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2019/06/212019/06/24 12:33 PM
Trade union Solidarity joined the various dissenting voices by describing President Cyril Ramaphosa’s state of the nation address SONA) on Thursday night as a “pipe dream of an African utopia”. Ramaphosa outlined seven priority areas and several goals for the next 10 years that included that no person in South Africa will go hungry and that two million more young people will be in employment. “Our schools will have better educational outcomes and every 10-year-old will be able to read for meaning. Violent crime will be halved,” said Ramaphosa.

But like many opposition parties, Solidarity tore into the president’s desire to “build an ethical state” saying he failed to mention “how those guilty of shockingly squandering South Africans’ tax money would be brought to book”. Monica Mynhardt, a researcher at the Solidarity Research Institute (SRI), said Ramaphosa sidestepped important issues. “The president did not come forward with any definite plans to turn ailing entities such as the South African Broadcasting Corporation, South African Airways and Denel around; on the contrary, he did not even once refer to those state-owned entities.”

“In a feverish attempt to keep power in government’s hands, the president announced that an absurd bail-out of R230 billion would be given to Eskom over the next ten years. ” Mynhardt said a bail-out without real change and actual plans does not mean much. “Promises about unbundling Eskom were made earlier, but this proposal seems to have died a silent death as no mention was made of it in this State of the Nation address,” Mynhardt said. “In spite of the fact that we live in a country where the government is unable to keep the lights on, the president dreams of high-speed trains and a technologically advanced economy. “Another perturbing issue is the government’s actual plans to have the National Health Insurance approved by the sixth parliament despite justified opposition from all quarters. The same goes for the land reform issue.” Mynhardt said the government’s plans to accelerate land reform in rural and urban areas leave South Africans and foreign investors uncertain about the future of food security and property rights. “The president shockingly contradicted himself when he emphasised that accelerated economic growth, among other things, required a clear property rights regime,” Mynhardt said.

“However, it is absurd of the president to expect agriculture to play a key role in economic growth amid the fact that this sector is the one suffering the most because of the concept of expropriation without compensation. “One highlight of the state of the nation address was the president’s assurance that the [SA] Reserve Bank would remain independent, but in light of the empty promises and the devastating ideologies in which the ANC [African National Congress] is rooted. “It would be extremely naïve to believe that the ANC will surrender at any time soon the centralised power it had acquired with so much effort.” The president rounded off his speech on a positive unifying note saying: “Working together there is nothing we cannot be, nothing we cannot do, and nothing we cannot achieve.” But that did not soften the stinging criticism by Solidarity, which echoed the reaction of the Democratic Alliance leader Mmusi Maimane who said Ramaphosa’s intended ambitions for certain projects was a “nightmare for ordinary South Africans”.

Economic Freedom Fighters leader Julius Malema said of Ramaphosa: “The man wanted to be president for the last 30 years, for more than three decades … he still doesn’t know what he wants to do for South Africa except to tell us he has been dreaming.”
  
2019/06/212019/06/24 12:36 PM
The government will accelerate its effort to address the country’s health challenges by attending to the capacity of health facilities in the next five years, President Cyril Ramaphosa said in parliament on Thursday.

“In the next five years, we will accelerate the provision of well-located housing and land to poor South Africans. To improve the quality of life of South Africans, to reduce poverty in all its dimensions and to strengthen our economy, we will attend to the health of our people. We must attend to the capacity of our hospitals and clinics,” said Ramaphosa as he tabled his State of the Nation Address on Thursday evening in Cape Town.

He told parliament that “an 80-year-old grandmother cannot spend an entire day in a queue waiting for her medication”.

“An ill patient cannot be turned away because there is a shortage of doctors and nurses. A woman in labour cannot have her unborn child’s life put in danger because the ambulance has taken too long to come,” the president said.

As part of the work, the government must urgently improve the quality of the health system, he said. “We are finalising the Presidential Health Summit Compact, which draws on the insights and will mobilise the capabilities of all key stakeholders to address the crisis in our clinics and hospitals.”

He said that government was far advanced in revising the National Health Insurance (NHI) bill’s detailed plan of implementation, which included accelerating quality of care initiatives in public facilities, building human resources capacity, the establishment of the NHI fund structure, and costing the administration of the NHI fund.
  
2019/06/212019/06/24 12:38 PM
The National Education, Health and Allied Workers’ Union [NEHAWU] notes the tabling of the State of the Nation Address (SONA) to the Joint sitting of both the National Assembly and the National Council of Provinces, by President Ramaphosa last night.

The 20th of June is a day that marks 106 years since the introduction of the Natives Land Act – an act that introduced humiliation, indignity and suffering to the majority of South Africans, an act that is still the burden of the past in the present day South Africa. President Ramaphosa, tabled the sixth administration SONA in a context of high levels of unemployment, poverty, deepening income and social inequality, deindustrialization, stagnant economy and low levels of investments into the economy. NEHAWU welcomes the sixth administration focus in the next ten years as outline by the President last night. President in his speech said that his administration will focus on the following seven priorities as a response to the countries problems:

 Economic transformation and job creation
 Education, skills and health
 Consolidating the social wage through reliable and quality basic services
 Spatial integration, human settlements and local government
 Social cohesion and safe communities
 A capable, ethical and developmental state
 A better Africa and World

NEHAWU will work tirelessly in making sure that the seven priorities, and five goals outlined by the President are realised, and will mobilise society to deal with any attempts by reactionary elements to frustrate these national ambitions.

As NEHAWU, we further note that the sixth administration as led by President Ramaphosa, has identified five goals for the next ten years, in tackling the triple challenges of unemployment, poverty and social inequality, the five goals outlined from SONA are that:

• No person in South Africa will go hungry.
• Our economy will grow at a much faster rate than our population.
• Two million more young people will be in employment.
• Our schools will have better educational outcomes and every 10 year old will be able to read for meaning.
• Violent crime will be halved.
 
We welcome the prioritisation of the building of a capable, ethical and developmental state. In our National Policy Conference scheduled for the 26th to the 29th June 2019 we extensively discuss the notion of a progressive developmental state and locate our role in building such a state. The Ramaphosa administration must note that in order to build such a state we must do away with privatisation, outsourcing, agenticification and PPP’s. Government must build its own internal capacity to undertake its core functions. Moving forward, government can no longer just be reduced to steering the ship but must also row it as well.
 
NEHAWU has been calling for the immediate and full implementation of the National Health Insurance to ensure universal access to healthcare for all. Welcome the announcement by the President that they are far advanced in revising the NHI detailed plan of implementation, including accelerating quality of care initiatives in public facilities, building human resource capacity, establishment of the NHI Fund structure, and costing the administration of the NHI Fund. We hope that the implementation will begin as soon as possible and that government will not bow down to pressure from private hospital groups and medical aid companies. The national union welcomes efforts to fight corruption, looting of State Owned Enterprises and the restoration of trust to our state institutions. In this regard we salute the efforts of saving ESKOM and we fully support the President’s efforts in this regard to allocate the R230 billion fiscal support to ESKOM in the next ten years because as a country we cannot afford to allow ESKOM to fail.
 
NEHAWU welcomes efforts to re- industrialise our economy. In this regard we support the targeted growth sectors such as, clothing and textiles, gas, chemicals and plastics, renewables, and steel and metals fabrication sectors. The sectors identified are labour intensive, with multiplier effects in the economy, and would lead to the eradication of unemployment and are in line with the demands of the progressive trade union movement for a broad-based industrialisation that is inclusive. NEHAWU, welcomes the 100 billion seed infrastructure fund and call upon government to accelerate the implementation of social and economic infrastructure projects, as an attempt to fix apartheid spatial inequalities. We further support attempts to fill critical vacancies in the public service in order to strengthen public service delivery, through a democratic, capable, developmental state that delivers on quality public health care, education, a social wage to the poor and the working class.
 
NEHAWU, support the pronouncement by the President that the Reserve Bank has to pursue its dual mandate of price stability and employment and growth targeting.
As NEHAWU, we wish the sixth administration under the stewardship of President Ramaphosa well in its endeavour to “Grow South Africa Together”.
  
2019/06/202019/06/24 12:24 PM
Long hours and poor working conditions are negatively impacting the personal health of many South African healthcare professionals, according to the 2019 PPS Graduate Professional Index (GPI) results.

Up to 73% of respondents felt that a large number of medical professionals are depressed and suffering burnout, due to long hours (38%) and poor working conditions (23%).

Meanwhile, 72% did not think that the National Health Insurance will improve the sustainability of the profession. When asked what can be done to improve the healthcare system in South Africa, 26% mentioned anti-corruption and better management of funds, and 12% suggested adequate staffing based on merit.

When asked what can be done to encourage doctors to stay in South Africa rather than move abroad, 33% thought that the socioeconomic situation needs to be improved, 30% suggested better working conditions, and 19% suggested better salaries and incentives.

“Much is needed to be done to improve the working conditions for medical professionals, the caregivers of our nation of South Africa who seem to be reaching their own professional tipping point,” says Motshabi Nomvete, technical marketing specialist at PPS.
  
2019/06/20
2019/06/24 12:25 PM
Today's State of the Nation Address could be a tough one for President Cyril Ramaphosa. First, some of the opposition political parties have already stated that his honeymoon is over. This means the president can forget about having them in his corner when he delivers his address. Second, he will present it with resignations of key ANC members from Parliament still fresh in his mind. Third, the president will not have recovered from the recent war of words in the past few weeks, which saw ANC secretary general Ace Magashule and the Minister of Finance Tito Mboweni singing from different hymn books.

Besides these issues, some of which are primarily ANC ones, the president has a number of challenging national realities he has to confront and pronounce on as the nation has expectations of him. The most burning issue is the country's economic situation. The economy is not growing at the pace we all would like to see. Figures for the first quarter showing the economy contracted by 3.2% makes this address even more important. South Africans and the international community will be closely listening to Ramaphosa to learn how government plans to take the country out of this quagmire. Rating agencies will also be eager to hear what the president will say about the country's economic future. Any lapse in concentration by Ramaphosa could have serious negative implications for the country's already slow performing economy. He put himself under unnecessary pressure a few weeks ago when he spoke about the "nine wasted years" under former president Jacob Zuma. He was the deputy president of the ANC and the deputy president of the country for some of these years. The question that follows is whether he was also part of those "wasted years". It would be disingenuous for him to play innocent with the hope that he will receive South Africans' sympathy. South Africans will be keenly listening to Ramaphosa to find out how his government will deliver on its election manifesto to create permanent jobs.

He has already hosted the Jobs Summit It would be unwarranted to promise the country more jobs summits when the outcomes of the previous one have not been fully implemented if at all . For the country to create jobs it needs a strong infrastructure. This means that Ramaphosa's speech would be incomplete if it does not spell out government plans to improve the country's infrastructure. The recent resignations of Phakamani Hadebe from Eskom and Vuyani Jarana from SAA have brought the issue of state owned enterprises SOEs back on the agenda. The state of the SABC has also not helped. To crown it all, Ramaphosa appointed Pravin Gordhan into his Cabinet and saddled him with the responsibility to rescue SOEs. Given that he was holding the same position in the fifth Parliament when the country experienced the so called "load shedding" means that South Africans will be expecting to hear what is new that the government will offer in this regard. Allegations of racism raised by black and Indian doctors against medical aid schemes mean that when talking about the country's health, Ramaphosa should go beyond repeating that plans to roll out the National Health Insurance are under way.

The common incidents of train accidents which take lives put pressure on Ramaphosa to make clear pronouncements on the government's plans to address this issue. Last, volatile political situations in countries such as Sudan, South Sudan, Libya and many other African countries deserve inclusion in the address. Ramaphosa should project South Africa as a global player. Mngomezulu is a professor of political science and the deputy dean of research in the department of politics at UWC.
  
2019/06/202019/06/24 12:26 PM
In order to reduce fragmentation, address risk rating, strengthen cross-subsidies and simplify benefit options, the Council for Medical Schemes (CMS) has proposed the amalgamation of smaller schemes, which fall below the legislated minimum threshold of 6,000 main members. The council has acknowledged that certain schemes below this threshold are doing well on many fronts, namely advantageous average age profiles, lower non-healthcare expenditure, and positive acceptable scheme surplus levels and solvency. But of the 29 schemes in South Africa with fewer than 6,000 main members, 26 are closed schemes, and essentially these are constrained in recruiting new members, affecting both their claims experience and the number of member benefit options available within these schemes.

The most appealing of the consolidation methodologies considered by the CMS is the umbrella medical aid fund arrangement. These have successfully been implemented within the pension fund industry over the last 15 to 20 years. In my opinion, this is a very positive consideration, which would allow for risk pooling, benefit consolidation and cost reduction.

Statistical approach

The council says it is in the unique position to identify beneficial amalgamations resulting in the optimal pairings of schemes given their financial, demographic and clinical considerations, which they will extrapolate using long-term simulations of claims. These factors along with claims experience and the uniqueness of membership, should all be used to inform the consolidation basis going forward.

If, over the next year, the council gathers sufficient data on chronic medication, demographics of additional dependants, average size of claims per risk factor, eligibility criteria and subsidy policies - with a view to using these in a mathematical analysis of the interaction of these factors - to gauge how they contribute to the financial sustainability of schemes and the healthcare industry, I firmly believe the council will be in a good position to define a new set of criteria which would encourage amalgamation in the most favourable and cost-effective method, and also which would benefit scheme members first and foremost. If the proposed umbrella medical scheme format resembles the Government Employees Medical Scheme, which could see the healthcare industry following the path of the employee benefits and pension fund industry, this would bring about a significant reduction in governance requirements and associated management costs, offer members more options and benefits, and further the objectives set out in Section 322 of the NHI White paper released in 2017 - amalgamating options and schemes.

Taking an innovative statistical approach to analysing schemes, to ensure the most beneficial outcomes for members, will lead to suitable alternatives for consideration. The role to be played by large industry players, who may be better suited to absorbing these smaller schemes, remains to be seen. It may be that the council encourages amalgamation only among smaller schemes, which I believe could still be attractive to smaller schemes because of the resultant creation of a greater geographical network and member cohort, allowing for, among other benefits, the negotiation of better rates from service providers.

The council’s pragmatic approach appears to be siding with the medical scheme member more vigorously than before, and this will deal effectively with the number of schemes under review and that the umbrella scheme format will go a long way to stabilising the industry at large. Back to top

NHI REVISING PLAN AT AN ADVANCED STAGE
2019/06/20
SANEWS

President Cyril Ramaphosa says the strategy to revise the National Health Insurance (NHI) detailed plan of implementation is at an advanced stage. President Ramaphosa said the plan includes accelerating quality of care initiatives in public facilities, building human resource capacity, establishment of the NHI Fund structure, and costing the administration of the NHI Fund.

Presenting the State of the Nation Address (SoNA) to a joint sitting of Parliament on Thursday evening, President Ramaphosa said government will attend to the health of the nation to improve the quality of life of South Africans, reduce poverty in all its dimensions, and strengthen the country’s economy. “We must attend to the capacity of our hospitals and clinics. An 80-year-old grandmother cannot spend an entire day in a queue waiting for her medication. An ill patient cannot be turned away because there is a shortage of doctors and nurses… A woman in labour cannot have her unborn child’s life put in danger because the ambulance has taken too long to come,” President Ramaphosa said.

As part of the work that must be urgently done to improve the quality of the health system, the President announced that government is finalising the Presidential Health Summit Compact, which draws on expert insights, and will mobilise the capabilities of all key stakeholders to address the crisis in the State’s clinics and hospitals. Meanwhile, President Ramaphosa has raised concerns about increase in HIV infection rates, particularly among young women, and the relatively low numbers of men testing for HIV and starting treatment.

He said government will intensify its work to implement the 90-90-90 strategy to end HIV as a public health threat, which includes increasing the number of people on treatment by at least another two million by December 2020.
  
2019/06/202019/06/24 12:28 PM
Speaker of the National Assembly, Ms Thandi Modise, Chairperson of the National Council of Provinces, Mr Amos Masondo, Deputy President David Mabuza, Chief Justice Mogoeng Mogoeng and esteemed members of the judiciary,

Former President, Mr Kgalema Motlanthe, Former President, Mr Thabo Mbeki, Former Speaker of the National Assembly, Dr Frene Ginwala, Former Speaker of the National Assembly, Mr Max Sisulu, Former Speaker of the National Assembly, Ms Baleka Mbete,

President of the Pan African Parliament, Mr Roger Nkodo Dang, Veterans of the struggle for liberation, Dr Dennis Goldberg, Dr Andrew Mlangeni, Advocate Priscilla Jana, Ms Joyce Dipale, Ms Lillian Keagile, Ms Smally Maqungo, Ministers and Deputy Ministers,

Premiers and Speakers of Provincial Legislatures, Chairperson of SALGA and Executive Mayors, Governor of the South African Reserve Bank, Mr Lesetja Kganyago, Heads of Chapter 9 Institutions, Leaders of faith based organisations, Leaders of academic and research institutions, Members of the Diplomatic Corps, Invited Guests,

Honourable Members of the National Assembly, Honourable Members of the National Council of Provinces, Fellow South Africans,

We gather here at the start of the 6th Democratic Parliament, 106 years to the day after the Natives Land Act – one of the most devastating acts of dispossession, pain and humiliation – came into force.

We recall the words of Sol Plaatje on that tragic event, when he said:

“Awakening on Friday morning, June 20, 1913, the South African native found himself, not actually a slave, but a pariah in the land of his birth.”

Our people suffered gravely and endured untold hardships as a result of the implementation of the Natives Land Act. The effect of that law are still present with us.

More than a century after that grave injustice, we are called upon to forge a South Africa where no person will be slave or pariah, only free and equal and respected.

We gather here at an extremely difficult and challenging time in the life of our young democracy.

Yet, we are also at a moment in our history that holds great hope and promise.

In 25 years of democracy we have made remarkable progress in building a new nation in which all South Africans have equal rights and broadening opportunities.

Over 25 years, we have done much to meet people’s basic needs, to reduce poverty and to transform a devastated economy that was built to serve the interests of the few.

Working together, we have laid a firm foundation on which we can build a country in which all may know peace and comfort and contentment.

Yet, we also meet at a time when our country is confronted by severe challenges.

Our economy is not growing. Not enough jobs are being created.

This is the concern that rises above all others.

It affects everyone.

It affects you, the young man eMzimhlope, out of school five years now and still not employed.

It impacts you, the single mother from Delft, whose grant supports not just yourself but your grandchildren too.

It hurts you, the worker in Nelson Mandela Bay, who despite earning a salary is struggling to make ends meet.

It is hard for you, the young student from the Sol Plaatje University, who must rely on a thin stipend from your parents to feed yourself.

Yours are the lived struggles of the people of this nation.

We have heard you, and many others.

Sinizwile. Hi twile. To zwi pfa. Re itlwile.

Through the elections held in May, you provided all of us with a clear mandate for growth and renewal.

All of us have heard you – I, Hon Maimane, Hon Malema, Hon Buthelezi, Hon Groenewald, Hon Meshoe, Hon Holomisa, Hon Zungula, Hon De Lille, Hon Magwaza-Msibi, Hon Galo, Hon Lekota, Hon Nyhontso and Hon Hendricks.

The persistent legacy of apartheid has left our country with extreme structural problems – both economic and social.

At the same time, we have to contend with rapid technological change that is ushering in a new world of work, that is reshaping the global economy and that is redefining social relations.

Together with all the nations of the world, we are confronted by the most devastating changes in global climate in human history.

The extreme weather conditions associated with the warming of the atmosphere threaten our economy, they threaten the lives and the livelihoods of our people, and – unless we act now – will threaten our very existence.

We have heard the voices of the young people who marched to the Union Buildings last week urging us to take action to protect our planet.
It was to address these fundamental challenges that we adopted the National Development Plan in 2012 to guide our national effort to defeat poverty, unemployment and inequality.

However, with 10 years to go before we reach the year 2030, we have not made nearly enough progress in meeting the NDP targets.

Unless we take extraordinary measures, we will not realise Vision 2030.

This means that we need to prioritise.

We need to focus on those actions that will have the greatest impact, actions that will catalyse faster movement forward, both in the immediate term and over the next 10 years.

It is worth noting that the Medium-Term Strategic Framework for the last five years had more than 1,100 indicators by which we were to measure progress in the implementation of the NDP.

Now is the time to focus on implementation.

It is time to make choices.
Some of these choices may be difficult and some may not please everyone.

In an economy that is not growing, at a time when public finances are limited, we will not be able to do everything at one time.

As we enter this new administration, we will focus on seven priorities:

- Economic transformation and job creation

- Education, skills and health

- Consolidating the social wage through reliable and quality basic services

- Spatial integration, human settlements and local government

- Social cohesion and safe communities

- A capable, ethical and developmental state

- A better Africa and World

All our programmes and policies across all departments and agencies will be directed in pursuit of these overarching tasks.

At the same time, we must restore the National Development Plan to its place at the centre of our national effort, to make it alive, to make it part of the lived experience of the South African people.

At the inauguration, we said that this is a defining moment for our young nation.

We also said that it is through our actions now that we will determine our destiny.

As South Africa enters the next 25 years of democracy, and in pursuit of the objectives of the NDP, let us proclaim a bold and ambitious goal, a unifying purpose, to which we dedicate all our resources and energies.

As we enter the last decade of Vision 2030, let us even more clearly define the South Africa we want and agree on the concrete actions we need to achieve them.

To ensure that our efforts are directed, I am suggesting that, within the priorities of this administration, we agree on five fundamental goals for the next decade.

Let us agree, as a nation and as a people united in our aspirations, that within the next 10 years we will have made progress in tackling poverty, inequality and unemployment, where:

- No person in South Africa will go hungry.

- Our economy will grow at a much faster rate than our population.

- Two million more young people will be in employment.

- Our schools will have better educational outcomes and every 10 year old will be able to read for meaning.

- Violent crime will be halved.

Let us make these commitments now – to ourselves and to each other – knowing that they will stretch our resources and capabilities, but understanding that if we achieve these five goals, we will have fundamentally transformed our society.

We set these ambitious goals not despite the severe difficulties of the present, but because of them.

We set these goals so that the decisions we take now are bolder and we act with greater urgency.

Our determination that within the next decade that no person in South Africa will go hungry is fundamental to our effort to eradicate poverty and reduce inequality.

In addition to creating employment and other economic opportunities, this means that we must strengthen the social wage and reduce the cost of living.

It means we must improve the affordability, safety and integration of commuter transport for low income households.

While we have made great progress in providing housing, many South Africans still need land to build homes and earn livelihoods.

In the next five years, we will accelerate the provision of well-located housing and land to poor South Africans.

To improve the quality of life of South Africans, to reduce poverty in all its dimensions and to strengthen our economy, we will attend to the health of our people.

We must attend to the capacity of our hospitals and clinics.

An 80-year-old grandmother cannot spend an entire day in a queue waiting for her medication.

An ill patient cannot be turned away because there is a shortage of doctors and nurses.

A woman in labour cannot have her unborn child’s life put in danger because the ambulance has taken too long to come.

As part of the work we must urgently do to improve the quality of the health system, we are finalising the Presidential Health Summit Compact, which draws on the insights and will mobilise the capabilities of all key stakeholders to address the crisis in our clinics and hospitals.

We are far advanced in revising the NHI detailed plan of implementation, including accelerating quality of care initiatives in public facilities, building human resource capacity, establishment of the NHI Fund structure, and costing the administration of the NHI Fund.

We remain concerned about rising HIV infections rates, particularly among young women, and the relatively low numbers of men testing for HIV and starting treatment.

We will intensify our work to implement the 90-90-90 strategy to end HIV as a public health threat, which includes increasing the number of people on treatment by at least another 2 million by December 2020.

If we are to successfully address the challenge of poverty across society, we need to provide skills and create economic opportunities for persons with disabilities.

It is therefore a matter of great concern that there are around half a million children of school-going age with disabilities who are not in school.

In responding to these challenges, we have moved the coordination of disability initiatives to the centre of government, in the Presidency.

We have revived the Presidential Working Group on Disability, and will submit the Protocol on the Rights of Persons with Disabilities in Africa to Parliament this year for ratification.

To address the problems of the working poor, the national minimum wage has been in place for six months and the early indications are that many companies are complying.

The National Minimum Wage Commission is expected to conclude research on the impact of the minimum wage on employment, poverty, inequality and wage differentials by the end of September 2019.

We cannot turn our fortunes around without a relentless focus on economic growth.

Within the next decade, it is our ambition that our economy should be growing at a rate far greater than our population.

It is only when we reach consistently high rates of growth that we will be able to reverse the economic damage of our past.

We make this assertion at a time when the economic outlook is extremely weak.

Following the sharp contraction in growth in the first quarter, the Reserve Bank now projects that growth in 2019 is likely to be lower than anticipated in the February Budget.

One reason for the lacklustre economic performance has been the load shedding early this year, together with the continued uncertainty in the supply of electricity and the state of Eskom.

The lesson is clear: for growth, we need a reliable and sustainable supply of electricity.

Eskom is facing serious financial, operational and structural problems.

Since the load shedding earlier this year, Eskom has made much progress in implementing its nine-point plan, ensuring better maintenance of its generation fleet, reducing costs and ensuring adequate reserves of coal.

In line with the recommendations of both the Eskom Sustainability Task Team and the Technical Review Team, Eskom is deploying its most skilled and experienced personnel to where they are needed most.

The utility’s financial position remains a matter of grave concern.

With the current committed funding from government, outlined in the 2019 Budget, Eskom has sufficient cash to meet its obligations until the end of October 2019.

For Eskom to default on its loans will cause a cross-default on its remaining debt and would have a huge impact on the already constrained fiscus.

We will therefore table a Special Appropriation Bill on an urgent basis to allocate a significant portion of the R230 billion fiscal support that Eskom will require over the next 10 years in the early years.

This we must do because Eskom is to vital to our economy to be allowed to fail.

Further details will be provided by the Minister of Finance in due course.

We will announce the appointment of a new CEO following the Mr Phakamani Hadebe stepping down. He came in at a difficult time at ESKOM and has done a great deal with the board led by Mr Jabu Mabuza to stabilize the company.

We will soon also be appointing a Chief Restructuring Officer, who will be expected to reposition Eskom financially with careful attention to the mix between revenue, debt and cost structure of the company.

Eskom is working with government and other stakeholders to address its overall debt as well the debt owed by municipalities and individual users.

As a country, we must assert the principle that those who use electricity must pay for it.

Failure to pay endangers our entire electricity supply, our economy and our efforts to create jobs.

The days of boycotting payment are over. This is now the time to build it is the time for all of us to make our own contribution.

Fellow South Africans,

To meet our growth targets, we will rebuild the foundations of our economy by revitalising and expanding the productive sectors.

This requires us to reimagine our industrial strategy, to unleash private investment and energise the state to boost economic inclusion.

It requires the state to effectively play its role as an enabler that provides basic services and critical infrastructure, a regulator that sets rules that create equitable opportunities for all players, and a redistributor that ensures that the most vulnerable in society are protected and given a chance to live up to their full potential.

We will give priority attention to the economic sectors that have the greatest potential for growth.

Drawing on our successes in the automotive sector, we will implement master plans developed with business and labour in industries like clothing and textiles, gas, chemicals and plastics, renewables, and steel and metals fabrication sectors.

We are going to substantially expand the agriculture and agro-processing sector by supporting key value chains and products, developing new markets and reducing our reliance on agricultural imports.

We will bolster the mining industry by developing markets for South African minerals through targeted beneficiation, reduced costs of inputs, and increased research and development.

Through spatial interventions like special economic zones, reviving local industrial parks, business centres, digital hubs and township and village enterprises, we will bring economic development to local areas. We will also focus on small medium enterprises in our cities, townships and rural areas and create market places where they trade their products.

We will make good on our ambition to more than double international tourist arrivals to 21 million by 2030.

This will be achieved through the renewal of the country’s brand, introducing a world-class visa regime and a significant focus on Chinese and Indian markets and air arrivals from the rest of our continent.

We are determined to ensure that tourists who come to our country are safe.

We will expand our high tech industry by ensuring that the legal and regulatory framework promotes innovation, scaling up skills development for young people in new technologies, and reducing data costs. Wherever we have gone young people have continuously raised the issue of the excessive high data costs in South Africa.

To provide impetus to this process, within the next month, the Minister of Communications will issue the policy direction to ICASA to commence the spectrum licensing process.

This process will include measures to promote competition, transformation, inclusive growth of the sector and universal access.

This is a vital part of bringing down the costs of data, which is essential both for economic development and for unleashing opportunities for young people.

We call on the telecommunications industry further to bring down the cost of data so that it is in line with other countries in the world.

We are intensifying our investment drive.

Of the R300 billion of investments announced at our inaugural Investment Conference last year, just over R250 billion worth of projects has entered implementation phase.

We continue to build a pipeline of investments, which will be showcased at the second South African Investment Conference to be held on 5 to 7 November.

At a time of uncertainty, the work of the investment envoys has built important bridges between government and the business community.

From their feedback, it is clear that much more still needs to be done to improve the investment climate.

This includes reviewing the way Government coordinates work to resolve challenges faced by investors and reforming our investment promotion policy and architecture.

Good progress has been made through the Public-Private Growth Initiative, which is being championed by Minister Nkosazana Dlamini-Zuma, Mr Roelf Meyer and Dr Johan van Zyl.

The private sector has committed to invest R840 billion in 43 projects over 19 sectors and creating 155,000 jobs in the next five years.

In discussions with business, government has committed to remove the policy impediments and accelerate implementation of these projects.

We are urgently working on a set of priority reforms to improve the ease of doing business by consolidating and streamlining regulatory processes, automating permit and other applications, and reducing the cost of compliance.

Infrastructure is a critical area of investment that supports structural transformation, growth and job creation.

It is essential to our economic rejuvenation, to giving meaning and effect to our new dawn.

Our new approach to infrastructure development is based on stronger partnerships between the public and private sectors, and with local communities.

It includes a special package of financial and institutional measures to boost construction and prioritise water infrastructure, roads and student accommodation through a more efficient use of budgeted money.

As announced in the previous SONA, Government has set aside R100 billion to seed the Infrastructure Fund.

We are working to institutionalise the fund, which will be managed by the Development Bank of Southern Africa, with the newly configured Department of Public Works and Infrastructure playing an oversight role.

We have been doing this in consultation with private investors, such as pension funds, who are enthusiastic about participating in the Infrastructure fund.

These reforms will ensure better planning of infrastructure projects, rigorous feasibility and preparatory work, improved strategic management, impeccable execution and better governance.

This will provide a much-need boost to the construction sector.

We will stimulate local demand and grow South African manufacturing by making sure the ‘Buy Local’ campaign is everywhere and ever-present.

We call on all South Africans to deliberately and consistently buy locally-made goods.

The suit, the shirt and the tie I am wearing today was locally made by South African textile workers working at the House of Monatic here in Saltriver Cape Town.

Let us all buy locally-made goods to drive up demand in our economy.

Within this next year, we seek to conclude agreements with retailers to stock more South African goods on their shelves and to actively promote the great products made by South African hands.

At the same time, we will promote our products more actively to the rest of the African continent and the world.

These measures are underpinned by our strong commitment to a macroeconomic and fiscal policy framework that will continue to boost confidence and investment.

We are committed to prudent borrowing and stringent expenditure management to stabilise our public finances and lower the debt trajectory.

The South African Reserve Bank is a critical institution of our democracy, enjoying wide credibility and standing within the country and internationally.

Price stability is a necessary but not a sufficient condition for economic growth.

Rising prices of goods and services erode the purchasing power of all South Africans, but especially that of the poor.

Inflation further undermines the competitiveness of our exports and our import-competing firms, putting industries and jobs at risk.

For these reasons, our Constitution mandates the South African Reserve Bank to protect the value of our currency in the interest of balanced and sustainable growth.

Today we reaffirm this constitutional mandate, which the Reserve Bank must pursue independently, without fear, favour or prejudice.

Our Constitution also requires that there should be regular consultation between the Reserve Bank and the Minister of Finance to promote macroeconomic coordination, all in the interests of employment creation and economic growth.

If we are to be internationally competitive, if we are to attract investment, we must address the high cost of doing business and complicated and lengthy regulatory processes.

We must reach a point where no company need wait more than six months for a permit or licence and new companies should be able to be registered within a day.

We will continue to reduce the cost of doing business by reducing port export tariffs, pursuing lowest cost electricity generation options, and making rail transport more competitive and efficient.

Guided by the NDP, it is our responsibility to pursue inclusive, sustainable development that is resilient in the face of climate change.

Working in partnership with the private sector, labour and the international community we will step up our adaptation and mitigation efforts.

We have the opportunity to be at the forefront of green growth, of low-carbon industrialisation, of pioneering new technologies and of taking quantum leaps towards the economy of the future.

We must increase the contribution of renewable and clean energy to our national energy mix and explore the potential of the hydrogen economy.

Faster economic growth also requires accelerated land reform in rural and urban areas and a clear property rights regime.

We have received the report of the Presidential Advisory Panel on Land Reform and Agriculture, which will now be presented to Cabinet for consideration.

The panel’s recommendations will inform the finalisation of a comprehensive, far-reaching and transformative land reform programme.

In the immediate term, government will accelerate efforts to identify and release public land that is suitable for smart, urban settlements and for farming.

In the stimulus and recovery package announced last year, we promised to prioritise funding for emerging farmers.

Over the medium term budget period, R3.9 billion has been allocated to the Land Bank to support black commercial farmers.

An essential part of South Africa’s growth strategy is the integration of our economy with those of our neighbours and the rest of our continent.

The African Continental Free Trade Area will improve the movement of goods and services, capital and means of production across the Continent.

Our revitalised industrial strategy focuses on the expansion of our trade and investment links with the rest of the Southern African region and the Continent at large.

Within SADC, we will prioritise development of cross-border value chains in key sectors such as energy, mining and mineral beneficiation, manufacturing, infrastructure and agro-processing.

Fellow South Africans,

The growth of our economy will have little value unless it creates employment on a far greater scale.

The fact that the unemployment rate among young South Africans is more than 50% is a national crisis that demands urgent, innovative and coordinated solutions.

And because more young people are entering the labour force every year, the economy needs to create far more jobs for youth than it currently does merely to keep the youth unemployment rate steady.

The brutal reality is that when it comes to youth unemployment, we have to run just to remain in the same place.

It is therefore essential that we proceed without delay to implement a comprehensive plan – driven and coordinated from the Presidency – to create no fewer than two million new jobs for young people within the next decade.

This plan will work across government departments and all three tiers of government, in partnership with the private sector.

We are already working with the private sector to create pathways into work for young people through scaling up existing pathway management networks.

These are networks that allow young people who opt in increased visibility, network support and opportunities to signal their availability for jobs and self-employment.

They make sure that youth from poorer households – and young women in particular – are empowered to take up the new opportunities.

Government will continue to provide employment through the Expanded Public Works Programme, especially in labour intensive areas like maintenance, clearing vegetation, plugging water leaks and constructing roads.

We will continue to develop programmes to ensure that economically excluded young people are work ready and absorbed into sectors where ‘jobs demand’ is growing.

These sectors include global business processing services, agricultural value chains, technical installation, repair and maintenance and new opportunities provided through the digital economy and the fourth industrial revolution.

Government will also ensure that young people are employed in social economy jobs such as early childhood development and health care.

We will expand the National Youth Service to take on 50,000 young people a year.

Government will support tech-enabled platforms for self-employed youth in rural areas and townships.

We will expand our programmes to enable young people to gain paid workplace experience through initiatives like the Youth Employment Service, and also facilitating work-based internships for graduates of technical and vocational programmes.

We are going to roll out small business incubation centres to provide youth-driven start-ups with financial and technical advice as they begin their journeys.

Yesterday, I had the great privilege to meet and engage in dialogue with several young South Africans who are doing amazing work to build our country and develop our people.

They are entrepreneurs and community builders, activists and artists.

If there is one thing we have learned from our engagements with this country’s youth is that we cannot impose our solutions: everything we have to do must be led by them.

They have told us what they want, and what they need.

They want to be employed, yes, but they also want to become employers.

They are brimming with ideas, they are at the forefront of innovation, and they want to do things for themselves.

We have to support the fire of entrepreneurship, because the fortunes of this country depend on the energies and creative talent of our young people.

Fellow South Africans,

If we are to ensure that within the next decade, every 10 year old will be able to read for meaning, we will need to mobilise the entire nation behind a massive reading campaign.

Early reading is the basic foundation that determines a child’s educational progress, through school, through higher education and into the work place.

All other interventions – from the work being done to improve the quality of basic education to the provision of free higher education for the poor, from our investment in TVET colleges to the expansion of workplace learning – will not produce the results we need unless we first ensure that children can read.

It is through initiatives like the National Reading Coalition that we will be able to coordinate this national effort.

All foundation and intermediate phase teachers are to be trained to teach reading in English and the African languages, and we are training and deploying a cohort of experienced coaches to provide high quality on-site support to teachers.

We are implementing the Early Grade Reading Programme, which consists of an integrated package of lesson plans, additional reading materials and professional support to Foundation Phase teachers.

This forms part of the broader efforts to strengthen the basic education system by empowering school leadership teams, improving the capabilities of teachers and ensuring a more consistent measurement of progress for grades 3, 6 and 9.

We also have to prepare our young people for the jobs of the future.

This is why we are introducing subjects like coding and data analytics at a primary school level.

Honourable Members,

The South Africa we want is a country where all people are safe and feel safe.

Let us therefore work together to ensure that violent crime is at least halved over the next decade.

The first step is to increase police visibility by employing more policewomen and men, and to create a more active role for citizens through effective community policing forums.

Currently, there are over 5,000 students registered for basic training in our police training colleges and we envisage that this number will be increased to 7,000 per cycle over the next two intakes.

We are working to improve success rates in investigating and prosecuting crimes, and to ensure better training and professionalisation throughout the criminal justice system.

Violent crime is a societal problem that requires a society-wide response.

We are working with civil society organisations on strategies to end gender based violence and femicide.

Following intensive consultations and engagements, we are working towards the establishment of the Gender Based Violence and Femicide Council and a National Strategic Plan that will guide all of us, wherever we are, in our efforts to eradicate this national scourge.

We are capacitating and equipping the police and court system to support survivors of gender-based violence.

We are stepping up the fight against drug syndicates through the implementation of the National Anti-Gang Strategy and the revised National Drug Master Plan.

Ladies and Gentlemen,

Distinguished Guests,

The achievement of all these objectives requires a capable and developmental state.

This is a state that not only provides the institutions and infrastructure that enable the economy and society to operate, but that has the means to drive transformation.

Earlier this month we announced the reconfiguration of a number of government departments to enable them to deliver on their mandates.

Our decision was premised on efficiency, cost-containment, cooperative governance and strategic alignment.

This is the start of a wider process of arresting the decline in state capacity and restructuring our model of service delivery so it best serves our citizens.

We will be adopting a district-based approach – focusing on the 44 districts and 8 metros – to speed up service delivery, ensuring that municipalities are properly supported and adequately resourced.

To ensure that the state is able to effectively enable economic and social development, it is essential that we strengthen our state owned enterprises.

Through the Presidential SOE Council, government intends to create alignment between all state-owned companies and to better define their respective mandates.

Through the Council, we will work with the leadership of SOEs to develop a legal and regulatory environment that promotes innovation and agility and enhances their competitiveness.

We will build on the work we have already begun to address problems of poor governance, inefficiency and financial sustainability.

We are committed to building an ethical state in which there is no place for corruption, patronage, rent-seeking and plundering of public money.

We want a corps of skilled and professional public servants of the highest moral standards – and dedicated to the public good.

The decisive steps we have taken to end state capture and fight corruption, including measures to strengthen the NPA, SIU, SARS and State Security, are achieving important results.

But there is still much more work to do.

We have asked the National Director of Public Prosecutions to develop a plan to significantly increase the capacity and effectiveness of the NPA, including to ensure effective asset forfeiture.

We need to ensure that public money stolen is returned and used to deliver services and much needed basic infrastructure to the poorest communities.

We expect that the new SIU Special Tribunal will start its work within the next few months to fast rack civil claims arising from SIU investigations, which are currently estimated to be around R14.7 billion.

South Africa will continue to play an active role in international relations in the quest for global peace and security, people-centered development and prosperity for all.

We renew our determination to work in concert with the international community to preserve and protect the rules-based multilateral system with the United Nations at its head.

We will use our membership of the UN Security Council to promote the peaceful resolution of disputes particularly on the African countries.

Fellow South Africans,

If we are to achieve the South Africa we want, we need a new social compact.

We need to forge durable partnerships between government, business, labour, communities and civil society.

This places a responsibility on each of us and all of us.

Government must create an enabling environment, use public resources wisely and invest in developing the country’s human potential.

We would like business to consider the country’s national strategic objectives and social considerations in their decisions and actions.

We agree that labour should advance the interests of workers while, at the same time, promoting the sustainability of businesses and the creation of jobs.

Civil society needs to continue to play its role in holding government to account but must also join us in practical actions to attain our common goals.

We look to the parties in this Parliament to be a vital part of this partnership, lending support, insights and effort to promoting the national interest.

This social compact requires a contribution from everyone.

It will also need sacrifices and trade-offs.

It is upon the conduct of each that the fate of all depends.

If we are to reinvigorate the implementation of the National Development Plan, we must cast our sights on the broadest of horizons.

We want a South Africa wherein all enjoy comfort and prosperity.

But we also want a South Africa where we stretch our capacities to the fullest as we advance along the superhighway of progress.

We want a South Africa that has prioritised its rail networks, and is producing high-speed trains connecting our megacities and the remotest areas of our country.

We should imagine a country where bullet trains pass through Johannesburg as they travel from here to Musina, and they stop in Buffalo City on their way from EThekwini back here.

We want a South Africa with a high-tech economy where advances in e-health, robotics and remote medicine are applied as we roll out the National Health Insurance.

We want a South Africa that doesn’t simply export its raw materials but has become a manufacturing hub for key components used in electronics, in automobiles and in computers.

We must be a country that can feed itself and that harnesses the latest advances in smart agriculture.

I dream of a South Africa where the first entirely new city built in the democratic era rises, with skyscrapers, schools, universities, hospitals and factories.

This dream has been fuelled by my conversations with four people: Dr Nkosazana Dlamini-Zuma, Dr Naledi Pandor, Ms Jessie Duarte and President Xi Jinping, whose account of how China is building a new Beijing has helped to consolidate my dream.

This is a dream we can all share and participate in building.

We have not built a new city in 25 years of democracy.

Seventy percent of South Africans are going to be living in the urban areas by 2030.

The cities of Johannesburg, Tshwane, Cape Town and Ethekwini are running out of space to accommodate all those who throng to the cities.

Has the time not arrived for us to be bold and reach beyond ourselves and do what may seem impossible?

Has the time not arrived to build a new smart city founded on the technologies of the 4th Industrial Revolution?

I would like to invite South Africans to begin imaging this prospect.

We are the South African nation that with its Constitution gives hope to the hopeless, rights to the dispossessed and marginalised, and comfort and security to its men, women and children.

Though we may have faltered, we have not forgotten who we are, and what we stand for.

We are still that nation.

You may ask how I can be hopeful at such a difficult time.

I am hopeful because I have walked with the people of this country – the nurses and health care workers, our men and women in uniform, the teachers in our schools, the students who despite their family’s hardship are determined to succeed, and the youth who are trying to start their own businesses, to invent and create, and to rise above their circumstances.

It is you who give me courage, and to whom I offer courage in return.

Working together there is nothing we cannot be, nothing we cannot do, and nothing we cannot achieve.

As we enter this new era, let us take to heart the words of Ben Okri, when he says:

Will you be at the harvest,

Among the gatherers of new fruits?

Then you must begin today to remake

Your mental and spiritual world,

And join the warriors and celebrants

Of freedom, realizers of great dreams.
You can’t remake the world

Without remaking yourself.

Each new era begins within.

It is an inward event,

With unsuspected possibilities

For inner liberation.

We could use it to turn on

Our inward lights.

We could use it to use even the dark

And negative things positively.

We could use the new era

To clean our eyes,

To see the world differently,

To see ourselves more clearly.

Only free people can make a free world.

Infect the world with your light.

Help fulfill the golden prophecies.

Press forward the human prophecies and the  future is greater than our past.

I thank you.
  
2019/06/192019/06/24 12:09 PM
Civil society organisations, SECTION27 and the Institute of Economic Justice have urged Health Minister Zweli Mkhize and Finance Minister Tito Mboweni to urgently increase funding for public health.

In an open letter to the two ministers, the organisations say the objective of a long and healthy life for all South Africans cannot be achieved with the current inadequate and inefficient health resourcing, both financial and human. They say the implementation of austerity budgets by the previous democratic government severely undermined the public health system and the viability of NHI.

 “Spend per uninsured person increased only 1% (in real terms) on average annually between 2015-2016 and 2019-2020, despite a rising burden of disease and high medical price inflation. This is not enough to address the historical and current inequalities that persist in healthcare,” they wrote. The organisations point out that the NHI White Paper, recognised that healthcare spending had to double if quality healthcare is to be provided for all. However, the February 2019 budget allocated R700 million less to health than was proposed in the medium-term budget in October last year. “Taking stagnant economic growth into consideration, the Davis Tax Committee’s projected R72 billion shortfall in NHI funding by 2025 is likely to significantly understated,” they observed. Referring to human resources, the societies noted that shortages of specialists and other staff in the public health sector have been exacerbated due to budget cuts.
They urge the ministers to implement a health financing strategy that will more appropriately define how much money will be raised, allocated and spent on improving healthcare outcomes and achieving universal healthcare.

“We are committed to NHI, but we urge you to take specific concerns with the current NHI Bill seriously. Matters such as the role of the provincial health departments and protecting NHI funds from corruption are just two examples of critical questions that require clarification,” they wrote.

They also urge the Ministers to support the finalisation of the Health Market Inquiry into the private sector and implementing its recommendations, adding that NHI will not be achieved without significant reform of the private sector.
  
2019/06/192019/06/24 12:15 PM
SA's private healthcare sector is under pressure to reform and adopt alternative billing models while the traditional fee-for-service model is coming under pressure, says Icon Group COO Dr Ernst Marais.

The shrinking economy – with the country's gross domestic product taking its biggest plunge since the 2008 global financial crisis, a 0.8% decline in household expenditure and a weakening rand – will hit local medical aids hard, according to Marais. “Add to this ageing risk pools, higher incidence of expensive diseases such as cancer, and stagnant member bases, we will see more members downgrading to more affordable healthcare options, placing further strain on medical aids,” says Marais, who champions the value-based care (VBC) model as a tenable alternative to the current fee-for-service model used in the South African private healthcare system.

But ultimately it is the consumer who will be affected the most by rising healthcare costs and less access to quality care.

As consumers tighten their purse strings, they first scale back on gripe purchases such as insurance products. “This includes medical aid membership and the recent increasing trend of anti-selection by members. This is when members downgrade to a more affordable option or reduce the number of dependants they have on their medical aid,” says Marais. This trend, compounded by tough market conditions, is likely to continue, placing medical aids under increasing pressure to reinvent themselves. Says Marais: “The solution is VBC, which places the patient at the centre. For nearly a decade the Icon Group has advocated for the VBC model in local oncology. Our studies show that VBC reduces oncology costs by as much as 27% without compromising patient care and outcomes.”   The VBC model drives efficiencies in terms of costs and efficacy, both in the treatment of and outcomes for patients. This leads to cost efficiencies for medical schemes without compromising the quality of patient care.

Recent research published by Icon shows that patients treated using evidence-based treatment protocols led to cost efficiencies while showing no evidence of inferior care. The Icon approach, which supports protocols and integrates evidence-based medicine, showed a significant reduction in costs compared with scenarios where no protocols were applied. Patients received appropriate and quality care at a much lower cost. VBC places patients firmly at the centre of their treatment by aiming for the best clinical outcomes and patient experience (quality) at lower costs for both the patients and medical schemes. “This means that often there is more money left for life-saving treatment and less wastage on administration,” says Marais. VBC in oncology is not the only disruptor in the industry. One of the biggest game-changers introduced by Icon is real-time authorisation for in-protocol treatment. “Real-time authorisation is without a doubt an industry disruptor. It significantly reduces both the administrative burden and costs in practices. Importantly, it also reduces the conflict between practitioners and medical aids. It also has a tangible impact for patients who prior to this intervention had to wait for weeks before treatment could start,” says Marais.

Representing more than 80% of oncologists in SA, Icon Group has the richest oncology database (more than 92,000 cases) in the country, adding about 20,000 new cases per year. “We use this data to build efficiencies into the business process. Importantly, from a clinical point of view, it helps in the ongoing development of the treatment protocols based on measured performance and efficacy data,” says Marais. “The future of private healthcare will be driven by new-generation models such as VBC, and early adopters have a competitive advantage by securing an alternative revenue stream with built-in efficiencies. Icon Group is proof that the VBC model works “by putting the patient at the centre and reducing wastage and costs, while improving efficiency and efficacy for all”, says Marais.
  
2019/06/192019/06/24 12:16 PM
Tomorrow President Cyril Ramaphosa will deliver the State of the Nation Address (SONA) following the 2019 national and provincial elections just 6 weeks ago. Despite the current fractious position we find ourselves in, there remains a collective sense of expectation that just maybe this SONA will mark a break from the past and charter a new way forward for our nation.

Make no mistake, our country is at the precipice and ready for change. Racial, linguistic and nationalist tensions are worryingly high, the economy is a friend to very few, and the overwhelming majority of South Africans live in fear for their lives and livelihoods. Things are fast approaching boiling point, and the time is ripe for social and economic reform.

As Leader of the Official Opposition, I have been steadfast in my approach towards the President. The DA will not be opposition for opposition’s sake. Mr Ramaphosa will have my full support when he acts in the best interests of South Africa. Similarly, he will face the full might of the official opposition when he acts to the contrary. Tomorrow the President has a unique opportunity to restore confidence in the country by providing policy certainty that steers our economy towards a path of growth and prosperity. A future in which citizens feel safe, corruption is seriously dealt with, and services such as healthcare and education are delivered in a fair manner to all South Africans.

It is our view that in order to do so, he must make bold, uncompromising decisions despite how unpopular they may be within certain factions of his party. The future of South Africa hangs in the balance, and President Ramaphosa must now show the nation that he indeed is fit to lead.

It is within this context that we today set out the DA’s expectations for the State of the Nation Address.

Jobs and the Economy

The only way to create jobs, sustainably lift millions out of poverty, and give people the hope of a future of shared prosperity is an economy growing at much higher levels. Developing economies across the world have demonstrated that when sustained growth is achieved, more jobs are created, salaries and wages increase, and the quality of life is objectively better.

The key impediments to growth are the supply and cost of electricity, labour legislation reform, fundamental policy uncertainty, uncertainty around the protection of property rights, and low levels of investment – both domestic and foreign.

1. Electricity cost and supply

President Ramaphosa needs to announce government’s intention to allow major cities to procure electricity from any capable supplier, establishing a competitive market for power generation that lowers costs – especially for the manufacturing sector. This would in turn create much needed power for the under-resourced national grid, staving off the need for rolling power cuts. Secondly, the President should proceed with the breaking up of Eskom into separate entities, one for generation and the other for supply. This is the most sustainable way of protecting the grid while allowing new producers to come on board.

This should be coupled with a decision to not allow any more bailouts for Eskom. Our country cannot be coal dependent for much longer, and there ought to be a concerted effort to pursue alternative, cleaner energy sources including wind, solar and gas.

2. Labour Legislation Reform

To mitigate the protracted strikes, the President should implement the DA’s strike ballot proposals. This includes:

- Making it a requirement for ballots to be held before there is a strike action by unions a key initiative to ensuring all strike action stems from a democratic decision of workers;

- Holding labour unions accountable for any damage to public or private property as a result of strike action; and

- Holding labour unions financially accountable to pay damages to individuals who have successfully brought cases of intimidation and/or assault against trade union members during strike action.

In addition to this, an independent committee tasked with reviewing our rigid labour legislation regime and its impact on investment, growth and job creation should be established.

Our labour policy is some of the most archaic in the world and the main inhibitor to job creation. This labour legislation review would need to include reforming the National Minimum Wage with Sectoral Minimum Wage as the ideal alternative.

We need to explore the option of allowing people to exempt themselves from minimum wage legislation which will allow higher access to work for those unemployed South Africans.

3. Policy uncertainty

One of the primary inhibitors of inclusive economic growth is the guess game many local and foreign investors have to play when it comes to government policy. There exists very little certainty as to government’s “rules of the game”, with doublespeak occurring on a regular basis.

Providing policy certainty is the “cheapest” stimulus that Ramaphosa could announce as it requires no money and would have a profoundly positive effect on business sentiment and confidence.

This begins with the President at once stopping speculation about the role and nationalisation of the Reserve Bank and end the self-defeating discussion on the expropriation of private property without compensation. There is also uncertainty in the mining sector causing the near-collapse of the industry, which remains a vital export earner and employer in the economy. The dispute over empowerment requirements must be resolved in favour of investment and growth because a greater empowerment share of an ever-shrinking industry is pointless and does not serve anyone’s interests.

In trade, there is a genuine threat that South Africa will suffer as an innocent victim in a trade war between the trade “superpowers.” This is an opportunity to speak with moral authority and make the case for more open global trade based on mutually agreed rules. We should show leadership in this by working to complete the Continental Free Trade Area (CFTA) and Tripartite Free Trade Area (TFTA) urgently.

Such announcements would send a clear signal that South Africa is open for business, which would in turn grow our economy and create much needed jobs.

4. Public investment

In order to invest in infrastructure, we have to cut costs elsewhere as the public purse has run dry. This requires a fundamental spending review focused on the public wage bill, which is clearly unsustainably inflated in favour of very expensive “head office costs” - with not enough allocated to frontline delivery staff like nurses, doctors, teachers, police officers, social workers, and border patrols.

The President should announce a salary freeze on all nonessential public sector posts, with a view to drastically cutting middle management and redirecting that money to funding much needed infrastructure projects across the country.

5. Additional measures

There is an urgent need for SOE reform across the board and the President needs to announce his intention and table a solid plan for full SOE reform of all SOEs.

A moratorium on bailouts to SAA should be announced, and the airline placed in business rescue before the end of June 2019. This would demonstrate that government will not waste another cent on badly run, corrupt SOEs.

The Carbon Tax should be scrapped immediately. It is nothing but a tax on manufacturing, when we should be looking to lower the costs of doing business for manufacturing companies by all means possible. The cost of this tax will be borne disproportionately by ordinary consumers through higher electricity charges and manufacturing businesses and will have no major benefit in reducing carbon emissions, since the greatest emitter is Eskom.

Safety

In recent months there has been an unprecedented spike in violent crimes affecting rural and gang-ridden communities. This follows promises made by President Ramaphosa before the elections to bring about rural safety and security in South Africa.

It is high time the President acts and reintroduces rural safety units at once.

South Africans deserve safer communities and an honest and professional police service that actually serves them. However, provinces remain severely under-resourced, under-trained, under-equipped and under-staffed. President Ramaphosa should therefore also announce his intention to devolve the South African Police Service (SAPS) powers to capable provinces so that the SAPS can ensure more efficient and effective planning and responsiveness closer to the ground.

Corruption

For the past two decades, corruption has seeped into every organ of the state. From the Arms Deal to Nkandla, rooting out corruption requires bold leadership from the very front.

For the past seven months, President Ramaphosa has been embroiled in a corruption scandal relating to Bosasa, a company that has questionable ties to the ANC for over 20 years. The President – and his son, Andile - have allegedly benefitted to the tune of millions from a company well known for bribing government officials. This is now subject to a Public Protector investigation following a complaint I laid.

I have today written to the Speaker of the National Assembly, Thandi Modise, calling for the establishment of an Ad Hoc Committee on the Public Protector’s imminent Bosasa report to interrogate the Bosasa scandal – which includes President Ramaphosa’s dealings.

If the President is truly serious about rooting out corruption, he should have no qualms in publicly supporting my call and subjecting himself to the Ad Hoc committee.

Service Delivery

It is high time the President takes a decisive stand against the South African Democratic Teachers’ Union (SADTU) which continues to hold South Africa and its children to ransom. The union has fought against all accountability for teachers, placing the interests of millions of children second to the interests of union bosses.  The implementation of teacher competency tests and principal performance agreements that SADTU has been blocking for half a decade would be a welcome show of independence from the unions by President Ramaphosa, and he should introduce these tomorrow.

To add to the list of dangerous policies that needs to be scrapped must surely be the National Health Insurance (NHI) which is unsustainable and unfeasible. The President needs to announce that that the NHI will be scrapped.

Conclusion

The question that should be on the President’s mind as he addresses the nation tomorrow is where the country is going and how we are going to get there. If his answers to these questions are in the best interests of the people of South Africa, he will have my full support going forward. Mr Ramaphosa needs to be bold, brave and uncompromising. He ought to place the nation’s interests ahead of the ANCs interest. Only then will we begin to move our country forward. Issued by Mmusi Maimane, Leader of the Democratic Alliance, 19 June 2019.
  
2019/06/182019/06/24 11:53 AM
Two civil society organisations have called on finance minister Tito Mboweni and new health minister Zweli Mkhize to increase public sector funding for health, arguing that the government’s goal of achieving “a long and healthy life for all” cannot be met with the available resources.
In an open letter to the ministers released on Tuesday, the Institute for Economic Justice (IEJ) and Section 27 said the implementation of austerity budgets in the previous administration severely undermined the public health system and the viability of National Health Insurance (NHI). “Spend per uninsured person increased only 1% (in real terms) on average annually between 2015-2016 and 2019-2020, despite a rising burden of disease and high medical price inflation. This is not enough to address the historical and current inequalities that persist in healthcare,” they wrote. The organisations said the NHI white paper, which spells out government’s policy for universal health coverage, recognised that healthcare spending had to double, yet the February budget trimmed R700m from the spending plans set out in the October 2018 medium-term budget policy statement.

“Taking stagnant economic growth into consideration, the Davis Tax Committee’s projected R72bn shortfall in NHI Funding by 2025 is likely to be significantly understated,” they said.

Cost in lives

“Shortages of specialists and other staff in the public health sector have been at crisis levels for some time. These were exacerbated in the past five years due to budget cuts. In May 2018, 38,000 public health posts were vacant as a result of the implementation of wage expenditure ceilings — one of the tools the Treasury has used to curb expenditure — at an avoidable cost to lives. Provincial health departments have faced difficult choices as a result: cut non-personnel budgets or reduce headcounts,” they wrote.

The health department had not responded to Business Day’s request for comment at the time of going to press.

The February budget set aside R208.8bn for consolidated health spending in 2018-2019, with spending plans that grew by an average of 7% over the medium term to reach R255.5bn in 2021-2022. The Treasury projected at the time that inflation would rise by 5.2% this year.  The budget also saw the Treasury move R2.8bn in unspent money from the NHI indirect grant to fund critical healthcare posts over the next three years.
  
2019/06/182019/06/24 11:55 AM
South Africa is facing many crises and the key amongst these is the 37% and growing level of unemployment and the ongoing retrenchments that are decimating workers. We also face a possible collapse of Eskom, SABC, SAA and other key parastatals, declining public services and uncontrollable levels of corruption.
 
COSATU and workers across the nation expect the President to show bold leadership and take decisive actions and set reasonable timeframes to deal with these ticking time bombs.  The federation expects the President to make it clear that there will be harsh consequences for those who undermine these objectives. The President needs to exercise his new democratic mandate to act with speed and vigour to execute the desperately needed policies to save South Africa from a return to an economic recession. The Federation understands the pressures against the President are great; however, there is no time to waste.  There is no honeymoon because workers and voters, in general, expect the government to deliver on its election promises and mandate.

Unemployment
 
COSATU sees the present unemployment rates as a national crisis. While we do not expect millions of jobs to be created overnight, we do expect a comprehensive plan for job-creation that involves the creation of new businesses, and the expansion of the economy into growth industries, such as energy, water, auto-manufacturing, agriculture, tourism, education, health, clothing, electronics etc. The creation of jobs and spurring economic growth cannot simply be left to the Department of Trade and Industry alone.  Each department must contribute.  Each department must be allocated job creation and economic growth targets, be adequately resourced and held accountable for any failures.  Without this, the nation will not be able to move forward. Any department that fails to implement the Auditor General’s recommendations or fails to spend money should see its political leadership and senior bureaucrats dealt with.
 
The President needs to hold business accountable for its failures to honour the Jobs Summit Agreements.  Equally, the President needs to rein in the SOEs and Treasury who seem to believe that retrenching SOE workers will stop their bleeding and contribute towards economic growth and job creation.

State Enterprises
 
The Federations is deeply worried about the dire state of our SOEs.  However, to date, we have not seen any tangible plans to halt their decline, stabilise and grow them.  All that the workers have heard is that the SOEs wants to retrench the in their thousands. Clear plans are needed for Eskom, SAA, SABC, Denel, Prasa etc.  These need to give confidence to the country that the government is on track towards saving these SOEs.
 
COSATU expects the President’s commitment that SOE workers will be accommodated into a jobs plan and will not be unilaterally retrenched to be honoured by the SOEs. We need a solid plan that will accommodate the reskilling, upskilling and redeployment of all those workers whose jobs will be dislocated by any turnaround plan.
 
Climate Change
 
COSATU expects the president to recognize the major threat that climate change poses to all South Africans, specifically workers. From farm workers who will suffer from drought to those involved in manufacturing, who will be retrenched due to the economic crises that will arise from warming earth – we expect their needs to be addressed.
 
We further expect policy plans that will focus on the renewable energy industry and jobs that will be created in industries that actively adapt to climate change, and mitigate its effects. E.g. sustainable farming, urban farming, recycling, and businesses that use environmentally friendly production processes. Government’s climate change plan needs to go far beyond carbon taxes.  It needs to be based upon creating new environmentally friendly, sustainable and jobs intensive sectors such as electric vehicles, water conservation, industrial and consumer recycling, land rehabilitation and more scientific methods for agriculture.
 
Corruption and Looting
 
Corruption is a national crisis and COSATU has already voiced its disdain at the state of looting in the country. We expect a firm commitment to prosecuting corrupt officials. We also expect a bolstered set of internal policies for preventing future corruption. It is time to match rhetoric with some action. Corruption is tantamount to treason and should be treated with a sense of urgency.
 
COSATU welcomes the imprisonment of the former MEC for Finance in the Northern Cape but much more needs to be done.  The NPA and SAPS must act upon what is being revealed at the Commissions of Enquiry, media etc.
 
Transport
 
The transport crisis has scarred workers since the days of apartheid. Their income is sunk into unsafe and inefficient private taxis, or into broken public transport. The failures of Prasa amount to an attack on workers. We expect the president to prioritize the recovery of Prasa, expand public transport in urban areas and regulate dangerous taxis.
 
Metro Rail is broken and it must be fixed ASAP.  The government must also accept that the E Tolls have been rejected and come up with a plan to sort them out.
 
Land Reform
 
It is time that the government acted on the cry for comprehensive land reform.  Workers in urban areas can no longer live in shacks, backyards or overcrowded housing.  Land for decent urban settlements must be released.  Equally, the government needs to intensify land reform to ensure that farm workers, village residents and others who wish to farm are given the land.  This must include all the necessary financial, resource and logistical support to ensure emerging farmers survive and grow.
 
Parliament and the government must act with speed to pass the relevant land reform legislation and constitutional amendments to ensure that land reform happens.
 
Healthcare
 
Public healthcare is in a massive crisis and the President needs to step in and ensure that it is fixed.  The SONA needs to flesh out what is the government’s plan and timeframe towards building a National Health Insurance.  It can no longer be acceptable to have doctors, paramedics and nurses being attacked on duty, to have clinics run out of medicines, for ambulances to be so overstretched that they take hours to deal with an emergency situation.
 
Education
 
COSATU calls for the protection of teachers and learners from violence and drugs.  The government must make schools safe for both teachers and learners.
 
The SONA needs to indicate how far the government has moved to ensure all schools have decent sanitation and when this national disgrace of not providing learners with decent sanitation will end.
 
4th Industrial Revolution
 
COSATU calls on the government to begin the process of reskilling the population for the 4th Industrial Revolution. Further increases in unemployment must not be made worse by automation, mechanisation, digitisation and the shifting of entry skills of the modern economy. We call on the government to include digital literacy in the school curriculum, allow for apprenticeships in information industries or any other policy choices that will prepare South Africa for the changing economy.
 
The Presidential 4th Industrial Revolution Commission needs to be reconfigured and relocated from the Department of Communications and Digital Technologies to the Presidency.  It cannot simply look at the 4th Industrial Revolution in isolation from the entire spectrum of the economy.
 
Crime, Drugs and Policing
 
We call on the government to expand the police service, improve its operations and pursue innovative policies in reducing crime. We expect the President to offer leadership and support to those South Africans who have suffered from this plague.  The deployment of SAPS personnel must be shifted away from the head and provincial offices and desk jobs to community policing and specialised units.
 
Labour
 
Workers applauded the adoption of the new National Minimum Wage.  Further action is needed against employers who still refuse to abide by the NMA Act.  The CCMA and Labour Courts need to be adequately resourced.
 
The LRA must be amended to end labour broking once and for all.  The LRA must further be strengthened to make retrenchments an act of last resort and to compel employers to reskill and absorb workers where needed.
 
The Basic Conditions of Employment Act must be amended to limit the working week to 40 hours.  Workers need to be allowed adequate time with their families and to rest.  This must be done in a way that will also protect their wages.
 
The Public Holidays Act and the BCEA must be amended to declare Freedom, Elections and Workers’ Days as non-trading public holidays.  The existing public holiday's legislation is woefully inadequate.  Workers must be guaranteed their right not to work on public holidays.  The 2019 elections have seen thousands of workers being disciplined; wages docked and even dismissed for not working on Election Day, especially in the retail, service and agricultural sectors.
 
Immigration policy
 
The government needs to explore a sober immigration policy that will ensure that we do not have an immigration system that drives down wages of the poor and benefits the rich. Poor immigration policy and open borders are bad for the economy and the poor workers are the ones who suffer. The government already has many solid policies that are not being implemented.
  
2019/06/182019/06/24 12:05 PM
Please find attached an open letter addressed to Dr Zweli Mkhize and Mr Tito Mboweni The letter seeks to discuss the current status of the Health and financial sectors in South Africa, and possible solutions for reform. The letter is written by SECTION27 and the Institute for Economic Justice.
  
2019/06/142019/06/24 11:38 AM
The pharmaceutical sector - both locally and globally - is following suite with general retail and going through uncertain times. More consumers are shopping the basics with baskets of necessities only. As CEO of the Shoprite Group, Pieter Engelbrecht, said in response to their interim results (which speak for the average South African), “In the external operating environment, economic conditions have left the group's core customer under significant financial pressure.”

In a recent interview, I was asked how to launch a new product in the pharmaceutical market. My first response was, “With difficulty.” It’s not only that the consumer is cash strapped; it’s also that there are fundamental changes happening within the industry itself. For anyone looking to be involved in new product development, here are five key things you need to know.

1. Government to Open a State Owned Pharmaceutical Company
A state-owned pharmaceutical company is likely to form part of the government’s transition to the National Health Insurance (NHI) system. President Ramaphosa confirmed this in his February State of the Nation address, reiterating that the NHI is in its final stages and will soon submitting to parliament. He said, “By introducing the NHI together with a multi-pronged quality improvement programme for public health facilities, we are working towards a massive change in the health care experience of South Africans.”

We don’t know what the exact outcome of this will be but approved NHI partners will be the ones who have the footprint with doctor’s scripts. Also, as Erik Roos, Chief Executive of Pharma Dynamics points out, “(We) will see a change in the balance of power across the healthcare value chain as governments and medical aid providers start to exert more pressure on pharmaceutical companies to drop their prices. “Greater transparency with regards to the cost and sale of medicines will also be necessary.

2. The Decline of the Independent Pharmacy
Independent pharmacy is taking a beating at this point and time. Traditionally they used to represent between 50% - 51% of the pharmacy retail market in South Africa. This was because they were conveniently located in the suburbs and had relationships with the customers living around them. Independent pharmacy also dominated in script-driven business, although not in sales at the front of the shop. This is changing as more Independents are becoming owned, or part-owned by bigger players in the industry, the Dis-chem Group, for example, there is also major competition for the Independents from a big pharma player like Clicks, who has over 600 stores, of which more than half have a pharmacy and most of the others have the potential to become a pharmacy. Lastly, as already noted, more people are being forced to shop where it’s cheapest and Independent pharmacies will battle to compete on price with the pharma chains –unfortunately, loyalty will only take you so far in today’s market.

3. The Rise of In House Brands and Healthcare Products & Apps
Dis-Chem has around 140 stores in South Africa but they are winning in the marketplace with their House Bands which now cover less traditional products such as toothpaste and adult incontinence aids, for example. This direction is based on international trends that have focused on In House products we would never have seen in pharmacies a few years ago. Now there isn’t a product category in Dis-chem where their own product doesn’t feature. In addition, these brands are no longer named after the store so the consumer is less likely to perceive them as “budget” or “low quality” items.

Another trend changing the status quo is the rise of preventative healthcare products rather than reactive medicine. This can be seen in the increase in sales in vitamin products, health foods, immune boosters sporting tonics, etc. Where this will encourage new industry players is actually outside of FMCG products and into technology such as health tracking apps and through partnerships with Medical Aids. Some examples already running in South Africa are with Discovery Vitality and the benefits linked to health foods sold in store at pharmacies.

4. Shoppers Choice – More Supply than the Demand
The domination of the pharmaceutical market in the future will largely be through innovation and customer relationships. In South Africa, Dis-chem is the current success story in the marketplace as their business model is all about Shoppers Choice. They have the option of 100 different deodorants, for example. They are all about choice – giving people the option to buy things they didn’t even know they wanted, which is why customers walk out of the store saying, “I only came to get two things and look how much I bought.”

In addition, if you can’t find something in a Dis-Chem store you will find it online. They’ve always had surgical wheelchairs and walkers available, for example, but their online store has ten times more of these types of products backed up with online specialists who can assist the customer. But while they have the market covered at the moment, new global innovations from Amazon or Alibaba could change all that quite quickly.

5. Move beyond the Product – Indirect Marketing
Another global trend is aligning stores with services outside the products they sell. Again Dis-Chem is a good example of how to do this; they have a lot going on external to direct sales, including:

• Wellness Clinics
• Homeopaths
• Beauty salons offering make-overs, massages, etc.
• Sponsoring of sporting events
• Stands with specialists at baby shows
• A strong radio presence, and;
• The Dis-chem Foundation including food gardens – a great CSI initiative giving back to the community.

In summary, 2019 will continue to be tough for those of us in the pharmaceutical industry. At the moment it is costing some businesses to stay in business. Those who can ride the current wave will be around to embrace the positive changes we hope to see within the next year.
  
2019/06/142019/06/24 11:41 AM
The success of restructuring and re-engineering healthcare in SA by introducing NHI must be developed along the lines of an integrated, coordinated and collaborative delivery model and integration, coordination and collaboration by multiple stakeholders. Integrated care is similar to coordinated care and is prefaced on a collaborative ideology. This is contraposed to fragmented and episodic care.

THREE PRINCIPAL DEFINITIONS:

1. A process-based definition. It is a model that creates connectivity, alignment, and collaboration between the participants in the ‘care’ sector. The goal is to enhance the quality of life, consumer satisfaction and systems efficiency for people, by cutting across multiple services, providers and settings. It is an interconnecting set of processes aligned with a continuous support process over time.

2. A User-led definition. Care determined by the people themselves.

3. A Health System based definition as used by the WHO Regional Office in Europe. “Integrated Healthcare Services delivery is defined as an approach to strengthening people-cantered health systems through the promotion of comprehensive delivery of quality services across the life-course. It is designed according to the multiple dimensional needs of the population and the individual. It’s delivered by a coordinated multi-disciplinary team of providers, working across settings and levels of care.” The system is managed to ensure optimal outcomes and appropriate use of resources based on the best available evidence. Important and entrenched in the concept is that it has, “feedback loops to continually improve performance and tackle upstream causes of ill health and it promotes well-being through inter-sectorial and multi-sectoral actions” [WHO].

Implicit in the definition is the notion that Integrated Health Services Delivery (IHSD) should be cantered on the need of individuals, their families, and communities. Two interrelated factors that are driving Integrated Care Delivery:

1. The growing prevalence of chronic diseases.

2. The population aging – placing a heavy burden on the Health Systems.

Chronic diseases are the leading causes of death and disability throughout most of the world. It now accounts for 75% of the Global Healthcare spend (likely to increase in the next few years). This aging population is associated with increased comorbidities, increased medication, increased modalities of care, increase hospitalization and length of stay in the hospital, resulting in increased costs.

Managing this group of patients and providing care is inadequate due to fragmented healthcare delivery, poor communication between practitioner and patients. The product of fragmentation results in ineffective care and often duplication of care. This is evidenced in South Africa. Compounding these challenges is that the “absence of a good interface between the health system and social services allows elderly patients to ‘fall through the cracks’ because neither side understands the full extent of the patients’ problems.

Care fragmentation also frustrates patients who have difficulty in navigating multiple providers.” The importance of integrated care strategies is that it brings together different groups involved in patient care so that, from the patients’ perspective the services delivered are consistent and coordinated. Too often providers focus on a single episode of treatment, rather than the patient’s overall well-being.

There are three broad categories of integrated care:

1. Integrating Primary and Secondary Care. This is an attempt to provide ‘one stop shop’ service for patients, to improve care coordination, especially for people requiring long term care (who by definition include chronically ill and elderly patients) or to ensure the more appropriate use of Healthcare services.

2. Integration between Healthcare and Community care. This is an effort to coordinate a wide range of services including social services and community nursing services.

3. Integration between Payer and Providers. Efforts are designed to more closely coordinate care planning, commissioning and delivery. Payer and Provider integration make it easier to ensure that incentives within the system encourage all providers to maximize care quality while minimising costs. “When patients are managed in an integrated and coordinated manner with a closely coordinated follow-up care, it leads to the decreased need for costly emergency interventions and significantly reduced risk of death.”

In low- and middle-income countries, it is easy to understand the benefit of an Integrated coordinated care strategy. The challenges are enormous: lack of skilled health professionals, lack of resources, fiscal constraints, the rise of infectious disease epidemics and the tsunami of NCDs, and lack of access to essential medicines and basic equipment as well as lack of access to care.

This is a challenge we have in South Africa as we plan to deliver Universal Healthcare via the NHI programme. Also, there is a challenge to meet the SDGs by 2030. It will be prudent that as we prepare for 2030, we begin to create a platform for an Integrated Care model.

“The success for this will be a paradigm shift from how we tweak the present fragmented, unsustainable and inaccessible care model to a set of services where the primary goal is to improve management of basic healthcare and of chronic conditions by minimising hospital admissions and maximising care delivered in the community. This is achieved through primary care physicians, specialists, home nursing services and perhaps other community-based health professionals.”

MODELS OF INTEGRATION

1. Structural – different organisations or groups either merge or have some form of formal partnership or joint venture

2. Virtual – integration requires only that the organisations or groups work closely together.

Both cases, the best results are achieved through effective governance, strong performance management, value-based reimbursements and the evaluation of outcomes of care. A shift towards integrated care is usually a substantive change for a healthcare organisation. It must include good clinical leadership, good communication programmes, a clear and concise vision, and taking the entire team including the staff to understand and embrace this new way of thinking and understanding what the objectives are.

Care Coordination is not ‘One Size fits all’.

There are five core components of coordination in the literature:

1. Institute a team-based approach

2. Know the details of your population to effectively manage the population’s health risk. Need proper data systems, workflow data, and expertise to analyse data

3. Expand access and relationships to include more than medical care.

4. Care now includes determinants on an individual’s overall health. Prevention and treatment have moved beyond the hospital and office walls to pharmacies, urgent call clinics, and retail centres.

5. Reimbursements – invest in individualized care

6. To obtain a return on investment organizations need to define and communicate their desired outcomes and measure performance against those outcomes and assure that processes are continuously adjusted for consistency with best practices. ROI in healthcare cannot be just the profits at the end of a balance sheet

7. Prepare for a shift to new payment models, driving towards Value-Based reimbursements. There are two approaches to improving healthcare, especially in the LMICs – vertical and horizontal programmes. It is better to have horizontal Health System Strengthening, rather than the isolated vertical programmes. In LMICs the horizontal platforms are not adequately strengthened. There is a need to strengthen the facilities, increase healthcare professionals and human resources, adequate IT platforms, availability of medication, healthcare management services and financial support.

Without this vertical disease-specific programmes and selective programmes will not have a platform to work off. Often, donor and funded programmes focus on disease-specific vertical programmes. They may be financially rewarding but may operate in silos, without necessarily improving all the areas of healthcare deficiencies. Primary Care itself must be a component part of the horizontal care platform. It must serve to strengthen the health system to support multiple vertical programmes.

This is a major undertaking and not a mere adjustment, it is a call for a “Fundamental Paradigm Shift in the way health services are funded, managed and delivered.” NHI programme in SA will be successful if it embarks on an important and necessary horizontal approach of Health system strengthening with Primary Care firmly entrenched as part of the horizontal programme. The vertical focus will then incrementally deliver the other modalities of care to support the Alma-Ata Declaration and achieve the SDGs by 2030. Prof. Morgan Chetty, visiting Prof: Health Sciences, DUT chairman, IPAF, CEO: KZNDHC.
  
2019/06/132019/06/24 11:36 AM
The public, including entities, institutions, and organs of state have until the end of the month to make submissions on the Section 59 investigation into allegations of racial profiling against black, coloured, and Indian private medical practitioners.

Chaired by advocate Tembeka Ngcukaitobi, the probe follows allegations made by members of the National Health Care Professionals Association (NHCPA) that they had been unfairly treated and had their claims withheld by medical aid schemes based on race and ethnicity. After the submissions, the panel may request a deponent or a person to appear before it and be interviewed on specific aspects. In a statement, the Council for Medical Schemes (CMS) said Ngcukaitobi would be able to get to the bottom of things.

CMS chief executive and registrar Dr Sipho Kabane said: “For the next four months, advocate Ngcukaitobi and his team of advocates, Adila Hassim and Kerry Williams will get to the bottom of these allegations. “The CMA believes that advocate Ngcukaitobi, a respected legal mind, will help go to the root of the allegations of racial profiling, blacklisting for payments, blocked payments, demands of confidential clinical information, bullying and harassment, coercion, entrapment and use of hidden cameras.” The CMS said the total cost of fraud in SA’s private healthcare system was estimated at about R22 billion every year.

At the start of 2019 at the Fraud Waste and Abuse Summit, private healthcare representatives signed an industry charter against fraud. According to Section 7 of the Medical Schemes Act, the CMS’s mandate is to protect the interests of medical scheme members, and take any steps it deems necessary, the CMS said.  Written submissions from interested parties should be sent to cmsinvestigation@medicalschemes.com by no later than June 30.
  
2019/06/132019/06/24 11:37 AM
Today the DA’s Shadow Cabinet for the 6th Parliament officially met for the first time since its appointment. The purpose of the meeting was for the DA Leader, Mmusi Maimane, to outline his vision, his objectives and guidelines for the work of the Shadow Cabinet ahead of its work in the 6th Parliament.

Guided by the vision of building a moderate, non-racial centre that builds One South Africa for all, the Shadow Cabinet has been tasked with:

• Putting forward strong, credible policy alternatives;

• Holding the Executive accountable, but equally supporting the Executive when it works in the interests of the people;

• Jobs, opportunities and the economy must take centre focus; and

• Taking the work we do in Parliament to communities.

The Shadow Cabinet has been tasked to focus on the DA's Agenda for Reform noting the need for urgent economic reform. The Shadow Cabinet has been tasked to use Parliament to table our Jobs Bill and Cheaper Energy Bill, focus on city-led economic growth, fight for labour legislation reform, oppose any changes to the Reserve Bank independence and mandate, propose alternatives to the current State Owned Entity (SOE) ownership framework, propose alternatives to the current Mining Charter, and oppose threats to the economy and fiscus such as NHI and expropriation of property and land without compensation.

The Shadow Cabinet will sit every fortnight to discuss the upcoming legislative agenda; to deliberate on new policies, debates, and motions; and to table any other matters of national importance. Shadow Cabinet noted the statement by the Presidency on the Public Protector’s investigation against President Cyril Ramaphosa’s Bosasa scandal; this is nothing more than a delay tactic to frustrate the investigation and release of the final report. We eagerly wait for the final report which must be tabled with the Speaker of Parliament. It is high time that Presidents’ who mislead Parliament are held to account to the fullest might of the law.

We have also noted today’s announcement stating that Deputy President David Mabuza has been appointed Leader of Government Business (LOGB). This is an important position, which is responsible for among other things, ensuring that Members of the Executive, including the President, account to Parliament. The DA Leader will in the coming weeks, write to the LOGB to schedule a meeting so as to outline the Party’s approach to the Executive. We are on track to effectively start our work as the Official Opposition, contribute to making our nation prosper and help build One South Africa for All. Issued by The DA.
  
2019/06/122019/06/24 11:09 AM
The Interim Chair of the soon-to-be-launched Health Federation of South Africa (HFSA), Prof Morgan Chetty has invited all stakeholders in the public and private health sectors to attend the official launch at the BHF Conference in July.  It will take place on 21 July at the ICC in Cape Town.

The HFSA will be part of the African Healthcare Federation (AHF) and is a Public Private Partnership (PPP) Programme that will be working with the government to assist in the NHI and other health-related programmes. After the launch, it will be presented to the National Department of Health and the Government.

“This follows the success of the AHF in East Africa, West Africa, Central Africa and the AHBS III that was held at the Hyatt in Sandton in October last year. The rest of Africa has successfully demonstrated the benefit of PPPs in health and this programme is coordinated by the AHF. It is formed by like-minded people who feel that South Africa has a number of health and other stakeholders who want to work towards a successful implementation of NHI,” Prof Chetty said. The HFSA will include all stakeholders in healthcare irrespective of their size. The only qualifying criteria is to volunteer to work and offer services in the healthcare space to implement NHI and also to participate in programmes to ensure the sustainability of NHI.

The HFSA will be invited to present in October in Addis Ababa, where the North Africa Healthcare Federation will be launched and where it will also join the East and West Africa Health Federations, Central Africa and other affiliates to the AHF. Stakeholders wishing to attend the launch of the Health Federation of SA should contact Petra Vandenbergh at petra@kznmcc.co.za to finalize details.”
  
2019/06/122019/06/24 11:32 AM
The number of business liquidations increased by 53.1% between April 2018 and April 2019.  And the number of insolvencies increased by 30.1% between March 2018 and March 2019.

Given that the economy has been growing at a pedestrian 1%-2% for a few years now, it is highly unlikely that this increase is due to more businesses being opened. I believe it is safe to take these numbers at face value. South Africa is becoming an increasingly hard place to do business because of the regulatory and tax burden. Policies such as EWC (Expropriation without Compensation) will only increase the risks of running a business here.

South Africa still appears to be a good potential investment destination but, in some respects, possesses the worst combination of factors that exist in developing and developed nations: advanced industry and financial services alongside pockets of underdevelopment. This means that much of the low-hanging investment fruit has already been picked. To develop the economy further, we need investors who are willing to risk money in an emerging market for lower returns than other emerging markets and developed markets in many cases.

At the government policy level, the investment environment should be as attractive as possible. It requires going further in economic deregulation than many other economies. Otherwise, the businesses that have had to close down will not be replaced by new ones. I personally believe that the government should use something like the Fraser Institute’s economic freedom index (EFW) against which to measure policies. Other indices such as the competitiveness index, the ease of doing business index and the corruption perceptions index can be used, I am not saying that only the EFW can measure policy effectiveness but for the purposes of growing the economy and creating jobs it is the perfect tool. We should aim to reach the top global position in that index, displacing the likes of Hong Kong and Singapore. This would lead to a rate of economic and job growth never before seen in South Africa. It would lead to more businesses opening rather than closing. It would lead to us regaining our place as one of the world’s best economic growth stories. President Ramaphosa has just been re-elected as President of the country. Many of the regulations making it harder for business to operate are within the power of the executive branch to kill since the applicable laws give bureaucrats and ministers so much power in creating regulations. The president himself during an investor conference after the elections lamented the regulatory burden South Africans have to deal with.

If this was more than just rhetoric, we would expect the president and his new cabinet to start making the changes that are within their reach. We have already seen encouraging signs with the announcement that NERSA will start issuing power generation licenses for businesses at between 1-10MW per project. This is a good sign and it will surely alleviate some of our power woes but it should be followed up by other steps. For me, the priority should be our dire labour market situation. The more businesses find it difficult to operate, the more jobs the country loses. Job creation is linked to creating a conducive environment for small business. The government must take decisive steps to start dismantling regressive labour policies. Something in this regard can be done at the regulatory level by starting to exempt small businesses and certain categories of employment from the National Minimum Wage (NMW) as one example. Instead of a discount, the Minister of Labour can rather offer true exemptions as laid out in the Act.

Finally, I hope it is clear to everyone that the President and his cabinet have the requisite powers to start moving towards deregulating the economy. The shocking increase in liquidations and insolvencies should spur government officials to action considering the fact that 38% or 9,994,000 adults are sitting at home unemployed. Policies such as EWC and government fiscal irresponsibility inherent in policies such as the NHI will only make it even harder for business to operate.

Mpiyakhe Dhlamini is a data science researcher at the Free Market Foundation. He recently studied data science at Explore Data Science Academy. He is a self-taught programmer and writer for an online publication, Rational Standard.
  
2019/06/122019/06/24 11:33 AM
Die Demokratiese Alliansie (DA) sê hulle het verlede week aan die nuwe aangestelde Minister van Gesondheid, Zweli Mkhize, asook die Gesondheidsombudsman, Professor Malegapuru William Makgoba, geskryf na berigte onvtang was dat daar ‘n tekort aan antiretrovirale (ARV) behandeling in gesondheidfasaliteite regoor die land is.

Partywoordvoerder, Siviwe Gwarube, sê minister Mkhize het Sondag, deur middel van ‘n mediaverklaring, gereageer op die ARV-epidemie waar hy gestel het dat die lae inhoud van ARV-behandeling in gesondheidsfasiliteite nie’n krisis is nie. Gwarube sê die grootste kommer oor die minister se reaksie, is dat Mkhize nie aanvaar dat hy verantwoordelik is vir die vertraging in die verskaffing van ARV-behandelings aan hierdie gesondheidsfasiliteite nie.

Sy sê die DA is ingelig, volgens die verskaffer – Mylan – ly hulle onder ‘n wêreldwye tekort aan lamivudien wat benodig word vir die produksie van hierdie middels, en daar is ook ‘n vertraging in die toekenning van die tender aan Mylan van die Departement van Gesondheid.
  
2019/06/112019/06/24 11:00 AM
It appears as if ‘Ramaphoria 2.0’ is dead on arrival – and analysts are now looking ahead at what lies in store for South Africa for the rest of the year. The spurt of hope following the outcome on the national elections and the appointment of a very slightly slimmer cabinet at the end of May was quickly undone when the realities of South Africa’s struggling economy were laid bare.

GDP data from Stats SA showed that the country had experienced its biggest quarterly decline in a decade, while high profile chief executives called it quits on two of South Africa’s biggest problem companies – Eskom and SAA. At the same time, the face of unity presented by the ruling ANC ahead of the elections was quickly unravelled as Luthuli House and deployees to national government openly battled over key policies, such as the mandate of the South African Reserve Bank, and quantitative easing. This has all added to the pressures facing the president. According to Intellidex analyst, Peter Attard Montalto, it has become evident that Ramaphosa’s stimulus plan, introduced in 2018, has effectively fallen flat – primarily due to lack of trust and buy-in from the private sector, and a lack of capacity in government itself. This means that strategies have to shift, and new plans need to be formulated.

What comes next?

While steps have been taken to reign in government spending by downsizing cabinet (and putting tighter restrictions on what municipalities can blow cash on), there is very little wiggle room for a complete shift in government strategy.

To this end, it is expected that the government will choose to rather go for low-hanging fruit, Intellidex said – which could have both positive and negative effects on the economy. This includes moves on visas, spectrum, the National Health Insurance (NHI), land reform and other populist topics. A reworked plan is also likely to come, where the government would, for instance, focus on a limited number of sectors and economic development zones, or tackle procurement. However, until there is action, there is some doubt on how a new plan would differ from any old plan, the advisory and research firm said. More information and possibly more detail around any future action will be forthcoming from the state of the nation address scheduled for 20 June 2019.

Ramaphosa’s advisory unit

A keynote in the Intellidex analysis is the view that president Ramaphosa may also try to strengthen intergovernmental controls between departments to avoid poor policy making and deal with blockages in government – a strategy that previously worked in Thabo Mbeki’s administration.

Following his re-election as president, Ramaphosa announced that he would be reinstating the presidential advisory unit that had previously stood before the Zuma administration came in, to help guide policy and speed up execution. It was previously reported that a new growth plan and industrial policy will be developed by the unit, which will reportedly be led by a senior minister with good standing within government and the ANC. While this would be a positive move, Attard Montalto said it wouldn’t be easy, with doubts around whether such an advisory system has the necessary support (factionally or ideologically) to take any decisive action.

“At issue here is whether there are those around the president with the ability to deploy political capital to undertake policy formation and the implementation,” Attard Montalto said.
“This is where we are sceptical, especially within the new Presidential Policy and Research Services, which may simply replicate existing functions in departments, within the National Planning Commission and other forums.”
  
2019/06/102019/06/24 10:55 AM
A lot has been written on what exactly went wrong for the Democratic Alliance in the May elections after the party, which has experienced years of growth in support suddenly dipped, leading to the loss of 5 seats in the National Assembly and their official opposition role in two provinces, Mpumalanga and KwaZulu-Natal. It has been regarded as a bad performance by any measure, attributed by many to the numerous own goals that the DA has been scoring due to infighting. The biggest failure of the DA was not to capitalize on being the incumbent in two metros and not being able to grow support under urban Black voters. This past weekend the DA had the first sitting of its federal council after the elections where DA leader Mmusi Maimane blasted party members for their ill-discipline, which he believes resulted in a loss of votes for the party.

He also announced a party-wide policy review chaired by a former CEO of the DA, Ryan Coetzee. Maimane has been accused of steering the party to the left as an ANC-light version leading to the loss of voters to the Freedom Front Plus. In a statement, released after the federal council sitting he said the DA wanted to retain and grow the political centre and “not pander to racial mobilization or populism on both sides.” What is at stake is not only turning the tide on support, but Maimane’s future leadership of the party
  
2019/06/102019/06/24 10:57 AM
The Council for Medical Schemes (CMS) has announced that Advocate Tembeka Ngcukaitobi will chair a four-month investigation into allegations of racial profiling against black and Indian private medical practitioners by medical aids, including allegations of the "use of hidden cameras".

The CMS regulates private health financing through medical aid schemes. In mid-May, the council announced that it would be moving forward with the investigation, after members of the National Health Care Professionals Association complained they were being unfairly treated and their claims "withheld by medical aid schemes based on the colour of their skin and ethnicity". The NHCPA is a body that represents medical practitioners.

In a statement on Tuesday Dr Sipho Kabane, the chief executive officer and registrar of the CMS, described Ngcukaitobi as a "respected legal mind". He will be assisted by advocates Adila Hassim and Kerry Williams. The investigating panel will probe allegations of racial profiling, blacklisting for payments, blocked payments, demands of confidential clinical information, "bullying and harassment, coercion, entrapment and use of hidden cameras”. “Our mandate is to measure the quality and outcomes of relevant health-care services by medical schemes, and to investigate complaints and settle disputes in relation to the affairs of medical schemes as provided for in the Medical Schemes Act," said Kabane.

The inquiry will take place under section 59 of the Medical Schemes Act. The probe will receive written submissions from interested parties until June 2019. Interviews and public hearings will be conducted between July and September 2019. The final report will be delivered by the Investigating Panel on November 1, 2019.
  
2019/06/092019/06/24 10:25 AM
In addition to this, there is a sustained attack on the independence and the mandate of the South African Reserve Bank, says the DA leader. The root causes of South Africa’s economic woes are political, not monetary, Democratic Alliance leader Mmusi Maimane said on Sunday.

“Without doubt, the single most pressing issue facing our country today is our catatonic economy, which is failing to halt runaway unemployment and taxing to death a dwindling tax base,” Maimane told journalists in Johannesburg following the DA’s first federal council meeting after the May 8 general elections. Since May 8, unemployment had hit a record high of 38 percent, with 9.9 million people without a job. This was compounded by economic growth contracting by 3.2 percent during the first months of this year – the biggest decline in a decade.

”In addition to this, there is a sustained attack on the independence and the mandate of the South African Reserve Bank (SARB). South Africa is running out of money, and the proposed solution is to print more money through ‘quantitative easing’. This is a disastrous policy, and we need look no further than our northern neighbours Zimbabwe for evidence of this. Federal council was unanimous that the independence of the Reserve Bank is sacrosanct. The root causes of the country’s economic woes are not monetary, they are political,” Maimane said.

South Africa’s economic stalemate could not be ignored for one more day. Without a vibrant, growing economy, millions more would join the ranks of the unemployed, inequality would broaden, and all South Africans would become poorer and poorer. The country needed complete reform, and the DA had an agenda for reform which would be its focus over the coming 100 days and beyond.

This would include tabling the DA’s Jobs Bill and Cheaper Energy Bill, fighting for labour legislation reform, opposing any changes to the Reserve Bank independence and mandate, proposing alternatives to the current state-owned entity (SoE) ownership framework, proposing alternatives to the current Mining Charter, opposing threats to the economy and fiscus such as National Health Insurance and expropriation of property and land without compensation, and championing a focus on city-led economic growth, Maimane said.
  
2019/06/092019/06/24 10:27 AM
AfriForum condemns the announcement by Dr Zweli Mkhize, the new Minister of Health, that the National Health Insurance (NHI) plan must be implemented as soon as possible. Mkhize said at a press conference today that it is not a question of whether the NHI would be implemented, but rather when, and that this system would eradicate inequality in health care. Mkhize’s promises of an Utopia for the South African health system is however simply a smokescreen for the ANC to further its communist agenda.

“The vast majority of state hospitals and clinics do not comply with medical standards. That is why the state health sector spent up to R56 billion (a quarter of last year’s budget for health services) for the payment of negligence claims. It is a clear indication that the government cannot even properly manage the state health sector. This interference in the private health sector is contrary to free-market principles and will eventually lead to the total collapse of the industry,” says Natasha Venter, Campaign Official at AfriForum. Despite this, Mkhize is of the opinion that all issues in the Department of Health need not be resolved before the NHI is implemented. “According to the Auditor General’s report, the Department of Health received one of the worst audits of all the departments in the 2017/2018 financial year. Hence, Mkhize’s argument that hospitals have little resources due to the country’s overall financial woes and therefore cannot provide services properly is weak,” says Venter.
It is ironic that the Minister chose to hold the media conference at the Mamelodi Hospital, where Martha Marais’s (76) hands were tied behind her back and she was left on the floor for eight hours. “AfriForum is currently in the process of compiling a report on the defects of the health sector. The stories we receive from the public are frightening and the implementation of the NHI will only lead to further and even worse horror stories. This is because the NHI will deprive every one of their right to decide which service provider they want to use, which will mean that private hospitals and clinics will no longer have to compete for patients,” says Dr. Eugene Brink, AfriForum’s Strategic Advisor for Community Affairs.
  
2019/06/08
2019/06/24 10:22 AM
The Western Cape is set to receive R1.2 billion in upgrades to health care infrastructure over the next year. Of this, R6 million is going towards the design phases of the new Klipfontein Regional Hospital, which will serve as a desperately needed replacement for the defunct GF Jooste Hospital in Manenberg but will only be ready in 10 years' time. The single biggest ticket item on the Western Cape Department of Health's budget is the brand new Observatory Forensic Pathology Service lab, which is already under construction close to Groote Schuur Hospital. R100m is set aside for construction costs this year, with a further R44.3m for equipment and R10m to install ventilation. Department spokesperson Mark van der Heever said the facility was scheduled to open around April next year.

It would replace the overburdened Salt River forensic pathology facility and was aimed at "extracting, analysing and preserving the integrity of evidence for use by the criminal justice system". The new design boasts 26 autopsy tables, compared to Salt River's 10, and 360 refrigerated body spaces, compared to the old 150. It will also allow space for health care science students from UCT to train and learn. As for the ailing Tygerberg Hospital, Van der Heever said the provincial department was still in negotiations with National Treasury for funding of the Tygerberg Hospital Redevelopment Project. In the meantime, the province has set aside R101m for maintenance and improvements this year to keep Tygerberg running until it can be overhauled. The construction of new emergency centres at existing hospitals is also a high priority on the budget. Helderberg Hospital is receiving a new emergency centre, which is under construction, with R35m budgeted towards the building this year and an additional R9m for equipment. A new emergency centre is also being built at Victoria Hospital in Wynberg, with R36m set aside for that construction and an additional R7m for equipment.

The project should be completed by November next year, Van der Heever said. Construction is under way at Gansbaai Clinic, Laingsburg Clinic and Swartland Hospital in Malmesbury, where repairs and extensions are under way after fire destroyed a portion of the hospital. These projects combined cost more than R57m. For those anxiously awaiting the new Klipfontein Regional Hospital, which has been desperately needed since GF Jooste was decommissioned, relief is not imminent. It is only projected to open in 10 years' time. To Page 2 City to build two new clinics by next year From Page 1 "The new Klipfontein Regional Hospital is intended to be a facility larger than even the Khayelitsha and Mitchells Plain district hospitals," Van der Heever said. The City of Cape Town is also ploughing money into health care infrastructure. The city council's health department plans to break ground on two new clinics within the next year: Fisantekraal and Zakhele. It has budgeted R1 7.6m to upgrade existing facilities. However, many facilities are being damaged faster than they can be main tained.

"Community facilities are extremely vulnerable to theft and vandalism, as we witnessed recently with the attack on the Ikhwezi clinic in Nomzamo, Strand," said Zahid Badroodien, mayoral committee member for community services and health.
  
2019/06/08
2019/06/24 10:22 AM
AfriForum veroordeel Dr. Zweli Mkhize, nuwe minister van gesondheid, se aankondiging dat die Nasionale Gesondheidsversekering (NGV)-plan so gou moontlik ingestel moet word. Mkhize het Vrydag tydens ’n mediakonferensie beweer dat die vraag nie is óf die NGV ingestel gaan word nie, maar eerder wanneer, en dat hierdie stelsel ongelykheid in gesondheidsorg sal uitwis. “Mkhize se beloftes van ’n utopie vir die Suid-Afrikaanse gesondheidstelsel is egter net ’n rookskerm vir die ANC om hul kommunistiese agenda verder te dryf,” het Natasha Venter, veldtogbeampte by AfriForum, in ʼn Verklaring gesê.

“Die oorgrote meerderheid van staatshospitale en -klinieke voldoen nie aan basiese mediese standaarde nie. Daarom het die staatsgesondheidsdiens tot R56 miljard (’n kwart van verlede jaar se begroting vir gesondheidsdienste) aan die uitbetaling van nalatigheidseise bestee. Dit is ’n duidelike aanduiding dat die regering nie eers die staatsgesondheidsdiens na behore kan bestuur nie. Hierdie inmenging in die privaat gesondheidsektor druis in teen vryemarkbeginsels en sal uiteindelik tot die ineenstorting van die bedryf lei.”

Venter sê tóg is Mkhize van opinie dat al die kwessies binne die gesondheidsdepartement nie opgelos hoef te word voordat die NGV ingestel word nie. “Volgens die ouditeur-generaal se verslag het die gesondheidsdepartement in die 2017/2018-boekjaar een van die slegste oudits van al die departemente gekry. So Mkhize se argument dat hospitale – weens die land se algehele finansiële probleme – min hulpbronne het en daarom nie na behore dienste kan lewer nie, is maar flou,” het Venter bygevoeg. “Ironies genoeg het die minister besluit om die mediakonferensie by die Mamelodi-hospitaal te hou, waar Martha Marais verlede maand op die vloer van die hospitaal met haar hande agter haar rug vasgemaak is en vir agt ure só moes lê.”

AfriForum is tans besig om ’n verslag saam te stel oor die gebreke in die gesondheidsektor. “Die stories wat die publiek vir ons stuur, is angswekkend en die instelling van die NGV gaan net tot verdere en erger rillerstories lei,” het dr. Eugene Brink, AfriForum se strategiese raadgewer vir gemeenskapsake, gesê. “Die NGV gaan enige iemand van hul reg ontneem om te besluit watter diensverskaffer hulle wil gebruik, wat sal beteken dat privaat hospitale en klinieke nie meer vir pasiënte hoef te kompeteer nie.
  
2019/06/06
2019/06/10 02:51 PM
The ANC is under pressure to offer the chairperson post of the standing committee on public accounts Scopa to the DA. Falling short of demanding that the governing party return the favour after the ANC was offered the post in the Western Cape legislature, the DA said the post should be given to the largest opposition party. The National Assembly's Scopa chair has in the past three terms been held by former MP Themba Godi from the small opposition party, African People's Convention. Speaking at a media briefing in Parliament yesterday, the DA chief whip John Steenhuisen said the ANC should do the right thing: "We are the largest opposition party. Tradition has it that Scopa chair should go to the largest opposition party." DA leader Mmusi Maimane said when it came to parliamentary accountability, "size" does matter. "I would urge that whatever back ground discussions are taking place, if the ANC is serious about account ability, this will be the route to go to ensure we can exercise appropriate accountability." The DA has fielded "excellent can didates" Alf Lees and Benedicta van Minnen to serve on Scopa, with Lees as their preferred candidate for the chairperson post. "Any government that is serious about transparency and accountability would, surely, want to submit itself to the best forms of oversight to ensure transparency and accountability," Steenhuisen added.

ANC caucus spokesperson Nonceba Mhlauli said the governing party was finalising persons to serve on commit tees, including the chairpersons. "Once that process is finalised, an announcement will be made to that effect," Mhlauli said. On the portfolio spokespersons, Maimane said they had men and  women who were diverse and came with different competencies. "What you can expect from this team is a team to put forward fresh ideas. We got to demonstrate to the people of this country that there are alternatives." He said his party would table an agenda for reform and pieces of legis lation that focus on city led economic growth, labour reform and reform of state owned entities. "We will certainly oppose the cur rent mining charter and threats to the economy and all matters like National Health Insurance that seek to hamstrung our fiscus." Maimane also said they would oppose the amendment of the Con stitution to allow expropriation of land without compensation. "Not only will it be dangerous for the economy, it will equally be danger ous for private property rights, which are crucial for South Africans to be able to advance their ability to own, pros per and create work for our citizens."

Notable omissions from the shadow cabinet were MPs holding elected positions in the DA such as federal executive chairperson James Selfe, deputy chair of the party Mike Waters and federal executive deputy chairperson Thomas Walters. "There is work that must be done in Parliament, but there are certain members I want to focus on some work in the party and advance electoral objectives as we go to 2021."
  
2019/06/062019/06/10 02:52 PM

The ANC is under pressure to offer the chairperson post of the standing committee on public accounts Scopa to the DA. Falling short of demanding that the governing party return the favour after the ANC was offered the post in the Western Cape legislature, the DA said the post should be given to the largest opposition party. The National Assembly's Scopa chair has in the past three terms been held by former MP Themba Godi from the small opposition party, African People's Convention. Speaking at a media briefing in Parliament yesterday, the DA chief whip John Steenhuisen said the ANC should do the right thing: "We are the largest opposition party. Tradition has it that Scopa chair should go to the largest opposition party." DA leader Mmusi Maimane said when it came to parliamentary accountability, "size" does matter. "I would urge that whatever back ground discussions are taking place, if the ANC is serious about account ability, this will be the route to go to ensure we can exercise appropriate accountability." The DA has fielded "excellent can didates" Alf Lees and Benedicta van Minnen to serve on Scopa, with Lees as their preferred candidate for the chairperson post. "Any government that is serious about transparency and accountability would, surely, want to submit itself to the best forms of oversight to ensure transparency and accountability," Steenhuisen added.

ANC caucus spokesperson Nonceba Mhlauli said the governing party was finalising persons to serve on commit tees, including the chairpersons. "Once that process is finalised, an announcement will be made to that effect," Mhlauli said. On the portfolio spokespersons, Maimane said they had men and  women who were diverse and came with different competencies. "What you can expect from this team is a team to put forward fresh ideas. We got to demonstrate to the people of this country that there are alternatives." He said his party would table an agenda for reform and pieces of legis lation that focus on city led economic growth, labour reform and reform of state owned entities. "We will certainly oppose the cur rent mining charter and threats to the economy and all matters like National Health Insurance that seek to hamstrung our fiscus." Maimane also said they would oppose the amendment of the Con stitution to allow expropriation of land without compensation. "Not only will it be dangerous for the economy, it will equally be danger ous for private property rights, which are crucial for South Africans to be able to advance their ability to own, pros per and create work for our citizens."

Notable omissions from the shadow cabinet were MPs holding elected positions in the DA such as federal executive chairperson James Selfe, deputy chair of the party Mike Waters and federal executive deputy chairperson Thomas Walters. "There is work that must be done in Parliament, but there are certain members I want to focus on some work in the party and advance electoral objectives as we go to 2021." Back to top

DA: RAMAPHOSA’S QUIET DIPLOMACY’ ON SARB IS ADDING TO SA’S ECONOMIC CRISIS
2019/06/06
Polity

The ruling party’s policy schizophrenia on the South African Reserve Bank (SARB) has already cost the South African economy dearly, with the Rand losing almost 2% on Tuesday following the confusion. The silence from President Cyril Ramaphosa is deafening. It is time that President Ramaphosa publicly clarifies the ANC and his government’s position on the SARB.

The President should stop ANC Secretary General Ace Magashule from ever speaking on the economy, and should publicly explain and clarify how the ANC’s National Executive Committee came to make the damaging statement that it did. This cannot be explained away as an innocent miscommunication. Both the Minister of Finance, Tito Mboweni, and the SARB Governor, Lesetja Kganyago, have come out in defence of the SARB’s mandate and ruled out "quantity easing", after Magashule announced on Tuesday that the NEC had decided to change the mandate of the SARB and that quantitative easing will be considered. However, investors are still not convinced.

President Ramaphosa has not consistently protected the mandate and independence of the SARB, and has yet to quell the uncertainty created by the contradictory statements given by the ANC and Ministers. The South African economy is performing very poorly, having contracted by 3.2% in the first quarter of 2019. As confirmed by the International Monetary Fund, there is nothing wrong with our monetary policy, as overseen by the SARB. Our malady is bad policy in government, that is strangling growth in the economy.

To get the economy working, we need to:

Address the systemic problems at our State-owned Enterprises, specifically Eskom and SAA. The DA has a plan to stabilise and secure South Africa’s power supply, as detailed in our Cheaper Energy Bill which seeks to break Eskom into two separate entities and introduce a competitive energy market;

Protect and support SMMEs as proposed in the DA’s Jobs Bill; and Oppose threats to the economy and fiscus such as NHI and expropriation of property and land without compensation. South Africa cannot afford the kind of reckless utterances coming from the ruling party as the consequent policy uncertainty will continue to compromise investment, economic growth and job creation.

The independence and current mandate of the SARB must remain intact. The DA will use all mechanisms at our disposal to strongly oppose any attempts to change the SARB’s mandate or compromise its independence. Issued by The DA
  
2019/06/052019/06/10 02:38 PM
Today, I am proud to announce the DA’s new Shadow Cabinet. This diverse group of MPs – comprising of talented South Africans from all walks of life – will hold national government accountable for the exercise of their powers, while putting forward fresh ideas and credible alternatives to the plans and policies of national government.

The people of South Africa re-elected the DA as the country’s Official Opposition in this 6th Parliament, and we do not take this privilege and responsibility for granted. We will work each and every day to ensure that this Parliament works for the people. We will do so by committing to:

Fulfil our constitutional mandate, in terms of Chapter 4 of the Constitution, to hold every exercise of public power by the National Executive to account. Through motions, oral and written questions, and persistent work in parliamentary committees, we will not allow the ruling party to relegate Parliament to a toothless lapdog of the executive; Oppose damaging legislation, regulations and government policy that does not have the best interests of the nation at heart; and Propose credible, workable and implementable alternatives before Parliament, including policy papers, alternative budgets, and Private Members Bills. Our work will focus on an Agenda for Reform. The most pressing of these is the need for urgent economic reform. In this light, we will use Parliament to table our Jobs Bill and Cheaper Energy Bill, focus on city-led economic growth, fight for labour legislation reform, oppose any changes to the Reserve Bank independence and mandate, propose alternatives to the current State Owned Entity (SOE) ownership framework, propose alternatives to the current Mining Charter, and oppose threats to the economy and fiscus such as NHI and expropriation of property and land without compensation.

It is with this that I present to you the DA’s Shadow Cabinet:

Ministry Shadow Minister Shadow Deputy Minister
The Minister in the Presidency
Solly Malatsi Ghaleb Cachalia
The Ministry in the Presidency: Women, Youth and Persons with Disabilities
Luyolo Mphithi Nazley Sharif
The Ministry of Justice and Correctional Services
Adv. Glynnis Breytenbach Werner Horn
The Ministry of Public Service and Administration
Leon Schreiber Michelle Clarke
The Ministry of Defence and Military Veterans
Kobus Marais Maliyakhe Shelembe
The Ministry of Home Affairs
Joe McGluwa Angel Khanyile
The Ministry of State Security Dianne Kohler Barnard Dr Mimmy Gondwe
The Ministry of Police
Andrew Whitfield Okkie Terblanche
The Ministry of Trade and Industry
Dean Macpherson Mathew Cuthbert
The Ministry of Finance
Geordin Hill-Lewis Dr Dion George
The Ministry of Agriculture, Land Reform and Rural Development
Annette Steyn Thandeka Mbabama
The Ministry of Human Settlements, Water and Sanitation
Leon Basson Emma Powell
The Ministry of Basic Education
Nomsa Marchesi Desiree van der Walt
The Ministry of Health
Siviwe Gwarube Lindy Wilson
The Ministry of International Relations and Cooperation
Darren Bergman Mergan Chetty
The Ministry of Higher Education, Science and Technology
Prof. Belinda Bozzoli Baxolile Nodada
The Ministry of Environment, Forestry and Fisheries
James Lorimer Hannah Winkler
The Ministry of Transport
Chris Hunsinger Thami Mabhena
The Ministry of Mineral Resources and Energy Kevin Mileham Cheryl Phillips

The Ministry of Social Development Bridget Masango Thandi Mpambo – Sibukhwane

The Ministry of Public Enterprises
Natasha Mazzone Erik Marais
The Ministry of Sports, Arts and Culture
Tsepo Mhlongo Veronica Van Dyk
The Ministry of Employment and Labour
Dr Michael Cardo Michael Bagraim
The Ministry of Public Works and Infrastructure Patricia Kopane Samantha Graham

The Ministry of Small Business Development
Zakhele Mbhele Henro Kruger
The Ministry of Cooperative Governance and Traditional Affairs
Haniff Hoosen Cilliers Brink
The Ministry of Communications and Telecommunications
Phumzile Van Damme Cameron Mackenzie
The Ministry of Tourism
Manny De Freitas Hlanganani Gumbi
SCOPA
Alf Lees Benedicta Van Minnen
SCOAG Phillip De Lange Eleanore Bouw-Spies
Appropriations Denis Joseph
Ashor Sarupen

This Shadow Cabinet will officially meet every fortnight. The purpose of these meetings will be to discuss the upcoming legislative agenda; to deliberate on new policies, debates, and motions; and to table any other matters.

I am confident that our Shadow Cabinet possesses the requisite skills, experience and expertise to bring forward innovative alternatives to move our country forward. Comprising of youth and experience, academics and activists, orators and operators – I am proud to lead this Shadow Cabinet.

We are ready to roll up our sleeves and get to work in furthering the cause of democracy and fighting for a future South Africa that belongs to all.
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