The National Council of Provinces (NCOP) hosted a policy debate on the Department of Health’s adjusted budget, recently tabled by the Minister of Finance to respond to the spread of the corona virus. In his opening remarks, the Deputy Minister of Health, Dr M Joe Phaahla, gave a brief overview of medical interventions to date and where we are at currently in the fight against the pandemic.

Dr Phaahla said that South Africa has 91% of cases and 90% of deaths in the Southern African Development Community region. In South Africa, Gauteng has now surpassed the 103 0000 cases mark, leaping the Western Cape’s 90 00 cases, and is now the epicentre of the virus.

“The storm we have been talking about, preparing for has indeed landed,” he said, and there is no reason for complacency. “Currently, Gauteng has the highest population density of 15 million. It’s densely populated in terms of residential and industrial areas, as well as its modes of transport.”  

As for the adjusted budget, “The virus has stretched the resources to trace contacts and to quarantine them. It has also stretched our intensive care facilities, oxygen, linen, food, emergencies services and human resources, such as doctors and nurses get stretched.” The adjusted funds will assist in addressing the spike in infection rates by enabling increased testing and will “help to cater for more hospital beds and appointment of more staff to have spare capacity, because some health workers have been infected and need to be replaced.”

Reflecting on the debate at hand, Ms Maurencia Gillion, a delegate for the African National Congress in the NCOP (Western Cape), said access to healthcare is a human rights issue. This is even “proclaimed in our Constitution,” she maintained. In addition, the National Health Insurance’s provision of the universal healthcare coverage seeks to uphold healthcare as an apex priority. As such, it’s “a critical component that can reduce social inequalities and promote better management of health facilities to prevent the spread of diseases.”

In her view, healthcare is not about building clinics. “Healthcare is at the centre of human development. For it can give access to equitable and quality healthcare irrespective of one’s ability to pay to keep the population healthy and alive.”

In her view, it is untenable to have 4.4 percent of gross domestic product (GDP) spent on 17% of the population that is well off, leaving 84% of population that is destitute to share 4.1 % of the GDP that forms part of our country’s health budget. “We are the only country that spends huge sums of money on the minority of our population. The NHI will ensure funding and resources are racially and evenly distributed.”  

The current system is not sustainable, because “it serves a tiny number of the population. It’s for this reason that NHI represents a sustainable and substantial reorganisation of the current health system, which derive its mandate from the National Development Plan.” 

As unfortunate as that may be, the infection of high-profile politicians, such as the premiers of Gauteng and the Western Cape could create awareness of the impact of the disease and encourage people to take appropriate precautions, contended Ms Sonja Boshoff for the Democratic Alliance (Mpumalanga).

She called for the increase of awareness campaigns so that people know “there is no effective cure for the virus and if that is not achieved, we will not flatten the curve.” She also pointed out that 1 200 doctors and nurses are still needed, “and if these numbers are not met we will not eradicate the backlog we are faced with in our healthcare facilities”.

The provincial healthcare system is in such a dire state that when the Premier of North West became infected with the virus, he had to abandon the hospitals in his province and go Gauteng for treatment, said Mr Benjamin Cloete for the Freedom Front Plus (Free State). “What does this say about our public healthcare facilities. Why does the premier not trust his own doctors? And what does this say about the state of public healthcare in his province?” he asked.

Fortunately, the premier is at liberty to choose where he wants to be treated, “but does the general public of North West have such a privilege to choose where they want to be treated?” This is an indication that government has failed in the “last 26 years to provide equitable and efficient healthcare system,” according to Mr Cloete.

Ms Mmabatho Mokause (Economic Freedom Fighters, Northern Cape) did not mince her words when she proclaimed that “we reject this budget on grounds that it is not adequate enough to respond to the spike of the virus infections in the country”.

We need more allocation of budget to curb the spike of the virus, she maintained. What puzzled her is that “despite the sharp increase in infection cases, government has bowed to the pressure of capitalists and opened up the economy and relaxed lockdown regulations. That is the biggest mistake government has made in the fight against the pandemic. It’s evident that opportunity was not utilised effectively.” The solution is to return the country back to level 5. “That is the only way we can win the fight against the pandemic.”

The current storm has exposed the chronic underspending on our healthcare system, said Dr Phophi Ramathuba, MEC for Health in Limpopo province. “This budget will navigate the narrow fiscus road posed by the corona virus, which has laid bare the issues of underfunding of health infrastructure. This has been compounded by the cutting of the infrastructure grants.”   

As a result, we have to “reprioritise our health budget within the shrinking budget to ensure that the procurement of the personal protective equipment (PPE) for doctors and nurses are made available.” As such, the reprioritisation of the budget is unavoidable. It will go a long way in fortifying our interventions, the MEC stated.

Mr Dennis Ryder (Democratic Alliance for Gauteng) said he viewed the deputy minister’s budget statement on health as nothing but “a press release.” He further emphasised “we deal with real lives here and we need real interventions and you have provided very little contribution to the debate at hand”.

 He was adamant that the budget will not mitigate the inefficiencies of the healthcare system or facilities. “We now are one of the 10 countries in the world with the highest active infection cases, but we have few beds made available.”

And how can we expect that the adjusted budget will be spent effectively, he asked. “No amount of funding would assist us when it is in bad hands” prone to corruption.

The current challenges faced by our healthcare system have their roots in the apartheid system, said Mr Elleck Nchabeleng, current chairperson of the Select Committee on Education, Technology, Sports, Arts and Culture. It is a system that “secured it in favour of the minority. Which led to gross inequality, anticompetitive behaviour in the sector. Legislative intervention that seek to bring about the National Health Insurance is aimed at addressing the inequitable system that is currently at play.”

The recent adjustment of the budget of R20 billion additional funds for healthcare signals that “government cares. In recent weeks and months government had to save lives and livelihoods. Why would government feel compelled to allocate R20 billion in healthcare if it was not a caring government?”

We welcome the adjusted budget to ensure that there is equitable PPE, beds, laboratory tests, procurement of thermometers and most critically the additional nurses and doctors and information technology,” he said.

What remains important is the need to cultivate the South African spirit of invincibility to soldier on. He cited Nelson Mandela’s wisdom to underscore that. “We can change the world to make it a better place. It’s in our hands to achieve that. The battle against Covid-19 is truly in our hands,” he concluded.