House Chairperson, hon Ministers, hon MECs, allow me to firstly pay tribute to one of our dear colleagues who, sadly, is not here with us today: the hard-working, dedicated, late Deputy Minister of Health, Dr Molefi Sefularo.
Hon Minister Motsoaledi's candid and honest recognition of the many challenges in our public health care sector is very encouraging and gives us hope that our Health department is in the right hands.
Until now, our health care sector has been largely curative in nature and little attention has been focused on prevention. This recognition has to be the first step in building a healthy nation for the future. The ID is therefore encouraged by the mass education programme campaigns on TB and the immunisation of children across the country. In line with our belief that health education forms the cornerstone of any preventative health care strategy, the ID calls for the reintroduction of health education in all schools across the country.
The ID fully supports the 10-point plan and welcomes the prioritisation of its 20 deliverables. However, the plan will fail without strict monitoring and evaluation.
The release of the recent burden of disease report brought to light some extremely worrying trends. The high incidence of alcohol abuse in our country is having a devastating impact on our ability to address the huge health care challenges, especially in relation to HIV and Aids, TB and other diseases. The government had a vigorous campaign against smoking and we would like to challenge the Minister to have the very same vigorous campaign against the abuse of alcohol. This should include a complete ban on alcohol advertising. Irresponsible behaviour linked with high levels of alcohol abuse also has a direct impact on the violent crime rate.
Billions are needed to overcome health care inequalities. The ID reiterates its support for the National Health Insurance scheme, because it will help poor South Africans, including our people who have been suffering for such a long time. However, we call on the Minister to take the nation into his confidence and release the scheme's plans and costs as a matter of urgency.
We are encouraged by the department's recent acquisition of flu vaccine to treat millions of South Africans. However, South Africans who visit private doctors are now unable to access this vaccine as the department has bought the whole lot.
Lastly, the ID would like to hear from the Minister when he plans to make these vaccines available to the public. The ID supports the Budget Vote. I thank you. [Applause.]
Dr S M DHLOMO (KwaZulu-Natal): Deputy Chair, hon Minister of Health Dr Motsoaledi, hon Minister of Home Affairs Dr Nkosazana Dlamini-Zuma, our Deputy Minister, hon members of the NCOP, my colleagues, MECs, hon chairperson of the portfolio committee of the province where I come from, Ms Z Ludidi, and the other member of the portfolio committee, Dr Roopnarain, allow me also to offer my condolences to the Sefularo family and to our Minister of Health who, together with the Deputy Minister, has been providing a cohesive and united leadership in guiding and supporting us as MECs for health.
I am expected to participate in this Budget Vote and also give account of what is expected of my province. I hope to do just that and not be tempted to speak about other provinces where leaders of those provinces can greatly assist us to understand the issues there. There are challenges in the Department of Health nationally and that is the accumulative picture of all provinces. We, in KwaZulu-Natal, are very mindful that of the four districts that have an HIV prevalence of above 40%, three of those are in KwaZulu-Natal, and those are: eThekwini, uMgungundlovu and Ugu.
We are, therefore, very mindful that what we do or do not do in KwaZulu- Natal has a significant positive or negative impact on the health outcomes, not only of KwaZulu-Natal but of the whole country. It is this understanding, therefore, that makes us realise that we have to accelerate health service delivery in the province. Our Minister has given his Budget Vote, which we support, and in view of this therefore I have decided to actually indicate some of the 10-point plan achievements in the province.
The department has appointed hospital boards and clinic committees at major hospitals, community health centres and clinics. Even though these posts have not all been filled and it's a work in progress, we are happy with the progress that has been made thus far. The management of health facilities is strengthened in various ways including unannounced visits, encouragement of walkabouts by managers in their institutions and attending to patient complaints timeously.
Over the past 11 months one has been fortunate to visit 30 hospitals, 3 community health care centres and 12 clinics. Those visits were mainly to go about thanking the management, hold hands and give them support, identify challenges and work with them in giving support and also thank our workers who are dedicated to continue doing their work.
We, under the instruction of our Minister, commenced with what we called the "Look like a hospital campaign" last year, where we had six areas of focus. These were cleanliness, staff attitudes, infection control, safety and security of patients, accessibility to services, availability of drugs, blood and laboratory testing, as well as a reduction of waiting times, as our hon member Rasmeni mentioned. Negative media publicity still exists despite the successes in most hospitals in the province. Quality in emergency services has improved with the addition of 124 new ambulances that strengthen our fleet to about 423. We have two helicopters as support, with one fixed wing for aerial medical services. However, this remains a challenge. Our province is largely rural and some of our people still wait long hours before they get ambulance support. There are 37 telemedicine sites that are used for training and patient management. We need to maximise this technology, as it has the potential to enhance patient care.
The department has put in place plans to revitalise the primary health care approach with a strong focus on community-based services. It is acknowledged that the department is experiencing a shortage of professionals. On the issue of human resources, the department is in the process of splitting the posts of finance and systems managers in order to fill the finance posts with candidates who have appropriate finance experience, among other things, because we have been noticing serious challenges with regard to this matter. The department has put 17 chief executive officers on the Master's Programme for Public Health.
Health care professionals can be seen as a scarce resource for developing countries. It is difficult to retain health care professionals in the country. It is even worse to get them to work in the rural areas. For example, a doctor who lives in Durban will be reluctant to drive 50km every day to go and work at Stanger Hospital. The same doctor will have absolutely no desire to go and work at Rietvlei Hospital in Umzimkhulu. How then do we go about getting the health care professionals to work in these remote areas? In our province, we are considering various options. These include, amongst others, the case where the government, for example, allocates you a bursary on the basis that you were born in Umzimkhulu; you should then serve not just the whole province, but go and start serving at Umzimkhulu before you can move around the whole province.
The department is focusing on appropriate skilled management for infrastructure development and maintenance of existing facilities in KwaZulu-Natal. We must actually say this up front so that members don't get shocked that in the KwaZulu-Natal department of health we underspent close to about R2 million on infrastructure last year. I must mention that I raised this matter in the KwaZulu-Natal cabinet yesterday, and we should go beyond complaining and maybe get reasons why we are not doing well on the infrastructure grant and revitalisation programmes.
All districts have drawn up their detailed plans for the HIV counselling and testing campaign which will kick in shortly. Currently, the department has 304 999 patients who are on treatment, which is a third of what we have in the whole country. We aim to reach about 470 000 by the end of this year. I notice that my time is ticking very quickly. HIV/Aids counselling is provided for in all our facilities currently, which include hospitals, clinical advisory committees and even mobile clinics. We have actually strengthened this by employing more lay counsellors and mentors for these patients.
The department has expanded the scope of the HIV programmes by integrating TB services into the HIV programmes. This integration therefore will ensure that all HIV-positive patients are routinely screened for TB infections, as our Minister has indicated, and that all patients identified with TB are put on treatment, while patients found to have no TB are started on isoniazid prophylaxis. While we have seen an improvement from 55% to 62%, the target cure rate for the country is 85%, and we are far from that. We are very excited, Minister, about your bold reminder and an announcement that all HIV-positive women should have a pap smear done. Also, all rape victims should be seen and examined before they go and look for police stations, and have that done first, before going to the police stations.
I should mention here that we are excited about the announcement that was made by His Majesty our king, on 5 December 2009, which has since been pronounced by our premier as one of the programmes that this department must run with, and we actually have over the past week circumcised 300 males out of an overwhelming surprise of over 500 males. The remaining number will be circumcised this coming weekend. Of the 2,5 million males to be circumcised, we are leaving 1000 for our Minister, and we will hear from him about when he is actually coming to circumcise them.
On the training of nurses, last year we had more than 2 255 nurses who graduated, and some are already starting their community service.
We would like to thank our Minister, the premier, and the chairperson of the portfolio committee in the province for all the support that they have given our department. I would like to actually reiterate, as the speech of the Minister indicated, that our province will be maximising our focus on TB and HIV maternal outcomes, perinatal and neonatal outcomes and the outcomes for children under five. Maybe what underpins these is the realisation that, after all, health is about mothers, babies and children. The death of a mother, such as an event related to pregnancy, is a disaster. If I were to borrow from the words of our premier, Dr Zweli Mkhize, he says in isiZulu: "Inyanda imuke nezibopho" [One has lost everything].
For those who collect firewood, it means that you have lost everything. We noted the comments that were raised by the member of the NCOP when they visited our province, and we will be working on that. Thank you. [Applause.]