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1. The National General Council noted the presentations to the commission on the Mid-Term Report and the National Health Insurance (NHI).

2. The NGC further noted the resolution of a meeting between ANC Officials and all the Premiers, MECs, ANC Provincial Chairpersons and the Chairperson of the Portfolio Committee, that provinces should prepare ANCQuarterly Health Monitoring Reportsthat must include information on:
appropriate appointment of HODs, CFOs, hospital CEOs, district health and clinic managers, with relevant competency and qualifications;
financial expenditure patterns of provincial health departments;
the Infrastructure Delivery Improvement Programme and capital projects (under-spending will not be allowed);
increase in employment of doctors, nurses, health technicians and other health professionals;
integration and increase of Community Health Workers;
the re-introduction of nurse training and re-opening of nursing schools and colleges;
increased training of doctors and other technicians;
monitoring of the availability of medicines, especially on antiretrovirals (ARVs), anti-TB drugs and chronic medication;
mortality trends on stillbirth rate, infant mortality rate, maternal mortality rate and avoidable deaths.
Health as a national priority
The NGC identified the following ongoing deficiencies and challenges:
Delays in the referral system.
Ineffective complaints systems.
Lack of cleanliness.
Insufficient communication between the public and the Department of Health.
Inconsistent compliance with the National Health Act.
Lack of space in clinics, especially in KwaZulu Natal and Eastern Cape.
Unavailability of emergency services, which contributes to infant mortality.
Competition among provinces, especially in attracting health workers
The NGC re-emphasised resolutions of the 52nd National Conference, of making health a priority, and the following principles:

4.1 Capacity building and training of Hospital CEOs, District and Clinic managers and HODs.
4.2 Appointments of managers subject to signing of performance agreements.
4.3 Emergency medical services should be decentralised.
4.4 Strengthen the monitoring systems in the ANC.
4.5 Political education for health workers to enhance service delivery.
4.6 Equitable distribution of resources.
4.7 Review the funding formula to consider previously disadvantaged areas.
4.8 Improve disaster management in hospitals.
4.9 Extend services hours for clinics and community health centres, which should be standardised in all provinces.
4.10 Batho Pele principles should be upheld by all, including clerks, porters, cleaners and gardeners.
4.11 Ethics should be taught to social, health and education workers.
4.12 Attitudes of health workers is of great concern and must be improved.
4.13 Provision of food vouchers for people who are taking TB and ARV treatment.
4.14 Supervisors should do their work.
4.15 The infrastructure in some clinics and hospital in rural areas is dilapidated.
4.16 Extend coverage of immunisation.
4.17 Offenders to be looked after properly to avoid high defaulter rate.
4.18 Shortage of appropriate drugs in clinics.
4.19 Clinics should be fully staffed with all relevant professionals.
4.20 Provincialisation of municipality clinics must be concluded.
4.21 Sick bays in schools should be utilised to promote relevant health campaigns like contraception and a service point for various health needs.
4.22 Re-visit the resolution on the "creation of a single public service".
4.23 Toll free number for emergency services.
4.24 Availability of officials of DoH for engagement with stakeholders.
4.25 A healthy nation with a bias to rural and poor areas.
4.26 Collective bargaining in the public sector should be done in time and include multi-year agreements instead of annual agreements.
4.27 Environmental Health Officers or health inspectors should be relocated to provinces.
4.28 Nurses and doctors in rural areas be provided with accommodation.
Community Development Workers (CDW)/ Home Based Care Workers (HBCW)/ Community Health Workers (CHW)

5.1 Training of CDWs should include accredited certificates.
5.2 CDWs should be integrated into the public sectors.
5.3 Ensure that CDWs are paid their stipends on time.
5.4 CDWs should be paid salaries not stipends.
5.5 There should be a flagship programme that integrates the work of social development, health and rural development at the level of the ward.
5.6 Community Health Workers do a lot of work, and as such need to be given necessary recognition. They should be paid their stipend in time.
Public participation, mass mobilisation and campaigns

6.1 Encourage health volunteers, who should also be trained in basic life-support skills.
6.2 Strengthen hospital boards and clinic committees.
6.3 Redistribute the pamphlets on the health and education campaigns.
6.4 Branches should organise health awareness campaigns.
6.5 Educate the communities about the referral system.
6.6 Integration of CBOs/NGOs in the provision of comprehensive health care.
6.7 Popularise exclusive breast feeding.
6.8 Encourage all households to have First Aid kits.
6.9 Popularise the healthy lifestyle campaign.
6.10 Provide free sanitary towels to all women, especially to girls and young women.
6.11 Stricter enforcement of the Liquor Act, which provides for age restrictions.
6.12 Ban alcoholadverts on TV and radio.
6.13 Promote a gun free South Africa.
6.14 Organise HIV Counselling and Testing at all major events of the organisation.
6.15 Protect community facilities like clinics and schools.
6.16 Promote primary care health principles.
6.17 Simplify the Patients' Rights Charter and translate it into different languages.
6.18 Femidoms should be made available freely to all women.
Human Resources Challenges

7.1 Utilise retired professionals.
7.2 Encourage trained doctors from rural areas to return to their area.
7.3 Remuneration of health workers should be improved.
7.4 Nurses' salaries should be improved to curb moonlighting.
7.5 Recruit health workers who have emigrated to other countries.
7.6 Consider recruiting Cuban professionals who have been laid off, as part of our solidarity work.
7.7 Address the skills and deployment mismatch.
7.8 Develop a common understanding and agreement of the definition of what constitute essential services.
7.9 Restructuring should be in line with Occupation Specific Dispensation (OSD).
7.10 Train more researchers on different fields, which are important in health care.
7.11 As part of research work a group of three African scientists have developed a Nano-technology capsule for the treatment of TB.
Nursing Training

8.1 Evaluate broadly the training of nurses.
8.2 Reopening of nursing schools and colleges should be uniform across all provinces.
8.3 Training of nurses should be hospital-based and decentralised.
8.4 An holistic approach has been neglected by the health worker.
8.5 Nurses should be more practical.
8.6 A nursing directorate should be established.
Health cost drivers

9.1 Review the National Health Laboratory Service (NHLS), as it's one of the cost drivers.
9.2 Establish a state owned pharmaceutical company.
9.3 Promote renewable energy.
9.4 Establish partnerships with cooperatives.
Priority groups

10.1 Develop targeted approaches to the health of women, children and the elderly.
10.2 Address the situation in provinces where health is combined with other mandates, so that it can be a stand-alone mandate.
10.3 Environmental health be prioritised as part of health campaigns.
National Health Insurance

Support and implementation

11.1 The NGC noted the overwhelming support for the National Health Insurance (NHI). The implementation of NHI should be fast-tracked, but done correctly within a reasonable time frame.
11.2 Widespread publicity on the NHI needs to be undertaken, involving road shows, TV and radio adverts e.g. "NHI is here, feel it".
11.3 The ANC must lead the implementation of the NHI and its promotion among the general populace. The involvement and support of the Alliance is crucial.
11.4 The roll out should begin in the rural areas.

Service providers

11.5 There should be freedom of choice of service providers
11.6 Accreditation shouldn't disadvantage under-resourced hospitals and clinics.