Health MEC’s  2017/18  budget and  policy  speech

Honourable  Speaker; Honourable  Premier;
Honourable  Members  of  the  Executive  Council; Honourable  Members  of  the  Provincial  Legislature; Chief    Whip  of  the  Ruling  Party;
Leadership  of  the African  National  Congress  (ANC)  and  its Alliance  Partners; Leaders  of  other  Political  Organizations  represented  in  this  House; Chairperson  of  the African  National  Congress  Standing  Committee  on  Health; Chairperson  of  the  Eastern  Cape  House  of Traditional  Leaders;
Ministers  of  Religion;
Director  General  of  the  Province;
Superintendent  General  of  the  Department  of  Health; Departmental Management and Staff;
Departmental  Stakeholders; Distinguished  Guests; Ladies  and  Gentlemen;
Bhotani  nonke  mzi  wakowethu,

Madam Speaker I am honoured and thankful for the opportunity to address this august House which is named after one of the stalwarts of our movement, utata uRaymond Mhlaba. This is more relevant for me this year which is declared and dedicated to celebrating yet another great leader of our movement; a stalwart who dedicated his life to the struggle for the emancipation of South Africa; utata uOliver Reginald Tambo who would be celebrating his centenary year in 2017, had he been alive.

He was a selfless servant of the people and an embodiment of the struggle for democracy, non-racialism, non-sexism and unity. O.R, as he was  affectionately  known, not only dedicated  his  life  to  serving  the  movement  but  his  entire  family  joined  him in the  sacrifice as  they  were compelled  to  spend over  two  decades abroad  while he was busy advancing the African National Congress’ (ANCs) agenda of liberating South Africa  from  the  cruel  regime  of  apartheid.

We  salute  OR Tambo  and  pledge  to  follow  in  his  footsteps, living  up  to  his  values as we  deliver  health  care  services  to  our  people.

I stand here on behalf of a department which carries a mandate that is most critical and is one of the priority areas for the governing party. This priority finds expression in many policy documents of the country, including the National Strategic Plan for HIV, STIs and TB (NSP) and the  National  Development  Plan  (NDP)  /Vision  2030  which are  policy  guiding  documents for  South Africa.

 

In relation to Health, the NDP envisages  an  increase  in  life  expectancy  rate  to  at least 70 years  for  men  and  women;  HIV  free  youth  (under 20s);  radical  reduction of quadruple burden of disease; an infant mortality rate of less than 20 deaths per thousand live births and an under five mortality rate of less than 30 deaths per thou- sand; as well as availability of universal coverage. Our efforts as this department are therefore directed  at  ensuring  that  these  objectives  are  realised  come  the  year  2030.

Madam Speaker, as an accountable servant of government and of the people  of the Eastern Cape Province, it is  important  that  as  I  table  the  Budget  and  Policy  Speech for 2017/18, I take stock of how the department has progressed in implementing the objectives and priorities it  set  out  for  2016/17  after  which  I  will  outline  our  plans for  2017/18.

2016/17 Key Service Delivery Achievements

In 2016/17, the Department of Health received an allocation of  R20.244  billion (twenty billion, two hundred and forty-four million rands) to advance its service delivery priorities for the financial year which resulted in many positive achievements that we would like to share with the people of Eastern Cape, however due to time limitations, I  will  highlight  but  a  few.

In relation to the quadruple burden of disease which affects our Province, the department prioritised key programmes including prevention and treatment of TB and HIV/Aids; provision of Emergency Medical Services (EMS); strengthening Primary Health Care; provision of health infrastructure; implementation of Chronic Care Medicine Direct Delivery (CCMDD), to mention just a few.

We continued to offer pregnancy testing to all women of child bearing age who vis- ited health care facilities. This resulted  in an  increase in  the percentage  of ante-natal first visits before 20  weeks  of  pregnancy, from  a  2015/16  baseline  of  59.7% to 64% by  mid-year  2016/17.

The impact of the early visit is that this offers an opportunity for midwives and doctors to pick early conditions that could cause risk to the pregnancy, provide counselling and testing to pregnant mothers to detect HIV infection and provide timely treatment to prevent mother to child transmission. We believe  that  the  early  atten- dance of clinics by pregnant women with the support of Mom-Connect assists the department to identify, classify, manage and prevent the causes of perinatal conditions that  lead to  Cerebral  Palsy  and  avoidable  maternal  deaths.

One of the strategies  of  government  to  prevent  disease  in  the  first  24  months  of life is to provide vaccines that prevent measles, TB, pneumonia, diarrhoea, measles, whooping cough and rubella. We are pleased to report that our province has already exceeded  the  2015/16  baseline  of  81%  and  stood  at  86%  by  mid-year  2016/17.

The WHO and National Department of Health require that we achieve at least 85% coverage to prevent measles outbreaks and for this reason, the province has for many years  not  experienced  measles  outbreaks  because  of  this  high  herd  immunity  levels.

Our provincial measure of disease and deaths averted shows that we have achieved a substantial reduction in deaths related to diarrhoea  cases  in  children  under  five  (5) years which reduced to 3.4%, from  a  2015/16  baseline  of  3.6%.  This means there were 147 less children dying from diarrhoea than the previous year baseline.  Child under 5 years pneumonia case fatality rate also went down from 3.7% at end of 2015/16 to 2.7% by mid-year of   2016/17.

The extensive Human Papilloma Virus (HPV) vaccination campaign undertaken during 2016/17 contributed in decreasing the number of young girls susceptible to cervical cancer. At the end of  2015/16  year, 99.4%  of  the  targeted  80 643  eligible  school girls were vaccined, and progress in  the  implementation  of  the  campaign  shows  that the department will achieve the 2016/17 target as well. Cervical cancer screening coverage reached the  60%  mark  by  mid-year, up  from  the  previous  year’s  baseline of  57.4%.

The Department has  also  increased  efforts  to  prevent  non-communicable  diseases by screening  clients  and  initiating  treatment   to  those  with  diagnosis. To date, over 1.7 million and 1.5 million clients presenting at health facilities have been screened for hypertension and diabetes respectively. In 2016/17, through the Integrated School Health Program (ISHP) the department managed to provide health screening services to 103 824 learners across the Province. These include Nutritional assessment; Physical assessment (gross and fine motor);Vision; Oral health; Hearing; Chronic illness;  TB screen; Speech; Psychosocial support; and mental health. Furthermore, the department managed to deworm 27 112 learners; identified and managed 1 092 cases of malnutrition and under-nutrition; 1 557 cases of obesity and also immunized 26 441 learners. Through  this  program, the  department  was  able  to  provide  referral  services  for  14 527  children  with  various  ailments  such as  suspected TB;  speech  problems;  hearing; oral  and  eye  health.

Honourable Members simanxadanxada siphucula sikwaphuhlisa ukunikezelwa kweenkonzo kumaziko ezempilo, aquka izibhedlele zeliPhondo.  During the 2017 State of the Province Address the Honourable Premier made reference to improvements we have made at the Bedford Orthopaedic Hospital. Indeed the long waiting times for Orthopaedic Operations at this facility have been drastically reduced as a result of the provision of specialists and procurement of more theatre equipment. We are now proud to report that surgery waiting period has reduced from an average of three (3) months in September 2016 to less than one month in January 2017.

The Spinal Services at Nelson Mandela Academic Hospital (NMAH) have been boosted through a  supportive  collaboration  with  the  Head  of  Orthopaedics  at  the  University of Pretoria. This collaboration ensures that this rare service is strengthened for  the benefit of the people of the this province. Furthermore, we are busy installing  a Cardiac Catheterisation Laboratory (Cath Lab) at Nelson Mandela Academic Hospital, which will be run by our homegrown Cardiologist and will provide much needed cardiothoracic services to communities of O.R Tambo and Alfred  Nzo  Districts. Previously these patients had to be bussed to Port  Elizabeth  but  this  will  now  be  a thing of the past. We are indeed pleased to have  trained  and  recruited  the following seven  (7)  super  specialist for  Nelson  Mandela  Academic  Hospital:

• Anaesthetist  and  Intensivist;
• Physician  and  Rheumatologist;
• Physician  and  Cardiologist;
• Paediatrician  and  Neonatologist;
• Ear  Nose  & Throat  ( ENT  Specialist );
• Orthopaedic  Specialist; and
• Paediatrician and Infectious Disease specialist.

This accomplishment will surely go  a  long  way  in  the  provision of specialist services to the people of the Eastern Cape Province. In addition, we now have a qualified Gynaecology Oncologist who is stationed at Dora Nginza Regional Hospital and a qualified Radiation Oncologist both of which will be working hard to boost our fight against cancer.

As a victory for  children  born  with  deafness, we  are  pleased  to  announce  our plans for Cochlear Implant services. These children are usually condemned to a life of permanent disability, especially those who come from low socioeconomic backgrounds. To date Cochlear Inplant services were only available in Cape Town, with only limited space available for Eastern Cape patients. In 2017/18 the Nelson Mandela Academic Hospital in collaboration with Walter Sisulu University (WSU) and Stellenbosch University Academics  will  open  up  these  services right here in our province.

Honourable Members, on TB and HIV/Aids, the department has already over- achieved its annual targets for HIV testing services and condom  distribution,  and further  managed  to  reduce  the  HIV/Aids  prevalence  rate  for  people  between 15  and

49 years of age from 10.4% in  20 14  to  7.7%  by  2016. Our  intensified  strategies on ARV distribution; targeting key populations; pregnant mothers as well  as  our partner- ships and collaboration with other sectors such universities and TVET colleges and development  partners  have  significantly  attributed  to  this  success.

The department continued to implement the 90-90-90 strategy on TB and HIV man- agement, and to date has noted positive progress through  the  monthly  monitored tracer indicators. In September 2016, we started implementing the Universal Test and Treat (UTT) policy which is aimed at improving the number of new patients initiated on ARV treatment. We are finding that the new shortened regimen for MDR patients is bearing fruits and we are now  experiencing  fewer  patients  that  are  lost  to  follow up. Because of these interventions, we have been able to achieve the following outcome:

 

• Screening  a  total  of  985 250  clients  by  mid-year;
• A total of 361 404  clients  remained  on ART  by  mid-year  already  reaching  76%  of the planned annual target of 473 089 and higher than the 2015/16 baseline of 361 166;
• We reached a total of children  under  15  years  remaining  on ART  of  11 942; and
• Applying the  same  90-90-90  strategy  to  the  TB  Program  was  an  important decision taken by the department and  as  such  by  mid-year, 1 424 752  clients  who are 5 years and older were screened in facilities for TB symptoms. TB Treatment success rate stood at 83.6%, whilst the number  of  TB  patients  lost  to  follow-up was 598 out of 8 242 patients on TB treatment, which is equivalent to the targeted defaulter  rate  of  7.2%.

 

Madam Speaker as part of our preparations for the National Health Insurance (NHI) we are making good progress  in  preparing  health  facilities  to  be  ideal clinics  through the Ideal Clinic Realisation and Maintenance (ICRM) programme.  This  is  an  initiative which ensures that health facilities have good infrastructure, adequate staff, adequate medicine and supplies, good administrative processes  and  sufficient  bulk  supplies that use applicable clinical policies, protocols, guidelines as well as partner and stakeholder support, thus  ensuring  the  provision  of  quality  health  services  to  the community.

The department  is  increasing  universal  access  to  health  care  through  implementation of the National Health Insurance (NHI) readiness programme in the pilot districts. Appointment of WBOTS; WBOT leaders; ISHP teams; contracting of General Practitioners (GPs); and Central Chronic Medicines Dispensing and  Distribution (CCMDD) project roll out are some  of  the  readiness  programmes  implemented  in our  pilot  districts, and good progress is made by the department in these areas.

Honourable Members, the 141, 4x4 ambulances that we had committed to deliver in 2016/17 have now arrived albeit delays with the finalisation of the national contract. for EMS vehicles We are now focusing on the urgent conversion of these vehicles to get them ready for operating as ambulances. We hope to distribute all the ambulances to districts  by  end  of  May  2017.

Madam Speaker, on the delivery of infrastructure for health we have made  good progress in building, refurbishing and renovations of our facilities within the province. Amongst  the  infrastructure  projects  that  have  been  completed  in  2016/17,

I would like to make a special mention of the Frontier Regional Hospital; St Patricks

District Hospital  and  the  flagship  project  at  Cecelia  Makiwane   Regional  Hospital.

Facilities with high maternal deaths and life support requirements have received the required equipment such as Ultrasounds Units, Cardiotocography (CTG) machines and Infant Warmers. These facilities are Butterworth; Madwaleni; Mthatha Regional; St Eliz- abeth; St Patricks;  All Saints; Wilhem Stahl; Aliwal North; Grey; Dora Nginza Hospitals.

The equipment is intended to improve services and clinical outcomes in  our  high priority areas, being maternity and labour wards; neonatal ICUs and nursery; theatres and recovery bays; emergency units and resuscitation rooms; and Out Patient Depart- ments (OPDs). With the availability of this equipment in our facilities the Department further envisions reduction of Medico Legal claims, as clinical services will now be improved. Furthermore, we have installed  x-rays  at  Middledrift,  Nontyatyambo  and Cala Community Health Centres (CHCs); Mthatha  Regional, Butterworth, St Patricks and  Grey Hospitals.

We  are  a  government  at  work  Honourable  Premier!!!

2017/18 Service Delivery Priorities

For the coming year, that is 2017/18 Madam Speaker, the department will continue focusing on the Re-engineering of Primary Health Care (RPHC), which is  a  funda- mental component of the National Health Insurance (NHI) program. The key service delivery elements that the department will be prioritise during this period includes strengthening District Clinical Specialist Teams (DCST); Ward-based Outreach Teams (WBOTs); contracting of General Practitioners (GPs); Integrated School Health Pro- gramme; as well as the Centralized Chronic Medicine Dispensing and Distribution (CCMDD) which has now been  rolled  out  to  all  districts.  The number of WBOTs will be increased in order to extend coverage of households visited. Outreach Household Registration visit coverage is targeted to reach 30% by the end of 2017/18 financial year.

The department will continue  to  strengthen  its  integrated  service  delivery  planning and implementation  at  the  community  level  using Ward  Base d Outreach Teams.  This is in line with the Operation Masiphathisane’s Integrated Service Delivery Model (ISDM), which was launched in May 2016. Furthermore, the National Health Council has resolved that the stipend for eligible Community HealthWorkers be increased from R 2000 to R 3000 with effect from April 2017.

To ensure drug availability and effective management of  drug  stock  outs, the  depart- ment will strengthen use of the Stock Visibility System (SVS) which was rolled out to all  Primary  Health  Care  (PHC)  facilities  and  hospitals.

Madam Speaker, in 2017/18 our department will be expanding and effecting the Ideal Clinic Realization and Maintenance Model in more than 50% of the provincial  PHC facilities to improve the quality  of  services rendered  in  our  clinics  by  strengthening the  service  platform  and  management of  facilities.

We are moving ahead to prepare the province for the National Health Insurance (NHI) and therefore the department will continue to focus on the two (2) pilot NHI districts of OR Tambo and Alfred Nzo. Honourable Members, our intension as the department is to take lessons learnt from the two pilot sites and some components of the NHI, and roll these out to all districts.

Madam Speaker, we take note of the successes drawn as a result of the World Health Organization’s (WHOs) 90:90:90 strategy on HIV, STIs and TB and we are resolute to continue its implementation  during  2017/18, even  beyond  management  and  treatment of HIV, STIs and TB. HIV Counselling and Testing (HCT) will continue in order to improve the HIV testing coverage in the province. For the 2017/18 year, the department is targeting to:

• Test  1.4  million  clients   for  HIV;
• Have  over  500,000  HIV  positive  adults  remaining  on ART; and
• Improve  on  the TB  treatment  success  rate  which  is  currently  above  82%.

Our intention Madam Speaker is to adopt the  90-90-90  strategy  and  expand  it  to other chronic conditions such as diabetes and hypertension. The burden of Non Communicable Diseases will be decreased by screening at least 900,000 clients for hypertension and an equal number for  diabetes  by  end  in  2017/18.  Both  hyperten- sion and diabetes are silent killers, accounting for a high number of mortalities in our country and therefore a programme of this nature  will  come  in  handy  in  addressing this  challenge.

In an endeavour to reduce child and maternal mortality  the  National  Department of Health has approved a new policy (BANC+) which will see an increase in the number of clinic visits by pregnant women to eight (8). This is another of the department’s in- terventions to reduce maternal mortalities, especially as a result of hypertensive disease.

This policy will be implemented alongside other proven programmes such as Mom- connect which has helped improve the quality of Antenatal care services and  reduce maternal mortality in the province since its initial rollout. Mom-connect has been received well by our communities and I will  share  briefly  with you  feedback  from some of the service beneficiaries. “Mom connect you are so special in young mothers’   lives. You  helped  me  whilst  I  was  pregnant  until today,  my  baby is  eight  (8)  months  old.   Wow  you  are  so  marvellous,  keep  it up”.

“Ndincoma impatho ka PN VUSANI wase Thembelihle Clinic,  unempatho usisi akabaphakameli abayofuna uncedo. Unesineke akadikwa, umbona kwase- busweni unothando  uyawuthanda  umsebenzi  wakhe”.

Madam Speaker, we are pulling all necessary stops to reduce the Medico Legal burden to our department. In 2017/18 we will continue to give training to our clinicians on Essential Steps in Management of Obstetric Emergencies (ESMOE) as well as fire drill trainings  to  ensure  that  they  are  well  capacitated  to  handle  such  cases.

This year going forward our maternity  services  and  reproductive  health  service  will have additional investment in staffing, essential life saving equipment and modern tech- nology to monitor and identify easily high risk pregnancies and provide best support for new borns to prevent birth related harm and sequelae. All facilities that provide Caesarian  care  will  be  provided  with  C-PAP  breathing  support  service.

We are exploring digitisation of clinical records especially patient records to improve management of records and enhance efficiencies. A team from Head Office undertook a benchmarking exercise in other provinces for  this  purpose.  The  department  will soon be migrating to an electronic records management system which will be preceded by  the  clean-up  of  manual  records  through  sorting  and  archiving  processes.

Honourable Members, also as part of our tireless efforts in the fight against medico-legal claims, we are continuously assessing our medico legal strategy and incorporating  ad- ditional measures to limit our exposure in this regard. We appreciate efforts by the Executive Council and the interactions with the Provincial Treasury and Office of the Premier to manage this scourge. We are at advanced stages of appointing a panel of medico-legal experts that will assist in defending these  cases  in  court.  The  depart- ment is also taking action against the unscrupulous attorneys who charge exorbitant settlements with intentions for self enrichment. Together with the equipment procured and specialists appointed, the department is confident  that  it  is  in  the  right  direction with  regards  to  the  fight  against  this  scourge.

Emergency Medical Services (EMS) by its nature will always remain a priority for the department. In the past two (2) financial years the department has made significant investments in additional EMS  vehicles  and  personnel.  In 2017/18  the  department will introduce nine (9) Ambulance Busses which have a six  (6)  stretcher  and  25 seated carrying capability for transportation of patients. These buses will bring much needed relief to our patient transportation system, thus making ambulances more available for other emergency calls. Each district will be allocated one bus, except for Sarah  Baartman  District  which  will  receive  two  buses  due  its  vastness.

Furthermore the National Minister has   signed   the new   EMS   Regulations   which will do away with EMS short course training in the country. In line with this regulation, our Department will be working closely with the two Universities, Nelson Mandela Metropolitan University (NMMU) and University of Fort  Hare  (UFH)  to  bring  our EMS  practitioners to  the  required  level  of  qualification.

Madam Speaker the department recognises that in order to achieve our service delivery mandate, a skilled workforce is vital.  To this effect the department continues to service its financial and contractual obligations regarding bursaries that we have already committed to. Currently we have 848 bursary holders, of which 58 are new added  beneficiaries  who  have  been  awarded  bursaries  for  the  2017  academic  year.

Honourable Members, the department has made good progress in the training of junior doctors, moving from 276 to 348 medical interns. This will accordingly improve our capacity to absorb new doctors, especially the Cuban trained contingent.  To further prepare for the Cuban trained doctors; we are expanding the platform and preparing fifteen (15) District hospitals to form part of the training platform for doc- tors. in addition we have also placed Cuban specialists at St Elizabeth; Cecilia  Makiwane; and St Patrick’s Hospitals to focus on Mother & Child care. More training will also be provided this year that will target specialist doctors and nurses to address scarce skills for theatre, ICU, Oncology, surgery and advance speciality services.

Of the 289 clinics that we committed to provide appropriate leadership for, we have only managed to appoint for 57 clinics and these managers assumed duty as of 01 March 2017. We willnowprioritise the appointment of managers for the remaining facilities in this financialyear.

Madam Speaker, as has been confirmed by both Premier Masualle and MEC Somyo  in their State of the Province Address and Provincial Budget Speech respectively, it is important to have an adequate workforce for health. Accordingly, in our R14 billion Compensation of Employees (COE) allocation we will provide a capable workforce for the health sector. Priority will be given to filling of critical clinical posts like Mortuary Attendants; General Workers; Laundry Workers as well as critical administrative posts at district and facility level.

The department has also concluded its process of putting a new organogram in place, however the essential consultation process took longer than anticipated and this delayed its planned implementation. We now envisage to implement the new structure from 01 April 2017.

Madam Speaker the country’s economic outlook poses a serious challenge to service delivery, be that as it may, Infrastructure delivery will continue to receive priority. The department will focus  on  areas  which  will  yield  improved  clinical outcomes  in the  most  cost  effective  manner  as  follows:

• Renovations  of  Clinics  and  Community   Health  Centres;
• Renovations  of  district  hospitals;
• Fencing  and  guard  houses;
• Rehabilitation  of  mortuaries  and  Forensic  Pathology  Services  Units;
• Procurement  and  maintenance  of  medical  equipment;
• Upgrade  of  water  treatment  plants  and  sewerage  system;
• Emergency  Building  Repairs;
• Electricity  and  water  connection;
• Electrical  and  mechanical  plant  and  machinery  upgrade;
• Lift  maintenance  and  upgrade;
• Repairs  and  renovations  of  accommodation  units  for  health  professionals;
• Eradication  of  mud  and  inappropriate  structures;
• Renovations  and  maintenance  of  the  Emergency  Medical  Services  Bases;
• Maintenance  of  health  facilities  plant, equipment  and  machinery; and
• Capacitation of the Infrastructure Unit.

Over the 2017 MTEF, an allocation of R4.5 billion is set aside to pursue all these critical health infrastructure areas. The department will also prioritise rehabilitation and refurbishment of Mjanyane and Nessie Knight Hospitals over this period.

Honourable Members in May 2017, the Premier will be officially opening one of our key infrastructure projects in the province, the Cecilia Makiwane Hospital flagship project. We will be welcoming the people of Mdantsane  and  surrounding  areas  to the newly established wing of the hospital to access the technologically advanced and improved service package. Other facilities  that  will  be  opened  and  officially  handed over in 2017/18 include: Maxwele; Lotana; Malepelepe; Tikitiki; Nkanga; Nkwenkwana; Isikhoba; Qebe; Vaalbank; Mahlubini; Zabasa; Centuli and Ngcizela clinics as well as Frontier Hospital’s  main  Casualty  &  OPD  and  St  Patricks  Hospital’s  OPD.

2017/18 Budget and Programme Allocation

Madam Speaker, I wish to table the 2017/18 budget appropriation for the Eastern Cape Department of Health. For this financial year, the department has been appropriated an amount of R 21 707 165 (twenty one billion, seven hundred and seven million rand) to do its work. Below is the breakdown of the budget per programme and economic classification:

PROGRAMMES	ALLOCATION
1.   Administration	687 001
2.   District Health Services	10 937 544
3.   Emergency Medical Services	1 222 366
4.   Provincial Hospital Services	3 322 570
5.   Central Hospital Services	3 108 963
6.   Health Sciences and Training	853 145
7.   Health Care Support Services	130 759
8.   Health Facilities Management	1 444 817
Total	21 707 165

 

ECONOMIC CLASSIFICATION	ALLOCATION
Compensation of employees	14 415 656
Goods and services	5 657 287
Transfers and subsidies	290 342
Payments for capital assets	1 343 880
Total	21 707 165

 

Conclusion

Madam Speaker and the Members  of  the  Legislature, I  recognise  the  sacrifice  that our sister departments  make to ensure  that health and education  receive the biggest slice of the shrinking budget cake and I would like to assure the people of the Eastern Cape that the organisational reforms that we are implementing are  aimed at providing a comprehensive service package, that is of quality and  universally  accessible  to  all those who  are in need.

The department is committed to collaborate and act as one with other departments to address the social conditions that make our people vulnerable and at risk of diseases as a results of the social determinants of health and life style diseases. The department is shifting  resources  to  the  frontline  services  and  expanding  the  capacity to reach the community in their households through the streams of  PHC  reengineering, ensuring that medicines are delivered to communities and that children in schools are  provided  with  health  promotion  and  preventative  services.

We believe that we should take and use lessons learnt from ORT pilot sites to transition all our districts to NHI districts. Our organisational reform based on the new organogram has made provision for strong district and hospital management team led by high ranking leaders who are empowered to exercise management decision to manage resources and deliver quality services. HIV and AIDS, communicable diseases, maternal and child health remain the high priority for the department as these conditions contribute to the global disease burden of  the  province  and  combine  to inflict  the  highest  number  of  preventable  deaths.

Health care services depend on trained and dedicate personnel and in many of my presentations to this House and to other fora  of  government, I  have  pleaded  for more health workers and support staff to  enable  us  to  respond  to  the  shortage  of staff at our health facilities which  is  the  constant  cry  of  our  people.  I  must  admit that although significant resources have been  allocated  to  the  department  over  the past years, we  remain  constrained  and  unable  to  fulfil  our  constitutional   mandate of providing quality and accessible health care services including quality hospital and emergency care at reduced waiting times, as well as  reduced  waiting  at  primary health  care  facilities.

Despite all these challenges, I continue to receive support from members of Executive Council under the leadership of the Premier Masualle; the Chairperson and Members of the Health  Portfolio  Committee;  fellow  Members  of  the  Provincial  Legislature; the Head  of Department, Dr Mbengashe and his team, and from the many dedicated health professionals  to  workers  in  health  facilities, districts  and  Head  Office.

I wish to also take this opportunity  and  appreciate  my  family  for  their  support  and being  a  source  of  inspiration  for  me  to  do  even  more  for  my Province.

Honourable Speaker, I hereby table the Eastern Cape Department of Health’s 2017/18 Budget and Policy Speech as well as the Annual Performance Plan and Operational Plan for 2017/18 financial year.

Enkosi.