the MEC for Department of Health Pierre Uys, Provincial Legislature, Cape
Town
1 July 2007
Welcome
Speaker, agbare lede en gaste, dit is my voorreg om u te verwelkom by die
voorlegging van die 2007/08 gesondheidbegroting vir die Wes-Kaap. Vandag op
Gesondheidsbegrotingsdag vier ons ook Internasionale Kinderdag wat in 1925 in
Geneve, Switserland by die W�reldkonferensie oor Kinderwelstand ontstaan het.
Daarom is dit belangrik dat ons ook reflekteer oor hoe ons as departement tot
die gesondheid en welstand van ons kinders bydra. Later in my toespraak sal ek
in meer besonderhede daarna verwys - vir nou volstaan ek daarby om ons opnuut
daartoe te verbind om hand-aan-hand met ander regeringsfere, die NRO-sektor en
ons gemeenskappe te werk om gesondheidsrisiko's vir ons ouers en kinders te
help uitwys en, waar nodig, ondersteuning en behandeling te bied.
In the foreword to the National Health Plan for South Africa released in May
1994 by the African National Congress (ANC), we read the following, "The
challenge facing South Africa (in 1994) is to design a comprehensive programme
to redress social and economic injustices, to eradicate poverty, reduce waste,
increase efficiency and to promote greater control by communities and
individuals over all aspects of their lives". It continues, "In the health
sector this will involve the complete transformation of the national health
care delivery system and all relevant institutions" and further "ensuring that
the emphasis is on health and not only medical care, encouraging and developing
comprehensive health care practices that are in line with international norms,
ethics and standards and reducing the burden of disease and risk of disease
affecting the health of all South Africans". And that, "Recognising this need
for total transformation of the health sector in South Africa, the African
National Congress initiated a process of developing an overall national health
plan based on the primary health care approach".
The Western Cape Provincial Health Plan released in 1995, in turn indicates
that only the adoption of the, "Bold recommendations (outlined in the plan)
will rescue the health service from its long term unsustainability".
It is indeed noteworthy that many of these recommendations such as the
development of the district health system and focus on levels of care are to be
found in the Comprehensive Service Plan (CSP). It is also noteworthy that key
recommendations such as the closure of Conradie Hospital and the relocation of
the spinal unit to Groote Schuur Hospital have been achieved.
The Comprehensive Service Plan for the implementation of Healthcare 2010
builds on what went before and provides the blueprint to give practical and
detailed effect to the transformation of health services in our province.
In die Omvattende Diensplan (CSP), verbind die regering homself tot die
beginsel van goeie, toeganklike gesondheidsorg nader aan die mense wat van ons
dienste gebruik maak. Ons benadering met die opstel van hierdie plan was om die
behoeftes van ons mense te ontleed om uiteindelik 'n model te skep wat met ons
beskikbare hulpbronne aan daardie behoeftes kan voldoen. Noudat belanghebbendes
oor die plan geraadpleeg is, en dit dienooreenkomstig verbeter en goedgekeur
is, kan die regering voortgaan om hierdie doelwit na te streef.
I intend with this budget to drive forward transformation and the
implementation of the comprehensive service plan. I will ensure that such
transformation and change is placed on a path that will ensure better, more
accessible and quality health services for the people that we serve. This means
better services for the poor, the working classes, men, women and children in
need not only in the Western Cape but from outside our borders as well.
Improving healthcare in our province
Speaker, I want to reassure the people of our province that in the process
of improving healthcare in the Western Cape, government will act responsibly.
The benefits inherent in the CSP are broader than mere bed shifts at any one
hospital and extends to building a health service that not only responds to
current needs, but that plans ahead with future needs and realities in mind.
This government accepts it can and must do better in providing health services
to our people, therefore today with this budget:
* We will support better service at primary level by increasing the numbers
of specialised nurses called clinical nurse practitioners.
* We will create more opportunities for the training of nurses and other health
professionals and provide for increases in the salaries of nurses.
* We commit resources towards improved response times by our Emergency Medical
Services with additional trained staff.
* We begin to provide more hospital beds where they are desperately needed,
especially in our regional and district hospitals.
* We undertake to build new healthcare facilities with an accelerated programme
of revitalising older hospitals and clinics in the metro and towns throughout
the province.
* We will protect the core of essential highly specialised services in our
Tertiary or Central hospitals like Groote Schuur, Tygerberg and Red Cross
Children's hospital and will seek to work with our universities to address the
health needs of our people.
* Today, we take the decisive action necessary to begin the process of
providing healthcare appropriate to the needs of our people.
We build from a foundation of strength
* In the Western Cape we have 52 public hospitals and 423 Community Health
centre's and clinics providing in the health needs of our people.
* Close to 26 000 health staff members of whom the vast majority work at the
coalface of health delivery.
* At R1 812 per uninsured person, the highest per capita health spend per
person in the country. The 2007/08 budget provides for an allocation of R312
per uninsured persons for primary healthcare which will fund an average of 3,7
visits to a primary healthcare facility per uninsured person per annum. An
amount of R91 is allocated per uninsured person per annum for access to
Emergency Medical services and R6,25 has been allocated to provide planned
patient transport to uninsured patients which translates into the capacity to
transport 47 000 patients.
However, government faces a number of challenges in building a healthcare
system that can deliver in the needs of the people of the Western Cape.
* Our Burden of Disease (BoD) including HIV and AIDS and TB, violence and
other categories such as childhood illnesses, cardiovascular diseases, diabetes
mellitus and mental illness continue to put pressure on our health system. With
this in mind the Schools of Public Health from the Universities of Cape Town,
Stellenbosch and the Western Cape and other research agencies such as the
Medical Research Council (MRC) were commissioned to recommend how the burden of
disease in the province could be reduced, not just through preventive health
interventions such as health promotion, primary, secondary and tertiary
promotion, but also through interventions that are of a more multi-sectoral and
developmental nature. Key findings in a recently submitted report include:
* HIV and AIDS and TB mortality is increasing and interlinked. However,
there are encouraging findings showing the positive impact of Prevention of
Mother to Child Transmission (PMTCT) and Antiretroviral treatment (ART)
programmes on mortality.
* Chronic diseases such as diabetes are increasing.
* Although still unacceptably high injury mortality is decreasing and continues
to be linked to the risks associated with youth, males, alcohol and other
substance abuse.
* Alcohol, road-user behaviour, sexual practices and health-seeking behaviour
contribute to the burden of disease and are themselves linked to the so-called
'upstream' infrastructural risks of material and social deprivation.
In order to distil the critical interventions that the provincial government
should prioritise, a Burden of Disease Symposium is to be held on 25 and 26
June 2007 which will be attended by a wide range of provincial and other
representatives.
Looking in more detail into some of the challenges related to BOD it is
important to note the following:
* Trauma en noodgevalle in besonder plaas steeds groot druk op
gesondheidsdienste in ons provinsie, met hoe pasientetalle en 'n eweneens hoe
voorkoms van ernstige gevalle. Dit lei tot 'n verhoging in die koste van
akutesorg by traumagevalle asook gespesialiseerde rehabilitasiedienste. Weens
die groter behoefte vir noodtrauma-operasies, het die wagtyd vir beplande
operasies ook toegeneem. Vroee dood weens opsetlike of onopsetlike geweld,
d.w.s. manslag/geweld en padverkeersongelukke, maak altesaam 20% van sterftes
in die Wes-Kaap uit.
* The HIV and AIDS pandemic contributes significantly to the load on the
services both in terms of patient numbers and acuity of illness. Although the
mortality rate from HIV and AIDS in the Western Cape (14,1%) is lower than the
national rate of 39,0%, HIV and AIDS is still a major cause of premature death
in the Western Cape.
* Tuberculosis (TB) rates remain high and co-infection of TB and HIV has
resulted in uncommon forms of presentation and late diagnosis of the disease.
Lately, the addition of Extreme Drug Resistant (XDR) TB has significantly
impacted on the workload in our TB and other hospitals. The incidence of TB in
the Western Cape is 1 041 cases/100 000 population for all TB cases. This is
the highest in South Africa. Tuberculosis remains a significant cause of
premature death.
* An ongoing cause for concern is the Infant Mortality Rate (IMR) which is
indicative of the burden of disease in some of our communities. While the IMR
in the Western Cape at 30 per 1 000 live births compares favourably with the
national IMR figure of 59 per 1 000 live births we have to address the
underlying inequalities in communities such as Khayelitsha where this figure is
44 per 1 000 live births before we will see a turnaround. Heart disease remains
one of the top five causes of death in our province.
* Baie van ons hospitale is oorvol; besettingskoerse oorskry dikwels 100%. Die
gebruikskoers van beddens in Wes-Kaapse streekshospitale is 101% in vergelyking
met die nasionale gemiddeld van 72,3%; in distrikshospitale is dit 80% - die
hoogste in die land. Ons gemiddelde bedbesetting in sentrale hospitale is
bykans 84%, weereens veel hoer as in ander provinsies. Die beskikbaarstelling
van 220 bykomende distrikvlakbeddens in die metro sedert 2005 het die situasie
in 'n sekere mate verlig. Meer distrikvlakbeddens is egter nodig om die
diensdruk in die Khayelitsha- en Mitchells Plain-gebiede te verlig.
A budget focused on better healthcare
Speaker, government is facing these challenges head-on in the 2007/08
budget. Let me share some of the proposed budget initiatives that will result
in better healthcare in our province in the years ahead. These include:
1. Strengthening our District Health System (DHS)
DHS will see around 13 million PHC contacts at an average cost of R76 per
visit, which is one of the lowest costs per contact in the figures reported in
the most recent provincial quarterly performance report for health released by
the National Treasury. This is the level of care where most people access the
service (90%) and where the pressure of numbers and the demand for services is
the greatest. It is the level of care where communities complain about long
queues and sometimes of the quality of care received. Therefore, the CSP
focuses on the strengthening of District Health services by providing the
complete primary healthcare package of services and extended hours of service
at key facilities.
Government is committed to providing accessible, quality DHS services.
2. More resources to battle against HIV and AIDS
We committed ourselves to integrating the HIV and AIDS programme into the
general health services in such a way that the additional resources lead to
strengthening the general health system rather than creating a vertical HIV and
AIDS service delivery model. Included amongst the various successful HIV and
AIDS programmes managed by my department are:
* 375 projects funded through community-based organisations with targeted
work undertaken in high transmission areas, e.g. sex workers and truckers,
women and youth.
* The peer education programme with 11 501 peer educators in grades 10, 11 and
12 throughout the province trained to support and spread the message of
prevention.
* Voluntary Counselling and Testing (VCT) is offered at 441 health facilities.
There are 23 non-government organisations (NGOs) who employ 373 lay counsellors
who provide the bulk of the pre and post test counselling services. Our VCT
target for this year is 484 000.
* Die program vir die voorkoming van moeder-na-kindoordrag het 'n sukseskoers
van 95% behaal, en stappe vir verdere verbeteringe is in plek.
* Rakende sorg vir MIV-positiewe persone: Al die departement se
gemeenskapgesondheidsentrums (GGS'e) en klinieke bied eerstekontak- sorg aan
MIV-positiewe pasi�nte, insluitend CD4-tellingtoetse vir verwysing na 'n
ARV-perseel. Primere-gesondheidsorgfasiliteite bied ook behandeling vir
opportunistiese infeksies asook dieetkundige ondersteuning.
* A targeted 35 863 patients on ARV treatment at 62 treatment sites by the end
of this financial year. Of course, there is a huge challenge here in that we
have funding for only 28 392 patients. We are however in discussion with
various funding agencies in this regard and I am positive about the outcome of
these discussions.
* Ons tuisversorgprogram bestaan reeds uit 81 NROs, en het 1 300 tuisversorgers
in diens. Tans word 20 189 pasi�nte op hierdie manier versorg, en word daar
gemiddeld 285 316 besoeke per kwartaal afgele. Teen Maart 2008 behoort 2 605
gemeenskapgebaseerde gesondheidswerkers in hierdie provinsie hulle opleiding te
voltooi.
* Daar is 16 hospiese/verligtingsentrums met 254 gefinansierde beddens vir
verligtende sorg aan binnepasiente. Die bedbesettingskoers is 77 - 96%, en
pasi�nte bly ongeveer 18-36 dae.
Government is committed to turning the tide against HIV and AIDS.
3. Attacking the scourge of TB
In response to the TB epidemic, we developed strategies to accelerate an
enhanced response in controlling TB in the province. The strategy has been
refined in 2007/08 financial year as follows:
* An improved community-based TB control service with an improved
TB-medicine adherence support programme that draws from the success of the ART
adherence programme.
* An improved PHC service for TB with additional resources deployed in the 22
highest burden TB clinics, to achieve better patient care and follow-up and
basic administrative system improvements.
* An improved in-patient TB service with the provincialisation of all TB
hospitals to be completed in this year.
Government is committed to improving its response to TB.
4. Promoting women's and child health.
Vrouegesondheid bly 'n prioriteit. Fokusgebiede is die bestuur van
verkragtingslagoffers, voorgeboortesorg - veral voor die swangerskap 20 weke
ver gevorder is - en toetsing vir servikskanker.
With regard to child health, s pecific target areas that also relate to the
Social Capital Formation strategy are the Integrated Management of Childhood
Illnesses (IMCI) with an emphasis on the management of diarrhoeal disease and
immunisation.
* The diarrhoeal disease intervention campaign from February to May each
year includes support at community level for the early identification of danger
signs in ill children for immediate referral to a health worker, use of
sugar/salt solutions and hand washing programmes. All Primary Health Care
facilities will have oral rehydration corners and extra paediatric bed capacity
remains available at Red Cross Children's Hospital, Tygerberg, Lentegeur and
Somerset hospitals.
* Improving immunisation remains a priority. Full Immunisation coverage for
under one's has remained above 90% in the last three financial years.
* The province is currently extending school health services to the rest of the
province in line with National Policy.
Government is committed to the ongoing promotion of women's and child
health.
5. Beter bestuur van chroniese siektes
Van al die sterfte-oorsake in die provinsie, tel chroniese siektes soos
kardiovaskulere toestande en diabetes mellitus onder die grootstes. Oor die
afgelope jaar is daar in elk van die ses distrikte 'n alternatiewe
resepteermeganisme in plek gestel, en is daadwerklike pogings aangewend om die
werking van die Kaapse mediese depot te verbeter. Met die groot impak van
nie-oordraagbare siektes op die gesondheidstatus van gemeenskappe, moet
gesondheidsbevordering, siektevoorkoming, behandeling en rehabilitasie
ge�ntegreer word. Die provinsie sal in lyn met die W�reldgesondheidsorganisasie
se omskrywing 'n oorkoepelende beleid vir die bestuur van chroniese siektes
asook 'n minimumsorgpakket vir elke fasiliteit met hierdie dienste in werking
stel.
Die regering is verbind tot die doeltreffende bestuur van chroniese
siektes.
6. HealthCare goes beyond physical well-being.
We must reach out in practical and compassionate ways to those struggling
with mental illness. The introduction of the new Mental HealthCare Act obliges
the department to improve access to 72 hour services within the general acute
hospitals and we are committed to strengthen capacity in these hospitals to
manage mentally ill people which include infrastructure and human resource
measures. The department will also establish a licensing and inspectorate
capacity for community based residential and day care programmes. In 2007/08
the financial allocation to the non-profit organisation (NPOs) providing
services to these clients will be increased by 50%. The Act also makes
provision for a Mental Health Review Board, which has been established in our
province and is fully functional.
Government is committed to ensure respect and dignity for people with mental
illness.
7. Working to modernise our health services.
My department will be investing R75,5 million in providing state of the art
medical and other equipment as well as technical staff to our central or
tertiary hospitals. Funds will be allocated to:
* complete the strategic plan towards digitising medical imaging for the
services and commence with the first steps towards implementing a Picture
Archiving and Communication System (PACS)
* strengthen radio oncology services
* acquire equipment to enhance diagnostic imaging
* implement the Western Cape Nuclear Medicine Services imaging communication
system
* acquire equipment that will enhance efficiency or where there is an urgent
need
* clinical engineering staff to support the maintenance of equipment
Inligtingstegnologie by primere-gesondheidsorgfasiliteite sal ook verbeter
word. Die gefaseerde rekenarisering en elektroniese-netwerkprojek in ons
gemeenskapgesondheidsentrums het 33 van hierdie fasiliteite met
inligtingskommunikasietegnologie, (IKT)infrastruktuur toegerus. 'n
Pasientregistrasiestelsel, die pasientmeesterindeks (PMI), is hoofsaaklik in
die metro by 22 fasiliteite in die provinsie geinstalleer as deel van die
eerste fase van die projek. Die langtermyndoelwit is om 'n omvattende
inligtingstelsel vir primere-gesondheidsorg te h�, met 'n individuele
elektroniese pasi�nterekord vir elke pasient op die
prim�re-gesondheidsorgplatform. Dit sal pasient-verwysing en opname
versnel.
Die regering is verbind tot moderne gesondheidsorg.
8. Increasing training to ease critical staff shortages.
The continued shortage of critical staff including some categories of nurses
and other health professionals impacts severely on our ability to provide
services to all those in need. Therefore, my department is investing in
training of staff. Our targets for 2007/08 include:
* one thousand, six hundred and seventy eight bursaries awarded for nurse
training
* five hundred and thirty two bursaries awarded for health science training for
categories of staff other than nursing
* four hundred and six nine emergency care personnel in training
* four thousand training interventions to PHC personnel
* three hundred and fifty Adult Basic Education and Training (ABET) learners
will benefit from training interventions
* one hundred and fifty learnerships to be provided to unemployed people
* two thousand, six hundred and five people to be trained as community-based
health workers
Government is committed to providing a trained and fully staffed health
service.
Budget 2007/08
Die Wes-Kaapse departement van gesondheid is verantwoordelik vir die
voorsiening van kwaliteit gesondheidsorg aan 3,6 miljoen onversekerde mense met
die beskikbare hulpbronne in ons begroting. Ten einde aan hierdie mense se
gesondheidsbehoeftes te voldoen, het die Wes-Kaapse regering vir die 2007/08
boekjaar R7,095 miljard aan die departement van gesondheid toegewys. Hierdie
bedrag maak 34% van die provinsiale begroting uit en verteenwoordig 'n 9,6%
verhoging in die gesondheidsbegroting.
Of the increase of R771,680 million in comparison to the previous financial
year an amount of R349,737 million is accounted for by inflation at 5,5%, a
further R255 million is earmarked for specific allocations to services such as
forensic pathology, emergency medical services, equipment in the central
hospitals, extended public works programme, HIV and AIDS and infrastructure
grants. A further R154 million has been allocated for improvement of nurses'
salaries (R97 million) community service posts (R21 million), State Information
Technology Agency (SITA) payments, increased government motor transport tariffs
above inflation, phasing out of European Union funding for home-based care and
hospital management and quality improvement. This, Speaker, results in the
discretional portion of this budget being very limited to address in particular
the ongoing increase in patient numbers and in particular to address resultant
service pressure in the district and regional hospitals.
Ons finansiering kom grootliks uit die provinsiale billike-deel, wat R4,5
miljard van die begroting van R7,095 miljard uitmaak. Voorwaardelike
toekennings van die nasionale regering kom op R2,17 miljard te staan. Dit word
aangevul deur inkomste wat veral in ons sentrale hospitale deur die departement
gegeneer word - wat 'n verdere R363 miljoen by die begroting voeg.
Programme 1: (Administrasie)
Program 1 (Administrasie) ontvang 'n begroting van R367,2 miljoen - 'n
verhoging van R199,5 miljoen. Dit is egter grootliks weens geoormerkte
finansiering wat onder andere R97 miljoen vir verhogings in verpleegsalarisse
insluit.
Programme two: (District Health Services)
Programme two is allocated R2,4 billion or 34,4% of the total vote in
2007/08 in comparison to the 30,5% that was allocated in the revised estimate
for 2006/07. This translates into an increase of R464,2 million or 23,49% in
nominal terms.
Contributing factors includes:
* The assumption of responsibility of personal primary healthcare in the
rural districts will be finalised during 2007/08. As of March 2006 the
provincial Department of Health assumed operational responsibility for PPHC
services in the rural districts. The process of transferring staff, moveable
and immoveable assets from municipalities are far advanced.
* Aligned to the CSP the department is planning to convert some of the level
two beds to level one beds in the Metro in anticipation of the planned two new
210 bed district hospitals in Khayelitsha and Mitchell's Plain. In the interim
90 level one beds have been placed at Tygerberg Hospital.
* The transition from regional hospitals to predominantly level one hospitals
with some level two capacity will be managed systematically within the context
of the implementation of the CSP.
* An additional amount of R11 million has been allocated to GF Jooste Hospital
for 2007/08 to deal with service pressures.
* The budget for HIV and AIDS in the coming year is R289,1 million in total. At
the end of March 2007 the number of patients on ARV treatment in the Western
Cape was 26 111. In order to meet approximately 65% of the need it is necessary
to enrol � 1000 patients onto ARVs every month and the target for March 2008 is
to have 35,863 patients on ART. Assuming a unit cost of R7,000 per patient
treatment year there is a projected shortfall on the budget for 2007/08 of R44
million. Discussions in this regard are ongoing with both government and donor
organisations.
* The prevention and treatment of TB remains a challenge. The impact of the TB
Crisis Plan implemented during 2006/07 is apparent in the improved TB cure rate
in the Breede Valley from 68,5% to 73,6%. Khayelitsha also showed a significant
improvement in the cure rate from 51% to 72% in a year. While the average for
the province stands at 71,3% with a target of 73% set for this year.
* As mentioned women's, child and youth health remain priority areas.
* Also related to Social Capital Formation is the focus on the management of
chronic diseases. Support groups for patients with chronic diseases of
lifestyle have been established and strengthened at all Community Health
Centres.
* The transfer of the Medico-legal mortuaries from the South African Police
Services to the provincial department was successfully implemented with effect
from 1 April 2006. The department established a new Forensic Pathology Service
(FPS) that renders a service via two academic Forensic Pathology Laboratories
in the Metro, three referral FPS laboratories and smaller FPS laboratories and
holding centres in the West Coast, Cape Winelands, Overberg, Eden and the
Central Karoo districts.
Programme 3: (Mediese Nooddienste)
Mediese nooddienste ontvang R344,7 miljoen, of 4,8% van die
gesondheidsbegroting, in 2007/08. Dit verteenwoordig 'n verhoging van 20,4% of
R58,4 miljoen.
* Die Kaapstad-metrodistrik het 'n nuwe kommunikasiestelsel ontvang wat oor die
volgende drie jaar ook in die landelike gebiede ingefaseer sal word. Hierdie
elektroniese kommunikasiestelsel is noodsaaklik om versnelde reaksietye,
doeltreffende ontplooiing en ko�rdinering met ander nooddienste moontlik te
maak; hierdie aspekte lei alles uiteindelik tot beter pasientesorg. Die
instelling van 'n rekenaargesteunde uitstuurstelsel en outomatiese
voertuigopsporingstelsel het ook die bestuur van die mobiele NMD-hulpbronne
verbeter.
* 'n Geoormerkte bedrag van R58,2 miljoen is bewillig vir die uitbreiding van
mediese nooddienste.
* R46 miljoen word aan noodvervoer toegeken.
* R10 miljoen gaan vir beplande pasientevervoer.
Training of emergency care personnel is a key issue and we will train 775
personnel over the next three years. In this regard, the Emergency Medical
services plans to recruit 200 student Emergency Care Practitioners and appoint
them from 1 July 2007. In addition the training of 24 paramedics and 48
Ambulance Emergency Assistants will commence from 1 July 2007.
Another exciting development as part of the expanded communication system is
the use of mobile data terminals in ambulances. A pilot project in this regard
will kick off in this month and thereafter the system is to be rolled out to
the rest of the fleet. It is anticipated that 100 ambulances will be equipped
with these devices by the end of the 2007/08 financial year. These mobile data
terminals will facilitate the distribution of ambulances and also the capturing
of patient related data on an electronic patient record that will speed up
patient admission.
Programme 4: Provincial hospital services
Programme 4 is allocated R1,17 billion or 16,5% of the vote during 2007/08.
Some of the challenges in this programme include:
General hospitals
* The main challenge is the reconfiguration of the services in line with the
CSP according to which the majority of the level two services will be
consolidated in the central hospitals. This requires the reclassification of
beds and the reconfiguration of the packages of care and referral routes.
* In line with the CSP a project will be initiated to manage the transition of
the midwife obstetric units (MOUs) from Mowbray Maternity Hospital to the
District Health Service by 1 April 2008.
Tuberculosis hospitals
* The provincialisation of Harry Comay, Paarl Tuberculosis Hospital
(Sonstraal), Malmesbury Infectious Diseases Hospital and DP Marais requires the
department to upgrade the services and facilities of these hospitals to
increase their capacity to care for more acutely ill patients.
* An additional amount of R6,5 million equitable share funding has been
allocated to address quality of care issues at these hospitals.
Psigiatriese hospitale
* 'n Groot uitdaging is die middelmisbruikprofiel en ho� voorkoms van
metamfetamien-/TIK-misbruik in ons provinsie. In Junie 2006 het
Stikland-hospitaal 'n opiaat-ontgiftingseenheid langs die bestaande
alkoholrehabilitasie-eenheid geopen. Die ontgiftingseenheid bied 'n
24-uurhulplyn aan algemene gesondheidsorg-nooddienste, en sal voortgaan om die
meeste eerstekontak- ontgiftingsdienste aan beide buite- en binnepasi�nte
regdeur die provinsie te lewer. Die eenheid bied bystand aan hero�en- en ander
opiaatverslaafdes om veilig van hierdie middels te onttrek voordat hulle aan 'n
erkende rehabilitasieprogram deelneem.
* 'n Opleidingskollege by verwante psigiatriese hospitale sal 'n
geakkrediteerde n�-basiese psigiatriese verpleegkursus aan beroepsverpleers
bied wat via die oorbruggingskursus daarvoor in aanmerking kom. Hierdie kursus
sal hulle daartoe in staat stel om as geestesgesondheidsorgpraktisyns te werk.
Die kollege sal ook voortdurende professionele-ontwikkelingsgeleenthede vir
gesondheidswerkers bied.
The Western Cape Rehabilitation Centre
* The Western Cape Rehabilitation Centre Public Private Partnership
commenced on 1 March 2007. The aim of this partnership is the provision of
equipment, facilities management and all associated services for the Western
Cape Rehabilitation Centre and Lentegeur Hospital.
Dental training hospitals
* A comprehensive Oral Health Plan will be implemented in order to provide a
more effective service to patients.
Programme 5: Central Hospital services
The Central hospitals are allocated R2,17 billion or 30,6% of the vote in
2007/08. As mentioned earlier the department is committed to the preservation
of an essential core of highly specialised services in support of the district
and regional services where most patients are seen. It would make no sense to
have tertiary highly specialised hospitals in the absence of appropriate
clinics and district hospitals in the areas where people live.
Much has been said recently in the media about bed shifts from the Groote
Schuur and Tygerberg hospitals. Suffice it to say that firstly the bed shifts
are marginal, and secondly our health services will not collapse as a result.
Indeed I regret that the comments even if made with the best intentions have
resulted in concern by those who use our services. I want to assure them and
the general public that our services will continue as before. Our intention
remains to reshape health services in our province to benefit the poor and
working class people who depend on our service.
Speaker, despite pressures our Central hospitals continue to provide quality
health services. Included among the services to be provided in the year ahead
are: At Tygerberg Hospital
* More than 28 000 operations will be performed of which 650 will be open
heart surgery.
* The hospital will handle 550 000 outpatient visits and to admit 61 000
patients. Of these admissions, some 7 400 will require intensive care.
* The Trauma Unit will manage some 20 000 injured patients of whom 8 500 will
require admission.
* Over 10 000 paediatric emergencies will be managed and over 6 000 adults with
medical emergencies will be admitted.
At Groote Schuur Hospital
* More than 24 000 operations will be performed.
* More than 45 000 patients will be admitted. In addition 11 541 will be
managed in the Trauma Unit and 32 035 to the Medical Emergency Unit.
* Eight thousand babies will be delivered.
* Three hundred and seventy thousand outpatients will visit Groote Schuur
Hospital of whom 300 000 will be seen by specialists.
* 2 600 patients diagnosed with cancer will receive treatment at the cancer
unit.
* one thousand and four hundred patients will receive dialysis at Groote Schuur
Hospital.
At Red Cross Children's Hospital
* Red Cross War Memorial Children's Hospital will continue to provide
comprehensive dedicated tertiary paediatric services with a wide range of
sub-specialties.
* On average 750 operations per month, inclusive of all surgical disciplines
will be performed at RCCH.
* Building on the RCCH's status as a national centre for paediatric liver
transplants, approximately 15 (renal and liver) transplants will be performed
in 2007/08.
Programme 6: Health Sciences and Training
Health Sciences and Training is allocated R142,2 million or two percent of
the budget in 2007/08. This amounts to an increase of 40,2% or R40,8 million.
This makes provision for:
* R30 million for the Nursing Training College, R53 million for bursaries and
R6,7 million for Emergency Medical Services training.
* An earmarked allocation of R49 million is made in 2007/08 for the Expanded
Public Works Programme (EPWP) which is intended to provide an opportunity for
the training of unemployed persons as community based health workers, nursing
assistants and pharmacists assistants. A portion of these funds will be
allocated directly to the home-based care programme provided by contracted
NPOs. A total of 1 830 learners will be trained through the EPWP during
2007/08.
* Four thousand training interventions will be provided to PHC staff throughout
the various regions of the Western Cape to improve and update their
skills.
* Forty Pharmacists-assistants, 20 of whom will receive basic training and a
further 20 post-basic training, will also be training during this financial
year.
Program 7: Gesondheidsorg-Steundienste
Program 7 ontvang R85,4 miljoen, of 1,2% van die begrotingspos in 2007/08 in
vergelyking met die 1,4%-bewilliging volgens die hersiene 2006/2007-raming. 'n
Mens vergeet maklik die groot klomp was- en strykwerk wat deur ons
gesondheidsorgfasiliteite gegenereer word. Die afgelope week het ek die
bekendstelling van die nuwe ho�spoed-tonnelwasser ter waarde van R6,5 miljoen
by Tygerberg-hospitaal bygewoon. Hierdie wasser hanteer die wasgoed van 44
instellings, en kan 1 500 kg wasgoed per uur doen. Tygerberg-hospitaal beskik
ook oor lakenstryktoerusting wat 1 200 lakens per uur kan stryk, vou en stapel.
Ons jurkverwerkingstoerusting kan 900 jurke per uur droogmaak, vou en stapel.
In 2007/2008 sal ons interne wasserydienste 14 miljoen stukke was terwyl 'n
bykomende 7 miljoen stukke deur privaat instansies gewas sal word.
Programme 8: Health Facilities Management
Programme 8 is allocated R368,6 million or 5,2% of the vote in 2007/08. This
translates into a nominal increase of 8,5% or R29 million. Included in this
programme are:
* The building of Khayelitsha and Mitchell's Plain district hospitals is
critical to the implementation of the Comprehensive Service Plan, the Western
Cape's service transformation plan. The business cases for these hospitals were
approved by the National Department of Health but National Treasury has not
been able to allocate the required funding. Although there is insufficient
funding to take the planning process to the tender stage the department is
committed to achieving this during 2007/08 by reprioritising.
* Business cases have been submitted and accepted in principle, pending formal
approval and the allocation of funds for Brooklyn Chest, Tygerberg, Hottentots
Holland, Victoria and Mossel Bay Hospitals.
* Ander belangrike projekte sluit die omvattende opknapping en opgradering van
Mowbray-kraamhospitaal, die opgradering van Caledon- en Riversdal-hospitale, en
die verbetering van ambulansstasies in.
* The construction of new community healthCentres for Montagu, Stanford,
Wellington, Simondium and Swellendam is in progress.
* The forensic mortuaries have been transferred from the South African Police
Services and the physical infrastructure is being upgraded to meet the
requirements of the Forensic Pathology Service using the Forensic Pathology
Services conditional grant.
In conclusion, I wish to thank everyone who participated in this budget,
including my Cabinet Colleagues, Treasury, in particular the Head of
Department, Professor Craig Househam for his leadership, the management of the
department for their support and every staff member working in Health
throughout our province for their commitment and hard work.
A special word of thanks also goes to the chairperson of the Social
Development Standing Committee, Mrs Matilda Vantura, and her committee members
for their positive contribution to quality health care in our province.
There is no denying that we faced some difficult choices in this budget. I
am however convinced after thorough evaluation of all possible options and
despite the understandable concerns, the decisions taken in this budget places
us in the best possible position to deliver health care to the majority of the
citizens that we serve.
Thank you
Issued by: Department of Health, Western Cape Provincial Government
1 July 2007
Source: Western Cape Provincial Government (http://www.capegateway.gov.za)
