DA Debates Gauteng 2014/15 Health Annual Report

Speech by: Jack Bloom MPL

“Gauteng health department on the verge of sinking”

  • In the period covered by this Annual Report, only 86 out of 160 targets were met, which is 54%.
  • Steve Biko Hospital is the only hospital in Gauteng that is assessed as being compliant with the non-negotiable extreme measures to prevent unnecessary harm or death.
  • R157 million was spent last year on settling court actions for medical negligence, and the figure this year is likely to be higher still.
  • Medico-legal claims rose by R3.5 billion from R6.6 billion to R10.1 billion.
  • We have enrolled more than one million people on anti-retroviral therapy in the last ten years, but only 700 000 are currently still on treatment.

The full speech can be obtained here.


Speech by: Neil Campbell MPL

“Departmental targets mean nothing if there is no delivery”

  • The AG is concerned by the many Departmental late payments to suppliers amounting to over a billion Rand.
  • Of the 160 set targets in the Annual Performance Plan, only 55% were achieved.  However, no monetary savings were noted so we overpaid for what was attained.
  • The ongoing problems associated with Community Healthcare Workers including non-payment of stipends, provision of infection control measures and career pathing must be addressed.
  • On numerous occasions the DA have called for a reliable computer system for the Department which must deal with patient informatics and be a reliable financial tool.

The full speech can be obtained here.


Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222


Dr Neil Campbell MPL

DA Gauteng Shadow MEC for Roads and Transport

082 387 2540

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The Democratic Alliance is not opposed to the view of decent work to South Africans. It is not opposed to a decent living wage to hard working individuals in the province and it is very important that it be noted that the DA believes in a prospering South Africa full of endless opportunities.  However, a clear perspective on what Community Health Care Workers are, the work they do and how they relate to both the community and government should be looked at.

Community Health Care Workers know very clearly communities they serve. They know in detail health care challenges in their neighbourhoods and all processes needed to be followed when assisting members of the community. These are trusted men and women in all are communities playing very important roles. It is on this basis that there is a need of consistent relationship between communities and government on health services rendered, therefore, Non-Government Organisations or NPOs are better placed to render these services and Community Health Care Workers would be better placed in NGOs than them being placed as another extension of a government wage bill. This of course will also mean that government should have a serious role to play in supporting the roles played by NGO’s who render community health care service.

It shouldn’t be the case that government fails to support NGOs and NPOs that are meant to promote health and wellness in communities because this will definitely reduce current existing pressures in all Gauteng Primary Health Care Centres. Our primary health care centres in Gauteng are pressured with high volume of patients of whom many could have been assisted by well-co-ordinated NGOs which would be offering a focused intervention programme on health education, wellness and disease prevention in homes, thus reducing number of people coming to primary health care centres.  Now, this Honourable speaker clearly shows the importance of Community Health Care Workers.

These NGOs and NPOs would further be able to access additional international funding based on the community work they do as they would also be responding to the millennium development goal that’s speaks of combating HIV, Malaria and other diseases. International funding and government support would enhance their programmes and I truly believe that they would be remunerated fairly and accordingly looking at the value they would be contributing towards the successes of their NGOs.

Honourable Speaker, the DA proposes this as a way forward in sincerely supporting community health work as performed by this dedicated men and women. Where we govern we excellently implement this strategy and it works. We urge on the Gauteng provincial government to seriously look at this progressive way forward.


Community Healthcare Workers are used to strengthen the Primary Healthcare system through illness prevention, the monitoring of postpartum mothers and babies, the supervising of recovery after illnesses, while also ensuring treatment adherence especially in TB and HIV cases and in providing end-of-life care.

Generally these workers provide a vital link between the community and the provincial healthcare structures and, crucially, the home based care services they provide encourage communities to take ownership of their health needs. They also provide education and awareness programs and identify numerous community health problems including environmental health issues.

In South Africa small scale projects have yielded better results than national initiatives because of a lack of national policy and funding from the ministry.

Community Healthcare Workers are often erroneously seen by both the public and provincial departments of health as a cheap and inferior type of healthcare worker, which couldn’t be further from the truth and much needs to be done to correct this misconception.

In Gauteng, Community Health Workers were initially employed by NGO’s and NPOs. Some Community Healthcare Workers complained that a few NGO’s were illegally withholding payment  or decreasing the quantum of meager stipends and this led to the then MEC for Health, Hope Papa, undertaking to remunerate Community Healthcare Workers directly from the Gauteng Department of Health although they have never been fully integrated into the Department and lack GDHS Persal numbers.

Following the GDH’s assumption of this payment responsibility to Community Healthcare Workers, there have been ongoing disputes regarding late or non-payment of stipends which leaves the workers no better off than when NGOs paid them. Payment by provincial departments of health is not universally the way these workers are remunerated with many still being successfully remunerated through NGOs in other provinces.

Community Healthcare Workers need to be responsive to community needs and to do this they require back-up from state healthcare structures which is often not forthcoming. In fact these workers are often denied the basic barriers to cross infection such as masks, gloves and hand swabs. This is not conducive to good healthcare and must be remedied immediately. Additionally they must walk long distances in carrying out their duties though scorching summers and freezing winters.

Similarly, Community Healthcare Workers have no real career pathway and seem doomed to be entry level workers indefinitely, despite many years of loyal and productive service. Advanced training is also lacking and these deficiencies must be rectified too.

In other countries Community Healthcare Workers have been of inestimable assistance in providing effective healthcare interventions and they are rewarded accordingly. In this country Community Healthcare Workers also provide positive health outcomes but remain out on a limb with no proper recognition for their services.

If we want to increase the footprint of Community Healthcare Workers in our communities, we must prioritize their skills development and their career paths and ensure that their services are decently and consistently rewarded with regular guaranteed pay packages. We must provide them with the tools they need to carry out their work including infection control measures. National government has shown little leadership regarding Community Healthcare Workers and it is necessary to develop nation-wide norms for the treatment of these much needed workers.

We believe that rather than dictating the path that the Department must take as detailed in this motion, it would better address the many problems of these workers if a national imbizo was held to clarify the many contentious issues raised and to prevent the exploitation of Community Healthcare Workers.

Through such an inclusive strategy, solving problems together we can improve the quality of Primary Healthcare and bring it closer to the communities we serve throughout the country.

I thank you Madam Speaker