P Phasha: Mpumalanga Health and Social Services Prov Budget Vote
2006/07

25 May 2006

Honourable Speaker and Deputy Speaker
Honourable Premier
Members of the Executive Council
Esteemed Members of the Provincial Legislature,
Traditional Leaders and Healers
Leadership of the Religious, NGO’s, Business, Labour and Social
Formations
Management and staff of the Department of Health and Social Services
Distinguished guests
Members of the media
The people of Mpumalanga

Ke ikutlwa ke le motlotlo ho nka karolo ka hara ntlo ena e phahameng ya
seetsa molao letsatsing lena le bohlokwa maphelong a bana. Modula setulo ya
hlomphehang, kajeno lefatshe ka bophara le ngata ‘ngwe ketekong ya letsatsi la
bana la machaba.

The struggle for and our mandate to create and realize the ultimate goal of
achieving quality health care and better life for the people of Mpumalanga
continue with more vigour and determination as we enter the Age Of Hope.

Ten years ago, South Africa entered into a new epoch in the evolution of
socio-political landscape with the adoption of the first ever democratic,
all-inclusive constitution. 1996 marked what could be called “the end of the
beginning.”

It marked the end of the very painful past, where race, gender and class
were key considerations in the provision of basic services such as health care
and many other services.

It marked the end of the fragmented health system and social development
policies, designed to perpetuate inequalities in the society. It formally ended
a system characterised by huge disparities between racial groups, rural and
urban populations with regard to service delivery.

Honourable Speaker, notwithstanding the achievements since the dawn of
democracy, we still need to employ greater effort in our pursuit of making
health services and social development accessible to many of our people in the
province.

This year we celebrate the 30th anniversary of the Soweto uprisings, a day
in our history that our people, in particular the youth, armed with nothing but
their determination to end the evil Bantu education, fought back the frontiers
of apartheid and colonialism and entrenched their role as one of the motive
forces for change.

They were deprived of their youthfulness and the opportunity to live a
normal life with their families in their own country.

It is in this context that we make a clarion call to our youth today to
seize the opportunities presented to them in the new dispensation to advance
the course of building South Africa competitive in the world economy.

I am honoured Honourable Speaker and Honourable Members to present my budget
and policy speech on the 1 June, International Children’s Day, whose theme for
2006 is “Caring communities protect their children”.

The challenges facing our children are immense. I therefore make a humble
plea in this august house to the honourable members and our communities to
assist in whatever way possible in addressing challenges facing our children.
This could include support to one or more organisations, adopting or fostering
a child in need of care.

The Nobel Peace Prize laureate Archbishop Desmond Tutu had this to say:

“Do your little bit of good where you are; it is those little bits of good
put together that overwhelm the world.”

The department has declared this year a year for intensifying and
strengthening primary health care and highlighting the plight of children. I
therefore appeal to every one of us to participate in all activities planned to
celebrate Child Protection Week and beyond.

Strengthening of Primary Health Care

Honourable Speaker, we are of the considered view that 80% of all health
challenges facing our people can be attended to at primary health care level,
thus reducing workloads and long queues found in our hospitals.

The primary health care approach is the underlying philosophy for the total
restructuring of the Health system. It embodies the concept of community
development, and encourages full community participation in the planning,
provision, control and monitoring of services. It also aims to eradicate the
inequalities in access to health services especially in the rural areas and
underprivileged communities.

Our endeavour shall therefore focus on:

* encouraging our communities to utilise primary health care
facilities
* strengthening of the referral system
* optimising the functionality of existing primary health care facilities
* employment of adequate personnel in all our clinics
* ensuring availability of essential drugs in our clinics at all times
* regular and consistent visits to clinics by doctors
* appointment of clinic committees
* transfer of all municipal clinics to the province
* improving clinic supervision
* integration of priority health programmes at district level

The department is convinced that the District Health System remains the
vehicle for the delivery of primary health care services. To this end, we
commit ourselves to the progressive movement towards comprehensive health care
service delivery at district level. Core to this approach is decentralisation
of management.

In this regard, all districts have established District Health Management
Teams (DHMT) that co-ordinate the provision of District Health Services through
a multi-disciplinary approach.

Our commitment to ensure improved service delivery and management of our
hospitals remains. In the previous year we committed ourselves to the
de-clustering of our hospitals. We have however been confronted with some human
resource and infrastructural challenges. Despite this, we will, this financial
year appoint in phases, additional hospital Chief Executive Officers (CEOs).
Financial and procurement delegations have been decentralised. Human resource
delegations will be decentralised to districts and facility managers in line
with President Thabo Mbeki’s directive during the State of the Nation
Address.

Honourable Speaker, in line with our endeavour to make primary health care
more accessible to our communities in the province, we undertook during the
previous financial year to construct six new Primary Health Care facilities in
the following areas: Grootvlei, Sakhile Ext six and seven, Sheepmore, Dludluma,
Mdlankomo and Fene.

All of these projects are progressing well and it is expected that they will
be completed during the current financial year.

During the joint sitting of Parliament on the 3 February 2006 the State
President Honourable Thabo Mbeki said:
“The future plans in the area of health include the further expansion of
infrastructure, refurbishment of existing clinics and hospitals and the
re-opening of nursing colleges to increase the number of these
professionals.”

Consistent with this and the department’s priorities we will during the
current financial year spend R15 million for the construction of four
additional facilities in the following areas: Siyabuswa, Kwa Guqa Ext 10,
Wakkerstroom and Block B in Nkomazi. A further R3 million has been set aside to
improve infrastructure, staffing and equipment in some of the existing
clinics.

Honourable Speaker, we have in accordance with the commitment we made last
year constructed accommodation facilities primarily for our nursing staff at
Verena, Lefiso, Nokaneng, Moloto and Amsterdam. Notwithstanding this progress,
challenges are still immense, partly due to the limited financial resource
allocation.

Ninety professional nurses who graduated from our Nursing College last year
have been appointed as part of our efforts to strengthen and expand services at
our facilities. These nurses have since been deployed to clinics and district
hospitals in the province.

To improve access to primary health care, especially for our people in
remote and farming areas, R6 million will be spent on the procurement of mobile
clinics.

We will continue our engagement with unions and the South African Local
Government Association (SALGA) in relation to the provincialisation of
municipal clinics. Progress is being made in this regard and we hope to achieve
the said objectives within nationally agreed time-lines.

In addition, preparations for the devolution of environmental health
services to district municipalities are at an advanced stage. In it envisaged
that the devolution of these services will be completed during this financial
year.

Health programmes

Operational Plan for Comprehensive HIV and AIDS Care, Management and
Treatment
The Operational Plan for Comprehensive HIV and AIDS Care, Management and
Treatment remains relevant to addressing the immense challenges of the
epidemic. A major focus will continue to be placed on strategies to enhance
prevention of the disease.

A National Accelerated Prevention Strategy in line with our focus on
prevention is being developed as agreed to by the African Health Ministers’
meeting held in Maputo, Mozambique in 2005.

Through intense social mobilisation, increasing uptake of voluntary
counselling and testing (VCT), strengthening of prevention of mother to child
transmission (PMTCT) programme and developing more appropriate messages, we
will ensure that people who are infected do not get re-infected, and those that
are negative remain so.

Honourable Speaker, It is well known that young female are relatively
vulnerable to HIV and AIDS. Our interventions will therefore continue to be
directed at this target group. To this end, we have, during World Aids Day, on
the 1 December 2005, launched the Mayihlasele Izazi project. This project
targets girls between the ages of 15 to 19 years and aims at encouraging them
to abstain and know their HIV status. To date, 180 girls have been trained to
be multipliers of information on abstinence and testing.

The department has increased the total number of health facilities providing
voluntary counselling and testing from 273 to 287.

We have also completed training on couple counselling for:
* professional nurses, and training for
* lay counsellors on voluntary counselling and testing (VCT).

All VCT sites have lay counsellors and are monitored through contracted
non-government organisation (NGOs).

We exceeded our target in the establishment of prevention of mother to child
transmission (PMTCT) sites. The sites have increased from 112 to 265, thus
exceeding the targeted 225.

We committed ourselves in the previous financial year to fund 145 home-based
care groups and this has indeed been accomplished.

In as much as we are advocating prevention strategy, we will increase our
Anti Retroviral Therapy sites from the current 18 accredited sites to an
additional nine sites during the current financial year. Honourable members,
let us all remember that abstinence, being faithful and condomising commonly
known as the ABC strategy remains at the heart of our prevention strategy
against the spread of HIV infection.

No Condom No Thola!

Tuberculosis (TB)

Honourable Speaker, Africa continues to be plagued by TB despite it being
curable. The African Ministers of Health meeting which I earlier alluded to
passed a resolution to declare TB as a crisis confronting the continent.

The National Health Council (NHC) approved a Crisis Management Plan which
identifies TB as one of the priority health programmes. The TB crisis plan
entails intense social mobilisation and is aimed at increasing the cure rate
and adherence to treatment. We will also strengthen the use of the electronic
TB register in order to improve our patient management and follow-up.

TB management has been successfully integrated into the mainstream of health
services in the province. Patients are now able to access TB treatment at all
levels of care in August 2005, the three former South African National
Tuberculosis Association (SANTA) hospitals were successfully integrated as
Public Health Institutions. These hospitals are providing specialised care to
patients requiring long-term hospitalisation.

Notwithstanding the above, the fight against TB continues to present
challenges both nationally and provincially. This is reflected by the fact that
the TB cure rate in the province remains below the national target of 85%.

Honourable Speaker, it is important for our people to know that TB is
curable. It is the responsibility of every TB patient to ensure personal
adherence to and completion of treatment.

Malaria

Collegues, mosquitoes know no borders. We will, working together with our
colleagues in Mozambique, Swaziland, provinces of Limpopo and KwaZulu-Natal
intensify our efforts within the Lebombo Spatial Development Initiative in
controlling malaria in affected areas. The key strategies in this regard
include vector control, outbreak response, disease surveillance, communication,
education and case management.

The department will continue to strengthen its work on indoor residual
spraying of targeted structures in the communities. It will also continue with
quality control visits regarding spraying operations. 158 512 structures have
been sprayed thus far.

On the occasion of the signing of the Agreement on Health Matters between
Mozambique and South Africa held in Tonga on the 8 December 2005, Minister
Manto Tshabalala-Msimang, the Mozambican Minister of Health Prof Paulo Ivo
Garrido and I had the opportunity of spraying a number of houses in Tonga,
Nkomazi.

Notified cases of malaria increased to 4 222 compared to the 3 528 in the
previous season as a result of heavy rains during the 2005/06 malaria season.
Despite this increase, the malaria case fatality rate remained below the
national target of 0.5%.

The department is determined to maintain the malaria fatality rate below
0.5%. This year an amount in excess of R18 million will be spent to further
strengthen existing interventions and also expand activities of the malaria
control unit.

Nutrition

Honourable Speaker, the Integrated Nutrition Programme (INP) is an essential
part of the holistic approach to primary health care. The emphasis still
remains the prevention and reduction of morbidity and mortality rates due to
malnutrition. The provision of specialised food supplementation to those who
qualify will be intensified during this financial year.

This will be directed to nutritionally-at-risk children less than five
years, pregnant and lactating women, patients infected with HIV and TB, those
on Anti Retroviral Therapy and all other chronically ill patients.
Coupled with this is the need to ensure that children’s nutritional status and
growth is according to body development standards. An initiative to do proper
growth monitoring will be implemented at all health facilities. This involves,
amongst others, efforts by the Department to ensure that each child less than
five years of age has a Road to Health Chart.

To date, the number of baby-friendly facilities in the province has
increased to 20. We will strive to ensure that additional six facilities
statuses are accredited during this financial year. The department remains
committed to ensure that all the hospitals in the province are accredited with
baby-friendly status by 2008.

Health promotion

Health Promotion remains a strategic intervention towards promoting healthy
lifestyles. Vuka South Africa, “Move for Your Health” campaign was launched by
the Minister of Health in Alexandra Johannesburg last year. Subsequently Vuka
Mpumalanga “Move for Your Health Campaign” was launched in the province.

During this event participants had the opportunity to be screened for
diseases of lifestyle such as Hypertension, Diabetes Mellitus and Obesity.

This campaign, Honourable Speaker, has since become a common feature of all
our activities. We encourage all departments to follow suit. Our Executive
Mayors and Councillors are encouraged to incorporate this campaign in all their
activities.

Honourable Speaker, you will recall that last year this province was hit by
typhoid outbreak in Delmas. Our health promotion efforts played a significant
role in containing the outbreak. Vigorous health promotion activities are
continuing in the high risk areas for the prevention of communicable diseases
in the province.

I want to pass my sincere gratitude to everybody who contributed to the
containment of the outbreak, in particular the Medical Joint Operations
Committee. We emerged from this experience better equipped not to quit in
trying times.

Mental health

The department has made tremendous progress in mainstreaming mental health
care in all our facilities. For some time, mental health care has been
stigmatised and neglected; and we will therefore intensify our services in this
regard through the provision of adequate resources, public education and
awareness campaigns.

Honourable Speaker, I made a pronouncement last year that we will be
transferring Chronic Mental Health Care users from facilities in Gauteng back
to the province. I am proud to report that we are currently accommodating 210
mental health care users in the Siyathuthuka facility operational in Belfast.
This initiative has improved contact between service users and their
families.

Improving hospital services

As indicated earlier on, and as per the directive by President Thabo Mbeki
in his State of the Nation Address in February this year, to improve capacity
and management systems, hospital managers have been given financial and
procurement delegations. Human resource delegations will be decentralised to
facilities during the current financial year.

Quality improvement:

The Council for Health Service Accreditation of Southern Africa (COHSASA)
programme, which commenced in May 2004 and will be phased out during this
financial year, has played a pivotal role in the departmental quest to improve
quality of care and services in our facilities.

I am pleased to report that our hospitals have demonstrated an overall
improvement in their baseline scores, and plans to ensure that the standards do
not deteriorate will be put in place and monitored.

For the first time in the history of the department, a Client Satisfaction
Survey was conducted in all 28 hospitals to obtain the views of our patients
and clients in respect of the services they are receiving in our health
facilities. This survey has revealed shortfalls in certain areas of service
delivery. An Intervention Plan is currently being developed to address these
shortfalls.
We undertake to work vigorously to ensure that our hospitals become areas of
excellence, as our people deserve nothing less than that.

Hospital service improvement plan

In an attempt to improve the service delivery at all hospitals, a provincial
plan which include all components of service delivery, namely; improving
management, clinical services, patient satisfaction and governance in line with
the National Service Improvement Plan, is being implemented.

Cost centre accounting

Honourable Speaker, in my previous budget speech, I indicated that Cost
Centre Accounting would be implemented at five additional hospitals to total 18
hospitals. Cost Centres have been established at 19 Provincial hospitals, this
has enabled the department to monitor the efficiency of hospitals with regards
to key cost drivers, such as personnel, medicines and laboratory tests. During
this year cost centre accounting will be established at an additional five
hospitals.

Secondary and tertiary services

The department has expanded the secondary and tertiary services at Witbank
and Rob Ferreira hospitals as part of our strategy of further reducing the
referral of patients to Gauteng Province. 21 full-time medical specialists are
currently in the employ of the department. We have also procured the latest
health technology in support of the specialist units established in previously
mentioned hospitals. Furthermore, the department is committed to the
establishment of basic specialist services at Ermelo and Themba hospitals.

Hospital revitalisation and upgrading

Revitalisation, upgrading and renovation of our hospitals remain a challenge
that the department will have to confront unapologetically. Renovation and
upgrading of infrastructure is just one component of the hospital
revitalisation programme which seeks to transform public hospitals into centres
of excellence. Revitalisation also entails the provision of equipment, health
technology, quality assurance, monitoring and evaluation and organisational
development, which includes staffing.

The department has successfully completed construction of accommodation at
Shongwe, Themba, Sabie, KwaMhlanga, Mmametlhake and Amajuba Hospitals.
Furthermore, the upgrading that commenced at Groblersdal, Mmametlhake,
KwaMhlanga, Delmas, Witbank, Ermelo, Standerton, Evander, Rob Ferreira, Sabie
and Themba Hospitals during the course of last year, is at various stages of
completion and will inevitably be completed within the Medium Term Expenditure
Framework (MTEF) period.
An amount of R94 million will be spent on revitalisation and physical
infrastructure improvement during this financial year.

Emergency medical services

Honourable Speaker, the respected Greek philosopher Aristotle declared
that;
“Excellence is an art won by training and habituation. We do not act rightly
because we have virtue or excellence, but rather we have those because we have
acted rightly. We are what we repeatedly do. Excellence, then, is not an act
but habit”.

Our quest for provision of integrated quality health care will not be
complete if our Emergency Medical Services (EMS) directorate is not provided
with requisite support.

We have as undertaken in this august house, appointed and trained 219
additional staff. In addition, we purchased 24 and 13 response vehicles. Full
radio network is functional in all the districts leading to the enhancement of
communication within Emergency Medical Services; this in turn has led to the
reduction of ambulance response times.

For the first time in the history of our ambulance service in the province,
we have purchased two Intensive Care Unit ambulances fitted with advanced life
support medical equipment. This equipment includes neo-natal ventilators and
incubators for newborn babies. These two ambulances are stationed in Nkangala
and Ehlanzeni districts. In the current financial year we will procure an
Intensive Care Unit ambulance for Gert Sibande District.

During the course of this financial year we will spend R9,5 million to
establish seven new Electronic Management System (EMS) stations at Waterval
Boven, Matsulu, Malelane, Hendrina, Kriel, Lothair and Matibidi in an attempt
to further improve our response times. An additional 28 ambulances and response
vehicles will be purchased and equipped to service these new stations.

I want to take this opportunity to commend our EMS personnel for the
sterling work that they continue to perform by ensuring a professional service
to many of our people in need of emergency care. Their response during the
recent fatal Moloto Road accidents and other areas, made all of us proud.

Specialised services

Forensic Pathology Services

Honourable Speaker, we have realised that we are able to learn much about
the health of the living by examining the bodies of the dead.

“It is the living that closes the eyes of the dead, but the dead open the
eyes of the living”.

Forensic Pathology Services has always been entrusted to the South African
Police Service, however the services have with effect from April 2006, been
successfully transferred to the Department of Health and Social Services. A
Conditional Grant to the value of R40,3 million has been made available to
manage and further develop forensic services in the Province, a task that we
undertake to diligently perform.

Eye care services

Last year the department was the proud recipient of the silver trophy at the
Premier’s Service Excellence Awards Ceremony in recognition of the department’s
practical Batho Pele efforts of reaching out to visually impaired elderly in
the community. The department has within the available human resources set
itself a target to reach 25 000 patients who will be screened and 2000 for
cataract operations. The department will endeavour to reach more clients
requiring eye care services.

Oral health services

An Oral Health Unit was established at the provincial office during the
course of the past financial year. A plan will be developed to improve and
expand these services throughout the province.

Pharmaceutical services

The supply of essential drugs to Primary Health Care facilities has
significantly improved following the implementation of a direct delivery system
of pharmaceutical supplies from the depot to Primary Health Care facilities
bi-weekly.

In accordance with the amended Pharmacy Act the department is training 58
post basic Pharmacist Assistants who, on completion of their course, will be
deployed to Primary Health Care facilities.

Groundwork at the new depot site in Steve Tshwete Municipality has been
completed. A further R9 million will be spent this financial year on ongoing
construction at the site.

An electronic dispensing system will be piloted at; Rob Ferreira, Piet
Retief, Ermelo and Themba hospitals. This aims to reduce waiting times and
provide patients with printed labels in their own languages thus enhancing the
potential for improved compliance.

Human resource management and development

In our quest to develop human resources, particularly nurses, we have
increased intake at the nursing college last year. However, we have been
confronted with infrastructural and related challenges, which impacted
negatively on proper teaching and learning, a matter which we subsequently
undertook to prioritise. Together with South African Nursing Council, we have
identified gaps which we need to address.

An amount of R16, million will be spent this year on completing phase one of
Elijah Mango Health Sciences Training Centre.

Honourable Speaker, on the 7 April 2006, the National Department of Health
launched the first ever National Human Resource Plan for Health to address the
many challenges we have in the sector. The department will develop its own plan
in line with the national human resource plan.

Bursaries

Honourable Speaker, the Growth and Development of our province are dependent
on a requisite skills base. The department has consciously increased its
bursary budget for bursary allocation to reach more youth.

However, one of the challenges that we are faced with is the fact that many
of our learners do not apply in time for admission into Tertiary institutions
and are excluded because of lack of space at these institutions.

Last year we had an intake of 108 new of bursary holders and we have
increased this number to 219 this year.

In total, we have 494 bursary holders this year, excluding the 15 students
that are studying medicine in Cuba.

The number of new intakes this year is categorized as follows:

Medicine: 62
Pharmacy: 21
Radiography: 6
Psychology: 89
Dentistry: 15
Dietetics: 4
Human Nutrition: 6
Social Work: 82
Occupational Therapy: 7
Physiotherapy: 4
Speech and Hearing Therapy: 2
Optometry: 1

Governance structures

Honourable Speaker, in accordance with the National Health Act, we launched
the Provincial Health Council and the Provincial Consultative Health Forum.
These structures will advise the MEC on health related issues in the
province.
The Freedom Charter asserts that the ‘people shall govern’. It is important
therefore that this clarion call finds meaning in all aspects of our social
activity. Accordingly, and with a considered view that public participation is
central to the acceleration of quality service delivery, the department has
appointed 15 hospital boards comprising of 120 board members who will be the
voice of our communities in the management and governance of the hospitals. The
remaining boards will be established during the course of the year. Intense
work on the establishment of clinic committees will be finalised this financial
year.

Social development

Honourable Speaker, with regards to the Social Services component in the
department, a number of new developments have taken place since my last Policy
and Budget Speech. Two major changes have taken place in the component, namely;
the migration of Social Security to the South African Social Security Agency
(SASSA) and the review of the budget structure which resulted in the five
programmes being scaled down to three.

When I addressed this house last year, I mentioned that the migration of
Social Security to SASSA in April 2006 will enable us to refocus our attention
on the core business of providing developmental social services, which could
not be realized due to bias towards payment of social grants.

The integrated Service Delivery Model for Social Development was launched in
Cape Town in November 2005 by the Deputy Minister for Social Development Dr
Jean Benjamin.

Honourable Speaker, allow me to share with you some of the key focus areas
that will receive our attention this financial year in implementing the Service
Delivery Model:

* institutional capacity building by appointing additional personnel at all
levels
* strengthening management capacity to ensure implementation of the new
model
* provision of new and upgrading of existing infrastructure to accommodate
additional personnel to make services more accessible especially in rural
areas.* extension of funding to community-based organisations targeting those
in rural areas with the aim of transforming services so that there is equity in
the allocation of resources.

We welcome the additional financial resources allocation and believe that it
will enhance the repositioning of this component.

Honourable Speaker, let me highlight some of the gains we have made towards
the realisation of the repositioning agenda:

* We have re-graded all social workers posts as part of the retention
strategy.
* We have reviewed the organisational structure so that it reflects the new
budget structure.
* Thirty eight social workers, fourteen community liaison officers and thirty
administrative support staff have been appointed since the beginning of this
financial year.
* Eighty one additional posts, in various categories of staff have been
advertised or are in the process of being filled.

We believe this will strengthen administrative and management support at
both the district and provincial levels.

Social assistance

Honourable Speaker, as alluded to before, a seamless transfer of the Social
Security function to the South African Social Security Agency (SASSA) has
successfully been completed. The agency took occupation of its new offices at
No 2 Bester Street Nelspruit with effect from the 1 April 2006.

In our quest to put children first as government we allocated resources for
the extension of the child support grant to children under the age of fourteen.
As part of this extension of the child support grant, we set ourselves a target
of reaching 208 029 children.

At the end of 2005/06 financial year on 31 March 2006, 279 930 children
between 7 to 14 years were benefiting from the system. This exceeds the set
target by seventy one thousand nine hundred and one children. This is due to
the vigorous registration and awareness campaigns that were conducted.

In line with our commitment to improve the lives of the vulnerable, the poor
and marginalised groups, government will continue to provide a safety net of
social assistance. For the financial year 2006/07 the increase in payment of
social grants is as follows:

Old age: R820 00
War veterans: R838 00
Disability: R820 00
Foster care: R560 00
Care Dependency: R820 00
Child support: R190 00
Grant-in-aid: R180 00

We have already mentioned that we do not only have a responsibility to
provide services to our people, but to do so with utmost respect to human
dignity and due diligence. Accordingly, we have improved our turn around time
of processing of applications and payment of social grants to 21 days, which is
a national norm

Older persons
Honourable Speaker, the International Plan of Action on Ageing outlines
that:

“Ageing is a life long process and should be recognised as such. Preparation
of the entire population for the later stages of life should be an integral
part of social policies and encompass physical, psychological, cultural,
religious, spiritual, economic, health and other factors”.

There is therefore a need to recognise the value of our senior citizens in
this country. We should not only see our elderly as recipients of social grants
but as key partners in providing a safety net in our families and communities.
It goes without saying that they have increasingly been the sole care givers in
many of our communities because of the new socio-economic challenges.

It is for that reason that we convened an Older Persons Indaba in October
last year to strategise together with the elderly on how best we can support
them as government.

Emanating from this Indaba, an Integrated Provincial Plan of Action which
has been tabled to the Social Services Cluster has been developed. Progress is
already evident as I am reliably informed that government departments have
already started incorporating aspects of this plan of action into their
departmental plans. This confirms the notion that the needs of older persons
are varied and cannot be met holistically by a single department.

The department has developed the Elder Abuse Register as a way of protecting
our older persons both in residential facilities and within communities as well
as tracking the perpetrators. This register is going to assist us to get
statistical information on the extent of the problem of elder abuse with the
aim of coming up with appropriate intervention strategies.

We are also going to intensify our training of older persons on HIV and
AIDS, as most of them provide care to their own children and grandchildren
living with HIV and AIDS. The older persons also take care of orphaned
children.

To this end and for the first time we have allocated funds to assist 300
older persons through Community Based Care services.

Children

Speaking at the ceremony in receipt of the Nobel Peace Prize in 1993 in
Norway, the former State President Nelson Mandela said:

“Children are the most vulnerable citizens in any society and the greatest
of our treasures”.

Our children will remain the platform through which we need to invest to
correct many historical and present day challenges facing our society.

It therefore gives me great pleasure that the Children’s Bill has now been
finally approved. This has created a new legislative foundation for the care
and protection of children in our country. It is an important piece of
legislation that will go a long way in ensuring that the rights of our children
are upheld and promoted at all times.

We have reached a total of 403 children in terms of the child protection
programme. We further intend to reach 674 abused, neglected and exploited
children in the current financial year.

I wish to point out that all people who want to provide care to children
must at all times follow legal processes. We will not spare anyone found to be
contravening our laws under the pretext of providing care to our children.

I have been able to personally visit various residential and day care
centres that provide care to our children. I must indicate to this house that
all the children are looking up to us for support and love. The Age of Hope
that the President alluded to, in his State of the Nation Address must be felt
and experienced by all children through our collective efforts as government
and the civil society.

In our efforts to improve services in Early Childhood Development (ECD)
centres, an Integrated Plan on Early Childhood Development was developed in
partnership with our key stakeholders within the Social Cluster. This plan
promotes integration of services and optimal utilisation of resources by all
involved.

60 Early Childhood Development sites have been identified. This will benefit
180 learnerships, as part of the Expanded Public Works Program during the
current financial year. The ripple effects of these interventions will not only
be skills development for the educators, but will also lay a firm foundation
for the education of our children and improved performance in the later years
of their formal schooling.

The country has set a target of one million children by 2010. Our target in
the province is to reach over 222,235 children. It is on this basis that we
have undertaken to fund an additional 126 Early Childhood Development centres
taking care of 8724 children during the current financial year.

Crime prevention and support

The department will continue to provide services to children arrested and
awaiting trial by providing services ranging from preliminary inquiry,
diversion, alternative sentencing, assessment, detention, legal representation,
trial and sentencing of children.

In the previous financial year we had planned to divert 3926 children from
the Criminal Justice System. We exceeded our target by diverting 4782 children.
We plan to reach four thousand, 4161 children from the system in the current
financial year.

The biggest challenge is to identify risk factors within our communities and
address these challenges through prevention and early intervention services to
increase the healthy development and competency of young people.

To ensure that children awaiting trial are not kept in prisons, we will
increase capacity at the Hendrina Secure Care Centre from 35 to 70 by admitting
a total of 60 boys and 10 girls between the ages of 12 to 18 years who are
awaiting trial.

Amongst the planned outcomes for 2006/07 financial year, we are going to
strengthen the number of crime prevention programmes in the province by
appointing additional Probation Officers and Assistant Probation Officers in
order to expand the Home Based supervision services.

Substance abuse, prevention and rehabilitation

Honourable Speaker, substance abuse remains one of the major challenges
facing our society. Our province is not immune. Alcohol, drugs and the abuse of
other substances are clearly on the increase.

In the previous financial year a total of 348 victims of substance abuse
were admitted and treated in both government and non-government facilities
within the province, the 35 to 45 age group has been largely affected by
alcohol and dagga abuse.

This trend is now changing. We are witnessing more and younger people being
referred for drug rehabilitation treatment. In responding to this new
phenomenon, one treatment centre will be established and registered to
accommodate youth addicted to substance abuse. I want to emphasize to this
house that prevention is still better than cure.

We will intensify our Ke Moja programme in an attempt to reduce the number
of youth dependent on substance abuse, targeting youth in schools and training
of 365. The Ke Moja programme is a national campaign to raise awareness among
South Africans, particularly young people, about the dangers of drug abuse, and
is youth friendly.

HIV and AIDS

Mitigating the impact of HIV and AIDS on families especially children, will
remain one of the department’s priorities for the current financial year.

Efforts to address the needs of orphans and child headed households were
strengthened by not only providing material assistance but also giving life
skills training. 450 children were empowered to cope with life challenges.

During the year under review we have funded 45 home based organisations, and
trained 675 caregivers. Training on HIV and AIDS was also provided to 250 older
persons and 150 people with disabilities.

In the previous financial year we commissioned a study on orphans and
children living alone. This is now in its second phase. The aim is to establish
the extent of the problem so that we can respond more appropriately.

As part of developing sustainable strategies to cope with this challenge of
orphans in the province, a number of programmes are being implemented. The
Isibindi Model is one of them. The Isibindi Model is a programme aimed at
creating a safe, caring and supportive environment for orphans in child-headed
households, as well as vulnerable children in single-headed families. Three
projects implementing Isibindi Model to cater for families affected and
infected by HIV and AIDS will be supported. I am again calling upon civil
society to open their homes and hearts by adopting some of these children.

Sustainable livelihood

Addressing challenges of hunger, poverty and underdevelopment endemic in our
communities remains a priority for the department. We are committed to
ensuring, in line with the Millennium Development Goals, that our programmes
respond to poverty eradication and halving poverty by 2014.

In our endeavour to better the lives of vulnerable children, those that are
orphaned, abused, neglected, abandoned or heading households, the department
funded 31 multi-purpose centres and will further support 35 in the current
financial year.

These centres are home based care organisations dealing with the management
of HIV and AIDS. The funding has enabled them to provide a comprehensive
service to vulnerable children that include after school support, laundry
services, recreation activities and cooked meals.

Institutional capacity building and support

Honourable Speaker, our public and private partners continue to play a very
important role in assisting government to deliver equitable and quality
services to all our communities. These partners include amongst others, Home
based care organisations, youth and women formations, early childhood
development centres, organisations of people with disabilities, older persons
and faith based organisations.

We have since noted the disparity and capacity gaps between established and
emerging non-profit organisations (NPOs) and have, as a result embarked on a
structured capacity building programme for NPOs.

In the new financial year we will strengthen institutional capacity of 123
NPOs both existing and emerging, 51 youth entities and 60 entities for
unemployed people. This will improve effective administration and management,
as well as their capacity for self-sustenance.

In the previous financial year, a total of 489 NPOs were subsidised.
Additional 318 NPOs will be funded in terms of the Financial Awards policy.

Honourable Speaker, when I tabled the Policy and Budget speech last year I
informed this house that we will convene a consultative summit with
stakeholders. I am happy to report that on the 30 March 2006 we held a social
sector consultative summit in Middleburg.

We are fairly satisfied with its outcomes, as it created the necessary
dialogue between government and its partners on key policy and service delivery
issues.

We emerged with the Provincial Plan of Action, which will guide future
service level agreements with our partners in the NPO sector. This will be an
annual event where government will have ongoing dialogue with its partners.

One of the critical issues to which we challenged the NPO sector was lack of
co-ordination resulting in uncontrolled mushrooming of organizations in
communities within a close proximity to each other offering the same services.
Our view is that better co-ordination will improve the quality of services and
maximise the allocation, utilisation and sharing of limited resources.

Youth development

Honourable Speaker, our demographics indicate that we have relatively more
young people not only in the province but in the country as a whole. To this
end, we have established a Youth Directorate to contribute to the development
of our young people. The department will also provide financial support to 15
income-generating entities for the youth.

Our contribution as a department, in terms of youth development, will be to
intensify the empowerment and development of the youth and discourage reliance
on handouts and social grants.

Population and research

The department has commissioned and planned a number of research studies
that will inform our intervention strategies in some of our key priority
programmes.

The following research studies were initiated:

* Orphans and children living alone:

The main purpose this study is to investigate the needs and experiences of
orphans and children living alone as well as the development of an integrated
action plan for service delivery to this vulnerable group.

* Population, development and environment paradigm for Mpumalanga:

The purpose of this study is to identify a relevant “thought framework”
within which population, development and environmental issues can be
approached.

* Information and support needs of local municipalities to develop their
Integrated Development Plans (IDPs):
The purpose of this study is to improve support to local municipalities
regarding the integration of population and development information into
planning. A strategy to assist ten municipalities and three government
departments has been developed.

* Early Childhood Development:

The research entails a study to determine the early childhood developmental
needs of the children in our province.

* The monitoring and evaluation of population policy implementation:

The study will form the basis for the development of a continuous monitoring
and evaluation process.

Social Development Information Management System

One of the critical areas that will receive our attention is the
strengthening of management information system. The Social Development
Information Management System (SDIMS) is going to assist the department with
accurate and up-to-date information, which will be the key to planning and
future allocation of resources. Four modules will be rolled out during the
current financial year.

Infrastructure
Honourable Speaker, the growth in personnel implies a need for additional
infrastructure, because there has always been a backlog in the provision of
offices and other facilities in the Social Services Component.

It is for this reason that we allocated additional funds for infrastructure
in an attempt to address the huge backlog. This need will further be addressed
by our ten year infrastructure plan and the Medium Term Expenditure Framework
(MTEF) budget allocations.

During the current financial year we are going to build new offices in the
following areas: Tonga, Umjindi and Shongwe.

The following facilities and offices will be renovated and upgraded:
Swartfontein Treatment Centre, Piet Retief, Ermelo, Belfast, Verena, Waterval,
Dullstroom, Witbank, Marapyane and Delmas.

May I, Honourable Speaker in compliance with the Public Finance Management
Act requirements and the Treasury Regulations submit to this august house the
Budget Statement, Strategic Plan as well as the Policy and Budget speech of the
Department of Health and Social Services for 2006/07.

The house is requested to consider and approve the appropriation for Vote
10: an amount of two billion, nine hundred and twelve million, two hundred and
forty two thousand rand (R 2,912,242,000) for the Health component, and for
Vote 13: an amount of four hundred and thirty million, two hundred and seventy
nine thousand rand (R 430,279,000) for the Social Services Component for the
Department of Health and Social Services.

In conclusion Honourable Speaker, allow me to thank the Honourable Premier
and all Members of the Executive Council for their unwavering support and
leadership, the portfolio committee for their oversight role, to all our
stakeholders, and to the management of the Department and all Staff for their
commitment to the service of our people.

The budget is broken down as follows:

VOTE 10: health component

Programme one: Administration R192 019 000

This programme provides policy direction, overall strategic leadership of
the whole Department and monitoring and evaluation.

Programme two: District health services R1 491 165 000

This programme is the nucleus of the National Health System; it promotes
access to health services by the general community through primary health care
and includes amongst other programmes Tuberculosis (TB) management, HIV and
AIDS.

Programme three: Emergency medical services R118 416 000
This programme provides emergency services and planned patient transport
services.

Programme four: Provincial hospital services R435,347,000
This programme provides level two of Health Services and Specialised
services.

Programme five: Central hospitals R403 982 000

This programme provides level three Health services.

Programme six: Health sciences and training R91 293 000
This programme provides skills development, bursaries, medical allied training,
learnership and nursing training.

Programme seven: Health care support services R38,766,000

This programme provides pharmaceutical services, laundry services, orthotic
and prosthetic services and Health services workshops.

Programme eight: Health facilities management R141 254 000
This programme deals with infrastructure which include medical equipment.

Vote 13: Social services component

Programme one: Administration R95 000 000
This programme mainly caters for Head office and District management support
staff including infrastructure.

Programme two: Social welfare services R258 568 000
This programme provides integrated developmental social welfare services to the
poor and vulnerable in partnership with stakeholders and civil society
organisations.

Programme three: Development and research R76 711 000
This programme provides sustainable development programmes which facilitate
empowerment of communities, based on empirical research and demographic
information.

The author Henry Wadsworth said;
“Kind hearts are gardens,
Kind thoughts are the roots,
Kind words are the flowers,
Kind deeds are the fruits.
Take care of your garden
And keep out weeds,
Fill it with sunshine,
Kind words and kind deeds”

Ke a leboha,
Nakhensa,
Enkosi,
Ngiyathokoza
I thank you.

“Age of Hope for accelerated integrated, quality health care and social
development”

Issued by: Department of Health and Social Service, Mpumalanga Provincial
Government
25 May 2006