Chairperson, Ministers here present - I saw other Ministers coming in - I also noticed officials of the Department of Health here, the Board of Healthcare Funders of South Africa, BHF, and the National Health Laboratory Service, NHLS, I greet you all. It is indeed sad that we have an unoccupied seat here because of the death of our Deputy Minister. I wish to extend my condolences to his family.
We believe that the budget for Health can and must be passed. This is despite the fact that, when we look at the challenges of backlogs versus the health budget, both nationally and provincially, we feel that health is underfunded. I am saying this while understanding very well that funding does not make things happen if there is no passion and determination. If one is passionate, one can make things happen, even with limited funding. Similarly, if there is money but no passion and determination, nothing will ever happen. What brings us hope is that when one looks at this department, it seems to have turned the corner. It is headed in a positive direction, and, as the ANC, we have developed the hope that, with the Minister's passion and determination, things are going to happen in the Department of Health. Well done to the Minister! We really commend him for the work that he has done. [Applause.]
We must remember that everything always starts with a dream. The dream is followed by an internalisation of the problem, and this is followed by passion and determination. As I said, one might have money, but if one does not have passion and determination, nothing will ever happen.
The department has a 10-point plan which makes it easy for us to monitor and see whether or not it is moving in the right direction. However, over and above that, the department has 20 outcome-based results that we will be able to use to monitor it. Obviously - for this is a new thing in the Department of Health and it tells us that the department is serious about changing itself to make it responsive to our people - this is going to help us this year and in the years to come. As good and easy as these outcomes are, we, as the ANC, need to assist in certain contexts to make sure that the outcomes are achieved.
Let me say that the Department of Health does face challenges, but with the vigour and passionate determination that we have seen in its leadership, we are very hopeful that things are going to change.
Let me mention a few things that, if they happen, will obviously enable us to achieve these outcomes. Firstly, the public service has to transform, and we have to make sure that we sing from the same hymn sheet as the Minister with regard to his passion and determination. If we fail to do this, and fail to make sure that we are passionate and determined, we'll be unable to achieve what we want to achieve.
When we are servants, we need to be humble at all times and be prepared to help, even if it's not our terrain. We need to make sure that we help those who need help from us, and we must always remember that "I am what I am because of others".
Secondly, we need to make sure that we address corruption. I'm told that, in medicine, there is a condition called "being squint". Being squint is when one eye looks in one direction while the other looks in another direction. I think it is imperative that we have people who are not squint, but who look in one direction, because if one looks in different directions, one will have a result that is not right and service delivery will not happen.
So, I call upon us, when we accept to be servants of the people, not to look at other things, otherwise we will never be able to achieve the outcomes. We need to make sure that we deal with corruption head on, if we want to make sure that we achieve the outcomes that we are talking about.
If we still have a divided, unequal and distorted health service in South Africa, we can forget about dealing with these challenges. Hence, we talk of universal coverage for everybody that is going to assist everybody. In fact, we are unhealthy because we are unequal; we are divided.
Those who have good services will always be affected and infected by those who don't. That is why we are talking about the National Health Insurance, the NHI. In fact, if we think that we can retain these unequal and distorted health services, we might as well say that those who have good health services must keep apart from those who don't have good health services. This takes us back to apartheid, a situation to which the ANC will never go back. [Applause.]
One might find, for example, that someone from a place that does not have good health services and who has dormant TB goes to search for work where there are good health services, and that person, because he does not know that he has dormant TB, starts infecting those who have good health services! All of us then become collectively unhealthy. So, we definitely need this National Health Insurance. How we do it is going to be the question, but it is needed in order for us to have a good health care service and be able to achieve our outcome targets.
Primary health care has not worked well, despite it being the policy of the ANC and the policy of government. There are many reasons that have made it not work, but we hope that, with the new vigour and passion within the department, that is going to change.
Let me mention something that is very important, which I think is one of those things that caused primary health care not to succeed. There are four levels of health care: primary, secondary, tertiary and quaternary health care. For example, if I'm sick with minor flu, I can go to the Nelson Mandela Academic Hospital. However, it is more expensive to treat my minor flu at that institution than had I gone to a primary health care institution.
What one would suggest is that we take the tertiary and the quaternary services and make them national competencies and leave the provinces to handle primary and secondary health care. This will ensure that provinces have enough money to run their competencies from their equitable budgets. If that does not happen, the provinces will keep on using their small equitable shares to render services that are tertiary and quaternary. That will never allow us to reach where we want to reach. I am suggesting that we probably need to think about leaving primary and secondary health care to the provinces and take tertiary and quaternary services to the national level. I am referring to both human and financial resources, so that people can be deployed.
In any case, those are the areas that are handled by the national level. These interprovincial referrals would actually stop, because our referral system is still very poor.
We need to review those laws that restrict the national Minister from intervening when provinces have problems, as the person who answers at the end of the day is the national Minister. We need to review those laws so that we are able to achieve the outcomes that we want to achieve. Most of the things happen in provinces, but the national department has to answer for those problems.
The policy on public-private partnership by the ANC and government has not changed. Part of the problem is that I don't think we have a good understanding of what is going on in the private health care system. However, we need to know what's going on but not in a way that interferes with it. Our attempts at understanding must not be made in a vindictive, arrogant and divisive way, but should be done so that we understand where we can come together. The public sector could work with the private sector for better outcomes for our country.
The private health care industry, especially hospitals - not that they don't do primary health care, but there's very little that goes to primary health care - are mostly dealing with curative medicine. I think we need to see how we can promote primary or preventive health care in the private health care sector. We know profit might be lower than what you would want, but we can have innovative ways of making it happen.
To achieve these outcomes, we need human resources. There are places which are training health workers, be it doctors, nurses or paramedics. However, I don't think we understand what is happening in our universities; in the colleges of medicine; in our nursing colleges; etc. We need to understand whether they are producing the cadres that we want as the ANC, cadres who will carry on with these outcomes that we are talking about. We probably need to sit down with the medical universities; nursing colleges; colleges of medicine; etc to see how we can find a way of getting a cadre that we think will be able to do what we need to do, especially with such good outcomes from the department.
On the other hand, in primary health care, we have people who are called "health promoters". These people are doing primary health care; they teach people what needs to be done. However, there are health promoters who have not been placed properly, so that they could help in these outcomes that we are talking about.
In the Eastern Cape there seems to be an association of health promoters. They could be used to make sure that we promote the primary health care that we are talking about. They should be registered with the Health Professions Council of SA, HPCSA.
The achievement of these outcomes is paramount to the ANC to make sure that when they say health is a priority, it indeed becomes a priority. It might not be visible to the people outside, but the department has started turning the corner. We are hopeful that things are going to happen, as long as we make sure - repeating what I've said - that the public service is passionate and determined with or without funding. Not that there must be no funds, but nobody should do nothing because they claim there are no funds when there is passion. Passion can make things happen.
We need to separate the primary health care and the secondary health care from the tertiary and quaternary services for obvious reasons. We obviously need to change our attitudes and to remember that umuntu ngumuntu ngabanye abantu [a person is a person because of others]. We are the servants of the people. [Applause.]
The launches that the Minister talked about are something that we support as the ANC and we will always make sure that we are there. I'm hoping that other leaders will follow. We will make sure that we do it. The only thing that we probably need to think of, especially with the HIV issue, is how to make sure that people use the 1,2 billion condoms. In using them, we need to think of how we dispose of them so that the environment is not affected by these 1,2 billion condoms. It has to be done.
The department has changed gear and is moving in that direction. Minister, we want to commend you for leading this ship in the right direction. As the ANC, let's work hard, as if this is the only year we have to ourselves. Let's make sure that things happen within a very short space of time. We need to make sure that the mess that has happened will be changed into good messages. We need to make sure that the tears that have fallen for certain people are changed into smiles. Let's change the negatives to positives. Thank you, Chairperson. [Applause.]