Chairperson, hon Minister, Deputy Ministers present, members of the House and guests, my speech will focus more on primary health care and the overall budget.
About 17 years into democracy South Africans are facing a new challenge, for which the highest calibre of leadership, vision and commitment is needed. Fortunately for South Africans we have Dr Motsoaledi, a man with enthusiasm, who is going to lead this department.
The challenges exist. Universal access to care and equity, and sound information management and technology form the essential components of primary health care. Quality health statistics promote better monitoring and evaluation of services, and empower good decision-making.
The total spending on public health services has increased drastically over the past two years, and we are currently at R113 billion of which R41,9 billion, which is 7,6%, is allocated for primary or district health. Also provided in the department's budget is an additional R1,4 billion, part of which will be used for the training of 400 nurses and midwives. Minister, we can only hope that after their training 50%, if not more, will be placed in clinics to encourage primary health care. If possible, ensure that 50% of these trainees, if not more, specialise in primary health care nursing.
Primary health care requires a change in the socioeconomic status of our country; redistribution of resources, particularly in rural areas; a focus on health system development; and an emphasis on basic health services.
Hence the government needs to ensure that it addresses the socio-economic status of the country, especially for the poorest of the poor. It needs to ensure that there are intersectoral activities between the Department of Health and other departments, particularly in order to provide access to quality housing, to clean water, proper sanitation, and also to some extent to create employment - as soon as yesterday! - to ensure that the vision of better health for all is realised.
The ANC-led government's efforts in addressing root-cause issues have not responded adequately to the interrelationship between socioeconomic development and health efficiency and effectiveness. During oversight visits, the chief executive officers of most hospitals still complained of the malfunctioning and ineffective district health system.
To date, most primary health care facilities countrywide are still in a very bad state, and this means that most are still badly managed. Queues are still long, medicine shortage is still a daily battle in some rural clinics particularly, and working conditions are unbearable due to increased demand for primary health care services, and therefore increased workloads.
The DA welcomes the notion by the department of finally completing an audit to generate comprehensive information on primary health care infrastructure and services by 2011-12. This is long overdue.
In 1997 the government adopted a White Paper on Batho Pele principles and in 2007 the Policy on Quality in Health Care for South Africa, but to date the primary health care services are still lacking. One wonders what will happen to the health standards compliance office after March next year, and one only hopes that it does not become worthless and the standards compliance not adhered to. All we need is to enforce compliance and adherence to the service principles, policies and set standards or we will end up merely changing the names of strategic interventions every five years until we run out of synonyms for name changes! [Applause.] These will only be achieved if managers act responsibly and are held accountable for their facilities, the performance management and development system is adhered to in principle, and proper monitoring and evaluation are consistent.
Hon Minister, you mentioned in the Service Delivery Review, vol 7 no 3 of 2010, that utilisation of primary health care facilities by the poor has increased, but physical access to these clinics in many rural areas still remains a challenge. The Department of Health needs to fast-track the delivery and implementation of the Telemedicine System across the rural areas as this provides rural communities with access to physicians and specialist expertise available in major medical centres and will further support primary health care services.
During its first phase of implementation, funds were available to start a teleradiography pilot project in the Free State and North West provinces, a telepathology project in the Eastern Cape and a teleophthalmology project in KwaZulu-Natal. That was in September 1998, but to date the communities around those provinces have still not felt the real effects of telemedicine. It would be very interesting to analyse where we are as a country in regard to health technology.
The extent and nature of the changing profile of diseases, particularly the growing threat of noncommunicable diseases, which you have already alluded to, Minister, continue to increase demand and put severe pressure on primary health care services. This has negative and substantial implications for the poorly managed and understaffed centres, which are unable to absorb this significant emerging burden.
The decline in life expectancy, high levels of maternal and infant mortality and increase in the rate of HIV infections indicate the inability of the current district health system to cope with the emerging needs of the population.
The three health-related Millennium Development Goals, MDGs, may to the greatest extent be realised through strengthening primary health care. A lot still needs to be done to address funding constraints, procurement irregularities, corruption, investment in critical health care skills shortages and essential equipment.
Corruption in health care is derailing progress in infrastructure development, an example of which is the construction of Zola Gateway Hospital. The project was unveiled on 5 June 2007 by the former Gauteng Premier Mbhazima Shilowa, and to date it is still incomplete due to tender malpractices, which unfortunately might in future be regarded as classified information under the proposed Protection of Information Bill! Thank you. [Time expired.] [Applause.]