Letter sent to some striking Doctors in KZN yesterday (and a followup today)
Doctors
This email serves 3 purposes:
1. explaining our interest in getting a DA Students Organisation going at the Medical School campus in Durban
2. describing the DA support for the plight of Doctors and nurses in South Africa
3. motivating you to become involved in the Democratic Alliance as we work for a better future in this country
1. DASO UZKN Medical School
The DA Students Organisation has branches at all major Universities in South Africa and is engaged setting up branches in all tertiary institutions which provide for democratic representation. We are currently looking for people interested in setting up and standing for office in DASO at the Medical School. Please could anyone who is interested get hold of me.
2. Better Healthcare in South Africa
As per the press release below, the Democratic Alliance supports many of the issues which Doctors in KZN and around the country are currently protesting against. The DA has been consistently warning the ANC-led Government of the existing and looming crises resulting from wide-ranging issues in Public Healthcare. The DA supports better salaries for Doctors and nurses, more stringent check of qualifications and competence of hospital management, and better, more responsive procurement processes.
Please see the DA policy on Health here: http://da.org.za/our_policies.htm?action=view-policy&policy=624
3. How can you get involved
• Become a member of the DA and seek public office; get into Government and fight for improvements - email me for more information
• Become a DA volunteer and contribute to change www.contributetochange.org.za
• Spread the word of the DA an encourage people to use their vote to ensure positive change in South Africa.
Yours in better healthcare for all South Africans,
Warwick Chapman (Cllr)
Democratic Alliance, Durban
warwick@thusa.co.za
083 7797 094
http://warwickchapman.com
STATEMENT BY MIKE WATERS MP
DA SHADOW MINISTER OF HEALTH
DA welcomes salary increases for doctors
Release, immediate: Wednesday, June 24, 2009
The Democratic Alliance (DA) welcomes proposed pay increases for doctors announced by the health minister today, ranging from 29% to 53%. This will go some way to making working conditions in the public sector more tolerable and to closing the gap between what doctors should be entitled to earn, and what they actually earn.
It is unfortunate, however, that doctors had to go out onto the streets to fight to have the commitment the government made to them two years ago met. While on the one hand the government is devoting enormous resources to planning for a massively expensive National Health System, it is at the same time ignoring the basics of the health system. One of these basics is making working in the public sector tolerable for our doctors.
Following on from this, as the next step towards improving public hospitals, the DA calls on the government to conduct a comprehensive review of the qualifications and experience of all hospital CEOs.
MEDIA ENQUIRIES:
Mike Waters – 082 902 4523
Ross van der Linde – 076 543 7254
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A follow-up email was sent today entitled “DA Shadow Minister on Health Delivers Speech on State of Health in South Africa”:
SPEECH BY MIKE WATERS MP
DA SHADOW MINSITER OF HEALTH
DEBATE ON BUDGET VOTES 14: HEALTH
Release, immediate: Tuesday, 30 June, 2009
Mr Speaker,
The current crisis in the public health sector with regards to the doctor’s strike has been a long time in the making. It is extremely unfortunate that doctors have been forced to go on strike in order to have their grievances heard.
The groundswell of support for the strike among doctors must set the alarm bells ringing for the ANC government. The fact that a junior doctor in the public sector earns the same amount as a bus driver is indicative of the indifference with which this government has taken doctors concerns over the years and the degree to which it has taken advantage of their commitment and compassion. It also clearly demonstrates where in the ANC priorities in health care actually sit.
If one looks historically at the budget allocation for public health it is obvious that from 1998 to 2003, in per capita terms, the budget flat-lined because the government was spending all its available money on guns to fight non-existent enemies. In 2003 the government began to realize its mistake and the budget did start to increase in real per capita terms. However, the automatic notch and rank increases of 1998 and budget constraints meant that as people left the public health system they were not replaced, and an estimated 60 000 people left during this period. Hospitals have still not recovered.
And while the government may say that from 2003 there were significant budget increases, most of this allocation went to clinics and to the new ARV programme. No compensation has really ever been made available to reduce the strain the whole health system was placed under during those years.
We must remember that the burden of disease has increased dramatically, placing an ever increasing strain on hospitals. Given that hospitals’ budget allocations have been on the same trajectory since 1998, we have the current melt-down. As there were insufficient funds to replace doctors and nurses who left the public service, the work load increased and working conditions deteriorated.
You simply cannot offer a health service with 12 000 vacancies for doctors and 42 000 for nurses.
Equally you cannot neglect a system for so long and expect to fix it in a once off adjustment – it is obviously beyond this government’s capabilities. You as a department mishandled nurses’ OSD increases through grossly under estimating the cost to the fiscus, and now you cannot or won’t deliver on the doctors’ OSD increases. This ongoing neglect of 11 years is finally taking its toll.
Back in July 2007, some two years ago, the government promised through Resolution 1 of 2007 that they would implement OSD increases for doctors in July 2008. The ANC government reneged on that promise.
My question to you, Minister, is if the government made a promise some 24 months ago, why then were no budget allocations made in the 2008/09 budget or even this year’s budget? The answer is clear: this government had no intention of honouring it promise.
It was only after the doctors started marching and threatening industrial action that you, your department and this government sat up and started to take the doctors seriously.
The Doctors have been asking for a 50% increase, which may seem excessive to most South Africans. However, research commissioned by SAMA into doctors’ remuneration shows that in the South African public sector, doctors are paid 50% less than other professionals such as accountants, engineers and lawyers. That is what I call a disgrace.
Since the threat of industrial action, the doctors’ association and yourselves have been shut behind closed doors negotiating, when an agreement was expected to be announced last Wednesday.
However, in what can only be described as bizarre you made a public announcement on the doctors’ increases while negotiations were still ongoing – thus undermining the entire bargaining process and showed bad faith. You announced in your media conference that doctors would receive increases of between 29% and 53%, which most organisations welcomed, including the DA. However, this was misleading to say the least.
When one scrutinises the finer detail, it is clear that the offer was not genuine, and either you deliberately misled the nation or your officials misled you, I believe the latter. Who’s idea was it to hold a press conference while negotiations were still ongoing?
The real increases for most doctors range between 2% – 13 % over a two year period. The offer excluded experience and only commits itself at looking at this principle again in April 2011, subject to availability of funds!
There are also questions hanging over whether doctors have the right to strike – well it is entrenched in the constitution with a limitation clause, meaning that as an essential service, skeleton staff must be in place. After the 2004 and 2007 public sector strikes, the government agreed to negotiate a Minimum Service Level Agreement which would stipulate the conditions of industrial action, – surprise, surprise, this government still has not fulfilled this promise. How many more promises are you actually going to break?
Mr Speaker, the attitude of the MEC in KZN is also of concern, on what bases does a MEC state that there is a third force at play and doctors are destabilising the country? Dismissing doctors also won’t help either, there are so few of them you will have to re-employ them anyway unless you want a further meltdown in health services.
If the government can find an extra R1bn for an expanding cabinet, and R 2 – R4 bn for saving the SABC, it can surely find the money to pay the doctors.
The question of budget allocations also needs to be seriously looked at. The ramifications of the miscalculations of nurses’ OSD allowances continues to eat into the budgets of the Provinces and some health experts believe that by August this year, provinces will be running out of money and we will see a repeat of what happened in the Free State in the last financial, but on a much wider scale. The department also admitted that due to the lack of funds not everyone who is entitled to ARVs will actually be enrolled into the programme as there is simply not enough money, this Minister means people are going to die.
We need to separate the HIV/AIDS budget from the rest of the health budget. It should be treated as a grant where central government underwrites it and guarantees all who need ARV’S can access them.
Minister, whether you were misled by your officials with regard to the doctors’ increases only you will ever know and whether you were set up for failure by hosting a premature press conference only you will know.
However as the political head of the Department of Health you, sir, and only you, must take political responsibility for the atrocious mess we find ourselves in.
I thank you.
MEDIA ENQUIRIES:
Mike Waters MP – 082 902 4523
SPEECH BY EMMAH MORE MP
DA DEPUTY SHADOW MINSITER OF HEALTH
DEBATE ON BUDGET VOTES 14: HEALTH
Release, immediate: Tuesday, 30 June, 2009
The Honourable Chairperson, The Minister, The Deputy Minister.
Honourable members.
During the apartheid era most African people lived in poverty and degradation. Most African people earned very little to survive. Our history has been dominated by colonialism, racism, apartheid, sexism and repressive labour policies and we are definitely not going back, but moving forward to a free and better South Africa.
There will be no political democracy if we still have people living under adverse poverty conditions with no housing and food or other basic needs like access to health care. The public health care system provides low cost care to millions of poor South Africans and for this reason it needs to be prioritised, nurtured and revived — so that it is able to offer patients more compassionate care and higher quality of medical attention.
Constitutionally, everyone has the right to have access to health care services and it further stipulates that no one may be refused emergency medical treatment. This illustrates the seriousness with which we should treat the doctors’ strike and the EMS strike.
I will focus on the critical effects that this budget will have on quality service delivery, the realisation of Batho Pele Principle and the Patient’s Rights Charter.
After the briefing by the Department of Health on their Strategic Plan for 2009/10 – 2011/12 and the budget the biggest question was the alignment of the budget to the overall plans of the department. The two do not correlate. There is no sufficient money for the department to cover the programmes as outlined on the strategic plan.
Honourable Minister, health institutions are falling apart and will continue to do so and worsen if this budget is not urgently reviewed. For an example the biggest hospital in the southern hemisphere, Chris Hani Baragwanath Hospital is one of the tertiary hospitals deteriorating day by day and faced with problems that undermines the quality of healthcare (service delivery) like:
• Lack of resources (financial, human, equipment, drugs etc)
• Lack of management and administrative capacity
• Financial crisis and mismanagement
• Poor and inadequate referral system
• Lack of commitment and discipline
• High attrition rate leading to the shortage
• Lack of ICT
• Poor procurement processes with the GSSC as the middle man
The funds requested by the department of health for comprehensive HIV/Aids plan for the financial year 2009/2010 was R1.4 billion but only received R200 million, what a gap. Recently the Human Science Research Council released the results of their 2009 survey on HIV prevalence and related behaviour and the results indicated that irrespective of the decrease in prevalence among children there is an alarming increase in HIV prevalence in young women in their twenties. We are concerned.
Motsamaisi wa lefapha la bophelo, setjhaba sa Rantsho se a lla, se a bokolla ke lefu lena la Kwatsi ya Bosolla Tlhapi (HIV/Aids). Ha ho phomolo malapeng le moyeng wa batho. Moqebelo o mong le o mong, Sontaha se seng le se seng ke mafu ho bolokwa bafu ka baka la lefu lena.
Uwele hle! Motsamaisi bana ba setse ba le bang malapeng, ba hloka bahlokomedi mme ba qobelleha ho hlokomela ba bang (child headed families). Ho iphaphanya le boima bona ba tsuba dithethefatsi, ba nwa jwala, ba kena mekgahlong e sa lokang ya bakgothutsi, ba rekisa ka mmele ebe qetellong malapa a qhalana, lefatshe lea dubeha jwale ka ha le se le qadile
The cut in the budget for hospital revitalisation projects has serious implications on the deterioration of the health infrastructure conditions and poor work environment for health workers.
The DA believes that the provision of quality healthcare to all who live in SA is a key priority and should be given an urgent attention. In order to avoid a total collapse in healthcare, the Minister should put SMART interventions in place.
To minimise these effects the government should:
• Prioritise health programmes to ensure better health and therefore life for all
• Ensure that the appointment of health institutions managers is based on what a person can do (capabilities) and how hard he/she works, which is more important than who they are and who they know.
• Empower these managers not only to comply but to perform as well
• Have strict control measures in place to ensure responsibility and accountability by all (from top management to the operational people at the lowest levels)
• Cut the middleman the GSSC. Think about it, why should the centre buy milk, bread, sugar and other consumables on behalf of the hospitals in Gauteng. It does not make sense, as it prolongs the procurement process especially the delivery and the payment of companies. Hopefully the Gauteng Premier Ms Nomvula Mokonyane will consider what she calls an “exit strategy for the business people who are now multimillionaires through government tenders”.
• Do a statistical analysis of the staff count in relation to the staff to client ratios of all staff categories and this includes the allied medical personnel particularly the radiographers in hospitals.
The DA believes that no country can prosper without an affordable, effective and easily accessible health system. Such a system requires both a dependable primary healthcare network – that prevents diseases and treats minor illnesses – and a secondary and tertiary healthcare network to provide hospital-based care for more serious illnesses.
In conclusion honourable chairperson, health is life – it’s about the people who voted us all here in Parliament. The simple implication of this budget is that more people are going to suffer, even die, specifically of the opportunistic diseases related to the HIV/AIDS.
The department of health budget need to be reviewed and critically analysed and be placed as priority number one.
The president of South Africa, the Honourable Jacob Zuma stated during his state of the nation address:
“We are seriously concerned about the deterioration of the quality of health care, aggravated by the steady increase in the burden of disease in the past decade and a half”
We all need to work together towards the betterment of the health care.
I thank you.
MEDIA ENQUIRIES:
Emmah More MP – 083 988 8044
