December 13, 2018


Thandi Modise


theweekly.coThe National Council of Provinces (NCOP) recently visited Xhariep District as part of a programme called “Taking Parliament to the People”. The biannual oversight programme which was launched in 2002, focused on healthcare challenges faced by people in that district.

The Weekly’s Martin Makoni spoke to the NCOP chairperson Thandi Modise who led the visit, on the importance of the programme and what they hoped to achieve from the exercise.

Makoni also asked Modise why the NCOP had a particular focus on health amid a host other issues faced by the district and whether there will be time to consider other concerns which may be raised by residents. Excerpts:

By going to the Xhariep District with a particular focus on health, doesn’t that limit your scope given that there is a myriad of other issues affecting that area? Wouldn’t it be more prudent going there with a broader focus on service delivery?
Indeed, we are focusing on health, but this programme of “Taking Parliament to the People” welcomes any other issues. When we conduct such visits, we actually expect to hear about housing, roads and other issues. We take time to listen to all issues raised by residents. We don’t ignore other issues.

Why was Xhariep District so important in your selection given that there have been numerous reports on the poor health standards particularly in Bloemfontein where services have been bad and nurses trained by government are struggling to be placed on completion of their courses?
Well, it will be very nice to stay in Bloemfontein. It’s more comfortable, it has more people and most of them are educated and therefore more eloquent in expressing their views.

Further, the story will be told to a wider audience because all the journalists will be here. But that is not the focus of parliament.

We are going where we know, one, primary health care is the only form of assistance that is accessible to people. Remember that when it comes to a country like South Africa which is not developed, your first phase of defence in terms of health is primary health. Is it functioning here? When the ANC took over in 1994, we promised people clinics per village, accessible clinics, open clinics and we set standards, now we want to see if those things are happening. So, we did not just choose Xhariep. We do our homework.

We have been in the province several times and in terms of the research we have made, we know there are important issues to be addressed. Our focus is to take services to the people who may never in their lifetime, probably see parliament coming and say ‘we are here talk to us about anything.

We are certainly not locking ourselves out of the discussions. And as for the nurses, the Free State is actually lucky because nurse training in other provinces was stopped a long time ago. So, if the province is churning out excess nurses, they could be placed in other provinces and ease the shortages there.

The Free State is largely an agricultural province and there have been growing concerns about farm attacks over the past few years. Lately, the attacks have not been limited to farm owners but farmworkers have also fallen victim. What’s being done about this matter?
We are aware of this issue you are raising about farm attacks. In fact, there is a particular area we are looking at right now. It’s that region stretching from Ventersdorp to Parys.

The farms in that belt have been experiencing problems and the farmers have been in touch with us. We are setting up a meeting between the minister of police, the minister of agriculture and that farming community between the North West and the Free State. We are aware of it.

Let’s talk about the possibility or practicality of addressing issues raised by the communities, what happens next, given that in most cases programmes are not implemented timeously and fully, due to lack of funds, among other issues?
In my experience, there is never enough money in government. If we had enough money at national level, the National Health Insurance would be operational by now and we would have reached every little corner of this country. We would have reached the standard which we want to achieve in terms of primary healthcare.

We would have had hospitals and clinics which run 24 hours and we would have a doctor in every village as well as nurses. The fact of the matter is we do not have enough money to do what we want to do. But what can we do on an incremental basis?
The other problem we have is, because the economy has not been doing well, treasury will allocate funds to the national and provincial health departments as and when they get the money. They have to consider the priorities presented to them by the health department.

We are also very clear that once you say one of your apex programmes is health and once you say you want to push South Africa into a developmental state, you also know that education and health become very important because these two are equalisers. If you don’t manage them properly, inequality just balloons.

So, I do not think any national or provincial government would deliberately not attend to these matters.

Having said that, what would you say is your critical goal on this mission to the Xhariep District?
We want to make sure that ultimately, whether we beg or scream… the end result that we want is for the private citizen’s life to be improved. That is the real reason we are here. Our job is to hold the executive to account.

But you cannot hold somebody to account if you don’t understand the challenges faced by that person. If we find out that health in the Free State is deteriorating because national treasury is not allocating enough resources, we will go to national treasury and explain that to them and ask them to address the matter.

In some instances, money may be allocated to programmes that not really be critical to certain communities. If we find that, we may want to ask for those resources to be reallocated towards more pressing issues.

You may also know that for years at national parliament, we have been dealing with the power of parliament to change budgets. We have said it’s not enough to just pass the budget. The legislature must be able to say no, look, we want to reprioritise the items in this budget and therefore, we don’t think money should go there, or there.

We still have that tension between parliament and the executive but we feel it needs to be addressed. Presently, we can only make recommendations as parliament.

You obviously received reports on the situation in different sectors in the Free State before deciding to focus on health; are there any particular cases that you may say made pay particular attention on health?
You would know about the reports on Pelonomi and other hospitals in the province. We have paid equal attention to those health institutions at national level as well. But when you do that, you want to look at the overall picture of the province.

The Free State has done extremely well in other areas. It has taken education from one level to the current top spot. The same has happened with policing and tourism. The province has done very well. But health has remained a challenge.

So what we then did was to say, Free State, you are doing very well and you can be excellent. Let us go and look at these challenges that you have in the health sector. So, for us it is a visit which must happen because we take our programmes on a rotation but it is also zoning in on an area where we feel much can still be improved.

Not everyone really knows about the NCOP, parliament is more popular these days particularly because of the vibrant debates and all the drama, how seriously should communities take you, what powers do you have to address the issues they raise?
Well, it make take us the whole night to try and explain. But briefly… for a very long time, the parliamentary system in South Africa had two houses or chambers. At one point in the dying days of apartheid, we had three chambers.

When we took over we went back to two chambers, the national assembly and the senate. But because of the way we had been unequal and underdeveloped, there was a feeling that your constituencies which had not ever had access to experience or even see government, needed to be represented differently from where the senate was. So, we ended up with this idea of the NCOP after travelling the world, learning from others. It’s unique.

As a country we agreed that ours must represent people in the provinces and these people must not be elected but must be seconded through the legitimate representative houses of the people in the provinces. That is why… I went through the house of the North West province.

To cut a long story short, we are the only house in the country which represents local government. Essentially, intergovernmental matters is our business. We hold misters accountable. The president is expected to address the house and take questions.

His deputy also takes questions as well as all ministers. Our business therefore, is largely to represent provinces and not political parties. That is why there is less political grandstanding.

And what would you say were some of the major issues raised by communities in the Xhariep District?
Generally, in terms of health, people raised concern over the issue of transport to health centres. There is also the issue of mobile clinics. There should be a mobile clinic attached to each and every hospital or clinic so that people do not walk long distances.

This is largely a farming community and some people walk up to 14km to get to a clinic from the farms. There is also concern about the maintenance of some of the health centres. Security is also a major concern at most centres.

The availability of ambulances is also a concern as the call centres are not always responsive and when the ambulance eventually comes, it’s usually very late. Procurement, even for basics, is done at provincial level. There is need to localise some of the procurement for smaller items like cleaning material. All health facilities have critical personnel shortages which need attention.

We want the department to prioritise that.

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