1. STANDING COMMITTEE ON APPROPRIATIONS NATIONAL HEALTH GRANT PREPAREDNESS 8 March 2013 1

2. NATIONAL HEALTH GRANT The National Grant Consist of two components: –Health Facility Revitalisation Grant –National Health Insurance Grant –These two components split into Direct Provincial Allocations In-Direct National Allocation (Grant In-Kind) 2

3. REFORM OF INFRASTRUCTURE GRANTS AND PREPAREDNESS 3

4. Why Grant Reform? The following where the cost driver of grants reform: –HRG and NCSG are Schedule 5 while HIG is Schedule4 –Challenges on project planning Hospitals under HIG never peer reviewed HIG does not provide HT in most provinces HIG does not address organisational development Change of project scope of work –Budget re-allocation from one project to another or among provinces –Compliance with DORA conditions –AG audit frameworks separately even though the implementation is done jointly –Write to NT every time there is a shift from one grant to another 4

5. Why Grant Reform? –Advantage of one Infrastructure Grant: Three Grants (HRG, HIG and NCSG) will be treated as components in 2013/14 Provinces are allowed to shift money from one component to another and projects re-gazetting will be done once a quarter through NT Flexibility to move funds from poor performing project to performing project within the province and within the given envelop AG will focus on one set of conditional grant framework- easy to comply Easy to manage by both national and provincial department of health Available resources can be utilised as one team 5

6. NATIONAL HEALTH GRAN T 6

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10. INFRASTRUCTURE LEVEL OF PREPAREDNESS TO IMPLEMENT PROVINCIAL DIRECT ALLOCATION AND NATIONAL “IN-KIND” ALLOCATION 10

11. White markers indicate position of Deloitte Drawing Guides 7.40 cm 2.91 Inches 6.00 cm 2.36 Inches 8.00 cm 3.15 Inches  11.70 cm  4.61 inches 0.50 cm  0.2 inches   0.50 cm  0.2 inches 11.70 cm  4.61 inches  To view Deloitte drawing guides: 1.Right-click on slide and select ’Grid and Guides...’ 2.Check ’Display drawing guides on screen’ 3.Select ’OK’ Health Facility Infrastructure Grant (Direct Grant)-3 Components HRG Sub Component HIG Sub Component NC& S Grant Component National Health Grant (Grant in-kind/indirect grant) -2 Components Infrastructure Grant Component HRG Sub Component HIG Sub Component NC&S Grant Component NHI Grant Component National Department of Health Infrastructure Unit Grant Management Structure 11

12. White markers indicate position of Deloitte Drawing Guides 7.40 cm 2.91 Inches 6.00 cm 2.36 Inches 8.00 cm 3.15 Inches  11.70 cm  4.61 inches 0.50 cm  0.2 inches   0.50 cm  0.2 inches 11.70 cm  4.61 inches  To view Deloitte drawing guides: 1.Right-click on slide and select ’Grid and Guides...’ 2.Check ’Display drawing guides on screen’ 3.Select ’OK’ National Department of Health Grant Management Structure Health Facility Infrastructure Grant (Direct Grant)-3 Components R5124 M F/Y 13/14 HRG Sub Component R3752 M, F/Y 13/14 HIG Sub Component R1296 M, F/Y 13/14 NC& S Grant Component R76 M, F/Y 13/14 National Health Grant (Grant in- kind/indirect grant) -2 Components Infrastructure Grant Component R807 M, 13/14 F/Y HRG Sub Component R332 M 13/14 F/Y HIG Sub Component R401M 13/14 F/Y NC&S Grant Component R74 M 13/14 F/Y NHI Grant Component Somerset East Nursing School and Settlers Nursing school, new schools in 14-15 and 15-16 for two new nursing colleges in EC Manapo Nursing College in FS- SG Lourens Nursing College, Garankuwa Nursing College in GP Thohoyandou Nursing College in LP Three Nursing Colleges in MP- Tswaragano Nursing College in NC Taung Nursing School ; Mmabotho Nursing College in NW 5 new Clinics in EC under HIG 7 new Clinics in FS under HIG 5 new Clinics in PM under HIG 5 new Clinics (in NW under HIG Replacement of Tshilidzini hospital ; Elim Hospital in LP under HIG. In-Loco Supervision. GPs OA: (10 in NC, 70 in KZN and 30 each in other provinces) Two additional hospitals in EC under HRG New district Hosp in Shoshanguve GP under HRG Siloam Hospital in LP under HRG In-Loco site supervision 12

13. White markers indicate position of Deloitte Drawing Guides 7.40 cm 2.91 Inches 6.00 cm 2.36 Inches 8.00 cm 3.15 Inches  11.70 cm  4.61 inches 0.50 cm  0.2 inches   0.50 cm  0.2 inches 11.70 cm  4.61 inches  To view Deloitte drawing guides: 1.Right-click on slide and select ’Grid and Guides...’ 2.Check ’Display drawing guides on screen’ 3.Select ’OK’ Schematic Concept of contracting options, of various In-Kind funded Projects by NDoH Hospital revitalization in some NHI districts Building of new clinics in some NHI districts Nursing Colleges and Schools Revitalization G Ps Operational Accommodations Project Management Two additional hospitals in EC In NHI District, -One New district Hospital in Shoshanguve in GP In NHI District Siloam Hospital in LP in NHI District, Replacement of Tshilidzini hospital and Elim Hospital in LP, NHI District, 5 new Clinics in EC 7 new Clinics in FS 5 new Clinics in MP 5 new Clinics in NW Somer Set East Nursing School and Settlars Nursing school, new schools in 14-15 and 15-16 for two new nursing colleges. In EC Manapo Nursing College in FS SG Lourens Nursing College, Garankuwa Nursing College in GP Thohoyandou Nursing College in LP Three Nursing Colleges, new projects in MP- Tswaragano Nursing College, new projects in NC Taung Nursing School ; Mmabotho Nursing College ; new projects in NW Project Professional Service Provider per hospital using the Kahylitsha district hospital design Contractors Project Professional Service Provider, using prototype clinic design per province or one for all Contractors Project Management Alternatively, design and build contract/s for new ones One Project Management Project Professional Service Provider per nursing college or school Contractors Project Management Resident Engineers and Clerks of Works appointed for projects at construction stage, depending on the size, nature and level of supervision Existing project structure in the provinces In-Loco Supervision of HIG and NC grant funded projects in provinces In-Loco Supervision of HRG funded projects in provinces Alternatively, design and build contract/s for new ones All projects at construction stage in HRG, HIG and NC&S The PMs making sure the installations are properly done to the suppliers specification Project Management Suppliers 10 in NC 70 in KZN All other provinces 30 each 13

14. Thank you www.doh.gov.za 14