Keynote address, Gauteng Premier David Makhura at the 2016 Khanyisa Service Excellence Awards, Gallagher Convetion Centre
Director of the Programme, Ms Mapaseka Mokwele;
Gauteng MEC for Health, Hon. Qedani Mahlangu;
Head of Department, Dr Barney Selebano;
Senior Managers and CEOs of Hospitals;
Health Workers and Professionals;
Ladies and Gentlemen;
It is my great pleasure to join you this evening when we come together to shine the light on excellence and showcase the capabilities within the institutions of the Gauteng Department Health.
I would like to take this opportunity to convey my sincere gratitude to the men and women who keep our public healthcare system running relatively well, able to perform above the national core standards.
We have gathered here this evening to honour those of our health professionals and workers who perform their work beyond the call of duty; who have demonstrated a
citizen-centred and patient-oriented attitude; those who are innovative, passionate, professional and ethical in carrying out their work; those who put patients first. We owe these health workers and managers a huge debt of gratitude!
The Gauteng Provincial Government manages one of the biggest public healthcare systems in Sub-Saharan Africa. The Gauteng Department of Health employs 67 000 staff members. On an annual basis Gauteng hospitals service 7,1 million patients in 36 hospitals, 36 community health centres and 375 clinics. We provide health services to patients from our neighbouring provinces such as Limpopo, North West, Free Sate and Mpumalanga. Our annual provincial health budget is a whopping R34 billion. We also provide services to patients from SADC countries.
I am citing all these facts and figures to underscore the seriousness with which we must approach the job of managing the public health system in our province. We need to manage this system competently and ethically.
When I delivered my first State of the Province Address in June 2014, I made the following commitment that: “The urgent turnaround of the Gauteng Department of Health and all public health institutions is one of the priorities of this administration.
We will stabilise the finances of the department, improve the delivery of quality healthcare, reduce waiting times and queues, increase the number of professional staff and invest in health infrastructure and ICT as part of our programme of modernising public services and e-governance.
This was based on the fact that the Gauteng Department of Health had a history of intermittent administrative and financial problems which made it the problem child of the Gauteng provincial government. It has serious financial problems and it received recurring negative audit outcomes from the Auditor General. It attracted regular bad publicity from the media about shortage of medication, food and beds.
In order to achieve all our publicly stated commitments of turning around this Department, I made it clear when I appointed MEC Mahlangu and HOD Barney Selebano that we need to fix the performance of this department within two years.
The following areas were identified as the key areas of focus:
- Turning around our health department and all our heath institutions;
- Stabilising our finances stabilised;
- Improving the delivery of quality healthcare by meeting the national health core standards;
- Reducing waiting times and queues in our health facilities;
- Increase the number of professionals staff;
- Invest in health infrastructure and renovating existing facilities;
- Introduce ICT as part of our programme of modernising public services and egovernance;
Accordingly, I am delighted that many of you who gathered here tonight have contributed tremendously to the turnaround of the Gauteng Department of Health. This Department is today a home of many emerging centres of excellence and a hub of innovation in the provision of quality and modernised healthcare. In addition, the Department obtained an unqualified audit outcome this year. This is a remarkable achievement, of which we are extremely proud. Well done to our hard working and dedicated Team GDH. Well done MEC. Well done HOD. Next year, I look forward to you joining the league of clean audits in our province. There is no turning back!
Ladies and gentlemen, we still have a long way to go in meeting the expectations of our citizens with regard to access to quality and modern healthcare services. Eighty percent of Gauteng residents don’t have medical cover and therefore depend entirely on the public healthcare system. An overwhelming majority of these – 71% – interacted with either a clinic, hospital or other healthcare facility. We dare not fail them.
We must pull up our socks and ensure that we provide quality healthcare. Currently, the level of satisfaction with healthcare services is only 69%, according to the 2015 Gauteng City Region Observatory’s Quality of Life Survey IV. My target is that we must reach the 80% satisfaction level by 2019.
In particular, I would like to call on all of you, in line with our township economy revitalisation strategy, to have a dedicated focus on the revitalisation of the delivery of quality primary health care in the townships. The overwhelming majority of poor people live in the townships. We dare not fail them.
Some of the most common concerns of our citizens pertaining to the public healthcare system are the long queues, long waiting periods for operations and the bad attitude of health workers. As we gather here tonight, we must make a vow that we shall reduce the waiting period and change the attitude of health workers in our institutions.
Ladies and Gentlemen, the Khanyisa Service Excellence Awards are about promoting and acknowledging service excellence, innovation and a patient-centred approach to the delivery of healthcare. The Awards are also about deepening the values of Batho-Pele in our public health care system.
We are required to answer the question: “what is the best model of a functioning health system? In my considered such as system must have at its core a functional primary health care component. It is for this reason that we have always maintained that Primary Health Care is the backbone of a functioning public health care system.
Accordingly, we are encouraged that currently 175 of our clinics have reached the ideal clinic status - they open on time, are clean, are staffed by health professionals that practice the values of Batho Pele; they do not close until the last patient has been attended to and have reasonable waiting times.
However, we need to increase the number more rapidly to ensure that all our public health facilities reflect the model public health system illustrated by the ideal clinic.
A model public health system should also be comprised of interventions to encourage healthy lifestyles, including the provision of public gyms. Such a system must be staffed by capable, professional, accountable health professionals. It must be underpinned by proper financial management an absence of wastage, maladministration and corruption.
Hence we are putting in place measures to ensure that corrupt and incompetent officials and politicians have no place to hide in our system of government. It is for this reason that we have introduced the open tender system and integrity management units in all departments, as part of preventing fraud and corruption.
We must use the procurement process to promote local manufacturing and the township economy revitalisation. For instance, the Department is by far the biggest provincial spender on machinery and equipment. Over the next three years the Department will be spending more than R 3 billion in acquiring machinery and equipment. For the same period, the Department is expected to build new, upgrade, renovate and refurbish a total of 54 heath facilities. This budget must also be used to empower local enterprises in an open and ethical way.
Whilst we acknowledge that all linen contracts in our public health facilities have been allocated to women cooperatives, as part of boosting localisation, we believe we need to increase our targets in supporting the township entrepreneurs by procuring goods and services from them.
We are delighted that in 2015, Gauteng was the best performing province in assessments of compliance with national core standards in health. We were rated at 75.6% against the national average of 65.8%. This was made possible by the hard work of our dedicated health professionals.
Equally it is in part because of your hard work that the people of Gauteng now live longer. According to Stats SA, Gauteng’s average life expectancy at birth for females has improved from 59.0 years in 2001 to 65.8 years in 2016. For males it has improved from 56.4 years in 2001 to 61.3 years in 2016.
With regards to the fight against HIV and AIDS, we remain concerned that the number of people diagnosed with HIV in our province increased from 125 000 in 2009, to 227 000 in 2015. We however draw some comfort that our province’s contribution to the national HIV and AIDS prevalence has declined from 22.6% in 2009 to 15.6% in 2015.
One of the good indicators of quality of a country’s health system is the still birth rate. For an example, the South Institute of Race Relations, in its 2016 life in South Africa,
reasons for hope research report, indicates that South Africa’s still birth rate has declined. They argue that if the still rate is high, it means that pregnant women are
not receiving the care they need from midwives and medical professionals.
Therefore if the rate is declining, pregnant women are probably receiving better care. Because evidently, over the period 2001 to 2014, there has been a steady decline in
the still birth rate from 27 deaths per 1000 births to 21 per 1000 births – a decline of 22.2%. This in our view reflects the positive work being done by our midwives and
the health professionals in providing quality health care where it matters most.
We are delighted that in the 2015/16 financial year, revenue collection from patient fees increased by 6% or R13.3 million compared to the 2014/15 financial year. At the
moment at least 10% of the health budget is from own revenue. We are also collecting debt owed to us by other provinces, national departments and state-owned
entities such as NHLS, RAF and Workmens’ Compensation Fund. We need this money to deliver better public healthcare.
On the modernisation of public health care the Department will spend more than R 1.2 billion, over the next three years. We continue to make steady progress in leveraging ICT to support the delivery of health care services. To date 56 of our hospitals are now scanning medical records electronically. With regards to health infrastructure, since 2014, we have built 11 new clinics and community health centres and 78 health facilities have undergone refurbishment.
We are making progress in reducing waiting times and queues. To illustrate the impact this is having on ordinary citizens, allow me to relate a story that was told to us earlier this year.
I would to conclude by sharing with you an email I received from Ms Motloung from Soweto: “On the 11th of November 2015 I had the pleasure of consulting with the gynae
department at Baragwanath Hospital. To my pleasant surprise, everything was handled so proficiently. To elaborate more on the surprise: everybody has an impression on state
services and it is not flattering at all. To my pleasant surprise it was the opposite of what I had expected. I was expected to report for duty at around 17:00 in the evening. At the hospital I was told to be there between 07:30-08:00. When I left the house, I prepared for work, in case I delayed. I prepared myself to leave from the hospital to work.
I got to the hospital just before 09:00. When I got in, the queue was so long! The whole waiting area was full, including the line for the clerk's office. I had to stand on my feet, on the clerk's queue, that's how full it was.
That whole reception area was cleared by 11:00am!!! Imagine my surprise when I still had about 6hrs before I had to go to work! I think I saw about 10 doctors from one point to another. There was a Doctor Eldridge, who was directing the queue. Telling people which section they need to go to, monitoring how quickly the lines moved, and so on.
The energy around was that of professionalism, respect and kindness. If this is how our people are treated on a daily basis, I would urge the department to keep it up. It restores people's dignity and not once did I feel like I was in a public hospital.
When I went to drop off my appointment letter to the X-ray department, I went past another section, where there were a lot of people. They had queue marshals who made sure people didn't stand unnecessarily long on wrong queues.
Ms Motloung concluded her email by saying; “Please keep up the level of service you render. Hopefully it would only go up from here.”
Ladies and Gentlemen, this is the story of the progress we are making, which is often not told. We often hear stories of babies and patients who die in our hospitals.
We often hear stories of botched operations and huge amounts of money paid on medico-legal costs.
Let me state unequivocally that we regret any loss of life and share our grief with families of those who have died in our health facilities, in the care of the government. Any death causes enormous pain and anguish among bereaved families. Health is about saving lives. It is for this reason when a number of people pass on in our care, we must ensure that there is an impartial investigation into the causes and circumstances of death. Death is always painful.
However, we must make sure that the story of Ms Motloung is also heard. We need more of this kind of positive and inspiring citizen feedback on the work we are doing. I was admitted at Bertha Gxowa Hospital last year and I saw how hard doctors and nurses are working to care for all patients. Also last year, my father was admitted to the St John's Eye Hospital at Chris Hani Baragwanath where his cataract was removed. When I visited the hospital, I made sure that I spoke to all patients in the ward to check how they were being treated a week before my father arrived. They all expressed happiness and commended the staff. Such stories are only possible because of your hard work and dedication.
Those who we are honouring this evening and many others in our public hospitals, clinics and health facilities are making it possible for us to receive such acclaim from the public.
Let us always bear in mind that all we do must be about and for the benefit of the people we serve. It is them who must feel the impact of our work. It is them we must
seek to please.
Congratulations to all those who will be receiving Awards this evening.
May your achievements inspire your fellow colleagues to also strive for excellence.
Keep up the good work.
Thank you!
