Deputy Madam Speaker, hon members, fellow South Africans, we have lodged our achievement in our health care system and working together, we shall do more. I must also acknowledge that much more still needs to be done in terms of quality health care to make health services available to all South Africans and to ensure better health outcomes.
Our health system continues to face numerous challenges. South Africa has a burden of at least four types of diseases associated with epidemiological transition between poverty and lifestyle-related diseases. First, the country still bears a heavy burden of poverty-related diseases such as infectious diseases, malnutrition and diarrhoea. Second, South Africa displays a growing burden of noncommunicable diseases such as stroke, ischemic heart diseases, diabetes mellitus, etc.
The third burden relates to premature deaths due to violence, injuries and road accidents. The fourth greatest burden by far is HIV infection and Aids.
As a country we are struggling insofar as achieving the health- related Millennium Development Goals 4, 5 and 6 is concerned. Lack of sustainable human resources to provide quality health care is also a challenge.
The private sector's unsustainable increases in expenditure also pose difficulties. Bed occupancy in the private sector remains low, while there is overcrowding in the public sector. In our country today, about 65% of the population is entirely dependent on the public sector health services, whilst 21% of the population uses some services in the private sector such as doctors in private practice and retail pharmacies and pay for these services on an out- of-pocket basis.
This group is, however, heavily dependent on the public sector for specialists and in-patient care. This means that while the public sector is responsible for about 86% of the population for health care services, the private sector is responsible for only 14% of the population who are members of medical schemes who largely use private-for-profit health services. This inequity surely places a heavy burden on the public-sector health care system with regard to budget, human, material and IT resources.
It is also true that sometimes our people are ridiculed, ill-treated and mismanaged in the public health institutions. I believe that these are areas that need policy review as well as commitment and determination to aggressive implementation without fear or favour.
As this government, which is led by the ANC - the greatest movement of all times, tried and tested - we have responded, and we will continue to respond, to all these heavy burdens and challenges affecting our health systems. Let me inform the House as to how we have responded to these challenges within a short space of time being in government.
Since 1994 the government has achieved several public policy successes, some of which are structural policy or programme-oriented. Fourteen departments of health which were racially structured have been integrated into a single central national Ministry and nine provincial departments of health.
In 1994 we found a national health system which was based on a curative health care system and benefited the wealthy few. Not apologetic at all, we proudly introduced a primary health care system which emphasises prevention of diseases, the promotion and maintenance of health and benefits the majority. We reprioritised budgets and resources to focus on primary health care. We formulated an essential primary health care package which sets norms for the provision of comprehensive primary health care.
We increased access to clinics and hospitals by removing all fees for pregnant women and children under the age of six years. We expanded health services by building 1 345 new clinics, and 266 clinics have been upgraded. We also have extended our services outside of the health facilities to communities through a community-based programme.
Today, as we speak, about 95% of our people are able to reach a clinic within a 5km radius, and that is extraordinary. Minister Hogan informed the House about this on Monday last week. The outcomes of these initiatives are that malnutrition-related diseases have declined; our clinics are increasingly being used; we have reduced malaria and measles. This has never happened before; those who accumulated wealth and privilege and never cared about the majority of the people do not see these as important achievements but our people do.
Furthermore, since the inception of the hospital revitalisation programme, we have seen a number of new hospitals being built and other facilities upgraded.
We have made efforts aimed at contributing towards human dignity by improving the quality of care. This entails introducing the patients' rights charter, establishment of provincial equality assurance units and quality assurance programmes which include a complaint system at all delivery sites.
Another major area of change is the improvement in human resources. We introduced several initiatives such as changing the gender, racial and professional profile in health administration as a means of ensuring that the service providers represent the people they serve.
Due to major shortages in the number of health professionals, particularly in rural areas, government recruited Cuban doctors in the immediate post- 1994 period. We introduced compulsory community service for recent graduates as well as scarce-skills and rural allowances for health care professionals. We also developed a strategy for the retention of skilled workers through the occupation-specific dispensation for nurses, widely known as OSD.
To further augment the number of health workers, the government introduced the community health workers programme throughout the country. This is not a wish list, as the honourable leader of the DA, Ms Helen Zille says, but an existing concrete reality, which we implemented and funded.
We have made medicine affordable by introducing a comprehensive national drug policy. Our National HIV/Aids and STI Strategic Plan 2007-2011 is aimed at reducing the rate of new infections by 50% through an aggressive information and prevention campaign.
Since 2005, in particular, there have been increases in real per capita public health budgets. It is pleasing to note that even the 2009 budget has been increased and speaks to the resolutions taken in Polokwane in 2009, where we said we would prioritise health care services. For once, I heard the hon Pastor Meshoe telling the truth on TV about Minister Manuel. He said that the Minister has done sterling work, which is true.
He then continued by saying that if he, hon Meshoe, were the Minister of Finance, he would do exactly the same as the Minister. This, however, isn't true because the ACDP doesn't have prudent financial policies, if any at all.
The ANC is clear on the way forward in dealing with the challenges and strengthening the successes mentioned above. In our 2009 manifesto, the ANC identified 10 clear priorities for a major improvement in our health care system. Because of the time factor, I will only mention two: the implementation of national health insurance to provide universal access to health; and the improvement of the quality of health services through performance monitoring.
During the celebrations on 8 January, the president of the ANC, Jacob Zuma, said, and I quote:
The ANC government will strengthen the formal partnership against Aids in our country in the form of the South African National Aids Council. This structure brings together government, business, labour, women, youth, religious leaders, the entertainment fraternity and many others.
He said this because as the ANC, we believe that working together, we can do more.
In conclusion, the ship is indeed on course, as many of us will agree - our scorecard makes for interesting reading. The people of South Africa have every reason to want to associate themselves with the ANC. To the people of South Africa we say that our overarching priorities include accessible, affordable and quality health care for all. We are not saying that we will deliver all of this from above, but we are saying that with all of us working together we will transform our health care services. The ANC leads, the ANC lives!