Speech notes: Jane Cowley 6th Legislation 2019 SOPA debate

Honourable Speaker, Honourable premier, Honourable members of the House, officials and guests, I greet you all

When South Africa’s National Development Plan was launched in 2012, it included several admirable goals for the health sector, including raising the life expectancy of South Africans to at least 70 years, ensuring that the under 20s generation are largely free of HIV, significantly reducing the burden of disease and achieving infant and under five mortality rates of less than 2% and 3% respectively.

However, the goals set out in the NDP were all crafted on the assumption of a steady GDP growth rate of approximately 3,5%, which was the growth rate at the time. Considering that the GDP growth rate had averaged out at 5,2% over the 2004 to 2007 period, and taking into account our recovery from the negative growth experienced in the global crisis of 2009, this seemed reasonable. Sadly since 2012 our GDP has weakened year on year and at the first quarter of 2019, stood at exactly 0%.

This stagnation of our economy has dire consequences for the NDP, because the projections and goals contained therein have become impossible to achieve. Our fiscus is substantially less than predicted. We simply don’t have the money to breathe life into the NDP. It needs to be radically adjusted, or scrapped.

The Premier talks about feeling healthy when he walks into a new state of the art facility because it is clean. Madam Speaker, a building does not have to be new to be clean. A building needs cleaners to be clean. Many of our clinics do not have this luxury. I can assure you that hiring cleaners is substantially cheaper than building a new state of the art facility.

The Hon Premier is further impressed that the conduct of the staff in that state of the art facility is professional. Madam Speaker, I have to ask myself why he is so impressed? Surely it is his responsibility to ensure that all government employees in this province exhibit professionalism in the workplace? Professionalism should be standard. And if government employees are not behaving in a professional manner, what is he doing about it?

Hon Speaker, I am so sick and tired of the phrase “consequence management”. And I am so sick and tired of the fact that this phrase is only ever used in the future tense. We will do this, we will do that. So have you fired the fools that run the Mthatha medicine depot? Have you punished the pundits that vowed and declared that the Cardio cath lab was functional?  

Madam Speaker, in order to deliver services effectively within fiscal constraints, we need to be smart. We need to consider the financial implications of everything that we do. What we do NOT need, is yet another pie in the sky plan, this one called the NHI and yes, still unfunded, in the hopes that it will fix everything that is wrong in the state health sector.

Madam Speaker, let us be very clear. It is not the private health sector which has impacted negatively on the public health sector. It is the below par management of the state health sector that has impacted negatively on the state health sector. It does not require rocket science to see how politics has ingratiated itself in all of our administrations. It does not require quantum physics to see that cadre deployment has brought this province, and this country, to its knees.

You want to fix health? Here’s a five point plan:

  1. Employ competent, QUALIFIED people in key positions – regardless of their political affiliation. Specifically, empower your primary health care facilities with all those fabulous Cuba-trained doctors. Bring the medicine to the people.
  2. Learn to fix what you have and make it functional. Fix the disaster that is the centralised EMS service. It is ineffective, time consuming and as a result – deadly. Fix the disgrace that is the Mthatha depot by firing the incompetent managers.
  3. Stop doing favours for friends – an acting district manager costs tax payers in excess of R140 00 per month on travel and accommodation in Nelson Mandela Bay – this is a disgrace. A doctor who is no longer practising medicine but now holds an administrative post allegedly still gets a surgery stipend of R39 000 per month – disguised as rent. A DISGRACE!
  4. Get back to basics – The Premier’s comment about building waiting facilities for the sick and elderly who sleep on hospital floors treats the symptom and not the root causes of the problem, which are firstly a useless medicine depot which deprives rural clinics of necessary meds and results in patients traveling at their own expense to bigger facilities in order to stay alive; and secondly, the non- existence of a rural patient transfer system which would resolve the matter of patients having to sleep over on hospital floors on their way to provincial hospitals.

I cannot say this enough. Fix the depot by firing the incompetent staff and establish a rural patient transfer system such as the one in the Western Cape, which services 150 000 indigent rural patients per year. Viola! No more people sleeping on hospital floors.

  1. Be innovative. Madam Speaker, there is a global golden rule in health care. Medicine follows the patient; the patient does not follow the medicine. In South Africa, patients have to PAY to follow their medicine. This is a DISGRACE. So don’t talk about the fourth industrial revolution again. Do it. Do what Rwanda has done for rural patients and start delivering essential meds to rural clinics by drone. Drone technology is everywhere (except here). It is cheap and highly effective, and doesn’t need roads.

Madam Speaker, if we want to talk about bringing in technology, let us start with the digitalisation of patient records.

The Western Cape is only province to have digitised patient records in public healthcare, spanning 54 hospitals, 300 primary healthcare facilities, and 13 million patient records.

In closing Madam Speaker, I would like to caution the Honourable Premier that there will always be investors who will promise you all of the state of the art facilities you could dream of – and feel healthy in – and they will deliver. But Madam Speaker, they will want their pound of flesh. And they will get their pound of flesh. Please, I beg of you, do not sell your province for a state-of-the-art dream that you cannot afford.

I thank you.