S Belot: Opening of Medical Professionals' Summit 2006

16 November 2006

Programme Director,
Honoured guests,
Ladies and gentlemen,

The year 2006 is slowly drawing to a close and we all are starting to look
forward to a period of rest and time to spend with our loved ones. However,
before the holiday mood settles in I have asked the department to convene this
summit with the specific purpose to focus on the significant partnerships in
the delivery of quality healthcare in the Free State Province. This is also the
theme for the two-day summit. I am pleased to note that we have a wide range of
representatives from both the private and public sector attending the
summit.

Ladies and gentlemen, in all our endeavours to bring health to the people of
this province hard work and dedication stands out, but also the dire need to
form partnerships. This summit should be used as the platform from which we can
launch possible partnerships for the future. If we take the referral route for
example and closely investigate the effectiveness of the utilisation of the
various levels, should we not ask ourselves the question, how effective is the
service we are delivering at the entry point of the patient into the system? I
am referring here to the primary healthcare (PHC) level. A patient suffering
from diabetes should ideally have access to specialist care right at the PHC
level. The question I am asking is what stands in the way of a specialist
delivery / specialist diabetic care in a clinic? Will this not alleviate the
pressure at the next levels of care should this patient, in the end, needs to
be referred?

Another issue that I want to raise is the partnership this department has
with private doctors on the sessional doctor scheme. I often ask myself how we
can strengthen this partnership and how can we as the Department of Health
contribute more effectively. In the private sector a vast majority of patients
go to their local general practitioner (GP) but at the end of the day many of
those patients end up in our health facilities. The question I want to ask is
what happens to the patient and the responsibility of the service provider
after the patient's walks out of the consulting room at the surgery? How do we
more effectively utilise our human resources (HRs) and what can we say about
commitment to quality patient care? Keep the issue of partnerships in mind
during the deliberations for the next two days.

Ladies and gentlemen, during 2005 and 2006 I requested the department to
arrange a series of consultative meetings with the clinical staff of all the
regional complexes including the Academic Health Services Complex. At these
meetings medical professionals raised a variety of service delivery related
issues including the referral system, outreach programmes, personnel shortages
and resource constraints amongst others. As a result of this we convened this
summit to address all the issues raised extensively.

Programme Director, at the consultative meetings delegates raised the
following categories of issues and I would like to respond to some of the
challenges raised.

1. HR issues which centre on shortages, delays in appointments, the rural
allowance, sessional appointments and personnel development amongst others.

I would like to report that the stringency measures that were in place at
the time due to budgetary constraints have been lifted. The chief executive
officers (CEOs) of hospitals have also been given extended delegations for
personnel, finances and procurement. This has enabled the appointment processes
to proceed more efficiently. As a result of this there has been a significant
increase in the numbers of personnel appointed including sessional
appointments.

2. Management issues such as poor communication, de-motivated staff, lack of
equipment and poor marketing of the outreach programmes were raised and I am
pleased to say that with our new budgetary allocations, we have been able to
address most of the urgent equipment needs. Please note that all these issues
have been brought to the attention of all our CEOs and I expect that there will
be significant improvements in the communications between those that deliver
the services. I anticipate that after the deliberations of this conference, we
will have a more robust outreach programme that addresses the needs of all
stakeholders and that this will be felt particularly at PHC level.

3. Challenges regarding the referral system also came out during discussions
with back referrals, emergency referrals, transportation patterns of emergency
medical services and distances as well as cross border patients coming under
the spotlight. To address these issues we have purchased 52 ambulances which
will play a major role in the improvement of the efficiency of the upward and
downward referral of patients between the different levels of care
institutions.

We have also established a forum of heads of clinical services, whose main
mandate is to develop and implement clinical guidelines and protocols for the
efficient management and transfer of patients between facilities. There has
also been a revision of our Emergency Medical Services (EMS) model, to ensure
that the deployment of ambulances addresses the soft borders between districts
and the hard borders between provinces.

4. Some general concerns were also raised and during the presentation on
this, more light will be shed but from the comments received I noted that there
is a general high level of awareness of our efforts to continuously develop the
health system in the Free State.

Programme Director, during the next two days delegates will spent time to
deliberate not only on challenges facing the medical professionals in our
department but also in break away groups deliberate on the public private
initiatives, clinical guidelines and protocols, the referral system and the
outreach programme as well as the improvement of service conditions for the
health professionals.

Finally, I would like to express my appreciation for the representation from
the private sector as well as the Faculty of Health Sciences. I realise this is
a difficult time of the year but appreciate your willingness to participate in
this important summit. I would now like to declare the summit open and wish all
here good luck in the deliberations to follow. May the consultative decisions
taken here contribute towards a healthy and self-reliant Free State
community.

I thank you!

Issued by: Department of Health, Free State Provincial Government
16 November 2006