Hon Chair, the Premier of the Northern Cape, compatriots, members of the House, let me begin by once again expressing my apologies for not having been able to accompany you on your visit to the province earlier this year. I trust that you and the House accepted my apology and also accepted the participation of my Deputy who, I believe, represented us well. I am therefore very happy to be here today as we debate the report of your visit to the province. I really must regret my absence, as I can hear now that I missed a very good and educational visit to the Kgalagadi District. I've been there before. What I want to know is: Did they give you enough goat meat? What I would have enjoyed would have been the lamb from the Northern Cape.
I wish to congratulate the NCOP both for undertaking the visit to the areas affected by the changes in boundaries as well as for hosting this session. It is critical that we obtain feedback on progress as well as the remaining challenges that we face as a country. Changes in boundaries between provinces have significant implications for health, especially given that whilst health is a concurrent national and provincial function in terms of the Constitution, provinces have significant responsibility with respect to health service delivery.
I must also emphasise that when we speak about health, it is critical to remember that health is not merely an absence of disease but is also about mental and spiritual wellbeing. This means that we also need to consider other services that are or should be provided in the affected areas, including water, sanitation, electricity, education, housing, agriculture, recreational facilities, transport and others.
Our people seek health care services wherever it is convenient for them. In fact, our Constitution protects the right of people to obtain health care. This means that regardless of the provincial boundaries, we must take care of our point of departure that all provinces must ensure that health services are accessible to all South Africans and to all our citizens as a matter of principle.
Let me now turn to the progress that provinces have reported with respect to the handing over of facilities and transfer of personnel and other assets, as well as the extent to which there has been no disruption in service delivery to people living in the affected areas. The two departments of health - that is in the Northern Cape and North West - decided, in line with an implementation protocol signed by the two premiers, to enter into a service level agreement. This service level agreement provides for the North West department of health to continue until the end of the current financial year, that is March 2007, to provide health services in the affected areas. The service level agreement is being monitored by the heads of departments of the two provinces.
Joint technical task teams have been established in the following areas to ensure that the services are transferred to the Northern Cape department of health on 1 April 2007 - human resources, finances and other legal issues. These task teams will be meeting during this month, September 2006.
I wish to note that the North West provincial department of health is required to transfer services to both the Northern Cape as well as Gauteng. Like the service level agreement signed with the Northern Cape, the North West has also signed such an agreement with the Gauteng department of health. The North West provincial department of health has completed an audit of facilities, personnel and equipment that should be transferred to both the Northern Cape and Gauteng.
In summary, it is important to note that service delivery has not been disrupted as a result of the changes of provincial boundaries. Provinces have put in place processes to ensure that services, personnel and equipment are audited and to establish mechanisms for their transfer to the receiving province without disruption of services.
Permit me to take this opportunity to remind hon members of the challenges facing the Department of Health and what we are doing to address these challenges. The reason for doing this is that, in transferring services, we also need to ensure that these services improve both in terms of quantity and equality - importantly, in terms of quality.
Firstly, South Africa faces a triple burden of disease. We have to deal with communicable diseases, non-communicable diseases and unnatural causes of death, including interpersonal violence, motor vehicle accidents and suicides. This means that health services must be equipped to deal with all of these health problems in our country.
Secondly, we have a huge human resource problem in health. We need to train more health professionals, especially doctors, nurses, pharmacists and various therapists, and retain them in the public health sector.
And so, what have we done? One of the things that we've decided to do as the Department of Health is to begin to train mid-level health professionals. The retention of health professionals means that at least two things must be done: Improved remuneration - I hope Mrs Vilakazi is listening - improvements in environments, including revitalising of our health facilities, and increasing the number of existing categories of health personnel and developing new categories of health workers, for example, as I've said, mid-level health workers.
We as the National Health Council have also taken a decision in order to address the concerns that Mrs Vilakazi had pointed out -that we start off at least by building health posts where there are no facilities whatsoever and ensure that those health posts are at least managed by our community caregivers until we are able to catch up with the gap that we are experiencing.
So, those are some of the things we are trying to do. I hope that it can indeed also assist us to be a bit motivated and educate our people that community caregivers, in instances where there are no doctors, can be just as useful and that health posts are not a negation of their constitutional right to have community care centres and hospitals, but it does cost money and therefore we have to plan as we go along.
Thirdly, we need to further improve the quality of care that we are providing as a department. The public health system is often thought of as the provider of last resort. We must become both the employer of choice as well as the service provider of choice. We are delegating additional authority and responsibility to hospitals, CEOs, and we have introduced a hospital improvement plan.
Hon Hendrickse, I heard you are really concerned about some of our fellow South Africans who came crawling into the hall because they did not have the necessary devices to assist them. May I reassure you that the MEC and I will look into that matter and see how quickly we can provide wheelchairs or crutches for those people, if only you can give us a list of names of those you saw so that we can assist.
Fourthly, we must focus on a few priority health conditions but design our interventions so that we also strengthen the health system as a whole as we target these conditions. We are targeting the following areas: enhancing healthy lifestyles - I hope as you were in the Kgalagadi you did speak about healthy lifestyles so that people in that district don't have the same perfume but have different perfumes. Their perfume should not be the same because it's indicative of what they ... [Interjections.] I think Kgo?i had understood. We are strengthening our TB control. We are accelerating the prevention of HIV and Aids - I hope you spoke about that - and other conditions and diseases in our country and focusing on immunising all children to reduce vaccine preventable conditions as well as decreasing the number of mothers who die during pregnancy.
We know what needs to be done and we have strategies in place to focus on these issues. We need to enlist the participation of everyone to assist us to achieve these goals. Our goals are enshrined in the primary health care approach, which is about equity and about community involvement. I must praise the people of Kgalagadi if they raised their own money so that we can top it up to get them an ambulance. Please do convey our gratitude to them. The other component, of course, of primary health care is the intersectoral approach.
I wish to encourage members of this House to continue to work with us in order to improve the lives of our people by providing the necessary oversight, as you have done, in relation to the implications of the changes in provincial boundaries in the Northern Cape and North West Provinces. Please continue to give us oversight so that we can improve every day. I thank you very much for listening to me. [Applause.]