Speaker, Ministers and colleagues, allow me, while I have the opportunity, to bid the hon Mike Ellis farewell. I remember he was one of the few people from the opposition benches who actually welcomed me to this House in 1994. I thank you, Mike. Go well.
In terms of the topic - as far as health care is concerned and how we view health care - human rights is a universal guarantee protecting individuals and groups against actions which interfere with fundamental freedoms and human dignity.
Some of the most important characteristics of human rights are that they are guaranteed by international standards, legally protected, focus on the dignity of the human being, oblige states and state actors to act, cannot be waived or taken away, are interdependent and interrelated and are universal.
The right to the highest attainable standard of health, referred to as the right to health, was first reflected in the World Health Organisation, WHO, Constitution in 1946. It was then reiterated in 1978 in the Declaration of Alma-Ata in the World Health Declaration adopted by the World Health Assembly in 1998.
It has been firmly endorsed in a wide range of international and regional human rights instruments. The right to the highest attainable standard of health in international human rights law is the entitlement to a set of social arrangement norms, institutions, laws and an enabling environment that can best secure enjoyment of this right.
The most authoritative interpretation of the right to health is outlined in article 12 of the International Covenant on Civil and Political Rights, which has been ratified by 145 countries. The general comment from that covenant recognises that the right to health is closely related to and dependent upon the realisation of other human rights.
These include the right to food, housing, work, education, participation, the enjoyment of the benefits of scientific progress and its applications, life, nondiscrimination, equality, the prohibition against torture, privacy, access to information and the freedom of association, assembly and movement.
In South Africa, access to health care is a constitutionally recognised right under section 27 of the South African Constitution. It specifically recognises the right to access to health care, food, water and social security. Everyone has the right to have access to health care services, including reproductive health care. The state must take reasonable, legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights. No one may be refused emergency medical treatment.
In 1997 the South African Human Rights Commission, a statutory body assigned to evaluate the realisation of access to health care, held a public enquiry into the matter. The report was finally released in early 2009. This report found that the public health care system was - and continues to be - in a lamentable state. That is the view of the commission.
It further alluded to the fact that South Africa faces a number of challenges that complicate the progressive realisation of access to health care. The HIV and Aids statistics, for example, are amongst the highest in the world, placing a burden on public health. South Africa has the highest income inequality, globally, and the gap between public and private health care - with specific reference to affordability and quality of services - remains a major concern.
The South African government has obligations under the international and regional legal standards to ensure that all human rights are fulfilled, including the right to health, to life, to remedy, to be free from cruel, inhumane and degrading treatment and to nondiscrimination. The South African Constitution requires that international law must be taken into account when interpreting domestic legislation.
South Africa is party to many international and regional human rights treaties relevant to health care and access to remedies. At the international level, South Africa has ratified the following international instruments: The International Covenant on Civil and Political Rights, the Convention on the Elimination of all Forms of Discrimination Against Women and the Convention on the Rights of the Child. The convention protects children's rights by setting standards in health care, education, and legal, civil and social services.
Four of the Millennium Development Goals, MDGs, relate to health care, thus underlining the importance of the status of the health of a nation on the path to development. A number of laudable development targets for health had been agreed to at the Millennium Summit and at other United Nations, UN, conferences and international forums.
These targets include, for example, reducing the mortality rate for children under five by two-thirds, and measles, mumps and rubella by three- quarters by 2015; reducing HIV prevalence in all young people aged 15 to 24 years by 25% and the proportion of infants infected with HIV by 50%; and reducing TB-related deaths and prevalence and the burden of disease associated with malaria by 50% by 2010. South Africa has pledged to meet the eighth MDG goal by 2015.
In terms of regional instruments, we have the African Charter on Human and People's Rights and the African Charter on the Rights and Welfare of the Child. They are regional instruments that we are party to and we are obliged to observe and promote them.
The South African health care system is characterised as a fragmented and inequitable system due to the huge disparities that exist between the public and private health sector, with reference to the accessibility, funding and delivery of services. As a result, access to health care is unequal, with the majority of the population relying heavily on a public health care system that has a disproportionately lower amount of financial and human resources at its disposal in comparison to the private sector.
The mismatch of resources in the public and private health sectors relative to the size of the population each sector serves and the inefficiencies in the use of available resources has significantly contributed to the very poor health status of South Africans. This is particularly the case in the lowest income groups of the population.
I do not have much time left. I just want to quickly talk about the National Health Act, which actually gave effect to the provision in the Constitution. To ensure universal access to health care, South Africa proposed a national health insurance. Plans are already advanced to start with the phased-in implementation of the national health insurance scheme.
Therefore, South Africa is forced to strengthen delivery of quality health care services to its people as a fundamental right, which is entrenched in the Constitution of the Republic and which South African citizens should enjoy. The South African national health insurance is founded on a number of principles which I shall not go into.
In conclusion, South Africa has come a long way in providing greater access to health care. The country has a world-renowned Constitution that provides for the realisation of the right to health care.
South Africa has made progress in terms of the realisation of access to basic health care through legislation and policy development. South Africa is a member of international and regional instruments.
Therefore, it is essential that human rights are taken into account when delivering services to ensure quality care. Putting human rights at the heart of the way health care services are designed and delivered can make for better services for everyone, with patient and staff experiences reflecting the core values of fairness, respect, equality, dignity and autonomy. I thank you.