Truth and Prejudice

In its July 25, 2004 edition, the "Sunday Times" told its readers that it had made the startling discovery that "provinces (and) municipalities (have been) told to pay for (the expanded) public-works programme out of (their) own pockets." It reported that this is what the President said at the last meeting of the Presidential Coordinating Council (PCC) held earlier in July.

Accordingly, its report appeared under the dramatic headline - "Mbeki passes the buck on job creation." The "Sunday Times" thought that this matter so important that it decided to publish an Editorial on the issue, under the supposedly clever and sarcastic title - "Shrinking meaning of 'expanded' ".

So certain was the newspaper of the correctness of its discovery that in its Editorial it said: "Unless Mbeki is able to show he is allocating new resources to job creation, the unemployed will have to live with the fact that they were the useful idiots of the April election. For the moment, 'expanded' means 'more of the same'."

In the same Editorial, the newspaper correctly reported that, "The ruling party specifically stated the following objective in its election manifesto: 'Create one million job opportunities through the Expanded Public Works Programme.' The Editorial went on to say, "This played no small part in reassuring the poor that they remained on the ruling party's agenda."

But, clearly, the "Sunday Times" has come to the conclusion that the Expanded Public Works Programme died even before it was born. It is convinced that the Programme lived only in the deceitful election rhetoric of the ANC. As a vigilant "watchdog", it has taken on the responsibility to convince its readers that the Programme is nothing more than a very cruel ANC election hoax, aimed at deceiving the poor.

The newspaper is entirely correct in its assessment that the poor of our country have been reassured - by more than the Expanded Public Works Programme (EPWP) - that they remain central to the agenda of the ANC. It is entirely wrong in its discovery that no additional funds have been set aside for the EPWP, and therefore that the poor were "the useful idiots of the April election."

It is quite easy to demonstrate this, which we will do. Merely setting the record straight would not merit an entire "Letter from the President". But there are three important issues illustrated by the "Sunday Times" article and Editorial on which we wish to comment. These are:

• the newspaper's seemingly complete ignorance of published government documents, including the 2004/5 Budget and Medium Term Expenditure Framework (MTEF), already approved by Parliament;
• the newspaper's seemingly complete ignorance of how our 10-year-old system of government works, especially with regard to the three spheres of government; and,
• the conviction that the ANC is capable of massive dishonesty and fraud, such that it could put a critical transformation programme to the people, to get votes, knowing that no funds were available to finance this programme.

In his February Budget Speech, Finance Minister Trevor Manuel said: "Over the medium term, provinces and municipalities will prioritise labour-based infrastructure projects as part of Government's Expanded Public Works Programme. Over the next five years, R15 billion will be channelled to this intervention in part through the provincial infrastructure and municipal infrastructure grants. Together, these grants receive additional allocations of R3,2 billion over the MTEF, which will be partially earmarked for labour-based public works. Work opportunities will also be created in environmental programmes and in social development initiatives."

The 2004 National Budget Review says: "Strong growth in non-social services expenditure of 8 per cent over the next three years, will provide a significant boost to Government's efforts to address unemployment through the labour-based Expanded Public Works Programme and create economic opportunities across provinces.Payments for capital assets are budgeted to grow from R10,5 billion in 2003/4 to R11,6 billion in 2004/5 and to R13,8 billion by 2006/7."

The Budget Review also says: "National transfers to municipalities supplement own revenue to enable them to fulfil their developmental roles. The key local government priorities are the expansion and provision of free basic services (etc).(and) the creation of jobs through the Expanded Public Works Programme.Over the next three years, municipalities will receive an additional R3,9 billion."

Commenting on the EPWP, the Review said:

"The programme aims to provide employment opportunities and training to at least one million targeted unemployed people in its first five years. Work opportunities will be created in the following ways:

• Increasing the labour intensity of government-funded infrastructure projects under the leadership of the Department of Public Works;
• Creating work opportunities in public environmental programmes (e.g. Working for Water) under the leadership of the Department of Environmental Affairs and Tourism;
• Creating work opportunities in public social programmes (e.g. community-based care in health and social welfare and early childhood development) under the leadership of the Department of Social Development;
• Developing small businesses and cooperatives, including utilising general government expenditure on goods and services to provide the work experience component of small enterprise learnership/incubation programmes under the leadership of the Department of Trade and Industry."

It continued:

"Funds for EPWP programmes will be allocated to national departments, provinces and municipalities through the normal budgeting process.

"SECTOR ALLOCATIONS 2004/5 - 2008/9

"Infrastructure R15 billion.
"Environmental and cultural R 4 billion.
"Social, at least R 600 million.
"Economic, still to be determined."

All this information about additional resources, and not "more of the same", is contained in published documents. And as we have said, in addition, Parliament has already approved the 2004/5 Budget. Similarly, the Provincial Budgets have also been approved by the Provincial legislatures.

Contrary to and despite all this, the "Sunday Times" article made the bold statement that, "President Thabo Mbeki has told a meeting of premiers and mayors that there was no new money to co-finance the government's ambitious R15-billion Expanded Public Works Programme (EPWP)."

It is difficult to understand why the "Sunday Times" did not undertake the simple exercise of determining whether the National Budget provided the additional resources we had promised, and whether these had been transferred to the Provinces and Municipalities.

Instead, it invented the fiction that, on behalf of the national government, we had "told the provincial governments to re-order their existing budgets to come up with R15-billion for its 'expanded' public works programme." From this entirely false premise, it concluded that, "For the moment, 'expanded' means 'more of the same'."

It also chose to believe an unnamed "official who (allegedly) attended the PCC meeting, (who) said while they knew there would be no new money to finance EPWP, provinces, local governments and voters expected additional resources for the 'extended' part of the programme. He said municipalities and provinces were now being asked to fulfil the ANC's election promises." In fairness, we must presume that this ill-informed "official" actually exists, and actually spoke to the "Sunday Times".

The 2004 Budget Review also says:

"Since 2001/02, there has been a steady decline in the revenue share going to national government, with a concomitant increase in the shares of provincial and local government; this trend continues over the 2004 MTEF. By 2006/07, transfers to provinces will constitute 58,0 per cent and local government 4,6 per cent of allocated non-interest expenditure."

In his Budget Speech, Minister Manuel elaborated further on this, saying: "Provinces and local government are the primary delivery channels for basic services and will receive R30,2 billion of the total R44,5 billion allocated over and above the 2003 budget forward estimates (for basic services)."

Specifically with reference to the EPWP, Public Works Minister, Stella Sigcau explained in June, during her Departmental Budget Vote, and before the July meeting of the PCC, that, "The EPWP is mainstreamed on the budgets of departments, provinces, municipalities and State Owned Enterprises. The large-scale labour-intensive provincial and municipal infrastructure programme involves ring-fencing fifteen billion Rands (R15 billion) of the conditional infrastructure (transfers) to provinces and municipalities."

The simple fact of the matter is that "provinces and local government are the primary delivery channels for basic services". For this reason, "there has been a steady decline in the revenue share going to national government." For these reasons, the funds for the EPWP have not been put on the budget of the Department of Public Works, but on the budgets of "the primary delivery channels for basic services", the provincial and municipal governments.

Strangely, the "Sunday Times" concludes that when the provincial and municipal governments are reminded of this reality, this constitutes telling these governments "to re-order their existing budgets", since, according to the article in the newspaper, "national government would not fork out additional money."

Further to this, the Budget Review says: "The 9 provinces and 284 municipalities. are empowered to take resource allocation decisions within the context of broad medium-term priorities of government that are agreed through consultative processes in intergovernmental forums such as the Budget Council, Budget Forum, sectoral MinMECs, joint MinMECs and extended Cabinet meetings, in which provinces are represented by Premiers and local government by the chairperson of the South African Local Government Association."

If the "Sunday Times" had taken the little and undemanding trouble it needs to understand how government works, it would have found out that:

• the additional allocations for the EPWP are contained in the 2004/5 Budget;
• provision has been made for their transfer to the provinces and municipalities, as reflected in the Schedules attached to the Division of Revenue Act, 2004;
• with improvements in our system of governance, we have relied more and more on these spheres of government to act as the primary delivery channels for basic services; and that,
• because of the consultative intergovernmental process that precedes the elaboration and presentation of the national Budget, the provincial and local government participants at the PCC knew that the additional allocations for the EPWP were, in terms of the Division of Revenue, mainly incorporated in their budgets.

As the ANC and other parties conducted their 2004 election campaigns, they were aware of the allocations for the EPWP contained in the 2004/5 Budget, as well as the MTEF projections. This is for the simple reason that the Budget and the related documents were presented to Parliament on February 18th, almost two months before the April 14th election date.

Accordingly, what the ANC promised the poor of our country was based on available funds, provided for in the Budget whose details the "Sunday Times" reported when Minister Manuel presented this Budget.

The budgeted availability of these funds meant and means that the ANC had and has no intention whatsoever that "(provincial and municipal) money will be taken from Peter to pay Paul", and that "provincial governments (should) shuffle the budgetary deck chairs.(quashing the) hope that new money will be allocated to the (EPWP)," as the "Sunday Times" Editorial alleges.

The very fact that throughout the election campaign, and since, the opposition parties did not alight upon, and make a big song and dance about the startling discoveries it has made, should have warned the "Sunday Times" that there was something odd and fishy about its discoveries.

The strange and false discoveries of the "Sunday Times" with regard to the EPWP raise a number of serious concerns.

One of these relates to the quality of journalism in our country. The sorry tale told by the "Sunday Times" handling of the EPWP issue points to the reality of a serious national problem. Questions must necessarily arise about the extent to which we, and the general public, can rely on the media as a source of objective information, on which we should base our actions.

Another relates to the extent to which "political correspondents" actually understand the most basic elements of South African and other political reality and practice. This must be considered together with the peculiar notion that seems to be prevalent in some circles, that media independence must necessarily translate into a consistent effort to find fault with, and criticise the government and the ruling party, at all costs.

The third of these concerns arises directly from the obvious certainty on the part of the "Sunday Times" that the ANC ran a fraudulent election campaign, based on the brazen propagation of a big lie. This indicates that there are some within a media that proudly proclaims that it is committed to "objective, truthful, unbiased and balanced" reporting, whose fundamental assumptions about the ANC are far removed from what would qualify to be described as objective, truthful, unbiased and balanced.

The "Sunday Times" Editorial says, correctly, "After achieving a substantial majority, Mbeki said: 'The ANC has a duty.to do all of the things it has said it will do."

Indeed, the ANC will do all the things it has said it will do. This includes the provision of the resources required for the successful implementation of the EPWP. We can only hope and pray that the "Sunday Times" will report progress and problems in this regard, and with regard to other programmes, in an objective, truthful, unbiased and balanced manner, and make editorial comments based on such objective, truthful, unbiased and balanced reporting.

In October 2003, "Le Monde Diplomatique" published an article by Ignacio Ramonet entitled "Set the media free", in which he discussed the media globally.

He wrote: "As people are now beginning to realise, news is contaminated. It poisons our minds, pollutes our brains, manipulates us, intoxicates us, and tries to instil into our subconscious ideas that are not our own. This is why we now need to establish an ecology of news, to sort real news from a flood of lies. The enormity of the situation was apparent in the invasion of Iraq. We need to decontaminate our news."

Hopefully the situation will not arise in future when, as seems to happen so regularly with regard to negative social phenomena, somebody will claim a place for us as the global leader among the purveyors of contaminated news.

Health

An accessible, caring and high quality health system

As we celebrate our achievements of the first decade, we are dedicating ourselves within the health sector to ensuring that the fruits of the second decade exceed those of the first.

There are priorities from the first two terms of government that remain top of the agenda even now. These are programmes related to the goal of ensuring that all South Africans enjoy the fruits of our freedom and democracy.

We have achieved much in the past 10 years. Our major gains have been in relation to vaccine-preventable illnesses, better management of malaria, improved reproductive health services, a more focused approach to disability, reducing tobacco use and the gradual achievement of a truly comprehensive response to HIV and AIDS.

During the past 10 years this government has built more than 1300 new clinics in under-served areas of our country, and we now have functioning health districts right across the country. We undertook 966 hospital rehabilitation projects and built 18 entirely new hospitals.

We introduced a Patients' Rights Charter and saw provinces gradually initiate complaint systems, help desks and incentives for good service. The reform of the medical aid legislation has resulted in a stabilisation of the financial situation of the medical aid schemes to the extent that there have been no bankruptcies in the past two years.

We are working on a Health Charter that will provide a framework for the interaction of the public and private health sectors and which will also lay out the core values that the private health sector should seek to uphold, including the ownership of private health services, Black economic empowerment and how the public and private sectors should cooperate and complement each other.

Our country has also played a leading role in shaping the agenda of the SADC, Africa and more importantly, the World Health Organisation. We have put the interests of South Africa, Africa and the developing world firmly to the fore, for example in advocating action to make medicines more affordable, to manage the brain drain of health workers from developing to developed countries and to promote a comprehensive approach to disease management.

At the home front, we have agreed one vision - an accessible, caring and high quality health system. The new mission - which is how we hope to achieve this vision is:

• to improve health status through prevention of disease and promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.
• To work toward our vision, we set priorities for the next five years and the top ten of these are:
• Improving the governance and management of the National Health System;
• Promoting healthy lifestyles;
• Contributing towards human dignity by improving quality of care;
• Improving management of communicable diseases and non-communicable illnesses;
• Strengthening primary health care, emergency medical services and hospital service delivery systems;
• Strengthening support services;
• Human resource planning, development and management;
• Planning, budgeting and monitoring and evaluation;
• Drafting and implementing health legislation; and
• Strengthening international relations.

This list is not exhaustive but it represents those things that we must pay particular attention to amongst all the other things that we do everyday.

We have combined the management of communicable diseases and non-communicable illnesses. Together with promoting healthy lifestyles, this priority constitutes the core business of the national health system.

We recognise the need to develop our mental health services and interventions to reduce non-natural causes of death. We are seeing an increase in non-natural causes of deaths. These are deaths from traffic accidents, homicides and suicides.

We need to better understand the psycho-social underpinnings of these issues and shape our interventions accordingly. The national school health policy, introduced last year, will assist in the early detection of learners who may be considered high risk in terms of suicide.

Non-communicable diseases, such as diabetes, hypertension, cancer and osteoporosis, are increasingly being recognised as global health problems. Many developing countries face a growing burden of chronic, non-communicable disease - and South Africa is one of them.

Our priority over the next five years, therefore, is to develop meaningful strategies for preventing these diseases that are difficult to live with and costly to manage. The strategies for prevention are the same for many non-communicable diseases - they centre on good diet, responsible alcohol consumption, regular exercise and avoiding tobacco use. Government is going provide a policy framework that will contribute to responsible alcohol consumption.

In the absence of a cure, our response to HIV and AIDS emphasizes the centrality of prevention. We are intensifying our programme to encourage especially young people to abstain from sex and those who are sexually active to be faithful to one partner. We are proactively marketing the free high quality male condoms and their distribution has increased by 80% over the past six years. We are also implementing the programme to reduce the risk of mother to child transmission of HIV - the guidelines for this programme will soon be reviewed in line with the recommendations of the Medicine Control Council.

Our Comprehensive Plan for Management, Care and Treatment of HIV and AIDS also emphasizes the strengthening of the national health system for it to sustain a series of interventions aimed at mitigating the impact of AIDS. We have a target of establishing a service point in each of our 53 districts within this financial year ending in March 2005 and a service point in every local municipality within five years. We believe that this approach will enable all South Africans to have access to a comprehensive package of quality services irrespective of their geographical location within our vast country with a history of inequitable distribution of resources.

These services include a series of interventions aimed at prolonging the progression from HIV infection to development of AIDS-defining conditions and ensuring optimal health for people living with HIV and AIDS including nutritional support, traditional medicine, treatment of opportunistic infections and antiretroviral therapy.

We are increasing our effort to combat TB which remain the major challenge in the country. Our interventions are focused on better case management and providing support for those on TB treatment because TB is curable even in the presence of HIV.

Central to all these interventions is our health workers. Health is a labour intensive sector and we spend 60% of our budget on personnel. We are therefore determined to recruit and retain adequate numbers of health workers to provide quality services. We are intensifying our effort to improve their working conditions and ensure a fulfilling career growth within the health system.

There is so much to do. Dealing with all these health and social problems requires social mobilisation and involvement of all sectors of society. We must therefore commit ourselves as South Africans to working together to ensure a better life for all.

Let us bring dignity to our people through quality health care.

*Manto Tshabalala-Msimang is the Minister of Health and a member of the National Executive Committee

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