Health MEC’s Bud­get speech

African Times - - Front Page - Ma­ter­nal, Woman, Child, Youth and Ado­les­cent Health Ser­vices

Health MEC Dr Phophi Ra­math­uba on Tuesday tabled her R19.5 bil­lon bud­get for the 2018/2019 fi­nan­cial year at the Pro­vin­cial Leg­is­la­ture in Le­bowak­gomo. The bud­get rep­re­sents an 8.1 per­cent in­crease from the 2017/2018 bud­get and con­sists of R16.6 bil­lion eq­ui­table share, R2.7 bil­lion con­di­tional grants and R168 mil­lion own rev­enue. It bud­get ac­cel­er­ates the gov­ern­ment’s march to­wards fun­da­men­tal trans­for­ma­tion of the pub­lic health­care sys­tem, to en­sure that the de­liv­ery of qual­ity health­care ser­vices to the pub­lic be­comes a re­al­ity re­gard­less of the size of their pock­ets

AC­CORD­ING to the Dis­trict Health In­for­ma­tion, in­sti­tu­tional ma­ter­nal mor­tal­ity ra­tio has de­creased from 130/100 000 live births in 2016/17 Fi­nan­cial Year to 111/100 000 live births in 2017/18 Fi­nan­cial Year, com­ing from 182 / 100 000 live birth in 2014/15 Fi­nan­cial Year.

Whilst this rep­re­sents progress, we are how­ever far from be­ing sat­is­fied, hence fur­ther ef­forts are in progress to re­duce in­sti­tu­tional ma­ter­nal mor­tal­ity ra­tio as in­di­cated in the Sus­tain­able De­vel­op­ment Goals. To this end the de­part­ment has ini­ti­ated a project called MOTHER AND CHILD CEN­TRE OF EX­CEL­LENCE in each dis­trict. Honourable Premier, it is about time that all of us as a Gov­ern­ment and so­ci­ety be­yond po­lit­i­cal af­fil­i­a­tions, rally be­hind this project. The Mother and Child Cen­tre of Ex­cel­lence must suc­ceed. Mother and Child Mor­tal­ity must fall, it is about time!

Honourable Speaker, se­vere Acute Mal­nu­tri­tion case fa­tal­ity rate has de­clined from 8.3% in 2016/17 F/Y to 5% in 2017/18 F/Y. This is at­trib­uted to the fact that as a de­part­ment we are im­ple­ment­ing a pro­gram called In­ter­graded Man­age­ment of Child­hood Ill­nesses (IMCI) in all our Pri­mary Health Care Fa­cil­i­ties. We have dur­ing the pre­vi­ous fi­nan­cial year trained 91 pro­fes­sional nurses in IMCI and 40 in Emer­gency Triage and Treat­ment of chil­dren. We are how­ever wor­ried by the fact that in the year 2018 we still have chil­dren dy­ing of mal­nu­tri­tion de­spite all gov­ern­ment pro­grams in­clud­ing child sup­port grant, so­cial re­lieve of dis­tress grant, “fetsa tlala” and school nu­tri­tion pro­gram. We will con­tinue to work with our sis­ter de­part­ments within the So­cial Clus­ter to erad­i­cate mal­nu­tri­tion. It is about time!

Honourable Mem­bers, the health and well­be­ing of our school go­ing chil­dren re­mains our pri­or­ity hence the In­te­grated School Health Pro­gramme. We have estab­lished up to so far 57 school health teams in the prov­ince. We have vis­ited

1 485 quin­tile 1, 2 and 3 schools al­low­ing us to screen 60 906 grade 1 learner and 30 037 grade 8 learn­ers. A to­tal num­ber of 4446 learn­ers have been re­ferred to health fa­cil­i­ties for eye care, 6943 for oral care, 2976 for hear­ing, 736 for speech re­lated prob­lems, and 32092 were im­mu­nized for te­tanus and diph­the­ria. Learn­ers who were re­ferred to hos­pi­tals did re­ceive their as­sis­tive de­vices rang­ing from hear­ing aids to spec­ta­cles. No African child must drop out of school be­cause they can’t see or hear prop­erly. It is about time!

Honourable mem­bers, we con­tinue to im­ple­ment the Hu­man Pa­pil­loma Virus vac­ci­na­tion cam­paign for pre­ven­tion of cer­vi­cal can­cer tar­get­ing young girls of 9 and 11 years of age. Dur­ing the 2017/18 F/Y a to­tal num­ber of 58 131 were vac­ci­nated.

Honourable Speaker, we are also pleased to an­nounce that the Hu­man Pa­pil­lo­mavirus Grant of R27 mil­lion has now been de­cen­tral­ized to the prov­ince. This will speed up the vac­ci­na­tion of young girls in pub­lic and spe­cial schools to pre­vent mor­tal­ity as­so­ci­ated with cer­vi­cal can­cer in fu­ture. De­spite the much ef­fort of free ac­cess to this life sav­ing vac­cine at a cost of R800 per dose, there are many par­ents who still refuse to give con­sent in or­der for their chil­dren to be vac­ci­nated.

Hon­or­able mem­bers, we call on par­ents to please take this op­por­tu­nity to pro­tect their chil­dren from dy­ing of cer­vi­cal can­cer later in life while it is pre­ventable and ke ma­hala- proudly brought to you by the ANC gov­ern­ment. This vac­cine has been tested and it is safe. African chil­dren must no longer die of pre­ventable dis­eases. It is about time!

Com­mu­ni­ca­ble Dis­eases HIV and AIDS

Honourable Speaker, 2018 has been de­clared the year of our first demo­crat­i­cally elected pres­i­dent who would have been 100 years. In his own words, Pres­i­dent Nel­son Rolih­lahla Tata Madiba had this to say about HIV and AIDS;

“Let us give pub­lic­ity to HIV-AIDS and not hide it, be­cause the only way to make it ap­pear like a nor­mal ill­ness, like TB, like can­cer, is al­ways to come out and to say some­body has died be­cause of HIV. Aids to­day in Africa is claim­ing more lives than the sum to­tal of all wars, famines and floods and the rav­ages of such deadly dis­eases as malaria … We must act now for the sake of the world … Aids is no longer a dis­ease, it is a hu­man rights is­sue.”

Hon­or­able Speaker, in honor of Madiba Lim­popo AIDS Coun­cil con­tinue to func­tion prop­erly al­beit the chal­lenges in other dis­tricts which are re­ceiv­ing at­ten­tion.

We are proud to an­nounce that Capri­corn and Vhembe Dis­tricts have launched their AIDS Coun­cils. Capri­corn has fur­ther launched all its lo­cal mu­nic­i­pal­i­ties’ AIDS coun­cils. We will con­tinue to sup­port all our mu­nic­i­pal­i­ties through Lim­popo AIDS Coun­cil as led by the Premier him­self in­clud­ing ward AIDS coun­cils.

Tata Madiba would have been proud that in his cen­te­nary year we have al­ready reached 1 242 111 clients for HIV test­ing in the third quar­ter against the an­nual tar­get of 1 024 546. For the 2018/19 F/ Y we have in­creased our tar­get to 1 351 938.

Honourable Mem­bers, as we con­tinue to honor Tata Madiba we will launch the sec­ond round of HIV Test­ing Ser­vices (HTS) Re­vi­tal­iza­tion Cam­paign as pro­nounced by SANAC in the first quar­ter of 2018/19

F/ Y tar­get­ing key pop­u­la­tions, com­mu­ni­ties at risks and vul­ner­a­ble groups in­clud­ing those with non­com­mu­ni­ca­ble dis­eases. Our ma­jor fo­cus will be on the hard to reach ar­eas such as farm­ing ar­eas in or­der to re­al­ize our 90-90-90 strat­egy.

Hon­or­able Speaker, Madiba’s dream of an HIV free gen­er­a­tion is within reach. By the third quar­ter we had al­ready re­duced mother to child HIV trans­mis­sion from our an­nual tar­get of 1.1% to 0.7%.

This means that 99.3 per­cent of ba­bies born to HIV pos­i­tive moth­ers are HIV neg­a­tive. This calls for a cel­e­bra­tion. Th­ese chil­dren would not be sub­jected to anti- retro­vi­ral for life. We will con­tinue to draw lessons from the peo­ple of Cuba to make sure the re­main­ing 0.7 per­cent equally be­comes neg­a­tive. It is about time! Ke nako!

The use of ad­her­ence clubs has yielded re­sults in mak­ing sure that pa­tients re­main on treat­ment. To date 319 174 clients re­main on ART against a tar­get of 317 551 in the third quar­ter. It pleases us to an­nounce that we have part­nered with pri­vate en­ti­ties like Exxaro, ZZ2 and our two univer­si­ties which we have for­mally li­censed to pro­vide ARVs de­spite be­ing non-med­i­cal sites.

Hon­or­able Speaker, we are proud to an­nounce that we have estab­lished eleven clin­ics at all our TVET sites fo­cus­ing not just on HIV/ AIDS but also re­pro­duc­tive health for the girl child in line with SHE CON­QUERS Cam­paign. All th­ese part­ner­ships are prov­ing suc­cess­ful in in­creas­ing ac­ces­si­bil­ity to ARTs. We call upon other com­pa­nies to join in this cam­paign. With­out a healthy work force we will never grow our econ­omy, cre­ate new jobs and at­tract new in­vest­ments. Af­ter all, the time for good cor­po­rate cit­i­zen­ship is now. Ndi tshifhinga!

Honourable house, the ef­forts to in­ten­sify STIs case find­ing has yielded good re­sults. We have dis­trib­uted 73 350 800 male con­doms and 2 685 677 fe­male con­doms by the third quar­ter. We man­aged to med­i­cally cir­cum­cise 48 959 males against the an­nual tar­get of 36 910 in the third quar­ter. We are call­ing upon all un­cir­cum­cised men to take ad­van­tage of this free ser­vice. #Fore­skin must fall. It is about time.

Hon­or­able Speaker we have launched the Pre-Ex­po­sure Pro­phy­laxis (PrEP) for HIV neg­a­tive clients that are at high risk (i.e. sex work­ers, men hav­ing sex with men, dis­cor­dant cou­ples) and vul­ner­a­ble (i.e. ado­les­cent girls and young woman).

Hon­or­able mem­bers, gov­ern­ment is hard at work in in­tro­duc­ing pro­grams to­wards erad­i­cat­ing HIV and AIDS within our com­mu­ni­ties.

How­ever, the onus still lies with each one of us. Launch­ing of th­ese pro­grams must never be mis­taken for tak­ing away our ba­sic and key cam­paign of ABC, Ab­stain, Be Faith­ful and Con­domise. Now is the time to end HIV and AIDS. Ix­he­sha li fik­ile!

Honourable Speaker, we wel­come the in­crease of com­pre­hen­sive HIV and AIDS grant by R226 mil­lion to R1.6 bil­lion for the 2018/19 F/ Y, a 16.4 per­cent in­crease.

TB Con­trol

Honourable Mem­bers, we are happy to re­port to this au­gust house that TB screen­ing has im­proved in all our dis­tricts. We man­aged to im­prove TB screen­ing ser­vices to at least 84.8% (10 530 399/ 12 403 811) against a to­tal tar­get of 80% in all PHC fa­cil­i­ties. A to­tal of 214 171 TB sus­pects have been iden­ti­fied and 200 191 sus­pects for TB have been tested giv­ing us 93.4% test­ing rate which is more than our tar­get for the 90-90-90 Strat­egy.

Hon­or­able mem­bers, you will be pleased to know that there has been a de­cline in the num­ber of TB cases from 18 623 in 2014, 17 425 in 2015, 15 559 in 2016 and 14 374 in 2017. GeneXpert Ul­tra Ca­tridge to as­sist in early di­ag­no­sis of TB in HIV pos­i­tive clients has been in­tro­duced in all our fa­cil­i­ties

We have also in­tro­duced the FAST (Find­ing TB cases Ac­tively, Sep­a­rat­ing safely, Treat­ing (ef­fec­tively) Strat­egy in all hos­pi­tals within the prov­ince. This is aimed at pro­tect­ing both staff and other pa­tients from be­ing in­fected by TB.

Hon­or­able Speaker, the num­ber of MDR TB de­cen­tral­ized sites have been in­creased from 12 to 22 ac­tive sites in 2017/2018 F/Y. This will as­sist in in­creas­ing ac­cess to MDR TB treat­ment and re­duce num­ber of de­fault­ers since pa­tients will be man­aged at a fa­cil­ity nearer their homes. For this F/ Y we plan to in­crease our MDR TB de­cen­tral­ized sites to 30. It is our honor to an­nounce that the first pro­vin­cial MDR TB hospi­tal has been fi­nally gazetted as Modi­molle MDR TB.

Hon­or­able Mem­bers, TB is cur­able, Pres­i­dent Nel­son Man­dela was once in­fected with TB, but be­cause he com­plied with treat­ment he was cured. In his honor we have bud­geted R42 mil­lion to­wards TB pro­gram. It is time that our peo­ple take ad­van­tage of th­ese re­sources, get screened, and take treat­ment at no cost to them. TB must end. Ke nako! Dis tyd!

Malaria

Honourable Speaker, whilst we ap­pre­ci­ated good rains in the midst of a dev­as­tat­ing drought, it has un­for­tu­nately re­sulted in malaria up­surge in 2017. The un­usual cli­matic con­di­tions, trav­ellers mos­qui­tos or so called “Suit­case malaria” has re­sulted in the up­surge wherein even ar­eas which his­tor­i­cally were never malaria-en­demic, eg Sekhukhune and Water­berg found them­selves hav­ing to deal with malaria cases. This un­usual sit­u­a­tion ne­ces­si­tated for an ad­di­tional R11,8 mil­lion in the 2017/18 F/Y to pro­cure chem­i­cals, treat­ment, malaria tests and to em­ploy 342 sea­sonal spray work­ers.

The in­door resid­ual spray­ing tar­get was in­creased from 521 142 to 791 029 struc­tures to be sprayed in 2017/18 F/Y. This tar­get was sur­passed with 964,138 struc­tures sprayed dur­ing the last fi­nan­cial year.

Honourable Speaker, we call on our com­mu­ni­ties not to pre­vent our of­fi­cials from ac­cess­ing their prop­er­ties to spray and de­stroy the mos­quito and lar­vae. We would like to as­sure our peo­ple that the us­age of DDT has been proven to be safe.

Honourable Speaker, an amount of R96.7 mil­lion has been pro­vided to pre­vent and con­trol malaria in the af­fected ar­eas of our prov­ince.

An­i­mal bites

Honourable Speaker, we are once again proud to an­nounce that our col­lab­o­ra­tion with the De­part­ment of Agri­cul­ture in vac­ci­nat­ing our dogs against ra­bies and ed­u­cat­ing com­mu­ni­ties about ra­bies has borne fruits. In 2016, a to­tal of 9 228 peo­ple were pro­vided with post ex­po­sure pro­phy­laxis af­ter hav­ing been bit­ten by an­i­mals, and in 2017 a to­tal of 9 751 were also treated to pre­vent them from hu­man ra­bies. It is time to end Ra­bies.

Non-Com­mu­ni­ca­ble Dis­eases (NCD) and Dis­eases of Life­style

Honourable Mem­bers, Non com­mu­ni­ca­ble dis­eases (NCD) and their risk fac­tors con­tinue to threaten the health of our peo­ple. Th­ese are con­di­tions that can be pre­vented.

Honourable Speaker, we will con­tinue to en­cour­age peo­ple to live an ac­tive life. Our first cit­i­zen, Pres­i­dent Matamela Cyril Ramaphosa has taken a lead in mak­ing sure that we be­come phys­i­cally ac­tive ci­ti­zens. He equally made a call that all of us must join him in his quest to­wards a healthy na­tion.

Honourable Speaker, in our mist we have one of our coaches Dr Tsholo Tsiane, a 34 week preg­nant who run not less than 10km daily de­spite her con­di­tion. We con­grat­u­late

the ci­ti­zens of Lim­popo who have taken a de­ci­sion to do dif­fer­ent ex­er­cises. Th­ese ex­er­cises can help in re­duc­ing the R85 mil­lion bud­get spent on drugs monthly for Dis­eases of Life­style. Th­ese ex­er­cises can help in re­duc­ing the money we spend on am­pu­tat­ing limbs, the money we spend on re­nal dial­y­sis, the money we spend on car­diac by­pass. This is the money that could be redi­rected to­wards other ser­vices like build­ing of schools, roads, grow­ing econ­omy and cre­at­ing new jobs. We can only achieve that if we are healthy. Un­for­tu­nately, be­cause of our life­style, gov­ern­ment has to spend more re­sources on de­liv­er­ing health­care ser­vices.

Honourable Mem­bers, if coach Tsholo can run in her con­di­tion, why can’t we? #Mokhavha must fall. Coach Tsholo and many other run­ning clubs through­out our prov­ince are call­ing upon all of us join them. Inkarhi! Honourable Speaker, our fight against blind­ness from ci­ti­zens of dif­fer­ent ages is bear­ing fruits. We have per­formed 2 890 cataract surg­eries in the third quar­ter of the 2017/18 F/Y, sur­pass­ing our tar­get of 1 752. We are how­ever not sat­is­fied as our back­log re­mains high. Us­ing “let­sema” we shall en­gage the ser­vices of pri­vate and pub­lic oph­thal­mol­o­gists to as­sist us in re­duc­ing the back­log.

In­juries

Honourable Mem­bers, is still re­gret­table that we are ex­pe­ri­enc­ing fa­tal in­juries through mo­tor ve­hi­cle ac­ci­dents, sui­cide, homi­cides and oth­ers. Ac­cord­ing to STATS SA an es­ti­mated 4 903 peo­ple (10% of to­tal deaths) in this prov­ince lose their lives ev­ery year due to in­juries and vi­o­lence. Honourable Speaker, the high num­ber of ac­ci­dents dur­ing peak traffic pe­ri­ods on our roads, most re­quire our ser­vices, thereby con­sum­ing much needed re­sources that could have been redi­rected else­where. We will con­tinue to work to­gether with the De­part­ment of Trans­port and SAPS in re­duc­ing th­ese fa­tal­i­ties.

Honourable Mem­bers, it is our plea­sure to re­port to this house that through the as­sis­tance of spe­cial­ists from Gaut­eng and Free State led by Pro­fes­sor Mat­shidze we man­aged to re­duces the ortho­pe­dic back­logs. We con­ducted eight out­reach ser­vices and per­formed 243 ortho­pe­dic op­er­a­tions at Tshilidzini, Letaba and Mokopane hos­pi­tals re­spec­tively. It must be noted that th­ese spe­cial­ists who are rare species per­form th­ese op­er­a­tions uti­liz­ing their own time at no cost to gov­ern­ment. We call upon all other dis­ci­plines to join this “let­sema.” Tshifhinga tsha uri vhadzu­lapo vha Ha-Tshikun­damalema vha sa holefhale nga mu­rahu ha fu­vhalo nga nwambo ya tha­helelo ya dzi­lafho la muaro tsho swika.

Dis­trict Health­care Ser­vices

Honourable Mem­bers, our am­bi­tion to con­tinue in­creas­ing 24 hours ser­vices in our clin­ics is be­ing un­for­tu­nately ham­pered by crim­i­nal el­e­ments dis­arm­ing se­cu­rity of­fi­cers and at­tack­ing our nurses. We call upon Honourable Mem­bers, tra­di­tional lead­ers, community lead­ers and the community of Lim­popo, to be like the Mod­jadji Royal House, SANCO and other community for­ma­tions for mo­bi­liz­ing the com­mu­ni­ties in their area to pro­tect their clin­ics against th­ese crim­i­nals. Fol­low­ing th­ese in­ter­ven­tions the closed clin­ics have now been re­opened for 24 hours.

Hon­or­able mem­bers, the Pres­i­dent of the coun­try Cyril Ramaphosa in his State of the Na­tion Ad­dress said: “The time has now ar­rived to fi­nally im­ple­ment univer­sal health cov­er­age through the Na­tional Health In­sur­ance. Cer­tain NHI projects tar­get­ing the most vul­ner­a­ble peo­ple in so­ci­ety will com­mence in April this year”.

Through the Na­tional Health In­sur­ance ini­tia­tive, we con­tinue to im­ple­ment the Ideal Clinic Re­al­iza­tion and Main­te­nance Pro­gram, hence an in­crease in the num­ber of clin­ics that have reached the Ideal Clinic sta­tus from 42 in 2016/17 to 148 in 2017/18 F/Y.

Honourable Speaker, strength­en­ing the Dis­trict Health Ser­vices (Pri­mary Health­care) and dis­trict hospi­tal de­liv­ery sys­tems: R10.5 bil­lion. This is 54% of the to­tal bud­get of the de­part­ment. The bud­get of this pri­or­ity grows by an aver­age of 5.3% over the next years.

Emer­gency Med­i­cal Ser­vices

Honourable Speaker, since the 5th ad­min­is­tra­tion came into of­fice our fo­cus has been to ad­dress the back­logs of EMS ve­hi­cles. To date, we have pro­cured a to­tal of 250 ve­hi­cles. We have re­cently de­liv­ered 50 of which 4 are for MDR TB ser­vices and 10 Planned Pa­tient Trans­port. Our concern is that only 227 are on the road as a re­sult of theft, hi­jack, van­dal­ism, mo­tor ve­hi­cle ac­ci­dents and dam­ages by com­mu­ni­ties dur­ing protests. In re­sponse to that we have suc­cess­fully in­tro­duced sys­tems for fleet man­age­ment as promised namely; the Push-to Talk com­mu­ni­ca­tion sys­tem in all con­trol cen­ters and am­bu­lances. We are cur­rently in­stalling ac­tive ve­hi­cle track­ing in all EMS ve­hi­cles. This should im­prove our abil­ity to ren­der emer­gency ser­vices ef­fi­ciently- but equally we are call­ing upon com­mu­ni­ties to pro­tect th­ese prop­er­ties since they are theirs and are meant to save their lives.

Our fo­cus for the 2018/19 Fi­nan­cial Year is to equip those am­bu­lances with skilled per­son­nel and equip­ment. Out of the to­tal 2024 EMS per­son­nel, only 26 are ad­vanced life sup­port­ers, 1200 are ba­sic am­bu­lance as­sis­tants within our sys­tem of which the Health Pro­fes­sional Coun­cil has dis­con­tin­ued. We have started a process of up­grad­ing them. 5 BAAs have been taken to school for a Bach­e­lor of Health Sci­ence in Emer­gency Care in other prov­inces. An­other 5 BAAs will be taken to school this fi­nan­cial year. We are proud to an­nounce that our EMS Col­lege is ready to pro­vide train­ing for the in­ter­me­di­ate life sup­port course. The HPCSA will be vis­it­ing us on the 18th and 19th of April for fi­nal as­sess­ment and ac­cred­i­ta­tion. At the end of this ex­er­cise, all our qual­i­fy­ing BAAs will be trained as ei­ther in­ter­me­di­ate life sup­port­ers or ad­vanced life sup­port­ers.

SETA fund­ing has also been se­cured for this pur­pose, and also we are twin­ning with Univer­sity of Lim­popo, Mpumalanga EMS Col­lege for some of th­ese train­ing in or­der to catch up with th­ese numbers.

To this end we have put aside an amount of R736 mil­lion for the run­ning of Emer­gency Med­i­cal Ser­vices in the prov­ince. The time to meet EMS re­sponse time is now. Ke nako!

Phar­ma­ceu­ti­cal Ser­vices

Honourable Mem­bers, the in­tro­duc­tion of sys­tems like Stock Vis­i­bil­ity Sys­tems (SVS) and In­ten­der has re­sulted in the im­prove­ment of medicine avail­abil­ity. We are at an ad­vanced stage of over­haul­ing the Pro­vin­cial De­pot ware­house man­age­ment sys­tem.

Honourable Speaker, in or­der to im­prove the stock level at our clin­ics, health cen­ters and hos­pi­tals, medicine al­lo­ca­tion has been in­creased by 17% to R1.6 bil­lion. This in­cludes amount of R635 mil­lion for the pro­vi­sion of An­tiretro­vi­ral drugs to HIV pos­i­tive pa­tients and new in­take, and R205 mil­lion for Vac­cines to re­duce in­fant and child mor­tal­ity. Nako e fihlile ya gore bokoko ge ba etela dik­liniki ba se ka fiwa panado fela, as if ke yona ya go alafa mal­wetsi ka moka.

Health Tech­nol­ogy

Dur­ing the 2017/18 fi­nan­cial year we have pro­cured equip­ment amount­ing to R12 Mil­lion for PHC to­wards re­al­iz­ing the ideal clinic ini­tia­tive. A fur­ther R28 Mil­lion was uti­lized for up­grad­ing of es­sen­tial med­i­cal equip­ment for re­gional and dis­trict hos­pi­tals. Dur­ing this fi­nan­cial year we will fi­nal­ize con­tracts to op­ti­mize the de­liv­ery of x-ray ser­vices at all lev­els of care.

Honourable Speaker, as pro­nounced by the Premier Chupu Stanely Matha­batha, we are hard at work in the process of im­prov­ing our IT hard­ware in­fra­struc­ture as well as broad­band con­nec­tiv­ity. It pleases us to an­nounce that all our Pri­mary Health Care fa­cil­i­ties are at a 100% broad­band ac­cess while work is un­der­way to en­sure that the rest of our fa­cil­i­ties will in the com­ing few months be ex­pe­ri­enc­ing im­proved in­ter­net avail­abil­ity and speed. It is time that we erad­i­cate the chronic chal­lenge of files with pa­tient in­for­ma­tion be­ing lost which is key to­wards sus­tain­abil­ity of their sta­ble con­di­tions.

We are now im­ple­ment­ing an Elec­tronic Data In­ter­change and Pa­tients Ver­i­fi­ca­tion Sys­tem that would en­able the de­part­ment to ver­ify the el­i­gi­bil­ity of pa­tients to ac­cess the in­di­gent pay­ment waiver scheme so that those who must pay should be pay. This will con­trib­ute to the de­part­ment’s ef­fort to en­hance rev­enue col­lec­tion and gen­eral im­prove­ment of our fi­nances. The time is now!

Ab­sen­teeism and leave man­age­ment is a se­ri­ous chal­lenge as raised by the Au­di­tor Gen­eral. Pro­fes­sion­als like med­i­cal doc­tors who refuse to sign at­ten­dance reg­is­ters con­trib­ute to this neg­a­tive au­dit queries. It is against this back­ground that to­gether with Trea­sury we are procur­ing a work­force man­age­ment sys­tem that will as­sist us in man­ag­ing staff at­ten­dance at work, staff plan­ning and sched­ul­ing. This will con­trib­ute tremen­dously to the man­age­ment of over­time of all kinds, leave of all kinds and thereby help im­prove our fi­nances, while also im­prov­ing the level and qual­ity of ser­vices. It is time for the state to get value for money from all its work­ers.

Hu­man Re­sources

Honourable Mem­bers, guided by Ernesto Che Gue­vara when he said: “We must carry the war into ev­ery cor­ner the enemy hap­pens to carry it: to his home, to his cen­ters of en­ter­tain­ment; a to­tal war. It is nec­es­sary to pre­vent him from hav­ing a mo­ment of peace, a quiet mo­ment out­side his bar­racks or even inside; we must attack him wher­ever he may be, make him feel like a cor­nered beast wher­ever he may move”. Our enemy hon­or­able mem­bers is the bur­den of dis­eases which are found within our com­mu­ni­ties and our fa­cil­i­ties at all lev­els of care. It is on that note that we have suc­cess­fully launched #Of­fice Must Fall Cam­paign at Letaba Hospi­tal yes­ter­day. The cam­paign will see all our Ex­ec­u­tive Man­agers start­ing with the ac­count­ing of­fi­cer leav­ing the com­fort of their air­con­di­tioned and well-fur­nished of­fices to be where the enemy is. The enemy is nei­ther at Fidel Cas­tro House nor dis­trict of­fices, hence #of­fice must fall. It is time that our man­agers pick up chal­lenges in our fa­cil­i­ties not jour­nal­ists. It is time that our man­agers pick up chal­lenges in our hos­pi­tals and clin­ics and fix them not po­lit­i­cal par­ties. It is time that our HOD must dis­cover th­ese short­falls not pa­tients or the Hu­man Rights Com­mis­sion. Ke nako!

We have em­barked on a re­struc­tur­ing and ra­tio­nal­iza­tion project which has seen a re­duc­tion of Ex­ec­u­tive Man­age­ment po­si­tions. Since the enemy is not in the of­fices, we are in­vest­ing hu­man re­sources where the enemy is- where they are needed most. Our DDG po­si­tions have been re­duced from 6 to 4. Chief Di­rec­tors are fol­low­ing so are Di­rec­tors and oth­ers. For an ex­am­ple, at the dis­trict level we will re­main with only 2 di­rec­tors in­stead of 6. The process of en­gag­ing with warm bod­ies on their re­de­ploy­ment to where they are needed most, where the enemy is, has com­menced. This work will re­sult in all our hos­pi­tals by the end of sec­ond quar­ter to be fully equipped with man­age­ment to deal with the enemy. The time is now!

The re­cruit­ment pro­cesses to fi­nally ap­point the core sup­port per­son­nel in deal­ing with the enemy has be­gun. The fol­low­ing cat­e­gories of posts, namely; 1 071 ward at­ten­dants, 23 clean­ers and 368 grounds- men have been ad­ver­tised.

Hon­or­able mem­bers, we made a com­mit­ment that we will in source all our kitchen and we are proud to an­nounce that all our kitchens are now in­sourced, cre­at­ing in that process 119 de­cent jobs for our un­em­ployed young food ser­vice aid prac­ti­tioner grad­u­ates.

Health In­fra­struc­ture

Honourable Speaker, in his state of the prov­ince ad­dress, the Premier com­mit­ted us to in­source all our laun­dries as we did with our kitchens. This will re­sult in us once again cre­at­ing more de­cent jobs and re­duc­ing temp­ta­tions of cor­rup­tion through ten­der sys­tem.

Hon­or­able Speaker, the time for fo­cus­ing on ren­der­ing health care ser­vices in­stead of ten­der care ser­vices is now. A to­tal of nine laun­dries are at an ad­vanced stage to be com­pleted dur­ing the 2018/19 F/ Y.

We have com­pleted 10 new state of the art clin­ics, we have up­graded 10 clin­ics, we have con­structed three new EMS sta­tions in­clud­ing the EMS pro­vin­cial of­fices in Polok­wane, we have com­pleted malaria con­trol units at Wit­poort and Makuya clinic, malaria con­trol head of­fice in Tzaneen, 50 bed­roomed staff ac­com­mo­da­tion at five hos­pi­tals, in­clud­ing up­grad­ing of mor­tu­ar­ies and other health in­fra­struc­ture.

We have also com­pleted neona­tal in­fra­struc­ture projects at Tshilidzini, Pi­eters­burg, Mokopane, Nkhen­sani and Elim Hos­pi­tals in line with our Mother and Child Cen­ter of Ex­cel­lence Project. We handed over a state of the art Letaba Psy­cha­tric Ward that was once burned. This will go a long way in restor­ing the rights and dig­nity of men­tal health care users.

We are how­ever wor­ried by fam­ily mem­bers who dump their rel­a­tives in our fa­cil­i­ties and re­ject them even upon dis­charge just be­cause they are men­tal health care users. We have also up­graded the elec­tric­ity sys­tem at El­lis­ras, Philadel­phia, Pi­eters­burg, St. Ri­tas and WF Kno­bel Hos­pi­tals. A to­tal num­ber of 23 health fa­cil­i­ties have un­der­gone ma­jor and mi­nor re­fur­bish­ment in the Na­tional Health In­sur­ance (NHI) Pi­lot Dis­trict, while 18 health fa­cil­i­ties have un­der­gone ma­jor and mi­nor re­fur­bish­ment out­side NHI Pi­lot Dis­trict.

Honourable Speaker, an amount of R537 mil­lion has been al­lo­cated to health fa­cil­i­ties re­vi­tal­iza­tion pro­gram. This al­lo­ca­tion will be used mainly for hospi­tal re­vi­tal­iza­tion pro­gram and com­ple­tion of projects which are al­ready un­der­way

Now is the time to fo­cus on main­te­nance of all our build­ing in­stead of build­ing new struc­tures while our ex­ist­ing in­fra­struc­tures de­te­ri­o­rate to a level where you can’t main­tain any­more.

BUD­GET SPEECH: 2018/19 – BUD­GET BREAK­DOWN: VOTE 07: HEALTH

The 2018/19 over­all bud­get for Health vote has in­creased by 8.1% from the 2017/18 Main Ap­pro­pri­a­tion and by 4.9% from the Ad­justed Ap­pro­pri­a­tion. Eq­ui­table share grows by 3.8%, and 12.3% on con­di­tional grants from the 2017/18 ad­justed al­lo­ca­tion. In mon­e­tary terms, the to­tal bud­get in­di­cates a growth from R18.6 bil­lion this fi­nan­cial year to R19.5 bil­lion in 2018/19. The al­lo­ca­tion grows by an aver­age of 5.5% over the Medium Term Ex­pen­di­ture Frame­work.

Honourable speaker, the bud­get has been al­lo­cated to fund the fol­low­ing key pri­or­i­ties of the De­part­ment:

· Strength­en­ing Dis­trict Health Ser­vices (Pri­mary Health­care) and dis­trict hospi­tal de­liv­ery sys­tems: R10.5 bil­lion. This is 54% of the to­tal bud­get of the de­part­ment. The bud­get of this pri­or­ity grows by an aver­age of 5.3% over the next years.

· R2.5 bil­lion has been al­lo­cated for Re­gional and Psy­chi­atric hos­pi­tals.

· An amount of R68 mil­lion has been al­lo­cated to­wards the sup­port of our home-based Car­ers. Th­ese are our cadres who are in the front­line of our bat­tle field as we con­front the enemy- the dis­eases within our com­mu­ni­ties.

Th­ese are our cadres who walk bare­footed from one house­hold to an­other clean­ing, bathing, feed­ing our pa­tients. Th­ese are our cadres who have made sure that the vic­tory against HIV and AIDS is about to re­al­ized. Th­ese are our cadres who have long raised their hands and said, “THUMA MINA!” Our cadres who de­spite be­ing ex­ploited, robbed of their stipends and uni­forms, con­tinue to serve our peo­ple. Our “THUMA MINA” bri­gade, now is the time to end your ex­ploita­tion by Non-Profit Or­ga­ni­za­tions.

The de­part­ment is tar­get­ing to col­lect R168 mil­lion in the 2018/19 fi­nan­cial year. This is 8% re­duc­tion from the cur­rent tar­get of R182 mil­lion which is at­trib­uted to the in­creased num­ber of pa­tients that qual­i­fies for sub­sidy. We will put more ef­forts to achieve this tar­get as we are aware that this will con­trib­ute to the fund­ing of the health ser­vices in the prov­ince.

The De­part­ment will work with Trea­sury to en­sure that our sup­pli­ers of ser­vices are paid within the stip­u­lated 30 days to en­sure that Small Medium Mi­cro En­ter­prises are able to sus­tain their busi­nesses.

Honourable Mem­bers, let me thank the Honourable Premier Chupu Stan Matha­batha for his guid­ance and col­leagues in the Ex­ec­u­tive Coun­cil for ral­ly­ing be­hind us.

Com­pli­ments should also go to the sup­port­ive Chair­per­son of the Port­fo­lio Com­mit­tee Honourable Good­man Mtileni and his team for pro­vid­ing guid­ance and over­sight to the de­part­ment.

Let me thank the Head of the De­part­ment Dr Kgap­hole and his gen­er­als, foot sol­diers within the de­part­ment from the men in blue at the gate to the men at the mor­tu­ary.

I salute my friends, com­rades and mem­bers of the African Na­tional Congress, the South African Com­mu­nist Party, the Al­liance and the en­tire Mass Demo­cratic Move­ment for their sup­port and guid­ance. I want to fur­ther thank my si­b­lings for the un­wa­ver­ing sup­port they gave me through­out. To my mom I say Tsh­iongwe , Uri u a longwa muhwe !Mufamadi Vhe mashau lu­vu­vhu ha weli nga u shavha u tsuka milen­zhe! Wa thanga ya ludo I sheng­waho nga vha mano vha sina mano vha fhorot­shedza . Duhulu la Masingo a Rasikhuthuma. Ene wa Balan­ganani na Nya­muka­madi.

Ndo livhuwa , AAAAAAAAAAA !!!!!!!!!!!!!!!!!!!!

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