Hon Speaker, in the Negotiated Service Delivery Agreement the issue of maternal and child mortality is number two on the list of outcomes. A number of measures have already been taken to reduce maternal and child mortality rates in South Africa. The National Committee on Confidential Enquiries into Maternal Deaths has recently provided the latest tri-annual report on maternal and child mortality for the period 2008 to 2010, which records the number of institutional deaths, causes of mortality, as well as recommendations to reduce mortality.
The report found that by far the major cause of maternal mortality is ...
Mr Speaker, sorry, I think the Minister is reading the wrong reply.
Yes.
No, no, no.
The Minister is reading the correct reply, but to the wrong question. [Laughter.]
No, no, no. Oh, yes, my apologies.
This is Question 76.
Apologies! It is the manner in which I have put them here. My apologies, hon Speaker, that one is still coming. I am very sorry. [Laughter.]
The improvement of the performance of provincial health departments to spend funds does not entirely rely on the implementation of the National Health Insurance, NHI. The national and provincial Departments of Health are already implementing a number of programmes and initiatives to spend funds earmarked for vital infrastructure and health care improvement.
The Department of Health is already implementing a number of concurrent interventions to improve spending on health infrastructure. These interventions include the establishment of dedicated project management support units to focus on effectively managing the spending and performance of the hospital revitalisation and health infrastructure conditional grants.
Interventions that have already borne fruit in this area include co- ordinated monitoring and proactive interventions in collaboration with the provinces through specific service level agreements and business plans. As a result, spending on the infrastructure conditional grants is definitely improving.
With regard to health care improvement, funding has been allocated as part of the equitable share to provinces. Work is under way with regard to the finalisation of the health facility audit and the determination of interventions that will be implemented for health care improvement and the overall management and functioning of health facilities.
To this end, health facility improvement teams have been established to focus on the improvement of facilities, and we will put mechanisms in place to improve quality of care and health outcomes within identified districts.
Under the NHI, it is envisaged that the improvement of the health care will be achieved through various interventions, including the accreditation of providers according to criteria set out by the Office of Health Standards Compliance. Thank you.
Speaker, through you to the Minister, the infrastructure is going to play a very important role as far as the roll-out of the National Health Insurance is concerned. The Auditor-General's report, together with the research that has been released by the Health Systems Trust on the infrastructure depicted the provinces as faring very badly as far as the expenditure is concerned, and found that in the four district municipalities of Motheo in the Free State, Sedibeng in Gauteng, Zululand in KwaZulu-Natal and Pixley ka Seme in Northern Cape interventions were necessary.
In Motheo in the Free State alone, 77% failed in terms of cleanliness, 64% failed on availability of medicine supplies and 60% failed on improved patient safety. In Sedibeng in Gauteng, 79% failed in terms of cleanliness, 58% failed in terms of the medicine supply, etc.
The issue here is that if the people employed in these institutions are unable to do the basic things which they are employed for, how can we expect them to implement the infrastructure, especially because we all know that Public Works is a mess?
Hon Speaker, I need to inform the hon member that the report he is talking about was commissioned by me. It is not a coincidental report. We are the ones who commissioned a report on facility audit, and I am the one who at a press conference released those results about cleanliness, safety and security of staff, drugs stock-outs, the long queues, as well as infection control. That is our own report. So, what you are quoting comes from us, by the way. [Applause.]
The districts that you have identified, Motheo, Sedibeng, Zululand and Pixley ka Seme are where the facility improvement teams are going to start. We just chose these districts as a starting point to improve in terms of the issues you are talking about. That is the first thing I want to say.
The second thing about infrastructure is that we are also painfully aware of the weaknesses with regard to infrastructure delivery, especially within the Department of Public Works; the Minister has said that publicly. I have just informed you about the steps that we are taking, including hiring engineers within the Department of Health to form these tasks teams. I want to inform you that since that has happened, there is definitely visible improvement. Thank you. [Applause.]
Speaker, hon Minister, according to the ministerial task team report, it is clearly stated that no part of the health system is held properly accountable for the poor health outcomes and for poor service delivery. This makes it virtually impossible for the system to improve, as people lack the incentives to make it better.
Hon Minister, what will you do to make sure that the MECs and the heads of department will be held accountable for the poor health outcomes and for the poor service delivery? How will you make sure that the provincial departments are assessed according to the standardised benchmark or the target, so as to evaluate their performance?
If I am not mistaken, hon member, the ministerial task team report you are talking about is the integrated service delivery report which was commissioned by former Minister Barbara Hogan. We have taken that report and formed task teams consisting of various financial managers and chief financial officers in the provinces, headed by the national chief financial officer.
Firstly, we have gone through that report line by line to see what needs to be improved, and that is work in progress. Secondly, regarding the health outcomes, I have signed the Negotiated Service Delivery Agreements with the President and also with the individual MECs. During the National Health Council meetings, we go through those reports to see how far we are, and that is how we hold each other accountable. Thank you.
Speaker, the Minister stated that health facility improvement teams have been established to focus on the improvement of health care and infrastructure and will put mechanisms in place to improve quality of care and health outcomes. The Minister also indicated that the NHI, which is a universal coverage, will achieve quality health care for all.
Minister, based on your answer, do you think that we will meet the targets of the Millenium Development Goals, MDGs, 4, 5, 6 and 7 - improvement of maternal health, reduction of infant mortality, HIV/Aids reduction and also health environmental sustainability - by 2015? Thank you.
Hon Member, the issue of MDGs 4, 5 and 6 is a very big challenge for the whole of sub-Saharan Africa because of the very high incidence rate of HIV/Aids and tuberculosis, TB. It is not only a challenge here in South Africa; it is in the whole of sub-Saharan Africa, but we are not giving up. As I have told you, we have put in place our plans in terms of reducing maternal mortality, child mortality and fighting HIV/Aids.
Here in South Africa, you are aware that out of the four Negotiated Service Delivery Agreements which I signed with the President, three are about these MDGs. That's just how seriously we view this issue. Within the African Union, a project called Campaign on Accelerated Reduction of Maternal Mortality in Africa, CARMMA, has been launched within the African Union for each of the African countries, and we are still preparing to launch a similar thing here in South Africa in pursuit of the MDGs 4, 5 and 6, and we believe 2015 is still some distance away, so we will check where we are when we arrive there. Thank you.
Hon Speaker and hon Minister, I know legislation aimed at ensuring compliance is in committee right now, but what incentives and/or penalties for timeous and appropriate spending do you envision, and will these mechanisms be in place in time to meet the significant health department infrastructure spending proposed for this year?
Speaker, the Minister of Finance has already set such penalties, one of them being that on the conditional grant, if a province does not spend, that money will not be transferred to the province. The next tranche will be kept by the national Minister of Health. That, by the way, has already happened. So, we don't just release money to a province that is not able to spend it. We keep the money here, and the Minister is working on a mechanism to see how we can help from here to implement that project if the province happens to be failing. Thank you.
Steps to promote use of African language teaching and mother tongue education in schools
68. Ms L N Moss (ANC) asked the Minister of Basic Education:
1) What steps is she taking to promote the use of African language teaching in schools in order for African language learners to benefit more from the education they receive;
2) which stakeholders are involved in the promotion of mother tongue education and (b) what are the details of their contributions to educating learners in their mother tongue?