Address by Minister of Health, Doctor Aaron Motsoaledi, on the occasion of the debate on the president’s State of the Nation Address
15 February 2010
Honourable deputy president
Fellow ministers and deputy ministers
Honourable members of the house
Ladies and gentlemen
The issue of quality of our healthcare services, specifically in the public sector is ever in the minds and lips of our people. It does appear quite frequently on pages of our newspapers, just as it did this past weekend. It is also echoed in the electronic media time and again.
We as the ruling party are the first to publicly acknowledge it and speak about it openly. Prior to elections last year, when we were preparing to govern, we identified it and put it in our 10 point plan. Let me remind you of what the president said during his State of the Nation Address last year:
“Fellow South Africans, we are seriously concerned about the deterioration of the quality of healthcare, aggravated by the steady increase in the burden of disease in the past decade and a half”.
Since then, we have been dealing with this matter within the department. I personally have addressed a series of meetings involving people within the health sector. In those meetings, the problem of quality of care in our institutions was put forward for discussion. I have addressed the doctors’ unions and nurses’ unions, as well as unions of other workers within the health sector.
I have addressed the chief executive officers of our hospitals including their clinical, as well as nursing managers. I told them that as far as the 10 point programme is concerned, the quality of healthcare talks to them directly more than to anybody else.
In those discussions, we have specifically delved on issues like:
* cleanliness of our health facilities
* safety and security of patients
* attitudes of staff towards patients
* the long queues endured by our people
* availability of medicines
* maintenance of infrastructure
* infection control.
I advised the chief executive officers that they are going to be judged and evaluated on amongst others, these basic tenets of quality of care. Many opponents of the National Health Insurance Act (NHI) opportunistically cite these problems of poor quality of our healthcare services as a reason why the NHI will not work, and why it should not see the light of the day.
I have reassured them time and again that NHI is never going to be implemented in isolation away from the other items of our 10 point plan. The quality of provision of healthcare services is definitely going to be one of the criterions used before a health institution is accredited for purposes of NHI.
Honourable speaker, this is not going to be done just as a wish from the department. One of the legislations that is going to be put in front this parliament this year, is the establishment of the Office of Standard Compliance, to insist on agreed acceptable standard of quality of healthcare in each and every health institution, public and private. As a precursor to this office a unit has already been set in the department and it is busy working on the details of such standards.
However honourable speaker, we are not going to wait for the establishment of such an office before we demand quality of care in our institutions. The assessment tool on how to audit compliance with standards will be tested in all provinces starting from 8 to 12 March 2010. Thereafter, all hospitals and district managers will receive information on what is expected of them in order to meet the standards. Failure to meet the standards is not going to be without consequences.
In my budget speech last year, I elaborated on 11 different factors that contribute to the deteriorating quality of healthcare. Among these 11 factors was the inability of individuals to take responsibility for their commissions or omissions within the healthcare sector. The Office of Standard Compliance is going to be a legal way to impose such responsibilities on any individual managing our healthcare. Hence honourable speaker one of our most important activities this year is going to be the assessment of capacity, functionality and management in each and every health institution.
Honourable speaker, on 1 December last year, the president outlined our new battle plan against the pandemic of HIV and AIDS and tuberculosis (TB). Let us remember that the national strategic plan on HIV and AIDS says that we must cut the rate of infection by 50 percent by 2011 and make sure that 80 percent of people that need to be on drugs are reached by 2011.
While the president elaborated clearly the four new treatment interventions, he did also emphasise on the need to cut the rate of infection because the treatment of any disease starts with prevention. No amount of treatment can successfully replace the time honoured art of prevention of diseases. That is where the concept of primary healthcare emanated from and we shall never deviate from that.
The Honourable Meshoe has just asked what the president meant when he said we will implement all the undertakings made on World AIDS Day relating to new HIV and AIDS prevention and treatment measures.
I will clarify for you Reverend:
Immediately after 1 December last year, we formed a task team to work on and perfect a plan to implement the new measures. This task team consist of the:
1. National Department of Health
2. All 19 sectors that constitute South African National AIDS Council (SANAC) (by the way reverend, that 19 includes the religious sector, the only missing sector among this 19 are political parties, but rest assured that I am going to engage you as political parties to be gainfully employed in the fight against HIV and AIDS, and there shall be no period to idle)
3. Intergovernmental Agencies like:
* Joint United Nations Programme on HIV and AIDS United (UNAIDS)
* World Health Organisation (WHO)
* United Nations Population Fund (UNFPA) as well as donors such as President’s Emergency Plan for HIV and AIDS Relief (PEPFAR), Department of International Development (DFID), Swedish International Development Cooperation Agency (SIDA), United States Agency for International Development (USAID) and a list of others
The teams have been working around the clock to deal with individual facility, readiness and logistics, communication and social mobilisation. It is in this social mobilisation where I expect all political parties to access gainful employment, for it is all South Africans regardless of party political affiliation that are losing their lives to this merciless scourge. I will be communicating with you in the coming weeks about your respective roles.
I wish to state in this house today that at least two weeks before 1 April, we shall publicly outline our state of readiness in clearer details in terms of activities and locations and where appropriate, even in terms of numbers.
Furthermore Honourable Speaker, a treatment task team consisting of HIV and AIDS, specialists, clinicians, researchers and practitioners, has been hard at work since last month to draw out treatment protocols and guidelines in line with the president’s announcement. Doctors, nurses and other health workers within all our health institutions, even within primary healthcare institutions, shall be trained in a series of meetings starting in the next 10 days or so, on how to apply the new measures.
Honourable Speaker, I want this house to know that in our resolve to fight this pandemic, we are not prepared to pull any punches back. We shall never give up the fight.
Let me conclude by quoting again from the president’s World AIDS Day speech: “In another moment in our history, in another context, the liberation movement observes that the time comes in the life of any nation when there remain only two choices, submit or fight. That time has now come in our struggle to overcome AIDS. Let us declare now, as we declared then, that we shall not submit”.
Honourable Speaker, I am declaring again today, as the president declared on World AIDS Day, that we shall never submit, nomakanjani.
I thank you.
Issued by: Department of Health
15 February 2010