Chairperson, hon Minister, hon Deputy Minister, hon Members of Parliament, treasured guests in the gallery, ladies and gentlemen, the Freedom Charter of the ANC commits us to a preventive health service run by the state - free medical care and hospitalisation provided for all, with special care for mothers and young children.
Although there have been many achievements in improving access to health care, much more needs to be done in regard to the quality of care and making services available to all South Africans to ensure better health outcomes.
South Africa commands huge health resources compared with some of the developing countries, yet the bulk of these resources are in the private sector, as the Minister has already said. However, they serve a minority of the population, thereby undermining the country's ability to produce quality care and improve health care.
The ANC is determined to end the many inequalities that exist between the public and private sectors by making sure that these sectors work together.
South Africa is one of the few countries in the world where the transformation of the health system began with a clear political commitment to ensuring equity in resource allocation, restructuring the health system as a district health system, and delivering health care according to a primary health care approach.
The ANC-led government inherited a highly fragmented and bureaucratic system that provided health services in a discriminatory manner. Services for whites were better than those for blacks. Those in the rural areas were significantly worse off in regard to access to services compared to their urban counterparts. Expenditure on tertiary services was prioritised above primary health care services.
The ruling party, the ANC, takes the health of the nation very seriously. This is reflected in the manner in which it has been behaving since we came back from the Polokwane conference. Very serious actions and steps have been taken since then.
These include, among other things, the appointment of the Minister, Dr Aaron Motsoaledi, who works hands-on with his department. The Minister and the Deputy Minister have been tasked with the responsibility of steering the Department of Health so that it can achieve a long and healthy life for all South Africans.
Given how far we have come as a country, I am confident that this mammoth task is not insurmountable. All it needs is that no one should take his or her eye off the ball because, if we do, we may reverse the gains that we have achieved over many years.
I am not about to say that the road has been easy because, indeed, no one said that the road would be easy; but our energy and determination must match the long stretch that we still have to travel.
We are, thus far, fully aware that whatever we have achieved has been made possible by the ever hard-working and dedicated staff. They do their best under trying circumstances to deliver health services to the communities. These communities are not like you, me and others who are privileged. They have no second choice. They look to the nurses to help them, come rain or shine.
Some of these nurses work in far-flung areas of our country. Others are in areas where there is no network connection for mobile phones. Some are in areas where there is no access to reliable public transport, no choice of schools for their children, and no shopping centres, etc. In spite of all these problems, they continue to deliver services no matter what, most of the time against all odds. I know this because I come from among these people, both as a resident and as a health professional and former manager.
There are areas of concern, such as shortage of drugs, dirty facilities, an uncaring ethos and poor infection control. These are the service delivery problems that do not need money to solve them; they need sheer management.
I know for a fact that some of the reports that we read in the media about our health services are, indeed, correct and that the patients are treated badly. However, I also know, as we all do, that there are hundreds of health care workers who are doing their jobs with such selfless commitment. I do not think the few should spoil the good work that is being done. I want to pay special tribute to these nurses.
The government, as we have already heard, has built over 1 600 new clinics in the past 17 years, as part of the endeavour to increase access, expand service and ensure equitable distribution of health services.
This has enabled the old lady, who was previously forced to use her last cent to catch a taxi to the clinic, money which was supposed to be used to feed her grandchildren, now to visit the clinic just where she lives. This has enabled the young woman who would have missed her chance of family planning to easily pop in and have the service provided. This has enabled the mother with a mentally ill child to have the child seen to by the nurse on the day of her appointment with greater ease. This has also assisted the man with a small welding workshop, who cut his finger, to easily get it sutured at the clinic.
These are the things that have been achieved, among other things, but we know that a lot more still has to be done because, indeed, a journey of 1 000 miles begins with a step. I am confident that we are on course to getting to the apex of this long and steep mountain called "health for all". This goal is attainable in our lifetime.
We are of the firm view that it remains the responsibility of the state to care for its population, hence our undying commitment to the introduction of the National Health Insurance.
We are not oblivious either to the fact that a lot of work still needs to be done to ensure that the introduction of a national health system is a success, much against the expectations of the doomsayers.
The foundation of the success of the introduction of the National Health Insurance is an effective health care system. The success of an effective health care system is a well-grounded and well-founded primary health care system because, indeed, primary health care remains the bedrock and the bone marrow of the health service. In this regard, I would like to urge the Department of Health to fast-track the revitalisation of primary health care as it is captured in the annual performance plan. This is the only hope that the service delivery to our people can improve for the better. We as a portfolio committee must be ready to lend a hand to ensure that the good plans that the department has produced come to fruition.
I am making this clarion call because it has been discovered that a healthy nation needs a healthy health care system, and a healthy health care system needs a healthy primary health care approach. For everything to be achieved, we need stronger and more effective primary health care, now more than ever.
The ANC wants the Department of Health to spend the money that it has been allocated on starting to improve primary health care, and the rest will follow. Perhaps we need to say, "Primary health care first, and the rest shall be added onto it." The Department of Health must demonstrate that it is serious about primary health care and, as we work together with the department, we need to see that very clearly.
I want to say that people cannot be denied good health because they choose to live in rural areas. They cannot be punished for being born in Mamelodi, Ledig, Musina, Umlazi, Mareetsane and Khayelitsha. They have a right to access to health.
Modulasetilo, mo bofelong ke batla go gwetlha ntlo e e tlotlegang gore a re diriseng dikliniki tsa rona re le baemedi ba Palamente, gore baoki le bona ba re bona re tla kwa tliniking. Re tshwana le mosadi o a tleng apeele balelapa la gagwe dijo. Fa a sena go di apaya a bo a ba tsholela. Fa a fetsa go ba tsholela ena a bo a itira montle a ya go ja kwa lebentleleng la dijo gonne a gopola gore dijo tse a di apeileng di phalwa ke tsa kwa lebentleleng la dijo. ANC e tshegetsa ka maatla tekanyetsokabo e.[Legofi.] (Translation of Setswana paragraph follows.)
[Finally, Chairperson, I would like to challenge this honourable House, as Members of Parliament. Let us use our clinics. Let the nurses see us, too, consulting in the clinics. We are just like a woman who cooks food for her family and after dishing up for them, she titivates herself and goes out to eat at a restaurant, thinking that the restaurant food is better than what she cooked. The ANC fully supports this Budget Vote.] [Applause.]]