Chairperson, hon Ministers and Deputy Minister, what is important to Salga is a strategic planning process and the family agenda, which we build up from ward-based planning into municipal integrated development planning, IDPs, that informs provincial planning. We also welcome the fact that here we see two important strategic departments' Budget Votes being dealt with by the NCOP. The SA Local Government Association, Salga, is very honoured and pleased to participate in the first Budget Vote debate on Health and Social Development.
The question of the family agenda that I referred to earlier on is that social problems, social issues and social conditions prevalent in the wider society are experienced to varying degrees at community level: within houses, within streets, within towns, and so forth. The local sphere is the space where the day to day lives of people are lived, where there is the direct interface between the personal, the household, the family, the neighbourhood and the community.
It is here where the social, economic and political processes take place and where there is the greatest potential for action and interaction between government and the different role-players who can pool their resources, knowledge, experience and understanding of local conditions to meet the needs, build community assets and enhance social cohesion.
It is noteworthy that the department has given priority to the building and strengthening of the civil society sectors as active partners in sustainable development. This is a process supported by Salga, who views this sector as a critical element in the enhancing of service delivery, building social cohesion, assisting with job creation and focusing attention on issues of social and economic justice.
We would urge the Minister to enhance the funding flows to local level for the specific coverage of processes that build cohesive communities. Issues of migration, urbanisation and xenophobia are placing pressure on local resources and require a strategic and intergovernmental level response.
If we were to address the issue of poverty alleviation, it is important that mainstream poverty alleviation programmes and poverty must be viewed as a national challenge requiring a multisectoral approach. It is vital that there is ongoing co-ordination and attention to building coherence in implementation processes at all levels.
We propose that the following is needed for the effective implementation of poverty alleviation programmes: Firstly, policy coherence and the integration of different types and levels of policies, for example macro, sectoral and spatial policies.
Secondly, the co-ordination of implementation by different actors and spheres of government.
Thirdly, clear delineation of roles and responsibilities for different dimensions of the policy process from policy initiation and formulation through to implementation. This point in particular raises the question of what is guiding the party political issues within government, but we will get to this when we deal with health.
The fourth proposal is that of coherence and consistency in targeting beneficiaries, and lastly the issue of effective monitoring and evaluation.
Whilst the devolution of developmental responsibilities to local authorities is an important element in furthering community development efforts, there is likely to be little progress on the ground until there is more local and national financial support, together with a concerted capacity-building initiative to enable efficient delivery. Examples that support this need to be given to nongovernmental organisations is important so that together we can do more. We invite the Minister to work more closely with Salga in the furtherance of the department's aims, and we would encourage greater flows of funding to the local level to better enable effective implementation of social development related efforts.
When we have to turn to the Budget Vote on Health, Salga remains committed to working closely with the department to create an enabling environment in which all South Africans can enjoy accessible, caring and high quality health care. We realise and recognise the importance of an integrated and rationalised approach to delivery of health. On the question of primary health care, the 2005 resolution that triggered the issue of provincialisation of primary health care is something that we, as Salga, feel involved limited consultation and poor communication. Local government and the national government must find a process to ensure that this confusion and the fact that staff are demoralised are attended to.
At Salga's national members assembly held in June 2009, it was proposed that Salga could opt to support provincialisation on the basis that there must be progressive decentralisation of primary health care to municipalities that have the capacity to fulfil the function.
This position is in line with the constitutional framework for the division of powers and functions. If it is accepted that primary health care is a Schedule 4A function and the provincialisation is therefore supported, the Constitution, section 156(4), instructs national and provincial government to assign the function to municipalities that have the necessary capacity.
Ons raak siek by die huis. Ons raak nie nasionaal of provinsiaal siek nie. [We fall ill at home. We don't fall ill nationally or provincially.]
Furthermore, this position is in line with section 32(2) of the National Health Act, 2003, which provides that the provincial executive must assign such health services to a municipality in his or her province as contemplated in section 156(4) of the Constitution. The National Health Act thus provides that provinces must assign primary health care services to those municipalities that have the capacity to perform the function.
There are a number of practical issues. A full cost analysis of the assignment must be done, but this we can discuss with the National Treasury and the Financial and Fiscal Commission, particularly on the future division of revenue raised nationally between the spheres of government as required by section 214 of the Constitution.