Chairperson, hon Ministers, hon members and friends, it is an honour and pleasure to take part in this debate, especially on Vote 15 - Health. U sien, agb Voorsitter, dat gesondheid 'n sleutelprioriteit van 'n regering is. Dis geensins 'n guns of 'n buitengewone stap ten opsigte van die kiesers of die land nie. Allermins is dit die regering se plig of verantwoordelikheid om te sorg dat die gesondheidstelsel van die land in goeie kwaliteit en effektiewe werkende omstandighede verkeer. Anders word die nasie bedreig met uitwissing deur siektes wat erger is as oorlog. (Translation of Afrikaans paragraph follows.)
[You see, hon Chairperson, that health is a key priority of a government. It is by no means a favour or an extraordinary step in respect of the voters or that country. At the very least it is the government's duty or responsibility to see to it that the health system of the country is of a good quality and in an effectively working condition. Otherwise the nation will be under threat of eradication by diseases that are worse than war.]
I fully agree that value for money is a must, and it is the ultimate goal for Health.
The Minister said in his presentation to the select committee that we have a problem with managing our health institutions; that is rightfully so. One of the reasons for this is the incompetent appointees as managers and, directly, the appointment of cadres. This is a huge mistake and disgrace to the people of our country. It is the poor who suffer when poor service delivery is rendered. Poor delivery also degrades and does enormous harm to the innocent and most of the people who are already suffering under unemployment, poverty, shortage of food and others. This must be stopped now and forever.
Chairperson, poor management in Health can clearly be seen in the line item of consultants used by the department, because they must fill in where incompetent officials fail in their responsibilities. Let us look at the statistics. Under administration for consultants, the allocation for 2009- 10 is R7,6 million; for 2010-11 it is R7,9 million; for 2011-12 it is R9,013 million; and for 2012-13 it is R9,3 million. Under the same programme, there is another item for consultants. This allocation comprises R7,06 million for 2009-10, R3,1 million for 2010-11, R3,5 million for 2011- 12, and R3,6 million for 2012-13.
For strategic health programmes the allocation for consultants is as follows: R97,77 million for 2009-10, R105,59 million for 2010-2011, R110,73 million for 2011-12, and R110,73 million for 2012-13. For health planning and monitoring, the allocation is as follows: R10,56 million for 2009-10, R12,58 million for 2010-11, R12,35 million for 2011-12, and R9,023 million for 2012-13.
Chairperson, this department spends R133,85 million on consultants for the 2009-10 financial year and R129,28 million for the 2010-11 financial year. Like this, you can add the amounts for the 2011-12 and 2012-13 financial years too. This is clearly a statement that Health is being run and managed by consultancies. This can't be true and if it is then it must be stopped.
Voorsitter, ons mense verkies om eerder dienste by hospitale te gaan soek en vermy die kliniekdienste. Dit is ook die woorde van die Minister tydens die voorlegging aan die komitee. Primre gesondheidsorg misluk dus. (Translation of Afrikaans paragraph follows.)
[Chairperson, our people prefer to look for services at hospitals and to avoid the services at the clinics. These were also the Minister's words at the submission to the committee. Primary health care is therefore a failure.]
The problem lies squarely in poor service delivery by staff in clinics. This puts unnecessary pressure on the staff of hospitals. Our people don't receive quality and workable medicine delivery for their illnesses at clinics. I can actually say that these phenomena only happen in other provinces, and not in the Western Cape. The Western Cape's programmes and monitoring systems work and are in place.
Here is just one example. During our oversight visit in KwaZulu-Natal, a very sick old lady was lying in the passage on a bed waiting for the papers and administration to be completed to admit her to a ward to receive the necessary support. What is this, Chairperson and hon Minister? Is it total abuse and inhumane service delivery? This is unacceptable behaviour, and someone must account for this.
All of us agree that the HIV/Aids and TB pandemic must be stopped and controlled. We cannot do it by distributing millions and millions of condoms and by circumcisions. The wrong signals are being sent out. More and more advocacy must be done to better the morals and standards of our people. We must get the buy-in of people, as the government wants them to make use of the programmes and plans of government. Good money is wasted, which could be spent on other service delivery items.
The reimplementing of nursing colleges is a must. Not only will this help our youth to get earlier access to the job market, but it will also address the shortage of nurses and provide a better quality service in hospitals where needed.
Chairperson, hospitals cannot be supplied with medical machines and equipment that they cannot use or do not know how to use. Again in Limpopo, a hospital is furnished with this equipment, and it is a white elephant there. This equipment is expensive and must be used in hospitals where doctors and officials are trained and know how to use it.
Our state hospitals have the responsibility to render an effective and quality service to our people. Our government must guarantee this. I thank you. [Applause.]