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Introduction of Eastern Cape provincial Health Bill
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Speeches and Media Releases
 Health

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EASTERN CAPE PROVINCIAL GOVERNMENT

THE INTRODUCTION OF THE EASTERN CAPE PROVINCIAL HEALTH BILL

AT THE LEGISLATURE

BY THE M.E.C FOR HEALTH DR BM GOQWANA,

02 DECEMBER 1999



The Speaker of the House
 Chairperson of the Standing Committee
 Honourable MPLS

Introduction

The legacy of the past health policies is visible throughout the Province. What defines the Province is a set of policies that were not 
only meant to achieve the objectives of the architects of apartheid but also exposed total ignorance of health service management.

Like other provinces, the Eastern Cape government inherited three different administrations which were not only politically antagonistic to 
each other, but also had totally different cultures. That cultural identification has continues to exist despite attempts to inculcate new 
ethos. The situation has been worsened by the fact that one of the administration had within itself not only racial segregated service 
delivery institutions, but also fragmented and duplicated services. The Eastern Cape Department of Health falls within this ambit.

The Context

The 1996 Constitution of the Republic of South Africa states in its preamble among other things,

"We therefore, through our freely elected representatives, adopt this Constitution as the supreme law of the Republic so as to -:
 Improve the quality of life of all citizens and free the potential of each person,

Section 27 of the Bill of Rights which is enshrined in our Constitution explicitly confirms the right of citizens to access to health care 
services which includes emergency medical treatment and reproductive health care. Subsection 2 of the Clause further compels the state to 
take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of this right.The 
transformation of health services is being undertaken within the constitutional framework upon which the vision of this government is 
derived.

The Bill marks the fundamental shift from distorted and unsustainable health service to an integrated approach. Of course the ANC is not 
new to this philosophy. It has always viewed that the transformation of health and welfare services is crucial to the reconstruction of our 
traumatised society. This was discussed extensively in the Health and Welfare in Transition Conference held in Maputo in April 1990.

Though the geo-political landscape has changed since then and the principles have only been modified especially when one looks at the RDP 
White Paper of 1994. The Bill itself is an integral part of the government to rid our country especially this province of the ills of the 
past. We dare not to fail.

As stated before the Bill provides for n integrated provincial health service system which will facilitate the rationalisation of the 
provinces and district health system, set standards for qualitative and equitable health service delivery and identify priority areas.

The broad principles

The broad principles that inform the formulation of this Bill will address major contractions in this sector. These include-:

1. Equity-there must be fairness in the availability and accessibility of health services.
 2. Fragmentation-the health service must be integrated and comprehensive.
 3. Prevention-the emphasis must be on prevention rather than cure.
 4. Rural services-rural areas must rapidly attain levels of care appropriate for the population they serve and at least comparable to 
services available in urban areas.
 5. Affirmative Action-historical inequalities must be reversed in education and training of health personnel and in the delivery of health 
care.
 6. All investments and services must be subjected to cost-benefit and cost-efficient analysis.
 7. Priorities must be set for every level of health care on an objective basis.
 8. A subcontinental perspective with regard to the needs for high-tech expensive and tertiary care facilities.
 9. The gradual process of change that is not punitive, which does not sacrifice the principles above.

Mr Speaker, there are two areas that I wish to emphasise which I feel are the corner stone of our democracy, namely, public participation 
and transparency.
It is our view that in order to ensure that the clients receive what they had ordered it is imperative that they should not only be part of 
the system they should be actively involved in every aspect. As a consequent to that the Bill calls for the establishment District Health 
Council, Community Health Committees, Hospital Boards, Advisory Committees and Forums. These structures together with the Local Authorities 
will form District Health Authority.
 These structures are in no way a substitute to the right of citizens access to information.

We are mindful of the limitations that as a provincial department we have, for example finance and human resource capacity and also other 
factors beyond the national sovereignty sphere control. We strongly believe that these challenges will be dealt with in a manner that takes 
into consideration our circumstances.

Conclusion

Mr Speaker, in debating this Bill it is important that we do not perceive it as an absolute imposition to the health service provision. Let 
us rather take it to be an obligation on our part to setting in place proper check mechanisms and control measures on our role as health 
service participants and more importantly, committed and humble servants of our people. Let us do what is in the best interests of the 
people of this province.

We are all aware that our biggest challenge is the realisation of the Primary Health Care and its direct application to the communities of 
the province from the most complex cities to our remote rural settings. The biggest provocation upon us is also how to make it work and 
abruptly so. I have no doubt that the men and women representing our people in this province have wisdom and courage to tackle the 
challenge before us. Petty politicking and narrow sectoral interests should not hold the process. Lets put the interests of the province 
first.

I thank you.

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