Speech By The Honourable Aaron Motsoaledi, Minister Of Health During The Occasion Of The Debate Of The State Of The Nation Address

15 February 2010

Honourable Speaker
Honourable President
Honourable Deputy President
Ministers and Deputy Ministers
Hon Members of the House
Ladies and gentlemen

Let me join all the right thinking South Africans in thanking the President for the foresightedness of coupling the state of the nation address with the celebrations of 20 years of the freedom of Nelson Mandela and the freedom of the whole country and the world at large.

The issue of the quality of healthcare services, specifically in the public sector, is ever in the minds and on the lips of our people. It appears quite frequently on the 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, great as we are, are the first to publicly acknowledge and speak about it openly, because prior to the elections last year, when we were preparing to govern, we were able to acknowledge this issue and we identified it and that`s why we put it in our ten point programme.

Let me remind you of what the President said during the 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 have personally addressed a series of meetings involving people within the health sector. In those meetings this issue was thoroughly discussed. I`ve addressed the doctors` and nurses` unions as well as other unions within the health sector. I`ve addressed the CEOs of our hospitals, including their clinical as well as nursing managers. I told them that as far as the ten point programme is concerned, the issue of the quality of healthcare talks to them directly, more than to anybody else.

In those discussions we have specifically dealt with issues like the cleanliness of our health facilities, safety and security of patients, the attitude of staff towards patients, the long queues that are people are forced to endure, availability of medicines, maintenance of infrastructure and infection control. I advised CEOs that they are going to be judged and evaluated on, amongst others, these basic tenants of quality of care.

Many opponents of the National Health Institute, NHI, opportunistically cite these problems of poor quality as a reason why the NHI will not work and why it should not see the light of day. I have personally reassured them time and again that the NHI is never going to be implemented in isolation away from the other points on the ten point programme. The quality of the provision of healthcare services is definitely going to be one of the criteria used before a health institution is accredited for purposes of the NHI.

This is not going to be just a wish from the department. One of the legislations that are going to be put in front of this parliament this year is the establishment of the office of the office of standard compliance to insist on agreed acceptable standards of quality of healthcare in each and every health institution, whether public or private.

As a precursor to this office, a unit has already been formed within the Department of Health and is busy working on the details of such standards. However, we are not going to wait for the establishment of such an office before we demand quality 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 this year. Thereafter, all hospital and district managers will receive information on what is expected of them in order to meet the standards. Failure to meet these 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 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 one of our most important activities this year is going to be the assessment of capacity and functionality of management in each and every health institution.

On the 1 December last year, the President outlined our new battle plan against the pandemic of HIV and Aids and TB. Let us remember that our icon uBaba uNelson Mandela was also a victim of TB.

Let us remember that the National Strategic Plan on HIV and Aids says that we must cut the rate of infection by 50% by 2011 and make sure the 80% of people that need to be on drugs are reached by 2011.

While the President elaborated clearly the four new treatment interventions, he also emphasised 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. This is where the concept of primary healthcare emanated from, and we shall never deviate from it.

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 the new HIV and Aids prevention and treatment measures." I wish to clarify you Reverend. Immediately after 1 December last year, we formed a task team to work and perfect a plan to implement the new measures. The task team consists of the following: the national Department of Health; all the 19 sectors that constitute the South African National Aids Council; and by the way, Reverend, this 19 includes the religious sector. The only missing sector amongst this 19 is political parties, but rest assured, members, that I`m 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. So that even COPE might find something to do rather than dream in broad daylight.

We also have intergovernmental agencies like the Joint United Nations Programme on HIV/AIDS, UNAIDS, The World Health Organisation, WHO, and the United Nations` Population Development as well as funders like President`s Emergency Plan for AIDS Relief, PEPFAR, the Department for International Development, DFID, Swedish International Development Cooperation Agency, SIDA, United States Agency for International Development, USAID, and a list of many others. The teams have been working around the clock to deal with individual health facilities` readiness and logistics, communication and social mobilisation. It is in this social mobilisation that I expect all political parties to access gainful employment, for it is all South Africans, regardless of party political affiliation, who are losing their lives because of this merciless scourge. I`ll be communicating with you members within the coming weeks of your respective roles within this battle.

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 of what we`re going to do.

Furthermore, a treatment task team consisting of HIV and Aids specialists, clinicians, researchers and practitioners has been hard at work since last month drawing our treatment protocols and guidelines in line with what the President has announced. Doctors, nurses and other health workers within our health institutions, even within the primary healthcare institutions, shall be workshopped in a series of meetings, starting in the next ten days or so, on how to apply the new measures and work in this regard is fast approaching completion. I want this House to know that in our resolve to fight this pandemic, we`re not prepared to pull back any punches. We shall never give up the fight.

Let me also quote the President`s World Aids Day address when he said:
In another moment in our history, in another context, the liberation movement observed that the time comes in the life of any nation where there remain only two choices, to submit or to fight. That time has now come in our struggle to overcome Aids and let us declare now, as we declared then, that we shall not submit.
I am declaring again today, as the President declared on World Aids Day that we shall never submit nomakanjani.

I also wish to take this opportunity to inform the House about our state of readiness to host 2010 in as far as health is concerned. One of our biggest nightmares is the fact that 2010 is going to be held in June when there`s a possibility of another bout of H1N1. We all know what happened to our country as well as the world regarding H1N1, and if many people are going to gather in South Africa it is going to be a challenge to us.

I am happy to announce that the department has been able to acquire 1, 3 million doses of an H1N1 vaccine and we are going to be starting vaccination soon. It`s also my honour to announce that a day after the President`s state of the nation address we received a letter from the World Health Organisation telling us that they are going to donate to South Africa 3, 5 million doses of the H1N1 vaccine which will arrive in this country by March. This then means that we will be having 4,8 million doses. We are going to be vaccinating all the people who shall be selected, starting with pregnant women, people at the entry points, as well people who are involved in sports administration, and we wish to inform hon members that when the time comes, we would like your leadership to help to guide the nation. We are aware that we`ve got 50 million people in South Africa, but we are only going to be having 4, 8 million doses.

This donation from the World Health Organisation has saved the country no less than R250 million. We wish to take this opportunity to thank them as they are working with us on the fight against HIV and Aids, they will also work with us on this issue of H1N1, so that we have a very smooth and successful World Cup.

I thank you!