Chairperson, hon members and guests in the gallery, since 1994 the ANC has led the way in providing an integrated, holistic approach to major social and economic questions, including the provision of infrastructure. One of our major tasks when we came into government was to conduct a massive survey of infrastructure needs in the face of the obvious backlogs we faced.
Empeleni kufanele sisho sithi phela asikaqedi ngisho iminyaka engama-25 siphethe uhulumeni, sisaphila leziya zinsuku zikaDokotela Rina Venter kanye noDokotela L A P A Munnik, lapho kwakuthiwa abantu abangebona abamhlophe bazohlala laphaya bese abahlophe behlala laphaya. Ngakho-ke sisaphila kuleso simo kodwa siyasiguqula futhi sizosiguqula. (Translation of isiZulu paragraph follows.)
[In fact, we must say that we have not even been in government for 25 years, but it feels as if we are still living in those days of Dr Rina Venter and Dr L A P A Munnik, where people were classified according to their race. We are still living under such conditions, but we are definitely changing it.]
The National Development Plan, supported by the New Growth Path and other programmes, invites us to look beyond the constraints of the present to transformation imperatives of the next 20 to 25 years. The National Development Plan talks at length about health care and infrastructure improvement.
Sihlalo kubalulekile ukuthi ngisho ukuthi njengoba kwakhiwe izakhiwo eziningi, empeleni uKhongolose ufike kungekho zakhiwo. Niyakukhumbula lokho. UKhongolose ufike kungekho imitholampilo yabantu kodwa manje wakhe imitholampilo eseduze nalapho kuhlala khona abantu. UKhongolose usuwakhe nezibhedlela waphinde wavuselela nezinye izakhiwo ngendlela enesivinini esikhulu. (Translation of isiZulu paragraph follows.)
[Chairperson, it is important that I point out that many buildings have been built; in fact, these buildings were not there when the ANC took over. The ANC came into power when there were no clinics for the people, but now they have built clinics close to where people live. The ANC has built some hospitals and has also renovated some of the buildings as quickly as possible.]
The management of health infrastructure facilities focuses on co-ordinating and funding health infrastructure to enable provinces to plan, manage, modernise and improve the quality of care in line with national policy objectives and responsible for conditional grants, as well. I will say again that infrastructure delivery is a key priority of the ANC-led government, hence large amounts have been budgeted for this.
Phela izakhiwo lezi ezintsha zibalulekile ukuze izibhedlela zikahulumeni nazo zithandeke njengalezi ezizimele ezingezabadla izambane likapondo. Izibhedlela zikahulumeni noma zingaba zinhle kanjani ngeke zikhobole abantu, zibakhobolele ukuthi izakhiwo zazo ziyabiza. Uhulumeni uma, esesakhile isakhiwo sekuphelile; sesizosiza umphakathi ngendlela okufanele siwusize ngayo.
Siyazi ukuthi izakhiwo lezi zenzelwe ukuthi sikwazi nokuthi lolu Hlelo lwezeMpilo lukaZwelonke, phecelezi i-NHI esikhuluma ngalo lwenzeke kahle ngoba abantu bazobe bezithanda zonke izibhedlela futhi bazobe bethola usizo ngayo yonke indlela, ngaso sonke isikhathi ngaphandle kokuthi bakhiphe emaphaketheni abo. Ngakho-ke siyakuncoma lokho ngohulumeni kaKhongolose. Okulandelayo engizokusho Sihlalo namaLungu aHloniphekileyo ... (Translation of isiZulu paragraphs follows.)
[These new buildings are very important because as government hospitals they have to be just as admirable as private hospitals, which cater for wealthy people. Government hospitals, irrespective of how beautiful they are, will not overcharge the public just because their buildings were constructed at great expense. Once the government has completed the building, it will then serve the public in a way that it is expected to do.
We know that these hospitals are built to make sure that the National Health Insurance, NHI, is achieved, because people will like these hospitals and they will be getting help in every way, all the time without paying. Therefore we praise the ANC-led government.
The next thing that I will point out, Chairperson and hon members, ...]
... we are aware that there are four state-of-the-art hospitals and that they have been completed. These hospitals are modern, well equipped and top of the range. I am surprised that the IFP member says that TB seems to be rampant in hospitals, when we have these TB hospitals which are well constructed, which are well ventilated and which allow people to get better even when they have multidrug-resistant TB, because of the way these hospitals are constructed. Angazi ukuthi uzakwethu we-IFP uqonde ukuthini [I don't know what my IFP colleague is trying to say.]
The Portfolio Committee on Health, for example, visited state-of-the-art TB hospitals, which use the latest design innovations developed by the Council for Scientific and Industrial Research in South Africa. For instance, the Centre for the Aids Programme of Research in SA, Caprisa, has a wonderful TB hospital which used to be the old TB centre in KwaZulu-Natal. We went to Welkom as the committee and saw that they have a wonderful TB hospital. It's brand-new and has been constructed as a state-of-the-art TB hospital - hon IFP colleague.
The ANC, using its geospatial technology, is now able to map out where the greatest need for health services is likely to be. It takes into account the difficulty of transport in the area, and a number of other factors, and plans accordingly. The World Health Organisation uses five kilometres as a benchmark for access to health care. Where terrain and other factors impede delivery, mobile clinics are used. These include mobile clinics which visit schools, dealing with dental and ophthalmic or eye problems. The public health infrastructure comprises over 4 333 health facilities and is worth more than R300 billion. The ANC has specified that at least 5% of the budgeted amount for infrastructure must be set aside for preventative and routine maintenance.
The success of health infrastructure delivery is owing to infrastructure units within the Health department. These units include professional engineers who help to deal with the buildings that are being built. Whilst capacity is scarce, not to mention costly, it is an investment well made. In addition, the National Treasury's Strategic Projects and Support Unit has been helping the national department and provinces with capital and maintenance projects. It provides technical assistance and training in planning, procurement and management.
Some provincial departments have been sluggish in some key capital projects, thus causing backlogs. Gauteng spent only 34% of its budgeted expenditure on hospital revitalisation in the past financial year, despite a number of clinics and hospitals needing renovation. At the end of 2012, over 19 health facilities and 49 nursing colleges were in different stages of construction and refurbishment.
It is important to acknowledge the successes of the ANC in the area of health infrastructure delivery. However, a number of challenges remain. The key department used for infrastructure is not doing what it is supposed to do. The contractors come on and off and charge exorbitant amounts of money. This is going to be corrected in the near future.
Nursing colleges are going to be opened in various provinces. To date, 70 nursing colleges and schools are being refurbished. These colleges are in the following provinces: Eastern Cape 11; Free State 4; Gauteng 15; KwaZulu- Natal 12; Limpopo 6; Mpumalanga 4; the Northern Cape 1; the North West 8; and the Western Cape 11.
Kusho ukuthi sizoba nabahlengikazi abenele ngalezi zakhiwo ezizokwakhiwa. [Ihlombe.] Laba bahlengikazi bazokwenza umsebenzi odingwa nguMnyango wezeMpilo nabantu emphakathini. (Translation of isiZulu paragraph follows.)
[It means that we will have enough nurses because of the buildings that will be constructed. [Applause.] These nurses will render a service which is needed by the Department of Health and the people in the community.]
Major infrastructure projects are also under way in the tertiary centres. Feasibility studies are at an advanced stage in five centres: the Polokwane Academic Hospital in Limpopo, the Chris Hani Baragwanath Academic Hospital in Gauteng ...
... empeleni ngisakhuluma nge-Chris Hani Baragwanath Academic Hospital, lesi sibhedlela yisona sodwa esikwazi ukwenza uhlelo lwe-dialysis kubo bonke abantu abayidingayo ... [Ihlombe.] ... bese kuba yi-Dr George Mukhari Hospital e-Gauteng; kube yi-Nelson Mandela Academic Hospital eNtshonalanga Kapa; kube ne-King Edward VIII Hospital KwaZulu-Natali.(Translation of isiZulu paragraph follows.)
[... in fact, I'm still talking about Chris Hani Baragwanath Academic Hospital. This hospital is the only one which offers dialysis to people who need it ... [Applause.] ... Dr George Mukhari Hospital in Gauteng, and the Nelson Mandela Academic Hospital in the Western Cape; and also King Edward VIII Hospital in KwaZulu-Natal.]
The national Human Resources for Health strategy was launched in 2011. Work has started on the determination of norms and staffing needs for the country for primary and secondary health care. This is being done with the support of the World Health Organisation.
As envisaged in the Human Resources for Health strategy, a leadership and management academy was launched in 2012. Its vision is to be a centre of excellence and a beacon of good practice in health leadership and management. The academy's aim is to develop outstanding leadership and management in health in order to improve people's health and their experience of NHI.
Kubalulekile futhi ukuthi ngiphawule ngokuthi izinga lokuqeqeshwa kodokotela liyakhula usuku nosuku. Njengoba sekushiwo ukuthi odokotela bayaqeqeshwa e-Cuba futhi siyazi ukuthi kukhona odokotela abangama-40 abazoqeqeshwa yiNyuvesi yase-Witwatersrand lapho uNgqongqoshe enza amalungiselelo okuthi lokhu kukwazi ukwenzeka. Siyafisa ukuthi namanye amanyuvesi enze into efanayo. (Translation of isiZulu paragraph follows.)
[It is also important for me to mention that the level of training of doctors is improving day by day. It has been mentioned that doctors are being trained in Cuba and we all know that there are 40 doctors who will be trained by the University of the Witwatersrand where the Minister is making some arrangements for this to happen. We wish that other universities also do the same.]
The number of professionals undertaking community services is increasing, with 7 162 placements across all provinces from 2012, covering doctors, dentists, pharmacists and other specialists.
The Auditor-General's report on infrastructure delivery in both the health and education sectors listed a number of challenges. These challenges include, amongst other things: unsatisfactory planning escalating the cost of projects; a lack of capacity at the Department of Public Works, as I previously mentioned; challenges with procurement; challenges in project management; low quality of work resulting in new contractors being appointed to redo the work.
Of great concern is the fact that service delivery is delayed when hospitals and clinics are not completed on time. Some provinces tend to start a number or a plethora of infrastructure projects at the same time, and then are not able to complete them. In fact, all the provinces that came to the portfolio committee reported the same thing. This makes it very difficult particularly for the patients, because some projects commence whilst the facility is still in use and it becomes a great inconvenience. This inconvenience is made worse when long details in construction occur. One of the biggest challenges is the contractors, and I do not know how many times this can be repeated.
I must point out at this point that health education is a societal issue. It is not an issue for the Department of Health only, as it is an issue for all of us. No government in the world, irrespective of how good it is, can go from house to house to identify people that need to be taken to a health facility. [Applause.]
Health infrastructure delivery has been identified as a key to achieving fundamental reform of the health system in the country. There is also the issue of undoing the legacy of previous policies. This includes the distribution of infrastructure between urban and rural areas, something which is a tremendous challenge. However, as South Africa prepares for the implementation of NHI, this is a challenge that must be met.
I would like to conclude by reminding this House that in October 2011 the ANC government appointed a task team on education and training to take forward the recommendations from the April 2011 Nursing Summit. This has resulted in a national strategic plan being completed in February 2013. As a result, an e-health strategy has being launched to harness information communications technology to help the health system. The strategy aims to resolve the problems of the past, clearly articulated in the Negotiated Service Delivery Agreement from 2012 to 2014.
Ithi ngize kula bozakwethu abaziphumele endleleni bazisholo abakuthandayo. Angazi ukuthi bakuthathaphi konke lokhu abakushoyo kodwa angikusho konke lokho. Kumhlonishwa u-Kganare - awu!, usehambile? Kodwa-ke ngithanda ukusho ukuthi uKhongolose useduze nabantu, i-Cope ikuphi yona nabantu?
AMALUNGU AHLONIPHEKILE: Isenkundleni.