Deputy Chairperson, hon Minister and Deputy Minister, we are profoundly conscious of the complexity of the challenges facing our health sector. We know perfectly well that no budget is enough to drastically address and reform the health services. It is therefore clear that even the current budget is not consistent with the impossible challenges, ranging from HIV and Aids, TB, noncommunicable diseases, child and maternal mortality, and infrastructure, to the training of nurses and doctors. The list is long.

According to a United Nations, UN, report, the progress of ARV treatment in South Africa is still well below the estimated need. And then, annually 500 000 South Africans are estimated to have been newly infected with TB. The conservative estimates are that there are almost 50 000 children under the age of 15 in the country who have TB.

UCT's Prof Di McIntyre revealed that 58% of the North West province's population live in rural areas, compared to the South African average of 43%. In spite of this the province has the smallest number of doctors working in the state health sector, with big swathes of rural areas having little or no access to district or provincial hospitals.

Millions of South Africans are faced with drug shortages, fraud and the collapse of public health facilities. I could not help but pay attention to President Jacob Zuma's address at the first nursing summit this year. According to the TC guide, Zuma said that the health of the nation was in the hands of the nurses and that the summit was a moment of renewal for the profession.

He further said that nurses - ... are the backbone of our hospitals and clinics and the engine of our health care system.

The three-day summit ended on a high note with the signing of a compact.

However, South Africa is desperately short of nurses. At the end of March 2010 the vacancy rate was 42%, with approximately 109 000 more nurses needed, according to the Persal system. In Limpopo and the Eastern Cape only about one third of the professional nurses' posts were filled.

According to the 2009 General Household Survey by Statistics SA, 59% of citizens use public clinics frequently. However, the attitude of nurses needs a serious overhaul. South Africa's vision of a caring government and caring society will not be realised as long as we still have nurses in public facilities who are rude, uncaring and impatient.

I would like to commend the Minister for the commitment he has made to hiring more nurses to address the shortfall. We also urge the Minister to nudge the South African Nursing Council and Africa Health Placements to speed up the memorandum of understanding negotiations. Cope supports the Budget Vote.