Presentation to the Health Portfolio Committee

Presentation to Health

Portfolio Committee

Free State Department of Health

15 APRIL 2003

Vision:A Healthy and self-reliant Free

State community.

Mission:- Provide a quality, accessible and

comprehensive Health Care Services to the Free State community.- Optimally utilises health care resources to provide a caring and compassionate services.- Endeavours to empower and develop all personnel and stakeholders to the best of their potential.

Corporate Goals

A Healthy and self-reliant Free State community

2. Effective and efficient management of resources

6. Appropriate

infrastructure

4. Effective marketing

and communication of Health

Services.

5. Developed and

empowered personnel and stakeholders

1. Reduce burden of HIV/AIDS and TB

7. Accessible and quality services

at all levels

3. Functional

District Health System

Achievements on Strategic Objective

Reduce burden of HIV/AIDS and TB Develop Home Based Care and step down facilities in all districts in the Free

State within 3years. Manage 95% of HIV/AIDS and Tuberculosis (TB) patients at Level1 facilities

within 3 years. Reduce prevalence of HIV/AIDS by 1% per year over the next 3 years. Increase Tuberculosis cure rate of the new Tuberculosis cases to 85% within 3

years.

Effective and Efficient Management of resources Implement Public Finance Management Act (Act 1 of 1999 as amended by Act 29

of 1999) according to the Treasury regulations within 3 years. Improve the morale of staff within 3 years. Develop and implement an asset management and maintenance and

replacement system (facilities, equipment and Information Technology) within 3 years.

Functional District Health System Implement District Health System according to legislation within 3 years. Develop functions in line with legislation within 3 years

Achievements on Strategic Objective continue:

Effective Marketing and Communication of Health Services Develop and implement a services market plan within 3 years. Develop and implement an integrated, comprehensive communications strategy within

3 years.

Developed and empowered personnel and stakeholders Ensure all occupational classes of staff are trained in line with service needs within 3

years. Ensure availability of health professionals at appropriate service delivery levels within

3 years. Train and empower stakeholders within 3 years.

Appropriate Infrastructure Implement revitalisation of hospitals according to approved plans within 3 years. Implement clinic building and upgrading plans. Implement an electronic health information system at all levels of care within 3 years.

Accessible and quality services at all levels Accredit 12 institutions (2 at Academic Health Services Complex, 5 regional hospitals

and 5 district hospital) by Council for Health service Accreditation of Southern Africa (COHSASA) within 3 years.

Reduce the incidence of medico-legal incidents by 50% within 3 years. Provide 100% access to 24-hours services within Local Municipality Area within 3 years.

STRATEGIC PLAN

10 POINT PLAN FREE STATE DEVELOPMENT PLAN PROVINCIAL STRATEGIC POSITION STATEMENT INFORMATION/DATA NATIONAL AND PROVINCIAL HEALTH AND OTHER

LEGISLATION NATIONAL AND PROVINCIAL POLICIES

STRATEGIC PLAN DELIVERY MODEL

Funding throughprogrammes1 Administration2 DHS3 EMS4 Provincial Hospitals5 Central Hospitals6 Health Sciences and Training7 Health Care Support 8 Health Facilities & Management9 Supernumerary Staff

Corporate Business Plan

Clinical HealthServices

Finance HealthSupport

Integrated Delivery PlansThrough the Clusters

Department Strategic Plan

OperationalFunctions

OperationalFunctions

OperationalFunctions

Expenditure 2002/2003

Expenditure per Programme

Programmes Budget 2002/2003

Actual Expenditure 2002/2003

Under (Over) Expenditure 2002/2003

%

Health Administration

96,626 93,549 3,077 96.82

District Health Services

857,073 853,223 3,851 99.55

Regional and Specialised Hospitals

628,064 623,309 4,755 99.24

Central Hospital Services

421,145 419,661 1,484 99.65

Health Sciences

47,636 45,302 2,334 95.10

Health Care Support Services

31,651 27,053 4,598 85.47

Health Facilities and Capital Stock

113,263 71,509 41,754 63.14

Supernumerary Staff

64,484 64,256 227 99.65

Internal Charges

(20,776) (17,760) (3,016) 85.48

Authorised Losses

0 1,373 (1,373) 0

Totals 2,239,166 2,181,475 57,691 97.42

Expenditure per Programmes

(500,000)

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

Healt

hAd

minis

tratio

n

Dist

rict H

ealth

Ser.

Regio

nal &

Spec

ialise

dHo

sp.

Cent

ral H

ospit

alSe

rv. He

alth

Scien

ces

Healt

h Ca

reSu

pp. S

erv.

Healt

h Fa

cilitie

s&

Capit

al St

ock

Supe

rnum

erar

y

Inter

nal

Char

ges

Auth

orise

dLo

sses To

tals

Budget 2002/03 Actual Exp 2002/03 Under/(Over) Exp

Expenditure 2002/2003

Expenditure per Standard Items

Programmes Budget 2002/2003

Actual Expenditure 2002/2003

Under (Over) Expenditure 2002/2003

%

Personnel Expenditure

1,380,805 1,372,917 7,888 99.43

Administrative Expenditure

62,719 63,825 (1,106) 101.76

Stores & Livestock

347,633 353,708 (6,075) 101.75

Equipment 108,200 88,560 19,640 81,85

Land and Buildings

134 30 104 22.39

Professional and Specialised

Services

230,663 191,690 38,973 83,10

Transfer Payments

109,006 109,006 0 100

Miscellaneous 6 1,739 (1,733) 0

Totals 2,239,166 2,184,389 54,777 97,42

Standard Items

(500,000)

0

500,000

1,000,000

1,500,000

2,000,000

2,500,000

Pers

onne

l

Adm

inis

tratio

n

Stor

es &

Live

stoc

k

Equi

pmen

t

Land

and

Build

ings

Prof

essi

onal

&Spe

cial

ised

Serv

.

Tran

sfer

Paym

ents

Mis

cella

neou

s Tota

l

Budget 2002/03 Actual Exp 2002/03 Under/(Over) Exp

Departmental Receipts

Revenue items R thousand

Revenue generated1999/00 2000/01 2001/02

 2002/03

Projected Projected Projected2003/04 2004/05 2005/06

Patient fees

 Other  

30,531 

8,860

41,019 

10,103

49,350 

14,073

51,908 

12,154

56,842 

5,230

59,692 

5,297

62,646 

5,345

Total 

39,391 51,122 63,423 64,062 62,072 64,989 67,991

Departmental Receipts

0

10000

20000

30000

40000

50000

60000

70000

80000

Revenuegenerated1999/00

Revenuegenerated2000/01

Revenuegenerated2001/02

Revenuegenerated2002/03

Projected2003/04

Projected2004/05

Projected2005/06

Revenue items Patient fees Others Total

MTEF

An Overview

ALLOCATION  2002/2003 2003/2004

‘0002004/2005

‘0002005/2006

‘000

Final Totals for the Health Vote

2,239,166 2,474,912 2,719,741 2,935,227

- Equitable Share

1,756,936 1,752,970 1,886,180 2,037,240

- Own Revenue

- 75,798 83,220 85,410

- Conditional grants

482,230 646,144 750,341 812,577

MTEF 2000-2006

GRAPH

MTEF

0

500

1000

1500

2000

2500

3000

3500

Pers

onne

l

Adm

inis

tratio

n

Stor

es &

Live

stoc

k

Equi

pmen

t

Land

and

Build

ings

Prof

essi

onal

&Spe

cial

ised

Serv

.

Tran

sfer

Paym

ents

Mis

cella

neou

s Tota

l

2000

2001

2002

V/2003

B/2004

B/2005

Conditional Grants

  Allocated Budget

2002/2003‘000

Actual Expenditure2002/2003

‘000

Allocated Budget

2003/2004‘000

MTEF2004/2005

‘000

MTEF2005/2006

‘000

- Totals - Conditional grants

630,293 630,293 646,144 750,341 812,577

- National Tertiary services Grant

292,145 292,145 336,501

384,165 432,116

- Professional Training Dev

90,552 90,552 90,061 93,643 92,517

         

- PSNP 40,543 40,543 47,817 56,200 61,588

Hospital Rehabilitation

29,500 26,733 50,356 52,370 54,466

- HIV/AIDS 18,6570 18,657 30,144 40,843 42,621

- Provincial Conditional Grant

35,000 35,000 45,000 75,000 78,600

- Infrastructure Grant 32,876 25,511 28,390 35,065 37,276

- Infrastructure Grant (Floods)

50,687 19,265 5,145 0 0

- Hospital Management Improvement Grant

11,333 11,333 12,730 13,055 13,393

Conditional Grants

0

100,000

200,000

300,000

400,000

500,000Na

tiona

lTe

rtiar

ySe

rvice

sGr

ant

Prof

essio

nal

Train

ing D

ev. PS

NP

Hosp

ital

Reha

bilita

tion

HIV/A

IDS

Prov

incial

Cond

itiona

lGr

ant

Infra

stru

cture

Gran

t

Infra

stru

cture

Gran

t(Floo

ds)

Hosp

ital

Mana

geme

ntIm

prov

emen

tGr

ant

Allocated Budget 2002/03 Actual Exp 2002/03 Allocated Budget 2003/04MTEF 2004/05 MTEF 2005/06

Addressing Equity

Equity At provincial level, The Department motivates its needs to the

Provincial Budget Management Committee. The Department received 18.5% of equitable share and 22.3% of

total revenue including conditional grants. This compares to the 23.3% average of Provincial Health

Departments in the country. Two percent (2%) of the budget on Academic hospital level and

Provincial hospital level were shifted to Primary Health Care Services. An equity review is done on an annual basis and informs process

towards intra-provincial equity. All districts are undergoing DHER to look at intra-district equity District funding funds the district plans approved by the PHA and

managed amongst others through S L A The burden of inflation to the Health sector has a huge

impact,especially on replacement of equipment and medical consumables, and therefore equity.

Achievements

SUMMARY OF THE ACHIEVEMENTS OF THE MEC DELIVERABLES FOR 2002/03

Challenges The mission of the Free State Provincial Government is:

Enhancing economic development and job creation. Providing and facilitating sustainable infrastructure development. Investing in the development of people of the Province. Ensure a safe and secure environment.

To support these, the thrust on the Free State Department of Health remain:

Strengthening the Primary Health Care services. Implementation of district Health System. Improvement of quality care in all facilities. Decisively dealing with HIV/ AIDS and other communicable diseases. Efficient and effective management of resources including personnel.

Challenges: continue External and Internal factors affecting Health Care delivery

within the province:

The poor socio-economic status of the majority of the Free State population poses major challenges to the delivery of appropriate health care services.

Cross border flow and inappropriate self referrals affect the health budget. HIV/ AIDS epidemic requires sustainable and effective intervention if significant

cost implications are to be managed. The District Health system should form the foundation for the delivery of health

care. A monitoring mechanism is required, to ensure that public health resources are

aligned with Primary Health Care priorities. 24 hour Primary Health Care facilities are needed to enable treatment at the

clinically appropriate level. Completion of the transformation of Emergency Medical Services and Patient

transport system to support referral systems. Current Human Resources policy needs to be reviewed. Marketing of health services Provision of quality health care

Thank You