Remarks by President Cyril Ramaphosa at the launch of the Health Sector Anti-Corruption Forum, Union Buildings, Tshwane

Programme Director, Ms Khusela Diko,
Minister of Health, Dr Zweli Mkhize,
Deputy Minister of Justice and Constitutional Development, Mr John Jeffery,
Ministers, Deputy Ministers,
Premiers and MECs,
National Director of Public Prosecutions, Adv Shamila Batohi,
Director of the Financial Intelligence Centre, Adv Xolisile Khanyile,
Director of the Special Investigating Unit, Adv Andy Mothibi,
Representatives of the other parties to this agreement:
- Council for Medical Schemes
- Directorate for Priority Crime Investigation
- Health Funders Association
- Health Professions Council of South Africa
- Corruption Watch
- Section 27
- Board of Healthcare Funders
- Health Funders Association

Distinguished Guests,
Ladies and Gentlemen,
 
It is immensely encouraging to have amongst us such a broad representation of stakeholders on what is truly a historic occasion. 

The signing of the Terms of Agreement of the Health Sector Anti-Corruption Forum is one of the critical steps we are taking to transform the health care system in South Africa and to rid it of the inefficiencies of the past.
 
This initiative and the Health Market Inquiry Report that was released yesterday are concrete ways of reducing wastage and collusion and ending uncompetitive behaviour in the market.
 
Ladies and Gentlemen,
 
Health care is the third largest item of government expenditure, and yet there is a fundamental disjoint between what we are spending on health care and the health outcomes of our citizens.
 
We continue to rank low in global rankings on health care system efficiency owing to, among other things, inefficient resource management, poor institutional accountability, ineffective monitoring and evaluation, and corruption.
 
In the months leading up to the national elections earlier this year, I got to interact with men, women and children across the country to understand the everyday challenges they were facing.
 
It pained me, as it should every citizen of this country, to hear how this most fundamental of rights, of access to health care services, has been impacted by the stench of corruption.
 
In some parts of the country, citizens are forced to make payments to get access to medical treatment either at above the official rate or for services that are meant to be free.
 
In other places, our parents and grandparents are being turned away because doctors and nurses are moonlighting elsewhere during work hours. 
 
In other cases, state property in hospitals and clinics, including vehicles and equipment, are being stolen, hired out or resold.
 
This isn’t a problem confined to the public sector.
 
Suppliers and service providers are involved in false invoicing, collusion and price fixing especially on medicines.
 
It is because of problems like these, and the lack of accountability that accompanies them, that the audit outcomes of our provincial health departments continue to decline.
 
When there is corruption in our health care system, when the costs of unauthorised, fruitless and wasteful expenditure balloons, we all suffer.
 
Corruption in the health system is not a victimless crime.
 
It targets the poorest and most vulnerable in our society.
 
It further impoverishes people, it violates their Constitutional right to health, and it costs lives.
 
This initiative emerged from the Presidential Health Summit in 2018, which was convened to identify the challenges in the health sector and to agree on practical solutions to address areas of weakness.
 
One of the key recommendations to improve the quality of the health system was to address supply chain management of medicines, medical products, equipment and machinery.
 
This sector was considered to be vulnerable to corruption because of the large volume of goods and services transacted. 
 
These include fraudulent orders, tender irregularities, fiscal dumping through NGOs, bribery, over-pricing, poor governance, transfer of liabilities to the state, and fraudulent qualifications.
 
The Summit identified the serious challenge of corruption at all levels, coupled with lack of consequent management and an inadequate response from criminal justice system.
 
Political interference in the tendering system was also found to contribute to corruption.
 
These problems prompted the participants at the Presidential Health Summit to recommend that an anti-corruption forum be established in the health sector.
 
We are here because we share a commitment to ensuring that the substantial resources this country invests in health care are used for nothing other than the provision of quality health care to all South Africans.
 
The Health Sector Anti-Corruption Forum brings together several departments, government agencies, professional bodies and civil society formations to coordinate our national response to corruption in this critical area of development.
 
This initiative has become all the more critical as we prepare to implement the most-far reaching policy for social transformation this country has seen since 1994, namely the National Health Insurance.
 
One of the fundamental principles underpinning the NHI is that the funds spent on health in the public and private sectors annually should result in better care and outcome for all South Africans.
 
It is about spending money more efficiently and effectively.
 
It is about reducing wastage and excess.
 
But most importantly, it is about ensuring that our people live better lives, that they live healthier for longer, that they can be more productive and that they can emerge from poverty.
 
We cannot achieve these objectives for as long as corruption remains pervasive across the health sector.
 
The agreement that is being signed today is the product of many months of hard work by all the parties to develop an integrated and coordinated approach to these challenges.
 
It draws on the resources and capabilities of all these partners, recognising that they have separate but complementary powers and mandates.
 
Importantly, it acknowledges that no institution or body can undertake its work without cooperation and assistance from other players within the State and across society.
 
This agreement makes the important statement that it is only through working together that we can decisively rid our health system of corruption and maladministration.
 
This Anti-Corruption Forum must respond not only to the challenges of the health sector today; it must also respond to the challenges of a fundamentally transformed health system of the future.
 
As we plan to introduce NHI, it is critical to adequately prepare to secure the National Health Insurance Fund even before it starts transacting and when it is transacting.
 
The NHI aims to ensure that the use of health services does not result in financial hardship for individuals and their families. 
 
The National Health Insurance Bill is therefore intended to prevent undesirable, unethical and unlawful practices in relation to the NHI Fund and its users. 
 
Therefore, if corruption in the health care system is not addressed decisively, it will undermine the government efforts to ensure universal access to quality health care.
 
We must ensure that the pool of funds that is earmarked to ensure universal access to quality health care is not wiped out through fraud and corruption, and in this regard this Forum will play a critical role..
 
It has the potential to fundamentally transform our approach to corruption not only in health, but across many parts of the State and across the society.
 
This Forum is, therefore, seen as an essential mechanism to ensure that the NHI is not exposed to fraud and corruption.
 
For the Forum to be successful, it is important that its work is well-known, and that its mandate is widely appreciated and supported.
 
We will continue to rely on the support and cooperation of health professionals, patients and the general public.
 
I call upon all South Africans to become actively involved.
 
Where you see acts of theft and corruption, report them.
 
The government has a tollfree hotline that you can report to anonymously; make use of it.
 
Most importantly, don’t be party to such acts.
 
When you pay bribes to get treatment; when you offer money in return for securing or keeping a job in a clinic or hospital; when you buy equipment or medicines you know are stolen, you are adding to the erosion of trust and the decline in services.
 
Worse yet, you will be depriving someone else of access to a service that could mean life or death for them.
 
Remember that tomorrow it could be your child, your parent, and even yourself in that ambulance or hospital bed.
 
This needs to be a society-wide effort, in which all South Africans are actively involved and appropriately empowered to clean up our health system.
 
In conclusion, I wish to commend all the parties to this agreement and welcome the important work that has already been done.
 
I am certain that this Forum will live up to the great ambitions of its founding, and will prove itself worthy of the confidence that the people of South Africa have in it.
 
I thank you.