South Africa: Debate On Health Budget Vote

press release


Hon NJ Nkwanyana MPL, KZN Legislature

Madam Speaker, Honourable Premier,

Honourable Colleagues and Distinguished Guests

All protocol observed.

The IFP is delighted to share in this opportunity to contribute positively towards building a sustainable, equal and accessible healthcare environment for all the people of KwaZulu-Natal. We welcome the budget allocation of R36.5billion to the Department of Health but in view of the spending pressures on this department, the IFP believes that this amount is insufficient to provide the quality of health care that we aspire to.

We care and so this afternoon we recognise our people’s suffering and the need to expand public healthcare into the remote and sometimes hard to reach areas of the KwaZulu-Natal province. It is in this spirit that we offer feedback on the Budget Vote as well as on the Strategic, Annual Performance and Operational Plans of our provincial Department of Health.

The aim of the Department of Health is to promote the health of all the people in KZN through an accessible, caring and high-quality health care system. If one looks at the state of our health care system and the service that people actually get from it, then I am afraid that the Department is failing in its efforts to reach this aim.

There are numerous reports of a lack of clean bed linen in most hospitals and patients have to carry their own. The department had requested R162.5million to procure hospital linen but it has been allocated only R60million — over a million rand less than what it had requested. It is obvious that the shortage of hospital linen is a problem that we would have to live with even though spoiled linen in hospitals is a breeding ground for an untold number of diseases and infections.

The IFP has a number of pleas and comments submitted by mothers of young babies and toddlers who were forced to rely on private clinics for immunisation because they work and have very limited time to spend waiting at a clinic for injections and syrups to protect their babies. Government hospitals and clinics are generally in a run-down state and short of equipment and medicines. Anyone who has ever been to a government hospital or clinic would have experienced first-hand just how unpleasant this visit actually is. People have to wait for hours sometimes just to get medical attention and many people who are admitted to these hospitals are neglected and end up in a worse condition than when they arrived. The situation in rural areas is even worse as people have to travel for miles to receive medical attention from clinics and this costs them in terms of time and money which they cannot afford.

These women speak with one tongue. They say that they will lose their jobs if they have to wait at state clinics for service because the waiting time exceeds the length of their lunch breaks. They also say that because they are forced to choose between immunisation and their jobs they choose to keep their jobs. This is a very risky choice!

It is encouraging that the Conditional Grant for Health Facility Revitalisation is increased by R67.1million. The IFP hopes that this funding together with the allocation from the Department’s baseline allocation for infrastructure revitalisation, will be put to good use and we will see some improvements in our public health care facilities. The IFP welcomes the R85million that is made available to Ngwelezane Hospital for the construction of the 192-bed medical wards and new crisis centre. Our health care facilities in the rural areas have always been lacking in proper facilities.

For service delivery to have the desired impact, the department must ensure that its financial management is above reproach. For this financial year the IFP would like to see that the department plans and implements feasible targets for financial management. Targets must be backed by implementable strategies. We would like to see that the department improves its internal capacity to monitor its financial management, which was highlighted as a concern during the budget presentation.

The IFP is deeply concerned about the high number of litigation cases being brought against the Department. These cases are costing the Department huge amounts of money that could be put to better use in providing high quality health care to our citizens. This is money that we cannot afford to waste and every effort must be made to prevent litigation cases being brought against the Department.

Honourable Speaker, we will begin to see excellence in the health service sector once targets are consistently monitored and financial management is improved. The Constitution guarantees access to quality healthcare for all. This means realising and exercising our democratic freedom. However, our emergency services are failing to help us realise a free and fair society. The dire state of our health care system means that the less fortunate South Africans suffer the most as they cannot afford private healthcare. The inability of this department to fulfil its aims makes it more difficult for the poor to escape their lives of poverty.

I’m also concerned about the way in which our hospitals are treating patients. I have received a lot of concerns from patients being ignored and turned away by the doctors at Greys Hospital and Greytown Hospital. In Greys Hospital some patients are supposed to undergo operations but doctors turn them away although their conditions are deteriorating and some have referral letters from private doctors confirming that they need urgent medical attention but they are turned away from hospitals. They are being told to come back after one month or two months. In Greytown Hospital one of the patients, Hlengiwe Gwala from Ndwedwe who was in labour during the time she visited her relatives in Greytown was turned away by nurses because she has no card and this resulted to the death of her baby. This is totally unacceptable in our democracy. We demand that the MEC must investigate this matter and take necessary action against the doctors and nurses at both hospitals Greys and Greytown.

The allocation of R154million towards essential health technology equipment must be put to prudent use so as to ensure that hospitals acquire the essential equipment needed. While I speak of prudent spending, I must hasten to add that no amount of money will prove to be sufficient if it is squandered by unscrupulous officials. The Department needs to ensure that its Supply Chain processes follow the ethical procedures that are set down. Security at pharmacies must be stepped up to prevent theft of medicines supplies.

Our concern also extends to the NHI programme because we believe that there was no clear explanation provided to the people by the department on when this programme will be beneficial to them. The fact that about 87% of our population do not have health insurance, speaks directly to the urgency of having the NHI fully functional. We can see in the budget that the NHI Conditional Grant funding is being reduced and will be removed from the Province’s baseline in the future as the NHI function is going to be moved to the National Department. It must be remembered that there was much hype around the roll-out of the NHI a few years ago but now we can see that provinces have failed to meet their targets. This is yet another example of the ANC not being able to implement and sustain initiatives while wasting millions of rand of tax payer’s in announcing such programmes.

No mention is made about any involvement of or contribution by African Traditional Healers. Can the MEC clear the air in this matter because the public needs to know. We demand that the MEC must ensure that rural people are offered an opportunity to get proper explanation about NHI in their preferred language, IsiZulu not in English because even flyers and materials are written in English which is difficult for rural people, especially the elders to understand.

The IFP is concerned about the failure by the department to honour its promises made to the public to ensure safety in our clinics and hospitals. Recently there was chaos at KwaMashu Community Health Care Centre after nurses stopped working. They were demanding that the centre management prioritise safety measures. The department has also failed to honour the promise made to Mr Mngadi from Inchanga as the clinic was built in his land but no compensation has been made by the department since then. The Department has failed again to honour its promise to build the Mambulu Clinic in KwaMaphumulo as till today nothing has happened. The department has failed again to fast track the repairs of Gunjana Clinic in Msinga which was blown away by heavy storm in December but only to find out that the department is vandalising this clinic in order to build Ngabayena Clinic. This is totally outrageous.

The IFP wants to know form the MEC about what happened to the investigation into the activities of Dr Sibongile Zungu, the former Head of Department of Health in the issue of the R61 million bus tender. The MEC has been silent for a long time on this matter. We want to know the outcome of the investigation as the truth must be told. The public is in all ears about this matter which now the MEC seems to be hiding under carpet. Furthermore, we want to get proper explanation about what the department is doing to deal with the concerns of the students taking part in the Cuban Doctor’s programme especially to improve their living conditions where they are and to ensure that they complete their studies and return as qualified doctors.

The increase in Conditional Grant funding to cater for HIV, Aids and TB is most welcome. It is encouraging to note that through increased funding, TB screening procedures will be much faster as this will ensure early detection and treatment.

Drastic changes are needed within this department and our health care system if the aim of promoting the health of all South Africans is to be reached.

I thank You.