Date: 05/11/2009
Source: The Inkatha Freedom Party
Title: IFP: Buthelezi: Debate by the Leader of the IFP, on the Health six months service delivery protest, Durban

Madam Speaker

The past six months have been a period marked by the National Health
Insurance (NHI) vitriol, wildcat industrial action by doctors, the swine flu
furore, hysteria from the outbreak of measles, ARV rollout tragedy and
massive provincial budget over-expenditure. Some of the health institutions
are in a state of disrepair with collapsing roofs such as KEH, and there is
a lack of essential equipment. On Tuesday, it was reported in the media that
Addington Hospital in Durban is having cut its budget on bare essentials
such as surgical gloves, swabs and dressings. Other major hospitals are not
faring any better.

The freezing of medical and nursing posts affects service delivery, deepens
staff shortages, and prevents staff retention and professional development.
The Honourable MEC is faced with a daunting task of turning around the
Titanic of a public health system he has inherited from his predecessor
which has been a victim of many years of gross maladministration and
neglect. The province needs immediate and tough fiscal discipline to burrow
its way out from under a R2-billion deficit, ongoing incompetence, fraud and
appalling human resource management.

A special series of the respected medical journal, the Lancet, were
published in August focusing on the challenges of the South African
healthcare system. It spelled out in painful detail how many of our health
indicators are the worst in the world. South Africa is one of only 12
countries where mortality rates for children have increased since the
baseline for the Millennium Development Goals (MDGs) in 1990. The report
describes South Africa as a population overwhelmed by the quadruple of HIV,
TB, violence, poor maternal and child health and increasing chronic
diseases. The authors lay the blame for these poor indicators squarely at
the door of government. The Honourable MEC would do well in embracing the
scientific community following the hostile approach of his predecessor and
take constructive criticism without becoming furiously defensive.

The Lancet report does indeed make depressing reading. Years of
mismanagement and neglect in the provincial public healthcare sector have
taken a devastating toll in the last six months. Some of our statistics -
infant and maternal mortality rates, for instance - are rising, and our
tuberculosis and HIV epidemics are the worst in the world. We are also beset
by inequities among provinces where the Western Cape children under five
have a mortality rate of 46 per 1000 babies in comparison to KwaZulu-Natal's
116 children who die for every 1000 babies.

We understand that putting the mess to rights will be a lot tougher because
it is one thing to identify problems, and another to fix them. Until about
six months ago, government's response to these challenges has been marked by
denial, lack of political will, and poor implementation of policies and
programmes. However, since then, there have been notable achievements in the
expansion of TB control efforts and scale-up of the ARV treatment plan. But,
on the whole, decisive action is still needed to implement the Comprehensive
ARV programme and TB control measures.

I wish to present the IFP's perspective on these immediate challenges. We in
the Official Opposition welcome the vigorous debate on the National Health
Insurance (NHI). We welcome every initiative that seeks to address the key
challenges facing the current healthcare system. Despite our cautious
support of the NHI, the most urgent first step towards NHI is to improve the
standards of service in the current public health sector, which the majority
of South Africans continue to rely on.

The general public has to feel confident about using our health
institutions. There has to be public confidence in the levels of staff
training and competence. We all need to be reassured that the continuing
problems of stng addressed head on, the interaction between the health
professional and patient is empathic, medicines and medical equipment are
available, facilities are clean, the confidentiality and privacy of patients
is upheld, and waiting times are reasonable.

There is serious shortage of skilled health staff and thanks to the
ill-conceived decision to close a number of nursing colleges to save money
during the immediate past government as many as 40% of nurses are due to
retire in 5 to 10 years time. Poor leadership and failure to take
responsibility by health managers continue to run like invasive cancer
through the public health system. Many inexperienced managers have been
placed in positions of seniority through the ruling party's cadre deployment
and these managers have struggled to deal with major challenges,
particularly human resource management which has been centralised to Head
Office.

There must be an overhaul in the procedure of staff recruitment and
retention where the ability to deliver and rather than loyalty must be
rewarded. Managers must be held accountable for their actions when mistakes
have been made. The Department of Health must strive much harder to regain
the public confidence which is being progressively eroded by stories of
incompetence, failure and mismanagement. These are daunting tasks and it
appears they are getting more daunting by the day. Drastic measures have to
be taken to stop the rot and we in the Official Opposition can be relied on
to support such measures.

I thank you!