Speech by Gauteng MEC for Health Brian Hlongwa on the occasion of the 2006/7 Annual Report

4 December 2007

Honourable Speaker

When our government identified key priorities for the current term of office we were informed by the imminent challenges that faced us.

I am therefore pleased to report to this august house that we have made significant progress in many priority areas of our work. These areas of progress include:

Mr Speaker most of our targets were met and almost half of those were exceeded.

While it has indeed been a challenging task, we intend to build on these achievements and improve from the previous years and ensure that the people of the Gauteng Province continue receiving better health care.

These and other commitments have been met and I am glad to report back that in some instances we have exceeded our targets.

When I tabled the budget for the year in discussion I also made public commitments which were eventually used as a yardstick to measure our performance.

These commitments continued to guide our work throughout the year. We never shied away from those commitments and indeed we made good on most of them.

Promoting Health

We took a conscious decision to ensure that our programmes are geared towards reducing the burden of illness. Our programmes are now proactive in that they are not just a knee jerk reaction to conditions of illnesses.

Our focus is on enhancing the Quality of Health of the people of this province, hence we have redoubled our health promotion efforts, to ensure that our people do not fall victims of chronic diseases of lifestyle, such as stroke, obesity, diabetes and heart conditions.

In the year under review, we have embarked on health promotion radio programmes which are broadcast through community radio stations. Soshanguve Community Radio, Technikon Northern Gauteng and Vaal Technikon Community Radio Stations are some of the media we used to communicate with our communities about preventing illness, and managing health problems.

We have taken our message of healthy living directly to our communities.

Child Health

Honourable Speaker, in order to ensure that our children do not suffer from preventable diseases we increased immunisation coverage of children under the age of one from 83% to 91%.

In order to maintain this momentum we have ensured that everyday is immunisation day at our primary health care facilities.

We have also intensified a programme to immunise children between the age of six months and 15 years at our hospitals' in-and out patient departments and in children's homes in order to ensure that those who could have missed immunisation do not fall victim to preventable illnesses.

Our Community Health Workers are also assisting us in ensuring that the families they visit are well informed and educated about the importance of vaccinating infants against preventable illnesses. We also contributed to our country being declared Polio free in 2006.

Maternal Health

In order to reduce maternal deaths, we established a dedicated Maternal and neonatal clinical care unit. This is aimed at reducing avoidable maternal deaths.

I would like to continue to encourage expectant mothers to attend ante-natal clinics religiously, as this will assist in identifying complications early in their pregnancy.

It has been proven that most maternal deaths are attributable to negligible attendance of ante-natal clinics.

Approximately 101 000 women were screened for cervical cancer, this amounted to a 61% increase from 2005/2006 financial year.

About 8 861 women had mammography performed to detect breast cancer in the year under review.

Effective implementation of the Comprehensive HIV and AIDS Strategy:

Voluntary Counseling and Testing is now offered at all our Primary Health Care facilities - with a total of 252 130 people being tested.

Honourable Speaker

We regard Voluntary Testing as the entry point in the continuum of care for HIV and AIDS. We encourage everybody to know their status in order to take appropriate measures in response to their HIV status.

Ninety eight percent of our health facilities now offer the Prevention of Mother to Child Transmission of HIV programme. We will soon introduce the dual therapy.

We have a total of 47 accredited sites where Anti-Retroviral Therapy is provided. We have exceeded the target of the number of people on treatment. We are treating the highest number of adults and children compared to any other province in the country.

In the year under review we funded 115 Non Governmental Organisations that provide Home Based Care. We have taken measures to ensure that these NGOs are accountable in order to eliminate problems that are associated with non compliance which in some cases has resulted in delays in the transfer of grants.

We have also increased the number of facilities that support victims of sexual assault.

Honourable Speaker

Post Exposure Prophylaxis is now offered in 58 facilities which is an increase from 52 in the previous financial year.

Treatment completion remains a challenge, as in the year under review the treatment completion rate was at 39%. This course of treatment Honourable Speaker is meant to last only for 28 days.

Once more we plead with those who have been victimised to present themselves within 72 hours of the incident.

Honourable Speaker, this intervention does not even begin to address the nucleus of this malady because 60% of victims of sexual assault that have been seen at these facilities are children.

Violence against women and children continues unabated, I therefore make a call to men as partners to intensify their role in preventing this malady as we have begun the 16 Days of Activism for No Violence Against Women and Children campaign.

TB

The overall cure rate for TB has improved from 64% to 69%. I would like to commend the health workers and Community Health Workers in their tireless efforts in tracking down TB Patients and ensure that they adhere to prescribed treatment regimens.

The emergence of XDR TB had a severe impact on the day to day management of the TB programme. We have therefore declared Sizwe Hospital a dedicate Multi Drug Resistant and XDR TB hospital.

Primary Health Care

Primary Health Care is the bedrock of our Health System. If the Primary Health Care System collapses, then our Hospital Services will follow suit.

In order to strengthen Primary Health Care we have put in place statutory structures to ensure cooperative governance in the delivery of these services.

This cooperative governance is evident in the fact that I meet quarterly with Members of the Mayoral Committee for Health in three Metropolitan Councils and three District Councils, under the auspices of the Provincial Health Council.

This Provincial Health Council discusses policy and monitors implementation of Primary Health Care.

Honourable Speaker,

The increase in the number of people who visit our primary health care facilities means that our people are voting with their feet. They acknowledge the quality of health services being offered at our clinics.

This increase in clinic visits has also been partly due to the shift of some patients from hospital outpatient departments.

Our clinics also undertook extensive management of chronic conditions such as hypertension and diabetes. To illustrate this point I will provide you with the following statistics:

I do not want to enter into a debate whether our people are becoming sicker or not. What we acknowledge is that after we launched the Quality Health Care campaign this year, health awareness has increased, there have been more visits to our clinics by risk patients.

Management of conditions that were previously managed at hospitals has also increased confidence of our people in primary health care facilities.

Emergency Medical Services

Our Emergency Medical Services are the busiest in the country. In the year under review a total of 519 948 incidents were responded to and of these, 44% were priority one cases.

The percentage of priority one cases that were responded to within 15 minutes increased from 54% to 59% in the year under review. We have undertaken measures to address those areas that affect our rapid response times.

Human Resources

Shortage of health professionals remains a challenge. In the year under review we filled 22 900 critical posts out of 27 140 vacancies. Recruitment and retention of health professionals remains a priority for us.

Hospital Services

We have begun a process of de-linking beds and treatment of minor ailments from Chris Hani Baragwanath, Johannesburg, Pretoria Academic, and Dr George Mukhari Hospitals.

This is envisaged at ensuring that the resources that are at our disposal are utilised optimally.

We urge our people not to present minor ailments at these hospitals as this clogs the health system and leads to resources - human, financial and equipment not being deployed optimally.

We have strengthened District Health Services in order to achieve this end results.

At the beginning of February this year we opened a state of the art Pretoria Academic Hospital. This hospital is a national treasure which renders tertiary health services even to people who come from outside our province and beyond our borders.

Johannesburg Hospital was voted for the third time in 2006 since 2004 by the readers of The Star Newspaper as the best hospital.

Chris Hani Baragwanath Hospital continues to provide a unique range of services and it is the biggest hospital in the Southern Hemisphere.

Dr George Mukhari Hospital reduced its surgical backlog drastically in the year under review.

Revenue The Department generated revenue of R264 Million compared to R254 Million collected in 2005/06 financial year.

Patient fees constituted 79% of the total revenue that was collected.

Honourable Speaker,

Within the budgetary constrains that face us our health services continue being rendered. We have not sat back and moaned about insufficient budget allocations.

We have stretched the rand into rubber. We have been innovative in many instances in order to ensure that the people receive the best medical care available at our facilities.

Being mindful of the above we acknowledge that budget allocations will never be sufficient, especially in a province such as ours.

In most instances we have become victims of our own successes. People continue to flock to our province because they believe the grass is greener on our side and this puts more pressure on the resources that are available to us.

Honourable Speaker,

We will take to heart those matters of concern that will be raised in the Oversight Reports of the Health Portfolio Committee and the Public Accounts Committee.

As I promised in last year's debate we managed to obtain an unqualified audit, we will also endeavor to strengthen our systems in order to obtain an even cleaner audit.

I thank you.

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