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Honourable Chairperson of the NCOP,
Honourable Minister of Health;
Honourable Members,
Colleagues,
Ladies and Gentlemen.

INTRODUCTION

There is no question about the fact that the historical challenges before us are major. As I stand before you today, I am well aware of the historical backlog we are still faced with, particularly with regard to health service delivery. Our goal is not just health service delivery to the masses of our people but quality service delivery. This process must thus take into account a number of factors contained within Batho Pele and the Patient Rights Charter.

These historical challenges can be placed in broad categories such as Service Delivery, Access and Transformation. I will therefore like to address these challenges in the context of these categories.

HUMAN RESOURCE MATTERS

We have developed a human resource plan whose objective is to ensure that we have the optimum staffing levels in our institutions and that our personnel are well trained. Most of our critical posts have been and are continuously being filled. 1.1% of personnel expenditure has been budgeted for training. R9.8 million has been earmarked for bursaries for the training of under and post graduate health professionals, students from disadvantaged background are always targeted through our bursary scheme, for example this year 18 students were targeted through MBCHB, out of the 6 fields we are supporting. The Adult Basic Education and Training (ABET) programme and the Interactive Distance Education and Learning (IDEAL) programme are utilised as tools for the attainment of quality personnel. Through ABET we have already covered 825 personnel.

PRIMARY HEALTH CARE

The Department of Health has very successfully integrated all primary health care services into district health services. The latter has been organised to coincide with the 5 districts in the Free State. Outlined below are the challenges faced by primary health care services:

1. The establishment of District Health Authorities and the transfer of the Provincial Primary Health Care Services to the District Health Authorities over the next 2 years.

2. Improvement in the quality of care rendered. Here several projects are being implemented to help improve quality of care: - R9 million of equipment was purchased for primary health care facilities including district hospitals.

3. The Council of Hospital Accreditation Association of South Africa (COHASA) accreditation programme will be implemented in several district hospitals in the Free State this year. The programme will be rolled out to include all district hospitals over the next 4 years.

4. An Interactive Distant Learning System is being implemented in the Free State at a cost of R11 million. The system is based upon television broadcasting and electronic feedback using Department of Health networks and Telkoms network. The Department is in the process to hire a 24-hour satellite channel. The system enables the Department to train people online and to train 600 staff members at a time.

HOSPITAL REVITALISATION:

The conditional grant of R16 million for hospital reconstruction and rehabilitation and the R7 million for the maintenance of infrastructure should go a long way in ensuring that our facilities are world class.

EMERGENCY SERVICES:

We have indeed moved with speed in the direction of restructuring of Emergency Medical Services in the province. The service has been provincialised in accordance with the Health Act (Act 63 of 1977) and schedule 5 of our new constitution. We have now taken the service from Local Authorities, who previously ran it on an agency basis.

Following this provincialisation we put strategies in place according to which we planned to purchase 20 ambulances per annum so as to address the backlog around ambulance vehicles. 62 ambulances, 35 commuter transport vehicles and 19 emergency response vehicles were purchased at the end of the 2000/2001 financial year and there is a possibility of going beyond the 20 annual target of purchasing of ambulances.

Ambulance, emergency and commuter patient services will now be provided on a regional basis with a central co-ordinating control room situated in Bethlehem and Bloemfontein. This will enable the Department to provide a more effective and efficient emergency medical services.

QUALITY OF CARE

Factors that contribute to this goal include personnel, pharmaceuticals and equipment. In terms of personnel, we have managed to fill most of the posts which are essential in the delivery of health services. We have developed a Human Resource Plan to ensure that we have the optimum staffing levels in our institutions.

The state of our equipment is something that still requires urgent attention. Most of our equipment is not in good shape and requires repair if not total replacement. However, we believe that we are not at a crisis point, as we have effectively developed a three-year strategic plan for the management of procurement and maintenance of equipment.

The pharmaceuticals and medical consumables situation has improved a great deal. To address the availability of essential drugs, the department has put in place a three months stock level strategy. Strategies and programmes have also been put in place to alleviate the problem of theft of pharmaceuticals and medical consumables.

HIV/AIDS and TB:

There are major HIV/AIDS challenges that we have to address in our country. We are nonetheless moving drastically in terms of our interventions and strategies against HIV/AIDS. A comprehensive home-based care is being rendered in the province and a strategy was approved during the workshop held on 21 March 2001, to extend the service throughout the province. The step down facilities in under-utilised sections of hospitals are established in partnership with NGOs.

Ireland AID is considering a proposal to fund the Department of Health an amount of R2.5 million over the next three years with the aim to develop NGOs working with the Department of Health's financial and personnel management capabilities.

We are refining strategies in order for us to implement the Research and Training sites for Neverapine in Virginia and Frankfort by the end of June 2001. The department is also dispensing fluconozole in 3 of our hospitals; namely: Universitas, Pelonomi and Goldfields. This process will be extended to Bethlehem, Manapo and Boitumelo in due course.

We have upgraded the sub-directorate HIV/AIDS into a directorate from 1 April 2001.

The Free State has already established a provincial AIDS Council in February 2000 and will be establishing District AIDS Councils in each of the five districts by the end of June 2001.

In relation to TB, since the changeover to the new drug, no shortage has been experienced with TB drugs. MDR patients who are currently being managed at SANTA Sandtoord Hospital in Thaba Nchu will be taken over by the MDR unit at Moroka Hospital which will be functional by the end of March 2002.

REHABILITATION AND ORAL HEALTH SERVICES:

To access services for people with disabilities the department has reinvested money in the department for Assistive Devices as well as Prosthetic and Orthetic services from the last financial year. We have established structures where NGOs are fully represented, namely Assistive Devices and Rehabilitation committees. We have opened the third Orthotic and Prosthetic workshop in Bethlehem.

We have recently been blessed with the arrival of two Tunisian doctors at the Goldfields Regional Hospital in Welkom to assist with cataract surgery from the 4-15 June 2001. To date 514 cases of cataract have been done in the province.

In terms of Oral Health, we have procured 3 Dental Mobile Clinics and 13 equipment for new dental clinics in the province to make the dental services accessible to rural areas and schools.

NEW AGREEMENT WITH THE UNIVERSITY

On 19 March 2001, a new Joint Agreement between the Department of Health and the University of the Free State was signed. This agreement gives effect to the principles in the Co-operative Framework: promote the provision of high quality education, training, research and health services by the School of Medicine and to establish a commitment to a long-term, sustainable and quality Faculty of Health Sciences leading to excellent management, adequate funding and high standards

STRIDES ON REVENUE COLLECTION:

The Department of Health endeavours to efficiently and effectively manage revenue collection by developing and implementing appropriate systems that provide for the identification, collection, safeguarding, recording and reconciliation of information about revenue.

PUBLIC PRIVATE PARTNERSHIP

Further impetus to quality service delivery will be provided by the Public Private Partnership that we will be entering into at the Pelonomi and Universitas Hospitals around under-utilised beds at these institutions. This partnership will be operational before the end of this financial year. This will bring an injection of additional funds. This process will establish a very necessary working relationship between the public and private sectors and will take care that the Free State get maximal benefit from the available sources. I want to thank the Development Bank of South Africa for financing the appointment of transaction advisors to manage the project, as well as the Unit for Public-Private Partnerships of the National Treasury for its valuable assistance in this regard.

CONCLUSION

Honourable members, these actions we have taken as a province, as I have just outlined to you, are the end of the beginning and not the beginning of the end. As we travel on this path of quality health service delivery, we are busy conquering milestones in terms of access, transformation and service delivery. All the milestones we have conquered as the Free State province give us hope that we shall finally reach the end of this tunnel.

I thank you.

Enquiries: Tankiso Zola 083 459 7432

Issued by: Office of the MEC for Health, Free State, 12 June 2001