Chairperson, hon Minister, Dr Dlamini-Zuma, hon Minister Motsoaledi, Deputy Minister Gigaba, members of the NCOP, and distinguished guests, let me first express the select committee's condolences on the department's loss of Deputy Minister Sefularo.
Kusapho lwakwaSefularo, sithi akuhlanga lungehlanga. [We convey our condolences to the Sefularo family; as we are saying, may they find solace and comfort in these trying times.]
I am honoured, today, to focus on the broad policy perspective of the ANC on health and home affairs, respectively.
From the Freedom Charter to the Reconstruction and Development Programme until the present juncture, our movement has regarded health as a priority. It remains a basic need of our people and, therefore, has enshrined it in our Constitution. What is critical is that we ensure that the majority of our people have access to quality health care and that should in the future be free at point of entry. We have never regarded health as a commodity and it should not be treated as such. Section 27(1) of the Constitution states that:
Everyone has the right to have access to -
a) health care services' including reproductive health care; b) sufficient food and water; c) and social security.
The ANC seeks to ensure the necessary funding and delivery of health services for an efficient, equitable and sustainable health system. This is premised on the principle of the right to health, social solidarity and universal coverage.
The ANC is guided by the Freedom Charter's clarion call that, "there shall be access to health for all". The Freedom Charter commits us all to promote a preventive health scheme under the state, free medical care and hospitalisation with special care for mothers and young children. As a consequence there have been many achievements in improving access to health since 1994.
Our historic policy documents speak to the nature and form of the national health system that we envisaged. As this is a policy debate it is only correct that I reflect on the evolution of our health policy since 1994. An overview and assessment of this policy reflect the following:
That the provision of equitable health care should be guided by the aspiration of our people as enshrined in the Freedom Charter and by principles which reflect the Primary Health Care Approach adopted by the World Health Organisation, and the United Nations Children's Fund at Alma Ata in 1978. The primary health care approach is essentially that of community development. It aims to reduce inequalities in access to health services, promotes equitable distribution based on appropriate technology and integrates the many sectors of modern life such as education and housing. Further, it is based on full community participation.
Access to health care is a basic human right. This right is incorporated in the Constitution and the Bill of Rights and will be enforced by law.
Chairperson, let me state up front that the current policy priority of the ANC government of the introduction of the National Health Insurance system should not be conflated with or confused with a national health system. The first is a system of operational functioning in totality. The other is a funding model to unlock resources into the national health system and make health access free at the point of entry for all citizens of South Africa.
Getting back to policy evolution, and the creation of a comprehensive, equitable and integrated health service, there will be a single governmental structure dealing with health for the whole country. It will co-ordinate all aspects of both public and private health care delivery. It will be accountable to the people of South Africa through democratic structures.
The oversight visit of the Select Committee on Social Services gave us a first-hand impression of how health services are provided to our people. While doing oversight work in Hlabisa Hospital in KwaNongoma, KwaZulu- Natal, the outpatient department, OPD, was full to capacity of patients waiting to be examined by a doctor. During our interaction with the patients, we discovered that they slept at the OPD waiting to be examined by a doctor, but no doctor came to see them up until 16h30 on the day we were there. After talking to the chief executive officer, CEO, of the hospital, I was informed that the hospital on that day had about nine doctors on duty, but surprisingly there was no doctor allocated to the OPD to attend to the patients. This experience directly shows a certain degree of poor management and a dereliction of duty.
As the Select Committee on Social Services, we are convinced that the plans to overhaul the health system and the hands-on approach of Minister Motsoaledi will bring a huge change to these unacceptable practices.
The health service actively promotes community participation in the planning, provision, control and monitoring of services. Fundamental to this approach will be accountability to local communities and decentralisation of decision-making. The responsibility of health care will be co-ordinated between national, regional and district authorities. These will, as far as possible, coincide with regional and local government boundaries. Authority over, responsibility for and control over funds will be as decentralised as is compatible with rational planning and the maintenance of good quality care. Clinics and health care centres will be the points of first referral for medical ailments.
Rural health services will be given priority and made accessible with particular attention given to improving transport. The health service will give priority to children, mothers, the elderly, the mentally ill, workers, the unemployed, and the disabled. Appropriate services to adolescents and to young adults will also be provided. In addition, there will be a focus on the eradication and control of major diseases, especially Aids, tuberculosis, measles, and others. Attention will also be given to sex education, family planning, oral health, substance abuse, and environmental and occupational health.
Within the health service, health workers must respect the right of their patients to be treated as equals in all respects. Furthermore, individuals, interest groups, and the whole communities will be able to participate in the process of formulating and implementing a health policy.
Appropriate and efficient data collection will be an essential part of the health system; it will allow for rational management and planning and also relevant research to address the most important problems facing the community. The private sector will also be required to collect and submit both financial and clinical data in order to facilitate planning at local, regional and national levels.
The health service will be planned and regulated to ensure that resources are used in the best way possible to make essential health care available to all South Africans, giving priority to the most vulnerable groups. Health workers at all levels will promote general health and encourage healthy lifestyles. The health service seeks to establish appropriate mechanisms that will lead to the integration of traditional and other complementary healers into the health service.
At all levels of government the health sector should promote intersectoral co-operation to promote the health of communities. The health service will play a role in co-ordination of government authorities responsible for sanitation, water supply, fuel supply, food and agriculture, housing, and other social services. In the event that a threat to public health is identified, the health services will ensure that the necessary steps are taken to remove such a threat.
In the longer term, most health care should be provided by the public health service. The public services will be strengthened and made accountable to the communities they serve. At the same time, we envisage active co-operation between the two sectors, namely private and public, with the common goal of improving the health of the nation.
The statutory bodies governing the registration of health workers and the maintenance of standards are being restructured to protect the interests of all South Africans. Training of all health workers should be appropriate and community oriented. Training programmes are being implemented to continually upgrade the skills of existing health workers. In the light of this, the present health worker training institutions, particularly medical schools, are being transformed.
The health service provides sensitive and supportive care to victims of sexual violence and other forms of abuse against women. Special counselling and support for victims of rape and incest will be provided. Women have the right to control their own bodies. Contraceptive services will be based on informed choice, will be free and accessible, and will protect fertility. They are gender-sensitive and engage both men and women.
Women and female children are being provided with information to enable them to make free and informed choices about all matters relating to their fertility with the objective of quality health care and making services available to all to ensure better health outcomes. This has included one of the most comprehensive programmes in the world in the fight against HIV and Aids, TB and other diseases. In this regard, work to accelerate the mobilisation of available resources in both private and public health sectors is to ensure improved health outcomes for all South Africans.
To achieve this, the ANC has focused on public-sector-led development. It is the public-sector-led health system that can ensure access to health for all. The majority of our people are poor and need access to quality health in their millions. In this regard, the resources of the public health system need to be strengthened in the areas of personnel so as to deal effectively with disease control associated with HIV and Aids, tuberculosis, high infant mortality, and low life expectancy.
Towards the end of 2008, the ANC concluded a draft 10-point strategy for the revitalisation of health services. I have to go to Home Affairs quickly, Madam.
Hon members, in a constitutional democracy, the state becomes an important institution. The ANC supports both the Home Affairs and Health Budget Votes. Thank you very much. [Applause.] [Time expired.]