START OF DAY

							28 JANUARY 2009                                 Page 1 of 51

                       WEDNESDAY, 28 JANUARY 2009

                                  ____



                  PROCEEDINGS OF THE NATIONAL ASSEMBLY

                                  ____



The House met at 14:02.



The Speaker took the Chair and requested members to observe a moment

of silence for prayers or meditation.



ANNOUNCEMENTS, TABLINGS AND COMMITTEE REPORTS – see col 000.



  REVIVAL OF LEGISLATIVE PROPOSAL TO AMEND REMUNERATION OF PUBLIC

                           OFFICE BEARERS ACT



                           (Draft Resolution)



The DEPUTY CHIEF WHIP OF THE MAJORITY PARTY: Madam Speaker, I move

without notice:



 That the House revives the following item, which was on the Order

 Paper and that lapsed at the end of the 2008 annual session, for

 consideration by the National Assembly:
28 JANUARY 2009                                Page 2 of 51


 (1) Consideration of Report of Committee on Private Members’

     Legislative Proposals and Special Petitions (Announcements,

     Tablings and Committee Reports, 20 June 2008, p 1330 –

     Legislative Proposal to amend Remuneration of Public Office

     Bearers Act (No 20 of 1998) (Mrs S A Seaton)).



Agreed to.



  DEADLINE EXTENDED FOR REPORT OF AD HOC COMMITTEE ON CRIMINAL LAW

                  (FORENSIC PROCEDURE) AMENDMENT BILL



                          (Draft Resolution)



The DEPUTY CHIEF WHIP OF THE MAJORITY PARTY: Madam Speaker, on

behalf of the Chief Whip of the Majority Party, I move the draft

resolution printed in his name on the Order Paper, as follows:



 That the House –



 (1) notes that the ad hoc committee to consider the Criminal Law

     (Forensic Procedure) Amendment Bill was due to report on 23

     January 2009;



 (2) further notes that the committee has not yet reported on its

     mandate;
28 JANUARY 2009                               Page 3 of 51


 (3) notwithstanding Rule 214(6)(c), condones the continued

     existence of and the work conducted by the committee after its

     term had expired; and



 (4) resolves to extend the deadline by which the committee is to

     report to 13 February 2009.



Agreed to.



                     NATIONAL LAND TRANSPORT BILL



             (Consideration of Bill and of Report thereon)



Mr B L MASHILE: Madam Speaker, the committee considered the National

Land Transport Bill 2008 in August 2008. The completion of the

consideration of the Bill marked a major achievement in the

conclusion of the national land transport transitional regime in

South Africa. The consideration of this Bill saw a flurry of

interested parties making input from different sector perspectives.

These included owners, users and authorities of transportation

systems.



Considerable time and energy were spent to analyse and incorporate

the appropriate and useful input in the legislation. There is

consensus in the committee that the maximum benefit has been derived

from the variety of presentations made. As the country is mandated
28 JANUARY 2009                                 Page 4 of 51


to organise the 2010 Soccer World Cup, the provision of transport in

general is constantly under scrutiny to ensure successful

transportation of goods and the public during the tournament.



The transformation of our public transport system, in the form of

taxi recapitalisation and general public transport integration,

generates constant consideration of some aspects of the new land

transport regime. The committee feels that these emergent new

proposals cannot be incorporated now, given the parliamentary

legislative processes. We therefore strongly recommend that the

Department of Transport, in its wisdom, concede and consolidate

these new proposals for consideration by the fourth Parliament.



The difficulty of and intense work put into the crafting of this

legislation saw a lot of chopping and changing of a number of

clauses and text to the extent that the cleaning up of the body text

was not concluded satisfactorily. The majority, if not all, of the

amendments are text corrections and consequential amendments to

align it to the letter and spirit of the law.



As the Portfolio Committee on Transport we applaud the work done by

the Select Committee on Transport on this Bill by ensuring that the

final draft is clean of text mistakes. We are in agreement with the

consequential changes brought by the select committee.
28 JANUARY 2009                              Page 5 of 51


The Portfolio Committee on Transport is certain that a progressive

and transformative piece of legislation is in place to govern the

provision of land transport in South Africa. We, therefore, as the

portfolio committee, request this honourable House to accept these

amendments and consequentially pass the National Land Transport

Bill. I thank you.



There was no debate.



The DEPUTY CHIEF WHIP OF THE MAJORITY PARTY: Madam Speaker, I move:



 That the Bill be passed.



Motion agreed to.



Bill accordingly passed.



           BIBLE SOCIETY OF SOUTH AFRICA ACT REPEAL BILL



                       (Consideration of Bill)



Mr P A GERBER: Madam Speaker, thank you for the privilege to report

back to this august House on this very sensitive and emotional Bill.

The Bible Society Repeal Act was adopted by the Portfolio Committee

on Arts and Culture and then sent to the NCOP’s Select Committee on

Education and Recreation, which adopted it with amendments after
28 JANUARY 2009                              Page 6 of 51


consultation with the Bible Society and its lawyers. These

amendments are just technical amendments to soften the transition of

the Bible Society from a statutory entity to that of a section 21

company.



Many people, especially my colleagues, have asked me over the past

20 months how I got involved in the scrapping of these six old,

redundant religious Acts, and may I confess today that two people,

miles and poles apart, were indirectly and quite by coincidence

responsible for my discovering these old, redundant religious Acts.



The one person was Comrade Winnie Mandela. Without her, I would not

have discovered these old Acts. As a Member of Parliament, her

office was at E444, just above where we are sitting now – not far

from my office at E463. When she retired from Parliament, the

parliamentary cleaners threw all her old books and reports into the

passage, as they usually do. Amongst these was an old set of

statutes and, as I can’t stand any wastage, I took over the

ownership of these statutes which would otherwise have been turned

into toilet paper.



The second person was a frustrated sheep farmer from Fraserburg, a

Mr Van Schalkwyk, who I don’t think is related to Martinus, who

asked me for information about the Fencing Act of 1963. I had to

look this up in Winnie Mandela’s statutes which I had picked up from

the passage. Going through the alphabetical list of statutes, I
28 JANUARY 2009                              Page 7 of 51


discovered the Dutch Reformed Churches Union Act of 1911. I then

investigated all the statutes to see how many other religious acts

were on the Statute Book. That is how the process of repealing the

outdated, redundant Acts started 20 months ago.



It has been the greatest honour for me, as a Member of Parliament,

to have experienced this, to have been enabled to draft, process and

have both Houses of Parliament adopt these four private member’s

Bills of mine. After all, we are legislators. These four private

member’s Bills, as far as we know, are the only four private

member’s Bills that have been adopted since 1994, and I hope there

will be many more in future.



I would like to thank all Members of Parliament, the parliamentary

staff, the parliamentary legal advisers, especially Adv Adhikari,

the churches, the NGOs and everybody for their support. It has been

a learning exercise and experience for all of us.



Special thanks go to the chairperson of the Portfolio Committee on

Private Members’ Legislative Proposals and Special Petitions, the

hon Vytjie Mentor, the chairperson of the Portfolio Committee on

Arts and Culture, the NCOP’s select committee chairperson and acting

chairperson, the Speaker’s office, Mr Doidge’s office, while he was

still in his previous capacity and Mr Mansura, who was very

supportive all the way. Lastly, thanks go to the ANC, who never

doubted my intentions when I started with this process.
28 JANUARY 2009                              Page 8 of 51


To end, the decision to repeal the Bible Society Act was a very

difficult decision for me, having grown up in a parsonage as a son

of a “dominee” (minister of religion). But we had to take the state

out of the business of the Bible Society. We are actually liberating

the Bible Society of South Africa today. When I bought each of my

four young daughters a big, proper Bible for Christmas last year, it

was good to know that the Bible lying on the shelf of the bookshop

was there without state protection or privilege. May the Bible

Society of South Africa continue to enjoy its growth and may the

gods bless the whole of South Africa, never mind which book we read.

With these words, I put this report to you. I thank you. [Applause.]



There was no debate.



The DEPUTY CHIEF WHIP OF THE MAJORITY PARTY: Speaker, I move:



  That the Bill, as amended, be passed.



Motion agreed to.



Bill, as amended, accordingly passed.



CONSIDERATION OF REPORT OF PORTFOLIO COMMITTEE ON THE PUBLIC SERVICE

AND ADMINISTRATION - PUBLIC SERVICE COMMISSION’S FOURTH CONSOLIDATED

              MONITORING AND EVALUATION REPORT OF 2007
28 JANUARY 2009                              Page 9 of 51

   CONSIDERATION OF PORTFOLIO COMMITTEE ON THE PUBLIC SERVICE AND

        ADMINISTRATION - STATE OF PUBLIC SERVICE REPORT 2008



Ms M J J MATSOMELA: Hon Speaker, hon members, I would like to table

these two portfolio committee reports which are based on the reports

of the Public Service Commission.



The first report is on monitoring and evaluation. The Portfolio

Committee on the Public Service and Administration received a

briefing by the Public Service Commission on its Fourth Consolidated

Monitoring and Evaluation Report on 11 June 2008. The focus of the

fourth consolidated report was service delivery. The Public Service

Commission is perceived as an ineffective structure due to its power

to only make recommendations based on its constitutional mandate,

hence the portfolio committee’s decision to table these reports so

that the reports of the Public Service Commission are adopted as

reports of Parliament, so that we are enabled to enforce them.



The Public Service Commission’s findings in the report reflect

negatively on the Public Service’s ability to deliver services and

its embodiment of the nine basic values, as outlined in section

195(1) of the Constitution. There were, however, a few departments

that scored above average and, in some instances, scored 100% for

specific performance indicators.
28 JANUARY 2009                             Page 10 of 51


The Public Service Commission made many valuable recommendations in

this report, and overall the committee was pleased with the report.

The recommendations emanating from the report are the following.

Firstly, guidelines for public participation in policy-making should

be developed by the Department of the Public Service and

Administration in conjunction with the Department of Water Affairs

and Forestry and the Public Service Commission.



Secondly, departments mentioned in the Public Service Commission

report should put in place a strategy of prioritising skills

development activities. The Public Administration Leadership and

Management Academy, that we normally refer to as “Palama”, should be

consulted by the relevant departments.



Thirdly, departments should ensure that planned training is

implemented, and that the impact of the training on the enhancement

of service delivery is monitored. This, also, should be done in

conjunction with the Public Administration Leadership and Management

Academy.



Fourthly, a review of the disciplinary codes and procedures should

be done with a view to tightening enforcement of disciplinary

procedures, specifically related to absenteeism. The Department of

the Public Service and Administration should report to Parliament by

March 2009 on progress made with the aforementioned recommendations.
28 JANUARY 2009                             Page 11 of 51


The fifth recommendation is that the dispute-resolution time

periods, as set out in the disciplinary codes and procedures, should

be adhered to by the departments mentioned in the report and

unresolved disputes should be resolved as a matter of urgency.

Again, in this instance, we would like the Public Service Commission

to report before March 2009.



Members of the executive and directors-general of the departments

sampled in the Public Service Committee’s report should report to

Parliament on progress in the implementation of recommendations from

the above-mentioned report by the end of March 2009.



The Public Service Commission should report in writing to Parliament

by the end of March 2009 on progress made with departmental

implementation of recommendations from the Fourth Consolidated

Monitoring and Evaluation Report. So, we are expecting reports from

the departments, from members of the executive and directors-general

and from the Public Service Commission itself.



The Public Service Commission should consider, as part of its future

monitoring and evaluation reports, a section dedicated to

departmental implementation of previous reports. This will enable us

to keep track of the progress being made, to review the

recommendations and to make the necessary amendments from time to

time.
28 JANUARY 2009                             Page 12 of 51


The committee therefore recommends that the National Assembly adopt

the Portfolio Committee on Public Service and Administration’s

Report on the Public Service Commission’s Fourth Consolidated

Monitoring and Evaluation Report of 2007.



Regarding the State of the Public Service Report, the committee

again received a briefing by the Publication Service Commission on

the State of the Public Service Report of 14 May 2008.



The committee’s report focused on the findings and recommendations

of the State of the Public Service’s report per constitutional

principle. The basic values and principles governing public

administration are set out in the Constitution, Act 108 of 1996,

under section 195(1), which states:



 Public administration must be governed by the democratic values

 and principles enshrined in the Constitution, including the

 following principles:



 (a) A high standard of professional ethics must be promoted and

     maintained.



 (b) Efficient, economic and effective use of resources must be

     promoted.



 (c) Public administration must be development-oriented.
28 JANUARY 2009                              Page 13 of 51


 (d) Services must be provided impartially, fairly, equitably and

       without bias.



 (e)   People’s needs must be responded to, and the public must be

       encouraged to participate in policy-making.



 (f) Public administration must be accountable.



 (g) Transparency must be fostered by providing the public with

       timely, accessible and accurate information.



 (h) Good human-resource management and career-development

       practices, to maximise human potential, must be cultivated.



 (i) Public administration must be broadly representative of the

       South African people, with employment and personnel management

       practices based on ability, objectivity, fairness and the need

       to redress the imbalances of the past to achieve broad

       representation.



The Public Service Commission found that, overall, good progress has

been made during the period under review. However, there should be

an appreciation of the fact that more needs to be done and that the

quality and pace of service delivery should be accelerated.
28 JANUARY 2009                             Page 14 of 51


It was found that the Public Service has sufficient operational

experience in implementing new policies. It is important that

effective monitoring of performance continues and that action is

taken where concerns are identified.



The committee therefore made the following recommendations.

Departments identified in the Public Service Commission’s report

should implement recommendations made by the Public Service

Commission in its State of Public Service Report 2008. Progress on

the implementation of these recommendations should be reported to

Parliament by June 2009. The Public Service Commission should report

to the committee the success of departmental implementation of the

recommendations made in the State of Public Service Report in

writing by June 2009.



The committee recommends that the National Assembly adopt the

Portfolio Committee on Public Service and Administration’s report on

the Public Service Commission’s State of Public Service Report 2008.

I thank you. [Applause.]



There was no debate.



The DEPUTY CHIEF WHIP OF THE MAJORITY PARTY: Madam Speaker, I move:



 That the Reports be adopted.
28 JANUARY 2009                               Page 15 of 51


Motion agreed to.



Report of Portfolio Committee on the Public Service and

Administration on Public Service Commission’s Fourth Consolidated

Monitoring and Evaluation Report of 2007 accordingly adopted.



Report of Portfolio Committee on the Public Service and

Administration on State of Public Service Report 2008 accordingly

adopted.



 DEVELOPING AN IMPROVED HEALTH CARE SYSTEM CAPABLE OF DEALING WITH

                    NATIONAL AND REGIONAL CHALLENGES



                                (Debate)



The MINISTER OF HEALTH: Madam Deputy Speaker, events during the last

couple of months, from about mid-November, will convince us that

health in South Africa is not just a South African issue; it’s a

regional issue.



With the advent of cholera, we have seen that what happens in our

neighbouring states affects us here in our country. And, as we have

learnt, no country is an island unto itself. So, health is a

regional issue; it’s a national issue; and it’s an issue for each

and every one of us, everyone in this country.
28 JANUARY 2009                               Page 16 of 51


Before entering into this very important debate, I first of all want

to pay tribute to the thousands and thousands of health care workers

who, as we speak here today, are providing care and support to

millions of people in our country under difficult conditions, with

limited resources and for very long hours.



On a daily basis I get letters from people complaining about what

happened to them in this or that hospital. I have many MPs coming to

me to tell me what their experiences are in their constituencies.

Yes, those are very, very valid experiences, and this is what we

have to deal with in health. But, let us not forget those thousands

of health care workers who are valiantly working with much passion

to help our people with their health needs.



I am overwhelmed by the passion and devotion of people in the health

care profession. It is perhaps one of the few professions which is

almost a calling, in which health becomes a vocation, not just a

job. Okay, I can see the Minister of Education saying that teachers

are the same. We are in agreement, Minister. We have the same

projects in mind. Teachers – and, let’s add, policemen and

policewomen - are people with passion. So, I want to pay tribute to

these people in our country who assist us.



But what do we need to do as government? What do we need to do as

civil society to assist these people to do their jobs, to assist our

people to receive good quality care? It is daunting when you look at
28 JANUARY 2009                             Page 17 of 51


what we are up against. We inherited a system in which there was,

and still is, vastly inequitable access to health care. We have a

public health sector that services mainly the poor and we have a

private health care sector that services the middle class and the

wealthy. Access to quality health care is a constitutional right. It

cannot be dependent upon how wealthy you are and what kind of

arrangements you can make to access care in the private health care

sector.



But let us not just say that health care is bad in the public health

care sector and good in the private health care sector. We have all

had experiences to know that there is good quality care in the

public health sector and, at times, bad quality care in the private

health sector. Those who are dependent on the private health care

sector face escalating costs because their medical aid schemes can

no longer provide the insurance they thought they would get when

they accessed them.



Similarly, in the public health care sector, we face a number of

huge challenges. Let me start spelling out some of those challenges.

I do not want to give promises about how quickly and how fast these

will be dealt with. But, having spent time in the health care

sector, we, as the ANC, have outlined a number of initiatives which

we believe are essential for the transformation of the health care

sector. Firstly, there are the issues of governance, accountability

and strategic leadership. It is very difficult in the health care
28 JANUARY 2009                             Page 18 of 51


sector to deal with many, many levels of decision-making. In other

words, you have a national Department of Health, you have provincial

departments of health and you even have health care at municipal

level. There are many tiers of decision-making. In terms of what

goes from the equitable share to a province, a provincial Treasury

makes the decision as to how they will allocate to health care,

social development and so forth. So, it may be that the amount you

thought would go to health care in a province isn’t allocated. That

decision is up to the provincial Treasury. A provincial health

department has the constitutional right to decide how they will

allocate resources.



So, how do we get a national project with national priorities going

about the reform of our health care system when we have this

multiplicity – these dreaded schedule 4 functions - which put us in

difficult relationships with each other? How do we understand

accountability in that kind of environment? Take, for example, the

Ukhahlamba district and the failure of the health care sector there.

I had a very interesting question from an opposition party member

who asked: “Minister, what steps are you taking to hold people to

account?” I have pondered this time and time again. Who is

responsible? Is it the person in charge of that particular health

care facility? Is it the person in charge of the primary health care

district? Is it the MEC or the head of department of health in the

province? Who is it? Until we understand accountability and what

that range of accountability means, we cannot talk about an
28 JANUARY 2009                             Page 19 of 51


effective, functioning health care system. I have commissioned legal

opinion on this matter, on accountability within our health care

system, because that is an essential part of the system.



We can’t just look at provinces as being particular fiefdoms and at

the national department as somehow just being the standard-setting

department. We have to look at leadership in the health care sector.

We have a provision in the Act for a body called the National Health

Council. The National Health Council consists of the provinces with

their MECs and their heads of department, and of the Minister, the

Deputy Minister and the director-general. This is the agency at

which all policy decisions are passed and at which all decisions

related to health are taken. This is the engine with which we need

to start driving health care reforms and a holistic approach to

health care issues.



Finally, when we talk about leadership, we are also talking about a

social compact, those people in the health care industry who are

represented by unions. We need, more than ever before, a social

compact with these unions. There are encouraging signs that the

unions themselves are coming to the table in this regard.



Let me quickly go through the other issues. The first issue is that

of information systems. We are unable to dig down to get the

information we need. At times it is even difficult to know on a

daily basis how many people have highly drug-resistant TB. We can’t
28 JANUARY 2009                             Page 20 of 51


even get that. We have to develop information systems so that we can

manage health. We have initiated a patient information system, but

that is not enough. This will be a central focus of this department

in going forward.



The next issue is that of financial management. We know that we are

underresourced in terms of the baseline. We know that the cuts that

were effected in the health care sector from 1998 onwards have

affected us badly. But that does not mean that we abrogate our

responsibility for good financial management in the health care

system. We need to be able to present focused, good bids when we bid

for budgets. This cannot be based on inefficient spending.



The national Department of Health, with the agreement of MECs of

health, has already set up teams of people who will be going to the

provinces to assist provinces to analyse what the cost drivers in

our health care system are. We are experiencing massive overspending

in our health care system in all provinces at the moment. Some of it

might be due to bad and inefficient financial management. But there

are cost drivers there that, I think, we need to uncover and pin

down. Because, unless we begin to understand what those drivers are,

we are not going to be able to fund our system adequately.



We are also setting up a proper donor mobilisation unit in our

national Department of Health. There is a wide range of donors that

include the US President's Emergency Plan for Aids Relief, Pepfar,
28 JANUARY 2009                             Page 21 of 51


and the Global Fund that are able to provide funding, and we need to

get our act together in that regard.



The management of our human resources is critical. At the moment, we

do not have a national human resource strategy which indicates

specific targets for the provision of health care workers even

according to numbers of our population. How can we plan ahead if we

do not know what the basic package of care should be? This package

of care is going to be a very important focus. We have to start

specifying. I know treasuries don’t like it, don’t want norms and

standards, because then they are held to account in terms of what

the norms are going to cost. But we need to know because there are

far too many vacancies and far too many people who are

inappropriately allocated in our health systems for us to be able to

take a good view of how well we are delivering.



The reopening of our nursing colleges is very important. So, too, is

the placement of our academic hospitals. Are they at the right

level, the provincial level? Do they need to come to the national

level? Do we need to look at, as the ANC is saying, the

decentralisation of management - not the facilities, but management?



The management of our health facilities requires a lot. We

established the Office of Standards Compliance in April 2008 which

will examine the quality of care in each of our health facilities on

a routine basis every three years. They have already produced
28 JANUARY 2009                             Page 22 of 51


reports on 27 hospitals, and this is going to provide us with an

invaluable base for understanding what the problems are with our

quality of care.



It is not only the quality of health care, but what we call the

“hotel factors” - the queues, the lack of sanitation, poor quality

food – the kinds of things that our people constantly complain about

when they go to health care facilities. There are the difficulties

of just standing in queues and waiting and waiting and then having

to go to another queue for drugs. And so there is management of

that. Interesting exercises are being done at Chris Hani Baragwanath

Hospital, which are yielding very interesting results on how we can

better manage our health care facilities. There, of course, the

social compact with our partners is very important.



The issue of inequity of access is perhaps the primary policy

engagement that we have to have. We cannot have a well-funded

private sector and a poorly funded, underperforming public sector.

That is why national health insurance becomes an important policy

initiative. I will not go into details about this. But let me assure

everybody that on this particular initiative, we will be consulting

broadly and very widely and with a wide range of participants,

because we have to get this right. We cannot afford to get it wrong.

We look forward to lively engagement on this issue, particularly

because it is addressed to dealing with inequality of care. Let me

say upfront that national health insurance will only succeed if we
28 JANUARY 2009                             Page 23 of 51


bring the standards of care in the public health sector up to speed.

We cannot have national health insurance with a poorly functioning

public health care sector.



The revitalisation of the physical infrastructure of our health

facilities is extremely important and we have made good progress on

that. More than 249 facilities out of more than 400 hospitals have

undergone renovation already. Eighteen new hospitals have been

built, of which three are major teaching hospitals. That’s a

considerable achievement. But we need to then look at how we are

staffing these, how they are being maintained.



The accelerated implementation of HIV and Aids policies, the

reduction of mortality, and the care around TB and associated

diseases are vital ingredients in our health improvement plans. We

live under a high disease burden in this country, not only with HIV

and Aids – an actual pandemic – but with TB, malaria and cholera,

which we are now experiencing.



Obviously, we are very, very blessed to have the National Strategic

Plan on HIV and Aids and TB. With all our partners, we have agreed

to it in Sanac and now it is up to us to get this plan implemented.

We have now set in motion getting a proper secretariat for Sanac.

The resource mobilisation committee is now busy with our Round 9

proposal to the Global Fund and, hopefully, Sanac will now become an
28 JANUARY 2009                               Page 24 of 51


efficiently run organisation that will assist us to drive the HIV

and Aids prevention programmes and treatment programmes.



Let me say with pride that with regard to those on antiretrovirals,

we wanted to add on, in terms of the National Strategic Plan,

180 000 extra people this year. We have exceeded the target. We are

on 216 000 this year, which is a considerable achievement. I wish to

congratulate everybody.



That means that there are over 700 000 people in our country at this

moment who are on antiretrovirals, who do not need to be in our

hospitals, who have the possibility of a good life ahead of them,

who can care for their loved ones. That is what we want to focus on,

getting people onto those antiretrovirals. But at the same time

prevention is extremely important. We will be driving the prevention

of mother-to-child transmission programmes with a great deal of

energy and vigour.



We have identified 18 primary health care districts that are

performing poorly, not only in terms of PMTCT but also in terms of

health delivery. We have teams of people there at the moment who are

isolating the problems and preparing us for a massive uptake in the

prevention of mother-to-child transmission.



Let us not forget that these are not the only illnesses we have to

deal with. We have lifestyle diseases such as heart disease, stroke,
28 JANUARY 2009                             Page 25 of 51


diabetes, hypertension. How many people in our townships alone at

this moment are suffering from hypertension? How many people in this

room alone are suffering from hypertension? [Interjections.] Yes,

I’m sure the DA is suffering from hypertension. [Laughter.] We need

to have mass mobilisation around healthy lifestyles.



We need to look at the position of our people who are disabled. Are

they getting the quality of care that they need?



Finally, there is our drug policy. There is a lot that we need to be

doing around our drug policy. Do we need our own home-based

pharmaceutical industry? What is our procurement policy? Are we

doing things right?



I’m sure there are a lot of other things that we can speak about.

But what I do want to speak about is the necessity for us all to

join hands around improving our health care facilities in this

country. I have been struck by the activism of our opposition

parties with the number of questions they file to the department in

Parliament. This actually makes for very instructive reading and

often alerts you to where some problems lie. I look forward to an

engagement – a constructive engagement – with our opposition to see

what it is that we can do better. Every MP here has a constituency

office. Every MP here has contact with health facilities in their

area. And, in future, we would want to be able to receive accounts

from them about what we should be doing to improve our health care
28 JANUARY 2009                             Page 26 of 51


facilities - and then out there, in civil society, everybody must

come on board. We want everybody to be involved. We want everybody

to know that they have a role to play. And may we, in the years to

come, thrive and prosper, with a growing and improving health care

delivery system in our country. Thank you. [Applause.]



Mr M WATERS: Thank you, Deputy Speaker. Hon Minister and members,

how refreshing it is to hear the new Minister of Health speak

compared to the previous Minister of Health. The South African

health environment is vastly better today than it was six months

ago. We now have a Minister of Health who recognises that HIV/Aids

is a real disease and who does not dismiss the problems of our

hospitals and clinics as the hysteria of opposition parties. The

doctors and nurses and other health professionals who work so hard

every day to provide the best service they can now know that they at

least have a Minister who is working with and not against them.



Many organisations and individuals have expressed their enormous

relief at this change and have made themselves available to help

make our health system work better, which the Minister has just

appealed for. The DA shares this relief and we too will do

everything we can to help our system get back on track. The DA

intends to run, at least, the Western Cape after this year’s

elections. We have a range of policies which will make a substantial

difference to the quality of care in our public hospitals. But

nothing shows how far we still have to go than the cholera outbreak
28 JANUARY 2009                             Page 27 of 51


which the Minister mentioned. This has, so far, killed more than 30

people in our country and does not seem to be under control.



Cholera is an easily treatable disease from which no person should

ever die, but a basic rehydration mixture, costing only a few cents,

is not getting to people who are sick. We must remember that the

rehydration mixture is basically a primary health care

responsibility, primary health care that this government has been

prioritising for over 10 years but which still cannot ensure that

clinics have simple medication.



It is a hard reality to absorb that the life expectancy in South

Africa is now 12 years lower than it was in 1996 and that our

maternal mortality is worse than Iraq’s. In fact, we are one of only

12 countries in the world where the infant mortality rate is

actually increasing.



So what can we do? I would like to highlight three of the DA’s

priorities. The first is to improve the management of hospitals and

clinics. With all the money in the world, no health facility can

work without a capable, qualified, committed and dedicated manager.

There are many hospital CEOs and clinic managers who do exceptional

jobs. There are many others who have benefited from the ANC’s

closed, patronage approach.
28 JANUARY 2009                              Page 28 of 51


I would like to give an example. The CEO of the East London hospital

complex is a previous ANC councillor with no qualifications in

administration and is responsible for a budget of over R170 million

a year. He is also responsible for the dilapidated state of affairs

at Frere Hospital, which the then Deputy Minister of Health and now

Deputy Speaker went to see for herself, and who said that nurses

were playing God, deciding which babies should live and which should

die. In fact, in one year 199 babies were stillborn in that

hospital.



Replies to Questions the DA has asked about hospital CEOs from

across the province show that many others also lack the knowledge

and skills required to run a hospital properly. In any province the

DA controls after this year’s election, we will make it a priority

to audit the qualifications of all health facility managers to

ensure that they have the skills that the patients need. We also

undertake to regularly evaluate the quality of services that our

hospitals and clinics provide, as the Minister has also mentioned.

We call on the national department to expand the evaluation of

services in the 27 hospitals already done.



Our second priority is human resources. I do not have to mention the

figures. We all know how dire it is and that many hospitals and

clinics face devastating shortages. In any province the DA takes

over, we will embark on a vigorous international recruitment drive
28 JANUARY 2009                               Page 29 of 51


to attract foreign health professionals. We would like to see the

Minister of Health taking some of these steps.



For example, it is outrageous that the Health department restricts

the number of nurses that can be trained in the private sector.

Along the same lines, a policy decision that prohibits private

medical schools is in place. There are a couple of examples around

the world where successful public-private partnerships in developing

countries can be looked at. It would cost nothing for us to lift

these prohibitions.



In addition, it would also cost us nothing to include medical

professionals on the Home Affairs database scarce skills list. What

it would do is to enable us to attract them and get them into the

country a lot faster. I know of some nurses who have waited over two

years to be allowed to work in the country.



The DA would also utilise the private sector to reduce the long

queues at hospitals by allowing patients to choose for themselves

from which pharmacies they would like to collect their repeat

medication. Currently, tens of thousands of people have to take a

day’s leave in order to collect their medication.



There is more hope for real improvement of our health system now

than there has ever been. The DA and its health MECs, after the
28 JANUARY 2009                             Page 30 of 51


election, look forward to working with you to transform this hope

into reality. I thank you very much. [Applause.]



Dr R RABINOWITZ: Deputy Speaker, hon Minister, around the globe

health care has similar challenges, and, whether it is Democrats

under Obama or socialists under Motlanthe, governments must opt for

solutions that work. Essentially, challenges relate to reducing

health costs and corruption and increasing access and quality of

care.



More specific, issues of Aids, TB, malaria and cholera must be

addressed here. Our public sector is constantly under threat of

collapse and the private sector people are paying more, often for

less. How to respond?



A healthy lifestyle is the cornerstone of preventive primary health

care. As in the East, let’s organise daily workouts in public

spaces, switch off TVs and mobile phones and switch on sports, music

and art in schools and in our homes. Let’s immediately ban trans

fats as proposed in my private member’s Bill and agreed to by the

department and by the private members’ legislative committee. They

are produced for commercial gain and contribute to heart disease,

diabetes, weight gain and cancer.



To ensure quality treatment, let’s register conventional doctors,

homeopaths, acupuncturists, chiropractors, naturopaths, Ayurvedic
28 JANUARY 2009                             Page 31 of 51


and Chinese doctors through a single, independent, democratically

elected medical council. A traditional healers council should deal

only with herbalists, surgeons and birth attendance, not abaprofethi

[prophets] and sangomas whose work on a metaphysical dimension

cannot be monitored or controlled.



We must ensure that at national and regional levels formal

structures exist to provide for co-operation and collaboration

between all these health professionals. This should follow through

into working groups and research teams that tackle issues like Aids,

TB, malaria and cholera regionally and locally.



Hon Minister, we welcome and support many of your initiatives.

However, I will dwell on our differences. Let us scrap the most

damaging of our failed policies, the centralised model with unfunded

mandates, bureaucratic conditional grants - the idea that one size

fits all. It is confusing and lacks accountability and should be

simplified and decentralised.



Let national government establish frameworks and minimum standards.

Let provincial and local governments control funds and choose

priorities. Then hold them accountable. Let discipline be meted out

close to where doctors and nurses work; build stronger health

districts and improve co-ordination between hospitals, clinics,

mobiles in rural areas and between these schools and local police

and install integrated information systems - here we agree with the
28 JANUARY 2009                               Page 32 of 51


hon Minister. Let us remove constraints that prevent districts and

hospitals from negotiating partnerships with the private sector or

working with NGOs and international donors.



Currently, most NGO funding is politically motivated, weakening the

impact it has on major epidemics in South Africa. To improve access

to quality care, let’s embrace public-private partnerships, PPPs;

contract the private sector to run mobile services in rural areas

and to manage clinics or hospital works and to train nurses and do

away with licensing according to need - it is subjective and open to

patronage and corruption. We should rather draw health workers to

underserved areas through incentives which achieve more than

coercion.



The greatest burden on public hospitals is HIV and TB. Here, the IFP

also suggests major changes. Let us treat HIV like an ordinary

disease without special secrecy provisions. Testing should be the

norm with an opt-out provision for those who refuse it. Let us

change the focus of rights, from privacy to nondiscrimination. The

excessive pro-focus on privacy adds to the culture of denial and

gives people the sense that HIV is something to be ashamed of.



How do we reduce medical costs? Require all who work to pay a

percentage towards a medical scheme of their choice with a low-cost

option offered by government. Enforce caps on medical scheme

administration fees which enable schemes to hide huge profits.
28 JANUARY 2009                             Page 33 of 51


In hospitals, let government hospitals establish private wards and

retain profits. Let government reduce costs by bulk buying of

private services for registered patients, paid for per day or per

capita or per procedure. Where medicines are concerned, enforce

transparency along the entire chain of medicine supplies. Thank you.

[Time expired.]



Mrs C DUDLEY: Thank you, hon Minister. Deputy Speaker, at the heart

of all measures to improve the South African health system and

making it more accessible is the issue of transforming it from a

fragmented and inequitable system to a health system that is

integrated, inclusive and responsive to the needs of all South

Africans.



Primary health care services are the backbone of health care, and

equity, effectiveness and efficiency in the provision of these

services are critical to the functioning of the entire health

system. A stronger multisectoral approach is urgently needed as

rural health care has often been compromised by lack of

infrastructure and services such as roads, water and electricity.

Hopefully, integrated municipal development plans will offer some

solutions.



Of course, health systems remain severely underresourced despite

interventions such as recruitment of health professionals from
28 JANUARY 2009                             Page 34 of 51


outside South Africa, community service in underserviced areas and

rural and scarce skills allowances.



Migration of skilled workers from developing to more developed

countries remains a very real challenge, and efforts to counter the

situation must be reviewed and intensified along with innovative

measures to train health care aids to assist professionals in

communities. Disparities in salaries and service conditions between

health workers in provinces and municipalities - and disparities in

quality of service as a result of inequitable distribution of

resources - must also be addressed.



Reliable and timely health information is essential and sufficiently

strong and effective systems are not at present in place. We need

dedicated health information services personnel at hospitals,

subdistrict and district levels, relevant skills development, staff

training and ongoing support in all areas of health information

systems.



Lastly, HIV and Aids place enormous pressure on all aspects of the

national health system and must not continue to be just a funding

priority, but must be recognised as the national emergency that it

is. When we stand in any of our hospitals that are struggling with

no beds, people queuing, people sitting, people on floors and health

professionals depressed and stressed, we obviously realise the

emergency in a much more real sense. Thank you.
28 JANUARY 2009                             Page 35 of 51


Ms S RAJBALLY: Madam Deputy Speaker, poverty has left its scars on

every aspect of South Africans’ lives. It has indeed been this

democratic government that has churned its wheels to eradicate

poverty and diminish its effects on living in our country.



However, like most countries plagued by the challenges of poverty,

severe health risks and health problems exist. With the coming of a

new regime, there are great expectations that the country’s problems

will be wished away by the wave of a wand. But, over time, when the

changes do not meet the expectations, we are met with impatience and

intolerance.



The MF believes that the department’s focus has primarily rested on

making health more accessible to South Africans, especially those

from previously disadvantaged backgrounds. And we cannot argue that

many have gained this access.



However, the challenges of minimum resources and areas that still do

not have access to adequate health systems remain. It is time for us

to get back to our drawing board and address our challenges so that

our soon-to-follow Budget Speech by our hon Minister of Finance,

Trevor Manuel, will include special funding to address these

shortfalls and challenges.



The MF has full confidence in our new hon Minister of Health and her

abilities to steer South Africa to better and more accessible health
28 JANUARY 2009                             Page 36 of 51


care facilities. We feel that each province comes with its own

challenges, and we expect these to be reported to us and for much

more oversight to be done by Parliament so that we work efficiently

at tackling the country’s health issues and assist the department in

its endeavours in health care. I thank you, Madam Deputy Speaker.



Mr L M GREEN: Deputy Speaker, I wish to commend the Minister of

Health for her open and frank input here this afternoon. My input

starts by way of saying that despite improvements in living

conditions over the past decade, the health of South Africans has

worsened, according to the South Africa Health Review. It doesn’t

have to remain like that, but that’s the status as we see it.



The World Health Organisation has warned that in times of financial

crisis, people tend to turn to bad health habits, such as alcohol,

tobacco and drugs as measures of coping with such times.



A concern has also been raised by the World Bank that about 60

million people will be exposed to severe poverty if economic growth

in developing countries is halved during the year, which is a

possibility.



According to the South Africa Health Review published last year, the

overall health of South Africans has worsened considerably. HIV/Aids

is, of course, the major cause of our country’s worsening health.

The three main factors that impact on our nation’s health and
28 JANUARY 2009                             Page 37 of 51


mortality rates are unsafe sex, interpersonal violence and alcohol

abuse.



The FD, a member of the Christian Democratic Alliance, the CDA,

suggests that there is a need for increased public education

targeting bad behaviour patterns in an attempt to limit those

factors of concern. Considerably more must be done to improve public

health funding so that it keeps pace with rising inflation, and

district health services in poorer areas must invest more funds to

meet the growing demands of its people.



In conclusion, the FD feels that an intersectoral approach is

required since the first line of attack is to reduce the impact

poverty has on the behaviour of all our people. I thank you.

[Applause.]



Mr S SIMMONS: Deputy Speaker, hon Minister, the challenges of the

health care system are not limited to the national and regional

structures. This government has, since day one, embarked on

prioritising primary health care and rightfully so, I believe.



It therefore goes without saying that one departs with an analysis

of the primary health care system. It is clear that the primary

health care service has efficiency problems, putting immense

pressure on the national and regional health care systems. Sometimes

the solution lies in simple, yet effective, planning.
28 JANUARY 2009                                Page 38 of 51


I wonder if the hon Minister is aware of the fact that even before

the poorest of the poor can get to a clinic, they have to stand

outside these clinics most of the time, from as early as five

o’clock in the morning, and half of them are elderly or sickly

people - a situation that flies in the face of the ANC government’s

promise of a better life for all.



The NA wishes to share its concrete and practical approach to

problem solving. To the hon Minister: this situation can be

addressed by simply introducing a delivery system for those patients

receiving the same medication every month. This will alleviate

pressure on clinic staff and allow them to attend to patients that

need immediate and urgent medical attention.



I trust that the hon Minister will seriously consider this proposal

in the spirit of ensuring a better life for all. I thank you.

[Applause.]



Mrs S V KALYAN: Minister, your speech was very much like the vitamin

B12 cocktail, an inspiration and, I hope, an immune booster and an

injection of hope. A senior colleague of mine on the opposition

benches said this was the first time he could remember the

opposition applauding the Health Minister.



Aids treatment and prevention pose some of the greatest challenges

to our health care system. Currently, at least 16 000 new people go
28 JANUARY 2009                             Page 39 of 51


onto antiretroviral medication every month. Access to medication is

a human rights issue.



The MEC for health in the Free State, the hon Belot, is violating

this right as we speak because, despite a R9,5-million transfer from

Treasury, no new persons from the Free State are on antiretrovirals,

and baseline blood work for people living with HIV and Aids has been

suspended since November 2008. Other medicines are also in short

supply, no explanations are forthcoming and his silence and inaction

on the issue are only making the situation worse.



You alluded to taking legal opinion earlier and I hope that it

becomes available quickly, because, in my books, the MEC is

accountable.



Last year in South Africa, 64 000 children under the age of five

died, and one in seven deaths were Aids related. Currently, fewer

than 30 000 children are on treatment, and it has been proven that

effective mother-to-child-transmission interventions can

significantly reduce the infection rates, by 50% to 90%.



Minister Hogan, you have been referred to as a breath of fresh air,

but fresh air alone cannot save lives. Access to medication can. I

was stunned to hear at a recent seminar on HIV and Aids that five

years ago a month’s supply of ARVs cost R10 000, but that it now
28 JANUARY 2009                               Page 40 of 51


costs the state R250. So the question is not about affordability,

but more about accessibility.



HIV and Aids affect the economically active population, drain human

and financial resources, affect livelihoods and cause child-headed

households. The stigma and discrimination generated by this disease

were starkly highlighted by the desperate tragedy of the mother in

Lusikisiki who murdered her four children and then committed suicide

because she could not deal with the whisperings in the community

about her status. In view of this, it is the considered opinion of

the DA that a deputy ministry for HIV and Aids is vital so as to

deal holistically and yet specifically with the pandemic.



We in the DA also echo the Speaker of Parliament in calling on all

public representatives to encourage a culture of knowing your

status. We firmly believe that if you know your status, you can make

informed decisions on managing your health.



Minister, several months ago the DA wrote to the Department of

Health requesting a list of sites authorised to provide prophylactic

treatment for rape survivors. There has been no response to date. I

appeal to you today to publicise this information so that any person

who is raped will have access to antiretrovirals. As an MP I cannot

access this information, so can you imagine then the trauma a rape

victim goes through as they go from clinic to clinic looking for an

authorised site?
28 JANUARY 2009                             Page 41 of 51


In conclusion, I support the call by the Deputy Speaker for a cross-

party committee in Parliament specifically to address issues on HIV

and Aids and I echo the Minister’s acknowledgement of the many

dedicated health care professionals. I hope that you will go one

step further, Minister, and that you will inspire those health care

professionals who have left the country to return home. Thank you.

[Applause.]



Mr A F MADELLA: Madam Deputy Speaker, Deputy President, Ministers

and Deputy Ministers, hon members, officials of the national

Department of Health, distinguished guests, “dames” [ladies] and

“here” [gentlemen], firstly, let me take this opportunity to wish

everyone an excellent 2009, characterised by good health and

happiness.



The recent cholera outbreak that has hit our country is noted with

grave concern by the ANC. We wish to express our sincere condolences

to everyone who has lost a loved one, a mother, a father, a child, a

brother, a sister or a friend, to this dreadful disease.



A few days ago, Monday, 26 January 2009, to be exact the national

Department of Health indicated that a total of 6 202 cases of

cholera were reported across all nine provinces. The provinces with

the highest number of reported cases were Limpopo with 3 045;

Mpumalanga with 2 922; the Western Cape with 9, although I think the

figure is now 11; the North West with 7 - this is the province that
28 JANUARY 2009                             Page 42 of 51


the DA hopes to govern, but I have bad news for them, they will

still be in the opposition in a few months’ time ...

[Interjections.] They will continue to be in the opposition.

[Interjections.] In KwaZulu-Natal there were two cases, and the

Eastern Cape, the Northern Cape and the Free State had one case

each. A total, hon Waters, of 44 people died as a result of this

dreadful disease. Twenty-nine were from Mpumalanga whilst 11 were

from Limpopo; three were from Gauteng and one was from KwaZulu-

Natal. Statistically, we can say that KwaZulu-Natal is the worst off

province, with 50% of its cholera patients dying, but that would be

mischievous because they have had only two reported cases of

cholera.



What is cholera? How is it transmitted and who is at risk? Cholera

is a waterborne disease and is generally considered to be an acute

illness that results in profuse, watery diarrhoea caused by the

bacterium vibrio cholerae, an organism that lives in fresh water.



According to the distinguished professor Willem Sturm, head of the

Medical Microbiology and Infectious Diseases department at the

Nelson Mandela School of Medicine in Durban, there are more than 60

strains of cholera, but only two of them are deadly or cause

diarrhoea. The two strains are called serogroups 01 and 0139.

Serogroup 01, importantly, is prevalent in Africa – and this is

probably what we are confronted with at the moment. The other strain

is more prevalent in Asia.
28 JANUARY 2009                             Page 43 of 51


It is said that under normal circumstances your body, with specific

reference to the stomach, absorbs water and nutrients from the food

you eat and drink. However, when infected with cholera, the opposite

happens. The toxin released by the bacteria causes increased

secretion of water and chloride ions from the intestine, which

results in watery diarrhoea. Instead of absorbing water, you are

losing water. If the diarrhoea goes untreated, death can result from

severe dehydration and shock.



The national department presented clinical guidelines on cholera

infections. The following signs and symptoms characterise this

dreadful disease: its onset is very sudden; the diarrhoea is

profuse; the dehydration occurs very rapidly; and, of course, all

complications result from the effects of loss of fluids and

electrolytes in the stool; vomiting, muscle cramps, acidosis,

peripheral vasoconstriction and ultimately, renal and circulatory

failure may occur if treatment is not given timeously, which could

lead to death.



Cholera can be transmitted through the following means: drinking

water – and this is important - that has been contaminated, through

contaminated food, by soiled hands and, of course, through fish,

particularly shellfish taken from contaminated water and eaten raw

or insufficiently cooked.
28 JANUARY 2009                             Page 44 of 51


As said before, cholera is usually transmitted through contaminated

water and food and remains an ever-present risk in many countries.

It occurs especially in parts of the world where water supply,

sanitation, food safety and hygiene are inadequate. These kinds of

characteristics are more common in developing countries such as

ours. Our beloved South Africa has experienced outbreaks of cholera.



Without a doubt, the people most at risk of contracting this disease

are the poorest of the poor, those living in conditions in which

there is limited or no access to safe piped water and to adequate

and proper sanitation. Those who still have to access water for

their daily consumption from rivers and streams are most at risk of

falling prey to this disease.



The World Health Organisation argues that the treatment of this

disease is straightforward. It is basically, rehydration, and it

believes that, if applied appropriately, it could keep fatalities to

the absolute minimum and even prevent them. It further states that

in the long term improvements in safe water supply and adequate

sanitation are the best means of preventing cholera. In the case of

a cholera outbreak, the best control measures include the early

detection of cases and treatment of patients.



Improving the socioeconomic conditions of our people – and I’m happy

that many of the speakers have made reference to this - to prevent

communicable diseases is our number one priority. Indeed, the areas
28 JANUARY 2009                             Page 45 of 51


worst affected by the cholera outbreak, the Mpumalanga and Limpopo

provinces in particular, have communities that are still plagued by

conditions in which they have limited or no access to safe piped

water and are forced to fetch water from streams and rivers.



As the ANC, we acknowledge with pride the enormous progress our

government has made over the past 14-odd years in delivering safe

drinking tap water to millions of our people who, under the yoke of

apartheid, were denied this right. We also acknowledge the progress

made in eradicating the bucket system, prevalent in the main amongst

the poorest of the poor. Eighty-eight percent of our population

today have access to safe drinking water delivered through pipes to

their homes. Eighty-eight percent and more do not have to go to

rivers and streams to fetch water.



Sanitation has also improved tremendously over the same period. In

1994, when we came into government in this country, 609 675

households used the bucket system, whereas by June last year it was

a mere 14 812. Indeed, the complete eradication of the bucket system

is about to become a reality. These measures by our government

intend to improve the quality of life of our people and, indeed,

continue to create conditions for a better life for all.



Our ability as a country to contain the cholera outbreak tells us in

no uncertain terms that though we have done well, we must do more.

We are absolutely, resolutely committed to doing more. In the coming
28 JANUARY 2009                             Page 46 of 51


period we have set our sights on achieving the following objectives,

as outlined in our election manifesto: the continued democratisation

of our society based on equality, nonracialism and nonsexism;

national unity in diversity which is the source of our strength;

building on our achievements and experiences since 1994; an

equitable, sustainable, and inclusive growth path that provides for

decent work and sustainable livelihoods, education, health, safe and

secure communities and rural development; targeted programmes for

the youth, women, workers, rural masses, and people with

disabilities; and, of course, a better Africa and a better world.



As the ANC we acknowledge the many achievements in improving access

to health care and we would be the first to say that much more still

needs to be done in terms of quality of care and ensuring better

health outcomes. The hon Minister has referred to this.



We will continue to work towards reducing the inequalities in our

health system, to improving quality of care and to bettering public

health facilities. We will also continue, even after the elections,

when we are returned with an even larger majority, to boost our

human resources in the public sector, increasing our onslaught

against HIV/AIDS and other diseases. [Interjections.]



As the ANC, we can confidently say that through implementing

programmes to achieve these noble objectives, we will be able to
28 JANUARY 2009                             Page 47 of 51


avoid incidences such as the cholera outbreak we are currently

confronted with.



The short answer to the question, hon Deputy Speaker, as to whether

we are capable of dealing with this particular health challenge, the

cholera outbreak, is yes - a resounding yes. International

organisations, such as the Red Cross, have declared that we have

successfully contained this dreadful disease. This is a clear and

unambiguous vote of confidence in our government, our Ministry of

Health and everyone who assisted in fighting this disease.



This outbreak of cholera occurred in Zimbabwe, as the Minister has

indicated, in mid-October 2008, and within weeks areas bordering

Zimbabwe became prone to this infection. We want to stress that

cholera is spread by water and not by people. We cannot, and we

should not, fall prey to blaming people for this disease. We must

understand that it is spread by water.



We have noted with immense pride the speed at which our government

has acted to contain and prevent the disease from causing more harm.

In this regard, we wish to salute the Minister of Health, Comrade

Barbara Hogan, and her team of experts, officials from the national

Department of Health, the National Institute for Communicable

Diseases, the World Health Organisation, local and international

nongovernmental organisations such as the SA Red Cross Society, the

private sector, in particular the Hospital Association of SA,
28 JANUARY 2009                             Page 48 of 51


together with other officials from provinces, municipalities and all

other role-players, and especially members of the affected

communities who collectively worked round the clock to address this

disease.



The president of the ANC, the hon Comrade Jacob Zuma, accompanied by

the Minister of Health, Comrade Barbara Hogan, visited the Musina

area in Limpopo yesterday to apprise themselves of the good progress

being made, and to demonstrate ANC and government support and

commitment to all those who have been involved in the fight against

cholera and to the struggle for quality, accessible and free health

care for all.



As the ANC we strongly believe that rallying behind government’s

efforts to deal with this outbreak is the right thing to do.

Stopping this outbreak and eradicating all symptoms of cholera must

become a collective effort. Thank you very much. [Time expired.]

[Applause.]



The SPEAKER: Order! Hon members, I wish to recognise the presence at

this important debate of the Deputy President of the Republic. Thank

you, Ma’am, for attending this debate. [Applause.]



Debate concluded.



The House adjourned at 15:21.
28 JANUARY 2009                                                    Page 49 of 51


                                            __________



                 ANNOUNCEMENTS, TABLINGS AND COMMITTEE REPORTS



ANNOUNCEMENTS



National Assembly and National Council of Provinces



The Speaker and the Chairperson



1.   Introduction of Bill


     (1)   The Minister for Provincial and Local Government



           (a)   Cross-boundary Municipalities Laws Repeal and Related Matters Amendment Bill

                 [B 3 – 2009] (National Assembly – proposed sec 75) [Explanatory summary of Bill

                 and prior notice of its introduction published in Government Gazette No 31798 of 23

                 January 2009.]



                 Introduction and referral to the Portfolio Committee on Provincial and Local

                 Government of the National Assembly, as well as referral to the Joint Tagging

                 Mechanism (JTM) for classification in terms of Joint Rule 160.



                 In terms of Joint Rule 154 written views on the classification of the Bill may be

                 submitted to the JTM within three parliamentary working days.
28 JANUARY 2009                                                 Page 50 of 51


2.   Bills passed by Houses – to be submitted to President for assent



     (1) Bill passed by National Assembly on 28 January 2009:



           (a) National Land Transport Bill [B 51D – 2008] (National Assembly – sec 76(1)).



           (b) Bible Society of South Africa Act Repeal Bill [B 70D – 2008] (National Assembly –

                 sec 75).



National Assembly



The Speaker



1.   Membership of Committees



     (1)   The following members have been elected to serve on the Mediation Committee in respect

           of the Second-Hand Goods Bill [B 2D – 2008]:



           ANC

           Daniels, Ms P

           Maserumele, Mr F T

           Moathshe, Mr M S

           Nhlengethwa, Ms D G

           Sotyu, Ms M

           Van Wyk, Ms A
28 JANUARY 2009                                                   Page 51 of 51




           DA

           Kohler-Barnard, Ms D

           King, Mr R J (Alt)

           IFP

           Bekker, Mr H J



TABLINGS



National Assembly



1. The Speaker



   (a)   Reply from the Minister of Water Affairs and Forestry to recommendations in the Report of

         the Portfolio Committee on Water Affairs and Forestry on Public Hearings on Forestry

         Transformation Charter, National Forest Action Plan and Industrial Policy, as adopted by the

         House on 10 June 2008.



         Referred to the Portfolio Committee on Water Affairs and Forestry.