure
in fighting this scourge which includes the stipends paid to caregivers will be
R10,7 m for this year and R45, 4 m over the MTEF period.

Social security

Last year we informed the House that grant administration would from the 1
April 2006 become the responsibility of the South African Social Security
Agency, an agency established by national government to deal explicitly with
grant administration. We are pleased to say that the Northern Cape is one of
the first Provinces to successfully migrate the function from the Department to
South African Social Security Agency smoothly with no disruption in services to
beneficiaries.

Furthermore the backlog in the processing of grants has been eradicated.
Indications are that outstanding cases are only approximately 31 days old. In
fact the turn around time for processing of grants has progressively been
decreased to 21 days, and just last week we launched the Same Day Approval
Campaign for old age and child support grants, making us the first Province to
launch this campaign.

There has also been a conscious effort to ensure grant data integrity as
well as auditing processes to eliminate the opportunity for committing grant
fraud. To eliminate the attempts at fraud in the grant system, beneficiaries in
the Frances Baard and Pixley ka Seme Districts will now have their photos
attached to their application forms. During 2005 we worked closely with the SIU
to identify suspected fraud cases and I have pleasure to inform this house that
some 57 cases are ready for prosecution.

Other matters

The above tasks we set ourselves cannot be achieved without the internal
environment within the Department being conducive to enable officials to carry
out their functions diligently. We have thus strived to streamline and improve
internal processes of decision-making; we are in the process of employing
additional staff as well as ensuring that a training programme is in place to
build the capacity of staff; we have approved a departmental bursary policy to
improve the skills base of the Department. In our attempt to address the
shortage of social workers and other relevant skills needed by the Department
we presently financially support 51 students in different years of study, of
which 19 are social work students. National Government has also awarded 20
scholarships to Northern Cape students to study social work.

Budget in perspective:

The total budget of the Department for this financial year is R215,025 m.
This represents a 12,7% increases in our allocation from last year. The
seemingly high percentage is due to the focussed funding for specific
intervention programmes. Our personnel costs amount to 37,7%, which is
extremely low considering that our services are largely people driven. We also
strive to be efficient in the way we render services with administrative
expenditure representing only 25% of the total budget.
The Total budget for transfers to our social partners amount to R48,726 m,
which is 22,7% of our total budget.

Acknowledgements

Before I conclude, I wish to take this opportunity to firstly applaud
members of the private sector who have partnered with us in the delivery of
services to the most vulnerable sectors of our society.

Notably amongst the many are ABSA, FNB, Gariep Motors, the Mining companies
mentioned here today and especially the staff of Department of Correctional
Services in Kimberley.

I also want to express my profound gratitude to the following people:
* the Premier and my colleagues in the Executive Council for their
support
* the Chairperson and members of the Portfolio Committee for their constructive
engagements
* our social partners in the NGO fraternity
* Provincial Treasury and other Departments for their support
* but especially the staff of the Department for their hard work, loyalty and
dedication. They have delivered - often under extremely difficult conditions.
We are proud of the work you perform.

Conclusion

As a Department, we have a mammoth task ahead of us if we want to deliver on
our mandate of providing a caring and a protective environment to vulnerable
individuals and groups. But we are confident of meeting this challenge head on,
as we explore new and innovative ways of delivering services to our people. We
are mindful that the resources at our disposal will not be adequate for the
plethora of services to be rendered but as a Department we are committed to
rendering a quality service to our constituency with the resources at our
disposal.

Thank you

Issued by: Northern Cape Provincial Government
15 June 2006

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