Mail & Guardian'Schools should not adopt one religion to the exclusion of others' - judgeMail & GuardianSix schools that believed that a case by Ogod (Organisasie vir Godsdienste-Onderrig en Demokrasie) — seeking a court order to declare it unconstitutional for any public school to promote one religion — would promote atheism in schools, have lost in ...Solidarity pleased that religious practices may continue in public schoolsCitizenPublic Schools
Independent OnlineDignitaries in Botswana for Sir Masire's send-offIndependent OnlineGaborone - Former Botswana president and Southern African Development Community (SADC) chairperson Sir Ketumile Masire will be buried Thursday morning. Tell a friend. Ketumile Masire. Masire, who died last Thursday at Bokamoso Hospital aged 91, ...Mugabe jets off to BotswanaBulawayo24 News (press release) (blog)Botswana: Vice President Signs Book of CondolenceAllAfrica.comBotswana's ex-
Cape Town - Security at police stations is once more in the spotlight after a policeman was shot in the head in a brazen attack on the Lingelethu West police station in Khayelitsha.
He is in a stable condition. Police said his name was being withheld out of concern for his safety.
The attack happened at the same time that the Institute for Race Relations (IRR) released a report showing showing that the killing of police officers had more than halved over the past 22 years. However, it said that despite this, South Africa remained a “relatively dangerous country in which to conduct police work”.
Police spokesperson Andrè Traut said about the latest incident that a sergeant at the Lingelethu West police station was shot in the face by three men, under the guise of reporting a robbery.
“One of the suspects produced a firearm and shot a police sergeant in his face. Police returned fire and the suspects fled. They are yet to be arrested. The wounded member was admitted to hospital in a stable condition.”
Chairperson of Khayelitsha Development Forum (KDF) Ndithini Tyhido described the incident as a "military-style attack".
“A male came to the CSC at Lingelethu West SAPS pretending to report a robbery case. The next moment, two more suspects entered and they started shooting with long rifles in the CSC. The first person jumped over the counter and one of our members retaliated and shot at the man."[email ;protected]
The ANC narrowly beat the DA to win back the mayoral seat in Mogale City after a marathon council meeting on Wednesday.Patrick Lipudi, the former council speaker, was voted in as mayor with 39 votes to former mayor Michael Holenstein’s 36. Two votes were spoiled.
One member of the coalition government would have voted for Lipudi with the ANC to secure the result.
Holenstein was removed in a motion of no confidence earlier this month following months of political turmoil in the municipality.
The ANC had retained the positions of speaker and chief whip after the party lost its majority following the 2016 local government elections, but lost the mayoral position to the DA-led coalition.
Lipudi had been asked to recuse himself as speaker after he was nominated for the mayoral post. Lipudi, however, refused and chaired the meeting.
Alan Fuchs, DA constituency head of Mogale City, cited several discrepancies. He said Lipudi did not use an independent body to manage the electoral process, and councillors had to use stamps to vote. Parties had used pens to colour block their votes in the motion of no confidence that removed Holenstein.
Fuchs said the DA would consider its legal options on the matter.
Nation – Google News – News24 Hackers post gory images, message on basic education websiteNews24Cape Town – Hackers gained access to the Basic Education Department's website on Wednesday evening, posting gory photos and a message addressed "to the government, the American people and the rest of the world". Spokesperson Elijah …
South Africa’s pre-match press conference as they prepare to meet New Zealand on day five of the ICC Women’s World Cup 2017. source
eNCA Yende murdered ahead of whistle-blowing on copper syndicate: SAPSeNCAYende murdered ahead of whistle-blowing on copper syndicate: SAPS. South Africa; Wednesday 28 June 2017 – 7:02pm. FILE: Yende was found dead in her office at one of the power utility’s substations last month. Photo: Facebook / Lucia Thembisile Yende. and …
The sharks’ livers had been removed with surgical precision. One was missing its heart, and another its testicles and stomach. Orcas are the suspected culprits source
South Africa government blamed as millions live in shacks South Africa is one of the largest industrial economies in Africa, but up to 10 million people live in shacks in informal settlements. Some residents say been waiting decades for government housing programmes to help them. Al Jazeera’s Malcolm Webb reports …
Pretoria - The business partner and lover of North West billionaire Wandile Bozwana told the North Gauteng High Court in Pretoria that she heard several shots being fired at them as they stopped their car at the Garsfontein off-ramp, east of Pretoria, in October 2015 but she could not see where the shots came from or who fired them.
Mpho Baloyi was severely injured when about 12 shots were fired at her and Bozwana. She, however, recovered in hospital from her injuries.
Bozwana, who was in the passenger seat of the car driven by Baloyi, died a few hours after the shooting in the Unitas Hospital.
He tried to shield Baloyi from the bullets by leaning over to her side and covering his body with his.
The four men accused of the murder and attempted murder this week pleaded not guilty to the charges. They said they knew nothing about the incident.
They are Sipho Patrick Hudla, 34, Matamela Robert Mutapa, 40, Vusi Reginald Mathibela, 30, and Bonginkosi Paul Khumalo, 36.
Baloyi, meanwhile, testified that she and Bozwana were lovers since 2013. They had spend the evening before the incident together and the next morning they went to Sandton City to a tailor and a hair salon.
They then had lunch at McDonald's in Greystone Avenue, where she received a call from her financial director that the tracker device on her car had been disabled.
Baloyi said she checked it, but could not see anything wrong.
The couple then headed to Pretoria along the N1 to go to a car dealership in Menlyn.
Baloyi said as they stopped at a red robot at the Garsfontein off-ramp, she and Bozwana noticed a silver BMW sports car behind them.
They commented among each other how nice the car was.
Baloyi then noticed an unknown man opening the back door of the vehicle, but she did not pay much attention. The next moment she heard sounds, followed by the firing of bullets.
Bozwana, who was trying to shield her, slumped between her seat and the passenger seat and although she was also injured, she decided to speed away and summon help.
Bozwana was at the time of his death embroiled in legal proceedings with the North West province regarding the allocation of tenders.
The trial continues.
Gauteng Department of Health Budget Vote for 2017/18 tabled by the MEC for Health Dr Gwen Ramokgopa at the Gauteng Legislature on 27 June 2017
Honourable Members of the Executive Council;
Honourable Members of the Legislature;
Members of the Mayoral Committees for Health from all the Municipalities of our Province;
CEO's of Health Care Groups
Senior Management of Health
Labour and Health Professional Associations
Deans of the Medical Schools and Principals of Nursing Colleges;
Representatives of Hospital Boards, Clinic Committee's and Families of Mental Health Care Users
Family and friends;
Ladies and gentlemen,
Madam Speaker, thank you for affording us this opportunity to table the 2017/18 Budget Vote for the Gauteng Department of Health. The budget allocation for this financial year amounts to R40,2 billion which represents a 1% increase in real terms.
Given the economic challenges due to sluggish global economic growth, local economic challenges and the fact that the health inflation remains higher than the consumer price index, our task is to ensure that the health sector observes the imperatives of prudent financial management with more focused attention on efforts and innovations that must assure optimal patient safety and the reduction of the disease burden.
As the Department, we remain focused in working with the affected families to restore the dignity of Mental Health Care Users by fully implementing the Health Ombud's recommendations as well as to institutionalize the inputs of the family committee and other stakeholders. Three of the critical inputs that will be implemented in this financial year are:
Family Committees be established in facilities that look after long term involuntary and assisted Mental Health Care Users. This decision will affect the Cullinan Rehabilitation Centre, Weskoppies, Tara Hospital and Sterkfontein hospital, as well as the Private Facilities and NGO's with whom the department more stringently licenses to provide the service.
Family Committees are over and above the hospital boards and this process will be implemented over the next six months in public institutions and by the end of this financial year in the licensed private and NGO sectors.
The single province-wide Mental Health Review Board be replaced by District Based Mental Health Review Boards with secretariat support that must ensure independence as required by the Mental Health Care Act.
With the assistance of experts and leaders in the field, Drs Motlana and Grobler, nominated candidates were shortlisted for the five regions. The vetting process of checking criminal background and verification of qualifications was done, shortlisted candidates were informed and advised to confirm their availability to serve in the committee.
I am pleased to announce that appointments have been made after this rigorous process over the last four months.
Based on the Health Ombud's recommendations the members of the previous Board have been suspended and will be subjected to an enquiry on their fitness to hold office as prescribed by the Mental Health Act.
Working together with the Family Committee and Stakeholders, the Mental Health Month of October this year is dedicated to heightening public awareness and hosting a summit on Mental Health.
Regular stakeholder forums be established to both monitor the sustained implementation of the Health Ombud's recommendation, to serve as a platform for involvement and social solidarity as well as to institutionalize a more comprehensive and human rights based approach to mental health promotion and management.
In this financial year quarterly meetings will be convened culminating into the annual Provincial Health Consultative Forum which must be convened in terms of the National Health Act.
Honorable Speaker, the Department is committed to continuously strive to be guided by Batho Pele Principles in complying with spirit and prescripts of the Constitution and Laws of our country and to reaffirm the United Nations Universal Declaration of Human Rights as we say Mental Health Rights are Human Rights.
The Constitution of the World Health Organization says "health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".
Mental Health is everyone's business, and we should pledge solidarity to break the silence, tackle the stigma and optimize the treatment, rehabilitation and care as we promote mental well-being in our society.
In appreciating the role of the media in assisting my office in particular to inform the public on the progress being made in implementing the Health Ombud's recommendations and healing the nation, I would like to reflect on one of the substantive questions that one of the journalist asked - 'What else did you find in the Department? '
As we debate the budget today, I wish to reiterate what I have shared as a frank answer to this question having being privileged to address the Discover's Health Journalism Awards a few days ago - that 'I would want take this opportunity to work with you to uncover fully what is in the public health system for just one purpose - to assist the public to take full ownership of its valuable asset and institution. Let us work together unearth the good and the bad, the excellence and the mediocrity.
I would like to offer health journalist transparency that would help society to appreciate the full health ecosystem - unravel its complexity and fragility and empower society to shape it for its own wellbeing.
We will also strengthen the internal communication and team building efforts within the Department in order to mitigate the unnecessary disruption of essential services to the public as we experienced in the last few weeks of the work-to-rule protest by the Forensic Medical Officers. We wish to extend our sincere condolences to the bereaved families and regret the inconveniences suffered with the delays in post-mortems that had to be done as required by law in all cases of unnatural deaths. The Department appreciates the long hours spent by Forensic Pathologists and the assistance of the sessional doctors, the South African Military Health Services and all other partners who eased the pain of the affected families whilst working within the law.
I have met with the labour within my 100 days in office and we committed to work together to provide a leadership dispensation. This, to ensure we work together within the legal framework to strengthen the effectiveness of labour relations platforms.
Madame Speaker, in advancing the progress made to prepare for the introduction of the NHI the Department will be focused on the WHO six building blocks of a health system which are:
Leadership and Governance
Health Systems Financing
Health Information System
Health Service Delivery
Access to Medicines and Other Commodities
In 2016/17 financial year, the Department delivered Primary Healthcare services to cover 22 million patient visits at 369 clinics, of these 17 million were adults and 4 million children below the age of five (5) years. The District, Regional, Tertiary, Specialised and Central hospitals provided services to approximately 5.2 million people.
Honourable members, the 2015 Gauteng GCRO Quality of Life Survey indicated that the majority of people still use Public Health Facilities. With increasing demands on the Gauteng Public Health Service placed by in migration there is a greater need for us to put effective measures to urgently deal with Adherence to Treatment protocols, Medical Litigation, Accruals, over-charging by service providers, wastage of resources and poor Human Resources Management. Failure or further delays may result in the collapse of the health system to the detriment of those who have no other alternatives.
I would like to appreciate the support of the Premier and the Executive Council in appreciating the challenges facing the department and instructing that monthly reports be provided on the progress we are making.
We have prioritised the following interventions in this financial year -
With the input of specialists in the field and the lessons from the current quality assurance program, we will establish a Patient Safety Committee that will include Health Specialist, Senior Legal Experts, Leaders in Ethics and Human Rights. Their role will be assist in developing a risk register to patient safety in the department and to audit and accredit all public service platforms against patient safety norms and standards.
Extend the mandate of SAICA beyond the clean audit program and to also address strengthening of financial controls at various institutions and in head office. This includes aligning the budget and the demand management plan to the annual performance plan, inventory management and revenue management as well as ensuring financial controls and integrity of monthly financial reports.
Involve experts in Human Resource Development to capacitate management in facilities and districts to ensure that the Performance Management System improves productivity, addresses poor attitudes of staff, reduces absenteeism (including of supervisors), backlogs in grievance management and service excellence recognition.
To review the organizational structure to align with the core functions of the department as guided by the Ministers of Health and Public Service Administration and to ensure that the system of delegations empower frontline managers. In this way governance structures such as hospital boards and clinic committee will be enabled to play a meaningful role in their oversight role. Currently top management is dominated by support functions, has centralised powers and is weak in being patient focussed.
Transformation, Modernization and re-industrialization agenda will assist the department in consolidating all ICT systems and resources towards an integrated interoperable eHealth and mHealth enterprise wide architecture. We have engaged the support of the National eHealth team, the CSIR and the Department of eGovernance in this regard. Already significant progress has been made in reducing waiting times in patient administration, improving availability of medicines, improving communication with pregnant mothers for antenatal and postnatal care as well as in saving costs due to inventory management. Building on these successes an integrated interoperable system will enable better care of patients, empower patients to understand their health and access to the health system as well as improve the efficiency of the health system.
Is South Africa alone in these economic pressures and is there a need for prudent management of finances? Secondly, should prudence in financial management result in the less patient safety as we observed with the tragedy around the Mental Health Users in this province.
The answer to both these questions is no and most certainly no.
Globally many public and private health care institutions are facing the challenge of the need to improve access to quality care and patient safety in the face of rising health inflation, the imperative to mitigate litigation costs and efficiency.
It is in this context that it was easier to reach a global consensus in the UN for introduction of universal health coverage (UHC) for affordable and quality care for all citizens in each country. As a country we have reached this consensus across various divides, in the NDP 2030 on the need to introduce the NHI.
One of our expert partners from SAICA recently shared with me the case of the elite Mayo Clinic which is a 153 year old institution in the US that pioneered the concept of patient centered care and is renowned for diagnosing and treating medicine's most complex patients more like our Central, Tertiary and Regional Hospitals are doing.
The Wall Street Journal reports that when Canadian-Born Dr. John Noseworthy, Mayo's Chief Executive officer, saw declining revenue from accelerating efforts by government health programs, private insurers and employers to rein in health-care costs as a looming threat to the clinic's health he pushed surgeons who were requesting more resources. So when surgeons asked for two more operating rooms to meet demand for open-heart surgery which is one of the clinic's major revenue sources, he not only said no but also pushed them to redesign all facets of heart-surgery care and cut costs 20%.
Indeed he said, "Turning around a successful organization is not that easy," Dr. Noseworthy says. Hundreds of Mayo doctors "who assumed life was great weren't immediately eager to change how they work."
Reflecting on Rochester, Minn - "Change is hard. It is especially hard when the organization in question is amongst the top in its field"
Madam Speaker, the health sector reforms, transformations and revolutions go wrong when -
there is denial and resistance to the need for change;
there is lack of leadership by experts in the medical field, poor multidisciplinary approaches and silo mentality;
sub-optimal involvement of patients themselves, their families, stakeholders and weak governance structures;
poor investment in building a vision community, partnerships and team effort
Some of these factors unfortunately also characterized the Mental Health Project tragedy. I would like to commend both management and staff that acknowledge these challenges and weaknesses and are working harder to rebuild the trust and partnership with our people. We will continue to be intolerant of arrogance, bad attitudes and ill-discipline by a few who tarnish the image of the many diligent and professional men and women in the public service. We must all say not in our name!
Just to appraise the house on the 6 GDoH-specific recommendations;
The development of Information Systems with patient registers: an e-Health Committee of experts has been formed to advice and make recommendations to the MEC and senior management on assessment of the systems in place, and on developing a strategy to implement full e-health systems. The recruitment process for the position of a CIO is at an advanced stage.
Adherence to the Mental Health Act and its related Regulations: a full assessment of the mental services in the province has just been completed, and training on the MHA and all related Regulations and Guidelines has been undertaken at various levels, including the Interim MHRB.
The District Health Services capacitation to ensure adherence to regulations, and to provide clinical support to NGOs: the Mental healthcare professionals in each Health District have been visiting each NGO more frequently since March 2017 to assess and ensure well-being of all patients in the NGOs, and advising the NGO managers and staff on quality patient care.
De-institutionalisation of MCHUs implemented with provision of structured community mental healthcare services: Community Mental Health Services have been strengthened with the decision to appoint and install a five-person Mental Health Review Board in each of the 5 Health Districts in the province (total a membership of 25 for the province).
Specialist-run Community Psychiatry Services: the process of ensuring the appointment of a Psychiatry Specialist has commenced, and the Health Districts already have a Psychiatry Specialists in their District Clinical Specialist Teams.
GDoH must develop a capacity programme for all newly-established NGOs: For each NGO assessed by a multi-disciplinary team (using a newly-developed assessment tool), an individual report has been written, and the results shared with the NGO owner/manager, including what needs to be corrected if the NGO is not compliant.
The essence of what we deliver here today should remind this esteemed House that the budget is about people. It should reflect our intentions to have an equitable and quality health care. We must through this budget put the aspirations of our people firmly on the agenda, and patient care at the centre of service delivery.
Honourable members, I would like to pay homage and respect to the legions of youth who sacrificed their lives for the advancement of our struggle for democracy and freedom. It is fitting that on the same year that we commemorate the 41st Youth Day, we also celebrate Oliver Reginald Tambo's 100th birthday and the 62nd anniversary of the Freedom Charter. Our Department is refocusing its efforts to the realisation of a health system which delivers Quality Patient Care to the people of Gauteng. The Freedom Charter states that "A preventive health scheme shall be run by the state. Free medical care and hospitalization shall be provided for all, with special care for mothers and young children."
Our goal ultimately is to achieve the National Development Plan's Vision which "We envisage that in 2030, South Africa has a life expectancy rate of at least 70 years for men and women". Let me borrow from the wise and inspirational words of the first African woman, a Kenyan to win the Nobel Peace Prize and social activist Wangari Maathai:
"It is very important for young people not to be afraid of engaging in areas that are not common to the youth, get involved in local activities, get involved in local initiatives, be involved in leadership positions because you cannot learn unless you are involved, and if you make mistakes, that is alright too, because we all make mistakes and learn from those mistakes, you gain confidence from learning, failing and rising again."
We are proud to say that these words resonate and come to life in the Health Department. We don't only celebrate young people but also endevour to nurture and allow them to flourish. We want them to be involved in the health system, come up with innovations and spearhead ground-breaking initiatives and become leaders of tomorrow as alluded to by Maathai.
It is for this reason that we can proudly say that 37% of our staff establishment comprises of young people. Of note is the higher proportion of Allied Health and Medical Practitioners who are youth. In this financial year, we have injected a group of exuberant young people in our facilities, such as Felicity Mncube and Nkosinathi Mahlebe who are nurses and diligently serving the people of Gauteng.
We have invested in young people by offering bursaries to pursue their studies in various health sciences programs. In the current financial year we are supporting 285 Health Sciences students. Dr Sule Burger represents a group of young Doctors that are making their mark in the public service. We also have beneficiaries from the Cuban program such as Dr Lesego Pooe who is a young CEO of one of our Hospitals. We are also joined by Mr Nhlanhla Mphuti, a bursary recipient studying medicine at Wits University.
We also celebrate Dr Ncumisa Jilata this youth month, who has become Africa's youngest Neurosurgeon following her fellowship graduation on the 18 May 2017. Dr Jilata (29) was appointed by Steve Biko Academic Hospital as a registrar and now she is a specialist.
Honourable Members, the Department is also rendering various youth related services such as the Dreams and Take Charge campaign aimed at tackling together with them the high burden of HIV and unplanned pregnancy amongst young women. We call for young women to adopt dual protection by using contraceptives and condoms in addition to promoting reproductive health. This year we will strengthen the school health service and work with the department of higher education to reach out to campuses.
We provided various services at schools as part of the Integrated School Health Program wherein a total of 242 732 learners were screened in various interventions, for instance, we referred 10533 School learners for Eye Care, 3222 for Hearing problems and 27456 for Oral Health. We have dispensed 1 596 395 contraceptives in the past financial year as part of the family planning program.
We continue to be a leader in several health care procedures such as minimal invasive surgery (Laparascopic surgery). We have trained fellows from around the country and from other African countries in this surgical procedure at Dr George Mukhari Academic Hospital for the past three years. In this regard the department will investigate partnerships with other innovative initiatives that must enable us to improve patient recovery time and also to clear the surgical backlogs in the public sector.
Madam Speaker, as indicated above our allocation for this financial year as indicated amounts to R40,2 billion, of this R23,8b has been set aside for compensation of employees. R15,7b will go towards subsidies and transfers to municipalities, universities, NPO's and other areas. The remaining R14,8 billion is for goods and services directly provided by the department. The pressures of litigations, accruals and commitments leaves an estimated R3,9 billion available for the rest of goods and services in this financial year.
Progress in reengineering of primary Health Care Services
Ward Based Outreach Teams (WBOTS)
Over the past six years, 719 fully fledged and functional Ward Based Outreach Teams (WBOTs) have been established in 440 wards across the five Districts. In the current year we intend to increase the number of teams to 780.
Madam Speaker, an Ideal Clinic is a clinic with good infrastructure, sufficient staff that practices Batho Pele principles, has adequate medicine supplies, and good administrative processes. The Gauteng Department of Health according to National Department of Health has the highest proportion of facilities at 59% which had attained ideal clinic status.
An assessment from the National Department of Health findings indicated that a total of 217 clinics out of 369 attained ideal clinic status since the inception of the programme in 2015/16. Our target is to have 240 facilities certified with an Ideal Clinic status in this financial year.
Honourable members, in our efforts to move from a hospi-centric model, the Department is allocating more resources to District Health Services. The allocation has increased by 9% (R12 598 496 in 2016/2017 to R13 752 800 in 2017/2018). Over the 2017 MTEF, this programme received an earmarked allocation for accelerating the provision and improvement of PHC services, ward-based outreach teams, and district clinical specialist teams and, integrated school health services.
Central Chronic Medicine Dispensing and Distribution (CCMDD)
Madam Speaker, we are cognisant of the fact that our people spend an inordinate time in queues when they visit our facilities to collect medication. To decongest public facilities the Central Chronic Medicine Dispensing and Distribution (CCMDD) program has contracted a service provider to manage the dispensing of repeat prescriptions for chronic patients and the distribution of the repeat medicine parcels to both public and private pick-up points.
Mother and Child Care
The Department has retained the score of 53 (88.3%) in the regular annual assessments of facilities providing maternity services. These facilities are certified as Baby Friendly for promotion, support and protection of breastfeeding. We have 23 (88.4%) for hospitals that offer Kangaroo Mother Care services.
About 254 329 (antenatal coverage of 113.2%) pregnant women attended antenatal care in the past financial year, with particular focus on booking before 20 weeks standing at 148 492 (58.4%) through the 'every day is antenatal care day' programme.
The District Clinical Specialist Teams strengthened the implementation of measures to improve maternal mortality and morbidity meetings that are aimed at improving the management of the health of mother and child.
They made improvements in the updating of the maternal and child protocols, and the availability of appropriate medical equipment and medicine. The training was also offered to doctors and nurses to improve their skills pertaining to resuscitation of mother and child, emergency management, and conducted emergency drills in all the Maternity and Obstetric Units. The Department has been able to reduce both the in-facility under five year child mortality and infant mortality per 1000 live births from 45 to 6.7 and from 36 to 16.9 respectively.
There are currently six hospitals providing mammogram services. In the current year this service will be rolled out to four additional hospitals (Tembisa, Rahima Moosa, Sebokeng and Thelle Mogoerane.
The essential medicines have steadily increased from 97.2% to 98.13 %(target 98%) in the last financial year. In the 2017/18 we aim to improve on the 98% above target performance on medicine availability. Vital medicines has steadily increased from 96.85% to 98.56% at the end of the last financial year (target is 98%).
Non-Communicable Diseases and Healthy Lifestyles
Two of the top causes of death in Gauteng are diabetes and hypertension related diseases. One of the risk factors for diabetes and hypertension is obesity
Obesity is a growing problem in Gauteng, with 2013/14 prevalence rates of 36% among women, 10% of men and 2% of children under 5 years.
In this year we aim to mobilize at a ward level a health promotion movement and acknowledge those communities that are making a significant effort in improving their health including in dealing with substance abuse, being active , avoiding bad food including at schools and functions as well as public campaign like the MTN walk the talk initiatives. We will also partner with the programs such as vitality program towards our goal of a long and healthy life for all.
HIV and AIDS
Honourable members, you will agree with me that as Government together with civil society we have done a lot in the fight against HIV and AIDS. According to the Stats SA population estimates, Life Expectancy of Gauteng is estimated at above the national average of 62.4 years (2016). The aforementioned interventions in particular provision of ART is said to have contributed to increased life expectancy.
We have budgeted R3, 7 billion to fight the HIV and AIDS and Tuberculosis (TB) in the province. By March 2017, we distributed 196 million Male Condoms and 6.8 million Female Condoms to prevent new infections. We have tested over 3 million people for HIV, (including Antenatal Care Pregnant Women) and conducted 189 thousand new initiations on Anti-Retroviral Therapy (ART) and 835 thousand people remain on ART program.
We plan to initiate over one hundred and ninety thousand (195,300) people on ART; test about 2, 5 million people in the 2017/18 financial year as part of test and treat campaign.
The Gauteng TB programme has made great strides towards decreasing deaths through improving the 90-90-90 targets for TB that are spelled out in the Global Plan to End TB 2016-2020 specified below:
90% of all people who need TB treatment are diagnosed and receive appropriate therapy as required;
90% of people in key and vulnerable populations are diagnosed and receive appropriate therapy; and
Treatment success is achieved for at least 90% of all people diagnosed with TB.
An improvement in TB success rate from 84.2% in 2015 to 84.9% in 2016 amongst all TB cases was noted. Furthermore, amongst new cases, we noted a decrease of 87.4% in 2015 to 87.5% in 2016. The number of deaths decreased from 566 in 2015 to 486 in 2016 while those lost to follow-up cases decreased from 651 in 2015 to 576 in 2016. The Drug Resistant TB patients successfully treated improved from 398 (42.5%) in 2013 to 700 (56%) in 2016 out of 936 and 1251 started on treatment respectively.
With regards to decentralization and monitoring of the Drug Resistant TB, we will ensure that treatment and care is rolled out to all districts. We have contracted 44 Retired Registered Nurses to ensure that patients are traced and linked to care
We will continue to be guided by the collective effort of the Gauteng AIDS Council led by the Premier to build on these successes as we implement the NSP 2022 against HIV, AIDS and TB.
Madam speaker as outlined in the Transformation, Modernization and Reindustrialization (TMR) Strategy of the Provincial Government, let me highlight and share with this House the achievements in the five corridors for the past financial year and plans for the 2017/18 financial year. Let me start with the Eastern Corridor, Ekurhuleni.
Ekurhuleni District (Eastern Corridor)
Ekurhuleni is currently the second best performing district in the country at 89% in the Ideal Clinic program.
With regards to the National Core Standards, the Ekurhuleni district was the best performing region in Gauteng. The 11 Ekurhuleni District facilities are implementing the e-Health registration and this initiative is expected to improve the head-count data.
Goba Clinic, Ethafeni Clinic and Winnie Mandela Clinic will be offering 12 hour services as part of phase one and will then offer 24 hours services by 2018/2019.
We plan to build two new district hospitals in this corridor in the Kempton/Tembisa and the Daveyton areas as part of our drive to strengthen primary healthcare, while reducing patient load on regional, tertiary and central hospitals.
The construction of Thelle Mogoerane Regional Hospital new staff accommodation at cost of R241 million will be completed in the current financial year 2017.
Sedibeng District (Southern Corridor)
In the Southern Corridor, antenatal first visit below 20 weeks improved from 65,3% to 67%. Ward Based Outreach Teams, DCST, and hospitals intervention reduced severe Acute Malnutrition significantly.
Planning for major revitalization projects at Sebokeng Hospital is underway. Construction of the new Boitumelo Clinic in Emfuleni at a cost of R35 million will commence in this financial year. This will bring much needed comprehensive health services to this community.
Johannesburg District (Central Corridor)
In the Central corridor, we responded to the request of the community of Braamfischerville by opening a temporary clinic to expand primary health care and bring quality services closer to our people.
The Stretford Community Health Centre extended operational services to 24 hours. Whilst Noordgesig Clinic will be opened in this current financial year; Orchards Clinic is at 60% complete; and Esselen Gateway Hillbrow Clinic is at 90% complete. Finetown Clinic construction has begun;
Planning for the conversion of two CHCs, Discoverers, Lenasia and Hilbrow into district hospitals are at an advanced stage. Upgrading of Helen Joseph Hospital is underway;
The upgrading of Psychiatry wards in Hellen Joseph and Charlotte Maxeke is being prioritized.
A state-of-the-art training centre was opened and operationlised at Chris Hani Baragwanath Academic Hospital;
Refurbishment of Chris Hani Baragwanath Academic Hospital nurse's residence.
Tshwane District (Northern Corridor)
In the Northern Corridor, we continued to implement Maternal and Child Health Interventions and as a result, the Antenatal Care first visit rate before 20 weeks of pregnancy improved from 49% to 61.7%.
We will continue to build new facilities to ensure health services are widely available to our people across the length and breadth of our province. For this corridor the major infrastructure projects are as follows:
The planning of the new Soshanguve District Hospital is now done and await the release of land from the City. We thank the City for availing the new Block JJ Clinic which will be opened officially in the next month - the new Dewagensdrift and Kekanastad Clinics will also be officially opened this year .
Planning of major hospital revitalization projects at Jubilee, Mamelodi and Kalafong hospitals is underway;
Westrand District (Western Corridor)
The Western Corridor is providing Inter-sectoral management of severe malnutrition through provision of food supplements and detection of social determinants of health and referral to relevant sectors for proper management. Beneficiaries of the food supplement are 3274 children, 5783 adults, and 3990 pregnant and lactating women which all totals to 13047. The District has 98% drug availability including ARV's.
In an attempt to strengthen the quality of primary health care in the district, we have built and officially opened the state of the art Randgate Clinic in Randfontein at the cost of R42 million. The clinic serves more than 12 thousand patients in Randgate and surrounding communities.
Work on the construction of the Greenspark clinic, which will offer comprehensive health services is underway and we expect to complete the project next year. The construction of Mayibuye and Khutsong Clinic is underway; while Kagiso and Mohlakeng Community Healthcare centres are still at planning stages. The completed R 36 million renovations at Bonalesedi Nursing College, based at Leratong Hospital complex will be officially opened later this year.
Honourable Members, this sums up our work in the five corridors and demonstrates our efforts in improving the quality of healthcare at the coalface of service delivery in line with TMR and the deliverolgy intervention. The MOU and Service Delivery Agreement we signed with the Department of Infrastructure Development will go a long way to implement the R1,6 b infrastructure budget. We have also agreed to approach hospital renovations in a more strategic manner for high and sustained impact. With the assistance of the Development Bank of SA and National Department of Health, Standard Prototypes will developed for Ideal Clinics and towards Ideal Hospitals.
Emergency Medical Services
The Emergency Medical Services budget has increased by 6 per cent from R1.1 billion in 2016/17 to R1.2 billion in 2017/18. The growth makes provision for replacing ageing emergency vehicles so that the department can continue to provide effective and efficient emergency medical services. In 2017/18 financial year, we are going to add 200 ambulances and 20 rapid response vehicles at cost of R150 million.
Significant progress has been made with regards to strengthening activities of the Township Hubs around the province in priority areas to a total of R15 million (10%) for mechanical, panel (body repairs) and patient compartment improvements in the past financial year. We plan to increase the allocation to R30 million or 20% in 2017/18 financial year budget.
The Provincial Hospital Services budget increased by R1.3 billion. This is due to additional funding for higher municipal tariffs at institutions and non-negotiable line items.
Central Hospital Services increased significantly by 13 per cent, from R12.6 billion in 2016/17 to R16.4 billion in 2019/20. This is due to the enhancement of tertiary services, funding of non-negotiable items and budget pressures from increases in the prices of medical commodities and the payment of municipal services.
Central and tertiary hospitals have made a significant progress in improving access to highly specialized health care services including neurosurgery, burns care, hematological services, kidney transplantation, arthroplasty, establish a pelvic dysfunction clinic and implement a state-of-the-art mammography clinic, which provides tomosynthesis. In addition, specialized services such as Magnetic Resonance Imagery (MRI) Computed Tomography (CT) and Endoscopic Surgery had been made available at hospitals where such services were previously lacking.
A number of quality improvement initiatives were undertaken during the 2016/17 financial year. Of note is the reduction of waiting times at Leratong, Jubilee and Dr George Mukhari Hospital's through the implementation of Lean Management.
In terms of managing the Department's valuable asset, the human capital, we plan to improve our human resource component. We are going to implement Primary Health Care Normative Guide informed by the Workload Indicators of Staffing Needs (WISN) in all Primary Health Care facilities.
We will ensure compliance with performance management systems, while implementing employment equity, gender, youth and disability mainstreaming.
We plan to build capacity of human resource management in the institutions and districts facilities. To gauge staff gratification, we plan to conduct annual staff satisfaction surveys. The number of employees in the Department has increased substantially. An organisational structure was developed by the Department to increase the numbers of personnel in the District Health Services because of the re-engineering of Primary Health Care and the introduction of National Health Insurance.
As part of initiatives to ensure labour peace, the department will be having quarterly meetings with the Labour Organisations
We are working around the clock to clear accruals and ensure that suppliers are paid and services are not compromised. As such an amount to the value of 3.5 billion has been paid to suppliers since the beginning of the new financial year.
The Department received an unqualified audit for the 2015/2016 financial year and has been working tirelessly to maintain this, as we work towards a clean audit. Key to us being able to achieve a clean audit is addressing the high value of accruals as this impacts on our ability to effect payments within 30 days.
The Office of the Auditor General is currently in the final stages of the 2016/2017 financial year audit and based on the preliminary findings we are likely to have a similar audit outcome as in the previous financial year.
The strategic risk register for GDOH has been reviewed for the 2017/2018 financial year and clear action plans for risk mitigation have been developed to ensure that we reduce the risk exposure. The Department has identified key risks that can impact on its performance. These include: adverse events, ageing infrastructure, Health information management systems, inefficiencies including delayed payments, poor governance and accountability resulting in inefficiencies and wasteful and fruitless expenditure.
Governance and public participation
Any effective health system needs sufficient public participation and active oversight. It is in this light that we can confidently say we are making significant progress in the appointment of Hospital Boards and Clinic Committees. They will oversee and support the effective and efficient functioning of hospitals and clinics in our Province. While the Boards' primary role is to play an oversight role, holding hospital managers responsible, the Chief Executives Officers remain responsible and accountable for executive decisions and the day to day running of the hospital.
To date, we have appointed 180 board members, and we have 47 outstanding vacancies for us to reach the total number of 227 members. We have also finalised the terms of reference for Hospital Boards, and these will be shared with all appointed members. Hospital Boards are statutory bodies appointed according to the National Health Act, No 61 of 2003 and in conjunction with the Hospital Ordinance 14 of 1958 as amended in 1999. We also met with appointed Hospital Board members on 4th of May 2017.
Out of the 369 in the province, 330 facilities now have Clinic Committees. Of these, 143 are fully complemented while 187 are not fully complemented, 39 are without Clinic Committees. We will soon be filling the outstanding vacancies. We have stepped up our verification and recruitment process. Clinic Committees are statutory bodies appointed according to Section 42 of the National Health Act, No. 61 of 2003.
The main objectives of Clinic Committees include promoting effective and efficient governance through public participation; addressing the health needs of the communities they serve and ensure accountability and transparency. I have already met with all the appointed Clinic Committee members in our five districts in April and May 2017.
We will forever be indebted to Hospital Board Members and Clinic Committees that have agreed to give us their time to contribute to governance and accountability as we continue to restore our people's confidence in the health system. .
Medico legal claims continues to be an albatross for the Department and as a result it was forced to settle exorbitant amounts due to unavailability of clinical data. We developed a multi-pronged approach to mitigate against high claims such as introduction of mediation process, legal audit strategy. The Department does not budget for negligence as it is considered to be fruitless and wasteful expenditure and therefore budgeting for negligence is in contravention of the Public Finance Management Act.
Our view is that payments to settle negligence cases should not result in patient care and safety being compromised.
As we have said in the beginning health services is about the people and the leadership and governance must respond to their needs. In order to empower our managers in the frontline, fast track service delivery and decision making the department has finalised delegations in Human Resource, Finance, Supply Chain Infrastructure and Clinical Care.
These delegations are in pursuance of our resolve to strengthen performance management systems which will enable us to reward excellence and also deal with mediocrity, ineptitude and deal with bad staff attitudes.
We have worked hard to align the performance management system to the APP tabled at the Legislature. To strengthen participatory governance we have made progress in establishing boards and in this regard we are also working with the WITS school of Governance.
We will be modernising our security services by insourcing and implementing hi tech technology including implementation of E-health interventions aimed at improving patient registration, information management systems, clinical electronic systems and establishment of a health observatory.
Forensic Pathology Services
In this financial year, we are going to procure and install a self-track system on Forensic Pathology Services fleet, which will provide high level monitoring and control on Departmental vehicles. We are also going to procure new fleet consisting of 11 vehicles to supplement the existing fleet. To speed up post-mortems we are going to procure new medical equipment and strengthen in-house histology laboratory at Johannesburg Forensic Pathology Services.
We currently have 26 dedicated Clinical Forensic Medical (CFM) facilities that provide services to victims of crime inclusive of seven Thuthuzela Care Centres. These facilities offer various services, namely: management of victims of crime; domestic violence; sexual assault including (Post Exposure Prophylaxis) PEP Programme; child abuse (Physical or Sexual); substance abuse; human trafficking; and victim empowerment programme.
We continue to raise awareness and educate all sectors of society and communities about gender based violence and child abuse all year round. Through various programmes such as Child protection week campaigns; School outreach; Women's events; Men's events and 16 Days of activism on No Violence against women and children.
In conclusion, let me echo sentiments which were made by O.R Tambo at the 25th Anniversary of the Freedom Charter in 1980, when he asserted: "The enormous challenge posed by this historic mission makes it impossible for us to rest on the laurels of the past achievements. We cannot pause for a moment, but must examine afresh the obstacles in our path and see how to overcome them". We must pause at this Mid-Term point and examine the obstacles in our path and accelerate our five year vision that we developed at the beginning of the term.
Oliver Tambo's words remain true to this day!
We dedicate this speech to the many men and women in the Gauteng Department of Health who continue to embody the work ethos, dedication, activism and selflessness to serve our people like our fallen heroes and heroines, Albertina Sisulu, Maria Rantho, Charlotte Maxeke, Cecilia Makiwane, Dr Molefi Sefularo and Steve Biko - the list is endless.
May we all draw strength and learn from their legacy and continue emulating these icons of our people.
The most common and outstanding value out of all these leaders is that they understood the value of humanity, dignity, respect, and lived by these.
Let me take this opportunity to thank the Honourable Premier, Mr David Makhura for his unwavering support and guidance, and my predecessor former MEC Qedani Mahlangu, and my colleagues in the Executive Council.
We also want to express our sincere gratitude to the Chairperson of the Health Portfolio Committee, Ms Nompi Nhlapo and members of the Committee for their active oversight role. Let me, also thank the Acting Head of Department, Dr Ernest Kenoshi, the management team and all frontline staff. I also wish to thank my family for allowing me to do this job, it would be difficult without their support.
I Thank You!
Issued by: Gauteng Health
But legal experts said MPs could not face any form of court action over the way voted in the motion of no confidence because it is not a disciplinary procedure.
Paul Hoffman‚ director at the Institute for Accountability‚ said the no-confidence vote was a “popularity contest” where the president’s conduct was not being judged.
“There is nothing that can be done either in civil law or criminal law if a person makes a political judgement that it is okay to support a crooked president in a no-confidence motion‚ because it is a political decision‚” said Hoffman.
“The same does not apply in a vote on removal from office‚ which is a disciplinary procedure.”
Outa handed the 176-page dossier‚ titled No Room To Hide: A President Caught in the Act‚ to parliament on Wednesday with a request that each MP be given a copy.
In the document — which attempts to summarise all the evidence of state capture from reports‚ media exposés‚ affidavits and the #GuptaEmails — Outa says Zuma mismanaged his cabinet in a manner that has had a detrimental effect on the country and the economy; used or manipulated state resources or appointments to avoid prosecution on at least 783 charges; wilfully and maliciously lied or misled Parliament and the nation; and abused his position to enrich himself‚ his family‚ his friends and his cronies.
The extensive document‚ with six annexures‚ is made up of several chapters outlining ties between the Gupta and Zuma families; the alleged Zuma-Gupta plundering of public resources through state-owned enterprises; and the circumstances around the appointment and removal of various ministers.
The report said South Africans‚ through their elected representatives in the National Assembly‚ were entitled to hold the president to his oath of office and the obligations imposed on him and his cabinet by the constitution.
Said Duvenage: “All we want is for MPs to read the dossier‚ understand it and digest it. If‚ after that‚ they vote to keep the president in power ... we can confidently say that [they] have not exercised your constitutional duties to this country.”
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