The Minister of Health, Dr Aaron Motsoaledi,
MECs of Health present,
Leaders, managers, students and representatives of the nursing and midwifery professions,
Members of labour organisations, regulatory bodies, professional statutory bodies,
National and international representatives of nurse training and professional bodies,
Distinguished guests, comrades and friends;
Fellow South Africans,
Dumelang, Abusheni, Molweni, Good morning.
Today is a very important day in the promotion of good quality health care for our people, as we are meeting with professionals who are at the coalface of the delivery of health services.
On this special occasion, we recall the origins of the noble nursing profession of nursing in this country, as introduced by the missionary nurse Hendrietta Stockdale, who is believed to have been a descendant of the nursing pioneer, Florence Nightingale.
We also take this opportunity of this historic post-apartheid nursing lekgotla to salute the first black nurse to be registered in this country, Cecilia Makiwane, who was trained at Lovedale Hospital in Alice.
Ms Makiwane remains an inspiration to young people who enter this profession, and should be an inspiration to all nurses who should follow in her footsteps by building and promoting this profession.
We draw strength, hope and courage from the memory of these three inspirational women – Florence Nightingale, Hendrietta Stockdale and Cecilia Makiwane.
The values they upheld of sacrifice, caring for others and putting the patient first before other considerations - are the values that should drive nursing in our country.
Ladies and gentlemen,
This summit is a moment of renewal for the nursing profession.
It is a moment of discarding practices that do not work and embracing new methods and ways of doing things that will define the role of a nurse in a free and democratic South Africa, serving a free South African people.
It is important therefore that this valuable summit has brought together retired, practicing as well as student nurses.
We will gain from the wisdom of our retired nurses, appreciate the experience and challenges facing our serving nurses, and shape the thinking and practice of our future nurses.
This summit must unpack the role of a nurse in a new society, a society in which our people are protected by a Bill of Rights in a progressive Constitution.
The Constitution of the Republic states that everyone has the right to have access to health care services, including reproductive health care.
The Constitution also specifically states that all children have the right to access basic nutrition, shelter, basic health care services and social services.
It is their right, and not a privilege that can be taken away by government, any public servant or any other institution in society.
Working together as the administration and nursing professionals, we have a constitutional responsibility to ensure that our citizens, including children, obtain good quality health care as is their right.
This should be clear to all of us as we deliberate at this Summit.
I am emphasising this point because at times, public servants may think that they are doing members of the public a favour, when in fact they are providing services that citizens are entitled to.
We should note as well that this important Nursing Summit is not taking place in a vacuum.
We have convened it against the background of national priorities that we have committed ourselves to as government.
We have undertaken to make a difference in five priority areas: education, health, the fight against crime, rural development and land reform as well as creating decent work.
To achieve our goals in these areas, we have to work with and through public servants and professionals through whom government delivers the necessary services.
In the health sector, nurses are a pivotal service delivery unit.
This summit also follows meetings we have already held with other key public services professionals such as the Police, Municipal Managers, Directors-General and school Principals.
We are satisfied that we have been able to get our message across to these professionals.
Our message is simple and clear. We have to change the way the public service works otherwise there will be no improvement in service delivery. We are today formally bringing that message to the country’s nurses.
You will in the next few days deliberate on important matters of how to improve the quality of healthcare through nursing practice, training, development, management, leadership and research.
All of this will be happening in the context of the four primary goals that have been set to be achieved by the health sector during the years 2010 to 2014.
These are to increase the life expectancy, reduce the mother and child death rates, combat HIV and AIDS and tuberculosis and strengthen the effectiveness of our health system.
Currently the life expectancy of the South African people is 59 years for females and 54 years for males. We experience most deaths associated with HIV and AIDS-related illnesses and tuberculosis.
We also have a very high infant, child and maternal mortality, a rise in non-communicable diseases such as hypertension, and diabetes and also, to a lesser extent, injury and violence.
Mother and child mortality is of serious concern. High on the list of maternal deaths is HIV and AIDS, which is responsible for 43% of mothers’ deaths. But the other 57% is very worrisome because these are preventable cases.
These include untreated high blood pressure in pregnancy, bleeding before, during and after delivery, infection after delivery and poor nutrition.
As health professionals you are aware that the three most important determinants of safe birth and healthy motherhood are:
- Early visit to a maternity clinic
- Presence of a trained professional at birth
- Professional care after delivery.
I trust that you will discuss these during the summit, to contribute to the national response to this challenge.
To reduce infant and child mortality, government has begun to improve immunisation services and to promote good nutrition, family care and breastfeeding practices.
Nurses play a key role in these programmes.
HIV and AIDS remain a serious challenge but we are making tangible progress in dealing with the epidemic and in improving the quality of lives of those living with HIV.
We know that this epidemic has been an added burden to our health care system and to nurses in particular, given the extra care which they have had to provide to those who are seriously ill.
Government’s interventions announced on World AIDS Day 2009 are being implemented and will reduce the burden on nurses and other health professionals.
Government started last year to provide antiretroviral treatment to pregnant women with a CD4 count of 350 or less to enhance maternal survival; as well as to people co-infected with TB and HIV with a CD4 count of 350 or less, and children less than one year of age who tested positive for HIV, irrespective of their CD4 count.
We have also decided that pregnant mothers start prevention of mother to child transmission of HIV at 14 weeks rather than 28 weeks.
In April last year, government launched a campaign to mobilise all South Africans to get tested for HIV.
From April 2010 when the campaign was launched until mid-February 2011, just over nine million people were counseled and seven point six million were tested. 1.4 million tested positive. In the same period 4.4 million people were screened for TB.
Nurses are involved in the execution of various HIV prevention measures including medical male circumcision, prevention of mother to child transmission and general awareness campaigns.
These points make it clear that we can do a lot to minimise the death of our people, by simply being proactive, innovative and doing things differently.
The fourth goal of our administration is very central to this summit - that of improving the functioning of our health system.
We have already applied our minds as to how we can do this effectively. A critical intervention is to improve the training and recruitment of nurses, doctors and other professionals.
Our focus on nurses is not misplaced. Nurses are central to the achievement of health revitalisation goals, given the role they play in the health system. You are the backbone of our hospitals and clinics and the engine of our health care system.
For people who are critically ill and are hospitalised, the nurse is usually the first person they see on waking up in the morning and the last before retiring at night.
The nurse is the patient’s key source of information, comfort, assurance and delivery of treatment.
You are therefore very important to us and to the lives of our people. However, there is a shortage of nurses and we are aware that many are overworked. We appreciate the contribution that our nurses are making.
Many nurses work long hours tending the sick who are also at times irritable and too demanding, which can make nursing physically and emotionally draining.
There has been an ongoing call from various sectors in our country for the re-opening of nursing colleges, to ease the pressure on our nurses.
We announced in the State of the Nation Address that we would revitalise one hundred and six nursing colleges in the country in order to deal with the shortage of nurses and we are working to fulfill that undertaking.
A comprehensive audit of nursing colleges has been completed.
The results have pointed to a need to enhance the infrastructure at these institutions, to investigate the impact of the four-year training programme on the production of nurses for the public sector; and to enhance the recruitment of nursing educators to improve the production of nurses.
The results of this audit confirm that the training of nurses has been neglected and poorly coordinated over the years. As you are aware, problems began in 1986 when the apartheid government decided to change the manner in which nurses were historically trained.
More and more nurses now receive their training at universities and private colleges.
This has led to its own challenges. The main thing is that nursing is a practical profession and the bedside experience is very important in the training process.
We are not saying that we do not want our nurses to have university qualifications. But we believe that universities should be part of a range of our training platforms and not a primary mode of the production of nurses.
We look forward to hearing your views on this matter as people who are directly affected.
We also need to look into the skewed deployments in the nursing profession as well.
For example, we are producing more nursing sisters or professional nurses, than assistant nurses or enrolled nurses.
We are in essence producing more commanders and less troops for them to command.
I am informed that there are 115 000 professional nurses and only 52 000 enrolled nurses. I trust that you will look into this anomaly as well in your deliberations.
Parallel to the training of nurses, we also have to increase the number of the doctors we produce.
South Africa has been producing 1 200 doctors per annum for the last ten years, which is insufficient.
This is why we are now planning to establish the country’s ninth medical school, at the Limpopo Academic hospital.
Ladies and gentlemen,
As I said earlier, the improvement of health care delivery is not just about training.
Other interventions that we have identified as part of improving our health care system, is the appointment of the right personnel to senior positions.
Persons holding positions such as Heads of Department, chief financial officers, hospital chief executive officers, district health and clinic managers require the appropriate competency and qualifications.
There are challenges in this regard in some provinces, where you find a mismatch of skills, and even instances where people with no medical background are found in positions which require such a competency and qualification.
As part of improving the functioning of our health care system, we are also working to improve the infrastructure. Our hospitals and clinics need to be of the required standard physically.
The Infrastructure Delivery Improvement Program and Capital Projects are being prioritised.
Last year we paid attention to over 2 000 facilities, undertaking activities from minor repairs and maintenance to renovation and major construction works.
Renovations will continue on the flagship projects such as King Edward, George Mukhari, Nelson Mandela, Chris Hani Baragwanath and Limpopo Academic hospitals.
However, we can build as many beautiful hospitals and clinics as we can, but at the end of the day, the attitude of the people running the hospital counts.
Our vision is to have staff in our health facilities who receive members of the public warmly and who are always ready to provide assistance in an understanding and empathetic manner.
Citizens should not be treated as if they are a burden or a nuisance by staff that is employed to serve them.
The era of the rude, uncaring and impatient civil servant or nurse must be a thing of the past as we build a caring government and a caring society.
We are pleased that about one thousand two hundred Quality Improvement Plans are being implemented to enhance health service delivery in the public health sector.
These plans focus on six key areas that we want to be prioritised.
The attitudes must change, we must shorten the waiting times or delays in receiving care and health services personnel must ensure that all facilities are clean and tidy at all times.
Health professionals must prevent the transmission of infections and cross-infections inside hospitals and clinics, and ensure a reliable provision of basic medicines and supplies.
These are just some of the few improvements that are expected from all public health facilities.
If we implement these provisions, visits to our facilities will be a more tolerable and pleasant experience for our people.
It will be as pleasant as what we have been informed has happened at Prince Mshiyeni Hospital in uMlazi, Durban.
The hospital has been turned around from being the worst hospital in the country to one which is being praised by patients and the community for good service, efficiency and friendly staff.
Another way of improving the way our health care system works will involve making our nurses play a key role in our communities to promote healthy living and prevent diseases.
We want to see our nurses doing more to educate our people about how to manage their chronic conditions such as hypertension (or BP as ordinary people call it), diabetes, arthritis and other ailments.
Our nurses can and should be seen in schools teaching boys and girls about how to prevent pregnancies and sexually transmitted infections such as HIV, providing information on dental care and generally promoting healthy lifestyles.
We urge you to do this as much as is practically possible. Prevention will always be better than cure.
Ladies and gentlemen,
We are putting in place all these mechanisms as government because of our vision for health care.
What drives us is that we want to see South Africans having access to the best health care possible, which is accessible, efficient, effective and affordable.
We want our people to receive medical care in renovated public hospitals and clinics with the right equipment, transport and other facilities including adequate medical supplies.
They should be attended to by nurses, doctors and technical staff who are friendly, knowledgeable and willing to assist at all times.
We want to work with you and other health professionals to achieve these goals.
Ladies and gentlemen,
Indeed this is a very timely and opportune summit.
Let me take this opportunity to wish you all the best in your deliberations in this National Nursing Summit.
I look forward to the contribution of the nursing and midwifery professionals to the social and economic development of our country, through the achievement of positive and sustainable health outcomes.
I thank you.
Source: The Presidency
