Hon Chairperson, let me acknowledge the presence of everybody that Dr Goqwana already acknowledged. A budget is a resource, which should be utilised by the department to ensure that its plans, strategies and objectives are achieved. These intentions can only be assessed and evaluated by looking at and appreciating its outcomes.
When a budget is debated, we hear the intentions, look at the past outcomes and decide whether to support the Budget Vote or not. We also make suggestions concerning the implementation of and the allocation to programmes. Hon Minister, there are a lot of visible and encouraging interventions from your side, but unfortunately the implementation of health services occurs at provincial and municipal level.
Whether we achieve the Millennium Development Goals or not depends on what happens at hospitals, clinics and communities. There are people who continuously argue that although South Africa spends a significant amount on health, its health system provides poor value for money. This statement is premised on the fact that South Africa spends 8,6% of its Gross Domestic Product on health services, roughly the same as Brazil, England and Italy, and they all have better health outcomes. This argument is disingenuous because these countries have different histories from ours and never had to deal with the legacy of apartheid like us.
Cope's assessment of whether the department is dysfunctional or not depends on whether patients and staff feel safe and welcomed at our health facilities. We can be safe if the clinics and hospitals are clean, have adequate medication and laboratory services thats provide feedback to doctors on time, and there is equipment to provide quality health care services.
Chairperson, the Auditor-General made some disconcerting findings last year concerning financial management in the provinces. Let me list just a few of those that Cope feels demand urgent attention, and I quote:
Firstly, provincial departments of health across the country are breaking the rules and regulations when awarding multimillion rand tenders; secondly, it is a contravention of the Construction Industry Development Board Act to appoint a contractor that is not registered according to the correct grading.
Despite this, health departments from various provinces awarded tenders to the value of R876,8 million to contractors with no grade or with lower grades. In Soweto, the construction of Jabulani Hospital began in 2003 and dragged on until 2010, at a cost of R537 million, instead of R256 million.
These things, hon members, happened because some government officials meddled in the awarding of tenders. In most cases the supply chain management, SCM, process is compromised so that the anointed bidder is awarded the tender by hook or by crook.
In this instance hon Minister, I urge you to discuss the Lejweleputswa District SCM with your colleagues in the Free State. The suppliers in that area, who approached me, told me that all the staff members in the SCM knew who managed corruption and how it was managed.
They believe that senior management, which is aware of what is happening in the district, is either part of the corruption or those involved in the corruption are doing something. They are doing something that might be compromising senior management; hence they are intimidating or harassing any staff member who raises concerns about how corruption is being nicely managed, more so than the institution.
Hon Chairperson, whenever corruption is exposed, the ANC-led government will tell us that heads are going to roll, but every time I just see very big heads nodding. [Laughter.] Hon members, no one is corrupt by accident, hence I urge you and your colleagues to make an example of the Lejweleputswa District's SCM.
Corruption affects the poorest of the poor more than the affluent. The affluent can buy any service, but the poor will not be able to do that. It directly affects the provision of quality health care that can be directly linked to women and children's mortality rates. Hon Minister, millions of newborn children and mothers continue to die needlessly. Earlier this year, Carolyn Miles, the president and chief executive officer of Save the Children, said that although there has been a reduction in the mortality rate of under-fives, the deaths of newborns were still a stubborn part of the problem.
She also revealed that over 40% of children who die before they reach the age of five years will die within the first month after birth. Babies are dying of common diseases such as pneumonia, diarrhoea, preterm complications and asphyxia. Surely, hon Minister, these are not things children should be dying of.
If Malawi, as poor as it is, succeeded in achieving a 29% decline in newborn deaths since 2009 and is on track to meet the MDGs, we can surely learn a thing or two from them.
Hon Minister, one of the main strategies of reducing maternal deaths is the provision of contraceptives, on the one hand. On the other hand, one of the causes of maternal deaths is illegal abortions. Whilst on this subject of abortion, you might enlighten me as to whether there are other countries that advertise death to desperate people like we do. Newspapers and streetlight poles in our country are plastered with adverts for abortion. At the same time there are these people who advertise cures for Aids and cancer, and also talk about helping people to win the lotto in the same pamphlet. They continue to operate in our country. I want to check if there is any law that prohibits this type of practice. If not, can we look into formulating a law will prohibit these activities?
Minister, I am not going to talk too much about the NHI. As Cope, we support access to universal health care, but the issue should be clarified because the politicisation of the concept of a NHI is really a problem.
The private sector, which projected the NHI as the nationalisation of health, is at the forefront of challenging the NHI as projected. I think it is really up to us to clarify whether it is a financing model or a ... [Interjections.] [Time expired.] Thank you. [Applause.]