PRESENTATION TO THE SELECT COMMITTEE ON FINANCE 03

PRESENTATION TO THE SELECT COMMITTEE ON FINANCE 03 September 2008 2

VISION Health Service Excellence For All! 3

CONDITIONAL GRANTS 4

GRANTS • • • Forensic Pathology Services Hospital Revitalisation Comprehensive HIV & AIDS National Tertiary Services Health Professions Training & Development Infrastructure Grant to Provinces 5

TRENDS IN ALLOCATION 6

TRENDS IN ALLOCATION (cont. ) • The total conditional grant allocation shows an annual growth of 35. 3% • The main contributors are; – – – The introduction of Forensic Pathology Services. Hospital Revitalization Infrastructure Grant to Provinces National Tertiary Services HIV & AIDS 7

CONDITIONAL GRANT SPENDING TRENDS 2006/07 & 2007/08 8

CONDITIONAL GRANT SPENDING TRENDS 2006/07 & 2007/08 • Hospital Revitalization – Withdrawal of Upington & De Aar Hospitals due to implementation of Peer Review – Slow progress on New Mental Health due to capacity of contractor • Infrastructure Grant to Provinces Infrastructure – Late implementation of the infrastructure plan 9

CONDITIONAL GRANT SPENDING 30 JUNE 2008 10

CONDITIONAL GRANT SPENDING (cont. ) Q 1 -2008/09 • Department received 25% of allocated budget • Spent 17% of total allocation at 30 June 2008 • Experienced under expenditure on four grants; – Infrastructure Grant to Provinces – National Tertiary Services Grant – Health Professions Training & Development – Hospital Revitalisation 11

CAPITAL EXPENDITURE 12

CAPITAL EXPENDITURE Q 1 -2008/09 13

HOSPITAL REVITALISATION 14

BUDGET VS EXPENDITURE 15

PROF ZK MATTHEWS HOSPITAL Barkly West 16

ACHIEVEMENTS & CHALLENGES • Achievements – Practical completion of the building infrastructure works – Procurement of health technology equipments – 30% delivery of health technology equipment • Challenges – Delay in finalization of minor outstanding works (snag list) – Delay in the delivery of health technology equipments 17

DE AAR HOSPITAL 18

ACHIEVEMENTS & CHALLENGES • Achievements – Compilation of revised service package as per STP guidelines • Challenges – Capacity challenge in HRP office 19

NEW MENTAL HEALTH HOSPITAL 20

ACHIEVEMENTS & CHALLENGES • Achievements – Construction – 60% • Challenges – Slow progress on site due to capacity of contractor 21

FORENSIC PATHOLOGY SERVICES 22

ACHIEVEMENTS Target 2008/09 Actual Q 1 Objective Indicator Improve forensic pathology services Number of mortuaries being upgraded 11 3 % of autopsies completed within 2 days of arrival at the mortuary 70% 5 100% 50% 2 0 Reason for deviation 80% 5 Deviation + 10% Process delayed: dispute - Increased fleet Establish Employee Assistance Programme for workers at the mortuaries % of employees making use of the programme Ensure that all mortuary personnel are adequately trained Number of training sessions held per annum (formal) (New programme) -2 (Building works disturbing work flow) impacts training 23

CHALLENGES Challenges Measures to overcome them q. Extension of EAP to all forensic pathology officers because of large province. q Arrange/design a referral system. q Training of mortuary staff. q Training (In-house) deferred until building works is completed. q. Training (formal) Awaiting accreditation from SAQA. (A Nationaldriven training). q Increased distances to be travelled and q Prepare and submit amended business plan to accommodate thus increased overtime to be worked additional staff. due to cancellation of undertakers’ contracts as a National directive. (Government Gazette 30075 of 20 July 2007: Regulation 636). 24

CHALLENGES Challenges q. Inadequate resources (human & capital) in the integrated North West and Northern Cape area (Moshwaweng and Pampierstad) q Delay in completion of building projects due to dispute with Implementing Agent. Measures to overcome them q Prepare and submit amended business plan to address resource shortfall. q Considering to re-negotiate with current contractor or discontinue 25

INFRASTRUCTURE GRANT TO PROVINCES 26

BUDGET VS EXPENDITURE 27

2007/08 PROJECTS • Achievements – Construction – average 60% • Challenges – Late inclusion of staff accommodation – Late decision on site allocation for Groblershoop maternity – Late start construction work at Dibeng 28

2008/09 PROJECTS • Achievements – Commencement of earthworks for: – Hartswater – Olifantshoek – Pampierstad • Challenges – Delay in the advertisement of tender- Hondeklipbaai – Delay in finalisation of service package for Pampierstad CHC 29

PROJECTS FUNDED THROUGH ROLL OVERS • Achievements – Tenders awarded for: – Kimberley Hospital Lifts – Kimberley Hospital Boilers • Challenges – Late submission of final account 30

COMPREHENSIVE HIV & AIDS 31

EXPENDITURE 32

ACHIEVEMENTS – 6 CCMT dieticians / nutritionists were appointed – A successful HIV and AIDS consultative stakeholder conference was held to facilitate the development of the Provincial Strategic Plan – Calvinia ART Service point now fully operational due to appointment of a medical officer – 5 Districts and 8 Local AIDS Councils established 33

ACHIEVEMENTS ART Programme • 1 st Quarter 2008 – Total Assessed: 2, 077 – On Treatment: 708 34

CHALLENGES & REMEDIAL ACTION Information management system slow and data received not up to date or reliable - Training on correct and effective management of data - Regular monthly meetings Delays in infrastructure refurbishment - Support Projects Office for infrastructure revitalization Minimal staff capacity at Provincial level Vacant Posts – 12 Filled Posts – 8 Advertised Posts – 7 Establish Step down Care in the Districts - Identify beds in district hospitals - Policy guidelines have been distributed for input 35

NATIONAL TERTIARY SERVICES 36

OUTPUTS 37

CHALLENGES & REMEDIAL ACTION • Challenges – Specialist skills shortage (Dr’s & nurses) – Increased patient load – Referral pathways • Remedial Actions – Posts advertised – Review of agreement with F/S & W/C and respective academic institutions – Streamline referral system – Strengthen outreach programme 38

HEALTH PROFESSIONS TRAINING & DEVELOPMENT 39

ACHIEVEMENTS • Supported training of: o o o o Doctors - 65 Radiographers - 18 Post-basic Nursing Programmes - 31 Clinical Psychologists - 5 Pharmacists - 2 Medical Registrars – 4 Nursing students – 232 • Two (2) medical students completed and are doing internship in 2008 40

CHALLENGES • Full implementation of the Registrar programme • Structured skills transfer programme in the regional hospital 41

MONITORING • Each grant managed by member of senior management • Monthly slot in senior management meetings for financial reports • Quarterly slot in senior management meetings for output reports 42