Chairperson, Ministers and Deputy Ministers present here, and hon Members of Parliament, this Budget Vote debate takes place when the health challenges are immense and require progressive resolution.
For us to assess progress, we have to look at the challenges and compare them with the achievements, and then we have chart the way forward to ensure that the challenges are reduced. We also have to assess whether the budget allocated will enable the department to make a dent in the health challenges facing the country.
In dealing with these health challenges, we should be guided by the Freedom Charter which states, and I quote:
A preventive health scheme shall be run by the state;
Free medical care and hospitalisation shall be provided for all, with special care for mothers and children.
[Interjections.]
I'll deal with you later! In addition, section 27(1)(a) of the Constitution states, and I quote:
1) Everyone has the right to have access to -
a) health care services, including reproductive health care ...
Some of the challenges can be summarised as: poor response times by ambulances, lack of staff in hospitals, shortages of medicine, and a lack of appropriate equipment.
At the workshop on the planned National Health Insurance Scheme, NHIS, held in Johannesburg, the participants raised concerns about how often patients' lives are put at risk in public health institutions. At the same workshop, stories were told about hospitals with new equipment, but none of the staff knew how to use it.
On 17 August 2010, hon Minister, I wrote you a letter concerning the bad treatment a patient, Ms Eunice Thembani, received at Worcester Hospital. Hon Minister, you neither bothered to acknowledge receipt of such letter, nor to respond to it. I don't know what to make of this, but probably that is how the ANC defines democracy, which is, to paraphrase Abraham Lincoln "government of the ANC, by the ANC, for the ANC".
Whilst on the issue of women and children, let me say that the private hospitals have created a new industry: birth by Caesarean section. This is despite the World Health Organisation's stating that Caesarean sections should be performed only as life-saving measures when there is a risk of fetal or maternal death. There are gynaecologists who allocate a day a week just to perform Caesarean sections. Apart from this being driven by greed, it is a violation of women's right to give normal, noninterventional vaginal birth.
This is done in private hospitals because they believe that what they do in their hospitals is their business. Since the hon Minister is the Minister of Health and not the Minister of public health, I therefore call upon him to monitor this unethical conduct in private hospitals and to take appropriate action in this regard.
I will not even talk about illegal body part transplants, which have been well reported by the media. Maybe the Portfolio Committee on Health should start calling the private hospitals to account for these unethical activities.
I hope that the establishment of the Office of Standards Compliance will ensure that private hospitals are also monitored and evaluated as public facilities will be.
One of the most serious challenges is the shortage of staff. The department should develop a clear human resources development strategy with clear achievable targets. This strategy is long overdue after more than 16 years of democracy. We don't have to wait for 300 years! The President in his state of the nation address emphasised the training of doctors and nurses, as well as the revitalisation of 105 nursing colleges and the refurbishment and renovation of hospitals and clinics. This should be one of the department's performance indicators.
Infrastructure development is vital, because the Treasury report highlighted the programme to upgrade existing hospitals as one of the most disappointing projects. Though they overspent on staff, the nine provincial health departments together left a quarter of the capital budget unused. The hon Minister has, in this regard, been quoted as saying, and I quote:
... in February this year, R813 million of infrastructure money could not be spent and had to be taken back to Treasury. It's a tragedy that we are faced with. It needs an urgent solution ...
Hon Minister, the solution must be provided by you and your colleagues in Public Works. I'm raising this because if one goes to Chris Hani Baragwanath Hospital, one finds committed and determined management and staff until one goes to the wards. In these wards, not only does the roof leak, but one can lie in bed and count the stars on a clear night! The staff can do nothing about this, because it is due to the failure of Public Works to perform, despite the availability of funds.
This leads me to raise the issue of security at public hospitals and clinics. Hon Minister, I asked you a question for written response concerning security at the Dr James Moroka Hospital in Thaba Nchu. Whilst the question is specific, it represents a general concern about all our hospitals. The question is: Are we waiting for what happened at Pelonomi Hospital to happen again before we do anything?
At Moroka Hospital, staff and patients are at risk. At month end and on Saturday evenings, drunken hooligans can get in and out of the hospital and threaten the staff. At the gate there is one person, who is clearly waiting for his pension and is more like a gatekeeper than a security guard. Yet he is expected to provide security for the whole hospital.
I am aware that the bulk of the budget will be transferred to provinces and municipalities. This transfer should be monitored and the necessary intervention be made where there are lapses. That's why Cope believes that the whole Eastern Cape Department of Health should be under administration. Hon Minister, this province is in crisis and requires urgent intervention. The fact that it does not appear in the media regularly does not mean that all is well.
I wish to thank the director-general and her staff for the manner in which they interact with the portfolio committee. In this regard, I wish to congratulate the hon Minister for the good appointment. I also wish to thank all the institutions that have appeared before the portfolio committee during the last year. I thank you. [Applause.]