Jajula's Policy Speech at the Eastern Cape Provincial Legislature
15 March 2007
Honourable Speaker
The Premier of the Eastern Cape
Members of the Executive Council
Members of the Provincial Legislature
Partners in health fraternity
The non-governmental organisation (NGO) community
Superintendent-General of Health
Heads of various institutions
Programme managers
Emergency care practitioners
Colleagues
Fellow South Africans
As we celebrate the 95th Anniversary of the ANC, we are reminded of the long
history of the struggle for freedom, democracy and a better life for our
people. This struggle must go on, because, even though we have made tremendous
strides in the past twelve years in making access to healthcare possible, we
must continue to ensure that nobody is denied access to healthcare because of
their location, or because of life status and class.
The National Executive Committee of our movement has declared that this is
the "Year to intensify the struggle against poverty as we advance in unity
towards 2012".
The war against poverty, crime prevention and social cohesion must therefore
be intensified at all fronts, including the health sector, to ensure that we do
not only treat diseases, but prevent them. More importantly we need to
contribute effectively to the restoration of the social dignity of our people,
in partnership with our communities. Social cohesion is key to the preservation
of health.
As the Department of Health, we contribute to the restoration of human
dignity. We are mindful that a complete state of wellness can only be obtained
if we approach health not just from the absence of disease or infirmity, but as
a state of well-being that includes the physical, psychological, social and
spiritual. The emphasis on creating the state of wellness is based on, firstly
prevention and promotion, and secondly, the healing and rehabilitation aspects
of healthcare.
1. The Goals of the Health System
Madame Speaker, the Millennium Development Goals, our country's Vision for
2014 and the PGDP, continue to be the guide and the basis of the health goals.
We need to remind ourselves of our commitments in terms of these policy
platforms and obligations and therefore, we are committed to:-
* reduce child mortality by two thirds including the under-five mortality rate,
by 2014,
* improve maternal health by reducing it by three quarters of the maternal
mortality ratio, by 2014, and
* combat HIV and AIDS, and begin to reverse the spread of HIV and AIDS, by
2014.
2. Building the District Health System and Primary Healthcare
One of the Strategic Goals of the Department is to implement an effective
service delivery platform through the District Health System based on the
Primary Healthcare approach.
To realise this goal, the Department is currently focusing on strengthening
and building capacity for the effective implementation of the priority health
programmes. This will improve health outcomes and strengthen the district
health system, which is based on the Freedom Charter, that free medical care
and hospitalisation shall be provided for, with special care for mothers and
young children.
Madame Speaker, during this financial year we will continue to implement the
project of transforming Clinics as Centres of Excellence, to improve the
functionality of Primary Healthcare Service Delivery Institutions, of the
Department. The Department, Madame Speaker has therefore identified 50 clinics
as benchmarks within the province to operate as Centres of Excellence in order
to implement Primary Healthcare approach.
With regards to District Hospitals, the Department has identified 25
District Hospitals to be assisted to perform at a higher level .
Madame Speaker, we are also mindful that some of the roads to our clinics
are a challenge and some of those clinics do not have power supply. Through the
cluster system of our government, we have engaged our sister department of
Roads and Transport to address some of the roads leading to our facilities.
With regard to power supply, we have provided the Minister of Minerals and
Energy with a list of 98 clinics that lack power supply and it is hoped that by
the end of this financial year, significant improvement regarding access to
power supply and proper roads will be made.
3. School Health Services
This financial year we will be targeting children at schools which forms
part of our Primary Healthcare approach. We will also be resuscitating School
Health Services to detect congenital defects and some which may arise during
birth especially from Grade R's. We have set aside a budget of R 17,5 million
to ensure that School Health Services and Health Promotion are effectively
implemented in our communities.
4. Building efficient and effective Emergency Medical Services and Patient
Transport
Madame Speaker, we announced during the last financial year that as part of
saving lives of our patients by transporting them to nearby health facilities,
the department will continue implementing its EMS Turnaround Strategy to
improve emergency medical services and patient transport. During the previous
financial year:
91 Ambulances were purchased during the last financial year and allocated to
various Districts and 48 ambulances were allocated as follows:
a) eleven were deployed to the Nelson Mandela Metropolitan Municipality and
Cacadu District
b) eleven were also deployed to Chris Hani District
c) eleven to Amathole District
d) eight to OR Tambo District
e) seven to Alfred Nzo District
Ten rescue vehicles were also purchased during the previous financial year
and:
a) four of the rescue vehicles were deployed to the Nelson Mandela Metropolitan
Municipality and Cacadu District.
b) four to Chris Hani District
c) one to OR Tambo District
d) one Alfred Nzo District
Ten Patient Transport Vehicles1 (PTV) were also procured and deployed to
various districts:
a) four of the PTVs were deployed to Chris Hani District
b) three to the Nelson Mandela Metropolitan Municipality and Cacadu
District.
c) one to Amathole District
d) one to OR Tambo District
e) one to Alfred Nzo District
During this financial year, the Department has targeted to:
a. build a new EMS District Head Quarter at Mt Ayliff and EMS Substation to
provide equitable emergency services in Alfred Nzo district at a projected cost
of R18 million.
b. develop a modern Emergency Medical Services (EMS) Station in Port Elizabeth
in preparations for the 2010 Soccer World Cup at an anticipated cost of R18
million. In addition to ensure that 50% of EMS Vehicles will be equipped with
advanced life support equipment, and this will cost about R14,2 million.
c. provide general equipment and necessary basic consumables in all EMS
vehicles at a cost of R7 million
d. establish a vehicle tracking and monitoring system to identify the location
of the vehicle, and to further improve response times and prevent duplication
of services when EMS vehicles are dispatched at an emergency site. This will
cost the Department an amount of R1,7 million
e. establish additional bases and sub-stations from 17 to 32, to reach a
projected target of 68 within the next three years. This will ensure
accessibility to the communities and improve response times especially in rural
areas of the province. This will cost the Department an amount R21,3
million
f. procure additional 100 EMS vehicles at a cost of R10 million
g. increase staffing levels by 220 to ensure that we reduce the single crew
ambulances and improve service delivery and provision in the most rural parts
of the province. This will cost the Department a projected amount of R30,5
million. It also is important to inform the House that the EMS College at Dora
Nginza that trains our emergency care practitioners has been accredited by the
Health Professions Council to train practitioners at Middle Level
Qualifications on a National Diploma. The first intake of 24 students to be
trained in this National Diploma will start in April 2007, and the subsequent
intake of 24 students will start in October 2007.
h. establishing a disaster management unit to facilitate disaster management
preparedness programmes within the province. This unit will fall within the EMS
Directorate and interface with all other Programmes within the Department, and
Districts in ensuring appropriate disaster management contingency plans are
ready for activation when there is disaster of any nature.
i. employ a Project Manager to enhance the implementation of the EMS Turnaround
Strategy.
Madame Speaker, we have also initiated a process of establishing a single
integrated and multi-disciplinary computer aided dispatching control centre
which will function on a 24-hour basis with a staff compliment of approximately
72 personnel. The idea is to:
a. rationalise from the existing five control centres which are scattered
throughout the province into one single centre similar to the one in the
Western Cape province and other countries, and
b. improve response times by ensuring a co-ordinated deployment of resources at
a single point of receiving and dispatching EMS Resources, like EMS
Vehicles.
It is anticipated that this Single Integrated Control Centre will be ready
by 2009 financial year.
5. Human Resources for Health
The Department is also charged with the responsibility of recruiting,
training and retaining human resources into a client centred service. Our
intention Madame Speaker, is to become an employer of choice within the Eastern
Cape province. We are all aware that the country is challenged with the
availability of health professionals and we have resolved to attempt to address
these matters.
Madame Speaker, the department has budgeted R100 million for the recruitment
of critical skills as part of the Project 5000. Included in the recruitment
process will be:
* 47 specialists doctors,
* 223 medical officers or doctors,
* 216 pharmacists,
* 180 assistant pharmacists,
* 1 790 nurses,
* 611 clinical support health personnel, and
* 813 healthcare givers to support health professionals in clinics and
hospitals.
6. Nurses salaries - closing the gap
Madame Speaker, it is also important to inform this Honourable House that
the salary package of nurses will improve. We have made available an amount of
R150 million to increase nurse's salary packages with effect from 1 July 2007
as part of the nurses package improvement process.
7. Provision of bursaries for health professionals
Over and above the normal recruitment and retention of health professionals,
the Department has made available an amount of R 45m for Bursaries targeting
specialised scarce skills. Critical areas include the following:
* pharmaceutical services,
* radiography,
* occupational therapists,
* physiotherapists,
* laboratory technicians,
* ENT specialists, and
* doctors.
8. Poverty Eradication and Employment Opportunities
As part of contributing to the Expanded Public Works Programme, and further
providing learning environment and employment opportunities to the youth of the
province through targeted learnership and internship programme, the Department
has budgeted R18 million for the 2007/08 financial year and will be
recruiting:
a. Five hundred and fifty (550) young people for the learnership programme in
the following areas:
* pharmacists assistance,
* enrolled nursing,
* hospital maintenance,
* customer care, and
* human resources functions learnership.
b. Two hundred (200) unemployed graduates will be deployed for the intership
programme of the Department and identified Service Delivery Health
Institutions. They will be deployed in financial management and auditing,
public health administration, health economics, human resources, information
technology and communication.
c. One thousand and fifty (1 050) young people to provide auxiliary support
services within our institutions or health facilities.
We are also pleased to announce that significant progress was made to clear
most of the employee service benefit backlogs. Funding came through adjustment
estimates to the tune of R300 million.
9. Infrastructure Development and Management
Madame Speaker, it is my privilege to announce today that the Department
will over the next three years:
* rebuild Cecilia Makiwane Hospital into a world class Level 1 modern hospital,
as well as building a community health centre on the western side of Mdantsane
izrefurbish and re-arrange the Frere Hospital to a modern tertiary hospital
with
a fully fledge trauma unit.
* upgrade Dora Nginza Hospital to a modern Level 1 hospital, including
relocating psychiatric services from Elizabeth Donkin Hospital to Dora Nginza
as well as relocating Empilweni TB beds to Dora Nginza. In addition we have
procured Cardiology Equipment for the two PE Provincial Hospitals for an amount
of R6 million. Furthermore we have budgeted an amount of R4 million to improve
services within the Burns unit at Dora Nginza Hospital.
* refurbish and re-arrange the PE Provincial Hospital to a modern Level 1
hospital
* refurbish and re-arrange the Livingston Hospital to a modern tertiary
hospital with a fully fledge trauma unit
* refurbish and arrange Mthatha General Hospital to a modern Level 1 hospital.
This process will also include the Bedford Orthortic and Prosthetic Centre. We
will also create 300 MDR beds, and 200 ordinary beds at the Mthatha TB
Hospital.
* build a world class Psychiatric Hospital at Mount Ayliff to improve access
to
Psychiatric Services on the eastern side of the province
* Empilisweni and Mlamli Hospitals will undergo a facelift this financial
year.
* Matatiele will receive 6 clinics at a cost of R17 006 247.
* Alfred Nzo will receive 10 clinics at a cost of R23 425 962.
An estimated 2 000 jobs will be created through the building of new
hospitals and clinics as well as their maintenance. Four hundred and fifty
local people will be trained in various job trades e.g. brick laying, plumbing,
electrical etc. as part of the expanded Public Woks Programme. These will be
funded from combined funding inclusive of the Provincial Infrastructure Grant,
which we are receiving for the first time and the Equitable Share
allocation.
10. International Partnerships
It is also important, Madam Speaker, to announce an exciting proposed
prospective development in terms of the manufacture of orthoses and prostheses.
This venture comes in the form of a proposed investment by the Chinese
Government to address the most scares skills service in the field of orthotics
and prosthetics.
This investment will be located at the Mount Coke Hospital. It will be the
first of its kind in Africa.
Our partnership with the Tunisian Government with regards to the Eye Care
Programme/Cataract will continue to relieve our people of many discomforts of
sight.
11. Intensification of Compliance with Occupational Health and Safety
Requirements
Madame Speaker, the work environment exposes our employees to many hazards.
Health facilities often contain risks and hazards that may harm our employees
if there are no management plans to prevent and further manage Occupational
Health and Safety.
Many workers are injured due to workplace incidents. This situation is
mainly caused by the lack of sufficient training of workers and their managers,
which results in lack of knowledge on how to manage hazardous chemicals etc.
The lack of knowledge of preventative and protective measures and the lack of
understanding hazards need to be identified.
In this financial year, the Department has budgeted an amount of R2,5
million in order to ensure that among other things, all health facilities and
administrative buildings will implement the Occupational Health and Safety Act
and its regulations. This will include a programme of awareness to prevent
occupational injuries and diseases, and especially the conducting of evacuation
drills for unforeseen disasters.
12. Improving health outcomes through the implementation of Priority Health
Programmes
Madame Speaker, it is clear that our challenge to create a better life free
of poverty, hunger and deprivation will require a collaborative effort from all
government departments, the private sector and civil society. We are happy that
we are getting closer to realising some of our targets regarding the accessing
of clean water and sanitation and the electrification of homes.
12.1 Improve maternal health and reduce child mortality
We remain concerned about the high levels of maternal deaths and infant
mortality. We introduced an intervention in the last financial year in the form
of the 'Saving Mothers, Saving Babies Project' in an attempt to reduce maternal
infant mortality. Twenty district hospitals are implementing this programme.
More still needs to be done to reduce these mortalities to ensure that all new
mothers and their babies enjoy an environment that is comfortable, safe and
friendly. A budget amount of R37m has been made available to address maternal
and infant mortality in designated Health facilities.
12.2 HIV and AIDS
Madame Speaker, our resolve to halt the spread of HIV and AIDS remains. We
will work harder with our partners within the context of the National Strategic
Plan on HIV and AIDS, to stop new infections especially among the young people.
The management of the Aids pandemic through the comprehensive plan remains our
priority. We must therefore improve health outcomes and create a better quality
of life, by increasing our efforts to prevent and treat the HIV and Aids
pandemic.
For this financial year, the Department has budgeted an amount of R299,420
million with the following targets:
a. to increase and upscale the access of comprehensive HIV and AIDS care,
treatment and management for people living with HIV and AIDS from 27 000 to 40
000 patients
b. To increase the number of facilities providing VCT from 803 to 834.
c. To increase the number of patients accessing Home Based Care from 121 482 to
150 000.
It is also important to inform the House that we are providing stipends to
813 healthcare givers who are assisting in the HIV and AIDS Programme. This
amounts to R66 million.
12.3 Tuberculosis (TB) Management
TB has reached crisis proportions in the country and in the province. Our
crisis plan is focussing on three districts, i.e. Nelson Mandela, Amathole and
OR Tambo Districts because of their high number of cases. Our minimum cure rate
will have to reach 50% by the end of the financial year. All efforts will be
made to mobilise all sectors of our communities to increase awareness and the
dangers of TB, especially the extreme multidrug resistant strains know as MDR
or XDR.
Madame Speaker, 08 new DR-TB cases have been diagnosed in the province which
brings the number of patients identified with the disease since November 2006
to 41. The Department is on full alert and has established three (3) isolation
wards at Jose Pearson TB Hospital in Port Elizabeth, Fort Grey TB Hospital in
East London and Nelson Mandela Academic Hospital at Mthatha.
Preventative measures have also been put in place to curb the spread of the
disease and all the cases identified have been put in isolation following
proper consultation. It is also important to emphasise that TB is curable.
For this financial year Madame Speaker, the Department has budgeted an
amount of R180,64 million and set the following targets for TB:
a) to increase awareness and advocacy campaigns about TB and Multi and
Extreme
Drug Resistant TB to all the communities of the province
b) to improve and strengthen management of specimen transportation and to
improve sputum turnaround time by ensuring that results of patients' sputum be
made available within 48 hours instead of 72 hours
c) to implement rapid assessment of MDR and XDR-TB case findings (test all
MDR-TB cases for second line drug resistance)
d) to increase the number of TB patients counselled and tested for HIV from 16
000 to 17 000
e) to increase the percentage of new smear positive PTB cases cured at first
attempt from 50% to 60%.
Similarly, Madame Speaker, we are also providing stipends to 1 422 Direct
Observation Treatment (DOT) Supporters at a cost of R17,64 million. DOT
Supporters are providing a critical community support services to TB patients
on behalf of the Department.
12.4 Health Promotion and Promoting Healthy Lifestyles:
Madame Speaker and Honourable Members of the Legislature, the Department of
Health also has the responsibility of promoting healthy life styles to ensure
that we have communities who are socially, physically and mentally well. A
budget of R4,2 million has been made available to ensure that this function is
enhanced and implemented throughout the province. In consultation with the
Department of Education we will be increasing Health Promoting Schools with an
extra 74 schools.
We therefore call all Honourable Members of the House to join and
participate in this programme. Furthermore, we are making this call to all our
School Governing Bodies, Hospital Boards and Clinic Committee Members to also
participate in the Health Promotion Programmes. A healthy lifestyle is the
core-business of every South African.
13. Mainstreaming of the Designated Groups
The mainstreaming of special programmes in relation to gender, disability
and youth in the Department remains our focus, especially the empowerment
programmes of the said designated groups.
Madame Speaker, the Department recognises that a lot still needs to be done
to ensure equal opportunities are available to advance the employment status of
women, disabled and young people. The Department will be focusing on economic
empowerment initiatives targeting women, young people and the disabled.
14. Financial Management and improving our audit outcomes
The Department of Health received a Disclaimer of Opinion from the
Auditor-General for the year ended 31 March 2006. It should be noted that the
department has received nine disclaimers of opinion in ten years.
Part of turning around this situation is working with the Provincial
Treasury to assist in the development and implementation of an audit
improvement plan funded to the tune of R30 million as part of the adjustment
estimates in the current financial year, that will:
a. address the 2005/06 audit queries raised by the Auditor-General
b. ensure continuous improvement in our audit outcomes beyond the 2005/06
financial year
c. initiate and implement financial and administrative interventions at
Head
Offices, Districts and Health Facilities
d. intensify the recruitment and absorption of employees with the appropriate
financial, human resources and supply chain management background and
skills.
15. The budget allocation for 2007/08 financial year
15.1 Madam Speaker, I hereby table the Budget Vote No 3 of the Eastern Cape
Department of Health which is R8,142,743 for 2007/08 financial year. The budget
has been appropriated in terms of the following budget programmes of the
Department:
Programme 1: Administration R369,065
Programme 2: District Health Services R3 555,512
Programme 3: Emergency Medical Services R380,734
Programme 4: Provincial Hospital Services R2 759,089
Programme 6: Health Sciences and Training R417,915
Programme 7: Healthcare Support R30,701
Programme 8: Health Facilities Dev and Maintenance R629,727
Total 8,142,743
15.2 For information purposes the above figures are also inclusive of
Conditional Grants which are:
Conditional Grants - 2007/08 Allocation
Comprehensive HIV & AIDS R233,204
Forensic Pathology R68,135
Hospital Revitalisation R246,750
Health Professionals Training & Development R133,945
National Tertiary Services R428,912
Provincial Infrastructure Grant R150,000
Total R1,260,946
16. Conclusion
Madam Speaker, we consider and view health as very sacred and essential
commodity and that is why we want to call on all citizens of the province to
ensure that they participate in the prevention and promotion of their own
health. We need to take responsibility for our bodies, families, and to live
healthy lifestyles.
The Department of Health in partnership with every citizen in the Eastern
Cape is calling everyone to please refrain from smoking and reduce excessive
drinking. We also appeal to young and old to avoid substance abuse.
Lastly, I would like to thank:
* The Honourable Premier for the strategic guidance and support she has shown
and provided to the Department of Health
* Honourable Members of the Executive Council for their continued advice
pertaining to health matters in the province
* Honourable Members of the Oversight Committees, both the Portfolio Committee
on health and the Provincial Standing Committee on Public Accounts for their
vigorous scrutiny of our activities
* Honourable Members of the Study Group of the African National Congress for
the continued support they have shown towards the Department of Health
* All health professionals and administrators who are working in stressful
conditions
* All our health partners, and stakeholders for showing a considerable interest
in the Provincial Public Health System
and finally to my family, for their constant emotional support especially my
two children and the 214 adopted children at SOS, Eluxolweni and Bethani Homes
at Mthatha.
In addition I would like to thank Mrs Bolofo and Sister Mary Paul for their
wonderful support.
Furthermore I would also like to include the communities of Mthatha, for
receiving those children during school holidays in their homes.
Issued by: Department of Health, Eastern Cape Provincial Government
15 March 2007
