SPEECH BY MR. MABALANA SIBUYANA - MP

Madame Speaker,

Twelve years ago, the Department of Health laid down the fundamental aim of its policies. It was to provide good quality health care, equally, to all South Africans. To that end the Department undertook a huge process of transformation and social engineering. One of the main features of this was to establish health districts to provide primary health care.

What do the latest statistics concerning the 53 health districts reveal? They reveal vast variations with respect to population and geographical size, health status and indicators, resource infrastructure and capacity available to improve the quality of health services. The expenditure on primary health varies from as much as R389 per person in Gauteng to R70 per person in Mpumalanga.

Although most Provinces are spending between R800 and R1200 per capita on health care, infant mortality is increasing, AIDS infection and deaths are increasing, TB and resistant TB are increasing and only life expectancy is decreasing.

We have to recognise that most that comes from central government is obstructive. In its obsession with equal services government is providing lesser services, particularly to the poor.

The IFP would have no problem with the health vote of R11.3 billion if the money were used efficiently. Rightly the largest increase was for Strategic Health Programmes, reflecting increased commitment to tackling TB, HIV and AIDS.

But, the 192 accredited sites still have only 112 000 patients on treatment in the public sector, far below a reasonable number to cope with the spreading epidemic.

The information systems for monitoring the sites are poor. Current statistics on all aspects of the pandemic are poor. There is inadequate provision of medicines and tests at clinics and hospitals and there is still a huge problem of denial. This could be overcome by leadership being more outspoken and united around HIV, by better partnerships between conventional and traditional doctors and by greater deployment of community health workers.

The IFP strongly believes that decentralising health decision-making powers and funding to provincial level would offer a solution to health care problems that afflict the state and the private sector. We should simplify and clarify political and financial accountability and responsibility. Let Provincial and Local Governments make health decisions, control funds and choose priorities.

We also firmly believe that it is high time to implement an unambiguous AIDS policy that treats HIV like an ordinary disease without need for special secrecy provisions and provides more testing, treatment, training and support.

We need far stronger health districts and far better IT systems for tracking numbers of people tested, infected, and on treatment. We would also improve our response to HIV if traditional healers and doctors worked more closely together.

Better funding and training of community health workers, motivation of nurses and doctors to work in rural areas through incentives, and more extensive use of mobile clinics would also improve the response to HIV/AIDS.

We acknowledge the goodwill in the Department and appreciate the intentions behind the measures adopted to try and distribute equal health care.
However, after 12 years we believe that the ANC should re-evaluate strategies such as co-operative governance, conditional grants and red tape and give the autonomy they always talk of to the provinces.

The IFP supports the budget.

Thank you.


FOR FURTHER INFORMATION CONTACT:
Mr. Mabalana Sibuyana: 083 662 5381
Noleen Hendricks: 082 886 9848