As Finance Minister Enoch Godongwana prepares to table his budget speech this afternoon, Health-e News reached out to civil organisations and political parties for their input on what should be prioritised.

They highlighted a range of pressing issues, including the power crisis, social grants, a crumbling public health sector, inadequate school infrastructure, the rising cost of living, high rates of crime and corruption, and persistent unemployment.

All agreed there is an increased sense of urgency to address these issues, which affect millions of South Africans daily. With hours to go ahead of the budget speech, all eyes are on Godongwana to see how he will address these critical concerns.

Rural Health Advocacy Project(RHAP)

RHAP Director, Russel Rensburg, told Health-e News accountability and reliable data are essential to improve the public health sector. He says to minimise the impact on those most at risk, the best available data must support decisions on resource allocation. “If we do not have access to good data, how are we making our decisions now? It means that our decisions are not well informed,” says Rensburg.

He also says hospitals account for 60% of health expenditure, so they must be more efficient. “We need better production data, particularly in outpatient departments where patients often arrive without a referral. Understanding why patients bypass clinics and implementing strategies to address these can improve the efficacy of hospitals,” says Rensburg.

Employee salaries currently account for over 60% of provincial health budgets, but we may not always be getting the best value for our money, often due to poor hospital administration. 

“Policies such as remunerative work outside the public sector (RWOPS) that allow doctors and dentists to deliver services in private facilities while in the state’s employ are poorly managed and often abused,” he says.

Another challenge, Rensburg says, is the demographic transition within the public workforce, with nearly half of nurses approaching retirement. Despite the country’s investment in the training of healthcare workers, budget constraints in the last ten years have resulted in less than 10% of post-community service healthcare workers being absorbed into the service. The trend is worsening, with many provinces opting to release bursary holders from their obligations. 

The Budget Justice Coalition(BJC)

BJC Deputy Chairperson Phemelo Khaas hopes the minister will not use the social budget to fund the current crises caused by bad spending habits. “Despite the assurance of access to socio-economic rights, BJC is disturbed about the trend we have witnessed over the years to reduce social spending,” says Khaas.

The current energy crisis is another concern. “Aa reduction in spending to address the R400 billion Eskom debt must not be implemented to the detriment of other constitutional rights. Namely, the right to education, healthcare, and basic services,” says Khaas.

Democratic Alliance

DA member of parliament Dr Dion George says South Africans are getting poorer due to the cost-of-living crisis. Households are battling to put enough food on their tables. As unemployment continues to rise, businesses bear the brunt of increasing electricity blackouts, and rapidly increasing debt is crowding out basic service delivery.

Factors under government purview compound these circumstances. This includes uncertain private property rights, onerous labour market legislation, inadequate national and local governance, and a large and inefficient public sector dominated by monopolistic state-owned enterprises.

“Uncertain energy supply coupled with an unstable political environment has drastically impacted the development of South Africa and severely limited the growth potential of our economy. There has been much talk regarding solutions for South Africa’s electricity crisis. But after 15 years of a scarce energy supply, not enough has been done,” says George.

Equal Education

Equal Education researcher Jane Borman says an education blackout is dimming the future of the country’s learners. “While many will be looking at how the National Treasury will tackle the electricity problem, another crisis-one that is undermining the future of our children will likely remain overshadowed,” says Borman.

She says everyday learners nationwide face serious difficulties and indignities at school. This makes it almost impossible to enjoy their constitutional right to basic education. “We are increasingly seeing overcrowded schools, insufficient teachers and learning resources, and deteriorating infrastructure. We call this crisis the #Education Blackout, a direct threat to the futures of learners. This must change,” says Borman.

Borman adds most recent figures show most of the country’s 23 276 public schools are still without libraries (17 832), lack reliable electricity (3 343) and water (5 836) supplies, or rely on dangerous pit toilets (2 130) as their form of sanitation.

Amandla.Mobi

In a public statement released on Monday, Amandla.Mobi says the increasing cost of living pushes more households into deeper poverty. “For years, people have called for proper social grant increases so people can live with dignity, but we have seen social grant increases as low as R10. Social grants must increase to help people because of rising inflation.”

The organisation says social grant increases have not kept up with the real cost of living. “Social grants have not been enough, to begin with. If we act quickly, we can ensure a proper grant increase. And this new would provide urgent relief to help households put food on the table”.

Black Sash

Rachel Bukasa, Black Sash Executive Director, told Health-e News that all social grants must be increased to align with the country’s inflation rate.

“The child support grant must increase to the food poverty line of R663.00. In his SONA 2023 speech, President Cyril Ramaphosa alluded to increased social grants in the upcoming budget speech. We await in anticipation to hear what the minister will say. These grants are not enough, but it’s better than nothing,” explains Bukasa.

Sash says the grants are below the poverty line. “The child support grant of R480 is 28% below the food poverty line. And 44% below the average cost to feed a child a basic nutritious diet of R853.04”.

Sash adds society needs to challenge the idea of ‘fiscal constraints’. “These constraints must be considered from a human rights perspective. We must prioritise people’s basic social needs over fiscal constraints,” Bukasa says.

Congress of the people(COPE)

COPE National spokesperson Dennis Bloem says the minister must address corruption that has destroyed the economy. The party also expects concrete solutions for the energy crisis, load shedding and crime.

“We are afraid that the minister will once present a lot of empty promises. South Africa is in an economic and political crisis,” says Bloem.- Health-e News.

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