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Date
: 10/06/2003
Source: Ministry of Health
Title: R Schoeman: Health Dept Budget Vote 2003/2004, NCOP
SPEECH BY RENIER SCHOEMAN, MP, DEPUTY MINISTER OF HEALTH, HEALTH
BUDGET DEBATE, National Council of Provinces, 10 June 2003
Honourable Chair
Hon. Minister
Hon. Provincial Ministers of the NCOP
When I was appointed as Deputy Minister of Health on 4 November
2002, I said that I saw my appointment not only as a challenge but
also as a great opportunity to serve my country and this view has
been reinforced by all my experiences since my appointment.
I have also made a point of repeating as often as I can that I
believe that there is a new positive political dynamic of putting
South Africa's interest first gaining momentum. I hold this view
because there is an increasing acceptance that the problems of
South Africa are shared problems which call for a shared commitment
to resolve. I will continue to play a positive role in this regard
to the best of my ability and in the knowledge that by serving the
common good, the interests of all are best served.
I also wish to record, in this House, my appreciation for the warm
welcome I have been accorded in the National Ministry and
Department of Health, from the Provincial Health Ministers and
their Departments, from the Chairs and members of the portfolio
committees dealing with health in the National Assembly as well as
the National Council of Provinces, and from the health private
sector. As a functionary in the National Ministry I have been
impressed by the excellent and valued co-operation in MINMEC
chaired and led by the Hon. The Minister of Health. It is a good
example of excellent tem work and the collective effort in a spirit
of common purpose.
Dit is vir my 'n voorreg om deel te wees van hierdie groot en
toegewyde span wat oor die lengte en breedte van ons land strewe
vir gesondheid en gehalte mediese dienste vir al ons mense.
SPECIAL ROLE OF NCOP
In supporting the budget vote for health in this chamber today, I
would like to recognise the special and valuable role played by
members of the National Council of Provinces especially in
portfolios where the Constitution assigns concurrent functions to
national and provincial spheres of Government.
The role of this Council in terms of the processing of legislation
is well understood but its value in terms of ensuring
accountability is perhaps underestimated and not always given
adequate recognition. In portfolios such as Health the greater part
of the "national" budget is effectively spent by provinces. The
Select Committee on Social Services under the able leadership of
the Hon. Loretta Jacobus promotes significant interaction with
provinces, which assists not only in monitoring expenditure but
also in understanding the particular successes and challenges of
individual provinces and I would like to acknowledge this
specifically today.
The combination of provincial visits by members of the NCOP,
reports to NCOP hearings and the active participation of Health
MECs in the debates of the NCOP contributes in a unique way to the
vital interactive role which the NCOP plays in health
administration in South Africa.
ROLE OF AND NATIONAL HEALTH LABORATORY SERVICE AND ITS SUPPORT FOR
PROVINCES
A critical factor in the quality of provincial health services is
access to support services, such as laboratories, blood supplies,
etc. Both of these services have been restructured in recent years
to form national entities that strive to serve all of South Africa
on an equal footing. The restructuring was perhaps more fundamental
in relation to the laboratory services where a large number of
provincial laboratories were drawn together with national research
organisations to form the National Health Laboratory Service.
The NHLS was born as a public entity in October 2001 and is sole
provider of laboratory services to the provincial health
departments. It has almost 300 laboratories around the country and
its budget presently runs close to R970-million - most of which is
funded by fees for service.
A high-profile component of the NHLS is the National Institute for
Communicable Diseases which has a well deserved reputation in the
international arena for research and for specialised support to the
continent of Africa in relation to outbreak control. But ultimately
the success of the NHLS will depend on its less high profile
elements - the laboratories, large and small, in all parts of the
country that support clinicians in thousands of public hospitals
and clinics in the provinces, on a daily basis.
I therefore say that the NHLS has a critical role to play in
building the health infrastructure of this country also in
provinces and also enabling rural hospitals, in particular, to
function at a more effective level.
I am therefore pleased to note that the NHLS has experienced a more
stable period in the last nine months, after a difficult year which
culminated in the resignation of the first chief executive officer.
We have had a caretaker CEO in place since October last year - in
the person of Dr Nicholas Crisp and under his guidance and dynamic
leadership and that of the chairperson, Ms Sesi Baloyi, the
organisation has stabilised and its services are improving
steadily. We wish to thank both Dr Crisp and Ms Baloyi for the
effort they have invested to get the service back on a firm and
effective footing.
It is against this background that a new CEO, Mr John Robertson,
has recently been appointed. I am confident that he has the
necessary insight and experience to continue to take the NHLS
forward, paying close attention to the needs of provinces where the
service is least developed, and the needs are greatest.
MEDICOLEGAL MORTUARIES
Another area in which restructuring has been long-awaited is the
medico-legal mortuaries. This year we expect to see further
movement n terms of the transfer of these mortuaries from the
police service to the provincial health departments.
Members of the NCOP will appreciate that it is in the interests of
justice that the medico-legal services are run by skilled
professionals, with well trained assistants, whose independence in
providing evidence to the courts is beyond question. The current
arrangement, whereby mortuaries are run by the police service and
mortuary assistants are police personnel, does therefore need to be
adapted so that that the service in its entirety will eventually
vest in the health sector, where it belongs.
Treasury has allocated funding for the capital works that need to
be carried out at mortuaries to create facilities conducive to high
quality work. We are discussing with Treasury the flexible
utilisation of such finance over two or three financial years. The
Police Service has confirmed that funding for all medico-legal
posts will be transferred to provincial health departments.
All provinces are giving their full co-operation and four provinces
have already indicated that they would be in a position to begin
the transfer of medico-legal mortuaries within 12 months of
receiving funding for the renovations contemplated. From the side
of the national Department we will continue to approach the matter
with a sense of urgency.
PHARMACEUTICAL FRAUD
Another area where collaboration with the criminal justice system
has become critical - and increasingly successful - is that of
pharmaceutical fraud. I am informed that a number of provinces have
in the past year made significant breakthroughs in unmasking
criminal syndicates at work selling state drugs to the private
sector.
But criminals are notorious for their inventiveness - and the
Internet is increasingly becoming a vehicle for illicit trafficking
in pharmaceutical products. The illegality of the practice lies in
the cross-border nature of the operation, the fraudulent issuing of
prescriptions to support Internet mail orders and the fact that the
drugs are often unregistered and of dubious quality.
Fortunately these operations are not immune to police investigation
and just last month one such operation was uncovered in Cape Town.
The "pharmacy" to which foreign clients were sending their
electronic orders was nothing more than a suburban home. The
prescriptions needed to dispense the schedule 5 drugs on offer were
issued by Cape Town doctors who had never seen their so-called
patients.
The public needs to be made aware of how dangerous such operations
are and that so called "virtual pharmacies" are no substitute for
the real thing. Fortunately for the public, the medicines industry
is a competitive field and there are thousands of legitimate
operators who are on the side of the law and who have also proved
to be valuable sources of intelligence about illicit operations for
which we must thank them.
HIV/AIDS AND ANTI-RETROVIRALS
In my participation in the Health Vote in the National Assembly a
few weeks ago I made the point, that the view sometimes expressed
from outside the system, that the major challenges of HIV/AIDS and
TB are not taken seriously enough from the side of Government, does
simply not accord with the commitment I have seen within the public
health sector to strengthening our ability to face up to the twin
scourges of HIV/AIDS and TB.
The fact that at this very moment serious consideration is being
given by Government, inter alia, to the matter of the extent of
anti-retroviral treatment further underlines the seriousness with
which the challenge of HIV/AIDS is being approached.
Maar dit is ook nodig om weer op rekord te plaas dat die NNP wel
deurlopend konsekwent sy standpunt handhaaf oor 'n belangrike aspek
van die hantering van die MIV/Vigs probleem en dit gaan spesifiek
oor die kwessie van beskikbaar- heid van anti-retrovirale
middels.
The consistent view of the NNP on the highly topical issue of
provision of ANTI-RETROVIRALS is a matter of clear public record
and was articulated again recently, as, follows by the National
Leader of the NNP when he said and I quote:
"We say South Africa has a moral duty to assist the millions of our
fellow citizens who are infected with HIV/AIDS. We must intensify
our war against the pandemic. In this war we must stop at nothing
to win. The NNP therefore calls on Government to urgently spell out
its road map for comprehensively treating the millions of South
Africans already infected - especially with regard to rolling-out
the use of anti-retroviral (ARV) treatment.
The additional R3.3 billion in this year's budget for fighting Aids
is great news. Combined with the massive awareness campaigns,
home-based care initiatives voluntary testing and counselling and a
range of other measures, it shows that Government is serious about
this battle - but the critical element which is still missing at
this stage is a plan for harnessing ARV drugs as part of the
national treatment strategy.
We believe that for the millions of people who are living with HIV,
a clear, unequivocal commitment from Government will provide great
hope for those who need it most and this needs to happen as soon as
possible".
However, apart from this issue, I have said before and say so again
that I have come to appreciate the sense of purpose that lies
behind a clear programme of action that is unfolding in accordance
with the Department's five-year national strategy, and any claim
that there is currently no plan for HIV and Aids is simply not
true.
PUBLIC PRIVATE PARTNERSHIPS
Among the more interesting developments of the past two years is
the birth of various partnerships between the public health care
sector and private enterprise. Most of these PPP initiatives are
young and experimental and they are quite diverse in nature.
They range from enterprises where the shares are divided between
government and the private sector, to differentiated facilities
within public hospitals, to Government funding of non-profit
organisations and private sector sponsorship of public health
campaigns.
A new entity for vaccine production has been brought into existence
as a result of a partnership between the Department of Health and
the Biovac Consortium. The purpose of this partnership is to revive
South Africa's vaccine production capability through an infusion of
private investment.
Hospitals in a range of provinces have accommodated private
patients or private sector initiatives within their premises.
* Among these is the Johannesburg Hospital that experienced
immediate success with the provision of amenities for private
patients - to the extent that it had to expand its capacity within
just a few months of the launch last year
* Universitas and Pelonomi Hospitals in Bloemfontein have similarly
used excess ward space to provide private facilities and to
generate income for the renovation of both hospitals.
In KwaZulu-Natal the flagship PPP is the new Inkosi Albert Luthuli
Hospital where a range of non-clinical functions has been
outsourced. The underlying objective is to achieve better service
especially in fields where the public sector has not been
particularly effective. These include the provision and maintenance
of medical technology and information technology.
When it comes to partnerships with non-profit organisations, the
Department has recognised the potential of loveLife to add value to
public health programmes. The Department has entered into a
three-way partnership with loveLife and the Kaiser Family
Foundation to enhance health services for young people. At the
heart of this programme is the process of creating "youth friendly"
services within primary health care clinics. The aim by the end of
2003 is to have 150 youth friendly clinics up and running.
Thereafter the pace of roll out should increase to reach 3 000
clinics in three to five years. The partnership also sponsors the
loveLife Games, which are sporting events arranged in accordance
with the normal school sporting calendar but which offer
participants opportunities to develop life skills and improve their
knowledge of sexual health.
The recent multi-country Racing against Malaria initiative could
not have been achieved without the generous sponsorship of a whole
number of private sector companies. The 4X4 vehicles for the rally
as well as many other costs were covered by donation. And - as in
all the above examples - the real beneficiaries have been the
millions of people who depend on the public health sector.
CONCLUSION
Since taking up my position as Deputy Minister, I have come to
appreciate the special and useful co-operation that exists between
the health ministers of the SADC countries. I have also become
aware of the extent to which Minister Tshabalala-Msimang plays a
significant role in promoting and nurturing this co-operation. For
example her presence at every major event along the route, of the
recent malaria rally, really demonstrates the kind of time, energy,
and commitment she devotes to regional co-operation to the benefit
of the entire region.
Chairperson and members, I propose that the budget vote for health
be supported. The programmes that are funded are appropriate. They
are central both to the continuing improvement of the health sector
and to providing ongoing support to provincial health departments
in their delivery of services to the people of this country.
Ek steun graag hierdie begrotingspos en doen dit met
vrymoedigheid.
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