e 2008/09?department h

2008/09 Budget: R20 millionMadam Speaker, we announced last year that we were concerned and are still concerned about the high level of maternal deaths and innt mortality in our health cilities. We also indicated that we introduced an intervention to address these challenges in the form of the Saving Mothers Saving Babies Project as an attempt to reduce maternal and innt mortality.Our targets for the next financial year will include the following: increase advocacy and education campaigns about pregnancy and its complications

2008/09 Budget: R374,644 millionMadam Speaker, our careful planning is undermined by the escalating numbers of extreme (XDR) and multi drug resistant (MDR) tuberculosis, HIV and AIDS. In improving the health outcomes and better quality of life and addressing the HIV and Aids pandemic, it is important to report to the house that based on the results of the 2006 antenatal care survey that we undertook: 28.6% of pregnant women were HIV positive in the Eastern Cape in comparison with a prevalence rate of 29.5% in 2005. This finding suggests for the first time that the Eastern Cape epidemic may be beginning a downward trend.

abscond from Jose Pearson Hospitals in Port Elizabeth.Other strategies for the next financial year will include the following: increasing and multiplying the awareness and advocacy campaigns about TB and multi and extreme drug resistant TB to all the communities of the province

2008/09 Budget: R30,729 millionAs part of its responsibilities in the province, the department provides orthotic and prosthetics to indigent members of the community. For the next financial year the department will be increasing the provision of orthotic and prosthetic services, and in this regard:

surveillance and containment of communicable diseases, especially in terms of the quality of food, water and sanitation, waste management, informal vendors and possibilities of food poisoning outbreaks

Total Conditional Grant Funds restored after being taken away in 2007 Adjustment Estimate: R100 00014.2 For information purposes, the above figures are also inclusive of Conditional Grants which are:

develop and implement interventions that are designed to resolve and eliminate the Auditor-General (AG) issues and ensure the department obtains an improved audit report in 2008/09.

building of staff accommodation at Joubertina Hospital.An amount of R174,2 million has been made available for the next financial year, specifically to continue rehabilitating and upgrading of primary health care cilities like clinics and community health centres. This commitment is based on our resolve to ensure that we bring health services closer to communities than before.Madam speaker, these clinics will be fully resourced with professional nurses, sufficient drugs and consumables, as well as essential equipment for them to be fully functional. We will officially open the Nontyatyambo community health centre which is located at zone two, Mdantsane, in June 2008, in order to reduce the patient flow to Cecilia Makiwane Hospital.8.1 Hospital Improvement Programme

Stipend have been paid to 6545 community workers, with 42 280 patients are on the home based care program as part of strengthening the community based services.

strengthen our engagement with traditional birth attendants as the majority of pregnant women in rural areas still consult them.2.4 Integrated Nutrition Programme2007/08 Budget: R28,219 million

Madam speaker, there is also a number of hospitals that are on the national revitalisation programme with a budget of R282,288 million. These hospitals are Frontier, Madwaleni, St Elizabeth, St Lucys and St Patricks. Construction work is continuing and contractors are on site.8.3 Provincially Funded Hospital Upgrading Programme

242 emergency medical rescue service (EMRS) practitioners to be placed at the emergency medical services throughout the province in order improve the response time in urban and rural areasAs per the resolution of the EXCO regarding the unemployed graduates who were placed in the internship programme, we will absorb and deploy them in relevant areas according to their expertise.4.5 Retention StrategyAs an attempt to address some of the deficiencies associated with recruiting and attracting health professionals, the department implemented the Occupational Specific Dispensation (OSD) for nurses that we announced at this house during the policy speech of 2007/08. This intervention which has seen a significant increase in nurses salaries was made at a cost of R173 million.During the next financial year, we are going to implement the second phase of the OSD where we are targeting doctors, pharmacists, EMRS practitioners and other health professionals. Currently, health institutions are identifying all nurses with particular specialisation and thereafter they will be remunerated accordingly5. Building an effective Emergency Medical and Patient Transport Services2007/08 Budget: R333,912 million

clinical engineers and others.In responding to the call of the EXCO, the department will be awarding bursaries to students who come from rural areas, especially those who are from the 11 poorest municipalities. This is part of our contribution in addressing poverty.4.3.2 Health Professional Training and DevelopmentThe department is also responsible for the training of health professionals to improve their skills and the department has budgeted an amount of R199,641 million which is earmarked for transfers to universities and health resource centres for professional learning and development of senior health professionals.4.4 Skills Development Learnerships and Internship ProgrammeThe department also provides learning and employment opportunities to the youth of the province. For the next financial year department will recruit:

increase the number of hospital gardens from 11 to 21 hospital gardensMadam speaker, as part of our collaboration with sister departments, especially the Department of Agriculture, we believe that, through this programme, we will also be able to contribute to the Household Food Security that the Department of Agriculture is championing.3. Environmental Health2007/08 Budget: R15 million

2008/09 Budget: R13,5 millionOur commitment in taking care of the health of the citizens of the Province is illustrated by our emphasis in providing access to health and addressing the challenge of non-communicable diseases including diseases of lifestyle. The e-Health Programme which provides access to diagnostic and therapeutic support to clients and health practitioners residing in most remote and rural areas of the province is to be expanded as it is currently piloted in the eastern part of the province. Through the e-health programme, the department has planned to: Increase the clinic connectivity to an additional 25 clinics which means that by the end of the financial year, 50 clinics will be on the e-health programme in the most remote and rural areas of the province.

providing recreational cilities for the patients housed at TB hospitals so that they will not experience boredom and homesickness

intensifying campaigns on HIV prevention, including the rapid implementation of the guidelines on Prevention of Mother to Child Transmission (PMTCT).

Terms & conditions

Health promoting schools will be increased from 182 to 360 and there will be focus on substance abuse such as illicit drugs and alcohol.

the upgrading and maintenance of reticulation and electrical systems in health cilities.Madam Speaker, it is important to report to the house that procurement process regarding this exercise has commenced and appropriate documentation has already been generated accordingly. Currently, maintenance of generators, incinerators, and autoclaves in our health cilities is underway.9. Contribution to the 2010 FIFA World Cup

The department has embarked on a performance budgeting approach in an attempt to give effect to an effectively planned, implemented, monitored and controlled process. The rigid implementation of budget committees at all levels of the department, including health cilities, will be used to further entrench corporate budget accountability.10.2 Procurement plans that have been developed

all cilities are supplied with colour coded and purposeful designed containers for medical waste management

Included in the overall budget of infrastructure Madam Speaker, is R50 million for alternative power sources and generators for health cilities to mitigate the current power outages. The replacement of generators, Madam speaker should not be seen in isolation. There are various activities that we are going to be urgently implementing. These include the following:

orthoses will be increased from 4 014 to 4 500 for deserving clients.Madam Speaker, Honourable Premier, an amount of R3 million was paid as a grant to a NGO this year that cilitates the availability of prosthesis to amputees within the province. A further adepartment health eastern cape provincemount of R3 million has been allocated for the next financial year to further address the backlogs in the provision of prosthesis to amputees in the province.8. Infrastructure development and management2007/08 Budget: R789,165 million

The upgrading of Siphethu Hospital has been allocated funding of R15 million for 2008/09 financial year including the Tayler Bequest Hospital at Mt Fletcher for a budget amount of R2 million

1 341 learners for the learnership programme where they will be placed for learning in different health cilities

2008/09 Budget R 4,237,898 millionMadam Speaker, we cannot over-emphasise our role of strengthening primary heath care which is a cornerstone of the District Health System. In this regard, we are continuing with the implementation of a project on Clinics as Centres of Excellence to ensure that primary health services are accessible to communities. The following targets will be implemented: The number of these clinics as Centres of Excellence has been increased from 50 to 60.

2008/09 Budget: R62,092 millionMadam speaker, we also contribute to the improvement of the nutritional status of the people of the province and in this regard, we have planned to:

Vuka South Africa Move for your Health which will focus on the youth, children, the aged and the disabled to address and promote healthy life styles.

improving and strengthening management of specimen transportation to improve sputum turn around time by ensuring that results of patients sputum be made available within 48 hours instead of 72 hours

2008/09 Budget: R42,000 millionMadam speaker and honourable members of the house, the availability and supply of pharmaceuticals at all material times has never been more critically challenging than currently. This realisation has prompted the department to drastically turnaround the supply chain management of pharmaceuticals by:

One of our key focus areas in 2008/09 is to build strong financial management and better compliance. The state of financial management is being reviewed through the audit improvement project. The objectives of the Audit Improvement Project, Madam Speaker, are to:

preventing the spread of TB, and containing the Multi Drug Resistance (MDR) TB and treat the Extreme Drug Resistance (XDR) TB.

increasing the TB cure rate from 57% to 70% by the end of the 2008/09 financial year.The department has allocated an additional amount of R30m for the provision of food parcels for TB clients at OR Tambo, Amathole, and Nelson Mandela Metropolitan Municipality which are the three TB crisis districts.2.3 Maternal, Women, Child and Youth Health2007/08 Budget: R23 million

building the capacity of the department to implement its mandate, and to improve service delivery and accountability

183 tanks in the 11 poorest municipalities where our clinics are located.Madam Speaker, as per the resolutions of the 52nd Conference of the ruling party regarding health promotion, the above activities will intensify our efforts to create an environment that promotes positive individual behaviour in our communities, especially amongst young people.1.2 e-Health Programme2007/08 Budget: R12,2 million

2008/09 Budget: R3 0millionThe department has an obligation to comply with Occupational Health and Safety Regulations and the focus for the next financial year will be to ensure that:

2008/09 Budget: R395,756 millionMadam speaker, the department is committed to saving the lives of patients by transporting them to nearby health cilities through Emergency Medical and Patient Transport Services. During the last financial year we announced that we will:

Primary healthcare cilities to provide Voluntary Counselling and Testing has been increased to 750 which means all the health cilities in the province will render this service.

medical health services policy based on FIFA requirements in terms of the waiver of registration by medical and allied health professionals during the 2010 World Cup Soccer Tournament

and Maternal Obstetric Units has been increased from 18 to 40.1.1 Healthy Lifestyles and Health Promotion2007/08 Budget: R7,2 million

a disaster management strategy including a communication strategy to deal with the dissemination of information relating to victims and milies of the affected

5.1 Build new EMS bases at Mt Ayliff, Mthatha and Queenstown to strengthen the capacity of the EMS at a projected cost of R18million. The construction has commenced and is at an advanced stage with the projected completion date being July 2008. In Queenstown, the new EMS base is being built at Komani Hospital and the projected completion date is August 2008.5.2 Furthermore, we will develop a modern EMS station in Port Elisabeth in preparations for the 2010 FIFA Soccer World Cup, at an anticipated cost of R18 million. Madam speaker, the design for this station has been completed and documents are being prepared for the tendering process. The anticipated completion of this project is December 2009.5.3 We also indicated that we will establish a vehicle tracking and monitoring system to identify the location of the EMS vehicle, and to further improve the response time and prevent duplication of services when EMS vehicles are dispatched to an emergency site. All EMS vehicles have been installed with tracking systems.5.4 Madam speaker, the department will continue implementing the projects that we started with during the last financial year and we will further procure additional 80 Emergency Medical Services Vehicles (Ambulances) and five rescue vehicles in the next financial year.Madam speaker, at this moment, I would like to express my sincere appreciation to all the EMS staff who sacrificed their time by manning our national and provincial routes during the festive season as part of saving the lives of those who were returning to the province for holidays as well as those who constantly utilise our road network. They have made us very proud.6. Pharmaceutical Services2007/08 Budget: R33,912 million

final disposal of medical waste to the approved landfill sites will be carried out as efficiently as possible

In ensuring that all our hospitals comply to minimum set of standards, which are, patients safety, financial management, clinical governance, hotel services provision, the department will enhance its oversight responsibility to ensure that these standards are met.A national programme that has identified a number of hospitals to be on this programme will also be implemented in the province. There are five health cilities in the province that have been identified and they are Frere, Livingstone, Butterworth, Komani Hospitals and Ngqamakhwe community health centre.8.2 National Funded Hospital Revitalisation Programme

e 2008/09?department h,intensifying the campaign on communicable and non communicable diseases, to reduce the burden of diseases.

Bi-weekly, in-year monitoring and budget accountability reviews will be conducted in order to maintain the momentum of the targeted expenditures, which will be reconciled to cash management reports. Planned quarterly reviews to determine organisational performance in relation to budget expenditure are going to be implemented to ensure that the budget spent is accounted for with reasons for not spending sanctioned accordingly.11. Conclusion

165 health post to encourage and foster partnership with communities and traditional leaders to promote healthy living styles will be established.

health professionals, especially professional nurses with the aim of strengthening the primary healthcare services and to ensure that our clinics and community health centres, in particular, those situated in rural areas, have sufficient health professionals

350 unemployed graduates who will be deployed in the different administrative, financial, human resources and information technology (IT) areas of the department including the health institutions, and

HR Budget 2008/09 Budget: R29,2 million4.1 Human Resources for HealthProject 5000 and Filling of Critical VacanciesThe department has set aside a budget amount of R600 million, which is made up of R500 million planned by the department for critical vacancies as well an additional amount of R100 million for Project 5000 received from Provincial Treasury. The recruitment will include the following:

2008/09 Budget R619,993 million4.3.1 Bursary AllocationMadam Speaker, the department has also increased the bursary fund from R45m in the 2007/08 financial year to R96 million for the next financial year, targeting specialised scarce skills which will include among others, the following:

ensure that the department is fully capacitated in financial management by 2009/10.A project plan in this regard has been developed and is funded to a budget amount of R 48,8 million.10.1 Budget management

finance and human resources (HR) specialists to improve the financial management of the department including health cilities.The department will ensure that the majority of these officials are appointed by the end of the first quarter of 2008/09.4.2 Foreign Force Recruitment

Campaigns to detect congenital defects will be enhanced through the home visits.Madam speaker, the department will also provide water tanks to areas that are vulnerable to waterborne diseases and in this regard, we are going to avail: 17 water tanks in health promoting schools throughout the province

increase the number of food parcels provided to malnourished children, TB and HIV clients from 69 000 to 138 000 in the province

commencing with the upgrading of seven clinics to become fully-fledged 24 hour community health centres

readiness for the 2010 FIFA Soccer World Cup.Madam Speaker, I will now elaborate on these priorities1. Strengthening Primary Healthcare and District Health Management

The implementation of the budget spend for the next financial year is strongly reliant on the structured procurement planning processes put in place as compulsory requirements.10.3 Tighter monitoring of expenditure by programmes

examining the distribution mechanism of drugs from manucture to the two depots in the province to health cilities and finally to the patients

strengthen outreach programmes by specialist doctors to mentor junior doctors at district hospitals in order to deal with complications of expectant mothers

The department is significant strides in provision of Comprehensive Care, Management and Treatment of HIV and ADS (CCMT). In the past year, 62 sites have been accredited to provide CCMT, with 42 280 clients enrolled on the antiretroviral (ART) program.

A Provincial Men in Partnership Summit was held to highlight the role of men in the fight against HIV and AIDS.Madam Speaker, Government is committed to the implementation of the HIV & AIDS National Strategic Plan 2007 to 2011 for the next financial year. The department has therefore planned to implement the following targets regarding the HIV and AIDS which are to:

12.1 Madam Speaker, honourable members of the house, I hereby table the Budget Vote, Vote No. three of the Eastern Cape Department of Health which is R9,7 billion for 2008/09. The budget has been appropriated in terms of the following budget programmes of the department. Comprehensive HIV and AIDS: R500 522 000

2008/09 Budget: R1 129,266 millionDuring the last financial year the department opened 63 clinics throughout the province to strengthen primary healthcare. For the next financial year, the department has prioritised the following:

strengthening public-private collaboration in TB management as the majority of clients are consulting private practitioners

2008/09 Budget: R8,2 millionDuring my last policy speech, I invited all Honourable Members of the House to participate in our health promotion programme. This year, I am once more, extending an invitation, not only to participate in our health promotion programme, but to effectively lead and champion the success of the implementation of the programme in all our constituencies.The following projects are going to be implemented:

Ensure that all 768 primary healthcare (PHC) cilities will be providing access to Voluntary Counselling and Testing (VCT) and Prevention of Mother to Child Transmission of HIV and AIDS (PMTCT) services.

the procurement and installation of un-interrupted power supply (UPS) mechanism in all health cilities

strengthen human resources in order ensure the timeous delivery of essential drugs to all healthcare cilities and, once again to the patients.A multi-task team consisting of pharmacists, supply chain management specialists, finance and human resources management specialist, has been deployed to identify the most critical areas to strengthen service delivery at the two pharmaceutical depots. More, significantly, is to turnaround the performance, the pace and efficiencies of supply drugs to the needy patients of the province.7. Orthortic and Prosthetic services2007/08 Budget: R23,977 million

4.2.1 Tunisian ProgrammeAs part of our commitment to address the shortage of medical personnel in rural areas, the department has, through the technical agreement signed between the Republic of South Africa and Tunisia recruited 40 doctors from Tunisia, and the first contingent arrived in the province on 12 December 2007. 17 Tunisian doctors are currently undergoing an orientation programme at the three hospital complexes and will be ready to be deployed in rural areas of the province in April this year.The second phase of this process will be finalised by the end of June 2008 and it is hoped that all the remaining 23 doctors will be recruited, orientated accordingly and deployed to rural parts of the province.The co-operation between our countries resulted in the launch of a National Cataract Surgery Project with a total of 369 operations performed by Tunisian ophthalmologists at Butterworth hospital during their initial visit in January and August last year.4.2.2 Cuban ProgrammeWe have also sent 23 students doctors to Cuba for medical training and 9 qualified doctors who were also trained in Cuba have been deployed throughout the province to service our rural communities.4.3 Training and Development/Human Resource Development2007/08 Budget: R355,687 million

57 non-governmental organisations have been accredited as Voluntary Counselling and Testing (VCT) non-medical sites.

commencing with the rehabilitation of six clinics to become proper clinic structures with wellness and counselling rooms. Our strategy to ce-lift health cilities will be st-tracked and enhanced. The following health cilities have been prioritised for the next financial year:

8 000 community caregivers to receive nationally determined stipends and to be trained according to the Community Care Worker National Qualifications Framework levels.2.2 Tuberculosis (TB) Management2007/08 Budget: R193,7156 million

increase the number of clinic gardens producing fresh vegetables from 48 to 96 clinic gardens. We commend the Department of Agriculture on their effort and support to make this programme a success.

Fellow citizens of the Eastern Cape ProvinceThe well-being of any nation is a culmination of various interdependent actions and interventions. Accelerated shared growth and development, accompanied by the reduction in unemployment and poverty, and the general improvements in the creation of a better physical and natural environment, will have a positive impact on the quality of health of the population that we are striving for.Madam Speaker, our movement has declared education and health to be prioritised as the core elements of social transformation for the next five years. This is in keeping with the process of service delivery improvement that the Department of Health has embarked upon, which we are going to accelerate in the coming years.The Department of Health is committed to meet the targets and the call made by the President that the work and approach starting this year is Business Unusual. We are today presenting this policy and budget speech with a clear focus of the resolutions of the ruling party.It is clear Madam Speaker, that if we are to realise the health targets set in the Millennium Development Goals, and the PP, we would have to drastically increase the pace at which we do things, and to integrate more as government, and to strengthen collaborations and partnerships with our communities, labour and the private sector.The priorities we will be pursuing in the coming financial year which are also informed by the APEX targets announced by the President are: strengthening primary healthcare to become the first point of call for the patients.

ensure that dedicated emergency medical services (EMS) vehicles are available for transporting pregnant women to nearby health cilities whenever necessary

As part of improving our hospitals in the province, the department will continue with the following work that we started in the previous financial year:

43 health cilities will be linked to the mindset channel with particular emphasis on HIV and AIDS, tuberculosis (TB) and Health Promotion.2. Intensifying the campaigns on communicable diseases, focusing on TB and HIV and AIDS.2.1 HIV and AIDS2007/08 Budget: R299,819 million

50 PHC cilities will be offering the comprehensive package of ual assault care in accordance with the National Policy on Sexual Assault Care.

training of health professionals and medical waste operators in our health cilities will be done.4. Building the capacity of the department and improving accountability

a provincial mechanism to manage the exemption and control of drugs that are brought into the country by the international teams.An amount of R45 million for Livingstone Hospital Trauma Centre has been made available to ensure that we deliver a successful 2010 FIFA World Cup.10. Putting our finances in order

an initial amount of R6 million has been allocated secure the site for the development of the Mt. Ayliff Psychiatric Hospital.8.2 Management of Power Outages

2008/09 Budget R87 millionHonourable members of the house, the department has estabe 2008/09?department hlished a 2010 Co-ordinating Unit to make sure that all ministerial guarantees regarding health and medical services are adhered to. The unit is working towards the 2010 Health Summit to be held around June 2008 and this summit will form part of sharing the government plans and 2010 Health Priorities will all the relevant stakeholders.Extensive progress has been made in terms of finalising our Integrated 2010 Health Blue Print which addresses 2010 Strategic Intervention areas. These areas include the following:-

2008/09 Budget: R201,643 millionThe department is going to focus more on tuberculosis (TB) as per the resolution of the 52nd conference of the ruling party which indicated that diseases such as TB and cancer should be given special attention.Madam speaker, honourable members of this house, as a response to this call, we are going to develop our own provincial war room in order to engage senior clinicians, health experts, traditional leaders, traditional healers, religious leaders and other key stakeholders in seeking multiple solutions to address the MDR and XDR TB problem in the province. We are inviting all honourable members of the house to participate in this exercise as well as in our campaigns to address TB and, further communicate that TB is curable and preventable.Madam Speaker, let me take this opportunity to express my sincere gratitude to Honourable Member of Executive council (MEC) Martins for the critical role the Honourable MEC has played in addressing the issue of TB patients who wanted to

Implementation of the Dual Therapy PMTCT guidelines and treatment of pregnant women to ensure optimal prophylaxis regimen and interventions to be st-tracked.

Madam Speaker and honourable members of the house, as I conclude, I have the honour to report that the department was ranked number one in the country in the management of the geriatric programme and in the restoration of sight through the Cataract Surgery Programme. I would like to thank Ms Mayekiso for this possible. In addition, the Madwaleni Hospital was awarded a Premiers Award for best Voluntary and Counselling Test (VCT) Centre.I would also like to commend the health promotion programme for taking strides to bring our school children on track and to promote healthy lifestyles.Once again a special thanks to our youth in the department who ran the Youth Outreach Program that brings services closer to the people, which takes place for a week in various districts led by Mr Tafeni of intergovernmental and SPU.The department, Madam Speaker, is therefore committed to strengthen the functionality of the provincial public health system by building its capacity to deliver. Campaigns to promote and strengthen healthy living and health lifestyles to focus on prevention of diseases will be implemented. Furthermore, we are going to enhance the credibility of the public health system through effective communication of real progress, successes and the challenges cing us.The department, Madam Speaker, is therefore committed to strengthen the functionality of the provincial public health system by building its capacity to deliver.Honourable members of the house, we are going to institutionalise and entrench change including the manner we do our business. The approach and the pace of our work is going to be Business Unusual – Hands on the Deck. Drastic changes in terms of our attitudes, behaviour, and practice in ensuring that the communities of the province access quality and safe health services will be prioritised through the introduction and implementation of a change management process for our staff.A readiness session which took place from the 21 to 23 February 2008 to implement our annual programme was hosted by the superintendent-general with the Departments senior management team.Our managers are ready and capable of responding to all the challenges that we are going to be addressing, but more significantly, will be the promotion and revitalisation of customer care and patient culture including the strengthening of the Batho Pele principles in all our health cilities, without exception.12. Budget allocation for 2008/09 financial year

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