KZN Faced by Health Service Delivery Challenges

Mark Steele, MPP

DA KZN Spokesperson on Health

Speech delivered in the KZN Legislature

Madam/Mr Speaker As part of the Mandela week oversight visits I visited a number of clinics in and around Pietermaritzburg. Those in Vulindlela reported common problems with the availability of ambulance services, especially in the case of emergency maternity cases.

As is reported in the Health Department APP, ‘response times are still far below the acceptable norm in both urban and rural areas and remain a serious challenge’. Clearly the supply of sufficient vehicles is only part of the problem as we need to manage staff and resources most efficiently so that ambulances are available when they are most needed which will often be during the night. This is where maternal health is most critically affected – getting problem birth deliveries to facilities that have skilled obstetrical staff available is the difference between life and death for both mother and child.

In 2011 the response times saw only 11% of calls responded to in less than 15 minutes in urban areas, and 36% in less than 40 minutes in rural areas. The targets are 30% and 50% respectively but we cannot be satisfied in this House that the overall performance in 2011/12 was 51% of calls answered within 60 minutes. Effectively that means emergency patients have a 50% chance of being attended to in time.

Rape and domestic violence continue to have a huge impact on the safety and well-being of the women and children of our province. There is an alarming increase in the rape of the elderly while school girls continue to be preyed on by adults who should be in positions of responsibility and care such as teachers. Those who are expert in counselling rape victims such as Rape Crisis remind us that rape is as much a crime of violence as it is sexually motivated. Given the appalling incidence of violent crime in this country it is not surprising that women who are raped, often experience a range of other brutal assaults and physical injuries. Reducing rape means reducing the horrendous incidence of violent crime generally. It is important that rape screening kits are available at all SAPS stations where the crime is reported.

Teenage pregnancies remain an issue both for the health and the education authorities. Schools are the reluctant custodians of young women who may have specific medical needs during pregnancy which teachers are ill-equipped to provide. Contraceptive counselling to all pupils who are sexually active is the priority that must be provided across the board. Teenage pregnancies are not only a health or education issue however. Sadly having an unplanned baby while still at school will impact on the future education, career and life chances of the young mother and produces a vicious cycle of cross-generational disadvantage.

It is encouraging that cervical cancer screening through routine Pap smears is aimed to increase to 70% of women over 30. This will lead to a significant reduction in what remains a major killer of adult women. However, there is also the issue of how we can prevent the occurrence of cervical cancer in the first place. What performance targets has the Department set for the rolling out of a vaccination regime aimed at reaching girls aged 11 and 12 against HPV? According to the Centre for Disease control two vaccines are available to protect females against the types of HPV that cause most cervical cancers. Either vaccine is recommend for use with girls before they become sexually active, and we need to see this programme rolled out at primary health clinics where it can have the most impact.

The MEC is serious about changing both the health standards and conditions of life of girls and women across KZN. Efforts to improve maternal and child health have a direct effect on the quality of life of the whole population and his efforts are to be commended by all in this House.

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