Modulasetulo ya kgabane le Maloko a Palamente a hlomphehang, ntlafatso ya bophelo bo botle ke e nngwe ya dintho tse ntle tse tla etsang hore re lokise masalla a kgethollo. Kgethollo e ile ya qhelela batho ba rona ba batsho ka thoko ditshebeletsong tsa bophelo bo botle. Ba ile ba iphumana ba tlameha ho tiisetsa le ho mamella mahlonoko a kotelo le ho se natswe. Kahoo mmuso o tlameha ho etsa makgobonthithi wohle hore ho be le tekano le boleng ditshebeletsong tsa bophelo bo botle ho Maafrika Borwa wohle ho sa natswe hore mang ke mang, haholoholo batho ba bileng mahlatsipa a kgethollo. (Translation of Sesotho paragraph follows.)
[Mrs S P KOPANE: Hon chairperson and Members of Parliament, the improvement of the health system is one of the decent things that will address backlogs that were caused by apartheid. Black people had been disadvantaged in the past in terms of health services due to discrimination. They were obliged to accept the bitter fact that they were not considered as people. As a result, government should come up with initiatives to bring equality and quality in health care services for all South Africans, irrespective of who they are, especially those who were previously disadvantaged.]
Every South African deserves quality health care because, as we all know, a sick nation can never be a successful nation. The provision of accessible, affordable and quality medical care to our people is not only a right but a moral and economic imperative. Therefore it is the responsibility of the House, together with the Minister of Health and the Department of Health, to make sure that we are provided with a plan that is going to fix our public health care system and provide every South African with quality health care.
Let us face the fact, hon members, that the system we have now is failing our people. We are constantly confronted by its failures on a daily basis. When I visited the Marantha Clinic in Brandfort in the Free State last month, I saw nurses and doctors dutifully trying to help the community of Majwemasweu, even though there was no water at the clinic. I was struck and inspired by the commitment and determination of the medical professionals to help the people of the community, even in the face of immense challenges. However, the nurses told me they could not help everyone because there was no water.
The workers there have done their utmost to make the best of their circumstances, but we have not kept our side of the bargain. As hon members, we should be ashamed of what happened at Marantha. Needless to say, there are countless other clinics and communities across the country, just like the Marantha Clinic, that we have left behind and forgotten about.
So, let us come to one of the critical questions of our time: What are we going to do to address the situation? I have no doubt that hon Minister Motsoaledi, together with his team from the Department of Health, has worked tirelessly to find the solution.
I have the utmost respect for Minister Motsoaledi. Minister, I respect your commitment and work ethic, and I fully understand that you have approached this problem with the best of intentions. However, with due respect, the hon Minister and the Department of Health have used the wrong approach in dealing with this issue.
Chairperson, let me state it clearly that the National Health Insurance, is going to be a complete disaster for the very people who hope to benefit from it. I say this because the NHI will be an enormous drain on the fiscus. Nobody knows what the actual cost of the NHI will be over a long period.
Hon Minister, I am sure you are going to give the House some assurances today regarding an accurate costing of NHI. Could you please tell this House how much it is going to cost the taxpayer? What we do know is that it is going to drain resources away from service delivery objectives. The poor will pay for the few available NHI resources, and that is a fact.
Secondly, the NHI will create an inefficient and bureaucratic health superstructure. It is highly unlikely that a bigger bureaucracy will solve our problems in health care.
Thirdly, the NHI will not fix the real problem in our system, which is the provision of low-quality health care. Instead, the Green Paper on the NHI focuses on accessibility and financing. As we all know, we already have universal accessibility and enough funding to run a good public health care system. The problem is that the quality produced by our system at the moment is not good enough. Nothing in the NHI proposal will solve the quality problem.
In the fourth place, the NHI does not adequately address the matter of accountability or management structures. The ministerial task team report on health care funding states that:
No part of the health care system is held properly accountable for the poor health outcomes or poor service delivery.
While the Green Paper calls for the establishment of an office of Health Standards Compliance, its members will be appointed by and answerable to the Minister of Health. With such a set-up this office will not really and truly be independent. This will make it vulnerable to political interference, not necessarily by the current Minister but from future Ministers who might not have the same good intentions as you, hon Minister.
Fifth, we lack the human resources to implement the NHI. We need to triple the 27 000 doctors that we currently have in our country, for the NHI to be effective. However, we train only enough doctors each year to keep pace with the number of doctors who retire or emigrate. The state is unable to train the necessary number of doctors or nurses in our country. Hon members, let us be honest about this issue: The numbers do not add up to what we are looking for.
Finally, throwing money at a problem does not always solve it. A good health care system requires a minimum threshold of funding to be effective. However, greater expenditure beyond that threshold does not guarantee better results. Other factors, such as accountability, governance and functionality, determine the quality of health care.
What does the DA suggest we do about our health care system? I hope this is the intention of all of us as Members of Parliament today. We have to focus on fixing the accountability, governance and functionality of the system that we already have. To attempt to build a complex, highly bureaucratic superstructure on top of a broken system is a recipe for disaster. Instead, we must focus on fixing the system we already have.
We need to create a national framework with national targets and minimum norms and standards for health care providers and effective oversight for both private and public health care sectors. We need to strengthen the capacity of the provincial health departments for better delivery by giving them more freedom in policy-making and holding them to account not only for compliance but also for health outcomes. The Western Cape has shown that this can be a success - just look at the world-class hospital the Western Cape government has built in Khayelitsha.
We need to capacitate health care providers to take responsibility for their performance. Public hospitals and clinics need increased autonomy and accountability and less micromanagement.
We need to create an independent health care oversight body with the powers to investigate complaints of poor health care services and hold those to account. This should be coupled with a quality-rating system applied to all private and public health care providers.
We need to promote public-private partnerships to increase the quality of health care in the public sector by allowing private companies to run public hospitals and by making private resources available to the public sector. We also need to work aggressively to reduce the medical skills shortage by promoting the establishment of private medical schools, increasing mentoring and apprenticeships and retaining the number of doctors and nurses in our country.
Spending on these programmes will benefit all South Africans more through improved health care, rather than spending on a bloated NHI system, which will never benefit all. The time has come for all of us to start thinking about what is practical and possible, given our constraints in human and other resources.
Re le mokgatlo wa DA re dumela ka hohlehohle hore bokamoso ba naha ya rona bo itshetlehile hodima diqeto tse nkwang ke rona batho ba etsang molao. Ho hlakile hore re na le matla a ho phahamisa dintle le ditoro tsa Maafrika Borwa le ditakatso tsa Ntate Mandela tsa Afrika Borwa ya setjhaba se le seng se nang le bokamoso bo le bong. Ke a leboha [Mahofi.] (Translation of Sesotho paragraph follows.)
[As the DA we fully believe that the future of our country depends on decisions that we take as lawmakers. It is evident that we have the power to uplift the morals and the vision of South Africans as well as President Nelson Mandela's wish of a united South African nation that has one vision. Thank you [Applause.]]