Minister of Health Budget Speech & response by ANC, DA & ACDP


12 Jul 2019

Minister of Health, Dr Zweli Mkhize, gave his Budget Vote Speech on the 12 July 2019


Speaker of the National Assembly
Honourable Chair of the Portfolio Committee on Health and members of parliament
My Colleague Deputy Minister of Health
MECS of Health
Heads of our Public Health Entities and Statutory Councils
Deans of Faculties of Medical Sciences
Health professionals who have joined us today;
Distinguished guests;
Fellow Compatriots
Ladies and gentlemen

It is a pleasure to table the National Department of Health Budget for 2019/20 of R51.46 billion (R51,460,690, 000).

The President stated in the state of the nation address of the sixth parliament that we must attend to the capacity of our hospitals and clinics. To this end we have a social compact that emanated from the deliberations of the Presidential Health Summit held in October 2018.

This compact will be signed with the President of the Republic of South Africa to confirm the partnerships between government and the private sector, academia, health professionals, civil society including organized labour to build a health system for the country that will be ready to implement Universal Health Coverage.

We recently attended the joint session of the G20 meeting of Ministers of Health and Finance where we reconfirmed our commitment as part of our shared understanding to strengthen our health system and health financing with an aim to achieve universal health coverage.

In the case of South Africa, we are implementing National Health Insurance(NHI) as a way to achieve Universal Health Coverage. The Director-General of the World Health Organisation, Dr Tedros Adhanom Ghebreyesus, articulated well a case for the implementation of UHC. He said that the potential payoff of UHC is tremendous.

“It’s children who survive beyond their fifth birthday because they are immunized. It’s women who are able to start small businesses because they don’t spend all their capital on health care. It’s men who don’t die before their time from a noncommunicable disease”.

It is against this backdrop that we have the confidence to commit to this cause despite the existing challenges of the shortage of staff and medicines, aging infrastructure, inequity of access and inadequate equipment amongst others.

We will use health as one of the critical levers to narrow the gaps and bring about the resolution of the country’s woes of low economic growth, inequality, poverty and unemployment and prevent the recurrence of human rights violations such as the Life Esidimeni tragedy.

This is the basis on which our people through their President have issued strong messages demanding improved services and elimination of long queues in health facilities.

What people have raised is in line with the National Development Plan and the Sustainable Development Goals which will be our guide as we address the health system challenges.

The major challenge of the health system is increasing burden of disease and the twin epidemics of communicable and non-communicable diseases.

Guided by the outcomes of the Presidential Health Summit, allow me to point out our plans that address the challenges contained in the nine pillars of the Health Summit compact. Progress on the plan will be reported upon periodically.

These are some of the interventions to help transform the health system, correct weaknesses and create a platform for NHI implementation.

National Health Insurance is a way of providing good healthcare for all by sharing the money available for healthcare among all our people. The health benefits that you receive will depend on how sick you are, not on how wealthy you are.

Under the NHI, health facilities and health workers will also be available to provide services to all, much more equitably. It all depends on our willingness to SHARE as ONE NATION. If we can feel and act in unity about sports, surely, we can do the same when it comes to matters of life and death, health and illness. National Health Insurance is a chance for South Africans to join hands in a way that really counts, regardless of race, gender or creed.

None of us would like a fellow human being to die, become disabled or live in pain just because he or she could not get decent healthcare. But this is happening in our country where poor people often have second rate healthcare while wealthier people can pay for good treatment. South Africans from all walks of life and all parts of our country have the power to change this tragic situation.

In my discussions with the health sector team, I have indicated that there are adequate reports and diagnosis of the problems in the health sector. We must now dive into the Implementation.

NgesiZulu kunesisho esithi umkhonto wegwala uphelela etsheni.

Loosely that means the spear of a coward gets destroyed by unending effort to sharpen it instead of getting on with the battle.

We must stop sharpening the spear now and march to battle and Implementation NHI.

There will never be a perfect plan nor a perfect timing. Poorer countries have implemented NHI and poverty cannot be cited as a reason to delay NHI.

The following interventions to improve the health services should be implemented simultaneously with preliminary steps to introduce the NHI.  

  1. Equitable Funding for the public health sector:

In my consultation and briefings with provinces, serious concerns were raised about the public health sector being significantly underfunded. The current baseline is below the expected level of funding considering the population size, disease burden and the expected quality of services required. To this end, we are engaging National Treasury to explore various modalities to adequately fund health services. In the long term the investment in NHI will create funding mechanism that will permanently resolve underfunding. Expenditure in health must be seen not as wastage but as an investment in a healthy population and contribution to economic growth.

  1. Shortage of staff- The shortage of frontline service delivery staff needs to be eliminated once and for all. We have identified shortage of staff which require immediate attention. Of the 4143 required medical officer positions, we will fill 2680 in this financial year. A proportion of the nurses, Allied Health Professions and Community Health Worker positions will also be filled within the same period. We are undertaking to absorb all the qualifying 2625 medical interns, and 6786 community service health professionals, including anticipated 700 additional graduates from the Nelson Mandela Fidel Castro collaboration programme on training medical students in Cuba. The joint team of National Department of Health and National Treasury have met to reprioritize the budget for this focus with the view to permanently correct shortage of staff involved in caring for patients.
  2. Supply of medicines – The budget for medicines must be ring-fenced and protected to prevent stockouts. We are developing a mobile App (software Application) linked to a call centre that will allow instant reporting by patients or civil society every time that vital medication is not available in clinics and hospitals. This information will enable authorities at provincial and national level to immediately intervene.

Where there are global shortages of medicines, we will endeavor to timeously identify alternative global suppliers or therapeutic alternatives. We will pursue strategies for local production of active ingredients to ensure security of supply of medicine. The South African Health Products Regulatory Authority (SAHPRA) will be strengthened to ensure that the registration of medicines and capacity for local production of active ingredients as well as removal of application backlogs are accelerated.

We are also exploring procurement of available software for prescription and delivery of medication to centres closest to patients making it possible to eliminate the need to go to health facilities for the sole purpose of collecting medication.     

We will be partnering with Non-Governmental Organisations to take advantage of IT systems that have already been piloted in the country. In this way we want to ensure that the entire health system can guarantee security of supply of medicine and timely delivery of chronic medication in areas including townships, informal settlements and rural areas.

I have instructed officials to identify areas where the system to improve supplies and eliminate shortages will be up and running within three months in all provinces. Thereafter provide a plan for wider rollout.

The impact of these two steps above will be reduced patient waiting time, less overcrowding and manageable patient workload on staff at health facilities.

4. Quality improvement – We welcome the reports by The Global and National Lancet Commissions on quality care. The quality of health care in the government-run facilities must improve to make the public sector a service of choice in terms of access, affordability, availability and appropriateness, technical competence, skills, effectiveness, efficacy, respect and caring amongst others.

We will implement quality improvement in all our public health facilities to ensure compliance with standards set out by the Office of Health Standards Compliance (OHSC). Within the first year, 25% of our facilities will undergo interventions that will prepare them for certification by OHSC in readiness for accreditation for NHI

Furthermore, client satisfaction surveys will be used to gauge and influence the quality of health services. I have directed that the department should develop a programme to run on mobile devices to empower the public to provide feedback on a few basic items such as quality of food, linen, cleanliness and attitude of staff to enable the department to effect corrective measures. These are non-negotiable measures that are needed to support the delivery of health services.

This will assist in strengthening support systems such as laundry, patient meals preparation to ensure efficient delivery of health services.

Office of Ombudsman. The Office of the Ombud is a channel by which the public can raise their concerns about quality in our health facilities. This office will be strengthened to ensure that it plays its central role in improving accountability within the health sector.

A combined strategy of improved clinical care, efficient administration backed by strong legal interventions will be used to reduce medicolegal lawsuits by more than 50 %.

  1. Improving Management and Governance - We intend to strengthen leadership at various levels in a way that will bolster service delivery and place the patient at the centre of care. A review of organograms will be undertaken, to eliminate bloated and inappropriate structures. Delegations will be adjusted to ensure appropriate levels of authority for effective decision making. This exercise should be completed in the next six months. Management systems will be strengthened to eliminate corruption and ensure efficiency. The intention is to promote ethical leadership and eliminate wastage of resources.

Consultation with the heads of specialist disciplines will be undertaken to strengthen clinical guidelines at tertiary and regional hospital level and build capacity of managers in all aspects including labor relations.

To improve governance in our health facilities, the department will ensure that all clinic committees and hospital boards are up and running by the end of this year. These structures will be trained to ensure that they are effective voices of the public to assist management to run the health system in a responsive manner and thereby improve the quality of health services.

  1. Infrastructure Build – It will be impossible to convince the public about the virtues of NHI unless the health infrastructure is rebuilt as a matter of urgent priority. Currently, an amount of R19 billion has been set aside for the MTEF period to refurbish maintain and build 4 hospitals and 34 clinics for R6 billion, 85 hospitals and 120 clinics for R5.2 billion and maintain 485 clinics for R8.9Billion. While this is a significant amount, it is grossly inadequate.

The department has done an audit of all facilities and costed the entire program of infrastructure build.

A team of experts in finance and health and infrastructure from both National Treasury and Health has been established to seek creative financing mechanisms and alternative models of delivering of health infrastructure.

They have been given a clear directive to accelerate the refurbishment of all old hospitals and clinics and deliver new ones within 5 to 7 years. This is the basis on which NHI will be operating. Preliminary indications are that this is feasible. Based on the developed plan I will engage provinces and other stakeholders to rally support on this matter.

  1. Strengthening PHC and reorganizing the District Health System – The move towards Universal Health Coverage through the implementation of NHI will be based on a PHC approach. This will require that we strengthen community mobilization in health promotion, screening, disease prevention, rehabilitation and early treatment of disease. An expansive network of CHWs and Community Care Givers serving a catchment population will be linked to support the delivery of PHC services in our communities. A well-organized referral system needs to be built to support the delivery of PHC services through referral to our clinics. Medical Officers based at District Hospitals will be required to perform outreach services at clinics so that we reduce the need for patients to be referred to hospitals to access care.

We also plan to review the operating hours of Primary Health Care centres with the view to ensure that service are more accessible.

We also plan to expand the contracting of General Practitioners such that they could deliver services. This role is supported by various stakeholders such as the South African Medical Association, Unity Forum of Family Practitioners and Progressive Health Forum amongst others.

Work is advanced to define the role and relationship with traditional healers and various other complementary health professions as part of PHC.

This matter has been discussed with the leaders of the various professional councils as well as with the Health Professions Council of South Africa, Pharmacy Council, and Nursing Council, Interim Traditional Health Practitioners, Council and the Allied Health Professions Council. We appreciate their support, guidance and advice in strengthening our institutions in preparation for the NHI.

We value the safety of our health workers in our facilities and measures are being put in place in partnership with the SAPS to prevent ghastly attacks such as happened in Pelonomi hospital in Free State and other provinces.

  1. Stakeholder management –. There is a strong need for cooperation between the public and private sector, civil society, patients’ associations, academics, researchers including labour in transforming the health system. We intend to have a dialogue with a wide range of stakeholders to aid the flow of information amongst parties within the next six months. I have consulted with most of the stakeholder groups and encouraged by their support in strengthening the health system. We appreciate that many are represented in this budget hearing.
  2. Implementation of National Health Insurance – Cabinet has approved the NHI Bill for tabling in Parliament for public consultation. In the interim the structure of the National Department of Health will be reorganised to support the implementation of the NHI. The NHI Implementation Unit will be established while the legislative processes are underway. This unit will form the embryo of the National Health Insurance Fund and a platform for capacity building for staff.  

As South Africa moves towards the implementation of the NHI we have developed the Health Patient Registration System. This system will form the backbone of an electronic health patient record. We have already registered 42, 6 million users on the system and all South Africans will be registered by the end of this financial year.

We support the Department of Home affairs in the birth registration of babies in our hospitals as they will then be registered automatically on the NHI patient register. NHI will require a digital health information platform that will support the operations of the NHI Fund and work has already commenced in this regard.

In consultation with the Deans and heads of specialist disciplines we will strengthen service delivery by streamlining clinical guidelines to direct services at tertiary and regional hospital level to strengthen our health system.

We will also build capacity of managers to implement NHI utilizing the bilateral agreements with Japan (JICA), UK (DFID), French government and EU funds amongst others. We have identified over 30 managers who will leave within the next four weeks to learn about NHI in different countries as well as anchors who will make implementation sustainable throughout the country.

The department of health will collaborate with academic institutions in building capacity for NHI including identifying academics and managers that will be trained abroad and using twinning arrangements to build sustainable local capacity.

Health Programmes – HIV/AIDS remains a high priority in public health with the aim to meet the 90/90/90 goals, Undetectable HIV Viral Load equals untransmissible and reduced illness and death rates. The department continues to work with the major donors PEPFAR ($700m), Global Fund ($635m, UNAIDS, WHO and Stop TB Partnership to meet the objective of Epidemic Control of HIV/AIDS and Tuberculosis.

Innovative strategies to increase the capacity of the National Health System, public and private will be scaled as a national priority. The investment from Government in the conditional grant for HIV/AIDS and TB treatment and Prevention is R22,038,994,038 for this financial year.

  • In this financial year we will ensure that 90% of all people living with HIV know their HIV status (6.8 million people, including 195,000 children), 90% of all people with diagnosed HIV infection receive sustained antiretroviral therapy (6.1 million people, including 175,000 children), and 90% of all people receiving antiretroviral therapy are virally suppressed (5.5 million people, including 158,000 children).
  • We will test 90% of all people with TB (408,600), treat at least 90% of them and ensure a 90% treatment success rate for drug-sensitive TB(and at least a 65% treatment success rate for multi-drug resistant TB).
  • We will Reduce TB incidence by at least 30%, from 834/100,000 population in 2015 to less than 584/100,000 by 2022. We will also increase the detection and treatment of asymptomatic STIs by 50% in high HIV prevalence districts.
  • We will ensure access to rehabilitation, psychosocial and mental health services for all, particularly people living with HIV and TB in every district. We will reduce new infections among youth from 1.2% to 0.7% and overall reducing new infections to below 100 000 by 2022.
  • The National Health Laboratory Service, Tier data systems (TB) and HPRS will be merged to provide improved case management monitoring and evaluation, medicine supply chain, budget and planning.

The National Department of Health will contract General Practitioners to broaden capacity to manage HIV/AIDS and Chronic diseases.

It is important for me to specify what will be in this initial critical package of services. In line with the Astana Declaration the PHC package will include the following services:

  • Maternal and child and neaonatal health services
  • Sexual, reproductive & adolescent health
  • Services required by older people
  • Rehabilitative care and palliative care
  • Non-communicable diseases: We will tackle Non-Communicable diseases working with partners– we will screen and put people on treatment for diabetes, hypertension, cancer, and we will provide integrated mental health services.
  • We will accelerate our efforts on screening and early detection of cancers to ensure that we provide timeous oncology services.
  • We will continue to address risk factors and promote health and prevent these silent killers.
  • Mental health: strengthening community mental health services including community level interventions for substance abuse, psychosocial support especially
  • Communicable diseases like HIV/AIDS, TB and Malaria will also be part of the initial critical package.

Finally, I believe it’s important to celebrate excellence in the public institutions as leaders in health care, innovation and academic training and research. I salute the hard working, upright and dedicated public servant whose lives are dedicated to doing good for the good health of our society.

I would also like to congratulate South African Medical Research Council on its 50th Anniversary; Dr Lindiwe Sidali from Inkosi Albert Luthuli Hospital on being South Africa’s first African Female Cardiothoracic surgeon; and Professor Mashudu Tshifularo who became the first person in the world to transplant middle ear bones using 3D-printed technology at Steve Biko Academic Hospital.

I wish to call upon my colleagues, the fellow health workers and South Africans to join the government and all stakeholders in health on a journey to revamp the health system and renew our vows to our professions.

May I take this opportunity to thank the President for his guidance, the Deputy President as Chairperson of SANAC, Deputy Minister and other Cabinet colleagues, the Director General, DDGs and the entire department for all the support. The stakeholders in health in academia, statutory councils, labor and professional bodies, private sector and civil society, have all made immense contribution in crafting this budget speech. I salute you all.

This is not time for diagnosis and debates.

As President Ramaphosa has put it.

It is time to KHAWULEZA!!
I hereby table this budget vote for your approval. I Thank You!


Deputy Minister of Health, Dr MJ Phaahla, gave his Budget Vote Speech on the 12 July 2019


Honourable House Chairperson
Minister of Health Dr Zweli Mkhize
Ministers and Deputy Ministers present
Chairperson of Portfolio Committee For Health Hon. Dr S Dhlomo and Honourable members of the committee
Honourable members of The National Assembly
Distinguished Guests

Thank You honourable Chairperson .The debate on our budget vote takes place just 6 days before we celebrate Mandela Day which  this year marks 101 years since our icon was born. This is also 25 years since President Mandela led our country into a peaceful transition from Apartheid tyranny to Freedom and Democracy.

Over and above leading us into the establishment of our democratic state based on constitutionalism  and establishing the key institutions which anchors the state, President Mandela  led in focussing on access to basic and social services to the most vulnerable in society . In his first 100 days he introduced feeding schemes at primary schools and free health services for children under 6 years and pregnant women. In his lifetime he established the Nelson Mandela Children's Fund and thanks to that initiative we today have a long-lasting memorial for him., the Nelson Mandela Children's Hospital.

Another impactful legacy of our icon is the Nelson Mandela -Fidel Castro Medical Training program which is based on the cooperation agreement signed by the two leaders in 1995.As of today this program has contributed 731 Cuban trained South African  medical doctors to our country and hundreds of Cuban nationals who are doctors in our health services. Just last Friday on the 5th July  we witnessed the graduation of 87 young new doctors conducted by the Rector of the Medical University of Havana at Walter Sisulu University in Mthatha. The overwhelming majority of these graduates are serving in rural areas. One of the graduates of this program is Dr Lindiwe Sidali , she is the first black African Female cardio-Thoracic surgeon operating at Inkosi Albert Luthuli Hospital in KZN. She  comes originally from rural Eastern Cape -Idutywa but like many families they migrated with their mineworker father to Wonderkop in North West near Rustenburg where she grew up and matriculated .If it was not for this program she would have  never realised her dream of becoming a medical doctor.

We are currently in the process of bringing back to South Africa 647 students who completed their fifth year of study in Cuba and will be starting their final year integration in local medical schools between 20th July and 1st August .The second chartered SAA flight with 215 students landed at ORTIA on the 11th July , yesterday and the last one will arrive 15th July.

These Cuban trained doctors will add a lot of impetus into the improvement of our Health Human resources with a major focus in Primary Health Care .They are going to be our building blocks on capacitating our primary health care services at district level.

As we have often stated , nurses are the bedrock on which our health services are built. The process of restructuring nursing education is at advanced stage .All public nursing colleges have been  restructured into one main nursing college per province  with sub-campuses in the districts which are 76 in total for the whole country.

Three national curricula  were finalised and used to develop province specific curricula. The new three year Diploma in  Nursing as well as the one year Advanced Diploma in Midwifery  and selected post- graduate  diplomas have been prioritised by all colleges. These programmes will be offered in a phased in approach commencing with the three year basic diploma in 2020.Prioritisation is aligned to the PHC re-engineering agenda and the national health priorities.

The Department of Higher Education is in the process of developing regulations for declaring Nursing Colleges as Higher Education Colleges in terms of The Higher Education Act. These regulations will specify that the nursing colleges , while established under the Higher Education Act (101 of 1997) as amended , will operate under the administrative  oversight and management of the  National Department of Health . In terms of a protocol to be signed by the two DGs the colleges will in the transition be able to continue operating until they are formally declared as Higher Education Colleges. The 9 provincial colleges , with 53 campuses will commence  with the 3 year Diploma in Nursing in January 2020.Further  campuses will offer advanced diploma in midwifery and other post graduate diplomas in critical care, trauma and others in a phased in approach from 2021.

Honourable Chairperson , noncommunicable diseases continue to outstrip infectious diseases in South Africa according to STATS -SA . A huge chunk of the deaths  are due to diabetes and cardiovascular diseases including strokes. Cancer has also been rising to epidemic levels. These developments can be attributed to urbanisation , commercial determinants of health, risk behaviour such as tobacco use, harmful use of alcohol , unhealthy diets and lack of physical activity.

The challenge of NCDs is also global and as a result , in September 2018 a High Level meeting of the UN General Assembly was convened by the Secretary General to focus Heads of States and governments on this  matter. Our own President Ramaphosa was a participant and we were there to support him and participate in several parallel sessions and civil society activities.

The General Assembly passed a political declaration which amongst others  expressed concern at financial and  human cost of NCDs on developing countries which was estimated at 7 trilion  US dollars over the next 15 years. The assembly reaffirmed the primary role of  governments in responding  to the challenge of NCDs by developing adequate national multisectoral responses.

The leaders committed to "strengthen our commitment, as Heads of State and Government , to provide strategic leadership of prevention and control of NCDs by promoting  greater policy coherence and coordination through whole -of- government and health-in-all policies as approaches and engaging stakeholders in an appropriate, coordinated , comprehensive and integrated, bold whole-of-society action and response" Implement affordable and evidence -based interventions. Accelerate implementation of  World Health Organisation  Framework Convention on Tobacco Control without interference by tobacco industry.

Get alcohol industry to contribute towards reducing harmful use of  alcohol and take steps to eliminate  marketing of alcohol to minors.

So these are the commitments  our leaders made at the UN in New York on 27th September last year 2018.

In this regard there are a number of steps we have taken.

1)New  draft legislation on tobacco control was published  in May 2018 which advocates a zero- tolerance policy on indoor  smoking in public places , including removal of smoking areas in restaurants and also regulating ecigarettes and vaping.

2)Introduced regulations to restrict salt permitted in 13 categories of foodstuffs through which most of us consume salt.

3)Tax on sugar -sweetened beverages was implemented from 1 April 2018.

4)DTI is leading , supported by DoH in enhancing visible health warning labels on alcoholic beverages , increasing  age restriction on purchase  of alcohol from 18 to 21 years and regulating alcohol advertising.

The DoH is in the process of designing front package labelling  which will alert  purchasers and users to the amount of sugar , salt and fats  in products in easy to read signs.

Following the call by President Ramaphosa in 2018 SONA to respond to the cancer pandemic , a number of steps have been taken.

1)National Cancer campaign was launched in October 2018 in KZN,

2)A number of Linear Accelerators were purchased  including for Charlotte Maxeke and Universitas Academic Hospitals and are being installed for radiotherapy treatment of cancer .

3)We continue to roll out the HPV vaccine in  two doses to grade 4, 9 year old girls to prevent cervical cancer .

Mental Health services remain severely under resourced but there is a focussed approach to increase capacity .In this year's budget we have allocated funds to contract private sector psychiatrists and psychologists to reduce the backlogs in both forensic assessments and referred patients  from primary health care facilities.

We are also retraining medical officers and nurses in district hospitals to better manage patients with psychiatric conditions.



The department of health has prioritised the elimination of malaria by 2023 which means zero local cases  by then. From year 2000 to 2018, cases have decreased by 73% from 64.622 in 2000 to 17 625 in 2018 .Deaths have decreased from 459 in  2000 to  116 in  2018 which is 74% down.

Challenges Ahead are:

Movement of mobile migrant population from endemic neighbours to RSA. We are working with them esp, Mozambique, Zimbabwe and Eswatini.

Some provinces do not secure  funding for indoor spraying , there are 3 affected provinces , Limpopo , Mpumalanga and KZN. We have secured R90m conditional grant from National Treasury to top up the budgets.

Before next rains we must ensure 90% Indoor Residual Spraying Coverage and  strengthen cross border collaboration.


The South African Medical Research Council continue to produce excellent scientific output by NRF-rated scientists including two NRF-A rated  scientists in its leadership.

Just to highlight some achievements:

a) Discovered new gene -CDH2 which predisposes young adults and athletes to sudden cardiac arrest, research done through a global collaboration.

b)Undertaking the first National TB Prevalence survey with fieldworkers visiting households in Eastern Cape.

c)Collaborated with the Agricultural Research Council and a company called Afripex which deals in wellness  products to produce Afripex GRTTM which is one of  key actives in Rooibos. This product will help in managing conditions linked to cholesterol, blood glucose and insulin resistance.

d)Established the Centre for the study of Antimicrobial Resistance (CAMRA) at UCT in response to the emerging antimicrobial resistance crisis.

e)The SAMRC received R10m to assist  young South African Scientists who are studying towards their PHDs in clinical and health research for the National Health Scholars Program from the Public Health Enhancement Fund, the programme has been  renamed the "Bongani Mayosi National Scholarship Programme.


The CMS has made significant  progress in the review of Prescribed  Minimum Benefits in order to enrich member entitlements and to ensure  preparation  for Universal Health Coverage.

The CMS regulated 78 medical schemes , 26 administrators , 15 managed care organisations  on behalf of 8.8 beneficiaries. The Medical Schemes Industry paid out  claims that totalled R172bn in 2018 with aggregated reserves of R62bn  and these excludes payments to administrators. If you  add the claims paid plus reserves =R234bn to service 15.5% of the population.

On the other hand the total budget allocation for 2018/19 for National and Provincial health departments was a total of R242bn to service the  remaining 48m South Africans or 84.5% of the population, a difference of only R6bn to serve 40m more people.

The office of Health Standards and Compliance received 1904 complaints in  2018/19 related to following domains :Patients Rights , Clinical Support Services, Leadership and Corporate Governance, Facilities and Infrastructure, Public Health and  Operational Management.

During  2019/2020 The office will issue certificates of compliance to  health establishments compliant with norms and standards. The certificate will be valid for 4 years and is subject to renewal.



The National Health Laboratory Services continues to be  the mainstay of Laboratory services to all public  primary health and hospital facilities. It also  trains pathologists and medical scientists. The board and management have stabilised it with a turnaround from  R1.8bn deficit to R1.4bn surplus for 2 years running. Thanks to the Acting CEO-Dr .Kammy Chetty and her management  team and chair  of the board Dr. Eric Buch and his team.

There is improved efficiency , service delivery as demonstrated by  improved turnaround times and quality.

The NHLS also runs two renowned  institutes, the National Institute  for Communicable Diseases and National Institute for Occupational Health. The NICD continues  to respond within 24 hours to notifiable outbreaks-recently being Flu, Ebola, malaria , measles etc.

The NHLS aims to continue improving quality of service and turnaround times by investing in equipment, IT, training and recruitment of professionals and improved quality management systems .


2018/19 was SAHPRAs first financial year as a public entity .This was a year of setting up to operate independently  and retain revenue collected through  fees from the pharmaceutical industry. The board  focused  efforts towards developing and implementing  strategies to address the backlog of applications for product registrations. Authorisation for section 21 applications were amended from manual to electronic which reduced the time for approval.

Amongst many achievements in its KPI SAHPRA managed to:

a)Issue a consolidated  5910 establishment licences , narcotic and psychotropic substance permits and registration certificates

b) Inspect 169 establishments for Good Manufacturing Practice , Good Clinical Practice  , and Good Wholesale Practice Compliance.

In the current 2019/20 financial year , amongst other SAHPRA will work on:

a)Roll out and implement the backlog elimination strategy and reduce it by 40%

b)Digitization of operational pathways and processes

Hon Chairperson the NDOH is ready to respond to the President's call for all of us to be ready to be sent and to move with speed , Thuma Mina and Khawuleza in the realisation of Universal Health Coverage