Honourable Chairperson
The Chair of Portfolio Committee for Health Hon . Dr. Sibongiseni Dhlomo
Hon Minister of Health, Dr Zwelini L. Mkhize Hon. Ministers and Deputy Ministers present Honourable Members of The National Assembly MECS of Health present
Heads of Public Entities and Statutory Councils Distinguished guests
Good Afternoon
I am very honoured to take part in the budget vote for the Department of Health which is taking place just a day after International Nurses Day when we celebrated the gallant contribution of our nurses in ensuring Long and Healthy Life for all South Africans,
I wish to take this opportunity to say again that as the Ministry and the Department of Health we have no hesitation in acknowledging that our nurses are the backbone of our Health Services at all levels from the basic primary health services at community level to the most advanced tertiary services. Without the nurses none of these services will be viable.
Honourable Chairperson our country and the world remain in the grip of the COVID-19 pandemic which has been with us just for over a year now. In this last challenging 15 months we have been blessed with outstanding leadership by our President, President Matamela Ramaphosa , cabinet collective, the Coronavirus Council and Team Health led by my colleague Minister Mkhize.
We extend our thanks to the cooperation we enjoyed from colleagues MECs and HODs of all provinces. We appreciate the support and cooperation we enjoyed from the leaders of civil society and community leaders. Without cooperation from traditional leaders , religious leaders , political leaders ,labour and business we would not be where we are, with the relative stability we have where our health services have not been overwhelmed. You can imagine if leaders of some of the big churches such as ZCC, st Engenas and Shembe had decided not to cooperate with government.
We all owe a lot to our health workers, not only the nurses but everyone from security at the gate to heads of clinical departments. Our health work force has been resilient, and we want to say to them that the fact that our fiscus has not enabled us to show the gratitude in monetary form is only because the pandemic has also battered already weak economy. You are the heroes of all South Africans and many of your colleagues have paid the highest price, life itself, we mourn with their families, may they get solace in the knowledge that their deaths were not in vain.
Honourable Chairperson and members it is common knowledge that the Annual Performance Plans of the NDOH for 2020/2021 were vastly disrupted and lot of adjustments had to be made as was the case with the life’s of South Africans in many respects
We now have more than 12 months experience in dealing with the pandemic but the reality remains that what will happen in the next weeks and months remain unpredictable .Minister Mkhize has already spoken about disruptions to our planned services such as HIV and AIDS testing treatment , TB services , maternal and child services etc and the fact that we are clawing back lost ground in these areas. We are of course concerned about the signs of rising numbers and that the 3rd wave may be on us sooner than expected.
Honourable Chairperson as we battle this pandemic, we must not lose sight of some of the quadrable burden of diseases where we still had lot of ground to cover and one such is the non- communicable diseases.
Diseases of Lifestyle remain serious challenge in our society which include diabetes mellitus, hypertension and cardiovascular diseases, kidney diseases, various cancers and mental illness. As we know most of these diseases are associated with unhealthy diet and lack of physical activity. I am aware that government came under criticism during hard lockdown when exercise opportunities were limited but this was just temporary. On the other hand, we made some gains in weaning people off tobacco and alcohol addition during the periods when these products were not available.
What adds more pressure on all of us not to take our eyes off the ball is that it has been proven all over the world that persons who don’t have these NCDs such as diabetes and hypertension and who are not obese have a higher chance of not getting severe COVID-19 complications .What these implies is that investing in healthy diet, regular exercise, avoidance of tobacco and alcohol puts you in a better position to avoid various NCDs or control them if already there and limit the risk of severe COVID-19 .
The closure of alcohol sales also contributed to the reduction of a second member of the quadruple burden which is trauma and accidents. I am aware that there was a glamour from some well meaning South Africans that we should prolong the closure or limit of alcohol and tobacco under the National Disaster provisions but this was legally unsustainable. What we need to do urgently is to speed up the tabling of the Tobacco Amendment Bill and to finalise a Bill on control of Alcohol advertising sale. As we know South Africans rank amongst the highest consumers of alcohol in the world.
Another area in which we need to refocus is the provision of Mental Health Services. As we know the Life Esidimeni debacle exposed our weaknesses. The COVID-19 pandemic has added more mental stress not only amongst the general public but also for health workers. There are many families who lost both parents and many more lost livelihoods adding more mental stress and in the current financial year we need to pay attention to these challenges.
We are conscious of the fact that the key answer is to improve on integrated health services wherever we do COVID-19 screening, testing and management, we should include HIV and AIDS, TB, mother and child and NCDs. As both our financial and human resources get stretched out, we are going to depend on integration from community outreach up to tertiary services. Even as we roll out vaccination, we are including basic screening for COVID-19 and other health risks. We urge honourable members to also promote healthy lifestyles at your constituencies such as the Thuma Mina walks initiated by President Ramaphosa
Honourable Chairperson and members, provision of adequate and suitable human resources is fundamental in managing the pandemic and sustaining a health service platform. One of the major contributors to the supply of well equipped medical personnel is the Nelson Mandela -Fidel Castro medical training program. Since its inception in 1997, this program started modestly with maximum of 80 students sent to Cuba per year. In 2012 they provided an option for additional students on an expanded program paid for by the sending government. Thanks to the visionary leadership of amongst other the chair of our Portfolio Committee Dr. Dhlomo for seizing this opportunity and sending hundreds of young students from rural and township disadvantaged families. The total number of graduates who have been contributed by the program stands at 1979 and out of this 1374 are those who were funded largely by the RSA government through provincial budgets since 2012 and they started coming back in batches of up to 700 students to complete in local universities since July 2018.In the last 3 years graduates from the NMFC program constituted 1/3 of all medical graduates in RSA. Currently we are having another 643 final year students in the local medical schools who will finish their clinical integration in December 2021.Another 463 final year students are expected in July this year to start their 18 months integration. By the end of 2022 we expect this program to have contributed more than 3000 doctors who are well trained in primary health care more than just Curative Medicine largely serving rural communities. What we need to address is to make sure that they are utilised in line with their strength which is our S. African weakness viz. Primary Health Care. I know that some members of the opposition only look at the cost and not the benefit while they claim to believe in business principles.
The HPCSA is continuing to look at better ways to enable South African medical graduates who qualified in universities not from the recognised list to be given a chance to go through requirements for registration so that they can practice. There are currently existing systems including a non-exam route for those from recognised universities and an exam and clinical training route for those from non -recognised universities. We will continue to work with the HPCSA to look at ways to streamline these processes. In the meantime we urge parents and students to check with HPCSA before they incur huge costs of going abroad to study medicine only to be frustrated on return.
Honourable Chairperson on the transformation of Nursing Education, 8 of the 9 provincial nursing colleges as well as the South African Military Health Services have been fully accredited to offer three year Diploma in Nursing leading to registration as a general nurse and started offering the new programme from January 2020.
The Eastern Cape is at an advanced stage of accreditation for the 3 year diploma. In addition, all colleges have been designated to offer certificates, degrees and postgraduate diplomas which are being offered in a phased approach from 2021.
Honourable Chairperson, the NHLS remains the cornerstone of provision of diagnostic pathology services in South Africans with a network of approximately 233 laboratories across the country, catering for 80% of such services for the population. It runs the largest HIV and TB program in Africa and can test for priority diseases. After some difficult administrative and financial challenges, it has now turned the corner and is stable both financially and in governance. It has also been able to tackle corruption where it has reared its ugly head. We thank our provincial counterparts for cooperating with the NHLS. NHLS also provides vital training for pathologists and medical scientists not only for RSA but the continent wide.
The NHLS rose to the occasion of COVID-19 growing capacity rapidly from two testing labs at the beginning to 130 across the country as we speak. Together with NICD they provide daily epidemiological information to us as to where the pandemic is. We acknowledge and thank the private labs for cooperating with NHLS.As of 11 May 2021, the NHLS conducted 4,800 342 COVID-19 tests of which 4 106 886 were PCR and 693456 were rapid antigen.
The other entity which is playing a major role in the fight against COVID-19 is the South African Health Products Regulatory Authority (SAHPRA)which has upped its game in making sure that we get speedy access to diagnostics, treatment, and vaccines. This young entity has risen to the occasion under tremendous pressure. Over the medium term it will focus on accelerating the clearing of its backlog of medicine products licensing.
The South African Medical Research Council is providing and supporting cutting edge research including in various aspects of COVID-19 in support of government.
The research support together with DSI includes areas such as the development of diagnostic products, treatment and prevention and vaccine studies. The two are also supporting network for Genomics Surveillance in South Africa which led to the discovery of SARS-COV-2 501y.V2 variant which has set an international precedent in Genomic Surveillance and is extending its services to support the Africa CDC.
As we know the SAMRC is a key player in the rolling out of Sisonke vaccination which will complete the vaccination of at least 5000 000 health workers by the 17 May 2021.
The Council of Medical Schemes has played a major role in mobilising medical schemes to come on board to fund vaccination of COVID-19 as a Prescribed Minimum Benefit and to participate overall in the vaccination program.
Honourable Chairperson the way ahead in 2021/22 is going to be long and tortuours but I believe we have learnt a lot over the last 15 months. We can only defeat the invisible enemy by continuing to work together. The next few months are going to be critical as we roll out vaccines while we remain vigilant with the Non Pharmaceutical prevention methods.
Let’s continue to be guided by science behind our leader President Ramaphosa working together we can prevail.
I Thank You.
