17 May 2012

Address of the Member of Executive Council for Health, Honorable Mxolisi Simon Sokatsha, MPL on the occasion of the Northern Cape Department of Health Budget Vote Speech, Kimberley

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HONORABLE SPEAKER MR. JACOBUS VAN WYK,
HONORABLE PREMIER MS HAZEL JENKINS IN ABSENTIA,
HONORABLE ACTING PREMIER MS CRIZELDA CJIEKELLA,
MEMBERS OF THE EXECUTIVE COUNCIL,
MEMBERS OF THE PROVINCIAL LEGISLATURE,
MAYORS AND COUNCILORS,
MEMBERS OF OUR HEALTH GOVERNANCE BODIES,
HEADS OF DEPARTMENTS,
REPRESENTATIVES OF ORGANS OF STATE,
STAKEHOLDERS OF THE HEALTH SECTOR
DISTINGUISHED GUESTS
MEMBERS OF THE MEDIA
LADIES AND GENTLEMEN


Thank you very much for affording us this opportunity to address this august house during the consideration of the Budget Vote Ten (10) of the Northern Cape Department of Health.

Let me also extend a special welcome to our valued stakeholders, their generous contribution and support both monetary and in-kind cannot be quantified in numbers but through their unwavering commitment towards the provision of quality health care to all citizens of our beloved province, the Northern Cape.

The year 2012 in which the people’s movement, the African National Congress celebrates a centenary of selfless struggle, is being and will continue be remembered globally and locally as representing a tipping point and paradigm shift of opinion to perceiving health care as a public good and a fundamental human right not a privilege for selected few.

Kuloko sisithi wonke ubani unelungelo lempilo engcono, singakhethe bala nasini. Siyaphambili ngemizamo nemigudu yokulungiselela impilo kawonke-wonke phantsi kwe National Health Insurance, kuba siyazi kamhlophe kuf’ ayayo, kwaye zezitsalayo inkabi ezibethwayo. Sithi phambili ANC, wena khaya lenkedama nabasweleyo, ngokukhondaza ulwela impilo engcono kuye wonke umntu. Kwaf’amaqhawe namafana-nkosi singa, singa-ngabanye abasebenzileyo ukuphucula impilo yoluntu.

Dr Margaret Chan Director General of the World Health Organization characterizes this epoch as the point “when the World woke up to the dangers of assuming that market forces, all by themselves, will solve social problems. They will not…. Fairness, especially in matters of health, comes only when equity is an explicit policy objective”.

This fundamental paradigm shift comes as a time honored recognition of the struggles waged by the ANC and the many heroes and heroines of our people who put their faith in posterity; believing in our global cause for a just, fair and prosperous humanity.

Today as we stand at the threshold of a fundamental shift from the relentless commercialization of social services we can say we have labored for a better humanity; in a century of selfless struggle.

Especially as far as health is concerned, as symbolized by the Freedom Charter of 1955; our movement has been part of those progressive forces that have ensured that the words “equity” and “social justice” entered the vocabulary of World leaders and policy. A development recognized by Dr Chan of the World Health Organization representing a global paradigm shift.

Our country has entered a period of irreversible social change, through our conscious and methodical efforts. On April the 13, 2010 delivering his Budget Vote Minister of Health Dr Aaron Motsoaledi remarked; “we will continue overhauling the health system. Our twin strategies for achieving this include refocusing the health system on Primary Health Care; and improving the functionality and management of the health system.

The primary health care approach remains the mainstay of our health system, based on the principles of equity. We will reinvigorate this approach throughout the health system, based on the principles of equity; quality; efficiency; integrated and comprehensive care; community involvement and intersectoral collaboration”.

In his Budget Vote last year the Minister stated that the; “healthcare system is at cross-roads. We may choose the best route or the worst one ever…The choice lies with us South Africans in general but as elected leaders in particular”.

The Honorable Premier in her state of the province address buttressed these significant observations by stating that the province, as part of a national project of health reforms is in the throes of significant changes to win the war against the burden of disease and improve the management of the health system.

Having reached the mid-term milestone of the fourth democratic government we can attest to the progress that has been made in what are continuous rapid and sometimes gradually advancing efforts of putting the health system on a higher and healthy pedestal.

We have not rested on our laurels, we have not deceitfully conjured lofty ideals whose materiality has no meaning to the livelihood of ordinary South Africans whether in Heuningsvlei, Wegdraai, Hanover, Majeng, Mier and anywhere else where the people served by this Government reside.

We have sought to put tangible goals on the basis of which the impact of the work of government can be monitored and evaluated; especially health. As you will know, health as fundamental human right is one of the priorities of this government led by the ANC.

In general, government has twelve expected outcomes whereof the achievement of outcome two (2) of those is of particular significance to health:



“A long and healthy lifestyle for All South Africans”



In pursuit of a Long and Healthy Lifestyle, government has identified four strategic outputs which the health sector must achieve. These are:

Output 1: Increasing Life Expectancy
Output 2: Decreasing Maternal and Child mortality
Output 3: Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis
Output 4: Strengthening Health System Effectiveness



We are in the course of one of the greatest social projects undertaken since Former President Mandela through the ANC initiated and led the process of the formation of a democratic nation, united in its diversity. This fourth democratic government has as a result initiated fundamental health reforms characterized as the Ten Point Plan.

Like in that age of Nelson Mandela as Head of State, we are not short of our own doubting Thomas’s who in time too will have their Damascus moment of a gestalt switch as far as the reforms and changes of our health system are concerned.

To them we retort in the words of Franklin Rooseveldt; “let not the defeatists tell us that it is too late. It will never be earlier. Tomorrow will be later than today”.

Honorable Speaker, we must summon the collective strength of our people, partners and stakeholders to succeed, each shoulder must be put to the wheel. Civil servants in the sector have a duty to act out the strategic orientation of the department captured in the departments vision “Health Service Excellence for All”.

Change management is a difficult and sometimes very painful process which I expect the new Accounting Officer to drive with zeal to remove barriers to change and service delivery.

Both subjective and objective factors that serve to retard progress should not impede us as we accelerate and move at a breakneck speed. I expect managers to manage for success. Our health reform process requires an increased work ethic, loyalty to the objectives of the department and decisive action to curb any forms of abuse of state resources and corruption.

Ek glo dat die vermoë om suksesvol te wees en selfs die verbetering van die oudit-uitkomste van die department is daar. In die afgelope jaar is daar n beduidende ontwikkeling in so ver as die versterking van die bestuur en kapasiteit van die department. In die onlangse aanstelling van me Gugu Matlaopane as Hoof van die Department seel dit die sterk fondament vir die bestuur van verandering.

Honorable Speaker, to foster a shared understanding of what I am trying to convey to this house, kindly allow me to present first the programmes and their allocated budgets for the Financial Year 2012/13.

In terms of PROGRAMME ONE (1) which deals with Administration, the Department has a budget allocation R150 426 million:

In the last year significant progress has been made in dealing with the systematic and legacy issues that reflected negatively in terms of the perceptions and effectiveness of the department, these include, strengthening the policy and governance instruments of the department.



The vacancy rate of the department at the end of the 2011/12 financial year stood at 26% which is more than a 6% reduction from last year. The objective is to reduce the vacancy rate to about 10% by 2014. Priority posts have already been identified, budgeted for and the process of filling them for the current financial year has started.

Over the MTEF period starting this year, the department has planned to issue hundred and ninety (190) bursaries in areas of scarce and critical skills in the health sector. This figure is in addition to the more than three hundred (300) students whose studies we are funding in numerous fields of the health and allied health sciences.

Honorable Speaker, a significant development that signifies our commitment to build the requisite skill base and provide the much needed educational opportunities required by our people especially the rural and urban poor, the youth in particular, is that this year in terms of our Cuban Programme we will have an intake of fifty (50) students from the Northern Cape who will get full bursaries to go and study medicine in Cuba. There will be ten students from each region.

This is a national effort to increase the output of doctors to enable government to respond to the imperatives of an effective Primary Health Care approach; and simultaneously upscale the capacity of the state to implement the National Health Insurance (NHI) as it gets progressively implemented over the fourteen years.

The National Ministry of Higher Education and that of Health as you may know, have spoken to the question of increasing the capacity of our educational institutions to meet the demand for a variety of health professionals, this is an example of the sectoraly elevated position occupied by education and Government’s agenda in the current epoch.

Honorable Speaker, allow me once more to remind the house that during the 2011 State of the Nation Address, President Zuma made a pledge for government to appoint qualified people to manage the public health sector. In response to this, the Minister of Health passed new regulations on hospital designations and policy on how they should be managed. In addition, the National Health Act has been brought into force in its entirety, which creates a sound base for NHI implementation and the creation of District health management and governance structures.

Therefore, the strategic thrust of our service delivery model is premised on strengthening the human resource outputs in terms of training and employing appropriately qualified personnel as has been seen in re-advertisements of posts of all hospital CEO’s is part of the changes and reforms for health system effectiveness that the Honorable Premier annotated in her State of the Province Address.

The department is now in the process of firming its retention strategy especially in rural communities where skills retention is important for service delivery. The emphasis of the retention strategy shall primarily deal with health professionals.

The budget for compensation of employees is R1 706 942 billion, it is a main cost driver constituting 54.7% of the departments allocation; this must be seen in the context of health being labor intensive and utilizing exclusive or rare skills. The compensation of employee’s budget increased by 15.4% from the adjusted budget of 2011/12 as numerous policy priorities needed to be addressed.

The allocation of compensation of employees as a portion of the budget is followed by goods and services at 27.4% and payment of capital assets at 16.2%.

The risk management plan of the department is fully aligned to ensure that our efforts are geared towards realizing our part in building an efficient developmental state.

In terms of PROGRAMME TWO (2) where District Health Services are located, with a budget allocation of R1, 392, 305 Billion:

District Health services is the bedrock on which the service platform of the department primarily rests. It is in terms of this programme that our orientation as an aspiring developmental state will be tested.

The following policy priorities have been funded:

Improvement of revenue collection at District Hospitals;
Implementation of OSD for Doctors and Therapists;
Improvement of Hospital Norms and Standards;
Stabilization of personnel, goods and services budget and
Improvement of financial management capacity in the districts



Honorable Speaker, it is quite clear we will not succeed in tackling our burden of disease if we fail to prevent them in the first instance, if we do not promote healthy lifestyles, and if we fail to in still good behavioural patterns in our communities. In our endeavours we embraced and incorporated the National Minister of Health, Dr Motsoaledi’s recipe for success through primary healthcare that integrates clinical and public health. This we have already started through our three work streams of clinical specialist teams, school health, and ward based primary health care teams. For us to succeed in implementation we have agreed on non-negotiables at our recent National Health Council. These non-negotiables are protected against under-funding as they are given prominence and quaranteed in this budget for 2012/13, outlined as follows:-

Infection Control Services
Medicines and Medical Supplies including Dry Dispensary
Cleanining Materials and Services
Essential Equipment and Maintenance of Equipment
Laboratory Services: National Health Laboratory Services (NHLS)
Blood Supply and Services: South African National Blood Services (SANBS) or Western Province Blood Transfusion Services (WPBTS)
Childrens Vaccines
Food Services and Relevant Supplies
Maternal and Child Health Services
Maternal and Reproductive Health Services
Registrars
Pilots Districts Full Complement (of teams)
District Specialist Teams
Infrastructure Maintenance
HIV and AIDS and Non- Communical Diseases
TB and Infection Control Diseases
Security Services


Therefore, success in the implementation of NHI, in the improvement in service delivery will only be measured by how well we are doing in reducing our mortality particularly that of children and women. Improving Maternal, Child and Women’s Health is a core for all outputs of the outcome on Long and Healthy Life for all South Africans and for the general development of our country. Improving maternal health and child survival is therefore a basic requirement for increasing the life expectancy and improving lives of our people irrespective of their economic status.

Honorable Speaker, post the Second World War the British health system stood at a cross-roads just as ours does today. They took the bold decision of implementing a national health insurance system that has been progressively improved over a period of fifty years.

Today we have the district of Pixley ka Seme here in the Northern Cape as the leading pilot amongst all ten NHI pilot districts in terms of the implementation of the NHI.

Hayi luntu lwaseMntla-Koloni sesifikile, asigiki siyaphambili, sicela ntonye masibambisane kuba siqinisekile i-NHI iyakuyiphucula indlela ekunikezelwa ngayo iimfuno ezingundoqo kumntu wonke ngabaphandle kwebala nasini. I-lungelo lokufumana inkathalo yezempilo libhalwe kuMgaqo-siseko, asizenzeli masolotya aphikisana nomthetho.

A total budget of R1 Billion has been allocated by the National Government to be distributed among the ten pilot districts. The Minister of Health Dr Aaron Motsoaledi took time from the 6 – 8 May, to brief school principals, school governing bodies, hospital boards, clinic committees, councilors, municipal managers, local leadership structures and departmental staff about the implementation of the NHI in Pixley ka Seme District.

Honorable members of this august house we are pleased to state that his message was welcomed by all our partners. The Minister of Health shares our view that the doubting Thomases will be confounded. I must take the opportunity to thank the both Provincial and District Leadership and management especially our district specialists under the stewardship of Dr Kenny Jacobs whose extra ordinary skills as a team leader has assisted us to be a beacon of hope in the first phase of NHI implementation. In deed the work has just started the route ahead is still long.

Allow me once more to quote Dr Margaret Chan: “Universal Coverage is a clear pursuit of equity and social justice. Universal Coverage is also a powerful equalizer. Moving towards Universal Coverage is never easy, but every country, at any level of development, and with any level of resources, can take immediate and sustainable steps in that direction”

Honorable Acting Premier, we have undertaken the process of reclassification of, amongst others, our District Hospitals to ensure that our facilities are classified within the norms and in accordance with the level at which they have been historically functioning, this is critical for building an efficient health service delivery platform and clear referral pathways.

Once the process of actual implementation is finalized there would be fourteen district hospitals in the province. This articulates significantly with the draft Service Transformation Plan of the Department.

Honorable Speaker, In March during World TB Day the Department and the Provincial AIDS Council which is led by the Acting Premier, including all stakeholders; community and religious formations launched and signed the Provincial strategic Plan for HIV,STI’s & TB 2012 – 2016 in Victoria West.

The budget for HIV and AIDS has doubled over the last seven years and for 2012/13 is R283 135 million growing to R341 738 million, it signals the amount of resources we have had to invest as a means of rapidly dealing with HIV as it has the potential to harm the efficacy to deal with other challenges of our society if we do not join hands against both HIV and TB.

The new strategy was launched in the context of a buoyant mood as far as our fight against HIV is concerned. A tendency of HIV prevalence stabilizing is now developing into a trend. This is a far cry to the period of the mid-nineties when the decease spiraled almost out of control. But the threat of HIV and AIDS remain real and imminent for many in our province and society.

The total number of patients on Anti-retroviral treatment has increased from 23 400 to 28 655 this is thanks to the vigorous HIV Testing Campaign undertaken by the Department. Similarly we saw the total number of HIV – TB co – infected patients placed on ART increase from 30% to 75% as we test all HIV patients for TB.

Honorable Speaker, in as much as these figures speak to the herculean effort we are making to save lives and stop AIDS; they should also be seen as a factor in the increasing health expenditure. It is a challenge that we must together contend with as we build a caring society in a World in which good health is bought at a maximum price. Pharmaceuticals and associated costs are very high!

The programme to collaboratively deal with HIV and TB is proving to be a silver bullet in detecting new cases of TB and putting patients on treatment.

The TB tracer project is progressing well in all the districts. We expect to see a gradual improvement in terms of outcomes. Our outlook in 2012/13 is to improve the treatment success rate to 80%.

Notwithstanding what we are working towards there are various determinants of health that we have to deal with; both as the economic and social sector in order to overcome TB.

In geen geringe mate is die misbruik van alkohol ‘n groot bydraende faktor tot ons huidige las van siekte. Dit dra baie dikwels by tot die onderbreking van die behandeling wat kan lei tot die eskalasie van erenstige stamme van TB soos Extreme Drug Resistant TB wat verkry kan word sonder om gewone TB te gehad het.

Geagte Speaker, ons almal moet saam werk om te verseker dat ons suksesvol TB oorwin deur middel van godsdienstige nakoming van behandeling deur pasiënte, meer belangrik, ons moet hygiene, veilige werksomstandighede en leef ruimtes bevorder.

It therefore became appropriate in view of the above developments and our policy positions, to launch and introduce a cadre of workers that will contribute to strengthening our efforts to address TB across our province; namely our TB Goodwill Ambassadors who have been appointed in each of our five districts.

The TB ambassadors are people who were treated for TB whether susceptible, multidrug resistant or extensively drug resistant, who have taken their treatment correctly and were subsequently cured.

These Ambassadors will raise awareness about TB in their neighbourhoods and encourage those patients who are not adherent to their treatment, as well as promoting healthy as promoting healthy life styles and infection control practices.

Much work is being done to reduce child and maternal mortality, hence the appointment of district health specialist teams which is a process that will be phased in over time.

We have already started the process of the appointments in Pixley ka Seme District which is an NHI pilot site. Over time these will be supplemented with Primary Health Care Teams based in wards and the revamping of our school health and community based services to the extent that we want to move to a scenario where we will have the health profile of each household.

The Primary Health Care Teams are a critical arsenal in the multi sectoral war against poverty. The war on poverty campaign of government has the Health Sector as one of the key stakeholders and we see the Primary Health Care Teams fitting like a glove into what is one of government’s elite campaigns.

We intend to maintain a high immunization rate, we will continue to create public awareness and increase the Vitamin A coverage to babies up to eleven (11) months old. It is important that society as a whole work with us to encourage mothers to undertake antenatal care. The failure of pregnant women to undertake antenatal care is a major contributor to child and maternal deaths.

We want to increase the antenatal prospective mothers initiated on AZT and maintain a PMTCT rate of 100%. Accountability for maternal deaths at facility level or where ever they may occur in our system is one thing that is receiving greater and greater attention. We cannot fold our arms where there is neglect of duty and we clearly not succeeding to meet all the objectives of the millennium development goals.

Ons stryd vir vroue-emansiepasie en die skepping van n regverdige en gelyke samelewing vereis dat ons omstandighede skep waarin vroue hul reproduktiewe regte kan uit oefen in veilige omstandighede.

We remain determined to succeed and create conditions in which the scourge of disease that has been eating away our life expectancy can recede. In this war we are also faced with the battle of the increasing costs of drugs and laboratory services that sometimes fail to recognize that health is a public good and not a commodity for commercialization.

In terms of PROGRAMME THREE (3) which deals with Emergency Medical and Patient Transport Services, the allocated Budget is R197 203 million and it grows to R219 359 million over the MTEF: There is an intertwined trinity of challenges that confront our Emergency medical Services these are:

The capital programme that includes the replacement of ambulances, procurement of equipment and provision of ambulance stations.
Improving the staffing arrangement to have the correct number of staff and grades; and
Training and development which includes matters such as continuous professional development



Working together we can find lasting solutions to these challenges and build a service that meets the clinical needs of our people. The department has developed an Emergency Medical Service – Turn - Around Strategy 2012 – 2015 to address the identified challenges.

Honorable Speaker the national norm is to have one ambulance per 10, 000 citizens. In the Northern Cape we have 184 ambulances that have to cover vast distances and as a result, instead of having about 20% off the road at any given time for maintenance this can be as high as 40%. This reduces the number of vehicles available to respond to emergencies.

A comparative analysis done with the Free State province shows that the Northern Cape replaces its fleet after a longer duration, which is mainly due to financial considerations, with the result that actually more is spent on maintaining vehicles out of warranty and on major repairs.

Based on the conclusions drawn from this comparative analysis the department is taking the following actions amongst others to modernize Emergency Medical Services:

One third of the 184 ambulances will be replaced each year;
Satellite tracking will be installed in all vehicles to monitor movements and produce exception reports. This will also assist with rapid deployment of vehicles.
A R40 Million budget has been set aside for machinery and equipment to ensure that Emergency Rescue Vehicles and ambulances are well equipped.



In order to jump start this programme the Department successfully negotiated with one of the large mining houses, Kumba Resources in the Northern Cape, a donation of sixty (60) ambulances, twelve (12) none emergency patient transporters and five (5) Emergency Rescue Vehicles to the tune of R37 million. In addition, Kumba Resources donated R19 million to procure nine units of Batho-Pele clinics serving the isolated villages of the John Taolo Gaetsewe District, delivering free primary and secondary health care services. Lastly, the Kolomela Mine assisted our infrastructure through the renovation of one PHC clinic and the purchasing of 2 mobiles for the Groenwater, Skeifontein and surrounding farming areas at an estimated cost of R 6million.

Honorable Speaker, I am equally delighted to inform this house and the public that another negotiation with the John Taolo Gaetsewe Developmental Trust has secured an additional donation of R22 million. With which we shall procure ten (10) dedicated obstetric/critical care ambulances, specialist paramedic equipment as well as funding for training. This is over above the construction and furnishing of Madibeng Clinic in the previous financial year.

Let me also just state that the process of establishing a fully fledged and well equipped EMS college is now on track, two possible buildings have been identified in Galeshewe.

In terms of Programmes of the Hospital Services Budget the total allocation for the 2012/13 R814 418 million and it grows to R944 719 million in 2014/15:

The Kimberley Hospital has now been reclassified as a tertiary hospital and new Upington Hospital is being gradually being prepared to function as a Regional Hospital are also undergoing significant developments in terms of their service package as per the new classification.

The Budget for Hospital Services has increased by 1.6% from the 2011/12 adjustment budget. Kimberley Hospital had identified revenue generation as one of its key priorities for the 2011/12 financial year. The following measure was undertaken:

Private wards for paying and Medical Aid Patients were revamped with the addition of hotel amenities such as television sets, air conditioning, lighting, upgrading of en suite bathrooms, new curtains and linen.



In last year’s Budget Vote we made particular commitments pertaining to growing and improving the service platform at Kimberley Hospital. We are pleased to announce the following critical developments geared towards reducing transfers outside the province and affirming our commitment towards quality service delivery.

A fully functional Hip and Knee replacement unit was established. The first two hip replacements were successfully done in the last quarter of 2011/12. This will reduce the number of referrals to the Free State province and provide a much needed service to the people of the Northern Cape.
A hot line has been established for patient queries, information on how to access services and to report and deal with patient dissatisfaction; for the benefit of the public the hotline is 0800 009112;
The paediatric specialized clinic which I had announced in 2010/11 was refurbished due to a growing demand and the need to modernize services;
A satellite blood bank was established on site, this is of great help especially in emergency situations.
The picture archiving communication system allowing for clinicians to access patient X-Rays on computer screens amongst others eliminating the possibility of losing X-Ray films.



Honorable Speaker, science has made it possible for significant advances in health technology critical for us in the health sector. We deliver a service that is a public good and is necessary to improve and save lives. In the new financial year we have committed to do the following in the interest of public health.

Establish a Mammography Unit which will improve women’s health and also help with the early detection of breast cancer. This service is unique to the public sector in the Northern Cape. A Mammographer completed her training at the Central University of Technology and will work with the Mammography Unit.



The Accident and Emergency Unit will be refurbished; this is critical to have an environment that can manage patient flow, reduce long queues, improve access to emergency care, reduce the waiting time in line with national standards and use our limited resources effectively.



The MDR and XDR unit at West End Hospital was successfully refurbished and proper ventilation was installed; the facility now boasts up to standard infection control measures. I must thank the Global Fund which has made all of this possible, for the last three years they have walked every step of the way with us in the fight against TB.

The issue of the safety of visitors, patients and health workers is not just one that finds expression in our Ten Point Plan; but it has in fact become one of the major issues in the past year. We have seen fatal incidence and even babies being snatched at health facilities. We think you would agree with us that one of the things that we ought to do this year is to install Closed Circuit Television at KH. Its sheer size says to us despite limited resources we cannot delay such a move based on the growing challenge of security at health facilities.

We deal with the accreditation of our facilities to resume the training of auxiliary nurses, this medium term project is important as we seek to deal with the need to create the appropriate skill mix and offer young people an opportunity for career opportunities and pathing.

In terms of PROGRAMME SIX (6): Health Science and Training which currently pertains to the Henrietta Stockdale College and other training initiatives: The budget for this Programme has increased by 4.7% from the adjustment budget.

Over the MTEF period the budget increases significantly from R84 009 million in 2012/13 to R104 859 million, the bulk of this represent an increase in the goods and services budget of the college.

We are again going to issue bursaries to about sixty (60) new students to train at the college. This represents a drop in the ocean as we are hamstrung by the capacity of our college which is accredited to take only sixty first year students per annum.

Hence we have used the opportunities where they have availed themselves to train students in other provinces. There are currently hundred and seventy six (176) nursing students from the province with bursaries studying elsewhere in the country. We hope to issue ninety (90) bursaries to qualifying and deserving students in the nursing field in 2012/13.

An amount of R19 300 million for each year of the MTEF period has been set aside for bursaries. Last year out of the sixty students recruited, fifty eight (58) students commenced training at the Henrietta Stockdale College. In the current financial year we have twenty nine (29) nursing students that are graduating. Furthermore we had awarded four hundred and fourty five (445) health science bursaries in 2011/12.

In terms of PROGRAMME SEVEN (7) which deals with Health Care Support Services, the budget for Health Care Support Services has increased by 5% to R32, 532 million. Over the past few years the Forensic Medical Service improved because of the acquisition of new equipment and vehicles, this is critical in providing dignified services to the families of those who have departed. Soon we will have to plan to replace the current fleet as it ages.

However there are particular personnel capacity issues that we will attend to in the current financial year to optimize the service. The key objective in terms of our quality service indicators is to complete 70% of the total number of autopsies within two working days.

We have put reasonably sufficient money as per the request of all our districts for pharmaceuticals. Despite an overall decline in the goods and services budget of the department by 5% pharmaceuticals, just as in the case of the Henrietta Stockdale College, pharmaceuticals are unaffected by this decline.

The issue of the supply management of pharmaceuticals especially those on the essential drug list will be improved; in the medium term we should move to a situation where the stock actually moves quicker to the districts and facilities.

We are also seeking to reduce the waiting times of patients at hospital pharmacies to less than fourty five minutes. The issue of waiting times, sometimes reflected through the attitudes of health workers is a major concern for the public health system.

In terms of PROGRAMME EIGHT (8) which deals with health facilities management, the budget is R450 660 million for 2012/13 and it grows to R485 469 million over the MTEF period.

Honorable Speaker, we are pleased to announce that the new Upington Hospital is due to be completed in the second quarter of 2012/13; a team has already been established to work on the commissioning of the facility. The total cost of this twenty first century concept facility is R531million.

The new Upington Hospital will be a regional hospital offering a significant number of specialist services. This development will significantly have an effect on the number of patients from both Namakwa and Siyanda that in the past had to travel long distances to Kimberley. This new Upington Hospital will function as a regional hospital and preparations in that direction have also started.

The Department of Public Works has now appointed a contractor for the completion of the Kimberley Mental Hospital, whilst construction on the De Aar Hospital is progressing well and this facility is projected to be completed in 2014.

The Kuruman Hospital is in a project planning phase, the actual construction is scheduled to start in 2016.

Honorable Speaker, Infrastructure development in respect of Primary Health Care facilities is pivotal in our desire to shift significantly from a Hospicentric model of service delivery and strengthen the performance and capacity of our District Health System. Barring capacity constraints our endeavor is still to ensure that we offer Primary Health Care Services on a twenty four hour basis especially at our Community Health Care Centres.

In our endeavor to put shoulder to the wheel in the national effort towards energy efficiency and reduce greenhouse emissions, importantly save on our electricity expenditure we are installing hot water solar systems at the following Community Health Centres: Pampierstad, Kenhardt, Brandvlei and the following two hospitals in Jan Kempdorp and Douglas.

The work we are doing is to build capacity in that direction, we have engaged in an unparalleled programme of revitalizing infrastructure, in the process we have had to deal with a legacy of neglect that has seen many facilities deteriorate beyond redemption.

In this year 2012/13, the Construction of the Community Health Centre in Williston is scheduled to be completed in 2014 and the Port Nolloth CHC construction will also start, even though we had experienced difficulties with some of the clinic construction projects. A record of twenty six (26) clinics in all districts will be refurbished and upgraded in the current financial year.

The values of any society are not measured by the extent to which its members prosper but by the extent to which it uplifts and treat the weakest and vulnerable. It is based on the ability of those who can and who have; the extent to which they can put themselves at the disposal of others.

Honorable Speaker, the Department has a budget of R3.121 billion that escalates to R3.581 billion over the MTEF. The budget for 2012/13 has grown by 4% from the adjusted budget of 2011/12.

However, the departmental baseline was reduced by an amount of R69,707 million over the 2012/13 and MTEF period. This reduction was brought about as a result of adjustments due to data updates and health component changes.

The bulk of the funding allocated to the Department is conditional grants which are allocated to provinces. I shall focus on these given that they give effect to health priorities for the financial year.

The budget for National Tertiary Services Grant R235, 948 million for the financial year 2011/2012 and is R266 million for the 2012/2012 financial year reflecting an increase of 11,5%.

The budget for the Health Professions Training and Development Grant was R65, 510 million and is R68 million, increased by 4,5%.

The Hospital Revitalisation Grant was R406, 892 for 2010/2011, and is R346 million recording a decrease of 17,6%.

The Health Infrastructure Grant was R107, 710 million has decreased by 9,6% to R98, 000 million.

The Comprehensive HIV and AIDS Grant was R248 million and increased by 14% to R275, 736 million.

The Expanded Public Works Programme Incentive Grant was R2, 073 million and is now R1 million owing to the fact that it is being phased-out.

Furthermore, the Department received additional allocations to fund the National Health Insurance pilot site with an additional R11,5 million and R6 million allocated to the Nursing College.

Whilst these increases may appear to be substantial, it needs to be considered against the backdrop of a low baseline. This means that given the historic under funding of health services, increases over a short period of time will not be sufficient to deal with our backlogs. We need to have significant increases over a long period of time to erode the backlogs and cope with an increasing burden of disease and growing population.

In conclusion, Honorable Speaker, since this year marks the centenary of the ruling party selfless struggle to champion the cause of the poor and vulnerable in society.

Public Health in a developmental state best embodies these values; it represents the flagship of the values of any democracy as it best exemplifies the ethics of a society. I believe that those of us who work in health seek to model ourselves along these values. We are going back to basics in all respects by treating health as a calling that seeks to secure the wellbeing of our people.

Theses virtues implore us to create an effective and efficient health system, a strong primary health care approach and a National Health Insurance for the benefit of all South Africans at the best and at the worst of times.

In conclusion, I would like to thank all who make our advances possible - the Honorable Premier Hazel Jenkins in absentia, the Honorable Acting Premier Grizelda Cjiekella, my colleagues in the Executive Council and the Provincial Legislature, the new Head of Department Ms G Motlaopane, the previous Acting Deputy Director-General, Dr Dion Theys, the hard working, committed and competent team of departmental officials, Ministerial Advisory Statutory Bodies (Provincial and District Health Councils, Hospital Boards and Clinic Committees) that provide much needed advice. In particular, I wish to thank the Chairperson of the Portfolio Committee on Health, Ms Alexandra Beukes, and members of the Portfolio Committee on Health - all of whom play a unique and critical role in enabling us, not only to dream a new health order, but to also contribute towards manufacturing a new reality for our Department.

I therefore request this House to pass the Health Budget Vote.

Thank you!