Date: 05/06/2009

Source: Democratic Alliance

Title: DA: Waters: Speech by the DA shadow minister of health at the State of the Nation debate in Parliament

Mr. Speaker.

Hon President, Deputy President and Members.

Healthcare in our country is a constitutional right.

The Constitutions states that "Everyone has the right to have access to health care services."

The Democratic Alliance believes passionately in this right that all South Africans no matter how poor should have access to health care. However, having a constitution stating this right is not good enough in itself. We need to deliver on this right.

Currently most South Africans can access free health care through the many clinics and hospitals. What most South Africans still do not have access to, though, is quality health care. And despite the hard work of many nurses and doctors in our public health system our public health care is in need of fundamental emergency attention if we are ever to provide quality health care.

When the previous Minister of Health was appointed less than a year ago, Mr Speaker, the DA offered a hand of co-operation to the Minister. We promised we would work hand in hand with the Minister in order to improve health care in our country, today we extend that same hand to the new Minister and offer to work with him for the betterment of health care.

We may not always see eye-to-eye but that in itself does not mean we both do not want the same outcomes.

The first thing we all need to do, if we are to improve health care is to admit that we are in a crisis. If we refuse to admit that we will never improve health care.

In the Sunday Times this weekend, Dr Lucas Ntyintyane wrote "Heath providers are gatvol. They are not appreciated and their social needs ignored. Health Ministers are not fired for incompetence, but for losing political favour. Manto Tshabalala-Msimang is a case in point. Today the country is reaping the rewards of her incompetence and inefficiency."

As we must hold all our elected representatives accountable we too must hold those accountable who are supposed to be managing out hospitals and clinics.

Management of any institution is critical if we want to provide better health care. If we take the appointment of CEOs of hospitals as a joke and an opportunity to give jobs to pals then we must not be surprised when these very institutions crumble through the quality of services they provide. It is no wonder doctors and nurses are pulling their hair out due to the lack of basic equipment such as lax co gloves and masks. This prevents them from doing what they see as there vocation. Not a job but a vocation.

Take the appointment of the CEO of the Frere Hospital complex for example. Situated in East London and responsible for the health care of tens of thousands of people. It is also the hospital where we have a high number of stillborn deaths each year. We failed to appoint a person who has some qualification in administration and in doing so we failed the people of Greater East London. We appointed - we meaning the department of Health - an ANC Councillor form Buffalo City.

If we do not take the appointment of vital positions seriously we simply do not take the quality of health care seriously. And we will simply continue wasting valuable taxpayers' money through continued inefficiencies and incompetence.

The Hon President mentioned in his speech that the National Health Insurance scheme would be phased in. Before we do that we need to get the basics right as far as the appointment of good managers at all levels of the health system. Failing that, no amount of money will be able to improve health care.

The DA is also concerned that there has been no formal public participation or scrutiny with regards to the NHI. A policy of such significant public importance demands extensive consultation. It is also of great concern that while doctors are not being paid we do not know how much all these extra layers of bureaucracy are going to cost us. We would like to see the costing report from treasury being made public.

The current crisis with regard to the working conditions and salaries of doctors needs urgent attention. The fact that a junior doctor in the public sector earns the same amount as a Gauteng bus driver is indicative of the apathy with which the government has taken doctors concerns and the degree to which it has taken advantage of their commitment and compassion.

The Government has over the years allowed a climate to be created where doctors see no other option but to strike during their lunch hour. The Democratic Alliance fully supports the doctors' call for improved working conditions and salaries.

In a situation where the public sector is buckling under the weight of 12 000 vacant doctor positions and 42 000 vacant nursing the government should be dealing with the doctors strike as an emergency failing to do so will not only increase the number of doctors leaving the public sector but also deter young people from becoming doctors and nurses.

Another burden on our already over stretched resources is the burden of HIV/AIDS. You stated, Mr President that one of your government goals is to reduce the rate of new HIV infections by 50% by the year 2011.

Every day 1000 people die from AIDS and 1 700 are infected with HIV.

Uganda has shown us all that a key ingredient in the fight against HIV/AIDS is political leadership with a consistent understandable message, something which has been severely lacking in our country for the last 15 years. This, Mr President, must be a top priority for you and your new Government - we desperately need political leadership if we are ever going to combat the spread of HIV and for you to achieve this goal.

Another priority for the new Government has to be the growing child mortality rate - or the number of children dying before they reach the age of 5. South Africa is one of only a few countries in the world where the number of children dying is rising. Across the country, almost one out of every 10 children born will not survive until the age of five.

Mr President, the health of young people in this country is intertwined with the way in which young people are treated; with the levels of crime and the assistance we offer to victims. Two years ago we heard in a State of the Nation address that "the abuse of women and children continues at an unacceptable level". Earlier this year, President Motlanthe stated that "crimes against women and children have not abated in any significant measure." The rhetoric has remained unchanged, but we are failing to win this battle.

We cannot build a united prosperous nation while so many of the poorest South Africans, the most vulnerable South Africans, feel trapped in a web of terror and crime. We cannot build a united prosperous nation while the crucial centres for victim support, such as the Family Violence, Child Protection and Sexual Offences units, are sidelined by government. Just as centralisation and cadre deployment continue to stifle our ability to deliver healthcare to South Africans, so the same problems hinder the support we offer to those needing healthcare, including victims of crime.

Mr President, the DA reiterates its commitment in improving health care for all South Africans, yes there are many challenges but none to difficult to conquer if we are prepared to make those tough decisions and by holding to account those who fail to deliver and reward those who do.

I thank you.