Hansard: NCOP: Unrevised Hansard
House: National Council of Provinces
Date of Meeting: 17 Jul 2024
Summary
No summary available.
Minutes
UNREVISED HANSARD
NATIONAL COUNCIL OF PROVINCES
WEDNESDAY, 17 JULY 2024
PROCEEDINGS OF THE NATIONAL COUNCIL OF PROVINCES
Watch video here: Plenary
The Council met at 14:04.
The Chairperson took the Chair and requested members to observe a moment of silence for prayers or meditation.
The Chairperson announced that the hybrid sitting constituted a Sitting of the National Council of Provinces.
ANNOUNCEMENTS
Hon delegates, before we proceed, I would like to inform delegates of the Rules relating to visual and hybrid meetings and sittings, in particular sub-Rule 21, 22, and 23 of Rules 103 which provides as follows: The hybrid sitting constitutes a sitting of the National Council of Provinces. Delegates in the hybrid sitting enjoy the same powers and privileges that apply in the sitting of the National Council of Provinces. For purposes of the quorum, all delegates who are logged on to the virtual platform shall be considered present. Delegates must switch on their videos if they want to speak. Delegates should ensure that the microphones on their electronic devices are muted and must always remain muted unless they are permitted to speak. All delegates in the Chamber must use the microphones. All delegates may participate in the discussion through the chat functionality.
Hon delegates, I would like to request delegates who experience connectivity issues to use a still photograph for identification on the virtual platform. In addition, all delegates on the virtual platform log on with one device only, as logging on with two or more devices further lowers bandwidth.
Further, kindly note that the interpretation facility is active. Permanent delegates, special delegates, members of the executive, and SA Local Government Association, Salga, representatives on the virtual platform are requested to ensure that the interpretation facilities on the electronic devices are properly activated to facilitate access to the interpretation services. Permanent delegates, special delegates, members of the executive, the Salga representatives in the Chamber should use the interpretation instruments on their desks to access the interpretation facilities.
APPROPRIATION BILL
(Policy debate)
Vote No 5 – Home Affairs:
The MINISTER OF HOME AFFAIRS: Good afternoon, Chairperson of the National Council of Provinces, the Deputy Minister of Home Affairs, Mr Njabulo Nzuza, the chairperson of the Select Committee on Security and Justice, the hon Ms Jane Mananiso, hon members of the Select Committee on Security and Justice, hon members of the National Council of Provinces, the Director-General of the Department of Home Affairs, Mr Tommy Makhode and his team, as well as members of the media.
Ladies and gentlemen, the Department of Home Affairs is central to the life of every South African. We interact with this department at the very beginning of our lives, when our parents apply for a birth certificate. It is also the last department that touches all our lives when we pass away and the loved ones, we leave behind must collect our death certificate. Home Affairs is there for the highs and for the lows in the life of every South African. When we enter adulthood, when we open a bank account, when we start our first job, when we get married, when we lose loved ones, when we have children, Home Affairs is part of every major event in all our lives. This is also the department that confirms our very identity as South Africans.
Since 1994, this is the department that has made us all equal. It is in Home Affairs where the foundations of racial discrimination, the Population Registration Act, and the despised passbooks were dismantled and replaced with a single South African identity card. When you hold the ID smart card in your hand, you are grasping the embodiment of the constitutional injunction that we must build a South Africa that belongs to all who live in it, united in our diversity, no matter what your background is, whether you are rich or poor, whether you live in a city or a rural area. On the IDs issued by Home Affairs, we are all equally, simply, and completely South African.
At its heart, Home Affairs is therefore about dignity. The dignity of having an identity and a nationality, the dignity of belonging somewhere in this great big world, the dignity of being able to travel beyond our borders, the dignity of giving your child a name, and the dignity of being able to access a bank account and an old age pension.
As your newly appointed Minister of Home Affairs, I not only recognise and acknowledge that dignity is at the heart of this department. I will also make it my mission to restore dignity to the interactions with Home Affairs, both for the many dedicated officials who have found their calling by serving the people of South Africa through this vital department and to our valued clients.
Chair, there is nothing that brings dignity like a job. That is why we are also going to position Home Affairs as a powerful engine for economic growth. The apex priority of the Government of National Unity, GNU, as captured in our shared statement of intent is to generate rapid, inclusive, and sustainable economic growth, to create jobs.
Home Affairs has a critical role to play in this vision, by accelerating the reforms introduced by the President through operation Vulindlela. According to operation Vulindlela’s last 2022 review of the work visa process in South Africa, there is a 1,25% increase in employment for South Africans for every 1%
increase in skilled legal immigration. The National Treasury has similarly found that increasing the availability of scarce skills in the labour market is the second most powerful step we can grow the economy and create jobs for South Africans, just behind the eradication of load shedding. For every 12 tourists that visit our shores, one new job is created for the people of South Africa. It is in fulfilment of this mandate.
Of the GNU that Home Affairs will enhance our role as an economic enabler by accelerating the implementation of operation Vulindlela’s reforms. Alongside steps that have already been taken, such as the streamlining of required documents and the introduction of a trusted employer scheme, we will do much more. This includes critically the finalization of the points-based system for work visas, rolling out the remote working and start-up visas, updating the critical skills list more regularly and making it easier for more tourists from around the world to visit our beautiful country and spend their valuable foreign currency right here in South Africa.
However, for us to be effective in unlocking scarce skills and growing tourism to create jobs, Home Affairs must urgently clear the backlog in the processing of permits. The department has set up a dedicated team to reduce the backlog. I am
pleased to report that we are starting to see progress. Our dedicated team has already reduced the backlog by processing
96 000 applications out of a total of 306 000, this is a reduction of 30% and I am very pleased to say that between Monday and today over 4 000 applications have been cleared from the backlog. This is the dedication we are seeing from this team. Chair, we must do more because clearing this backlog is the only way to avoid a further extension of the concession on visas, waivers, and appeals that has already been granted three times. This is an abnormal situation, and we must get this backlog under control so that further extensions are no longer necessary. For this very reason, I have asked to be provided with daily reports on the state of the backlog until it is completely eradicated.
Another encouraging sign comes from the department’s partnership with Business Unity SA, which will see the auditing firm Deloitte as well as First National Bank providing additional resources for the visa backlog team. This not only lays the foundation for overcoming this key obstacle to economic growth and job creation, but also for a more constructive relationship with the private sector. Repairing our relationship with key stakeholders is vital to building trust and the partnerships Home Affairs needs to move forward.
This is especially urgent because the department is currently inundated with costly court cases that it cannot afford. In many instances, these cases stem from an inability to process applications in a timely manner, forcing clients to seek judicial relief. In other cases, they reflect a serious breakdown in trust between the department and stakeholders. To rebuild this trust, I have decided to reactivate the Immigration Advisory Board in terms of section 42 of the Immigration Act. This board provides for a powerful platform for key stakeholders to engage with the department on an ongoing basis about problems affecting the sector.
Importantly, the Advisory Board can provide the Minister with evidence-based advice on tackling critical matters such as the court ordered process of consultation on the future of the Zimbabwean exemption permit. Going forward, the Advisory Board will serve as a vital forum where problems can be ironed out before they escalate to the courts and where scientifically researched, and evidence-based advice can help us address key challenges.
Even as we work to implement the GNU mandate for a better visa system to welcome people who want to contribute to South Africa legally through their skills, investments and as tourists, we must acknowledge that there is another side to
this coin. South Africa needs to do much more to combat illegal immigration. We must do so, both because it is central to our national security, but also out of our commitment to economic growth, for the reality is that no one will want to visit or invest if we allow our country to lose control over its borders and internal security. This problem needs to be tackled in a sustained, integrated, and collaborative way in the coming year, over fares will increase the number of inspections at restaurants, spaza shops, farms, and mines by over 50% to act against people who are illegally employed, including through deportations. But these inspections are most effective when done in collaboration with other departments such as Employment and Labor, the SA Police Service and local government. I will be reaching out to colleagues in those relevant departments with the aim of conducting joint operations to maximize our ability to hold everyone involved in illegal activities to account.
To date, the Border Management Authority, BMA, and border guards have intercepted and deported over 296 000 individuals who had attempted to enter the country illegally. In addition, over 300 vehicles were intercepted when criminals attempted to illegally take them out of South Africa. These illegal cross- border activities will further be combated by the BMA through
funding received from the Criminal Asset Recovery account, which is being utilized to procure critical security and ICT equipment such as drones, body cameras and speedboats through Armscor. But the reality is that the BMA, like Home Affairs itself, is underfunded. If we want to properly manage our borders, hon members, we will have to invest more resources in doing so.
A further urgent priority in improving the dignity of interactions with Home Affairs is to stabilize the online system. It is unacceptable that in the year 2024 and in the age of artificial intelligence, we still do not have reliable IT systems at Home Affairs. The days of system offline need to come to an end because I want to be your Minister of system online. To achieve this, we need to embrace modern technological solutions. One of the options under consideration is the recommendations from the Council for Scientific and Industrial Research, CSIR, to optimize the department’s IT infrastructure network. I am pleased to report to this House that the first set of offices have now been upgraded to fiber connections, ensuring operating speeds at one gigabyte per second throughout. These advancements have been made possible through Home Affairs migrating these offices to the SA National Research Network, resulting in
notable enhancements at the pilot sites. But we now need to expand reliable connectivity to every single Home Affairs office.
The problem of long queues must be similarly tackled if we are to restore dignity to interactions with Home Affairs. While technological upgrades will assist in this regard, I intend to review the way in which queues are managed at Home Affairs offices to identify appropriate business process reforms that optimize the existing online booking system and better manages queues on the ground. Another way to shorten queues at Home Affairs offices is by expanding our footprint and taking services closer to the people. I am pleased to report that the project to expand into shopping malls has seen the opening of conveniently located offices in the Menlyn Mall, in Pretoria, in Cresta Mall, in Johannesburg, and in the Pavilion Mall, in Ethekwini. This will shortly be followed by the opening of a new office inside the Tygervalley Mall, right here in the Western Cape, as well as modernized services at the Stellenbosch office.
We will work with the Department of Public Works and Infrastructure to address the stalled construction of modernized offices in Taung in the Northern Cape, Thohoyandou
in Limpopo, and Kwadukuza in KwaZulu-Natal. We have also relocated offices to a new site in Chatsworth, following the flooding of facilities there. The department’s additional 100 mobile trucks that were recently launched by President Civil Ramaphosa are now in operation. In fact, I saw them in action alongside the Deputy Minister, just last week, when we visited oThongathi to hand over new ID smart cards to the victims of storms and the tornado that ripped through the area last month. This mobile fleet and the diligent officials who serve a community there that had lost so much exemplifies how we can restore dignity to the people through Home Affairs.
Hon Chairperson, corruption is the enemy of dignity. Theft, fraud and other forms of maladministration pose an existential threat to our vision for a dignified Home Affairs that powers economic growth. This includes by devaluing our official documents. Even though the announcement by Ireland last week that citizens of South Africa and Botswana now require visas to visit the country did not specifically mention this issue, I am still going to request a meeting with the Irish Ambassador to understand the extent to which concerns over corruption may have influenced this regrettable decision.
Investigations by the Special Investigating Unit, SIU, are also ongoing. I urge the unit to prioritize these Home Affairs investigations, including specifically the ones identified in the Lubisi Report. Home Affairs has its own counter corruption and security services branch that must be strengthened even as we work to empower diligent officials in the department. I must make it clear that there will be absolutely no tolerance for corruption under the administration of the Government of National Unity. Recently, 56 officials have been dismissed across the 9 provinces and the provincial offices, with most of the cases coming from Gauteng.
A good example of what we expect from disciplinary processes, but also the criminal justice system, comes from just last month when a Pakistani national, Arfan Ahmed, was convicted for bribing Home Affairs officials at the Krugersdorp office to the tune of R45 000. He was sentenced to a term of eight years in prison and is facing additional charges. I look forward to his conviction on those additional matters as well. So far, six officials were also convicted and sentenced to a combined 70-year imprisonment. The rest of those criminal cases are pending, and I will be following them closely, for this is the type of accountability that all South Africans want to see more often for people both foreign and local
officials who debase our country through their corruption and greed.
Chair, both the Independent Electoral Commission and the Government Printing Works, GPW, also fall under this Budget Vote. The IEC has a budget of R2,3 billion to do its work this year. The Independent Electoral Commission is set to undertake a review of the 2024 election. This process will include key stakeholders, including political parties represented in this House. South Africans expect the review process to be thorough so that operational and technical challenges are addressed ahead of the 2026 local government elections. The Electoral Amendment Act of 2023 contemplated the appointment of an Electoral Reform Consultation Panel. Predicated on this Act, the panel members have been appointed and the panel has commenced its work and must conclude its task within 12 months of the recently concluded elections. I would therefore like to encourage all South Africans to engage with the important work of this panel.
Unlike the IEC, which is an independent institution in terms of Chapter 9 of the Constitution, the Government Printing Works is an entity of the department and serves as South Africa’s security printer. The GPW prints documents such as
travel and identity documents and examination materials. And it is also responsible for securing for security certification. Importantly, the GPW currently is a profitable state-owned entity with revenue of R1,7 billion in the 2023-24 financial year. During the current administration, both the passport and ID smart cards will be refreshed and updated to enhance the security features of these documents, with the aim of building trust in more countries and organizations worldwide.
Hon Chairperson, last but most certainly not least, I want to share with you 2 anecdotes that demonstrate the dignified department that we aim to build. The first one involves Ms Dudu Mahlangu, who works at Visa Facilitation Services. Two weeks ago, she physically got on a plane and flew to East London from Johannesburg to assist a client who faced an emergency. And she is not the only official in this department who goes above and beyond delivering. At the Belleville office here in Cape Town, Mr Fuzile Sibetha and Mr Mthetheleli Draai are two more service delivery champions. I found out about both when I received a heartwarming message from a social media user on X. The user posted about his positive experience at the Belleville Home Affairs office. He reported that Mr Sibetha and Mr Draai went out of their way to assist his
autistic child to apply for his enabling document in a dignified manner. Chair, these actions by these service delivery champions exemplify our mission to bring dignity to all the services rendered by Home Affairs. We need to see much more of it across all the branches and components of this vital department, because a working Home Affairs makes South Africa work. I thank you.
The CHAIRPERSON OF THE NCOP: Thank you very much, hon Minister Schreiber. And we also want to take this opportunity to congratulate you on your appointment. And of course, we wish you all the best in your new responsibility and indeed may Dudu Mahlangu and the rest multiply. Thank you so much. I would now call upon the next speaker, who is hon Mananiso.
Ms J S MANANISO: Chairperson, hon Minister, hon Deputy Minister, director general, DG and deputy director generals, DDGs, hon members, distinguished guest, ladies and gentlemen, fellow South Africans. Let me start by congratulating Minister and the Deputy Minister, and whoever is deployed in your offices that, let us to the just to our people and congratulations.
The ANC supports this budget with the commitment made by the Minister to do more. We, noting one of the priorities of that lekgotla, that is to create job opportunities. So, we are not just adopting or considering this budget, but we have umphako for you as the Minister to deliver job opportunities.
Hon members, one of the department outcomes is the inclusion of all citizens and democracy and development is an enabled by providing them with a status and identity that gives them access to rights and services. These outcomes speak directly to the fact that the Department of Home Affairs is so critical to the everyday lives of our people, each and every citizen, from birth to death. The previous Minister used to say, from cradle to grave, so from cradle to grave your department is important.
For this reason, these services of the department have to do efficient and accessible to all communities, including those that are at the rural. We don’t want to leave anyone behind.
Hon Minister, the select committee has therefore recommended that the department should roll out mobile units in far reaching rural areas. This will ensure that people get necessary services. There was a view that to those who are
excluded, more, especially those who have the amakhosi, let the amakhosi be brought to book, so that we use their services as part and parcel of mobile offices for the Department of Home Affairs.
Department efforts and improvement in the live birth registration. However, we have noted as a committee that the Northern Cape had no health facilities to accommodate the live capture of births, and the province is very fast.
The committee encouraged the department to increase its footprint in all provinces to ensure that this important service, amongst others, is rolled out. I would like to just confirm to the people of Northern Cape that you have your own hon Mukai, who actually raised this issue to say that Northern Cape must not be seen as a small, province. However, lebona ke batu [They too are people] they need to be realized and get services equal to other provinces.
Fellow South Africans, I want you to note in this debate that your issues have been noted, most of you, some of these issues you have raised when all these political parties were doing door to door, were selling their manifesto and we want to say to you as the select committee we have heard your cry. The
issue of long queues in the department will be the issue of the past.
As the Department of Home Affairs is focusing on its efforts on working harder and including more mechanism and strategies to ensure that our people do not stand in low queues, often from 3:00 to 4:00 AM in the morning to late in the afternoon.
People often complain further about the constant downtime of Home Affairs system. And we recommend, as the department that these issues must be addressed and can only be addressed with proper equipment for Information and Communications Technology, ICT, and other innovations of technologies.
Further priorities for the Department of Home Affairs are to facilitate the acquisition of the critical skills, needed for economic growth as determined by the Department of Higher Education and Training, to build our own skills base. To this end, the committee has made the following recommendations:
The department should be responsive and implement measures to provide the employment of graduates and make provision for learners. To young people of South Africa and those that are
35 and above, I hope you are listening to us that
opportunities will be created through learnerships and internships. That is why we are actually adopting this budget.
The issue of gender and rights of vulnerable persons were brought to the department’s attention. In this regard, the committee recommended that the department mainstreams to gender-based violence and femicide, GBVF, in all these programs and addresses parity, gender equity and to strengthen its work in relation to GBVF.
Another key outcome of the Department of Home Affairs is to continue to drive integrated and coordinated border management to ensure that our borders are effectively protected, secured and well managed and we want to congratulate the Border management Authority, BMA for actually rolling out and launching a successful program.
In respect of the BMA, it is important for our borders to be protected and managed appropriately, as it serves as the direct doorway to our neighbouring countries in the respect of people and goods, and ensuring proper and secure border management demonstrates to other countries that South Africa is respected and regarded as a good trade partner.
To this end, it is imperative that the BM Authority implements a clear communication plan towards achieving improved coordination and cooperation among stakeholders within the border management environment. Here we are referring to SA Police Service, SAPS, here we are referring to different levels of law enforcement agencies.
It is also important that all forms of corruption and fraud are eradicated at borders and therefore the BMA should work towards eradicating all forms of fraud and corruption at all ports of entry and ensure that good ethics are instilled in those working within the BMA. This means that those who are bo ausi bacold drink in our borders, this will come to an end in this Seventh Parliament.
The select committee has committed to grow and oversee the operation of the BMA and it will be an important area of oversight for the committee moving forward and we are going to prioritize this because our people are tired of illegal immigrants.
We also received presentation from the Independent Electoral Commission, IEC and we were alive to the fact that we have just successfully completed an election. However, evaluation
and introspection are of the utmost importance, after the election and we will look forward to the evaluation report of the election from the IEC. Upon receipt thereof, the committee will engage on the outcomes.
The committee further recommended that the IEC should strengthen its civic education programs, which should be continuous, and which should not only be undertaken during the election period.
To our young people, to fellow South Africans who’ve been looking for job, this is an opportunity for you to use data and check these opportunities because we are considering this budget, which should we continuous and which should not only be undertaken during the election and period, you know most of our people they are getting these opportunities as volunteers or hired for two days or three days. So, we have proposed to the IEC that they need to come with the mechanism where they have permanent vacancies for our people.
So, IEC will open the doors, IEC is going to hire you. Those who come from Gauteng, we are saying that less talk more work to the IEC in terms of creating opportunities.
Hon members, we further recommended that Government Printing Works, GPW, and IEC should engage and collaborate on possibilities of the GPW printing a portion of the IEC ballots for the next elections, collaboration and innovation is the way forward, particularly in light of limited budgets, the department and its entities have to work together for the people of our country and should also showcase its good stories moving forward.
Live birth, registration in hospital, online booking system to address long queues are just some of the good stories. And we have urged the department and its entities that from now on, we need to see their good stories that they have shared with us as members of the select committee. We no longer want to rely to TikTok. We no longer want to rely to other social medias. We want to be informed by the department about all those good stories.
Hon members, we are supporting this budget with appreciation from the department and entities that they are not proud about where they come from. As alluded, we have indicated this issue of long queues and choosing the department footprint in all provinces.
What we are saying with this budget, what is happening in Gauteng, must find expression in all other eight provinces, esaba apule/banana. What we are saying they should be institution that is professional, uniformed across the country, as we don’t want to leave anyone behind. With their motivation put in place. We are sure as the ANC that we will prevent and control issues that are delaying the implementation.
During our interaction with them, we have requested the department not to leave anyone behind, men and women of this country, children, youth, persons with disability, persons with albinism, lesbian, gay, bisexual, transgender, intersex, queer/questioning, asexual, LGBTQIA, plus society, and all of those in our rural areas.
Yes, to our elders, we want them to be informed and know their rights, that in our Home Affairs Department nobody is going to be on a queue, persons with disability, nobody is going to be on the queue, Minister. Those who supposed to get preferential assistance and preferential services as they knock to our doors, they will get access. Accessibility is no longer the story of the past. We are going to ensure that they get access
as promised by our manifestos as we are here in the government of national unity, GNU.
However, the following must be done. I’m happy that some of the officials are here. We have given you a petition that from now on we need proper planning. We need to ensure that we plan smart so that sufficient allocation of budget reaches all our priorities of focus. We have set yourself well, we must see continuous capacity building programs across the country, 365 days because some of us, we are the product of civic education.
We are not saying to you go and look for the budget with the human resource that you have. We need to be seeing every individual of the IEC knocking without the election and telling our people what the IEC is, what is the role of the society in ensuring that we get this outcome of the results that is free and fair.
It is the responsibility of IEC to ensure that they champion civic education without any other seasons or task assigned to them.
Hon Chairperson, robust communication and marketing strategy, we have actually said that it’s something that needs to be implemented soonest, so that those who are not patriotic or being citizens of this country, they start imagining the country and the new South Africa that we are in after 30 years.
Deployment of advancement innovation, technologies; I’ve said it and I want to repeat it that, this is a matter of agency because as we know the Council for Scientific and
Industrial Research, CSIR, in South Africa, has capabilities and is capable to deliver these services. We are calling to them, to be responsive and have responsive initiatives like increase of human resources. I want to say to our young people, to those that are 35 and above that we have heard your cry, employment opportunities will be rolled out, surely in the Seventh Parliament, because we are passing this budget.
As I conclude 24/7 operations are underway because GPW is working on the night shift. So, in that night shift, we’ll be having opportunities, Minister, Deputy Minister, these opportunities are not for your friends, are not for your families and not for your colleagues, but for everybody who lives in South Africa. I thank you.
Mr O J MOKAE: Hon Chairperson, hon members and fellow South Africans, good day. When you are born the Department of Home Affairs is your first point, when you die, this department is your point, and everything in between underpins the importance of this department to all South Africans. There is no way you can function without this department. It is against this backdrop that high standards of professionalism and efficiency should be at the centre of the service delivery model for this department.
Recording and issuing one’s personal details should be accurate and truthful. Despite the important function this department plays, it is sadly still battling major financial and human resources capacity that hampers adequate delivery.
It was revealed during the annual performance plan, APP, and budget presentation that the department only has 44% of its total staff complement. This cannot be hon Chairperson and members.
While we welcome the assurance given by the Minister and his team that they will continue to steer the ship under these difficult circumstances, it is very important that we join the crusade to mobilise for the much-needed resources for this
department. This call is from all of us in the Council. The National Treasury should be engaged to give additional resources for the work to continue. It cannot be business as usual. It is comforting that the department is willing and prepared to do more with far less we can only commend you for this.
Fraud and corruption are the enemies of progress and growth. They rob the citizens of South Africa of the much-needed services and puts the department on the backfoot. We welcome the effort and measures put in place to counter fraud and corruption. The department has set the following targets, and I will call them, and they are very ambitious.
First, is the 16 business processes reviews to identify vulnerabilities to fraud, corruption and security breaches. Secondly, they target to achieve 80% of reported fraud and corruption cases be finalised within 90 working days per year. Thirdly, to conduct over 40 threat and risk assessments, TRAs, per year in accordance with the requirements of the minimum information security standards and or the minimum physical security standards to mitigate risks. Lastly, is to complete about 400 vetting files referred to the State Security Agency for evaluation per year. These amongst others should assist
the department to root out fraud and corruption. They are bold and ambitious targets but should send a strong message that corruption is not going to be tolerated.
We need a stronger attitude to deal with corrupt activities. We must have a zero-tolerance for such. The day that this department make headlines regarding officials that have been found wanting should be a thing of the past. It cannot be that those who are entrusted to deliver vital services to the citizens of this country particularly the poor and vulnerable are the same ones with their hands in the cookie jar. We implore the department that in the next cycle of reporting we must be presented with full conviction rates so that the message should go out that crime and corruption doesn’t pay, and if you are in the wrong you will suffer the consequences.
We welcome the reinstatement, as announced by the Minister, of the Immigration Advisory Board as announced by the Minister.
The Immigration Act makes provision for this board that must include representatives of organised business and labour as well as experts on immigration laws and administration. This is a crucial body in the Public Service of our country.
Amongst others the body will assist in deterring legal battles and will serve as a crucial space to restore trust between the
department and its stakeholders. Such initiatives truly signal a turning point for the betterment of the Home Affairs portfolio.
Now, I turn to the entities of the department. The Independent Electoral Commission is one of the entities of this department, although it is a distinct body as a Chapter 9 institution, it is mainly entreated to ensure free and fair elections. One thing we noted across the entities is the issue of the limited budget. We have recommended as the select committee that the Independent Electoral Commission, IEC, must maximise on its civic and democracy education programme to empower voters and get many citizens to be eligible voters.
The Constitution of the Republic of South Africa clearly states that every citizen as a right to vote and equally we have a responsibility to value this right.
The Boarder Management Authority, BMA, is a fairly new official entity of this department and is already challenged with financial constraints. As the committee we noted and welcomed the stance the leadership of this body is taking to invest in technology advancements. We are living in the digital age and any concerted effort to embrace science and technology is welcome.
The Government Printing Works is the sole custodian of all security documents of the state and is therefore at the centre in the broader Justice, Crime Prevention and Security cluster. The entity has committed to strengthen their internal capacity to address backlogs in their operations. This is a step in the right direction so that the citizens of our country can receive adequate service delivery. The entity will continue to focus on refurbishing its new office building at an estimated cost of R200 million over the medium-term. It worth noting that the entity also plans to procure a new enterprise resource planning system and resuscitate the e-Gazette system at an estimated cost of about R100 million over the Medium- Term Expenditure Framework, MTEF, period. An estimated
R433 million over the same period is earmarked for extensively revamping the entity’s information and communication technologies, ICT, environment.
In conclusion, challenges will always be there. No house is perfect. However, what sets us apart is our willingness to roll up our sleeves and get our hands dirty. I believe no problem is insurmountable. With the right attitude and a strong political will, all of us can make this government of national unity work so that we can rescue South Africa. I want
to close with these words, where there is a will, there is a way. I thank you.
Ms N CAPA (Eastern Cape): Afternoon, Chair, I am on the virtual platform; am I audible?
The HOUSE CHAIRPERSON (Mr B A Radebe): Yes, ma’am.
Ms N CAPA (Eastern Cape): Chairperson of the NCOP, chairperson of the Portfolio Committee on Home Affairs, Minister of Home Affairs, Deputy Minister of Home Affairs, members of the NCOP, ladies and gentlemen, good afternoon. We welcome the opportunity to debate the the Department of Home Affairs Budget Vote as tabled by the Minister last week.
The Department of Home Affairs might not be a department at a provincial level, but this is one of the departments that we, as the Eastern Cape Department of Health, work closely with. As a department that is there for when new life comes on earth and when someone passes away at our facilities, the Department of Home Affairs is there with us side by side. Teams of Home Affairs officials visit our facilities to ensure that children are recorded at birth and quickly make birth certificate for them. This did not happen before 1994 at the public health
facilities. By so doing, the current government of the people for the people has taken this crucial Home Affairs service to new mothers. Before, mothers who would have to stand in long queues at Home Affairs, only to be told the system is down.
This is not the case anymore.
As we continue to ensure that we improve our services, it is our hope and our dream that there will be a Home Affairs official at every health facility ready to assist with birth certificates. Because of this timely intervention, mothers are able to register their children for government social grant, by extension, this results in better health outcomes.
We have seen that when children from poor families are not receiving the social support grant for one reason or the other, children end up not getting nutrients they so need in order to be healthy. As a result, we have a big challenge of severe acute malnutrition problem. To drive this point home, between 2019 and 2023, thousands of children under the age of five years were hospitalised with severe acute malnutrition in the Eastern Cape.
During the 2019-20 financial year 1 498 children ...
IsiXhosa:
... baye balaliswa ezibhedlele belaliselwa ukungondleki noxa abali-149 baye baphulukana nobomi babo ngenxa yesi sizathu sinye. Ukanti ngonyaka mali wama-2020-21, abantwana abangama- 838 balaliswa kwaza kwasweleka abangama-72. Ngowama 2021-22, siphinde sabona amanani abantwana abalaliswa esibhedlele belaliselwa ukungondleki ephinda esenyuka ukuya kutsho kwi-1
314. Ngelishwa ke, abantwana abali-127 baye basishiya.
Kunyaka mali wama 2022-23, abantwana abangama-4 116 bafumaniseka bengondlekanga, kodwa abaninzi kubo baphila kuba bangama-93 abathi baphulukana nobomi babo.
English:
Without government support social grant, maybe the number would have been more. The Department of Home Affairs is crucial in ensuring that every child who should be receiving a social grant support gets it.
History tells us that when we were fighting against the unjust and vile apartheid system, freedom fighters sought the refugee in other countries. Many guerrillas went to exile and trained in other countries. This is why we will forever be grateful to the global community for their support during those dark
years. However, we must strengthen our borders so that people do not enter our country illegally.
IsiXhosa:
Xa inguvula zibhuqe ...
English:
... the public health system also gets overwhelmed because we do not turn sick people away. Our health care workers are already overstretched, and the health system is stretched thin. It becomes pivotal that we do not put the system under more pressure.
We welcome the plans to rid the Department of Home Affairs of any wrongdoing because corruption and fraud is a cancer that we must cut out. Anyone found to have accepted a bribe or bribed an official, must be dealt with harshly by the law. It can’t be that corruption will be allowed to happen under our nose. We are confident that the Government of National Unity will continue to put more measures in place to ensure that everyone in the country is here legally. I thank you.
Ms N P MCINGA: Hon Chairperson, hon members, Ministers, I greet you. All protocol observed. I greet you all in the name
of Jesus Christ, my Lord and saviour. I also greet you in the name of my president commander in chief Julius Malema. My president mentioned earlier this year during an EFF jazz concert, as he always likes to feed us with information and everyone that he meets, he always gives wisdom. He says just like Jesus does, he’s always giving us information. He said:
Time in politics is very important. And the timing in politics is very important. So, we need to make sure that politics work for us.
That’s why I urge the South Africans right now to take this advice from the commander in chief, to take this mess that is happening in South Africa as an advantage to educate ourselves about our rights. To educate ourselves of actually what is going on in this country so that we can be able to fight. He carries on and says, if you are not educated - it doesn’t mean going to school, but you need to educate yourself. If you are not educated, you don’t know your rights, you won’t be able to fight educated people.
So, I urge South Africans right now to take this opportunity to learn to google and find out what our rights are. Why are politicians always going to people to go and ask for their
votes? It’s because the people must govern. This is not the government of Cyril Ramaphosa. This is not the government of the Government of National Unity, GNU. This is the government of the people, but people don’t know that. When we say ...
IsiXhosa:
... amandla ngawenu ...
English:
... we mean that ...
IsiXhosa:
... amandla ngawenu ...
English:
That is why we’re making these speeches and we’re Taking the Parliament to the People. Chairperson, the EFF firmly rejects the proposed Budget Vote of the Department of Home Affairs, as presented by the Minister of Finance and supported by the committee.
When we convened to deliberate on this draft budget, it was concerning to note the absence of critical stakeholders and strategy.
IsiXhosa:
Silujongile olu hlahlo lwabiwo-mali sathi, hayi le ayithethi nabantu bethu. Ingaba luthetha nabani olu hlahlo lwabiwo-mali? Ndiye ndahlala phantsi mna ndalujonga.
English:
As the Department of Home Affairs is tasked with critical responsibilities and must be held accountable, we reject the budget of the department, which in 2024 still lacks so far behind in terms of its technology. I was listening to you Minister today and to the lady that was here, the hon member. It’s just lip service. How many times has South Africans been hearing the same thing that we are going do this? This is going happen. The jobs are coming. They’ve been waiting and it’s been 30 years.
Thirty years before, there was a mess or people not even being employed. Now all of a sudden, the Minister of Home Affairs who comes from those ancestors that made sure that our people don’t have jobs, are now coming with solutions that we are going to ... [Inaudible] ... did not do it before.
Hon Chairperson, simple software applications to capture and upload birth registration in real time is still not available
to the poorest of the poor. Mothers across all provinces still leave hospitals and daycare clinics without birth certificates. How is that possible in this day and age?
IsiXhosa:
Asivumi Sihlalo.
English:
We as the EFF are saying that we are not agreeing with this. Chairperson will not support a budget which does not make way for death certificates to be issued from hospitals. When most people pass on, in this day and age, we still need to wait for death certificates. We’re still need to wait for birth certificates. How come? There’s an hon member that was busy doing some payments here. He was holding his phone like this, because then there is a system that can identify your face.
We are asking for budget all the time. For what? For us to be doing the same dinosaur system thing? No, this is 2024. Even when we call our people ...
IsiXhosa:
... nabantwana bethu sithi ngama-2000 ...
English:
... meaning the Fourth Industrial Revolution, 4IR is the future. Why are we still reading a budget that has the old same systems? No ...
IsiXhosa:
... asivumi Sihlalo.
English:
We will not support this budget. If you control births Minister from when a child is born to death, when a person passes on and matches that number with new people entering and leaving our country, my simple maths says that, census in virtual real time every day is possible.
I always ask myself, maybe these things are deliberate. But listen to me, hospitals should have small Home Affairs offices that can quickly issue birth certificates and death certificates. Delays caused by too much paperwork and not enough facilities are not acceptable and violate the citizens’ rights. Additionally, implementing new technology, a biometric system that captures fingerprints at birth, will help identify individuals without identity documents more efficiently.
This will enhance the system’s ability to manage records accurately from the start of life and to ensure fair and efficient service delivery. Chairperson, the EFF will not support a budget that does not demonstrate how we will transform our old dinosaur systems to new technologies.
IsiXhosa:
Hayi khona Mphathiswa asivumi.
English:
This budget seeks to do the same thing the same way, and we expect a different result for service delivery to our people. This is the definition for madness. We unconditionally reject the capital and operation spend on the information and communication technology; ICT spend by the Department of Home Affairs.
Chairperson, my friends living in Johannesburg tell me that they don’t go to queue at Home Affairs when they are applying for their passports, they go to First national Bank, FNB and Standard Bank and they make an appointment. Within 10 minutes, their application is sorted. In a few days, they go back and get their passport.
Hon Chair is South Africa the new animal farm where some are luckier than others? Where the privileged few can go to secure space to apply for passport, while others like us who are from the villages in the Eastern Cape must stand in queues at Home Affairs offices for hours, days in order to access service?
IsiXhosa:
Asivumi.
English:
We reject this budget as there still exists a serious backlog as the Minister was saying that there is a backlog. If I was the Minister, I wouldn’t say that because people know their frustration when they have to wait for identity documents, IDs. There is a backlog in processing IDs, passports and other crucial documents. Thousands of South Africans are left waiting for months or even years, impacting their ability to access healthcare, education and employment opportunities.
Recent data shows that many South Africans are not even officially registered on this system. This possesses the risk of national security and makes it harder for people to take part in the economy.
Minister, during COVID-19 I took hundred homeless people in the Eastern Cape and I assisted them in a shelter called CC Classen. Some of them didn’t have IDs. I went to the forest in Kidd’s Beach where I cut wood and selling at garages and Spar so that I can take this money and give these homeless people to make. IDs.
When I called the Department Home Affairs in East London, it took forever for them to even come to the shelter. No, we will not agree to this. Not so long ago, two months ago Minister, there’s a white lady that we had assisted in the Eastern Cape, her name is Jasmine Rose. Jasmine’s child waited for three years to get a birth certificate. If the EFF had not come to the rescue, Jasmine Rose would not have had the birth certificate for her child.
We went to the Home Affairs and even when we were there, we were told to come back the following week because the supervisor is at Mdantsane. We had to wait to come back the following week. Does Jasmine Rose have this money? By the way, Jasmine Rose is a white person. When you guys say that the EFF doesn’t like people. No, we don’t want racism, and we just want our land back. We helped Jasmine Rose. You can google it; it is all over. We went there.
Home Affairs offices across the country are severely understaffed. This doesn’t only prolong the waiting times, but also it forces citizens to make multiple trips, often at their own expenses. Yet there are no jobs. You were saying now South Africans don’t have jobs. Why does Home Affairs always say, come back next week, you will get an SMS. Where must they get the money? Is this budget going to include the tax fares for people to claim back Minister? I just want to know. I hope you’re going to answer me.
This department has over the years failed in its duty to implement robust systems to manage immigration and citizenship affairs efficiently. These failures have serious consequences impacting both national security and individual rights. This budget does not focus on the important issues that affect the Department of Home Affairs and the people it serves.
Instead of having meaningful discussions around the challenges with that we face, we are pressured to agree with observations and recommendations that are made without real input from the people we represent. This kind of process undermines the fundamental principles of democratic oversight and accountability.
Chairperson, when it comes to how well policies fit together, there are still doubts about the department’s overall plan and how effective it is at handling important national concerns like immigration, citizenship and civil registration.
Since commencing office, this administration has not shown real improvement in service delivery, which continues to worsen the difficulties experienced everyday by South Africans. There still exists a clear gap between what the department is supposed to do and how well it actually operates. This mismatch is obvious in the ongoing delays and administrations obstacles the citizens face when trying to access vital services.
Chairperson, the budget allocated for 2024-25 is R10 billion, which is lower than what it was before Minister. Minister Majodina was here saying that the EFF is rejecting every budget, we don’t want money for our people. How can we want money that we know ...
IsiXhosa:
... ukuba ingena kwiipokotho ezivuzayo?
English:
How can we when we know that the same budget did not take care of our people. Now we need to agree.
IsiXhosa:
Hayikhona asivumi Mphathiswa.
English:
This decrease is worrying because the department plays a crucial role in empowering citizens and ensuring national security. Whilst it is good to prioritise employee compensation, there is a pressing need for additional funds to update infrastructure and make service delivery more efficient. It is our position as the EFF that Home Affairs should focus on empowering citizens by delivering essential services promptly and efficiently. Guaranteeing every South African’s right to dignity and access to necessary documentation.
We must demand comprehensive presentation from all relevant stakeholders. It is imperative that we develop a robust committee report that reflects a genuine oversight and commitment to the interests of South African people. The EFF is firm to reject this proposed budget because it doesn’t fix the major problems with the Department of Home Affairs and its
ability to serve our country well. Chairperson, the EFF rejects this whole budget.
IsiXhosa:
Ifana nale nto kaMphtahiswa weSebe leMicimbi yezeKhaya – ngubani? nguLeon Schreiber.
English:
Excuse me Sir for pronouncing your surname incorrectly. It’s German origin. I can’t speak German. If maybe it was African, I would be able to pronounce it. Excuse me for that. I can only ...
Adv M NONKONYANA: Chairperson, on a point of order. The point of order is this, we are all hon members. To refer to one of us who is the Minister by his name is wrong. I would urge the hon member to correct that and withdraw.
The HOUSE CHAIRPERSON (Mr B A Radebe): Alright, thank you hon Nonkonyana. I think that if you go to our Rules, Rule 62 in particular, it is very clear that we cannot refer to each other on first name terms. So, the point of order is sustained. Please refrain from that moving forward. She cannot withdraw now, it’s done.
An HON MEMBER: She should apologise.
IsiXhosa:
Knsz N P MCINGA: Ndicela ukhe uyithethe ngesiXhosa tata, andiyiva. Andikuvanga nyhani.
English:
Okay, let me see if I can explain what you were saying. Are you saying that I must not say Minister Leon Shreiber?
The HOUSE CHAIRPERSON (Mr B A Radebe): No, you referred to him on first name terms. According to Rule 62, you cannot do that.
Ms N P MCINGA: I apologise. It’s just that I can’t speak German. I quote your posters Minister ... [Interjections.] We were quiet here when your people were talking. Can you please just keep quiet so that I can ... Chair, can you please ask the hon member to be quiet here.
The HOUSE CHAIRPERSON (Mr B A Radebe): Order! A point of order is being called. Hon Makesini. Hon ... [Inaudible] ... there is a point of order here. When we deal with a point of order, it is only the Chairperson who has precedence. Please, let us respect that. Hon Makesini.
Mr M MAKESINI: Chairperson, can you please protect the speaker on the podium. If a member has an issue with whatever that is raised. She cannot be harassed by hon Badenhorst. Please.
The HOUSE CHAIRPERSON (Mr B A Radebe): Thank you, hon Makesini. We know very well that according to our Rules that people can heckle, but we cannot drown the speaker. Let us refrain from drowning the speakers. Because I think what is critical here is that she’s representing a particular constituency in which we must hear what she’s here for. Thank you.
An HON MEMBER: Thank you for protecting me Chair.
Ms N P MCINGA: I quote you Minister as you’ve got posters that are going viral on social media. One of them reads:
In the coming year the department will increase the number of inspections at restaurants, spaza shops, farms and mines by over 50% to act against people illegally employed, including through deportations.
He says that no one will want to visit or invest if we allow our country to be in a mess. This urge to get tourists and
investors to come to South Africa is of concern to me, Minister, because you are not raiding white areas.
We know that Robert Mugabe chased white people away from Zimbabwe and they came to South Africa. Why don’t you start in Camps Bay here in Cape Town and just raid white people? I think the dom pass era must come back so that every white person can take out an ID so that we can scan. Minister Senzo Mchunu needs to start with the white people not always to be fighting with black people.
Minister, you need to change your posters. You need to mention that even in right communities - and we want to see it on TV. We don’t want to see our brothers and sisters. [Inaudible] ... people Israel ... [Inaudible] ... in Israel and they came to South Africa. They have not gone back. You don’t chase those, Minister. Why are you always chasing black people? Black people are always oppressed. [Time expired.]
The HOUSE CHAIRPERSON (Mr B A Radebe): Hon Mcinga, you time has expired unfortunately. Can you take your seat. Hon delegates, the speaker on the podium will be hon Peter with five minutes. I don’t see him in the Chamber.
Mr B J FARMER: On a point of clarity Chair. The farmer without land. This side. Chairperson, I just need clarity on a point that was raised earlier, a point of order. While we were taught that a point of order is only raised with reference to a Rule. The individual raised the point of order without reference to a Rule. You then referenced a Rule in your ruling. Is that the norm of how we do things now?
The HOUSE CHAIRPERSON (Mr B A Radebe): Thank you and hon member for raising that issue. The very same Rule on the point of order, Rule 69 is saying that the member can refer to a Rule directly or deal with a principle of the Rule. So, I used the issue of the principle. The second part of Rule 69. So, everything is still in order.
The next member who must come to the podium is hon Peter. Is he in? No. I will call the next speaker who must come to the podium. It is the Deputy Minister of Former Affairs. Hon Nzuza, the floor is yours.
The DEPUTY MINISTER OF HOME AFFAIRS (Mr N Nzuza): Chairperson, I would like to extend my greetings to the Minister of Home Affairs, Dr Leon Schreiber, the chairperson and members of the select committee and all hon members that are here with us
today, the leadership of the Independent Electoral Commission, IEC, and the leadership of the Department of Home Affairs, led by the director-general and the entire management team of Home Affairs, the chief executive officer, CEO of Government Printing Works, who's also here with us today, hon members, distinguished guests, fellow countrymen and women.
The budget that we are presenting today empowers citizens and residents of South Africa to claim and secure the illegal identity without which no one can prove their existence and meaningfully interact with the universe. This budget gives identity and affirms the existence of our newly born citizens and thereby securing the future existence of our motherland.
This budget allows our youth access to education and allows citizens access to economic services. The budget we are presenting enables our citizens to travel the world, driving economic growth and solidifying our existence and influence in the global world.
The allocation of the department’s resources to its key programme in this Budget Vote allows us to contribute immensely to the improvement of the lives of our people. The budget we are presenting to this august House reflects growth
in allocation from R9,751 billion, which was in the previous financial year to R10,495 billion in the current financial year. So, there is no reduction of budget. There is growth of budget.
We will continue being prudent with the resources allocated to the department. This commitment is displayed by not regressing in terms of our audit outcomes having maintained seven conservative unqualified audit reports. We, however, must do more towards the attainment of a clean audit opinion.
The 2024-25 budget will allow us to realise our objective to make convenient the manner we offer services to our clients. Just in the previous financial year, we added hundred more mobile units so that we can be able to service rural communities in far-flung areas, so it is not true that they have been left out.
Those mobile units are working. If you want to talk about jobs, the addition of these 100 mobile units brought with it employment opportunities for 200 young people, others serving as operators of the mobile units, other savings serving as service clerks. So, it is untrue that we are not contributing to job creation. Facts must be checked before speaking.
The mobile units will further enable us to continue delivering on our Memorandum of Understanding with the Department of Basic Education to visit schools and take smart identity document, ID cards to 16-year-olds. The mobile units have enabled us to expand our smart ID drive to schools to reduce the number of pupils who write grade 12 without their identification.
Just last year, we visited 2196 schools to ensure that learners do not have to come to us, but we use mobile services to go to the learners. Over the medium term, the department will continue to invest in modernising our information, communications and technology, ICT infrastructure and investment of new technology like the branch appointment booking system, which is available to everyone. It is not for the selected few that live in Gauteng. It is available at all branches, and I will indicate that members must read.
[Inaudible.] ...that 224 modernised offices. It has been a great pride for us as Home Affairs that 1,6 million people and branch appointment booking system, BABS appointments were honoured by clients, which means that clients are using the
branch appointment booking system in order to be serviced at their own convenience.
Last year, we indicated again that our service improvement plan encompasses modernisation of old offices currently own the manual system. We committed that six more offices will be modernised in the 2023-24 financial year, bringing the total number of modernised offices to 205.
House Chairperson, I am happy to say that we delivered on this commitment. Life capture has been rolled out to Mapulaneng and Nkomazi in Mpumalanga, Taung and Molopo in the North West. If you know there's areas, you will know that they are rural areas and we are there, as far as Taung. We have also done so in Temba and Carletonville in Gauteng, and this budget will allow us to add to our modernisation pack by introducing 14 more offices.
House Chairperson, I'm delighted to announce that we now have presence in 169 health facilities, 169. So, there are Home Affairs offices in health facilities and our commitment with this budget is to grow those offices. So, it is not true that there is no Home Affairs. I can take you to Dora Ngiza, I can
take you to rural hospitals where you will find offices of Home Affairs.
House Chairperson, in the 2023-24 financial year, we registered a total of 900 258 births of which 744 610 we registered within the 30 days while 108 336 births were registered between 31 days to a year. Cheers. This displays our efficiency in birth registration.
House Chairperson, allow me to make this very fundamental point. Only birth registration is a societal responsibility. It involves both the mother and father. We strongly discourage what seems to be a new normal wherein fathers disappear during the birth registration of a child. We also discourage parents who fail to register births and leave children undocumented with grandparents or family members. This effectively disadvantages the child from many state interventions, resulting into a child and innocent child suffering the scandal of invisibility.
This budget Chairperson ensures that we continue to play a leading role in the ID4Africa Multi-Stakeholder Forum. And I must say this South Africa is position two in terms of civic registration in Africa, meaning we are ahead of our peers.
South Africa has been able to demonstrate through its modernisation programme, the techniques that led to the issuance of smart ID cards with the latest technology and security that has not been cracked thus far.
It is for that reason that South Africa continues to be a benchmark for other African countries in terms of its latest technology. We are well ahead of our peers more especially when it comes to civic registration. However, Chair, this is not the end, and we are not arrogant about it because we understand that there is still more that must be done, and it is Martin Luther King who teaches us that:
“Our very survival depends on our ability to stay awake, to adjust to new ideas, to remain vigilant and face the challenge of change.”
In the 2023-24 financial year, the department issued
2,8 million smart cards to citizens in aged 16 years and above. our target remains 2,5 million for the upcoming year. We also contribute further to social employment through our modernisation projects, which saw many young people being employed within the Department of Home Affairs. These are some
options that we utilise to promote our social employment package.
As we speak right now, a cumulative of total of about
30 million records have been digitised and the total of 29,8 million are yet to be indexed.
In conclusion, Chair, I would like to congratulate the chairperson of the select committee, yourself House Chair and all the members of the National Council of Provinces who have been elected and I wish for us to work together and I wish to express our commitment that we will continue to work together because we know that working together, we can do more.
I would like to also thank the management of Home Affairs as led by the director-general. I would also like to mention a very specific thanks to the Minister of Home Affairs, Dr Leon Schreiber, and let me extend my gratitude to you, Minister, for the leadership that you have displayed in such a short period of time.
House Chairperson, Home Affairs is too important for it to fail. It is important to the unborn, the living and the dead, and so as members of this House, we collectively carry the
responsibility to make sure that this institution works. I thank you.
Mr S A ZULU: Hon Chairperson, hon members of the NCOP, esteemed colleagues, esteemed colleagues and fellow South Africans, I stand before you today on behalf of the MK Party, to address the serious defects in our immigration system and the rampant abuses of the asylum and refugee system. This issue evokes strong emotions and widespread public debate, and it is our duty to address it with the agency and seriousness it demands.
House Chair, on 10 November 2023, the Department of Home Affairs published the White Paper on Citizenship, Immigration and Refugee Protection. This document towards a complete overhaul of the migration system in South Africa calls for the public comments, which were overwhelmingly received from various stakeholders including citizens, asylum seekers, refugee public interest group and international organisations. Following extensive consultations with the Cabinet approved the final White Paper on 10 April 2024 published in the Government Gazette on 17 April 2024. This Seventh Parliament must carry forward the crucial reform left unfinished by our predecessors.
South Africa’s current legislative framework comprising the Citizenship Act, Immigration Act and Refugee Act, is fragmented and outdated. These pieces of legislation have been amended piece meal, leading to the significant disharmony and problems, especially concerning refugee protection and asylum seekers. The United Nation adopted the 1951 Refugee Convention and the 1967 Protocol Relating to Status of Refugees, while the African Unions endorsed the 1969 Organisation of African Union, OAU Convention to address refugee problems in South Africa. Adhered to this convention has positioned us as a hospitable nation for refugees and asylum seekers.
However, this has also resulted in a disproportionately large number of individuals seeking refugee here. Overwhelmingly, our capacity as a developing country has 3% in 1994. South Africa embraced democracy, and by 1996 we had succeeded in various international agreements, including the 1951 Convention, the 1967 Protocol and the 1969 OAU Convention.
Unfortunately, these commitments were made without a clear policy on immigration and refugee, protecting a hasty oversight and holds us today.
The Refugees Act of 1998 aligned with international conventions and provide the refusal of entry expansion or
extradition of asylum seekers and refugees. This legislation places an undue burden on our government allowing individuals to enter the country with minimal scrutiny. The onus should be on the asylum seekers and to prove their claims upon arrival. South Africa has garnered a reputation for its generosity and compassion towards immigration and refugees. Our robust and unparalleled on the continent and our Constitution reflects our commitment to human rights.
However, this generosity comes at a significant cost. House Chairperson, our asylum system is being exploited by individuals filling in fraudulent claims to gain entry in South Africa. The courts frequently issue rulings that protect illegal immigration immigrants, while foreign funded NGOs politicised immigration reform and challenge our legislation.
This dysfunctional system determines our laws and hinders genuine claimants with credible asylum cases.
The MK Party believes that the current ANC-led government is complicit in undermining our asylum system. We therefore, advocate for mandatory detection of arriving asylum seeking until their claims are verified. These measures will prevent individuals from absconding into our communities and ensure
that our only legitimate asylum seekers are granted protection parallel from detention should be granted only in exceptional circumstances.
In conclusion, we must address the serious defects in our immigration system and the abuses within the asylum and refugee process. The MK Party is committed to ensuring that, our laws protect the integrity of our nation while upholding our humanitarian obligations. It is time that our immigration system, guided by a clear policy framework that balances compassion with scrutiny. Let us work together to create a system that is fair and sustainable for all South Africans. I thank you, House Chair. We, therefore, as the MK party, reject this proposed Government of National Unity budget. Thank you very much.
Mr M M PETER: Hon Chair, let me apologise in this House that I am an isiXhosa-speaking person. Therefore, I will use isiXhosa. So, if we do not have an interpreter, my apologies. Hon Minister...
IsiXhosa:
... molweni. Ndithi mandikubulise ngesiXhosa. Okokuqala, namhlanje andibili kakhulu. Into endenza ukuba ndingabili
yimincili ngendlela uMphathiswa ayizobe ngayo intetha yakhe. Zimbini Mphathiswa izinto endiza kuthetha ngazo. Siyi-UDM, uhlahlo-lwabiwo mali oluthe thaca apha siyaluxhasa.
English:
We vote for your budget, Minister. So, what makes us vote for your budget? It is the manner in which you address this House.
Mr F J BEDENHORST: Hon House Chairperson, on a point of order: I just want to bring it into your attention that the translation service is not working. We do not want to be deprived of the maiden speech of this young man. Thank you.
The HOUSE CHAIRPERSON (Mr R Ryder): Thank you very much. Indeed, hon Badenhorst, I also struggled to get on to the translation services. The Table, I did note, reacted, and they will attend to it now. Thank you very much. For that hon Peter, you can continue.
Mr M M PETER: Thank you. Thank you. I will try to speak English as well, but I need my people in my Eastern Cape to understand what I am saying. Hence, I am speaking isiXhosa. Is it fine? All right. Thank you very much.
IsiXhosa:
Kaloku sifuna bave nabo phaya emakhaya. Mphathiswa, siyavuya ukuva ukuba abantu bethu abasayi kuphinda bame emigceni emide.
English:
The major challenge is the long queues. According to the programme...
IsiXhosa:
... siyi-UDM siyayixhasa kuba besinengxaki yabantu abama kule migca mide. Okwesibini, Mphathiswa ohloniphekileyo, baninzi abantu abangena ngondlela-mnyama. Siyafuna ukuba iSebe lemiCimbi yaseKhaya liyimele le nto. Kukho abantu abangena ...
English:
... without even permit through the corruption you have alluded to, Minister.
IsiXhosa:
Ngoko ke, ilizwe lethu liphelile kuba kukho iindawo ezithinjwayo ngaba bantu basuka kumazwe angaphandle. EKorsteen, yindawo apho ehlala uninzi lwabantu abasuka ngaphandle abangenazo neempepha kodwa banemipu engekho semthethweni. Siyabulela xa iSebe leMicimbi yezeKhaya liza
nobuchwephesha boomatshini abaza kuphelisa le migca ingaka kumaziko enu. Ngaloo mazwi, siyayibulela loo nto siyi-UDM kwaye sibulela yonke le nquleqhu yokuhlanganisa abantu abantsundu nabamhlophe ukuba babebanye...
English:
... because it was a vision of tat’uMandela and our forefathers that black and white come together.
IsiXhosa:
Siyabulela kuba...
English:
... there is no one who is going to blame each other. As the UDM, we support you. Thank you.
Mr N GOTSELL: Hon House Chairperson, hon members and fellow South Africans, David and Pamela Morton are an Irish couple who recently fell in love with the picturesque town of Stanford in the Western Cape. They loved it so much that they purchased a property there, employ people who help them with the upkeep thereof, and enjoy the culinary and other hospitality treats that the Overberg District and Cape Town has to offer.
I was sad to learn recently that they consider returning to Ireland as a result of uncertainty about whether they would timeously be issued a financially independent visa which would allow them to live in South Africa, contribute to the economy and migrate freely between countries; all whilst not being a burden on the state. This certainty does not only lie with David and Pamela. It lies with many other people; people who are not as fortunate as they are to simply pack up and leave again.
When we talk about non-South Africans, we immediately revert to the negative of illegal foreigners who take our jobs, steal from us or murder our fellow countrymen and women. We frame migration in the language of fear and not in the language of opportunity.
I take solace in the fact that the Minister of Home Affairs has announced the urgent reactivation of the Immigration Advisory Board and that he has stated in his speech to this House that the department is serious about rebuilding trust in Home Affairs by respecting expert advice and addressing policy questions in a consultative, scientific and legally compliant manner, and that they will restore dignity.
By allowing stakeholders in this field to consult on important issues affecting the sector, backed by properly researched data and evidence-based advice, we can slowly move from a language of fear to a language of opportunity when we talk about migration.
The language of fear communicates that our focus is simply on kicking people out, whilst the language of opportunity communicates that we are serious about treating qualifying people with dignity, respecting their freedom of movement and their human rights, and that we value the principles of Operation Vulindlela, identified as the cornerstone of priorities for the Government of National Unity.
It is heartening to see the department’s ambitious targets for the adjudication of work and business visas within an eight- week period. With this in mind, the Select Committee on Home Affairs resolved that the department should clear all backlogs in respect of the processing of visas and permits, and increase capacity and training to expedite this process.
The department must, within 30 days of adoption of the committee’s report, submit an action plan to the committee on how it will address these backlogs. Minister, I wish to
congratulate you and your team on the incredibly fast reduction in processing backlogs.
People migrate for various reasons. Some do so in search of a better life for them and their family, others want to join their loved ones and some are passionate about a specific career or field of interest. Regardless of the reason, they all migrate in the hope of a better life. South Africa offers hope for many people but it also offers trade and investment opportunities and fantastic tourism opportunities.
By providing an efficient and transparent process for migration, these opportunities will inevitably contribute to a growing economy; one that provides jobs and opportunities for all. As the Minister has said, nothing provides dignity like a job.
The notion that foreign migrants compete for public resources and jobs must be tempered with the fact that legal migrants also pay rent and taxes, transfer skills and knowledge, and purchase goods and services which in turn contribute to South Africa’s revenue.
A 2018 joint study by the Organisation for Economic Co- operation and Development and the International Labour Organisation found that migrant labour contributes significantly to the South African economy. It found that legal migrants generally do not displace native-born workers; raise income per capita by up to 5%; and have a positive effect on the government’s fiscal balance through the payment of income tax and value added tax. It is thus safe to say that qualifying migrant workers overall contribute favourably to our economy.
By using the language of fear, we say that foreign nationals compete against South Africans for scarce public resources when in fact competition and the lack of public resources is the result of the high rate of unemployment and corruption.
South Africa is a fantastic place to live in and whilst we advocate for a greater focus on the reforms provided for in Operation Vulindlela, we certainly do not endorse the views of some opposition party leaders who in November last year said that borders between African countries must be abolished.
Credible border control remains the most important function of the department and its associated entities in order to protect national interests and to enhance national security.
The select committee has noted the call from the Border Management Authority, BMA, for more funding towards the functions within their mandate. These include the strengthening of border security through joint law enforcement operations to prevent the illegal cross-border movement of people, undocumented persons, illicit goods, as well as cross- border criminality on South Africa’s international borderline, air and sea.
It was noted that the main area of focus, in terms of budget constraints, was the allocation of funds towards the BMA’s information and communications technology, ICT, needs, in particular drones and other technology which the entity requires.
In conclusion, to this extent the DA has requested that the select committee undertake an oversight programme at its earliest convenience to thoroughly investigate their needs and to allow the committee to thoroughly fulfil its oversight function. The committee unanimously adopted this recommendation and further resolved on 16 July this year that the BMA should work towards eradicating all forms of fraud and corruption at all ports of entry and ensure that good ethics
are instilled in those working within the BMA. Chairperson, I thank you.
Mr H J VAN DEN BERG: Chair, all members, the Minister and other guests of this House, yes, as citizens of South Africa we may look different but our identity documents, IDs, are all the same. We also heckle and fight towards the same goals, namely security, service and fair treatment to name but a few. However, in my hometown of Kimberley a visit to Home Affairs is a dangerous excursion. Situated in the worst part of the city centre and with no parking available, walking to these offices becomes a security issue. This cannot be. The capital of the Northern Cape province can surely find another location to place the Home Affairs office. Why that building? Minister, your action plans indicate that you are considering opening offices in large malls such as Cresta Centre. Why not Kimberly as well?
Registering a child becomes very difficult when the system is down or not accessible. When young mothers struggle, many young babies throughout the country grow up into the future undocumented and therefore never being able to participate in the health, welfare and education system. Minister, your department mentions a roll-out of 41 digital stations to
facilities across the country. However, I need to remind you that there are over 400 public hospitals and 200 private hospitals in South Africa. I am, however, aware of the fact that offices from Home Affairs do visit some hospitals but the roll-out is simply not enough.
Afrikaans:
Welkom by hierdie Departement van Binnelandse Sake, Minister Schreiber. Ek wil u egter alle sterkte toewens omdat die probleme baie groot is.
English:
You referred to performance indicators and specifically registered births within 30 days, indicating a current number of just under 780 000 births on average per month. However, you only plan registration of a targeted future total of
750 000 births per month. If this is indeed the case, you will theoretically fall behind by 30 000 birth registrations per month, leading to an estimated backlog of 360 000 birth registrations in one year. Should your department not update their estimations and future targets? Do we not plan to fail by failing to plan?
Minister, allow me to remind you about the Batho Pele principles, meaning people first based on the Bill of Rights in Chapter two of the Constitution ... rights, namely equality, human dignity, the right to an open and fair government, freedom and security, etc. Let us go back there.
Colleagues, we have all been given a wonderful opportunity to lead this country through the seventh term. The number seven reminds us of fulfilment and completion. Let us all work together to lead the country into prosperity and blessings, and let us be righteous leaders. We will all account for our tenure. Let us not be found wanting.
Yes, we cut our budgets to make up for a bloated system but let us now become our brother’s keeper and lead by example in every state department as the goal to serve our nation is larger than ourselves. When all state employees work together, we can stretch the value and performance of our budgets.
Therefore, the time has come to put our differences aside and my humble request to you, Minister, is to use the budget wisely and take us there. I thank you.
Ms O D MEDUPE: Hon Chair, thank you very much. Am I audible enough?
An HON MEMBER: Come back to the House, Chair.
The HOUSE CHAIRPERSON (Mr D R Ryder): Yes, you can continue, hon member.
Ms O D MEDUPE: Hon Chair, hon Minister, Deputy Minister, hon Chairperson of the Select Committee for Security and Justice, hon members of the National Council of Provinces, Director- General and the Deputy Director-General present, distinguished guests, ladies and gentlemen. Hon Chairperson, it is a great privilege and honour for me to be part of the debate on Budget Vote 5 of the Department of Home Affairs. Sovereignty and our nationhood will among other things, depend on the securing of our national borders and how we manage the movement of persons and goods across the borders. It should be understood that the movement of persons and goods across the border it’s a global issue, not only for South Africa. Every country does welcome people from other countries, and that citizens of the country do visit other countries as in case with South Africa. What is important is the movement of persons and goods across the borders and should be undertaken within the environment of legality. For our case, we have a Border Management Authority, BMA, which is a section 3(a) public entity in accordance with the Public Finance Management Act.
The BMA is critical in the facilitation of movement of persons and goods within the border law enforcement area at the ports of entry. The Border Management Act provides for the co- operation and co-ordination of the BMA law enforcement function with SA Police Service, SAPS, the SA Revenue Services, Sars, and the SA National Defense Force, SANDF. In line with the Medium-Term Budget Strategic Framework, MTBSF, the BMA will contribute to a capable, ethical and developmental state. In this regard, the BMA will institutionalise excellency that will be distinguished by good corporate governance and ethical leadership. On its contribution to economic transformation and job creation, the BMA will enhance trade and socioeconomic development.
Setswana:
Bagaetsho, re le mokgatlho wa ANC, re leboga se Tona e fetsang go se bua gonne re lemogile dipalo-palo tsa baiwa ba rona ba ba ileng ba ntshiwa kwa mebileng gore batle ba thapiwe ke setlamo sa rona sa BMA. Seno se thusitse go fokotsa go tlhoka tiro. Re le mokgatlho wa ANC ...
English:
... we have raced the country, making commitment that we shall create jobs for those who have been jobless, and we shall
continue doing so. In contribution to social cohesion and safer communities, the BMA will secure borders and, in that regard, protect national interest and enhance national security. The BMA will also contribute to a better Africa and wealth, by strengthening the co-ordination and co-operation among stakeholders within the border management environment. This budget shall enable the BMA to implement the above- mentioned priorities as part of its facilitation of movement of persons and goods across the borders.
Setswana:
Re le mokgatlho wa ANC, ga gona gore re ka tlhoka go ema nokeng tekanyetsokabo eno gonne re il era ikgolega ka ditshwanelo tse tekanyetsokabo e e tshwanetseng go di diragatsa.
English:
As the ANC, we are aware of the concerns raised by people of South Africa with regards to challenges of cross-border crime as well as illegal migration. The BMA has already recorded positive strides in implementing its mandate of border management and control.
Setswana:
Bagaetsho fa pula e na, lefatshe le a koloba, ke ka moo re leng ANC re reng re lo utlwile.
English:
In its report of the festive season, the BMA reported that it was able to detect about 15 924 individuals who were attempting to enter South Africa without requisite documentation through our ports and vulnerable segments of the borderline. Following the interception of illegal migrants, the BMA took their fingerprints and declared them undesirable and banned them from re-entering South Africa for a period of five years and keep the record in a biometric movement control system, BMCS, and got them deported back. These are some of the positive operations that BMA has engaged in as part of implementing its mandate.
Now this reminds me, hon members, through you, Chairperson, that indeed, if you came being a negative person, even if there are records of positives that we are registering, you shall never see that because, already, you have confined your mind that you will never see anything good about the then ANC- led government. These are form of the positive operations that BMA has engaged in S part of implementing its mandate and we really appreciate, and we shall support. We support the
Minister of Home Affairs’ argument of the economic and security justification for increasing the funding of resources. For the BMA, for the BMA to deal with illegal crossing of borders into South Africa.
Further, that the plans for the allocation of roll out of BMA coast guards should be accelerated in line with the required duties. In its sought analysis, the BMA pointed to the potential threats of instability in the neighbouring countries, as some of the sector that may affect border control. In this regard, there is the need for collaboration with the neighbouring countries to strengthen regional and collective security, especially, in the management and control of the movement of people, persons and goods across the border. Therefore, Chairperson, as the African National Congress, we support Budget Vote 5 of the Department of Home Affairs. So, I move.
The HOUSE CHAIRPERSON (Mr D R Ryder): Thank you very much for your contribution, hon member.
Mr B J FARMER: Point of order, Chair.
The HOUSE CHAIRPERSON (Mr D R Ryder): Yes, hon Farmer.
Mr B J FARMER: Chairperson, I rise on Rule 59 © or 59 (3). Can the Chief Whip please explain to the House who is the Inkatha Freedom Fighters on the list?
The HOUSE CHAIRPERSON (Mr D R Ryder): Thank you, hon Farmer, I don’t believe that’s a point of order, thank you. I think maybe you can take that up outside the Chamber when we’re done today. Hon members, we move on with the debates and I now call the Deputy Chairperson to the podium, hon Governor, thank you.
The DEPUTY CHAIRPERSON OF THE NCOP (Mr P Govender): Thank you, hon House Chairperson, the Minister of Home Affairs, Dr Leon Schreiber, members of the executive, the Chairperson of the Portfolio Committee on Home Affairs, members of the Portfolio Committee on Home Affairs, distinguished guests, ladies and gentlemen, the Department of Home Affairs plays an important role in our lives. It operates as a device that monitors each and every aspect of our lives, from our nation’s security, identity management, immigration and other services.
Ensuring that this department is adequately funded is not merely a matter of administrative efficiency but a cornerstone of the country that we all call home. While we welcome the budget allocation for the 2024-25 financial year, we
acknowledge that it is not sufficient to finance the many pressing priorities of your department. When tabling the budget, the hon Minister spoke to a wide range of issues – many of which are not too far off from our priorities of the IFP.
For example, during our campaign towards the 2024 General Elections, we issued a 13-point manifesto plan. Point number 3 of our plan deals with illegal immigrants. We resolved that while fairness is necessary, illegal migrants are lawbreakers by their very presence illegally in our country. They pose a threat to the safety and security of all of us and they also place a heavy strain on our resources, especially in the health care sector.
The Minister spoke about securing our borders for security and economic growth. We would like to assure you Minister that you have our full support in this endeavour as it speaks to what the IFP stands for – and that is the rule of law. We also echo the Minister’s initiative to try and advance the department towards a more efficient digital governance so that queues can be reduced while ensuring efficiency.
We are aware of the fact that the department over the years has faced significant challenges, including corruption, inefficiency and a backlog of applications. Resolving all these challenges will not be an overnight process. It will require time, effort and consistency. We therefore hope to see improved changes in the upcoming years.
Hon Minister, I come from Chatsworth, in KwaZulu-Natal. The Office in Chatsworth needs a permanent and fully functional home, so that its affairs can be more efficient. It has only six members of staff and I am hopeful that when new offices are opened, it will be adequately staffed and equipped. While people apply for documents in Chatsworth, they still have to go to the Umgeni Road offices to pick up documents. This is very inconvenient and costly. I am hopeful that this process will be rectified in the near future.
I am encouraged that the Minister touched on the issue of visa applications and the challenges in the regard. Delays in issuing visas have a negative impact on the tourism sector as well as the economic sector.
In closing I would like to say that, as the IFP, we believe that this budget allocation is an investment in our nation’s
future, and we would like to see a further increase in the upcoming years. By adequate funding and capable leadership, we are convinced that this department will ensure the security of our borders, the efficiency of our public services, the integrity of our national identity, and the harmonious integration of our diverse communities. Minister, we wish you well. We congratulate you on your appointment and we are confident that you will take our country forward. I Thank You!
Mr M BILLY: Hon Chairperson, hon Minister and Deputy Minister, hon members, and fellow South Africans, it is a fact that the Department of Home Affairs has for the longest time faced challenges that have prevented it from performing efficiently and to its optimum level. The challenges that have persistently plagued the department can be located in the overall management and administration, with a particular focus on issues of immigration, border control, and more importantly for today, the availability of budgetary resources.
The failure to adequately manage immigration, control our borders and sufficiently resource the department's operations poses a serious threat to the security of our country and its citizens. Long queues, outdated systems and insufficient
staffing are but a few of the issues that plague this critical department.
Hon Chairperson, fellow South Africans, the administrative and operational challenges that exist in the department, if not addressed, will continue to hinder its ability to function efficiently. Many of these inefficiencies not only frustrate our citizens and those who want to enter our country legally, but also create gaps that are abused by corrupt officials and those seeking to enter the country illegally.
Indeed, because South Africa is a country of opportunities, it does easily attract good and bad people from neighboring countries and other parts of the world. While South Africa has always been a welcoming nation, we must ensure that our hospitality does not come at the expense of our laws and national security. Illegal immigration strains our public resources, places an additional burden on our social services and can lead to increased social ills.
Chairperson, this House must commend the department under the new leadership of the new Minister, Dr Leon Schreiber, who has immediately embarked on resolving some of these issues within days after he was sworn in as a Minister. For example, the new
minister has intervened in the department’s visa backlog of over 300 000, as he has mentioned earlier on, today, by taking a decision to extend temporary visa concession for foreign nationals in South Africa, who are still awaiting the outcome of their visa, waiver and appeal applications due to processing delays. I am glad that the Minister has said that he is receiving daily reports on this matter.
While we welcome this temporary measure taken by the department, we must better utilise the available budgets appropriately to constantly pursue the modernisation programme of the department, so that the processing of visa applications can be quick, and we reduce acts of corruption and the cost of doing business. This includes leveraging technology to streamline visa applications, residency permits, and citizenship processes. By doing so, we reduce bureaucratic delays and improve service delivery, making it easier for skilled individuals to join our workforce.
Border control is another crucial aspect that demands our attention. We must bolster our border security measures to prevent illegal crossings and trafficking, while ensuring that our border policies uphold human rights and dignity. That is what our Minister also emphasised a lot on. This requires
proper training for our border security personnel and investment in surveillance and monitoring technologies. In this regard, we must support efforts to strengthen the work of the Boarder Management Authority, BMA, so that they are able to proceed with the work that is required from them.
Chairperson, in conclusion, the availability of budgetary resources for this department is vital for its efficiency and success. It is quite sad to notice that there are parties that seek to oppose this budget. One can only assume that the intention of such is to try and cripple the department. So that we can open and unprotected borders. This House and National Treasury have to prioritize enough funds for the department so that its operations are enhanced for the betterment of the country and its citizens.
We need to acknowledge and support the good work that Minister, Dr Schreiber. We need to continue to support that. The department must upgrade its IT infrastructure, increase staff capacity and enhance border security measures. This is the time, that together, we must put our national security first, and provide South Africans with efficient civic and immigration services. I thank you. [Time expired.]
Adv M NONKONYANA: Chairperson, hon Ministers and Deputy Ministers present, the director-general and the staff, distinguished guests, ladies and gentlemen, wherever and whenever you are. Good afternoon.
First and foremost, I must apologize for the horse voice. I suspect that something has been sent to me so that I don’t speak, but my ancestors have refused, that, I should speak.
Let me thank the hon members who have contributed positively towards the goal of approving the budget.
The hon Minister, together with the Deputy Minister and the director-general and the staff and all the entities, spent almost the whole day with us. Having provided us with a document a week before, so that we all read and they gave us an opportunity to actually interact with them and ask them questions. We did that at the select committee. And what was impressive is that all the heads were there, and all the heads gave us the respect we deserve as hon members.
I am taken aback by the hon member, Mcinga, from an organization that I think we all respect, EFF. We all know that EFF has fundis, has some people who read and who I must
understand. The hon member said that there’s a government, I didn’t hear before that ... but may have expect me ... refer to our President as Cyril Ramaphosa, without the prefix.
Hon members, we have all subscribed to the oath of office, to uphold the Constitution of the Republic ... [Interjections.]
Mr V GERICKE: Chair, on a point of order. I submit respectfully that the previous Chair has ruled on this issue and there is no need to repeat same. Thank you.
The HOUSE CHAIRPERSON: COMMITTEES (Mr D R Ryder): The hon
member is participating in the debate and responding, so, I believe he’s in order at this stage. Thank you.
Adv M NONKONYANA: We all must read and we must all, if we don’t understand, ask.
There’s another issue that has been raised, the attack on the Government of National Unity, GNU. Let me be clear on behalf of the ANC. The ANC is the only party that is having the majority votes, but because of its magnanimity and understanding of the situation on the ground and respecting the electorate, decided to invite everyone to be part, to make
... [Interjections.] ... no one has been excluded. And now we are told ... that says GNU, as if it’s a different entity.
I also listened attentively, as I should, at the Whip of the select committee to all of you. I listened carefully to the basis of rejection of this budget vote by the hon member representing the EFF. She said some things about there are nothing in the hospitals and things like that. But thank you, Deputy Minister, rubbished all that.
And we all know ... in fact, because we are on the ground and there are ... and I think the Department of Home Affairs has done a lot. Yes, there are challenges, as members of this hon House correctly pointed out. We didn’t fail our people.
Then, you asked if that was the only ground on the basis of which the EFF was saying we must reject this ... has been rubbish ... is thrown through the window. What else? So, there is no ground whatsoever.
Let me deal with hon Zulu. Thank you, hon member. This is exactly what we are expecting from the members. Raise the issues. You raised quite correctly the issue that has been raised by the comrades and many other people before me, about
the issue of immigration. And you submitted a proposal, that, let us do something to address that. We all agreed. But you amazed me when, at the end, you said: well, we reject. [Laughter.] On what basis? On what basis, hon member? On what ground? There is no ground other than an unholy alliance between the EFF and yourselves. [Laughter.] There’s no ground at all. And thank you, therefore, hon members.
I must also join my colleagues, hon Minister, for really thanking you for acknowledging that your predecessors have done something good for this country and you are prepared to contribute positively towards those progressive steps taken by the ANC government. And if you could see, and everybody can see, is that there is institutionalized memory in the Deputy Minister, and therefore, you told everyone who can hear that you must work together. I heard one member say: black and white, let us hold each other’s hand to deliver a better life to all South Africans. Thank you very much, Minister, and for having respected us.
You, hon members, have stolen the thunder. You must be fined because whatever is contained in my speech, you took it. [Laughter.] But except those that I have put online as a Whip. But everyone, everyone, you have made me proud today. I’m sure
South Africans are very proud, are very proud of you MEC from my province, hon Capa.
I’m very, very proud of all those people that participated in the virtual platform. All of us are one, that this department deserves everything from all of us to succeed. And the budget that has been provided is a budget that we understand because of the financial constraints, but they deserve more.
And I’m very, very happy then that you have realized that, hon Minister, there must be registration of marriages. But they missed one thing, which is very important to me and many South Africans, the customary marriages, and particularly to those few royalties in the country that have got no more than one wife. We want them to be registered, ondlunkulu [queens] [Laughter.] ... in order so that there is no confusion as we part in this world. Thank you very much.
We understand, you make us to understand that there are challenges that are facing this department. And not only understanding them, but you have plans that you have put before us so that we can actually monitor to make sure that we succeed, we support you and by actually approving this budget.
I’m going to give you something at the end so that you will be proud when you leave this Chamber.
Some of the concerns, of course, that have been raised, the question of queues, as my hon member from my province correctly pointed out, and he’s quite correct. But there’s a thing that you have identified. You said it must be addressed and we suggested that you must actually do more. And you clearly indicated that you are willing, you, not as an individual, passes the collective, the entire department as well as all these entities to actually deliver services even to those far-flung areas, the rural areas that are far.
And you clearly indicated that you are able and willing to work with everyone, including the institution of traditional leadership and Khoi-San leadership in the country, with a view that traditional authorities’ offices, amongst the other thing, you consider using them so that they can actually assist you.
We understand, perhaps it is not in your portfolio. But we understand that there are internet challenges, especially in rural towns as well as in rural areas. But we will assist you
to make sure that our people, even in rural areas, do get excellent service that they deserve.
We appreciate the department’s system to allow our people to make appointment for their services at Home Affairs. This is what is termed Branch Appointment Booking System, BABS. Obviously, this system works well in town, but there may be challenges where there is no network.
Therefore, the department, in our view, should prioritise its services through the mobile trucks that are able to reach far- flung rural areas, as I said, in Limpopo, Eastern Cape, Free State, KwaZulu-Natal, Mpumalanga, Northern Cape and last but not least, North West. The mobile trucks will assist in bringing Home Affairs services closer to our people.
And we can also attest to what Deputy Minister correctly said, you are visiting schools. And that programme is very, very good, which necessitates that indeed we needed to give you what you have proposed before us.
We encourage, of course, that in this budget the Department of Home Affairs prioritises the issue of access to rights and services by citizens.
However, the issue of border control. Our colleagues have dealt with that matter. I’m going to summarize and paraphrase my submission by saying the Border Management Authority has presented a plan that we are very, very pleased about it.
Since its establishment in April 2023 as section 33(a) entity in accordance with Public Finance Management Act, PFMA. We encourage them to do what they must do.
On this issue of foreign nationals. People, I’m really, really hurt, hon members from the EFF, to encourage the coming in of people in South Africa without ... they rape, they kill, they do a lot of things to our people. They don’t pay taxes. They have now taken even spaza shops, even the things that are being done by our people in streets. How can you encourage that? People who are here legally, yes. But those that are not here legally, of course, they must do that.
I’m sorry Independent Electoral Commission, IEC and others, my time is almost up. But thank you very much for delivering the elections for this year. And you deserve more. And we are very, very happy about what we have presented before us. And with us, we are going to assist you in taking this matter forward.
In conclusion, I’m encouraged by the department in its process of implementing the findings that recommendation of the Ministerial Committee on Home Affairs, that was led by former Director-General in the Presidency, Dr Lubisi.
We are also glad that the department has deployed and approach to implement the recommendation from Zondo Commission of Inquiry.
We are, therefore, pleased that indeed this department is determined to stamp up corrupt and corruption and fraudulent activities within the department.
The ANC, through me, has no option but to now ... have mandated me to append the royal seal of approval to this budget. Thank you, Chair.
The MINISTER OF HOME AFFAIRS: Chair, I would like to thank everyone who made constructive input here today, as we, indeed, need to work together to take this crucial department forward. So, I’m very heartened by some of those inputs. Let me start with the hon Mananiso on the mobile units and one thing that was really echoed here was the Northern Cape. I
think the hon Mokae and Van den Berg also mentioned it. So, I have some good news for all three of you.
Afrikaans:
Ek het groot geword in die Noord-Kaap.
English:
I come from the Northern Cape, and I can assure you that I hear very clearly the need to not leave behind some of our rural and less dense areas. The issue on the Kimberley office, I think, we can have a chat offline, and see what we can do there. But certainly, the intention is there for urban, rural, doesn’t matter where you are. Home Affairs really wants to move itself forward. So, thank you for making that point.
On the staffing shortages that were mentioned also by various speakers, yes, I think it is about 44% of capacity and that is a huge challenge for any department. So, I think we need to be honest about that one. As much as the department can go out of its way to embrace technology and innovative thinking, it really is important that we have support of this House, as we engage in budget processes, going forward. I do think Home Affairs has borne a disproportionate brunt.
I know everyone says that they have been cut, but if you look at the numbers, Home Affairs has probably been cut the most, and that includes the Border Management Authority. So, if you are serious about these priorities, and if this House is serious about these things, as it has said today, then I would plead with, in whatever avenues you can, to help us just to correct some of the cuts at Home Office, so we can move forward.
The member from the EFF, Mcinga, you asked why these solutions weren’t brought before. Well, because the GNU wasn’t here before. It’s here now and we are working together and we’re bringing these solutions.
I mean, there were points raised about the borders, but I think you must go listen to your own party leader. He is on record saying in an interview in 2019 with Radio 702, and I quote: “Those things of borders, we will not have them.” So, I think it is the EFF that really needs to look into its own position on this issue.
I was quite shocked by a statement that was made that I think deserves a response. I think the hon member said and I quote her here about the “dompas coming back”. It was something like
that. I find it to be a disgraceful statement by the EFF. A shocking, shocking indictment on this country’s fight for democracy. And I want to make it absolutely clear, as long as the DA is here, as long as the GNU is here, there will never be a reversion to such regressive racist practices. It is unacceptable! Absolutely unacceptable! And I think we can all see, in fact, why the EFF is not part of the GNU, because it stands for things like dompas that is unacceptable.
We are not surprised by the rejection of the EFF of this budget. I think the EFF rejects any budget that doesn’t have a line item for VBS, so really that is not something that we are going on about.
In a more constructive vein, I think there were some good inputs made. The hon Zulu made some good points on the issue of the asylum refugees. I think it is something that we also need to take up at a global level, because the truth is the funding cuts have come domestically, but also from the international stage and migration is an international problem. So, we really need to take this to the global stage and get those international partners to actually help us manage that backlog. I can tell you there is another serious backlog there and we need to tackle that. The funding is not going to come
from us domestically. That is clear. So, that is an issue that I will take up on the global stage.
On behalf of this country, hon Peter, please, never again apologise for speaking your native language. Please, please, please. We need to get the translation things fixed, but we must embrace our diversity. So, I hear you loud and clear on that.
Hon Gotsell, I think you made some valuable input on what I refer to as, we must be able to walk and chew at the same time. You must be able to understand two things at the same time. And that is so that we need secure borders, unlike the EFF’s position, and we need to be able to embrace people who bring skills and contribute to South Africa, growing our economy. So, I agree with you on that.
As I wrap up, I want to say to hon Govender from the IFP, I can confirm to you the Chatsworth Office is almost complete and best news of all, it is one of the modernised offices. So, let us chat about that offline and see if you can join us for opening that one. I conclude by saying, I hope I will have the support of this House. The Deputy Minister and I are working hard together so that we can move forward to address all of
the challenges we have discussed here today. Thank you very much.
The HOUSE CHAIRPERSON (Mr B A Radebe): Hon Schreiber and hon Nzuza, I joined the other presiding officers in congratulating you and being part of the GNU. I hope that you will be the diligent servants of the people.
Hon delegates, we are now going to the second order of the day, which is the Policy Debate on Budget Vote 18, Health.
Debate concluded.
APPROPRIATION BILL
(Policy debate)
Debate on Vote No 18: Health:
The MINISTER OF HEALTH: Hon House Chairperson, my colleague, the Deputy Minister of Health, Dr Joe Phaahla, the Chairperson of the Select Committee on Health and Social Services, Ms Desiree Fienies and members of the committee, hon members, distinguished guests, ladies and gentlemen, I also need to
start by apologising like the hon Nonkonyana, I think whoever send something to him, mistakenly send it to me because I was not part of the package. I am very sorry about that. [Laughter.]
Hon members, greetings to you.
It gives me great pleasure to present the 2024-25 Budget of the National Department of Health to this House, and to also outline our plans for the 2024-25 financial year of R62,218 899 000,00. This is a 3,5% increase from R60,1 billion of the last financial year. The details of how this money is going to be spent are well elaborated in the annual performance plan, APP, of the department. Hence, I will move to other very important matters.
House Chairperson, it is not an exaggeration to aver that the topical issue on health in our country is National Health Insurance, NHI. Debates started raging furiously after the President assented to the National Insurance Act, and signed it into law on the 15th May 2024 – the President did this publicly by the way, something that he does not usually do, and this signifying the importance of this piece of legislation.
I have listened to many such debates in our media and other fora, including legislature houses across the country. I could not help but conclude that many get involved in these debates based purely on what they read in the print media or what they hear over the electronic media. I believe, his is very unfortunate. It is for this reason House Chairperson that I have decided that today in this debate, these matters need to be clarified, and I will start right from the beginning.
According to the World Health Organisation, WHO, a health system anywhere in the world consists of six building blocks. You may call them six pillars of health if you wish. The first one is leadership and governance of the system; the second one is access to essential medicines and other commodities; the third one is health workforce which we commonly call the human resources; the fourth one is health systems financing; the fifth is health information systems and the last is health service delivery. I did not mention them necessarily in any order of important.
Anyone of these six building blocks should not shake and be found wanting, because if that happens, the whole health care system will be on a shaky foundation. As you can see, one of these six building blocks according to the World Health
Organisation, is Health Systems Financing. In our country we chose to call this NHI and we know it has generated a lot of heat and fury in some quarters.
Well, this is not surprising, because NHI is a health financing system that is designed to be an equaliser between the rich and the poor. Everybody agrees and I do not think in this House anybody will disagree that we are the most unequal society in the whole world! Anyway, many institutions have pointed to that, and I do not think there is any debate about that. However, the moment a proposal is made on how to deal with the inequality, that is when the well-to-do people show their true colours. Sharing with the poor or giving the poor their place under the sun becomes somehow an insult to the rich. This is happening in most parts of the world, but it seems its roots in South Africa are deeply entrenched. Perhaps it is because in South Africa, poverty and black actually seem synonymous, hence the persistence in the gross inequality.
On the 23rd May 2012, the then Director-General of the WHO, Dr Margaret Chan, officially opened the 65th Session of the World Health Assembly in Geneva, Switzerland. The World Health Assembly is an annual gathering of all Ministers of Health around the world with health experts under the auspices of the
World Health Organisation. It is a supreme Health policy- making body only surpassed by the United Nations, UN.
Dr Chan chose Universal Health Coverage as her theme for that particular World Health Assembly. She mentioned seven structural problems of healthcare around the world. Two of these structural health problems relate to Health Care Financing or Universal Health Coverage or NHI as in the case of South Africa. She quoted the two among the seven as and I quote, “costly private health care for the privileged few, but second-rate care for everybody else”. Secondly, I quote again, “schemes for financing care that punish the poor”.
House Chairperson, if you want to see costly private health care for the privileged few, but second-rate care for everybody else, you come to South Africa. If you want to see schemes for financing health care that punish the poor, you also come to South Africa. Such a scheme is of cause called medical aid. No way can we, with a straight face continue in this manner.
House Chairperson, I am painfully aware that, I am standing in front of human beings in this House today who fall within this category of a privileged few who receive costly private health
care at the expense of the poor. Well, it is painful to say, but unfortunately it is true. Hon members, time to change has arrived. Ironically, it is actually we the privileged few who must bring that change and who must usher it.
House Chairperson, as public representatives we dare not claim that we do not know the history of our country. Our country has been seeking a solution for an equitable financing of health care for the past 96 years. Well, if you think I made a mistake I am repeating it, 96 years. This is recorded history and history cannot just be erased. History records the 1928 Commission of Old Age pension and NHI, the 1941 Collie’s Committee of Inquiry into NHI, the 1943 African Claims that proposed equal treatment in the Scheme of Social Security, the Dr Henry Gluckman National Health Services Commission of 1943 to 1944 which proposed the NHI, the Freedom Charter as adopted by the Congress of the People in 1955, the 1994 Ministerial Committee on Healthcare Financing, the 1995 Ministerial Committee of Inquiry into National Health Insurance, the so- called Broomberg and Shisana Report, the 1997 Social Health Insurance Working Group, the 2002 Committee of Inquiry into a Comprehensive Social Security System, the Committee on the Tylor Report.
House Chairperson, what we have been doing as South Africa for the past 96 years, was to keep on sharpening the spear for change, but without using it. In isiZulu they say “Umkhonto we gwala, uphelele elitsheni”.
Even today, we are going to argue that the spear still needs to be sharpened before we implement. We are going to argue that the spear is not ready to be used. We are going to argue that we still need another Commission to tell us what is wrong with the health care system.
Hon House Chairperson, we know what is wrong with our health care system. We are not just willing to tackle that because we belong to the group of the selected few. We are beneficiaries of a wrong system, and we dare not meddle with because of our own comfort.
House Chairperson, in order to understand just how important health care financing is, read the editorial of The Lancet of September 2013. The Lancet is a British medical journal, one of the four best highly rated medical journals in the world. The Lancet argues that since human beings started populating this planet called Earth, health care has undergone only two global transitions. The first health transition which is
called the Demographic Transition. It began in the 18th century and changed the planet in the 20th century through public health improvements, it was nothing that looked extremely medically complex. Simple clean running water, basic sewerage and sanitation. You may believe that it is something very small. This helped to reduce premature deaths greatly around the whole world. People use to die very young, before the transition took place.
The second health transition is called: The Epidemiological Transition. It began in the 20th century and eventually reached even the most challenged countries around the world in the 21st century. This is what today we call immunisation or vaccination. For communicable diseases, starting with smallpox which annihilated more than 300 million globally, since 1900 alone, were vanquished or controlled on a scale unimaginable. The demographic transition and the epidemiological transition changed the planet irreversibly. Now, The Lancet said a third transition is upon us. It is called Universal Health Coverage, UHC. It is the manner in which health care is financed, so that there is no difference between the rich and the poor when it comes to health care. When The Lancet said this 11 years ago, and since that time there have been a huge push-back from those who are beneficiaries of the present system.
What is wrong with the present health care financing in our country? The World Health Organisation, WHO, has declared that for a country to have a good health care system for all its citizens regardless of their financial status, that country needs to spend at least 5% of its gross domestic product, GDP, on health. This 5% is not about the budget of a country, it is about the total wealth of a country. The gross domestic product according to the World Health Organisation. Now, what is happening in our country, the country has far surpassed that recommended 5%. We are already at 8,5% which is averagely what European countries are, but our health care system look like chalk and cheese, but why?
Well people will come with many stories here. Such as corruption, which I will not deny, about poor management, which I will not deny, lack of maintenance, which I will not deny, but what they will be running away from is the central question, the issue that is central is the manner in which the 8,5% of the GDP is divided in South Africa as against all the other countries. In South Africa, this 8,5% of the total wealth of the country; 51% of it, is only spend on the 14% of the population. Unfortunately, all of us here are part of that 14% me included of course. The remaining 49% goes to serve a whopping 86% of the population. Now when we say we are the
most unequal society in the whole world, we are not joking. These are facts written down! Everybody agrees that we are the most unequal society in the whole world.
Hon House Chairperson we are saying this has to stop and stop now. No one here in this House as it happens in every debate about NHI is going to stand up and say they do not support Universal Health Coverage. All of you are going to stand up and say yes, we support it, but we do not support it in this form of NHI, but in the way it is. Well, fair enough, let us then sit down and say in what form. For you cannot throw the baby away with the bathwater. You cannot wish away the inequalities I have quoted here.
House Chairperson, we hear a lot about money supporting private health care being private money, that is what many of you are going to say. Why did you meddle with medical aids, it is private money from individuals, they pay from their own pockets. The state has no business in interfering on how I do, that is my own choice. Really? Is that true? Just how private is this money? Let me tell you today: Our government, the state, subsidised private health care for the rich in a way unimaginable. A total of 1,3 million public servants, plus all Members of Parliament and all legislatures, and all judges of
our country, are subsidised by the fiscus, to the tune of R70 billion every year. This is done by subsidising you in your salary individually through the medical aid schemes. We are forced as Members of Parliament to belong to one of the most expensive medical aid scheme ever in the world. It is expensive. Do not think we never tried to get Parliament out of it. However, because there are people who benefit, there is resistance. It should not be existing this medical scheme called Parmed. There is no scheme consisting of so few people! [Interjections.]
Any person in our country who is on medical aid, regardless of who they work for receive a tax rebate I am made to understand by SA Revenue Service, Sars, that this tax rebates has now reached R30 billion.
Hence House Chairperson, we are running a health care system where no less than R100 billion every year moves from the fiscus to subsidise the rich and the poor do not have entitlement to that money. We will have to start changing from this.
Let me give you more figures, perhaps if we do not understand. This whooping amount of money highly subsidised by the fiscus,
helping only 14% of the population, what is the situation on the ground? Every year 1,2 million women fall pregnant in South Africa. Put differently, every year, 1,2 million babies arrive in this world. This huge amount of money that I have just mentioned, from our fiscus, this huge amount of our gross domestic product helps on 140 000 pregnant women every year.
It takes care of only 140 000 newborn babies. This meagre amount that is left for the poor, has to help 1,60 000 women who are pregnant help them through their pregnancy until they give birth to their babies. Those newborn babies, only 140 000 are taken care of. Then the remaining 1,60 000.
Now people are going to tell us of all sorts of management etc. Let me tell you, House Chairperson, anywhere in the world, people follow money. If you take money from this area and put it in that area, human beings are going to go there.
I am challenging you today, just divide the legal system into public and private. Put one legal system for those who are rich and say they must go to that court under that judge and senior councils and put the other one for the poor, you will see what will happen.
All the prominent judges, lawyers and everybody who is an expect will go to the side where there is money. That is what is happening in health today. Everybody who is good not only doctors, even auditors, financiers’ people who have skill in managing things, they all go to the 14% because money is there.
House Chairperson, in 2013, we made a calculation of one private hospital and one clinic in Johannesburg. I am not going to name it. I know it very well. I will not name it because I do not want the speech to concentrate on me attacking certain individuals. I am just stating facts, because we state facts. That one private clinic in Johannesburg had more gynaecologists than Mpumalanga, Limpopo and North West all added together. Why, because people follow money. You can go to others you will find a similar system.
So, when we are talking about financing health care, in such a way that is equitable we are not talking about stealing money as people are claiming. We are here changing a system that is primitive. We are following a primitive system which unfortunately, started the same year as an icon of this country did something for the world. Dr Christiaan Barnard did a heart transplant in 1967. I am sure many of you are asking
yourselves: Why am I not mentioning it in the transitions that took place in the world? It is a great job, but it is not a transition, because it only helped individuals to live long.
It did not change populations. The transitions I have mentioned here changed the whole population even if they do not know. However, in the same year, Dr Chris Barnard did that miracle. Something happened in South Africa in 1967. The first law to establish medical aid came into being. Dividing sickness into the rich and the poor. Today we are still faced with it. When we need to change, we start fighting.
House Chairperson, there is no way we can go on like that. [Interjections.]
You are not the House Chairperson, please. Just leave me alone.
So, let me conclude.
[Interjections.]
No changing of any time!
Why are you wishing that I finish quicker?
Let me conclude by thanking my colleague the Deputy Minister, Dr Joe Phaahla, the Director-General Dr Sandile Buthelezi and the officials of the National Department of Health. Finally, House Chairperson, I hereby submit the National Health Budget of 2024-25 financial year and pray for its approval by this House. I thank you. [Time expired.]
Ms D W FIENIES: Hon Chairperson, hon Ministers, hon Deputy Ministers, hon delegates, director-general, all officials and distinguished guests, good afternoon. The journey of conceptualisation of the National Health Insurance, NHI, as its roots as back as the African claims document which was presented by the president general of the ANC, Dr Alfred B Xuma. More than 80 years later, the National Health insurance was signed into law by President Cyril Ramaphosa on 15 May 2024.
As reflected during the signing, the NHI is a fulfillment of an 80-year old promise to make healthcare accessible to all South Africans regardless of their race, gender and socioeconomic standing. Adopted unanimously by the annual conference of the ANC at Bloemfontein on 16 December 1943. The African claims laid the foundation which challenged an unjust stratified health system which was conditionally assessed and
intended to marginalise the poor and the vulnerable. This perpetuating the poverty and inequality gap which exists between black and white South Africans.
Between the poor and the rich, recognising the hurdles in realising such aspirations, Dr A B Xuma made a call stating: “On behalf of my committee and the ANC I call on upon chiefs, ministers of religion, teachers, professional men and women of all ranks and classes to organise our people to close ranks and take their place in this mass liberation movement and struggle express in the Bill of citizenship rights until freedom right and justice are won for all races and colours to the honour and glory of the union of South Africa whose ideals, freedom, democracy and human decency cannot be attained until all races in South Africa participate in them.”
As accurately predicted by Dr Xuma, the finalising of the NHI is being met with a lot of resistance from those who wish to maintain the status quo. They misinform the public and instigate unwarranted panic underplaying the overdue realisation and the transform health system towards improving the health outcomes of all of South Africa and the realisation of universal health coverage. They seek to maintain a system where the private sector - like the Minister has said - serves
about 14% of the population which the public sector serves the majority of the population at about 86%. They seek to maintain unjust spending of South African taxes where about R27 000 is spend yearly on people who use the private sector, while only R5,200 spend yearly per person dependent on the public sector.
The composition of such a system is unsustainable, it contradicts the development objection of the Bill of Rights of the Constitution, the National Development Plan, as well as the United Nations Sustainable Development Goals. To mention a few, strategic documents will guide the governance and trajectory of our nation. During the 2024 state of the nation address, President Cyril Ramaphosa reflected on the critical role played by health workers in responding to health threats and improving health outcomes.
As amplified during the COVID-19 pandemic, our healthcare system is held together by our health workers who often risk their lives in the face of outbreaks and disasters to ensure that those in need receive the required medical attention. As a global community which lives under continuous threat of health outbreaks such as COVID-19, it is through the dedication and expertise of health workers that we will be able to withstand and effectively deal and manage our health
crisis. Even if we suffer through natural disasters such as currently was witnessed in the Western Cape, it is our health workers who are at the end of these devastations who assist in mitigating the effects of this occurrences and ensure that lives are preserved.
The above mentioned solidify the President’s sona remarks. The support for health workers is essential for us to build a responsive and resilient healthcare system. Despite fear instigated by cynics who are pushing for the migration of health workers, following the signing of the NHI government is committing to ensuring that favourable and equitable conditions are created in the health sector. Numerous initiatives have been undertaken to support and attract health workers, for example, the health sector has been a beneficiary of the introduction of the presidential stimulus package and the human resource training ground in the financial year 2021-
22. Through the creation of 73 370 new roles, health related and support staff both permanent and on contract in order to boost public health services.
From 2021 to 2023-24, 24 822 healthcare workers were appointed on permanent as well as on contract with focus on key services. Furthermore, 8 976 medical interns and 30 626
community service practitioners were hired between 2020 and 2024. There have been advances in the strengthening and capacity building of healthcare workers as evidenced by the Nelson Mandela Fidel Castro Medical Training programme which is a result of bilateral health co-operation agreement signed with Cuba in 1996, which aims to provide an opportunity for South African students to undergo medical training in Cuba.
Today, South Africa has produced 3 1071 doctors under the Nelson Mandela Fidel Castro Medical Training Programme. The department also continues to maintain positive relationships with the local Higher Education institutions on the enrollment and successful completion of medical students to feed the workforce. Such interventions are critical in ensuring that our country has an adequate medical supply of the health workers. Closing the skills gap and ensuring gender representation in the field as evidenced by the 454 graduates of the Nelson Mandela Fidel Castro Medical Training programme, 40% of whom were women.
Despite these accomplishments, more can and must be done. There remains a huge shortage of health workers which results in many being overworked and underpaid. There are challenges of health workers not being afforded the necessary
psychosocial support to cope with the various traumas they witness in their line of work. In addition, medical resources and other critical supplies are often lacking, this training the ability of health workers to provide the necessary care to the patients. The NHI is the will of the people. After having undergone an extensive consultation process across all nine provinces including with the general public civil society health workers and unions among various groups, the NHI emerged favourable to the majority of South Africans.
The health workers under the NHI are critical in improving health outcomes through their continued role in promoting active living and healthy lifestyle choices. They play an instrumental role in attending to patients at the primary healthcare level and assisting with early diagnosis and getting people on treatments along with providing other broad services to the citizens of our country. Under the NHI, we will ensure that synergies are improved between the healthcare workers and the health institutions such as between hospitals and clinics through digitised patient medical records, strong primary healthcare, accessible specialist and seamless referral and follow up protocols. This efficient co-ordination is vital for managing patient care reducing long waiting lines
and ultimately positively improving patient care, patient satisfaction and the health outcomes.
Under the NHI, health workers will be aligned to the mandate of ensuring that they uphold realities of equity, respect, fairness and inclusivity. Health workers and the critical service they provide are at the heart of successfully implementing the NHI and realising universal health coverage. We emphasise that the budget will expand on existing strides to further support and address the new needs of health workers. Through the Budget Vote, we emphasise that government and other relevant stakeholders will work with the health workers to bring in resources and expertise to strengthen our health system and find solutions to the health challenges our people are confronted with.
We are encouraged by a future where all South Africans are willing to roll up their sleeves and play their role in the development of our country and ensure that no one is left behind. We are encouraged by the commitment of health workers since the signing of the NHI towards serving the Republic and protecting the most vulnerable in our nation. Through this Budget Vote, the government commits to investing in training, recruitment and support provisions which enable health workers
to undertake their duties. This support includes; career development prospects, adequate staffing improved working conditions to prevent burnouts and sufficient supplies of necessary resources.
As we prepare to remind the life and contribution of utata (father) Nelson Mandela tomorrow, Thursday 18 July 2024, let us remember the words he spoke at the Nelson Mandela award for health and human rights in 1995 where he stated that “Healthcare cannot be a question of income it is a fundamental human right” This is necessary to make sufficient investments strengthen interventions to support the healthcare workers in order to realise the healthcare system we strive for. We, as the ANC, therefore, support the Budget Vote on Health. I thank you, Chairperson. [Applause.]
Mr P GOVENDER: Hon House Chairperson, the hon Minister, Dr Aaron Motsoaledi, Deputy Minister, members of the Portfolio Committee on Health, hon members and distinguished guests in the platform upstairs, there is no doubt, hon Minister, that our country’s health care sector is overburdened and underfunded. We understand that due to staff shortages as well as equipment shortages, the department is working under severe strain. This is evidenced by the ratio of 7,9 physicians per
100 000 people in the health care system. It is, indeed, not a healthy situation to have doctors working 24-hour shifts and, in many cases, longer. How is that work? How can a doctor provide optimal health care when he or she has not slept for such a long period of time?
We acknowledge that the health care budget is far from sufficient to meet the challenging demands that the department is faced with. Treasury estimates inflation with average 4,7% over the next three years, meaning that the health budget shrinks in real term whilst expenditure grows by a nominal 3,4% over the medium-term. Inadequate health care funding has proven just how significantly it can impact on services rendered. The deaths of babies at the Chris Hani Baragwanath Hospital over the past three years could have been avoided if there was adequate infection control and neonatal intensive care unit, ICU, beds.
Further, we have more than 800 qualified doctors remaining unemployed. It is simply unacceptable that we have parts of our country where people have not been fortunate enough to be examined by a doctor and yet we have qualified doctors who are sitting at home. In KwaZulu-Natal earlier this year, we had an instance where 50 doctors staged the sit-in at the
department’s head office in that province to ensure that they have received appointment letters, whilst over 200 qualified doctors in KwaZulu-Natal and nurses handed over a memorandum to the Department of Health seeking placement in health care facilities. Unfortunately, these doctors were urged to be patient as the department aimed to address their concerns.
I understand that funding is a serious impediment and, therefore, as the IFP, we want to urge for more funding for the Department of Health. The IFP has said this before, and we will continue to say this until our pleas are no longer ignored. Our country can ill afford to have a shrinking health care budget. This new administration has no choice but to do better. Any equipment that is not well-maintained is bound to break down at some point. We cannot afford to have a critical health care system where equipment is not functioning properly due to nonmaintenance. Accurate diagnosis and appropriate treatment are critical in saving lives and providing proper medical treatment to patients.
In conclusion, hon Minister, the IFP calls for this new administration to ensure that health care is prioritised by improving conditions for our medical staff and the overall condition and availability of equipment at public hospitals.
Hon Minister, I am also suffering with that cough that you have, and I want to wish you well. The IFP supports your budget. I thank you.
Mr M P SIBANDE: Hon Chairperson, hon Ministers, hon members and all protocol observed ...
SiSwati:
... Ngcongcoshe weTemphilo, singu ANC sikuphakamisela umbhelebhele, sitsi dvundvubala uphokophele embili, babe. Futsi siyalusekela lwabiwomali lwakho.
English:
South Africa has a long-standing healthy challenge with communicable and non-communicable diseases as we may all be aware, communicable diseases are categorised as diseases which are infectious and can be transmitted from one person to another, like tuberculosis, COVID-19 and HIV. On the other hand, non-communicable diseases are non-infectious diseases that are informed by factors, such as genetics, lifestyle choices and environmental factors. These diseases include cancer, diabetes, heart disease and mental health. The high burden of communicable and non-communicable diseases has negatively impacted the health outcomes of 1,000000 million of
South Africans and as such has been a high priority for the department. To this end, program three of the department's 2024-25 annual performance plan is dedicated to communicable and non-communicable diseases and finding strategies to mitigate their impact on health outcomes.
For many years, the leading health threats have been communicable diseases such as HIV. As noted in the National Strategic Plan for HIV, TB and STIs 2023-28, despite the notable progress in the fight against HIV over the past decades. The HIV prevalence rate remains extremely high with the prevalence rate estimated to affect about 13,9% of the South African population. As of 2022, it was estimated that above 8,45 million people living with HIV in the country of the infected population, it is reported that about 5,7 million people are on treatment, creating a gap of about 5,7, which accounts for about over 2 million people who should be on treatment but are not. This group of people poses huge challenges for both themselves through a high risk of deteriorating health and high change of infecting other people, thus increasing the infection rate.
However, more recently, the World Health Organisation has observed that noncommunicable, mainly cardiovascular diseases,
diabetes, cancers and chronic. Respiratory diseases are the leading cause of death worldwide. They present seven out of 10 main causes of death, equivalent to 74% of all deaths globally. This includes more than 15 000000 people who die prematurely every year from a major of NCD between the ages of
30 to 69 years, 85% of these premature deaths occur in low- and middle-income countries. In a Statistics SA Report published last year, on 17 October 2023 titled Non- Communicable Diseases, findings from Death Notifications 2008 to 2018, it is reported that non-communicable deaths are on the rise in South Africa, with diabetics, the related death increasing from 10 846 in 1997 to 26 880 in 2028. They were followed by cancer related deaths, which increases by 60% from
27 052 in 1997, to 43 613 in 2028. Death due to the
cardiovascular diseases increased by 46,5 from 54 701 in 1997 to 80 183 in 2028. The rise of communicable and noncommunicable is a direct threat to the prosperity of our nation and to our health system. It overburdens our financial resources and infrastructure increases through and the strain on our health professionals. Fortunately, communicable and non-communicable are preventable.
The budget vote supports health interventions that can benefit both citizens. Healthy outcome to the point where Programmes
three of health budget on communicable and non-communicable diseases accounts for the largest allocation out of the national budget amounting to R25,2 billion out of the
R62,2 billion budget allocated. Through the implementation phases of the NHI, we will improve our health infrastructure, increased support and the treatment of health professionals and access to medicines and other essential resources. Having quality and real-world system in place, we can drive impactful awareness campaigns and promote active living and healthy lifestyle choices. We can improve the care provided at primary health facility to improve early diagnosis and promptly get people on treatment under the NHI.
We will improve our tracking system to ensure that people who start treatments stay on treatment through awareness campaign and public health interventions. People will also be encouraged to have regular checkups, which is instrumental, and prevention and early detection focus area. The realisation of this aspiration cannot be realized in isolation without addressing socioeconomic determinants, which play a tremendous role in informing health outcomes. We know very well that people with good financial standing tend to have better access to health care and nutrition. Thus, positively impacting, the health outcomes.
On the other hand, the majority of South Africans live in poverty and unfavourable conditions, which cause them stress and mental health challenges making them susceptible to abuse, lack of access to proper nutrition often exposed to detrimentally, external environmental factors such as pollution. Poor access to quality health care, coupled with the above-mentioned challenges fuel the inequality gap between rich and poor South Africans. This goes against the Constitution of our Republic and our developmental aspirations. Therefore, as health is a crosscutting issue which affects all of us, regardless of race, class, and financial standing as evident during the COVID-19 pandemic. It is our collective interest to actively share responsibility in improving the health outcome of this country and challenging socioeconomic factors, which negatively informed people’s health outcomes such as unemployment, education, housing and water and sanitation. The search of communicable and non- communicable diseases is not merely a health issue but is intricately linked to the country’s social economics and political reality. Let us collectively rally our support to achieve targets of the department into including striving for HIV 95-95-95 targets aimed at ensuring that by 2023 95% of all people living with HIV know their HIV status 95%. [Time
expired.] I thank you.
Ms N S DU PLESSIS: Hon Chairperson, hon Minister, Deputy Minister, hon members, fellow South Africans, good day. I would like to start by saying, that my sister has been in health care since 1994 and speaks very highly of your knowledge within medical realms, and one can see that.
However, as I continue the speech, I would like to answer some questions you have posed about the National Health Insurance, NHI, but let me start.
Health care is an inalienable human right and speaks to the very core of our wellbeing as human beings. Health care ranges from the common cold to stress-related anxiety, and life- threatening noncommunicable diseases and potentially debilitating neurodivergence. It is obvious that each of us here has experienced or witnessed the impact of health care needs, be it through personal struggles, family illnesses or the battle of friends or loved ones. The universal experience, therefore, underscores the critical importance of a robust and effective health care system. Yet, despite the intrinsic role that health and wellbeing play in our lives, the reality for many South Africans is a far cry from what we aspire to. When we speak to the average South African about their experiences within our health care system, the stories are, more often than not heartbreaking. Even the best-laid plans have failed,
and they have failed to translate into tangible improvements on the ground.
There is a glaring absence of increased accountability and political will in many of our provinces to ensure that every budgeted cent is spent wisely and effectively on health care. The annual budget, while comprehensive, reveals little faults on paper. We welcome the concept of decentralisation; however, it would have been nice if this was more impactful since 2013 when it was initially brought into the spectrum of health care systems. Similarly, we welcome the creation of the Electronic Data Repository, EDR, but, we must question the efficacy of the millions, almost billions spent since 2013 and in many provinces, 2009 on eHealth systems that are just not there.
The notion of Ideal Clinics and Hospitals is commendable, however, the discrepancy between reported data and actual conditions in these facilities is stark. Many clinics, if not most, lack the necessary infrastructure, staffing, and supplies to meet the standards of an Ideal Clinic, and this disconnect is exacerbated by the absence of facility managers at announced oversights. I need to be quite honest; I have never met a facility manager at a provincial clinic, and I have conducted up to 15 oversights in the past three years.
Importantly, health care cannot be politicised. It must be solely focused on the well being of our people, and political ideology has never prevented or healed a bedsore, nor has it decreased the burden of disease. Only excellent health care systems, based on accurate data and scientific best practices, have changed the face of health care. Unfortunately, our current system is riddled with misappropriation of funds, inaccurate reporting and gross medical negligence, decades of neglected building maintenance, and the migration of health care professionals to the private sector. I want to repeat that. Our nurses are leaving the public sector for the private sector for lower salaries.
This further illustrates the system’s failure, and to achieve Universal Health Coverage that respects patient dignity and choice, we need a functional health care system. To be clear, the NHI is not Universal Health Coverage. These two have fundamental differences. We can learn from countries that have effectively implemented Universal Health Coverage, UHC, countries like Canada, Brazil and Spain. They have all built robust public health care systems over decades and every one of them has a different political system.
They have achieved success through sustained investment in accountable, decentralised health care systems, primary health care centres that meet international standards, world-class and independent award-winning public hospitals and a well- supported health care workforce. Accurate data systems and accessible patient records are crucial to their success, without these foundations, and without allowing people the choice of private health care, these countries would not have achieved their current levels of success. They would also not have been able to achieve success without a robust and growing economy. R3,8 million was spent on Kopanong COVID-19 Hospital, it has foundations, walls, and nothing else.
When we look at eHealth, I have mentioned millions spent on it. When we look at generators that have been budgeted for, thousands of rand, but when you get on the ground, they do not function, nor do they have the necessary diesel that has been paid for, but just not delivered. Basic maintenance like toilet doors takes years to accomplish, and I am not even talking about Pinetown Clinic, which took eight years to rebuild and is still not functioning. Medico-legal cases, Life Esidimeni, broken radiology machines, and nurses leaving the public sector for the private sector, all show that our system is broken.
This is not a time to gloss over key issues with political language and smart sidesteps. This is the time that we step up and do not reward ineptitude. This is the time that we do not turn a blind eye to corruption. We do not oppose the budget or the plan in principle, but we are concerned that there is a visible history of a disconnect between money spent and actual impact on the poor on the ground, as well as the critical difference between the NHI and a successful system of universal health care coverage. To build a world-class health care system, the people of South Africa should not be expected to pay for the financial historical misconduct within this crucial service.
Additionally, every person who is in the health system, needs to implement and live by Batho Pele principles, more especially No 8, which is value for money. That means spending money, and not taking it. Spending it on people, and those who do not follow this, need to be held to account. Let us start with the foundations. Let us follow due process and diligence. The people of South Africa deserve this and more. I thank you.
Ms N CAPA (Eastern Cape): House Chair, hon Chairperson of the Portfolio Committee on Health, Health Minister, Dr Motsoaledi, Deputy Minister, Dr Phaahla, hon members of the NCOP, MECs of
health present here today, ladies and gentlemen, good afternoon. We welcome the Budget Vote for the Department of Health for the 2024-2025 financially, as tabled by Dr Motsoaledi, our Minister of Health. Welcome back, Minister. Rightfully so, Minister reminded South Africans when tabled the budget vote that the National Health Insurance, NHI is a South African’s chosen vehicle to universal health coverage. We are happy that after extensive consultation, the NHI was signed into law during the Sixth Administration. South Africa is now one step closer to levelling the playing fields so that everyone will have access to the same level of care regardless of their economic status.
The Minister of Health outlined the history of our country and the healthcare when he tabled the budget vote. So, I will not repeat it.
IsiXhosa:
AmaXhosa ke, athi, unendlebe nje unetyala.
English:
Hon members, the NHI is the Freedom Charter of healthcare in South Africa. We dare not fail our people and we will not fail them. There will be equality in the healthcare sector and we
will achieve that through the phase-in implementation of the NHI. As you know that NHI pilot site is in Eastern Cape. We have been hard at work reading state-of-the-art facilities in preparation for the NHI. Dr Phaahla can attest to that, that Siphethu Hospital is in deep rural Ntabankulu, which is in Alfred Nzo District Municipality, one of the poorest District Municipality in the Eastern Cape, is a facility that one might say, is better than most private hospitals. The ANC-led government invested R680 million on Siphethu Hospital. That was money well spent. We are also committed in filling all the vacancies within the available budget.
Unfortunately, because of the budgetary constraints that hon members must be aware of, we are unable to fill these vacancies all at the same time. We will continue to train healthcare workers in the Eastern Cape as part of skills development and ensuring that our country has enough healthcare workers. Just like last week, 466 nurses graduated from Lilitha College of Nursing. They are all gaining valuable experience as they are all doing their community service in our facilities.
Despite the many challenges that we have in the Eastern Cape, one thing I can say is that we might not be perfect, but we
are doing our best. We do so because the majority of our people depend on the public healthcare sector. There is always a room for improvement and we are constantly working to address challenges in their infancy. Through the Centralised Chronic Medicine Dispensing and Distribution, CCMDD programme, we are able to help chronic stable patients to receive their medication closer to where they live and work without needing to go to a facility every month. By so doing we are ably addressing queues waiting times in our in our facilities.
The CCMDD programme, remains one of the programmes to improve access to medicine in the province. By the end of the last financial year, 383 761 patients are on the CCMDD programme. Hon members, the ANC, in its National Health plan for South Africa in 1994 stated that:
It envisaged an integrated, equitable, comprehensive health system based on the primary healthcare approach.
The Constitution of the Republic of South Africa was trusted with the right of access to healthcare in section 27. To make this directive the reality from the ANC founding documents, our first democratic elected President, the late President, Rholihlahla Nelson Mandela, whose birthday we will be
celebrating with good deeds tomorrow, within 90 days in office, declared a free health services for pregnant women and children in the public health facility.
In fulfilling our constitutional mandate, we are guided by the wise words of President, Nelson Mandela, who once said:
Health cannot be a question of income. It is a fundamental human right.
I cannot speak for the dearly parted, but present Mandela would have been proud that we are a step closer to achieving a universal health coverage. Hon members, ideal clinics and ideal hospitals accreditation are a prerequisite for registration as service providers under the NHI. By the end of 2023/24 financial year, there were 491 facilities that achieved ideal status in the Eastern Cape. This is a story of a good progress because we are coming from a low base. A total of 221 facilities has accreditation certificates by the Office of Health Standards Compliance.
In conclusion, when we were attacked by the invisible enemy COVID-19, we showed up and our resilience and the united South Africans. Thousands of lives were saved, largely due to the
dedication of healthcare workers and adherence to the nonpharmaceutical measures. We are confident that we will again defeat the monkey pox, which is showing its ugly head in some of the provinces. We are blessed that we have not recorded any, any confirmed case in the Eastern Cape. Working together we can defeat the monkey pox just like we did with the COVID-19. Again, Chair, as the Eastern Cape we welcome the Budget Vote of the Department of Health, 2024/25 financial year, as tabled. I thank you.
Mrs N N CHIRWA-MPUNGOSE: We take this opportunity to invite all of you to the 11th anniversary of the EFF at A R Abass Stadium in Kimberly, invite for you, invite for you, invite for you, and invite for everybody. The EFF rejects the Budget Vote 18 on Health. This department once again presents to us today a budget which indicates that there is no appreciation for the depths of the rots in the public health care system. The Minister paints a rosy picture of the state of health care in this country. Whilst in reality health care facilities are in shambles, some are running out of basic necessities such as syringe needles, leaving doctors struggling to resuscitate patients to draw blood and to get medicine from ... [Inaudible.] ... These are some of the many examples of how lies have short legs, because this department also has a
tendency of fabricating reports indicating that suppliers wait no more than 30 days for payment, when in reality we know that that is not the case, as in Livingstone Hospital where suppliers wait for months on end for payments to be made.
More than 85% of our population is dependent on underfunded public health care facilities, where you are unlikely to receive medical attention, medication with medical staff overburdened and long waiting times which exceed several hours. This was the remaining 15% of the population, which is largely white, has access to adequately performing private health care institutions. To this, we note with concern that the government is subsidising private medical health care with a staggering R70 billion. This revelation highlights the gross misallocation of public funds in the country where public health care is in a state of crisis. It is an affront to our people that when the wealthy benefit from this exorbitant subsidy, our public hospitals are nothing short of inhumane death threats.
We therefore reject this budget as class and race still determines one’s ability to receive good quality health care in this country today. Therefore, the upcoming National Health Insurance, NHI, implementation will see no fundamental change
to this reality so long as things like the referral system are still in place in the NHI Bill. Minister, patients shouldn’t be treated better simply because they can afford to pay more and because they live in cosmopolitan areas in comparison to those who are poor and who live in townships and rural areas.
This department must find a way to make sure the availability of care is spread more evenly throughout the country. We can’t look at the private institutions and private sector and the public sector separately. We reject this budget as the decline in the quality of health provision held over the years caused the public to lose trust in the health care system of South Africa. We reject this budget of the department, which is only known for its widespread inefficiencies, staff shortages, differences in skills set between rural and urban areas, and poor patient management. We reject the budget of the department which is also largely known for its shortage of ambulances in general. The ambulances in KwaZulu-Natal and in Limpopo province are not working and if they are, their service is poor. The result of this is fatality. Oh, people die because of the ambulance, Minister.
In the Eastern Cape, Gauteng and North West province, there have been numerous reports on the shortage of beds, poor
medicine supply or a total shortage thereof of long queues and rude staff that humiliate and condemns the dignity of our people. The maternity unit at Frere Provincial Hospital in East London is in a crisis, Minister. It is overcrowded, forcing pregnant women, some of which are in labour, to sleep on chairs and benches due to the unavailability of hospital beds. Some patients spend over a week sleeping at the foyer and others on the floor with some who are due for caesarean section surgeries having to wait for their surgeries in vain. The result of this Minister, as you would know, is women taking back children who are permanently disabled.
The delivery of equal and quality health care is a constitutional obligation in South Africa, but this department faces numerous challenges at all levels and fails the very patients which it is designed to help. Daily, pensioners, pregnant women and women in labour, the terminally ill stand in long queues outside of clinics as early as 4:00 desperately in need of medical attention. Yet, the Minister operates health facilities according to office hours, and together with this Parliament you rejected the opening of clinics for 24 hours and seven days a week, as proposed by the EFF.
The Auditor-General, AG, on its 2022 and 2023 report on Ideal Clinic Realisation and Maintenance Programme in 27 primary health care facilities in the nine provinces had some negative findings that included: Maintenance schedules that were not implemented, lack of functional backup electric supply, and or piped potable water. The AG in its report also reported a lack of hand hygiene facilities. However, in the Eastern Cape there isn’t even a bar of soap, Minister, in hospitals for patients to wash themselves. Perhaps explain to us in layman terms, Minister, in the province like the Eastern Cape in KouKamma, where there aren’t any private hospitals to hide your failures behind of building a public sector. How exactly does the NHI improves their lives when the money meant to provide health care for them to build the clinic in Twee Riviere, to pay community health care workers in ... [Inaudible.] ... and Joubertina or how the NHI will benefit those in Misgund whose clinic is in the toilet at the back sit of the petrol station when the money that meant to build their clinic will be used to pay the Netcare bills for you and me, Minister. Explain to those people in the Eastern Cape, in layman terms, what they NHI will mean for them.
If the department leadership continues to ... [Inaudible.] ... their oversight responsibilities concerning financial and
performance reporting, compliance and related controls leading to material misstatements and material findings, documented on the audit report. How can we support the Health Budget Vote?
How do we support the Budget Vote on Health, where the management did not implement the proper record keeping in the tiniest manner to ensure that complete, relevant and accurate information was available to support financial reporting resulting in the material findings that are reported?
The department appears to change indicators on a regular basis. This impedes and hampers on continuity and monitoring the effectiveness of the programmes of the department. The real crisis that South Africa has in health care currently is that the health needs of our people exceed the capacity, the leadership and the political will of the government of today. There are no simple solutions to the Department of Health’s crisis. Yet our generation has a once in a lifetime opportunity to begin addressing the crisis and the hopelessness through the Economic Freedom Fighters, which has for 11 years, been aggressively advocating for real quality universal health care that leaves nobody behind.
The EFF maintains that only genuine way to ensure that access to quality health care is resolved, and is the intentional
focus on primary health care, prevention and education as fundamental principles of rebuilding the public health care system. We need clinics to open for 24 hours and seven days a week, Minister. Those that operate for 24 hours must have trained security personnel that is insourced by the state, Minister. All community health care workers must be permanently absorbed by the Department of Health. We need to train, employ and remunerate properly all health care workers in this country. We need to have public hospitals that are up to the task of servicing the health needs of the 86% of the citizens of this country who can’t afford medical aid.
The Life Esidimeni inquest has confirmed with this judgment to this country that the lives of our people are not important to you, Minister. There was an awareness that the patients will be transferred to an ill-equipped facility, and that some of the personnel were not adequately qualified to care for the mental health care patients. You failed our people, nonetheless. The gutted parts of Charlotte Maxeke Johannesburg Academic Hospital, due to the fire in April 2021, are still not fully operational, nearly 18 months after the fire.
In Leratong Hospital in Krugersdorp the theatre is not functional, and the patients had to wait for five weeks for a
broken leg that needed to be operated. Long waiting times, too few clinic staff in place to meet the needs of public health care users and shortages of stock out of different medicines, contraceptives and vaccines at the end of the day in the department you’re leading, Minister.
The National Health Insurance Act signed into law just before the elections is an insufficient legislative measure and will only enrich private hospitals and not improve the quality of services in public facilities, which is your primary responsibility, by the way, the public sector. The EFF rejects this Budget Vote because in the case we have to choose between the establishment and our people, we will choose our people.
We reject the Vote.
Ms N NKOMO-RALEHOKO (Gauteng): Hon Chair, I’m just surprised about what this member from the EFF is saying about Gauteng because it is not true. If she wants to visit Gauteng she must come and check Shallotte Maxeke Hospital, and not talk about something she doesn’t know. By the way I am available, and we will brief her. Anytime that she want to come to Shallotte Maxeke Hospital we will tell her. She must not use a blanket approach when she come to the House.
Hon Chair, Chairperson of the NCOP, hon Minister, Dr Aaron Motsoaledi, Deputy Minister Joe Phaahla, Ministers, Deputy Ministers, hon members of the House, my colleagues from the other provinces, distinguished guests, ladies and gentlemen, I’m honoured to present to this distinguished House the crucial contributions of the Gauteng Department of Health to the South Africa’s health care system in this Budget Vote.
With a population exceeding 15 million residents, Gauteng province plays a very important role in our nation’s development agenda necessitating a resilient and responsive health care system and current fiscal constraints the Gauteng Department of Health remain resolute in its commitment to optimise health care services to meet the diverse needs of our growing population. The importance of the Department of Health cannot be overstated. It serves the basis of societal wellbeing, ensuring access to quality health care services, promoting public health initiatives and addressing health disparities across our communities.
By prioritising innovation, equity and efficiency, we aim to build a health care system that not only meets immediate health care, but also lay a sustainable foundation for the future generations. Optimisation of the health business
process requires a comprehensive digital programme. It is important that we capitalise on digital health opportunities implementing comprehensive enterprise architect that would enable seamless data exchange among key stakeholders facilitating data-driven decision-making and ensuring effective continuous care and health care users.
Initiatives such as the integrated health information system, queue management system and an integrated data procurement layer will enhance data sharing mining and analysis capabilities thereby optimising health care outcomes and advancing health care development goals.
Our commitment to improving access to quality health care services remain solid. We prioritise critical areas such as neonatal health, TB and HIV treatment which cascade to mental health and oncology services. Through initiatives like these ones, we have the surgical marathon programme now which is part of our activities for the Mandela Day tomorrow. We aim to significantly the surgical backlogs and improve health care outcomes for patients that have been waiting, including the interventions that we need to do as Gauteng province. These efforts are essential ... [Interjections.]
The HOUSE CHAIRPERSON (Mr D R Ryder): Hon MEC, I’m sorry to stop you there briefly. We have a request from the media that if you don’t have problems with the bending light, please turn on your camera and show us your face so that we can see you.
It would suit us best if you could leave the camera on for us, please.
Ms N NKOMO-RALEHOKO (Gauteng): Yes, I hear you sir, but I have problems with the bending light.
The HOUSE CHAIRPERSON (Mr D R Ryder): Thank you very much, MEC. Please continue.
Ms N NKOMO-RALEHOKO (Gauteng): As the department, we are dedicated to create a conducive environment and enhance patient experiences through streamline service delivery initiatives like the surgical backlog that I have said.
The capacity development of our health care workforce particularly professional nurses remain critical. The department is committed to offer a range of training programmes that are aligned with the health care needs. This includes providing bursaries for staff pursuing professional nursing qualifications at institutions like the Gauteng
College of Nursing, GCon, as we call it. We also continue to prioritise continuous professional development to ensure our health care professionals stay abreast of the latest medical advances and the best practices.
Investing in our human capital extends beyond formal education and training. We will continue to create a supportive work environment that foster career growth and job satisfaction among our health care staff. Through mentorship programmes and skills enhancement initiatives, we empower our workforce to deliver high quality compassionate that meet the evolving needs of our diverse population. As we look to the future, we remain proactive in the developing innovative strategies to attract and retain top talent in the health care sector. By investing in our human resources, we ensure a sustainable health care workforce that is capable of delivering excellent health care services and improving health care outcomes across the province.
In our pursuit of a universal health coverage, as the Gauteng Department of Health we will continue to upgrade health care infrastructure across the province. Our focus is on ensuring compliance with occupational health and safety standards and refurbishing facilities to enhance usability of both patients
and health care providers. These initiatives are integral part of our support in effective service delivery and improve health care outcomes.
The Gauteng Department of Health again deeply appreciates the allocated conditional grant which is the funding from the national Health department amounting to R14,3 billion. This funding places an important role in supporting tertiary health care services, advancing HIV and Aids initiatives and furthering the training of health care professionals across the province. It enables us to expand critical health care services, enhance medical infrastructure and improve health care delivery efficiency.
Moreover, we are committed to the prudent financial management and accountability in the allocation and utilisation of these funds. We strive to ensure that every rand is accounted for.
We maximise its impact on improving health care outcomes in addressing health care challenges faced by the communities.
As the Gauteng Department of Health, again, we are proud to pride ourselves on creating a conducive environment and serving our people with a smile. Our commitment extends beyond clinical excellence to ensure that every interaction with
health care service is supportive, compassionate and respectful.
In fostering a positive atmosphere and prioritising patients’ welfare, we aim to instil confidence in our health care system and foster lasting relationship in our community.
In conclusion, as we said before, we remain resolute in our mission to enhance health care accessibility, quality and equity for all residents of our province harnessing innovation, investing in our workforce, upgrading infrastructure and leveraging financial resources effectively and efficiently. We are prepared to address current challenges and build a resilient health care system that meets the needs of today while preparing for the future demands. Thank you, hon Chair of committees. “Ngiya bonga” [Thank you].
Ms S M MOKOENA: House Chair, Minister Motsoaledi, Deputy Minister Phaahla, and hon members and distinguished guests, it is an honour and a privilege for my party uMkhonto weSizwe to stand here and represent the hopes and aspirations of the working poor and the unemployed of our country in the Budget Vote 18, whose hopes and lives rely heavily on our public health system.
Section 27 of our Constitution states that everybody has a right to access health care services. Therefore, uMkhonto weSizwe Party will stand firmly on the principle of equal quality health care at every facility in South Africa.
However, the reality on the ground starkly contrasts the ideal our public health system is riddled with insufficiencies and inequalities that affect the most vulnerable amongst us. If you are a young black person or a black person like me, you have experienced the appalling services that the patients receive simple because they cannot afford medical aid. The system neglect is a clear violation of our constitutional mandate and the disgrace to our nation’s principles of equity and justice.
Minister, I acknowledge the clarity that you gave earlier on the National Health Insurance, NHI, but we still believe that as it stands, it brings no hope for the real people on the ground. In simple terms, it is nothing but the outsourcing of public healthcare into the private. Furthermore, over 40% of South Africans consult traditional healers, yet too little has been done to integrate traditional healing into the mainstream health system, despite the National Traditional Health Act.
There is a need for institutionalised research and development for a standardisation and regulation of traditional medicine. Integrating traditional healing practices into our health system can enhance accessibility and provide culturally relevant healthcare solutions, especially to those of us who live in the rural areas and are underserved areas. Minister, from personal experience, not much has been done about the horrific long queues that are endured by pregnant women in many hospitals. I am talking about places like Harry Gwala Regional Hospital from my hometown, places like Grange Youth Clinic, Imbalenhle Clinic in Imbali. These conditions are unacceptable and highlight the urgent need for systematic reform and increased accountability within the health facilities.
Mental health care is another area where our system falls short. Patients suffering from mental health conditions are often ignored, stigmatised, leading to a significant stress and depression for their family. The distribution of mental healthcare facilities is uneven currently, which some provinces like Limpopo showing obvious signs of how tribalism, where services are concentrated in areas serving specific language speaking groups, insufficient mental health care beds
lead to some patients being discharged before being referred to appropriate healthcare facilities.
The Esidimeni tragedy is still a painful reminder of our failure to protect the most vulnerable amongst us. We must revitalise home care-based systems which have proven effective, providing healthcare, particularly in the elderly and in the children. Our people are still dying from preventable diseases. We must also acknowledge that the infant mortality rate is still frighteningly high. People in deep rural areas do not even bother to call ambulances anymore, as these services are non-existent. This is a tragic sign of the lack of trust in our emergency services and urgent need to improve these in our areas.
The District Health Programme Grant is intended for the implementation of important programmes such as cancer, HIV/Aids, tuberculosis, TB, etc. Despite this, patients from provinces such as Mpumalanga and Limpopo are still being transported to other provinces for treatment due to lack of facilities and specialists.
Hon members, the challenges facing our health systems are immense, but they are not insurmountable. With strategic
reforms and a commitment to equity and excellence, we can transform our health system into one that truly serves all South Africans.
We also need a government that is committed to the expansion of these universities: Mpumalanga University, Lipompo University and Walter Sisulu University. So that these institutions have enough space for expansion. Expanding our medical education infrastructure is critical to training the next generation of health professionals in this country and addressing the skills shortage in the sector.
As the uMkhonto weSizwe Party, our mandate is very clear, we call for an increase in primary health care education. We believe that prevention is much better than cure. Health education and promotion can empower individuals and communities to take charge in their health and reduce the burden on our system. Critical vacant posts need to be filled. Yet we still have unemployed doctors and nurses roaming around in our system. We also demand that all clinics be open 24 hours for seven days a week and not operate like businesses, opening 8:00 in the morning to 5:00 in the afternoon.
The Auditor-General, AG, has continuously found worrying findings within the nine provinces in South Africa, lack of backup electricity supply. And yet, we once had a Minister who challenged a court case on load shedding exemptions in our hospitals. This continues to be a challenge. There is also inadequate management of medicine. Lack of training and support to our healthcare workers and improper record keeping. It is time for bold and decisive action to overhaul our healthcare system and ensure that it serves the needs of all South Africans regardless of social economic status. We therefore reject this Budget Vote. Thank you.
Ms J M ADRIAANSE: Hon Chairperson, hon Minister, hon Deputy Minister, hon members, fellow South Africans, good day, I rise to address a matter of utmost urgency and gravity that strikes at the core of our nation’s values of dignity, compassion and especially accountability.
The Northwest province has become horrible. The scenes of neglect and despair in our state, hospitals, hospitals and nothing short of a national disgrace. About the delivery of healthcare services in the province, multiple facilities, experienced shortages of medication. Overcrowding, lack of cleaning supplies, limited emergency medical services,
inadequate staffing, vandalism, damaged wheelchairs and even sweat linens, hospital gowns and malfunctioning blood pressure machines. Patients are forced to navigate inhumane circumstances to access basic sanitation. This is not the standard our citizens deserve. This is not the South Africa we strive to build.
Let us turn our attention to the pressing issue of communicable a communicable disease. Even with the best doctors and medical ability, our efforts are undermined by lack of basic sanitation and hygiene and our health care facilities. We cannot effectively combat diseases when our hospitals themselves are breeding grounds for infections.
Dear Minister, I draw the attention of this esteemed House to an extremely important matter concerning the Charlotte Maxeke Hospital. It concerns the repairs and revitalization following the fire. Following the devastating fire that ravaged Charlotte Maxeke Johannesburg Academic Hospital in 2021, it is imperative that the department provides a comprehensive report on the progress of repairs and resuscitation efforts. Is the hospital now fully operational and have all services resumed to ensure interrupted service delivery? For the community, it
says. It is imperative. That our Community Committee takes stock as soon as possible.
We also need to know what progress has been made in the investigation. In addition, I call on the department to shed light on the financial commitment to maintaining the infrastructure and equipment of the health care system. How much funds have been allocated for these important tasks?
More importantly, how are the maintenance contracts monitored to prevent any instances of fraud and corruption that might undermine the integrity of the system.
In addition, it is essential that the department provides a detailed report on the hospital system sub programme outlining how they allocated are used to enhance the quality and efficiency of healthcare services. Transparency and accountability in the management of public resources sources or paramount to ensuring the well-being of all our citizens and the sustainability of our healthcare infrastructure. As representatives of the people, we have a duty to oversee and scrutinise the allocation and utilisation of resources to guarantee that they are directed towards improving the lives of all South Africans.
In conclusion, I would like to ask how it is possible that in 2022/23 only 57,7% of the national Department of Health targets will be achieved. At the same time, 97,4% of the budget has been used. We must ensure transparency and commitment to upholding the dignity and rights of every patient in our care through our oversight and demand accountability.
As this system reflects our nation’s values and it is time to put integrity and compassion back at the heart of a public service, we must finally stand together at the forefront of work towards a future that every South African can have. Thank you.
Ms D MASHEGO (Limpopo): Hon Chairperson, the chairperson of the portfolio committee hon Health Minister, Dr Motswaledi, hon Deputy Minister, Dr Phaahla, members of executive council of the province, MECs, of health, from different provinces, hon members of the House, ladies and gentlemen. It is always an honour and a great privilege for us as Limpopo to participate in the debates in this august House. Let me start by welcoming the speech by our Minister, Doctor Aaron Motswaledi, and I want to commend the Minister for his commitment to the National Health insurance, NHI. This
commitment goes well with the vision of the first democratically elected President of South Africa uTata Nelson, Mandela. President Mandela had showed his wish for the universal health coverage through the declaration of free access to quality health care for women and children.
Hon Chairperson, this happened during his term of office as the President of the Republic. This declaration was intended on reducing infant and maternal mortality. We should utilise the National Health Insurance, NHI, as a progressive vehicle towards the realisation of President Nelson Mandela’s dream of universal health coverage. Chairperson, there is no befitting way of celebrating both Madiba’s birthday and legacy than the practical implementation of the NHI. He laid a solid foundation during his presidency by building around 150 clinics and affording women and children free quality health care regardless of the size of their pockets. This administration has an obligation to turn the NHI into a moving vehicle in the quest to deliver accessible free and quality health care. We are happy that President Cyril Ramaphosa has signed the NHI Bill into law, hon Chairperson.
It is clearer now and necessary for us to expedite the introduction of the National Health Insurance, NHI. This
funding model propagates for an equal access to quality health care, giving no consideration to colour, ethnicity or religious background. The South Africans will get access to free quality and accessible health care regardless of the size of their pockets. Indeed, the National Health Insurance, NHI, will go a long way in solving our funding challenges. It is the duty of the Sevent administration to ensure that we roll out the National Health Insurance, NHI, for the total benefit of our people. Indeed, hon Minister, your speech succeeded to highlight the milestones we have traversed as a nation in the past 30 years of our freedom and democracy. There is no doubt that our multifaceted health care policy approach is beginning to pay dividends. As hon members would know, our health care approach is anchored on health promotion, preventative healthcare, curative and rehabilitative services. It is this approach which has seen us gradually winning the war against the burden of diseases, which undermines the full productive capacity of our people.
House Chair, there can be no doubt that the over R62 billion budget presented to this House will go a long way in improving functioning of the public health care system. We also appreciate that this is an increase of 3,5% from the previous R60,1 billion from the last financial year. This budget will
certainly complement our efforts to improve our health care facilities, hire more qualified and experienced health care professionals and specialists, and ensure that our facilities have a sufficient supply of life-saving medication. We want to take this opportunity to thank your leadership, hon Minister, in supporting the idea of an academic hospital for Limpopo Province. We are proud to announce that the actual construction of the hospital has since commenced. As you would know, this initiative will help create an important platform for research and training of medical students and other health professionals. It will also help provide clinical services at the highest level, such as heart and kidney transplant. Hon Chairperson, Limpopo is a province with its own unique demographic and population dynamics. Our province is a gateway to the rest of Southern Africa.
This dynamic comes with both opportunities and challenges. In most cases, as a province, we find ourselves having to deal with diseases, and outbreaks from our sister countries inside towns such as Musina, Makhado, Polokwane and Phalaborwa are truly cosmopolitan because they are a home of so many people from outside the borders of our country. This dynamic imposes a heavy burden on our facilities and our resources. This reality should inform our planning and resources allocation.
The Minister correctly raised some of the issues we have as provinces relating to what is supposed to be equitable funding for the public health care sector. The improved funding methodology should consider the differences in burden of diseases. We will take this significant debate to our provincial Treasury for consideration.
We believe that the implementation of NHI will go a long way in addressing challenges of access, improving public health funding regime, addressing issues of shortage of healthcare professionals and ensuring sufficient supply of medicine in our facilities. On behalf of the people of Limpopo, we want to add our voice to the collective in supporting the Budget Vote and policy statement as delivered by the hon Minister Aaron Motswaledi. We believe that the machinery is properly oiled and in good hands. We are moving forward to a destination of a healthy population and improved quality of life, I thank you, House Chairperson.
Setswana:
MODULASETULO WA BOSET?HABA WA KHANSELE YA DIPOROFENSE: (Rre D
R Ryder): Ke a leboga Mme Mashigo.
English:
We appreciate your input on the debate. We move on. Now is the time to welcome the Deputy Minister of Health, hon Dr Phaahla.
The DEPUTY MINISTER OF HEALTH: Hon House Chairperson, Deputy Chairperson of the NCOP, our chair of the select committee, my colleague the Minister of Health, Dr Motsoaledi, other colleagues, Ministers and Deputy Ministers present, hon members of the NCOP, MECs present and on the virtual platform, all hon members, ladies and gentlemen, I thank you very much for this opportunity to participate in the Budget Vote of our national Department of Health.
This Budget Vote takes place at a very significant time in the history of our country, firstly at the advent of our Government of National Unity, and as we concluded on 27 April this year, 30 years of freedom and democracy, which have changed the lives of the majority of South Africans. We are now at the doorstep of beginning the next 30 years of freedom and democracy, and to continue to build on what has been achieved.
A lot of ground breaking progress has been made in terms of improving the quality of life of the majority of South Africans. Various indicators recognised by both the World
Health Organisation, WHO, and other world bodies, including the United Nations, UN, attest to the fact that there’s been a lot of progress which can be quantified, and it is also undeniable, nevertheless, that a lot more needs to be done.
We have committed ourselves both in terms of our own goals under the National Development Plan, NDP, and under UN and WHO. The Seventh Administration, which starts this year until 2029, will be the last full five years of an administration before the conclusion of the targets set by the UN in terms of the Sustainable Development Goals, SDG, but also in terms of our own goals, which were set up under the NDP 2012. So, in my presentation here I will allude to some of those areas and indicate some of the progress and challenges.
In terms of the SDG, the relevant goal which falls under the SDG for health services is SDG 3, which commits us to achieve good health and wellbeing. It aims to ensure healthy lives and promotes wellbeing of all at all ages. Target 3.1 of SG3 commits us that by 2030 we should have reduced maternal mortality ratio to less than 70 per 100 000 live births. This is also aligned to the NDP Goal 3 under health which also speak not only to reducing maternal mortality but also reducing infant and under five mortalities.
We have made good progress in reducing maternal mortality ratio by 2019 in our endeavour to reach the 70 per 100 000 minimum. We had already achieved just under 198 per 100 000. We lost some ground at the height of the COVID-19 pandemic, during the years of 2020-21, but the figures had already bounced back by 2022, showing that we are again getting closer to serious reductions at the level of 109 per 100 000. This comes from very high levels of up to 250 in prior years.
In as far as the reduction of neonatal and under-five mortalities, again a lot of progress has been made. The SDG target is a maximum of 12 per 1000 live births. In this regard, we have made significant progress, having struggled in the beginning, but with the rollout of antiretroviral treatment and a number of vaccination programmes for preventable diseases of children, we have seen this progress being moved very drastically to the extent where by 2022 our neonatal mortality rate was just 12,7 per 1000, which means we are just a mere 0,7% closer to actually achieving the SDG goals.
Similarly, in as far as the under-five mortality where the UN has set the target of 30,7 per 1000 live births, we are moving very steadily already at the rate where we are ... in fact,
the UN has set a target of 25 and we are already at 30. So, a mere five per 1000 live births. All this is due to various interventions which are in fact making a significant impact.
Contrary to what the hon member from the EFF was shouting here, that there is no progress, numbers don’t lie. If you look at all these various indicators, they actually show that there’s significant progress which has been made and continuing to be made in reducing mortality rates and in making sure that South Africans live longer.
In as far as the NDP on life expectancy, the NDP project us to commit that by 2030 South Africans should be living an average of 70 years - both males and females. Just before COVID we were already getting closer to that, having surpassed 65 years on average. We were then knocked down by COVID, but again we have already started to rebound and approaching the 65 years of average life expectancy for males and females.
In the area of maternal mortality, I must just mention that the things that drag us backwards are amongst others, the continuing stubborn teenage pregnancy - because most of the mortalities are found largely in those who are not yet matured to be pregnant - and neonatal mortality because those babies
are usually born premature and result in these stubborn numbers. However, with our roll out of reproductive health services, we are quite confident that this will also be defeated.
In as far as another major target set by both the UN and our own NDP, is that of defeating HIV and Aids, TB and malaria as public health threats. We are also making significant progress in this regard. In the area of HIV and Aids, the UN under the UNAIDS has set all countries a target that by 2020 we should have reached an average of 90% people knowing their status, 90% on treatment and 90% suppressed, as hon Patric Sibande mentioned, and reaching 95-95-95 by 2025 which is next year.
I am pleased to say that we have reached the first 95 as the country, but we are still grappling with the middle 95 of sustaining treatment because, as a result of COVID-19 especially, we lost quite a few people who were already on treatment. We have already embarked on renewal strategies to make sure that we can catch up.
In the area of tuberculosis, significant progress has been made, and none other than the WHO itself has assert South Africa as one of the few countries which are likely to realise
the target of making sure that by 2030, we would have dealt significantly with TB as a public health threat.
Similarly, malaria is not a major issue in South Africa except for three provinces, but a lot of progress has also been recorded in this regard, not just by ourselves but by international bodies.
So, hon Chair and members, I want to say that indeed we are on course to make sure that the targets set by ourselves in the NDP and under the United Nations and other international bodies, we will be able to achieve, not alone as government, not as the Department of Health, but as all of government all of society. I thank you.
The HOUSE CHAIRPERSON (Mr D R Ryder): Thank you, Deputy Minister Phaahla. As we prepare to call the next member, I would like to remind people that are participating virtually, please it is required that you turn on your cameras even it is if it is for a short while. Please, we would like to see your face. For those that debate regularly, virtually, we do prefer a picture on your identifier so that at least when we can’t take a live video feed, we can at least see your face. Having
said that hon members, I would like to call the Mpumalanga MEC for Health, hon S Manzini.
Ms S MANZINI (Mpumalanga): Hon House Chair of the NCOP, hon Minister, Deputy Minister, hon members of this House, distinguished guests and my colleagues, MECs from different provinces, I rise on behalf of the ANC - the people’s movement
- and the 5,1 million people of Mpumalanga - the province of the rising sun - to add our voice in congratulating Dr Motsoaledi on his reappointment and engaging on the budget, also the Deputy Minister.
As we engage the budget and policy speech in front of this House, I have no doubt in my mind that any person with a sound mind would agree that the budget and policy speech was honest, visionary, and seek to place health at the centre of South Africa’s development agenda. Congratulations once more, Minister. It is now common cause that this month we celebrate the life and times of President Nelson Mandela. A noble son of the African soil who permanently departed the land of the living in 2013. President Nelson Mandela taught us:
We must ensure that treatment is made available to those who need it, most especially to those who cannot afford it. Health
cannot be a question of income; it is a fundamental human right. We must give people hope that it is possible to lead a healthy, fulfilling life.
The budget policy speech we are debating here today is testimony of our commitment to fulfilling Madiba’s wishes of ensuring that those who cannot afford has access to quality healthcare. The budget and policy speech brings hope to the down so that living a healthy life and is possible in a democratic South Africa, irrespective of the size of your pocket.
The Minister has outlined in terms of what it means in terms of National Health Insurance, NHI. For us as provinces is to make sure that we give progress as far as how far are we in terms of implementing. The budget policy speech brings NHI at the centre of the health agenda and allows us to address a number of issues in the health sector which relates to the unequal structure of the nation’s health system. Our health sector is characterised by stark inequality based on race, class and gender. For example, the data in terms of Statistics SA General Household Survey 2018 reveals that only 16% of South Africans have access to medical aid as outlined by the Minister.
The budget and policy speech places primary healthcare at the centre of delivering health services. In this financial year, various health studies proved that South Africa’s health system is overly curative. This has significant implication for health service cost and the nation’s disease profile. A clear example is the continued rise of non-communicable or lifestyle diseases. South Africa requires a preventative health paradigm and system which is not over dependent on curative health technologies and intervention.
The policy and budget speech and the NIH provides the building blocks for such a system through prioritisation and institutionalising the primary healthcare module. It focuses on health system decentralisation through community health care workers, school health teams and district health structures. These institutionalised arrangements are more suitable for achieving primary healthcare within communities.
As part of our commitment to strengthening and expanding primary healthcare services - a top priority in the province - we are dedicated to ensuring that all our people have access to quality healthcare. And currently, I can probably report that 287 out of 292 clinics have attained ideal clinics in the province of Mpumalanga. It is worth noting that out of that,
126 of these clinics have already been certified and complied in terms of the Office of Health Standards Compliance. Meaning that Minister, if tomorrow you want to implement NHI, Mpumalanga can have 126 clinics to say that we have started to become ready as a province so that when you finally start implementing the NHI, the province of Mpumalanga is ready.
As a province, we have provided training to a total of 294 Cuban doctors that have qualified. Their training emphasises primary healthcare and community medicine. Furthermore, the province has contracted more than 47. But also here Minister, you will find exactly what you said that people follow money. You might have money to contract GP, but because it’s in a rural province of Mpumalanga, they are unable to go, they want to go to the urban. So it’s exactly what you have said in your budget speech. So we want to make sure that ... [Inaudible,]
... service to primary health care facilities. This initiative aims to bring expert healthcare services closer to the communities, insuring that people can access quality healthcare conveniently within their local areas.
Seven of the provinces have established 253 Ward-based Primary Healthcare Outreach Teams, PAC, programmes aimed at enhancing healthcare accessibility and provision at the household level.
The initiative is strengthened by the deployment of 5 348 community healthcare workers, all of whom received stipend. Also we are working together at the NSC level to make sure that we improve what they are getting in terms of a salary, but we need a model. So the issue of the community healthcare is not like at the level of the Minister and NSC. We are ignorant and we are also not recognising the work that they are doing. They have done a good job, and we are continuously making sure that we improve in terms of what they are getting as they support the primary healthcare.
The Central Chronic Medicines Dispensing and Distribution programme has expanded significantly, reaching 901 ... [Inaudible.] ... patients by 2024-25 from 507 313 in 2022-23 alongside the full implementation of the health patient registration system across the 292 facilities with an impressive 85% patient satisfaction rate in primary healthcare facilities meeting the national target. These are the people who are saying, we are visiting your clinic, and we are happy, without being forced by us. This is the feedback that we are getting. So more than 85% of the people that you are providing services to Minister, they give feedback to us in terms of the services. You can say it when you are not receiving ... But also Minister I can say to you, the very same people who are
saying that we are unable to provide services, when their medical aid is finished and they are transferred to a hospital, and they call us. MEC, can you arrange for us? To go to the very same facilities that they are saying we are not ready, only when we must implement NHI.
We can say that in the province we have these state-of-the-art hospitals, Middelburg, Bethal, Mmametlhake, Balfour clinic, Kwazamokuhle, Delmas, just to mention a few. But we can say that the piloting also in Gert Sibande has ... [Inaudible.]
... in terms of the results of the ... [Inaudible.] ... Indeed, there is progress that we see.
Priority has been placed on ensuring that consistent availability of medicine and medical suppliers. Currently we can say that in terms of the primary healthcare facility, we are standing at 90%. Meaning that we have reached the national target. Systems have been implemented to monitor medicine availability in our facilities, our clinics and hospitals for a certain primary healthcare ... [Inaudible.] ... system. This shift towards primary healthcare support and health model which is advancing the ... [Inaudible.] ... publication entitled Epidemics and the Health of African Nation. This
model connects diseases burden to social, economic and environmental and cultural sectors.
The budget and policy speech remind us that health is not just a medical issue, but a human right and a socio-economic issue. This point was properly emphasised by Martin Luther King Junior when he stated that: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” There are many other socioeconomic factors that impacts on health. These factors include income, education, employment, water and sanitation and community safety.
According to NDP, South Africa health system is based on the principle of primary healthcare and the district health system. Primary healthcare system refers to universal access, equity and participation and integrated approach. It includes focusing on prevention first with a patient focus approach and a district health system is supposed to be decentralised area based and people centres. Hence, we have so many programmes, Cheka Impilo and also working with our traditional leadership where we go to their facilities in terms of extending.
Everyone must know their centres in the province of Mpumalanga. We must appreciate that AboNdabezitha and all different sectors are joining hands to say, health is everyone
else’s business. However, this is not what is happening. In reality as I have stated earlier that South Africa has imbalance and ... [Inaudible.] ... between the public and the private sector, from spending to distribution of services.
The NDP notes that:
The inability to get primary healthcare and the district health system to function effectively has contributed significantly to the failure of the health system.
There are further issues that we are always saying that we are point fingers, but also what the Minister has said in terms of the reality is the is the reflection of what we are seeing and what is happening on the ground. Lack of accountability with reconstruct links between different levels of services. And you can say that the aim is to have the health system that raise the life expectancy of South African to at least 70 years. It would include dealing correctively with HIV and reducing ... [Inaudible.] ... and violence and substance abuse.
According to Statistics SA midterm population, it has estimated that South Africa’s life expectancy increased from
55.1, in 2001 to 57,1 in 2011 and now 6,5 in two years. We will continue with integrated effort to achieve the target of
70 years by 2030, and this comes out very clear on the budget and policy speech of the Minister.
This budget and policy speech allocates significant resources to combat communicable and non-communicable disease. It also invests in the recruitment and training of healthcare workers, as well as medical research and innovation to ensure that our healthcare system remain all at the cutting edge of science and technology. While we may have put the COVID-19 pandemic in the ... [Inaudible.] ... this speech demonstrate commitment in public health goes beyond the pandemic and the budget policy recognised that ... Yes, we support the budget. Thank you very much. [Time expired.]
Ms T BREEDT: Hon House Chairperson, the department envisions a long and healthy life for all South Africans. This week, this was not the case for a toddler in Botshabelo in the Free State that passed away after a tooth extraction. In this same week, there was also another death in the Free State that the provincial Department of Health is investigating. And this just emphasises the problems that are faced by this department and that we are a long way from what we need to achieve.
The mission, vision and mandate of the department further goes on to say it aims to consistently improve the health care delivery system by focusing on access, efficiency, quality and sustainability. Currently, this is but an idle dream that the department thinks will be saved by the NHI, but I have bad news, the NHI will not magically fix the deficiencies that are being experienced in this sector.
Afrikaans:
Gesondheidsorg word gekniehalter, weens ’n gebrek aan onvoldoende hulpbronne, beperkte of geen voorraad van medisyne, ’n tekort aan personeel - dokters, verpleërs, en ander paramedici – en verouderede en stukkende infrastruktuur. Die probleem is nie moielik om op te los nie. Stel meer personeel aan, die wat by die huis sit; maak seker medisyne is in voorraad, doen jou voorraad opnames elke maand, en doen gereeld herstelwerk en opgaarderings aan infrastruktruur.
Wat ook kommerwekkend is, is die begroting en hoe dit tans verdeel is. En ek sal graag spesifiek na oordraagbare en nie- oordraagbare siektes wat in Program 3 is wil verwys.
English:
In Programme 3, we see that six subprogrammes receive less than 1% of the programme’s budget. This includes TB management; women’s maternal and reproductive health; child youth, school health and noncommunicable diseases, NCDs; and the health promotion and nutrition subprogrammes. This is extremely worrying, taking into account that 23% of children in South Africa live in severe child food poverty and are at the risk of life-threatening malnutrition and related health complications. I do not need to expand further on how these implications impact children.
Afrikaans:
In program 4, wat primêre gesondheidsorg aanspreek, is een van die departement se tykens om toe te sien dat 2 700 primêre gesondheidsorg-fasiliteite na die ideale klinieke omskep word. Hierdie gaan ’n uitdaging wees, want klinieke soos die in Hillstraat in Kroonstad val uitmekaar uit. Die plafonne het gate in, die toilette en wasbakke is gebreek, daar is sekuriteitsprobleme, ’n personeeltekort en die personeel wat daar is, se kontrakte word nie hernu nie, die fotostaatmasjien werk nie en dan is die rekenaar boonop gesteel. Daarom werk die telefone wat hulle egter vir Boitumelo Hospitaal moet leen, want hulle telefone werk al sedert Januarie nie.
Program 4 verwys ook verder na nooddienste soos ambulanse. Wat ’n katarsis! Ek weet van verskeie gevalle regoor die Vrystaat waar ambulanse nooit opgedaag het nie en in sommige gevalle was dit telaat.
Dit is nodig dat daar aan vereistes voldoen word, om seker te maak dat ambulansdienste aan die vereistes voldoen en dat dit nie net tenderpreneurs is, wat dink hulle kan die werk doen nie.
English:
Programme 5 speaks to the hospital systems and this, with all due respect, is no better than primary health care facilities. Facilities must be upgraded and need to have the basics like beds and linen and working telephones and an operating casualty ward, which is he first engagement.
Minister, you also had a lot to say about Cuba and the way that they manage health care, but I fear you look at them too much and should focus on issues back in South Africa. During my tenure in the Free State legislature during the Fifth Parliament, the department admitted that multidrug resistant TB was because of Cuban doctors who make wrong diagnosis. And let me just say this, if a country does not have a disease, it
does not necessarily mean that they eradicated it. It can also mean that there is not prevalence in that country.
Afrikaans:
Ek het met verskeie medici gepraat en hulle is eens – die gewilliges, wat ’n verskil maak, moet gebruik word. Suid- Afrika het die beste dokters en ander medici in die wêreld. As ons saamwerk, kan ons die gesondheidstelsel herstel en bou. Ek dank u.
IsiXhosa:
Mnu. M M PETER: Sihlalo weNdlu, mandibulise ngale njikalanga, ndibulise phaya kuMbhexeshi oyiNtloko we-NCOP, kuMphathiswa Motsoaledi, namalungu ahloniphekileyo. Mphathiswa, sigxwala phezu kwakho kuba izibhedlele zigcwele kwaye abantu abaphili. Iklinikhi zigcwele zizigulana, aziphili ngokunjalo nasezikhemesti. Ingaba la mayeza siwathatha kwamanye amazwe ayakwazi kusini na ukwenza abantu baphile ngokukhawuleza?
Makhe sijonge kwezi nzululwazi nizithembileyo, zala mazwe khe ziqwalasele ukuba ngenene nangenyaniso la mayeza ayasebenza kusini na.
Mphathiswa wam omhle, amayeza ezibhedlele awekho. Izibhedlele zishokoxekile, azinamayeza. Makhe sijonge phaya kukhuseleko
lwezibhedlele. Abasebenzi basezibhedlele basebenza phantsi koloyiko. [Inaudible.] ... Mphathiswa kula masebe. Ndisuke ke apho, ndiye kucoceko lwezibhedlele. Siyi-UDM sithi thina siyakuxhasa kuhlahlo-lwabiwo mali lwesebe lakho. Sikuxhasa sisithi, noxa nje sizibona ezi ziphene, loo nto ayithethi ukuba singakuxhasi. Sikuxhasa kangangoko Mphathiswa kuba xa singakuxhasi, sakube sithi, abantu bethu mabangayi ezibhedlele, mabangaphili. Asikwazi ukungaluxhasi olu hlahlo- lwabiwo mali noxa nje sikhala, sisithi kodwa iziphene zikhona zona.
Okokugqibela Mphathiswa, imbi imeko yoogqirha kwaye isebe makhe liyiqwalasele. Asikwazi ukuba sithathe abantwana apha, sibase eCuba, babuye bangasebenzi. Sisithuko eso. Lo mdolomba ungaka, woogqirha abangasebenziyo mawukhe uzanywe ukuncitshiswa, hleze udale inxakamo kwilizwe jikelele.
Makubekho indlela yokujonga nokulandelela ezi nkampani zicoca kwizibhedlele ezisemaphandleni apho ucoceko lungavamisanga ukuba semgangathweni ophezulu. Besinokuthanda nathi xa ninokusinika olu xanduva lokuba sinijongele ezi bhedlele.
Mhlawumbi singenza ngcono xa sinokungena ngokwethu. Siyakucela Mphathiswa. Enkosi.
Mr F J BADENHORST: Hon Chairperson, hon Minister and Deputy Minister, hon members, and fellow South Africans, good day. Just before I start, hon Arries, from the EFF, thank you so much for that invitation to the 11th birthday party of the baby that is getting slightly older. I wish I could say that the baby is getting slightly bigger, but it is not. There must be a reason why you are inviting us to your birthday party if you can’t get voters to go. Anyway, let’s move on.
It is a pity, Minister, that you came today to attend this Budget Vote on Health, and you deliberately made it a National Health Insurance, NHI, debate. Your Deputy Minister set a good example by making it a debate about health. You came today and said let’s talk about the NHI. So, now, let’s talk about the NHI because the NHI is probably one of the reasons why the ruling party has become the majority party after the last elections. Let us not be fooled by the panacea the NHI is being made out to be. It has major flaws. The obvious is how it will be funded. The opportunity it provides for corruption, and please tell me, over the last 30 years in this country’s history where there has been no corruption when you try to centralise something under a politician in a Ministry. It happens. It happened in the past and will happen in the future if you do that. The impact on medical aids and ultimately the
backtracking in universal access to health care will be devastating.
You cannot present an ideological solution to a health care problem without consulting the expert health care industry that exists in South Africa, and that is what has happened with the NHI here. Make no mistake, the DA has always been in support of universal health care, especially for the poorest of the poor. However, the NHI in its current itineration will not be able to realistically provide reasonable health care to all people in the current climate in South Africa. By removing the two-tier health care system, you will now be overloading an already overburdened public health care system.
Citizens currently using private health care will be required to use public health care, flooding the system and putting strain on the facilities that are already unable to cope. This has the potential to lead to a reduction in the quality of health care for everyone. The DA is committed, and I want to stress this again, to universal health care for all citizens. The key to achieving this over the next five years is to make the current district management model work through governance reforms by leveraging the strength of the private sector in
partnerships with the public sector, we can improve health facilities and the quality of care for all.
The devil is always in the details, Minister, and I know you have 20 minutes left to come and speak to us again after me. So, please use those 20 minutes to tell us exactly, as I conclude, where the estimated R200 billion per year will come from to fund the NHI. Some say it is a trillion rand a year. Come and tell us where you will find this money. Which health services will be available under the NHI, and which would be out-of-pocket expenses for patients? Come and tell us because, to this day, the Department of Health are unable to give us this information.
What will happen in eventual death? In 2021, the Eastern Cape owed R920 million in medico-legal claims and approximately R39 billion in contingency liability in unresolved claims.
Will the fund be responsible for these debts? How will this affect service delivery to other provinces? Thank you. [Time expired.]
Sepedi:
Mna M F MOKWELE: Modulasetulo wa Ngwako wa Palamente ya Bosetihaba yeo e hlokometiego diprofense tia Afrika-Borwa tie senyane, mohl Refilwe Mtsweni-Tsipane ...
English:
... also allow me to extend my greeting to the Deputy Chairperson of the National Council of Provinces, hon Govender, ...
Sepedi:
... gape ntumelele ke iie madume go Sefepisegolo sa yona Ntlo ye, mohl Mmoiemang ...
English:
... to hon members who are present here in the august House and those that are on the virtual platform, and the MECs that they have joined us also on the virtual platform and all sector departments that are here.
Chairperson, allow me to send the special greetings to our hon Minister, Dr Aaron Motsoaledi, and his Deputy, Dr Joe Phaahla. I also want to take this opportunity, Chairperson, to congratulate hon Dr Aaron Motsoaledi and his Deputy, Dr Joe
Phaahla on their renewed mandate, as we know that they are not new in this department.
Sepedi:
Re rata go le lebogiia, mohl Tona le Motlatiatona. Re tseba gabotse gore ...
English:
... in this department, ...
Sepedi:
... le bokadijela ba ka mo kgorong, ga le ba baswa.
English:
You know where you will take South Africans to, in order to make sure that, ...
Sepedi:
... bophelo bjo botelele bo tiwela pele....
English:
Chairperson, before I present on behalf of the committee, I just want to raise a small concern from an hon member from the EFF, those who portray to represent the poorest of the poor,
but they come to this august House to say that they reject the budget which seek to reverse the societal inequality that affect the people that that they pretend they represent. I am very much disappointed, but nonetheless, they will learn as we present.
As the committee, we received a presentation from the Health Department on Budget Vote 18, which shows to us, as the committee, that the department knows exactly where they are taking South African to, to make sure that South Africans live much longer. Chair, I am not going to dwell much. That is why, as the committee, we never hesitate to approve the budget book as presented by the Department of Health.
However, I will just venture on the situation that impacted our infrastructure in South Africa. The Covid-19 pandemic period marked the dark period in the global health sphere, claiming millions of lives. In our context, the pandemic also exposed our country through health care infrastructure, and how this impacts the ability on our health system to efficiently address health crises.
The country’s underdeveloped and strained infrastructure was evident through the measures which had to be undertaken to
respond to the pandemic, such as tents being set up to create more physical space to attend to patients.
Furthermore, our health care system had to expand human resources and repurpose existing spaces to make temporary testing stations and different facilities being outsourced as quarantine sites. Yeah, hon Chair! I want to applaud the province of Limpopo as one of the provinces, which during that situation allowed the quarantine sites to be set up in that province. I want to applaud the then Premier, Stanly Mathabatha and his predecessor, Premier Phophi Ramathuba, the then former MEC for health in Limpopo.
Chairperson, although the Covid-19 pandemic exhibited existing fractures in our health structure prior to the pandemic, numerous interventions had already been undertaken to improve the quality of our health infrastructure. For instance, the Ideal Clinic Framework was introduced in 2015 as a quality assessment initiative to measure the quality of health facilities.
According to this framework, at the end of 2020, about 59% of primary health care facilities had attained the ‘ideal clinic’ status. Despite all hurdles or despite all the challenges on
the path of getting primary health care facilities to obtain ‘Ideal Clinic’ status since inception, there has been an overall improvement from 2015, from 9% to 69%, by March 2023. Gauteng Province is reported to have improved from 24% in 2015, to an ‘ideal clinic’ of 79% - almost 100% - in sampled clinics.
In 2023, the KwaZulu-Natal province is also reported to have improved from 23% to 92%; and the Western Cape Province improved from 16 to 82%. The ‘ideal clinic’ status strides are also being undertaken in other provinces, where the Eastern Cape province, for instance, is reported to be at 25%; and Limpopo province at 23%, respectively. Hon members, in addition, the Ideal Hospital Framework has developed and commenced implementation in 2020. It is allocated at about 11%, translating to about 25 district hospitals having been designated as ideal.
Furthermore, the department has rolled out the National Quality Improvement Plan to 70%, and the public health facilities, making: 344 quality learning centers; 2 579 primary health care facilities; 259 public hospitals; 118 private hospitals; and 75 emergency services have been established.
That is why I was surprised when I was listening to our hon members when they said there were no strides since the dawn of democracy. Therefore, the significant role of improving our health infrastructure for the successful implementation of the historical National Health Insurance, and delivery effective health interventions to our people, cannot be overemphasised.
Through the continued implementation of the NIH, the Budget Vote will allow the department to continue to invest in improving and expanding our system infrastructure. Through the establishment of the robust and resilient health care system, our country will be better positioned to deal with health threats, such as Covid-19 pandemic. Yeah, hon Minister! As the committee, we want to assure you that we will walk along with you to make sure that indeed we are dealing with those social ills, making sure that all people are equal when we come to health services. We will walk with you!
Chairperson, the Covid-19 pandemic in South Africa unfolded against the bedrock of long-standing epidemics, such as HIV. This intersection was bothersome, not only on the infrastructure and human capacity of our health of our health care services, but also for the people with HIV, who had 30- 50% more likely to die from Covid-19, before the rollout of
vaccine. Also here, Chairperson, we want to applaud our President, the President of the ANC, President Cyril Ramaphosa, for making sure that he went all out in the country to save the lives of South Africans.
Due to the escalated rate of Covid-19 infections and the deaths, critical resources and structure establishment for the HIV management had to be redirected to manage the pandemic, such as testing services centers. The reallocation of resources resulted in difficulties for patients to obtain their medicines and contain access for testing facilities, access to condoms, as well as people participating in benefiting from awareness programs and other preventative measures.
The unintended consequences of Covid-19 interventions on HIV, include, interrupted treatment, which increases risk of drug resistant and transmission of heightened chances of HIV positive people contracting Covid-19 due to the weakened immune system, as underlying medical issues. In addition, the effect of this disturbance also increased the likelihood of people dying from both HIV and Covid-19.
Therefore, the convergence of the two health crises has demonstrated the need to reinforce the resourcing and capacitation of the health sector, in order to develop an agile and robust system which can provide adequate health care, particularly for the poor and vulnerable people.
Hon members, prior to the outbreak of the pandemic, South Africa was facing systematic and structural challenges, such as poor economic performance, which deepen inequality and threaten nation building. The emergence of Covid-19 increased existing vulnerabilities and inequalities of these fractures. The pandemic highlighted how having a strong infrastructure is instrumental in health preventative measures, in the testing and screening of people, thus leading to an early diagnosis and treatment.
Chairperson, in addition to improving our system infrastructure, which is instrumental for data collection, this enabled us to better understand the health patterns timeously, intercepting outbreaks and minimising the spread and the impact. Furthermore, accurate and updated health information better informs the allocation of human and financial resources to effectively respond to the crisis, such
as tracking for HIV or TB patients who need to be on treatment and on those who may have fallen off.
Does this encourage better monitoring capability? In line with the priority of the department, we support commitment aimed at improving the quality and standards of our health system.
Especially, we are encouraged by the commitments of the following: Expanding the achievement of the ‘ideal’ status of about 2 650 public health care facilities and 25 district hospitals; visiting 14 000 000 households for health screening services; linking community to facilities for appropriate care; as well as tracing patients that are lost to care, significantly contributing to gain, in both TB and HIV treatment.
Therefore, we are encouraged by the commitment to strive in improving the compliance quality and efficiency on our health care system. Such interventions go a long way in boosting public confidence in our health care system and lay a solid foundation for the successful implementation of the National Health Insurance.
We are also encouraged by the technological advancement which seek to make our system seamless and more patient centered, Minister. These collective efforts are the core of ensuring that South African health care system is responsive, innovative and result driven.
As I conclude, hon Chairperson, we seek to build from the lesson of health challenges and liberalism, more extensive investment and the progress made over the past 30 years, to build a better system, which embodies the principle enshrined in our Constitution, better aligned with global community and declared by the World Health Organisation’s statement, that, “All nations should strive towards the realisation of universal health coverage.” Thank you, Chairperson.
Mr F J BADENHORST: Hon Chair?
The CHAIRPERSON OF THE NCOP: Hon Badenhorst?
Mr F J BADENHORST: Hon Chair, may I rise on a point of clarity, please? [Interjections.]
The CHAIRPERSON OF THE NCOP: Okay
Mr F J BADENHORST: Hon Chair, in terms of our Rules – it’s just an absolute clarification for myself. In terms of our Rules, the Rule 60 regarding time limits for speeches - it says under 2(b), other delegates may not speak on a Budget Vote for longer than 10 minutes at a time, or on any other business before the Council for longer than 30 minutes at a time. The previous delegate, as far as I know, is not the President or the Deputy President, or the delegate in charge of the business before the House, and that delegate had 20 minutes. I should get clarification on that please. Oh sorry,
15 minutes.
The CHIEF WHIP OF THE NCOP: Chairperson?
The CHAIRPERSON OF THE NCOP: Hon Chief Whip?
The CHIEF WHIP OF THE NCOP: Chairperson, we have indeed rectified the area of concern that the hon Badenhorst is raising. So, that has been corrected. Thank you.
The CHAIRPERSON OF THE NCOP: Now that the Chief Whip has responded, indeed, what has happened, hon Badenhorst, you would notice that the Minister was equally allocated 20 minutes to wrap up the debate, but that has since been
corrected. He has now been afforded only 5 minutes to wrap up the debate. So, the previous speaker was allocated 15 minutes by his party and accordingly the Minister will wrap up in 5 minutes time.
Mr F J BADENHORST: Thank you. I was going ask you in my follow-up question about the Minister’s allocation, but just to clarify my question, the delegate who spoke now what was the delegates position in the NCOP? What was he here as? What was his ... because the Deputy President and the President is allowed to speak for longer than 10 minutes on a Budget Vote.
The CHAIRPERSON OF THE NCOP: Hon Badenhorst, as I have indicated that the matter has since been ratified because there was a technical error that we have picked up, hence we have reduced the time of the Minister to cater for the time that has already been spent by the member. So, it will not happen again, and it has since been ratified. If it will just accept that ...
Mr F J BADENHORST: Thank you, Madam. Thank you very much.
The CHAIRPERSON OF THE NCOP: And yes, we’ll indeed make sure
that we get back on track in accordance with the Rules. Thank you very much. [Interjections.] Yes.
The MINISTER OF HEALTH: Hon Chairperson, let me start with the perhaps the easiest and assure my sister from the MK party, hon Mokwena, that in the department we make use of all the systems and methods of health care. That is why we have got statutory bodies which deal with that. We have the Health Professions Council of South Africa, catering mostly doctors and dentists. We have the SA Nursing Council, we have the Allied Health Professions Council of South Africa. We have the SA Dental Technicians Council, but we also have the Interim Traditional Health Practitioners Council and the membership is paid into the Department of Health and they have that council and when they come to meetings, we pay them to discuss their issues about traditional medicine. So, we haven’t thrown it away.
The other areas I wish to take ... The hon Breedt, sent me a message that she had to go. She will watch virtually. She said something here that really disturbed me - that in our initial discussion with the select committee, I mentioned Cuba. I’m still mentioning it - and I am mentioning it proudly so. Cuba is the one country that is practicing primary health care more
than any other in the world. It is a fact that they vanquished a lot of diseases that we see here every day, which we will never find in Cuba. It is for that reason why our medical students who trained in Cuba come here and finish 18 months
... others are saying it is because the health care system there is inferior. No, it is because when they come back here, they are going to see diseases which they have never seen in Cuba, because they don’t exist there. I am very disturbed when someone in the Free State run away from the truth and say that multidrug-resistance TB is caused by Cuban doctors. Oh my God!
IsiXhosa:
“Owuu, madoda!”
English:
South Africa is number one country on TB and that is well known, and it is recorded. One of the reasons why we are number one country with TB infections in the world is because we are paying the price for what happened in our country with minerals. In the eighties, South Africa used to produce 80% of the world gold. All this gold mine dumps you see here are carrying TB, and it is not surprising that the information about multidrug-resistance TB you got from the Free State. It is one of the top with gold mine dumps - the areas around
Welkom there. They have gold mine dumps and all that – those are TB mine dumps. That is what our country is suffering from. So, let’s stop blaming the Cubans, please.
Madam Chirwa, the issue of primary health care – you know you have the right in your opinion, but you don’t have rights to your own facts. Primary health care has long been defined for what it is. A special conference was called in the small town of Alma-Ata which was in the Soviet Union, in Kazakhstan, from
6 to 12 September 1978. They debated the issue of primary health care, what it is and why the world needs to move into it. Hundred and thirty-four countries were represented, and 67 international organisations debated this issue. Primary health care is not necessarily the clinics, it deals with prevention of diseases and promotion of health, of course, it also includes them. The EFF believes all we need to do in South Africa is to open clinics for 24 hours and the problems will be solved.
I also want to take this opportunity to answer the hon Du Plessis because she kept on saying that politics and health should not be mixed. In the same primary health care conference, and I am quoting verbatim - they took a resolution that the existing gross inequalities in health status of
people, particularly between developed and developing countries, as well as within countries themselves, is politically, socially and economically unacceptable and it is therefore of common concern to all countries of the world. So, you can’t health away from politics, they are interrelated.
The decision we took here in South Africa to put more money for the rich for health care is a political decision and that has caused some of the problems we are faced with. Thank you, hon Chairperson.
The CHAIRPERSON OF THE NCOP: Thank you very much, hon Minister. Once again, we want to take this opportunity and congratulate you on your appointment. We have trust in you and confidence in you that you will turn the sector around for the betterment of the people of South Africa. And of course, with your predecessor, who is your Deputy Minister – we wish you all the best in your endeavors.
Hon delegates, that concludes the debate and the business of the day. I would like to thank the Minister, the Deputy Minister, permanent delegates, the MECs, all special delegates and SA Local Government Association, Salga, representatives for availing themselves for the sitting. Members are therefore
requested to remain seated after the procession has left the Chamber for the briefing by advocate in preparation of the opening of Parliament address tomorrow.
Business of the day concluded.
The Council rose at 19:20.
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