Mpumalanga Department of Health: Budget speech Health vote 10 2011 policy and budget speech by MEC Dikeledi Mahlangu
31 May 2011
The Honourable Premier
Members of the Executive Council
Honourable Members of the House
Leader of House of Traditional Leaders Inkosi Mahlangu
The Director-General of the Province Mr Rabodila
Head of Department of Health Dr JJ Mahlangu
Management of the Department of Health and all its employees
Leadership of Labour and Business
Leadership of the NGO sector
Traditional Healers Thokozani bogogo
Members of the media
People of Mpumalanga
Ladies and gentlemen
Honourable Speaker, today as we table this policy and budget speech, may I remind you that we are 17 years into freedom and democracy. We are in the third year of the fourth democratic term of office. We stand here therefore today to measure progress we have made in this important journey. As we do so, we are steadfast that progress has been made. We have no fear to be proud of the progress made.
This progress is not about us as leaders; it’s about improvement of lives of ordinary South Africans, black and white, pursuing a common goal of a united, non racial, non sexist and prosperous nation.
The objective of our journey is well defined; its better life for all. This is the rallying call that continues to inspire us to say what we have achieved is not enough, because more can still be done. We do so and seek no reminder from any quarter, because we fully understand where we come from and remain hopeful that the future is promising for all the people of South Africa.
We fully understand as present leaders that we carry a heavy responsibility to actualise the vision of our fore- bearers, many of whom died without taste of the freedom for which they sacrificed their lives. We are indeed humbled that when history is told, we would have done the little we are doing to further enhance that historical mandate of restoring the human dignity of our people.
Honourable Speaker, history can never be re-shaped. No matter how appealing it may appear to be at any given moment in time, history can never be re-shaped. We can never isolate any of the struggle heroes and heroines from their organisation and make them stand-alone saints. Our leaders, all of them, past and present are what they are because of their movement; the African National Congress. The values which they espoused and continue to do so; those of selflessness, sacrifice, commitment, service, humility are derived from this organisation, our organisation, the African National Congress.
It should not surprise us therefore when we hear claims of this heritage. On the contrary, what this confirms is that our message of hope and that South Africa belongs to all those who live in it, black and white, united in their diversity, is embraced by all, as led by very same organisation, the African National Congress. We shall forge ahead with this historic mission for we fully know that history has afforded us a privilege to serve.
In the two years of this administration we can look back with pride on the progress made. Health is one of the five identified priorities of this government. Our government has developed twelve (12) MTSF priorities as an elaboration of the five priorities. We then developed a Ten Point Plan, as a road map to take forward the aims and objectives of the MTSF priorities.
This plan serves as an overarching framework for health care delivery in the current term. The measure of our success or otherwise should be fully understood in the context of these outputs.
In line with the adopted outcome based approach, government has identified “A long and healthy life for all South Africans” as an area of focus for the Health Sector. As a province we have embraced four key strategic outputs of this outcome as identified nationally, and as reflected in our Annual Performance Plan and the Negotiated Service Delivery Agreement.
These outputs are:
1: Increasing life expectancy
2: Decreasing maternal and child mortality
3: Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis
4: Strengthening health system effectiveness
Output 1: Increasing life expectancy
Honourable Speaker and members, South Africa is faced with a serious challenge of a declining life expectancy. The consequences for a declining life expectancy are dreadful to the country. We lose economic active people and reliance on state support continues to surge, putting limited resources on further strain.
According to Statistics South Africa, Life expectancy in South Africa has declined from 52.7 for males and 56.6 for females in 2001 to a low of 50.8 for males and 52.6 for females in 2006. Although there has been recovery to 53.3 for males and 55.2 for females in 2010, Life expectancy at birth is still expected to decline to low levels that were experienced in the period before 1955. Death notifications among young adults in the 25-39 age groups have almost trebled between 1997 and 2006. This is definitely an abnormal situation, where the number of young people dying exceeds those of elderly population.
Life expectancy is affected by communicable diseases such as HIV, tuberculosis (TB), malaria, respiratory infections, and non-communicable diseases such as diabetes and cardio vascular diseases. These are compounded by high burden of trauma related injuries.
We therefore have to accelerate all measures aimed at improving the Life expectancy of our people. These measures include amongst others, combating death due to HIV and AIDS by putting people who are HIV positive on Anti-Retroviral Treatment (ART). We are therefore pleased to report that we managed to put 111 402 people on ART as opposed to our target of 102 855.
All HIV and TB co-infected patients with a CD4 count of 350 or less, have been initiated on ART. The provincial TB Cure Rate has progressively improved from 64.5% in 2008 to 70.8% in 2009, and in this financial year, we intend to improve this further to 85% in line with World Health Organisation target.
Our fight against Malaria has also shown commendable progress. We are however concerned that lives continue to be lost as a result of Malaria. To us, one life lost is one too many. 2010 has proved to be a different year with unusual heavy rains which have resulted in the increase of malaria cases. In total we recorded 3 106 cases with 22 fatalities. We have however observed that many cases reported in our province are infact imported cases coming from other provinces and neighbouring countries.
Our goal is to make a concerted effort to decrease the incidence of malaria from 1.5 to 0.5 local cases per 1 000 population in the current financial year. We also want to reduce the malaria case fatality rate fromthe current 0.71% to 0.5% as per national target.
Cabinet has approved the strategy for reduction of maternal and child mortality. The strategy aims to put up interventions to mitigate against unnecessary deaths of mothers and babies due to complications that arise as a result of pregnancy and child birth.
Another intervention is the provision of Termination of Pregnancy (TOP) services. I must hasten to indicate and warn that TOP is not a birth control measure. We have observed unpleasant developments where young women use this service (TOP) as a contraceptive measure. In one reported case, one young woman underwent TOP three (3) times in six months. This is clearly risky and not healthy, and it should be discouraged
Output 2: Our second output of our Service Delivery Agreement is to “decrease maternal and child mortality”
Mother and child health
Maternal and child health is one of the important Millennium Development Goals (MDGs). Maternal and child health is an important measure of the wellbeing of any nation. It is one of the key indicators of development for any country.
Mothers and children have unfortunately not escaped the scourge of HIV and AIDS in our country. As an effort of preventing the HIV and AIDS to children, we have increased infants requiring nevirapine for Prevention of Mother to Child Transmission (PMTCT) from 95% in 2009 to 96.6% in 2010.
We have also increased facilities which review maternal and perinatal deaths from 45% in 2009 to 100% in 2010. This exercise helps to indentify causes of deaths amongst mothers and children so that we are able to institute corrective measures.
In order to address the gaps and challenges we still have in the facilities, we will conduct an audit on the implementation of the Basic Ante Natal Care strategy with clear plans and deliverables.
Again to increase access to safe termination of pregnancy, we have increased the proportion of designated health facilities that provide termination of pregnancy from 25% in 2009 to 35.6% in 2010.
Another intervention to improve child health is immunisation against preventable childhood diseases. Our measles and polio coverage has decreased from 91% to 69.8% in 2010; this was as a result of the interruptions in the supply of vaccines both by the manufacturers and suppliers. We are happy to report that this problem has since been resolved.
During the 2010/11 Polio and measles campaign, we had a target to immunise 1.1 million children under 15 years against measles; however 1.2 million children were immunised translating into a coverage of 107.4%.
For polio we had a target to reach 300 000 children under 5 years and managed to reach 400 000 translating into a coverage of 106%. These figures indicate that given an uninterrupted supply, the province is capable of achieving a target of 100% on immunisation.
Output 3: The third output is “combating HIV and AIDS and decreasing the burden of disease from tuberculosis"
Honourable members will remember that on the occasion of commemoration of the 2009 World AIDS Day, President Jacob Zuma announced ground breaking measures in the fight against HIV and AIDS. Our province continues to show high prevalence and we remain the second highest after KwaZulu-Natal. For the past four years our HIV prevalence rate has shown an upward trend.
We must however report Honourable Speaker that our prevalence rate has for the first time in four years shown a downward trend, although it remains at unacceptably high levels.
Honourable Speaker, Gert Sibande remains the district with the highest prevalence in the province, although it has shown a decline from 40.5% in 2008 to 38.2% in 2009. This is progress, but we should not be blinded because the district and indeed the province remain very high.
We have also observed that Nkangala District which has always had a relatively low prevalence has surprisingly shown an increase in the 2009 survey. This observation Honourable members, has forced us to review our strategy to adopt a holistic approach and not to be overly concerned with the districts with high prevalence at the expense of those with low prevalence.
Our statistics over a ten year period appear to have stabilised around 33% prevalence; hence our prevention should be intensified if we are to realise a meaningful decline. In this context, we have introduced two important prevention measures which are; HIV Counselling and Testing (HCT) and the Male Medical Circumcision (MMC).
These measures are not isolated from the comprehensive approach of treatment, care and support as contained in the National and Provincial Strategic Plan for HIV and AIDS. Our approach has now shifted to the paradigm of prevention, prevention and prevention.
Honourable members, as we put all these new measures, we should not lose sight of the urgent need to improve the general living conditions of our people which continue to undermine our efforts. Poverty not only undermines the dignity of our people, but it is also a huge negative social determinant of health.
As part of this new prevention paradigm shift, last year we set ourselves a target as a country to encourage 15 million people to voluntarily test and know their status. Our province set out to reach 1.095 823 people to test by June this year. In pursuit of this noble campaign, Honourable Premier DD Mabuza launched the HCT campaign in Lekwa Municipality on 30 April 2010. As part of demonstrating exemplary leadership, he voluntarily tested.
We continue to make this clarion call to our leaders including Members of this House, to demonstrate leadership in the fight against HIV and AIDS and get tested. Since the beginning of this campaign, 735 750 people tested of which 181 198 tested positive as at 1 May 2011. This accounts for 24.63% positivity rate of the people who got tested.
Honourable members the intention of this campaign is not about positive or negative status, but about self disclosure for all of us. On this note allow me to acknowledge the presence of sis Beauty Grootboom. She is a special ambassador of positive living and is working very close with the department. She has been living with HIV for the past 11 years and remains strong and positive about life. I therefore want to request her to take a bow. We derive strength in her courage to disclose her status and continue to live positively.
Testing provides each person a window of opportunity to make informed decisions about their lives from the moment of knowing their status. Whether positive or negative, we all need to lead a positive lifestyle including but not limited to safe sex, avoiding smoking and excessive use of alcohol, good nutrition and exercise.
We also set ourselves to encourage all males especially between the ages of 15-49 years to get circumcised. Research has shown that circumcision reduces the risk of infection by 60%.It should however be noted that circumcision is not a replacement for condom use.
We therefore encourage those who do not practice traditional circumcision to do medical circumcision in our facilities. Circumcision is now free in our public health facilities. When we launched this program in November 2010, our target was to reach and encourage 10 000 males to circumcise by end of June 2011.
By end of April 2011, 6 256 males had already been circumcised as part of this campaign. We plan to increase this number to 38 970 in the current financial year. We once more extend the invitation to all males in this age category to get circumcised.
We currently have five (5) high volume sites; Piet Retief, Tonga, Themba, Barberton and Mapulaneng hospitals providing MMC. These are sites that have capacity to do 20-30 circumcisions a day. We plan to increase these sites to twelve (12) in the current financial year.
Additional health facilities identified as high volume sites are Embhuleni, Ermelo, Amajuba, Witbank, Middelburg, Mmamethlake hospitals and Kwaggafontein Community Health Center. All other hospitals also provide Male Medical Circumcision although on a smaller scale.
Another important aspect is to increase the percentage of pregnant women testing for HIV. It is therefore pleasing to report that we have seen a percentage increase of pregnant women testing from 90% in 2009 to 95% in 2010.
The Prevention of Mother to Child Transmission (PMTCT) program has proven to play a pivotal role in the reduction of transmission of HIV from a Mother to the Child. In this regard we shall intensify the PMTCT program in all facilities that offer antenatal care so that we save all children born to HIV positive mothers.
Honourable Speaker, we have made an unfortunate observation about the decreasing use of condoms in some parts of our province, especially Nkangala district. This clearly indicates that our rallying call of “no condom no thola” is not finding resonance in many people, which is central to our prevention efforts. We shall therefore continue to increase condom distribution in the province and encourage more people to use them. I want to reiterate that; “no condom no thola”.
In the previous year we increased male condom distribution from 21 million to 30 million. We will further increase this number to 41 million in the current financial year.
We have also increased distribution of female condoms from 180 000 to 300 000 in the previous financial year, and we plan to increase the distribution by at least 30 000 per year going forward.
I have earlier mentioned that all these prevention interventions should not negate the other equally important pillars of the comprehensive HIV and Aids strategy which are support, care and treatment. In this regard, we have increased number of patients on ART, from 70 064 in 2009/10 to 111 402 as at the end of 2010/11 financial year, thus exceeding our target of 102 855. For the new financial year we shall increase patients on ART to 137 855.
Honourable Speaker, with respect to treatment of TB, I have already alluded to an increase in cure rate in the province which has improved from 64.5% in 2008 to 70.8% in 2009. Our plans are to further improve the cure rate to acceptable levels of 85% in the current financial year.
We have also achieved in that all our TB and HIV co-infected patients with a CD4 count of less than 350 are now initiated on ART. In line with the new measures, all Multi Drug Resistant-TB patients, who are HIV positive, are also initiated on ART, irrespective of the CD4 count.
We also plan to reduce the TB defaulter rate from the current 8.2% to 6% in this financial year in order to move towards the national target of less than 5%. We will intensify the Direct Observed Treatment (DOT) support program in order to accelerate TB contact tracing to 90%.
An important aspect is consistent availability of TB drugs in all our facilities. We will therefore ensure that at all times all essential TB drugs are available in our health facilities.
Output 4: Our fourth output is to strengthen health system effectivenes
The central thrust of this output is the emphasis that health is not solely the responsibility of the Department of Health. The health system should be people driven and participatory in nature. All people therefore have a role to play in improving the general health of all our people.
It is in this context that upon assuming power in 1994, our overarching transformational mandate has been about strengthening primary health care as a cornerstone for effective and efficient health care service. All our efforts are aimed at achieving four important imperatives in the provision of health care; access, affordability, equity and quality.
The National Health Act has given further meaning to these principles but has further made it mandatory that communities must be involved in the management of health facilities in the areas where they stay.
Health facilities should respond to the specific needs of local communities at all times. In this regard, the Health Act gives rise to establishment of Hospital Boards for all hospitals and Clinic Committees for all clinics.
Accordingly, we have established 27 Hospital Boards and 279 Clinic committees. The few remaining facilities will be finalised in this financial year. We will focus on the training of these governance structures so that indeed they are empowered to discharge their mandate.
Community based health care is another important component of the health system for ensuring provision of quality health services at the doorstep of the community. The cadre at this level of care provides a critical interface between local communities and health facilities.
We are working around the clock to finalise our plans to integrate the community home based care workers as part of the new mandate and efforts to create new job opportunities.
As alluded earlier, primary health care is the only effective and efficient means to provide quality, affordable and accessible health service to all the people in the province. Another important aspect to achieve this noble goal is to strengthen primary health care supervision.
We have therefore increased the number of PHC supervisors from twenty one (21) in 2009/10 to 28 in 2010/11. This has translated to PHC supervision rate increasing from 61% in 2009/10 to 62.5% in 2010/11. We acknowledge that there has not been optimal progress in attaining the overall improvement in the quality of health care in our PHC facilities. We will therefore intensify measures that address key quality issues.
Linked to strengthening of PHC supervision, we have also aligned our plans with the six national quality improvement priorities that we think if adequately addressed, approximately 80% of all health care delivery challenges would have been attended to. These are patient safety, infection control, long waiting times, availability of essential drugs, cleanliness and staff attitude.
All facilities have developed Quality Improvement Plans (QIPs) to focus on these key priority areas. As an indicator of this improvement in facilities, one of our rural clinics in Bushbuckridge, Shatale community health center was able to adequately assist one of Honourable Members here, Honourable le JP Ngobeni who collapsed during the legislature election education program. On behalf of the entire workforce, I want to congratulate the Shatale clinic staff for job well done.
Honourable Speaker and Members we live in an increasingly changing environment. Throughout the world we witness unprecedented tragedies that wreak havoc in the lives of many people, mainly poor communities.
This has brought about new disease patterns throughout the world and poor nations are worst affected, as they cannot keep up with investing more resources into health care delivery.
This phenomenon highlights the historical need for preventive health care approach instead of the curative approach. At the heart of preventive health care system, is a need to emphasise health promotion in our communities.
The rallying call is that all of us, as individuals are ultimately responsible for our own health and wellbeing. This responsibility should not be relegated to government only. Although government has a duty to provide a conducive environment for health, we also have responsibility to our own health as individuals.
Let me reiterate that, we all have a responsibility to lead healthy lifestyles. This includes a balanced diet, daily physical activities, and practicing safe sex and avoidance of smoking, illicit drugs and alcohol abuse.
Honourable Speaker and members, remember Life is not like a car that can be damaged and be repaired. Life is precious, when damaged it is irreparable, thus it requires constant care and maintenance. Impilo iyasetshenzelwa!
Emergency Medical Services (EMS)
Another important aspect of improving and strengthening the health system is the provision of quality emergency medical services. This is one programme which has benefited directly from the legacy of hosting the 2010 FIFA World Cup.
As part of 2010 FIFA World Cup legacy, for the first time in the province we now have a fleet of over 400 emergency vehicles, 96 additional emergency care practitioners appointed; stadium equipment; medical equipment for ambulance stations; integrated information system as well as the upgraded EMS control centres.
This has provided a sound basis for us to further improve our response time to calls made by the communities. We have also completed the installation of phase one of the integrated computerised information system which will assist in real time tracking of ambulances.
Honourable Speaker and members, the availability of drugs and pharmacists at most of our facilities remains the cornerstone of delivering effective health service to our communities. Honourable members will recall that in our previous presentation of the policy and budget speech, I made a personal commitment to ensure improved availability of drugs in all our facilities in the province.
I am happy to report to this august House that we have improved drug availability from 67% in 2009/10 to 90% in 2010/11. The remaining 10% shows that more work still needs to be done so that indeed all our people are able to access all essential drugs in all facilities. We have also significantly reduced the stock out of chronic medication in our facilities.
The optimal functioning of the new depot at Steve Tshwete Municipality has successfully contributed to the availability of drugs in all our health facilities. The province will intensify strategies to ensure that there is continuous availability of all essential drugs in all the facilities, especially primary health care facilities.
Human resources management and development
Honourable Speaker, another important and critical aspect of strengthening the effectiveness of the health system is the ability to recruit, train and retain skilled personnel in the department. The scarcity of health professionals is a global challenge, and developing countries like ours are worst affected.
Over the past few years, our country has embarked on numerous efforts trying to mitigate the shortage of health professionals and their impact on service delivery. These efforts included amongst others recruitment of foreign health professionals from countries that have surplus human resources.
While these efforts assist in the short term to mitigate acute shortage we experience, they are not sustainable in the long run. We have to find solutions that will benefit the country in the long run.
One of the thorny issues with regard to retaining of health professionals has been the improvement of their conditions of service, in particular adjusting salary levels through the Occupation Specific Dispensation introduced in 2007. Implementation of this new approach has been skewed and provinces unfortunately implemented based on different interpretations.
In this regard, instead of improving salary levels across the provinces, Mpumalanga still finds itself lagging behind other provinces which are paying more than us, resulting in unnecessary competition for the limited available skilled professionals.
We have finalised our Human Resource Plan, which will assist us to mitigate some of the challenges in recruiting, training and retaining of skilled personnel. We wish to correct the perception that our salary bill is proportionally high. Our compensation of employee’s current budget is 53%, which on the surface looks like a good indicator. However, this comes at the expense of under-paying across most levels of our workforce and result in the net outflow of employees from Mpumalanga to other provinces.
It is therefore important to correct the perception that we are spending more on compensation of employees. Unlike other departments, Department of Health is Labour intensive. In fact comparatively, Department of Health spend less than many departments in the province on compensation, including other departments of health in the country.
As part of our efforts to find long-term solution to the acute shortage of health professionals, we offer bursaries to academically deserving and financially needy students that pursue careers in health studies. Our focus is on the rural communities and child headed households which have high levels of poverty.
For us, the opportunity to pursue tertiary education contributes significantly towards reduction of poverty and importantly cutting that cycle of poverty in the households and communities.
The following are the number of students per category who have been awarded bursaries and are at different levels of study:
Bursary Holders at different stages of training
Students who completed at the end2010
Registrar (Prospective Specialists)
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Honourable members, in pursuit of increasing our skill base in the province, we have awarded 232 bursaries to local learners to pursue health studies in the 2011 academic year. As mentioned here above, the number of students produced across all fields of study are not enough to make a meaningful dent on the acute shortage we have, however we should not demean the impact in the long run.
In the last financial year only R35.7 million was available to fund this important area of work. We clearly need additional resources to enable us to increase our intake.
We have further been able to produce eighty seven (87) auxiliary nurses, 14 pharmacy assistants and 75 data captures through the learnership program. The important aspect of efficient service delivery is our ability to produce PHC trained nurses. In this regard, we have trained 39 PHC nurses and 217 nursing students completed their studies at the Mpumalanga Nursing College in the previous academic year.
Service Transformation Plan (STP)
Honourable Speaker one of the key instrument for an effective and efficient health care delivery, is a need to transform our service delivery platform, which should assist us to invest resources where most needed.
We are happy to report to this august house that we have finalised and approved the Service Transformation Plan at the end of April 2011.
One of the important aspect that enables us to deliver on our mandate, is prudent management of our resources, in particular our financial resources. Honourable members will recall that when we got into office in 2009, we had accruals of R421 million. We have been able to significantly reduce the accruals to R99.2 million in the financial year that ended in March 2011.
Slowly this allows us to free resources to more service delivery areas, thus improving the overall performance of the department. To strengthen this area of work we have been able to appoint a permanent Chief Financial Officer and key finance personnel.
Over the years, asset management has always been a major challenge towards attainment of clean audit by the department. Honourable members we should not underestimate the complex nature of our asset base as a department. We are pleased to record that we have been able to develop a credible asset register which should contribute significantly in our endeavour towards a clean audit.
Honourable Members, one issue that still gives me sleepless nights, is the slow pace of our health infrastructure delivery. Unfortunately, our performance as a department is judged against our ability not only to spend infrastructure budget, but also our ability to deliver quality projects on time and within budget.
The completion of health infrastructure projects has remained a constant challenge for our province over the years. Many of these projects have gone beyond their planned delivery timeframes. Most facilities which were reported to have been initiated and should have been completed last year are regrettably still not complete.
Despite these sad developments, I must report that significant progress has been made on the hospitals that took longer than planned. These include Rob Ferreira, Ermelo, Themba, and Middelburg hospitals. Most of the work in these hospitals has been completed and only minor work is outstanding which only leave the projects on the retention phase.
As we reported last year the following facilities will be completed in this financial year:
- Hluvukani CHC in Bushbuckridge Local Municipality
- Masibekela CHC in Nkomazi Local Municipality
- Tekwane CHC in Mbombela Local Municipality
We will spend R50 million for planning and design for the Revitalization of Barberton, Kwamhlanga, Lydenburg, Tintswalo and Witbank Hospitals.
As part of implementing the Comprehensive Rural Development Programme, we have set aside R100 million that was set aside for the provision of Mobile clinics, to construct the following 5 community health centers:
- Greenside CHC in Dr JS Moroka, Nkangala district
- Tweefontein G CHC in Thembisile, Nkangala district
- Phosa Village CHC in Mkhondo, Gert Sibande district
- Sinqobile CHC in Pixley KaSeme, Gert Sibande district
- Mbhejeka CHC in Albert Luthuli, Gert Sibande district
Further, two community health centers will be built in this financial year as part of integrated human settlement.
- Klarinet CHC in Emalahleni, Nkangala district
- Mashishing CHC in Thaba Chweu, Bohlabela district
We will further spend R60 million from the equitable share to construct the following facilities:
- Wakkerstroom CHC in Pixley KaSeme, Gert Sibande district
- Pankop CHC in Dr JS Moroka, Nkangala district
- Ntunda CHC in Nkomazi, Ehlanzeni district
We will undertake major renovations in the following facilities as part of our facility maintenance plan:
- Vlaglaagte 1 Clinic in Thembisile Hani, Nkangala district
- Lefisoane Clinic in Dr JS Moroka, Nkangala district
- Perdekop Clinic in Pixley KaSeme, Gert Sibande district
- Lebogang CHC in Govan Mbeki, Gert Sibande district
- Oakley Clinic in Bushbuckridge, Bohlabela district
- Makoko Clinic in Mbombela, Ehlanzeni district
- Zwelitsha Clinic in Mbombela, Ehlanzeni district
- Kanyamazane CHC in Mbombela in Ehlanzeni District
On this note Honourable Speaker, allow me to present the budget of the Department of Health vote 10, and request the house to approve the budget as presented. The total budget is R7,365,135 000.00
Breakdown per Programme as follows:
Programme 1: Administration: R397 912 000.00
The purpose of this program is to provide overall management of the department, and provide strategic planning, legislative and communication services and centralised administrative and financial support through the MECs office and administration.
Programme 2: District health services: R3,925,513 000.00
The purpose of this program is to render comprehensive primary health care Services to the community using the district health system as a model.
Programme 3: Emergency medical services: R243,958 000.00
The purpose of this program is to provide pre-hospital medical services, inter-hospital transfers, Rescue and Planned Patient Transport to all inhabitants of Mpumalanga Province within the national norms.
Programme 4: Provincial hospital services: R846,176 000.00
The purpose of this programme is to render secondary health services in regional hospitals and to render TB specialised hospital services.
Programme 5: Central hospitals: R771,778 000.00
The purpose of this programme is to render secondary and tertiary health care services and to provide a platform for training of health care workers including research.
Programme 6: Health science and training: R252,563 000.00
The purpose of this programme is to ensure the provision of skills development programmes in support of the attainment of the identified strategic objectives of the department.
Programme 7: Health care support services: R112,590 000.00
The purpose of this program is to improve the quality and access of health care.
Programme 8: Health facilities management: R814,645 000.00
The purpose of this programme is to build, upgrade. Renovate, rehabilitate and maintain facilities.
Allow me as I close; to thank all stakeholders of the Department of Health, without whom, our work would not be easy. We will continue to rely on your insightful guidance, input and generous contribution towards making health services better in the province.
Once more, I want to thank the Head of Department Dr JJ Mahlangu for his sterling and courageous leadership and spirit of unity in the department. Let me also express my sincere gratitude to the entire management and all our employees for their continued service to the people of our province.
My special thanks go also to all members of the Portfolio Committee on Health and Social Development led by Honourable P Ngobeni, for their continuous guidance.
I once again want to thank the support of Premier Honourable DD Mabuza, my colleagues in the Executive Council and my family for their valued support.
Honourable Speaker, we shall never tire in this historic journey we have undertaken. We are indeed inspired by the continued trust and confidence demonstrated by people of Mpumalanga in us.
We work every day of our lives knowing very well that our task to serve is a privilege that history has afforded unto us. We shall not tire for we know that the journey ahead is long, tedious and requires focus, selflessness and sacrifice. In this journey, we promise not to tell any lies nor claim any easy victories.
The road the department has traversed is a long and rocky one. We still have a long way to take. Our journey is without hurdles. As a team steering the ship, we have remained focused on the work at hand and have steadfastly kept our eyes on the ball.
We remain committed to ensuring that nothing distracts us from making sure that we take a giant leap into the future, creating a department filled with excellence and success.
The children of Israel endured many years of hardship and suffering on their journey to their promised land. Many of them died before reaching that Promised Land. They knew that even if they themselves would not reach that Promised Land, many generations would come to bear the fruits of their hardship and that there is absolutely nothing that equates human dignity, freedom and prosperity.
Mpumalanga let us forge ahead for victory is certain. Our pioneering spirit enjoins us to constantly find solutions to our own challenges. Our pioneering spirit commands us not to be fulfilled with what we have achieved, for we all know that much more can still be achieved. We shall therefore tell no lies and claim no easy victories in this journey! In Mpumalanga siyanakekela!
Source: Mpumalanga Provincial Government
Issued by: Mpumalanga Health and Social Development
31 May 2011
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