FREE STATE PROVINCIAL GOVERNMENT DEPARTMENT OF HEALTH PORTFOLIO COMMITTEE ON HEALTH BUDGET HEARINGS...
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Transcript of FREE STATE PROVINCIAL GOVERNMENT DEPARTMENT OF HEALTH PORTFOLIO COMMITTEE ON HEALTH BUDGET HEARINGS...
FREE STATE PROVINCIAL GOVERNMENT
DEPARTMENT OF HEALTH
PORTFOLIO COMMITTEE ON HEALTH
BUDGET HEARINGS
APRIL 2001
VISION STATEMENT
A healthy and self reliant Free State community
MISSION STATEMENT
The Free State Department of Health provides a quality comprehensive health care services to the Free State community optimally utilises health care resources to provide a caring and compassionate service endeavours to empower and develop all personnel to the best of their potential
STRATEGIC THEMES
THEME 1: PROMOTING THE WELL BEING OF ALL THE
PEOPLE
THEME 2: MEETING COMMUNITY DEMANDS
THEME 3: RENDER QUALITY COMPREHENSIVE
AND AFFORDABLE HEALTH SERVICES AT ALL
LEVELS OF CARE
THEME 4: EMPOWERING AND DEVELOPING ALL PERSONNEL
AND THE RELEVANT STAKEHOLDERS
THEME 5: TRANSFORMING HEALTH SERVICES TOWARDS
PRIMARY HEALTH CARE FOUNDED ON DISTRICT
HEALTH SYSTEM
THEME 6: IMPROVING THE MANAGEMENT OF HEALTH
SERVICES
KEY STRATEGIC OBJECTIVES FROM THE STRATEGIC PLAN
STRATEGIC THEME 1
PROMOTING THE WELL BEING OF ALL THE PEOPLE
Implement an integrated health promotion strategy through an inter-sectoral approach
Increased interventions in HIV/AIDS– Voluntary Counseling and Testing– Mother to child transmission– Home-based care
Ensure improved management of Tuberculosis Implement and maintain a system for improved rural health Ensure the development and rendering of Environmental Health Services Ensure the implementation of an Integrated Nutrition Programme Ensure services are accessible to people with disabilities Ensure services are accessible to personnel
STRATEGIC THEME 2
MEETING COMMUNITY DEMANDS
Cultivate an Organisational Culture that is characterised by staff that are: – Proud of being health workers– Enjoy working for the department– Caring for colleagues and the clients
Improve Customer Satisfaction at all levels of service
STRATEGIC THEME 3
RENDER QUALITY COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES AT ALL LEVELS OF CARE
Render comprehensive health care services at the most appropriate level
Improve quality and efficiency of services rendered Render affordable and equitable services
STRATEGIC THEME 4
EMPOWERING AND DEVELOPING ALL PERSONNEL AND THE RELEVANT STAKEHOLDERS
Training in line with service needs Implement Interactive Distance Education and Learning Implement ,review, maintain and monitor the induction
programme Ensure availability of health professionals Develop and implement intervention strategies to address the
impact of HIV/AIDS on health personnel Empower the community (Hospital Boards and College
Councils)
STRATEGIC THEME 5
TRANSFORMING HEALTH SERVICES TOWARDS PRIMARY HEALTH CARE FOUNDED ON DISTRICT HEALTH SYSTEM
Implement District Health Authorities in line with the Provincial Health Act (Act 8 of 1999)
Implement District Health System in line with District Health Plan per district
Ensure an extended access to 24 hour health services in all districts
Ensure and render comprehensive maternal services to rural communities
Restructure and re-organise integrated psychiatric and mental health services according to the Mental Health Bill
STRATEGIC THEME 6
IMPROVING THE MANAGEMENT OF HEALTH SERVICES
Access to and use of management information Effective Financial Management Develop and maintain Human Resource Plan Public Private Partnership Strategic Planning Ensure sensitivity for gender issues International co-operation Implementation of the PFMA Service Level Agreements (Municipalities) Loss of cohesion in Top Management Rationalisation of services
FINANCIAL RESULTS
1997/1998 - R 141 MILLION OVER EXP - 9.28%
(BUDGET R 1,518 BILLION)
1998/1999 - R 98 MILLION OVER EXP - 5.95%
(BUDGET R 1,646 BILLION)
1999/2000 - R 135 MILLION UNDER EXP - 7.83%
(BUDGET R 1,724 BILLION)
2000/2001 - R 60,3 MILLION UNDER EXP - 3.28%
BUDGET R 1,833 BILLION
BUDGET AND MTEF
BUDGET 2001/2002 - R 1,880 BILLION
MTEF 2002/2003 - R 1,985 BILLION
MTEF 2003/2004 - R2,099 BILLION
REVENUE
REVENUEPROJECTED
2000/2001
ACTUALREVENUE2000/2001
VARIANCE % MTEF2001/02
MTEF2002/03
MTEF2003/04
PATIENTFEES
R31,8 mil 40 mil 8.2 mil 25.49 33 mil 35 mil 37.7 mil
OTHERREVENUE
4.7 mil 5.5 mil 765,000 16.28 5 mil 5 mil 5 mil
TOTAL 36.5 mil 45.5 mil 8.9 mil 24.31 38 mil 40 mil 42.7 mil
HOSPITAL AND OTHER CLINICAL SERVICES
Policy decisions that will be implemented this year– Implementation of EDL
– Strategic Physical Facilities Plan
Policy decisions intended for the MTEF period– Performance Agreements with Hospitals
– Implement District Health System together with local government in line with management plan and legislation
Significant problems and constraints faced in achieving key objectives
– Improve staff morale and attitudes
– Lack of specific skills - Bio-Engineering
The impact and usefulness of conditional grants– Support Outreach Programme
Issues relevant from National policy perspective– Quality Assurance and Accreditation for all hospitals using COHSASA Programme
Recommendations– Improved equity and access
PRIMARY HEALTH CARE PROGRAMMES
Policy decisions that will be implemented this year– High dose of Vit. A to woman after delivery– Feeding of learners at identified schools
Policy decisions intended for the MTEF period– Develop and implement provincial guidelines, capacity building strategies,monitoring tools
and Health Promotion Programs for all Primary Health Care programs
Significant problems and constraints faced in achieving key objectives
– The burden of HIV/AIDS and TB epidemics divert funds and other resources needed for transformation
The impact and usefulness of conditional grants– Grants for Integrated Nutrition Program utilised appropriately– Squezze of Central Hospital Grant.
Issues relevant from National policy perspective Develop and implement Primary Health Care packages for clinics
Estimated HIV/AIDS impact Prevalence of HIV remained the same as 1999 survey - plateau phase has been reached
Recommendations– Funding need to reflect the impact of the twin epidemics of HIV/AIDS and TB
TEACHING AND TRAINING
Policy decisions that will be implemented this year Strategic areas of training
– Adult Basic Education and Training programmes– Pharmaceutical services: Assistant Pharmacists– Radiographic services:Supplementary Radiographers– Nursing services: Assistant nurses on supernumerary to be trained as
professional nurses
Bursaries– Education and training of all health professional– Award bursaries to meet the needs of the Department
Training in line with Skills Development Act– Development of skills according to the needs of the Department
PSYCHIATRIC AND MENTAL HEALTH SERVICES
Policy decisions that will be implemented this year– District Psychiatric services– bed capacity at specific levels of care
Policy decisions intended for the MTEF period– Restructure District Psychiatric Services
Significant problems and constraints faced in achieving key objectives
– To appoint and retain Psychiatrists at Regional complexes
Recommendations– Restructure psychiatric services
TB SERVICES
Policy decisions that will be implemented this year– Improve management of TB statistics– Improve DOTS to decrease defaulter rate
Policy decisions intended for the MTEF period– Training of community doctors to manage TB– Hospitalisation of TB patients in district hospitals
Significant problems and constraints faced in achieving key objectives
– Financial and personnel constraints where additional beds need to be established
Issues relevant from National policy perspective– Coordination with HIV/AIDS program to decrease the impact on the TB
program
EMERGENCY MEDICAL SERVICE
Policy decisions that will be implemented this year– Maintain a quality Provincial Emergency Medical Service– Establish a Provincial Commuter Service (patient transport)
Policy decisions intended for the MTEF period– All patient transport to be accommodated within EMS sub-directorate– Training of 20% of staff to an advanced level
Significant problems and constraints faced in achieving key objectives
– Severe staff shortage if Conditions of Employment Act is implemented and the total staff establishment is not filled
Issues relevant from National policy perspective– Provincialisation of Emergency Medical Service (EMS)
Recommendations– Guidelines for EMS regarding personnel, equipment and vehicles to be
developed and implemented
SUPPORT SERVICES
Policy decisions that will be implemented this year– Implement Antifraud and Corruption system– Implement Monitoring and Evaluation system
Policy decisions intended for the MTEF period– Implement Transport and Fleet management policy– Unlocking resources within private sector for public sector delivery
Issues relevant from National policy perspective– Implement Antifraud and Corruption system – Implement PFMA– Implement Administrative Justice and Promotion of Access to Information
legislation as well as Employment Equity Plan– Ensure Batho Pele culture and attitude change
PERSONNEL
Shortage of key staff– All health and related professions and specialists
Development and implementation of staffing norms consistent with a strategic plan
– Provincial Human Resource Plan
Critical problem areas involving Human Resource issues requiring urgent attention from government as a whole
– Implement Departmental Performance Management System– Current rewards and incentives system is still protected by collective
agreements.– Training staff in new performance management system
KEY HEALTH PROBLEMS
Trends– HIV/ AIDS is stabilising
Health service interventions– Establishment of Health Promotion strategies– Promotion of advanced midwifery training– Establishment of Disease Outbreak Response Teams in every district– Implementation of Step-down facilities and Home-based care – Establishment of Victim support Centres and training– Implementation of Cervical Screening Programs in collaboration with
CANSA– Building capacity to manage HIV/AIDS patients at Primary Health Care level – Dissemination of information to the community using the media