Speech by Gauteng MEC for Health And Wellness, Nomantu Nkomo-Ralehoko, on the occasion to present the 2024/25 Budget for the Department of Health And Wellness, Gauteng Provincial 
Legislature, 31st July 2024 

Madam Speaker and Deputy Speaker;
Honourable Premier;
The Chief Whip;
Members of the Executive Council;
Honourable Members of this House;
Comrades and Friends;
Residents of Gauteng;
Ladies and Gentlemen.

As we embark on the 7th administration, we look back on the trials we have endured, from the global pandemic, cholera outbreak, the Boksburg gas tanker explosion, Joburg fire and many other and the recent Mpox (previously known as Monkeypox). 

These challenges have tested our resolve, but they have also highlighted the commitment and sacrifice of our dedicated personnel. Their empathy, compassion, and professionalism have not only enhanced patient care but also restored public trust. Many voices can now attest to the real improvements within this department.

One of the most heartwarming examples of our work is the Mandela Day Surgical Marathon. Through this initiative, we were recently able to offer life-changing adenoton sillectomy surgeries to children like Regomoditswe Nazo. Regomoditswe, an eight year-old from Khutsong, frequently missed school and struggled with severe throat infections and breathing issues. The surgery has given him a new lease on life, allowing him to attend school and play with his friends without the constant burden of illness. His grandmother, Mmabone Mokwena, who joins us today, can truly attest to the profound difference this has made for their family.

Another deeply touching story is that of Ziyanda Sithole, a courageous burn survivor from Orange Farm. After heroically rescuing children from a blazing fire, Ziyanda endured severe burns himself. With the dedicated care of our burns unit and physiotherapists at Chris Hani Baragwanath Academic Hospital, he has made an incredible recovery. Ziyanda now shares his journey to raise awareness about fire safety, helping to prevent others from facing similar hardships. His presence here today as my guest is a indication to his resilience and the transformative impact of our healthcare team.

These stories of hope and recovery demonstrate the heart of our mission. They remind us that our work is not just about providing medical care but about changing lives. Our collective success reflects the dedication and teamwork of every member of our 
department. It is this spirit of unity and compassion that defines Team Gauteng Health, 
and it is this spirit that continues to drive us to make a meaningful difference in the 
lives we touch.

Madam Speaker and Honourable Members, the Gauteng Department of Health is presenting its 2024/25 Departmental Budget Vote, with an allocation of R64.8 billion for this fiscal year and R202.6 billion over the Medium-Term Expenditure Framework. 
This funding focuses on priority interventions under the Gauteng 2030 (GGT2030) health and wellness initiative, especially targeting townships, informal settlements, and hostels. Aligned with Sustainable Development Goal 3, which aims to ensure 
healthy lives and promote well-being for all ages, the budget emphasizes accelerating performance towards both local and global health goals by 2030.
 
Key to this effort is the commitment to Universal Health Coverage (UHC), ensuring access to quality healthcare without financial hardship. As the department, we acknowledge the past hospital-centric approach and commit to optimize the District Health System (DHS) by reconfiguring primary healthcare (PHC) service models. This shift is encapsulated in the theme "From Cradle to Grave - Promoting Health of Communities," focusing on improving health outcomes by investing in PHC.

Past Performance
Madam Speaker and Honourable Members, Gauteng Province, a home to 15 million (15,099,422) people, continues to provide good healthcare despite growing demands, disease burdens, fiscal challenges, and social determinants of health. Our health 
system has improved life expectancy for both women and men. Since the introduction of elevated priorities, we have successfully launched the AsibeHealthyGPProgramme, expanding health literacy and prevention through community partnerships.

Through this programme and extensive health and wellness campaigns, we established 164 physical activity programmes in 80 TISH (townships, informal settlements and hostels) areas across five districts, with over 116,358 participants by March 2024. To support the Integrated School Health Programme, we procured and deployed seven mobile units in priority townships. This also include dispatching of weekly mobile health clinics in six hostels providing PHC services to 61,061 residents, ensuring equitable healthcare access.

Infrastructure improvements include completed and handed over employee wellness centres at Thelle Mogoerane and Kopanong hospitals. These initiatives enhance staff wellness and health infrastructure, improving healthcare delivery. The Dablap Meds 
programme (formerly CCMDD) has significantly reduced queues and waiting times by transforming medication access for chronic patients. By the end of the 2023/24 financial year, close to one point four million 1,384,697 patients were registered on this 
programme.

This budget vote reaffirms our commitment to the 2030 development agenda. With six years remaining to achieve the NDP and SDG goals, the Department will focus on strategic drivers to enhance health systems performance. Key investments include 
digital health, neonatal health and mental health improvement initiatives, and interventions to improve the quality and safety of our facilities for both users and providers.

Following the Life Esidimeni tragedy the provincial government has made concerted efforts to ensure that the rights of mental healthcare users are promoted and safeguarded. Five district Mental Review Boards are functional and effective. 

In response to the growing need for mental health services, we have prioritised the refurbishments and repurposing of some of our healthcare institutions to improve mental healthcare infrastructure and services across the province. Facilities such as 
Bertha Gxowa, South Rand, Tshwane District, Tembisa, Edenvale, Dr George Mukhari and Chris Hani Baragwanath Academic Hospitals have mental health units that have already been refurbished and opened including the newly opened Kopanong Gateway Specialised Mental Health Day clinic, to ensure enough acute mental health beds in hospitals and to increase mental health resources, including specialized professionals and rehabilitation services.

Digital Health Advancements
Prioritizing innovation, equity, and efficiency, we aim to build a healthcare system that meets immediate needs and lays a sustainable foundation for future generations. We will capitalize on digital health opportunities to create a world-class, digitally enabled health system that provides equitable, high-quality, and efficient healthcare services to all Gauteng residents, setting new standards for eHealth technology innovation.

We plan to enhance real-time monitoring of health system performance through the Integrated Health Information System. We aim to reduce wait times and improve resource allocation through digital tools, queue management systems, and an integrated data layer, enhancing data sharing, mining, and analysis capabilities to optimize healthcare outcomes and advance health development goals. Ensuring robust data security and privacy to protect patient data is crucial.

Integrating social sector systems to monitor child and adolescent wellbeing is critical. The Department is working on harmonizing data sharing and surveillance of adolescent and child services. We believe in acting swiftly for children. As Gabriella Mistral beautifully highlights in her poem: "Many things we need can wait, But the child cannot. Right now is the time; His bones are being formed, His senses are being developed, His blood is being made. To him, we cannot answer, 'Tomorrow.' His name is 'Today.'"

This urgency propels us to ensure comprehensive preventive, curative, and rehabilitative interventions for children through various programs such as Integrated School Health Programme, Therapeutic Services, Expanded Programme of Immunisation, and adolescent wellbeing programs, including capacity development for healthcare providers. Tracking these service interactions electronically is crucial for timely interventions. The Department has set aside R284 million in 2024/25 and R893. 

million over the MTEF for the rollout of the comprehensive health information system to realize the 1 patient 1 file dream. This also includes digitizing A series records.

Our commitment to improving the experience of care continues, demonstrated by initiatives such as the queue management system. The process of procuring a comprehensive electronic queue management system has been initiated, with plans to pilot it at targeted a Community Health Centre and hospital. This is allocated R9.8 million in 2024/25 and R29.4 million over the MTEF. The safety of personnel and healthcare users matters to the Department hence we are investing in a facial recognition and biometric system for movement control

Emerging infections: Update on M-POX 
Madam Speaker, the Department has in the past three months been dealing with the Mpox. As of the 30th of July we had eleven (11) confirmed Mpox cases in Gauteng Province with one death reported during the June month. The cumulative number of 
Mpox cases by district are highest at Johannesburg district with four cases (4), Tshwane (3), Ekurhuleni (2) Sedibeng (1) and West Rand (1). We remain diligent in tracking the patterns of Mpox. With great lessons learnt in dealing with Covid-19 and Cholera we have reestablished the Incident Management Team (IMT) which meets weekly and have partnered with key population and HIV/AIDS, sexually transmitted infections (STI) and TB (HAST) stakeholders to carry out Mpox awareness and screening at facilities and in the community.

Health infrastructure 
In our pursuit of universal health coverage, as the Gauteng Department of Health, our efforts will focus on ensuring compliance with occupational health and safety standards and refurbishing facilities to enhance usability for both patients and healthcare providers. These initiatives are integral to supporting effective service delivery and improving health outcomes. Accessibility to quality health care facilities that are safe remain critical for the Department. Special attention will be placed on our Accident and Emergency Departments and Casualty. In addition, targeted expansion of neonatal facilities as part of the integrated interventions to improve neonatal health care outcomes is anticipated to yield fruits.

Priority will be on getting our facilities compliant with OHS Act and regulations, Implementation of Integrated management system as prescribed by national and international standards of ISO 45001 on Occupational Health and Safety, ISO 14001 on environmental management and ISO 9001 on quality management. Specific focus will be on OHS compliance in our Accident and Emergencies Departments. We will also put emphasis on sustainability water and electricity as part of our Sustainable Water and Energy Supply Initiative

Certification and enhancement of the quality-of-care initiatives 
Gauteng has the highest proportion of hospitals with 68% of its assessed facilities achieving ideal hospital status nationally. These ideal hospital assessments help facilities to prepare for OHSC inspections. Office of Health Care Standards (OHSC) conducts inspections across hospitals and PHCs. In the last assessments which took place in the last quarter of 2023/24 of the 14 hospitals inspected, all of them were compliant and were certified as compliant for NHI. 

Over the years, the department had not done well regarding non-negotiable areas of assessments largely due to shortage of consumables and essential equipment. There are now various health systems strengthening mechanisms in place through SCM 
process to ensure that they provide support to clinical services through consultation with clinical end users and contracting for consignment stock and consumables. The auditing of essential equipment at primary health care facilities is underway to ensure 
that our facilities have appropriate essential equipment in the right quantity which must also be maintained for effective quality care.

The department will continue to ensure that the health facilities are ready for National Health Insurance (NHI) certification for which R1.7 billion in 2024/25 and R5.3 billion over the MTEF is set aside.

Expansion of coverage of services 
Gauteng Emergency Medical Services have been improving service delivery within the province. We have seen the percentage growth of service accessibility through the increasing number of emergencies that have been responded to, by closing of the 
financial year 2023/24 we responded to more than 1,1 million emergencies and managed to treat and transport more than 940 000 emergencies clearly demonstrating that more people are gaining access.

We have since on boarded 1200 interns that are already qualified as junior paramedics, the aim is to assist them to gain experience and to fund themselves to become market ready by obtaining drivers licenses and other requirements. We have also noted the positive impact that the interns brought to improve service delivery and we are exploring ways to create opportunities to advertise permanent posts and recruit from the pool of EMS interns, they will strengthen Gauteng strategy to open more EMS stations within the townships closer to the communities. 

We will be advertising our first intake for paramedic program later this year as Lebone College of Emergency Care has been approved to offer Higher Certificate program through Council of Higher Education platform. In relation to wellness programmes, 
extensive life course health and wellness campaigns and physical activity programmes 

in prioritised townships, informal settlements and hostels will continue and it receives R38.1 million in 2024/25 and R119.7 million over the MTEF. This funding will ensure that these areas receive the much-needed services it require. 

Furthermore, R13 million in 2024/25 and R46 million over the MTEF is allocated towards the deployment of school health mobile clinics in priority townships. Provision of assistive devices and vision aids for the learners to improve their learning including 
preventive health screening must continue. Strengthening mental healthcare services remain a priority of which R474.6 million in 2024/25 and R1.4 billion over the MTEF is made available for key initiatives such as additional mental health acute beds, the 
appointment of district mental health teams and filling of mental healthcare posts. 

Human Resources Development
Hounarable Members, health care delivery is human resources intensive. The capacity development of our healthcare workforce, particularly professional nurses, remains critical. The Department is committed to offering a range of training programs aligned 
with healthcare needs. This includes providing bursaries for staff pursuing professional nursing qualifications at institutions like GCON. We also continue to prioritize equitable distribution of health care workers and ensure continuous professional development to ensure our healthcare professionals stay abreast of the latest medical advancements and best practices. By investing in our human resources, we ensure a sustainable healthcare workforce capable of delivering excellent healthcare services 
and improving health outcomes across our province.

Clinical Interventions 
Our commitment to improving access to quality healthcare services remains solid. We prioritize critical areas such as neonatal health, TB and HIV treatment cascades, mental health, and oncology services. Assisted by specialists In the area of neonatology, the department has commenced with its efforts to address gaps in this area of care which includes addressing long standing challenges of neonatal bed capacity, human resources and essential equipment’s for neonatal care. 

Surgical Backlogs and Oncology services 
Through initiatives like the Surgical Marathon Programme, which is part of our activities for Mandela Day, we were able to reduce surgical backlogs and improve health outcomes for patients awaiting interventions. These efforts are essential in ensuring that every patient receives timely and effective care that enhances their quality of life. The second instalment of the surgical marathon for GDoH proved to be yet another success story. 

The target set for surgical marathon was 700, but GDoH clinicians surpassed it by completing 742 procedures as at 17h30 on the 18th July 2024. These surgeries performed cut across general surgery disciplines inclusive of Oral Health procedures. 

The project of special marathon will continue throughout the month of July, in honour of our late Nelson Mandela. There were 30 hospitals that participated to make a difference in the lives of our patients and communities.

Our commitment to addressing the burden of diseases due to cancers remains solid. 

In this regard, the Department has set aside funds for the reduction of oncology (radiation) backlog in facilities receives R261 million in 2024/25 and R819 million over the MTEF.

In conclusion, I extend my heartfelt thanks to Premier Panyaza Lesufi and my cabinet colleagues. Their support has been important in our collective achievements and has significantly advanced our shared goals. Together, we have made great strides, and 
together, we will continue to make a meaningful difference in the lives of those we serve.

I also want to express my sincere appreciation to the Health and Wellness Portfolio Committee, led by Adv. Ezra Letsoalo, and the entire committee for their dedicated oversight and support

My deepest gratitude goes to Mr. Lesiba Malotana, Head of the Department, and the entire healthcare team. Their exceptional leadership, dedication, and expertise have been crucial in ensuring the smooth operation of our department.

I now present the 2024/25 Budget Vote of the Gauteng Department of Health and Wellness for consideration by this House.

Thank you