Programme Director
Head of the Department, Maj. Gen. (Dr) M Radebe
Executive managers of the department
Esteemed Members of the governance structures
Valued partners and representative of the North West University
All delegates of the Provincial Health Consultative Forum
Distinguished guests
Ladies and gentlemen
Dumelang bagaetsho!
I take this opportunity to thank the North West University for partnering with us in this programme.As government, our challenges are varied and there are so many service delivery programmes that we can never achieve if we do not mobilise the relevant expertise from across all sectors.The university is the right place to harness skills, knowledge and expertise.
Understanding governance structures
Governance structures are quite a critical initiative of our government. The ruling party, the African National Congress has always believed in the government of the people by the people. And when we say the people shall govern, it should be demonstrated in a practical sense.For this reason, the formation of governance structures as established in terms of National Health Act 61 of 2003, represent the will and aspirations of our people in terms of how we should provide them with health care services. So, we can never assume that we know the health needs of our people unless the people themselves tell us how we must service them. We must working together with our people so that they may inform our policies and programmes for better health outcomes.
Antoine de Saint-Exuper, a French pilot, a writer and author of 'The Little Prince', who lived between 1900 and 1944 once said, “If you want to build a ship, don't drum up people together to collect wood and don't assign them tasks and work, but rather teach them to long for the endless immensity of the sea”.
So, instead of just providing health care services to our people, let rather share with them our vision of health care and invite them to pursue this vision together.
We meet here today in this very important occasion, the meeting of the Provincial Health Consultative Forum.This forum meets at a very crucial time, just a few weeks after our country had a resounding success with the local government elections. It is also almost two months since we delivered the budget policy speech for the current financial year, in which we made a number of undertakings to the people of North West.
I am sure that we have all observed the intensity in which local government elections were contested. In particular, we have heard on the media how our communities were extremely vocal in demand of improved services.Ladies and gentlemen, we must respond to the needs of our communities. In particular, essential needs and services like health care will always be in high demand by our people and we must not fail them. Healthcare service delivery will also always be under public scrutiny. We will always bare the brand of criticism either constructive or destructive but we must equally always understand why this has to be the case. Health is such a critical service and sometimes it’s a matter of life and death. So, we cannot blame the public for coming hard on us when they demand the best and quality healthcare services.
In responding better to the needs of our people, there are two government Programmes that you must fully understand. We are in a process of transforming health care with two critical interventions, being Re-engineering Primary Healthcare Programme and the Service Transformation Plan. This programme will run concurrently and the Service Transformation Plan in particular carries a 20 years vision and it is important that you are on board, you know the vision and are able to share it with the communities you represent.
Re-engineering primary healthcare
We are serious about the Re-engineering Primary Healthcare (PHC) programme because we believe this is a programme that will improve the face of health care at local level. PHC is closer to our communities. If we succeed with the re-engineering of PHC programme we are set to solve many challenges, not only at PHC level but health in general. I elaborate a lot in terms of how we plan to implement the Re-engineering of Primary Healthcare (PHC) programme during the budget speech but whatever plans we have, we depend entirely on local people and stakeholders to make this a success. PHC is essentially a local government service because it’s rendered at local level where the majority of our people live.
The World Health Organisation (WHO) defines PHC as essential health care based on practical, scientifically sound and socially acceptable methods and technology that are universally accessible to individuals and families in the community through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-determination. You will remember that PHC was adopted at the 56th World Health Assembly held in Alma Ata and became a core concept for the World Health Organisation serving as the basis for the WHO's goal of Health for all. The Alma-Ata Conference mobilised a “Primary healthcare movement” of professionals and institutions, governments and civil society organisations, researchers and grassroots organisations that undertook to tackle the “politically, socially and economically unacceptable” health inequalities in all countries. Once again, this emphasises the need for a multi-sectoral approach to PHC and with the Provincial Health Consultative Forum, we are well on track to mobilise intellectual and material resources to make PHC work.
Governance structures to be effective, they need to fully understand how PHC and what is their role in it. From what I have said, you can understand that governance structures are core to an effective PHC. When talking about re-engineering PHC, it is important that you understand this programme as intended to get health care back to the basics.
School health services
In going back to the basics, one the things we need to resuscitate is school health services. In this regard we need you are councillors in various communities, dikgosi, baruti and all members of the community to play a role. I said during the budget speech that we will be discussing this matter with our counter parts in the department of basic education to see how we can collaborate in order to accelerate the manner in which school health services are delivered effectively.
Specialist teams
One critical aspect in PHC is specialist teams. These teams will be appointed to support the delivery of health services in the district. The teams will be comprised of gynaecologists, family medicine specialists, paediatricians, advanced midwives and primary healthcare nurses, among others. We will work very hard to ensure that we get these specialists to work in our districts.
We want to invest in the primary healthcare area so that the patients can have confidence in the manner in which we render services. Once this confidence is regained, we are sure we will see most of our patients utilising clinics and community health centres. This will assist to reduce overcrowding of the outpatients departments of hospitals; which if not addressed stands to undermine the quality of care for the hospitals.
Ward Based PHC Teams
The last aspect is Ward Based PHC Teams. The success of reengineering of PHC rests on the model that was learned from Brazil which is called Family Health Teams approach. Learning from the successful Brazilian model, we will be embarking on the establishment of the Primary Health Teams. These teams will be organised around the municipal wards, so that they are closest to where people live and work. They will work with the structures that are currently there on the ground. The teams will be comprised of Professional Nurse, Enrolled Nurse and a team of community health care workers. The team will be responsible to take care of a number of households within a ward, and will work closely with the Primary Health Facility for support, quality assurance and supervision. Once again, the governance structures will be critical in this area.
Decentralisation of budget to the districts
We have already decentralised the budgets for maintaining our health facilities to the districts as a way to improve the pace of service delivery. We have also delegated authority to the districts in the areas of appointments and procurement. With the emphasis on primary health care, this will go a long way in ensuring that unnecessary bureaucracy and bottlenecks in decision making are cleared. It is however important to remember that districts will still have to be accountable in exercising this authority. While we eliminate red tape, the execution of our responsibilities must be done in the spirit of good governance and prudent financial management.
Service Transformation Plan
The North West Department of Health has completed the Service Transformation Plan outlining its vision for improving service delivery and health outcomes during the decade 2010-2020, and beyond. This plan is a result of a directive from the National Health Council meeting of October 2009 that the health sector must produce new long-term plans, which are aligned to the health sector’s 10 Point Plan for 2009-2014. As you will know, the 10 Point Plan entails the following key priorities:
- provision of strategic leadership and creation of a social compact for better health outcomes
- implementation of a national health insurance plan
- improving quality of services
- overhauling the healthcare system and improving its management
- improving human resources management
- revitalisation of physical infrastructure
- accelerating the implementation of the HIV and AIDS Plan and reducing
- mortality due to TBand other communicable diseases
- mass mobilisation for better health for the population
- reviewing the drug policy
- Strengthening research and development.
So, the Service Transformation Plan is aligned to the Re-engineering Primary Health Care Programme and it is also intended to make the imminent National Health Insurance (NHI) a reality and sustainable.
I am happy because the development of the Service Transformation Plan has accommodated your views and comments going forward. However, it is important that you continue to familiarise yourselves with this plan so that you may in turn share its vision with our communities.
Conclusion
In conclusion Programme Director, I wish to advice all of you to take this forum seriously and use it fully having in mind the challenges before us. We are confronted with diseases and we need to fight diseases to increase the life expectancy of our nation. Re-engineering Primary Healthcare will assist us to better fight diseases when our people are better informed on how to lead a healthy lifestyle.
I take this opportunity to thank you for availing yourselves for these two important days and wish you a successful forum. May this forum achieve its objectives and remember,
“Working together we can deliver quality health services for all”
“Working together we can build better communities”
I thank you!
