Date: 15/02/05
Source: Ministry of Health
Title: Tshabalala-Msimang: Debate on State of the Nation Address
Speech by the Minister of Health, Manto Tshablala-Msimang on the Debate on State of the Nation Address
15 February 2005
Madam Speaker, President Mbeki, Deputy President Zuma, Honourable Members,
In the State of the Nation address that you delivered last Friday, Mr President, you asserted that we as a people have every reason to be proud of our recent achievements. Central to this must be our "success in advancing our country away from its divided past, and towards the realisation of the vision contained in the Freedom Charter, written 50 years ago - that, South African belongs to all who live in it, black and white. Accordingly, today I will focus on the clause in the Freedom Charter that asserts: "There shall be houses, security and comfort!"
There are four sub-clauses, under this clause, that clearly underpin our current approach to the provision of housing, health care and social security:
1. One: "all people shall have the right to live where they choose, be decently housed, and to bring up their families in comfort and security";
2. Two: "A preventive health scheme shall be run by the state";
3. Three: “Free medical care and hospitalisation shall be provided for all, with special care for mothers and young children"; and
4. Four: "the aged, the orphans, the disabled, and the sick shall be cared for by the state".
Mr President, the Freedom Charter envisioned a society in which people enjoy the right to live wherever they chose, where they would be housed decently, and they would be able to bring up their families in comfort and security. Our government has made great strides towards the realisation of such a society.
The Ministry of housing has been working very hard to develop a comprehensive plan dealing with human settlement and social infrastructure, including rental-housing stock for the poor. Such a plan was submitted to Cabinet in August last year.
This plan introduces a fundamentally different housing mode to what we have seen before. Amongst other things, it expands the scope of the housing mandate to enable government to address the integration of the primary and secondary housing market. It introduces a shift from the current commoditised focus of housing delivery towards more responsive mechanisms, which address the multi-dimensional needs of sustainable human settlements.
The plan also develops mechanisms for the enhancement of the partnership between government and the private sector in the development of sustainable human settlements. Finally, the plan outlines tools through which the urgent challenge of informal settlements will receive its urgent attention.
The Minister of Housing yesterday announced the process of implementing the N2 Gateway Project as a lead pilot project of this new Comprehensive Plan.
In essence the project seeks to address the need for services, shelter, and socio-economic development of an estimated 15 504 households in some twelve existing neighbourhoods, and a further 6 141 households in backyard shacks, totalling around 22 000 households within the city of Cape Town.
Impela amaVoloniya ase Kliptown asekhona nangasekho ahleka kuvele elomhlathi uma ebona ukuthi izithukuthuka zawo aziwelanga phansi kodwa zivindise umhlaba owenileyo, kwazise phela nansi intombi kaSisulu owayekhona le eKliptown ifeza iphupho likaYise.
On Social protection, Mr President, our Comprehensive Social Security System, which we have been gradually developing over the last ten years, has seen many of our people, especially the most vulnerable, receiving direct support from the state, as a means of protecting them against extreme poverty. Currently our expenditure on social grants of one kind or the other has reached more than R50 billion a year.
This benefits more than 9 million people, especially children, people with disabilities, and elderly people. In addition, our government has made a significant contribution to what is termed the "social wage".
This represents a package of services that are provided to citizens by the state “in kind”, including health care, primary and secondary education, housing, electricity, water, sanitation and refuse removal, amongst others. The value of the social wage was estimated at R88 billion in 2003.
The Social Sector continues to improve the efficiency of our social security system, including efforts to eliminate corrupt practices. The Minister for Social Development, Minister Skweyiya, has issued a call to our people to come forward and join the fight against corruption and fraud in our social grant system. We are confident that implementation of the Social Security Agency in April this year will be a key element in this strategy.
Mr President, in relation to health, I am also pleased to report to the nation that we are still driven by the vision of for health care espoused by the Freedom Charter.
In 1994 we began to provide free public health care services for children under 6, and pregnant and lactating women. In 1996 we went further and began to provide free primary health care for anyone who did not have the means to pay. During the same period we initiated a clinic building and upgrading programme, which, over the last 10 years, has resulted in the building, and upgrading of more than 1 300 clinics.
In addition, we have initiated and are sustaining a hospital revitalisation programme in which 30 hospitals are currently being upgraded. The most recently completed projects are in the Northern Cape, in Colesberg and Calvinia. I wish to invite honourable members to visit these facilities and to see the success of our revitalisation programme.
This year we will continue with this very important programme, and the Health Minmec will, in the next week, reflect on expenditure trends in this regard, and take corrective steps to accelerate expenditure, where it has been less than satisfactory.
We trust, Mr President, that this will go some way towards allaying your concerns about the slower pace of building essential infrastructure, especially in so far as it relates to the management and coordination processes in the three spheres of government.
Madam speaker, one of the fundamental elements of access to health care for all is the provision of safe and affordable medicines. Although our attempts at achieving these two interlinked objectives have been, and are still the subject of court actions, I am pleased to say that we are making significant progress. We are continuing to provide dispensing licences to the hundreds of doctors who have applied for them.
These doctors have undergone basic training in the handling and safe keeping of medicines. We can therefore safely say that we are gradually eliminating a situation where medicines are kept in unsafe environments, leading to adverse effects on the patients.
We are also pleased to see that many pharmacies have demonstrated that the claim that we are bankrupting pharmacists through our pricing measures is a lie. The most affordable medicines in our country today are found in those pharmacies that are actually following our pricing regulations to the letter. We are awaiting the decisions of the courts on these matters, and we will abide by those decisions. But we will not be detracted from achieving the vision of the Freedom Charter, as expressed in the clauses I have referred to.
Madam Speaker, our Department is also poised to launch a massive campaign to reduce non-communicable and communicable diseases, as well as non-natural causes of death. This campaign will focus largely on the promotion of healthy life styles. We will intensify our messages aimed at stopping people from smoking, and highlighting the dangers of alcohol abuse. Our actions in this area will be accompanied by the necessary legislative steps, such as the enactment of regulations that will require labelling on all liquor products.
On the tobacco side, we are pleased to note that Parliament intends, within the next two weeks, to approve South Africa's ratification of the World Health Organisation's Framework Convention on Tobacco Control. This will allow us to take our place among world's leading tobacco control nations.
Our healthy life-styles campaign will also focus on the importance of nutrition, and exercise. As you have said Mr President, the broad trends in our mortality studies all, and I emphasise all, point to a worrying emergence of diseases of lifestyles, such as diabetes, stroke and heart disease. We cannot ignore this and we must take the necessary steps to prevent it from growing.
We will also intensify our work around TB, as research has shown that even in the context of HIV and AIDS, TB can be cured.
Mr President, some in this house have commented negatively on your assertion that the government's comprehensive plan against AIDS is among the best in the world, suggesting that you are making false claims. All I would like to say to them is this: very few plans are as comprehensive as ours, bringing together elements of prevention, nutrition and a variety of different treatments.
I have challenged my department, Mr President, to ensure that we are never detracted from the implementation of that plan in all its comprehensiveness.
For example, I do not believe we have done enough as a country to focus on the issue of stigmatisation. I am also concerned about our ability to monitor how all the people who are using ARVs are doing, and why some of them stop the programme. Nor are we currently putting enough emphasis on a healthy living for people living with the virus. Finally, I am also pleased to announce that the technical obstacles to the tender for the procurement of treatment regimes have been removed, and the tender will be finalised soon.
May I urge all of us to become champions of a comprehensive fight against HIV and AIDS. And may I further urge all of us, especially those of us who have been elected as representatives of the people, to lead by example, and to be shining examples of living healthy lifestyles.
Mr President, I am pleased to report to you and to the nation that our Community Health Worker programme is poised for expansion, and an injection of extra resources into this programme will be most welcome.
This year we plan to have another conference which will bring together all our community health workers and to ensure that we are all reading from the same script when it comes to service to our people. In addition, we are also currently working to develop a new cadre of health workers, at the middle level, which we might call Medical Assistants. This is an attempt to provide quality health care to people, in all settings, especially in rural areas.
Mr President, we have been concerned at the number of health professionals we are losing to the developed world. To deal with this matter we have embarked on a number of strategies, including entering into bi-lateral agreements with countries like the UK, to regulate the movement of health professionals. We have also been meeting with some of these professionals themselves to find out how we can assist them to be reabsorbed into our system. Many have expressed their desire to come back and work in South Africa. We are working to remove any obstacles that prevent them from returning, including some conditions of employment in our public service.
And, we have also targeted certain countries to augment our supply of health professionals with scarce skills. Recently we signed an agreement with Iran in this regard.
I will provide details of all these programmes, as well as of our Human Resource Plan, later this year, when I present the Health Budget.
Mr President, let me end by focusing on the matter of what has become known as "bugs and super-bugs in our hospitals". This was discussed at our firs Minmec of the year as a critical matter to be addressed urgently. We have requested the Medical Research Council to provide us with an evidence-based understanding of the challenges, so that we can plan accordingly. Meanwhile, we have also embarked on a "back to basics" approach around sanitation in hospitals. Minmec will continue to make this a focus area for our meetings, as we also include matters related to physical safety in our hospitals.
For we must ensure, Mr President, that all our people enjoy security and comfort, especially in hospitals, as the Freedom Charter enjoins us to do. This year, Mr President, we commit ourselves to do more, and to do it with urgency to ensure that we move even more closer to the ideal, where all our people, black and white, rich and poor, shall indeed feel that South Africa belongs to all who live in it," and that we "All have a right to human dignity".
I thank you!
Issued by: Ministry of Health
15 February 2005
Source: Department of Health (http://www.doh.gov.za)
Source: Ministry of Health
Title: Tshabalala-Msimang: Debate on State of the Nation Address
Speech by the Minister of Health, Manto Tshablala-Msimang on the Debate on State of the Nation Address
15 February 2005
Madam Speaker, President Mbeki, Deputy President Zuma, Honourable Members,
In the State of the Nation address that you delivered last Friday, Mr President, you asserted that we as a people have every reason to be proud of our recent achievements. Central to this must be our "success in advancing our country away from its divided past, and towards the realisation of the vision contained in the Freedom Charter, written 50 years ago - that, South African belongs to all who live in it, black and white. Accordingly, today I will focus on the clause in the Freedom Charter that asserts: "There shall be houses, security and comfort!"
There are four sub-clauses, under this clause, that clearly underpin our current approach to the provision of housing, health care and social security:
1. One: "all people shall have the right to live where they choose, be decently housed, and to bring up their families in comfort and security";
2. Two: "A preventive health scheme shall be run by the state";
3. Three: “Free medical care and hospitalisation shall be provided for all, with special care for mothers and young children"; and
4. Four: "the aged, the orphans, the disabled, and the sick shall be cared for by the state".
Mr President, the Freedom Charter envisioned a society in which people enjoy the right to live wherever they chose, where they would be housed decently, and they would be able to bring up their families in comfort and security. Our government has made great strides towards the realisation of such a society.
The Ministry of housing has been working very hard to develop a comprehensive plan dealing with human settlement and social infrastructure, including rental-housing stock for the poor. Such a plan was submitted to Cabinet in August last year.
This plan introduces a fundamentally different housing mode to what we have seen before. Amongst other things, it expands the scope of the housing mandate to enable government to address the integration of the primary and secondary housing market. It introduces a shift from the current commoditised focus of housing delivery towards more responsive mechanisms, which address the multi-dimensional needs of sustainable human settlements.
The plan also develops mechanisms for the enhancement of the partnership between government and the private sector in the development of sustainable human settlements. Finally, the plan outlines tools through which the urgent challenge of informal settlements will receive its urgent attention.
The Minister of Housing yesterday announced the process of implementing the N2 Gateway Project as a lead pilot project of this new Comprehensive Plan.
In essence the project seeks to address the need for services, shelter, and socio-economic development of an estimated 15 504 households in some twelve existing neighbourhoods, and a further 6 141 households in backyard shacks, totalling around 22 000 households within the city of Cape Town.
Impela amaVoloniya ase Kliptown asekhona nangasekho ahleka kuvele elomhlathi uma ebona ukuthi izithukuthuka zawo aziwelanga phansi kodwa zivindise umhlaba owenileyo, kwazise phela nansi intombi kaSisulu owayekhona le eKliptown ifeza iphupho likaYise.
On Social protection, Mr President, our Comprehensive Social Security System, which we have been gradually developing over the last ten years, has seen many of our people, especially the most vulnerable, receiving direct support from the state, as a means of protecting them against extreme poverty. Currently our expenditure on social grants of one kind or the other has reached more than R50 billion a year.
This benefits more than 9 million people, especially children, people with disabilities, and elderly people. In addition, our government has made a significant contribution to what is termed the "social wage".
This represents a package of services that are provided to citizens by the state “in kind”, including health care, primary and secondary education, housing, electricity, water, sanitation and refuse removal, amongst others. The value of the social wage was estimated at R88 billion in 2003.
The Social Sector continues to improve the efficiency of our social security system, including efforts to eliminate corrupt practices. The Minister for Social Development, Minister Skweyiya, has issued a call to our people to come forward and join the fight against corruption and fraud in our social grant system. We are confident that implementation of the Social Security Agency in April this year will be a key element in this strategy.
Mr President, in relation to health, I am also pleased to report to the nation that we are still driven by the vision of for health care espoused by the Freedom Charter.
In 1994 we began to provide free public health care services for children under 6, and pregnant and lactating women. In 1996 we went further and began to provide free primary health care for anyone who did not have the means to pay. During the same period we initiated a clinic building and upgrading programme, which, over the last 10 years, has resulted in the building, and upgrading of more than 1 300 clinics.
In addition, we have initiated and are sustaining a hospital revitalisation programme in which 30 hospitals are currently being upgraded. The most recently completed projects are in the Northern Cape, in Colesberg and Calvinia. I wish to invite honourable members to visit these facilities and to see the success of our revitalisation programme.
This year we will continue with this very important programme, and the Health Minmec will, in the next week, reflect on expenditure trends in this regard, and take corrective steps to accelerate expenditure, where it has been less than satisfactory.
We trust, Mr President, that this will go some way towards allaying your concerns about the slower pace of building essential infrastructure, especially in so far as it relates to the management and coordination processes in the three spheres of government.
Madam speaker, one of the fundamental elements of access to health care for all is the provision of safe and affordable medicines. Although our attempts at achieving these two interlinked objectives have been, and are still the subject of court actions, I am pleased to say that we are making significant progress. We are continuing to provide dispensing licences to the hundreds of doctors who have applied for them.
These doctors have undergone basic training in the handling and safe keeping of medicines. We can therefore safely say that we are gradually eliminating a situation where medicines are kept in unsafe environments, leading to adverse effects on the patients.
We are also pleased to see that many pharmacies have demonstrated that the claim that we are bankrupting pharmacists through our pricing measures is a lie. The most affordable medicines in our country today are found in those pharmacies that are actually following our pricing regulations to the letter. We are awaiting the decisions of the courts on these matters, and we will abide by those decisions. But we will not be detracted from achieving the vision of the Freedom Charter, as expressed in the clauses I have referred to.
Madam Speaker, our Department is also poised to launch a massive campaign to reduce non-communicable and communicable diseases, as well as non-natural causes of death. This campaign will focus largely on the promotion of healthy life styles. We will intensify our messages aimed at stopping people from smoking, and highlighting the dangers of alcohol abuse. Our actions in this area will be accompanied by the necessary legislative steps, such as the enactment of regulations that will require labelling on all liquor products.
On the tobacco side, we are pleased to note that Parliament intends, within the next two weeks, to approve South Africa's ratification of the World Health Organisation's Framework Convention on Tobacco Control. This will allow us to take our place among world's leading tobacco control nations.
Our healthy life-styles campaign will also focus on the importance of nutrition, and exercise. As you have said Mr President, the broad trends in our mortality studies all, and I emphasise all, point to a worrying emergence of diseases of lifestyles, such as diabetes, stroke and heart disease. We cannot ignore this and we must take the necessary steps to prevent it from growing.
We will also intensify our work around TB, as research has shown that even in the context of HIV and AIDS, TB can be cured.
Mr President, some in this house have commented negatively on your assertion that the government's comprehensive plan against AIDS is among the best in the world, suggesting that you are making false claims. All I would like to say to them is this: very few plans are as comprehensive as ours, bringing together elements of prevention, nutrition and a variety of different treatments.
I have challenged my department, Mr President, to ensure that we are never detracted from the implementation of that plan in all its comprehensiveness.
For example, I do not believe we have done enough as a country to focus on the issue of stigmatisation. I am also concerned about our ability to monitor how all the people who are using ARVs are doing, and why some of them stop the programme. Nor are we currently putting enough emphasis on a healthy living for people living with the virus. Finally, I am also pleased to announce that the technical obstacles to the tender for the procurement of treatment regimes have been removed, and the tender will be finalised soon.
May I urge all of us to become champions of a comprehensive fight against HIV and AIDS. And may I further urge all of us, especially those of us who have been elected as representatives of the people, to lead by example, and to be shining examples of living healthy lifestyles.
Mr President, I am pleased to report to you and to the nation that our Community Health Worker programme is poised for expansion, and an injection of extra resources into this programme will be most welcome.
This year we plan to have another conference which will bring together all our community health workers and to ensure that we are all reading from the same script when it comes to service to our people. In addition, we are also currently working to develop a new cadre of health workers, at the middle level, which we might call Medical Assistants. This is an attempt to provide quality health care to people, in all settings, especially in rural areas.
Mr President, we have been concerned at the number of health professionals we are losing to the developed world. To deal with this matter we have embarked on a number of strategies, including entering into bi-lateral agreements with countries like the UK, to regulate the movement of health professionals. We have also been meeting with some of these professionals themselves to find out how we can assist them to be reabsorbed into our system. Many have expressed their desire to come back and work in South Africa. We are working to remove any obstacles that prevent them from returning, including some conditions of employment in our public service.
And, we have also targeted certain countries to augment our supply of health professionals with scarce skills. Recently we signed an agreement with Iran in this regard.
I will provide details of all these programmes, as well as of our Human Resource Plan, later this year, when I present the Health Budget.
Mr President, let me end by focusing on the matter of what has become known as "bugs and super-bugs in our hospitals". This was discussed at our firs Minmec of the year as a critical matter to be addressed urgently. We have requested the Medical Research Council to provide us with an evidence-based understanding of the challenges, so that we can plan accordingly. Meanwhile, we have also embarked on a "back to basics" approach around sanitation in hospitals. Minmec will continue to make this a focus area for our meetings, as we also include matters related to physical safety in our hospitals.
For we must ensure, Mr President, that all our people enjoy security and comfort, especially in hospitals, as the Freedom Charter enjoins us to do. This year, Mr President, we commit ourselves to do more, and to do it with urgency to ensure that we move even more closer to the ideal, where all our people, black and white, rich and poor, shall indeed feel that South Africa belongs to all who live in it," and that we "All have a right to human dignity".
I thank you!
Issued by: Ministry of Health
15 February 2005
Source: Department of Health (http://www.doh.gov.za)
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