Department of Health

1
Department of Health

• Presentation
• to the
• Select Committee on Finance
• on
• 3 May 2006

2
Conditional Grants

• National Tertiary Services Grant
• Health Professions Training Grant
• Revitalisation Grant (Capital)
• Provincial Infrastructure Grant (Capital)
• HIV/AIDS Grant
• Integrated Nutrition Grant
• Hospital Management and Quality Improvement Grant
• Forensic Pathology Services Grant

3
Expenditure Trends
4
Allocation, Transfers Expenditure
National Tertiary Services 2004-05 2005-06
Allocation R1 727 736 000 R1 760 465 000
Amount Transferred R1 727 736 000 R1 760 465 000
Spending Total Budget spent Total Budget spent
Health Professions Training Development
Allocation R560 778 000 R554 039 000
Amount Transferred R560 778 000 R554 039 000
Spending Total Budget spent Total Budget spent
5
Allocation, Transfers Expenditure
Integrated Nutrition Programme 2004-05 2005-06
Allocation R10 307 000 R11 333 000
Amount Transferred R10 307 000 R11 333 000
Spending Total Budget spent R9 876 000
Hospital Management Quality
Allocation R20 776 000 R18 510 000
Amount Transferred R20 776 000 R18 510 000
Spending Total Budget spent R7 987 000
6
Allocation, Transfers Expenditure
HIV/AIDS 2004-05 2005-06
Allocation R134 231000 R185 048 000
Amount Transferred R134 231 000 R185 048 000
Spending Total Budget spent Total Budget spent
Revitalisation (Capital Projects)
Allocation R155 126 000 R88 955 000
Amount Transferred R155 126 000 R88 955 000
Spending R61 200 000 Total Budget spent
7
Allocation, Transfers Expenditure
Provincial Infrastructure 2004-05 2005-06
Allocation R47 160 000 R73 955 000
Amount Transferred R47 160 000 R18 488 000
Spending Total Budget spent R73 955 000
Forensic Pathology
Allocation R0 R16 944 000
Amount Transferred R0 R16 944 000
Spending R0 R7 879 000
8
Allocation, Transfers Expenditure

• Expenditure on 3 grants is at 100 - National
  Tertiary Services Health Professions Training
  Development and HIV/AIDS.
• Integrated Nutrition Programme R9,9m of the
  R11,3m allocated budget has been spent i.e.87.
  Delay by supplier to supply invoice for payment.
• Hospital Management Quality expenditure
  amounted to R8m which is 44 of allocated budget.
  Initial business plan submitted to National
  Health but was not accepted as Department had to
  rework it. Second business plan was approved on
  the 29th November 2005. This was too late for
  some projects to be implemented.

9
Allocation, Transfers Expenditure

• Revitalisation The full allocation was spent
• Provincial Infrastructure R18,5m of the R74m
  allocation was transferred to the department.
  Expenditure for the year amounted to R74m. R55,5m
  was withheld by National Treasury because other
  departments did not comply with the conditions of
  the grant, although Health complied.

10
Allocation, Transfers Expenditure

• Forensic Pathology expenditure on this grant
  amounted to R7,9m which constitutes 41 of
  allocated budget.
• Appointment of personnel delayed
• Certain equipment was not delivered in time.
• Allocation only approved in December 2005

11
Capital Expenditure
12
Capital Expenditure - Continued

• R55,6 million was spent on equipment costing less
  than R5000.00
• R19,5 million was spent at the New Pretoria
  Academic Hospital. R19,3 million of this relate
  to medical and allied equipment.
• This amount is classified as Goods and Services

13
Achievements 2005/06

• Pharmacy project Upgrade of pharmacies at the
  following hospitals has been completed to meet
  new legislative requirements
• Kopanong Hospital
• Edenvale Hospital
• Coronation Hospital
• Weskoppies Hospital
• Pholosong Hospital
• Waste Management Medical waste areas have beem
  upgraded to comply with Provincial and National
  Health Care Waste Management Regulations

14
Achievements 2005/06

• Tshwane District Hospital (Old Pretoria Academic
  Hospital) - Master plan completed
• New Pretoria Academic Hospital Hospital
  commissioned during February and March 2006.
• Chris Hani Baragwanath Hospital - Project
  Implementation Plan for Phase 3 approved and
  construction is proceeding to schedule.
• Sebokeng Hospital New revitalisation approved
  project
• Natalspruit Hospital - bulk site-works was
  awarded in April 2006 and contractor on site

15
Achievements 2005/06

• Zola District Hospital - The relocation of the
  hospital has been agreed to and the hospital will
  now be erected on a site in Jabulani. Contractor
  will be on site in June 2006
• Daveyton Hospital - Contractor will be on site in
  June 2006.
• Lilian Ngoyi District Hospital - Contractor is
  expected on site in September 2006.

16
Achievements 2005/06

• Weskoppies Hospital - 2 new wards completed and
  operational
• Kalafong Hospital Upgrade of theatres completed
  and operational
• Soshanguve Block L Officially opened in March
  2006
• Helen Joseph Hospital - The project to establish
  the breast clinic at Helen Joseph Hospital as a
  centre of excellence has been completed and is
  operational.
• Period contracts in place in 85 of institutions
• Anti Retroviral Therapy (ART) - 33 Sites are
  operational. Special Project initiated to
  facilitate roll out of ART to additional sites.

17
Monitoring Capacity

• Two initiatives were implemented by DPTRW and
  Health to fast track delivery of projects -
• Appointment of Project Management Resource Groups
  (PMRG) by the Department of Public Transport,
  Roads and Works (DPTRW) to increase capacity on
  site in order to manage and expedite capital
  projects.
• Appointment of dedicated project managers by GDoH
  for each Revitalisation project in order to
  strengthen the capacity to manage and expedite
  revitalisation projects

18
Monitoring Capacity

• The planning cycle of projects was reduced from
  27 to 20 months
• Flagship projects were identified which merited
  special attention by both Departments.
• Closer cooperation and communication with
  institutional Facility Management Units has been
  implemented in respect of planning to finalise
  user requirements before a brief, requirements
  and schedule of accommodation is conveyed to
  DPTRW.
• This has reduced the need for subsequent
  amendment of design briefs which was often a
  cause of delays

19
Monitoring Capacity

• Projects were planned to tender documentation
  stage that could be initiated at short notice if
  cash flow trends demanded expedited expenditure.
• Projects were initiated to exceed the budgeted
  amount in order to allow for delays or under
  expenditure. A target budget for 2006/07 has
  already been agreed. Projects for the 2006 / 2007
  financial year have already been conveyed to
  DPTRW.

20
Monitoring

• Financial
• Monitoring done on different management levels
• Compliance with reporting requirements
• Performance
• Compliance with reporting requirements
• No qualification from Auditor General on
  conditional grants for 2004-05
• Will be further strengthened during 2006/7. A
  post dedicated on the level of Deputy Director
  was created for the control of conditional grants
  in the Branch reporting to the CFO.

21
Reporting

• Financial Reporting
• Report done on template provided by National
  Treasury
• Finalised and submitted every month on the dates
  stipulated by the DORA (15th of each month)
• Performance Report
• Submitted quarterly as required
• Other ad hoc

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Service Level Agreements
Grant SLA Signed
National Tertiary Grant Yes
Health Professions Training and Development Grant Yes
Revitalisation Grant (Capital) Yes
Provincial Infrastructure Grant (Capital) Yes
Hospital Management and Quality Improvement Grant Yes
HIV/AIDS Grant Yes
Integrated Nutrition Grant Yes
Forensic Pathology Services Grant Yes
23
Challenges

• Accuracy and reliability of data
• Allocations do not take cross border flow of
  patients into consideration
• Range of eligible services provided at each
  institution exceed grant allocations
• Complex nature of Gauteng, means that some
  services e.g. renal dialysis provided by some
  regional hospitals which are not funded
• Psychiatric tertiary services not funded

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Challenges

• Allocation for Revitilisation Grant for 2006/7
  amounts to R307million.
• Projected expenditure for this 2006/7 year is
  R600million
• Increase in monitoring capacity
• Approval on nine Revitalisation projects
• Projected cash flow is major challenge

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• Thank you