Presentation to the National Health Portfolio Committee

1
Presentation to the National Health Portfolio
Committee

• Presented by Dr H N Manzini
• HoD Health Social Development 16th March 2005

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Presentation to the Portfolio Committee

• Limpopo Department of Health and Social
  Development

3
Mandates

• The Departmental operations are guided by the
  following Mandates.
• - Applicable National Provincial
  Legislations
• National Ten Points Plan
• Provincial Strategic Priorities
• Health Core Functions
• The Strategic Plan is based on these principles.

4
National Ten Points Plan

1. Improve Governance and management of the NHS
2. Promote healthy lifestyles
3. Contribute towards human dignity by improving
   quality of care
4. Improve the management of communicable and
   non-communicable illnesses
5. Strengthen Primary Health care, EMS and Hospital
   service delivery systems
6. Strengthen support services
7. Human Resource Planning, Development and
   Management
8. Planning, Budgeting and Monitoring and
   Evaluation
9. Prepare and implement legislation
10. Strengthen International Relations

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Provincial Priorities

• TB/STD/HIV/AIDS other communicable diseases
• Maternal, Child, Women, Youth Adolescence
  Health
• Integrated Poverty Alleviation
• Health Promotion
• District Health Development Primary Health Care
  
• implementation
• Hospital Revitalisation
• Health Planning, Logistics Support Services
• Quality of Care
• Mental, Chronic, Disabilities Geriatric Health
• Communication, Collaboration Community
  Participation
• Development of a Medical School

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Core Functions

• Formulate and implement provincial health
  policies, norms, standards and legislation   
• Provide regional and specialised hospital
  services as well as academic Health Services,
  where relevant.
• Render and co-ordinate Medical Emergency Services
  (including ambulance service)
• Render health services to the detained, arrested,
  charged.
• Screen applications for licensing and inspection
  of private facilities.
• Quality control of all health services and
  facilities.
• Inter-provincial and inter sectoral co-ordination
  and collaboration.
• Co-ordinate the funding and financial management
  (budgetary process) of the district health
  services

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Core Functions

• Provide technical and logistical support to
  health districts.
• Render specific provincial services programmes,
  e.g. TB programme.
• Provide non-personal health services.
• Provide and maintain equipment, vehicles and
  health care services.
• Effective consultation on health matters at the
  community level.
• Provide occupational health services.
• Research on, and planning, co-ordination,
  monitoring and evaluation of health services
  rendered in the Province.
• Ensure that functions delegated by the National
  level are carried out.
• Render Medico-legal services.

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Section A

• Strategic Priorities and Objectives 2004/05

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Programme 1 Health Administration

• PRIORITIES
• Improve governance and the management of the
  Provincial Health System (PHS)
• Strengthen admin support services
• Human resource planning development and
  management
• Planning, budgeting and monitoring and evaluation
  
• Prepare implement legislation
• Implementation of fraud prevention and risk
  management plan
• Management of records and information systems

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Strategic Objectives and Targets

• In the next five years Provincial Health
  Legislation will be aligned to the National
  Health Legislation.
• Achieve full implementation of supply chain
  management policy the end of 2005/06
• Outsourcing of the following Renal dialysis,
  Concession of hospitals, Staff accommodation,
  Laundry services and EMS on a PPP basis by the
  end 2006/07.

11
Continue

• Payment of creditors within 30 days by 2005/06
• 100 of staff must have signed PIs by 2005/06
• Development of a full HR Strategy in the next by
  the end of 2005/06
• Approved organizational structures for the
  Department during 2005/06
• All institutions to have Governance Structures by
  2005/06

12
Continue

• 100 of all institutions in the Department have
  effective Risk management policies and practices
  by 2005/06
• Accurate information available and disseminated
  to correct stakeholders at all times by 2005/06
• 100 compliance with National Archives guidelines
  by 2005/06

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Programme 2District Health Services

• PRIORITIES
• Integrated Primary Health Care
• District Health Services and Devolution
• Communicable Disease Control
• Malaria programme
• HIV AIDS, STIs TB
• Decentralization of Hospital Management
• Strengthening of Partnerships with NPOs

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Strategic Objectives and Targets

• 100 provision of comprehensive primary health
  care package at all PHC facilities by 2006/07
• 100 access to primary health care services by
  2007/08
• All designated PHC Facilities to render 24 hrs
  service by 2007/08
• 100 implementation of devolution strategy by by
  2005/06
• Service Level Agreement will be signed with
  District Municipalities for provision of Primary
  Health Care Services by 2005/06

15
Continue

• 95 immunization coverage of children under 1year
  by 2007/08.
• gt1 reduction mortality and morbidity through
  rapid response to outbreaks of diseases by
  2006/07
• Reduce Malaria incidence by 10 per year.

16
Continue

• 85 Access to Provision of comprehensive
  HIVAIDS, care, treatment, management and support
  including ARVs and nutritional supplements by
  2007/08
• Cure rate of new smear positive TB cases at first
  attempt increased to 85 by 2006/07
• Strengthen partnership with EU on PDPHC, HIVAIDS
  by formalising LSAs with NPOs by 2005/06

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Programme 3 Emergency Medical Services.

• PRIORITIES
• HR development
• Improve access to EMS services
• STRATEGIC OBJECTIVES AND TARGETS
• Outsourcing of Emergency Medical services Fleet
  by 2006/07

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Programme 4 Provincial Hospitals Services.

• PRIORITIES
• Revitalization of Hospitals.
• Implementation of Secondary Hospital Package.
• Decentralisation of Hospital management
• Specialised Hospital Services.
• Accreditation of facilities for teaching purposes.

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STRATEGIC OBJECTIVES AND TARGETS

• 100 full decentralized Hospital Management by
  2006/07
• Complete Revitalisation Projects by 2007/08
• 100 transformed nursing services by 2007/08
• 100 revenue collection targets achieved by
  2005/06

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Programme 5Central Hospitals - Provincial
Tertiary Services.

• PRIORITIES
• Revitalization of Hospitals
• Implementation of Tertiary Hospital Package
• Decentralisation of Hospital management
• Accreditation of facilities for teaching purposes
  
• Development of a medical school.

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STRATEGIC OBJECTIVES AND TARGETS

• Reduce ALOS to 5 by 2007/08.
• Usable bed utilization rate increased to 84 by
  2007/08.
• Reduce patient waiting time to 1hr by 2007/08.
• Complete consolidation of developing tertiary
  services package (MTS) by 2006/07
• Fast track and consolidate efforts to develop
  Academic Departments to support the Limpopo
  University Medical School between 2005/06
  2007/08 (budgets other resources)

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Programme 6 Health Sciences and Training.

• PRIORITIES
• Conduct research in nursing
• Train mid level workers
• Train nurses
• Provide bursaries
• Train Emergency Care Practitioners

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STRATEGIC OBJECTIVES AND TARGETS

• 100 operational post basic diploma nursing
  program by 2006/07
• 80 student intake from rural and nodal
  communities by 2007/08.
• Initiate and improve partnerships with
  institutions of higher learning and other
  relevant institutions by end of 2006/07

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Programme 7 Health Care Support Services.

• PRIORITIES
• Supply of medicines to health facilities
• Monitor rational utilisation of drugs
• Inspectorate Services.

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STRATEGIC OBJECTIVES AND TARGETS

• Increase drug availability at the depot,
  hospitals, health centers and clinics to 95 by
  2007/08.
• Pharmaceutical programme managed in line with
  national policy on an ongoing basis.

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Programme 8 Health Facilities Management

• PRIORITIES
• Upgrade and Building of PHC facilities
• Hospital revitalisation
• Maintenance of Health Facilities

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STRATEGIC OBJECTIVES AND TARGETS

• Built 100 clinics in the next five years at the
  rate of 20 clinics per year
• All PHC facilities have clean water and
  sanitation by 2007/08
• All PHC facilities fully electrified by 2008/09

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Section B

• MTEF Budget
• Expenditure Trends

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New Equitable Share Formula

• The growth in the provincial equitable share
  primarily caters for the three-year wage
  agreement for public servants and further
  adjustments to the remuneration of educators.
• It also provides for funding of the primary
  health function in non-metropolitan
  municipalities, strengthening of school based
  education, and the expansion of developmental
  welfare services.
• The division of the equitable share allocation
  among provinces is done through an objective
  redistributive formula.
• The formula is reviewed and updated annually and
  takes recommendations of the Financial and Fiscal
  Commission into account.
• A broad-ranging review of the formula has been
  undertaken for the 2005 / 06 and MTEF.

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New Equitable Share Formula cont..

• The formula consists of 4 main and 2 minor
  components
• Education 51 and uses census data for the
  school age cohort and official estimates of
  school enrolment weighted equally.
• Health 26 is based on estimated number of
  people with and without medical aid coverage and
  weighted at a 1 4 ratio.
• Institutional 5 allocated equally across
  provinces to cover core provincial administration
  costs.
• Basic 14 is calculated on the basis of the
  population share of each province.
• Poverty 3 reinforces the redistributive
  basis.
• Economic 1 to cater for provincial revenue
  raising powers that have not changed

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Limpopo Provincial Equitable Share Allocations
over the MTEF
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MTEF Budget 2005/06 to 2007/08
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MTEF Budget 2005/06 to 2007/08

• There is concern for Non PE in the outer years.
• As can be seen the allocation for Non PE reduces
  in the 2006/07 year by R 70.299 m with once off
  costs of R65.2 m from the previous year.
• The 2007/08 year shown an increase above the
  previous year of R 6.803 m that leaves a almost
  no growth in the budget for Non PE for two years
  running.
• The rest of the budget is ring fenced and cannot
  be rerouted to fund Non Personnel Expenditure.
• The allocation for the purchase of drugs does
  show real growth and these funds are ring fenced.

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Summary of Conditional Grant Allocation
35
MTEF Budget 2005/06 to 2007/08
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MTEF Budget 2005/06 to 2007/08- HealthBudget
Allocation per Programme
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MTEF Budget 2005/06 to 2007/08- HealthBudget
Allocation per Programme

• The increase in the Personnel Budget is intended
  for the filling of critical vacant positions in
  both Clinical and Administration posts
• Clinical Posts Other
• 2005 / 06 270 R 62.7m 424 R 22.9m
• 2006 / 07 444 R 49.3m 481 R 46.4m
• 2007 / 08 358 R 38.1m 351 R 34.1m

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Departmental Revenue Collection2001 /02 -
2004/05 Budget 2005/06
Revenue R000 2000/01 Actual 2001/02 Actual 2002/03 Actual 2003/04 Actual 2004/05 Budget 2005/06 MTEF Budget
Revenue Targets 50 037 57 209 56 990 60 409 60 000 63 911
Revenue Received 48,703 58,022 59,011 58,267 64 974 Estimated N / a
There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards. There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8 increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected. Other departmental tariffs will also be adjusted upwards.
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Expenditure Trends 1995/96 2003/042004/05
Estimated and MTEF Budget
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Personnel v/s Non-Personnel trends
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The End
Working as A Team has potential to assist in
rolling back the frontiers of Ill health and
Poverty globally