CLUSTER: HOSPITAL SERVICES Presentation to Portfolio Committee on Health 3 April 2001

Cluster Manager…….R m Health Technology…….R m Facilities Planning…….R m Hospital Management…….R m Emergency Medical Services & Disaster Management…….R m Radiation Control…….R m Total …….R m Conditional Grants…….R bn CLUSTER DIRECTORATES AND BUDGETS:

HEALTH FACILITIES PLANNING

Integrated Health Planning Framework (IHPF) Quantifies National Policy Updates existing National Planning Framework Integrates health planning: 1.HR, finance, technology, quality 2.HSS, acute & chronic care, PHC Dynamic tool Long term Planning What is IHPF?

Development of affordability cost model Conditional grants and other funding to be investigated Generic Provincial Strategic Plan IHPF (continued) Activities

Implementation of Hospital Revitalisation Identifying pilot projects for Revitalisation Develop Business Plans Investigating World Bank funding Provincial allocations transferred and monitored Components Land & buildings Organisational development Health Technology / Equipment Quality of care

Conditional Grants Support rehabilitation of over 400 projects Assisting with commissioning of 3 Academic Hospitals (Durban, Umtata and Pretoria) OTHER ACTIVITIES Continue to -Develop databases and combined standards and guidelines for public and private health facilities -Develop database, standards and guidelines for mortuaries and EMS -Develop planning and commissioning guidelines

HEALTH TECHNOLOGY (HT) POLICY

HT - Policy Framework and Legislation HT Policy Framework - Approved by MINMEC in 02/01 - Implementation to resume - HT System Development Programme to be declared - HT System Programme Major Projects  HT ‘Scoping Study’  HT Audit  Essential HT Packages HT Legislation - To be finalised after the completion of HT policies - Develop strategy to close the present gap on critical equipment - Finalize Schedule of equipment for the CON

HT- (HT Management & Planning) HT Management Policy to be finalised - Meant to ensure equipment safety - Meant to reduce equipment downtime and disruption of service delivery - Equipment donor guidelines to be delivered - Staffing Norms to be finalised - HT Managers already trained for 7 provinces Organ Transplantation - Policy to be revised - Expert Committee to be put in place - Ongoing coordination of unrelated living donor transplants & evaluation of requests for non-South Africans

HT System - (Scoping Study) Scoping Study to provide  Analysis of RSA and International HT scenario  A strategy for HT System development including phasing of the four subsystems  Required resources (Rand, HR, Infrastructure)  Legal Implications  Evaluation and monitoring mechanisms including the time frames and indicators

HT System - Essential Health Technology Packages (EHTP) Integrated HT planning tool for (Essential Med equipment + related Cost & links to EDL and Essential HR)  To be finalised for Maternal & Child Health  Development at MRC (NDoH & WHO main funders)  RSA piloting the Field-Testing for 25 countries (RSA, Mozambique, Namibia reps for the region)

HT System – HT Audit To identify equipment gaps, physical status, deployment etc HT audit guidelines produced Pilot audit in 2 provinces to be completed (NP & EC) Completed Audits in 3 facilities (for EHTP field-testing)

HOSPITAL MANAGEMENT Decentralization of Hospital Management

Equip managers with appropriate competencies & skills Achieve competency framework agreements for all levels of hospital managers Device agreed role profiles for levels of management Capacity building for managers Business planning training in hospitals Information systems development Labour relations Cost centre training Orgnisational development HOSPITAL MANAGEMENT

Facilitate implementation of decentralisation of hospital management Develop a Nationally agreed policy on decentralisation process Identify criteria for conferring decentralised status Develop an assessment/audit tool

HOSPITAL MANAGEMENT Implementation of management systems & structures Complete the implementation of cost centres in the pilot hospitals Support Provinces roll-out of cost centres Improve and support the efficiency of Hospital Boards Produce guidelines on the functioning of hospital and community boards

HOSPITAL MANAGEMENT Improve the effective and appropriate spending of financial resources Improve the financial monitoring & reporting mechanisms Business plans Monthly & quarterly reports - intervention

HOSPITAL MANAGEMENT STRATEGIC POLICY DIRECTIONS Building Financial Management Capacity Ensuring democratic Public Hospital governance Attainment of nationally agreed approach to decentralisation

EMERGENCY MEDICAL SERVICES AND DISASTER MANAGEMENT

EMERGENCY MEDICAL SERVICES PROVINCIALISATION OF SERVICES Support the North West, Eastern Cape and Gauteng in their provincialisation process North West and Eastern Cape due to complete exercise in June 2001 Gauteng unlikely to complete before year-end

EMERGENCY MEDICAL SERVICES NORMS AND STANDARDS Include in National Planning Framework Develop costing models Regulations Pre-hospital emergency medical services In-hospital emergency centres

DISASTER MANAGEMENT Policy and Guidelines for National and Provinces establish focal points in provinces develop contingency plans Resource Data Base resource support project health reaction teams

DISASTER MANAGEMENT Red Cross Act community capacity enhancement program auxiliary body to Health in an emergency Training source appropriate training in district management establish development program for district management personnel

RADIATION CONTROL

PRIORITIES: 2001 Revise and broaden the quality Assurance programme to include CT and dental x-ray units Start a programme to license the use of industrial radio-frequency equipment Update the sale database and publish a 2001 sourcebook of licensed electromedical equipment Investigate a regulatory fee structure Tighten control over Industrial Radiography - start re-registration process

CONDITIONAL GRANTS

Central Hospital ProvincesBudgetTransfExpected Expend Varian ce E. C13,000 3,00010,000 GP1,492,868 0 WC961,949 0 FS237,538 0 KZN406,645 0 Total3,112,000 3,102,00010,000

ProvBudgetTransfExpected Expend Variance EC 52,830 0 MP 23,480 0 NC 23,480 0 NP 23,480 0 NW 23,480 0 GP 503,646 0 WC 292,326 0 FS 84,528 0 KZN 146,750 0 Total 1,174,000 0 Health Prof Training & Research

ProvBudgetTransfExpected Expend Variance EC 84,000 40,00044,000 MP 35,000 0 NC 8,500 7,0001,500 NP 69,490 0 NW 40,000 36,7103,290 GP 55,000 0 WC 28,362 0 FS 32,261 20,34211,919 KZN 70,526 0 Total423, ,43060,709 Hosp Reconstruction & Rehab

ProvBudgetTransfExpected Expend Varian ce EC 67,437 0 MP 56,169 O NC 26,039 O NP 75,481 0 NW 53,914 0 National6,90500 Total285,945279,040 6,905 Red of Highly Spec Services

New Durban Academic Hospital ProvinceBudget Transfered Expected Expend Variance KZN273,000 0 Total273,000 0

Umtata Academic ProvinceBudgetTransferedExpected Expend Variance EC111,855 0 Total111,855 0

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