Benoni, 2 November 1999
Honourable Deputy President, distinguished guests, ladies and gentlemen,
For many decades the majority South Africa have either denied their fundamental human rights or they have fallen victim to gross violations of that which we all have come to expect to morally or socially correct and fair in our own daily lives. Many of us did experience disadvantages, a loss of dignity, repression, and often, terrible suffering. This state of affairs required a total turnaround in order to improve quality of life for all of us and to free the potential in each one of us. So, when we adopted our new Constitution in 1996, we by implication actually declared that we as a nation we undertake to heal the divisions of the past and establish a society based on democratic values, social justice and fundamental human rights.
Since our democratic elections in 1994, the Government has invested a great deal of time and effort to inculcate values such as equality, freedom, social justice and fundamental human rights in our communities and society at large. We have included a comprehensive Bill of Rights into the supreme law of our country, the Constitution, which to my mind is one of the most substantive and propitious frameworks within which fundamental political and social change can be effected. The Government has also over time become a signatory of many international and regional declarations and treaties that address human rights of some kind or other.
For example, we have endorsed The Universal Declaration of Human Rights as well as the Convention on the Rights of the Child. During the latter part of 1998, we launched and handed over to the United Nations the National Action Plan on the Promotion and Protection of Human Rights as part of the 50th anniversary of The Universal Declaration of Human Rights. With this Action Plan we seek to secure the rights of individuals with a promise to improve the lives of everyone in the country. To uphold this promise of ensuring the improvement of the quality of life for all our fellow citizens and to bring into effect the noble principles of the Batho Pele initiative, I am delighted to launch today our National Patients' Rights Charter.
The National patients Rights Charter, expresses the government commitment to the fundamental values of the National Health System; a comprehensive service available to all, responsive to the expressed needs of the people and above all a service that is delivered with respect and compassion, at all times preserving the dignity of the recipient of service. I am delighted to launch this Charter because now for the first time ever, patient, and for that matter, the general public, are afforded the opportunity to take the centre stage and drive our attempts to improve the quality of health care we so desperately need to achieve.
The Charter therefore provides true meaning to the concept, 'people first' (Batho Pele). I am quite sure that like elsewhere in the world, the Patients Rights Charter will continue towards raising the awareness amongst both our patients and our health workers on patients' entitlement to be treated with dignity, to complain, and the right to information, to mention but three of the twelve rights we have included into our Charter. (It is worth noting though, that unlike in some other countries, we are keeping the Charter as a social agreement or pledge, and not putting it into law to minimise any negative sentiment the Charter may evoke).
The outcome of the greater awareness created by the Charter will be raised expectations of patients, a change in the attitudes of health workers, and ultimately the strengthening of the all-important partnership between patient and health workers. I believe that our Charter will stimulate a greater participation by our people in health matters, thereby contributing towards a deepening of the culture of democracy. It is also my wish that the Charter be viewed by both the patient and health workers as a tool to assist in changing our health system into a caring and compassionate health care delivery system, which will serve us all with pride, because for just too long have our services been characterised by indifference, arrogance negligence, covering up, and, at times, total disregard for human dignity, respect and privacy. Just recently some of these weaknesses in our health care system were again highlighted in a report published by a Commission of Inquiry into Hospital Care Practices in Gauteng. Launching this Charter represents one big stride and a positive programme of action for all communities to help turn these rights into realities for all South Africans. Benoni has had the good fortune of being chosen for this important historic event. We hope that it will assume the status of a role model, take the lead in making this charter not just a promise but reality and influence the whole East Rand Region, and eventually the entire country. We shall be watching Benoni and how it rises to the challenge, and I hope we shall not be disappointed.
Improving service delivery is not a one-time job, but a continuous process of setting, meeting and then raising standards over time. It is a dynamic process in which the recipients of services are able to bring pressure to bear on the providers to ensure that the customers, who are our patients, are key in the setting of priorities which should determine both the nature and the level of services to be provided.
The status of the quality of health care throughout the entire health system is perhaps the Achilles heel of our health system. We are sparing no effort in fighting this disgraceful scourge that has afflicted our health care system. Currently the Department of Health is working with other stakeholders on initiatives such as:
We intend entrenching some of the key principles of these initiatives in the National Health Bill to be tabled next year. We need to make the point, however, that to sustain these initiatives and entrench a culture of quality, our training institutions need to review selection criteria, the content of curricula, as well as confronting the difficult challenge of ensuring that our educators themselves are appropriate role models for the younger generation.
In particular we need to promote a caring ethos in out health workers; create conductive working environments; speed up the process of change management; empower communities to interact constructively with our institutions to ensure that their needs are met; empower individual users to claim their right to dignity. Every complaint should be welcomed as an opportunity to improve the service, and staff should be orientated and encouraged to handle complaints appropriately so that weaknesses can be identified and remedied.
The move towards decentralising management of services to focus on improving quality, and establishing and empowering clinic committees and hospital boards, should be primed up and intensified. I am calling for ongoing research into professional practice, training in ethics and professional conduct, and the transformation of institutions to build a culture of human rights within the health sector, and identifying patients' rights within the health sector, and identifying patients' rights and ethical dilemmas in the context of democratic transformation. Critical self-study is the responsibility of every health worker without exception. It has been worrying that many poor communities are not convinced that human rights also extend to them. We have to admit that we are to blame for that perception. In fact the situation is worse than just being a perception: it is true that in rural, poor communities, where people are more vulnerable, we become cold-hearted, arrogant and uncaring tyrants. Isn't it time we cleansed ourselves of this image?
This Charter has been developed through your participation and through you help; we hope it will remain a powerful and relevant tool in the hands of all South Africans. This Charter is meant to empower you. We believe it accords with the health objectives spelt out in the Reconstruction and Development Programme, the vehicle for socio-economic transformation in our country. Help us break this shame of silence by telling us about your experiences of the National Health System - good and bad, so that we can improve the service we offer.
We will agree that in recent years, a great deal of emphasis has been placed on the importance of all people experiencing freedom, freedom that will not compromise or restrict our rights, but will enable us to live full and meaningful lives. Being free, however, does not remove the obligation to take responsibility for one's actions. Having unlimited freedom and showing little or no responsibility, or overplaying one's rights, reminds me of the story of the son who was charged for murdering both his mother and father, and then pleaded that being an orphan is extenuating circumstances. As human rights do bring along certain obligations, and so does the granting of health rights to patients implicitly bind them to certain responsibilities.
We have therefore included as part of the Charter, responsibilities that each patient, if competent to do so, should honour. I sincerely hope that taking on these responsibilities will contribute towards ensuring that patients' rights are met, the health providers rights are respected, and that partnership between health workers and patients is strengthened.
Although launching the Patients' Rights Charter is a milestone in our quest for improving the quality of health care, our excitement and the impact of the Charter will be short-lived if the set of health rights and accompanying obligations are not popularised within our communities. The mere fact that we now have a Charter does not necessarily mean that patients and health workers will suddenly find meaning in the rights and responsibilities. We, gathered here today, as well as our colleagues and co-workers, all have the major responsibility of popularising our National Patients' Rights Charter. We need to write, talk and demand these rights and educate our fellow citizens about their health rights.
The three spheres of government, NGOs and the private sector have to unite in the promotion of common goals. The people of South Africa have to realise that without their active participation and involvement, little progress can be made in improving their health status. Every effort should be made to ensure the improvement in quality of services at all levels in both the private and the public health sectors. We are well aware that having a Patient's Rights Charter is by no means a panacea for all our ills; major challenges still confront us:
We consider it absolutely vital, given the need to make rapid progress, to identify best practice so that experience can be quickly shared, and put to good use. As a first step, we are currently undertaking a national quality survey and we are encouraged by the support shown by all the participating PHC facilities within both Local and Provincial Authorities, all the district, regional and provincial levels.
The survey will bring together a wealth of information on new quality projects, progress towards quality, and performance against set standards and goals. Good ideas are always worth sharing, and only by communicating our efforts to one another can we make real progress as a nation, and not sporadic pockets of success here and there. I am aware that the Patients' Rights Charter we are launching here today, is the culmination of work done by my Department, based on invaluable earlier work done by various organisations within South Africa as abroad, which on request was shared with the Department.
I know that many of these organisations went through lengthy and time consuming processes in their endeavours to address and protect the rights of their respective customers or constituencies. In this regard the Department and I would like to offer our gratitude to especially the National Progressive Primary Health Care Network, the Patient Advocacy Resource Centre, Lawyers for Human Rights, the South African Medical Association, the South African Nursing Council and the Health Professions Council, the office of the Disabled People of South Africa, The Centre for Applied Legal Studies at Wits, Addington Hospital, and the South African Local Government Association, for contributing and sharing with us your experiences in a selfless manner.
Ladies and Gentlemen, despite the many real and even perceived impediments that could hamper us in keeping to our pledge, the Government is committed to seeing that the health rights listed in our national Charter are honoured. May we all unite in this commitment, because only then can we be assured that each and everyone's right to dignity is not compromised.
To give true meaning to this effort, let me categorically commit myself to uphold these rights in your presence and as part of the process of health reform, I invite you all to join me in this effort across the political divide.
It is my sincere hope that this charter will inspire all of us to work in unison towards instilling the culture of respect and caring ethos in health care, improving the health of our nation, and ensuring a brighter future for our children. May this effort inspire all of us, rich or poor, urban or rural to take individual and collective responsibility for our health, and to build a health system that is relevant, appropriate, effective and efficient, and above all, one that is free from the shame of patients' rights abuses.
In that way, we shall truly honour those who sacrificed enormously to ensure that our country today stands proud at the dawn of a glorious future.
Thank you