Health Budget Must Address Many Challenges

Andrew Louw MPL

DA Leader in Northern Cape

Agbare speaker, agbare premier, agbare lede van die uitvoerende raad, lede van die huis en dames en here in die gehoor

Ek wil graag die debat open met ‘n paragraaaf uit een van N.P. van Wyk Louw se boeke: Dit sê “so noodsaaklik soos die bloedsomloop vir die liggaam is, so noodsaaklik is die sirkulasie van gedagte: dis die vrye uitspreek van eie mening en die aandagtige luister na die mening van ander, sodat ‘n wisselwerking ontstaan en mettertyd ‘n wederkerige begrip en ‘n mate van gemeenskaplike oortuiging. En hiersonder is geen gesonde politieke lewe moontlik nie.”

Honourable Speaker, before I start to unpack the details of my speech, allow me to touch on questions that remain unanswered.

The Hospital Information System is one of the departments biggest cost drivers. Therefore it is only prudent to question the efficacy and value of money hereof. Considering this, how will the department explain the current system, as this is the department with the highest level of irregular expenditure, which according to the AG’s report of 2010/2011 hit the R1 billion mark? It is the DA’s submission that the clarity on the costs for this system since its inception, including the monthly costs, would assist to a large extent to allay fears of possible corruption.

When he closed his budget debate last year, the MEC indicated his disappointment in being here and highlighted how the opposition had contributed nothing to the debate. This is poor leadership based on the above.

Poor leadership is also a concept not new to this department. In his 2010/11 annual report the AG once again states that “an environment that is conducive to good governance and service delivery through positive attitude, integrity, competence and ethical behaviour has not been established within the department.” Management philosophy, operating style and especially, lack of communication did not promote effective control. The department has failed to properly analyse the control weaknesses and implement appropriate follow-up actions that adequately address the root causes. This has resulted in the audit findings from the prior year report being repeated in the current year. Disclaimers, disclaimers, disclaimers …

It was also in his closing remarks during the previous budget speech that the MEC made a total blunder with regards to the allocation of the medical waste removal contract. He argued that it was a racial matter and that we should stop asking questions about it. However, the special investigation by the AG revealed otherwise and the DA believes that our suspicion of financial misconduct was verified.

Financial misconduct is also not something new to the department. It is interesting however to see how the department deals with it. Disciplinary hearings are not speedily dealt with – if at all – and no submissions of reports or schedules of the outcome of disciplinary proceedings that were completed were submitted to relevant authorities as required by law. This is what is called a lack of accountability.

When the DA refused to accept the budget of the department last year we mentioned all these points: poor leadership, poor financial management which hinders service delivery, the endemic disclaimers. We raised our special concern with regards to disregard shown for supply chain management which can mean that money is spent on bloated contracts and which seriously undermines fair and competitive business practices and employment creation. We pointed out as the AG did before that the information the department provides with regards to their service delivery and actual output on the ground is for the most part not valid, accurate or complete.

Die vraag ontstaan dus, hoekom moet ons die departement en die begroting nou glo…dat die geld sal gaan waarheen dit moet en dat die dienste en teikens dienooreenkomstig op tyd gelewer en bereik sal word? Wat is dan nou so anders? Die DA aanvaar nie die begroting nie vir presies dieselfde redes as die afgelope twee jaar. Ons het selfs verlede jaar so ver gegaan as om ‘n voorstel te maak oor hoe om die situasie te red, waarna die LUR duidelik nie geluister het nie. Ek het nie nou tyd om die LUR weer met ‘n lepeltjie te voer nie, maar hy kan gerus gaan kyk na ons voorstel.

I think what is further important to discuss however is the NHI. Every South African deserves quality healthcare. But, let me say it clearly in this House today – the proposed National Health Insurance (NHI) scheme is going to make life worse for those who are currently denied access to quality healthcare. Why?

Firstly, because it is the poor who will bear the brunt of the cost of the NHI. Initial policy documents indicated that the NHI will cost a minimum of R145 billion – many experts believe this budget is likely to be exceeded. The only way to pay for this will be to take money away from other programmes designed to alleviate and combat poverty.

Secondly, the NHI will create an inefficient and centralised health superstructure. If we are going to improve healthcare for all, we need less bureaucracy, not more.

Thirdly, NHI does not fix the real problem in our system, which is low quality health care provision. Instead, the Green Paper on NHI focuses on accessibility and finance.

The truth is that we already have universal accessibility and enough funding to run a first rate public health care system. Kyk wat het die DA gedoen in die Wes-Kaap en hoe ons dit reg gekry het. Sterk leierskap, streng finansiële beheer en ‘n sisteem wat verantwoordbaarheid beklemtoon en korrupsie nie toelaat nie. Die begroting is streng gevolg, verhoudinge is gebou met die privaat sektor en ‘n fokus op voorkoming en opleiding is verskerp.

If we can just focus on getting the basics right, which in our case is going to mean very strong leadership and structural change in this department, we can revolutionise healthcare in our province. And this will not cost all the extra money that the department keeps on insisting is the reason for poor performance.

Ten einde wil ons die amptenare van die departement bedank vir hulle moeite om die departement goed te laat lyk. Daar is as sulks niks verkeerd met die allokasies wat gemaak is nie. Die vraag is of dit werklik gaan realiseer en omstandighede op grondvlak werklik gaan verander. Gebasseer op die geskiedenis van die department, dink die DA nie so nie.

Ons wil baie dankie s? spesifiek aan alle mediese personeel vir hul toewyding om mense te help en gemeenskappe te dien ten spyte van geweldige moeilike omstandighede. Ons hoop ook dat die agbare Sokatsha werlik hierdie laaste woorde van N.P. van wyk Louw ter harte sal neem: “As ‘n staatsman werklik en eerlik na die besware van die teenstander luister, sal sy oplossing in elk geval minder tydelik wees.”

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