by MEC Thokozile Xasa
20 March 2006
Honourable Speaker
The Premier of the Eastern Cape
Members of the Executive Council
Members of the Provincial Legislature
Partners in health
The non-governmental organisation (NGO) Community
Superintendent-General of Health
Heads of various institutions
Programme Managers
Colleagues
Fellow South Africans
The earnest quest and our mandate to create conducive conditions for the
realisation of the ultimate goal of achieving a better life for all our people
continues. During the negotiations for democratic change in South Africa many
professionals left the public sector with some immigrating to other countries
where they thought life would be better for them. The prediction at the time
was that services would collapse and there would be chaos in administration
especially with the amalgamation of the three very distinct administrations in
this province. It is without doubt that this further paralysed the provision of
health services.
The pre-democracy historical circumstances made us to believe that there
will be no time for honeymoon. In 1994 we had a choice to continue to provide
services in the old way or to be driven by the needs of our communities. We
chose the latter. The road ahead was winding, with more up-hills and detours.
This definitely would make us look like we are moving at a snail's pace.
Notwithstanding all these historical factors, the shared vision the millions
of our people have and the experiences of the past, people have continued to
live in hope that even if they may not enjoy quality of health now, they are
confident that tomorrow will be even better.
This optimism, hope and confidence are inspired by the visible delivery of
both infrastructure and services, and the transformation of society in general
which support delivery of health services in a new democracy.
Hon. Speaker our province as one of the rural provinces with huge backlogs
in sanitation infrastructure development continues to be vulnerable to
opportunistic water-borne diseases such as cholera and typhoid outbreaks. Over
a number of years, our department has earned a reputation of an effective
buster of life threatening outbreaks due to our improved turn-around times and
ability to deploy response teams.
However, our continued successes in these endeavours depend on sustained
co-operation based on co-operative governance, and increased awareness and
health education at community level.
At a provincial level, outbreaks such as these described above can only be
eliminated through the implementation of government's programme to address
water and sanitation backlogs. As part of this programme, the department will
work with relevant departments and state agencies to ensure that health
priorities are effectively addressed.
In pursuance of our policy objectives of developing primary healthcare, the
department will be embarking on the provincialisation of primary health-care
consistent with National Health Council (PHC) resolutions. Such
provincialisation will enable us to consolidate PHC services at local level,
strengthen District Health Services, and move us towards our goal of creating
single District Health Authorities.
We are hopeful that over the next decade we would be ready to implement the
devolution of primary healthcare to local government as envisaged in both the
ANC Health Plan and the White Paper on the Transformation of Health Services in
the country.
During the course of the next financial year, the department in partnership
with the departments of Housing, Local Government and Traditional Affairs and
in conjunction with district municipalities will be implementing the devolution
of municipal health services. This will ensure that many of our communities,
especially those in rural areas will, for the first time, have access to
environmental health services. This will also strengthen our resources in
preventing preventable communicable diseases such as cholera, typhoid, etc.
The year 2005/06 has seen us make significant strides in improving our
effectiveness as a department as well as in improving the quality of services
we provide. I am happy with the progress that we are making in achieving access
to services by all our people, and in achieving equitable allocation of
resources. Also, we have made significant progress in meeting our targets in
relation to the increase in the numbers of HIV and AIDS patients with low CD4
counts who present themselves to our accredited sites for treatment. Even more
impressive has been our ability to respond to the huge demand for treatment as
evidenced by the numbers that have already been put in the treatment regime of
anti-retrovirals.
We will continue to align our strategic thrust to get in tune with major
policy pronouncements such as the Accelerated Shared Growth Initiative for
South Africa (AsgiSA). As a health sector, we view our contribution towards
making AsgiSA an achievable mission as indirect namely, investing in the
general health of our people to ensure that they contribute to the economy
through various Accelerated Shared Growth Initiative for South Africa (AsgiSA)
projects.
For this financial year that we are concluding, I pronounced on the
following priorities which I will now address in terms of progress made during
the past year:
1) Strengthening primary healthcare (PHC)within the context of District
Health System
The department has exceeded the World Health Organisation (WHO) norm of
providing one fixed PHC facility to every 10 000 population, by providing one
fixed health facility per 8 000 population on average in the province. The rise
in the head count (15 229 490 in 2004 increasing to 15 435 727 in 2005) of
patients visiting our institutions has been confirmed by the increased
utilisation rate that moved from 2.33 in 2004 to 2.38 in 2005.The above
statistical representation might be under-representing the significant increase
realised over the period under review.
Infrastructure development
Madam Speaker, we are proud to announce that during the previous financial
year, the Department has managed to complete 13 new clinics. Of these 13
clinics nine were new structures replacing the muddy structures which were
built by the communities. In addition to the clinics, there was also provision
for residential accommodation for nurses as part of our strategy to attract and
retain them in needy underserved areas.
Periodic infrastructure surveys conducted from time to time ensure that
these facilities also provide all necessary services and are equipped with the
necessary functional equipment.
2) Revitalisation of health institutions
As part of the initiative of the national Department of Health, the
department is implementing the revitalisation project aimed at infrastructure
revival and installation in select district and provincial hospitals. One of
the major projects that have been completed is the relocation and rebuilding of
Mary Theresa Hospital in Mt. Frere. The hospital has been commissioned and
ready for official opening in June 2006.
Apart from highlighting our achievements we have also been bold enough to
acknowledge the limitations and challenges in providing the required services
to our people. One illustrative issue is the challenges in fully utilising
capital budgets, which include the shift or R10 million from the province.
Amongst other measures to address this issue, the department is contracting
other project management capacity such as Independent Development Trust (IDT)
and Coega.
The Letsema Programme
In addition to the Revitalisation Programme, the Department has embarked
upon a programme of face-lifting/beautification of certain facilities that are
dilapidated. The project is intended to allow managers in these hospitals to
utilise a specially allocated budget for minor repairs to buildings, painting,
grass cutting and tree felling, installation of signage, cleaning of storm
water channels, fencing, etc. The overall objective of this project is to
create an attractive and conducive physical environment.
Apart from this objective, the project contributes towards job creation and
local economic development through the employment of locals and awarding of
contracts to local suppliers. As the project has community involvement it also
enhances community ownership of the facility.
The following hospitals would be revamped by August 2006. This campaign is
in line with the Council for Health Service Accreditation (COHSASA) programme
of ensuring that our institutions meet basic standards of quality
healthcare.
Integration of provincially aided hospitals
One of the inherited systems of the old dispensation in public healthcare in
the province is the so-called state-aided hospitals. These institutions have
been geared towards serving interests of mainly white members of the population
in small dorpies throughout our province whilst receiving 90% of their funding
from government regulated on the basis of service level agreements (SLA).
Countless problems e.g. utilisation rates below the norm in certain
hospitals, failure to provide satisfactory account for resources provided, and
alleged racism in others have characterised these hospitals.
We are proud to announce that the department has managed to integrate these
hospitals into our district hospitals to facilitate alignment with provincial
government vision and plans. This step we regard as an initial one towards
complete take-over and absorption into the ambit of the department in the near
future.
Regional Service Delivery Model
With a view to consolidating our service delivery platform, the department
has adopted and started implementing a regionalisation service delivery model.
This model sub-divides our province into three regions namely, Western, Central
and Eastern regions. The regions are based on the grouping of all health
facilities that fall within district municipalities located within such
regions. Amongst others, the regional model will:
* ensure seamless patient care, linking PHC services to tertiary
services
* unblock problems associated with the referral system amongst various levels
of care
* achieve economies of scale through procurement
* share scarce expertise through e.g. rationalisation and consolidation of
services
* enable integrated planning and budgeting which also links-up with integrated
development plans (at municipal level).
3) Strengthening Quality Assurance Systems
To ensure compliance with internationally accepted health service delivery
norms the department has instituted the following measures:
* the enforcement of infection control measures in all our facilities. The
intention is to limit the spread of harmful bacteria such as klepsiella and
deterring the pests;
* eleven district hospitals have been added to the 24 hospitals that have been
placed on COHSASA Accreditation Programme with a view to get necessary support
to improve the quality of care. The significance of accreditation is that
district hospitals will maintain high standards in healthcare.
* a regulated patient referral system to avoid overcrowding and congestion at
the health complexes.
A complaints management system and full-time functional call centre. Between
February 2005 and February 2006, 5 911 calls were received by the Call Centre.
Of these calls 829 were complaints of which 642 were resolved while the
remaining 187 were referred. It is also interesting to note that most of the
calls made were related to administrative matters, followed by the emergency
medical services, whereas calls related to clinical services are relatively
lower.
Madam Speaker, the Department is proud to announce that it has refined,
adopted and started with the implementation of an infection control policy.
4) Promote Partnerships and Public Participation (PPP)
The Department continues to utilise PPPs as a vehicle to inject cutting edge
technologies, skills and systems, to ensure improved delivery of services.
Though there are teething problems in the implementation of the Pharmaceutical
PPP, the Eastern Cape Department of Health (ECDOH) prides itself as being the
leading government organisation in South Africa to venture into the concept of
PPPs.
Concerning public participation in health service delivery, the Department
has a reasonable amount of functional hospital boards spread throughout the
province and many clinic committees still trying to define themselves. A new
policy on Hospital Boards introduced in line with the National Health Act, 2003
will commence from May 2006.
The significance of such participation by communities in the governance of
these institutions will enhance needs determination, quality assurance, as well
as planning of services.
To compliment the shortage of doctors in certain underserved areas the
Department has engaged services of 395 private doctors in the capacity of
part-time medical officers to do sessions. We will continue to explore other
avenues especially in relation to other scarce health professional skills.
Community participation
The role of various partners in healthcare, especially those community-based
stakeholders remains the hallmark of our democracy. In recognition of this
tenet of our democracy, the department is finalising a programme to create
necessary conditions for structures such as hospital boards and clinic
committees to have meaningful roles that they play in the governance of the
department.
Provincial Health Council
In June 2005 the department launched a Provincial Health Council (PHC) as a
culmination of a decision by the former health MinMec which resolved to
constitute itself into the National Health Council (NHC) and directing
provinces to do likewise hence PHC. The PHC continues to provide leadership in
regard to health policy issues within the context of inter-governmental
relations framework.
Partnering with academic institutions
As a professional department, health needs to have close ties with
institutions of higher learning for reasons of collaboration to shape research
and development, etc. In this instance, the department is in discussion with
the Nelson Mandela Metropolitan University to cement a partnership which would
look at co-operation towards the development of certain categories of health
professionals. This needs driven type of training will ensure that the
university produces the cadre of healthcare practitioners that are needed based
on the burden of disease or disease profiles of our various communities.
5) Ensure compliance across all sectors
In tune with prescriptive requirement for compliance in terms of certain
legislative provisions, the Department has:
* launched an Anti-Fraud Strategy which details a framework to be instituted to
ensure that our Department can respond adequately to risk
* appointed a Chief Financial Officer and Chief Director Risk Assurance
Management with the full staff compliment to be appointed during April
2006
* an Audit Intervention Plan is being implemented with a view to improve our
audit outcomes.
The department will continue to strive to ensure that it regularises the
manner in which it conducts its business to realise highest levels of
compliance as required.
6) Improving and re-engineering business processes for long-term sustainable
quality healthcare delivery
As a department undergoing restructuring, we have launched a number of
projects targeted at improving business processes such as:
* Business Process Re-engineering (BPR) which will provide the revision of
business processes across sectors of the department with a view to increased
value add Systems Review which entails the reviewable of amongst others, legacy
systems (e.g. PERSAL, BAS, LOGIS) with a view towards improved integration and
interfacing Document Management System which will create an integrated,
seamless records and information management platform to enable compliance as
well as organisational memory
* Departmental Procurement Strategies on SMMEs and Broad-based Black Economic
Empowerment (BBBEE) to align procurement in the department with broad
government strategy
* these and other initiatives begin to launch our Department onto a path
towards a modern, professional and world class organisation and service to our
people.
7) Long range planning towards a quality public health system
The Department is about to commence the process towards development of a
long term healthcare vision for our province, vision 2020.Such long term
planning will respond to the Millennium Development Goals, National Health
Strategies and Frameworks, provincial priorities encapsulated by the Provincial
Growth Development Plan, etc. It is for this reason that we are embarking upon
consultative processes such as the Provincial Health Summit/Indibano, health
systems review project, rationalisation of district hospitals, and others, to
canvass as a broad a view as possible. Such a widely consulted vision would
enable ownership of such a vision by all sectors of society in this
province.
Provincial Health Summit/Indibano
During June 2006, our department will host a Provincial Health Summit. The
summit with its broad stakeholder participation will set our department and
province on a path towards a widely consulted long-range health plan for 2014
2020. The summit will also enable our government to bridge the gap between
public and private sector health service providers and cultivate a common
vision for the province. With the private sector having certain advantages in
terms of skills and resources in healthcare, processes would be put in place to
enable closer co-operation through research and development, skills transfer,
and general best practice models. Other social partners to enrich this process
are trade unions within our sector, community based organisations, NGOs within
our sector, etc, and all play a huge role in the process of helping to
determine needs of communities to inform long range planning as contemplated
above. Come join us in this exciting enterprise.
8) Strengthening information systems towards more effective monitoring and
evaluation
Previously, we undertook to strengthen our Monitoring and Evaluation system
in order to measure the impact of our social investment. Our main objective is
to ensure that we meet the reporting requirements laid out at different levels
of government and the United Nations. It is against this background that we
have incorporated within the strategic framework the Millennium Development
Goals and how we would measure ourselves against these.
Furthermore, we will enhance our capacity to do monitoring especially at
programme implementation level.
9) Improve overall organisational performance through intensification of
Performance Management and Development Systems
In broad terms, the Department's overall performance and capacity to render
services has improved significantly. This is illustrated by the almost
full-compliment of senior and executive management appointments, successful
implementation and adequate management of key programmes, etc, all of which
could be attributed to the strengthened layer of leadership across the
department. The recent re-appointment of our CFO has strengthened our financial
management capacity. We a re certain that overall performance management will
also be enhanced as our capacity grows.
10) Effective communication and branding of the department, institutions and
its programmes
In the next financial year 2006/07, the Department will embark upon an
aggressive image building campaign. Seeds of such image building have been
ploughed through the successful launch in June 2005 of a Departmental brand,
the establishment of a website, and the launch of the Health Radio Service
(HRS) and the Impilo Newsletter.
Some of the initiatives of such image building endeavours would also focus
on the department's internal clients to promote their greater participation and
entrench the notion of workplace democracy.
Priorities for 2006/07
Our priorities for the current year include:
1. Emergency Medical Services (EMS)turn-around plan which was unveiled on 23
February 2006.
In line with the strategy of building a caring, modern and professional
organisation, the Department has formulated an integrated Strategy for EMS in
the Eastern Cape that seeks to position the department as the best provider of
emergency medical services.
The basic aim for this plan is among other things, to provide a world-class
emergency service for the province and also improve response times especially
in rural areas.
For this financial year, the Department will allocate an additional R130
million for this project to ensure the implementation. Over the next three
years, the Department will expend an estimated additional R600 million.
The spin-offs of the plan include amongst other things:
* creating +/- 1000 jobs of various categories of EMS practitioners spread
throughout the province
* acquiring sufficient emergency vehicles allocated on an equitable basis
* upgrading of ambulance control centres i.e. automation of call centre to
enable tracking of vehicles and ensuring effective utilisation
* the introduction of the new systems will lead to an estimated saving of +/-
R3,6 million owing to efficient use of resources. This will enhance value on
human life
* the completion of the project will coincide with the 2010 Soccer World Cup
and our province will have a world class emergency service for both its
residents and visitors.
2. R100 million towards primary healthcare
Having noted the challenges and the slowness of the pace of ensuring
effective primary healthcare, we are proud to announce that the Department will
be spending an additional R100 million towards the expansion of primary
healthcare in this province. Amongst others, the money will be channelled
towards a home-grown model of turning a clinic into a Centre of Excellence,
explained below, as well as improvement initiatives towards better management
of TB in the province.
Tuberculosis (TB)
TB has been identified as a serious concern by the World Health Organisation
(WHO) and the Eastern Cape Department of Health is responding to that challenge
by declaring TB as a lead project for 2006/07.
The Department has developed a strategy to urgently raise awareness and
advocate for TB activities at community level. Thus involving community health
workers, schools and youth organisation, traditional leaders, traditional
practitioners, and faith based organisations in the fight against TB.
An additional R9 million, over and above the allocated budget of R28,300,000
million, will be dedicated towards this campaign.
The spin-offs of the campaign in conjunction with other programmes such as
Directly Observed Therapy Short-Course (DOTS) will enable the Department to
increase its current coverage from 50% to 85% through utilisation of community
health workers.
Clinic as a centre of excellence
The clinic as a centre of excellence simply refers to developing a
self-sufficient system that is able to fully address the primary healthcare
challenges in the locality of that clinic whilst improving effectiveness from
the point of view of strategic planning and budgeting, operational decision
making, staffing, etc, all conceptualised and implemented at clinic level with
minimal interference and much guidance from district / head office level. In
this way, clinic managers will be armed with broad management principles
empowering them to make decisions, plans and execute such plans at service
points.
Implementation of this concept will ensure full staff compliments exist in
all our clinics, adequate drug supply, and access to services by communities'
at all material times will be rolled-out during the cause of 2006.
HIV and AIDS Management
Madame Speaker our efforts in the implementation of the Comprehensive
Treatment and Management Plan of HIV and AIDS are growing in leaps and bounds.
Currently, our coverage is 28 sites which are hospitals which are complimented
by a ratio of five clinics per facility / hospital. Our Voluntary Counselling
and HIV Testing (VCT) coverage stands at a staggering 96% with the Prevent
Mother to Child Transmission (PMTCT) treatment at 74% coverage.
Our target for the current year is coverage of 15 000 and we are currently
at 12 500. We are confident, Madame Speaker that we will still meet this
target.
For the current financial year, we have set a new target of 27 000 where we
would extend the number of sites from 15 Local Service Areas (LSAs) to 25 LSAs.
This new target also means an extension of accreditation to Community Health
Centres which would also be included as sites.
Saving Mothers Saving Babies - Fathers as Partners
During 2005/06, we pronounced a campaign on Saving Mothers Saving Babies.
Initial work on project design and implementation has revealed a number of
challenges that we need to tackle. Some of these are:
* uninformed communities who make late bookings or would not have the prenatal
historical records required when giving birth
* health workers that need to be capacitated and re-oriented to be responsive
care-givers
* need refined / aligned referral system, modern equipment and training for
users within all delivery wards, access to proper transport
* our plans going forward include dedicated budget geared towards revamping and
redesigning maternity wards into baby friendly facilities. We would also
intensify community awareness and building of partnerships with community based
organisations.
During this month of March 2006, the first intake of our nursing personnel
would enrol onto a diploma in Advanced Midwifery. This training will go a long
way towards ensuring that a high calibre of midwives is reproduced throughout
our province.
Madam Speaker, we are proud to announce that our department will be hosting
the National Congress of Midwives during December 2006. The congress serves as
s platform for practicing midwives to sharpen skills and share experiences.
Human Resource Planning (retention and attraction initiatives)
The Department will embark on an aggressive recruitment drive of key health
professionals namely, nurses, doctors, pharmacists. To this effect, an
estimated amount of R50 million of the personnel budget will be ring fenced. In
addition to this amount, R63 million has been set aside for the recruitment of
emergency medical services personnel.
Similarly, various initiatives are afoot aimed at retention of those already
in service as well as those still to be recruited. For instance, incentives
such as the scarce and rural allowances are being reviewed with a view to
expanding it to a majority of our health professionals.
The positive spin-offs is that the underserved areas e.g. Ikwezi
Municipality, Gariep Municipality which are remote areas, as well as deep rural
areas e.g. Lundini Municipality would all get an improved level of care.
Epidemiological profile of the province
During our policy pronouncements for 2005/'06 we announced a collaborative
research venture with the Walter Sisulu University (formerly Unitra) aimed at
compiling a burden of disease profile of our province. We are pleased to
confirm that indeed this study has been conducted, with a preliminary report
already submitted and a final one due at the end of March 2006.
The department eagerly awaits this report which would enable it to solidly
determine how to plan around the vision of wellness and quality of healthcare
in our province. The results of this study would come handy and as food for
thought during our planned Provincial Health Summit/Indibano. It would also
serve as one of the key ingredients or building blocs towards the process of a
programme of action linked with the 2014 Plan and Vision 2020.
This means our ability to respond to the growing burden of disease in a
scientific way supported by empirical evidence would be enhanced. In other
words, our planning and commensurate interventions would be thrust in the right
direction dictated by this disease profile.
Integrated Nutrition Programme
In line with the Provincial Growth and Development Plan (PGDP), the
department has linked with the Department of Agriculture to address household
and community food security issue. In this instance, an intensive programme of
clinic gardens has been launched in the OR Tambo District Municipality
culminating in a pilot of 30 such gardens for OR Tambo alone.
A further one pilot clinic garden per Local Service Area (LSA) has also been
embarked upon for municipalities outside OR Tambo District Municipality.
An additional 13 hospitals have received 'baby friendly' certification.
These hospitals are spread throughout the length and breadth of our
province.
Circumcision
The rite to manhood is marred by serious challenges. Many preventable and
unacceptable deaths still occur. The department needs to strengthen its
collaboration with relevant stakeholders, particularly the traditional leaders
to reverse these deaths.
An additional amount of R3 million has been set aside heighten awareness and
strengthen such collaboration.
Development of Service Standards
As part of the department's Turn around Strategy, a consultative process is
underway in the department to develop service standards. As one of the Batho
Pele principles, service standards will go a long way towards transforming our
health institutions into responsive service points that are people driven.
We are also mindful of the fact that a paradigm shift of the kind
contemplated by introduction of service standards in an environment where there
have been none before, would require re-orientation on the part of our
officials on the one hand, and communities as end users of services on the
other. It also means potential increase in demand for quality service, better
planning and implementation of programmes, etc.
Our environment needs to be properly prepared and supported in order for us
to achieve this goal.
We will continue to align our strategic thrust to get in tune with major
policy pronouncements such as the Accelerated Shared Growth Initiative for
South Africa (AsgiSA). As a health sector, we view our contribution towards
making ASGISA an achievable mission as indirect namely, investing in the
general health of our people to ensure that they contribute to the economy
through various AsgiSA projects.
The Budget
Honourable Speaker allows me to present the budget for 2006 /07 financial
years. The total amount allocated for health service delivery is R6,892,701
billion. This figure is financed as follows:
â¢R5 927 757 - Equitable Shares
â¢R905 102 - Conditional Grants
The actual allocations / broken per programme can be obtained from the
Department.
Strengthening institutional capacity
Madam Speaker, the above outline represents our resolve to consolidate on
the various initiatives that are central to our turn around strategy. Amongst
other things, this strategy aims to improve institutional capacity through
strengthening managerial leadership to enable our health facilities to achieve
higher levels of effectiveness. To this end, we have clustered district
hospitals and appointed cluster CEOs to pay closer attention to institutions.
In turn cluster CEOs report to District Managers who are expected to provide
strategic direction in their respective districts. Corporate service managers
have also been appointed in most districts to provide corporate support in the
various institutions within the district. At complex level the system has been
in place for a number of years and it is beginning to pay-off.
However, we are under no illusion about the nature and extent of challenges
that we still face in these very institutions. Nonetheless, remain positive
that the light ahead of us is that of the end of the tunnel of deliverance.
This view is informed by some of the initiatives already cited to help improve
our situation:
â¢Letsema âbeautificationâ programme
â¢CEOs Forum launched to provide continuous support and bridge capacity gaps
among hospital managers
â¢regionalisation model which consolidates service delivery co-ordination,
monitoring and evaluation within newly clustered regions. It will help enhance
our referral system.
Acknowledgements
â¢South African Medical Association
â¢Afrox
â¢Netcare
â¢Lifecare
â¢Walter Sisulu University
â¢Nelson Mandela Metropolitan University
â¢NGOs
â¢Eastern Cape Aids Council
â¢Health Professions Council of South Africa
â¢Trade Unions within Public Health & Welfare Sector
â¢Hospital Boards
â¢Clinic Committees
Conclusion
In conclusion Hon. Speaker I would like to thank the people of the Eastern
Cape for the confidence they have in the governance of this province. The voter
turnout and the choice of the governing party is an affirmation of the hope
that tomorrow will even be better if there is continuity.
However, this age of hope will diminish if we fail in our duties to
accelerate service delivery. In doing so Hon. Members I recommit myself, the
management and staff that we will do all we can, within the limited resources
and historical conditions imposed upon us, improve health service delivery
diligently and professionally.
Lastly I would like thank
1. The Hon Premier for the unwavering support and guidance and confidence
she has shown in the Department of Health
2. Members of the Executive Council for their availability in times of
need
3. Members of the Oversight Committees for their vigorous scrutinisation of our
activities and keeping us on our toes. Through this they have endorsed the
legislative role and the principle of separation of powers
4. The management, staff and valuable stakeholders in health service for
ensuring that we meet our targets and commitments
5. The staff in the Office of the MEC, and those who have made it possible that
I have the necessary resources and empowered to do my job
6. My family for allowing me to be an absent father and husband in pursuit of
the better life for all.
âThe people have spokenâ¦â¦. Tomorrow will even be betterâ.
I thank you;
Issued by: Department of Health, Eastern Cape Provincial Government
20 March 2006
