G Lucas: Northern Cape Health Prov Budget Vote 2007/08

22 June 2007

Madame Speaker
Honourable Premier Ms Dipuo Peters
Members of the Executive Council
Chairperson of the Portfolio Committee
Members
Senior Managers
Members of Provincial AIDS Council
Our corps of volunteers
Our distinguished guests
Members of the public in the gallery

Allow me to wish my colleague MEC Shiwe Selao a good rest during her period
of maternity leave. We want to use this opportunity to once again congratulate
her on the recent birth of a baby boy. She also requested that on her behalf, I
pass special gratitude to the Premier, colleagues in the Executive Council,
members of the house, the Department of Health and her office, including the
public, for their unwavering support, well wishes and prayers that carried her
throughout this period. She is doing well.

Madame Speaker, there can be little doubt that today's Budget Speech comes
at a time when many eyes are focused on the Northern Cape Department of Health
after persistent overspending has plagued the provincial health Sector.
Continuous disclaimers by the Auditor-General, as well as negative perceptions
portrayed in the media about the current state of affairs of this department
have unfortunately done little towards projecting a stable and fully competent
image of our government.

To such an extent that Provincial Government has stepped in to assist and
that Provincial Treasury will now provide assistance in issues of Financial
Administration, including Supply Chain Management, Financial Management and
Financial Accounting of the department. This measure should be viewed in a
positive light because it is an active step towards boosting and improving the
capacity of the department. Continuous planning meetings held with the
Provincial Treasury are proving beneficial and the attitude of health officials
who give full co-operation is reassuring.

I am therefore confident that the Turnaround Strategy, which is currently
being drawn up by both the Departments of Health and Treasury, will form a key
stepping stone towards restructuring the Department of Health. This would be
done in such a way that not only will overexpenditure be extricated and
administration problems be ironed out, but also that the department will have
the opportunity of growing into a truly effective and efficient department.

This will in part be achieved by plans to prioritise critical posts, while
at the same time possibly combining other posts in a bid to reduce expenditure.
A complete review of all posts will form the basis of this. At the same time, I
must add that in spite of all the criticism by some being levelled against the
department we have nonetheless managed to achieve a number of successes in the
past year:

* Alexkor's Alexander Bay Hospital was successfully transferred to the
Northern Cape Administration.

* To improve service delivery and efficiencies in the system, we have
assigned delegations of duties to District and Hospital Managers. The final
implementation of this measure will maximise performance within the entire
District Health System.
* The training of personnel has been a major priority in order to maximise
capacity and potential. This is particularly so in the area of scarce
skills.

* In 2006/07, thirty students were funded to study Radiography and thirty
Professional Nurses were sent on the following specialist courses, namely:
Primary Health Care, Critical Care, Theatre Technique, Midwifery and Advanced
Midwifery.

* In addition to the students who are currently partaking in the
department's nursing and doctors' funded programmes, both inside and outside
the country, there is also a success story of a young doctor from Kgalagadi,
who has been studying in Cuba and is due back in July to commence with her
internship.

* The transfer of the medico-legal mortuaries from South African Police
Services (SAPS) to the province has been completed and was effected on 1st
April 2006. The implementation will be gradual over the next Medium Term
Expenditure Framework period.

* We have appointed five District Chief Pharmacists for the Namakwa,
Siyanda, Pixley Ka Seme and Kgalagadi Districts.

* In the assessment of the work done by the department, it is important to
note the construction and opening of new clinics that occurred including the
new Joe Slovo Hospital in Garies, which was opened on 25th March this year.

* A generous contribution from the Dettol Company as well as assistance from
the Nelson Mandela Foundation enabled the construction of this hospital, which
is a prime example of the power of partnerships.

* In terms of the formation of partnerships, this is perhaps one field that
the Department of Health has managed to excel in by creating formal
partnerships with the Community Health Workers, Traditional Healers and the
Faith Based Sector in line with the fight against HIV/AIDS

* The department was also able to launch the Provincial TB Crisis Plan and
extensive TB Blitzes were held in each of the province's five districts in an
attempt to halt the spread of the disease, with the Executing Authority
visiting various households.

* The Diseases Outbreak and Control Unit was further nominated by the
National Institute for Communicable Diseases (NICD) and received an award in
the control of Anthrax in Schmidsdrift in a non-academic category at an
infectious disease conference. It also received an award in 2006 for best
performance in the control of a diarrhoeal outbreak in Kakamas.

* Diseases Outbreak and Control Unit measures have also proved to be hugely
effective as demonstrated by the manner in which the province was able to halt
the cross border spread of polio from Namibia.

* The department has an ongoing pilot project in partnership with the
national Department of Health and a Non Governmental Organisation (NGO) called
"Health Sciences for Life." The objective of this project, which impacts
directly on the quality of care, is to test the feasibility of the infection
control quality assessment tools that will be used to accelerate the
implementation of the infection control policy. This pilot project is intended
to be shared with the whole country. However, the road to responding to our
constitutional obligation in so far as the provision of quality healthcare is
concerned is never easy and the Department of Health is faced with a number of
challenges.

* The most obvious of which is the ongoing strike which is hampering service
delivery. It is therefore appropriate that I take this opportunity to thank our
essential services personnel who have heeded the call of government to continue
to serve our people for the duration of the public servants strike. These
include all personnel who even under strenuous circumstances, never forget to
put public service at the forefront.

* Given the shortage of critical personnel in the districts, especially in
the platteland, the scarce skills allowance did not have the desired effect for
the Northern Cape, simply because it was also available in most urban
provinces. Hence the issue of scarce skills remains a challenge.

* As a result of the cross boundary developments, the number of health
facilities under our jurisdiction has increased from 152 to 183. We can state
that we have been successful in integrating the two administrative systems thus
far. However, with regards to upgrading the facilities, poor road conditions
and inadequate staffing, a new set of challenges is born.

* While our 18,5 % HIV prevalence rate in the province remains the second
lowest in the country, the fact that our syphilis rate which is at 8,5% is the
highest in the country is particularly worrying. It is for this reason that we
have to develop new and innovative strategies of tackling HIV and other
Sexually Transmitted Infections.

* Furthermore, on top of the high incidence of TB in the province, there has
also been an increase in cases of Multi Drug Resistant TB (MDR) and emergence
of Extreme Drug Resistant (XDR) TB.

* Another challenge is the recent decrease in conditional grants caused
mainly by the reduction in the Hospital Revitalisation Grant thus derailing our
hospital infrastructure development plan for 2007/08.

Madame Speaker, our total budget for this year amounts to R1,459 941
billion, which is a 13,1% increase from last year's allocation. To further
respond to the challenges mentioned we have defined our priorities for this
year as follows:

* To create synergy across the province in terms of service delivery and the
inclusion of the Kgalagadi District an amount of R163 620 million has been
budgeted.

* To improve the remuneration package of Professional Nurses. For this
objective to be realised an amount of R16 693 million has been set aside for
the Occupational Specific Dispensation (OSD).

* To further enhance the Department's Recruitment and Retention Strategy. We
have injected R6 620 million for additional posts for health professionals
because as a government we cannot over emphasise the need to continue our
efforts to attract and retain critical professional skills to achieve our goal
of service excellence.

* Owing to our commitment to turn around the overall performance of the
department and improve service excellence we will prioritize the filling of
vacancies in key programmes and components of the Department such as Districts,
Mother Child and Women's Health and the Projects Office. This includes the
posts we indicated earlier.

* With plans for the World Cup well underway, the need to strengthen our
Emergency Medical Services (EMS) cannot be overemphasised. We have allocated
R1.454 million for the 2010 preparations. Thus we would continue to revitalise
certain aspects of EMS, including the training of Emergency Care Practitioners,
replacing old vehicles, as well as improving our communication systems.

Madame Speaker, with the continuous advancements of Information
Communication and Technology (ICT), the need to upgrade our Health Information
Systems is inevitable. Hence we have set aside R 926 000 for this purpose. To
combat the increase in maternal deaths we have crafted a plan that responds to
reducing both the maternal and child mortality rate. We will pay particular
attention to the question of the efficient data gathering at facilities level
and the utilisation thereof for optimal decision making.

Madame Speaker, our conditional grants allocation for this year, in respect
to the Comprehensive Treatment and Management of HIV/AIDS has increased by 8%
to R74 091 million. Similarly, the Health Professionals Training and
Development allocation has increased by 5% to R43 122 million. The Forensic
Pathology Services allocation has also been increased by 2,3% to R 24 185
million as well as the Provincial Infrastructure Grant which shows an increase
amounting to R36 993 million. As earlier mentioned, the Hospital Revitalisation
Grant has decreased by 44,9% to an amount of R172 966 million, however the
outstanding projects such as the construction of the De Aar, Upington and
Postmasburg Hospitals would continue towards the new financial year in 2008/09.
The new Barkly West Hospital is on track and is due to be completed by August
2007.

Madame Speaker, critical to the delivery of quality health care services to
our communities, and in order to achieve full compliance with legislation such
as the National Health Act 2003 by establishing the Office of the Inspectorate
of Health Establishments and functional Hospital Boards and Clinical
Committees, we have an administration budget of R64 866 million. In District
Health Services we have apportioned R 699 703 million which is 47,9% of the
total budget of the department. This is essential to note because we want our
resources to be primarily spent on service delivery. In line with our National
Health Priorities we thus put particular emphasis on strengthening the District
Health Services.

Madame Speaker, previous investments in the essential services have resulted
in significant improvements and now, for the first time we have ambulances in
far flung areas such as Kuboes. To further achieve the aforementioned priority
in providing excellent emergency services we have allocated R99 729 million. In
today's World, to create a progressive health environment that can amongst
other things attract and retain staff, hospitals must work hard to keep pace
with advances in technology in addition to providing facilities that support
the modern delivery of healthcare.

In the public sector this is critical to guarantee the quality of care to
the poorest of the poor. A budget of R354 053 million has been allocated to
Hospital Services for this objective.

Madame speaker, moreover, as a sign of valuing the users of our services we
need to continue to develop our staff and infrastructure and make the best use
of our human and financial resources. We intend to enhance effective record
keeping thus improving the availability of patient information at the Kimberley
Hospital Complex. Major projects are earmarked for the current financial year
at the Kimberley Hospital. These are the following:

* revitalise the boiler system
* refurbishment of the lifts in Block A to improve access to operating theatres
and Intensive Care Units
* install a Satellite Radiology Unit at the Specialised Clinic.

In line with the plans previously announced by the Premier to improve
capacity and staff training, including improving the learning conditions of our
students and the ability to attract appropriate staff, a budget of R23 966
million has been set aside for Health Sciences. This is mainly dedicated
towards upgrading the Henrietta Stockdale Nursing College. We have made it a
point to make a recognisable impact on the lives of the community and we
acknowledge the need to strengthen our Health Care Support Services for which
we have thus allocated R7 960 million. Further emphasis will be put on the
maintenance of our equipment and facilities as there is continuous strain on
our Engineering Services for which we have set aside a budget of R2 058
million.

The same holds for our Orthotic and Prosthetic Services for which we have
set aside a budget of R2 318 million to curb the current backlog of assistive
devices such as wheelchairs. At this point, allow me to thank the Sexwale
Family Foundation for their generous donation of 50 wheelchairs, as well as the
Premier for her initiative in securing this contribution. These wheelchairs
will do much to improve the quality of life of 50 people with disabilities in
the province, many of whom are bed-ridden and can't even go to church or to the
shops. We would like to further urge other stakeholders to join efforts in
fulfilling their social responsibility through partnerships such as these to
make a difference in the lives of our people.

Honourable Members, our partnership with the Department of Education and
other stakeholders should continue to nurture our strategies in addressing the
scarce skills shortage. We need to emphasise the importance of the enrolment of
learners in the fields of Mathematics and Science to cultivate excellence in
these subjects as required for the training of health professionals.

Madame Speaker, in conclusion, the department has made a commitment to
achieve definite targets as spelled out in our Vision 2014 � which is the
Health Plan of our Provincial Government and we are therefore bound to a set of
deliverables by which our contributions can be clearly measured against. We are
constantly re-inventing ourselves and building a team that understands the need
to educate and influence a culture of healthy living and health awareness,
which would bear its fruits in aiding the department to better cope with the
enormous challenges it faces. In so doing, we are striving for health service
excellence for all.

I thank you.

Issued by: Department of Health, Northern Cape Provincial Government
22 June 2007