Somlomo, Mongameli, Sekela Mongameli, amalungu ahloniphekile kanye nezivakashi zethu, sivela esikhathini lapho isimo sempilo besicheme ngendlela esabekayo. Besihlukene ngendlela esabekayo. Bekunezindawo zokwelapha ezibhalwe amagama abantu, ezikhetha abantu kanye namabala abo; amakamelo okulaphela ahlukene kanye nemitholampilo ehlukene. Sivela kuleso simo esinjalo. (Translation of isiZulu paragraph follows.) [Mrs B T NGCOBO: Speaker, Mr President, Deputy President, hon members and our visitors, we went through very difficult times when we were severely discriminated against. We all lived completely separate and distinct lives. Health centres were designated according to one's skin colour; we had different consulting rooms and clinics. That is where we come from.]
Mr President, you were correct when you made health one of the Apex Priorities, among others, and when you introduced the National Health Insurance, NHI, which allows for equitable universal access and coverage, as required by the Constitution, the Freedom Charter and recommended by the World Health Organisation. During the 20th century, the Alma Mater called for Health for All by the year 2000. The country is fulfilling that call now.
Izitini zokwakha sezibekiwe ukuze sikwazi ukuqala uMshwalense kaZwelonke weZempilo, yize noma kungaxhamazelelwa futhi kungagijinywa kodwa zikhona zibekiwe. Ukwakhiwa kabusha kwezindawo zempilo, ukwakhiwa kwezibhedlela ezintsha nemitholampilo kuyindlela eyizitini zokwakhela uMshwalense kaZwelonke wezeMpilo.
Siyancoma-ke ukuthi noma kuza kancane kodwa kuyenzeka ngoba izibhedlela lezi ezizimele azisilungelanga thina esihlwempu ngaleyo ndlela siye sizithole sesibandlululeka. Thina esimpofu ukuze sikwazi ukuzuza impilo, lento ekuthiwa nguMshwalense kaZwelonke weZempilo izosisiza. (Translation of isiZulu paragraphs follows.) [The foundation to establish the National Health Insurance has been laid. We are not in any hurry, though, it will happen in due time. The renovation of our health centres and the building of new hospitals and clinics is the beginning of the implementation of the National Health Insurance.
We are very pleased with the progress so far, even though it is quite slow. Private hospitals are too expensive for the poor masses and they are unable to receive proper health care. The National Health Insurance is therefore going to benefit them significantly.]
The Green Paper on the NHI was published in August 2011 for public comment. We are awaiting the White Paper on the NHI. Many people commented on the Green Paper. We were quite excited that there was a lot of talk about the National Health Insurance. In 2012, a Bill on the establishment of the Office of Health Standards Compliance was published. Public comments on the Bill took place and it was passed by the National Assembly in November 2012. However, there are some additions that came from the NCOP, and they will be taken into account. The Act calls for the establishment of the following units: the inspectorate, the ombudsman and the certification office.
Ngizothi-ke qaphu qaphu ngezifunda okuzokwenziwa kuzo inhlolovo ezikhethwe uhulumeni: eMpumalanga Kapa kune-OR Tambo; e-Free State kuneThabo Mofutsanyana; eGauteng kuneTshwane; KwaZulu-Natal ngoba phela ibiyaziwa njengendawo eneningi labantu abahlaselwe ubhubhane lwesifo seNgculazi, uhulumeni wakhetha uMzinyathi noMzimkhulu, kodwa isifundazwe sona uqobo lwaso sazifakela Amajuba ngesimanga sokuthi sifuna ukuyisebenza kakhulu le nto yeNgculazi ukuze abantu babe ngcono; eLimpopo iVhembe; eMpumalanga i- Gert Sibande; eNyakatho neKapa i-Pixley KaSeme; eNorth West i-Dr Kenneth Kaunda; eNtshonalanga Kapa i-Eden.
Siyazi-ke ukuthi njengoba sikhuluma ngalezi zifunda, mningi umsebenzi osuwenziwe ukuxoxisana nabo bonke abantu abahlala kulezi zindawo ezinalezi zifunda. Kuxoxiswane nemiphakathi, amakhosi, abezakhiwo zenkolo, izikole, amakhansela nabo bonke abantu, akekho okungaxoxwangwa naye. Umuntu ongathi akazi, uzobe angalikhulumi iqiniso. (Translation of isiZulu paragraphs follows.)
[I want to mention a few districts selected by the government for the survey: O R Tambo in the Eastern Cape, Thabo Mofutsanyana in the Free State, and Tshwane in Gauteng. Since KwaZulu-Natal has always been known as the province with the highest rate of HIV and Aids infections, the government selected two districts, namely uMzinyathi and uMzimkhulu. The province added the Amajuba district, to intensify the fight against HIV and Aids in order to save lives. In Limpopo it is the Vhembe district, Gert Sibande in Mpumalanga, Pixley ka Seme in the Northern Cape, Dr Kenneth Kaunda in North West and Eden in the Western Cape.
Already, in the selected districts, extensive work has been done to discuss the matter with all the relevant communities. We have consulted with communities, traditional leaders, religious structures, schools, local councillors and everyone else. Those who pretend not to have been informed about it would not be telling the truth.]
Mr President, in April 2013, the National Health Insurance will be rolled out to 533 designated pilot clinics in various districts. [Applause.] Six hundred general practitioners have been registered to date to see patients at the ten clinics. There are more doctors that are committed, but because they are not registered we will wait until they are registered in order to know their numbers. Various health personnel will be included to do the work in order to assist with the National Health Insurance, including the community health workers. Retired nurses and nurses that are still in practice will assist with this.
Further, the President announced that the funds for the NHI will be made available in the coming year. This will allow for primary health care to take place within the designated districts. The President announced in 2009, regarding the HIV and Aids programme, that pregnant women were to be started on antiretroviral treatment should their CD4 count be 350 or less, and start attending clinics within 14 weeks so that whatever diagnosis and conditions they have can be identified in good time and be treated, other than their just receiving the antiretroviral treatment. Also, prevention of mother-to-child transmission has declined from 8% in 2008 to 2,7% in 2011. [Applause.] There is a decline in the mortality rate of infants and children under the age of five. [Applause.] These estimates are reported by the Medical Research Council, the MRC.
The President also encouraged the voluntary counselling and testing, VCT, campaign. This has taken place. More than 13 million people participated in the VCT campaign. Unfortunately, those who came were predominantly women. Even now we are asking, what has happened to their male counterparts? Don't they experience HIV or Aids in their lives, seeing that they did not come forward? We are expecting men to come forward and be tested. Those who tested HIV-positive from the group that came forth for testing are now on antiretroviral treatment.
Male medical circumcision has become the issue of the day. We are seeing young men going for medical male circumcision en masse. We applaud this because many men will become less vulnerable to HIV and Aids, provided they condomise after circumcision. We are quite encouraged and excited that the Zulu monarch is supporting this initiative. The President is leading the HIV and Aids campaign, supported by the Deputy President as the Chairperson of the SA National Aids Council, Sanac, and the Minister of Health is assisting with this.
South Africa has the largest treatment programme in the world. The World Health Organisation is actually quite happy about this because South Africa seems to be turning around the HIV and Aids problem for the better. There has been a reduction in the cost of antiretroviral drugs. The price of antiretroviral drugs has been reduced so that the country is able to buy more. The amount of funding that was to be spent on the antiretroviral drugs is now used for those people who have been left out of antiretroviral therapy.
According to Old Mutual, the industry has reported a decline in absenteeism in the workplace, and that people are no longer as sick as they were before the intervention through antiretroviral drugs. The MRC reported that an individual's life expectancy has been extended up to 61 years. We have to start on family planning because, as we speak, more young people are getting pregnant. Even ...
...abantwana abafunda ibanga lesikhombisa sibafica bekhulelwe. Kungani lokhu kwenzeka? Ngiyacabanga-ke ukuthi kwenzeka ngoba sinalomthetho wethu wokuhushula izisu, abawusebenzisa kabi ngoba umthetho awuvimbi ukuthi abantu bakhulelwe usetshenziswa uma abantu sebekhulelwe futhi kunezingqinamba zokuwusebenzisa. Awusetshenziswa inoma ikanjani.
Mhlawumbe uBab'uMphephethwa uzosisiza lapha kule mpicabadala esinayo. Bab'uMphephethwa, sinenkinga yamakolishi abahlengikazi, avulwa engavuli, aqalwa engaqalwa. Njengamanje nje ngisho abahlengikazi esibaziyo njengabahlengikazi abasaziyo isiguli sisekhaya, sisembhedeni, noma ngabe sikuphi esibhedlela basazi njengoba bezazi, bazimisele futhi bazinikele. Sibaswele labo bahlengikazi abenze njalo. NjengoNgqongqoshe wezeMfundo ePhakeme nokuQeqesha ngiyacabanga ukuthi wena ungenza lokho ukuthi kwenzeke, mhlwawumbe ubambisene noNgqongqoshe wezeMpilo. Siyethemba ngelinye ilanga sizowathola lama kolishi asebenza kahle. Okwamanje sinawo amakolishi asemanyuvesi afundisa abahlengikazi. Nami nje ngibafundisile abahlengikazi lapho, kodwa ababona ongqoshishilizi njengabahlengikazi abafundiswe emakolishi. Futhi siyazi ukuthi kunamakolishi lawa angoqhibu khowe abiza ngendlela emangalisayo. Athi ebiza enjalo, asikhiqizele abahlengikazi abangekho esimeni esikahle ngokwezidingo zanamhlanje. Bab'uMphephethwa ngiyethemba ukuthi leso simo uzosibheka, futhi usheshise ukusibheka ngoba sisenkingeni siyiNingizimu Afrika.
Siphinde futhi sikhulume ngamanyuvesi. Amanyuvesi uma sixoxisana namanye awo siwuMnyango wezeMpilo, athi: ubukhulu bawo busenjengoba babunjalo kudala ngaphambi konyaka we-1994. Manje awakwazi ukuthatha odokotela abadlula inombolo leyo ababeyithatha ngowe-1994. Kepha-ke umhlola wukuthi i- Wits ibathathile odokotela abangama-40. Ukuthi yona inwebeke kanjani-ke? Ngeso lakho elikhulu, Mphephethwa, ngiyacabanga ukuthi ungakwazi ukubhekisisa ukuthi amanyuvesi anwebeka kanjani ukuze sikwazi ukuthi sithole odokotela abaningana kunalaba abakhona. (Translation of isiZulu paragraphs follows.) [... schoolgirls as young as those doing grade seven get pregnant. Why is this happening? I think it is encouraged by the fact that abortion is legal in this country. We should, instead, have laws against untimely pregnancies, instead of dealing with them when they have happened already. Legal abortions are restricted; they can be performed only at the earlier stages of pregnancy.
Maybe Mr Mphephethwa [Dr Blade Nzimande's clan name] can provide a solution to this problem that we have: Mr Mphephethwa, we were just wondering about the reopening of nursing colleges. We no longer have very good, dedicated nurses who are well- trained to do their job. We, therefore, appeal to you as the Minister of Higher Education and Training, together with the Minister of Health, to give this some serious consideration. We have high hopes that one day the colleges will be open again.
For now, we do have nursing colleges at our universities. I have also taught some student nurses there but they are not as good as those that were trained at colleges. We are also concerned about the fly-by-night nursing colleges which are not only extremely expensive but they do not produce nurses who provide high standards of practice and care. These nurses cannot perform to the required level and do not meet the modern demands of the nursing profession. Mr Mphephethwa, we hope that you will give the matter the urgency that it deserves.
One other point to consider is the state of our universities. As the Department of Health, we have consulted with them and this is what they had to say: Not all of them have increased their capacity since 1994. Therefore, they cannot admit a number of medical students that exceeds their admissions in 1994. What we do not understand, though, is that Wits University has admitted 40 medical students. I do not understand how that has happened, since the capacity of the university has never increased. Therefore, Mphephethwa, we are appealing to you to ensure that our universities admit more medical students than they do now since we have a serious shortage of doctors in the country.]
On that note, we are quite excited that some of the departments have taken young people and trained them so that they are able to assist with primary health care as well as with the implementation of the National Health Insurance. We are hoping that in time the war against HIV will be won. I thank you. [Time expired.] [Applause.]