Hon Chairperson, members and guests, the DA is heartened by the enthusiasm, zeal and hands-on approach that the Minister has displayed since his appointment. However, if we look at some recent newspaper headlines, we will see that he has inherited a health department that is in deep trouble: "State health care in crisis", according to the Sunday Times.
In the Weekend Post, referring to the dilapidated Elizabeth Donkin Psychiatric Hospital in Port Elizabeth, I read of this hospital of horrors, where a disturbed patient recently committed suicide ... [Interjections.] ... after ward conditions became unbearable because of overcrowding and other factors. There was no proper monitoring by nurses because their station had been removed to accommodate yet more patients.
Is this the mark of a country that has a Patients' Rights Charter and a Constitution that upholds human rights, dignity and the right to a safe and healthy environment? Why do we read of abusive and uncaring nursing staff? Can it be that their working conditions are so bad that they are demoralised and at the end their tether? [Interjections.]
I believe that nurses at Cacadu have not yet been paid for January, February or March. In some municipalities, cash collections have had to be made to buy electricity to keep the fridges in hospitals running so that the medication and vaccines for babies does not go off. Is this perhaps one of the reasons we have had so many tragic deaths of babies in neonatal units?
The overcrowding and lack of resources at the Charlotte Maxeke Academic Hospital, horrific conditions at the Dr George Mukhari Hospital, the shortage of drugs, Disprins and equipment at Chris Hani Baragwanath Hospital and the deaths of 180 babies at the Nelson Mandela Academic Hospital in Mthatha, all bring shame to our nation. What will the national department do to wake up hospitals and management and get competent, dedicated professionals into state institutions? Minister, why was the Hospital Revitalisation Programme budget underspent by R1 billion in 2010- 11? How is it possible that there is underspending if so many of our hospitals and clinics are falling apart and their needs are so critical?
In The Herald, I read about the critical staff shortages. This resulted in the country's first acute surgical unit, at the Livingstone Hospital, having to be closed because of the dire staff shortage in the casualty unit. It is regrettable that this unit, which was to provide expert treatment and was a signal of progress, had to be closed.
The shortage of medical practitioners - on average, 30% of the registrar training posts of the Health Professions Council of South Africa and 75% of subspecialist positions are vacant - is a matter of grave concern. Is this perhaps because the hospital managers do not have the required skills and financial expertise to run the hospitals properly? Staff appointments must be based not on favours for comrades, but on qualifications, fitness for purpose and experience - as we see in the Western Cape. All South Africans, particularly the poor, who suffer the most, need to know what programmes your Ministry has in place to ensure competent and dedicated staff members are appointed.
Minister, why did the key activities for improving training facilities not take place in 2011, for example, the accreditation of facilities, external audits of health facilities and the establishment of the Ombudsman Office?
We have massive problems with health compliance in South Africa. Why is only 2% of the health budget being spent on health regulation and compliance management? The budget of R62 million for the Office of Health Standards Compliance may not be sufficient. All across the country, there are doctors, nurses and health institutions that are not complying with the basic minimum standards in health care.
The chaos and lack of quality health care, especially in the Eastern Cape, must be improved. It is a basic right, one which the Western Cape administration adheres to and where the life expectancy is 65 years. [Interjections.]
The NHI, your plan to turn the system around, will be stillborn without sufficient doctors and without specialists in every district. We need to be assured that the vast amount of money, the R900 million, to be spent on the NHI over the three years will be well spent.
President Zuma said in his state of the nation address that women's health care programmes would be a focus area for the financial year. In the build- up to 2015, when we assess our progress in reaching the Millennium Development Goals, particularly regarding maternal and infant mortality, the decrease of almost 40% in the budget is a concern. Women's health care is not covered adequately in the strategic plan. To talk about maternal, child and women's health is not enough. We need decisive action to make a difference. We need to utilise our resources correctly to make sure that the most vulnerable people in society get the care they deserve. Primary health care services have also received a relatively small allocation in the budget. This does not gel with the Minister's stated intention to achieve a primary health care approach as opposed to the current hospicentric approach.
The spending of R800 million on the use of consultants is very worrying. We need to know what they will be doing, the projects they will be involved in and whether the department will be getting value for money.
The Auditor-General of South Africa has found significant challenges in infrastructure delivery at provincial departments of health. The current meltdown in the national Department of Public Works is harming the poor in all provinces, as they are the people who suffer most when clinics and schools cannot be built, due to interminable delays caused by government red tape.
After 17 years of freedom, the government has failed us. South Africans deserve better health care. Minister, we trust that you will be able to act as a catalyst and turn the situation around to improve it. We look forward to an improvement under your care. I thank you. [Applause.]