Budget Speech 2007/2008: Department of Health (Vote 6) | Western Cape Government

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Budget Speech 2007/2008: Department of Health (Vote 6)

31 May 2007
Welcome

Speaker, agbare lede en gaste, dit is my voorreg om u te verwelkom by die voorlegging van die 2007/08 gesondheidbegroting vir die Wes-Kaap.

Vandag op Gesondheidsbegrotingsdag vier ons ook Internasionale Kinderdag wat in 1925 in Genève, Switserland by die Wêreldkonferensie oor Kinderwelstand ontstaan het. Daarom is dit belangrik dat ons ook reflekteer oor hoe ons as departement tot die gesondheid en welstand van ons kinders bydra. Later in my toespraak sal ek in meer besonderhede daarna verwys - vir nou volstaan ek daarby om ons opnuut daartoe te verbind om hand-aan-hand met ander regeringsfere, die NRO-sektor en ons gemeenskappe te werk om gesondheidsrisiko's vir ons ouers en kinders te help uitwys en, waar nodig, ondersteuning en behandeling te bied.

INTRODUCTION

In the foreword to the National Health Plan for South Africa released in May 1994 by the African National Congress, we read the following,

"The challenge facing South Africa (in 1994) is to design a comprehensive programme to redress social and economic injustices, to eradicate poverty, reduce waste, increase efficiency and to promote greater control by communities and individuals over all aspects of their lives"

It continues,

"In the health sector this will involve the complete transformation of the national health care delivery system and all relevant institutions" and further "ensuring that the emphasis is on health and not only medical care, encouraging and developing comprehensive health care practices that are in line with international norms, ethics and standards and reducing the burden of disease and risk of disease affecting the health of all South Africans"

And that,

"Recognizing this need for total transformation of the health sector in South Africa , the African National Congress initiated a process of developing an overall national health plan based on the primary health care approach"

The Western Cape Provincial Health Plan released in 1995, in turn indicates that only the adoption of the,

"Bold recommendations (outlined in the plan) will rescue the health service from its long term unsustainability"

It is indeed noteworthy that many of these recommendations such as the development of the district health system and focus on levels of care are to be found in the Comprehensive Service Plan. It is also noteworthy that key recommendations such as the closure of Conradie Hospital and the relocation of the spinal unit to Groote Schuur Hospital have been achieved.

The Comprehensive Service Plan (CSP) for the implementation of Healthcare 2010 builds on what went before and provides the blueprint to give practical and detailed effect to the transformation of health services in our province.

In die Omvattende Diensplan ("CSP"), verbind die regering homself tot die beginsel van goeie, toeganklike gesondheidsorg nader aan die mense wat van ons dienste gebruik maak. Ons benadering met die opstel van hierdie plan was om die behoeftes van ons mense te ontleed om uiteindelik 'n model te skep wat met ons beskikbare hulpbronne aan daardie behoeftes kan voldoen. Noudat belanghebbendes oor die plan geraadpleeg is, en dit dienooreenkomstig verbeter en goedgekeur is, kan die regering voortgaan om hierdie doelwit na te streef.

I intend with this budget to drive forward transformation and the implementation of the comprehensive service plan. I will ensure that such transformation and change is placed on a path that will ensure better, more accessible and quality health services for the people that we serve. This means better services for the poor, the working classes, men, women and children in need not only in the Western Cape but from outside our borders as well.

 

IMPROVING HEALTH CARE IN OUR PROVINCE

Speaker, I want to reassure the people of our province that in the process of improving healthcare in the Western Cape , government will act responsibly . The benefits inherent in the CSP are broader than mere bed shifts at any one hospital and extends to building a health service that not only responds to current needs - but that plans ahead with future needs and realities in mind. This government accepts it can and must do better in providing health services to our people, therefore today with this budget:

  • We will support better service at primary level by increasing the numbers of specialised nurses called clinical nurse practitioners;
  • We will create more opportunities for the training of nurses and other health professionals and provide for increases in the salaries of nurses;
  • We commit resources towards improved response times by our Emergency Medical Services with additional trained staff;
  • We begin to provide more hospital beds where they are desperately needed, especially in our regional and district hospitals;
  • We undertake to build new healthcare facilities with an accelerated programme of revitalising older hospitals and clinics in the metro and towns throughout the province;
  • We will protect the core of essential highly specialised services in our Tertiary or Central hospitals like Groote Schuur, Tygerberg and Red Cross Children's hospital and will seek to work with our universities to address the health needs of our people; and
  • Today, we take the decisive action necessary to begin the process of providing healthcare appropriate to the needs of our people.

We build from a foundation of strength.

  • In the Western Cape we have 52 public hospitals and 423 Community Health Centre's and clinics providing in the health needs of our people;
  • Close to 26 000 health staff members of whom the vast majority work at the coalface of health delivery; and
  • At R1 812 per uninsured person, the highest per capita health spend per person in the country. The 2007/08 budget provides for an allocation of R312 per uninsured persons for Primary Health Care which will fund an average of 3,7 visits to a Primary Health Care facility per uninsured person per annum. An amount of R91 is allocated per uninsured person per annum for access to Emergency Medical Services and R6.25 has been allocated to provide planned patient transport to uninsured patients which translates into the capacity to transport 47 000 patients.

However, government faces a number of challenges in building a health care system that can deliver in the needs of the people of the Western Cape .

  • Our Burden of Disease (BoD) including HIV and Aids and TB, violence and other categories such as childhood illnesses, cardiovascular diseases, diabetes mellitus and mental illness continue to put pressure on our health system. With this in mind the Schools of Public Health from the Universities of Cape Town, Stellenbosch and the Western Cape and other research agencies such as the Medical Research Council (MRC) were commissioned to recommend how the burden of disease in the province could be reduced, not just through preventive health interventions such as health promotion, primary, secondary and tertiary promotion, but also through interventions that are of a more multi-sectoral and developmental nature. Key findings in a recently submitted report include:
  • HIV and AIDS and TB mortality is increasing and interlinked. However, there are encouraging findings showing the positive impact of PMTCT and ART programmes on mortality.
  • Chronic diseases such as diabetes are increasing.
  • Although still unacceptably high injury mortality is decreasing and continues to be linked to the risks associated with youth, males, alcohol and other substance abuse.
  • Alcohol, road-user behaviour, sexual practices and health-seeking behaviour contribute to the burden of disease and are themselves linked to the so-called 'upstream' infrastructural risks of material and social deprivation.

In order to distil the critical interventions that the Provincial Government should prioritise, a Burden of Disease Symposium is to be held on 25 and 26 June 2007 which will be attended by a wide range of provincial and other representatives.

Looking in more detail into some of the challenges related to BOD it is important to note the following:

  • Trauma en noodgevalle in besonder plaas steeds groot druk op gesondheidsdienste in ons provinsie, met hoë pasiëntetalle en 'n eweneens hoë voorkoms van ernstige gevalle. Dit lei tot 'n verhoging in die koste van akutesorg by traumagevalle asook gespesialiseerde rehabilitasiedienste. Weens die groter behoefte vir noodtrauma-operasies, het die wagtyd vir beplande operasies ook toegeneem. Vroeë dood weens opsetlike of onopsetlike geweld, d.w.s. manslag/geweld en padverkeersongelukke, maak altesaam 20% van sterftes in die Wes-Kaap uit.
  • The HIV and AIDS pandemic contributes significantly to the load on the services both in terms of patient numbers and acuity of illness. Although the mortality rate from HIV and AIDS in the Western Cape (14.1%) is lower than the national rate of 39.0%, HIV and AIDS is still a major cause of premature death in the Western Cape .
  • Tuberculosis rates remain high and co-infection of TB and HIV has resulted in uncommon forms of presentation and late diagnosis of the disease. Lately, the addition of XDR-TB has significantly impacted on the workload in our TB- and other hospitals. The incidence of TB in the Western Cape is 1041 cases/100 000 population for all TB cases. This is the highest in South Africa . Tuberculosis remains a significant cause of premature death.
  • An ongoing cause for concern is the Infant Mortality Rate (IMR) which is indicative of the burden of disease in some of our communities. While the IMR in the Western Cape at 30 per 1 000 live births compares favourably with the national IMR figure of 59 per 1 000 live births we have to address the underlying inequalities in communities such as Khayelitsha where this figure is 44 per 1 000 live births before we will see a turnaround. Heart disease remains one of the top five causes of death in our province.
  • Baie van ons hospitale is oorvol; besettingskoerse oorskry dikwels 100%. Die gebruikskoers van beddens in Wes-Kaapse streekshospitale is 101% in vergelyking met die nasionale gemiddeld van 72,3%; in distrikshospitale is dit 80% - die hoogste in die land. Ons gemiddelde bedbesetting in sentrale hospitale is bykans 84%, weereens veel hoër as in ander provinsies. Die beskikbaarstelling van 220 bykomende distrikvlakbeddens in die metro sedert 2005 het die situasie in 'n sekere mate verlig. Meer distrikvlakbeddens is egter nodig om die diensdruk in die Khayelitsha- en Mitchells Plain-gebiede te verlig.

 

A BUDGET FOCUSED ON BETTER HEALTH CARE

Speaker, government is facing these challenges head-on in the 2007/08 budget. Let me share some of the proposed budget initiatives that will result in better healthcare in our province in the years ahead. These include:

1) Strengthening our District Health System (DHS).

DHS will see around 13 million PHC c ontacts at an average cost of R76 per visit, which is one of the lowest costs per contact in the figures reported in the most recent provincial quarterly performance report for health released by the National Treasury. This is the level of care where most people access the service (90%) and where the pressure of numbers and the demand for services is the greatest. It is the level of care where communities complain about long queues and sometimes of the quality of care received. Therefore, the CSP focuses on the strengthening of District Health Services by providing the complete Primary Healthcare package of services and extended hours of service at key facilities.

 

Government is committed to providing accessible, quality DHS services.

2) More resources to battle against HIV and Aids.

We committed ourself to integrating the HIV and AIDS programme into the general health services in such a way that the additional resources lead to strengthening the general health system rather than creating a vertical HIV and AIDS service delivery model. Included amongst the various successful HIV and Aids programmes managed by my department are:

  • 375 projects funded through community-based organisations with targeted work undertaken in high transmission areas, e.g. sex workers and truckers, women and youth.
  • The peer education programme with 11 501 peer educators in grades 10, 11 and 12 throughout the province trained to support and spread the message of prevention.
  • Voluntary Counselling and Testing (VCT) is offered at 441 health facilities. There are 23 NGOs who employ 373 lay counsellors who provide the bulk of the pre and post test counselling services. Our VCT target for this year is 484 000.
  • Die program vir die voorkoming van moeder-na-kindoordrag het 'n sukseskoers van 95% behaal, en stappe vir verdere verbeteringe is in plek .
  • Rakende sorg vir MIV-positiewe persone: Al die departement se gemeenskapgesondheidsentrums (GGS'e) en klinieke bied eerstekontak- sorg aan MIV-positiewe pasiënte, insluitend CD4-tellingtoetse vir verwysing na 'n ARV-perseel . Primêre-gesondheidsorgfasiliteite bied ook behandeling vir opportunistiese infeksies asook dieetkundige ondersteuning.
  • A targeted 35 863 patients on ARV treatment at 62 treatment sites by the end of this financial year. Of course, there is a huge challenge here in that we have funding for only 28 392 patients. We are however in discussion with various funding agencies in this regard and I'm positive about the outcome of these discussions.
  • Ons tuisversorgprogram bestaan reeds uit 81 NRO's, en het 1 300 tuisversorgers in diens. Tans word 20 189 pasiënte op hierdie manier versorg, en word daar gemiddeld 285 316 besoeke per kwartaal afgelê. Teen Maart 2008 behoort 2 605 gemeenskapgebaseerde gesondheidswerkers in hierdie provinsie hulle opleiding te voltooi.
  • Daar is 16 hospiese/verligtingsentrums met 254 gefinansierde beddens vir verligtende sorg aan binnepasiënte. Die bedbesettingskoers is 77-96%, en pasiënte bly ongeveer 18-36 dae.

Government is committed to turning the tide against HIV and Aids.

3) Attacking the scourge of TB

In response to the TB epidemic, we developed strategies to accelerate an enhanced response in controlling TB in the province. The strategy has been refined in 2007/08 financial year as follows:

  • An improved community-based TB control service with an improved TB-medicine adherence support programme that draws from the success of the ART adherence programme.
  • An improved PHC service for TB with additional resources deployed in the 22 highest burden TB clinics, to achieve better patient care and follow-up and basic administrative system improvements.
  • An improved in-patient TB service with the provincialisation of all TB hospitals to be completed in this year.

Government is committed to improving its response to TB.

4) Promoting women's and child health.

Vrouegesondheid bly 'n prioriteit. Fokusgebiede is die bestuur van verkragtingslagoffers, voorgeboortesorg - veral vóór die swangerskap 20 weke ver gevorder is - en toetsing vir servikskanker.

With regard to child health, s pecific target areas that also relate to the Social Capital Formation strategy are the Integrated Management of Childhood Illnesses (IMCI) with an emphasis on the management of diarrhoeal disease and immunization.

  • The diarrhoeal disease intervention campaign from February to May each year includes support at community level for the early identification of danger signs in ill children for immediate referral to a health worker, use of sugar/salt solutions and hand washing programmes. All Primary Health Care facilities will have oral rehydration corners and extra paediatric bed capacity remains available at Red Cross Children's Hospital, Tygerberg, Lentegeur and Somerset Hospitals .
  • Improving immunization remains a priority. Full Immunisation coverage for under one's has remained above 90% in the last three financial years.
  • The province is currently extending school health services to the rest of the province in line with National Policy.

Government is committed to the ongoing promotion of women's and child health.

5) Beter bestuur van chroniese siektes

Van al die sterfte-oorsake in die provinsie, tel chroniese siektes soos kardiovaskulêre toestande en diabetes mellitus onder die grootstes. Oor die afgelope jaar is daar in elk van die ses distrikte 'n alternatiewe resepteermeganisme in plek gestel, en is daadwerklike pogings aangewend om die werking van die Kaapse mediese depot te verbeter. Met die groot impak van nie-oordraagbare siektes op die gesondheidstatus van gemeenskappe, moet gesondheidsbevordering, siektevoorkoming, behandeling en rehabilitasie geïntegreer word. Die provinsie sal in lyn met die Wêreldgesondheidsorganisasie se omskrywing 'n oorkoepelende beleid vir die bestuur van chroniese siektes asook 'n minimumsorgpakket vir elke fasiliteit met hierdie dienste in werking stel.

Die regering is verbind tot die doeltreffende bestuur van chroniese siektes.

6) Health care goes beyond physical well-being.

We must reach out in practical and compassionate ways to those struggling with mental illness. The introduction of the new Mental Health Care Act obliges the Department to improve access to 72-hour services within the general acute hospitals and we are committed to strengthen capacity in these hospitals to manage mentally ill people which include infrastructure and human resource measures. The Department will also establish a licensing and inspectorate capacity for community based residential and day care programmes. In 2007/08 the financial allocation to the NPOs providing services to these clients will be increased by 50%. The Act also makes provision for a Mental Health Review Board, which has been established in our province and is fully functional.

Government is committed to ensure respect and dignity for people with mental illness.

7) Working to modernize our health services.

My department will be investing R75,5 million in providing state of the art medical and other equipment as well as technical staff to our central or tertiary hospitals. Funds will be allocated to:

  • Complete the strategic plan towards digitizing medical imaging for the services and commence with the first steps towards implementing a PACS system (Picture Archiving and Communication System).
  • Strengthen radio oncology services.
  • Acquire equipment to enhance diagnostic imaging
  • Implement the Western Cape Nuclear Medicine Services imaging communication system.
  • Acquire equipment that will enhance efficiency or where there is an urgent need.
  • Clinical engineering staff to support the maintenance of equipment.

Inligtingstegnologie by primêre-gesondheidsorgfasiliteite sal ook verbeter word. Die gefaseerde rekenarisering en elektroniese-netwerkprojek in ons gemeenskapgesondheidsentrums het 33 van hierdie fasiliteite met inligtingskommunikasietegnologie- (IKT-)infrastruktuur toegerus. 'n Pasiëntregistrasiestelsel, die pasiëntmeesterindeks (PMI), is hoofsaaklik in die metro by 22 fasiliteite in die provinsie geïnstalleer as deel van die eerste fase van die projek. Die langtermyndoelwit is om 'n omvattende inligtingstelsel vir primêre-gesondheidsorg te hê, met 'n individuele elektroniese pasiënterekord vir elke pasiënt op die primêre-gesondheidsorgplatform. Dit sal pasiënt-verwysing en opname versnel.

Die regering is verbind tot moderne gesondheidsorg.

8) Increasing training to ease critical staff shortages.

The continued shortage of critical staff including some categories of nurses and other health professionals impacts severely on our ability to provide services to all those in need. Therefore, my department is investing in training of staff. Our targets for 2007/08 include:

  • 1,678 bursaries awarded for nurse training.
  • 532 bursaries awarded for health science training for categories of staff other than nursing.
  • 469 Emergency Care personnel in training.
  • 4,000 training interventions to PHC personnel.
  • 350 ABET learners will benefit from training interventions.
  • 150 learnerships to be provided to unemployed people.
  • 2,605 people to be trained as community-based health workers.

Government is committed to providing a trained and fully staffed health service.

BUDGET 2007/08

Die Wes-Kaapse departement van gesondheid is verantwoordelik vir die voorsiening van kwaliteit gesondheidsorg aan 3,6 miljoen onversekerde mense met die beskikbare hulpbronne in ons begroting. Ten einde aan hierdie mense se gesondheidsbehoeftes te voldoen, het die Wes-Kaapse regering vir die 2007/2008-boekjaar R7,095 miljard aan die departement van gesondheid toegewys. Hierdie bedrag maak 34% van die provinsiale begroting uit en verteenwoordig 'n 9.6%-verhoging in die gesondheidsbegroting.

Of the increase of R771, 680 million in comparison to the previous financial year an amount of R349, 737 million is accounted for by inflation at 5,5%, a further R255 million is earmarked for specific allocations to services such as forensic pathology, emergency medical services, equipment in the central hospitals, extended public works programme, HIV and AIDS and infrastructure grants. A further R154 million has been allocated for improvement of nurses' salaries (R97 million) community service posts (R21 million), SITA payments, increased Government motor transport tariffs above inflation, phasing out of European Union funding for home-based care and hospital management and quality improvement. This, Speaker, results in the discretional portion of this budget being very limited to address in particular the ongoing increase in patient numbers and in particular to address resultant service pressure in the district and regional hospitals.

Ons finansiering kom grootliks uit die provinsiale billike-deel, wat R4,5 miljard van die begroting van R7,095 miljard uitmaak. Voorwaardelike toekennings van die nasionale regering kom op R2,17 miljard te staan. Dit word aangevul deur inkomste wat veral in ons sentrale hospitale deur die departement gegeneer word - wat 'n verdere R363 miljoen by die begroting voeg.

PROGRAM 1: (ADMINISTRASIE)

Program 1 (Administrasie) ontvang 'n begroting van R367,2 miljoen - 'n verhoging van R199,5 miljoen. Dit is egter grootliks weens geoormerkte finansiering wat onder andere R97 miljoen vir verhogings in verpleegsalarisse insluit.

PROGRAMME 2: (DISTRICT HEALTH SERVICES)

Programme 2 is allocated R2,4 billion or 34,4% of the total vote in 2007/08 in comparison to the 30,5% that was allocated in the revised estimate for 2006/07. This translates into an increase of R464,2 million or 23,49% in nominal terms. Contributing factors includes:

  • The assumption of responsibility of Personal Primary Health Care in the rural districts will be finalized during 2007/08. As of March 2006 the provincial Department of Health assumed operational responsibility for PPHC services in the rural districts. The process of transferring staff, moveable and immoveable assets from municipalities are far advanced.
  • Aligned to the CSP the Department is planning to convert some of the level 2 beds to level 1 beds in the Metro in anticipation of the planned two new 210 bed district hospitals in Khayelitsha and Mitchell's Plain. In the interim 90 level 1 beds have been placed at Tygerberg Hospital .
  • The transition from regional hospitals to predominantly level 1 hospitals with some level 2 capacity will be managed systematically within the context of the implementation of the CSP.
  • An additional amount of R11 million has been allocated to GF Jooste Hospital for 2007/08 to deal with service pressures.
  • The budget for HIV and Aids in the coming year is R289,1 million in total. At the end of March 2007 the number of patients on ARV treatment in the Western Cape was 26,111. In order to meet approximately 65% of the need it is necessary to enroll ± 1000 patients onto ARVs every month and the target for March 2008 is to have 35,863 patients on ART. Assuming a unit cost of R7,000 per patient treatment year there is a projected shortfall on the budget for 2007/08 of R44 million. Discussions in this regard are ongoing with both government and donor organizations.
  • The prevention and treatment of TB remains a challenge. The impact of the TB Crisis Plan implemented during 2006/07 is apparent in the improved TB cure rate in the Breede Valley from 68,5% to 73,6%. Khayelitsha also showed a significant improvement in the cure rate from 51% to 72% in a year. While the average for the province stands at 71.3% with a target of 73% set for this year.
  • As mentioned women's, child and youth health remain priority areas.
  • Also related to Social Capital Formation is the focus on the management of chronic diseases. Support groups for patients with chronic diseases of lifestyle have been established and strengthened at all Community Health Centres.
  • The transfer of the Medico-legal mortuaries from the South African Police Services to the Provincial Department was successfully implemented with effect from 1 April 2006. The Department established a new Forensic Pathology Service (FPS) that renders a service via two academic Forensic Pathology Laboratories in the Metro, three referral FPS laboratories and smaller FPS laboratories and holding centers in the West Coast, Cape Winelands , Overberg, Eden and the Central Karoo Districts.

PROGRAM 3: (MEDIESE NOODDIENSTE)

Mediese nooddienste ontvang R344,7 miljoen, of 4,8% van die gesondheidsbegroting, in 2007/2008. Dit verteenwoordig 'n verhoging van 20,4% of R58,4 miljoen.

  • Die Kaapstad-metrodistrik het 'n nuwe kommunikasiestelsel ontvang wat oor die volgende drie jaar ook in die landelike gebiede ingefaseer sal word. Hierdie elektroniese kommunikasiestelsel is noodsaaklik om versnelde reaksietye, doeltreffende ontplooiing en koördinering met ander nooddienste moontlik te maak; hierdie aspekte lei alles uiteindelik tot beter pasiëntesorg. Die instelling van 'n rekenaargesteunde uitstuurstelsel en outomatiese voertuigopsporingstelsel het ook die bestuur van die mobiele NMD-hulpbronne verbeter.
  • 'n Geoormerkte bedrag van R58,2 miljoen is bewillig vir die uitbreiding van mediese nooddienste.
  • R46 miljoen word aan noodvervoer toegeken.
  • R10 miljoen gaan vir beplande pasiëntevervoer.

Training of Emergency Care Personnel is a key issue and we will train 775 personnel over the next three years. In this regard, the Emergency Medical Services plans to recruit 200 student Emergency Care Practitioners and appoint them from 1 July 2007. In addition the training of 24 paramedics and 48 Ambulance Emergency Assistants will commence from 1 July 2007.

Another exciting development as part of the expanded communication system is the use of mobile data terminals in ambulances. A pilot project in this regard will kick off in this month - and thereafter the system is to be rolled out to the rest of the fleet. It is anticipated that 100 ambulances will be equipped with these devices by the end of the 2007/08 financial year. These mobile data terminals will facilitate the distribution of ambulances and also the capturing of patient related data on an electronic patient record that will speed up patient admission.

PROGRAMME 4; (PROVINCIAL HOSPITAL SERVICES)

Programme 4 is allocated R1,17 billion or 16,5% of the vote during 2007/08. Some of the challenges in this programme include:

General Hospitals

  • The main challenge is the reconfiguration of the services in line with the CSP according to which the majority of the level 2 services will be consolidated in the central hospitals. This requires the reclassification of beds and the reconfiguration of the packages of care and referral routes.
  • In line with the CSP a project will be initiated to manage the transition of the midwife obstetric units (MOUs) from Mowbray Maternity Hospital to the District Health Service by 1 April 2008.

Tuberculosis Hospitals

  • The provincialisation of Harry Comay, Paarl Tuberculosis Hospital (Sonstraal), Malmesbury Infectious Diseases Hospital and DP Marais requires the Department to upgrade the services and facilities of these hospitals to increase their capacity to care for more acutely ill patients.
  • An additional amount of R6,5 million equitable share funding has been allocated to address quality of care issues at these hospitals.

Psigiatriese hospitale

  • 'n Groot uitdaging is die middelmisbruikprofiel en hoë voorkoms van metamfetamien-/TIK-misbruik in ons provinsie. In Junie 2006 het Stikland-hospitaal 'n opiaat-ontgiftingseenheid langs die bestaande alkoholrehabilitasie-eenheid geopen. Dié ontgiftingseenheid bied 'n 24-uurhulplyn aan algemene gesondheidsorg-nooddienste, en sal voortgaan om die meeste eerstekontak- ontgiftingsdienste aan beide buite- en binnepasiënte regdeur die provinsie te lewer. Die eenheid bied bystand aan heroïen- en ander opiaatverslaafdes om veilig van hierdie middels te onttrek voordat hulle aan 'n erkende rehabilitasieprogram deelneem.
  • 'n Opleidingskollege by verwante psigiatriese hospitale sal 'n geakkrediteerde ná-basiese psigiatriese verpleegkursus aan beroepsverpleërs bied wat via die oorbruggingskursus daarvoor in aanmerking kom. Hierdie kursus sal hulle daartoe in staat stel om as geestesgesondheidsorgpraktisyns te werk. Die kollege sal ook voortdurende professionele-ontwikkelingsgeleenthede vir gesondheidswerkers bied.

The Western Cape Rehabilitation Centre

  • The Western Cape Rehabilitation Centre Public Private Partnership commenced on 1 March 2007. The aim of this partnership is the provision of equipment, facilities management and all associated services for the Western Cape Rehabilitation Centre and Lentegeur Hospital .

Dent al Training Hospitals

  • A comprehensive Oral Health Plan will be implemented in order to provide a more effective service to patients.

PROGRAMME 5; (CENTRAL HOSPITAL SERVICES)

The Central Hospitals are allocated R2,17 billion or 30,6% of the vote in 2007/08. As mentioned earlier the department is committed to the preservation of an essential core of highly specialized services in support of the district and regional services where most patients are seen. It would make no sense to have tertiary highly specialized hospitals in the absence of appropriate clinics and district hospitals in the areas where people live.

Much has been said recently in the media about bed shifts from the Groote Schuur and Tygerberg hospitals. Suffice it to say that firstly the bed shifts are marginal - and secondly our health services will not collapse as a result. Indeed I regret that the comments even if made with the best intentions have resulted in concern by those who use our services. I want to assure them and the general public that our services will continue as before. Our intention remains to reshape health services in our province to benefit the poor and working class people who depend on our service.

Speaker, despite pressures our Central Hospitals continue to provide quality health services. Included among the services to be provided in the year ahead are:

At Tygerberg Hospital

  • More than 28,000 operations will be performed of which 650 will be open heart surgery.
  • The hospital will handle 550,000 outpatient visits and to admit 61,000 patients. Of these admissions, some 7,400 will require intensive care.
  • The Trauma Unit will manage some 20,000 injured patients of whom 8,500 will require admission.
  • Over 10,000 paediatric emergencies will be managed and over 6,000 adults with medical emergencies will be admitted.

At Groote Schuur Hospital

  • More than 24,000 operations will be performed.
  • More than 45 000 patients will be admitted. In addition 11,541 will be managed in the Trauma Unit and 32,035 to the Medical Emergency Unit.
  • 8 000 babies will be delivered.
  • 370 000 outpatients will visit Groote Schuur hospital of whom 300,000 will be seen by specialists.
  • 2 600 patients diagnosed with cancer will receive treatment at the cancer unit.
  • 1,400 patients will receive dialysis at Groote Schuur Hospital .

At Red Cross Children's Hospital

  • Red Cross War Memorial Children's Hospital will continue to provide comprehensive dedicated tertiary pediatric services with a wide range of sub-specialties.
  • On average 750 operations per month, inclusive of all surgical disciplines will be performed at RCCH.
  • Building on the RCCH's status as a national centre for pediatric liver transplants, approximately 15 (renal and liver) transplants will be performed in 2007/08.

PROGRAMME 6: (HEALTH SCIENCES AND TRAINING)

Health Sciences and Training is allocated R142,2 million or 2% of the budget in 2007/08. This amounts to a increase of 40,2% or R40,8 million. This makes provision for :

  • R30 million for the Nursing Training College , R53 million for bursaries and R6,7 million for Emergency Medical Services training.
  • An earmarked allocation of R49 million is made in 2007/08 for the Expanded Public Works Programme (EPWP) which is intended to provide an opportunity for the training of unemployed persons as community based health workers, nursing assistants and pharmacists assistants. A portion of these funds will be allocated directly to the home-based care programme provided by contracted NPOs. A total of 1 830 learners will be trained through the EPWP during 2007/08.
  • 4 000 training interventions will be provided to PHC staff throughout the various regions of the Western Cape to improve and update their skills.
  • 40 Pharmacists-assistants, 20 of whom will receive basic training and a further 20 post-basic training, will also be training during this financial year.

PROGRAM 7: (GESONDHEIDSORG-STEUNDIENSTE)

Program 7 ontvang R85,4 miljoen, of 1,2% van die begrotingspos in 2007/2008 in vergelyking met die 1,4%-bewilliging volgens die hersiene 2006/2007-raming.

'n Mens vergeet maklik die groot klomp was- en strykwerk wat deur ons gesondheidsorgfasiliteite gegenereer word. Die afgelope week het ek die bekendstelling van die nuwe hoëspoed-tonnelwasser ter waarde van R6,5 miljoen by Tygerberg-hospitaal bygewoon. Hierdie wasser hanteer die wasgoed van 44 instellings, en kan 1 500 kg wasgoed per uur doen. Tygerberg-hospitaal beskik ook oor lakenstryktoerusting wat 1 200 lakens per uur kan stryk, vou en stapel. Ons jurkverwerkingstoerusting kan 900 jurke per uur droogmaak, vou en stapel. In 2007/2008 sal ons interne wasserydienste 14 miljoen stukke was terwyl 'n bykomende 7 miljoen stukke deur privaat instansies gewas sal word.

PROGRAMME 8: (HEALTH FACILITIES MANAGEMENT)

Programme 8 is allocated R368,6 million or 5,2% of the vote in 2007/08. This translates into a nominal increase of 8,5% or R29 million. Included in this programme are:

  • The building of Khayelitsha and Mitchell's Plain district hospitals is critical to the implementation of the Comprehensive Service Plan, the Western Cape 's service transformation plan. The business cases for these hospitals were approved by the National Department of Health - but National Treasury has not been able to allocate the required funding. Although there is insufficient funding to take the planning process to the tender stage the Department is committed to achieving this during 2007/08 by reprioritizing.
  • Business cases have been submitted and accepted in principle, pending formal approval and the allocation of funds for Brooklyn Chest, Tygerberg, Hottentots Holland, Victoria and Mossel Bay Hospitals .
  • Ander belangrike projekte sluit die omvattende opknapping en opgradering van Mowbray-kraamhospitaal, die opgradering van Caledon- en Riversdal-hospitale, en die verbetering van ambulansstasies in.
  • The construction of new Community Health Centres for Montagu, Stanford, Wellington , Simondium and Swellendam is in progress.
  • The forensic mortuaries have been transferred from the South African Police Services and the physical infrastructure is being upgraded to meet the requirements of the Forensic Pathology Service using the Forensic Pathology Services conditional grant.

CONCLUSION

In conclusion, I wish to thank everyone who participated in this budget, including my Cabinet Colleagues, Treasury, in particular the Head of Department, Prof Craig Househam for his leadership, the management of the department for their support and every staff member working in Health throughout our province for their commitment and hard work.

A special word of thanks also goes to the chairperson of the Social Development Standing Committee, Mrs. Matilda Vantura, and her committee members for their positive contribution to quality health care in our province.

There is no denying that we faced some difficult choices in this budget. I am however convinced after thorough evaluation of all possible options and despite the understandable concerns, the decisions taken in this budget places us in the best possible position to deliver health care to the majority of the citizens that we serve.

Thank you

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