SPEECH NOTES BY JOHN CUPIDO, HEALTH BUDGET DEBATE 2013/14, 18 JUNE 2013

Hon Speaker

Madam Premier

Members of the House

Guests of the House

Last year in the budget debates I enlightened the house about the psychological model called the Kübler-Ross Model, more commonly known as the five stages of grief.

As a quick reminder, the five stages are:

1. Denial

2. Depression

3. Anger

4. Bargaining

5. Acceptance

When I presented this speech a year ago it was very clear that the department was in denial. Although the MEC and ANC admitted that there were problems, these problems were downplayed and the severity of the dysfunctional state of health care in the Eastern Cape completely ignored.

With the exception of the Democratic Alliance, every party in this Parliamentary House refused to admit the obvious deficiency of the budget, refused to stand up and say that the budget presented to us last year was not in any way sufficient in providing reasonable and effective health care to the citizens of the Eastern Cape, especially the poorest of the poor. Those that rely on us to make laws and decisions that ensure when they fall ill, they are met at clinics and hospitals with sufficient numbers of staff, efficient staff, clean hospitals, working medical equipment and enough of the right medication to heal them and minimise their exclusion as breadwinners and productive members of the economy.

I’m standing here today, to tell you that we have failed them, we have failed the elderly gentleman from Matatiele that passed away while waiting for two days for an ambulance to transfer him to the hospital in Mthatha, we have failed the pregnant young lady that went to the hospital in Mount Fletcher on the 2nd of March this year, was seen by the doctor on the 3rd, and finally told on the 5th that her baby is dead. That alone is inexcusable, but what makes it worse than horrific is that only once I was notified almost two weeks later, and with the help of the MEC, she was transferred to Mthatha to have the dead foetus removed. One can only imagine the psychological trauma that this 20yr old lady has gone through.

We have failed her.

We are the ones that approve the budget and exercises oversight and control measures to ensure that there are enough doctors and nurses, that the equipment works properly and that there is enough medication.

When challenged by the community and the media on health care failures, the department’s spin-doctor immediately shifts the blame to the doctors, the nurses and the hospital admin staff… What we need to realise is that the doctors, the nurses, the hospital admin staff ARE part of the department, the department IS provincial government, and the people sitting here today IS the provincial government.

How can the department place the blame on the doctors and the nurses when it is the department that removes posts off the organograms and does not ensure that there are enough staff? Doctors and nurses are overextended, working far more hours than they should, stressing about how they are going to feed their families or pay their debts because of inconsistent or non-existent salaries and other payments owed to them.

How can the department shift the blame for salaries not being paid because hospital admin staff are not submitting paperwork on time, when it is the department that should be holding them accountable and ensuring that they do their work properly?

When the portfolio committee meets with the medical staff at the various hospitals we see first-hand how demoralised they are, how overextended they are, how difficult the department makes it for them to do their work properly.

The reality of the matter is that in outstanding salary arrears, OSD, leave gratuity, overtime and other allowances, the department still owes doctors R14.6 million and nurses, a whopping R69.5 million.

The monies outstanding to staff across the Eastern Cape Department of Health comes to a total of R154.9 million.

Paying this ever increasing amount is not fully budgeted for, meaning that only some of the people will be paid, thus inevitably meaning that there is a significant chance that the remaining unpaid staff will protest and will strike, and when medical staff strike… Patients die!

Last year the Democratic Alliance did not support the budget because we felt that it was severely deficient. The denialists in this House scoffed at us and pushed through the budget regardless.

Less than one month later, the Department of Health admitted that the budget was severely deficient and stated that they needed help.

In the Kübler-Ross Model, admitting the problem is part of the Depression stage, stage 2.

Later last year, the Health Portfolio Committee, infuriated by the incompetence of the department, called for a takeover by the National Department of Health. That is stage 3, Anger.

As we sit here today we are at stage 4, bargaining.

The new budget has had a significant increase from R15.1 billion to R16.5 billion, and with the on generously promised exclusions and allowances by the Provincial Treasury, it brings us closer to closing the gap between what is needed.

The increase in spending on infrastructure and maintenance is welcomed, however, this does still need to be significantly increased, because even with the bigger spend, we are only ensuring that the health care infrastructure backlog increases by a smaller margin this year and we should actually be working at decreasing that backlog and essentially increasing infrastructure. The current terrible state of health care in the Eastern Cape is one of the reasons that the Census shows people leaving this province in droves.

The final stage of the Kübler-Ross Model is that of Acceptance…

I hope and pray that we do the opposite.

That we do NOT accept the current state of health care in the province.

That we do NOT accept the existence of corrupt officials within the department.

That we do NOT accept excuses for work not done properly and excuses for incompetence.

That we do NOT let our doctors and nurses go without salaries and proper working environments.

That we do NOT let the people that rely on us remain ill or die unnecessarily.

This budget is not a perfect budget, it does not sufficiently address what is outstanding to our current medical staff or to increase the number of critical staff to what would be reasonable, however it is a significant improvement on what was presented to us last year and with the support of the Provincial Treasury undoubtedly a step in the right direction. Because of this, the Democratic Alliance very tentatively supports this report and budget.