The HOD Mr JS Dlamini
Dr Sibongile Zungu
Representatives of labour
Management
All Participants
I have been tempted when preparing this input to avoid any reference to the thick documents you have in your possession. This temptation is brought about by my frustrations with government systems and its employees and how these two interface.
I increasingly observe a calculated pattern by civil servants, a pattern that I think negate the founding principle of the government of the people by the people and for the people. I have observed that more often than not, we plan and implement within prescripts but outside our people whom we purport to serve. We hardly put a human face to any of our plans. We hardly think hard about what implications our actions or inactions have on this human face.
I have observed that perhaps in South Africa we have not as yet appreciated fully what it means to be called a public servant.
Year in and year out we put up grand plans that some of us are made to pronounce in the legislature. These plans indeed ooze confidence to many of our people that their government is doing something about their plight; but they disappear on the air like smoke disappear in the thin air. They are never followed to their logical conclusion.
Our explanations are the same year in and year our lack of capacity. Colleagues until when are we going to bemoan lack of capacity. Can we realistically expect our people 15 years after freedom and democracy to bear with us and have patience? If it’s not capacity it has to be lack of resources, but we can not even use the little we have efficiently and productively.
Do we ever think that all the people we serve in our facilities do not have choice, because if they did they would not even dare use our facilities? Why are making excuse of the systems and processes because these systems were after all created to assist you to deliver services faster to our people? Why are they constraining us? How do explain a situation where a patient lies for three our weeks in Barberton hospital waiting for surgery because Rob Ferreira turned her back so many times? Do we expect our people to understand whatever legitimate explanations there could be for this case? No I do not think so.
It is these reason that I had this temptation to write my input outside the grant plans. I too will gradually loose confidence in these plans because they seldom relate to the daily struggles of our people. The Africa National Congress (ANC) has said health is a priority for the next five years. This statement places mammoth responsibility on our shoulders.
We have a duty to add flesh to that statement. Putting health as a priority do not mean we are likely to receive more money, it means should start doing things differently and more efficient. It means fewer meetings for CEO’s because your work is to manage facilities we have otherwise employed you to do. It would mean fewer trips to Durban by CEO’s and more time in the wards. We will be under constant watch by everyone in the next five years.
Colleagues it is not by accident that the ANC has prioritised health. It is out a correct understanding that our developmental agenda as a country rests squarely on a healthy nation.
We should also not loose sight of our health transformation imperatives and as we plan we should be able to answer questions on how far we have in each of these pillars; access, affordability and equity.
We need to finalise the strategic transformation plan. But before we do that, we need to develop consensus on what model of primary health care located within the district health management system we want to adopt in our province. An observation made is that we have divergent understanding of our model.
Our province is faced with acute challenges of staff shortages which is a serious impediment towards effective service delivery. While many these challenges are historical and some are outside of our realm, we however also need to have plans to address them. We need as matter of urgency to finalise our overarching Human Resource Plan that that can zoom over into the future.
Equally important is the need to develop a medium to long term infrastructure plan located within our vision of the STP. We can not afford to have ad hoc interventions on infrastructure. We must be able to focus into the future while equally not ignoring maintenance of the present asset base.
Colleagues many of the challenges with our health system is the disjuncture of platforms or levels of care to our communities. We fail to achieve efficiency because we have not adequately attended to this important element of service delivery-our referral system. I have observed that this element has been a subject discussion for quite a long time without finalisation and implementation.
If asked by any member of public on what as department we are doing about advocacy of preventative care and health promotion, I cannot be in a position to answer without fear of contradictions. This issue is like a doctor who has correctly diagnosed a patient but continuously prescribes wrong medication.
We know about problems of health and all causal factors but ignore health promotion as a strategic intervention towards resolution of many of our challenges. It goes again to communication. The level to which we are able to communicate our programmes to our communities leaves much to be desired. It my considered view that these two areas are a strategic point of departure in building a healthier nation.
The national health act has brought about governance structures for all our health facilities. For these structures to perform their expected functions they require our undivided support. A government of the people by the people and for the people is not distant people rhetoric; it finds meaning through establishment of these governance structures. They are not a luxury but necessary instruments to build government.
The National Health Council has identified a ten point plan that requires our collective effort in the next five years. If the road map plan remains an exclusive agenda of management and is not adequately communicated to all our stakeholders in particular staff in lower ranks it will fail before it starts. We often think that it is by the way; or luxuries to bring on board all stakeholders on important government policy direction.
We are host of the 2010 FIFA soccer competition next year. Related to this is the fact that we are neighbouring countries and our preparations should adequately respond to this reality.
Programme director I mentioned when I started that while preparing this input I had my temptations not to go into these issues that in your language you call strategic. I am equally tempted to believe that at the end of this important exercise, shall emerge a document that relates adequately to the daily struggles of our people.
My crucial expectation is to see how to you respond in a programmatic manner to lack of efficiency in the department. This efficiency relate to systems, processes, management and how we use our finances. Managers especially CEO’s spent a worryingly less time in their facilities.
I wish you well in your deliberation in the next two or three days and sincerely hope that your plans shall begin to put a human face, for that is only when we shall comprehend fully the task at hand.
Thank you.
Issued by: Mpumalanga Provincial Government, Department of Health and Social Development
21 August 2009
Source: Department of Health and Social Development, Mpumalanga Provincial Government (http://www.mpumalanga.gov.za/healthsocserv/home.asp)
