NATIONAL DEPARTMENT OF HEALTH

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NATIONAL DEPARTMENT OF HEALTH PRESENTATION
TO THE SELECT COMMITTEE ON SOCIAL SERVICES 24
May 2002
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Brief Explantion of the New Grant Framework for
Tertiary Services and the Health Professionals
Training and Development

• Thabo Sibeko
• Chief Director
• Hospital Services

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Need for Change

• Central Hospitals and Health Professionals
  Training and Research Grant Frameworks flawed
• Redistributive Grant inadequate
• Review undertaken to examine the location, and
  volume of Tertiary Services provided in SA (all
  nine provinces)

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Data

• 529 specialised service units
• 62 hospitals in all 9 provinces
• Major effort by provinces to complete additional
  data collection yielded significant benefits

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National Tertiary Services

• Based on the review of HSS the following policy
  findings were observed
• All provinces provide a significant level of
  Tertiary Services, however
• Some provinces have low provision, low access and
  low funding requirements (Mpu, NW and NP)
• Some provinces provide significant level of
  Tertiary services but receive no funding (EC, NC)
• Some provinces provide significant level of
  Tertiary services but receive less funding than
  is required to deliver these services (KZN, FS)
• Some provinces provide significant level of
  Tertiary services but receive more funding than
  is required to provide these services (GP, WC)

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National Tertiary Services

• New framework funds all provinces for the
  tertiary services they provide based on the
  volume of services they provide and the costs
  incurred in providing these services
• attempts to address the policy findings mentioned
  earlier
• The NTS grant replaces the CHG, RTS and HPTR
  grants
• Full costs of NTS exceed the envelope of what was
  allocated for the CHG and RTS by R280m
• Hence, drew down from HPTR grant.

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National Tertiary Services

• PURPOSE
• To fund national tertiary services
• To ensure equitable access by all South Africans
  to basic tertiary health care
• To ensure nationally coordinated planning for
  tertiary services

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HPTD

• R280m less in value (to fund NTS)
• Original HPTR allocations and criteria retained
  but proportionately reduced for all provinces
• Development funds added (R227m over 5 years),
• which seeks to strengthen Level II services in
  Provinces without medical schools by funding
  additional registrar and medical specialist posts
  to bring all provices up to the national per
  capita level

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CONDITIONAL GRANTS (HOSPITAL GRANTS)
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LIST OF OLD NEW GRANTS
LIST OF OLD NEW GRANTS
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Notes

• Service Agreements for NTSG and HPTD prepared
• Business plans for other grants are developed and
  approved
• Expenditure according to business plan /service
  agreements
• Progress against action plan
• List of indicators pertaining to expenditure vs
  cash flow
• RDP and INP indicators

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Notes (Cont)

• Provincial heads of health submit monthly and
  quarterly financial reports
• Certificates signed by Provincial Accounting
  Officer at the end of the financial year.
• Provincial liaison and technical support visits
• Regular meetings per financial year between
  national and provinces

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Payment Schedule

• National Tertiary Services and HPT D-monthly
  transfers
• Hospital revitalization ,Pretoria Academic-
  quarterly advances
• and Hosp Mx Quality Improvement- 3 advance
  installments

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Payment Schedule

• National Tertiary Services and HPT D-monthly
  transfers
• Hospital revitalization ,Pretoria Academic-
  quarterly advances
• and Hosp Mx Quality Improvement- 3 advance
  installments

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NTSG
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Hospital Mx Quality Improvement
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HPT D
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Hospital Revitalization
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PROVINCIAL HEALTH BUDGETS 2002/03 Portfolio
Committee on Health 24 May 2002
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Expenditure 2001/02
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Expenditure on conditional grants
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PROVINCIAL PER CAPITA SPENDING (excl CGs)
1600
1400
1200
1000
Series1
800
Series2
600
400
200
0
Eastern Cape
Free State
Gauteng
KwaZulu-
Mpumalanga
Northern
Northern
North West
Western
Total
Natal
Cape
Province
Cape