Date: 24/06/2004
Source: Ministry of Social Development
Title: Z Skweyiya: 75th Anniversary of Alexandra Health Centre


SPEECH DELIVERED BY DEPUTY MINISTER, DR JEAN BENJAMIN, ON BEHALF OF DR ZST SKWEYIYA, MINISTER FOR SOCIAL DEVELOPMENT AT THE 75th ANNIVERSARY OF THE ALEXANDRA HEALTH CENTRE AND UNIVERSITY CLINIC, Sandton, 24 June 2004

Distinguished guests
The management and staff of the Alexandra Health Centre and University Clinic
Representatives of community structures in Alexandra
Ladies and gentlemen

It would be inappropriate to begin this address without first acknowledging and thanking the dedicated doctors, nurses, technical staff and workers of the Alexandra Health Centre and University Clinic who have given 75 years of dedicated service to the people Alex.

Many of those staff and workers whose dedication inspired and sustained the Centre during its early years and during the dark days of apartheid are longer physically with us. Today, we celebrate their memories, and remember their friendship and solidarity. Today, as we celebrate and give thanks, we also re-dedicate ourselves to emulate their humanity, passion, fighting spirit, resilience, and spirit of self-sacrifice. Everyday, but especially today, is a day to make sure we pass on to future generations the stories of their humanity and valour.

It would also be inappropriate to begin this address without first saluting the sons and daughters of Alexandra; and all the former residents of Alexandra, including the first President of a democratic South Africa. The joys and sorrows, the boycotts, struggles, defeats, and victories of the people of Alexandra are embedded in our country's history. The culture, creativity, energy and destiny of the people of Alexandra encapsulate our country's future.

Everyday, but especially today, is a day to make sure we pass on to future generations the story of the humanity and vibrancy of the people of Alexandra. Alexandra, the "native township and black spot" - exists, it has survived, and it will thrive!

Seventy-five years and counting. We must not loose sight of the fact that critical institutions and great nations are built day by day through the countless acts of solidarity.

Programme director, I appreciate the opportunity to address this gala breakfast to celebrate the 75th anniversary of the Alexandra Health Centre and University Clinic. I have been requested to speak on the issue of delivery of social welfare services as this relates to health of our people and the economic benefits to our country. As I understand this topic, it is premised upon partnerships and solidarity between communities, professionals, organised business and labour, and government. So I will also speak to this issue, primarily in terms of the role and importance of corporate social investment.

I should pause here and ask for your indulgence for the long preamble. Before I speak to these specific issues, and I believe - in order to understand these issues properly - its first necessary to explain the concept of social development. The importance of community mobilisation, the issue of what are appropriate social welfare services, the question of how social welfare relates to individual and family health, the role of corporate social investments, and how all of these elements relate to the broader economy - I submit that all of these interrelationships are given coherence when anchored to a concept of social development.

In many ways the base document for the concept of social development is the Copenhagen Declaration of 1995, made at the conclusion of the World Summit for Social Development. The Copenhagen Declaration is a commitment to give the "highest priority in national, regional and international policies and actions to the promotion of social progress, justice and the betterment of the human condition, based on full participation by all."

The declaration acknowledges the "urgent need to address the profound social problems, especially poverty, unemployment and social exclusion that affect every country. It states, "it is our task to address both their underlying and structural causes and their distressing consequences in order to reduce uncertainty and insecurity in the life of people."

Based upon this understanding of social development and division of responsibilities among Cabinet portfolios, the strategic thrust of the work of the Department of Social Development was re-oriented to ensure:

* A commitment to social transformation,
* A focus on the task of reducing poverty and promoting social integration,
* Our work is based on partnerships and the Batho Pele principles of service delivery,
* Our actions are based upon solidarity and engender self-reliance,
* Our services encompass a range of human services

Our commitment to social transformation

We are committed to the agenda of social transformation that is embodied in the principle of social justice and the Bill of Rights contained in our Constitution. We endeavour to create a better life for the poor, vulnerable and excluded people in our society.

Our task is to reduce poverty and promote social integration. Our task is to develop and monitor the implementation of social policy that both creates an enabling environment for and leads to the reduction in poverty. We ensure the provision of social protection and social welfare services to all people who live in our land. We conduct research that develops social indicators necessary for programme implementation and public accountability.

Our work is based on partnerships and the Batho Pele principles of service delivery. All our work requires extensive and on-going consultation with all sectors of our society. Our programmes are integrated with those of other government departments and all spheres of government. We work in partnership with NGOs, faith-based communities, the business sector, organised labour, and other role players. We are committed to Batho Pele (People First) principles and use them to improve service delivery to our clients and the public.

Our actions are based upon solidarity and engender self-reliance. As social service professionals, we act on the basis of solidarity with all of humanity. We seek to empower communities and engender self-reliance by creating conditions for sustainable livelihoods. This involves expanding the range of choices available to communities.

Our services encompass a range of human services. Our development, social protection and social welfare services span the entire life cycle of human life and encompass advocacy, promotion, prevention, care, mitigation and palliation.

What does all of this mean for the people of Alexandra and how does it relate to the Alexandra Health Centre and University Clinic? The first step in answering this question is to specific the particular material conditions and context in which the social development challenges must be addressed? From both a national and community perspective the key elements of the challenge are poverty, unemployment, the HIV and AIDS epidemics, and the imperative of broad-based economic empowerment.

From the perspective of government's policies and programmes, the context and challenge is clearly detailed in government's Ten Year Review Discussion Document. Arising from this review, government has articulated its implementation programme for Vision 2014. The goals in Vision 2014 are:

* Contributing to reducing unemployment through sustainable community livelihoods
* Contributing to reducing poverty through comprehensive social security, and improved household and community assets
* Providing skills, building capacity and providing resources to encourage self-employment
* Ensuring that all South Africans, especially the poor and those at risk - children, youth, women, the aged, and people with disabilities - are able fully to exercise their constitutional rights and enjoy the full dignity of freedom
* Ensuring compassionate public service to the people; that national, provincial and local officials are accessible; and that citizens know their rights and insist on fair treatment and efficient services
* Contributing to reducing malnutrition and turning the tide against HIV and AIDS
* Contributing to building a society that can actively challenge crime and corruption and that promotes programmes that address the social roots of criminality
* Contributing to building a South Africa that is growing, prospering and benefiting all Africans, especially the poor.

From the perspective of social partners represented in the Nedlac process -organised business, organised labour, community organisations and government - the particular material conditions and context in which the social development challenge must be addressed are articulated in the agreements of the Growth and Development Summit. The summit identified key areas that require joint interventions from the Nedlac constituencies. They were: more jobs, better jobs and decent work for all; the skills challenge facing our economy; utilisation of socially responsible investment opportunities; and mobilisation of local collective action.

At the summit, business made a commitment to explore the potential for synergies between their corporate social responsibility programmes and

* Government's expanded public works programmes,
* Government's geographically targeted poverty eradication initiatives (namely, the Integrated Sustainable Rural Development Programme and the Urban Renewal Programme), and
* The Integrated Development Plans (IDPs) of municipalities.

The agreement reach at the Growth and Development Summit, the public investment initiatives it details, and the socially responsible investment opportunities it outlines; is a framework for our collective response to the social development challenges facing the people of Alexandra.

Given this macro level framework, the pertinent question is - at a less abstract level, how does this relate to the delivery of social welfare services, the health of our people and the economic benefits that must accrue? I will use the remaining part of this address to answer this question.

The mission of my Department is to build a caring and integrated system of social development services that facilitates human development and improves the quality of life of all of our people, especially children, youth, women, older people, and people with disabilities. We primarily do this through the provision of social assistance, our largest programme by far. The system of social grants that the department manages is currently the government's most effective programme to alleviate the income poverty of our people. The national South African Social Agency, which we are establishing, will manage a budget of over R50 billion and provide services to more than 12 million beneficiaries.

Further to this, the Department develops and implements its priority programmes in conjunction with other departments in the social sector cluster of government. These priority programmes, in addition to government's comprehensive strategy on HIV and AIDS, include the Expanded Public Works programme, the Urban Renewal Programme, and the Integrated Food Security and Nutrition Programme.

Alexandra is the site of a major urban renewal project whose track record of implementation is a matter of public record and public debate. For purposes of illustrating the linkages between social welfare service, health and the economy, this address focuses on the Expanded Public Works programme, and the Integrated Food Security and Nutrition Programme.

It is important to underline the fact that the Expanded Public Works Programme in social cluster is aimed, first and foremost, at expanding the provision of social services. Secondly, it is aimed at enhancing skills, and thirdly creating work opportunities. The programme specifically targets women who bear the brunt of poverty and unemployment. In the short term, the programme focuses on enhancing Early Childhood Development (ECD) services and the provision of Home and Community Based Care services.

With respect to Early Childhood Development services, it was estimated in 2000 that only 16% of children under the age of six years old, had access to these services. In addition, 85% of the caregivers at these ECD facilities required further training. We will endeavour to sustain our ECD interventions by linking them to the National Food Emergency Scheme and the School Nutrition Programme, with the ultimate objective of ensuring that all children attend school and receive at least one meal a day. It is envisaged that the Early Childhood Development component of this Programme will include work-based experience and structured learning for community members to become Childcare Workers and even eventually Grade R teachers.

The Home and Community Based Care is directed at people infected with HIV and living with AIDS. It is also benefits children affect and infected by AIDS. Another component of Home and Community Based Care services focuses on older people, especially those who are frail. With respect to existing Home and Community Based Care facilities, it is estimated that they are staffed by approximately 2,500 full time caregivers and 20,000 volunteers. Only a quarter of these volunteers receive stipends of any kind. The Home and Community Based Care Services component of the expanded public works programme will include work-based experience and structured learning for community members to become qualified as 'Community Care Givers' and 'Child and Youth Care Workers'.

Government has made a special allocation of R70 million for the Department to support and increase the number of home and community based care sites. Increased support for the establishment of community child care forums is also envisaged.

The Department is also coordinating an umbrella research project on the impact of HIV and AIDS on social service provision in government. With respect to HIV and AIDS, the Department extends its services to all communities especially those that are severely impacted by the epidemic. Services that are in high demand include provision of psychosocial support, material assistance in the form of food parcels, social relief in distress, burial grants, as well as foster care and child support grants.

The second priority programme of the social cluster in cabinet is the Integrated Food Security and Nutrition Programme. In discussing this programme I will focus on the National Food Emergency Scheme - the part of the programme that my department is directly responsible for. The scheme focuses only on the poorest households - that is households who spend less than R200 per month on domestic essentials and do not have a household member who receives a social assistance grants in excess of R200.

Given the urgent human needs and the logistical challenges faced, the National Food Emergency Scheme has largely gone well but there have been some problems. Although community organisations have assisted in the identification of needy families and child-headed households, the non-involvement of civil society structures has in some cases raised problems. Service providers have, by and large, coordinated their distribution of food parcels with some traditional leaders and faith-based organisations, but a more inclusive approach could have been used.

During this year the Department will be working to standardise the use of stakeholder forums in the identification of households to receive in-kind emergency food relief. The Department will also be investigating all contracted service providers to ensure that the food parcels that are distributed contain foodstuffs of a good and nutritious quality to the value of R300, as required. We have found cases where this has not been the case, which raises questions about the ethics and practices of some of these service providers. We are currently reviewing the entire programme in order to make it more effective and efficient; and ensure that it is both implemented correctly and reaches the most vulnerable households.

In order to ensure sustainability and ultimate independence of the beneficiaries of food parcels, a number of other elements of the programme need to be effectively implemented. These are registration of all entitled social grant beneficiaries, provision of agricultural starter packs, and the linking of households to food production initiatives.

Government recognizes that not all qualifying households have the capacity to prepare food for themselves. Therefore designated drop-in centres have been established to provide prepared meals and nutritional supplements to child-headed households, frail older people, TB patients and frail people living with HIV and AIDS.

Both of these priority programmes of the social cluster of Cabinet have to be seen in the context of our strategy to transform and enhance social welfare services. This strategy encompasses the following initiatives:

* The retention strategy for social workers and the development of associated social service professions;
* The upgrading of the salary levels for social work professionals
* The proposed introduction of incentives for professionals working in rural areas,
* The development of an appropriate service delivery model; and
* A policy framework for the granting of financial awards to non-governmental organisations that renders welfare services.

This latter point has been a matter of on-going concern to all non-governmental organisations that work with:

* children who are under the age of 18 years and are abused, neglected, orphaned, abandoned and living in especially difficult circumstances;
* youth who are between the ages of 14 and 28 years and who are at risk, in conflict with the law, out of school and unemployed;
* families who are vulnerable, such as single or child headed families, destitute families and families that are refugees;
* women who are vulnerable such as victims of violence and those who are unemployed; older people who are frail, indigent, or abused; people with physical, intellectual and psychological disabilities; and
* people affected or infected by HIV and AIDS.

The existent policy on the granting of financial awards to non-governmental organisations that render welfare services is antiquated and does not channel adequate resources to the welfare institutions that need the assistance the most. Many welfare institutions, in particular those created in the past ten years are under financed and do not have the necessary trained staff. Many institutions, civil society and faith-based organisations find themselves unable to cope with the need and demand for their services. We are working on putting into place an all-encompassing framework that will assist these welfare institutions, civil society and faith-based organizations - especially those working with orphaned and vulnerable children.

Programme director, to conclude, let me say that I hope that the community projects and government programmes that I have outlined, and the socially responsible opportunities for business that they represent, provide a basis for reflection and more importantly for collective action.

Government is committed to working with the business sector, religious organisations, community and non-governmental organizations, and social service professionals to make sure that we succeed in combating poverty, unemployment and HIV and AIDS.

I thank you.

Issued by: Ministry of Social Development
24 June 2004