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14 February 2008

As the Social Sector Cluster, we appreciate the opportunity to discuss with you the programme of action of government for the year 2008. As you know, there are two Social Cluster briefings this morning. This session will focus on health, human settlement and social cohesion while the next session will address issues of poverty alleviation, social security and second economy interventions.

We aim to complete the work on the comprehensive social security system, benefiting from the consultations that have started with social partners. The progress made in the implementation of the Programme of Action for 2007/08 constitutes a basis for implementation of the Programme of Action for 2008/09. Therefore, while we highlight the focus areas for this year, we will also reflect on the progress made last year.

Social cohesion

Efforts to improve social cohesion amongst all South Africans are being intensified. As part of popularisation of national symbols to promote national identity, 1817 flags have been installed in schools. Positive values and national identity are also promoted through the indigenous music and oral history project. A draft national pledge or national oath has been completed and national discussions involving communities on the draft national pledge/national oath will be held as part of promoting the South African national identity.

Nation wide public hearings on the standardisation of geographical name changing will also be held to promote an over arching sense of belonging to South Africa. The implementation of Social Cohesion Framework is being intensified to address threats to social cohesion which are lack of a common purpose and shared values; and lack of tolerance and respect for others' rights. The aim is to create peaceful existence of citizens, free from deprivation, whether in terms of basic needs, human rights or in terms of culture, language and intellectual expression.

Comprehensive healthcare

Promotion of healthy lifestyles continues to be a critical intervention in addressing the major causes of death in our country, which are communicable and non-communicable diseases as well injuries and trauma.

The 22nd of February has been declared a national healthy lifestyles day. We will be using this day to galvanise all South Africans to participate in all the five elements of the healthy lifestyle campaign which are:

* promotion of good nutrition
* regular physical activity
* tobacco control
* interventions against alcohol and substance abuse
* promotion of safe sexual behaviour

Part of our nutrition interventions is the mandatory addition of vitamins and minerals to all maze meal and wheat flour to address micronutrient deficiencies and improve well being. To assist millers to comply with the food fortification programme, I am glad to announce our readiness to pay a once off subsidy of R23 million for purchase of fortification equipment. The grant awards a 100% subsidy for micro and small enterprises while medium-sized and large millers are given a grant of 75% and 50% of their capital expenditure, respectively.

Wheat flour is a critical vehicle for delivery of much needed micronutrients to our people. It is that context that we condemn bread price fixing not only as a bad business practice, but as major barrier in improving health of people affected by micronutrient deficiencies.

We will be intensifying our efforts to address the challenge of non-communicable diseases such as diabetes, asthma and hypertension. Our focus is on raising awareness and promoting screening, early diagnosis and management of these diseases.

As outlined in the State of the Nation address, we are intensifying implementation of the National Strategic Plan against HIV and AIDS with prevention of HIV infection through the ABC strategy remaining the cornerstone of our response. The programme for prevention of mother to child transmission of HIV has been expanded to 90% of facilities with an uptake of 60%. Treatment protocol has been improved to include dual therapy and this intervention will be expanded during this year.

More than 585 000 people are benefiting from home and community based care services provided through more than 2 600 non-governmental organisations (NGOs) and community-based organisations (CBOs). By the end of October 2007, more than 66 000 caregivers had been trained and more than 2800 of these received ancillary healthcare training National Qualifications Framework (NQF) level one.

The number of patients initiated on treatment was at 408 218 by the end of November 2007 and these services are available in 366 health facilities (including Correctional Centres and South African National Defence Force [SANDF])

On tuberculosis (TB), our focus is on the implementation of the five-year strategic plan to improve cure rate and reduce defaulter rate from ten to seven percent this year. More than R400 million has been made available to strengthen our response to multiple drug resistant and extremely drug resistant (XDR) TB. We are determined to ensure that more than 3 000 health workers are trained in TB management during the course of the year.

As you have witnessed since the beginning of this year, we are paying particular attention to improving accessibility and affordability of private healthcare. Already our interventions are beginning to bear fruits with the review of exorbitant hospital tariff increases for 2008. Private hospitals are also agreeing to comply with the single exit price legislation with regard to the billing for anaesthetic gases which was previously overcharged.

Building from the progress made in the regulation of medicine prices, we are developing regulations that should empower the Department of Health to regulate the private health sector. The aim is to create transparency and curb escalating costs that are driven by various factors throughout the private healthcare delivery system. These regulations should be out for public comment by April.

The case of collusion amongst pharmaceutical companies bidding for state tenders that made headlines this week highlights once again the urgent need for government intervention to address unscrupulous practices and increase transparency in this sector. The Department of Health will be reviewing all tenders awarded to the companies implicated in this case to establish whether there were any irregularities.

Preparation for the implementation of the risk equalisation fund (REF) has been completed and is awaiting the passing of the Medical Schemes Amendment Bill this year for full implementation.

Housing and human settlement

The focus of the Department of Housing in the coming financial year will be its programme of slum eradication and the implementation of the lessons, learnt from the Breaking New Ground Strategy to expedite delivery of housing for the poor and middle-income groups. Housing delivery will continue to be fast tracked with the objective of accommodating all those seeking homes within formally planned settlements by 2014.

To achieve this objective government and its partners seek to increase the current delivery rate of 300 000. Our target is the delivery of 500 000 housing units. To enhance and expedite the increased delivery, the Department of Housing has strengthened its capacity to directly assist provinces to enhance provincial project management capacity and streamline planning process for effective and faster delivery.

In addition, the department will continue to focus on increasing the number of affordable housing for those who earn between R3 500 to R7 500 through the Memorandum of Understanding (MoU) signed with the banks. The department is also finalising processes to ensure access to housing for veterans of the struggle against apartheid within the overall comprehensive social security programme of government. Work with Social Contract partners to remove all the obstacles and blockages that inhibit the speedy delivery of human settlements will continue.

We are hoping that the National Council of Provinces (NCOP) will shortly debate and pass into legislation the Social Housing Act (SHA). With the implementation of the SHA, we will be subsidising the creation of various forms of rental accommodation and thus contribute to our goal of the elimination of slums by 2014. Non-governmental organisations and the private sector will be encouraged to participate in the programme and access the grants that will become available through this act. We are hoping that this will go a long way to alleviate the shortage of rental accommodation and encourage innovation in the rental market.

Every new home in the country will become energy efficient. In addition to the prescripts in the National Housing Code and the Cabinet statement on this matter, the department of housing is finalising energy regulations that will become part of the national building regulations. The National Homebuilders Registration Council (NHBRC) will continue to the minimum standards set by government and will have the authority to stop any contractor who does confirm.

As part of its programme to access well located land, the department has finalised its negotiations with Transnet and Department of Public Works to acquire a significant portion of land for human settlements. The moratorium on the sale of land by municipalities will ensure an additional supply of parcels of well-located land. This land will be transferred to the Housing Development Agency.

In terms of the department's parliamentary programme, this year will see the introduction of the Housing Development Agency Bill (HDA). The agency will enable government to finally redress apartheid spatial planning. The key instrument of the agency will be the release of well-located land and serviced sites for human settlement programmes. Once the bill is signed, Thubelisha Homes and Servcon will be integrated into the HDA. We are expecting the HDA to serve as a catalyst for social cohesion, racial integration, job creation, and economic growth. Finally the Department of Housing is support the provincial legislative processes to prevent the mushrooming and re-emergence of informal settlements and slums around the country.

Basic services - water and sanitation

In February 2005 government made a commitment to eradicate the bucket sanitation system that was in use by 252 254 households in formal established areas. In an unprecedented effort involving partnerships with key stakeholders and a massive resource allocation of R1,8 billion through the Municipal Infrastructure Grant, municipalities managed to replace 81% of the buckets by December 2007 with appropriate sanitation. The remaining 19% (49 010) are at advanced stages of construction and will be completed shortly.

Unsuitable ground conditions, a lack of bulk water supply and material supply shortages have caused delays in some instances. We believe that the bucket replacement programme has brought dignity to the lives of over one million South Africans. Following from the lessons with implementing the bucket eradication programme, government is applying a similar integrated and programmatic approach to accelerate universal access to water, sanitation and electricity. The aim is that by 2014 all our settlements are decent and sustainable and all households in these settlements at least have access to basic services.

As part of government's human settlement programme, the Department of Provincial and Local Government, together with Department of Water and Affairs and Forestry, Department of Minerals and Energy and the Department of Housing, will work with each province to co-ordinate and support the development and implementation of an infrastructure delivery programme specific to each municipality to meet the national targets. In 2008 this delivery programme will focus mainly on accelerating access to water.

It is estimated that up to 90% of the total population will have access to basic water supply services by end of 2008 through the addition of another 250 000 households. Just over 1 million households will still remain without basic water supply by end of the 2008. By the end of the current medium term expenditure framework (MTEF) period (2009/10), this backlog will be reduced to about 870 000 households.

It will be possible to supply all people living in existing houses with a basic water supply by 2012. Water to people in informal houses will be provided through an integrated programme driven by Housing and to be completed by 2015. With regard to provision of free basic water, at least 73% of indigent households and 77% of all households in the country have benefited.

Conclusion

Our view is that significant progress has been made in improving the social conditions of the people of South Africa. However, there are still many challenges that still need to be addressed before our goal of a better life for all can be attained.

Issued by: Department of Health
14 February 2008