Hansard: NCOP: Unrevised hansard
House: National Council of Provinces
Date of Meeting: 01 Jun 2022
Summary
No summary available.
Minutes
UNREVISED HANSARD
NATIONAL COUNCIL OF PROVINCES
WEDNESDAY, 1 JUNE 2022
Watch: Plenary
PROCEEDINGS OF THE NATIONAL COUNCIL OF PROVINCES
____
The Council met at 14:01
The Deputy Chairperson took the Chair and requested members to observe a moment of silence for prayers or meditation.
ANNOUNCEMENTS
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Hon delegates, before we proceed I would like to remind you of the
following; the virtual sitting constitutes a sitting of the National Council of Provinces, that the place of the sitting
is deemed to be Cape Town where the sitting of the National Council of Provinces is, that delegates in the virtual
platform enjoy the same powers and privileges that apply in a sitting of the National Council of Provinces, that for the
purpose of a quorum all delegates who are locked in the virtual platform shall be considered present, that delegates must switch on their videos if they want to speak, that the delegates should ensure that the microphones gadgets are muted and must always remain muted, that the interpretation facility is active and that permanent delegates, special delegates and SALGA representatives are requested to ensure that the interpreting facility on their gadgets are properly activated to facilitate access to the interpretation services, any delegate who wishes to speak must use the “raise your hand” function or icon. I have been informed that there will be no Notices of Motion or Motions Without Notice, except for the Motion that is on the Order Paper, that is written in the name of the Chief Whip. Before we proceed to hear the Motion, I will now give to the Chief Whip in the place of ruling on what transpired yesterday. Just to assist us with his view, particularly as the custodian of discipline in the House of the NCOP. Over to you, hon Chief Whip.
The CHIEF WHIP OF THE NCOP: Thank you, Deputy Chairperson, hon Lucas, I thought that in light of yesterday’s incident, just before the end of the debate on policy on Human Settlement, and also having received a specific complain from the affected members and also having discussed with the presiding officers that I should make an appeal to all hon members to respect the decorum of the House. In our discussion with the presiding officers, concern was expressed that should the decorum of the House deteriorate in a manner that it happened yesterday, it will have serious implications in the decorum of the House and how the public should view this as a respectable House ofdiscussion and mutual respect. Respecting each other goes a long way in maintaining the decorum of the House. I want to make an appeal to all members of the council to make an effort in pronouncing each other’s surnames correctly. The term is
almost over and by now we should all be able to pronounce each other’s surnames correctly. If you are not sure of each other member’s surname, just refer to them as hon member. You can still ask them to assist you to learn how to pronounce their surnames correctly because our surnames are a big part of our
identity. We want to emphasise to members to always switch their videos on when addressing the House. If any member has challenges, you must firstly notify or seek permission from the officer presiding. We have also noticed members who continuously hackle or interject with their videos off. This is unacceptable. Together with the Whippery at its Whips Forum, we will discuss and suggest decisive action against members who continue to undermine the decorum of the House. I thank you, Deputy Chair. I hope that all of us do really appreciate one another and deal with each other in a manner that really stands with the decorum of the House. I thank you.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Thank you very much, hon Chief Whip. Hon Chief Whip, I hope you have also mentioned the fact that whatever is being said on the chat group becomes part of the record of this House. So members must also be careful what they are saying to one another or about one another in the chat groups. Thank you very much to our Chief Whip. I want to emphasise that we must respect the decorum of the House and uphold it as hon members that have been sworn in this House. So now I would like to call on the Chief Whip. Chief Whip, there is a motion in your name that is in the Order Paper. We will now allow you to read that Motion.
Mr W A S AUCAMP: Hon House Chair, on a point of order, if I may. Its hon Aucamp, Chairperson. Deputy Chairperson, I agree
with the Chief Whip. We must really look into the decorum of the House. What actually transpired yesterday was not about a
mispronunciation of a surname of a member ...
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Hon Aucamp, if I may. I think yesterday we agreed that the Deputy Minister
said sorry and have withdrawn. And then there was a specificcomplain that was to the Chief Whip. Because of the commotion
that transpired, and also because of the fact that the presiding officer complained that she felt that she was being
undermined and it was not the first time. We have decided to deal with this issue in this manner. Otherwise, if you want us
to go into details and speak about everything and deal with it the way you want us to deal with it, it will then have to get
to a point where we will have disciplinary investigations and so on. So can I from my side as the presiding officer of this House in the absence of the Chairperson, accept the way that the Chief Whip has dealt with this specific issue and if at all, hon Aucamp doesn’t accept the apology of the Deputy Minister or the fact that she said sorry and she withdrew, if you don’t agree, can you then put it in writing, sent it to
the Chief Whip so that he deals with it. For now, the Chief Whip tried to deal with a particular issue and try to see how
we can deal with it without taking this thing to other extent. So can I request that now we accept the way the Chief Whip
dealt with the issue. If we don’t accept, put it in writing and we will deal with it in that way. Because I am afraid that
everyone will want to explain now about what happened and what didn’t happen and we don’t have the time. We cannot afford to
do it now. Otherwise put it in writing and we will deal with it in that fashion.
Mr W A S AUCAMP: Deputy Chairperson, we really do accept that and we will most certainly do that. Thank you for the guidance
on this. I just wanted us to have the facts straight. We cannot agree with the Chief Whip if what he said is not
correct. Yesterday’s argument was not about the pronunciation of a surname. It was what was said about that group of people
that belongs in South Africa. But I will leave it at that. Thank you very much.
The DEPUTY CHAIRPERSON OF THE NCOP: Thank you very much, hon Aucamp. That deals with issue and we will now go to First
Order of which the Motion that is there and it is written in the name of the Chief Whip. Chief Whip, can you please then table the Motion.
APPOINTMENT OF SECRETARY TO PARLIAMENT
(Draft Resolution)
The Chief Whip of the Council moved: That the Council, on the recommendation of the Speaker of the National Assembly and the
Chairperson of the National Council of Provinces and in concurrence with the National Assembly, appoints Mr Xolile George as Secretary to Parliament on a five-year performance based contract, with effect from 15 June 2022.
Declarations of vote:
Ms C LABUSCHAGNE: Hon Chair, the Zondo Commission Report has exposed the crippling effect of corruption and its far-
reaching hand, this being evident by one of our very own Chairs being referred to the Joint Committee on Ethics and
Members Interests. I’m mentioning this because this position we are voting on is of such paramount importance and that is
why we need to get the appointment correct.
I want to be clear that I am not rising to question the validity on whether Mr Xolile George is fit and proper to take
on the position of Secretary to Parliament. It is evident that Mr George is highly educated and comes with the experience of being the chief executive officer, CEO, of the SA LocalGovernment Association, Salga, for the past 15 years andpreviously on the board of the Passenger Rail Agency of SA,
Prasa.
My contention lies with the fact that the only information
that will allow me to vote in good conscience was not provided
to myself or any other Whip through the NCOP. There was no
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report tabled or discussed with the Whips of the NCOP for this
House to make a sound decision, bar minimal information
provided by the Chief Whip. One question we have to ask is,
why Mr George was chosen out of that shortlist when he does
not have any parliamentary experience. However, most glaring
is that currently Mr George earns R5,8 million at Salga but
the Secretary to Parliament’s position has a salary of
R2,5 million. We cannot know the intentions of Mr George in
taking such a massive pay cut but one cannot wonder if this is
typical cadre deployment, which is concerning given the
gravity of this position for the democracy of our country. For
these reasons, we oppose. I thank you.
Mr T S C DODOVU: Hon Deputy Chairperson, I rise to support the
motion as tabled by the Chief Whip of the NCOP hon Seiso
Mohai. In the first instance, I think it is to emphasise the
fact that Parliament needs a substantive leader from an
administrative point of view and a person who is going to
stabilise Parliament in terms of ensuring that he is a
substantive accounting officer. This appointment comes at the
right time when Parliament has for a while had a vacant
position of secretary, and in this particular instance it is
quite important that we have that substantive leader who is
going to lead Parliament by ensuring that he puts the systems
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and structures in place and ensures that Parliament does what
is expected of it in terms of lawmaking, in terms of public
participation and in terms of oversight.
I rise to say and register this point that Mr Xolile George
stands in the right position. He is the right candidate to
take Parliament to majestic heights. He has the necessary
qualifications, he has the necessary skills and he has the
necessary experience. Whatever is happening at local
government cannot be attributed to one person. He comes from
an organised labour association called Salga and he has
demonstrated, in so many ways, that he is a capable leader who
can take Parliament forward.
I want to congratulate ... the process ... was clean, the
process that was fair ... that has helped Parliament to arrive
at this point where ultimately we are able to appoint a
substantive accounting officer. We need that particular person
for the very same reasons that hon Labuschagne mentioned, that
we need to ensure financial management and control of
Parliament. We need to ensure that whatever problems that were
obtained in the past is addressed. Sitting here with the
temperament that Mr Xolile George has, I have the firm belief
and ... [Inaudible.] ... commitment that he is going to make
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us proud and take Parliament forward in a way that will impact
on the work that we do as Members of Parliament. In that
sense, I rise to fully and wholeheartedly support the
candidature of hon Xolile George. Thank you very much, hon
Chair.
Question put: That the motion be agreed to.
IN FAVOUR: Eastern Cape, Free State, Gauteng, KwaZulu-Natal,
Limpopo, Mpumalanga, Northern Cape, North West.
AGAINST: Western Cape.
Motion accordingly agreed to in accordance with section 65 of
the Constitution.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Thank you
very much. Hon delegates, before we proceed to the First and
Second Orders, I would like to take this opportunity to
welcome the Deputy Ministers of Co-operative Governance and
Traditional Affairs, the Minister and Deputy Minister of
Health, MECs, and all special and permanent delegates to the
House. We will now proceed to the First and Second Orders,
which are the Policy debate on Vote No 3 — Co-operative
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Governance and the Policy debate on Budget Vote No 15 —
Traditional Affairs Appropriation Bill B7 — 2022 National
Assembly section 77.
Just before we give over to the Deputy Minister, I just want
to indicate that we have received an apology from the Minister
of Co-operative Governance and Traditional Affairs ... that
she is not well. She is not even attending the Cabinet’s
retreat because she is suffering from ill health. So, I will
now call upon the hon Obed Bapela the Deputy Minister of Co-
operative Governance and Traditional Affairs to open the
debate.
APPROPRIATION BILL
(Policy Debate)
Debate on Budget Votes 3 and 15: Co-operative Governance and
Traditional Affairs:
The DEPUTY MINISTER OF CO-OPERATIVE GOVERNANCE AND TRADITIONAL
AFFAIRS (Mr K O Bapela)[ON BEHALF OF THE MINISTER OF CO-
OPERATIVE GOVERNANCE AND TRADITIONAL AFFAIRS]: Hon Deputy
Chairperson of the National Council of Provinces, chairperson
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and members of the Select Committee on Co-operative Governance
and Traditional Affairs, Deputy Ministers for Co-operative
Governance and Traditional Affairs, Ms Thembisile Simelane-
Nkadimeng, members of provincial executives, delegates from
the provinces, representatives of the SA Local Government
Association, Salga, leaders of labour, business and civil
society, directors-general of the Cogta family, CEOs in our
sector, on behalf of our Minister, Dr Nkosazana Dlamini-Zuma,
and the Cogta family, I have the pleasure to present the 2022-
23 Budget Votes 3 and 15.
We present this budget speech with heavy hearts on account of
the passing of King Zanozuko Sigcau of the AmaMpondo Kingdom,
whom we had a very close working relationship with. He passes
at a time when he was on the mission of securing to realise
the unity of his vision of a consolidated and progressive
AmaMpondo nation and a working relationship amongst the
various strands of the AmaMpondo.
In that unity the Eastern Seaboard Development was to play a
central role. On behalf of the Minister, our government, and
the people of South Africa we wish to extend our condolences
to the AmaMpondo Nation and the people of the Eastern Cape, in
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him South Africa has lost a true developmental monarchy,
critical thinker and a visionary.
I also wish to extend the apology of the Minister who could
not be with us today in these Budget Votes. This is because of
the engagement of the economic retreat of the national
executive, which is currently underway. However, she is not
feeling well and she could not even attend the meeting that is
convened by President Cyril Matamela Ramaphosa. The Retreat
seeks to ‘turbo charge’ the economy towards meeting the 2030
targets of the National Development Plan and Agenda 2063: The
Africa We Want.
Of great coincidence and significance is that the retreat
follows the successful hosting, by the Deputy President, of
the Minister for Agriculture, Land Reform and Rural
Development of the National Communal Land Tenure Summit
between the 27 and 28 May 2022. We say ‘of great coincidence’
because, in fact, the matters related to our economy are
greatly intertwined with the question of land, which for us is
synonymous with the national question.
For us the land question is a source of the African paradox of
a rich Africa, but poor Africans, which the Minister often
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refers to. In our view, our economic and social troubles
started on 3 February 1488, with the spotting of the crew of
Bartolomeu Dias just outside Mossel Bay by the native
herdsmen. Our history and identity were to be tempered
forever, with that colonial and accumulation projects formally
taking shape on 6 April 1652 when Jan Van Riebeeck set foot
onto our land.
This majority was confined to 13% of the land at the end,
which was unproductive. Consequently, it is the provinces of
KwaZulu-Natal, KZN, the Eastern Cape, Limpopo, Mpumalanga and
the North West, which had the Bantustans, that experience the
highest levels of poverty. As a result, in seeking to reverse
that apartheid legacy, Budget Vote 3 skews allocations and
support to these poorest provinces. Thus, over the MTEF these
provinces will receive just under 64% of the R244 billion
Local Government Equitable Share budget over the MTEF.
However, because of a lack of opportunities in rural South
Africa, we must also constantly address inward migration
flows, which are placing undue pressure on the limited urban
infrastructure and services. Therefore, the provinces of
Gauteng, KZN and Western Cape, which have high inward
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migration flows have also received 48% of the Local Government
Equitable Share budget.
Unfortunately, because we have not fully completed our
discussions with the National Treasury and other stakeholders
on the funding formula. Despite the great need and the vast
travel distances, the provinces of Free State and Northern
Cape continue to receive the smallest share with 5,9% and
2,6%, respectively. It is discussions and propositions we
intend to finalise this year in the context of the 21-Year
Review of Local Government Report, which we will conclude by
the end of this calendar year.
Hon Chairperson, the mass degradation, which Mahmood Mamdani –
the academic from Uganda - refers to, was patriarchy based and
defined the majority as noncitizens whilst locating them in
the most unsuitable of land and in the fringes of urban South
Africa. Thus, Africans and the poor, as well as women and
children have been the most affected by the recent floods,
which have been experienced in Kwa-Zulu Natal, Eastern Cape,
North West and the Northern Cape. Because of the legacy of
apartheid and the lack of opportunities in rural South Africa,
many people in urban areas are living on flood plains,
potential landslide areas and dangerous sites.
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Consequently, 448 people lost their lives during the initial
floods in April, and an additional 11 lost their lives because
of the recent May heavy rains, bringing the total to 459. To
all those families, we take this opportunity to extend our
condolences once again. We also wish to thank the individuals,
private sector organisation, and public sector institutions
who have made it possible to provide dignified burials to
those families who required such support. 88 people are still
missing, and we are hard at work in finding those missing
persons.
We have deployed 4 698 of security, search, and rescue
personnel to find those compatriots. In the meantime, the
Department of Social Development continues to provide
Psychosocial support to those families and those that lost
their loved ones.
This disaster has also brought about unprecedented distraction
of infrastructure, including schools, clinics, bridges, and
roads. This has directly affected about 130 thousand
households, with over 22 000 houses being partially or fully
destroyed.
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An additional 6 793 people are now homeless in KZN alone.
eThekwini Metro is the most affected. Because 90% of our
imports and exports are conducted by sea and the Durban Port
is one of Africa’s busiest ports, with about 83 000 containers
passing there. The floods are of national and regional
consequence.
Thus, in the initial phases we concentrated on repairing the
Bayhead Road into the port as well as damages to the N3 and
N2, which link the port to the rest of our country. In
eThekwini the productive and factory-based area, known as the
Southern Basin, where Toyota is based, is amongst the most
affected areas. The area contributes R91,4 billion per annum
to the Durban economy, which is about 31% of the city’s gross
value added, GVA.
It also provides the city with R452 million in rates and taxes
per month, and generates 40% of Durban’s electricity. The
floods have affected that area, with over 40 000 jobs either
temporarily or permanently lost. No doubt, our recovery will
take months if not years. We have therefore assembled a three-
phased response plan, wherein the first phase we have focused
on humanitarian relief.
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For this phase we have housed over 7 200 people in
91 shelters, whilst providing basic needs such as food,
blankets, and clothing to them, since most of them have lost
everything of the little they had. For them and others, to be
registered and receive rights to health, education and social
protection, the Department of Home Affairs has gone into a
registration drive, so that they may receive the necessary
birth certificates and IDs.
For this phase of our response, we have received heart-warming
responses from the public, NGOs, and the private sector, as
well as the diplomatic community. Just this weekend, we
received a plane full of goods from the people and Government
of Qatar.
IsiXhosa:
Sithi nangamso kuni nonke!
English:
There are so many of you that to mention all of you would take
all the time allocated to this very important Budget Vote. We
will, in due course, publish all the donors, goods and amounts
we have thus far received.
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Eighty percent of the water services in eThekwini have been
restored, except for the Northern parts around La Mercy and
Tongaat, which have about 45% restoration on account of the
huge damage in that area. Nonetheless, N2 South was re-opened
on Friday. The N2 North is also under construction, and will
be complete in the next two weeks.
Going forward, we will pay greater attention to our risk
mitigation parts of our disaster management strategies. Thus,
as part of the third phase of building back better, we are
identifying and securing public land we can utilise to
resettle the affected communities. This will also require that
key sector departments, such as Human Settlement, Water and
Sanitation, as well as our departments and agencies,
reprioritise the existing grants and municipal allocations.
We may also require additional allocations from the Disaster
Relief and Infrastructure Grants. Once we quantify and develop
appropriate proposals, we will return to this and the other
House, with the hope that we will receive your support as hon
members.
Deputy Chairperson, from this disaster and the Covid-19
pandemic, we have learnt that our responses ought also to
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carry with them regional and continental dimension. Pandemics,
adverse weather conditions and disasters know no colonial
borders. Thankfully, we had already put in place the Africa
Centre for Disease Control, thus our ongoing response to the
Covid-19 pandemic and our vaccination drive is bearing better
fruits.
However, we must strengthen that institution. As we do that,
we must also pay attention to our SADC region’s early warning
systems and play a leading role in developing the necessary
institutional mechanisms and frameworks for the continent.
Another valuable lesson we have learnt from these recent
disasters is the need for all sector departments and the
spheres of government to integrate disaster management
principles in day-to-day operations. We also saw this when we
allocated the R157 million to address the effects of tropical
storm Eloise in 2021, which directly affected tens-of-
thousands of people in the provinces of Mpumalanga, KwaZulu-
Natal and Limpopo.
The effects of climate change are now a glaring reality, as
simultaneously we also had to allocate R221 million, in this
past financial year, for drought relief efforts in the Eastern
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and Western Cape. Scientists tell us that because the western
parts are likely to be drier and the eastern parts are likely
to be wetter. These types of weather patterns of floods and
droughts will be with us into the distant future.
The District Development Model, DDM, approach has been a
significant and effective feature of all our responses. Thus,
in finalising the ‘district and metro one plans’, we shall
bring the matter of disaster management and risk mitigation to
the forefront. This will also require that we simultaneously
review the 2005 National Disaster Management Framework,
because the type and quantum of disasters has progressed since
then.
The framework ought to be more responsive to prevention and
reduction of exposure and vulnerability to disaster, whilst
increasing preparedness for response and recovery. This will
also strengthen resilience.
The DDM approach has also favoured us with the opportunity to
take a deep dive in understanding the specific challenges
confronting each locality and district. We have had several
engagements with the provinces, municipalities, and
stakeholders in many localities, with over 40 DDM forums
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already established. The DDM presidential post-Sona izimbizo
have also added impetus to our outreach and dynamic
communications.
Already, we have visited the provinces of the North West, Free
State and Mpumalanga. It is our intention that the President
should visit all the provinces by the end of this calendar
year. Again, we are drawing many invaluable lessons from those
engagements. We believe that they could also act as a
supplementary programme to the ongoing parliamentary programme
of, Taking Parliament To The People, which the NCOP is very
much alive with. Thus, we hope that the constituency offices
of hon members, as representatives of communities, can play a
more significant role in future izimbizo.
Deputy Chairperson, last year, we also reported that we were
putting the DDM into action in the Eastern Seaboard
Development in the four districts, being OR Tambo, Alfred Nzo,
Ugu and Harry Gwala. We are happy to report progress in that
regard. The president has launched the project, the
interdepartmental national steering committee meets
fortnightly, and several community engagements have been
hosted by various Ministers and Deputy Ministers, as well as
some of our development partners.
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The Minister of Agriculture, Land Reform and Rural Development
will soon gazette the declaration of the area as planning and
implementation region, in line with the Regional Spatial
Development Framework, RSDF. This will facilitate for
accelerated implementation and the possibility of a special
purpose vehicle. Thus, bringing to reality catalytical
projects such as the Mzimvubu Water Project, Cannabis Project,
the Port St Johns Habour, amongst many others.
Hon members, the terms of office of National Houses of
Traditional and Khoisan Leaders are coming to an end, and the
new national house will be reconstituted once its term of
office ends on 30 June 2022. We have accordingly advised
provinces to start the reconstitution processes of Local
Traditional House, including the Traditional Council Houses.
We have also urged them to ensure that as the reconstitution
process takes place, gender equity in the composition of
houses will not fall by the wayside. Which has commenced with
its work as from 1 September 2021.
Deputy Chairperson, in our last Budget Vote speech we reported
on the preparations we had undertaken for the Local Government
Elections. Once again, South Africa has proved to the world
that we are amongst the best democracies in the world. Our
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elections were free, fair, and peaceful. At the time of our
last Budget Vote speech, we reported that we had also set
aside R350 million as gratuity to nonreturning councillors.
To date we have paid over R339 million to 4 987 councillors,
indicating a 97% achievement. All the former councillors in
Mpumalanga have been paid. About 26 councillors are still
outstanding in Gauteng; eight in the Eastern Cape; five in the
Free State; three in North West; three in KwaZulu-Natal; two
in Limpopo; two in the Northern Cape; and one in the Western
Cape. The outstanding payments are due to incorrect
documentation or wrong Sars numbers being submitted.
If there is an important lesson to be learnt from this
exercise, it is that we must pay greater attention to the
support, skilling and reskilling of the members of council –
particularly, the current councillors who have just moved into
office - and the staff at municipalities.
In this financial year, through the Municipal Infrastructure
Support Agent, Misa, we are training 500 municipal officials
in the requisite technical skills whilst enrolling another 100
officials in the recognition of prior learning programme. This
will ensure that they get formal qualifications in various
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infrastructure operation and maintenance disciplines. These
will be complemented and supported by the 300 young people who
will this year participate in our apprenticeship, experiential
learnership and young graduate programmes.
This skills challenge is also apparent especially when
considering that, as we went into elections 32 municipalities
were under various types of interventions, as we speak. In
comparison: KwaZulu-Natal had the highest number of
interventions with 10 municipalities; while Limpopo has the
least number of interventions, with only one municipality.
Post 2021 Local Government Elections, eight provinces retained
interventions that were existing prior to the elections,
except for North-West province. As of yesterday,
30 municipalities were still under intervention. Out of
30 municipalities, the three municipalities, being Lekwa,
Enoch Mgijima and Mangaung are under national interventions.
The Deputy Minister Thembi Nkadimeng will then be telling them
as to that particular engagement.
Deputy Chairperson, we also want to indicate that as we are
dealing with Budget Vote 15 of the Department of Traditional
Affairs, we see millions of young men are preparing to go to
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initiation schools. Sadly, 13 initiates in Mpumalanga have
already passed on since the resumption of the winter
initiation season. We extend our condolences to those families
that have lost their sons. It is our hope that the National
Initiation Oversight Committee, under the capable leadership
of Nkosi V Mahlangu, will provide us and the communities with
guidance on how we can once-and-for-all stop these unnecessary
deaths as we move on.
I also wish to take this opportunity to thank the National and
Provincial Houses of Traditional and Khoisan Leaders,
respectively, who have made this possible. Allow me to thank
them for their services as their terms come to an end this
month. We also want to thank the Khoisan Letters Commission
that has started its work and has advertised that those of the
Khoisan people who are claiming queenship or kingship or
traditional leadership must do so by 2024. The processes have
now been opened, they can really go in there and also be part
of the indigenous communities.
In conclusion, I wish to thank the Minister and the Deputy
Minister of Cogta, who is present here now, for all their
leadership. I also wish to thank the directors-generals and
staff of Cogta, the two departments and entities for their
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commitment and support as we work towards securing resilient,
sustainable, vibrant, cohesive, connected, nonsexist,
nonracial and climate smart communities, as we build for the
future. I thank you
Mr T S C DODOVU: Hon Deputy Chairperson of the NCOP hon Sylvia
Lucas, Deputy Ministers of the Department of Co-operative
Governance and Traditional Affairs, Cogta, hon Obed Bapela and
hon Thembi Nkadimeng, Chief Whip of the NCOP, permeant
delegates, special delegates, representatives of the SA Local
Government Association, Salga, ladies and gentlemen, our
flicking efforts to fix local governments as the weakest
sphere of government and the corn face of service delivery
must be continued. We must do so to ensure that local
government is a sphere that genuinely promote accountable
governance, a sphere that provides basic services to our
people in a very sustainable way, and a sphere that promotes
participatory democracy where the voices of the people reign
supreme.
Through our work of law-making, public participation and
oversight we must make sure that local government become a
sphere that truly works to promote social and economic
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developments as well as creating a healthy and safe
environment where people live.
This policy vote comes against the backdrop of a successful
2021 local government elections where the people of South
Africa deepened the democratic project and took another step
towards a nonracial, nonsexist and democratic society. We
would like to start by congratulating the people of South
Africa for displaying their commitment to the democratic
project in the midst of the challenges which have recently
engulfed the nation.
Towards the local government elections Cabinet released the
state of local government report. This report revealed that
whilst we have made advances in building a democratic and
developmental state we are yet to achieve our vision in the
local sphere of the state. The report highlighted that local
government was mired in challenges in political administrative
interface, financial mismanagement, misgovernance and service
delivery challenges. This report revealed that 166
municipalities experienced one or more of these challenges. Of
these municipalities 64 had reached a state of
dysfunctionality and 30 were under administration in terms of
section 139intervention of the Constitution.
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In the Select Committee on Co-operative Governance and
Traditional Affairs, Water and Sanitation and Human
Settlements, we can attest that in the process of conducting
our work we’ve interacted with these issues in municipalities.
In the oversight committee on the section 100 intervention in
the North West specifically, we saw a glimpse of this picture
where we found that these issues were also pronounced and were
at the heart of the collapse of municipalities in the North
West province. The provincial Department of Co-operative
Governance and Traditional Affairs was placed under section
100(1)(a) of the Constitution for reasons that it had failed
to finalise the organisational structure, 20 out 22
municipalities were dysfunctional and poor financial
management and a lack of implementation of audit
recommendations was the case. There was weak municipal support
from the department and water and sanitation support functions
were also weak. The lesson we’ve drawn from the experience in
the North West is that the weaknesses found in provincial
governments also contributes to the degeneration in our
municipalities and the exacerbation of the challenges
identified in the state of local government report.
Whilst we have made significant interventions using
constitutional mechanisms such as sections 100, 139 and 154 of
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the Constitution in addressing these challenges in at local
government, these interventions require continuous
strengthening such that they don’t become ad hoc, undefined
and in most circumstances this intervention take place when
municipalities are already in a weak position. This results in
interventions not making the desired impact and falling short
in the outcomes. The research conducted by the National
Treasury on section 139 interventions concurs with our
observations. We look forward to the reintroduction of the
Intergovernmental, Monitoring and Interventions Bill which has
been delayed for some times now. The research by National
Treasury argues that what is required is one piece of
overarching legislation that can be owned both Salga and the
Treasury, and includes appropriate parts of existing
legislation including the Municipal Finance Management Act,
Act 56 of 2003, MFMA, that guides the entire intervention
framework. This legislation in our view must address the
following key issues. It must ensure that section 139 is
implemented as intended, keeping in mind both the spirit and
the latter of the law. This implies that section 139 is no
longer seen as an intervention of last resort when a
municipality has collapsed, but as a framework to prevent such
collapse. Standardised and clear regulation of the entire
section 139 framework including the provision of clear
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definitions. In 2013 it was dismissed for failing to do this,
and the development of detailed threshold levels across a
range of indicators. Standardised and transparent
administrative practice must be introduced across all types of
interventions. Lastly, supporting institutions must also be
strengthened.
Hon members, adding to the picture painted by the state of
local government report was Statistics SA’s financial census
of municipalities report which was released in July 2021. It
revealed that an overwhelming number of our municipalities
relied on local government equitable share as a source of
income. This means that most of our municipalities are
financial unsustainable. The Financial Census of
Municipalities report reveals that if we consider the national
picture looking at the 257 municipalities, 71% of the total
income in 2020 was self-generated whilst the remaining 29% was
from government grants and subsidies as well as from donations
and contributions. This may seem impressive but this distorted
picture is skewed in favour of urban municipalities. An
important aspect to consider is that the eight largest cities
dominate the municipal financial landscape accounting for
almost 60% of the total municipal income. This was determined
using the municipal infrastructure investment framework which
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was developed by Cogta together with the Development Bank of
South Africa.
The Financial Census of Municipalities report also revealed
that there was a relationship between good political-
administrative interface, proper financial management and
improved service delivery with increase in self-generated
income. The report revealed that in local municipalities such
as Kamiesberg in the Northern Cape, Hessequa in the Western
Cape and Amahlathi in the Eastern Cape, there was a
significant increase in self-generated income while there was
a decrease in Renosterberg in the Northern Cape, Collins
Chabane in Limpopo and Mthonjaneni in KwaZulu-Natal. This
report must assist us to study the different contexts in these
local municipalities and see what lessons can be transported
to ensure that municipalities are put on a path towards
financial sustainability.
Another aspect to this problem of is the municipal debt crisis
which has reached crisis proportions. In the previous
financial year Eskom announced that the debt owed by our
municipalities had ballooned to R35,3 billion. It was also
revealed recently that the municipal debt to water boards had
also increased to R14 billion. We need to suggest creative
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ways in which this can be addressed because it hampers the
ability of municipalities from taking advantage of the newly
amended electricity regulations which provide that
municipalities in good financial standing may produce or
procure their own power.
On the inverse, municipalities are also confronted with a
culture of impunity which encourages the nonpayment of
municipal services. This was revealed by the Local Government
Revenue and Expenditure report which is part of the in-year
management, monitoring and reporting system for local
government. It revealed that as off 30 September 2021, the
aggregate municipal consumer debts amounted to R264,7 billion
compared to R194,2 billion reported in the first quarter of
2020-21. Government debt accounts for 7,4% or R19,6 billion
R16,7 billion reported in the fourth quarter of 2020-21 of the
total outstanding debtors.
We welcome that as part of the municipal support and
intervention package during the past financial year, 50 civil
engineers, 15 electrical engineers, 15 town planners, nine
assistant provincial managers and nine provincial managers
from the Municipal Infrastructure Support Agent, Misa, were
deployed to various provinces across the country. These
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professionals are supporting various infrastructure projects
and are supported by the 519 municipal officials who were
trained by Misa in this past financial year in infrastructure
management.
Additionally, a total of 382 young people were supported
through technical skills apprenticeships, leaderships,
graduate programmes and bursaries. This is complemented by
assisting some 100 young graduates in practical experience so
that they may complete their professional registration
processes.
Going forward, our select committee will align its quarterly
programmes in line with the annual targets of the Department
of Co-operative Governance and Traditional Affairs in order to
ensure the monitoring of performance, ensuring executive
accountability and in exercising parliamentary oversight in
the implementation of the annual performance plan as well as
the budget of the department. As Members of Parliament,
therefore, we must monitor and oversee the executive actions
of this department focussing on the implementation of laws on
spending their budgets appropriately, on implementing their
strategic plans and annual performance plans, on strict
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observance of the laws of Parliament and the Constitution as
well as the effective management of government departments.
Lastly and importantly, we must ensure that the laws that we
pass, especially the Bill that is in the pipeline, makes a
contribution in a true sense of the word – in the nonracial,
nonsexist, prosperous creation of our society as well as
making sure that local government work better to all of our
people. It is in that context that I rise to support the
budget of the department. Thank you very much.
Mr I M SILEKU: Hon Deputy Chair, hon members, hon special
delegates from provinces, let me also wish the Minister well
in terms of her illness and I am assured that she has better
chances of recovering, as compared to our municipalities.
Afrikaans:
Ek vra die Adjunkminister van Cogta en haar departement om
vandag mooi na my te luister.
English:
I made an easy conclusion after the department briefed the
Select Committee on Co-operative Governance and Traditional
Affaires, Water and Sanitation about the annual performance
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plan and the budget allocation of 2022-23. The budgeted money
does not correlate with the mammoth task. This department is
mandated to facilitate sound and honest municipal governance.
The Minister surely knows that the funding available for
municipalities and the public’s expectation from local
government are mile apart.
Afrikaans:
Adjunkminister, die waarheid oor plaaslike regering is ’n
tragedie. Van die 278 munisipaliteite is daar ’n handjievol
instaat om te funsioneer en dienste te verskaf, soos die
strukture en stelsel werklik vereis.
English:
There is a continued debate about a possible failed status of
the collective state of South Africa. I suspect the answer
regarding national and provincial government is that they are
failed entities. I know that municipalities, with a few
exceptions, of course, primarily in the Western Cape, have
failed long ago.
I am not playing cheap politics. The matter is far too serious
for that. The figures that I am about to mention come from a
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report delivered to Parliament’s Portfolio Committee on Co-
operate Governance and Traditional Affairs in August 2021. It
has been mentioned by hon Dodovo. An amount of 163
municipalities are under financial distress, 108
municipalities have unfunded budgets, 29 municipalities had
been placed under administration and just last week, during
our select committee meeting, we learned that a provincial
executive committee of KwaZulu-Natal has resolved to place
eight municipalities under section 139 of the Constitution.
This is seven months after the local government election.
Afrikaans:
Wat ’n skande!
English:
An amount of 64 municipalities are dysfunctional, 111 carries
a medium risk, 66 municipalities offer a low risk, 16
municipalities are stable. Incidentally, 12 of the 16 stable
municipalities are low risk and they are in the Western Cape.
Deputy Minister, surely, this is an indication that something
is done right and everything is done wrong, where we, as the
DA, does not govern.
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From the report, it is clear that the department is putting
their hopes on the district-based model to close the
disconnect between government at a national and local level,
and to remove silo planning, budgeting and implementation.
Afrikaans:
Die regering se respons op die chaos in plaaslike owerhede is
nog ’n plan en nog ’n eksperiment.
English:
Her party is excellent in the drafting of plans, but fails
with implantation. The department has a revised vision,
mission, objectives, priorities, focus and required outcomes.
This is a good thing, but these new things are not going stop
the sewage running in Jan Kempdorp or the water crisis in
Musina or the inability to spend cent of the MIG funds in
Kgama Kgama and the Richtersveld in the Northern Cape or the
Jagersfontein water crisis or the sewage solution in many
municipalities across the country.
The extend and duration of substandard municipal service
delivery in South Africa is intense and hurting the poorest of
the poor. People are starting to understand that nothing will
effect change. We have just heard this morning that petrol is
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rising, leaving us not using our cars, because the state of
the economy is terrible and we have to walk to work.
Unemployment is rising by the day. The ability to buy services
is declining due to a lack of funds and services. Access to
free and decent services is busy collapsing. If one considers
the levels of unemployment, the lack of government funds, the
implosion of infrastructure, and failed municipal governance,
we are heading towards the perfect storm. I want the Deputy
Minister and her department to convey the message that the
people had enough
Afrikaans:
Hulle het genoeg gehad.
English:
As recent as April this year, four civil society organisations
took the Minister to court about the failed intervention by
the Eastern Cape provincial government in struggling
Sakhisizwe Local Municipality. I am not surprised that the MEC
from Eastern Cape, who were supposed to speak before me, is
not here, because they are failing to fulfill their
responsibility.
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We have seen this happening in the past and we will see it
happen on a daily basis, if this government fails to
capacitate municipalities.
This government needs to streamline intervention in struggling
municipalities. It is very frustrating that there not urgency
to table the Intergovernmental Monitoring, Support and
Intervention Bill. This Minister highlighted this as a remedy
for her challenges experienced in the invoking of section 139
of the Constitution. The Bill is urgent, especially in light
of the Cabinet decision to intervene in 64 dysfunctional
municipalities, with possible desolation of some
municipalities, and guess what? The majority of those
municipalities are under the leadership of the ANC, who will
be losing power in 2024.
I warned them that, if they don’t start focusing on the
development of municipal service delivery and the building of
effective and sustainable municipal abilities, capabilities
and capacities, the storm would be ... [Inaudible.]. I warned
them if they continue to steal the little resources that is
left, ... [Interjections.] ... employment, they will be in a
... [Interjections.] ... in South Africa.
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I want them to start taking municipalities and service
delivery serious. It they don’t, people will take action. They
are already doing this in several local governments. Civil
rights entities received court approval for them to intervene
and restore municipalities.
The year 2024 is around the corner.
Afrikaans:
The ANC moet terugstaan, sodat ons bietjie regeer. Baie
dankie.
IsiXhosa:
Ndiyabulela. (Thank you.)
Mr M A DUKWANA (Free State): Hon Deputy Chairperson of the
NCOP, Sylvia Lucas, hon Chief Whip, Seiso Mohai, may I also
take this opportunity to wish our Minister, Dr Nkosazana
Dlamini-Zuma a speedy recovery, ladies and gentleman, today
marks a very important occasion when we have to appear before
you and indeed the people of our country to debate Budget
Votes no 3, considering the central role played by Co-
operative Governance and Traditional Affairs, CoGTA,.
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We engage in this process confident that the noble work we
have started of strengthening local government shall continue
unscathed. We join this debate cognisant of the many problems
and challenges that beset local government in our country and
in our province to be specific. The bulk of which could have
honestly been avoided.
We affirm the progressive policy interventions of our
government, particularly in relation to what needs to be done
at the local sphere of government. However, we appreciate that
the challenges we face require a lot more than strategic
sessions, progressive policy decisions and political
posturing. In this regard, the former President Thabo Mbeki
had the following to say and I quote:
The policies might be there but are people benefiting
from the policies? You do find that in many instances,
though the policies exist, they are not having the
necessary impact. That is a particular challenge in local
government, because that is where all the services get
delivered.
We restate these words to illustrate our belief that policies
must be championed through local government as a machinery
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located closest to our communities in order to make manifest
all developmental targets of our democratic government. It is
a travesty for local government, on the one hand, to expect
communities to comply with regulations and pay for services,
when, on the other hand, we are failing to implement our
policies and deliver services.
The fact that our people are beginning to demand answers from
municipalities, - What’s the plan? What is local government
doing for us? Is a perfect indication that municipalities
represent the closest reference point of government in the
imagination of our people.
As more and more people raise their voices and become active
in the affairs of local government, it is our expectation that
municipalities will take decisive action to improve their
overall service delivery performance. It is precisely for this
reasons that we need to be intentional about the role of local
government, with particular focus on the resourcing of
municipalities.
We need a collective effort and unity of purpose and
partnership with all leaders in municipalities in provinces
and the national government. We are committed to improve the
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political management of municipalities that are responsive to
the needs and aspirations of our communities. We are equally
aware of the fact that for us in the province to change things
around, we need desperately leadership with a vision to change
and the leadership with the calibre to drive the change
process.
The people in the province in our local municipalities are
ready for inspiration from the common purpose that is driven
by a leadership that is committed to serve. Our actions need
to move from intent to generating impact on the ground. To get
all the municipalities out of these dysfunctional state, we
need to enforce current policies and legislation and
enforcement of the system for managing consequences. And these
are equally very important, plus good governance. Which means
among other things, holding of council meetings as legislated,
the functionality of oversight structures, section 79 audit
committees, and district Inter-governmental Relations, IGR,
forums.
We must also assess the existence and efficiency of anti-
corruption measures and that is what we intend doing in the
province. To make sure that we’ve got anti-corruption measures
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that will ensure that the money that is used in our
municipalities is used for the purpose intended.
The extent to which there is compliance with legislation and
enforcement of bylaws, the rate of service delivery protests
and approaches to address them is very important for us if we
are to deal with good governance. But we also need to ensure
public participation does happen and for us to be able to
measure whether this happens, we need to look into the
existence of the required number of functional ward committees
and also of the grants that is spent in those ward committees.
To ensure that you are able to measure what we are doing and
what is happening in the municipalities.
There is also a very important element of financial management
and we need as the province to deal with the disclaimers in
the last financial three to five years. We need to deal with
these things and make sure that we ... [Interjections.] ...
there is some disturbance.
THE DEPUTY CHAIRPERSON OF THE NCOP: Hon Dodovu, can you mute
please? Apologies MEC and you may continue.
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Mr M A DUKWANA (Free State): ... Let me see you may continue.
We need also to look into the efficiency and functionality of
the supply chain management in the province. Hon Deputy
Chairperson, these are issues that I think we need to focus on
to turn things around in the province and to make sure that
we’ve got the proper leadership that will drive all this
process.
One of the biggest challenges in our municipality is shortage
of skills. And one of the primary reason for our poor service
delivery records is this issue. In the past, people used to be
appointed on the strength of political convenience and private
social relationships. The performance of municipalities in
delivering quality services to the people while the furthest
consideration during that period. This accounts for many
challenges that face our municipalities up until today.
Furthermore, there are inadequacies in the procurement
processes across all our municipalities. There appears to
exist an appetite for malicious compliance. For instance,
procurement processes are used to simply tick procedural
boxes, but not necessarily to extract value for our
communities. A bottle of water which you buy for R10, at a
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store is sold R100 to government. This is a battle which we
have committed ourselves to fight and win.
As CoGTA in the Free State, we have no quarrel in joining
hands with all our municipalities to address service delivery
challenges that have plagued our province for over a decade
now. We have committed ourselves to combating the collapse of
ethics, malfeasance and corruption. Good governance should be
the only ethic that is deeply embedded in the Deoxyribonucleic
acid, DNA, of our municipalities.
In future, these challenges will be avoided provided we
acquire the support of all stakeholders in the local sphere of
government. Thus, we have started to activate engagements with
municipalities, South African Local Government Association,
SALGA, communities and civil society organisations with a view
to establishing a common programme to deal with the challenges
we are facing.
Going forward, we will prioritise greater co-operation between
the provincial government and municipalities. Our government
cannot afford to be immersed in silo operations which
generally impede the overall progress in government effort.
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Mr A W BREDELL (Western Cape): Hon Chairperson, hon Deputy
Minister, hon members, thank you for the opportunity to
participate in this important policy debate. Local governments
in South Africa are on fire. We are seeing on a daily basis
that municipalities are unable to provide the most basic
services to our people. We are seeing municipalities that are
bankrupt. This is the real South Africa’s crisis. As it is,
the interface between people and us as government
representatives, it does not have to be this way. The good
news is that the changes that needs to be made to turn the ...
[Inaudible.] ... where our local government of health are well
within our reach. The good news is that we do not need the
services of expensive international consultancy forms or a
huge budget to turn local governments around.
Allow me to make a few realistic and within reach suggestions
to fix the current challenges we all across the country and
within all our provinces are experiencing. We all love our
democracy and nobody in this House will argue that democracy
is not working, but democracy also brings a measure of
instability and uncertainty to the people. Imbalance is a good
thing, unfortunately we are going through a phase in our
democratic journey where the instability in democracy is
phased out. The place where this is most evident is in our
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local government. Democracy is currently giving a bewildering
number of coalition arrangement in our municipalities and we
are not prepared to deal with.
In theory, coalitions are good for democracy but in our case,
it is creating instability to an extent that service delivery
is suffering or in some instances not happening at all.
Counsellors are spending all their energies fighting for
positions and have forgotten the public they have to serve. At
the disruption of regular by-elections, one can understand the
chaos on the ground. Surely, this was not the outcome our
democratic fathers and mothers had fought for us.
We need a revised legal framework that will allow for
stability in local government service delivery in this new
context of coalitions. The story of Nelson Mandela by local
municipality is not the 10-party coalition which is refusing
to work with the ANC council. The real story is that a large
metro in South Africa is running out of water and people
tasked to deal with it are occupied in political coalition
infighting. We need a legal framework to prevent this from
happening.
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On infrastructure, before we blame all the misfortunes on
political instability and coalition, we must be honest and
admit that underspending on infrastructure in local
governments have been with us longer than the coalitions on
the last elections. If we do not spend our capital budgets,
with care and long–term planning, we are going to face more
and more serious service delivery disasters. We are a country
with a positive population growth. More people mean more
infrastructure needs. We simply must plan better and develop
long –term visions that transcend political terms.
Budgets such as the Clanwilliam Dam on new electricity
generation sometimes takes decades or longer from conception
to completion, but we have to start and then we need to have
discipline to keep to the plan. The right people for the right
job and the right salary. We need to attract the right calibre
of professionals to work in our municipalities as engineers,
financial managers and municipal managers. Good and qualified
people are not willing to enter the ... [Inaudible.] ...
currently dominating our local governments.
Minister, we need to change this. We need young people to
study and qualify themselves in these fields, and we need them
to take up positions in our municipalities. We need to create
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an environment for stable and rewarding employment
opportunities in our local governments. A simple action in
this regard will immediately make work of the revisions needed
to the prescribed offer bands for salary structures of senior
officials.
Deputy Minister, revise these prescripts so that we can
attract and retain the needed skills in our municipalities -
The power to act when needed. Minister, I think I speak for
MECs of all the provinces when I ask for the following. As
MECs for local government, our hands are tied when we
desperately need to intervene in municipalities where things
are not going in the right direction. Currently, section 139
prescripts are unclear and confusing, and we end up in courts
and when interventions are finally approved, it is almost
always too late. Surely, we do not have to allow a town to be
destroyed before we can admit that outside interventions is
needed. Please, revisit the legal framework to support us in
this regard.
On fraud and corruption, another easy intervention that will
immediately show results in local government is a national
fraud and corruption unit in the national department of Co-
operative Governance and Traditional Affairs. Minister,
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establish such a unit that can be able to support local units
where they exist or fill the void where needed. Corruption and
fraud are cancers and they are killing our towns. Please help
us to administer the correct treatment in this regard.
On disaster management, the recent and tragic floods in
KwaZulu-Natal has shown us how important disaster management
is. Please strengthen the National Disaster Management Centre
and let us train and plan frequently together with provinces
to be better prepared come any future disaster. We need to
work together as provinces. Provincial borders are our
creation. Mother nature does not recognise or care about them.
We owe this to the people of South Africa and we can do it as
a gesture of respect to our loved ones who were lost in the
previous disaster. This is a leading national Department of
Co-operative Governance. It is said that a fish rot from its
head, and we as politicians have often rightly so and
sometimes unfairly been at the receiving end of these insults.
Let me say this that if we are to have stability in local
governments, we first need stability in the national
Department of Co-operative Governance.
Minister, through your leadership and wisdom, please support
us with a more stable and well-capacitated department as it
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will provide a positive example to our provinces, districts,
and local municipalities to follow. Local governments can
flourish if they realise that co-operation and collaboration
with other entities are the keys to success. In a complex and
fast-changing world, nobody can prosper in isolation. We are
seeing it play off at Eskom and private sector New Engineering
Contract, NEC, companies. We are seeing it in large
infrastructure projects where government alone does not have
the budget or skills to deliver on its own, that is why we
have developed an initiative, the Joint District and Metro
Approach, JDMA, in the Western Cape. This is an approach that
encourage and facilitate collaboration between stakeholders
irrespective of the department, spheres of government or
public or private sector status. The JDMA allows team work
without threatening mandates or muddling responsibilities.
I conclude, local government does not have to be in the midst
it is currently in our beloved country. There are serious
financial constraints and again, we are faced with
unprecedented political instability, but through careful
planning and with the right people in the right positions, and
together with some revisions of current legislation, we can
turn the ship around. We should not despair. Let us take small
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steps in the right direction, and let focus on the future and
not only on the next by-election. I thank you.
Mr S ZANDAMELA: Thank you Deputy Chairperson, the EFF rejects
Budget Vote 3 on Co-operative Governance and Traditional
Affairs. We reject the Budget of this department which has 64
municipalities which are considered high risk and
dysfunctional, with 111 municipalities considered medium risk,
but also highly dysfunctional, with only 16 municipalities
considered stable in the whole country.
There is lack of political leadership at the Department of Co-
operative Governance and Traditional Affairs, which has led to
the dysfunctional state of municipalities in the country, as
municipalities continue to fail to uphold their constitutional
mandates of providing services to their communities in a
sustainable manner.
The financial state of municipalities continues to worsen as a
lack of accountability and poor governance continues to reign
over the country at local government level.
Under the leadership of this department, municipalities are
characterized by aging infrastructure, poor maintenance,
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potholes, corruption, water leaks and electricity shutdowns,
which are the order of the day.
The state of municipalities is dire. Municipal finances are
handled in a hazardous way, with 46% of recoverable revenue
and equitable share used for salaries and council
remuneration, while only 2% was spent on maintenance.
Property owners, who pay rates and taxes, hardly see any
services delivered in an adequate manner.
The municipalities fail to uphold their constitutional
mandates of providing services to their communities in a
suitable way to promote a safe and healthy environment for
communities to thrive.
The dysfunctional state of municipalities has been public
knowledge for a while, and yet there seems to be no appetite
for fixing the mess that is in these municipalities. Year in,
year out, the Auditor-General reports the failed state of
municipalities, but there exists little appetite in government
for relooking the structure of municipal funding, which
favours more urban municipalities where residents are able to
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pay their rates and self-finance the operations at these
municipalities.
The department has failed to provide decisive leadership on
the dysfunctional municipalities which is a great concern. The
high level of poverty, unemployment, poor and lack of basic
services is the order of the day in most municipalities.
The state of local government has a direct impact on
businesses and livelihoods of communities. Municipalities
therefore contribute to the worsening of the country’s already
constrained fiscal situation. Supervision and monitoring are
not taking place and there must be better accountability for
these failures.
Municipalities continue to drown in corruption and that
Illustrates the lack of improvement or solution of the
hostility between mayors and municipal managers while
communities are the ones that are suffering.
The most disgraceful of these municipal failures is the lack
of urgency in which the disaster of Kwazulu-Natal has been
handled by both the department and the Ad hoc committee. Both
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the committee and the department have deserted people the
people of KwaZulu-Natal.
This department, like many others, needs to be properly
capacitated and free from any political interference. The
department is preoccupied with cadre deployment within its
programmes.
The Department of Co-operative Governance and Traditional
Affairs is overshadowed by factional politics of the ruling
party whereas the people continue to suffer the consequences
of an incompetent leadership in the department.
All section 139 interventions of the Constitution have proven
fruitless without monitoring, because like every incompetent
department, oversight of all programmes is to ensure that
interventions are effective and efficient. For more than two
decades the interventions by provincial governments in
municipalities have not worked. The overall intervention
system in local government needs a complete overhaul.
Oversight was recently conducted in the Free State province,
and the state of municipalities in that province is shameful.
In all 23 municipalities of the Free State, mayors are
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fighting with municipal managers for the control of tender
opportunities. This happens while our people are crying out
for services.
The Community Works Programme has been used as a tool for
looting, and has not had the intended outcomes of empowering
people and alleviating poverty.
People of South Africa must do as the people of ward 3 in
Phokwane in Northern Cape did, and the people of ward 5 in
Mafikeng did in the recent by-elections by voting for the EFF
and reject this corrupt ANC. The EFF rejects the Budget of the
Department of Co-operative Governance and Traditional Affairs.
Ms B M BARTLETT: Hon Deputy Chairperson, hon members and
colleagues, good afternoon. The vision of a developmental
state that is outlined in the National Development Plan, NDP,
is rooted in the broader context of a mixed economy. The state
is envisaged to be playing a role of directing public
investment into productive sectors of the economy whilst also
providing incentives for the private sector.
The Economic Reconstruction and Recovery Plan that was
outlined by the President following the devastation of the
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COVID-19 pandemic on our economy demonstrated that the ANC
remains committed to the perspective of the developmental
state. The Economic Reconstruction and Recovery Plan was
outlined to have three phases.
The firstly is to engage and preserve, secondly, recovery and
reform, thirdly, reconstruct and transform.
The Plan also identified the following key priorities as part
of the interventions to be made: Firstly, aggressive
infrastructure investment, employment orientated strategic
localization, energy security, support for tourism recovery
and growth, gender equality and economic inclusion of women
and youth, green economy interventions, mass public employment
interventions and strengthening food security.
Hon Deputy Chairperson, as we strengthen the capabilities,
professionalism, and ethics in the local state, to harness its
developmental energies we must also locate the role it should
play in the context of the Economic Reconstruction and
Recovery Plan. The local state that has a responsibility to
provide services to our local communities and ensure champion
local economic development must come up with programmes that
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ensure that the economic reconstruction and recovery plan
becomes a reality in our local communities.
With regard to infrastructure development, hon Chairperson and
hon members, investment in the building and maintenance of
infrastructure is not only critical for service delivery and
dignifying the lives of our people in their communities, but
we view it as a necessary to attract investment into our local
communities. Private capital will invest in areas where basic
services such as water and sanitation, electricity, and roads
and transport infrastructure is provided, the task of local
government is to ensure that these are provided for in a
reliable and consistent manner.
It is totally unacceptable that in areas such as Hammanskraal
in Tshwane Metropolitan, Ditshobotla Local Municipality, and
Maluti-A-Phofung Local Municipality, small-medium enterprises
which should be the engine of job creation have to from time
to time shutdown operations because of the lack of the water
in those areas. The state should direct public investment into
such areas to ensure the building of bulk water projects and
maintenance of raw water infrastructure. We would like to see
strategic localisation in these infrastructure projects as
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outlined in the Economic Reconstruction and Recovery Plan, hon
Deputy Chairperson.
We are also impatient with the slow progress in the resolution
of the energy challenges confronting the nation, whilst there
are numerous ongoing interventions from national government to
ensure that Eskom is more efficient and allow independent
power producers to make their contribution in stabilising the
grid, but equally important is that we should locate the role
of the local state in providing permanent solutions.
The newly amended electricity regulations allow municipalities
in good financial standing to develop or procure their own
electricity, our interventions in this regard should be first
aimed at addressing the municipal debt crisis. Secondly,
building the necessary capacity in our municipalities to play
a role in the production of energy. This can be done in
ensuring that municipal integrated development plans, IDPs,
are aligned to what is articulated in the Integrated Resource
Plan, IRP.
Hon Deputy Chairperson with regards to the District
Development Model, DDM, we remain convinced that the District
Development Model will go a long way in addressing the
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identified challenges, this approach is intended to foster
practical intergovernmental relations to plan, budget, and
implement jointly to provide coherent “One Plans” for almost
all of the 44 Districts and seven metropolitan municipalities
have been developed and we are steaming ahead.
During the pilot stages of the DDM we have been able to see
success in the three municipalities, draw lessons, and also
identify challenges that should be addressed going forward.
In the Waterberg District for example, in order to address
youth unemployment focusing on driving a skills revolution,
the Development Bank of Southern Africa, DBSA, has approved
R52 million for the establishment of DBSA Developmental
Laboratories, D-Labs, which are aimed at creating spaces which
result in a community-based economic ecosystem.
Hon Deputy Chairperson the One stop facilities that have been
introduced as a critical part of South Africa’s antirape
strategy aiming at reducing secondary victimisation and to
build a case ready for successful prosecution.
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In OR Tambo 50 Small Micro Medium Enterprises, SMMEs, and co-
operatives have already received support from the district and
partners in the form of financial support.
A Youth Incubation Programme is being implemented in the
district focusing on a number of sectors including furniture
manufacturing and is undertaken in partnership with Furntech
and provides incubation support to 30 entrepreneurs.
We have also drawn lessons from these three pilots, one of
them is that although there is a shared agreement and
understanding among the stakeholders on the importance of
periodic monitoring of development outcomes at a district
level, there is also a need to develop an Integrated
Monitoring and Evaluation Framework. This framework supports
the institutionalization of the DDM by further advancing an
outcomes-based approach.
Hon members, we are aware that the DA-governed Western Cape is
opposed to the DDM, this is why they have not produced their
One Plan for development like other metros and districts.
There is no mystery in this position taken by the party
because the DA opposes anything that has a chance of reversing
the colonial apartheid legacy such as the racially skewed
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spatial development. Recently the Godmother of the party, the
racist Halen Zille, said that it is better to be poor in Cape
Town than any other place. This statement should demonstrate
that this party has no interest in shared growth and
prosperity that integrates the development we see in white
suburbs with the township areas such as Khayelitsha, Nyanga,
and Langa.
The District Development Model enables government and social
partners to locate each district’s competitive advantage and
utilise it for shared growth and prosperity. By purposefully
linking local economies with our district and national
economies we can massify, optimize and transform the structure
of the economy. This will require that we also pay particular
attention to the inclusion of women and youth, by reskilling
them and facilitating greater access to financing and credit
for ventures in a sustainable way.
The DDM hubs must serve as a functional network of support and
a facilitation system for intergovernmental planning in
relation to a specific district space. This must be guided by
the national government’s transformative policy objectives.
The economic development potential of rural regions such as OR
Tambo in the Eastern Cape, where only 15% of the people are
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employed and 65% live in poverty, will be unleashed through
the DDM.
As I conclude hon Deputy Chairperson, let me state that we
remain unapologetic in our quest to change the patterns of
distribution and the structure of the economy which is still
racially skewed in favour of the minority of this country, to
ensure that blacks in general and Africans in particular,
participate and are liberated from the shackles of poverty and
unemployment. In the process of the democratisation of South
Africa we have managed to create access in the economy to
allow for the participation of the historically disadvantaged
and this has unleashed a black middle class which is one of
the significant drivers of the economy. The ANC shall deepen
the program of radical socioeconomic transformation. The ANC
supports this Budget Vote. I thank you, hon Deputy
Chairperson.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Hon
members, we will now call on the hon Boshoff. After the hon
Boshoff, the hon House Chairperson Ngwenya, will continue with
the presiding duties. Thank you very much.
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Ms H S BOSHOFF: Hon Deputy Chair, municipalities throughout
the country, similar to everything that is under ANC rule bar
those that are ruled by the DA, are under a new threat. That
threat is that municipalities which fail to honour their Eskom
debt are in all likelihood staring down the barrel of a total
shutdown by Eskom, as it can no longer continue to maintain
its infrastructure and continue supplying electricity for
free. On top of this, ANC-run municipalities are so
dysfunctional and stripped of skills and expertise that
residents are subjected to rotational load shedding due to the
lack of maintenance of the infrastructure and also because of
the Notified Maximum Demand agreements being exceeded. We see
residents and businesses in many towns sitting without
electricity for 10 hours or more per day. This is leading to
many businesses having to close their doors as they cannot
function without the supply of electricity, especially now in
light of the increased fuel prices.
The impact on families with babies, hospitals and old age
homes is catastrophic. They cannot survive this. Power cuts
have caused sewerage plants to pack up, fouling the water
supply and causing untreated sewage to wash down roads and
through dwellings, and of course into rivers and streams.
Think of the health implications this brings about. The
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potable water supply also becomes insufficient and unsafe,
which means that schools and hospitals alike are unable to
maintain a standard of hygiene.
Representing Mpumalanga in the NCOP, I wish to concentrate on
municipalities in this province that are in arrears with their
electricity accounts. Emalahleni owes more than R5 billion,
Govan Mbeki R2 billion, Lekwa R1,5 billion and Thaba Chweu
currently stands at R1,046 billion. There are seven more
municipalities that are nearing the R1 billion mark and
together with them the total amount owed to Eskom as of
31 March 2022 stood at more than R13 billion. This is shocking
as neither the provincial nor national departments of Co-
operative Governance and Traditional Affairs have spoken out
on this issue. I would drop my head in shame if I were the
custodian of Co-operative Governance and Traditional Affairs.
Unfortunately, the Minister is not here today, so shame on
you, Deputy Minister!
Hon Deputy Minister, this behaviour of not honouring account
payments should not be tolerated, as it threatens the security
of supply to citizens residing in these supply areas. Why
should these citizens who diligently pay their monthly
accounts, mostly via prepaid meters, be held hostage? What
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should be done is that the money generated from the citizens
for electricity should be ring-fenced so as to prohibit
municipalities from utilising it for their operational budget
spending, like the purchasing of new vehicles, paying of
salaries, lavish lekgotlas, imbizos and many more senseless
expenditures.
You, like I, Deputy Minister, know that these municipalities
have a constitutional responsibility and duty, not only to
Eskom but to their customers, to fulfil their financial
obligations for the bulk supply of electricity, to afford
Eskom the opportunity to meet its obligations.
Deputy Minister, let me take this a step further and speak on
the illegal connections which is another factor that is
hampering the supply of electricity to paying customers. Thaba
Chweu, the municipality that I reside in, has seen and
experienced many protest actions with reference to these
illegal connections. In the town of Sabie, 92% of residents
are not contributing to the fiscus for the use of electricity.
However, hon Deputy Minister, at times I can understand the
frustrations of the people of municipalities, as they are not
afforded the opportunity to be able to connect to the bulk
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supply as no new infrastructure is provided by the relevant
municipality. The questions that remain unanswered are the
following. Where does the money disappear to? What do they use
the grants for? This is what we need answers on.
Deputy Minister, together with the communities in the areas
mentioned, I call upon you to urgently address this matter to
ensure that these people are not left in the dark. Your
intervention through interaction with the Mpumalanga
provincial MEC to seek and implement solutions would go a long
way to secure peace and stability. I thank you.
Afrikaans:
Mnr S F DU TOIT: Agb Voorsitter, ek het aanvanklik oorweeg om
slegs op plaaslike regering te fokus, maar die Minister het
tydens haar begrotingsdebat in die Nasionale Vergadering tot
’n redelike mate op die onlangse oorstromings in Natal
gefokus.
English:
It is always interesting to observe some politicians when they
deliver speeches. Some speechwriters have the ability to spin
a situation and to play with words to create the illusion that
something is being done about a problem, by only acknowledging
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and identifying the issue. This is exactly what Minister
Dlamini-Zuma’s speechwriter managed to do.
Afrikaans:
Voorsitter, daar is erkenning aan die 448 persone wat tydens
die oorstromings gesterf het gegee, maar ... nie gesê dat die
hoeveelheid afgestorwenes minder sou gewees het as
ontwikkeling volgens munisipale regulasies plaasgevind het.
English:
Mention was made of more than 6 500 houses that were destroyed
and 10 000 houses that ... partially destroyed, but nothing
was said about the fact that in one of the districts — almost
two months after the disaster — out of the 88 houses that were
destroyed ... where temporary housing units were supposed to
be built, only four slabs have been cast up to now.
The Minister sincerely thanked and has been, “warmed by the
empathy and solidarity displayed by millions of South Africans
who have, individually and collectively, contributed to the
129 000 affected residents”. What the Minister neglected to
mention was that none of the Solidarity Fund’s ... has been
paid over to affected municipalities to assist the
129 000 affected residents.
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Afrikaans:
Die Minister het in haar toespraak genoem dat die ramp die
werklikheid in toename van honger, armoede, werkloosheid en
ongelykheid vererger. Dit is korrek. Wat die Minister nalaat
om te noem is dat haar regiede, onmenslike
inperkingsregulasies daartoe bygedra het dat tuseen twee en
2,2 miljoen persone hul werke en inkomste sedert 2020 verloor
het; dat haar regulasies veroorsaak het dat skuldvlakke
verhoog het; dat kinderhonger toegeneem het; dat geweld teen
vroue en kinders toegeneem het; dat miljoene kinders se
onderwys en geletterdheidsvlakke negatief geraak is; dat
onwettige handel in sigarette, wat belasting vordering
negatief raak, deur die dak geskiet het; en dat ongelykheid
weens haar regulasies vergroot het.
English:
The Minister mentioned that, despite the extent of these
challenges, that the effect of the disasters ... they had
implemented in their programmes ... which seek to build safe,
nonsexist, sustainable, prosperous, cohesive, connected and
climate-smart communities, and that they must reconstruct and
build back better.
Afrikaans:
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Voorsitter, deur u aan die Minister in haar afwesigheid,
indien u en u departement so ernstig was om ’n beter lewe vir
almal te verseker, hoekom sou beide die Burgemeester en
onderburgemeester van die eThekwini-munisipaliteit, een van
die areas wat die ergste deur die oorstromings geraak is,
opsetlik die besoek van die adhoc-komitee oor rampe vermy?
Minister, hoekom gee u voor asof die regering die belange van
ramp-slagoffers vooropstel terwyl u van reeds sukkelende
munisipaliteite verwag om hul eie, uitgeputte en soms
verwronge begrotings aan te pas; begrotings wat reeds tot ’n
groot mate tot medium en langtermyn projekte verbind is, te
herprioritiseer om vloedskade aan te spreek?
English:
Minister, how can you say that your programmes seek to build
safe and prosperous communities when the government promised
R1 billion towards disaster relief; funds that have not been
availed yet; funds that will not seem to be new money ... be
reprioritised funds that might or might not be available only
after September this year? This, whilst individuals, no
communities, will have to stand in queues for drinking water,
whilst mothers and children are reliant on hand outs in
shelters, expecting a better tomorrow with winter knocking on
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the door and their dignity hanging in the balance? How can you
sleep at night? In closing, Chair ...
Afrikaans:
... Voorsitter, plaaslike regering se toestand is die
spieëlbeeld van die ANC se nalatenskap. Hulle hoef nie ’n
R22 miljoen vlagmonument op te rig nie. Die vervalle
munisipaliteite, monumente van hartseer, nagelate
infrastruktuur, riool en waterbesoedeling, donker strate en
ewig-teenwoordige slaggate ... dit is u nalatenskap.
English:
The only cohesion that your department managed to establish is
protest actions, in and around municipal areas. Thank you,
Chair.
The HOUSE CHAIRPERSON (Ms W Ngwenya): Hon members, the next
speaker is the hon L Miga MEC of the Department of Co-
operative Governance, Human Settlements and Traditional
Affairs in the North West province. The hon L Miga.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Hon House
Chairperson, hon Miga did indicate that she has serious
connectivity problems. So, I do not know whether she is back
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in. If not, let us continue. We might come back to her. I am
sorry I did not indicate upfront.
The HOUSE CHAIRPERSON (Ms W Ngwenya): Thank you very much hon
Deputy Chairperson. The next Speaker is the hon T Nkadimeng,
the Deputy Minister of Co-operative Governance and Traditional
Affairs. The hon Nkadimeng.
The DEPUTY MINISTER OF CO-OPERATIVE GOVERNANCE AND TRADITIONAL
AFFAIRS (Ms T Nkadimeng): Good afternoon hon House
Chairperson. Let me also take the opportunity to greet the
Chairperson of the NCOP, the Chairperson and members of the
Select Committee on Co-operative Governance and Traditional
Affairs, our hon Minister Nkosazana Dlamini-Zuma in absentia
and we wish speedy recovery to her, the Deputy Minister,
Bapela and members of the provincial legislature, executives
and delegates from provinces, representatives from the SA
Local Government Association, Salga, our labour business and
civil society, good afternoon. Thank you very much for
affording us hon House Chairperson, this opportunity to
present to this august House the Budget Votes for both Co-
operative Governance and Traditional Affairs.
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Hon House Chairperson, the NCOP constitute an integral part of
our democratic dispensation especially as it pertains to local
government sector which is charged among other things the
responsibility to be at the forefront of integrated service
delivery and transformation economically of our
municipalities.
Rightfully, we can never downplay the role that the NCOP is
playing in terms of enriching the law-making process and the
quality of the laws, particularly in ensuring provincial
interest are considered at the national sphere of government,
but also in keeping with the injunctions of co-operative
governance. These injunctions nicely neat in and enjoins with
our local mandate as the Department of Co-operative Governance
and Traditional Affairs, of facilitating co-operative
governance through strengthening legislation and integrated
planning for inclusive development.
Hon House Chairperson, our budget presentation this afternoon
comes at a time when our country is still reeling from the
devastation of the floods that wreaked havoc in the parts of
KwaZulu-Natal, Eastern Cape and the North West provinces, just
over a month ago. We extend jointly, our heartfelt condolences
to all those who lost their lives as a result of the floods.
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We are working together to protect the gains of our democracy
by ensuring that the democratic and a participatory local
government sphere is vibrant.
The hon Bapela did on behalf of the Minister, touched on that
prior to the 2021 Local Government Elections, 32
municipalities across the country were subjected to various
types of interventions in terms of section 139 of the
Constitution. I will focus post the 2021 Local Government
Elections. All provinces retained the interventions that were
existing prior to the elections, except for the North West
province which terminated four discretionary interventions
postelections, but invoked mandatory interventions on all the
four municipalities, plus an additional other four that means
a total of eight under mandatory intervention.
So, to this effect, the department has worked together with
the National Treasury and Salga and we have issued a circular
on the management of interventions post the local government
elections which sought to provide guidance and regulate
amongst other things the management of interventions as it is
articulated after the local government elections.
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Of course hon Bredell dealt with two issues which took too
long to be resolved, but also, I will articulate the issues of
the legislature.
So, nine of the 30 municipalities that is Emfuleni, Lekwa,
Goven Mbeki, The West Rand, Inkosi Langalibalele, Mtubatuba,
Msunduzi, Abaqulusi and Beaufort West Local Municipalities are
hung councils. All these municipalities are experiencing
extreme number of challenges that range from being
dysfunctional to a total collapse of financial governance and
administration.
However, support is unfolding in all these nine
municipalities, including the Mangaung and Enoch Mgijima
Metros are both being placed under section 139(7) which is a
national intervention and this happened in Mangaung in March
2022 and subsequently Enoch Mgijima Metro in 2022.
Hon House Chairperson, the Financial Recovery Plans are
attached to all these nine municipalities, including the two
metros. An indication has been made with regard to services
that are short or are not adequate with regard to the Nelson
Mandela Bay Metro. The Minister has signed together with the
National Treasury a concurrence agreement with regard to
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assistance by the Department of Water and Sanitation with
regard to water provision in Nelson Mandela Bay Metro.
So, several engagements in line with our Municipal Support and
Intervention Plans have been made together with the National
Treasury, but to take home today is that an Intervention
Framework has been developed and finalized. It does indicate
now key processes, roles and responsibilities of what the
national Department of Co-operative Governance and Traditional
Affairs is supposed to do? What provincial Department of Co-
operative Governance and Traditional Affairs is supposed to
do? What other sector, departments and municipalities within
the intervention support plan framework are supposed to do?
We further clarify that the primary responsibility of the
implementation of this Municipal Support and Intervention
Plan, MSIP, will remain with the municipalities themselves.
Therefore, council need to make sure that they make it their
responsibility to institutionalise and incrementally increase
these plans into their five-year Integrated Development Plans,
IDPs, post the local government elections.
So, this approach is intended to ensure that all challenges
are identified in the state of local government report, but
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are also implemented by council, but over the IDP circle. So
the department is also equally supporting municipalities with
regard to technical assistance and data management as
identified as a weakness by the Auditor-General. Records
management identified by the Auditor-General, water and
electricity distributions.
This is in line with the spirit of support which is
encompassed in the District Development Plan, DDP, which is
our operational model which was adopted by the department
after the pronouncement by the President.
To date, 46 One Plans have also been subjected to rigorous
quality assurance. They have been made and standardized with
the framework that I spoke about which also encompass support
with regard to section 154.
So, to this effect, hon House Chairperson, this afternoon,
this Budget Vote aims to strategically enable a conducive
condition to collectively harness all the resources that are
in a municipality coming from all the three spheres of
government.
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This neat closely with the proposals which we have made with
regard to the Amendment of the Intergovernmental Relations
Framework Bill and Municipal Structures Act that are both
section 84 and 85 to ensure that we collate all the intense
consultations that have been made to look into the technical
and political intergovernmental platforms to support the
spirit of the District Development Model, DDM, using the
relations framework.
Now, I will come to what the hon Dodovu and the hon Bridell
did raise with regard to interventions, but also the inputs
with regard to Intergovernmental, Monitoring, Support and
Intervention Bill, which is currently undergoing changes
because there is no national legislation regulating
interventions in provinces in terms of section 100 of the
Constitution and section 139 with regard to municipalities.
However, Chapter 13 of the Local Government Municipal Finance
Act of 2003, regulates that there should be where there are
calls for interventions of financial nature.
On the other hand, we need to find the legislation which
regulates interventions arising from other forces besides the
financials. So, we are currently, with the amendment of that
Bill. We submitted in October 2021 to the State Law Advisor
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and we obtained a compulsory certificate for Cabinet which was
submitted on 2 December 2021. We are currently busy with the
engagement within the Service Level Agreement which has been
undertaken and comprehensive aural and written submissions
which will then have to be put into process.
The Bill will be revised accordingly and a preliminary
constitutional compliance certificate was obtained on the Bill
which is providing a greenlight for the department to start
the process of tabulating the Bill into Cabinet. We envisaged
that Cabinet during or before the end of this financial year
will allow us to do public consultation with an intention of
filling the void of interventions in both section 100 and 139.
We also are looking in terms of the authorization of the
Municipal Structures Act and the Municipal Systems Act and
work has also occurred.
Some of you might recall that the Municipal Structures
Amendment Act came into operation on 1 November 2021 and it is
indeed a game changer. For example, it provides or it allows
an MEC to remove a councilor from office for A Bridge of the
Code of Conduct for Councilors which should have been adopted
by council. The previous practice was councilors can be
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removed from office and can only be able to stand immediately
after removal. That has been done away with. The Bill provides
that in no less than two years that member is not illegible to
stand.
So, the amendment for example also introduced a new section
79(a) of the Municipal Structures Act which prohibits
municipal office bearers such as mayors and deputy mayors,
Chief Whips, executive committee, Exco, or members of the
mayoral committee, as we know them to become Members of the
Public Accounts Committee, MPAC. It is envisaged that this
will ensure transparency which members have been complaining
about, effective oversight and accountability.
Also, an inclusion or an insertion of a new task - it talks to
MPAC. Hon House Chairperson, I will include with the support
that you are giving to 25 municipalities with regard to
Municipal Infrastructure Grant which now allows them to do
that. Hon House Chairperson, let me say we request this House
to adopt and support this budget which allocates R358 billion
and R554 million, respectively over the Medium–Term
Expenditure Framework, MTEF, period for Budget Vote No 3 and
15. Thank you very much, hon House Chairperson.
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Mr M P NDLOVU (Mpumalanga): Hon Ngwenya, thank for your time
and greetings to the Deputy Chairperson of the NCOP, hon Chief
Whip of the Majority Party, hon Deputy Minister, Mr Obed
Bapela, hon Deputy Minister, Ms Thembi Nkadimeng, part time
and full time members of this august House, the SA Local
Government Association, Salga, representatives from provinces,
our esteem traditional leaders present here and senior
officials, we thank this opportunity provided to the province
to contribute on this lovely debate on the two votes presented
by the Deputy Minister Bapela on behalf of the intelligent
soft spoken principled, our mother, the hon Minister Dr
Nkosazana Dlamini-Zuma known by some of us as Minister NDZ. I
wish her a speedy recovery.
Chairperson, we are an amassing country most of the writers
and the researchers agreed that in South Africa the governing
party does not manipulate elections but Independent Electoral
Commission, IEC, is managing and running elections without the
interference of the governing party. In this country of
President OR Tambo, Deputy President Walter Sisulu, President
Mandela and others, elections are always credible, including
the recent 2021 local government elections all parties as
usual accepted the outcome of the election. We have once more
establish a government that is not only closer to the people
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but is with the people. Together, we are building better
communities.
I don’t want to sound arrogant, hon Seleki, but through the
will of the people we will renew our social contract with our
people in 2024. We are not even having for a coalition
government. Zonkeys are unproductive. Right from the
beginning, let me indicate that after accessing, evaluating
and reflecting the responsibilities entrusted to the two
departments, I can proudly say that they have delivered.
The Department of Co-operative Governance identified 64
dysfunctional municipalities in the country and six are from
Mpumalanga. The department give support to all these
municipalities and they were assisted to develop their
municipal support an intervention plan. The plans were aimed
on responding to specific challenges in each of the
municipalities. The plan responds to the specific challenges
identified in municipalities. The province has also
established a committee comprised of Treasury, the SA
Municipal Local Government Association, Salga, Municipal
Infrastructure Support Agent, the affected municipality and
the district municipality.
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As we speak, these municipalities are in transit – from the
state of dysfunctionality to a healthy state where they will
be able to discharge their mandate. Thanks to the support of
the National Department of Co-operative Governance. The
department also welcome the view of the national department
that in future we should deploy teams not just only one
technocrat to assist dysfunctional municipality.
All our municipalities passed credible funded budget except
three, Lekwa, Thaba Chweu and Govan Mbeki. They are affected
more by Eskom and water board. We insisted that they should
regard their unfunded budget for 2021-22 financial year as a
turning point to start to zero rate the unfunded budget.
As a public representative from the ANC we were taught after
the first administration that we should not talk about plans
and programmes that are not budgeted for. We also discourage
our municipalities to fund their capital programme from their
ambitious projected revenue collection. On this financial year
2021-22, by the end of April our Municipal Infrastructure
Grant, MIG, spending was at 80%. Since that period, our
capital expenditure has exponential improve. The province and
the application for rollover do not mix, we always exhaust our
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R1,8 billion allocations. Thanks always to the support of the
Department of Co-operative Governance and Traditional Affairs.
In this province access to water has risen to 87,9%. We are
always working towards 100%, access to flushing of chemical
toilets is at 64,4% and electricity stand at 92%.
In Mpumalanga when the sun rises, we work hard to improve
access to basic services. I did not say that our people have
100% access to service delivery. I was just tiredt by the DA
in the last debate that I was not representing the people of
the province but I am representing my party. I don’t
understand how they want to exclude the main public from the
public. So, it was a problem to me. They also said that there
are still communities in Mpumalanga that are without water.
Yes, that is true. They are part of the 12,5% that we are
prioritising for the next financial year. I think the
opposition is not fair. Maybe one should accept that fair is
foul and foul is fair. We are not elected to this important
institution to come and critisise only but we must also
develop possible solution to the challenges that are affecting
our people.
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As public representative from the ANC, we don’t surprise to
the view that we should support whatever the enemy opposes and
we should oppose whatever the enemy support. We don’t support
the view of Mauzido. We have been taught by our forebears to
support the view of Maimonides that: ‘You must accept the
truth from whatever source it comes.’ So, we want to request
that instead of criticism always they must come to a party and
assist us to come with solution. We thank the guidance
provided to us during the difficult times of Covid-19
pandemic.
Municipalities were given extra grant to pay special attention
on Covid-19. The grant enables most of our municipalities to
fight against Covid-19 pandemic. Through the provision of
clean safe water, replacement of mechanical parts in the waste
treatment plant.
Since 1994, we develop so many programmes to create jobs. But
the exponential population grow outwards the risk of job
creation. We will also assist to create jobs by prioritising
the revival of our township economy, remove various or red
tape to do business with our municipalities rolled down red
carpet for investment. We will continue with Community Work
Programme, CWP, which is regarded as an intervention aimed for
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the poorest of the poor to have a bread on the table. In the
province, more than 27 000 people were contracted on an annual
basis.
All the concerns raised which include minimisation of
consultancy and channel resources towards real labour
contribution to create more jobs opportunities are receiving
our attention in the province. All these programmes,
Mpumalanga province is serving as a pilot for the whole
country.
Ward committees are established in the province. We are just
left with only eight wards out of the total of 500. We have
developed plans to assist municipalities to improve their
audit outcome. We have also adopted Financial Recovery Plan.
We will monitor the implementation of this plan.
Chairperson of the House, we welcome the staff regulation that
have been promulgated by the department which comes into
effect on with effect from 1 July 2021. We know that the
regulation will pay special attention on the bloated and
unfordable municipal administration. We must pay special
attention also in the province. We will deal with incoherence
HR practices, irregular and inappropriate appointments toward
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skill development programmes, ineffective performance
management, lack of accountability, poor planning, under
expenditure by municipalities on capital budget, ineffective
revenue collection strategies, incoherent disciplinary and
grievance procedures.
As a province, we will be monitoring all our municipalities to
ensure that these regulations are fully implemented by all our
municipalities.
Hon Chairperson, I must indicate that the five-year term of
current Provincial and Local House of Traditional and Khoi-San
leaders in Mpumalanga is coming to an end. Local houses are
being set up afresh through election of members and we have
set the date for 7 June 2022 for the elections of the
provincial house. We will soon be embarking on the
reconstitute of traditional councils.
In conclusion, let me indicate that as Mpumalanga we continue
to work hard and better the lives of our people. We know fully
Deputy President of the ANC, Comrade Water Sisulu said: “What
counts in life is not the mere fact that we have lived. It is
what difference we have made to the lives of others that will
determine the significance of the life we lead.” Mpumalanga
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province support the approval of the Budget Votes 3 and 15 for
the Department of Co-operative Governance and Traditional
Affairs. Thanks.
Mr N M HADEBE: Thank you, hon Chairperson. Hon Minister in
absentia, hon Deputy Minister, whilst we have established a
strong institutional mechanism by virtue of our Constitution,
and its framework legislation, the evils of corruption
continue to be spread by some individuals working within
government, who have the sole purpose of lining their pockets
with ill-gotten gains at the expense of the South African
citizens.
This has been going on for so long without criminal sanction,
that one can only conclude that such theft is either state
sponsored by a captured state, and that there is no political
will by this government to prosecute corrupt officials. We are
facing a crisis.
It is undeniable that our beloved country is confronted by
political and social turmoil. And now more than ever before
the Cultural, Religious and Language Rights Commission, CRLRC,
‘s mandate to promote unity within cultural, religious in
linguistic communities is essential. The commission must
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function optimally. And the question must be asked whether the
commission is honestly serving the people of South Africa.
Although the IFP fully endorses the portfolio committee’s view
that the funding of the CRLRC must be on par with the scale of
duties the commission has to fulfil, we cannot accept that 65%
of the commission’s budget is allocated towards internal
administration at the expense and opportunity cost of service.
This fact cannot and should not be accepted
Chairperson, the IFP has consistently called for the
strengthening of co-operation between traditional leaders and
formal governance structures. Traditional leaders speak on
behalf of millions of South Africans, and they cannot play a
distant second fiddle in the development agenda.
Our Constitution is being undermined by government not giving
due and proper effect to the prescriptive that national
legislation should provide for a greater role for traditional
leadership as an institution at local level on matters
affecting local communities. Traditional leadership can and
does play a critical role in governance and must be included
in local governance structures.
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Finally, the IFP is greatly concerned about the Community Work
Programme, which despite the fact that 85% of the department’s
fund for the programmes are allocated to this programme is not
serving its critical purpose, namely, to create employment
opportunities in our rural communities. The people of South
Africa deserve answers and deserve an accountable, transparent
and responsible governance.
Hon Chairperson, with the above being said, the IFP wishes to
accept the Budget Vote and wishes the hon Minister a speedy
recover. Thank you, hon Chair.
Ms C VISSER: Thank you, hon House Chair. Hon members and hon
Deputy Minister, members of the executive committee, MECs of
all the provinces and all protocols observed, for 28-years,
Co-operative Governance and Traditional Affairs, Cogta, and
the ANC must acknowledge the regression of municipalities in
South Africa and the failure to enforce the implementation of
any of its initial initiated paper plans over this period.
Local Government has collapsed beyond disaster levels,
destroying every municipality where the ANC governs to a point
of no return.
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Despite the indicators of collapse, red lights splashed with
every Auditor-General’s report widely published in the media
for all to see. Hon members, if you do not recognize and
identify the elephant in the room, that local government will
forever be present in a landscape of disaster. Should it
continue like it is at the moment, subjecting South Africans
to the ongoing infringement of human rights and the suffering
of the most vulnerable people. So wake up and smell the
coffee.
For 28-years, the Annual Performance Plans, APP, of Cogta
reflects measures and objectives to increase employment,
eradicate poverty and reduce inequality. The stark reality is
that Parliament in its executive oversight could not ensure
that government delivers on these plans in its roles and
responsibilities.
Government must make use of its limited resources and mitigate
the risks of economic and political turbulence in every one of
the municipalities in South Africa. But sadly, despite the
given imperatives, the governing party struggled to change the
organization’s behaviour within the deeply divided factions,
cadre deployment, looting of municipal coffers and the failure
to comply with their constitutional obligations, the Batho
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pele principles and the functional delivery of services
expected from the communities they are supposed to service.
The ANC leadership in all these municipalities under the
watchful eye of Cogta, national and provincial, failed to
drive progress within every initiative, for the past 28-years
towards the most important policy outcomes.
Hon Deputy Minister, you presented Cogta’s APP to this House,
with the exception to receive approval and the standing
ovation with Cogta completely failed in its functions for 28-
years, leaving South Africans, not one of the formal plans
were successfully implemented ever.
The District Development Model further caused confusion of
inter government relations, and the delegations of power and
service level agreements, because the function of democracy is
designed to protect communities against the singularity of a
central government. You know that for sure because the
District Development Model of which was a pilot project at OR
Tambo District Municipality, was the first one where covid
funding corruption and fraud involved in.
Cogta turned a blind eye in the concurrence, capacity and
integrity of appointments of municipal managers and chief
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financial officers, CFOs, in the areas where they govern.
Knowing the background with every one of these officials that
are recycled within the redeployment because of their
commitment to public service, their hands-on approach, their
dealing with local challenges, the people-centred approach,
their professionalism and goal-orientated commitment, their
excellence accountability and outstanding performance, their
integrity and dedication to fight fraud and corruption.
Nothing of that is any more important, but the level of which
this municipal manager or accounting officer is in the level
of his branch outside of the of the municipality.
Adherence to these values will contribute to the expected
required state of local government. We want to see people with
the values that will improve municipalities where they govern.
Sound financial management must be restored. At this stage,
Chairperson South Africa’s faith in its municipalities has
collapsed. Municipal rot amounts R289 billion and growing. The
Auditor-General, Tsakane Maluleke explicitly confirmed the
deterioration of local government and the downward trend in
municipal health in well documented media reports of financial
mismanagement and maladministration.
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Hon Dodovu, the consumer debt, I agree, is outstandingly not
understandable. But you are aware that for the past two to
three-years, about two or three municipal accounts went out to
consumers. Why is this thing then that consumers have to take
the flak because municipalities cannot do the work?
The Eskom prepaid electricity is also understandable. There
is a huge debt as hon Bosshof have said of the outstanding
Eskom accounts. How can you receive prepaid electricity money
for electricity that wasn’t even used yet? But you cannot pay
the accounts. So what is wrong with the whole Eskom prepaid
electricity bill, as well as the way the prepaid meters was
installed? It should be investigated and I have discussed that
with you previously.
The civil society group Corruption Watch has published in its
report of 2021, highlighting the types of corruption causing a
devastating effect on South Africa. They found that most
corruption occurred within the office of the municipal
manager. Representing 34% of all reports received which have a
direct link to service delivery. The report also points to
nepotism, bribery and disregard for policies and laws with
implicated officials that are rarely being held accountable.
The report says and I quote:
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They are these cocktail-like structures operating within
municipalities. These are companies that have and
continue to receive tenders provided for by the managers.
But what we found is that people are still not receiving
the services that are said to be done by these companies.
But no, no accountability, and or subsequent consequences
happens to these accounting officers guilty of financial
misconduct. The easy way out for provincial administration is
to select one of the section 139 constitutional interventions
with an appointed administrator and the endemic corruption
continues unabated.
The ANC factional fights intensify paralysing municipalities,
into the chaos of dysfunctional governance allowed by the ill-
discipline of the ANC on the members and the councillors.
South Africans consequently lost faith in the eroded and
corrupt local government system.
South Africans deserve the better live Madiba promised us all,
to effectively turn this around. Best governance is required
and that only the DA can deliver it. We need leaders who will
lead and then the citizens will follow. Thank you very much.
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The HOUSE CHAIRPERSON (Ms W Ngwenya): Before I call hon Mkiva,
I would like to check if hon L Michalakis is back? Then I am
continuing. I will now call hon Z Mkiva from the ANC?
Mr Z MKIVA: Hon House Chairperson, good afternoon and also to
the House at large. Allow me to express my sincere greetings
to the hon Deputy Minister, Mr M O Bapela who presented
earlier on behalf of the hon Minister Dr Nkosazana Dlamini-
Zuma. I also want to acknowledge the Deputy Minister
responsible for the Department of Co-operative Governance and
Traditional Affairs, hon Ms T Simelane-Nkadimeng and the MECs
that come from all the provinces of our country. Hon Chair and
hon members, the ANC remains committed to the vision of a
capable, ethical and developmental state that was articulated
in the National Developmental Plan, NDP Vision 2030.
This was defined as a state with the capacity to mobilise all
sections of the society including market forces behind the
developmental agenda aimed at the resolutions of the
challenges of poverty, unemployment and inequalities. We have
always emphasised the central role of the state in the
transformation of South Africa from the ruins of the colonial
apartheid towards the non-racial and non-sexist and truly
democratic and prosperous society.
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Whilst we have made significant progress in the
democratization of the state and building its capabilities, we
recognize that this task has been difficult at the local
sphere. We are still to attain the vision we laid out in the
1998 White Paper on Local Government where it was expressed
that the constitutional mandate of local government included
creating sustainable, integrated, equitable, and viable cities
and towns within the framework of co-operative governance.
This perspective does not leave out the rural communities of
our country as we know that we are also predominantly a rural
society.
This requires the fundamental transformation and redesign of
this sphere of government so that it is adequately equipped to
provide services and play a developmental mandate within the
paradigm of democratic, inclusive growth, and development. Our
perspective remains that we need to bring new capabilities,
attitudes, and approaches which strengthens relations between
municipal councils and administrators, management and the
workforce, and municipalities and service users in our
communities.
Last year our young democracy attained another milestone in
its maturity when we successfully held the sixth local
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government elections since the democratic dispensation. Once
again, the people of South Africa who conducted themselves in
a peaceful and democratic manner affirmed the ANC as a capable
instrument at the hands of the people to transform society and
deliver a better life for all. The challenges we face at local
government were vividly highlighted in the State of Local
Government Report which the Cabinet released ahead of the
elections.
This report cited challenges in the political-administrative
interface, governance, financial management systems, and
service delivery. The report revealed that 166 municipalities
out of 257 were experiencing one or more of these challenges,
out of these 64 had reached a state of dysfunctionality and
service delivery had collapsed completely. The report further
told us that at the time, 30 municipalities were under section
139(7) intervention of the Constitution. I am sorry about that
interruption, hon Chair, it is the network problems.
The ANC is off the view that government must propagate
policies and programs aimed at supporting and intervening in
municipalities to ensure that we attend to the identified
challenges and turn around the situation at local government.
One of the most critical aspects in building a developmental
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state is the aspect of human resources. It is important that
we ensure that local government is ran by a qualified,
ethical, and professional public service.
The lack of proper human resources is one of the factors which
contribute to the degeneration of service delivery and the
mismanagement of resources, this is what was emphasized by the
Auditor General in the 2019/20 in the report titled: Not
enough to go around, yet not the right hands at the till. The
report revealed that almost a billion rand was spent on
consultants by municipalities to put together financial
statements yet there are people hired in finance and audit
departments.
The report of the Public Protector on Ditsobotla Local
Municipality in the North West revealed that the blurring of
the lines in the political and administrative interface also
leads to poor human resource capacity in municipalities. This
report revealed that family, friends of relatives of
councillors were hired and given responsibilities in the
municipality despite only having matric and grade 11 as their
highest qualifications.
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Even worse it revealed that the Audit Manager in the
Municipality only has a matric certificate as their highest
qualification, this explains the absence of financial
management control systems in the municipality.
Mr I M SILEKU: Who is governing in those municipalities?
The HOUSE CHAIRPERSON (Ms W Ngwenya): Order, hon member.
Continue hon Mkiva.
Mr Z MKIVA: This tendency is epitomized by what we see in the
City of Tshwane, where the DA-led coalition appointed a
Municipal Manager whose qualifications stand disputed by SA
Qualifications Authority, Saqa which they claimed were
obtained from some university in the United Kingdom. We have
also seen the re-emergence of apartheid job reservations for
whites in the DA-led municipalities. It is in this context
that we welcome the newly amended Municipal Systems Amendment
Bill which has been sent to the President for assent. Once it
has been signed into law it will deepen our agenda for the
professionalization OF local government and foster a healthy
political-administrative interface in municipalities.
Furthermore, these amendments will allow for the de-
politicization of the municipal staff appointments.
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Mr I M SILEKU: Deploy better councillors next time. Deploy
better councillors.
Mr Z MKIVA: Can you please stop your disruptive and
distracting conduct. What you are doing is totally
unacceptable ...
Mr J J LONDT: It is heckling. [Interjection.]
Mr Z MKIVA: ... because it points to the municipalities that
are run by the DA. Now you want to stand out and defend when
we are outlining the facts of what is actually happening on
the ground.
In the 2020 Local Government week of the NCOP we identified
the lack of financial control systems as one of the challenges
that characterize local government, this was subsequently
confirmed by the State of Local Government Report. The
Auditor-General in the 2019/20 Municipal Finance Management
Act Report highlights that as a result of the lack proper
financial management systems in municipalities, fruitless and
wasteful expenditure stands at R14,61 billion. It has also
been highlighted that 30% of our municipalities ended the year
with a deficit.
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This challenge has become more vivid in the advent of the
Covid-19 pandemic where municipalities and government had to
procure personal protective equipment, PPEs and other services
on an emergency basis. In the Special Reports on Covid-19 the
Auditor-General confirms that there was a flouting of supply
chain processes and some of the services were procured at a
price above what was set by Treasury. The ANC will support the
Auditor-General in utilizing the new powers granted by the
amended Public Audit Act of 2019 to issue notice for material
irregularities and ensure the recovery of funds.
Another challenge cited by the Auditor-General is that
municipalities are not responsive to audit opinion and every
year we are subjected to repeat findings. The Department of
Co-operative Governance and Traditional Affairs, Treasury, and
Municipal Budget Councils must come with sound proposals to
ensure that municipalities put in place and action audit
plans. The ANC in line with its heightened oversight approach
will ensure that this is results driven and the key barometer
of this will be the reduction of irregular and fruitless
expenditure.
The 2019 General Household Survey showed that while there has
been a general improvement in service delivery between 2002
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and 2019, in particular access to drinking water, but this has
been dampened by that access to drinkable water had declined
in about five provinces. The largest decline was in
Mpumalanga, Limpopo, and the Free-State provinces. Our
interventions at the local state will not mean much if they do
not address the unequal patterns of distribution of water.
We must be deliberate about resolving the challenges of water
in Maluti-A-Phofung Local Municipality in the Free-State, in
Polokwane in Limpopo, and Dr J S Moroka Local Municipality in
Mpumalanga. These challenges lead to uneven economic
development as these have a negative impact in not only the
social lives of communities but also small and medium
enterprises. The ANC-led government should invest more in the
building, maintenance, and upgrade of existing infrastructure
in these struggling regions. It is that we are focused on
doing and as the Deputy Minister was speaking here, clearly
outlining what the President outlined in the state of the
nation address about the interventions that we are going to be
making in ensuring that we invest more in the struggling
regions.
Mr I M SILEKU: Do not forget to invest in councillors as well.
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Mr Z MKIVA: No, shut up man.
Investment in the infrastructure would not only improve the
quality of life and bring dignity to the people of these
communities but it would also have some developmental spin
offs and contribute towards turning these municipalities
viable economic spaces.
Mr C F B SMIT: Hon House Chairperson, on a point of Order: I
believe it is unparliamentary for the hon member to tell
another member to shut up. So, can you please ask the hon
member to refrain from saying and withdraw that?
The HOUSE CHAIRPERSON (Ms W Ngwenya): Hon member, can you
withdraw?
Mr Z MKIVA: Hon Chairperson, I meant to say ...
IsiXhosa:
... thula ufe ...
English:
... but I will withdraw that one. We must also ensure that
local government plays its role in the resolution of energy
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challenges we are currently facing. This is dependent upon
resolving the municipal debt crisis. We must inculcate a
culture of paying for municipal services by those who afford
...
Mr E M MTHETHWA: Hon House Chairperson, on a point of order: I
have got a problem with the way the DA is trying to interrupt
the speaker on the podium. He was disturbed more than three
times while he was presenting his speech. Please note that
there is nothing that they are raising as a point of order
except to disturb the speaker. This is not even heckling to
the point but they are just disturbing the speaker.
The HOUSE CHAIRPERSON (Ms W Ngwenya): Thank you very much hon
member, hon members, please. I think the Chief Whip and the
Deputy Chair, did talk to all of you when we started the
meeting. Let us respect each other and avoid to provoke each
other. Please hon members. Thank you.
Mr Z MKIVA: Thank you very much hon House Chairperson for that
protection and not allowing minorities to bully us in a
democratic state. We must inculcate a culture of paying for
municipal services by those who afford and ensure that
municipalities also meet their obligations to water boards and
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Eskom. The view of the ANC on energy is captured in the
Integrated Resource Plan, IRP, which, amongst other things,
called for the decentralization of energy. President Ramaphosa
in the 2020 state of the nation address announced that
municipalities who were in a good financial standing would be
allowed to develop or procure their own power generation
projects. Our role is to ensure that municipalities become
financially sustainable and are in a position to take
advantage of the newly amended electricity regulations.
In conclusion, we would like to emphasize that building a
capable, ethical, and developmental state at a local sphere
will allow us to unleash and harness the comparative and
competitive advantage of our districts and local economies
which is crucial for our development. The ANC will continue to
build upon the democratic gains which we have registered since
1994 and deepen the implementation of our program for radical
socioeconomic transformation. The ANC is very clear that it
supports this budget vote for one reason and only reason that
it pursues what we have always said that it is about the
betterment of the people.
IsiXhosa:
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Siyafuna ukuyicacisa into yokuba kulungile ukuba abantu xa
begxeka kufuneka bagxeke ngenkathalo. Abantu bayayazi ukuba
amehlo karhulumente we-ANC ajoliswe ngqo ekukhupheni abantu
bakuthi kwiimbandezelo zentlupheko nentswela-ngqesho ezithe
tshitshilili kulo lonke eli limiweyo. Yiyo loo nto
singathingazi xa sisithi, urhulumente we-ANC makaqhubeke
esebenzela abantu kuba wonyulelwe loo nto kakade. Kufuneka
angavumi nakancinci ukuphazanyiswa ngoofunz’eweni abasoloko
bekhetha iphela emasini. Ngaloo manqaku sithi, siyi-ANC,
mayiye phambili levoti iqinisekise ukuba abantu bakuthi
bayaphuma endlaleni. Enkosi.
The DEPUTY MINISTER OF CO-OPERATIVE GOVERNANCE AND TRADITIONAL
AFFAIRS (Mr K O Bapela): Chairperson, I give thanks to all
members who have contributed to the debate. Quite a number of
members acknowledged the challenges that are faced in local
government, but also provided some ideas and tentative
solutions that we could begin to embark on to turn the
situation around so that people can live a better life and
they can get better services. We will definitely take those
points into a plan and a programme that will then begin to say
... since the release of this report on the challenges of
local government, which many members had also quoted, we will
then be able to go to the era that we have diagnosed and then
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some suggestions ... [Inaudible.] ... merged in that report.
However, I think some of the ideas that are emerging from this
debate will also be included, so that we can now embark on a
journey of turning the situation in local government ... I
will also pass on the get well messages, as expressed by quite
a number of members during the debate, to the Minister.
Service delivery is everybody’s business and I think we should
all be concerned that, if municipalities do not perform to
that particular function and task, it is our duty as hon
members in our oversight function to begin to expose such
municipalities and indicate those elements, so that across the
country, whether it’s an ANC-led municipality or a DA-led
municipality ... there are challenges and these challenges
know no borders and know no political affiliation. They just
beset themselves in the municipalities. Therefore, let’s all
of us work together collectively to really make sure that
service delivery is improved.
With regard to the unfunded budgets, I just wanted to say,
yes, the unfunded budgets are a worrying matter. They accrue
as a result of many factors. Amongst them is the inward
migration that imposes itself on the big towns and small
cities and metros, and in other situations it is as a result
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of the unco-ordinated planning between national, provincial
... and the municipalities, where schools just get built
without engaging the municipalities around their integrated
development planning, IDP, processes in terms of whether water
will be accessed by the school institutions and so forth.
However, with the District Development Model, we hope it will
then be a matter of the past so that these unfunded budgets do
not accrue. Disasters are another factor that comes in, which
we also need to look ...
I agree that we need to build smartly, and adapt and mitigate
against climate change issues. Skills is another area that was
mentioned. We need the best skills ... be produced but on a
continuous basis the recruitment of young people ... so that
we can then begin to see the right people in the right jobs.
The Minister ... release an article sometime this week, saying
... in local government what we need is nothing else but the
skills that are needed there to come and help in the
situation.
We fully agree with fighting corruption ... Definitely ...
[Inaudible.] ... corruption ... it’s people’s money and we
must therefore really begin to work very hard to ensure that
we are able to defeat ... including the new capture of
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municipalities by external forces that are business
orientated. Some are personal in ... capturing all our
municipalities for this particular issue.
The issue of Eskom and the water boards ... [Inaudible.] ...
is under the care ... as we are engaging with the SA Local
Government Association, Salga, other departments, Eskom and
the water boards themselves, in mitigating on some of the
issues that are leading municipalities to continuously not pay
for those particular services, whilst at the same time taking
cognisance that with the high level of unemployment, the
revenue of municipalities is also shrinking. Therefore, we
then have to work very hard to ensure that we turn the
situation around.
So, with that, we really just want to welcome all the comments
and proposals that are there, which will help us in
strengthening the plan to really now begin turning local
government ... to be a functional sphere of government,
supported by provinces, supported by departments and supported
by everybody across all political parties. With that, we just
want to thank you for the support of the Budget Vote. Thank
you.
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Debate concluded.
APPROPRIATION BILL
(Policy debate)
Vote No 18 – Health:
The MINISTER OF HEALTH: Thank you very much, hon Chairperson of
the National Council of Provinces, let me pass my greetings to
my colleague, Deputy Minister hon Dr Dhlomo, the MECs who are
here, members of the NCOP present and all other honoured guests
on this platform. We thank you, hon Chair and hon members of the
House for this opportunity for us to present the Budget Vote for
the Department of Health for 2022-23 financial year.
We present this Budget to you, cognisant of the fact that the
last two years have been challenging to all of us both in the
country and the world, but even more, for those of us in the
portfolio of Health and in the health sector overall. The
pandemic has had devastating effects, with many of us losing
loved ones, friends and colleagues, including both in the NCOP
and the National Assembly. We also honour our heroic health
workers who saved many lives while risking their own lives and
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the lives of their families and friends. Regrettably, some of
them lost their lives in line of duty.
We want to say that we feel indebted to them and to their
families especially for those who paid their dearest price of
life itself. We want to take this opportunity also to thank the
leadership of our country under President Ramaphosa, members of
the Cabinet, and also provincial and local leaders for providing
leadership under this very difficult circumstances. We also want
to thank leaders of various formations amongst our political
parties both in Parliament and outside - religious, traditional
leaders, business and labour movements – for working with
government in the process of mitigating against the effects of
the pandemic and protecting our society.
When we instituted a number of public health measures, most of
the leaders of the country supported these measures and worked
with us. We know that as people started to get tired of some of
the measures, some of them started not to give 100% support. We
welcome the support. It is normal that with time people start
to see faults even where there is none. We welcome the support
over the long period especially during the hard lockdown and the
various waves as we know that we went through four major waves
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and the last big wave being in December of last year, 2021,
going up to February.
We have just gone through what looks like a possibly milder wave
of what was considered a fifth wave, which came and never went
high, not much devastation and less admissions to hospitals. We
hope that this is possibly how the COVID-19 is going to become
endemic rather than more of a pandemic or epidemic.
Currently, we know that we still have a few measures in place
and we urge the country for more patience as we try to navigate
a proper exit so that we don’t have a resurgence of this pandemic
and don’t regret having invested a lot in the safety measures.
We are very optimistic that what remains now will be just for a
short period. We once again, wants to thank the leadership of
our President for going out of his way to help us acquire
lifesaving vaccines, not only for our people here in South Africa
but also for the whole continent working together with the
leaders of the continent.
Today, we are able to report that as of last night, we have
administered just over 36 150 million doses of vaccines to
just under 20 million individuals – we are standing at
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19 930 million – about 17 000 short of full 20 million adult
South Africans who have been vaccinated. This constitutes 50%
of all adult members of the population having at least one
dose of the vaccine.
The 60 plus age group are very exemplary, they responded very
well. We have just passed 70% of coverage of the 60 plus. The
50-59 plus age group, just under 60% at 55,8%, and the 35 to
49 just under 54%, that is at 53,8%.
Where we have major uphill battle is with the young people of
between 18 and 34 years, we are struggling at just over 37%.
We believe that this is largely due to the influence of social
media which spreads a lot of antivaccination messages. The
COVID-19 pandemic is not yet over. We continue to make a call
to all South Africans, 12 years and over to come forward to be
vaccinated because we want to defeat this pandemic once and
for all. We also encourage adults over 18, especially the 50
years and over to come forward for boosters as they are
already available through variants regimes, whether you have
had the Johnson & Johnson or the Pfizer vaccine. I am sure hon
members and members of the public are now familiar. We are now
going into further boosters. All adults are eligible for the
third dose of Johnson & Johnson and the third dose of Pfizer
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as we also navigate the winter and hope to be exiting the
pandemic.
We appreciate the effort of some of our young health
professionals who launched a campaign called KeReady to
encourage young people to come forward and be vaccinated.
On Friday, this week, we will be launching the Global Vax
campaign in partnership with the US Embassy in UMgungudlovu,
Pietermaritzburg in KwaZulu-Natal, which emanates from the
commitment of the President Joe Biden of the US, to donate
more than 1,2 billion vaccine doses globally to contribute to
the vaccination of over 70% of the world population.
The pandemic did derail some of our major programmes as we
diverted a number of resources including human resources into
containment and management of its impact. In the process, we
also learned some positive lessons such as learning to work
together as all of government from local, provincial and
national governments but also including some of our entities.
We also learned to work with the private sector, starting with
the procurement of personal protective equipments, PPEs, to
diagnostics, therapeutics and even more to the acquisition of
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vaccines. The administration of 36 150 million vaccines, which
I alluded to earlier on could not be done by government alone.
The private sector also came to the party. We also thank the
many health scientists and researchers who came forward to be
part of our ministerial advisory committees and also providing
cutting-edge research in viral genome sequencing surveillance
which enabled us to be recognized the world over in sharing
advanced information. I can report to this House that just a
week ago, we were in Geneva, at the World Health Assembly, all
members of the World Health Organization assemble yearly to
share a number of information experiences and policies. During
this assembly, South Africa was in demand for bilateral by a
lot of countries wanting to, amongst others, congratulate us
with regard to our cutting-edge scientific research but also
wanting to work with us.
In this financial year, our major focus is in recovery and
also in comprehensive health services programmes, which as I
have mentioned, we lost some of the pace as we focused on the
pandemic. We have agreed with the colleagues and MECs - some
of whom I can see on this platform - and we will be speaking
that going forward, we will be integrating the COVID-19
mitigation measures into a comprehensive basket of services at
the primary health care level upwards, in terms of our chain
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of services including the vaccination programme that must now
be integrated into our daily services. It will also include
the catching up on delayed surgical procedures. We know that
there were many people who were due for a number of surgical
procedures who were delayed for weeks and months, and some
even for years as a result of the pandemic occupying most of
our focus in the health facilities.
There is evidence from the WHO that there are a number of
infectious diseases and noncommunicable diseases, NCDs, which
contribute to almost 70% of the mortality of our population.
From the infectious diseases, we know that major killers on
the communicable side is Tuberculosis, TB, especially where it
occurs in combination with HIV and Aids. In the last two
years, COVID-19 has added to this. While on the NCDs, we know
that high blood pressure leading to strokes, heart diseases,
diabetes mellitus, cancers, and chronic lung diseases
contribute to this 70% of the mortality in our population.
With the advent of COVID-19, we lost some ground in finding
people with HIV and TB to be put on treatment. We have lost
some of our targets in terms of the 1990 agreement as agreed
with the United Nations programme on HIV/Aids, UNAIDS. We are
making sure that we can catch up. We have even lost ground in
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so far as the promotion family planning, which has seen an
explosion of teenage pregnancies. A few months ago, on the
NCOP platform, we held a debate to discuss teenage pregnancy
problem. These are areas in terms of reproductive health and
rights which we are also catching up to ensure that family
planning can also get into the platform and be promoted.
With NCDs, we know very well that they are driven by certain
lifestyles key to which are lack of physical exercise, smoking
of tobacco products, unhealthy diets and harmful use of
alcohol. We welcome the fact that during the lockdown time, we
saved a number of people from smoking due to the ban on sale
of tobacco even though government became unpopular in some
quarters but we did save some smoking habits.
Yesterday, our department led by Deputy Minister Dhlomo and
the MEC for Health in the Eastern Cape, led in the launch of
our National Strategic Plan on Prevention and Control of
Noncommunicable Diseases 2022-27 in Somerset East in the
Eastern Cape. This was also the World No Tobacco Day. The
National Strategic Plan provides a platform to mobilize
communities for awareness, know-how and active action for
healthy living to defeat noncommunicable diseases.
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As we breathe a sigh of relief from the acute pressure of
COVID-19, we want to turn our attention to the improvement of
the quality of services in our health facilities in line with
the aspirations and the targets of the National Development
Plan, NDP, the Presidential Health Summit decisions of 2018,
and the Health Compact signed in 2019 by various stakeholders.
In doing so, we want to deal with long queues and waiting
times at our clinics and hospitals, congestions sometimes
leading to patients sleeping on the floors, and shortages of
commodities such as medication, even linen and food stuffs.
These are matters of the essential services improvement which
we are now able to focus on as the COVID-19 pressure gets
less.
Our allocated Budget for 2022-23 is an amount of
R64,5 billion, of which 86% or just around R55 billion would
be transferred to provinces as Conditional grants to support a
number of programmes various such as the fight against TB, HIV
and Aids, sexually transmitted infections, STIs, and NCDs. The
funds will also support human resources, especially training
for scarce skills such as medical specialists and also
statutory training functions such as medical interns and
community service doctors. A significant amount will go
towards infrastructure which means procurement of new
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facilities, replacement or refurbishment and maintenance of
health facilities because we can’t talk of improvement of
quality without addressing infrastructure and equipments at
our health facilities.
Just to give some examples without going into a lot of
details, the National Tertiary services grant will receive an
amount of R14,3 billion. In terms of this service, it will,
amongst others, go towards oncology services, radiation
therapy for cancer, chemotherapy, renal dialysis and also
acquiring some of the specialist skills. The Health
Professions and Training grant, which will also augment human
resources including the training of in-training specialists,
what in medical terms we call registrars. These are some of
the funds. Also, R5,5 billion will go into the Training grant.
The fight against HIV and TB will get R24 billion. As we
mentioned, a significant allocation will go towards
infrastructure, maintenance and revitalization. In this case,
an amount of R6,79 billion is allocated directly to provinces
as part of the National Health Insurance, NHI, grant. This
will cover the construction, upgrading and rehabilitation of
various facilities.
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Over and above this, a further amount of R1,5 billion will be
spent in various provinces from the national department to
support provinces as part of the upgrade of various
facilities, just as an example, some of those who will benefit
in the Limpopo province is Siloam hospital, in the Eastern
Cape is Zithulele district hospital and Bambisanani hospital
in the OR Tambo district. The long-awaited Limpopo Academic
hospital will be covered with an amount of R500 million, which
will allow the start of the construction.
In addition, we are working with Gauteng Department of Health
to speed up the rehabilitation of Charlotte Maxeke Academic
Hospital, following the fire last year. The Accident and
Emergency Unit has already been commissioned for service and
is fully functional, covering services such as trauma, medical
and surgical emergency, obstetrics, Pediatrics, mental health
and also COVID-19 emergencies. The CT scan which has
unfortunately been vandalized is already fully functional,
that’s why they are also able to deal with accidents and
emergencies. The rest of the hospital is expected to be fully
functional by the end of next year, 2023.
As a government of the ANC, we are fully committed to the
implementation of the Universal Health Coverage. We appreciate
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the fact that the National Assembly portfolio committee is at
the end stage of finalizing the NHI Bill. We are looking
forward and hope that the members of the Assembly will adopt
this into an Act and forward it to yourselves, as the NCOP. We
urge you to support this Bill when it comes to the House. This
Bill will help us to close the gap between the rich and the
poor. It would create a platform for a game changer of
equalization of opportunities irrespective of the income of
individual South Africans. It will lay the foundation for an
integrated health services.
We have learned a lot from the COVID-19 to also try and lay
the foundation for closer co-operation between public and
private health sector in terms of sharing hospital beds. We
are able to report daily on how many COVID-19 beds are
occupied. Laboratory tests were able to update the nation
daily and use a common platform on the vaccination, which is
wholly-owned by the state in terms of the Electronic
Vaccination Data System, EVDS.
With regard to further strengthening and creating conditions
for the NHI, some of the funds will be allocated directly to
start the preparation with regard to making sure that the
infrastructure is prepared and that we lay the ground for
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contracting of private service providers also in support of
digital health platform through which health information
systems can also be ready to implement the National Health
Insurance scheme.
The Health Patient Registration system is already well
advanced with more than 57 million people already registered
in our public health facilities. We are very advanced in the
creation of a single portable patient record system which will
help us to create a good foundation for the National Health
Insurance and its information system.
The quality of care is very key, and to achieve this, human
resources for health are key. We are very grateful that as
part of the fight against COVID-19 there were some stimulus
funds which were allocated to the department, and through
this, we were able to hire an additional 73 000 health
workers; nurses, community health workers and other
professionals. Unfortunately, as this was a temporary
solution. It has supported us for two years and we are now
reducing as other functions must also be funded and we know
that this has put pressure on many of our provinces because
they will not be able to continue with some of the short-term
contracts and this is creating a gap in various services
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because it is not only because of COVID-19 - we knew that we
already have a gap in staffing in almost all the provinces.
We also appreciate the fact that a major issue, which has been
a chronic problem, which is the funding for the internship of
medical interns and community services were able to receive
additional funding from our National Treasury for an amount of
R2,1 billion.
A major issue which is also a drain to our fiscus in the
health system is the Medico-Legal claims. We want to assure
the House that we are working with all our provinces to make
sure that we can reduce this drain on our fiscus or our very
scarce resources being financial resources of health. We are
working together on a common system through which case
management can be improved to make sure that when there is
such litigation, we can respond speedily. With regard to
specialists’ services for forensic investigation because many
of them are fraudulent, they have no basis. If you don’t
investigate, you may end up been taken to court and part with
very key resources for health.
As I go to the end, I want to assure the House that from the
health side on the KwaZulu-Natal floods disaster, we have been
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working with the province to identify areas where there is a
need for intervention. We are very fortunate that the damage
to health facilities was not very severe, but where there has
been such damage, our infrastructure team is working very well
with the province to make sure that the repairs can be
attended to and facilities can be returned to full
functionality.
We are happy to see that in major hospitals such as Prince
Mshiyeni Memorial hospital in Umlazi water has been restored
and the hospital is able to function fully because there was a
major difficult where water had to be transported by tankers
into Jojo tanks to run the hospital services which was not
really possible. We welcome the progress in this regard.
I want to say again to us that the National Health Insurance
is our future. It is the future platform through which if this
legislation can be passed and becomes the legal framework, we
can be able to have an equalizing framework to make sure that
the rich and the poor can all benefit. We can all stop
spending so much of scarce money which we earn towards
additional spending on health services. We will all contribute
into one kit and this will be able to cater for us whether we
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utilize public or private services. We again want to urge
members to support the Bill when it comes to the NCOP.
We want to remind all South Africans at this time and say
COVID-19 is not yet over. We are in a very promising
situation. The indications are that the severity part is
probably passing and we are probably going to endemic but we
still have to be vigilant and therefore more vaccinations are
required. Now and then we update the public health measures
which we need to still adhere to protect ourselves.
As I conclude, let me say I want to thank the Deputy Minister
Dhlomo for his support in this portfolio, the director-general
and all senior managers and my colleagues - the MECs of all
provinces for their full co-operation in tackling all these
difficult tasks - Without their support, we will not be where
we are. Thank you very much, hon Chairperson.
Ms M N GILLION: Thank you, hon House Chairperson. Greetings to
the Chairperson, Deputy Chairperson, the Chief Whip of the
NCOP, Minister and Deputy Minister, all members of the
executive council, MECs, present, all special delegates and
members of the NCOP, allow me Chairperson to give an input as
the chairperson of this Budget Vote.
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The global capitalist system has led to the commodification of
various basic services which ought to be accessible to all as
a basic need. Due to the market supply and demand of private
healthcare services, this has concentrated health financial
and technical resources within the private sector resulting in
an unequal distribution of quality healthcare. The unequal
distribution has also been shaped by the legacy of apartheid
which distributes resources unevenly for urban and white
communities while townships and rural areas are inhabited by
the black and African majority.
Hon members, despite the challenges in our healthcare system
we should note that the 2021 General Household Survey by
Statistics SA reported that 72% of households said they would
go to public clinics, hospitals or other public institutions
while 27% would first consult private healthcare services.
Above 9 million South Africans are on medical aid whilst 50
million are covered by the government. This demonstrates the
significance of this Budget Vote as it supports the overall
majority needs of all South Africans.
The lack of development of adequate health facilities to serve
communities in an accessible manner is a major backlog in
public healthcare. This is the spatial inequality development.
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The department of health has been earnestly working to address
the backlog challenges. It is for this reason that universal
healthcare coverage is imperative to guarantee all South
Africans quality healthcare services and not based on class.
Through the phased implementation of the National Health
Insurance, NHI to address the infrastructure gap and the
maintenance of current healthcare infrastructure, over the
Medium-Term Expenditure Framework R8,8 billion has been
allocated through the National Health Insurance indirect
grant. This is a significant allocation and it demonstrates
the policy orientation of the department in preparing our
healthcare system to meet the required National Health
Insurance, NHI, norms and standards.
Chairperson, this allocation is important in improving the
service provided by our healthcare system. For the current
Budget Vote 40, public healthcare facilities will be
constructed or revitalised, whilst 21 hospitals will be
constructed or revitalised and 120 public healthcare
facilities such as clinics, emergency base stations, and
hospitals will be maintained. The intervention will not close
the infrastructure backlog, but it will go a long way in
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improving and expanding healthcare services in areas with
great health needs.
House Chairperson, the backbone which determines the strength
of a healthcare system is its human capacity. Health
professionals such as nurses, doctors and other specialties
play a major role in the provision of healthcare. We must
applaud and pay respect to our healthcare workers who have
been on the frontline in the fight against the coronavirus
pandemic. They stood by their oath in the most uncertain
period in this 21st Century. Our health capabilities were not
only through our healthcare workers but health scientists who
are an integral part of the healthcare system.
The World Health Organisation has commended South Africa in
its health response to the pandemic which was based on
cutting-edge research from our scientists and global research.
Science and innovation in health is a critical area in which
the department needs to strengthen its policy approach to be
embedded with the optimal use of research in responding to the
nation’s disease burden.
South Africa is also impacted by the migration of healthcare
practitioners who move to developed countries for work
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opportunities. This is a risk that will continue to exist.
What is critical is how the department implements its human
resources strategy. We need to continue learning from the
health systems around the world such as Cuba and also begin
developing our indigenous medicines such as herbs and others
medicines like the Chinese do. To arrive at this level of
mainstreaming indigenous medicines requires investment in
their development.
We need to ensure that our higher education institutions
should expand their health faculties to produce more doctors
and other health specialised health skills. We acknowledge and
commend the strategic international co-operation such as the
Nelson Mandela-Fidel Castro initiative. This medical programme
which was established in 1996 by President Mandela and
President Fidel Castro of Cuba has benefited South Africa
increasing our health and human capacity. We commend the 8
provinces which support this programme except for the Western
Cape government. We should expand and improve the quality of
training of nurses.
We shun the Western Cape government for not prioritising the
training of students as part of a program established by
former President Mandela. Though the DA tries to use the image
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of the former President of the ANC, they do not support one of
his major programmes. The Democratic Alliance of narrow,
right-wing and liberalism are resulting in disadvantaging new
students who would love to study medicine in Cuba.
Hon members, to increase healthcare practitioners we need to
also increase our health facilities and health colleges to
increase the number of healthcare workers. One of the major
challenges affecting public health expenditure is the
increasing expenditure on medical cases due to acts of
negligence. It is also of concern that there are also
allegations of collusion of medical staff and lawyers. These
unethical and fraudulent practices require closer scrutiny by
law enforcement agencies. The Eastern Cape in the previous
year had an abnormal increase of medical cases and we implore
the department to strengthen accountability systems to ensure
quality assurance of the healthcare provided to patients to
curb medical cases.
House Chairperson, Tuberculosis, TB, human immunodeficiency
virus, HIV, acquired immunodeficiency syndrome, AIDS, and
cancer remain a major cause of death in our country. It is
also important that we consistently monitor our health through
testing. We welcome the support provided to the tracking and
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tracing of patients lost to follow up for Tuberculosis, TB,
and human immunodeficiency virus, HIV, treatment traced by
community health workers at 350 000 for the current year and
the department targets to start having 221 900 on
Tuberculosis, TB, treatment. We also welcome the introduction
of the human immunodeficiency virus, HIV, self-screening to
200 facilities will assist with efforts to monitor infections
and to provide support to the infected persons on time.
Community health workers are a critical arsenal in promoting
preventative measures and providing support for the needy in
the communities. Fighting the coronavirus pandemic also
requires tracking and tracing to stop the spread of the virus
through testing to ensure that people take precautionary
measures all the time. We need to have a more preventative
system that promotes a lifestyle that enhances the health of
the population. Testing and taking health precautionary
measures should be part of a normal routine to ensure
treatment is provided before severity.
To build a capable developmental state, the state needs to be
agile and be a learning organisation that adapts its policies
and practices based on its experience. The experience of
managing the coronavirus pandemic has surely built new
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capabilities in our health system. It has also demonstrated
the capacity of the healthcare system which despite the strain
relatively responded to this crisis. Some of the developed
countries experienced major challenges as their health system
struggled to contain the pressure induced by the coronavirus
pandemic.
The department should infuse the lessons to improve practice
and enhance the agility of the department. The African
National Congress supports the Budget Vote and calls on the
department to continue to improve our healthcare system to
ensure quality services. Challenges will always exist in a
course of social transformation. However, what matters most is
our determination to ensure we create a better life for all
through protecting the wellbeing of all particularly the poor
and marginalised. I thank you, House Chair.
Mr M BARA: Hon Deputy Chairperson, hon members and hon
Minister, the plight of COVID-19 has made government turn a
blind eye on other societal health issues and challenges such
as TB, HIV, sexually transmitted infections, STIs, teenage
pregnancy, substance abuse and mental health. In the ... Sorry
Chairperson, just a little bit. Thank you. Yes, Deputy
Chairperson. This can be done and concluded ... No, no, no! I
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am not ... I am struggling, Deputy Chairperson. I’ll be ... I
am struggling with my device, if you can just give me a
minute.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Will a
minute be enough? Are you ready now?
Mr M BARA: Let me just see, Deputy Chairperson.
[Interjections.]
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): He was born
during the technology age. He cannot be saying like us that he
was born before technology.
Mr J J LONDT: Load shedding, Deputy Chair. Load shedding!
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): It’s a
problem. You may continue. Hon Bara, are you ready?
Mr M BARA: Almost there, Deputy Chair.
Afrikaans:
Mnr J J LONDT: Voorsitter, hy lyk net jonk, maar hy is ook
maar ouer. So, gee hom net ’n oomblik, asseblief.
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Die ADJUNKVOORSITTER VAN DIE NRVP: Dit is nie volgens sy
geboortesertifikaat nie.
English:
Mr M BARA: Deputy Chair, I am ready. Thank you so much. the
plight of COVID-19 has made government turn a blind eye on
other societal health issues and challenges such as TB, HIV,
STIs, teenage pregnancy, substance abuse and mental health. In
the face of COVID-19 we saw the government moving swiftly
putting things in motion under the corrupt hand of those that
fed themselves without a shame, whereas people were in agony
of losing their loved ones who were dying - and yes I am
referring to your predecessor Minister.
More people died due to poor health care services, lack of
hospitals and staff not properly trained to handle pressure.
Not only did COVID-19 kill people, but mere ignorance and
arrogance of our government turning a blind eye while
panicking. Tuberculosis killed more people than COVID-19 did.
People were chased away from the facilities because of
government incompetence. Don’t think we forgot about you
banning grilled chicken! Teenage pregnancy went sky high,
mental health took a toll and HIV management collapsed. The
same zeal and commitment that the department demonstrated to
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handle COVID-19 should be used to holistically deal with other
chronic ailments.
The Special Investigating Unit, SIU, has investigated 5 467
contracts awarded to 3 066 service providers with a total
value of R14,3 billion. Investigations into 4 549 contracts
that has been finalised of which 2 803 were found to be
irregular. In essence, this means that 61,2% of all
procurement was irregular. We therefore want to urge that this
be done and concluded with utmost urgency so that people can
see that the government does no favours for those caught of
wrong doing.
The Health department has to act on recruitment of doctors and
nurses. For instance, the budget for nursing services has only
increased by 1,3% and this can’t be enough given the fact that
health care professionals were working under unimaginable
stressful conditions and continue to do so in the face of
COVID-19.
I cannot speak on health issues and not mention the province I
come from, Gauteng. The province’s department of health failed
to spend R2,6 billion of its budget despite unfilled posts and
hospitals that require urgent attention. On top of all that,
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there’s also R658 million unauthorized expenditure. The good
thing to note is the appointment of a head of department and a
chief financial officer, which might make things better than
they have been in the past.
COVID-19 continues to be a thorn in the flesh to the greater
society of South Africa and yet the department doesn’t seem to
be winning the battle due to a lack of commitment. There is a
need for a more aggressive vaccine literacy program to educate
the masses of the benefits of the vaccine to dispel the myths,
but we all know how Digital Vibes ruined that. A clear and
visible leadership should lead in undertaking these campaigns
to give communities a vote of confidence. Although we have
lost Members of Parliament due to COVID-19, there are some
members who feel strongly that they are not going to be
vaccinated. If members of Parliament are not in support of the
initiative how is the government going to win that with people
outside of Parliament.
There is a need for a strong collaboration with the civil
society organisations to ensure that no one is left behind in
accessing health services that are integrated with primary
health care, noncommunicable and communicable diseases. These
services should go to the people through mobile clinics and
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the use of home-based carers should not be underestimated
since they are people from these communities and therefore are
familiar with them. Government should empower and invest in
our own people before they seek to look elsewhere. There’s
been a huge increase in budget allocation to health as a
result of the pandemic but has it been used effectively to
build the system for future responses? The answer is no. It is
important to utilise the resources available to avoid the
situation we just witnessed with COVID-19.
The repeated fires in hospitals and health centres are a big
issue. Either it is a breakdown of the system or a sign of no
maintenance. It could be sabotage that shows dissatisfaction
of the people in the system. [Interjections.] These are the
same people that the system depends on to make it work. If
they are dissatisfied, this points out to a lack of
maintenance of relationship with frontline workers. It is
therefore important to undertake thorough investigations so
that we know what the causes of the fires are.
Queueing time at clinics has become a problem as people get
back to normal. Clearly clinics are not back up to full
capacity to provide services, meanwhile these are the closest
health institutions to people in our communities. The
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department needs to urgently deal with that as a matter of
urgency. The catch up of operations and procedures that were
postponed due to COVID-19 is not happening adequately. There
is still a huge backlogs and waiting times are too long.
Minister, this needs urgent attention in trying to get things
back to normal. In addition, there is a problem with mobile
clinics as they seem to be unreliable. For instance, in
Midvaal there is a thought of doing a petition to address this
growing discomfort. This also requires a speedy response
Minister.
These are but some of the observations and proposals to
address regarding the issues pertaining to health in South
Africa. Urgent attention to these could go a long way in
trying to bring better health services to the people. I thank
you, Deputy Chairperson. Thank you very much for indulging
with me.
The DEPUTY CHAIRPERSON OF THE NCOP (Ms S E Lucas): Thank you
very much, hon Bara. We will continue with the debate and we
will call on hon Tsiu, the MEC of the Free State. Hon Tsiu?
Ms M TSIU (Free State): Deputy Chair of the NCOP, The
Chairperson of the Select Committee on Health, Minister of
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Health, hon Joe Phaahla, the Deputy Minister, hon Sibongiseni
Dhlomo, leaders of the political parties, members of the
media, ladies and gentlemen.
The 2021-22 was a year that preceded the most ever challenging
period in the history of the Department of Health. Where we
were confronted with the COVID-19 pandemic. However, during
the year under the review, we experienced reduced number of
infections, because of the intervention. The implementation of
the vaccination and also more people being now educated on the
issue of using the non pharmaceutical interventions.
We saw that there was reduction in the number of people that
were infected, even the admissions in the hospitals got
reduced.
Although the department was faced with such a challenge, we
had to refocused implementation on the catch up to improve
performance on the other priorities, especially on the issues
of other communicable diseases and the non communicable
diseases.
As we saw that during the COVID-19 pandemic at its height,
when the hospitals were really battling under pressure, many
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of the people that are on treatment, especially on the chronic
treatment. Many of them did not get their treatment, so we
really trying as much as we can to make show that we catch up
on those...So make sure that our community care workers, as
they visit the families they now do not only concentrate on
COVID-19, but also concentrate on other communicable diseases
including the non communicable diseases.
Indeed, we said COVID-19 affected the services at all levels
care, although infections we say they were lower in this
financial year. This can be attributed to the vigorous
department which we employed in dissemination information of
the COVID-19 to our people.
Primary health care re-engineering continues to be a
cornerstone of health care services. And the department
intensified implementation of the ... [Inaudible.] ...
programmes such as: Integrated School Health Programme and
Ward Based Outreach Team.
With the issue of the problem of us experiencing the high
teenage pregnancy, our primary health care facilities have
been urged to implement the adolescent corners in their
clinics so that all the adolescents can visit the facilities
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without being afraid that they will judged, where they will
have the nurses that will be talking to them. Giving them
skills on how to deal with the issue of an adolescence. The
development that happens within the adolescence.
And also making sure that those that are already sexually
active get the contraceptive without mixing with the elderly
in the ... [Inaudible.] ... will to come for the clinic, where
they have to be attended by a special nurse that would be
attending to the adolescents.
To date we have been able to appoint 2423 as Free State,
community care workers as part of the Ward Based Outreach
Team. Because, we wanted at least to reach more of our
communities and have been able to achieve that. We are now
covering 50% of the population of Free State. We are now at
154 wards, covered by the Ward Based Outreach Teams. When we
have 309 wards within the Free State Province.
The households’ visits conducted by the war boards increased
from 77 822 in 2020-21 financial year, they increased to
116 023 in 2021-22 financial year.
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With the child health immunization coverage, this year, under
review, it improved from 77,4% at the of 2020-21 financial to
year 91,3% as at the end of 31 March 2022. This was a result
of full implementation of immunization catch up drive at all
districts. And also making sure that we combine the work of
COVID-19 together with the vaccination of the young ones.
The mental health, the total number of 320 000 people were
screened for mental disorders and referred after they have
been assessed by the mental health care and were referred to
the clinic for interventions.
The department is implementing the strategy to achieve
universal mental health assess, which includes; the
contracting of mental health practioners. In the previous
financial year, two clinical psychologists were contracted at
the primary health care, to manage and provide psychosocial
services at 514 mental health care users.
To reduce the backlog that we are experiencing of forensic
mental evaluation and treatment of state patients in
correctional facilities, additional clinical psychologist,
occupational therapist and social workers will be contracted.
This is what we are planning to do in this financial year. To
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strengthen institutional capacity on mental health, we have
appointed two fully functional mental health with ...
[Inaudible.] ... boards to uphold the rights of the mental
health care users and institutions in the Mental Health Care
Act no 17 of 2002.
On HIV, human immunodeficiency virus and AIDS, acquired
immunodeficiency syndrome we know that at the time of the
COVID-19, this too also suffered a lot as the main programmes
we had to look at. The department remain committed to
achieving 1990 strategy. Though our performance during the
COVID-19 like I say was affected and it went down.
But the District of Thabo Mofutsanyana remained in the top
five districts that achieved the 1990 strategy and we trying
to copy from what Mofutsanyana did, all other districts so
that we achieve the 1990 strategy in all our districts. We are
also working with our community health workers to make sure
that we achieve the 1990 strategy in all other districts.
The other intervention that we are doing is that we have
increased the number of patients that we have enrolled on
Central Chronic Medicines Dispensing and Distribution, CCMDD,
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as we are trying to ... [Inaudible.] ...and also trying to
deal with the issues of patient’s waiting time at the clinic,
when they come to get their medicines. So we have enrolled
more patients on the CCMDD [Interjection.]
Deputy Chair, the department would never have been where it
is, if it were not for health care workers, who relentlessly
remain at the forefront of the pandemic despite the
difficulties that we are facing and we are committed to
ensuring that we catch up on all the programmes suffered
during the hype of COVID-19.
And we are also really glad that the community of Free State,
they were able to respond very well, when we were working on
the COVID-19 vaccination and we are at this point in time
above 50% of the total target population, that have been
vaccinated. And above 70% on the very vulnerable age of above
60. So we are really doing very well but we are still not
there at the 70% and we are encouraging our people to visit
our vaccination programmes and we are going to continue with
visiting all the communities at their places, where they stay
so that we are able to increase the number of vaccinated
people in the province. I thank you Deputy Chair.
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Dr N MOKGETHI (Gauteng): Hon Deputy Chairperson of the ...
[Interjections.]
The DEPUTY CHAIRPERSON: Mute hon MEC Free State. Mute, please.
You may continue, hon MEC Mokgethi.
Dr N MOKGETHI (Gauteng): Thank you very much, hon Deputy
Chairperson for the opportunity. Greetings to the hon
Chairperson of the NCOP, hon Minister and Deputy Minister of
Health, members of the provincial executive, hon members of
the NCOP, hon Chief Whip of the Majority Party, delegates from
various provinces, ladies and gentlemen.
This National Council of Provinces House Sitting takes place
during Youth Month, where we commemorate the historical
selfless struggle championed by young people during the dark
days of colonial apartheid government. During the month of
June, the Gauteng Department of Health will be focusing on
different programmes promoting healthy behavioural change,
including themes on economic empowerment and career
opportunities to uplift young people in our province.
Hon Chairperson, the overall thrust of this Budget Vote is
anchored around the objectives of strengthening our Gauteng
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health system to be more responsive to patients’ needs. We
will demonstrate how we are looking to carry out the
department’s Annual Performance Plans and the prudent
deployment of the allocated budget, thus providing a
comprehensive rationale of our considered decisions.
Hon members, for the 2022-23 financial year our Department
received a total of R59,4 billion and further R178,2 billion
over the 2022 Medium Term Expenditure Framework, MTEF. With
this allocation, the department intends to transform the
health system and improve the quality, safety and overall
coverage of health services it provides to the citizens of
Gauteng. Furthermore, a total amount of R1,5 billion is
allocated for the Comprehensive Health Response to the COVID-
19 pandemic. This is assigned for administering the
vaccination rollout programme, amongst others. Included in
this amount is the R1,1 billion, which is designated to
sustain filled posts created for the COVID-19 response
programme.
On the critical positions, I am happy that hon Bara did
acknowledge that we did appoint the head of department and the
CFO. The recent appointments of the CFO and the head of the
department, including the deputy director general for
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corporate services, Ms Basani Baloyi, with effect from 1 March
2022, marks an important milestone in our transformation
journey, and it sets the strategic tone for the department.
In addition, the department has set aside an amount of
R35,2 billion in the 2022-23 financial year and, to sustain
the current staff compliment and fast track the filling of
critical posts in all our institutions. This is part of the
concerted efforts to strengthen leadership and administration
capabilities in the department, and to improve the quality of
healthcare in the province.
The department continue to run one of the biggest HIV
preventive and treatment programme in the country. In light of
this immense workload, we remain committed towards the
priority of reducing the burden of HIV and AIDS and
Tuberculosis, TB, as outlined in the UNAIDS 90-90-90 strategy
for HIV, TB and non-communicable diseases. To achieve this
objective, a total of R6,2 billion in 2022-23 financial is set
aside for HIV and TB programme. The foremost focus in these
areas will be on the revitalisation of the HIV Counselling and
Testing campaign, and the intensification of interventions on
the highest risk populations for HIV infections and
transmissions. The department will also intensify
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antiretroviral, ARV, rollout to initiate more people on ARV
treatment, implement strategies aimed at improving viral
loads, an adherence strategy and improve the source and
quality of data management to prevent the loss of clients by
conducting follow-ups.
The department has managed to conduct over 5 million HIV tests
in the 2021-22 financial year, with 151 771 people testing
positive for HIV. We have also managed to place and retain 1
178 819 clients on the ART treatment. The viral load
suppression amongst adults has been attained, and more still
needs to be done for the children on treatment with only 64,7%
on treatment virally suppressed. We also intend to continue to
integrate the HIV and TB services into the COVID-19 screening,
testing and contact tracing. We have a responsibility to
ensure that COVID-19 pandemic does not threaten the gains we
have made in the fight against both diseases. In addition, we
are directing our focus on the health screening of learners in
schools to address health barriers to learning and educating
through the Integrated School Health programme. This programme
has received R349,7 million in the 2022-23 financial year.
On mental health, hon Chairperson, another area of priority
the we have identified is the mental health programme. Mental
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health disorders are extremely prevalent in our society, and
are responsible for poor quality of life, increased mortality
and have direct attributes towards economic and social costs.
Therefore, mental health care services are allocated
R474,6 million in the 2022-23 financial year. With this
allocation, the department will improve the mental health
services through prioritising district health institutions and
regional hospitals, linking it with adoption of a multi-
disciplinary team and inter-sectoral approach, such that we
achieve a people-centred mental healthcare services.
On emergency services, hon Deputy Chairperson, our emergency
medical services will receive R1,6 billion for the 2022-23
financial year to improve emergency response times in urban
and rural areas. It is equally important to note that,
emergency medical services will be equipped to deal with neo-
natal cases through dedicated vehicles to attend to obstetric
emergencies within facilities and from the communities. In
order to reduce and improve patient waiting times during
referrals between health facilities, we are currently piloting
what is called Gauteng the Scheduled Emergency Transport, G-
SET, across all districts. This is the new innovative way of
responding to patient needs and will see a shuttle service
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transporting patients through predetermined routes within a
cluster of health facilities at scheduled times.
Hon members, our country is facing a challenge of shortage of
healthcare professionals, and this phenomenon is affecting
many countries across the globe. As a department we have set
aside an amount of R321,1 million in the 2021-22 financial
year, allocated to bursaries and training opportunities. The
provision of quality health service is highly reliant on
functioning healthcare infrastructure for patient care.
Appropriate health infrastructure is a significant pillar to
support the fundamental objectives of promoting improved
standards of care and wellbeing of patients. To meet this
expectation, a total amount of R2,3 billion in the 2022-23
financial year is allocated to implement health infrastructure
projects. These projects are directed at construction of new
facilities and the rehabilitation, upgrade and maintenance of
existing facilities.
With regards to further expansion of service platforms, the
following clinics, Phillip Moyo in Ekurhuleni, Mandisa Shiceka
in Tshwane and Sebokeng Zone 17 in Sedibeng are earmarked for
handover and opening during this financial year. Furthermore,
we have prioritised the Primary Health Care re-engineering
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programme which will receive R1,3 billion in the 2022-23
financial year. The provision of 24hour x-ray services in the
community health centres will continue, which will ensure to
avoid the transfer of patients to hospitals for simple x-rays
that can be done at primary health care level.
Hon members, the National Health Insurance, NHI, remains one
of the key priority we are determine to advance. We have
dedicated an amount of R271,4 million, towards the
implementation of the NHI over the 2022 MTEF to prepare our
healthcare system. This budget is earmarked for improving
patient care, clinical outcomes, achieving the Ideal Clinic
Status and Ideal Hospital Status.
As I conclude, hon Deputy Chair, we pride ourselves having
been identified as a province that is leading in this
priority. We are fully determined to deliver this essential
programme, for the majority of the people in Gauteng.
Our priorities are in line with Growing Gauteng Together 2030
vision which is our provincial blueprint, mandating us to
ensure that 90% of our clinics, community healthcare centres
and regional hospitals meet the ideal clinic standards. To
further ensure that our health service centres open on time,
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with adequate medicines and equipment, providing safe and
patient-cantered services. I thank you, hon Deputy Chair.
The CHAIRPERSON OF THE NCOP (Ms S E Lucas): Order, hon member.
Thank you very much, hon MEC Mokgethi. We will now call on hon
Luthuli, and in the same vein handover back to hon Nyambi who
will proceed presiding over the programme. Over to you. I see
hon Lehihi standing in for hon Luthuli. It is what I can take
from the fact that you show me your beautiful face. You may
continue.
Ms S B LEHIHI: Thank you, Chairperson.
Setswana:
Ke a leboga, Modulasetilo.
English:
The EFF rejects the budget on Health. The delivery of quality
healthcare is a constitutional obligation in South Africa, yet
under this department, healthcare inequality is worse for
poor, black South Africans than it was under apartheid,
especially in the rural parts of this country, such as the
Eastern Cape and North West Provinces. Challenges faced in
healthcare have worsened over the years due to shortages of
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healthcare workers across all provinces. This is coupled by a
shortage of hospital equipment and work backlog which cause
extended delays for patients awaiting treatment.
Setswana:
Dikago tsa pholo jaaka maokelo le dikleniki ga di na ditirelo
gotlhelele. Dikago ga di tlhokomelwe, gape ga go na tsela e e
thibelang tshelano ya maletswe ka kamano. Balwetsi bae ma nako
e telele ko bookelong gonne maokelo ga a mo seemong se se
siameng go tlisa ditirelo tse di maleba mo baaging. Batho ba
ba ba fetang 84% mo Aforekaborwa, ga ban a ditlamelwana tsa
pholo kgotsa di sekema sa boitekanelo. Ba lebeletse thuso go
tswa mo lefapheng, mme mo go lona go tshwana le hube, go go
setlha fela. Batho ba tlhaolwa ka gore o mang, le gore maemo a
o nang le one ke a feng mo setšhabeng?
English:
Chairperson, the North West Province healthcare e bodile [is
rotten,] while Members of this House have access to proper
health services, and specialists, while our people across the
country do not have access to basic services. After a visit to
Mafikeng, Mr Ramaphosa once commented that ...
Setswana:
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... Mafikeng e leswe.
English:
... which translates to, Mafikeng is dirty. As usual, he
failed to properly categorise the root-causes of the dirt in
the North West Province, but let us provide clarity to that
effect.
Setswana:
Bokone Bophirima e leswe, ...
English:
... because Bophelong Provincial Hospital in Mafikeng is
failing to provide basic hygiene. There, exists shortages of
beds, pregnant women are subjected to inhumane condition in
maternity wards, and the infrastructure is dilapidating and
very soon it will become a hazardous area.
Setswana:
Ke lona leswe la Mafikeng leno. Bokone Bophirima e leswe ...
English:
... because Tshepong District Hospital in Klerksdorp is in its
worst state, Minister. Our ailing parents, sisters, brothers
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and children are returned home almost every week due to
shortages of medicine. There is shortage of nurses and doctors
even though the hospital services the surrounding areas such
as Maquassie Hills, Matlosana and Tlokwe.
Setswana:
Bokone Bophirima e leswe, ...
English:
... because clinics across the province close at 16h00. Our
people in Boskuil cannot afford to pay more than R100 to
access health services in Wolmarranstad, which is about 25km
away. Minister what rational reasons lie behind closing
healthcare facilities at 4pm while are people need services
throughout the day and night?
Setswana:
Mafikeng le Bokone Bophirima di leswe, ...
English:
... because a girl child is deprived of her constitutional
rights to be at school when she goes on her menstrual cycle,
mainly because, your department is failing to provide free
sanitary towels, yet it continues to provide condoms.
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Minister, sex is a choice, menstrual cycle is not. Health
services, healthcare institutions and facilities across the
country remain inaccessible and inconvenient to large numbers
of our people. This department has failed to make available
good health services which are within reach of those who need
them.
This department has failed to extend opening hours in clinics
and other healthcare facilities in our townships. The reality
which our public healthcare system is faced with, along with
other departments, is that this is a department which is
plagued with the leadership of the ANC which refuses to
account for the failings of this department. The SA Health
Products Regulatory Authority, SAHPRA, is in a constant state
of deception. Two years later, SAHPRA has still not done the
work to save and protect our people from Johnson and Johnson
surgical mesh debacle.
While they do this, SAHPRA is dead set against approving
vaccines developed by companies from Russia and China. They
are gambling with the health of our people in their pursuit of
factional scientific preferences.
Setswana:
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Bokone Bophirima e leswe, Tona, mme e diriwa leswe ke
boeteledipele jo bo leswe jwa mokgatlho o o busang. Porofense
ya Bokone Bophirima e ikgatolositswe ke Lefapha la Pholo. Bana
ba tlhoka go tsena sekolo ba sa kgorelediwe ke maemo a tlhago
kgotsa goya bosading jwa bone.
English:
We need a budget that will ensure provision of sanitary towels
for a girl child, in particular, and of urgency, to schools.
This can be done in partnership with the Department of
Education. We need to have ... [Interjections.] [Time
expired.]
The DEPUTY MINISTER OF HEALTH: Chairperson, thank you very
much for allowing us to be part of this debate. To the
Chairperson of the select committee, the Chairperson of the
NCOP and Deputy Chair, hon members of the select committee. My
apology for our Minister who had to go to another pressing
Cabinet meeting. Other Deputy Ministers who are here and
Members of the Executive Council, MECs.
It’s always an honour and not something to be taken for
granted to be invited by this House to debate on this
important budget of health.
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Let me start by saying, we support this budget. And we want to
say this debate takes place two years after the COVID-19
pandemic that began and changed our lives and the economy in
our country. The battle is not over yet, as the Minister has
indicated, covid is still with us.
But, indeed, we’ve come a long way. The lives of our people is
beginning to normalize, then post-pandemic. Yet much still
needs to be done to rebuild our economy, improve the uptake of
health services, reduce morbidity and mortality which got
worse during COVID-19.
The impact of COVID-19 will live with us for many years still
to come. We need to mobilize communities and individuals to
get back to healthy lifestyle activities, health promotion and
preventative care. We need to deal with challenges of non-
communicable diseases to ensure ... [Inaudible.] to rise,
before the COVID-19 as well as its impact.
The escalating burden of non-communicable disease, including
mental health, serious impact on health and development of our
communities is estimated that 80% of commonly experienced non-
communicable disease result from preventative risk behaviours,
and this increasing burden is presently resulting in high
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mortality, morbidity and disability as great cost to patients,
families, communities and to the health system and the economy
at large.
During the COVID-19 pandemic we observed persons with known
and unknown heartbeat [Inaudible.] getting worse because of
what actually is the core comorbidities with these illnesses.
According to the United Nations Children’s Fund, UNICEF,
report of 2019, South Africa has the largest percentage of
overweight children under age of five years and between 10 to
19 years of Eastern and Southern Africa.
The South African demographic and health survey of 2019 found
that a significant percentage of men and women who perceive
themselves to be either underweight or of normal weight were
overweight.
The impact of determinants of health on the poor and
vulnerable is very complex, not only do they have
disproportionately access to care but poverty results in these
communities being also less likely to afford healthy foods,
are more likely to live in environments which fail to allow
safe space for exercise and recreation and expose them to air
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pollutions; all of which leave them little or no flexibility
on their choice that they make.
Perhaps more disturbing, the impact of the commercial
determinants driven by the private whose marketing and
availability of products such as tobacco and food and
beverages with increased levels of salt, sugar and trans fats
keep our people unhealthy in the interest of maintaining their
profits.
Hon Chairperson, just yesterday, the 31st of May in the
District of Sarah Baartman, we did a two-in-one. Firstly, it
was recognition of a no tobacco day and also recently our
approved strategic plan for the provision of controlling of
non-communicable disease 2022-27.
Just on the note on no tobacco day, there was also a report
that was tabled by the SA Medical Research Council, SAMRC, and
that report said very concerning things, firstly, 93% of
smokers in South Africa do understand that they are involved
in a risky behaviour by smoking; secondly, 40% of smokers in
our country are planning to quit and they wish to be supported
if they could; thirdly, the report was actually telling us
that there’s already smoking at the age 15 and above.
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So, when we were there we were then wondering, when do we
actually start to see people smoking?
The Mayor of Sarah Baartman District, Cllr Deon de Vos,
actually mentioned that he is aware of people as young as 9
years old, who have started to experience with smoking. That’s
a very worrying factor.
Whilst aligning its deliverables to existing legislation,
policies and sureties including on the tobacco control,
obesity, cancer and mental health conditions, a key focus of
this plan is to ensure the early identification, diagnosis
treatment and control of persons with or who are already
having high risk of hypertension and diabetes.
The essential process to link persons to care and promote the
control of their conditions will be achieved through the
rollout of this strategy that we actually launched yesterday.
The aims and objectives of the strategy are to strengthen the
district’s community-based multisectoral response with the
initial focus on hypertension, diabetes, obesity and mental
health.
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The recent increases of disasters have, and especially in the
province we have had, have already added to the strained
mental health services needed. Of great concern is the long
term and far-reaching human psychological, social and economic
consequences of the pandemics, disasters and emergencies on
the entire community that we serve.
We’ll also like to indicate that we will continue to improve
the decentralization and intervention of mental health
services because this is what our people have shown that they
do need.
We also are going to invest in primary care and community-
based mental health services to improve access and
efficiencies in services rendered to our people.
The regulations for the licensing of community day care and
essential care facilities for people with mental illnesses and
severe or profound intellectual disability will soon be
published for our people to comment on.
South Africa remains committed to providing comprehensive,
sexual and reproductive services with an equitable and rights
based approach.
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Unsafe termination of pregnancy remains one of the major
causes of maternal morbidity and mortality and needs to
addressed to further reduce the South Africa’s maternal
mortality rates to the sustainable development goal of at
least 70 maternal deaths per 100 000 live births by 2030.
Despite South Africa’s liberal abortion law, the country
continues to face problems with unsafe and self-induced
abortions at a relatively high rate. The illegal abortionists
are advertising themselves pasting their adverts on the
municipal poles and encouraging young women, adolescent and
youth to utilize their services. To address this problem, the
department in collaboration with other government departments
and different stakeholders started a campaign against illegal
abortion, youth engagement and promoting healthy lifestyle.
The first province to host this campaign was North West in
Bojanala District in February, followed by the Eastern Cape in
two areas, one was in Buffalo City and the other was in the OR
Tambo Districts in May this year.
We are targeting to go into the next province this month,
June, in Ehlanzeni in Mpumalanga and the national department
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will continue to support and aim to cover all other provinces
and let our leaders there continue with the process.
We are systematically addressing common issues that are raised
by young and health managers during these campaigns: shortage
of staff, overcrowding facilities and also there’s a need to
capacitate and mentor clinicians especially the on-long acting
reversible contraceptives.
Young people are actually saying there are negative attitudes
of our staff in some areas, young people always are judged as
they access these sexual reproductive services, most
facilities are not offering the comprehensive variety of
contraceptives, there’s little privacy and confidentiality as
young people access these; of course these are young people,
sometimes they don’t want to be seen by the people in the
villages that they are coming in to access.
However, we continue to strengthen our adolescent and youth-
friendly services. Currently we have, to these challenges that
young people are raising, the department, therefore, approved
a National Adolescent and Youth Health Policy in 2017 whose
main objective is to empower adolescent and young people to
engage with the policy and programming on youth health. This
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has translated into what was called youth zones, to facilitate
the implementations of the adolescent and youth-friendly
services.
A comprehensive package of health interventions was delivered
during dedicated ... [Inaudible.] for young people including
adolescent, sexual reproductive ... [Inaudible.] to prevent
teenage pregnancy.
The involvement of young people in designing such
interventions to address their challenges align with the five
objectives of the She Conquers campaign, which is very crucial
to the success of this campaign is commendable.
The department is committed to the recommendations outlined in
the National Youth Policy of 2030. Currently we do have 1 405
of our primary healthcare facilities that already are actually
embracing ... [Inaudible.] use on approach. We aim to have
much more by the end of this year ... by 2025 at least to have
actually got 2 500 of our primary healthcare facilities.
A total of over 4,6 million of our adolescent and young people
have accessed our health services that offered in these
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facilities that are already youth-user friendly; that is up to
the 31st of March.
To demonstrate that indeed our facilities are accessible and
available for young people, we want to continue to strengthen
the quality of the service that give to them in collaboration
with the social development and other programmes that we do
have ...
The HOUSE CHAIRPERSON (Mr A J Nyambi): As you conclude, Deputy
Minister.
The DEPUTY MINISTER OF HEALTH: As we conclude, we want to
continue to strengthen our support and work relationship on an
integrated programme in the school health programmes that is
championed by the Department of Basic Education. we want to
say, we are champions, we are mandated to support the
programmes that are focusing mainly on young people and we
would want to continue doing that. Thank you very much, Chair,
for allowing us to [Inaudible.] raise these issues. Thank you
very much.
Ms D C CHRISTIANS: Hon Chairperson, hon members and hon
Minister, fraud, corruption, cadre deployment and
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maladministration continues to destroy public health services
in this country.
The ANC government has systemically destroyed every single
public service entity in the country and citizens are left
asking how long before nothing is left of this country as we
continue to see cadre deployment and corruption wreak havoc.
Year after year we come to this platform to approve budgets of
billions of rands, yet most hospitals, clinics and health
systems in the country are in severe decline. Coffers continue
to be raided by callous thieves as these same budgets we have
to approve and debate year after year are systemically
syphoned into corrupt officials’ pockets.
Reports of infant deaths are on the rise, mothers are forced
to give birth in hospitals on cold floors screaming for mercy
as a shortage of beds, nurses and doctors are the order of the
day.
Mass immigration of health care workers have seen a shortage
in hospitals, the vacancy rate for nurses increasing by 21 453
and the patient/doctor ratio in hospitals are 0,31 per 1000
residents. This means a severe shortage of medical staff.
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The looting of the COVID-19 pandemic funds has shown just how
little this government cares for the people of this country,
as recently it was indicated that 61,2% of all procurement was
irregular.
Chairperson, let us focus our attention on the health system
in the Northern Cape for a minute, as it has been on a steady
decline for the last decade and matters have now reached
breaking point. There have been no improvements in audit
outcomes for the past five years, with the department stuck on
a qualified opinion and showing no will to try and recover. It
has not even bothered to attempt to put together an audit
action plan.
The department started the current financial year in a
deficit, owing R590,186 million on the previous year’s debt,
while its bank overdraft was at more than R100 million,
signifying financial unsustainability and once again casting
doubt on the department’s ability to function.
Ironically, this debt-laden department also managed to
underspend by R78 million due to a combination of factors,
including administrative delays in moving patients to the new
mental hospital, which in effect sees state patients still
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being housed in prison despite this being a gross human
violation of their rights.
Despite the almost R2 billion state-of-the-art mental health
hospital in Kimberley, minors are being admitted to adult
wards because the child and adolescent ward is not yet
operationalised.
The department failed to spend earmarked for the procurement
of emergency vehicles and the number of operational ambulances
on our roads is declining with the latest figures suggesting
that only 75 ambulances were operational, while 73 were
waiting to be repaired.
Cancer patients can’t get from Springbok to Kimberley for
treatment, while at the last known date, 28 Patient
Transporters were operational and the other 28 were broken.
How can we accept that there is an increasing number of babies
who contract Human Immune Virus, HIV, infection during the
postnatal period or that the department is failing to achieve
its target on the initiation of pregnant women on
antiretroviral treatment?
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Out of a mortuary fleet of 31, only six mortuary vehicles are
in a good working condition in the entire Northern Cape
province.
The state of clinics is on a severe decline, with only 23
facilities out of 159 achieving Ideal Clinic status compared
with 101 achieving the status in 2018-19.
Claims against the department stand at R1,890 billion and
medico-legal cases accounting for R1,624 billion, indicating
an ongoing increase in adverse events taking place in health
facilities.
Most hospitals and clinics suffer dire personnel shortages. In
fact, Robert Mangaliso Sobukwe Hospital in Kimberley can, on a
good day, only operationalise four out of nine theatres
because of a lack of nursing staff.
Sexual assault victims are not attended to due to the shortage
of available trained practitioners in Clinical Forensics.
Shockingly, for the previous year, 848 sexual assault cases
were reported at health facilities in the Northern Cape but
there was only DNA testing done on a single perpetrator, only
one.
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The DA in the Northern Cape has in a letter appealed to the
Minister of Health to take this department under its wing
while there is still something left to save this dysfunctional
and increasingly deadly department in the Northern Cape.
Yes, the previous government under the apartheid regime was
horrendous but for how long will the ANC government continue
to use this as an excuse for looting, corruption and
maladministration?
The people of this country can no longer tolerate the
incompetent and corrupt government by turning a blind eye to
the rot and decay we see everywhere.
As I conclude, this budget clearly does not have the wellbeing
of South Africans at heart but merely the personal bank
accounts of corrupt ANC cadre officials. I thank you.
Ms N NDONGENI: Good evening Chair. Chair, - I don’t know
whether ...hello Chair.
IsiXhosa:
ILUNGU ELIHLONIPHEKILEYO: Hayi siyakuva sisi, qhuba.
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Nksz N NDONGENI: Kulungile ndiyabulela.
ILUNGU ELIHLONIPHEKILEYO: Ndim usihlalo ngoku.
Nksz N NDONGENI: Hayi wena!
The HOUSE CHAIRPERSON (Mr A J Nyambi): Hon Ndongeni we can
hear you but we can’t see you.
Ms N NDONGENI: If you can’t see me, I have got a problem. I
don’t know what is going on with my gadgets.
The HOUSE CHAIRPERSON (Mr A J Nyambi): Okay, continue with
your speech.
Ms N NDONGENI: When I open my video, it is upside down. I am
sorry Chair.
The HOUSE CHAIRPERSON (Mr A J Nyambi): No, continue with your
speech.
Mr J J LONDT: Hon Chair, it is a user problem and not a gadget
problem.
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IsiXhosa:
Nksz N NDONGENI: Yhooo! Uyanqonyoza ...[Uwele-wele.] Hayi
uyanqonyoza lungu elihloniphekileyo uLondt, andiyazi ukuba
kutheni ekubeni uyindoda.
English:
Thank you Chair. Greeting to you Chair and the Deputy Chair,
Minister and Deputy Minister on the platform, permanent
delegates, special delegates and all members of the society.
We began this youth month with this critical debate which has
a direct impact on the well-being of all South Africans and
the healthcare system, which should support all South
Africans. We will debate a critical policy position of the ANC
which will also benefit the youth who are amongst the most
marginalized as there are impacted by the highest levels of
unemployment.
The democratic ANC government has been tasked to address a
legacy of colonialism and apartheid. Apartheid as a crime
against humanity created inhumane conditions for the black
majority and Africans in particular. Over the past 27 years,
the ANC has developed the health systems to respond to the
need of all South Africans, despite the progress in advancing
this transformational agenda, the structural constraints
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induced by apartheid and its capitalist accumulation resulted
in a skewed distribution of resources.
Chair, it is for this reason that the ANC’s health policy has
been premised on the realization of a universal healthcare
coverage. Universal healthcare coverage means that all people
should have access to equal health services needed, without
any financial hardships or class position. Subsequently,
despite some progress in expanding access to health, at least
half of the world’s population still cannot obtain essential
health services.
A joint study by the World Health Organization, World Bank,
and the Tracking Universal Health Coverage Global Monitoring
Report 2017 found that, close to 100 million people are being
pushed into extreme poverty because of health expenses, and
800 million spent more than 10% of their household income on
health care. Thus, achieving universal health coverage is not
just about better health outcomes but also about economic
development and equity.
According to section 27(1)(a) of the SA Constitution:
“Everyone has the right to have access to health services,
including reproductive healthcare”, Constitution of the
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Republic of South Africa of 1996. The SA government, through
the National Department of Health, is committed to moving the
country towards the goal of united health coverage, UHC, which
is being pursued in South Africa through the implementation of
the National Health Insurance, as articulated in the National
Health Insurance, NHI Bill.
The socioeconomic impact assessment of the NHI Bill makes the
point that although 43,6% of the population in South Africa
live in rural areas, they are only served by a 12% of doctors
and 19% of nurses in the public sector. Thus, residents of
urban areas are the beneficiaries at the expense of those in
rural areas. Similarly, it is reported that females 63,5% are
more likely than males 57,6% to use the public health sector
and therefore, suffer relatively more due to this limited
access. The creation of the Nation Health Insurance Fund as a
single purchaser is expected to be able to support the
creation of an environment and incentives that will rectify
this imbalance
Chair, the dual system of health should not be normalized and
the NHI offers an opportunity to ensure equitable access to
healthcare. The Nation Health Insurance Fund will function as
a single pool fund that will pool resources for maximum
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impact. One of the critical lessons from the COVID-19
responses by the healthcare system, was the integrated
approach and collaboration of the private sector and the
public sector, working together united to address the health
risk facing our nation.
The NHI will yield various benefits such as:
1. The establishment of the NHI Fund will augment public
sector resources, because it will balance resource
allocation between private and public healthcare
sectors.
2. The NHI will address skewed resource allocation,
currently, there are more resources in the private
sector than in the public sector.
3. The NHI is a healthcare financing system that will
ensure every member of the population can access health
services.
4. The NHI will address equity issues about medical
schemes’ tax credits and subsidy which is currently only
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benefiting the medical schemes’ members. The last but
not least;
5. The medical schemes only benefit a few. According to
Statistics SA, only 10,1% of blacks have access to
medical aid, compared to more than 70% of whites.
With NHI, medical schemes won’t be dumping to the state
facilities private patients, whose medical aid benefits have
been exhausted. Support the Bill because it will:
Change many things such as improvement of infrastructure,
medicine, reduced queues, and improved quality.
Ensure financial protection from the costs of health care
and provide access to quality health care services by
pooling public revenue to actively and strategically
purchase health care services based on the principles of
universality and social solidarity.
Create a single framework throughout the Republic for the
public funding and public purchasing of health care
services, medicines, health goods, and health-related
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products, and to eliminate the fragmentation of
healthcare funding in the Republic.
Promote sustainable, equitable, appropriate, efficient,
and effective public funding for the purchasing of
healthcare services and the procurement of medicines,
health goods, and health related products from service
providers within the context of the national health
system; and
Sustaining the current dual system will reproduce the
inequalities of access to healthcare. Citizens with
medical aid will continue to be exploited by the
exorbitant cost which has financialized a critical basic
service.
Medical aid holders also face numerous challenges as exposed
by the Competition Commission Health Market Inquiry which
found that:
The SA private healthcare market it is characterised by
high and rising costs of healthcare and medical scheme
cover, and significant overutilization without
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stakeholders have been able to demonstrate associated
improvements in health outcomes.
We have identified features that alone or in combination,
prevent, restrict, or distort competition. The market is
characterised by highly concentrated funders and
facilities markets, disempowered and uninformed
consumers, a general absence of value-based purchasing,
practitioners who are subject to little regulation, and
failures of accountability at many levels.
Chair, medical aid users still pay out of their pockets as
their allocations get depleted. It is for these reasons
amongst others that the ANC has prioritized the NHI Bill in
the Sixth Administration, thus far the process of the Bill is
at the clause by clause stage in the National Assembly. As we
debate this Bill, the National Assembly is about to conclude
the Bill before its submission to this House. This is major
progress towards the attainment of national health insurance.
We are not fazed by the rejection of the Bill by the political
extremes from the right to the ultra-left led by the FF Plus,
the DA and the EFF. These hon members display the lack of
commitment from these parties to creating a better life for
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all, wherein all South Africans receive equal opportunities
and equal health services.
This unholy alliance of rejection of progressive policies of
the ANC reflects the narrow philosophical and ideological
orientation of these opposition parties, which the right wing
aligned to protect the capitalist class and the retention of
the status quo whiles on the ultra-left the EFF argues left
but rejects progressive moves to the left. This is a clear
sign of the level of populism in the ranks of the EFF.
These opposition parties claim to support universal health
coverage, yet they reject the NHI, this is the highest level
of hypocrisy, and the people of South Africa should know what
these political parties stand for. They stand for stagnation
and a narrow focus on derailing progress.
The National Council of Provinces will have its public
participation process on the NHI Bill and as the ANC in this
House, we await the Bill to ensure it is processed to effect
the socioeconomic transformation required for an equitable
healthcare system. It is also important to note that the
majority of South Africans support the NHI, and as members of
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this House, we should orientate our approach to support the
aspirations of our people.
The ANC supports this Budget Vote, and we urge the department
to remain committed and steadfast for the progressive
realization of universal health coverage in South Africa.
I thank you Chair and I am sorry about the video.
Ms N SIMELANE (KwaZulu-Natal): Good evening, Chair, good
evening to the Minister Phaahla, the Deputy Minister Dr
Dhlomo, Chairperson of the NCOP as well as the Deputy Chair,
hon members, members of the media, distinguished guests,
ladies and gentlemen, good evening, I wish to start by warmly
welcoming the 2022-2023 budget speech as delivered by the hon
Minister of Health, Dr Phaahla on 10 May and delivered in this
meeting today. We also hereby express our gratitude as the
province to the ANC-led government for its leadership,
guidance and support during the various turbulent episodes
that our province has had to endure over the past two years.
Here I am referring to the COVID-19 pandemic, which was first
diagnosed in the suburb of Hilton near Pietermaritzburg. I am
also referring to the looting, vandalism and cold-blooded
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massacre of fellow compatriots during the July 2021 unrest. As
well as the two recent episodes of flooding, which occurred in
April that caused extensive damage in our province and our
hospital and health care facilities were not spared.
Invariably, these disasters have had a negative impact on our
budgets, which have already been shrinking since 2019 to date
as the province of KwaZulu-Natal. The shrinkage over a nearly
three-year period has set us back by at least R16 billion as a
province, which is extremely concerning and has serious
implications for us and the health care system. Be that as it
may, we fully support the commitments that our hon Minister,
Dr Phaahla has made in his budget speech, including the fact
that the major during the financial year and beyond will be on
regaining the ground lost due to the deadly COVID-19 pandemic
through offering the public a stronger and more comprehensive
package of health care services.
It is our firm belief that the integration of the COVID-19
vaccination programme into the comprehensive basket of
services, from primary health upwards, is indeed a step in the
right direction for the country. As the country’s second-
biggest province, we welcome this integrated approach because
any increase in the number of people who get vaccinated
against COVID-19 in KwaZulu-Natal translates into a serious
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boost to the country's efforts to attain population immunity.
Having said this, I must also be the first one to acknowledge
that, as a province of KwaZulu-Natal, we are indeed struggling
with getting our fellow compatriots to come forward and get
vaccinated.
However, we are working on it. We have programmes that we have
implemented and we are continuing to implement those
programmes. And together, working with it the national
Department of Health and the support that we have received
there, we think we will be able to achieve our targets
eventually. In the same breath, our strategic health
programmes incorporating HIV and Aids, TB, medical male
circumcision, condom distribution, and many others have taken
a knock due to the disruptions in the normal order of life
over the past two years. Again, the fact that we have been
able to reach fewer people with our health education and
health promotional messages, as well as through screening and
testing people for diseases, does not bode well for the people
of our province. And certainly not for the people of the
country.
That is why we appreciate the fact that from the national
Department of Health budget allocation of R64,5 billion,
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around R55 million will be transferred to the provinces as
conditional grants.
IsiZulu:
Siyakubonga kakhulu lokho. Siyacabanga ukuthi kuzosisiza
njengesifundazwe noma kuzosisiza, kusihlangabeze ukuze sikwazi
ukuthi ukuzuza izidingo zokunakekelwa kwezempilo ezifanele
esifundazweni.
English:
We are pleased that the conditional grants that we received
over the past financial year were well-managed and fully spent
in various areas of key service delivery. The list is endless,
but I can indicate that grant of National Tertiary Services,
HIV and Aids and TB, Malaria, HPV vaccination, and the COVID-
19 response grant. These conditional grants always go a long
way towards complementing various activities in all of these
critical areas. We also appreciate the fact that some of these
financial resources will cover infrastructure development. As
a province, we are extremely pleased to announce that we were,
once again, awarded an incentive grant by the National
Treasury and the national Department of Health to the tune of
R65 million.
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This was for our excellent management of the health facilities
revitalisation grant, which is in line with the prescripts and
various requirements of the Division of Revenue Act. We scored
92% in this regard, which was the second-highest. And of
course, we aim to be first in future. We are committed to
continuing to display such fiscal discipline as a testimony to
the effect that this ANC-led government is serious about
improving the manner in which it handles the public purse. We
have also taken note of the reduction of the health budget by
1,7% each year, as indicated by the Minister and in the medium
term. And that this does not take into consideration the harsh
realities of inflation. As then province of KwaZulu-Natal, we
have not been spared from these austerity measures which have
a serious knock-on effect on our day to day running of the
department. That is why we have called on the people of our
province to enter into a social partnership with us. A social
partnership that is rooted in disease prevention, regular
health screening and testing, as well as early presentation to
health care facilities. This will ensure better prospects for
successful treatment, cure or management of diseases.
Importantly, it will help us make a number of significant
savings on our limited and shrinking resources.
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As indicated earlier, the COVID-19 pandemic and the severe
floods that we have recently experienced, had a dire knock-on
effect on our budget as well. With COVID-19, we are forced to
put on hold many of our programmes and reprioritise our
resources so that we will be able to respond adequately to the
crisis. We were able to do that. However, we are still to
recover from that disruption. The severe floods we have had
caused extensive damage to our facilities, which will amount
to nearly R300 million for repairs. We are still concluding
the assessment. Another matter I want to bring to your
attention is the disruptive nature of the budget cuts on the
provision of health care at our different facilities as we are
unable to fill the posts that were made vacant by the 426
health care workers who perished during the COVID-19 pandemic.
This is in spite of the fact that these health workers who
passed on were on posts that are funded. In the same way, we
are unable to fill any posts that are made vacant by natural
attrition. again because we are not able to indicate that we
will be able to find those in the midterm space. But also of
utmost importance and it is the biggest one, is the fact that
we are now faced with a situation where we must ponder on the
future of our COVID-19 contract staff as we have been advised
they are no longer affordable to the system due to the fact
that our grant has been cut from the national budget. Whilst
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we understand why the nation had to cut but is affecting us
the hardest. And these COVID-19 contract staffers have become
the backbone of the health care system.
We are worried about that and we hope the National Treasury,
in particular, will assist the health sector when it comes to
the fiscus and the funds that we are supposed to be utilising.
We are fully behind the government’s ongoing efforts to
implement universal health coverage through the National
Health Insurance, NHI. It is considered to view that the
exclusion of people from accessing certain health care
facilities on economic grounds, even when they have life-
threatening health emergencies is unconstitutional. It is
wrong. It is immoral and unjustifiable. And the continued
subsidisation of the private health care sector by the
government for the benefit of a privileged few, therefore,
cannot be sustained. And it is for this reason that we echo
the calls by the Minister, that all Members of Parliament must
support the National Health Insurance Bill which is in front
of the Health Portfolio Committee as we speak, as an
instrument of universal health coverage as envisaged in the
National Development Plan 2030.
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We also agree that the COVID-19 pandemic has brought the
public and private health care sectors closer, reminding all
of us that after all, no health care system should be
exclusive or regarded as inferior or superior for that matter.
We are confident that the budget allocations made under NHI
will strengthen our public health service delivery platform.
This should go a long way to enable infrastructure upgrades,
the contracting of private primary health care doctors and the
acquisition of specialised health technology services,
including oncology services while boosting our capacity for
the provision of mental health services.
We are also hopeful that as part of improving the quality of
service, a significant amount of this budget allocation will
be channelled towards our eHealth solution in the province.
The hon Minister will remember the long queues of people that
we found waiting for files at the Prince Mshiyeni Memorial
hospital during his recent visit. And this is a challenge that
our communities face on a daily basis. This daily occurrence
at most of our facilities is a result ... [Interjections.] ...
I just wanted to indicate that the Minister had indicated that
they would provide support to the eHealth solution, which will
assist us in removing the outdated paper-based filing system.
And we think that is going to be a solution. As mentioned,
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Chair, we support the budget speech of the Minister. We
appreciate very much the support that we have been given by
the national government. Thank you very much, Chair.
Ms W F KAIZER-PHILANDER (Western Cape): Hon Chair, as South
Africans and residents of the Western Cape, we’ve been through
gruelling and difficult times. The reality of COVID-19 has
taught us many lessons and one, in particular, stands out for
me and that is, inter-connectedness.
We saw how our provincial government, how civil society and
private partners ensured that during this pandemic, instead of
pulling us apart, the common purpose of human dignity and
wellbeing were on top of the agenda. We saw how the
determination and resilience of healthcare workers instilled
hope in us all.
The impact of more than two years of a global pandemic has
without a doubt left its mark on not just residents’ lives,
but also that of public resources.
Prior to COVID-19 our country was already on a path of fiscal
decline where our mandates still needed achieving despite the
prevailing circumstances. And we can see the effects of this
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in respect to the Division of Revenue for this financial year,
wherein: The equitable share has increased by R600 million to
R21,1 billion in 2022-23, but then is expected to decrease
slightly over the 2022 MTEF to R19,9 billion in 2024-25.
Our total conditional grant contributions increased by
R431,345 million from R6,990 billion and that is the 2021-22
revised estimate to R7,421 billion in 2022-23. However, this
allocation is expected to fall by R300 million in the next
financial year.
Whilst these brief figures might provide some with the
impression that despite of some decreases, the Western Cape
would be in a better position thanks to this post-covid
budget.
But this couldn’t be more untrue. Even though there were a
number of budgetary increases, all of them are once again
below the inflationary increases and we have experienced over
the past few years. This means the Western Cape will have to
continue doing more with fewer resources over time.
Clearly now, we all find ourselves at crossroads: either we
blindly accept the scenario and allow the constrained fiscus
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to be a reason for a gradual decrease in the quality of health
services, or we innovate and find ways to further continue to
deliver quality healthcare for all our people.
In the Western Cape, we know we have chosen the latter path
and will do everything in our power to make a difference to
all communities. However, this decision doesn’t seem to be the
case with governments outside of the province.
By contrast, the Gauteng provincial government spent
R1,2 billion on COVID-19 hospitals, of which many, as the
Daily Maverick reported earlier this year, are laying to
waste, weed riddled, abandoned and unfinished where no citizen
can receive health services and which are currently the
subject of Special Investigating Unit, SIU, investigations.
Compare this to the Western Cape Hospitals of Hope where
world-class field hospitals with digital patient records, Wi-
Fi for patients and good, quality care. This field hospital
was later converted into a world-class mass vaccination
centre. No ruined, dilapidated, derelict buildings in the
Western Cape! This is an agile health department that cares
for you, for the citizen by delivering quality services.
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Recently, former Health Minister Zweli Mkhize has again been
implicated in corruption. Mkhize resigned last year after
being linked to the irregular R150 million Digital Vibes
communications tender. The tender was allegedly awarded to his
close associates. Now, according to media reports, Mkhize is
allegedly linked to corruption involving the Unemployment
Insurance Fund, UIF.
In the Western Cape, we live in a different reality. Our
doctors and nurses do not have to bring food for our patients
as seen in some ANC provinces. The Chris Hani Baragwanath
Academic Hospital in Johannesburg ran out of food two weeks.
Things got so bad that nurses had to use their own money to
buy patients bread for breakfast. Speaking to News24, one of
the doctor’s called this ‘a humanitarian crisis’.
This signals a complete moral decay and a total national
integrity compromise where sick and vulnerable patients cannot
be provided with a basic of health care and nutrition in
facilities where the ANC governs. The contrast between the
delivery of services to citizens in the Western Cape and other
provinces, is stark.
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Chairperson, it is for this reason why I would like to take
this opportunity to show what can be done in difficult
economic times. The budget for this year has been set to
R29 billion, which is an increase of R900 million or 3,21%
from the revised estimates of last year and speaks to a wide
range of opportunities. R114 million has been reprioritised
within the departmental baseline to fund projects linked to
addressing surgery backlogs, mental health platform
strengthening, addressing tech refresh backlogs, strengthening
occupational health and capacity, central warehousing of non-
pharmaceutical stock, obstetrics and neonatal improvements as
well as establishing capacity and capability for providing
palliative care services. And this is all already happening in
the Western Cape.
After centralising the procurement of personal protective
equipment, PPE, in 2020-21, it has resulted in a complete
warehouse being set up with PPE valued at R80 million in
total.
I want to highlight, Chairperson, this year, a significant
focus is being placed on infrastructure, as spending on
existing infrastructure assets increased by 10,91%, with
upgrades and additions and refurbishment and rehabilitation
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spending increasing by 99,28% and 54,51% respectively.
Moreover, new infrastructure spending is 110,11% more in
comparison to 2021-22. This is how a Department ensures
quality healthcare for you and all our citizens.
Infrastructure projects for this year in total equate to 107
in planning, in design, in tender or construction phase. In
the Western Cape, it is clear that we are committed to serving
our residents efficiently and safely.
Our communities can look forward to the following examples of
good governance in action: the new Avian Park Clinic, upgrades
and additions to the Gansbaai Clinic, a replacement clinic for
the residents of Gouda and surrounds, a replacement clinic for
Ladysmith, pharmacy compliance and general maintenance to
Nyanga CDC, replacement clinic for Sandy Point Satellite
Clinic, replacement clinic for Villiersdorp Clinic, a BMS
upgrade for Groote Schuur Hospital, 11 kilovolt generator
replacements at Tygerberg Hospital. And these are mere
snippets of what is possible when a provincial government
maximises its available resources in order to deliver quality
healthcare to all its residents.
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Despite the prevailing pressures, the Western Cape remains the
only health department in the country to have had three
consecutive clean audits; let alone a clean audit to start
with. Yet, that in itself is the very issue, why is it that we
are forced to go above and beyond our mandates and means to
deliver services when our money in real terms decreases from
national?
It is for this reason that we do not support this Bill. I
thank you.
Dr P RAMATHUBA (Limpopo): Thank you, hon House Chair. Hon
Deputy Chair of the NCOP, the hon Minister of Health, the
Deputy Minister, fellow members of the executive council,
MECs, permanent delegates and hon members, let me appreciate
and thank you for this opportunity to address this august
House today. Hon House Chair, Limpopo supports the Budget Vote
and we are fully behind all this progressive budget that is
looking at making sure that the lives of our people change for
the better. The centrality, House Chair, of the provision of
quality of health care to citizens can never be negotiated in
a progressive society like ours, notwithstanding all the
challenges which characterises the service delivery
environment. The ANC-led government has at all material times
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punched beyond its weight in order to ensure that it achieves
the important baseline of quality health care because without
the quality health care there can never be any
characterisation of a better life for all.
As impressed by the hon Minister, Dr Joe Phaahla, earlier on
in his speech before this august House, our focus should now
be on major recovery of comprehensive health care. This we do
as we count our cost from the devastation that accompanied the
coronavirus disease 2019, Covid-19, pandemic. House Chair,
those who wish to see this government fail have been hard at
work trying to convince all of and soundry that emanating from
Covid-19 pandemic our health outcomes will only paint a
picture that is characterised by doom and gloom we have
witnessed it even in this House. We are satisfied that that
has not been so. We are fixed our focus towards the heath care
recovery root. We are happy to note that our experiences
during the pandemic were not only about bad things, but a
mixed bag of challenges and successes. A successful health
care service is evidence by the prevention of avoidable death,
especially in pursuit of the Sustainable Development Goals.
We have all been witnesses of how this government has under
the recent periods of unprecedented difficulty steadfastly
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stood to confront all form of disease, both communicable and
noncommunicable. Government relentless fight against the
ruthless communicable diseases such as tuberculosis, TB, is
just one of many examples. TB has been in the top 10 causes of
death and the leading cause of death from a single infectious
agent ranking even above human immunodeficiency virus, HIV,
and acquired immunodeficiency syndrome, Aids, for the past
decade. More than 1,5 million people died last year as a
result of TB infection globally making it number two after
Covid-19. It is not true that we are not winning the battle
against TB. Therefore, I would like to draw, hon members, to
come and visit our province Limpopo where we are witnessing a
decline on the incident rate from 203 per 100 000 populations
in the financial year 1920, which in numbers we only detected
11 795 TB cases. It declined to 163 by 100 000 population in
the year 2020-21, a decline in numerically to 5 973 which is
far much below even more than 50% decline.
There are many dimensions to this House. However, we believe
the key among them is the health care intervention mechanism
implemented by government on the fight against this killer
monster. We are also focusing on integrating the TB screening
into comprehensive health care screening for both communicable
which include whether it’s Covid-19, HIV, Sexually transmitted
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infection, STI, including the monkeypox, we’ve already started
screening people in our border posts to make sure that our
people are safe from any disease, because we believe even the
budget that we are supporting today is a budget for health not
for diseases which unfortunately many hon members even in
their debate, it is very clear that they failed to appreciate
that this is a Department of Health not the department of
disease. Hence you only want to know about this department
when people are sick.
When mother-to-child in Northern Cape, mother-to-child
transmission of HIV, it should be the problem of all hon
members, because it is us as hon members who must go out to
the community and educate our people about the importance of
knowing your HIV status, of attending the antenatal clinic,
even before your 20-weeks so that we can test you if you are
HIV positive we will put you on antiretroviral, ARVs. There
are still mothers who are coming to deliver in our facilities
when they have never visited any antenatal. Therefore, those
are the ones who form the part of those who are transmitting
the virus to their children. Therefore, health must be our
problem all of us and even as hon members we should be running
this campaign.
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We have seen our integrated programme also looking at
noncommunicable disease. These are your hypertension, your
diabetic, your cancer which we are all, when we do the
screening now, we are not only doing one we give you under the
Cheka Impilo campaign including your mental health where we
just launched a programme of “Be kind to your mind” as this
ANC-led government. And also despite all the constrains and
barriers could be before us by Covid-19 pandemic, we had been
able to register requisite progress in our route to eradicate
death caused by malaria which for long time has been a
challenge to our people. If we are to summarise we have during
this previous year managed to reduce malaria cases from 3 169
to only 1 881. This is a signal of 59,6% reduction rate.
Therefore, on the same period the death due to malaria was
reduced by more than 56,25% from 16 cases in 2020-21 to nine
cases in 2021-22. This for us it’s a huge milestone
considering if you go five years back you will realise that
Limpopo registered 18 977 malaria cases and 160 deaths. This
is made possible by the grants that we are supporting today
which the Minister has already presented.
Hon members, the African National Congress is committed to
achieve the universal health care coverage for all its
citizens, and we must make sure that this happen in our
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lifetime. We have seen this during Covid-19 that the hospitals
that you are praising, the private health care system that you
are praising, we do have colleagues who died with medical aids
that have got comprehensive coverage, but the private health
care could not provide them with that health care system.
Therefore, for me no one will come and tell me that there is a
better health care system. Public health care system has its
own challenges which the Minister has already outlined and put
a plan on how we’re going to deal with them. Whether it’s
infrastructure whether it’s shortage of stuff and appreciating
the fact that the current fiscus, the current economic
challenges that face our country, but we must also remember
that private health care is for the few, people can’t even
access it.
However, otherwise as a province I will not be surprised when
listening to the DA, House Chair, the portfolio committee from
Western Cape who is speaking on behalf of my colleague here
and busy with Gauteng instead of talking about Western Cape. I
will not be surprised because Gauteng province as we speak
today treat patients from all over the provinces in the
country. They have never returned any patient because that
patient is not born and bred in Gauteng, they are treating
even those who are coming from outside the county. We must
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expect their challenges to be more. The DA unfortunately,
recently they even attacked some of us in Limpopo, why do we
allow patients from Mpumalanga to be treated in Philadelphia
Hospital. Why can’t they go to their own province in
Mpumalanga? That is why is not surprising that they even
chased away patients from Eastern Cape that they must be seen
in Eastern Cape. These are South Africans. These are our
people who must be seen by any health care professional. That
is why for us as professionals we will never refuse to see a
patient, disease does not know your colour, your political
affiliation, your skin, your province. A disease is a disease.
They will attack you. So, yes, our provinces will have
challenges of overcrowding in our hospitals because when we
see a human being, black or white, irrespective of political
affiliation we treat.
Hon House Chair, we want to congratulate because the support
we had as a province from the national government made it
possible that for the first time in the history since 1994, a
medical school was established in 2016 at Limpopo with the
support of the National Department of Health and the Higher
Education, both provincial government and the University of
Limpopo was able to see for the first time a black child
graduating in a university which people never thought will
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produce medical doctors. The first group of those doctors are
now doing internship amongst them the youngest doctor in the
county who is just 21 years. What a day to celebrate.
Therefore, this is a government that people are saying that we
are not doing a lot. And we must indicate that as the ANC-led
government, yes, we’ve learnt from Covid and we understand the
backlog that is facing our people, and we understand and
appreciate that rural health matters to us.
That is why as a province, Limpopo, we have come up with a
project that is called Rural Health Matters. In this past
week, we were vising hospitals in Capricorn which is the deep
rural Helena Franz Hospital, for instance, Botlokwa Hospital.
We take specialists from the cities and from the urban areas
because we still appreciate the unfairness distribution of
professionals. Hon Ndongeni put it clearly here that you will
find that Western Cape ... let me give an example of Groote
Schuur Hospital alone that has got more psychiatrists than
Limpopo, Mpumalanga, North West and Northern Cape combined.
This is the situation that people want the status quo to
remain. We will continue to blame ...
As I conclude I’m saying that there must be the redistribution
of professionals because rural health also matters. Our people
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in the rural areas continue to benefit from specialists in all
areas who agree to visit the rural areas. Therefore, if South
African people and if this House means business we must make
sure that we do prioritise even the people in the rural areas.
Thank you, hon House Chair. [Applause.]
Mr M A P De BRUYN: Hon Chair, I would like to start with a few
quotes from the Minister’s budget speech, I quote:
Our major focus will be on the recovery of our comprehensive
health services. We want to refocus on improving the quality
of services. Improvement of quality of service at public
facilities will be a major focus. Staffing of health
facilities is the key to the improvement of quality service.
There are more but let’s stop here.
Hon Minister, you have admitted over and over again, in your
own speech, that this department is not firing on all
cylinders and has not been doing so for the past two decades.
At government hospitals in the Free State, especially the
Pelonomi and national hospitals, the conditions are so poor
that there are not even the necessary cleaning supplies to
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clean and disinfect operating theatres, not to mention ICUs
and general areas. I was told that staff are mixing hand
sanitiser that was donated to these hospitals with general
chemicals and water, in an attempt to clean and disinfect
these hospitals. Furthermore, doctors and nurses are mostly
fighting a losing battle because the pharmacies at these
hospitals are severely understocked and simply doesn’t have
the required medication needed to efficiently treat patients.
At the Free State psychiatric centre in Bloemfontein, patients
have to use their bedsheets to block the cold from entering
through the broken windows. I would like to add that this
centre had a budget of more the R350 million for the last
financial year.
The R380 million Albert Nzula district hospital in Trompsburg,
where construction has started more than 10 years ago already,
is still not fully operational and is seen only as a glorified
clinic. This, whilst other hospitals in the area are
overflowing.
These are but a few examples and one can’t help but wonder
where has all the money budgeted for these hospitals gone. The
short answer would be, it landed in the pockets of the corrupt
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ANC and the tenderpreneurs. With a budget of R64,5 billion,
our health care system in South Africa should be the best in
the continent, but unfortunately, the poor in desperate need
of quality healthcare, never benefits from these budgets.
Those benefits are reserved only for the corrupt elite in
South Africa.
Instead of building more hospitals and clinics or upgrading
the current ones, this department rather allocates another R8
billion to the National Health Insurance programme. It is a
programme that is a bottomless pit, with billions being poured
into it, without a single person having benefitted from it so
far.
Hon Minister, some first world countries have given up on the
idea of a National Health Insurance, because it is simply not
financially viable and I can promise you, with this
departments track record of corruption, failure and
incompetence, the NHI in South Africa will be another one of
the countless ANC failures.
Every year, we hear the same promises of recovery, improvement
of infrastructure, quality health care and staff and new
hospitals and clinics, and so on. And every year, the
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disappointment is bigger than the previous one. The public and
we, as opposition, have learned the hard way that we can’t put
any faith in this department and we will surely not put any
faith in this budget. Thank you.
Mr N M HADEBE: Hon Chairperson, the health care in our country
finds itself at a critical juncture. Even before the outbreak
of Covid-19, our public health resources and infrastructure
were not equal to the task of health provision in the country.
Yet, our health care is a critical and essential service.
Over the past few years, it has become a custom that, if you
want good service, you need to seek private health care. In
addition to these pressures, our health care services must
contend with several regional and global challenges, such as
illegal foreign nationals, escalating humanitarian
emergencies, climate change and environmental degradation.
Whilst we support the principle of the NHI being introduced in
South Africa, we as the IFP, are concerned about how the
funding would be administered, given the current track record
by government.
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Health care is a vital and life-threatening sector in our
society. There is simply no room for irregular expenditure,
corruption and mismanagement for an NHI-driven health care
sector to succeed. Unfortunately, our current experience with
government departments in provinces paints a harrowing
picture.
Audit outcomes of KwaZulu-Natal and the Northern Cape
provinces require immediate intervention, as there has been
little or no improvement over the past five years by these
health departments, whose audits remain qualified.
Unauthorised, fruitless and wasteful expenditure are the
highest in the Eastern Cape and Gauteng. Why is this so?
Let me be constructive. It is because there is little to no
consequence management. It is criminal that health
infrastructure projects are delayed, due to mismanagement and
poor oversight and project management, especially given the
unequal distribution of health care infrastructure and even
shortages of essential items in our rural areas. For example,
the Nokuthela Ngwenya Community Health Centre suffers with a
shortage of supplements, as needed by dieticians to
sufficiently treat illnesses.
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This department needs to reprioritise its approach to how food
can be a solution and prevention to many illnesses. A
framework must be placed on top of government’s agenda of ways
it can incentivise healthy eating choices, in order to reduce
the country’s risk profile of combatting preventable
illnesses. We must pay attention to the importance that
dieticians play in reducing the overall cost of dependence on
medication.
As we become more integrated with the Fourth Industrial
Revolution and place greater reliance on their systems, we
must start capacitating our clinics and hospitals with the
same levels of equipment. This has the ability to
professionalise our health care centres. Currently, there are
basics that cannot be met, such as ensuring sufficient printer
cartridges to print, script and other relevant materials.
We call on this department to reconfigure and improve on the
way it makes use of technology, to ensure ease of access of
government systems. After all, government must remain
accountable and accessible to the public.
In conclusion, health care equity must be prioritised by this
government and the digital transformation of the public health
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care system must be embraced in order to innovate, transform
and build resilience into the sector. In concluding my debate,
I wish to state that the IFP nevertheless supports the Budget
Vote. I thank you.
Mr J J LONDT: Hon House Chair, hon Ministers, the MECs
present, hon members, what a whirlwind it has been since March
2020, when Covid-19 landed on our shores in greater numbers
and our then three-week lockdown started. This department
started relatively well under the circumstances, in uncertain
and unknown situations.
However, somewhere along the line, the plot was lost. The old
health department came back with tenders going to family and
friends of connected ANC cadres. It is a disease that is
infecting this country. You are unable or is it unwilling to
get rid of it?
Afrikaans:
’n Vis vrot van die kop af, met die vrot visreuk wat nog in
die voormalig Minister Mkhize se kantoor hang. Dit hang en dit
stink en dit gee ’n vrot reuk in elke ANC-beheerde
departement, provinsie of plaaslike raad af. Hoe kan jy dan
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ontslae raak van die siekte, as daardie vrot stink reuk in
julle geel, groen en swart kleure is?
English:
The sickly smell of the rotten fish, as mentioned above, is
affecting all of South Africa and the sooner we get rid of it,
the better.
Hon Gillion, I understand that you are embarrassed, as you are
representing the only province where the ANC does not govern
and you must therefore sing for your supper, but to make
matters even worst, you don’t even make any sense when you
describe the best run province.
You used the word narrow, right wing and liberal in the same
sentences to describe this province and the DA that runs this
province. I have messaged you a definition of each, so you can
go through it. I understand that you will struggle to
comprehend it, but you basically say that Usain Bolt is fat
and slow as well as super-fast. It does not make sense.
You must choose your criticism and stick to it. I guarantee
you, if you continue to deliver such services to the residents
of Gauteng, the Northern Cape and elsewhere in the country,
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you soon will be joining hon Gillion in the opposition
benches.
Hon Ndongeni from the Eastern Cape, I was anxiously waiting
for you to explain how much money your government is going to
spend on servicing the voters of your province. In 2016, the
South African Human Rights Commission found that you had a
crippling shortage in ambulances. Your solution was to buy
scooters with sidecars and then call that ambulances.
I found a fascinating quote delivered by the Eastern Cape MEC
having been responsible for these scooters. I do agree with
this quote up to a point and I am going to read it to you:
“This department has its fair share of challenges that we must
acknowledge.” That is true, but I don’t think you have
finished that quote. I will finish it for you. I will start
again: This department has its fair share of challenges that
we must acknowledge, chief of which is the political party,
the ANC, leading it.
It is time we remove you, we remove this rotten head and 2024
cannot come soon enough. I thank you.
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Ms A D MALEKA: Thank you Chairperson, can you allow me to
switch off my video due to the unstable network?
The CHIEF WHIP OF THE NCOP: No problem hon Maleka. you may
continue with your speech.
Ms A D MALEKA: Good evening Deputy Chairperson, Chief Whip,
our Minister, Deputy Minister, MECs, permanent and special
delegates.
Chairperson, to have a sustainable healthcare system that
reduces the burden of disease in the country requires certain
principles to be embedded in our healthcare philosophy which
will, in turn, shape our health policy which in turn shapes
the planning, budgeting programme, implementation, and
orientation of health practitioners.
It is therefore critical that we draw from the experiences of
other nations whiles at the same time we need to learn from
our health systems and the indigenous systems if we are to
truly provide healthcare for all.
The fact of the matter is that we have different types of
health responses in the country, one which is largely a
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product of scientific development and one which is largely
indigenous, though the majority of South Africans use the
public healthcare system, many South Africans also rely on
indigenous health responses. This, therefore, requires us to
invest in researching indigenous health responses based on
evidence like the Chinese, we should build our indigenous and
traditional systems.
The Department of Health should learn from the Cuban health
system which is a preventative health care model at the
primary care level, the family doctors oversee the health of
those who live around the clinic.
Key to the prevention model is the annual health assessment, a
full health check-up that every single one of their 1,287
patients will undergo, often at their homes. Cubans no longer
die of infectious diseases because of a hugely successful
vaccination programme, so people live longer.
We need to build such a system in South Africa, the healthcare
sector in South Africa has been assessed and evaluated and
numerous reports such as the 2018 Presidential Health Compact
have reflected the challenges in the sector and required
interventions.
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The National Development Plan describes it as a problem of the
performance of our health system despite a health expenditure
of 9,1 % of Gross Domestic Product. This brings to the fore
the quality of health expenditure and whether the health
system is producing health outcomes that are equal to the
spending.
Chairperson, Statistics South Africa indicates the main causes
of death as tuberculosis 8,8% of total deaths, influenza and
pneumonia 5,2%, HIV 5,1%, cerebrovascular diseases 4,9%,
diabetes mellitus 4,8%, other forms of heart disease 4,6% and
hypertension diseases 3,7%.
Tuberculosis, HIV, AIDS, and cancer remain major causes of
death in our country. It is also important that we
consistently monitor our health through testing.
With regards to the massive TB screening campaign, TB
screenings are done every time a client presents at a health
facility unless the client is already a TB patient. The MTSF,
Medium-Term Strategic Framework, target was to have 2 million
additional people screened for TB by 2020 and eligible people
initiated treatment. The MTSF target is to have a TB treatment
success rate of 90% by 2022 and 95% by 2024. The national
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average of all TB treatment success rates was 76,0% for the
period ending September 2021.
We have also noted the fact that the National TB Programme
will also need enablers to find missing TB people, and link
and retain them in care. Advocacy, communication, and social
mobilisation are very important. This is something we can help
with. TB data systems must also be improved to capture all
efforts and report so that the TB recovery plan can be
monitored by all stakeholders. These are clear interventions
to mitigate any lost focus on these diseases due to the focus
of the coronavirus pandemic.
Chairperson, the lowest maternal mortality in facility ratio,
MMFR, in 2020 was recorded in Western Cape with 43,6 deaths
per 100 000 live births followed by Mpumalanga with 67,1
deaths per 100 000 live births. The Eastern Cape and Northern
Cape provinces showed an increase in MMFR between 2019 and
2020. All other provinces showed decreasing patterns, which is
also reflected in the national pattern.
These are some of the gains of a preventative approach which
government should begin to expand its capacity if it is to
improve the health outcomes.
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On the 90 by 90 by 90 programme, the department reported that
it has reached the first 90 in all districts, with six
districts four in KZN and one in FS; one in Mpumalanga that
have reached all the three the 90s. This is an indication that
the department and the sector are recovering from the effects
of Covid-19 and are on a positive trail to meeting the
targets.
The ANC supports the purchase of comfort kits for Gender-Based
Violence, GBV, victims who are in most instances sexually
assaulted victims, we, therefore, support the planned
purchasing of over 500 000 comfort packs.
We need to zoom into the quality of healthcare support from
provincial departments and the Eastern Cape and Northern Cape
which saw an increase in maternal mortality in facility ratio.
Hon Minister, the coronavirus pandemic has demonstrated the
need for increased health practitioners. We need to strengthen
grassroots services such as clinics and use them as a nucleus
of a preventative system as they are within our communities,
and we need to ensure there are adequate facilities and staff.
South Africa had 0.79 doctors per 1 000 people in 2019.
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Moreover, research reports have found that between 75% and 95%
of people with mental disorders in low and middle-income
countries cannot obtain mental health services due to
financial constraints. This includes South Africa and we are
far off from the World Health Organization, WHO, guidelines in
providing adequate mental health care. There is a huge gap to
fill to redress mental health illnesses to be accessible to
all. We need to prioritise building capacity to respond to
mental health challenges.
The health sector has a central place in SDG 3, Sustainable
Development Goal, to ensure healthy lives and promote well-
being for all at all ages, underpinned by 13 targets that
cover a wide spectrum of World Health Organizations work. And
almost all of the other 16 goals are related to health or
their achievement will contribute to health indirectly.
Hon Chairperson, the universal health coverage then becomes of
paramount importance. It seeks to provide a preventive health
scheme that shall be run by the state; provision of free
medical care and hospitalisation for all, with special care
for mothers and young children, is what guides the ANC in the
realization of the National Health Insurance, NHI.
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Our national life expectancy was 64.13 in 2019 which is higher
than many developing counties and the Sub-Saharan Africa
average of 61.62%.
Our healthcare system has demonstrated its capacity to be
resilient through the coronavirus pandemic which is a security
and health risk to the nation.
Health is a critical priority if we are to have a productive
economy and enhance developmental outcomes you need a healthy
nation.
We must combat crime and corruption which also undermines the
health expenditure, we must transform the pharmaceutical
industry by building and supporting our state-owned company
Khetlaphela which should transform the health sector’s
consumables sector.
A critical priority for health in the current conjuncture is
overcoming Covid-19. Vaccines have proven to be the best
available defence against illness and death from Covid-19.
Though the government has already implemented the lowering of
restrictions through ending the National Disaster as it
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relates to the health pandemic to resume economic activity
toward optimality.
We should not lower the guard as a nation as the threat of the
pandemic remains and different variants which can be deadly
can emerge. It is therefore critical that we remain vigilant
as people and our healthcare system.
We congratulate the Ministry and the Department of Health on
the excellent work that they have done in the past two years
in fighting Covid-19. We need to ensure that all other
programmes that have been negatively affected by the Covid-19
pandemic will now receive the attention they require and be
prioritised. We support efforts by the Department of Health to
eliminate Malaria by 2030. We support the work done in
Northern KZN in uMkhanyakude and all the districts in
Mpumalanga and Vhembe and Capricorn Districts.
The African National Congress supports this budget vote and
calls on the departments to continue strengthening its
governance systems to sustain the required capability and
capacity to address the health problems confronting our
nation.
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The DEPUTY MINISTER OF HEALTH: Thank you very much, House
Chair and to all the members who participated in this debate
to note their issues that they have raised starting with hon
Maleka who says can we also kick start other programmes that
might still have been left unattended to. We really would like
to also thank particularly those who have supported this
budget, because they are indeed saying work must go on.
Despite the challenges that we have, work must still go on.
Hon Ndongeni, we thank you so much for showing explicitly the
amount of knowledge you have on the National Health Insurance.
Indeed, today the portfolio committee in the National Assembly
was dealing with it clause by clause ... which is almost
towards the end of the processes and very soon the bill will
be in this House and we are looking forward to hon Gillion who
supported in leading the select committee in finalising that
part.
The Minister alluded to the city scan now fully functional at
the Charlotte Maxeke Hospital, which means that now we could
get patients coming in with ambulances from the accident scene
or from the medical emergency straight to the Charlotte Maxeke
because now doctors can be able to assist going forward.
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Hon Bara, I would wish that maybe we agree that the issue of
teenage pregnancy is not a departmental issue, but is a
societal matter. All of us in the society must put our heads
on the block. I note your comments hon Christians with regard
to the shortage of rape victim kits, in some of the facilities
that you mentioned. I would like to promise that I will follow
up as you have always indicated some these in a very cordial
manner.
Our President, President Cyril Ramaphosa when he addressed
Members of Parliament on gender-based violence impressed upon
us that we must commit to check that all our facilities do
have these rape victim kits. We will correct that. I do not
know what hon De Bryun is looking into when he talks about
WHO. WHO is the one that is pioneering the Universal Health
Coverage in the world, not just in South Africa, but all over
the world.
Hon Hadebe your reservation on NHI, we need to talk about it
and see how we can improve on that part. I would like to thank
the MEC of Eastern Cape not here on the platform, working very
hard with the MEC for health in the North West in pioneering
the former miner worker’s plight in the country. I will be
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meeting the MEC of the Free State this Friday to deal with
those issues going forward.
We probably need to remind hon Londt and hon Kaizer Philander
that Tygerberg Hospital and Groote Schuur Hospital do not
belong to the Western Cape. It belongs to South Africa, and
all of us as citizens of this province and country should and
must be accepted there. Probably, they would have known that
the only province - but MEC Ramothuba mentioned that the only
province that have over and above its own citizens is Gauteng
- seizes other citizen from North West, Mpumalanga, Limpopo,
including Sadec is Gauteng. May get a bigger ... and probably,
it means if they were having a mentality like, we see in the
Western Cape, they would chase them back and say go back to
Eastern Cape you do not belong here. Now on average, Chris
Hani Baragwanath Hospital per day has got 30 caesarean
sections to do, half of those are not citizens of Gauteng they
come from elsewhere, but they continue supporting them because
it is important to do that.
I need Chair to mention this very last point that was actually
developed by hon Gillion. I have visited Cuba last week, I
found the history that, within 45 days in Cuba they had
vaccinated 93% of their population, because they use their own
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vaccines. The have a health promotion behaviour. The health,
education and prevention of diseases is very high and key in
that country. We also benefit. Cuba has supported us by
producing 2 556 doctors. For your information, they are not in
Tygerberg Hospital or Chris Hani Baragwanath, they are in the
most ever rural hospitals. These are children who would
otherwise have not had a space to go to UCT or Wits. They are
from Quintile 1 rural schools and when they qualify they go
back to help people who reside around those Quintile 1 schools
in most ever rural.
Children from Mbekweni, Gugulethu, Nyanga and Mitchells Plain
do not benefit from this programme because of the decision of
the Western Cape not to support children who come from the
poorest communities to go and actually support the poorest
communities of Western Cape. That is a fact. So, when you
balance up issue you must also note that there are certain
other things that are prioritised by these provinces because
they are pro-poor. Pro-poor for the patients and pro-poor even
in the selection of the students that must go and get trained
to go and service our people in the communities. Thank you
very much, hon Chair and thanks to the House.
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The HOUSE CHAIRPERSON (Mr A J Nyambi): Thank you, Dr Dlomo,
and hon members. That concludes the debate. I wish to thank
the Minister, Deputy Minister, all special and permanent
delegates for availing themselves for this very important
debate. Hon delegates, that concludes the business of the day.
The House is adjourned. Thank you very much.
Debate concluded.
The Council adjourned at 19:47
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