Hon Chairperson, hon Minister and members of the executive present, hon Deputy Minister, hon MECs, members of the department and distinguished guests, it is a great privilege for me to stand at this podium once more. By the way, the ANC supports the budget.
Now, and even more so in the future, the pursuit of a better health status in our society will be determined, to a large extent, by how effectively we are able to prevent and control noncommunicable diseases such as diseases of the heart and lungs, cancer, diabetes and mental disorders.
Last year, in your Budget Vote speech, hon Minister, you emphasised that these diseases were increasing, that you would be paying greater attention to addressing the main risk factors, as well as increasing screening and aiming for better control of chronic conditions. We see you and your department indeed making progress in this regard.
The additional actions that are outlined in your plan this year are absolutely in line with the recommendations arising from the Summit of Non- Communicable Diseases that was held in September last year. The General Council of the United Nations also held a meeting on noncommunicable diseases last year.
A healthy lifestyle combines two main approaches. The first is to facilitate better health through government interventions that support population health and the second is getting people themselves to change the unhealthy aspects of their lives and embark on healthy practices. More work must indeed be done to strengthen both of these levels.
Last year, hon Minister, you promised that you would bring out regulations for the reduction of salt in processed foods, as salt is a major contributor to hypertension and high blood pressure. It affects, on average, 31% of men and 36% of women in South Africa. We understand that since you made this promise, you have embarked on wider consultations, both locally and internationally, regarding reasonable targets and time frames for achieving them. We are encouraged by the work done thus far, although there is still a long way to go to achieve the goal of reducing noncommunicable diseases, morbidity and mortality.
Another risk factor inherent in noncommunicable diseases, but also communicable diseases like maternal disorders, child health and injuries, is alcohol. Hon Minister, we are encouraged by your commitment to fighting this serious issue and we are even more encouraged that you will be bringing out legislation on the advertising and marketing of alcohol. This is a great step indeed.
The evidence that is out there on what alcohol does to our society is very clear and all efforts must be employed to fight this disaster. Research shows that alcohol is the third-highest global risk factor for disability and it shortens our lifespan.
In South Africa, alcohol accounts for around 130 deaths per day. According to the WHO, we fall into the category of countries that have the highest consumption of alcohol. One study has put us as the tenth highest country for alcohol consumption in the world. In the past year, research has shown that we fall into the second-highest category of the WHO countries that have harmful patterns of drinking and heavy episodic drinking with over 30% for both male and female drinkers.
We also note from the survey conducted in 2008 by the Medical Research Council on youth risk behaviour that 34% of males and 24% of females in Grade 8 to Grade 11 are binge drinkers. This is different from the 29% for males and 18% for females figures discovered in 2002. Hon Minister, if we neglect to take heed of all this information and do not act on it, we surely would be failing in our duties as the custodians of and activists for health, and especially as government.
We note with concern that there are those who are opposed to your call for banning alcohol advertising and sponsorship. They argue that such action will not reduce alcohol-related harm. Hon Minister, we support you in this endeavour and we beg to differ with them on this matter. Research indicates that alcohol advertising and sponsorship bring about positive beliefs about drinking, and young people are encouraged to drink alcohol sooner and in greater quantities than they would otherwise. These are reasons enough for us to act. We must try to shift away from advertising harmful products, and we look forward to working with you.
Our success and great achievements with regard to restricting tobacco use in this country are well documented and we should be proud of that. This reminds me of all those sceptics who lamented and argued so strongly that the banning of tobacco advertising would result in massive job losses and revenue for this country. It is now clear, hon Minister and the House, that these arguments and claims were futile and are now history.
If I may, I want to take a step back to the topic of a healthy lifestyle and reiterate that we need a serious change in the attitudes of both government and citizens. Eating healthy food and exercising is a goal that we would like every person in South Africa to take very seriously.
We must do our utmost, through partnerships, to make healthier food more available and affordable, especially to poor people. We should facilitate more physical activities for children at school, but I also want to challenge our communities and every person in South Africa to start taking a healthy lifestyle more seriously.
We have serious behaviours that we need to change as a society, so that our health and that of our children can improve. These behaviours include eating junk food or fast food, lack of exercise, engaging in unsafe sex, excessive and irresponsible use of alcohol and smoking.
We must bring back and instil the culture that our parents had in the past, such as having small vegetable gardens at our homes and schools and walking to school rather than being driven there. We must distance ourselves from smoking and the use of alcohol. Our grandparents and parents were stronger and healthier because of these practices. [Time expired.]
THE DEPUTY MINISTER OF HEALTH: Hon Chairperson, Minister of Health, Dr Aaron Motsoaledi, Ministers and Deputy Ministers present, colleagues, MECs, the hon Chairperson of the Portfolio Committee on Health, Dr Monwabisi Gogwana, members of the Committee, hon members of the House, the Director- General, management at national and provincial levels, leaders of various statutory bodies, health unions and other health-related organisations, a special acknowledgement of Mme Yvonne Chaka Chaka - morwedi wa Machaka [daughter of Machaka], distinguished guests, ladies and gentlemen, it is my privilege to address the honourable House during the debate on the Health Budget Vote for the financial year 2012-13 within the medium-term framework.
This debate takes place as we celebrate the centenary of our liberation movement, the ANC, which represents the unstoppable determination of millions of peace-loving people of our nation and the world to usher in justice and democracy and a better life for all in our country.
In this month of April we also recall the hanging of Solomon Kalushi Mahlangu, the death of Mita Ngobeni and many other children and young people, who paid the ultimate price for the freedom we are enjoying today. For them a long and healthy life was not to be because of the apartheid regime.
Going down this painful but inspirational legacy of the triumph of humanity in our young democracy, I invite you to join me in paying tribute to all progressive health workers, who, individually and through organisations, were part of the liberation struggle in various ways.
Many remained true to their professional ethic and human conscience as they provided essential health services to the oppressed under difficult circumstances. They cared for survivors of the injuries inflicted during the mass protests and refused to trade their scientific knowledge for human healing for activities involving biological murder - or what is called biological warfare.
We pay tribute to the then aspirant and practising health workers who understood that peace, justice, freedom and democracy were also the foundation for, amongst other things, reducing the high levels of severe malnutrition, of which our children were dying. Today, they are no longer dying of this.
We have succeeded in reducing the high levels of trauma as a result of violence and shooting. We are also winning the battle against the ravages of tuberculosis, which first begins in unhealthy conditions in the mining and farming sectors.
We salute, amongst others, Dr Xuma, Dr Naicker and Dr Dadoo, who provided leadership under what was referred to as the Doctors' Pact, which unified our people across racial divides and paved the way for the adoption of the Freedom Charter, which pronounced on the rights of all South Africans. We pay tribute to Steve Bantu Biko and many aspirant health workers who suffered and died as human rights activists.
We honour Mrs Ruth Bowen, who is now 91 years old, Mrs Albertina Sisulu and Mrs Rosina Mphahlele, who have since passed on. In a disciplined and tenacious manner they nursed our people with distinction and with great care and compassion, despite the apartheid system.
We remember Dr Abu-Baker Asvat and Dr Ribeiro and his dear wife, who were murdered at their consulting rooms and homes respectively, within communities they served and for whom they were prepared to do whatever it took to improve their wellbeing.
As we build a developmental state today that has as one of its outcomes a vision for a long and healthy life for all, we remain inspired by the contributions that these and many others made to change the underlying sociopolitical and economic conditions that were a danger to our nation. We will commit ourselves with determination, and invite all within the health system to do so, as we recognise that the constitutionally protected health and reproductive rights are not yet accessible to all South Africans, especially in rural provinces.
Dr Gogwana, we sadly acknowledge that the interventions in the health departments of the provinces of Limpopo and Gauteng by Cabinet, through the provisions of section 100 of the Constitution, were indeed necessary to protect the health system for the benefit of mainly the poor in these provinces. We would have no choice when it comes to other health care services. We also wish to call on all stakeholders to work with us to defend the progress that we have made today.
We should continue to construct a society that is ready at all times, especially with regard to the health system, to democratically and in a disciplined manner intervene without fear or favour to combat the many ills and inexcusable actions or inactions of inefficiency, incompetence, fraud and corruption that put the heroes and heroines of our liberation struggle to shame because they threaten the health and wellbeing of our people. We believe that the introduction of the Office of Health Standards Compliance, which oversees the offices of the ombudsperson, norms and standards and the inspectorate, will certainly be valuable in guarding against these ills.
We want to thank the provincial leadership under the MECs, the premiers of these provinces and the heads of departments, who have worked with us in a very constructive manner to deal with many of these ills.
Some of these ills were inherited and some in fact happened whilst these HODs were in office. We would also like to call on those who are involved in these ills to be subjected to disciplinary action. You can discipline someone for incompetence as provision is made for this. We can discipline someone for fraud and corruption. Actually, we must do that to protect the interests of our people and the institutions for which many have struggled and died.
We must also guard against shallow and narrow political opportunism and the prejudices that underlie racism. For now I'll call it "prejudices" when some tend to dismiss the historical reality referred to by hon Kganare.
Indeed, there are provinces - Gauteng and the Western Cape, in particular - that benefited from the inequities of the past. Even previously, the resources of the Cape province were mainly invested in the Western Cape - around Cape Town, in particular - to the detriment of our people throughout the province. [Applause.]
We acknowledge the statement that was made in an interview and referred to our people, who are accessing services available in their country, as refugees. We really ask the DA party and its leader to have the integrity to formally apologise to the nation and to the people of the Eastern Cape, in particular. [Applause.] [Interjections.] Yes, I'm aware that you apologised, but it was a "by the way". The interview was not called specifically for that. [Interjections.]
Let me also acknowledge that it is important and it is our common goal to have a common vision, work together and redress imbalances. We will remember that South Africans have a right to access services throughout the country. We are all South Africans before we belong or live in one or the other city or province. We shouldn't reinforce the past, when people's birthright were not even acknowledged in the country of their birth.
We agree with hon Kganare that the context of a country is important. In this case, hon Kganare, in terms of the 8% expenditure that you referred to, only 3% of this expenditure is in the public sector to look after the majority of the population, whilst around 5% is in the private sector.
Over the next three days here in Cape Town, the Department of Health, Department of Science and Technology, as well as the Council of Health Research and Development, are hosting the Global Forum for Health Research conference under the theme "Beyond aid - research and innovation as key drivers for equity and development". This issue of equity and development is not unique to South Africa. It's a worldwide phenomenon, which we must work together to deal with.
We have begun to utilise evidence-based research to inform our policies and programmes. Already we are seeing significant progress and, amongst other things, the reduction of mother-to-child transmission of HIV by more than 50%, as referred to by the Minister.
We have also invested in convening various summits with experts, health workers and other stakeholders in the areas of noncommunicable diseases, mental health, breastfeeding and the NHI.
Indeed, hon Dube, the regulations on salt content control for industry are ready for the Minister's consideration and will be signed within the next few months. [Applause.] Beyond these regulations, together, we must empower our people to understand the vegetables that we eat contain naturally occurring salt. Over time, our tongues will get used to those levels of salt. Currently, we are using very large quantities of salt, and many of us pour raw salt onto our food even before we taste it. We want South Africans to live long and healthy lives.
The NHI system is a catalytic programme to ensure equity in and sustainability of the health system. We are very encouraged that all provinces, including the Western Cape, have agreed to participate in pilot projects. We have no doubt that your participation in these pilot projects will prove that what we have presented to you is a solution for the country; a solution that will work in the Western Cape and everywhere else throughout our country.
Led by Prof Mayosi and the National Health Research Committee, we have began to align scientific research and the innovation capacity available in our country and globally to find solutions to reduce the burden of diseases and premature deaths, as well as to strengthen the quality, efficiency and effectiveness of the health care system.
The work that Dr Bomela and the Ministerial Advisory Committee on Health Technology are doing will be enhanced by the enactment and the establishment of the South African Health Products Regulatory Agency later this year. Already, the National Health Council has approved the essential equipment list. This will help us to know what the minimum amount of equipment is that should be available in every facility throughout the country in order to ensure that our health workers have these tools and that our patients receive high-quality services.
We can also leverage technology better in an integrated approach for the benefit of health workers and the public. We have already presented a draft of the e-Health Strategy to the National Health Council. The strategy will incorporate information and communication technologies for health, such as telemedicine, mobile health technologies and other technologies.
We want to thank Prof William Pick, who has just retired, for his valuable contribution made as the chairperson of the Council of Medical Schemes, which we will leverage in terms of experience in protecting consumers, as we construct and pilot the NHI scheme throughout the country this year. The experience of regulating the medical aid schemes in the industry will indeed be very valuable.
We appreciate, and we will certainly support, the Minister's efforts to visit each of the 10 NHI pilot sites and districts, in order to meet with stakeholders and the public, as well as the private sector. However, we also call on you to support the Minister.
My office will also continue to visit other districts to ensure that management remains effective, that it improves accordingly and that the quality and impact of health services continue to improve significantly.
Indeed, Dr Goqwana, these changes must be visible. Our audits have indicated where the challenges are and, as the Minister has said, management teams have already been deployed from the national office to ensure that they work with provinces to deal with the gaps that have been found.
During the visits that we paid to Namaqualand, Amathole and Gariep Districts respectively, we were already able to interact with provincial and local government colleagues as well as stakeholders in the area. Indeed, we must share the excitement of the progress that we see in terms of public health being transformed locally. I want to thank everybody and state that we support the Budget Vote. Thank you. [Applause.]