Date: 27/02/2007
Source: Department of Health
Title: Madlala-Routledge: Launch of Health and Democracy
Speech of Deputy Minister of Health, Ms Nozizwe Madlala-Routledge at the launch of Health and Democracy, held at the Constitutional Hill
Friends,
Colleagues and comrades,
"Everyone has the right to have access to healthcare services including reproductive healthcare, sufficient food and water and social security including if they are unable to support themselves and their dependants, appropriate social assistance. The State must take reasonable legislative and other measures within its available resources to achieve the progressive realisation of each of these rights. No one may be refused emergency medical treatment. "Section 27 of the Constitution of the Republic of South Africa, 1996."
It gives me great pleasure tonight to be the keynote speaker at the launch of this important new publication on South Africa's legal and policy framework for health and how it connects with human rights. However, it also gives me an opportunity to speak about the link between 'better health for all' and the law and human rights. Understanding this link is very important to our communities' progress in their battles against diseases such as HIV and tuberculosis (TB), but also in relation to the progress that we make against non-communicable diseases such as cancer and hypertension.
Just over 10 years ago the final Constitution of our new democracy bestowed upon our people and made reality of an idea that we had always argued for during the years of apartheid that is, that access to healthcare services as well as to the conditions that favour health is a human right.
We included it in our Constitution as a message to the people of South Africa that, from now on, any government of our country must pay attention to progressively meeting the health needs of the population, that this is a duty and not a choice for government. Implicit in this decision was also our recognition that even in a free society, our people may need to hold government to account for the delivery of essential services.
Whilst we do not need to justify making health a human right in terms of South Africa's Constitution, there are of course other very important reasons why we must do all we can to improve health. These reasons are set out particularly clearly in the 2001 report of the World Health Organisation's (WHO's) Commission of Macro-Economics and Health, which showed that governments that invest in health will derive benefits in development and equality. Put another way this means that ensuring that people can live in dignity, free from disease, is good for development.
The opening pages of this book quotes from the judgment of the previous Chief Justice, Arthur Chaskalson in the Soobramoney case. There he said:
"We live in a society in which there are great disparities in wealth. Millions of people are living in deplorable conditions and in great poverty. There is a high level of unemployment, inadequate social security and many do not have access to clean water or to adequate healthcare services."
"These conditions already existed when the Constitution was adopted and a commitment to address them and to transform our society into one in which there will be human dignity, freedom and equality lies at the heart of our new constitutional order. For as long as these conditions continue to exist that aspiration will have a hollow ring." Soobramoney v Minister of Health, KwaZulu-Natal 1998 (1) SA 765 (CC) at para 8.
We are proud of the strength and independence of our judiciary which allows for judgments such as this. But well considered and groundbreaking judgments are not enough. If judgments such as this are not accompanied by a concomitant change in the living conditions of the poorest among us then we have failed in our respective duties as leaders, human rights lawyers, activists and citizens.
As we consider the Soobramoney case, let us be reminded that while those who have the means can buy lifesaving healthcare and medicines, the poor often die prematurely of treatable or curable diseases. While our decision to focus our limited resources on prevention and primary healthcare was the correct one, the disease burden in our country requires that we begin to reallocate resources to secondary and tertiary healthcare. Some of the diseases that were considered to afflict only the rich, like heart disease, hypertension and diabetes have reached epidemic proportions affecting even the poorest communities.
The values expressed in the Soobramoney judgment are encapsulated in the Freedom Charter and were held passionately even as we struggled for freedom, prior to the advent of democracy in 1994. They are views that have influenced us in the development of a raft of policies and laws that have been introduced since 1994.
Incidentally, one of the exciting things about this book is that it is to the best of my knowledge, the first time that all of our health law and policy have been described in one place. But the important thing for me tonight is to say that the recognition of human rights in our law begs another important set of questions. These are:
1. Are we doing enough to educate our communities about their rights to health?
2. Are we doing enough to educate healthcare workers and managers about their duties under these laws?
3. Are we doing enough to allocate our limited resources correctly to respond to the growing disease burden?
4. How can we assist poor communities so that they have access to legal services when they are forced to resort to the law to either protect rights or to demand them when we fail to meet our obligations as a government (at whatever level)?
In this respect, we see how the question of access to healthcare services overlaps greatly with the question of access to legal services and indeed there are many parallels between the challenges facing these two systems. Both the health and legal services are characterised by inequalities between the public and private sectors where people who can afford to pay can generally get good services. In both the legal and health sectors we suffer from a drain of our promising young graduates away from providing public care to providing private care.
My wish is that this book might help to inspire some of the young people who are now studying law in our universities to see the opportunities that our legal and policy framework has created for ensuring that we meet our obligations.
I hope that it might open the doors to a new generation of lawyers to see in the struggle for health, an opportunity to follow in the footsteps of lawyers such as Nelson Mandela, Braam Fischer, Victoria Mxenge (who started off as a nurse), George Bizos, Chief Justice Pius Langa, Kate O'Regan, Judge Yvonne Mokgoro, Felicity Kentridge and many others. All of these people represent the values of courage, compassion and selflessness which continue to inspire others who are choosing public interest law instead of going into the private sector where they can make lots of money. Similarly in the health sector, we have committed people who have chosen to remain in the public sector at great personal sacrifice. I hope that holding this launch here in the Constitutional Court tonight will highlight some of these connections.
Finally, I would like to say that, as the government puts the finishing touches to our country's National Strategic Plan on HIV prevention and treatment, it is very important that the pillar of human rights and law points a way forward to ensure that we take advantage of the framework described in this book but also fill the gaps in policy and law that may continue to have an effect in denying people access to basic healthcare services.
Thank you!
Issued by: Department of Health
27 February 2007
Source: Department of Health
Title: Madlala-Routledge: Launch of Health and Democracy
Speech of Deputy Minister of Health, Ms Nozizwe Madlala-Routledge at the launch of Health and Democracy, held at the Constitutional Hill
Friends,
Colleagues and comrades,
"Everyone has the right to have access to healthcare services including reproductive healthcare, sufficient food and water and social security including if they are unable to support themselves and their dependants, appropriate social assistance. The State must take reasonable legislative and other measures within its available resources to achieve the progressive realisation of each of these rights. No one may be refused emergency medical treatment. "Section 27 of the Constitution of the Republic of South Africa, 1996."
It gives me great pleasure tonight to be the keynote speaker at the launch of this important new publication on South Africa's legal and policy framework for health and how it connects with human rights. However, it also gives me an opportunity to speak about the link between 'better health for all' and the law and human rights. Understanding this link is very important to our communities' progress in their battles against diseases such as HIV and tuberculosis (TB), but also in relation to the progress that we make against non-communicable diseases such as cancer and hypertension.
Just over 10 years ago the final Constitution of our new democracy bestowed upon our people and made reality of an idea that we had always argued for during the years of apartheid that is, that access to healthcare services as well as to the conditions that favour health is a human right.
We included it in our Constitution as a message to the people of South Africa that, from now on, any government of our country must pay attention to progressively meeting the health needs of the population, that this is a duty and not a choice for government. Implicit in this decision was also our recognition that even in a free society, our people may need to hold government to account for the delivery of essential services.
Whilst we do not need to justify making health a human right in terms of South Africa's Constitution, there are of course other very important reasons why we must do all we can to improve health. These reasons are set out particularly clearly in the 2001 report of the World Health Organisation's (WHO's) Commission of Macro-Economics and Health, which showed that governments that invest in health will derive benefits in development and equality. Put another way this means that ensuring that people can live in dignity, free from disease, is good for development.
The opening pages of this book quotes from the judgment of the previous Chief Justice, Arthur Chaskalson in the Soobramoney case. There he said:
"We live in a society in which there are great disparities in wealth. Millions of people are living in deplorable conditions and in great poverty. There is a high level of unemployment, inadequate social security and many do not have access to clean water or to adequate healthcare services."
"These conditions already existed when the Constitution was adopted and a commitment to address them and to transform our society into one in which there will be human dignity, freedom and equality lies at the heart of our new constitutional order. For as long as these conditions continue to exist that aspiration will have a hollow ring." Soobramoney v Minister of Health, KwaZulu-Natal 1998 (1) SA 765 (CC) at para 8.
We are proud of the strength and independence of our judiciary which allows for judgments such as this. But well considered and groundbreaking judgments are not enough. If judgments such as this are not accompanied by a concomitant change in the living conditions of the poorest among us then we have failed in our respective duties as leaders, human rights lawyers, activists and citizens.
As we consider the Soobramoney case, let us be reminded that while those who have the means can buy lifesaving healthcare and medicines, the poor often die prematurely of treatable or curable diseases. While our decision to focus our limited resources on prevention and primary healthcare was the correct one, the disease burden in our country requires that we begin to reallocate resources to secondary and tertiary healthcare. Some of the diseases that were considered to afflict only the rich, like heart disease, hypertension and diabetes have reached epidemic proportions affecting even the poorest communities.
The values expressed in the Soobramoney judgment are encapsulated in the Freedom Charter and were held passionately even as we struggled for freedom, prior to the advent of democracy in 1994. They are views that have influenced us in the development of a raft of policies and laws that have been introduced since 1994.
Incidentally, one of the exciting things about this book is that it is to the best of my knowledge, the first time that all of our health law and policy have been described in one place. But the important thing for me tonight is to say that the recognition of human rights in our law begs another important set of questions. These are:
1. Are we doing enough to educate our communities about their rights to health?
2. Are we doing enough to educate healthcare workers and managers about their duties under these laws?
3. Are we doing enough to allocate our limited resources correctly to respond to the growing disease burden?
4. How can we assist poor communities so that they have access to legal services when they are forced to resort to the law to either protect rights or to demand them when we fail to meet our obligations as a government (at whatever level)?
In this respect, we see how the question of access to healthcare services overlaps greatly with the question of access to legal services and indeed there are many parallels between the challenges facing these two systems. Both the health and legal services are characterised by inequalities between the public and private sectors where people who can afford to pay can generally get good services. In both the legal and health sectors we suffer from a drain of our promising young graduates away from providing public care to providing private care.
My wish is that this book might help to inspire some of the young people who are now studying law in our universities to see the opportunities that our legal and policy framework has created for ensuring that we meet our obligations.
I hope that it might open the doors to a new generation of lawyers to see in the struggle for health, an opportunity to follow in the footsteps of lawyers such as Nelson Mandela, Braam Fischer, Victoria Mxenge (who started off as a nurse), George Bizos, Chief Justice Pius Langa, Kate O'Regan, Judge Yvonne Mokgoro, Felicity Kentridge and many others. All of these people represent the values of courage, compassion and selflessness which continue to inspire others who are choosing public interest law instead of going into the private sector where they can make lots of money. Similarly in the health sector, we have committed people who have chosen to remain in the public sector at great personal sacrifice. I hope that holding this launch here in the Constitutional Court tonight will highlight some of these connections.
Finally, I would like to say that, as the government puts the finishing touches to our country's National Strategic Plan on HIV prevention and treatment, it is very important that the pillar of human rights and law points a way forward to ensure that we take advantage of the framework described in this book but also fill the gaps in policy and law that may continue to have an effect in denying people access to basic healthcare services.
Thank you!
Issued by: Department of Health
27 February 2007
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