The People’s Movement South Africa, Section27 and Treatment Action Campaign, hosted the National Health Assembly, which was attended by 156 delegates from 31 organisations.
The reports and documents of the Assemble are below.
The People’s Health Manifesto
In 2016, the South African Constitution celebrates 20 years since it was signed into law by former President Nelson Mandela on 10 December 1996 in Sharpeville. The Constitution aims to redress the injustices of the past and to create a society founded on equality, human dignity, social justice and fundamental human rights. The Constitution most importantly entrenches the rights of everyone to have access to health care services and to reproductive health care, the right to not be refused emergency medical services and rights to a range of social determinants of health. The vision for our society that is enshrined in our Constitution is clear: it is of a society whose health system is undergirded by equality and human dignity. Despite our massive burden of disease and inequalities in health outcomes, not one of our political parties addressed health adequately in their manifestos during the campaigning for the recent local government election. We therefore, challenge all political parties to adopt the People’s Health Manifesto.
1. Children First! Healthy Living Conditions and Excellent Accessible Health Care for ALL Children Now!
Sixty percent of all children and 67% of Black children in South Africa live below the poverty line. Diseases of poverty and undernutrition are the key causes of deaths in young children. Section 28 of the Constitution gives children unqualified rights to basic nutrition, shelter, basic health care services and social services. Thus, no child should go hungry and ALL children, no matter where they live, should be able to access excellent quality health services near their home. We demand that all children be treated at fully staffed, fully equipped facilities that are accessible within a 20 minute walk from their home, and that are free from stock-outs of essential medicines and essential supplies.
2. Equal Excellent Quality Health Care for ALL at an affordable price!
Thanks to public sector austerity measures and privatisation imposed by neoliberalism through GEAR, public health care services are often poor quality, ineffective and provided in dirty, unsafe, unpleasant facilities in an undignified manner, after a long waiting time; private health care services are usually provided in clean, safe, pleasant facilities in a dignified manner, with a very short waiting time, although its effectiveness and quality are questionable and the cost is exorbitant. Why should we tolerate this difference in health care when health is everyone’s right and why can’t we all have excellent health care at an affordable cost? We demand Equal Excellent Affordable Health Care for All!
3. Health Care near our Homes
No community should be without an excellent health facility and yet in some peri-urban communities and many rural communities, there are insufficient health facilities. Adequate public health facilities including clinics, health centres and hospitals should be provided to everyone in the areas which they live in, so that everyone can easily access health care.
4. Dignified and Respectful Health Care for ALL!
Many public health care services are provided by staff who are disrespectful, abrupt, rude, and uncommunicative.. Why should we tolerate differences in how health care is delivered? Being treated with dignity and respect is everyone’s right. We demand Dignified Respectful Health Care for All, through a people’s National Health Insurance. .
5. 30-15 Max! Rapid Emergency Health Care when we need it!
In emergencies rapid effective care is essential. We demand that sufficient ambulances and emergency care units are provided to allow everyone access to effective emergency care. Ambulances should reach people within a maximum of 30 minutes from the time of calling for an ambulance. Emergency units should treat patients within a maximum of 15 minutes from the time of arriving at the emergency unit.
6. Councilors and Parliamentarians MUST Walk the Talk!
All councilors and parliamentarians should sign a pledge that they and their immediate family members will use only public health services, as they are politically responsible for providing excellent quality and sufficient public health services. Using public health services themselves will give them direct and immediate insight into the problems of the public health system and will motivate them to fix the problems. Let no councilor or parliamentarian say I did not know!
7. Public Health Staff should use Public Health Facilities
Why are the people who provide public health facilities not using them? This is like people at a restaurant refusing to eat the food which they have cooked! Is this an acceptance by public health staff that the services they provide are inferior? Would they provide better services if they and their families had to use those services? All health staff that work in the public health system should follow the example of the health minister and use public health facilities!
8. Stop Stock-outs!
Essential medicines when we need them! Essential medicines and supplies must always be available at all health facilities to ensure that people are properly treated at the time that they need treatment.
9. Stop Subsidizing the Private Health Sector!
At present the government pays medical aid subsidies to government employees who use the private health sector. The treasury also allows people on medical aid to claim a tax refund (rebate) on their medical aid contributions. The nett effect of this is that government money is being paid to the private health sector, instead of being invested in the public health sector which is extremely short of money. This must stop. The government must stop the tax rebates and stop paying medical aid subsidies to government employees who use the private health sector.
10. Health Professionals – heal your Community!
There are far more health professionals per person in the private sector than in the public health sector. However health professionals are trained at considerable public expense and hence they should at least work within the public health sector (where they are desperately needed) for the same length of time for which they received training. If they don’t, then they should be obliged to pay back the money which the government spent on their education for each year that they don’t work in the public health sector.
11. One clinic – One Committee – One Policy
Health care users must have a voice in the health system. Strong health committees, with one national policy giving them governance powers, put people in the driving seat of health facilities, to make decisions that improve access and the use of resources. Every health facility should have a community health committee which is accountable to communities and which exercises oversight in relation to quality and scope of services delivered through the facility. Local councilors should be actively involved in all health committees in their ward.
12. Community Health Workers valued for doing more things Everywhere!
Properly trained and equipped Community Health Workers (CHWs) can provide health promotion, disease prevention, home based care, health monitoring, basic treatment and emergency care referral services. Governmental employment of sufficient CHWs for each CHW to serve 250 households, will allow everyone access to this important level of care. To build trust, allow easy access and ensure travel safety, every CHW must live in the community area which they serve. They must be valued for the important work they do through support, appropriate training, remuneration and recognition.
13. All Eyes on the Health System
Monitoring and reporting on health rights violations and health systems failures must be established in all wards, with rapid resolution of the problems that gave rise to the health rights violations and health systems failures. Health Committees must be involved in ensuring that complaints are resolved in ways that strengthen the service and benefit communities. The Office of Health Standards Compliance must be properly staffed and resourced to fulfil its mandate of monitoring health care establishments for compliance with the Norms and Standards Regulations .
14. Health Beyond the Health Care System
Unemployment, our environment, housing, diets, access to water and other social determinants of health, continue to make us sick. We demand improvements to the social determinants of health so that everyone can live and work in a healthy environment.
Unequal Poor Quality Health Care cannot continue if WE Stand Up
Has your party adopted the People’s Health Manifesto?
The People’s Health Manifesto is endorsed by the participants of the National Health Assembly, held on 24 – 26 June 2016, including: People’s Health Movement South Africa, Treatment Action Campaign, SECTION27, TB/HIV Care, Rural Health Advocacy Project, Rural Doctors Association of South Africa, PSJ Creative Young Women, Makhaza, Stop Stock Outs Project, Hospersa, Juphasa, Women on Farms Project, Wellness Foundation, TWC, GroundUp, Age in Action, Eastern Cape Health Crisis Action Coalition, Nelson Mandela Bay Metro District Health Forum, Small Project Foundation, SA Community Workers Forum, UBH, KwaZulu-Natal Progressive Primary Health Care, South Durban Community Environmental Alliance, Blue Roof Centre, Health Enabled, Mamelani Projects, Sithandizinsane Care Projects, National Association for People Living with HIV/AIDS in South Africa