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TUESDAY, 14 JUNE, 2011
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PROCEEDINGS OF THE NATIONAL COUNCIL OF PROVINCES
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The Council met in the Old Assembly Chamber at 14:04.
The Deputy Chairperson (Ms T C Memela) took the Chair and requested
members to observe a moment of silence for prayers or meditation.
ANNOUNCEMENTS, TABLINGS AND COMMITTEE REPORTS – see col 000.
NO NOTICE OF MOTION OR MOTIONS WITHOUT NOTICE
The DEPUTY CHAIRPERSON OF THE NCOP (Ms T C Memela): Hon members, I
have been informed by the Whippery that there will be no notices of
motion or motions without notice today.
APPROPRIATION BILL
(Policy debate)
Vote No 16 – Health:
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The MINISTER OF HEALTH: Deputy Chairperson, my Cabinet colleagues,
the Deputy Minister of Health, Dr Ramokgopa, MECs for health from
various provinces, hon members of the House, distinguished guests,
ladies and gentlemen, I’m delivering this speech to you with a very
sore heart. It is just a few days since the brutal killing of
Dr Mkhize in Mpumalanga at the hands of somebody he was supposed to
be helping. It is very painful. The incident happened in my absence
when I was attending an Aids Conference with the Deputy President in
New York. We wish to express our condolences to the family and thank
MEC Dhlomo for having attended the funeral on our behalf.
I am delivering this speech at a time when the health care system is
at a crossroads. We may choose the best route, or the worst one
ever, which will, of course, make our situation even worse than
before. The choice lies with us as South Africans in general, but as
elected leaders in particular.
Last year I signed a performance agreement with the President as
part of the national service level agreement. We have identified
four measurable outputs which we must achieve in order to ensure
“long and healthy life for all South Africans”. You also know that
we have a 10-point programme on top of these.
Deputy Chairperson, extensive studies commissioned by the
prestigious medical journal, The Lancet, were conducted by our own
scientists and researchers in South Africa, and revealed that
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countries go through four different types of disease, which we call
a quadruple burden of disease. These are first and foremost HIV/Aids
and TB. The second is an unacceptably high maternal and child
mortality. The third is an alarming and ever-increasing incidence of
noncommunicable diseases, ie high blood pressure and other
cardiovascular diseases, diabetes mellitus, chronic respiratory
disease, and various cancers, as well as mental health. The fourth
and last is violence and injury.
Having said this, Hon Deputy Chairperson, let me also say that it is
a known fact that South Africa spends more money on health than any
other country on the continent, and even beyond, but our health
outcomes are worse than in some of these countries. We know that
that is because of health care resources that are skewed in favour
of the rich.
Hon Deputy Chairperson, let me take this opportunity to go through
the aspects of the quadruple burden of disease one by one, because I
want members to understand exactly what we are talking about.
Let me start with the first pandemic, HIV/Aids and TB. To summarise
it, South Africa has only 0,7% of the world’s population, but we are
carrying 17% of the HIV burden of the world. We have the highest TB
infection rate per population, and our co-infection rate between TB
and HIV is the highest in the world, at 73%. A total of 35% of child
mortality and 43% of maternal mortality is attributable to HIV and
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Aids. One in every three pregnant women presenting at our antenatal
clinics is HIV-positive.
Surely this needs very serious and extraordinary measures. Hence the
announcement by the President on World Aids Day, when we started
using new measures to combat HIV/Aids. If I may remind you of the
measures, all pregnant women are treated when their CD4 count is
350, and all HIV and TB co-infected people are also treated at 350.
The prevention of mother-to-child transmission, PMTCT, now starts at
14 rather than 28 weeks, as it used to do before. Fourthly, all
infants who are born HIV-positive are treated immediately on
diagnosis, and we don’t wait for the CD4 count.
Hon Deputy Chairperson, we need to understand what the scenario was
in February 2010, before these new measures. This was the scenario.
Only 490 health centres were able to provide ARVs. I am happy to
announce today that the number of centres that can now provide ARVs
has grown to 2 205. At that time, in February last year, only 250
nurses were certified to initiate ARV treatment. I’m proud to
mention that the figure has now grown to 2 000. Before the HIV
Counselling and Testing, HCT, Campaign was launched by the President
at Natalspruit Hospital on 25 August last year, 2 million South
Africans per annum used to be tested to know their status. I’m happy
to announce that at the last count, last month, 12 million South
Africans had been tested.
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Many South Africans want to know their status. Hence, last Sunday,
12 June, exactly two days ago, I, together with the House of
Traditional Leaders and Congress of Traditional Leaders of South
Africa, Contralesa, launched a massive HIV Counselling and Testing
Campaign for all our villages, and the village of Mafefe in Limpopo
was chosen for the launch. It was a very great success. Six kings
attended the event, and a lot of other traditional leaders. They all
pledged that they would open their villages for us to come to test
people, and that they would be the ones to take the lead.
Before the campaign at the end of February last year only 928 000
South Africans were on ARVs. Because of the campaign we have 1,4
million people on ARVs today. Deputy Chairperson, I also announce
with pride that in November last year we were able to reduce the
prices of ARVs by a staggering 53%, as we promised that we would do.
I have also worried time and again about the number of newborns in
South Africa who are born HIV-positive. At one stage the figure was
put at 70 000 children born HIV-positive. I am happy to announce
today that the studies done by the Medical Research Council show
that we have been able to reduce mother-to-child transmission by 50%
at about six weeks post delivery. This is a very big achievement and
the significant reduction has actually happened in the province of
KwaZulu-Natal which, as you know, has the highest prevalence of HIV.
When it came to reducing mother-to-child transmission, KZN was
number one.
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Deputy Chairperson, this is to be celebrated because it means that,
if we work hard enough together with the MECs, we can eliminate the
phenomenon of mother-to-child transmission by 2015, and we intend to
do so. The declaration of heads of state in New York last week
stated that by 2015 no child in the world should be born HIVpositive.
Deputy Chairperson, 24 March 2010 was World TB Day. We released
three strategies to combat TB.
The first one was the GeneXpert technology that we had acquired.
This is a new technology which, of course, has not been in use over
the past 50 years. In the past 50 years only one technology has been
used to diagnose TB and it was microscopy. If that failed, one did a
culture. It used to take about a week for us to know the diagnosis,
but with GeneXpert technology we know in two hours whether a person
has TB or not. Secondly, microscopy had a sensitivity of 72%,
meaning that you could miss 28% of people who had TB, but with
GeneXpert the sensitivity is 98%, meaning that only 2% can be
missed. Moreover, it used to take us three months to know whether a
person had drug-resistant TB. With GeneXpert technology, we know in
two hours, and not three months.
The second strategy we unveiled was that of active case finding. We
have put together teams of five people each, who visit families, and
there are 407 000 families in South Africa where there is TB. These
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teams have been visiting them at home to screen other members of the
family. We are doing this because every person who has TB can infect
15 other people in their lifetime. So, it is important to visit
them. I am happy to announce that since we started in February we
have already visited 41 000 families and screened 112 000 people.
Deputy Chairperson, the third strategy is that with money from the
Global Fund we have built nine multidrug-resistant TB, or MDR-TB,
hospitals. The difference between them and other hospitals is that
the nurses won’t be easily infected by TB from the patients they are
nursing.
Let me move to the second pandemic, which is the high maternal and
child mortality. A lot has been said about this in newspapers, all
over the media and even in this House. You have noted, hon members,
that most of our interventions in HIV and Aids are directed at
pregnant women and children because of these high mortalities, and
we will work hard to reduce them.
I want to remind this House that maternal mortality is not just the
death of a woman. It is the death of a woman because she dared to
fall pregnant! We also know that HIV mortality disproportionally
affects young women of childbearing age more than men. This can’t be
right, hon Deputy Chairperson.
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We now have no fewer than 1,3 million orphans in our country. Most
of them are maternal orphans, meaning that it is their mothers that
have died. This has serious consequences in society beyond health
care, such as crime, poor educational outcomes, teenage pregnancies
and abortions, and the total social disorientation of young men.
Hon Deputy Chairperson, it is a well-known fact that young husbands
lose direction in life when their partners die. The same does not
happen to women because a female partner is known to be a
stabilising influence on a young man’s life. South Africa is fast
losing this social stability due to the high maternal mortality
which, according to evidence at our disposal, as I said, affects
younger women more than older ones.
Let me go on to the third pandemic, which is the noncommunicable
diseases. Deputy Chairperson, noncommunicable diseases are spoken
about less, maybe because we speak a lot about HIV/Aids, as it has
shocked us, and there are many more strong nongovernmental
organisations, NGOs, that are fighting HIV/Aids than noncommunicable
diseases.
I tried to bring this issue of noncommunicable diseases to the
attention of hon elected members by presenting it to the Health
Portfolio Committee. Unfortunately, the media got very excited and
put into print that I was specifically raising the issue because of
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the dietary behaviour of Members of Parliament. It is very important
for me to explain what I actually meant.
Noncommunicable diseases, which are referred to as NCDs, are
diseases that are not propagated by germs from one person to the
other. In fact, it would be safe to say that the germ, bacteria or
virus that propagates an NCD is the human being. I am saying this
because NCDs are not only biomedical but largely diseases of
lifestyle.
These are divided roughly into four categories: high blood pressure
and other diseases of the heart and blood vessels; diabetes and a
few other metabolic disorders; chronic respiratory disease and
asthma; and cancers. One should realise that mental health is also
classified under that.
Moreover, there are four identifiable factors that predispose one to
these noncommunicable diseases: smoking, which is most important;
harmful use of alcohol; unhealthy eating behaviour, one’s diet; and
lack of physical exercise – always sitting, or sitting in the car
and even using your car to go to the toilet, Deputy Chairperson,
which is very common these days! [Laughter.] If all four of these
risk factors could be removed, the world would be a very safe place
to live in.
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The question is: How serious are these noncommunicable diseases?
Deputy Chairperson, they are a global phenomenon, but they are also
growing fast in sub-Saharan Africa. So serious is the issue that the
World Health Organisation and the Russian Federation called a
meeting of all Ministers of health in Moscow on 28 to 29 April this
year, in what was called the First Global Ministerial Conference on
Healthy Lifestyles and Noncommunicable Disease Control.
The Moscow Declaration was passed. It is a very long document but
let me mention two facts from the whole. It says that countries must
develop and rapidly implement policies that address behavioural,
social, economic and environmental factors associated with
noncommunicable diseases. Effective noncommunicable disease control
requires concerted leadership at all government levels - national,
subnational and local - and across a number of sectors such as
health, education, energy, agriculture, sports, transport and urban
planning, environment, labour, trade and industry, and finance and
economic development.
Deputy Chairperson, it is against this background that I said a
couple of weeks back that Members of Parliament should take the lead
in the matter of a healthy lifestyle, especially diet and exercise.
For example, I don’t expect you to smoke, as you are the ones who
passed the law against smoking. Unfortunately, in the media they
said the Minister was saying there was a “gravy train” in Parliament
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and he wanted to stop it. Deputy Chairperson, this is not a circus,
but a serious matter affecting humanity.
In 2009 there was a question in Parliament about the number of
people who were on renal dialysis. They were asking why the
government couldn’t increase the number of dialysis machines in
public hospitals. I argue that that is the wrong debate. It is no
different from asking the Minister why he can’t build more
mortuaries because there is a high demand! I say this because the
intelligent question to ask is: Why do so many South Africans have
failing kidneys? Why do we need to be on dialysis and why do we have
so many people who need a kidney transplant?
Just as an example, Gauteng alone has 561 people on dialysis, and
there are 238 on the waiting-list. And this is a province that has
facilities. What about all those receiving dialysis at R150 000 per
patient per annum in the public sector, and R300 000 in the private
sector? This is something that the country simply cannot afford.
Moreover, to be on dialysis one needs to be in hospital 3 times a
week for a minimum of 4 hours, whether one is employed or not. It is
a difficult task.
What causes this? We know that in 40% to 60% of people with endstage renal failure it is due to high blood pressure at an average
age of 39 years. What are the main risk factors for high blood
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pressure? They are smoking, lack of exercise and diet, and also high
salt intake.
So, we should not be demanding more dialysis machines, and
subsequently demanding new kidneys, to the extent that, as has
happened here in South Africa, the rich are trying to concoct
schemes to steal kidneys from the poor! We cannot allow that. What
we must do is reduce the prevalence of hypertension by eliminating
the risk factors.
I am not going to debate with you about tobacco. I want to come back
and strengthen the laws against smoking. In the case of alcohol, we
are going to ban the adverts. I make this point time and again
because the sooner the tobacco and alcohol industries understand
this, the better for all of us. We will never pull back.
On the issue of salt, I am going to ask Parliament to pass a law,
which will also go through this House, to reduce salt in foodstuffs.
This is because the average amount of salt that is needed in the
human body is 4 g to 6 g per day, but South Africans are known to
consume 9,8g per day. Deputy Chairperson, this is not a joke. In
Britain, just by reducing salt in foodstuffs by 10% they save 6 000
lives per annum. Our own research in South Africa shows that if we
reduce the amount of salt in just one foodstuff, bread, we will save
6 500 lives per annum. So, hon Deputy Chairperson, we are going to
do that.
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Obesity, which means extreme excess body weight, is a fast-growing
phenomenon, even among our children. Statistics from research by the
Medical Research Council show that 23% of schoolchildren are
classified either as obese or as overweight, and this cannot be
allowed, Deputy Chairperson. For us adults it is known that at least
60% of women and 31% of men are either obese or overweight. If we
consider people above 37 years, the figure goes to 70%.
Countries are doing something about this and we want our country
also to do something. For instance, Australia has come up with a
policy of regulating the advertising of junk food during children’s
programmes on TV. In fact, during children’s programmes they have
banned all advertising of junk food. We are aware that they want to
do the same thing in the United States. They want to ban the
hamburger, which has made them bulge. So, we must also look at what
makes us fat and get rid of it.
Deputy Chairperson, on the issue of violence and injury, we know
very well that in regard to Arrive Alive people talk about the
people who die. But research from Unisa and the Medical Research
Council of South Africa shows that for every person who dies in a
car accident, 30 are hospitalised and 300 are treated for minor
injuries. That is for every one person! So, as we talk about Arrive
Alive, let us talk not only about the dead; let us talk about those
who go to hospital and the effect this has on the health care
system.
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Deputy Chairperson, as regards the National Health Insurance, NHI, I
am painfully aware that for some people in this country what I have
said up to now won’t mean anything if I don’t talk about the NHI.
There are two different groups of people in this country in relation
to the National Health Insurance. One group is those who want
relief. [Interjections.] Is my time over, Deputy Chairperson?
The DEPUTY CHAIRPERSON OF THE NCOP (Ms T C Memela): Will the House
allow me to give the Minister five minutes to wrap up?
[Interjections.] Thank you.
The MINISTER OF HEALTH: Deputy Chairperson, I just want to say that
as far as the NHI is concerned, it is not just an important document
that everybody is waiting for. There is the preparedness of the
health care sector, and we are busy preparing it.
Why do we need to prepare the health care sector? It is because the
present health care system can be characterised by four clearly
identifiable negatives. It is unsustainable, it is very destructive,
it is extremely costly, and it is hospicentric or curative.
We need to change it to primary health care. We have three methods
of primary health care engineering which we are involved in. There
is a school health system which we are going to implement, a
district health system by clinicians and, lastly, the ward-based
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primary health care system, in which we want to put at least ten
primary health care workers in a ward.
Other countries have done more than us. Brazil has 30 000 primary
health care workers. India has 800 000 primary health care workers
distributed in the villages. In South Africa we want to put in only
40 000.
Deputy Chairperson, regarding the issue of workforce development and
human resources, HR, we will have completed our HR strategy by
August. Suffice it to say that for now we are producing only 1 200
doctors per annum in our 8 medical schools. That is why the
President announced that we needed to build a ninth medical school,
in Limpopo. Plans are afoot, but we are also going to improve
hospitals and have five mega hospitals to make sure that the intake
of medical students increases.
Hon Deputy Chairperson, allow me then to present the budget to you.
It has increased by 15% from R21,7 billion in 2010-11 to
R25,7 billion in 2011-12. At the national level an additional amount
of R422 million was allocated for 2011-12 and R692 million for 201213. I wish to take this opportunity to present this budget of the
Department of Health for the financial year 2011-12, amounting to
R25 731 554 000 – without the three extra noughts it is R25,7
million! - to the Council for adoption.
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In conclusion, I want to thank numerous people. These are the
President, the Deputy President who is also the President of the SA
National Aids Council, Sanac, the Minister of Finance and the
Cabinet for their understanding. I also want to thank my colleague,
the Deputy Minister of Health, Dr Gwen Ramokgopa. We have
complemented each other very well and I wish my colleague to
continue in this way.
I also wish to thank the director-general, DG, of the department for
steering the ship through very rough waters. I thank the chairperson
of the portfolio committee and the Social Development chairperson in
this honourable House for the way in which we have worked together.
I wish this to continue so that South Africans have “a long and
healthy life”. Thank you. [Applause.]
Mrs R N RASMENI: Hon Deputy Chairperson, hon Minister Aaron
Motsoaledi, hon Deputy Minister Gwen Ramokgopa, hon Members of
Parliament and comrades, let me take this opportunity to express our
condolences to the Mkhize family.
Sithi akuhlanga lungehli. [We send our condolences to you.]
The sections of the Freedom Charter on health commit us to a
preventive health scheme run by the state, and free medical care and
hospitalisation provided for all, with special care for mothers and
young children. Although there have been many achievements in
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improving access to health care, much more needs to be done in
regard to quality of care and making services available to all South
Africans through ensuring better health outcomes.
South Africa commands huge health care resources, as compared with
many middle-income countries. Yet, the bulk of these resources are
in the private sector and serve a minority of the population,
thereby undermining the country’s ability to provide quality care
and improve health care outcomes. The ANC is determined to end the
huge inequalities that exist in the public and private sectors by
making sure that these sectors work together.
It has been impossible to correct the disparities and contradictions
we have inherited in the short space of 17 years, but we do need to
speed up service delivery to our people. Health being a fundamental
basic human right compels our government, led by the ANC, the party
that received the support of the overwhelming majority of South
Africans, to fulfil this basic right.
Hence, we are beginning the process of implementing the National
Health Insurance, or NHI as it is more commonly referred to. There
has been a great deal of speculation in various quarters, mostly
negative, but what is it based on? We are still waiting for the
tabling of a document that will guide the process to a conclusion
that will hopefully satisfy all stakeholders.
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Parliament should track the use of the hospital revitalisation grant
by establishing how far the department is in regard to modernising
or transforming infrastructure and equipment in hospitals, and
monitoring whether the quality of care in hospitals is in line with
the national policy objectives.
Some may continue to argue for a free market in health, but this
cannot be justified when it hampers the fulfilment of a basic human
right to which our people are entitled. Through the NHI we can
achieve equity in health care, as the current disparities cannot be
allowed to continue.
Also, through the consultation process we will address the fears and
confusion of the general public. To correct the inequities in health
requires a process that moves our country towards universal access.
This also requires us to address the socioeconomic disparities that
prevail in our country.
The process of developing the NHI will require reaching consensus
with all relevant stakeholders on a few key elements, namely a basic
benefit package, a National Health Fund, and the role of private
funders and providers. The above will naturally follow the normal
democratic process of in-depth discussion and engagement, with a
view to finding the best solution which is practical and affordable.
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Chairperson, in addressing the health care inequities and as a key
component of the NHI, we also have to address the issue of human
resources. The retention of staff is critical if we want to succeed,
particularly in the rural and remote areas, where staff experience a
lack of equipment and, more critically, a lack of support.
The intervention by the department to deal with the long-standing
problem of damaged medical equipment piling up in hospital corridors
and the recruitment of 36 junior engineers to repair these
instruments is highly applauded. No more purchasing of equipment,
one piece on top of the other. This initiative encourages youth to
take issues of skilling and development seriously, and job creation
is also addressed by this initiative. It is critical for government
to review the incentives it offers to attract health care
professionals, but it is equally important to address the issues of
equipment, structural deficiencies and support.
The increased burden of disease is placing enormous strain on our
resources and the wellbeing of health care professionals and health
workers in general. As the burden of disease increases, it negates
the advances we are making in filling vacancies.
South Africa is faced with a quadruple burden of disease. It is thus
important for Parliament to assess the department’s interventions
and programmes to curb disease and illness.
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Tuberculosis, TB, is rife in South Africa, especially with the links
with HIV and Aids that have been found. It is thus important to
minimise the number of TB cases, and to ensure compliance with
treatment. That is why we support the department, which has acquired
the new GeneXpert technology. This total revolution in the diagnosis
of TB is the first breakthrough developed after more than 50 years
of relying on microscopy and culture run issues. We welcome this
innovation, Deputy Chairperson.
These are challenges we need to confront and resolve as we progress
towards the implementation of the NHI. In addressing these we must
also be mindful that the budget for Health has been declining in
real terms. As a key priority of government, we expect the budget
for Health to receive far more urgent attention in order for it to
meet the demands of our people.
Chairperson, a key priority is the programme of hospital
revitalisation, which also incorporates preventative maintenance to
ensure good maintenance of our health facilities in the provinces.
This demonstrates the urgent need for us to explore public-private
partnerships more vigorously and it also demonstrates the urgent
need for the sharing of resources to improve the health profile of
our country and achieving social solidarity.
A lot has been said about the high maternal and child mortality in
our country, and the challenges we face. You have noted, hon
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members, that most of our interventions in HIV and Aids are directed
at pregnant women and children. We will work hard to reduce the
mortalities of these targeted groups.
Deputy Chairperson, we need to move beyond making primary health
care a slogan, and make it a reality for us and our children and
grandchildren. We need it because it benefits the majority of South
Africans, who look to the state to help them. These are the people
that have put us where we are today, and the only favour we can
return is for us to strive for a better health system, which will
guarantee them better health. We want to ask the department to
double its efforts to give adequate attention to the primary health
care programme as our hope for the future. The hope for a better
life for some of our people is based on better health.
The initiative taken by the department to improve its management at
all levels is welcomed. Deputy Chairperson, this area of management
has contributed to lots of the problems experienced by the Health
department nationally. Properly qualified people and people with
relevant skills and experience will be appointed to these critical
positions in future.
Teenage pregnancy is a worry. It is still prevalent in our schools.
As the ANC we believe that the introduction of the school nurse
programme will alleviate the health problems we have in our schools.
We believe that recruiting retired nurses will yield positive
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results, because they are more experienced at all levels,
particularly in educating boys and girls on issues of sex,
prevention and pregnancy.
In the NCOP’s programme of “Taking Parliament to the People”,
provinces such as Limpopo and the Free State were visited. Deputy
Chairperson, it will be interesting to hear from the MECs to what
extent they have addressed the challenges identified and reported by
the NCOP visit. The same applies to KwaZulu-Natal, KZN. The Social
Services select committee also paid a visit to this province, where
a number of problems were identified and reported to the relevant
office.
In conclusion, the ANC-led government will continue to invest in
research and development in the health sector, including infant
mortality research, HIV prevention technologies, health status
surveys, development of new medicines and indigenous knowledge
systems. Lastly, I would like to support the report from the
department. I thank you. [Applause.]
Mr S GQOBANA (Eastern Cape): Deputy Chairperson, hon Minister,
Deputy Minister, members of the executive councils, hon members of
the Council, ladies and gentlemen, it is a great honour and
privilege for me to inform the NCOP that the Eastern Cape department
supports the Health Budget Vote 16 policy speech, as presented by
the hon Minister.
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This is because the department is absolutely forthright in directly
targeting the basic health needs of the poor, highlighting the need
for the re-engineering of the health care system, learning from best
practice from other developing countries, and defending the right of
the people of the Republic of South Africa to have a health service
which is affordable, effective, sustainable and preventive in
nature.
This budget policy speech has been all-encompassing in that it has
educated us on the extreme importance of preventing diseases, injury
and death, and of promoting healthy lifestyles, in contrast with the
present obsession with the treatment of individual diseases, when it
is already too late for many individuals, and at great cost to the
fiscus and the gross domestic product, GDP, of the country.
We agree with the hon Minister that South Africa is faced with a
quadruple burden of disease and state that the Eastern Cape is
committed, with all its energy and resources, to working as a
collective, supporting the hon Minister in decreasing, and
ultimately in the long term eradicating, these four challenging
areas of disease.
As he has already indicated, the Minister signed a performance
agreement with the President, and subsequently with us in the
various provinces, to ensure a long and healthy life for South
Africans.
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The health sector has adopted a 10-point plan which speaks to
priorities which the Minister alluded to in his policy priorities
and budget speech. The hon Minister’s speech also addressed the
issues that are critical in the eight government priorities.
Allow me, therefore, to highlight some of the major achievements of
the Eastern Cape department of health in answering the department’s
policy priorities, its 10-point plan, and how we are living the
negotiated service level agreement.
With regard to HIV and Aids and TB, the number of patients on
antiretroviral treatment, ART, has increased from 123 552 to
152 357. The number of people who have been tested for HIV is
1,2 million, whilst 1,3 million have been counselled. The number of
those who have been tested and are positive is 138 541, and 513 736
have been screened for TB. The number of ARV sites has increased
from 147 to 659. The uptake of nevirapine by newborn babies has
increased from 83,3% to 98,5%. The number of nurses trained on the
Nurse Initiated Management of ART, Nimart, is 943. We were supplied
with four GeneXpert machines to diagnose TB and to detect it in the
early stages. Eighty-five nurses have been appointed for communitybased management of multidrug-resistant TB, MDR-TB, and intensified
case-finding teams. We have achieved a cure rate of 66% according to
the electronic TB register. In answering the Minister’s directive to
focus our attention on HIV and Aids, we have established a special
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directorate to deal with HIV and Aids and it is headed by a chief
director.
In working together as a collective for the achievement of the
ultimate objective of ensuring “a long and healthy life for all
South Africans”, the Department of Health has started preparing the
health care system in the Eastern Cape for the eventual
implementation of the National Health Insurance, NHI, and
facilitating the gradual re-engineering of the health care system
according to the following three main streams, as indicated by the
hon Minister.
Firstly, the department has commenced revitalising its
organisational structure so that it is in line with the districtbased model, with a team of five specialists focusing specifically
on maternal and child mortality. We are doing this gradually,
because we want to draw some lessons from the national process.
Secondly, the department has proactively engaged in the
revitalisation of primary health care service delivery in the
Eastern Cape by piloting this stream in five subdistricts. Since
mid-2010, all five health subdistricts have been involved in the
development of a social compact for community mobilisation,
including the facilitation of job creation via co-operatives focused
on providing soft services.
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Thirdly, the department has obtained executive council support for
the implementation of the stream encompassing the ward-based primary
health care model deploying ten or more well-trained primary health
care practitioners per ward.
We are in agreement with the Minister’s comments on noncommunicable
diseases.
We are also busy attending to the issue of health care management by
making it less complex and ensuring that form follows function.
Furthermore, the department has employed 1 667 health professionals
from October to date, and 1 247 nurses as well as 22 clinic
associates graduated last year.
On the issue of infrastructure, on which both the chairperson of the
select committee and the Minister have spoken, we have committed
R1,9 billion for the revitalisation of the following hospitals:
Livingstone, Cecilia Makiwane, Frere, St Elizabeth’s, St Patrick’s,
Frontier, Nkqubela TB Hospital and Jose Pearson. We have created
1 500 jobs and we project creating 2 275 and further training 3 000
people at Cecilia Makiwane.
We have also opened five clinics and a state-of-the-art EMS base,
also containing a call centre, the latter costing 18 million. We
have also finished the construction of the Mthatha base at
R9,6 million and the Queenstown EMS base at R21,9 million.
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On emergency services, we have handed over 100 ambulances at a cost
of R57,7 million, and we have recruited 109 people and eliminated
one-man ambulance crews. We are stamping out the abuse of ambulances
by our personnel, as we have installed a tracking system in order to
know where the ambulances are. We are decentralising the ambulances
and attaching them to district and tertiary hospitals.
Due to improved protocols on mother-to-child transmission and
comprehensive treatment, there has been a decrease in the number of
babies born HIV-positive.
There are other challenges that we face. There is pilfering of
medicines and drugs in our depots. However, we are working with law
enforcement agencies in order to deal with this. The systems have
collapsed, but we are working on installing them and putting control
measures in place. We have arrested the culprits and are continuing
with the investigations.
There is an intergovernmental team that deals with corruption and
that comprises the Organised Crime Unit, Sars, Health and the Asset
Forfeiture Unit.
On the issue of conditional grants, while we have improved with
regard to expenditure, there are still challenges in regard to three
of those grants. One of them is HIV and Aids. We, together with the
affected managers, are dealing with that.
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We can now indicate that the department is effectively starting this
new financial year from a negative position, with expenditure
expected to exceed the budget by approximately R978 million,
including accruals and carry-through costs, which will be carried
over to the 2011-12 fiscal year. We would like this Council,
whenever it debates provincial matters, to give attention to this
matter.
In conclusion, through you, Deputy Chairperson, we thank the hon
Minister and the members of this Council, and we urge the Council to
support the hon Minister. We are fortunate to have leadership that
is passionate and hardworking, and if this time around we do not
change the situation in Health, I don’t know what will happen going
forward. Thank you. [Applause.]
Ms N MEKGWE (Gauteng): Deputy Chair, hon Minister, Deputy Minister,
hon MECs present and all hon members, the merger of the departments
of health and social development soon after the 2009 elections
presented us with an opportunity to tackle challenges which face our
province holistically.
It is a fact that poverty contributes to poor health outcomes;
therefore, programmes which seek to eradicate poverty will have an
impact on the health status of the people of Gauteng.
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As government, we have come to accept that budgets that are
appropriated to eradicate poverty and improve the health status of
our people are not mere expenditure. We regard these as investments.
A population that is ravaged by poverty and poor health care can
never be productive. This approach to budget allocations underpins
the manner in which we prioritise our interventions. Sustainable
development and improved health outcomes will ultimately impact on
the productivity of the people of Gauteng.
We are guided by the following outputs as set out in the negotiated
service delivery agreement, the Millennium Development Goals and our
five-year strategic plan. These are: increasing life expectancy;
decreasing maternal and child mortality; combating HIV/Aids and
decreasing the burden of disease from tuberculosis; strengthening
the health system’s effectiveness; strengthening early childhood
development; preventing and reducing substance abuse; strengthening
services for older persons; waging war on poverty; and mainstreaming
gender, youth and disability.
Chairperson, we have prioritised reduction of child and maternal
mortality. All hospitals and clinics with maternal obstetric units
in Gauteng are implementing the 10 recommendations of the Saving
Mothers report.
The availability of maternal obstetric ambulances and their quick
response is crucial to saving the lives of women who are in labour
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and their infants. To this end, we will increase the number of these
ambulances, which are especially dedicated to the transportation of
women who are in labour emergencies, from 5 to 10.
We have also initiated a campaign to encourage pregnant women to
book for antenatal visits before 20 weeks of pregnancy. This
campaign is born of the fact that our records attest to low figures
for women who attend antenatal clinics. The rate of antenatal visits
before 20 weeks increased from 27,3% in the first quarter to
30,7% in the fourth quarter. Although the increase is encouraging, a
lot of work still needs to be done to increase this number.
In order to reduce maternal and child mortality in Gauteng, we have
established two committees to advise the department on methods and
interventions to reduce maternal, neonatal, infant and child
morbidity and mortality. These committees are called the Maternal
Morbidity and Mortality Committee and the Neonatal, Infant and Child
Committee. They will ensure rigorous monitoring and analysis of
maternal and infant mortality in 2011-12.
In addition, all district, regional and central hospitals, including
specialised hospitals, conduct morbidity and mortality meetings each
month to investigate every death and improve management of
hospitals. Maternal and prenatal morbidity and mortality meetings
are held in all hospitals offering maternity services on a regular
basis. At these meetings, the causes of death are investigated, and
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issues of commonality are identified and discussed, and the
appropriate interventions are implemented to reduce the occurrence
of avoidable deaths and reduce mortality rates.
We will strengthen our immunisation programme to reach children who
could have been missed, especially those in informal settlements. In
2010-11 the department improved measles immunisation coverage,
reaching 111,5% by end of the financial year. This was possible
through monitoring and evaluation visits to districts and in-service
training on expanded programmes on immunisation and vaccine stock
management. Vitamin A coverage for children under the age of
one year and new mothers reached 104,4% and 97,8% respectively.
Through the expanded programme on immunisation, which encompassed
the Reach Every District Programme and the availability of vaccines,
measles coverage reached 111,2%. The target on rotavirus dosage
coverage was reached due to training, campaigns conducted and health
education to postnatal mothers on the importance of ensuring that
rotavirus vaccine is given within a 6-month period after birth.
The fact that targets for immunisation are exceeded is testament to
our efforts to ensure that children whose birth has not been
registered, as well as children born in other provinces and even
other countries, receive their immunisation in Gauteng. Hon members,
I take this opportunity to urge you to remind your constituents that
every day is immunisation day at our clinics. Even our hospitals
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have established vaccination points for catch-up in case of missed
opportunities.
We have already taken steps to increase the number of neonatal beds
at Charlotte Maxeke Johannesburg Academic Hospital, Dr George
Mukhari Academic Hospital and Natalspruit Hospital. Strict adherence
to infection control measures is monitored very closely. Every death
of a child from preventable diseases is one too many. The prevention
of mother-to-child transmission of HIV programme is bearing fruit.
We will continue to strengthen this programme in order to reduce the
overall incidence of HIV.
This year we will also strengthen our school health services. The
focus will be on screening obstacles to learning among Grade R,
Grade 1 and Grade 7 pupils. Currently, school health teams visit
1 431 schools, and we will collaborate with the Gauteng department
of education in this regard to reach more schools.
Chairperson, we are breaking the back of HIV/Aids. By the end of
March 2010 we had 412 191 people on antiretroviral treatment, ART.
Our target is to increase this number to 520 000 by the end of
March 2012. In order to provide treatment closer to where people
live, the number of ART sites will be increased from 162 to 366.
Timeous enrolment of people on ART, while also taking into account
their CD4 count, goes a long way towards warding off the onset of
Aids; hence we have trained professional nurses to initiate
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treatment. To date, more than 600 professional nurses who work in
clinics have been trained to initiate ART.
Hon members know that HIV is incurable. Therefore, our focus on
prevention can never be overemphasised. Medical male circumcision
will therefore be upscaled to reach 100 000 males by the end of
March 2012. We have already tested more than 1 million people since
the launch of the HIV Counselling and Testing Campaign. Our research
shows that there is an increase in the use of condoms across all
ages of the sexually active population.
Tuberculosis, TB, remains a burden to our health system. Early
diagnosis and treatment will ensure that we increase the cure rate
and reduce the spread of TB. TB is also the number one killer
amongst HIV-positive patients. Hence we have decided that all
TB patients will be screened for HIV/Aids in order to ensure that
those who are co-infected and have a CD4 count which is below 350
are initiated into ART. We have noted that admission of multidrugresistant TB patients for six months at Sizwe Hospital disrupts
their livelihoods, especially if they are breadwinners. That is why
we will soon launch a community multidrug-resistant programme to
ensure that these patients continue receiving treatment while living
with their own families.
We have procured the GeneXpert technology, which will ensure the
shortening of time with regard to availability of sputum results
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from a whole week to two hours. This will greatly reduce the loss of
patients to follow-up, as some do not come back for results. This
technology is already available at Chris Hani Baragwanath Academic
Hospital and Edenvale Hospital. We will also make this equipment
available to the rest of the districts in the course of this
financial year.
To reduce the spread of TB among families of patients, we will visit
their homes and screen them for TB. Those found to be already
infected will be placed on treatment immediately. Deputy
Chairperson, since we embarked on this process, we have found
53 038 new cases of TB, exceeding a target of 52 000. This has been
achieved through intensified case finding in door-to-door campaigns
and the HIV Counselling and Testing Campaign. We will continue to
ensure that TB cases are detected early so that those who are
infected are placed on treatment, thus curbing the spread of
infection in the community at large.
All of the above can only be achieved if we have an effective health
system. An effective health system hinges on primary health care
services which inspire confidence. We are re-engineering primary
health care in order to improve health outcomes and reduce the need
for curative services.
We have already begun to establish health posts which are located in
communities. This is a service unit that is embedded in the
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community and at the periphery of a clinic or community health
centre in which comprehensive primary health care is rendered to a
definite number of households. The aim of health posts is to ensure
that community-based services, including outreach services, are
provided to communities on a door-to-door basis. In Gauteng, a block
of 250 to 300 households or families in a community will be served
by a health post.
The health and social development teams will consist of a health
post doctor, professional nurse, social worker, health promoter,
enrolled nurse or nursing assistant, and counsellor. They will work
with appropriately trained community health workers and social
auxiliary workers who are placed within specifically designated
communities.
This model will reduce waiting times in the clinics, because
services will be brought closer to the people. This will be achieved
by taking chronic medication directly to patients at their homes,
attending to minor ailments, and providing elementary care closer to
where communities live.
Furthermore, health and social development problems will be detected
early and attended to in time, thus increasing chances of recovery
and minimising defaults on treatment. It is hoped the perceptions in
the community about the quality of care ...
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The DEPUTY CHAIRPERSON OF THE NCOP (Ms T C Memela): Hon member,
thank you. Your time has expired.
Ms N MEKGWE (Gauteng): Let me take this opportunity once more to
support the Minister’s efforts to drive the implementation of the
National Health Insurance, which will ensure that the district
system functions optimally and inspires confidence. Thank you very
much, Deputy Chair. [Applause.]
Mr M J R DE VILLIERS: Deputy Chairperson, Ministers, Deputy
Ministers, members and guests, indeed the health standards of the
Health department of government and the health departments in all
the provinces are very important for the people of South Africa if
we are serious about service delivery.
In 2010, the department identified four key areas to focus on,
namely: increasing life expectancy, combating HIV/Aids, decreasing
the burden of disease from tuberculosis, and improving health
systems’ effectiveness.
The Department of Health received R21,5 billion for the 2010-11
financial year, compared to the budget of 2009-10, which was
R18,4 billion. This shows an increase of 4,65% of the total national
Budget, which represents 9,36% in real terms. Chairperson, 94,9% of
the department’s budget goes to transfers and subsidies, 4,9% to
current expenditure, and 0,2% to payments for capital assets.
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This means that the national Department of Health must play a
pivotal role in the monitoring and evaluation of effectiveness of
implementation and performance in provinces. The national Department
of Health must have an IT system with a dashboard programme which
shows how, when, and on whom monies have been spent, the outcome
performance regarding quality, and the effectiveness of service
delivery.
This will arrest ineffectiveness in service delivery, like the
previous shortfall in antiretroviral drugs in the Free State; the
underspending of budgets; the deaths of babies, like in the Eastern
Cape and Gauteng; and the nondelivery of medicine to depots,
hospitals and clinics, etc.
Management and leadership across the department were identified as a
weakness. Yes, the departments across the provinces have started
with the upgrading of senior management, but we must take cognisance
of the fact that only fit-for-purpose and competent staff must be
employed in vacant posts advertised. No unfit and unqualified
persons should be appointed, or political deployments made. This
must not be the criterion to fill posts.
Deputy Chairperson, tuberculosis is an illness which can be cured,
but too many people are diagnosed with tuberculosis. An increase of
948 per 100 000 incidents has been identified, as well as a rate of
1 in 105 people in South Africa. A TB cure rate of 64% as against a
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target of 65% was achieved. I would like to express much
appreciation to the department in this regard.
Tuberculosis is very much related to poverty, no food or hunger,
joblessness or low income, and negligence in regard to health. We
must concentrate on the prevalence and giving support to families in
difficult circumstances.
The community development workers employed by government, provinces
and municipalities must concentrate on the comprehensive gathering
of information on people’s quality of life and their health status,
and supply it to our community health clinics. Then an ample number
of staff must be available to assist with food supplements and other
support immediately after their receiving the survey done by them.
The 25,9% growth in the HIV/Aids budget is significant and highly
appreciated in the combating of this pandemic. Deputy Chairperson,
the 29,3% prevalence rate, according to the 2008 National Antenatal
Sentinel HIV and Syphilis Prevalence Survey is still too high, and
programmes in regard to this issue must be more focused, and must be
intensified.
We must be mindful of the fact that the life expectancy of babies
and mothers can only improve with our supporting the mothers’ rights
from the start of and even before pregnancy. A healthy mother gives
birth to a healthy baby. Our hospital and maternity wards should be
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high quality. Staff, nurses and doctors must be high-quality health
professionals. Our equipment and other support materials should also
be high quality. If we fail, then loss, sadness, trauma and negative
emotions are inevitable.
A lot of savings can be made on expenditure, such as on food during
internal meetings, accommodation, and flight arrangements, to name
just a few. This has already been done by one of our sister
departments in government.
Deputy Chairperson, our Health department must succeed in all its
endeavours to create a healthy, competent and excellent health
sector in South Africa. If we are serious about service delivery,
then we must speed up this quality health system. Thank you.
[Applause.]
The DEPUTY MINISTER OF HEALTH: Hon Deputy Chairperson and
Chairperson for this sitting, hon Minister of Health, Dr Aaron
Motsoaledi, Ministers and Deputy Ministers present, hon chairperson
of the select committee, hon members, colleagues, MECs for health,
distinguished guests, and our senior management, led by the
director-general, I wish to join those members who have extended
condolences to the family of Dr Mkhize, a young, 27-year-old doctor
who was killed by a patient he was supposed to be assisting. Our
condolences go especially to his daughter, who shared with me that
she herself would like to become a doctor one day.
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It is important that the health sector work together with provinces
to continuously look at, and relook at, the issue of security in our
facilities, although indeed plans cannot necessarily be made to deal
with some of the incidents. However, it is our duty and
responsibility to continuously review the rigour of the security
system, both for our patients and our health workers.
It is indeed my privilege to address this honourable House on this
occasion in support of the Health Budget Vote for the 2011-12
Medium-Term Expenditure Framework, MTEF, as presented by the
Minister.
In participating in this budget debate, I wish to acknowledge the
significant turnaround the department has achieved under the
visionary and passionate leadership of Minister Aaron Motsoaledi and
through the contribution of my predecessor, the late Dr Molefi
Sefularo, working with the MECs of various provinces on the National
Health Council. I would also like to acknowledge the input of the
director-general and senior management in the national head office
and in the provinces.
This turnaround has been profound, especially with respect to
investing in strategic partnerships and in research and innovation,
and using knowledge to save lives, particularly in the HIV/Aids
programme. This budget we are debating today will build on these
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successes and achievements as we advance towards “a long and healthy
life for all South Africans”.
Since the advent of democracy, the diseases of extreme poverty like
kwashiorkor and marasmus are not as prevalent as before. South
Africa is on course to eradicate malaria. The prevalence of
oesophageal cancer in the Eastern Cape is on the decline as a result
of our interventions. Access to primary health care has
significantly improved, with over 40% of clinics built during this
era.
In this current term we have already reported a 50% decrease in the
mother-to-child transmission of HIV, and 12 million South Africans
have come forward to respond to the HIV Counselling and Testing
Programme. Over 1,4 million patients who would otherwise be in
hospices waiting to die are now alive on antiretroviral treatment,
ART. Through innovations in technology the time it takes to diagnose
TB and multidrug-resistant TB has been greatly reduced, by about six
weeks and almost three months respectively. These achievements that
South Africa has made, especially in the fight against HIV, have
been acknowledged widely as the world observes 30 years this year
since the first Aids patient was diagnosed.
We have now reached a turning point, but it is not as yet uhuru. We
dare not be complacent. This is just the beginning. We still have a
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long way to go in order to ensure that we do indeed push back the
frontiers of HIV/Aids and TB in our lifetime.
One of the key lessons that we must learn during this period is that
we need to be better prepared for new and emerging diseases. Above
all, we must leverage the best available scientific knowledge and
evidence, as well as appreciate the need to continuously innovate,
looking at new and better ways to achieve health and wellness goals.
We have also learnt that strategic leadership and effective
partnerships are catalysts in tackling complex problems that
humanity faces from time to time, problems of the magnitude of HIV
and Aids.
The Minister has aptly outlined the quadruple burden of disease, the
four epidemics that the country is facing now, with HIV/Aids, TB and
maternal and child morbidity and mortality in the lead. On
noncommunicable diseases, trauma and violence, we must not wait
until we are overwhelmed, as was the case with HIV in our country,
or as is the case in the developed countries with cardiovascular and
metabolic diseases.
In preparation also for the National Health Insurance system we have
prioritised interventions that promote wellness, prevent ill health
and improve the effectiveness of treatment and care.
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It is estimated that the indirect cost of hypertension and
cardiovascular diseases alone to the South African economy and
society is about R8 billion annually. What is more concerning is
that 70% of these deaths are of economically active members of
society who are younger than 55 years of age, and that almost
195 people a day die from these diseases. The good news, however, is
that 80% of these diseases are preventable. I think we must really
imagine this daily, so that we actually realise that we have a duty
and responsibility to opt for prevention.
Our goal is to reduce the burden of noncommunicable diseases by 5%
to 10% in this term and to ensure coverage of about 25% of districts
in regard to integrated programmes in this financial year. The
strengthened primary health care model, as announced by the
Minister, with the district-based specialists, community health
teams and school health programmes is a platform we will use to
achieve this goal.
We believe that South Africa must be spared another massive wave of
catastrophic epidemic, something which resulted in the doubling of
the death rate in the past decade when we experienced the HIV/Aids
epidemic. We will learn lessons from past failures and recent
successes, as well as successes in combating malaria and hosting the
2010 Fifa Soccer World Cup Tournament, in the way that we manage the
growing burden of noncommunicable diseases.
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We aim to host a multisectoral national lekgotla on noncommunicable
diseases, which will precede the global heads of state summit to be
held in September this year. We must emerge from this summit with a
strategic partnership similar to that of the SA National Aids
Council, Sanac, ready to begin a social movement for promoting
wellness and healthy lifestyles. Health must be a way of life, a
choice that South Africa makes as a contribution to “a long and
healthy life for all”. We can no longer afford to be oblivious to
the high price being paid by current and future generations socially
and economically. The huge burden of ill health is a risk to
sustainable development.
It is in this context, alongside the HIV/Aids Counselling and
Testing Campaign, that we called on South Africans to be tested and
screened and to know their status for diabetes, hypertension,
obesity and cancers. We will work together in ensuring that a
district and municipal ward-based disease surveillance system is in
place to enable us to have targeted prevention and treatment
programmes.
When I was in Ga-Rankuwa last month with the Move for Health
Campaign, together with the Tshwane University of Technology
community, the demand for testing in all these various screening
programmes was very high. This necessitated the various service
providers coming back the next day to assist the student community
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in getting to know their status and taking positive action. South
Africans are responding positively.
Chronic disease care will also form an integral part of the National
Health Insurance system. As part of strengthening the health system,
we are rolling out a long-term care model for diabetes and
hypertension throughout the health care system. This intervention
aims to improve the quality of life of patients and also to reduce
the high cost of complications like strokes, blindness, diabetic
amputations and kidney failure. The chronic disease management
register will be used as a monitoring tool for districts.
Regulations for organ transplants have already been published for
comment in order to avoid the unethical conduct that was reported a
few months ago.
We will continue to work with all stakeholders to achieve the World
Health Organisation Vision 2020 goal of eliminating blindness
through, amongst other things, cataract surgery.
We are in consultation with the Ministry responsible for water
services to finalise investigations and consultation on water
fluoridation for the prevention of tooth decay. As part of the
school health programme, primary prevention oral health services
will be implemented in schools, targeting a minimum of 10 primary
schools per province in this financial year.
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We support the Minister in his ensuring that we implement the Mini
Drug Master Plan that was approved by the National Health Council,
NHC, earlier this year. We are concerned about the massive increase
in alcohol advertisements, which seem to be targeting the
populations at risk, especially young people. We will engage with
the industry, the media, research institutions and society, as we
aim to strengthen measures to protect society, and also to protect
our economy, from the negative impacts of alcohol. We have already
commissioned research to examine the impact of alcohol on TB
outcomes. Such studies will also advise us on similar impacts on
treatment outcomes for other diseases. Industry and the media cannot
and must not be allowed to maximise profits from various commodities
and from advertorials at the expense of our youth, society and the
economy.
Tobacco regulations have yielded positive results. We are, however,
concerned that there are about 7 million South Africans that still
use tobacco, resulting in about 44 000 deaths annually.
[Interjections.]
On mental health, we aim to strengthen the implementation of the
Mental Health Care Act, Act 17 of 2002, by supporting and monitoring
provincial incorporation of community mental health services as part
of the primary health care, PHC, package. Interventions to reduce
the turnaround time for forensic observations, including the
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recognition of forensic nursing as a registered speciality with the
Nursing Council, are under way.
On injury prevention and emergency medical services, the high
morbidity and mortality burden of injuries in South Africa is driven
by a high rate of road accident injuries and interpersonal violence,
the latter accounting for 46%. It has been estimated that around
3,5 million people per annum seek health care for injuries. The
Medical Research Council of South Africa, MRC, reports that injury
and violence is the second leading cause of death in South Africa
after HIV.
The health sector is an important player in the attainment of the
objectives of the five pillars of the United Nations-led Decade of
Action for Road Safety, especially Pillar 5, which deals with postcrash responses. A report developed by the MRC setting out practical
and cost-effective interventions will be released later this year.
Violence against women and children is still very high. The rate of
female homicide by an intimate partner is 6 times the global
average, with a woman killed every 6 hours. Chair, 25% of women in
the general population have been a victim of physical violence by an
intimate partner, and 40% of men have perpetrated violence against a
female partner. As per an MRC report, 40% of all rapes reported to
the police are of children under 18 years of age and 15% of those
are under 12 years of age. The recent reports in the media on the
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brutal attacks on and killings of lesbian women, including that of a
13-year-old girl, are no less an indicator of this scourge in
society than the daily reported cases of rape and domestic violence.
As we participate in the 365 Days of Activism for No Violence
against Women and Children, we will work with the Social Development
department, the police, and the National Prosecuting Authority under
the Thuthuzela programme to strengthen the victim support services
programmes and mainstream the treatment and support of survivors.
Measures have also been put in place to reduce the backlog in
forensic laboratories.
We will be releasing an e-Health policy and strategy, after
extensive consultation. Currently, we are on the 19th draft of this
process.
We will also leverage the experience gained from various panels, and
specifically the 2010 Fifa Soccer World Cup Tournament last year, to
introduce mobile health solutions.
Currently, priority will be given to developing electronically based
surveillance systems able to deal with monitoring the Millennium
Development Goals, MDGs, and the nationally negotiated service
delivery agreements, which will be monitoring the prevalence and
incidence of HIV/Aids, and also the risk factors.
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Hon members, any effective health system must operate an effective,
reliable, quality, expert-driven epidemiology and disease
surveillance system. We need to identify new emerging diseases early
on, track our successes in various interventions, and also remain
vigilant for outbreaks and re-emerging diseases.
Next month, the National Health Research Committee will be convening
a health and innovation summit, where researchers in the health
sector will identify research and innovation gaps and priorities
aligned to the mandate in the negotiated service delivery agreements
that the Minister has signed with the President. The Department of
Science and Technology, academics, research institutions, and the
private sector have been invited to contribute to this task.
On health technology, the National Health Council has approved the
Health Technology Strategy. This strategy includes the recruitment
of bio-engineering and clinical engineering technicians to maintain
the many pieces of equipment, some of which are highly complex and
expensive, in hospitals and clinics. The Ministerial Advisory
Committee on Health Technology has already begun to work on
developing norms and standards for health technology. An essential
equipment list for various levels of the health care system is
already before them and will be released for consultation.
In his speech the Minister also referred to the reduction in price
achieved through the central drug procurement approach adopted by
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the NHC. Learning from this achievement, we will establish a central
drug procurement authority working jointly with provinces to act as
an enabler towards affordable and reliable access to
pharmaceuticals.
We want to thank the Minister for his leadership, and colleagues and
MECs for their co-operation and the leadership they provide in their
various provinces. Working together, we will consolidate our
achievements, especially in fighting the scourges of HIV/Aids and
TB, as well as improving mother and child health and ensuring that
they live a long and healthy life.
I want to thank the House for this opportunity, and say that its
support for this Budget Vote is support for contributing to the MDGs
and the national renegotiated service delivery agreements. Thank
you. [Applause.]
Mr M SOKATSHA (Northern Cape): Deputy Chairperson, hon Minister and
Deputy Minister, my colleagues, and hon members of this House, let
me join other members who have extended condolences to the Mkhize
family. I also want to extend condolences to the family of one of
our Cuban doctors who passed in a car accident yesterday.
I am honoured to be part of this important debate in the House on
the national Health Budget Vote, which the Northern Cape fully
supports. The hon Minister is indeed correct when he makes the
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seminal point that the entire health sector is currently at a
crossroads in our country. The choices that we have to make today
will determine our destiny for many years to come.
Minister Aaron Motsoaledi’s service level agreement is indeed a
worthy endeavour, directed at addressing the communicable and
noncommunicable diseases that we face today, as well as revitalising
the entire health system.
The national Ministry of Health must be applauded for the manner in
which it has mobilised the entire sector towards the achievement of
a clear set of goals. These goals are the four identifiable and
measurable outcomes, and the 10-point plan of health. All the
planning tools of the provinces have already been significantly
aligned with these objectives, so that there is a clear articulation
of what the intended purpose of our national health system is.
Needless to say, in the provinces our challenges differ, sometimes
remarkably. This imposes particular areas of emphasis for each of
the provinces, as we strive to address the health needs of our
people and those of the health system itself.
Amongst the most critical of our health system challenges in the
Northern Cape is the Emergency Medical Services, EMS. The national
norm for the number of EMS ambulances required is 1 per 10 000
citizens. This ratio works well in urban and semiurban areas.
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However, due to the vast distances in rural areas that have their
own peculiar and harsh conditions, this has been increased to
1,6 ambulances per 10 000 citizens.
In the Northern Cape the actual distribution of ambulances is as
follows: 1 ambulance per 10 000 citizens in Frances Baard District
Municipality, which is one of our biggest districts; 1,2 ambulances
per 10 000 citizens in Siyanda District Municipality; 1,2 ambulances
per 10 000 citizens in John Taolo Gaetsewe District Municipality;
2,3 ambulances per 10 000 citizens in Pixley ka Seme District
Municipality; and 3,2 ambulances per 10 000 citizens in Namakwa
District Municipality.
Clearly the backlog is huge, and the reality of having to annually
replace obsolete vehicles increases this burden, given the vast
distances and road conditions that ambulances have to travel in in
the Northern Cape, perhaps a minimum of 400 km to 700 km from the
other districts to the only facility that offers tertiary services
in the Northern Cape.
It means that at any given moment we exceed the acceptable ratio of
vehicles that are unavailable due to maintenance. This has the
effect of dramatically reducing the number of vehicles that are
available to serve the population. The reality is that countrywide
you will have about 15% to 20% of vehicles being serviced at any
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given moment. However, in the Northern Cape this figure rises to a
staggering 40%.
The national norm for the replacement of an EMS ambulance is every
two years or 250 000 km, whichever comes first. In the Northern Cape
we are failing to achieve this by a significant margin, with many
ambulances that are significantly older than this and have travelled
more than the maximum recommended number of kilometres.
This means that, in addition to routine maintenance, our ambulances
repeatedly break down and require major repair work, including
engine replacements. This impacts on the important function of
transferring patients. We all know that in many instances the time
factor in this regard is critical. Importantly, the coachwork of an
ambulance needs to be in good shape.
The department is often asked why it undertakes costly major repairs
of old ambulances, rather than spending that money on purchasing a
new vehicle. The calculation is not always that simple. A new EMS
ambulance costs an average of R450 000 which, when depreciated over
three years, is equivalent to R150 000 each year. This suggests
that, provided the refurbishment, repair and maintenance of an old
vehicle is less than R150 000 for one year, additional service
extending its lifespan may still be cost-effective. For each
decision, it’s a difficult prospective calculation that can often
only be proven in retrospect.
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The Northern Cape has a total of 46 planned patient transport
services vehicles. These vehicles are experiencing the same problems
as the EMS ambulances: high mileage, badly damaged internal
coachwork and high maintenance costs. Furthermore, these vehicles
are old and out of service for long periods of time.
If the department were to replace these vehicles every three years
or 300 000 km, this would necessitate replacing one third of the
fleet each year, and that is 15 planned patient transport services
vehicles. Typically, over recent years the department has had
sufficient capital funds to replace only two to three vehicles each
year.
The national norm for staffing the EMS ambulances – which is also a
critical point for the Northern Cape - as prescribed by the Health
Professions Council of South Africa, HPCSA, is two qualified
personnel. Planned patient transport vehicles do not always require
two people. However, when travelling long distances this is always
the case in order to ensure the safety of the crew and patients.
Furthermore, each ambulance station needs a station manager; each
subdistrict needs a subdistrict manager; and each district needs a
district manager. Currently, just two districts run their own
control room, and this needs to be established in all five
districts. In order for the Northern Cape to achieve the prescribed
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minimum level of staffing, it needs to increase the number of staff
from the current level of 560 to a new level of 1 823.
The estimated total spending per annum required for EMS and planned
patient transport services vehicles is about R35 million. The
current capital budget for these vehicles is only R12 million,
giving a shortfall of R23 million a year. The estimated total
spending per annum required for EMS and planned patient transport
services staff is R269 million. The current budget for staff is only
R87 million, giving a shortfall of R182 million. [Interjections.]
Hon Deputy Chairperson, our country is now being lauded by the
global community, based on the immense work that has been
accomplished in fighting the scourge of HIV and Aids, as well as TB.
The department of health in the Northern Cape in its ministerial
imbizo also embarked on a new strategy to prevent chronic diseases
and promote healthy lifestyles. This was done in conjunction with
the HIV Counselling and Testing, HCT, Campaign and TB screening in
all the districts.
Stalls were set up at all the strategic places in a community, and
the communities were screened for blood pressure and blood glucose,
ophthalmic examinations were conducted, and women were referred to
the nearest clinic for pap smears. Community members were also
educated regarding the benefit of having gardens to grow their own
healthy food, and eating a balanced diet. Seeds were distributed.
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Communities were encouraged to visit health facilities on time when
they had health problems. Home visits were also conducted. Pregnant
women were educated on the dangers of drinking alcohol and smoking
during pregnancy. Emphasis was put on early booking and its
benefits, so that they could be counselled and tested for HIV and
Aids, and be put on treatment early if they were HIV-positive in
order to reduce mother-to-child transmission.
Schools were also visited and learners were given health talks on
substance abuse, regular exercise, general hygiene, healthy eating
and also playing sport to keep fit. Kick TB soccer competitions were
held, schools were presented with soccer balls, and certificates
were handed out to participants.
There has been an increase in maternal deaths due to the scourge of
HIV and Aids. As a result, women who visit our antenatal clinics are
offered routine testing and screening for HIV and Aids, TB and
chronic conditions as part of routine screening for pregnant women.
There is also a campaign that encourages women to book early or
visit the nearest clinic when they have missed a period. The new
clinical guidelines for the prevention of mother-to-child
transmission are being implemented in all our facilities and
pregnant women are being prioritised for antiretrovirals, ARVs.
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Lastly, let me take this opportunity to thank the Ministry for their
efforts to make sure that they implement the National Health
Insurance and for their leadership. Thank you very much. [Applause.]
Mr T L BOTHA (Western Cape): Hon Minister of Health, Dr Motsoaledi,
Deputy Minister Ramokgopa, hon members of the House, guests, the
director-general and staff, ladies and gentlemen, I would like to
take this opportunity to congratulate and thank the hon Minister for
his leadership. He is leading the sector at a time when South
Africa’s health is at a crossroads and going through the pandemics,
as he has described. In fact, I think health systems all over the
world are facing particular challenges. I agree that we, as elected
leaders, face some important decisions.
In his speech the Minister highlighted HIV and Aids, TB, maternal
and child mortality, the incidence of noncommunicable diseases,
violence and injury. In my address to the House today, I would like
to point out the programmes that the Western Cape department of
health has implemented to address these pandemics in support of the
national challenge.
With regard to HIV and Aids and TB, the Western Cape department of
health has allocated R661 million to the HIV/Aids and TB programme.
This is augmented by a further R166 million from the Global Fund. We
are extremely appreciative of the ongoing support of the Global
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Fund, and their contribution over the Medium-Term Expenditure
Framework, MTEF, period is R579 million.
The Western Cape is the only provincial recipient in the country of
this grant. It will enable the department to strengthen grant
programmes and the management thereof, while expanding
antiretroviral treatment, ART, infrastructure, antiretroviral, ARV,
services, the prevention of mother-to-child transmission, PMTCT,
system, peer education and palliative care services in this regard.
The second phase will follow directly after this original period
funded by the Global Fund, and a further three-year period will be
funded by this grant.
Measures to reduce the burden of HIV and Aids and TB include: the
treatment, care and support of 80% of all people diagnosed with HIV;
antiretroviral therapy to 116 000 adults and children in the
province during 2011-12, whereas two years ago we had 36 000 people
on ARVs; PMTCT services, aiming to reduce the transmission to below
3%, although we believe we are already below 3%; and HIV and TB
services at all district, secondary and central hospitals for
clients with complex HIV or TB. We will also meet the target of
1,1 million and we will administer ARVs and HIV counselling and
testing, HCT, at all facilities in the Western Cape.
With regard to maternal and child mortality, the shockingly high
rate of child mortality, and a major cause of the burden of disease,
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is addressed through more prevention and promotion activities at
district level and in the strengthening of the maternal, child and
women’s health care programmes. The Western Cape department of
health aims to reduce the mortality rate of children under the age
of five years to 30 per 1 000 live births and the maternal mortality
rate to 90 per 100 000 live births by 2015.
We launched the Road to Health booklet at the Mowbray Maternity
Hospital on 31 May. Every mother will be issued with one of these
booklets when a child is born in this province, in both the private
and public sectors. We believe that these booklets, with a special
focus on prevention, are the key rallying tool to enhance the
wellness of children. All key partners, including nonprofit
organisations, NPOs, universities and the private sector, are
involved.
Focus areas for improving women’s health include: motivating more
pregnant women to seek antenatal care before the 20th week of their
pregnancy; targeting the reduction in the delivery rate of women
under the age of 18 years; increasing the cervical cancer screening
rate; and improving family planning services.
With regard to the incidence of noncommunicable diseases, the
Western Cape department of health is committed to increasing
awareness of, and drives initiatives to address the factors that
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contribute to the burden of disease. These include poverty, lack of
sanitation and potable water, and unhealthy lifestyles.
In addition, in the Western Cape we have continuously spoken about
the upstream causes of ill health, but we have decided that the
seriousness of these causes requires the issue to be taken to the
next level in our province. It is for this reason that the Western
Cape provincial government has implemented a platform to address
these issues intersectorally amongst spheres of government,
different departments in provincial government, nongovernmental
organisations and the private sector. Four working groups have been
established to address the upstream issues that contribute to the
burden of disease. We believe that the strategies and action plans
emerging from these working groups will have a long-term benefit in
regard to the disease profile of our people.
With regard to violence and injury, the injury burden, which
includes intentional injuries such as homicides and suicides and
unintentional injuries such as road traffic injuries and firerelated injuries, accounts for approximately 23,9% of the burden of
disease in the Western Cape. In comparison to the rest of the world,
violence is a particular problem in our province, where the injuryrelated mortality rate for men is 10 times the global average, and
for women 7 times the average. The Deputy Minister referred to it as
being 6 times, so I might be called a liar for 1 time.
[Interjections.]
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Substance abuse, particularly alcohol abuse, is one of the most
important drivers of the burden of disease in the Western Cape, as
it fuels both violence and road traffic injuries. There are two
primary drivers that place a burden of injury on the health system –
road accidents, and violence related to substance abuse, especially
the abuse of alcohol. To address these, two main strategies are now
being developed and implemented in our province. Firstly, there is a
strategy to increase road safety with the aim of halving fatalities
caused by road accidents; and, secondly, there is a strategy to
reduce the incidence and harmful effects of substance abuse,
including, and especially, alcohol abuse.
The Western Cape department of health is at a momentous time in its
history. We have come to the end of the Health Care 2010 vision. Our
evaluations show that the objectives of this plan have been
successfully achieved. The establishment of a primary health care
infrastructure has been completed. We are now standing at the gate
of the second decade of this millennium, with the vision for health
services to 2020 in mind.
The Western Cape department of health has put its focus on placing
the patient, patient experience and the quality of care for patients
back at the heart of our vision. This vision will be aligned with
the values of the provincial government of the Western Cape. These
are: caring, competency, accountability, integrity and
responsiveness. The strategy will provide the framework for future
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service, personnel, infrastructure and financial planning. This can
be achieved by positioning and strengthening our district health
services to form a solid base, with regional and central hospitals
and other support services as a strong support.
On this journey, the Western Cape department of health had a major
shift in focus, which sets the Western Cape apart, not only from the
rest of the country, but also from other governments. It is a fresh
approach to public health care that is certainly new and has the
potential to direct the debate on public health management in a new
direction. We gave it the name Strategic Objective 4: Increasing
Wellness. We launched this strategic objective last year. In terms
of this vision, the early detection and prevention of disease have
been prioritised through educational interventions. Effective
strategies in these areas will have a long-term benefit with regard
the disease profile of our people in the province.
In conclusion, the DA supports the budget. We congratulate the
Minister, and our province will not overspend. Thank you. [Time
expired.] [Applause.]
Ms M L MOSHODI: Thank you, hon Deputy Chair. Hon Minister, Deputy
Minister, MECs ...
... ka ho qolleha, Motlatsi wa Modulasetulo, ha ke hlomphe Letona la
tsa Bophelo bo Botle, Mme Mohlomphehi Fezi Ngubentombi, ho tswa mane
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porofensing ya Freistata. [... in particular let me show my respect
to the MEC for health, hon Fezi Ngubentombi, from the Free State.]
Hon Deputy Chairperson, hon members and colleagues, I am rising in
support of the Budget Vote. Mindful of the many challenges that
still face the health care sector in South Africa, I want to
congratulate the hon Minister, the Department of Health and the
relevant role-players for the remarkable and visible progress that
has been made during the past year under the competent leadership
and guidance of the hon Minister.
As the Minister has pointed out today, we are:
... at a time when the health care system is at a crossroads. We
may choose the best route, or the worst one ever, which will, of
course, make our situation worse than before. The choice lies with
us as South Africans in general, but as elected leaders in
particular.
It is common cause that South Africa’s health care sector is
characterised as fragmented and inequitable due to the huge
disparities that exist between the public and private health care
sectors with regard to accessibility, funding and delivery of health
care services.
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As a result of this state of affairs, the delivery of health care is
rendered unequally and disproportionately, as far as the majority of
the population relying on the public health care system are
concerned. This part of the population have a disproportionately
lower level of financial and human resources at their disposal
relative to the private sector. It is exactly this state of affairs
that the hon Minister and the government need to balance.
It is therefore necessary and important to design, develop and
implement innovative measures and policies to address the
disproportionate situation of the public and private health care
sectors with regard to human resources and financial strength. It is
necessary to develop a model that provides a benefit package, of
which the main aim must be to provide most benefits for most people,
given the pool of funds available.
It is necessary to unpack and address the challenges that lie ahead
within the limited time allocated to me. I will deal briefly with
only some of them.
The most important measure or vehicle to address the imbalances and
transform the health system into an integrated prepayment-based
health financial system that efficiently promotes the progressive
realisation of the right to health care for all is the National
Health Insurance, NHI.
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The hon Minister alluded to this in his budget speech in the
National Assembly on 31 May 2011, when he said that there were two
schools of thought about the National Health Insurance. I quote:
Those who correctly and legitimately hope that the NHI will bring
relief in their everyday hardships as far as their health care is
concerned.
And –
... those consumed by self-interest and greed that will shame even
the devil.
Section 27(1) of the Constitution of 1996 especially provides, among
others, that:
Everyone has the right to have access to —
(a)
health care services, including reproductive health care
This means that:
(2)
The state must take reasonable legislative and other
measures, within its available resources, to achieve the
progressive realisation of each of these rights.
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It also means that:
(3)
No one may be refused emergency medical treatment.
Mindful of this obligation to all the people of South Africa, the
ANC, prior to 1994, adopted the national health insurance policy
that was contained in the ANC Health Plan in May 1994 which has
guided the transformation of the health sector. In fact, since the
Freedom Charter in 1955 the ANC has regarded health as a priority.
It remains a basic need of our people, and it is therefore enshrined
in our Constitution. It is no longer a matter of whether there will
be a national health insurance in South Africa, but when. The
concept of universal coverage enjoys the support of most people.
The medical aid industry has consistently failed to control the cost
of health care. It has been unable to address efficiency and
equality in the private sector. Premiums and contributions cost a
medical aid member thousands of rands per year, while the health
benefits deriving from such high contributions are being cut or they
are exhausted before the end of the year. Furthermore, instead of
the money paid by members being used for health care, it is used for
administrative purposes such as marketing. The key lasting solution,
therefore, lies in addressing the needs not only of the more than
40 million uninsured, but also the millions who are currently
insured or underinsured by the medical schemes.
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It is precisely due to the current problems associated with the
medical schemes that the ANC has embarked on a policy process of
ensuring that South Africa reorganises the manner in which health
care is financed, by introducing the National Health Insurance. It
is therefore our duty to support the Minister and government in
finalising the National Health Insurance policy framework and
developing an appropriate model to suit South Africa.
Another serious challenge that needs to be addressed is the severe
and serious shortage of professional staff, such as nurses and
doctors, in the health care sector. The work nurses do is of such a
nature that a hospital or a clinic would not be able to function
without them. Research on nursing indicates that there is currently
a shortage of well over 30 000 registered nurses in the public
health care sector, with a further shortage in the private sector.
In some public hospitals and clinics, especially in the rural areas,
there is a 60% shortage of nurses. A shortage is also being suffered
in crucial areas such as intensive care units, operating theatres,
the work of midwives and mental health. Hospital care is not the
only aspect that is affected by the shortage of nurses in relation
to the number of patients.
There is also an additional pressure on hospital staff. An
inadequate nurse-patient ratio can even lead to violence being
directed against nurses. Patients who have to wait a long time for
attention do not come into contact with hospital management; they
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only see the nurses walking past to treat someone else, and this
often leads to verbal abuse and physical attacks on nurses. Nursing
shortages can have a negative effect, such as an increase in work
load, in deaths and in nursing turnover.
The launch of the new Nchebeko Skills Consultancy nursing college
for trainee nurses in Limpopo, with branches elsewhere, including
Cape Town, is therefore welcome as a step in addressing the shortage
of nurses. Like in other countries, we may also have to consider the
implementation of legally enforceable nurse-patient ratios as a
measure to address the shortage of nurses.
Another serious concern and challenge is the critical shortage of
capable doctors. Apart from there being a shortage of doctors, the
question should also be asked: Where are doctors currently working
and where are they needed most? Statistics indicate a serious
disparity and inequality in the distribution of doctors over the
country between the more affluent areas, and the poor and rural
areas.
The distribution of doctors between public and private practice
exacerbates the inequality further. Resources indicate that 85% of
the population do not have medical aid and are reliant on public
health care, whereas a much smaller percentage of doctors are
working in the public health sector.
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The Minister and the government have already done much to address
the shortage of doctors and to prevent doctors from leaving the
country, as well as attract doctors to the public sector. Some of
these measures are: the introduction of a scarce skill allowance; a
rural allowance; legislation aligned to boosting other forms of
health care; control of the geographical distribution of newly
registered doctors; and the introduction of compulsory community
service.
A concern, however, is the shortage of family doctors. Fewer women
currently choose the medical profession as career. Some of the
reasons listed by a prominent woman doctor are: a lack of part-time
training opportunities and rewarding jobs; the absence of
professional locums for pregnant doctors; and a lack of child care
facilities at the workplace. [Time expired.]
In conclusion, I support the Budget Vote. [Applause.]
Mr S H PLAATJIE: Deputy Chairperson, hon Minister and Deputy
Minister, we are profoundly conscious of the complexity of the
challenges facing our health sector. We know perfectly well that no
budget is enough to drastically address and reform the health
services. It is therefore clear that even the current budget is not
consistent with the impossible challenges, ranging from HIV and
Aids, TB, noncommunicable diseases, child and maternal mortality,
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and infrastructure, to the training of nurses and doctors. The list
is long.
According to a United Nations, UN, report, the progress of ARV
treatment in South Africa is still well below the estimated need.
And then, annually 500 000 South Africans are estimated to have been
newly infected with TB. The conservative estimates are that there
are almost 50 000 children under the age of 15 in the country who
have TB.
UCT’s Prof Di McIntyre revealed that 58% of the North West
province’s population live in rural areas, compared to the South
African average of 43%. In spite of this the province has the
smallest number of doctors working in the state health sector, with
big swathes of rural areas having little or no access to district or
provincial hospitals.
Millions of South Africans are faced with drug shortages, fraud and
the collapse of public health facilities. I could not help but pay
attention to President Jacob Zuma’s address at the first nursing
summit this year. According to the TC guide, Zuma said that the
health of the nation was in the hands of the nurses and that the
summit was a moment of renewal for the profession.
He further said that nurses -
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... are the backbone of our hospitals and clinics and the engine
of our health care system.
The three-day summit ended on a high note with the signing of a
compact.
However, South Africa is desperately short of nurses. At the end of
March 2010 the vacancy rate was 42%, with approximately 109 000 more
nurses needed, according to the Persal system. In Limpopo and the
Eastern Cape only about one third of the professional nurses’ posts
were filled.
According to the 2009 General Household Survey by Statistics SA,
59% of citizens use public clinics frequently. However, the attitude
of nurses needs a serious overhaul. South Africa’s vision of a
caring government and caring society will not be realised as long as
we still have nurses in public facilities who are rude, uncaring and
impatient.
I would like to commend the Minister for the commitment he has made
to hiring more nurses to address the shortfall. We also urge the
Minister to nudge the South African Nursing Council and Africa
Health Placements to speed up the memorandum of understanding
negotiations. Cope supports the Budget Vote.
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Ms D P MAGADZI (Limpopo): Hon Deputy Chairperson, hon Minister, hon
Deputy Minister, my colleagues from different provinces, and hon
members of this august House, it gives me great pleasure to be one
of the people who will contribute to and support the health
priorities of 2011-12, and also Budget Vote 16 in the NCOP.
We are meeting here today and we all have to agree with what the
Minister has said, that there is an urgent need to drastically deal
with the quadruple burden of disease. This is what we cannot avoid.
We in Limpopo can proudly say, in adhering to what the Minister has
said, that we have already counselled 1,2 million people, of whom
900 came to be tested. These numbers will actually be increased by
the fact that we have taken the campaign to the villages around the
province. As has been stated by the Minister, on 12 June 2011 we
were in the village of Mafefe, together with traditional leaders
from all over the country. The successes of this campaign have
inspired us as the Limpopo province so much that we will be
continuing with the programme of HIV Counselling and Testing, HCT,
in our rural villages throughout the districts of the province.
We will also make sure that we intensify our campaign in
institutions of higher learning, thus ensuring that we reach all
sectors of our society.
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We are doing this, very well aware of the fact that we are all
responsible, as we all have to know our status. In Limpopo province,
in working in partnership with many of the organisations, we are
strengthening the medical male circumcision campaign, distributing
both female and male condoms, and making sure of prevention of
mother-to-child transmission. These are some of the programmes that
we are intensifying and popularising. Of course, we are conscious of
the fact that, as we are doing this, knowing one’s status is
important.
We are also conscious of the fact that yet another problem burdens
people who are infected, and that is TB, which is wreaking havoc,
particularly in some of the rural villages. As a province, by way of
contributing to job creation and making sure that we deal with the
challenges of TB, we have bought 20 tracer cars and employed over 40
people who can trace our TB-infected people and make sure that they
take their treatment regularly, as we work with the DOTS supporters.
Our outreach programmes in the communities by way of making
household visits, and making sure that we screen TB patients, are
also yielding fruit in this regard.
In our endeavour to realise “a long and healthy life for all South
Africans”, we are also insisting on physical training for all our
people, knowing well that exercise is one of the potential ways to
prevent noncommunicable diseases. We are working very closely with a
number of stakeholders and in this regard I need to say that,
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together with the departments of sport, arts and culture and of
social development, we have taken this programme very seriously to
our communities out there. As a result, we have started to identify
groups, particularly amongst the elderly, that we are working with.
At the moment the internationally acclaimed soccer team, Vhakhegula
Vhakhegula, who are the world champions, are our healthy lifestyle
ambassadors. These elderly women are not only fit and healthy as
grannies, but able to dribble and play soccer. They are also elderly
women who champion indigenous food and styles of working. We are
working very closely with them so that our indigenous knowledge
system can improve.
This deliberate move that we are making indicates that we must move
away from an expensive, unsustainable and curative health system
towards a more desirable preventive health care system, as a way of
achieving a long and healthy life as South Africans. I dare to say
that preventive medicine is the only way to go, because it is
affordable, particularly to us in the rural provinces. It is also
how we can make sure that we contribute to the Millennium
Development Goals.
We are aware that this system requires, amongst other things,
strengthening primary health care; reducing the costs of medicine;
making sure that we control infections; and increasing access to
health care and many other things.
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As a province we went out on a campaign to make sure that we recruit
as many professional staff as possible. Our infrastructure is being
revamped, and we are partnering with many different organisations in
a quest to make sure that we live up to some of these ideals. In
this regard, we have partnered with several institutions, such as
clinics, to assist and make sure that we reach out to rural
communities. There are several specialists who are working with us
in the rural community of Phalaborwa, and we believe that with their
doing so we will definitely be able to deal with some of the
challenges that we are faced with in the public sector, which
include a lack of professionals.
Let me indicate that our hospital revitalisation is bearing fruit,
with several of our villagers not travelling many kilometres to
their nearest health centres. We also welcome the new medical
school, as announced by the President, to be built in Limpopo. This
is a clear indication that we can better the lives of our people. We
can also safely state that, as much as we have state-of-the-art
hospital facilities, there are still challenges, like a lack of
medicine, basic equipment and professionals. These are some of the
things that we are still faced with.
It is in this context that we as a province have decided to
standardise the procurement of medical equipment, including
developing a comprehensive procurement plan, so that we are able to
maximise the spreading of equipment to the different hospitals. The
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standardisation programme will assist a great deal in making sure
that our facilities are properly equipped, and that we do not send
people to faraway places, which exacerbates the condition of their
ailments. The same strategy will be employed in making sure that
there is a stocking-up of medicines and other related things where
there are shortages, so that what we are experiencing is dealt with.
A considerable number of patients found in our health facilities are
brought in by our emergency medical services, which sometimes
transport them through planned patient services. We as a department
have made sure that we have brought all these programmes under one
roof so that we can optimise the access of our people to transport.
We are proud to say that our emergency services have been set up in
the rural heartland so that in time of need our people can have easy
help and access to them.
Similarly, we are making sure that communication in this regard
becomes effective, as we are trying to network with the traffic
officers and the police so that as emergencies happen we are all
able to help one other. Of course, the challenges of infrastructure
networks, such as digital and data networks in the rural areas,
still exist. The challenge of roadwork networks is also one of the
things that hamper our response time.
We have also embarked on making sure that we convert several of our
ambulances into obstetric ambulances. We know that maternal and
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child mortality is one of the challenges, particularly in rural
areas. We believe that by working together and making sure that we
have the necessary equipment and human resources we will be able to
deal with this. I support the budget. Thank you. [Applause.]
Dr S M DHLOMO (KwaZulu-Natal): Deputy Chairperson and members of the
Council, hon Minister Motsoaledi, and two other Ministers, Minister
Gigaba and Minister Mahlangu-Nkabinde, Deputy Minister, the chair of
the select committee, senior officials from the national Department
of Health, my colleagues, MECs, and ladies and gentlemen, I support
the budget of the hon Minister, which will accelerate the programmes
that have been outlined by the Minister, and will also ensure “a
long and healthy life for all South Africans”.
Our health workers are under attack. In the month of May we buried a
member of our emergency medical rescue services, who died tragically
in Estcourt after he was attacked when responding to a distress
call. In the incident a young man had stabbed his parents, and the
family called an ambulance. On its arrival and while our member of
staff was trying to help the stabbed mother, the assailant stabbed
our member to death, as well as a policeman who was also at the
scene.
We have also heard the Minister and other colleagues extending
condolences to the Mkhize family. This doctor was laid to rest in
Durban on 11 June 2011.
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On the prevention of mother-to-child transmission of HIV, from 7 to
10 June, last week, the 5th South African Aids Conference was held
in Durban. Opening the conference, Chief Justice Sandile Ngcobo made
a profound statement. He said that we are not achieving the desired
results not so much because of the stubbornness of the virus but
because of ourselves.
Deputy Chairperson, in KwaZulu-Natal 20 000 children are infected
with HIV by their mothers each year. However, the conference was
briefed on the great strides that our province has made in reducing
the rate of transmission from mother to child. In 2008 it stood at
21% and now, by improving the quality of service at our facilities,
and by offering medication preventing mother-to-child transmission
of HIV to women at the correct time, it has been brought down to
below 3%. A number of interventions have been put in place to ensure
that we eventually eradicate the transmission of HIV from mother to
child. It is actually possible to have HIV-positive mothers giving
birth to HIV-negative babies.
We have achieved 100% Azidothymidine, AZT, initiation for all
pregnant women who have attended our antenatal clinics. However,
early booking is still a challenge in many areas of the province,
and I have called on all sectors to work with us in this regard.
What has strengthened this programme, however, are the following,
amongst other things. There are now 470 institutions, which include
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63 hospitals and 407 primary care clinics, where we provide
antiretroviral drugs, ARVs, in various areas in the province, and we
have 2 331 nurses who have been trained in the initiation of ARVs.
Of the 1,3 million South Africans on ARVs, 459 670 are in KwaZuluNatal, which is more than a third of the patients in the country on
treatment.
A challenge that we still have, and that also contributes to
maternal morbidity and mortality, is starting antenatal care very
late. Our President made a call for initiation of ARVs in HIVpositive pregnant mothers at 14 weeks, and this can only help to
improve this picture. Another challenge is teenage pregnancy, where
some of our teenagers report it very late because of fear. In fact,
World Health Organisation, WHO, guidelines mention that any
pregnancy of a woman of 18 years and younger is a risky pregnancy.
The quadruple burden of disease that the Minister has alluded to is
worse in KwaZulu-Natal than in any other part of the country.
Therefore, we have to double our efforts in dealing with this
matter.
In KwaZulu-Natal, since the launch of the campaign last year, we
have tested 2,3 million people out of the target of 3 million that
we set ourselves to achieve by the end of June this year. It is
worth noting that we have reached an average of 78%, but there are
districts that are still lagging behind. These districts are
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eThekwini, iLembe and uMgungundlovu. The House will also note that
these are the three districts where the prevalence is above 40%. In
moving forward we will intensify our campaign towards the 3 million
milestone at the end of June, and our efforts will be in these three
districts.
With regard to intensifying the fight against tuberculosis, TB, on
24 March 2011 our hon Minister, Dr Motsoaledi, unveiled a GeneXpert
Infinity 48 machine at Prince Mshiyeni Memorial Hospital in uMlazi,
Durban. That machine has to date processed 12 331 specimens with
22% positivity, and 6,5% is multi drug-resistant TB, MDR-TB. What it
means, hon members, is that within a period of two and half months
we now have 12 000 South Africans who know that they do or do not
have TB and, amongst those, they now know that they have TB that is
normal or not normal. All this information is made available on the
same day as patients present their sputum. It means treatment can be
started immediately. We thank the Minister for this.
In April this year the Deputy President officially opened the MDR-TB
Unit at Catherine Booth Hospital in the uThungulu district near
Stanger. It is a highly specialised 40-bed unit. This brings to four
the number of MDR units in our province, as the King George V
Hospital designated certain beds as MDR beds when we started having
this problem. There is also the Church of Scotland Hospital in
Msinga, where the extensively drug-resistant TB, XDR-TB, started,
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and the other one is Manguzi Provincial Hospital next to the
Swaziland border.
On medical male circumcision, I had the great pleasure of attending
the Scientific Advisory Board meeting of the Centre for the Aids
Programme of Research in South Africa, Caprisa, last week, where
researchers were making presentations to the board. I was elated
when there was unanimity on the number of prevention methods that
have been implemented by government. Scientists singled out the
roll-out of medical male circumcision in our province as having
opened the way for the uptake of this prevention method throughout
the country. We were informed that 140 120 men and boys have been
circumcised throughout the country and 25% of those, which
translates to 35 000, were from KwaZulu-Natal. As we approach the
June holidays, we will be having camps throughout the province to
continue with the programme of circumcision.
On the Nursing Summit, we had presummit consulting in the province,
which took place on 28 February, and out of the 2 000 participants
in the Nursing Summit 217 came from KwaZulu-Natal. This
groundbreaking summit was also graced by the attendance of our
President, the hon J G Zuma, as well as that of the Minister of
Health. The summit ended with the adoption of a Nursing Compact,
which is a declaration of better nursing service delivery to all the
people of South Africa.
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On the progress of recruitment of nurses and the filling of posts,
hon members, allow me to agree with the Minister of Health when he
said that throughout the world nurses were the backbone of health
care service delivery, and without them we could not begin to talk
of any health care system. We would like to report to this House
that as part of our bulk recruitment strategy we appointed
759 nursing assistants and 626 staff nurses in all districts in
January and February this year. A total of 183 professional nurses
were also appointed during the same period. It is with great
pleasure that I also report that since April this year we have
actually instituted what we call maintenance teams in all districts,
and we have also asked hospitals to prioritise the filling of vacant
artisan posts, as well as related support personnel.
Community health care workers are the backbone of the mobilisation
committee, and we have appointed 2 567 community caregivers in the
department, including community caregiver supervisors.
We are also happy to note that this year marks 15 years since the
start of Cuba-South Africa co-operation with regard to the training
of medical students. To date, hon members, 58 students who come from
our province have graduated as doctors, and we recently sent 14 more
to Cuba for training. These are students from poor backgrounds, who
would not otherwise have been able to achieve their dream of being
medical officers.
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In ensuring that students from poor communities and backgrounds have
an opportunity to study towards a health-related qualification, we
have also granted 283 nursing student bursaries for two-year and
three-year course programmes.
We have, among other things, also made the following appointments.
Deputy Chairperson, 24 pharmacy assistants were appointed; 256 new
learners commenced their nursing training for the four-year course;
342 professional nurses who are doing community service started in
January this year; 26 students are registered at Pretoria University
and Wits University, training as clinical associates; a group of
51 occupational therapy technicians will be trained at the
University of KwaZulu-Natal; the department has 313 vacant funded
basic ambulance assistant posts, which should be filled in August
this year; and, furthermore, the department has ring-fenced funding
of R82 million for the further training of 583 people for basic life
support posts. In summary, hon members, for the period from January
to date, the department has appointed a total of 5 122 personnel in
various categories.
According to an update on corruption and misconduct, in the month of
May alone the KwaZulu-Natal department of health suspended
20 officials to allow our officials to finalise investigations and
for internal disciplinary processes to continue without hindrance.
We have never suspended any official for longer than three months
without starting disciplinary hearings. Currently, 47 officials have
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either resigned or been dismissed, or they are appearing in various
courts for acts of misconduct relating to corrupt activities in the
department. What is striking is that these officials are alleged to
have siphoned off millions of rands of public funds from the
department that could have been best utilised to train nurses and do
many other things.
On the programme announced by the Minister, which we have called
Make Me Look Like a Hospital, in KwaZulu-Natal, the Minister visited
our province in 2009. Thank you very much. [Time expired.]
[Applause.]
Ms F NGUBENTOMBI (Free State): Hon Deputy Chairperson, hon Minister
of Health, Dr Motsoaledi, hon Minister of Public Works, Gwen
Mahlangu-Nkabinde, hon Minister of Public Enterprises, hon Gigaba,
our hon Deputy Minister of Health, chairperson of the select
committee, hon members of the House, the director-general of the
department, my colleagues, ladies and gentlemen, it is my privilege
and honour to be afforded this opportunity to address the House on
the state of affairs pertaining to the delivery of services in the
Free State, and also to respond to the Minister’s call to reengineer health care services. We support the Minister’s Budget Vote
No 16. I must also join my colleagues in expressing our condolences
to the Mkhize family on the passing away of their son.
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Today’s debate takes place two days before the 35th commemoration of
the historic day, 16 June 1976. The ever courageous youth of the
oldest liberation movement in Africa are today still geared to
liberating the oppressed and the marginalised majority of our people
on the continent.
In line with the theme of the current Youth Month, which is Youth
Action for Economic Freedom in Our Lifetime, the department of
health in the Free State will launch a programme called Thakaneng.
Amongst other things, this will involve youth activities for the
current financial year. These will be as follows: the launch of the
sanitary towel campaign on 21 June 2011 and Thakaneng Health Youth
Indaba on 1 and 2 July 2011. These and other programmes will form
part of the Youth Month activities for this year.
Our situation in regard to being responsive to the health needs of
the communities of our province, our country and the world is
gradually improving. We are putting in place systems that will
ensure the provision of quality health care through the
implementation of the 10-point plan that was presented by the
Minister, and by negotiated service delivery agreements.
Our budget in the Free State stands at R6,8 billion. Of that,
R2,6 billion, or 38,2%, focuses on Programme 2, which addresses
district health services.
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As in the rest of the country, maternal and child mortality remains
a challenge to the Free State department of health. Pneumonia and
diarrhoea are amongst the five leading causes of death in infants
and children. The Free State department of health’s maternal
mortality rate for 2010 is 243 per 100 000 live births. These are
deaths that occur in the facilities, and which are reported to the
National Committee on Confidential Enquiries into Maternal Deaths.
They exclude maternal deaths occurring outside health facilities.
The Expanded Programme on Immunisation is among the strategies
implemented that have been proven to be effective in reducing infant
and child mortality. Two new vaccines, against rotavirus and
pneumococcal conjugate, were introduced in 2010. The Expanded
Programme on Immunisation is at 90% for the province. The Integrated
Management of Childhood Illnesses, IMCI, is another key strategy for
the reduction of infant and child mortality. Paediatric
antiretrovirals, ARVs, have been included in the IMCI to increase
capacity for the roll-out of ARVs.
To combat the scourge of HIV and Aids, the HIV Counselling and
Testing, HCT, Campaign was launched in April 2010. The programme is
ongoing in various government activities. The Free State target for
the campaign was pre-test counselling of 1 059 396 clients and
testing of 957 889. The HCT policy also included TB screening of all
the clients that were pre-test counselled and this means that the
target for pre-test counselling and TB screening is the same.
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To date, three of the five districts in the province have tested
more than 200 000 people each since the beginning of the campaign.
However, the Free State province has pre-test counselled 946 195
people and tested 800 702 in total, of which 400 000 were done
between January and May this year. This places the province at 83,6%
of reaching its target. The prevalence of HIV for the Free State
province is 17,5%, based on the HCT data. The province has
accumulated a total of 84 325 patients who have been on treatment
from the inception of the programme up to April 2011. During the
period January to April 2011, a total of 10 602 adults and 1 019
children were put on treatment.
To date the province has a total of 22 operating sites for medical
male circumcision. Four of the five districts have exceeded their
targets and an additional 232 clients were operated on.
The programme for drug-susceptible tuberculosis is offered in all
our public health facilities. The two mines at Goldfields and the
Mangaung Prison are private sector institutions managing the drugsusceptible TB. The multidrug-resistant tuberculosis, MDR-TB,
programme is offered in two public health facilities in the province
- at the Dr J S Moroka District Hospital in Thaba Nchu, and at a
facility in Welkom, where we opened the new MDR-TB unit during World
TB Day. I cannot mention the other facilities at this point.
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In re-engineering primary health care, PHC, services, the Free State
is part of the broader process of transformation of health services,
which was called for by the Minister. The service transformation
plan is centred around PHC re-engineering with all its ramifications
and ripple effects on other levels of care.
The province has thus far made progress in the following matters
pertaining to the re-engineering of PHC. It has identified and
created posts relevant to the re-engineering. We have funded posts
meant for family health-based teams. We have held a workshop to
conceptualise the process and market it internally to the members of
top management of the department and districts. We have established
task teams working on different aspects of re-engineering. We have
planned a workshop for all the stakeholders and partners for the end
of June 2011 – this June.
In conclusion, as we have already established the new HIV/Aids and
TB chief directorate in line with the re-engineering, we have also
strengthened the supply of drugs through the review of the medical
depot. I believe we as a province have reached reasonable stability,
in that we are at 92% drug availability. Of this, what is at 100% is
ARVs, and TB and chronic medication. This success can be attributed
to the review of our drug policy and the functioning of the medical
depot. We thank you for the opportunity to address the House. [Time
expired.] [Applause.]
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Ms M G BOROTO: Hon Deputy Chairperson, hon Minister Motsoaledi,
Deputy Minister Ramokgopa, hon MECs, hon members and special
delegates, allow me to acknowledge the leadership, far-sightedness
and innovation of the ANC and its leaders, even from long before
1994, because it is through this innovative and caring leadership,
guided by the Freedom Charter of 1956, the Reconstruction and
Development Programme, and ANC policy, as well as the assistance of
the World Health Organisation and the United Nations Children’s
Fund, Unicef, that the government has since 1994 developed and
implemented a comprehensive health policy and health plan to
consistently improve the health care delivery system in South Africa
by focusing on access, equity, quality and sustainability in the
health sector.
At the outset I really want to commend and thank the Ministry, as
well as the government, for having delivered on their promises in
regard to the policy and plan, despite the many obstacles and
challenges still facing the health care sector in South Africa. Last
year we were introduced to the 10-point plan. We have followed it
and realised that it is working.
I must say that today in this House we are blessed. What shows how
this Ministry is working is the fact that we have seven MECs for
health in the House, and you may check, for it is a fact.
[Applause.] That shows that what we want is here, that the three
spheres of government should come together in this House and state
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what they are doing in their different provinces. We really
acknowledge your presence here, MECs. It shows we are working in
this Ministry, and I also thank you, Minister.
This tells me the following. When the Deputy Minister said that it
was not yet uhuru, I said to myself that although it was not yet
uhuru, we should assess and evaluate the tremendous progress in the
health sector up to where we are today, and to understand where we
are heading. For that it is also necessary to know where we come
from.
As I talk on this, I also want to say to the people from the Western
Cape and the DA that they should please stop talking about cadre
deployment. Maybe at this time you don’t really believe that
Africans are capable. However, if you check the statistics and the
website you will know the qualifications of the people - they are
highly qualified. Our President emphasised that when we put people
into positions, we must look at the qualifications. How could we
deviate from that? Please! Make sure of that if you have problems.
If people belong to the ANC, are affiliated to it, and are educated
and qualified, should we not put them into positions just because
you are going to talk cadre deployment? That is unfair. Let us
remember what happened when the DA took over the Western Cape. What
happened to our ANC managers there? They as senior managers were
replaced with the newer liberals. Let me leave it there. [Applause.]
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Hon Deputy Minister, the ANC government has inherited a society with
massive disparities in access to health care, income and other
things. It was the apartheid government that developed a health care
system that was sustained through the years by the promulgation of
racist legislation, and the creation of institutions for the control
of the health care sector with the specific aim of maintaining
racial segregation and discrimination in health care.
Siyakwazi lokho, sibuya khona. [We know that; we are from there.]
The health result was a system that was highly fragmented, and
biased towards curative care and the private sector - ineffective
and inequitable. Health care services were furthermore geared to the
needs of the minority of the population and sharply divided between
the private sector for those who could afford to pay and to belong
to medical aid schemes, and the public sector for the poor.
But, we didn’t just sit there. We in the ANC tried to address those
inequities and we have addressed them. In doing so the government
had to design and redesign a comprehensive policy and programme to
redress social and economic injustices, to completely transform the
health care delivery system, and to review legislation and
institutions relating to health, with the main objective being to do
the following, and we did this because of what we inherited.
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We placed emphasis on health care, and not only on medical care.
There was also redressing the harmful effects of apartheid health
care services, and achieving health for all through equitable social
and economic development. We had to develop comprehensive health
care practices that were in line with international norms, ethics
and standards. That had never happened before the coming of the ANC
government. There was also recognising that the communities were the
most important components of our health system.
One of the hon members talked about community development workers,
CDWs. CDWs are not trained health workers; they have their line of
march. Please ask the Minister for the Public Service and
Administration for the handbook on CDWs. Whilst we expect them to
assist us in our different communities, we must bear in mind that
they are actually not health workers. However, they can assist us in
a way.
In terms of section 27 of the Constitution of South Africa every
person has a right to have access to health care services, and the
state is responsible for creating the framework within which health
is promoted and health care is delivered. It is also a major
provider of health services and a single comprehensive, equitable
integrated national health care system must therefore be created and
legislated for.
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Chairperson, I now turn to certain issues facing the health sector.
Firstly, health problems have many complex causes, whose solutions
demand an intersectoral approach. The health sector has an important
role in ensuring that policies, programmes and plans in other
sectors take account of health. Health in this case has been defined
by the World Health Organisation as:
... a state of complete physical, mental and social wellbeing and
not merely the absence of disease or infirmity.
Therefore, social welfare has, for instance, a major role to play in
improving health status, as there are a number of areas that overlap
between social welfare and health, such as violence, alcoholism,
care for the elderly and services for people with disabilities.
A further challenge is the provision of adequate and equitable
primary health care services in the rural areas. The need to make
them accessible is of prime importance, with particular attention
also to be given to improving and providing health facilities, human
and financial resources, and transport.
The elderly and other vulnerable groups were neglected by an
uncaring apartheid regime. Elderly Africans, particularly those
living in rural areas, suffered even more. Particular attention will
therefore have to be given to the development of outreach and home
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care services. I must acknowledge, though, that the mobile clinic
service that we have in our different provinces is assisting.
Maybe I must also talk about transport and the carrying of people
across the provinces. There we still have a problem, where you find
that a person comes from KwaNdebele which is between Pretoria and
Limpopo, but when you take the person to certain hospitals, they are
turned away. For instance, if you go to Dennilton, you will be told
to go to Polokwane Hospital, which is about 200 km away. We would
like to have control so that our people get access to facilities
near them, irrespective of which province they are in. My place is
30 km away from Limpopo and 70 km away from Pretoria, but I cannot
access those services. I think we have to look into that and make
sure that it works.
On HIV/Aids, hon Chairperson, ga ke sa nyaka go bolela tše ntši [I
don’t want to say much any more].
What is significant about this is to note that South Africa has the
largest ARV therapy programme in the world, which has contributed to
stabilising HIV prevalence. The Medical Research Council recently
announced that the government’s programme to prevent HIV in babies
has achieved a 96,5% success rate in wiping out transmission from
pregnant mothers to children.
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Okusele nje ukuthi, uma lingekho ijazi lomkhwenyana, umuntu akatholi
lutho. [It boils down to no condom, no sex.]
I think we have done enough.
In conclusion, hon Chair, the National Health Insurance is based on
the principle of the right to health. Let us understand it in that
way. There is nothing new in the visions that the hon Botha was
talking about. I don’t have time; otherwise I would talk about them.
[Interjections.]
Lastly, I call upon all political parties and the role-players to
join hands to support the Minister and government in their continued
effort to transform the health sector and to improve health care
delivery. I thank you. [Applause.]
Mr D V BLOEM: Chairperson, on a point of order: I want to hear,
because I didn’t hear this thing. No thola, no ...? [Laughter.]
The DEPUTY CHAIRPERSON OF THE NCOP (Ms T C Memela): Hon Bloem, if
you want any clarity on that, meet Ms Boroto outside the Chamber.
The MINISTER OF HEALTH: Deputy Chairperson, let me acknowledge the
presence of my colleagues in the House, the Minister of Women,
Children and People with Disabilities, Mme Xingwana, the Minister of
Public Works, Mme Mahlangu-Nkabinde, and the Minister of Public
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Enterprises, Rre Gigaba. Welcome colleagues, and thank you very
much.
The newly found phenomenon or slogan of “No condom, no thola [sex]”
is not the policy of the Department of Health, but we welcome it
today. [Laughter.] We, together with the MECs, will embrace it with
both arms. Even though it has not been our policy, we will start
propagating it very strongly, because we got it from this House.
Chairperson, thank you for this very powerful debate, which I think
was very constructive. We agreed on lots of things, but I just want
to highlight a few things, especially the issue of human resources,
which was touched on by the hon Plaatjie and others. Unfortunately,
he is absent, because he has left, but there are some things which
have not been understood.
There is a general belief, especially among the elected members in
this country, that the shortage of health care workers and doctors
is a South African phenomenon. It is a global phenomenon; it is not
just South African. In fact, there is a shortage of a total of four
million health workers worldwide. If we want to have enough doctors,
nurses and pharmacists, etc, the whole world must produce four
million people. That is a big problem. Unfortunately, 80% of this
shortage is in sub-Saharan Africa.
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I am saying this because time and again we are told the following.
The Nursing Council is very strict and it does not want people to
come and work in this country. The Ministry is not making it
possible for people to come and work here. The Health Professions
Council must issue permits for people to come and work here. It is
good to say this type of thing.
Because this phenomenon is global and not just South African, the
World Health Organisation discusses it in the World Health Assembly
every year. They have even passed certain regulations about what
actually needs to be done. There is no Minister anywhere in the
world who wants to lose health workers to another country; it
doesn’t happen. So, there are rules, and one of the resolutions
passed is that we must try very hard not to recruit health workers
from a developing country because that country will collapse.
Chairperson, I could open up the situation tomorrow for all the
doctors and nurses from the African continent who want to work in
South Africa. If I could do that, they would come in their thousands
and I assure you of that because we have got thousands of
applications. But the moment you did that, the patients would have
to follow them. They couldn’t stay in their countries on the other
side of the Limpopo River when all the doctors had come to South
Africa. So, you must understand this phenomenon, and we are trying
to respect this. We are trying to respect those who are already in
the country, but we can’t actively recruit people.
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To show that this is a global phenomenon, when we debated this issue
at the World Health Assembly, representatives from Canada said that
if it had not been for South Africa, they would have been in
trouble. That is because all their doctors were going to the United
States. It means that the richer the country is, the more doctors it
gets. Doctors from Canada were migrating to the United States, while
Canada was making use of South Africa to fill up that space. Now you
want us to make use of the whole African continent to fill our space
- but they are still developing countries. Instead, we must have our
own home-grown staff.
Firstly, we started by calling for the Nursing Summit in order to
discuss the issue of the training of nurses in order to increase
their numbers. Secondly, with regard to doctors, we started with
mid-level workers. In that regard, I want to thank the Walter Sisulu
University for being the first university in the country which has
produced mid-level workers – there are 22 of them - and we are
encouraging other universities to follow. These are workers who are
trained for four years and will work somewhere between nurses and
doctors to help in situations where there is a lack of doctors. We
want other universities to start doing that.
In addition, we spoke to universities on this matter only two weeks
ago. We started with Wits at the beginning of this year. We asked
them to take 40 more medical students than they usually do. We gave
them money to do that, R8 million. They took 40 more students than
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they usually do, and that R8 million is to help them to expand that
programme. I have spoken to the deans of all the medical schools,
and they said that we should give them eight weeks to report back to
us, because we want all of them to implement this next year, so that
we can have our own home-grown personnel. It doesn’t help to believe
that we can just allow other countries to train personnel and we
will take them from them.
Lastly, one of the reasons why we are working with the Minister of
Higher Education and Training is to effect the demerger of Limpopo
University and Medunsa, because we want Medunsa to be a standalone
university and train more and more doctors, and Limpopo to get a new
medical school. This is so that we expand institutions rather than
merge them and decrease, because we want to grow our own doctors.
With regard to medical male circumcision, many MECs have mentioned
the hospitals where this is happening. At Chris Hani Baragwanath
Hospital in Gauteng they do 50 circumcisions a day, more than in any
other part of the country and they originally invited me to launch
that. I would just like to call on the MECs, colleagues, to let
every hospital do at least a few circumcisions per day. Every
hospital can do that. There is no hospital in the country which can
fail to do that. I mean it is one of the biggest weapons in the
fight against HIV and Aids.
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In fact, in KwaZulu-Natal the MEC challenged general practitioners
in this regard, and because I was addressing some of them last week,
I also gave them a challenge: If every general practitioner, every
person in private practice, every doctor, as a contribution to
society, could do just one free circumcision a day, we would be
getting somewhere. So, I am asking the MECs to challenge private
practitioners in their own ... [Inaudible.] ... to do just one
circumcision a day as a contribution to society. It would go a long
way in helping us.
With regard to the Office of Standards Compliance, which you will
very soon debate in this House, we have chosen six standards which
every hospital must comply with: cleanliness, attitudes of staff,
safety and security of patients, infection control, the long queues
and drug stock-outs. These are the standards we want to enforce.
[Applause.] The Bill to establish the Office of Standards Compliance
will very soon come to this House. The Treasury has already given us
R116 million in this current financial year to establish the office
that will make sure that these standards are actually complied with.
Thank you, Deputy Chairperson. [Applause.]
Debate concluded.
APPROPRIATION BILL
(Policy debate)
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Vote No 7 – Public Works:
The MINISTER OF PUBLIC WORKS: Hon Chairperson, hon members of
Cabinet, hon Deputy Minister of Public Works, hon members of the
provincial executive councils, hon members of the legislatures, hon
chairperson and members of the Select Committee on Public Works,
members of the South African Local Government Association, Salga,
acting director-general and senior officials of the department,
heads of departments, municipal managers, heads of state-owned
entities, members of the business community, distinguished guests,
comrades and friends, I greet you.
This month marks the 35th anniversary of the Soweto uprising, when
the youth of our country took a stand against the repressive
machinery of the apartheid government which saw a generation of
African people subjected to a system that denied them the privileged
right to inclusive education that would equip Africans for inclusion
in a growing South African economy. The year 1976 was the watershed
year for what was to become a long and hard “walk to freedom”, as
Nelson Mandela might have put it. Like any milestone, it did not
mean the end of the road; it rather signified the end of one stretch
and the beginning of another.
Thirty-five years later we are facing a different struggle, to
ensure that our young people are adequately equipped in mathematics,
science and technology as fundamental pillars of an inclusive
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education. It will prepare them to contribute positively to our
economy through participation in the built environment.
For this reason, allow me to dedicate my maiden Budget Vote speech
to the NCOP to all the youth of South Africa.
Three days after the nation laid to rest our mother and struggle
icon, Mama Albertina Sisulu, I also dedicate this Budget Vote speech
to the memory of Ma Sisulu, who emerged as a mother to many young
people during the painful liberation struggle. Her firm and quiet
leadership produced some outstanding and committed cadres, and
leaders of the liberation movement. They now serve the nation in
important portfolios and capacities. Ma Sisulu always emphasised
that freedom would come in her lifetime. Indeed freedom came in her
lifetime, and she served the democracy she fought for.
Last week, as black and white people gathered at the stadium in
Orlando to bid farewell to Mama Sisulu, I could not help but think
of her words about multiracial gatherings at a meeting of the UDF,
where she stated:
I am very happy to be one of those in the UDF because in all these
years I’ve been banned, it has been my wish that one day I would
get to such a gathering, a multiracial gathering, a gathering that
gives me hope that this South Africa, one day, will be a just
South Africa for everybody.
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Today, we say once again with gratitude in our hearts for the future
you built for us, rest in peace! Lala kahle, qhawekazi! [Rest in
peace, heroine!]
When the Freedom Charter was adopted in 1955 it spoke clearly of the
right of our people to work and security, regardless of race, sex or
creed. Fifty-six years later, in 2011, in his state of the nation
address His Excellency President Jacob Zuma reminded the nation, and
I quote:
However, we are concerned that unemployment and poverty persist
despite the economic growth experienced in the past 10 years. To
address these concerns, we have declared 2011 a year of job
creation, ... While looking to the private sector in particular to
help us create most of the jobs, government will certainly play
its part.
And Public Works should actually lead this.
The Budget Vote of the national Department of Public Works in the
fiscal year 2011-12 is about employment creation through inclusivity
at the national, provincial and local levels of government.
It is therefore with this compelling undertaking in mind, to create
decent employment opportunities, particularly among the youth, that
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I present this budget to you here today. For us, infrastructure
development and job creation lie at the centre of the mandate and
the strategic plan of the National Department of Public Works.
In response to the national priorities of government and the policy
directives of the New Growth Path and Industrial Policy Action
Plan 2, Ipap 2, the Department of Public Works took a strategic
decision to translate its mandate into labour-intensive programmes.
These would include substantial public investment in infrastructure
to create employment directly in construction, operation and
maintenance.
Our budget reflects the policy focus of government through the
detailing of financing and expenditure programmes, and it mirrors
the choices between accelerated service delivery, the promotion of
economic growth, job creation, infrastructural development and the
state’s asset management.
In the fiscal year 2011-12, the department has an allocation of
R7,8 billion. Of this allocation almost R1,4 billion has been
allocated for the improvement of state buildings and infrastructure,
with up to 60% of it allocated to current commitments, while the
remaining 40% is allocated to prioritised new projects, which are at
the core of service delivery, and are earmarked to be executed
mainly by the youth. We encourage hon members to join us as we walk
this path with the youth of our country.
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Historically, the Department of Public Works has been procuring
public immoveable assets to promote growth and development, and
create a better life for the people. Consequently government has
accumulated a huge portfolio of immovable assets and these
properties are vital in the reconstruction and development efforts
of government, necessitating the state to find a legal mechanism to
ensure their optimum, cost-effective use.
The strategic planning and the implementation of the Department of
Public Works’ plans are framed within the vital context of the
statutory framework provided for in the Government Immovable Asset
Management Act, Giama, of 2007. The objective of Giama is to ensure
efficient and effective management of immovable assets within
government, as well as to improve service delivery. Giama places a
substantive obligation on the national and provincial spheres of
government to lead the cost-effective management of the state’s
immoveable assets. The implementation of Giama is a challenge we
need to rise up to collectively as national, provincial and local
government.
It is no coincidence, therefore, that one of our strategic
priorities is to provide strategic leadership in effective and
efficient immovable asset management, while continuing to invest in
infrastructure development through the delivery of essential public
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facilities and other amenities calculated to improve the quality of
life of all South Africans, today and in the future.
As the custodian of state immovable assets, the department has
committed itself to using the state immovable asset footprint
towards realising government’s key national priorities and the
prescripts of the New Growth Path and Ipap 2.
Giama makes it imperative that we facilitate the provision of
accommodation and monitor the performance of the state’s immovable
assets, maximising their value through ongoing monitoring of
portfolio performance.
The department also remains committed to providing life-cycle
immovable asset management planning, based on credible portfolio and
property analyses. In this regard, allow me to add emphasis to an
increasing need to build sufficient capacity for the continuous
management and enhancement of the immovable asset register.
To this end, we will soon launch the amnesty campaign, aptly named
Operation Bring Back, in order to encourage South Africans to
reclaim lost and/or missing immovable assets. A number of job
opportunities have been identified for the youth, to identify such
recovered assets, verify them, and have them properly recorded in
the asset registers of the national and provincial departments.
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At the meeting of the Minister and the provincial MECs in April 2011
we unanimously agreed to work together to retrieve these assets.
These properties, we believe, were insincerely wrested from the
state in the turbulent transitional period following the demise of
apartheid, and were being unlawfully occupied, especially in the
former Transkei, Bophuthatswana, Venda and Ciskei, TBVC, Bantustans.
We would like to extend an invitation to hon members to co-operate
with and assist us. Upon recovery, these properties will either
enhance our disposal programme or contribute positively to our inner
city regeneration programme in revitalising the economy and making
the value of state-owned properties appreciate.
Most state-owned properties have over the years degenerated, forcing
government to rely increasingly on private leases for its
accommodation, at an exorbitant cost. A conscious strategy has been
adopted to reinvigorate our investment in continuous repair and
maintenance, as well as construction of new government buildings in
order to generate major savings for the state, a process we will be
embarking on in the three years.
Economic opportunities inherent in such a strategy will be directed
at empowering youth and women’s enterprises among others,
particularly targeting incubation programmes already being driven by
the department in the construction sector. In the final analysis,
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our aim is to relocate national departments to state-owned buildings
where it is feasible to do so.
We also acknowledge that our lease portfolio remains a challenge in
all tiers of government. The department will continue, as a matter
of policy, to find ways to structure its current leases in such a
way that the socioeconomic goals of government are realised,
including black, women’s and youth economic empowerment.
With regard to our own stock, we shall invoke the National
Infrastructure Maintenance Strategy, Nims, and the National
Contractor Development Programme, NCDP, to target investment in this
sector, much to the benefit of our small and emerging contractors.
Many more youth initiatives can be encouraged to benefit from
opportunities such as facilities management. We shall intensify our
engagement with the National Youth Development Agency, NYDA, to
develop tangible programmes to benefit our youth.
Linked to leasing management is the rehabilitation of underutilised
and unutilised public buildings for alternative usage or
utilisation. With many of our tertiary students around the country
being exposed to accommodation that is not conducive, and at high
cost, the department in collaboration with the Department of Higher
Education and Training decided to convert unutilised and
underutilised buildings to provide affordable student accommodation
where it is possible.
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In Gauteng, the upgrading and refurbishment of the H G de Witt
Building in Tshwane Central will yield accommodation for
approximately 180 students. The upgrading and refurbishment of the
Pelonomi Hospital in Bloemfontein, in the Free State, will yield
accommodation for approximately 700 students.
Through this intervention the department is looking to alleviate the
problem of a lack of decent student accommodation, whilst creating
job opportunities. This is part of our strategy to break the vicious
circle of intergenerational poverty, which many of our youths are
forced to inherit.
We shall continue to identify similar properties for various other
social uses in the different provinces in support of government’s
commitment to having humane human settlements for all. Properties
will be identified to assist needy communities, particularly
orphans, disabled people, child-headed households, and frail care
centres, as part of the 67 minutes of doing community work in honour
of our struggle icon, former President Nelson Mandela.
We are currently drafting a disposal policy that embraces the social
needs of a developmental state. This also requires the review of the
State Land Disposal Act of 1961, and its alignment to the current
constitutional imperatives.
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In addition to this, there is the plan driven by the InterMinisterial Cabinet Committee chaired by the Department of Rural
Development and Land Reform. The vesting of state immovable assets
in the correct sphere of government is critical, not only for proper
identification, ownership and geographical location of the assets,
but for responding to the social objectives of the country.
Proper vesting of state property will ensure that these assets are
used optimally for service delivery, and can be accounted for, in
accordance with the prescripts of the Public Finance Management Act,
PMFA, Act 1 of 1999, and the Government Immovable Asset Management
Act, Giama, Act 19 of 2007. And again, the provinces must be
commended for their role in helping to expedite the vesting process.
We have admitted that our maintenance record leaves much room for
improvement. We are also aware that as we make progress with our
maintenance record, we continue to experience challenges brought
about by the ageing stock we own, most of which is of heritage
value, and this compounds the costs associated with maintenance.
This has forced us to reconsider other options, which will be rolled
out in this fiscal year.
Energy efficiency in state buildings is central to the building
programme for this fiscal year. As a strategic programme it will
respond to the energy shortage facing the country. It is already
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being implemented through shared contracts and an Energy Code of
Conduct for users of public buildings.
We are mindful of the fact that we will always be judged by the
standards according to which we treat our valued clients. In-depth
consideration of the accommodation needs of our clients remains a
top priority for the department. Key account management in this
financial year will have an effect through well-managed immovable
assets in line with property portfolio strategies and effective
client/user management plans that address user requirements and
prioritised planned maintenance. Our regional offices in all nine
provinces will be instrumental in our achieving this objective.
Our clients’ needs have encouraged the department to proactively
engage with our clients, as successfully demonstrated by our recent
visits and continuing work at the military bases of the Department
of Defence and Military Veterans. In Lephalale, Limpopo province, we
are in the process of refurbishing houses for the South African
Military Health Service, SAMHS, and a health facility at De Brug.
The department is also paying attention to the deteriorating state
of the infrastructure in the harbours, beginning in Cape Town.
Facilities relating to the Department of Justice were recently
completed and handed over at places like Galeshewe, Kimberley,
Colesburg, Pietermaritzburg and Butterworth, amongst others. The
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Department of Public Works needs to ensure that client departments
function in proper and decent facilities in discharging their
constitutional mandate.
The accommodation needs of the South African Police Service, SAPS,
in the year under review will be extensive, given the need to fasttrack the goal of a safe and secure South African society. The
communities of Botokwa, Jane Furse, Chatsworth and Tsakane became
witnesses of their own development when these facilities were
officially handed over and opened, joining a long list of similar
facilities either built or renovated by the Department of Public
Works. Many community liaison officers employed at these project
sites were drawn from the ranks of the youth to mobilise the
communities and make certain that the community were part of their
own development.
Together with the provinces, the municipalities and our public
entities, we have grown and we now look beyond the narrow confines
of our mandates in our desire to expedite services to our people.
Supported by our public entities, we have sought to streamline new
technologies aimed at delivering basic but essential social
infrastructure and other services. We are overseeing the
implementation of an intensive programme for the construction of
safe schools.
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The school building programme in the Eastern Cape has seen the rapid
delivery of no fewer than 10 schools in the last six months. This is
in an effort to eradicate the lingering problem of mud schools and
others built from inappropriate materials.
The Willowvale Senior Secondary School stands as a beacon of hope
for similar structures in the country, after we transformed the
institution from a mud structure to a state-of-the-art 18-classroom
school, fully furnished, with 26 toilets, a resource centre, an
administration office, sporting facilities, and a kitchen to feed
pupils.
Still in the Eastern Cape, construction work is coming to an end at
two other schools, namely Hlwahlwazi and Mgwili in the Lusikisiki
area. Again working together with the traditional leaders, we shall
be handing these over very soon.
Construction work has also started on the two schools at Taung in
the North West province. The demand from other provinces is also
rising, and the Department of Public Works pledges to meet the
demand in order for our children to attain their birthright of
proper access to education.
UMakhulu [Grandmother] Nosizwe Mxhaka, a 72-year-old, broke down and
cried when a bridge was unveiled in her village. She lost her nineyear-old grandchild earlier this year, who drowned whilst crossing
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the river on her way to school. Makhulu said gratefully, and I
quote:
We are blessed with a bridge today. I wish my grandchild was still
alive to cross the bridge. I thank Nelson Mandela for shaping this
government to work for its people.
In partnership with provincial governments and municipalities, the
Department of Public Works has also launched a pothole
rehabilitation programme in response to the loud cries of our public
road users about the poor state of our roads. The programme is aimed
at reducing unemployment, particularly among the youth and women.
The department has committed itself to creating 400 job
opportunities for each metropolitan district through this pothole
rehabilitation programme.
Whereas the intention was to primarily target metropolitan
municipalities and then extend it to district and rural
municipalities, provinces such as North West have embraced the
initiative, and cannot wait to commence with the rehabilitation
work. According to the MEC in the province, the injection of an
additional 400 Orange Brigade members – Expanded Public Works
Programme, EPWP, workers - will bring his tally to 1 000 for
Mafikeng alone, and this will help paint the town orange, enhancing
the public visibility of the EPWP. Let me acknowledge the warm
reception and co-operation of the government of North West.
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Our engagement will go further and assist in other township
rejuvenation plans. More employment opportunities for the youth can
be expected when work begins, which includes the fixing of street
lights to fight crime, as well as cleaning cemeteries, building
internal streets using paving, and the cleaning and greening of open
spaces for the benefit of our communities. All these will be
undertaken through labour-intensive methods in order to maximise job
creation. We can announce that this project has long commenced in
Tshwane in Gauteng.
During my recent briefing with the Premier of the Free State, Mr Ace
Magashule, he invited us - and we accepted the invitation - to
partner in town development programmes in his province. His
Operation Hlasela, which aims to attack poverty, is in full swing
and my department will work closely with the province to achieve the
desired results. We are working with all the premiers in various
projects of the department.
Underpinning our building programme is the provision of access to
public buildings to disabled people, in order to promote the letter
and spirit of the Constitution. The programme is receiving priority
attention from the department. We launched our disability policy in
December 2010. It goes beyond national employment targets for the
disabled. Instead, central to the policy is the preparedness of the
department to involve disabled people in the core business of the
department, for real economic empowerment.
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Our contribution to Africa’s reconstruction remains on course. In
this regard, in the current financial year we will begin with the
construction of the Matola Museum and the Interpretation Centre in
Mozambique. Furthermore, acting in collaboration with the Department
of International Relations and Co-operation, we will be proceeding
with the construction of the South African Embassy offices in
Kigali, Rwanda.
Ahead of the country’s hosting of the 2010 Fifa World Cup Soccer
Tournament, the department successfully implemented massive
infrastructure development projects at key border posts, including
Lebombo, Golela and Vioolsdrift.
The HOUSE CHAIRPERSON (Mrs N W Magadla): Minister, you must please
conclude your speech.
The MINISTER OF PUBLIC WORKS: Deputy Chairperson, I conclude. The
New Growth Path expects public investment to create 250 000 jobs a
year in energy, transport, water and communications. I would also
like to mention that Phase 2 of the Expanded Public Works Programme
has just completed its second year.
Chairperson, I am not sure whether you have been made aware of the
fact that the Deputy Minister is not participating, and I therefore
prepared two speeches for this debate. But I do not want to take
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much of your time - I can touch on some of the things that remain
when I respond. Thank you. [Applause.]
Mr M P SIBANDE: Hon Chairperson, hon Ministers, hon members,
comrades and distinguished guests, ...
... sonke singofakazi bokuthi ngesikhathi sokhetho olusanda kudlula
sambona umholi we-ANC, uGedleyihlekisa Zuma, enza adume ngazo,
ngokucula futhi edansela ingoma yakhe esiyithandayo sonke, Umshini
wami.
Ngakolunye uhlangothi izingane zazeMzansi zona zindansela umdanso
wazo othi, Sika likhekhe. Sase simbona-ke umholi we-DA, u-Helen
Zille, naye engazibekile phansi ngomdanso wakhe welingisa. Singazike phela belu kunomdanso umculi, uVusi Ximba, awubiza ngokuthi yikicheren shoes, mhlawumbe uMama uZille ubeqonde wona lo mdanso
kaVusi Ximba.
Phela unkabi, u-Zille, uyakuthanda ukutuswa nokunconywa ngamandla
abanye abantu kuhle okwesibhuklabhukla sikalamthuthu sona sabona
inkukhu yasemakhaya ifukamela amaqada naso sasesifukamela awaso
amaqanda. Kodwa imiphumela yamaqanda afukanyelwe ulamthuthu abola
wonke kwathi amaqanda afukanyelwe isikhukhukazi sasemakhaya aphuma
amachwane. (Translation of isiZulu paragraphs follows.)
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[... we have all witnessed the leader of the ANC during the recent
election – we saw Gedleyihlekisa Zuma doing what he is popularly
known for –
singing and dancing to his favourite song that we all
like, Umshini Wami.
And on the other hand, South African youth were performing their
dance known as Sika likhekhe. We have also seen the DA leader Helen
Zille, not wanting to be outdone, with her imitating dance. We may
never know, as there was a dance known to the singer Vusi Ximba that
he called Kicheren Shoes - maybe Ms Zille’s aim was to perform this
dance.
By the way, Zille likes to be praised and commended at the expense
of other people’s hard labour, just like a fat battery chicken hen
did when it saw a free range hen hatching its eggs – it hatched its
eggs too. But the outcome was that the eggs that were hatched by the
battery chicken hen all got rotten, and the eggs that were hatched
by the free range hen produced chickens.]
Africa and South Africa’s late superstar, Brenda Fassie, would turn
in her grave if she knew that the DA, under Zille, was abusing her
song, Vulindlela, as a party-political song for their political
rallies in order to fire up their supporters, who jump all over the
stage flashing clenched fists, a salute similar to that of the ANC,
the SA Communist Party, SACP, the Congress of South African Trade
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Unions, Cosatu, the South African National Civic Organisation,
Sanco, and many more in Africa.
Surely, MaBrr’s son, Bongani, and the ANC Youth League could remind
the South African public that Brenda Fassie never benefited from the
colonial apartheid structures and that she was 100% ANC. Fassie
explained for all to know that she was not allowed to perform in
exclusively white areas.
The HOUSE CHAIRPERSON (Mrs N W Magadla): I recognise the hon member
Mr Feldman.
Mr D B FELDMAN: Hon Deputy Chairperson, I would like to ask the hon
member, Mr Sibande, whether he is in the right place, because we are
debating Public Works here. [Laughter.]
Mr M P SIBANDE: Maybe you are sleeping.
The HOUSE CHAIRPERSON (Mrs N W Magadla): Are you asking a question
or what? Hon member, are you prepared to answer a question?
Mr M P SIBANDE: Thanks, Madam. He must learn to listen and he will
get the answer. [Interjections.] Chairperson, the ANC ...
The HOUSE CHAIRPERSON (Mrs N W Magadla): No, no, hon member Bloem!
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Mr M P SIBANDE: Chairperson, the ANC national executive committee,
NEC, in its January 8 Statement 2011, states ...
The HOUSE CHAIRPERSON (Mrs N W Magadla): Hon Sibande, order, please.
[Laughter.]
Mr W F FABER: Madam Chair, on a point of order: Unless the
interpreter is not using the right words, the speaker is definitely
not on the subject of the debate and I would appreciate it if the
member would stay on the debate. Thank you.
The HOUSE CHAIRPERSON (Mrs N W Magadla): You are out of order. The
hon member Mr Sibande may continue.
Mr M P SIBANDE: You do not need to teach me how to speak! I know how
to speak. Chairperson, the ANC NEC January 8 Statement 2011 states
that 2011 will be the year of job creation and decent work through
meaningful economic transformation.
The Budget Vote reflects this emphasis, in that key components of
the voting of funds are geared towards: promoting economic growth
and strengthening the fight to eradicate poverty; creating an
efficient, competitive and responsive infrastructure network through
the Expanded Public Works Programme, EPWP; skills; and sustainable
human settlements and improved quality of houses.
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Public Works is critical to the developmental principle that
infrastructural development is a primary driver of economic growth
and social development.
We endorse efforts to strengthen the department’s capacity to
evaluate all current programmes with the idea of enhancing
procedures and overcoming institutional and operational difficulties
with regard to the co-ordination of government and state-owned
enterprises. There is a need to develop the human resource capacity
and systems to ensure that the effective management of the delivery
and maintenance of infrastructure is achieved. This Budget Vote must
ensure the expansion of Public Works capacity in infrastructure
development. The monitoring and evaluation capacity needs to be
strengthened.
This Budget Vote must ensure that human resources are developed in
all aspects of the infrastructure development programme, including
targeted skills development; small, medium and micro enterprise,
SMME, development; and learnerships targeting young graduates and
the unemployed. Our state must have the capacity to transform the
economy and society as a whole. It should ensure investment and
growth of the economy for the purpose of job creation in order to
improve the lives of the people.
The Government Immovable Asset Management Act has to ensure
efficient and effective planning of immovable asset management
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within government, as well as improve service delivery. Given that
the department is responsible for the provision of official
accommodation to all national departments and all Members of
Parliament, and the provision of construction and property
management services to client departments at the national level,
this Budget Vote must ensure that the EPWP will expedite investment
in infrastructure to promote social cohesion, local economic
development and job creation.
Some of the challenges require immovable asset register enhancement
to align it with generally recognised accounting practice. In this
regard, the Government Immovable Asset Management Act needs to be
vigorously implemented.
We welcome the fact that the Government Immovable Asset Management
Act makes it necessary for the department to facilitate the
provision of accommodation, monitors the performance of the state’s
immovable assets, and maximises their value through ongoing
monitoring of portfolio performance. We also commend the department
for its commitment to providing life-cycle immovable asset
management planning based on credible portfolio and property
analysis.
We recognise the increasing need to build sufficient capacity for
the continuous management and enhancement of the immovable asset
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register. We also note that through this Budget Vote the department
plans to launch an amnesty campaign called Operation Bring Back.
Njengoba uNgqongqoshe uke wachaza besifisa ukukucacisa lokhu ngoba
abanye abantu banezindlebe kodwa abezwa, banamehlo kodwa ababoni ...
[As you have explained, hon Minister, we would like to clarify this
because other people have ears but they do not hear, they have eyes
but they do not see ...]
... in order to encourage South Africans to reclaim lost or missing
immovable assets, especially those lost during the years of
transition.
The importance of state-owned real estate as a major revenue
generator for our country is critical. This property can contribute
positively to our inner city regeneration programme by revitalising
the economy and making the value of state-owned properties
appreciate.
The EPWP has mobilised stakeholders and partners to increase their
efforts in the implementation of infrastructural projects at local,
provincial and national level. In this regard, Kamoso Awards
recognise excellence in the implementation of projects from all four
EPWP sectors.
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Similarly, we appreciate the work of the Department of Public Works
in supporting nonstate sector programmes in the Bushbuckridge
community, which contribute immensely to poverty alleviation. Many
of these good initiatives should be spread throughout our
communities.
We acknowledge the department’s commitment to investing in the
repair, continuous maintenance and construction of new government
buildings in the next three years. The commitment could generate
major savings for the state.
President Zuma urged all the departments to ensure that they filled
vacant posts in line with the commitment to render services to our
people. It is through skilled human resources that we can ensure
implementation, evaluation and monitoring of the Expanded Public
Works Programme and its principles at that level of governance.
It is noticeable that in this financial year an amount of
R1,8 billion has been allocated for the property rates grants. The
amount has decreased by 3% from the 2010-11 allocation. Indeed
performance in this grant has improved notably in the past financial
year, 2010-11, showing improved spending of 92% by provinces, while
during the 2009-10 financial year it was 79%. Monitoring of grant
transfers to provinces is critical for the better life of all our
people.
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Siyazi abanye abantu bathanda ukukhuluma ngenkohlakalo kodwa abanabo
ubufakazi. [We know that some people like to talk about corruption
but they do not have evidence.]
In this regard, we note that the EPWP has been allocated
R679 million for incentive grants to municipalities, and
R267 million for provinces. The bulk of the budget for grants
includes the social sector, nonstate sector and intermediaries. It
increased from R1,2 million in 2010-11 to R1,3 million in 2011-12,
representing a nominal improvement of 5,6%.
I-ANC iyaseseka lesi Sabiwomali. I-ANC ithanda ukuhalalisela i-ANC
Youth League ngenkomfa yabo, ukuthi ihambe kahle, yangabi nezihibe
ngoba kukhona abanye abangayifisi inqubekela phambili ngoba
izinhlangano zabo zetsha zingenazo izinkomfa [youth league
conferences], bayabakhetha, bafake izicelo. Ngiyabonga. (Translation
of isiZulu paragraph follows.)
[The ANC supports this Budget Vote. The ANC would like to
congratulate the ANC Youth League on its conference which went well
without any hiccups, because there are others who do not wish it
well since their youth leagues do not have conferences; but they are
nominated and then they put in applications. Thank you.]
Mr H B GROENEWALD: Chairperson, hon Minister, hon members of the
NCOP, members of the public and guests, the Department of Public
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Works is the department in government structures meant to fulfil the
wishes of the President when he declared in his state of the nation
address that government would create millions of jobs in all the
state departments to better the lives of the people in South Africa.
The Expanded Public Works Programme, EPWP, must reach more people,
even if the economy grows faster. Half of the programme still aims
to intensify labour absorption in public infrastructure projects,
but the EPWP was also revamped to encourage municipalities, ward
committees and nonprofit organisations to generate opportunities.
The budget is a little hard to follow, but funds allocated
specifically to EPWP job creation rose from about R1,4 billion in
2010-11 to R2,5 billion in 2012-13. However, considerably more
funding will be needed – up to five times more.
The mandate of the Department of Public Works is provided for in the
Government Immovable Asset Management Act, Giama of 2007. If we look
at the Medium-Term Strategic Framework, MTSF, it has as its vision
speeding up growth, decent work and sustainable livelihoods; a
massive programme to build social and economic infrastructure; the
fight against crime and corruption; sustainable resource management;
and building the developmental state and strengthening democratic
institutions.
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These are nice words, and beautiful sentences and sounds on the
ears, but how many of these outcomes have really happened since
1994? Very few, because there is no discipline and no control, and a
lack of strong leadership and motivation in the department to attain
success in its goals.
Why did the Minister of Finance, hon Pravin Gordhan, withdraw eight
of the nine provinces’ money – R2,4 billion – for the development of
infrastructure in the last financial year? The reason is
underspending. Only the Western Cape spent its budget of
R794,8 million.
The problems and handicaps around underspending in the provinces are
caused by bad contract management, insufficient financial systems
and badly obtained policies. Because of incompetence, the management
of the department is really failing the people of South Africa in
regard to its discharging its responsibilities. Incompetence leads
to poor management.
Minister Pravin Gordhan finally cracked the whip on the departments
and he wants government to ensure that the supply chain processes
are as watertight as they can be. The DA also supports the
announcement of strict new regulations designed to crack down on
tender fraud and overpricing. Treasury will also monitor all tenders
above R500 000 at all levels of government.
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In the previous financial year, the department, as a custodian of
all government properties, failed to manage 780 state-owned houses
in Gauteng which were occupied by friends and relatives of
government officials. This is according to the department’s
infrastructure and development report. The report goes further to
say that some of the occupants had paid bribes to senior officials
to gain access to the houses.
The provincial government of Gauteng owns 826 houses across six
regions, but according to the report only 46 tenants had signed
lease agreements.
In Mafikeng, North West province, it is estimated that about a third
of public servants occupy state houses and apartments illegally,
while many other properties are understood to have fallen into
private hands over the years under the watch of the provincial
public works department. Of serious concern is that most properties
are neither recorded in the asset register of the department, nor
even traceable.
What is going on in the department, if it does not have its own
accurate records of state properties? I’m afraid, if the department
can’t take responsibility for immovable assets, I don’t know how
there will be accountability regarding all the other assets in the
department. The Minister and her executive must take responsibility
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and see that there is discipline, that policies are in place, and
that there is strong control and management in the department.
However, I do want to congratulate the Minister for having the guts
to put a moratorium on the department’s financial activities for the
next six months. It is the only way to deal with the corruption and
fraud going on in the department. The DA believes that the outcome
of this brave action will be to the benefit of all South Africans. I
thank you.
Mr R V CARLISLE (Western Cape): Madam Chair, hon Minister, chairman
of the committee, hon members, and those who work in the engine room
of the department, it is a great pleasure for me to be here this
afternoon and to talk about this incredibly important subject. It is
my hope, now that we have a new Minister and a new director-general,
that this constitutes a new beginning for this department, because
it is a new beginning that is very necessary.
It is an incredibly powerful department, if one looks at the
numbers. I am not sure of the assets, but I do know they are in
excess of R450 billion. This means we are looking at a business here
with an asset base of $100 billion. That makes it an enormous
business with an enormous base by any international standards. It
has a budget of R8 billion. It has leasing activity, if my memory
serves me correctly, in excess of R1 billion per annum. So, it is a
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massive department, with the capacity to really make a huge
difference to the economy of South Africa.
I think what we all find, whether we are at the executive level – at
the provincial level or the national level - is that our revenue
budgets are too small. The hon Minister mentioned, for instance,
having a problem with maintenance, with looking after our buildings,
etc. We all have that problem. That is common to you, and it is
common in the provinces. We never have enough money to do all the
things that we want to do in what we get from Treasury. However,
what I think is incredibly important is the money that we can
generate in Public Works. That becomes the important thing, and I
want to come back to that in a moment.
In regard to a new beginning, hon Minister, I want to talk about
three areas. The first area is one that you have tackled very boldly
- I think part of me thinks a little too boldly. It is the question
of honesty and integrity in the operations of your department, and
your determination to identify and stamp out corrupt behaviour. I
really must commend you on that. I think that to say that Public
Works - certainly in this province, I think nationally and, I
suspect, in most provinces - has been a haven of those who want to
steal the people’s money is unfortunately true. It was certainly
true here. [Interjections.] It was certainly true here and I had to
get rid of some of the people. [Interjections.] This is not a
political matter. This is a matter about the country.
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I want to say to the hon Minister that what we must be very careful
of is something we have just managed to stamp out here in the
Western Cape. I know it exists elsewhere, however. I am going to
give an example of what is happening in the Free State, and that is
the practice of people in the department colluding with so-called
property entrepreneurs outside the department. What is done is this.
They get a letter from the department offering a rental for a
certain building at an amount much higher than its historic rental
or its market rental. [Interjections.] The so-called entrepreneur
usually has an historically disadvantaged individual as a front, but
there are nearly always white people behind it. This enables them
then to purchase the building or to get loans to purchase the
building at virtually any price because of its enormous rental in
terms of this, and from that they secure the lease.
Let me give you an example. With three of my buildings, if those
leases had been signed, the province would have paid out R70 million
more than what it would have needed to pay out over the next nine
years. Just on three buildings - R70 million! I do not know if there
is anyone here from the Free State, but I would ask the
administration there to look at the property known as Cooper House,
157 St Andrews Street, Bloemfontein. They should look out for a
company trying to buy it called Cedar Creek Properties. That company
was the one that got involved in my territory. They should also look
out for two gentlemen called Peter Volkwyn and Juan Gossman ...
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[Interjections.] ... and stop whatever they are doing, because they
want to take the people’s money.
The second thing I want to comment to the hon Minister on is our
agenda as the Public Works family. In the few years that I have been
involved, I have found that our agenda has got a little bit stuck.
Whilst we discuss important things, we are discussing the same old
important things. While I think that we must not discard those
things – they are very important – we have to widen that agenda. In
particular, national government Outcome 6, I think, has to largely
determine our agenda when we meet in the family with the hon
Minister and the MECs from the provinces. We need to really start
looking at that. Our business is infrastructure, and that is what we
must be busy with.
I want to say to the hon Minister that I believe - and it is my
private opinion - that none of the ten departments is capable of
managing themselves in the whole complexity that they are faced
with, without skilled and properly procured outsourcing. That is my
experience and I pass it on to you after two years. I thought I
could manage all that; we just don’t have the resources and skills
in the departments to do it.
I also want to say to the hon Minister that vesting is taking too
long. It is being passed at the regional level of the hon Minister’s
department, but it is getting stuck somewhere between there and her.
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This is crucially needed – land for clinics at Du Noon, land for
schools at Grabouw, and so on - and it is just taking too long.
I want to move to the third area, and that is the question of using
our assets. I have to say that if we do not use our assets, we are
like that person in the Bible who is given talents but goes and
buries them in the garden. We may not do that. We have to use the
assets we all have at provincial level, at municipal level and,
indeed, at national level. They are a treasure chest and, as
important as the Expanded Public Works Programme, EPWP, is - and I
support the expressions of my colleagues and the hon chairman down
there - the most important thing to do is to create permanent decent
work. That is the most important thing we have to do. We own these
huge assets. If we make them work for us, we are able to create
permanent decent work. That has to be the prime goal for South
Africa and it is certainly the prime goal for this department.
I understand the hon Minister’s putting in place a moratorium while
she fishes for thieves and crooks and those who steal the people’s
money out of her department and deals with them. Sometimes I wish
she could deal with them in the way China does, but of course we
cannot. Once she has done that, however, I suggest that we should
not have a moratorium for too long. We are coming out of a recession
where we are simply not growing fast enough to create those
permanent decent jobs. Many other countries in the same economic
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position are using their public built environment to kick-start
their economy.
We have started here in the Western Cape, but it is not easy. We
have identified underutilised and unutilised pieces of land and we
are learning how to work. We have one absolutely key guiding
principle: we do not sell our land. We do not sell our land; we
lease it. [Interjections.] It is the people’s land and it must stay
with the people, all right? However, you can lease it and use it to
generate revenue to maintain your buildings, schools and roads.
[Interjections.] You can use it to generate economic growth.
[Interjections.] I am surprised that some people on that side are
starting to cackle like the chicken that the hon chair spoke about
... [Interjections.] ... because these are things that I would have
thought they would want to do for the people.
The HOUSE CHAIRPERSON (Mrs N W Magadla): Hon member, your time has
expired, and please address the Chairperson, not the audience.
Mr R V CARLISLE (Western Cape): I beg your pardon. I would hope
those hon members would want to be part of this process ...
[Interjections.] ... of a new beginning that creates decent,
permanent work for people using the assets of the state. Thank you,
hon Chair. [Time expired.] [Applause.]
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Ms L MABIJA: Mudzulatshidulo, muṱhomphei Vho Minisiṱa, miraḓo i
ṱhonifheaho, zwine nda khou tama u ṱahisa zwone nga tshino tshifhinga
ndi zwa uri ... [Chairperson, hon Minister, hon members, what I want
to say at this moment is that ...]
... job creation and a decent work commitment draw their historical
strength from the 1955 Freedom Charter’s clarion call that states
that “the people shall share in the country’s wealth”.
At the core of this commitment is the belief that political freedom
is incomplete without economic emancipation. We have unacceptable
levels of poverty and inequalities, and this situation requires us
to fight for the eradication of poverty through, amongst others,
programmes of government. These programmes need to target and focus
on the majority of the people, who are poor, women and young.
The ANC believes that it is not enough to say that a more equitable
sharing of economic growth will lead to the creation of jobs.
Structural economic challenges require vigorous economic
transformation that will lead to job creation.
The ANC at its 52nd national conference in 2007 stated in an
economic resolution that the creation of jobs must be the central
focus of our economic policies. This was translated into the ANC’s
2009 election manifesto priorities.
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This budget must ensure that social capital is built through the
creation of jobs in co-operatives, burial societies, stokvels and
community trusts. For this to happen, the development finance
institutions must give support to these programmes. The New Growth
Path speaks directly to such initiatives.
When it comes to creating sustainable jobs through the Expanded
Public Works Programme, EPWP, particularly for the youth and rural
women, one can say that significant numbers of jobs have been
created by the Department of Public Works through its EPWP in recent
years. This commitment is evident in the budget allocated for the
EPWP. This programme seeks to promote the creation of additional
employment opportunities. It does this by introducing labourintensive delivery methods and additional employment and skills
programmes for the participation of the unemployed in delivering
needed services.
The R75 billion is critical to support public employment programmes
as a transitional measure towards full and decent employment. It is
important that the department addresses the shortcomings in the
public employment programmes, more specifically the development of
skills to support better employability of EPWP and Community Works
Programme, CWP, participants.
We note that the spending focus over the medium term will be on the
creation of work opportunities and the provision of training for
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unskilled, marginalised, and unemployed sections of our society. It
is through this type of commitment by the department that we can
ensure equitable growth in our country, with skills development as a
critical measure to overcome past inequalities, in particular
regarding rural women and young persons.
Joblessness and a lack of scarce skills are root causes of poverty
and social dislocation. The ANC speaks of job creation and decent
work as an integrated process. We need to ensure that the Expanded
Public Works Programme increasingly results in sustainable jobs in
order to build the economy. Certainly we are concerned about the
quality of certain jobs in the EPWP.
We note that the department intends to provide support to public
bodies in different sectors to ensure that they reach the set
targets in regard to work opportunities and full-time jobs by 2014.
As the select committee we shall have to increasingly monitor the
targets relating to the youth and how these pan out in the creation
of decent jobs.
We will need to monitor the progress with the department’s plan to
fill its vacancies, especially given the pronouncement in the 2011
state of the nation address that all vacancies in the Public Service
must be filled within six months.
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Progress reports on the large infrastructure projects planned by the
department, the cost escalations incurred due to delays in the
tendering process, and the appointment of contractors will all need
the dedicated attention of the committee going forward. This must
equally apply to changes made to the scope of work once a project
has begun.
Ndi khou pfa ndo takala ngauri Vho Minisiṱa vho tou zwi amba zwavhuḓ
i uri u avhelwa ha dzithendara, hu ḓo imiswa lwa tshifhinga nyana vha
tshi itela u thoma u khwaḓhisedza uri zwishumiswa zwoṱhe zwine zwa sa
kone u sudzuluswa zwi ḓivhee uri zwi ngafhi. Izwo vha khou zwi itiswa
ngauri hu na zwishumiswa zwinzhi zwi sa sudzuluwiho, zwine zwa vha
zwanḓani zwa vhaṅwe vhathu. Ho vha na mukumbululo na u dzhiiwa ha
ndaka ya muvhuso hu si na thendelo nga tshifhinga tsha u tshintshana
ha mivhuso. Vho Minisiṱa vha khou amba zwone. Sa vhavhusi, riṋe ri ri
vha khou ita zwone. U bva tshe ra swika fhano Phalamenndeni, hezwo
ndi zwone zwe ra vha ri tshi khou lila zwone sa komiti yo
lavhelesanaho nazwo. (Translation of Tshivenḓa paragraph follows.)
[I feel delighted because the Minister said clearly that the
awarding of tenders would be stopped for a while so that she could
make sure of where the nonrenewable resources were. This has been
done because there are many resources that are nonrenewable, which
are in the hands of other people. There was the mobilising and
takingover of government assets without permission during the time
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of the transitional government. The Minister is right. As the
government, we say she is doing the right thing. Since we arrived
here in Parliament, this is what we have been waiting for as the
committee responsible for that.]
Indeed we should receive progress reports on the number of women,
youth and people with disabilities taking part in different sectors
of the EPWP, and what measures have been taken to ensure that the 2%
target is reached for the participation in the programme of people
with disabilities.
We welcome an estimated 75 women contractors who have had their
skills developed in 2011-12 to aid the development of women
contractors. This will increase by 90 women contractors in 2012-13
and by 110 in 2013-14.
Part of the challenge that should be addressed by this budget is the
need to transform the construction industry so that it is gendersensitive and conducive to having women in the workforce. This
should be done vigorously, and this transformation should change the
mindset of both men and women and create equal remuneration and
opportunities.
This leads me to a related challenge involving the fronting of women
by their male counterparts, knowingly, in order to secure contracts.
This practice must just come to an end, and the department must deal
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decisively with those found to have been involved in this practice
by listing them so that they are unable to secure any tender from
government again. The promotion of women empowerment in the
construction industry is critical for the future of this industry.
Musi ndi tshi vhuelela hafhu murahu kha zwi kwamaho zwishumiswa, Vho
Minisiṱa vha fanela u sedzesa nga maanḓa mafhungo a u tswa nga nḓila
ya tshiofisi ngauri ri a ḓi zwi pfa zwauri hu na u rengisiwa ha
zwithu zwi tshi rengiselwa vhathu mashangoḓavha, nga maanḓa henefha
Kapa Vhukovhela. Sa tsumbo, khamusi shango ḽiṅwe shango ḽo ḓa ḽa renga
vhuṅwe vhupo ha fhano. Hezwo zwithu zwi ḓo sia hafho hune ha khou
rengiswa hu si tsha vha nga fhasi ha ndangulo ya shango ḽa Afurika
Tshipembe. U ḓo wana kwo no vha kuṅwe kushango kana kuṱangadzime,
henefha kha ḽa Afurika Tshipembe. Musi vha tshi khou sedzesa izwo
zwishumiswa, vha sedzese na mafhungo haya a u rengisiwa hadzo dzi
tshi rengiselwa vhathu vhannḓa, ngeno riṋe vhane vha fhethu ri sa
khou kona u shuma. (Translation of Tshivenḓa paragraph follows.)
[Coming back to the issue of resources, the Minister should focus on
the issue of collusion because we can hear that there is the selling
of resources to people in foreign countries, especially here in the
Western Cape. For example, perhaps the other country has come to buy
a certain area here. This would make the area no longer under the
administration of South Africa. You will find it has now become a
part of another country, or an island here in South Africa. When
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focusing on those resources, focus also on collusion in regard to
resources with outside people, while we, the owners of the place, do
not work.]
In conclusion, we must ensure that this budget provides livelihoods,
in particular for the poor, rural women, the youth and people with
disabilities. This focus must happen across all provinces in order
that we truly create a better life for all our people.
Vho Minisiṱa, vha songo vhuya vha tshuwisiwa nga vhathu vhane vha
amba ngeno vhone vha tshi zwi ḓivha zwauri vha khou tou lwela fhedzi
u tsireledza zwishumiswa zwavho. Havho vhathu a vha na mushumo na
riṋe vhe ra vha ro tsikeledzwa kale. Ndi ḓo guma nga uri ri khou
tikedza hoyu mugaganyagwama 100%. Kha hu sedzuluswe avho vhane vha
khou tsireledza zwishumiswa zwavho vha tshi khou shumisa vhadzulapo
vha fhano. Hezwo zwi khou tea u fhela. [U vhanda zwanḓa.]
(Translation of Tshivenḓa paragraphs follows.)
[Minister, you should not be intimidated by the people who speak
while they know they are just securing their resources. These people
do not care about us who were oppressed for a long time. I conclude
by saying that we support this budget one hundred percent. Let those
who are protecting their resources using our citizens be
investigated. This should come to an end. [Applause.]]
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Mr Z MLENZANA: Hon Chairperson, we are two days away from June 16, a
day on which we honour the lives of our leaders who died while still
in their youth, and further celebrate the gains of the liberation
struggle. [Interjections.]
This debate is relevant today as the department’s focus remains the
creation of job opportunities and poverty alleviation through the
Expanded Public Works Programme, EPWP, infrastructure development,
rehabilitation of immovable assets, provision of financial aid in
job creation, and skills development.
I agree with the time frames set by the department for the filling
of vacant posts, but job creation remains a challenge for the
department. Hence, we need progress reports on the number of women,
youth and people with disabilities taking part in the different
sectors of the EPWP.
As for the EPWP infrastructure grant, how is the project monitoring
done? What informs this allocation? Is it performance-based or what?
I’m asking these questions because last year provinces spent only
55% and municipalities spent only 45% of their allocations,
respectively.
The department should focus on the rural youth. Remember, it spent
only 13% of funds allocated for rural development, which indicates a
lack of will to have rural development.
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Hon Minister, the persistent, ongoing challenge relating to the
development of the asset register is not on. That is why the
department pays rent on leased properties, while certain state-owned
properties are vacant. Furthermore, hon Minister, your asset
register should also take care of provinces and municipalities.
Cope is pleased to see that the Minister has made a commitment to
cleaning up the department with the six-month moratorium on all new
property deals. [Interjections.] However, the fact that the
department has asked the so-called experts to clean up the house is
mind-boggling. Furthermore, this will have a massive negative impact
on employment and projects in the building industry. Where did this
all go sour? And how long has it been going on? We cannot allow
things to go from bad to worse, without any checkpoints in place.
Cope supports this budget and believes that if the department’s
strategy can be implemented to the letter, the department’s image
will be resuscitated and South Africa will be saved. I thank you.
[Applause.]
The HOUSE CHAIRPERSON (Mr R J Tau): Hon Chair and hon Minister
Mahlangu-Nkabinde, I greet you. I saw hon Minister Xingwana, and
will address her in absentia. I also greet hon Gigaba. I must state
from the outset that I am tempted simply to engage with the debate,
instead of looking at this prepared speech of mine.
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I just want to say, lest we forget, that the historical mission of
the ANC is the creation of a nonracist, nonsexist, democratic and
prosperous country. When it speaks of prosperity, the key question
should come in: prosperity for whom? And probably, prosperity how?
From that historical mission it can be stated that the answer is
simple, that the prosperity we are talking about as the ANC is for a
primary motive force of the ANC, which is the working class. In the
main it is those who are at the periphery, those who are at the end
of the access to these kinds of resources.
As a result of having identified prosperity to benefit this
particular primary motive force of our revolution, it needs a
particular kind of state to handle it. This is to be able to ensure
that the processes, instruments and programmes that are put in place
are those that will be driven by this state which the ANC has come
to characterise as a developmental state. By a developmental state
the ANC simply means a caring and loving state, a state that is
going to take responsibility and intervene on behalf of the poor, a
state that will put in resources and ensure that such resources tend
to benefit the poor. And, as they benefit them, they change their
conditions of existence.
This particular department, Public Works, then becomes strategic as
a department that will be able to intervene and address the
interests of the poor. The key issues that have been identified by
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the ANC are poverty and unemployment, in particular among young
people, women and rural people.
There is a whole misconception about the EPWP, and this becomes
problematic if we continue to think of the EPWP in the manner in
which we argue in this regard. The EPWP was an interventionist
approach by the state, this caring state, in regard to the problem
which it saw there.
The market, unfortunately, the capitalists of this world or of South
Africa, those who own the means of production, do not have an
interest in resolving this problem. They don’t have an interest in
creating employment. They have not done it. They have, in actual
fact, failed when it comes to the issue of job creation. [Applause.]
Therefore the state said that it would intervene in the matter and
it would create jobs. Whether the capitalists call these short-term
jobs or whatever, the state said it would do something in order for
people’s lives to be better.
Therefore, with regard to the interventionist strategy that was then
implemented in the form of the EPWP, from the outset the department
said that this was a way of ensuring that it broke the culture of
people not working - just the culture of not working. It would
create a platform for people to be reoriented - to wake up and go to
work and get something. Young people, as they went out there, would
be able to include in their CVs the culture of work and capacity to
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work as things that they had acquired. That was one of the
objectives of the EPWP.
Secondly, let me come to the issue of skills, whether you call them
short-term skills or whatever. How do we inculcate a spirit of
wanting to do something in your own capacity, and wanting to do
something in order to be able to get something out of it at the end
of the day? Part of the intervention was to create an environment
where young people would be able to be trained. For example, they
could be welders - just a basic skill to be able to do something for
themselves.
When the issue of the EPWP is not understood in its proper context,
it has the capacity to divert us from the major issues that we want
to deal with. Of course, we as the ANC have accepted that one of the
evils we are going to fight is corruption within the state, and we
are making bold decisions and resolutions in this regard. As part of
doing that, we have even pronounced that it is not only in the
manner in which you characterise it. It goes beyond that, to the
question of women fronting. It’s not only about race or blacks, but
about women being used as fronts in the EPWP.
We as the ANC said that these were some of the things that needed to
be undone. These were the things that needed to be confronted headon in the department.
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We also said, hon Minister, that there was a lack of capacity at the
level of municipalities to drive the EPWP. We raised this matter
with the department, saying that part of what the department needed
to do was to move into the municipalities to build that capacity.
We have noticed that there is an unevenness, especially when it
comes to the expenditure or usage of the infrastructure grants that
are being transferred to municipalities, and so forth. As the ANC we
feel that this is very important, especially the roles. There is a
lack of clarity about the role of the provincial offices. How do
they complement the work that they are doing with the provinces by
assisting municipalities? That is one of the areas we have said it
is probably important that we look at.
Let me come to the other part on economic development, and I think
that’s where the hon member and I might differ, but this is the
position of the ANC as well. The establishment and strengthening of
co-operatives is a means of expanding and socialising economic
development. That is what we are saying. Moreover, it is not only
that. As a committee and as members we are engaging with the
department. Not only is it about the establishment and the funding
of co-operatives, but the education that goes with that. Cooperatives, as compared to the small, medium and micro enterprises,
SMMEs, are totally different. It’s a total paradigm shift in
thinking about what their contribution is; what their working values
and culture are; and how people see themselves as beneficiaries of
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these co-operatives. Therefore, that mindset, the thinking of the
participants, especially young people, is very important.
Unfortunately, the orientation of the South African population in
economic terms has always been influenced by capitalist values. Once
a person thinks of getting involved in a tender that was given to a
co-operative, the first thing he or she thinks is: “What I am going
to get at the end of the day? Am I going to get rich quickly out of
this kind of thing?” If they can’t get rich quickly, they get
frustrated. That is why you find that many co-operatives which were
established with good intentions collapse and do not achieve the
objectives they wanted to achieve. I think that it is important that
over and above the establishment, support and all the other things
to do with this, the department should educate people. The education
is quite critical, hon Minister.
I don’t know where the hon Groenewald got what he said about the
Western Cape, but let me not glorify the issues that he raised and
the manner in which he did so.
As I conclude, let me say that we want to congratulate the
department, especially on the manner in which it has set itself the
goal of ensuring that it confronts corruption and deals with it once
and for all, unlike other people who, of course, want to claim to be
champions of fighting corruption. I thank you. [Applause.]
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The MINISTER OF PUBLIC WORKS: Chair, I thank all the members who
participated in the debate you very much. I think the ideas that are
coming from the hon members are the ones that we are going to be
using in Public Works, because the majority of the people who spoke
were very positive and added value to the work of Public Works. We
really want to thank you very much for that.
I want to start with the Expanded Public Works Programme, EPWP. The
hon Tau spoke at length about the matter. I still want to hear from
the recipients or the beneficiaries of EPWP opportunities about any
condemnation of EPWP, but you will never find that.
That is because they understand that even when the economy of this
country was growing, before we had the recession, the economy did
not produce jobs. It is for that reason that the ANC said that they
would do an intervention - they should come up with something. This
was the EPWP. Where it operates, the people who benefit from it love
the EPWP, because they can take food to their children because of
it. We do not want our people to be begging on the streets.
What the EPWP is saying is that it should go into the communities
and be with people and assist them. We have started in the Free
State, where people are going to be looking after their own internal
streets. They don’t have to travel anywhere; they’ve got to work for
themselves there, and the EPWP is going to be taking care of them.
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We have looked at the matter of skills and spoken to Salga. We have
already met because we have understood the challenges that the
municipalities are faced with. We have also agreed at the national
level that some of our officials might have to be deployed to
municipalities, to go and make sure that the skills that are
necessary are actually transferred there. That is how serious we are
in saying that people should be able to access the EPWP and make
sure that it makes a difference in people’s lives. It does make a
difference.
I don’t want to take much of your time because we agreed on most
things. However, to the hon Groenewald, if you had listened when I
spoke, you would have heard me say that this department had made a
call to all those people who had state assets in their hands, assets
which did not belong to them. We are going to give them six months
to bring them back if they want to be legitimised, but if they do
not come back within the six months, the law will kick in.
Regarding all the problems that you spoke about, for example, the
houses, in fact, you are the first person who should come and speak
to us, because you are so knowledgeable about corrupt activities
that are occurring elsewhere. [Interjections.] Please! Bring that
information and if these people do not come forward within the six
months, I promise you, you and I will make sure that they are sent
to jail. [Applause.]
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We are definitely going to hold the workshops that we spoke about.
Let me tell you that I called in the professional services in Public
Works. A lot of you will be surprised that we have professionals in
Public Works. Why are we outsourcing so many functions, when we have
professionals? We have had a tendency of getting the work that can
be done by the people that we have in the department outsourced to
people who are actually equal in terms of education. Now they have
to do the work, because once it is done outside, any price can be
asked and we have stopped that. We have introduced a new word,
“insourcing”. We are using the capacity that we have in the
department to make sure that we can build the assets of the state
with the people that we have. They are already receiving a salary;
there is no need for us to be paying consultants when we can consult
our own people, as we are paying for those people.
We have agreed that we are going to hold the workshops. We have over
9 000 artisans. I went on for two weeks, calling for South Africans
who are artisans or who are just about to complete their studies to
come forward. Hon members, you must understand that even when you
have finally got a degree, you still need to have experience. That
is the level where the majority of our people, especially the
African people, have been frustrated. The system would make sure
that you didn’t proceed. We cannot say that the private sector
should give them that experience.
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Now we have taken a decision with the deputy directors-general,
DDGs, that we are going to make sure that Public Works becomes the
place where they are going to get the necessary experience. Once
they have the experience, we will make sure that we employ them,
because what is the purpose of giving them experience and the next
thing we leave them at home? How did we get these 9 000? These
people tell us that they have been there and that they are
qualified, but the system rejects them. We will bring them back.
If you look at the property ownership in this country, it makes you
think. Who are the people who own properties in this country? Where
do they come from, at the expense of South Africans? Those are some
of the things that we are asking. Let us look at it and change those
kinds of things so that our own people can be seen to be property
owners. Of course, you know very well that they are sent from pillar
to post because that is an area which is not meant for people who
are emerging!
Look at a simple thing. We have adopted “Re ya patala” in Public
Works to make sure that when you have done work for us, you are
paid. The state says payment should be made within 30 days. But we
have managed through our CFO to introduce a system of payment within
14 days. So, even if you are late, you still have another 16 days to
play around with, but it should be within 14 days.
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Whom do we pay? We pay the main contractor. Under him are the people
that he has subcontracted and he chooses whether to pay them on time
or not. Most of the people that are complaining that they are not
being paid are not the people whom we have the contract with. They
are the people that are subcontracting, and these are the emerging
black contractors that are trying to make a living. Once you don’t
pay them, it means you have killed them and kicked them out of the
system. We need to come up with something. These are some of the
areas that we are going to ask you as a select committee and
portfolio committee to help us with.
There is just no way that we cannot support the co-operatives. They
have worked very well in KZN. I don’t know how they make it
possible, but they have worked very well. My time is running out,
but I think we need to have a post-budget select committee meeting,
where we go through all the areas that have been raised.
We owe it to our nation, hon members. South Africa needs us. We can
create those jobs. Let us put politics and other things aside, and
look at the nation and say that with our mandate as Public Works we
can change the face of South Africa, and I know that we can. We can
empower youth, women and people with disabilities because we have
the commitment, the drive and at least a little bit of money. Let us
use it before we complain that we don’t have enough money!
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Let’s make sure that we go out, especially to the small corners of
this country where there is no access to the television. Let’s go
there and assist our people - they need us there. You have me too. I
will support you in any of your projects that you have, whether it’s
in your municipality or elsewhere. Where I am able to come, I will
come. That is because I see one country - there is one big South
Africa which is run by the ANC. As a member of that organisation, I
will be available wherever you would like us to make a difference.
Thank you very much. [Applause.]
Mr D V BLOEM: Sorry, Chair. Mr Groenewald has said that I must not
tell the Minister about his farm in Kroonstad. [Interjection.] I
won’t tell you about his farm; it’s a secret farm. [Laughter.]
Debate concluded.
YOUTH DAY - PARLIAMENT IN ACTION: ADVANCING YOUTH DEVELOPMENT TO
BREAK THE CYCLE OF GENERATIONAL POVERTY AND UNEMPLOYMENT
(Subject for Discussion)
The MINISTER OF PUBLIC ENTERPRISES: Hon Chairperson and hon members,
35 years have passed since that fateful, and yet heroic youth
uprising that started in Soweto on 16 June 1976. The nation has
still not forgotten about either the naked brutality of the system
of apartheid, or the remarkable heroism and extraordinary courage of
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all those that fought against the system - young and old, male and
female, and black and white.
It is important that we refuse to forget, lest we expose ourselves
to the risk of repeating the errors as well as the folly of the
past. We must continue to teach the youth about the supreme effort
it took to bring the country to where it is today, so that they
reject the proposition of those that demand that we should now
forget.
In commemorating such occasions as the 35th anniversary of the
June 16 uprising, we must allow the martyrs of the past to open our
eyes, as we once closed theirs when they died.
What we should strive for is to use such commemorations to unite our
youth, both black and white. Our history, as well as our future,
must be occasions to unite and not divide us. In commemorating the
historic landmarks of our struggle, the imprints of the past on
today, we must advocate a unifying perspective that places high on
the banner the collective interests of all South Africans.
These occasions allow us to heal together as a nation, as well as
focus our eyes on the challenges facing the youth of our nation. To
the youth of South Africa we must say that it is an honour to serve
your people and sacrifice in their name. However, whereas in the
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past the youth often had to die for the nation, today they must live
for it.
In paying tribute to the youth of 1976 we are paying tribute at the
same time to all the generations of youth, both before and after
1976, that participated in the struggle for freedom. June 16
dramatised the indignation of the youth towards the system of
apartheid, and their unwavering faith in united action and the
liberating power of education.
Lest we forget, it was in these exact Chambers, through the
apartheid parliament, that laws were passed that gave reality to
human rights violations, and injustice was made law to give truth to
a lie. The youth of 1976 exchanged their lives to uncover this lie
and lay it bare before the peoples of the whole world.
The theme of this debate is “Parliament in action: advancing youth
development to break the cycle of generational poverty and
unemployment”. This serves as a constant reminder of the task that
we have to perform, of continuing to dismantle the apartheid legacy.
The theme places a huge task before this democratic Parliament, the
tribune of our people.
We stand here today in this debate, presented with an opportunity to
ask ourselves some pertinent questions about how much, both in
content and form, we have progressed in delivering the society that
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Hector Pieterson yearned for as he stared death in the face and his
final hour struck.
It is true that Parliament, both the NCOP and the National Assembly,
must provide a platform to infuse the realities of our people in
law-making and thus give meaning and justification to their
struggles. Accordingly, conversations such as this one must help our
citizenry, especially our youth, to breathe the energy and
robustness inherent in their age to revolutionise the process of
legislation and oversight of this sphere of government.
The role the NCOP has played in raising the youth debate in the past
is laudable. This House has not been found wanting in its obligation
to recognise and acknowledge the historic role of our youth in
liberating South Africa. Of course, many among those produced in the
trenches by youth struggles are now sitting here as hon members.
In particular, the NCOP continues to work hard in promoting
socioeconomic rights as enshrined in our Constitution and Bill of
Rights, and issues of youth development have found pride of place
and have been placed high on the NCOP’s agenda.
Among others, the social and economic progress made by South Africa
is outlined in the 2010 Development Indicators, issued by the
Presidency. They indicate that real income and poverty headcount
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indicators show improvement in living standards of the poor,
explained in part by rising social grants transfers.
Spending on education has continued to increase, by 16% from 2007-08
to 2010-11, with additional allocations of R243 billion earmarked
over the medium term, among others to improve school infrastructure,
and increase access for poor students to further education and
training, FET, colleges and universities.
Mention should be made of the bold step by the Minister of Higher
Education and Training to radically restructure the sector education
and training authority, Seta, regime, to ensure effectiveness and
efficiency in delivering the skills requisite to the needs of the
economy, and also the hands-on approach of the Department of Basic
Education in putting under its administration the ailing Eastern
Cape department of education.
The percentage of households in formal dwellings has increased from
an estimated 64% in 1996 to 76% in 2009. HIV prevalence has been
stabilised, mother-to-child transmission has dropped to a paltry 3%
and government is at the forefront of intensifying its campaign
against HIV and Aids. This gives us a dipstick indication of the
performance of policy choices we have made, and the pace at which
such are being realised. What it points to is that whilst much has
been achieved since 1994, the dream of total emancipation that
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inspired the youth of Soweto 35 years ago is still worth pursuing,
as it is still far from being achieved.
Clearly, urgency is required, especially to reverse the tide of
youth unemployment which, according to the Quarterly Labour Force
Survey, has worsened over the past two years. Youth accounted for
about 40% of all job losses during 2009-10, as the employment of 15to 24-year-olds fell by 21,8%. Almost 15 million working-age adults
are under 30 years of age, equal to just under half of the country’s
working age population of 46%.
This situation of youth unemployment has been prevalent since before
the demise of apartheid. The truth is that whereas youth
unemployment is a result of aggregate unemployment in the economy,
it would be total folly to argue that because of this we should,
perforce, first create aggregate employment in order to address
youth unemployment. This would totally neglect the fact that there
are specific conditions in the labour market that create youth
unemployment and therefore specific interventions are required in
order to create employment for the youth and facilitate their
economic participation.
The New Growth Path proposes a long-needed paradigm shift, and
places the issue of youth development high on its agenda. Since 1996
South Africa has ushered in youth development institutions and
machinery to allow the interface between civil and political society
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on youth matters. We have ratified the African Youth Charter, and
Cabinet adopted the second generation National Youth Policy.
These have been supported by a range of programmes and strategies to
empower the youth in the various line functions, such as the
following, to mention but a few: the Expanded Public Works
Programme, EPWP, initiatives that saw young people involved in the
refurbishment, rehabilitation, and maintenance of community
infrastructure across the country; the youth focal points in more
than 60% of government departments, where direct engagement with
youth takes place; several departments have established youth
development machinery at all tiers of government; learnerships and
internships have focused on raising the skills capacity of young
people through Setas; and the upcoming launch of the Integrated
Youth Development Strategy, as announced by the National Youth
Development Agency, NYDA.
It is clear that as a country we have been engaged in finding the
solutions to the complex problems facing the youth today. We must
occupy ourselves with measuring precisely how all of these
endeavours come together to change the face of poverty and
unemployment, which continues to be younger, African, rural and
female in complexion. It should be done in line with the current
trend of outcomes measurement.
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We must implore our National Planning Commission, NPC, as it tries
to present a vision of what type of nation we wish to be, also to
address itself to the situation our youth find themselves in. That
must clearly bring everyone together towards a common effort to
steer the youth towards economic participation.
This House must find creative ways to factor into its DNA the
recommendations made by the Independent Panel Assessment of
Parliament, commissioned in 2009, which called for a systematic and
structured approach to ensure the integration of youth voices,
mobilised through these youth debates and youth parliaments, and
provide feedback to the participants.
We must do all of this in order to empower our youth for their
historic responsibilities at the head of the transformation of our
country, bearing in mind that they are the constructors, inheritors
and inhabitants of the future.
The skills required to accomplish this task are vastly and radically
different to those that were required to defeat apartheid in the
past. For the youth to accomplish these historic tasks, they need
education to master new knowledge and science, technology and
skills. In that effort, they need the support and contribution of
the entire nation. Older generations have taken us this far. To the
youth of South Africa we say, a glorious future awaits - pursue it
relentlessly!
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Finally, I would like to wish the ANC Youth League well at its
national congress, and congratulate it for continuing to be a
preparatory school for young revolutionary democrats of our movement
and country. I thank you. [Applause]
Me J L HARTNICK (Wes-Kaap): Agb Voorsitter, agb lede, dit is vir my
’n voorreg om vandag in die Nasionale Raad van Provinsies deel te
neem. Die tema van die debat is die ontwikkeling van ekonomiese
geleenthede om die jeug te bevorder en te bevry. Die jeug in SuidAfrika en wêreldwyd is een van die belangrikste sektore van die
gemeenskap. Dit is waar die leiers van die toekoms besig is om te
ontwikkel en om idees te vorm oor hoe om die samelewing en die
toekoms meer tegnologies gevorderd te maak, om beter ekonomiese
groei teweeg te bring, en om met probleme soos aardverwarming,
oorbevolking en besoedeling te worstel.
In Suid-Afrika het hierdie probleem nog ander dimensies. Probleme
soos grootskaalse werkloosheid, armoede en gebrek aan ekonomiese
geleenthede om as mens en moontlike entrepreneur te ontwikkel, is
faktore wat die bevordering van die jeug in die Suid-Afrikaanse
samelewing kortwiek.
Een van die waarhede in die debat is die besef dat die jeug in SuidAfrika ernstige probleme in die gesig staar om die siklus van
generasielange armoede en werkloosheid uit te wis. Daar word erken
dat apartheid ’n rol hierin speel, maar geleenthede moet ook deur
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die nasionale en provinsiale regerings van die land geskep word om
te verseker dat daar nie nog ’n generasie jongmense verlore gaan
nie.
Ons gee erkenning aan die rol wat die jeug gedurende die 1976opstande en die 1980-onluste gespeel het en hul bydrae om te
verseker dat Suid-Afrika vandag ‘n land is waar geleenthede vry en
oop is om ekonomiese bevordering aan te help en daar te stel.
Die Grondwet van die land verskans ook ekonomiese vryhede en moedig
alle vlakke van die regering en die privaatsektor aan om die
geleenthede daar te stel om ekonomiese bevordering en bevryding van
alle burgers van Suid-Afrika te bewerkstellig.
Die fokus op die jeug, as een van die belangrike dryfkragte van die
toekomstige ekonomie van die land, moet dwarsdeur die jaar
aangespreek word. Daar moet ook gelet word op hoe die fokus geplaas
word, en wat werklik gedoen word om die probleme van die jeug aan te
spreek. (Translation of Afrikaans paragraphs follows.)
[Ms J L HARTNICK (Western Cape): Hon Chairperson and hon members, it
is a privilege for me to take part in the National Council of
Provinces debate today. The theme of the debate is the development
of economic opportunities to promote and free our youth. The youth
in South Africa as well as the youth worldwide one of the most
important sectors of the community. This is where future leaders are
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in the process of developing and formulating ideas on making society
and the future more technologically advanced, bringing about better
economic growth, and grappling with challenges such as global
warming, overpopulation, and pollution.
In South Africa this challenge has additional dimensions. Challenges
such as large-scale unemployment, poverty, and a lack of economic
opportunities to develop as a person and possible entrepreneur are
factors which are hampering the promotion of the youth living within
South African society.
One of the truths in the debate is the realisation that the youth in
South Africa are facing serious challenges in relation to
eradicating the cycle of generational poverty and unemployment. It
is recognised that apartheid played a role in this, but
opportunities should also be created by both national and provincial
governments to ensure that we do not lose yet another generation of
young people.
We acknowledge the role that the youth played during the uprisings
of 1976 and the riots of 1980, as well as their contribution to
ensuring that, at present, South Africa is a country where
opportunities are free and open for furthering and realising
economic upliftment.
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Economic freedoms are entrenched in the Constitution of the country,
which encourages all spheres of government, as well as the private
sector, to create opportunities to accomplish the economic
upliftment and liberation of all South African citizens.
The emphasis on the youth as one of the crucial driving forces of
the country’s future economy should be addressed throughout the
year. Attention should also be given to how the emphasis will be
placed, and what exactly is being done to address the challenges of
the youth.]
The premier’s forum that was launched will address the various
issues pertaining to youth unemployment. Each provincial government
department of the Western Cape has its own developmental programme
directed at the empowerment of the youth through skills development
in critically needed areas in the public and private sectors.
The importance of transversal programmes cannot be emphasised
enough. Although each department has its own programme, collectively
a concerted effort to empower the youth will make the economy viable
and enable the youth to contribute to the gross income of the
province and the country as a whole.
It is of vital importance that the social problems surrounding the
youth are sustainably addressed and eradicated. Adequate assistance
with education during the first school years will go much further
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than assisting learners during Grades 10, 11 and 12. The improvement
of education during the first grades will enlarge the grasp of
knowledge of the young child, and will eradicate the fact that there
are vast numbers of dropouts in the higher standards.
Appropriate social and educational assistance and bursaries will go
the extra mile towards helping them and have the desired outcomes,
which will provide the necessary critical skills that will enable
the youth to be economically viable.
Teenage pregnancy has to be minimised and eradicated if the trend of
high unemployment amongst young women is to be stopped. Last year,
7 327 girls gave birth, which effectively places their children in
the social grant system. The youth must be given the opportunity to
make career choices without the burden of bad life skills choices.
Teenage pregnancy keeps the young woman firmly in the claws of
poverty and ensures that the legacy of poverty is carried over to
the next generation. We need to take stern measures now in order to
stop this.
Let us not close our eyes to the dire situations created by gangs
and drug enslavement. The skills development initiatives are as
critical to the uplifting of the youth as they are to freeing our
society as a whole from the social ills that surround acute poverty.
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We recognise the fact that the government alone cannot address a
problem of this magnitude. All three tiers of government - national,
provincial and municipal - and the economic and private sectors will
need to combine their endeavours.
We need to constantly remind ourselves of the potentially
destructive influence of the youth component in South Africa, of
whom almost 51% are unemployed. We need to acknowledge their
frustration and hopelessness, the devastating effects of habitforming substances, and the ensuing crime and violence.
Only one out of two successful matriculants stands a chance of
finding a job. That is, if he or she was one of the 364 513 learners
who passed matric last year. According to the Fast Facts which was
released in May 2011, a staggering 3,3 million young people in South
Africa are not in education, employment or training! And it is this
group that needs to be targeted so that they can become economically
viable in order to take care of themselves and a family financially.
There is an oversupply of unschooled or inappropriately skilled
workers and an acute shortage of specific skills to provide for the
needs of economically sustainable industries. For that reason, the
Western Cape government has pledged its involvement in establishing
the necessary skills development programmes to meet the ever-growing
needs of an expanding population.
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There has never been a time in our country’s history when it has
been so crucial for a cumulative effort to be made to equip the
youth with the necessary tools, such as excellent primary and
secondary education, followed by education at outstanding tertiary
institutions. We also need to ensure that they have the selfassurance and life skills to empower them successfully in the
economic market.
We welcome the forum’s oversight position on the type of critical
skills that will be needed for the required economic growth and on
implementing those skills in the training centres. Through the
generation of healthy co-operation between the public and private
sectors, the necessary funds and service delivery will stimulate
skills development.
We also welcome the strong contingent of youth that will represent
the interests of the youth in the forum and believe that a spirit of
entrepreneurship will be developed amongst the youth of this
province.
The DA will provide the best opportunities for the youth in this
province. Thank you. [Applause.]
Ms B P MABE: Thank you, Chairperson. Firstly, I want to comment on
what the hon Hartnick has said. She is an honest DA politician
because she has admitted and acknowledged that South Africa is
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underdeveloped because of apartheid. It could be one of the reasons
why Madam Zille does not deploy women in the Cabinet - they always
tell the truth!
We are debating the theme, “Advancing youth development to break the
cycle of generational poverty and unemployment”. The claim of the
youth to a bright future is unquestionable. Our youth have, in our
history of apartheid and hardship, borne much of the brunt of the
struggle. For many years under apartheid they were literally and
deliberately deprived of a future by a system which kept all blacks
in bondage in the country of their birth.
For many young people it meant enormous deprivation just at a time
when they would have expected to look forward to a full life. The
education system was specifically designed to keep blacks as hewers
of wood and drawers of water, as quoted from Joshua 9 in the Bible.
The ghettoes of apartheid in towns and cities, and also in alienated
bogus statelets called bantustans, kept blacks in conditions which
were depressing and hopeless.
The youth of 1976, and the generations of youth both before and
after them, were correct to fight without fear for freedom, in
pursuit of a South Africa in which all would share in the country’s
wealth and a South Africa that belonged to all who live in it.
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As youths emerged from the meagre training and education that was
available, they were prohibited from pursuing many avenues of
employment reserved for whites. They grew into a society that was in
the iron grip of repression. At long last freedom arrived in 1994,
when all South Africans set out on a nation-building expedition in
which all the youth had earned a prized place.
Youth development is an integral part of addressing the challenge of
postapartheid South Africa. The National Youth Development Policy
Framework therefore forms the basis for developing opportunities for
all young women and men in South Africa.
The legacy of apartheid has, however, resulted in a large proportion
of young people being subject to poor socioeconomic conditions
characterised by poverty, poor living conditions, abuse,
unemployment and a lack of access to education and recreational
facilities. The prevalent poor socioeconomic conditions severely
impinge on young people’s holistic wellbeing and further exacerbate
their vulnerability to peer pressure, substance abuse, crime and ill
health.
Chairperson, unemployment and poverty have emerged as major
developmental challenges and are, in fact, global phenomena, so much
so that poverty eradication is reflected as the number one goal of
the United Nations Millennium Goals, MDGs. The number one target is
to halve poverty by 2015 and the other target is to achieve full and
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productive employment and decent work for all, including women and
young people.
South Africa has a large youth population. About 35% of the South
African population are between the ages of 16 and 35. The youth form
70% of all unemployed persons in South African society, which
indicates a significant overrepresentation of youth amongst the
unemployed.
In addressing the needs and issues of the youth, government has
responded in various ways. Among them, government has included
issues facing the youth in a public policy framework that shapes and
informs a systematic and comprehensive government response.
The Youth Parliament was provided by Parliament as a national
discussion platform to encourage the youth through active debates to
take part in shaping the country and deepening democracy, with the
objective of debating issues affecting the youth, such as economic
participation and youth development. It also created an opportunity
for the youth to engage in Parliament, the provincial legislatures,
the national youth structures and local government.
Although youth development is a national responsibility, all spheres
of government, including local government, are involved in youth
development by virtue of intergovernmental relations. It is
therefore imperative for all municipalities to adopt a youth policy
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framework. Local government should also ensure that it works very
closely with the National Youth Development Agency and with youth
offices at each municipality run by skilled young people.
The government should as a matter of urgency consider major
investment in education in order to educate and uplift the youth to
achieve economic freedom and economic growth. Urgent consideration
should also be given to the introduction of entrepreneurial
development at high school level. Procurement policies should be
biased towards young people and finance made more accessible. Banks
should ease their credit requirements.
As we celebrate Youth Month and are optimistic about the New Growth
Path, the question is being asked by the youth, and quite rightly
so: what benefit will the youth derive from this new growth
initiative? How can we ensure that political freedom translates into
economic transformation? The answer to this is that it should be
ensured that the youth are the largest beneficiary of the R8 billion
job creation fund announced by the President.
I would be failing in my duty if I did not pay tribute to the ANC,
and in particular the ANC youth, who have sacrificed much and
suffered severe hardship and oppression, who know arrest, torture
and death itself, who liberated this country and ensured freedom for
all, and who also enabled a person like the DA spokesperson, Lindiwe
Mazibuko, and her friends to enjoy the same freedom, while they have
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betrayed the heroes and heroines of the struggle, like Solomon
Kalushi Mahlangu, Siphiwe Mthimkhulu, Ephraim Mogale, Tsietsi
Mashinini, Sibongile Mkhabela ...
Mr D A WORTH: Hon Chairperson, on a point of order, in fact two
points of order, if I may: Is it parliamentary for an hon member to
accuse another Member of Parliament of betrayal, in the first
instance? In the second instance, could you ask the member to refer
to the hon Mazibuko as the “hon” and not Lindiwe Mazibuko?
The HOUSE CHAIRPERSON (Mr R J Tau): To be honest, on the first part
regarding the “betrayal”, I did not pick that up. On the second, of
referring to the “hon” Mazibuko, who is not a member of this House,
I will need advice on whether that has any implications. Therefore,
I will not make a ruling now, but in the next sitting I will
definitely make a ruling on the matter. Hon Mabe, will you please
continue?
Ms B P MABE: Thank you, Chair, I was just about to conclude, and I
was saluting our heroes, like Solomon Kalushi Mahlangu, Siphiwe
Mthimkhulu, Ephraim Mogale, Tsietsi Mashinini, Sibongile Mkhabela,
Joyce Dipale and so many others. I thank you. [Applause.]
Mrs E C VAN LINGEN: Hon Chairperson, hon Minister Gigaba, and hon
members, it’s a pleasure to take part in this debate on behalf of
the youth today. Thirty-five years ago, on 16 June 1976, the
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students in Soweto started protesting for a better education. Today
we commemorate this day as National Youth Day. We celebrate Youth
Day as a nation. We can only do this if we as leaders and adults
respect each other, respect each other’s rights and learn from our
past.
The youth in South Africa make up almost half of the population.
Many face the reality of poverty, unemployment, crime and social
issues in our communities. So what are the problems we face? They
are a lack of nutritious food, clean water, housing and health care
- all that has an impairing and debilitating effect on poor South
Africans, but more so on the youth who cannot grow physically
without equal opportunities.
There are so many of our families that are child-headed. We are also
sitting with a large percentage of teenage pregnancies.
Better care could be taken of the youth with special needs,
especially in the education sector. In South Africa, poor children
with special needs have very limited resources, and grow into youth
that are not well developed and are dependent on state grants.
Opportunities must be given so that these children can be employed,
independent, and not dependent on the state.
We need to create opportunities to develop our youth, as they are
tomorrow’s generation. Where do we begin? We often hear of real
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jobs, but what are we doing about real education? Without real
education there cannot be real jobs. We must be mindful of poverty
in Africa, and the fact that it is due to the wrong choices made by
the leaders in Africa. Can we afford to make those changes?
The National Planning Commission disclosed in its report last week
all the errors in the Department of Basic Education, and all the
shortcomings in the outcomes-based education system. It is the
subject choices that debilitate our children in their going on to
further education. It’s either not explained to them properly, or
they don’t understand what it entails to get the right credits for
tertiary education. What does a child do with only a matric
certificate? Moreover, has he or she been given the economic
opportunity to empower himself or herself?
Sir, 74% of the unemployed in South Africa today are under the age
of 35, and therefore considered the youth. If a young person is not
employed in the formal sector after school or tertiary education by
the age of 24, the chances are that they will forever remain in the
informal sector - for the rest of their life. This comes from the
National Planning Commission report. It is not I who am saying so.
Economic empowerment starts with education and then employment. We
have young groups in this country who seem to be powerful. They seem
to be running the ruling party as well, and they are demanding the
nationalisation of mines and talking of land grabs. This culture of
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entitlement is rife. It creates unsustainable expectations. All this
is undermining investment security in jobs.
As the DA, we believe that we need to address the wrongs of the past
through sustainable economic opportunities, empowerment and
participation. Let us all be responsible and accountable for our
youth and our future leaders, so that we can change poverty into
economic empowerment and growth. I thank you. [Applause.]
Mr D V BLOEM: Good evening, Chairperson, Minister and everybody.
The youth of 1976 went into the streets of the country determined to
fight for their freedom, determined to lay down their lives for this
freedom that we enjoy today. I am quite certain that many of them
are turning in their graves after seeing what is happening in our
country today.
They see desperate young girls and women being used as objects,
where sushi is being served on their naked bodies and so-called
youth leaders are enjoying themselves, eating from these bodies.
Those in power abuse their offices to get rich, to become
millionaires and even billionaires. And respect and discipline are
slowly vanishing from our society.
The economic landscape in South Africa is dire for the generation
under 30 years old. In a South African Institute of Race Relations
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survey it was stated that 57% of the youth were unemployed in
January 2011. Two weeks ago Zwelinzima Vavi, the General Secretary
of the Congress of South African Trade Unions, Cosatu, warned that
unemployment of the youth in South Africa was a ticking time bomb.
Mr Vavi was saying this because the ingredients are there for an
explosion. Government has been promising to create jobs since coming
to power in 2009.
When you look at service delivery protests around the country, who
are the people that you see in the front line of these protests? It
is the youth! These youth are constantly met by police with teargas,
imprisonment and gunfire to suppress the protest.
Cope agrees with Mr Vavi on this point, and urges the government to
take this observation very seriously and address the issues of the
youth before it is too late. You must never underestimate the
patience of the youth.
In 1976 the youth said that enough was enough – they would lay down
their lives. Let us not have that situation repeating itself in this
country, because the youth of the country will say enough is enough.
Thank you very much. [Applause.]
Mr J J GUNDA: Thank you, Chair. Indeed, three minutes is not enough
to really debate this very important issue. Fortunately, I’m not
like the hon Mabe. Mabe has just heard about 1976; she was never
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part of 1976. Hon Mabe should learn to understand the seriousness of
the youth of 1976. She is sitting next to one of the veterans of
1976 and she must learn from the hon Dan so that she can be
somebody, somewhere, some day.
We speak on the youth of today, and we commemorate the 1976 youth,
who recognised the inequalities and had the courage to stand up
against them. It would be a great pity and an injustice to those who
lost their lives in the Soweto uprisings if, 35 years down the line,
we could not find sustainable solutions to our growing problem of
unemployment, which impacts directly on the economic wellbeing of
our youth.
Employment, skills development and entrepreneurial drives should be
focused on rural areas, which are often overlooked by government
bodies when they are planning youth upliftment programmes. Provinces
with rural areas should command equal attention and access to funds
and programmes designed to address challenges facing the youth in
this country.
A few months ago R100 million was spent on the National Youth
Development Agency, NYDA. I think, if we could have split the
R100 million among the nine provinces – that is, R11 million per
province – we could have done much better in educating and
empowering our youth, so that the youth could get somewhere.
Education is the only tool to overcome poverty.
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Chairperson, allow me to say this. A youth leader should embody
tolerance, self-discipline and respect in order to set an example,
like Dan Montsitsi, for his or her peers. It therefore concerns us
that this Julius Malema’s arrogance and disregard for leaders,
including the South African President, is being condoned. Why are
the leaders keeping quiet while Julius is rude and ill-disciplined?
He is a black child; he needs to be reprimanded. He needs to listen
to the older people because this ANC that has died for many people
was never ill-disciplined and never rude.
Let me just say this one thing further, Chairperson.
Die dapperheid en die opoffering van die jeug van 1976 moet nooit
gering geag word nie, want die visie wat hulle aan die dag gelê het,
het ’n aandeel tot ons vryheid vandag. Die jeug van 1976 is die rede
hoekom ons vandag soveel vryheid het. Hulle het ’n visie gehad,en
hulle het ’n doel in die lewe gehad. Ek wil dus ’n pleidooi lewer
dat ons nie die jeug moet onderskat nie. Die jeug moet ook nie
hulself onderskat nie, want dissipline sal maak dat die jeug sukses
behaal. Dankie. [Applous.] (Translation of Afrikaans paragraph
follows.)
[The bravery and the sacrifice of the youth of 1976 should never be
disparaged, since the vision they displayed has contributed to our
freedom today. The youth of 1976 are the reason why we are enjoying
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so much freedom today. They had a vision, and they had a purpose in
life. Therefore I would like to plead with you that we should not
underestimate the youth. The youth should also not underestimate
themselves, because discipline will result in the youth attaining
success. Thank you. [Applause.]]
The CHIEF WHIP OF THE COUNCIL: Chairperson ...
The HOUSE CHAIRPERSON (Mr R J Tau): Hon members, there is a request
from hon Ntwanambi. She does not feel well and therefore requests to
address the House whilst seated. [Interjections.]
Mr D V BLOEM: Chair, I agree that she can sit, but on one condition,
that she does not attack me! [Laughter.]
The CHIEF WHIP OF THE COUNCIL: I wish you were an issue, but you are
not!
Chairperson, I want to dedicate my speech to the fallen heroine and
great daughter of our nation, the late Mama Nontsikelelo Albertina
Sisulu, intombi yakwaThethiwe, uMandlangisa, oyintombi yaseXolobe,
eTsomo [a daughter to Thethiwe, Mandlangisa, from Xolobe village at
Tsomo].
[Interjections.] You see, Chair, there are people here who really
distract a person!
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If you look at MaSisulu, you will see she was one of the most
steadfast, dignified and disciplined pillars of our struggle for
liberation. She was a devoted servant who served our people with
humility until her last moments. She lived an illustrious life of
devotion to the struggles of our people. She was the embodiment of
the struggle against apartheid and also fought for gender equality
in our society. To some of us who took over the baton of the fight
for gender equality, the life of MaSisulu represented the embodiment
of the principles, values and ideals of the struggle waged by women
such as Madie Hall Xuma, Ida Mntwana, Lilian Ngoyi, Charlotte
Maxeke, Dorothy Nyembe, Florence Matomela, Rahima Moosa, Sophie De
Bruyn and many other women. As we speak about Mama Sisulu, I
remember just after her unbanning, she addressed a crowd and said
the following.
”Ixesha lala madlagusha liphelile.” Kwaye mna ndifuna ukuthi la
amadlagusha alibele ukuba ayiselo xesha lawo eli. Endaweni yokuba
ngewayemamele umama uSisulu ngokuya, asuka atshela okwentshwela
yomphokoqo embizeni. Kaloku íntshw ela yomphokoqo ubangayikrwela
imbiza ayisuki endaweni yoko umoshakalelwa yimbiza yakho.
Anjalo ke amadlagusha. Kwaye ke ayexhaphe kakhulu ke ngelo xesha.
Amandla wethu babewamfimfitha ude ubone ukuba wena uza kusala
ungasenalo negazi eli. Maze bangalibali ngoba nathi asilibelanga
kodwa sixolile. (Translation of isiXhosa paragraphs follows.)
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[“The time for the boers has come to an end.” I also want to say
that these boers have forgotten that this is not their time. Instead
of listening to Mama Sisulu, they resisted change. It is very
difficult to make people see change, and instead advocates for
change will be persecuted and murdered, to the detriment of our
country.
This is typical of the boers. During that time they were plundering
state resources. They were pitilessly exploiting our labour force.
They must not forget, because we have not, but we have forgiven.]
As I look at myself, I am thinking that 35 years ago I was what you
would call a Grade 10 student. That shows how South Africa has grown
and how the young people of this country, with their spirit of
asijiki [no surrender], turned this country into the South Africa it
is now. Before I continue - otherwise I will overrun my time - I
think I must say that when you have an unholy alliance you tend to
lose your morals and principles ...
... okanye uba lixoki ngesiXhosa esiphandle ngoba akubinanyaniso
kwaye uthengisa ngesiqu sakho. Amanye amalungu ahloniphekileyo apha
eNdlwini kufuneka esebenzele abaphathi babo ngoku yiloo nto
engasakwazi ukuthetha inyaniso. Bathetha izinto ezingenamsebenzi
nezingazukwakha.
Ndifuna ukuthi Sihlalo, abanye babo balibele ukuba asiyilibelanga
into yokuba xa ubeka ityala kwiinkokeli zaseAfrika uze ungalibali
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ukuba ngoobani abarhwaphilizayo nabasarhwaphiliza unanamhla eAfrika. Asikwazi ukukulibala oko. (Translation of isiXhosa
paragraphs follows.)
[... or you become a liar, to be precise, because you lack the truth
and you have sold your soul. Some of the hon members in this House
have to work for their masters and that is why they are unable to
speak the truth. They just speak about useless and worthless issues.
I want to say, Chair, that some of them have forgotten that we have
not forgotten that when people start accusing African leaders, they
must not forget those who swindled and are still swindling African
resources, even today. We cannot forget that.]
I also thought that at least the hon member Madam Van Lingen would
understand better. I thought she was highly educated and that she
had studied sociology, and would therefore know what causes teenage
pregnancy. She would be better off with what she knows about. She
always speaks on issues of education, so she would speak better on
them.
I want to ask again if they can show us - this is to the hon
Hartnick now – where they have empowered a particular black woman in
this province. I am not saying “African”, but any black woman who
would say she was a beneficiary of the Western Cape government. We
still have to see those.
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I am happy that hon Bloem has correctly quoted his own leader, hon
Smuts Ngonyama, who said, “I did not struggle to be poor, but to be
stinking rich.” Thank you very much. [Interjections.] Yes, that is
what he said, so thank you very much for reminding us. I had
forgotten about that one.
As we speak here today, I want to say that for decades apartheid
limited opportunities for women to break the cycle of generational
poverty and unemployment. It ensured that women had no opportunities
for self-advancement, such as access to education and skills
training, which left them to face poverty and unemployment. Where
there were opportunities, they were very, very few. You would be a
nurse, a clerk, or a teacher; you could not be anything beyond that.
In this regard, you could not count more than five medical doctors
in the entire country then.
Women in South Africa suffered the ravages of patriarchy, sexism and
discriminatory practices, which kept them outside social, political
and economic power structures. Young women in general, and
particularly African women and those in rural areas, suffered the
brutality of apartheid settlement.
It is still estimated that about 60% of the unemployed youth in our
country are females. It is also true that if you look at race, you
will find that 4,9 million young African people are still
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unemployed. Although unemployment of Africans in South Africa is
consistently higher than unemployment of other groups across the
different age groups, African youth face unemployment rates nearly
nine times higher than those of other groups.
The concept of a lost generation became a cynical and convenient
label for a mass of frustrated, poorly educated and traumatised
young people, impatient for change and yet increasingly sidelined
and deprived. By 1993, 14% of African young people had primary
education only, and only one in every 20 had a degree or a diploma.
Over 3 million people between the ages of 16 and 34 were unemployed,
of whom a significant proportion - 57% - were black.
What is worrying is that only 5% of school leavers among the African
youth with Grade 12 could find employment in the formal sector. It
was very difficult. The government’s review noted youth unemployment
and poverty as matters for serious concern in our quest to break the
cycle of generational poverty and marginalisation of our people.
So that I do not repeat what the Minister has said, let me say that
I think it would be very wise for our committees to consider the
speech delivered by hon Malusi Gigaba, the former president of the
ANCYL, who still leads the ANC. He said that we in the ANC have a
political school that cooks and prepares people for the future. How
I wish others could do the same.
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I also want to say that when we look at women, the poverty-stricken
women in the rural areas in particular are often financially
dependent, have limited access to employment, are unsupported
mothers, and must fulfil the role of being caregivers. As a result
they have few alternatives and options if they wish to leave a
violent situation or even a violent relationship. Moreover, in most
impoverished areas in South Africa women have limited access to
health, education, and social, psychological and legal services. The
result is that there is evidence to show that African women, who are
undoubtedly the poorest sector of our society, are more than
10 times more likely to experience an incidence of violence,
compared to their white counterparts.
Recent SA Police statistics also show that levels of rape are often
highest in provinces which are economically less developed. That is
what I was trying to teach you, hon Van Lingen. There are reasons
for this relationship between violence against women and poverty.
Apartheid’s economic exploitation and segregation systematically
resulted in much higher levels of poverty for black South Africans
and women in particular. A range of factors have contributed to high
levels of violence against women in poor areas.
We owe it to those women who suffered the double oppression of
poverty and violence to help them transform conditions of dependency
and hopelessness into those of empowerment and progress. It is our
responsibility as women in this institution to make sure that we
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educate, assist and further equip them regarding resources to assist
them.
It is a pity that I could not really continue with my speech because
of time constraints, but I must say that as we approach June 16 in
the next two days those of us who were there will remember it very
well, and those who were not there know it even better than us, and
that is why hon Mabe was the best choice of the ANC. Thank you.
The MINISTER OF PUBLIC ENTERPRISES: Chair, if ever there was
anything that ought to unite South Africans, it is the future of our
youth, as well as their empowerment in order to equip them with the
capability of constructing and inhabiting the future.
Today our nation’s collective wellbeing depends precisely on the
careful crafting of our future through our youth. The most urgent
challenge facing South Africa’s youth is that of economic
participation through job skills and economic empowerment, as well
as through education.
That education is important needs no further emphasis, I think, but
we must say that our nation needs to pay particular urgent attention
to the education of the black child who, even today, continues to
bear the brunt of the legacy of Bantu education and other weaknesses
in our current education system.
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The black child, when his or her contemporaries spend between six
and eight hours on learning from teaching and instruction, spends
about three. We need to pay urgent attention to this so that we
raise their level of education to that of their white counterparts
and the other black learners who have been fortunate enough to go to
historically white learning institutions and even private schools.
This means that we have to eradicate everything in the path of black
learners that inhibits their right to learning and do all we can
together as a society to enhance their opportunities in education.
We also need to urge South African youth to unite against xenophobia
and attacks on foreign nationals. The point made earlier today by
the Deputy President needs to be emphasised. We must never accept
that we can easily resort to blaming foreign nationals for all our
woes and all the challenges that we face as a nation, and
particularly as young people.
What the ANC Youth League is raising, hon Van Lingen, are issues for
debate which do not constitute ANC or government policy. They are
issues that the ANC Youth League is entitled to raise, issues that
every young person has a right to raise. They are not about
entitlement; they are about what policy choices different sectors of
our community think are required in order to move South Africa to
the next level in our quest for total social emancipation.
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Because they are young people, they sometimes raise them wrongly,
and sometimes in a disrespectful manner. I should know this because
I was once, not so long ago, in that position. But the duty of the
elders in society is to hone the youth, to get the youth in line, to
tell the youth when they are wrong that they are wrong, and to
direct the youth’s conduct and behaviour. And I think the South
African youth can learn, will learn and will listen.
Hon Bloem raised interesting things. Firstly, he talked about
corruption, as though it started after he had left the ANC. We can
remind him not only of incidents, but also of names of people that
have gone to Cope who can clearly be associated with corruption.
Secondly, he said government had been promising jobs since 2009, but
he knows that can’t be correct. This issue existed even when he was
still a member of the ANC. Conveniently today, and probably out of
opportunism, he has chosen to forget that, as though life started in
2009, after he had left the ANC.
The fact of the matter is that between 2001 and 2008, South Africa
experienced the most sustained period of not only growth but also
job creation. Sure, the number of jobs created was not commensurate
with the demand and need in our society but, in reality, jobs were
created. In reality, what destroyed jobs in South Africa was the
global financial crisis. And in reality, the number of jobs has
begun to grow again. But opportunism will never allow you to say
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this. The challenge that we are facing as a country didn’t begin
after he left the ANC.
The youth of 1976 were neither saints nor angels, and I think we
need to avoid the easy temptation to treat them as though Comrade
Dan and his generation were angels who never put a foot wrong.
There is a question we need to ask but, firstly, maybe what we need
to avoid is contrasting today’s youth with those of 1976 and using
the youth of 1976 as a whip to whip today’s youth. We should not be
saying to today’s youth that they are nothing, that they are
incapable, and that they can’t achieve because they are not part of
1976.
The question I ask, which I have asked before in this House, is how
the youth of 1976 would have behaved today, or, how today’s youth
would have behaved in 1976. Remember that it is not your ideas that
create your reality; it is your reality that creates, shapes and
moulds your ideas. [Applause.] I would put my head on the block and
swear that if you took today’s generation and placed them in 1976,
they would do exactly the same as Dan Montsitsi and his generation
did. The youth of 1976, if they had been put in 2011, would have
faced exactly the same challenges as we are facing today.
The challenge for us is never to give up on our youth. The challenge
for us is always to stand up for them, to correct them where they
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are wrong, to be firm with them, to encourage them when they do
right, to allow them to think and express themselves, and to correct
that thinking when it is expressed in a wrong manner.
Hon Comrade Bloem quoted Comrade Vavi on youth unemployment. In
actual fact, Census 1996 already pointed to the fact that 70% of all
unemployed people were youth. I remember this, as I was the
President of the ANC Youth League at the time. In 1996 we raised the
challenge of youth unemployment as the biggest challenge facing the
youth of our country and facing South Africa itself. So, nothing new
is being raised. When people who are sleeping wake up and realise
that there is a problem of youth unemployment, it can’t be treated
as though what they are saying is right just because somebody in
Cope thinks that they are right. [Interjection.] No, no! It is you
who think they are right.
Now, this problem is not new, and I think we need to address it with
the urgency it deserves. Again, it is a challenge that needs the
nation to unite.
The ANC does not fear the youth, nor do the youth think the ANC is
the enemy. Were that the case, we would not today be enjoying the
overwhelming support of the South African youth, as we do.
[Interjections.]
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Even as the youth raise the particular challenges they face, they
are clear that this is what they want government to address.
The sushi episode has been condemned by everyone, and I don’t think
we need to hang on to it as though it were the end of our country.
It was demeaning, it was embarrassing, and we condemned everyone who
participated in it but, Chairperson, life goes on. That episode
represented neither the youth of the ANC, nor the youth of South
Africa as a whole.
Finally, I think the obsession with the President of the ANC Youth
League really doesn’t help us to take this country forward. He is
not all that happens in South Africa. He doesn’t try to be all. He
may be outspoken, but we all were at one stage or another. If you
were not, you have lost out on your youth! [Interjections.] I know,
because I was once in that position. When you speak, you speak your
mind. When you speak, you say what comes into your mind and you will
be corrected later. [Interjections.] But the obsession with Julius
Malema doesn’t take South Africa anywhere. [Interjections.]
I think the people who are obsessed with him must start asking
pertinent questions about youth development in the provinces and
municipalities led by their own parties. We are not obsessed with
Madam Helen Zille. We are not obsessed with Madam Patricia De Lille
and the fact that she has hopped from the extreme left to the
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extreme right in one lifetime. [Interjections.] We are not obsessing
about it, so get over Julius Malema. Thank you. [Applause.]
Debate concluded.
The HOUSE CHAIRPERSON (Mr R J Tau): Order, hon members! There are
two quick announcements. One is that there is transport available to
ferry members to their villages after the sitting. The other is an
invitation by the Department of Public Works to a dinner at the Old
Assembly restaurant.
I remind members that the House sitting starts at 10:00 tomorrow
morning.
The Council adjourned at 19:17.
__________
ANNOUNCEMENTS, TABLINGS AND COMMITTEE REPORTS
TABLINGS
National Assembly and National Council of Provinces
1.
The Minister of Justice and Constitutional Development
14 JUNE 2011
(a)
PAGE: 194 of 194
First Report on the Implementation of the Child Justice Act, tabled in terms of section
96(3)(a) of the Child Justice Act, 2008 (Act No 75 of 2008).
National Council of Provinces
1.
The Chairperson
(a)
Notice of shortlisted candidates to serve on the Governing Board of the National
Research Foundation.
Referred to the Select Committee on Education and Recreation for consideration and
report.