Hon Chairperson, in order to promote the optimal utilisation of primary health care facilities, the department has embarked on a process of re-engineering these services in order to make them the first point of contact, based on convenience, quality and accessibility, as well as the effectiveness thereof.
This intervention of re-engineering is outlined in the Green Paper for the National Health Insurance system and it involves three aspects, the first one being the attracting of specialist teams in each district nationally. These specialist teams involve paediatricians, obstetricians, gynaecologists, anaesthetists, family physicians, advanced midwives, and primary health care and nursing specialists, amongst others. Each district, regardless of whether it is rural or urban, will have these teams responsible for the health outcomes of the health system.
The second area of intervention is introducing and strengthening school health services.
The third area is establishing municipal, ward-based health teams nationally. There are just over 4 000 municipal wards in the country, and we believe that having home-based caregivers under the guidance of the local clinic will assist, not only in health care services, but also in preventing diseases and promoting health amongst our people.
To date, the department has audited over 2 000 health care facilities, including clinics, to ensure infrastructure needs are also met. I thank you.
Sekela likaNgqongqoshe sibonga impendulo yakho, kodwa okwamanje sisalindele ukuthi kulungiswe kabusha usizo lwezempilo olusezingeni lokuqala (primary health care). Yini engenziwa ukuthi imitholampilo ibenazo zonke izinsiza ezisheshe zisize abantu, njengemithi. Abantu baya ezibhedlela ngoba ingekho imithi emitholampilo. Ngiyabonga. (Translation of isiZulu paragraph follows.)
[Ms B T NGCOBO: Deputy Minister we thank you for your response, but we are still waiting for primary health care to be improved. What can be done so that clinics have resources such as medicines that will speedily help people? People go to hospitals because there are no medicines in the clinics. Thank you.]
Chairperson, indeed, the issue of the availability of medicines is a key area of monitoring that the department has identified, and I must say that from the physical visits that we have made, the country has improved greatly in this area due to the systems we have put in place. We are also introducing technology, including m-health, or mobile health, to ensure that we support patients that are on chronic medicines. I thank you.
Chair and hon Deputy Minister, since the reality is that people tend to go to hospitals, regardless of how many primary health care facilities you have in an area, is the department going to determine to place primary health care facilities at hospitals, so that you can actually implement your plan without trying to change a whole culture of thinking? Thank you.
Chairperson, indeed, where it is convenient for patients to have what we call "gateway clinics" on hospital premises, these have been introduced as primary health care facilities. But ideally the primary health care facilities should be closer to communities, and in most cases they are communities where hospitals are at a distance. Yes, indeed, where primary health care facilities can be introduced on hospital grounds, it has been done. Thank you.
Chairperson and Deputy Minister, according to the General Household Survey for 2010, the quality of health care services at clinics still remains very poor, and this is most unacceptable to the DA. On what basis does the Deputy Minister guarantee that the steps she has alluded to will be implemented and monitored in order to improve the quality of health care services at our clinics? I thank you. [Applause.]
Chairperson, we have acknowledged that steps which are much more decisive need to be taken to assure the public of quality services throughout the health system, especially in the public health system. Indeed, clinics and primary health care facilities are included in this regard.
We have a monitoring system at the national level which is also assisting us in this regard. We have shared this monitoring system with the MECs for Health of all provinces, and we will be standardising the monitoring system. In addition, there are regular visits by senior management and us to ensure that we have first-hand experience, something to which I alluded earlier on.
I must say that the experience so far is that there is a mixed situation, and where we need to intervene we immediately take steps to ensure that the provinces do intervene. Where we need to support the provinces, especially in areas that are geographically vast, we also look at how we can work with provinces to ensure that all our primary health care facilities provide quality, reliable health care at all times. Thank you.
Deputy Minister, the problem here is a combination of perception and experience. The latter is where people have gone to primary health care centres and experienced bad service. On the other hand, the former is where people sometimes have the perception that the service is not up to standard. The issue is how to address both, and the truth is that there are primary health care clinics which are providing good service. Have you, as the department, decided on a programme of mobilising people to understand the importance of going to primary health care clinics before they go to hospitals and, secondly, dealt with the issue of ensuring that the service provided at these centres is up to standard?
Hon Chair, statistically over 40% of the primary health care facilities that we have were built during this time of the democratic era. So, there has been a great effort to improve services and situate them closer to where people live.
Secondly, the introduction of clinic committees has also helped, where the public and the communities participate in ensuring that they oversee and support the health management, and in ensuring that the quality of the services is responsive to their needs.
The other important intervention is the programme of the re-engineering of the primary health care system. In many instances, patients walk past primary health care services because there is no doctor. I think we have a doctor-based system and there isn't adequate appreciation for the fact that our nurses are highly trained. You can actually appreciate that by the rigour with which other developed countries poach our nurses.
I agree with you that education, mobilisation and active participation of communities will ensure that we achieve the objective of ensuring that primary health care services are more accessible and of good quality. Thank you.
Failure to submit report on maladministration at Central University of Technology in Bloemfontein
236. Dr J C Kloppers-Lourens (DA) asked the Minister of Higher Education and Training:
(1) With reference to his reply to question 2612 on 30 September 2011, what are the reasons furnished by the Central University of Technology in Bloemfontein (CUT) for KPMG's delay and eventual failure to submit the report on their investigation into maladministration at the institution;
(2) whether he verified these reasons with KPMG; if not, what is the position in this regard; if so, what are the relevant details;
(3) whether he has been informed that on the same day of 2 September 2011 that KPMG indicated that the report was ready, the council refused to take delivery of the report, terminated KPMG's services and instructed that the report be handed over to a certain person (name furnished) whose instructions were to review the scope of the work done by KPMG and to finalise the investigation of which a report had already been completed by KMPG; if not, what is the position in each case; if so, what are the relevant details in each case?