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Date: 29/07/2004
Source: Department of Health
Title: M Tshabalala-Msimang: Priorities for the National Health System launch


SPEECH BY THE MINISTER OF HEALTH AT THE LAUNCH OF THE STRATEGIC PRIORITIES FOR THE NATIONAL HEALTH SYSTEM, 2004 - 2009, 29 July 2004

Honoured guests, members of the media, ladies and gentleman.

It gives me great pleasure today as the new Minister of Health, to launch the new priorities of the Department of Health. You will recall that when I was appointed as Minister of Health in 1999 we launched the Health Sector Strategic Framework, 1999 - 2004 which was popularly called the Ten Point Plan because it had ten priority areas.

Before the elections in April this year we prepared a handover report for my successor as was required of all ministers. This was an essential review of the previous five years - listing both achievements and areas that still required our attention. The document contained both the review of both the National Department and provinces. It is on the basis of this report that the Strategic Priorities for the National Health System, 2004 - 2009 that we are launching today was crafted.

Progress of the past ten years

While we celebrate our achievements of the first decade, we dedicate ourselves to ensuring that the fruits of the second decade exceed those of the first. There are priorities from the first two terms of government that remain top of the agenda even now. These are programmes related to the goal of ensuring that all South Africans have access to health irrespective of their social status and geographical location.

We have achieved much in the past 10 years. Our major gains have been in relation to vaccine-preventable illnesses, better management of malaria, improved reproductive health services, a more focused approach to disability, reducing tobacco use and the gradual achievement of a truly comprehensive response to HIV and AIDS.

During the past 10 years we built more than 1300 new clinics in under-served areas of our country, and we now have functioning health districts right across the country. We undertook 966 hospital rehabilitation projects and built 18 entirely new hospitals.

We introduced a Patients' Rights Charter and saw provinces gradually initiate complaint systems, help desks and incentives for good service.

The reform of the medical aid legislation has resulted in a stabilisation of the financial situation of the medical aid schemes to the extent that there have been no bankruptcies in the past two years.

We are working on a Health Charter that will provide a framework for the interaction of the public and private health sectors and which will also lay out the core values that the private health sector should seek to uphold, including the ownership of private health services, Black economic empowerment and how the public and private sectors should cooperate and complement each other.

Reducing prices and dispensing of medicines

We are continuing with our efforts to improve access to quality, affordable medicine for all. Despite opposition from certain interest groups, our efforts to push down the prices of medicines and to ensure that those who dispense medicine have the necessary competencies has, for now, stood the test of our judicial system. We hope that the court will once again vindicates the validity of government endeavour to make medicine more affordable in the country when it rules on the medicine pricing regulations. While only the section relating to the single exit price is currently being implemented, these regulations are already making a difference in the prices of medicine with some analysts indicating that there has been a decrease of up to 16% on the prices of medicine. We expect a more significant saving for consumers when the limits with regard to dispensing fees charged on medicine come into effect on 2 August, subject to the court ruling on the matter.

On dispensing issue, we are going to object to any efforts by the National Convention on Dispensing to appeal against the decision of the Pretoria High court on this matter. All our energies should now be focused on assisting health professionals to comply with the law rather than adopting desperate measures to oppose this transformation process.

New Vision for 2004 - 2009

The Strategic Priorities for the National Health System for 2004 - 2009 contains several sections, which I wish to highlight. The first two are the new vision and mission for the national health system. The second is a situation analysis, which highlights our achievements and challenges. The last part is the list of priority areas with targets and indicators, which we shall use to monitor progress.

The new vision is: An accessible, caring and high quality health system. This is what we wish to achieve. We will work hard to ensure that every health worker, whether in the public or private health sector, whether manager or front line health worker, whether academic or researcher, embodies this vision as they perform their daily activities.

The new mission, which is how we hope to achieve this vision is: to improve health status through prevention of disease and promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.

Tuberculosis

The section entitled - Situation Analysis - provides a brief review of the progress and challenges we have faced in implementing our programmes over the past five to ten years. While there have been significant progress in almost every programme we are reporting on, the area of concern is around our inability to meet the targets on managing tuberculosis. We have agreed with the MECs for Health that we will review this programme in each province to identify challenges and resolve them as soon possible. Tomorrow, we are holding a summit on the Coalition Against TB in order to pull together various stakeholders to contribute towards addressing this challenge.

HIV and AIDS

We have made significant progress through the Partnership Against AIDS and this partnership approach should assist us in dealing with TB as well. We are intensifying the partnership approach as we work towards meeting our targets with regard to the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS.

We are scaling up the implementation of our prevention programme including the ABC campaign. During the second week of August, we will hold a national consultative meeting to look at our programme to reduce the risk of mother to child transmission of HIV in light of the recommendations of the Medicine Control Council on this matter. Government will thereafter decide on the appropriate approach. This decision will be informed by our determination to reduce the risk of transmission and to ensure quality health care for women and children of this country.

We are increasing service points to all districts where a series of interventions aimed at prolonging the progression from HIV infection to development of AIDS-defining conditions can be provided to ensure optimal health for people living with HIV and AIDS. These include nutritional support, traditional medicine, treatment of opportunistic infections and antiretroviral therapy. We expect the tender for long-term supply of antiretroviral drugs to be finalised by the end of next month.

Priorities for 2004 - 2009

Programme director, we have listed the top ten priorities that should lead us to our vision of an accessible, caring and high quality health system. I must stress that it does not mean that if a particular health matter is not on the list of priorities, the Department will ignore it. This list represents those things that we must pay particular attention to amongst all the other things that we do everyday. These priorities are:

* Improving the governance and management of the National Health System,
* Promoting healthy lifestyles,
* Contributing towards human dignity by improving quality of care,
* Improving management of communicable diseases and non-communicable illnesses,
* Strengthening primary health care, emergency medical services and hospital service delivery systems
* Strengthening support services,
* Human resource planning, development and management,
* Planning, budgeting and monitoring and evaluation,
* Drafting and implementing health legislation; and
* Strengthening international relations.

Why did we select these priorities and why did we package them in this way? You will note that we prioritised the strengthening of the management and governance of the national health system as well as human resource planning, development and management. The health system is labour intensive and more than 60% of our budget is spent on personnel. This means that we must strengthen the management of this resource.

We are launching the new vision, mission and priorities for the health at these premises of the South African Nursing Council because we believe that health workers are central to the delivery of health services. We are determined to ensure that we recruit and retain adequate numbers of health workers to provide these services. We are intensifying our effort to improve the working conditions and ensure a fulfilling career growth within the health system.

We have also put primary health care, the emergency medical services and hospitals into one set of priorities. We have done this deliberately. Patients must not experience any barriers to access to care regardless of who provides this service - be it provincial or local government or the private health sector.

We have prioritised healthy lifestyles because the burden of diseases from unhealthy lifestyles is growing very rapidly. We see this manifested in non-natural causes of death as well as diseases of lifestyle like diabetes, hypertension and obesity. We will accelerate our health promotion campaigns to strengthen our interventions in this area.

We have combined the management of communicable diseases and non-communicable illnesses. Together with promoting healthy lifestyles, this priority constitutes the core business of the national health system.

Issues of governance relate to public accountability. During this period we will focus on strengthening communication and consultation at all levels, from national to facility level where we interact with those who use our services.

We are committed to meeting the targets that have been set for the health sector. As you know, the Presidency is establishing a website which will be used to highlight progress on the achievement of the targets set in the President's State of the Nation Address. The national Department of Health will report the progress towards meeting these targets on a quarterly basis and will put these on our website as well.

To conclude, l am confident that we have the building blocks in place and that this five year term will further consolidate the gains we have made in the first 10 years of our democracy. Like health systems all over the world, there are many challenges facing us. However, I am confident that we have the means to fully implement this plan. It is within our means to create an accessible, caring and high quality health system.

I thank you.

Issued by: Department of Health
29 July 2004
Source: Department of Health (http://www.doh.gov.za)

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