KHULUMANI SUPPORT GROUP opposes the proposal to build a private hospital for the President, Members of Cabinet and other Elites. It was reported in the media on Friday February 25, 2011, that ‘according to the 2011 estimates of national expenditure released as part of the budget package, the refurbishment of Mahlamba Ndlopfu at the Bryntirion Estate will begin in April 2011 for a duration of 15 months and at a total cost of R191-million.’
The article continues, “the project includes upgrading infrastructure at the residence, such as bulk water, services and roads. Aside from this, a hospital will be built on the estate, which will cost an additional R62-million. An executive military health facility that will service the president, Cabinet and VIPs from outside countries is also being provided.”
The article explains that this refurbishment is the largest of any presidential residence, with previous renovations to the property totaling R50-million in the past 5 years alone.
The proposal for the refurbishment has apparently been supported by Minister of Public Works, Ms Gwen Mahlangu-Nkabinde, recently found by the Public Protector to have wrongfully backed the R500-million lease by Minister Bheki Cele of the Sanlam Building in Pretoria for use as SAPS Headquarters, despite having received two senior counsel opinions that it was unlawful.
The context is the extraordinary inappropriateness of this proposal given the access of the president, members of the cabinet and visiting VIPs to first-class medical facilities at many sites across Gauteng, including their own military hospital at Thaba Tshwane, the various academic medical training institutions in the province and a wide choice of private health facilities, that have to date effectively served the needs of presidents, cabinet ministers and visiting dignitaries
For the millions of South Africans who continue to be denied access to adequate quality health care services and resources, the expenditure of public funds on a private hospital and an executive military health facility to service a relatively small group of South Africa’s political elites, is a shocking abuse of the country’s limited resources.
Speaking after last Wednesday’s budget presentation in Parliament on February 23, 2011, Director-General in the National Treasury, Mr Lesetja Kganyago, warned that “We have played all our economic aces. (We have) no more room to spend, tax or borrow without growth. Whatever demands you have, whatever priorities you have as government, have got to be dealt with within the resource envelope you have. No new priority (can) be funded without sacrificing another to free up funds.” He continued, “The injudicious hiring of administrative staff instead of the nurses, teachers and artisans the country actually needs, has caused several provincial departments to cut back on capital projects that could underpin future growth to pay for current expenditure. It is more pressing now than it was last year. I cannot see how the cabinet cannot engage on it.” (Sunday Times, Business Times, February 27, 2011, Page 4)
It is against this reality that Khulumani roundly rejects the allocation of close to R200-million to refurbish the President’s estate and its infrastructure. Against the reality that South Africa has shrinking resources and a small tax base of only 5,9 million tax payers, this proposed refurbishment can only be characterised as a grossly unnecessary indulgence on the part of the President and his Cabinet and the demonstration of a callous disregard for the health care needs of the majority of poor South Africans.
South Africa is still grappling with the legacy of an unequal distribution of health care. South Africa’s health outcomes are worse than those of lower income country, despite being a middle income country. Over 5.5 million people in South Africa live with HIV. 2.5 million have died of AIDS since 1995. Tuberculosis, especially multi-drug and extremely drug resistance varieties of TB, have reached epidemic proportions. Since 1994, life expectancy has fallen by 20 years; while child mortality is increasing. This expenditure perpetuates this unequal distribution of health care.
How does this proposal give substance to the commitments in the South African Constitution to build a society ‘based on democratic values, social justice and fundamental human rights’ in which efforts are made to ‘improve the quality of life of all citizens and (to) free the potential of each person.’
.What should be the agenda for ensuring equity in access to adequate accessible health care services going forward? What should be on the agenda of the ANC in its manifesto for local government elections? Where does access to quality health care and education feature?
There has been a lack of understanding in government of the importance of health promotion and disease prevention in contributing to national development. The health of people has declined as socioeconomic inequalities in the country have grown. In 2007, the ANC adopted resolutions that “education and health must be prioritised as the core elements of social transformation”. In 2008, a road map for health reform was adopted by the ANC – a plan that foregrounds AIDS, TB and the resuscitation of health systems. But, Heywood, points out that it is not clear whether there is actually sufficient will to finance the reorganisation of health care and whether it is appreciated that the arresting and reversing of the health crisis requires massive social investment to reverse growing inequality.
The struggle has become one for the right of everyone to have access to quality health care services and to the conditions that make for health.
Can we block the plan to begin refurbishing the President’s estate, beginning in April 2011, through bringing an urgent interdict preventing this expenditure given the critical need to expand access to adequate and quality health care services for the poor?