Health MEC Bandile Masuku tables his inaugural budget before the Gauteng Provincial Legislature. In the speech, areas such as health facility upgrades and security as well as mental health services receive special priority. Read his speech in full.


Madam Speaker,

In the age where universal health coverage is an unstoppable global movement, we begin by recalling the words of President Nelson Mandela: ‘Health cannot be a question of income; it is a fundamental human right’. Today we know – as research shows – that access is no longer much of a problem, but quality is. This is why universal health coverage of high quality must be realised in our lifetime!

The National Health Insurance (NHI) will see us achieve social justice in healthcare within a generation. Countries like Botswana, Ghana and Rwanda are already ahead of us in terms of implementing their NHI models. There is absolutely no reason why Gauteng cannot spearhead the implementation of the NHI. 

Last week the country made remarkable progress when all stakeholders signed the Health Compact at Dr George Mukhari Academic Hospital. The Compact re-affirms the country’s commitment to the attainment of universal health coverage and asserts the fundamental principle of ‘One Country, One Health System.’ Indeed, the national consensus around the NHI and the Health Compact represents the greatest will of our people yet. 

Madame Speaker, 

It is a great honour and privilege to present the Health Budget Vote for the 2019/2020 financial year.  The total budget allocation provided for this financial year is R50.8 billion with nominal growth of 8.3%, whilst the real growth is 3% which is less than the Consumer Price Index indicator of 5.3%. The responsibility of leading one of the biggest public healthcare systems in the Southern Hemisphere is not taken lightly. 

Our priorities for the Sixth Administration year are centred on implementing the NHI, improving patient experience, improving clinical services, promoting public health education and; improving governance and leadership. 

Countries like Botswana, Ghana and Rwanda are already…implementing their NHI models. There is absolutely no reason why Gauteng cannot spearhead the implementation of the NHI.

Gauteng Health MEC Bandile Masuku

IMPROVING PATIENT EXPERIENCE 

Improving patient experience means compliance with National Core Standards such as; upholding patient rights, ensuring patient safety, ensuring that infrastructure is OHS compliant, and the improvement of clinical care. 

Infrastructure 

In line with our plans to get our facilities ready for NHI and making sure that they are OHS compliant, the current financial year will see us invest in excess of R1-billion for maintenance and refurbishment. 

Health infrastructure forms part of society’s social assets, and therefore important for eradicating asset poverty among our people. Some these resources will be directed to the ten hospitals requiring urgent improvements. In order to achieve the Premier’s mandate on prioritising the identified hospitals as a measure of transformation of healthcare in Gauteng, we will have to source additional resources towards the improvement of health care at Bheki Mlangeni, Jubilee, Mamelodi, Tembisa, Tambo Memorial, Edenvale, Dr. George Mukhari, Kopanong + Sebokeng ‘Complex’ and Thelle Mogoerane hospitals. 

The selection of these hospitals is not solely based on worst performance but also, on the potential of what an integrated, innovative and responsive health system in Gauteng can do. 

Improving staff morale 

Our staff is our greatest asset and pride. As part of the broader objective of changing organisational culture, improving staff morale will be a priority for the current financial year. Our staff works under challenging conditions and we have an obligation to make them feel appreciated. For this, we have allocated an initial R3 million for our Employee Value Proposition project. This is in addition to existing programmes such as the Employee Wellness and employee training.

We will recall that the two tragedies: Life Esidimeni and the Bank of Lisbon fire and other incidents across the province have had a huge impact on staff morale and perceptions of safety at work. 

The safety and security of our patients and staff is important. We have begun to stand up for our patients and staff against criminal elements

Gauteng Health MEC Bandile Masuku

Improving safety and security at our facilities 

The safety and security of our patients and staff is important for the system to function optimally and achieve better healthcare outcomes. We have begun to stand up for our patients and staff against criminal elements and we need the support of the community to win this battle. Coordination between Gauteng Health and South African Police Service (SAPS) is already underway. In the current financial year, R600-million is set aside to secure the safety of our patients and staff.  

I must also add that the process of exploring the insourcing models for security personnel has begun in earnest. 

IMPROVING CLINICAL SERVICES

Among other things, our priority on clinical services is about improving TB and HIV treatment, mental health services, accident and emergency services, maternal and neonatal services, surgical services and increasing 24-hour services. 

HIV/AIDS, STI and TB (HAST)

Madame Speaker, 

Gauteng remains the largest contributor in our national efforts to prevent and treat HIV and AIDS resulting in life expectancy rising to 64.8 years for males and 69.8 years for females according to StatsSA. 

We remain committed to the UNAIDS 90-90-90 treatment targets for combating HIV whilst maintaining close to 0% in mother to child transmission. For the current financial year, we will spend R4.9 billion for this important programme and an additional R443-million is allocated for XDR/MDR tuberculosis in particular.

Improving primary healthcare

Primary healthcare is the backbone of the health system anywhere in the world. The delivery of sound and proper primary healthcare services will help us reduce and manage the quadruple burden of disease, reduce congestion at our hospitals and save us money. In this regard, we have allocated R30-million to ensure that the last two remaining Community Health Centres (CHCs) in Zola (Soweto) and Boipatong (Sedibeng) edge closer to the national norms and standards in terms of their 24-hour operational capability. By the end of this year, all 32 CHCs across Gauteng should be providing comprehensive health services which include 24/7 access to X-Ray and laboratory services, maternity unit, accident and emergency services and pharmaceutical services. 

All 32 community health centres should provide comprehensive health services, which includes 24/7 access to X-Rays as well as maternity and emergency services.

Gauteng Health MEC Bandile Masuku

Improving mental health  

Arguably, mental illnesses are increasingly becoming a global epidemic. The Gauteng government remains committed to providing quality mental healthcare to our citizens. Psychiatric hospitals are allocated R1.4-billion this year. Of these funds, R347-million has been reprioritised within District Health Services to respond to mental healthcare needs which includes R202-million that is provided to Non-Governmental Organisations (NGOs) partnerships.

We have decided that the best approach to responding to the mental health epidemic is the ‘SANAC’ approach that involves civil society, business, labour and other sectors.  

Emergency Medical Services 

Emergency medical care is an important healthcare provision. It provides the public with swift medical care and creates ease of access to our health facilities free of charge to the indigent. A total of R49-million is allocated for fleet maintenance, tracking and improving security features. Furthermore, the provincialisation of Emergency Medical Services for Johannesburg and Ekurhuleni is going ahead as planned. Again, this is to ensure that we have more efficiencies and cost savings in the system. 

IMPROVING GOVERNANCE & LEADERSHIP 

Madame Speaker, 

We have accepted Premier Makhura’s mandate to build a people-centred, activist and responsive Government. It is for this reason that for the past 61 days, we have been on the frontlines of service delivery and engaging in the initial consultations with the Gauteng community and stakeholders. We are actively Growing Gauteng Health together with our people!

Gauteng Health has turned the corner and there is no turning back!

For the next five years, we will reposition Gauteng Health as an organisation that is patient-centred, clinician-led and stakeholder-driven. We are confident that our renewal efforts will restore hope and produce progress! 

We want to emphasise that part of turning the corner for Gauteng Health means that we must deal with leadership and governance issues progressively and decisively. A capable Gauteng Health Department will have a leadership with the right strategic orientation, high levels of ethical conduct and cutting-edge skills and knowledge. 

Gauteng Health is a learning organisation that takes advantage of 21st-century technology in order to modernise and change the manner we do things and thus impacting patient experience positively. 

A total of 1 974 posts will be filled in the current financial year with an allocation of R778-million.

Health MEC Bandile Masuku

Filling of critical posts

In order to improve the governance and achieve better clinical outcomes, we need the right skills in the right quantities. Although in Gauteng, the task of staffing our facilities is a fast-moving target, we are determined to meet the expectations.  A total of 1 974 posts will be filled in the current financial year with an allocation of R778-million. This amount also includes the grants for Extended Public Works Programme. 

We also wish to announce that all the 8 794 Community Healthcare Workers (CHWs) are now receiving their wages directly from Government, through the Persal system.  

In mid-August, the senior leadership of the Department will retreat into a Strategic Planning Session to ensure that our plans for the next five years are aligned with the expectations and the mandate from our people. The outcomes of the session will be communicated with all stakeholders. 

Funding model 

It is important to note that a large part of the appropriated budget is allocated to three of our eight programmes, namely; District Health Services (R17.2-billion or 33%), Provincial Hospital Services (R9.5-billion or 18%) and Central Hospital Services (R18.2-billion or 36%). For the latter programme, the provincial government has resolved to engage the National Department of Health and National Treasury on the funding model, especially the equitable share. 

Comparatively, Gauteng continues to bear the greatest responsibility for the provision of healthcare services due to high levels of migration and urbanisation and yet, the resources are not commensurate to the ever-changing and complex provincial healthcare system. 

PROMOTING PUBLIC HEALTH EDUCATION 

Our approach to promoting public health education is part of strengthening primary healthcare. Public Health Education is about creating Health Literacy among our citizens. In order to get the public engaged in improving health outcomes, we need to have conscious campaigns aimed at creating awareness and mobilising the active energies of our community and stakeholders.  Some of the workstreams include school health integrated programme, ward-based outreach teams (WBOTS), expansion of reproductive health campaigns and others. 

CONCLUSION 

Madame speaker, 

The provision of quality healthcare is about the restoration of human dignity. Beyond it being a constitutional obligation; it is a revolutionary and moral duty. Quality healthcare helps us defeat poverty and inequality and reaffirms the truism that all life is of equal worth! Good health sustains life and human civilisation itself. The nations with better health outcomes have a better quality of life, higher levels of productivity, economic growth and creativity!

We want a healthcare system that is not only curative but is preventative and responsive to Sustainable Development Goals. Much as we will build more facilities, it would be more rewarding to receive less patients because people have jobs, rising incomes, safer and comfortable shelter, quality water and sanitation, better education, greater life choices, better eating habits and lifestyle, more time for leisure and creativity so much that we are forced to close down some of our facilities. This would mean that the people will be their own health champions and liberators!

For the next five years, we will also be mobilising all stakeholders to volunteer in the work to improve the quality of healthcare in the province. We will engage each stakeholder to volunteer their insights, skills and resources. I will lead from the front by dedicating one day per month to do voluntary clinical work across the province. I hope that other health professionals will heed the call to volunteer!

Madame Speaker, 

I wish to thank Team Gauteng Health for the great effort and my Office in particular for all the hard work leading to this momentous occasion. My deepest gratitude to the men and women in white for all the good work even under difficult conditions. Our stakeholders remain part of the story, part of the journey and siyabonga! 

Most importantly, we wish to thank the people of Gauteng for the opportunity to serve, please travel with us. 

As I sit down, I wish to borrow from the words of the great Cuban poet Jose Marti when he said: “Other famous men, those of much talk and few deeds, soon evaporate. Action is the dignity of greatness.”

I hereby table this budget vote for your approval.  

Let’s Grow Gauteng Health Together!

I thank you.