The following speech extract was delivered by Dr Nomafrench Mbombo, the Western Cape MEC of Health, during the State of the Province Debate in the Western Cape Provincial Parliament
Honourable Speaker,
Honourable Premier of the Western Cape,
Members of provincial cabinet,
Honourable members,
Community leaders in the gallery,
Members of the media,
And most importantly, the people of the Western Cape.
Good morning.
Honourable Speaker, allow me to thank the Honourable Premier who on Friday reminded us that for government, building a capable state, is the great “moral imperative” for creating a decent life for the people of this province.
Our economy, at the hands of the opposition, is in decline. Those in business have been sounding the warning bells for some time.
However, this decline also impacts the pockets of the poor and on government’s ability to deliver public services - especially healthcare.
It is imperative for government to create an environment that improves the health of its population by investing in health services.
As the UN’s Ban Ki Moon said: “investment in basic services can bring a six fold increase in economic return. Healthy populations have higher life expectancy, go to school, are more productive, have lower birth rates and thus invest more in fewer children.”
Our country has invested in legislative frameworks, policies, strategies, charters, plans, protocols, guidelines and reforms.
Despite these interventions, nationally, health outcomes remain low and the poor quality of services is the norm rather than exception.
The question is why?
Honourable Speaker, let us not mince words.
The ANC national government does not care about giving poor South Africans access to healthcare. Look at the failure of the ANC government in building a capable health system.
Firstly, is appointment of a competent workforce.
Secondly, is the Human Resource for Health Strategy of 2011 is gathering dust.
Thirdly, the health leadership and management academy, formed in 2012, was nothing more than an attempt to reverse the damage caused by the appointment of incompetent cadres in the health sector.
The Eastern Cape is a prime example. They four HODs in one year continuing the trend of weak governance.
KwaZulu-Natal on the other hand, appointed a CFO suspected of financial management.
Madam Speaker, this is like appointing a fox to look after your chickens!
The actions of the ANC have frustrated access to healthcare services for the vulnerable members of our society.
By the end of the previous year it was estimated that there were some 14000 vacancies for doctors at state hospitals across the country.
This is not a new problem.
According to the Institute of Race Relations, in early 2013, Limpopo had the highest public sector doctor vacancy rate in the country, at 86%.
The Northern Cape was recorded at 57% while the Eastern Cape was set at 48%.
The vacancy rate for nurses was no better. Limpopo, once again, had the highest nurse vacancy rate at 68%, followed by the Eastern Cape at 67%, and the Free State at 47%.
With the slashing of provincial budgets, and still no tangible plan from national government for effectively filling vacancies, existing problems are sure to worsen across the country.
We have already seen government’s inability to absorb the new crop of health professionals into the system.
Madam Speaker, if we are prioritising redress and service delivery, then we cannot have young black medical professionals sitting at home nursing their degrees.
Any person with an understanding of our past, its footprint on our present and the current state of the economy will understand this.
As the Western Cape population grows, at 2. 6%, we are sure to see a rise in the number of people requiring access to public healthcare; irrespective of a shrinking public purse.
The question we are faced with is: How does government – in pursuit of creating a capable state – respond these conditions?
We all know how to build a strong resilient health system. The ANC however, from the very top, lacks the necessary leadership for this. We are all too aware that for the ANC of today, good governance and financial management are a long forgotten dream.
Near the end of last year, the Auditor General found that wasteful expenditure in Gauteng’s Health Department had amassed to R160-million. Not wanting to be outdone, Gauteng’s transport department followed suit with R251-million.
In the Eastern Cape, one of our least developed provinces, the Health Department, lost R74-million to wasteful expenditure. The North West Department of Health, amongst other departments in that province, found itself under administration and also accrued R263-million in irregular expenditure.
The ANC’s culture of financial mismanagement is woven into the fabric of the party. Millions that could be spent bettering the lives of ordinary South Africans are wasted lining the pockets of the ANC’s elite.
So what does effective and capable governance look like?
It is clean. It is innovative, responsive and governs with integrity. In the Western Cape we have maintained an 11 year track records of sound financial management as evidenced by unqualified audits.
We invest in and have revitalised healthcare infrastructure so as to improve the experience of patients and staff. By the end of the 2014/15 financial year, the Western Cape Health Department invested R712 923 000 in expanding and maintaining existing health infrastructure.
Honourable Speaker, rendering services that people need where they need them is critical to us. As I have mentioned before, the legacy of apartheid is evidenced by the vast inequality that still exists in our society.
As a result, the DA – led government is providing affordable quality healthcare to our people.
Honourable Speaker, on the score of service delivery, we have already achieved much.
- We have increased the number of clients on Anti-Retro-Virals from 75,000 in 2009/10 to 181 000 in 2014/15;
- Brought down the Prevention of Mother to Child Transmission rate from 3.6% in 2009/10 to 1.4 % in 2014/15. Gauteng only managed 2, 7 %.
- Our maternity mortality ratio is 78 as compared to the national norm of 146, the KZN ratio of 160, Mpumalanga at 173 and the worst performer, Limpopo with 185. In these provinces, being poor and pregnant is a death sentence.
- We have increased the TB Cure rate from 79.4% in 2009/10 to 80.6% last year, while our neighbours, the Eastern Cape, battle with 70.5% and Limpopo performing dismally at 64%.
Finally Honourable Speaker, responsiveness and innovation are at the heart of the Western Cape Government philosophy.
Even our loudest critics cannot dispute our track-record. The National Department of Health, in its National Health Insurance White Paper, borrows on best practice that already is the model for hospital management in the Western Cape.
One may say, rather late than never. We have already decentralized decision-making on budgets to the managers of healthcare institutions. By empowering healthcare professionals to make decisions about the priorities of their facility, the allocation of budgets and the appointment of staff can be tailored to the unique needs of facilities and communities.
Unlike in other ANC- governed provinces where facilities wait for months before a window is fixed, years before doctors are appointed and ages before service providers are paid resulting in medically compromising drug stock outs.
So deep is our commitment to providing quality healthcare, we have focused resources and policy development into integrating community healthcare workers in the Primary Healthcare system. Unlike anywhere else in the country.
Honourable Speaker, ours is a government that is quick on its feet. Indeed we have succeeded where others have failed.
Honourable Speaker, ours is a ready, able and capable government and the people of the Western Cape know it!
Media enquiries:
Luyanda Mfeka
Spokesperson to the Western Cape MEC of Health, Dr Nomafrench Mbombo
Cell: 079 546 9518
Email: luyanda.mfeka@westerncape.gov.za
