1. BUDGET PRESENTATION NATIONAL DEPARTMENT OF HEALTH PRESENTATION TO THE SELECT COMMITTEE ON SOCIAL SERVICES 24 May 2002

2. BUDGET PRESENTATION

7. Brief Explantion of the New Grant Framework for Tertiary Services and the Health Professionals Training and Development Thabo Sibeko Chief Director Hospital Services

8. BUDGET PRESENTATION 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)

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

10. BUDGET PRESENTATION

13. 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)

14. BUDGET PRESENTATION 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.

15. BUDGET PRESENTATION 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

16. BUDGET PRESENTATION 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

17. BUDGET PRESENTATION CONDITIONAL GRANTS (HOSPITAL GRANTS)

18. BUDGET PRESENTATION LIST OF OLD & NEW GRANTS HospitalMx& Quality Improvement Hospital RevitalizationHospital reconstruction & rehabilitation Pretoria Academic Health professional training & development Health professional training & research National tertiary servicesCentral hospitals and RHSS NewOld

19. BUDGET PRESENTATION 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

20. BUDGET PRESENTATION 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

21. BUDGET PRESENTATION Payment Schedule National Tertiary Services and HPT &D- monthly transfers Hospital revitalization,Pretoria Academic- quarterly advances and Hosp Mx & Quality Improvement- 3 advance installments

22. BUDGET PRESENTATION Payment Schedule National Tertiary Services and HPT &D- monthly transfers Hospital revitalization,Pretoria Academic- quarterly advances and Hosp Mx & Quality Improvement- 3 advance installments

23. BUDGET PRESENTATION NTSG

24. BUDGET PRESENTATION Hospital Mx & Quality Improvement

25. BUDGET PRESENTATION HPT & D

26. BUDGET PRESENTATION Hospital Revitalization

27. BUDGET PRESENTATION PROVINCIAL HEALTH BUDGETS 2002/03 Portfolio Committee on Health 24 May 2002

28. BUDGET PRESENTATION Expenditure 2001/02

29. BUDGET PRESENTATION Expenditure on conditional grants

30. BUDGET PRESENTATION

34. PROVINCIAL PER CAPITA SPENDING (excl CGs) 0 200 400 600 800 1000 1200 1400 1600 Eastern CapeFree StateGautengKwaZulu- Natal MpumalangaNorthern Cape Northern Province North WestWestern Cape Total Series1 Series2