1. INTRODUCTION List of Conditional Grants
HOSPITAL GRANTS
OPERATIONAL GRANTS
Central Hospitals
Health professionals training and research

2. List of Conditional Grants (cont)
CAPITAL GRANTS
Redistribution of specialised services
Hospital reconstruction and rehabilitation (R&R)
Construction
Pretoria
Durban
Umtata

3. List of Conditional Grants (cont)
PSNP & INP
Primary school nutrition programme (PSNP) and Integrated nutrition programme (INP)
HIV/AIDS
National integrated plan for children and youth infected and affected by HIV/AIDS

4. General Notes Conditions Business plans developed and approved
Expenditure in accordance with business plan
Monthly financial reports
Quarterly financial reports
Quarterly progress reports
Certificate signed by provincial Accounting Officer at the end of the financial year

5. General Notes (continue)
Monitoring
Provincial heads of health submit monthly financial reports
Statistical formats to be completed on quarterly basis:
List of indicators pertaining to expenditure vs cash flow
Progress against action plan
RDP indicators and INP indicators

6. General Notes (continue)
Monitoring (continue)
Provincial liaison and technical support visits
Regular meetings per financial year between national department and provinces

7. Administrative costs There are no material administrative costs.
The cost of planning and monitoring is material
These costs are carried by the national Department and have not not been quantified

8. Payment schedules
Central hospitals and Health Professionals Training and Research - On a monthly basis
All other grants – On a quarterly basis in advance

9. Capacity and preparedness of national transferring department
Officials in the national office are designated to monitor the grants
Supported by existing administrative staff
Additional staff to be appointed where existing staff cannot cope with the work load
Performance of the national Department to be assessed in terms of:
Regular visits to provinces
Timeous reporting to Department of Finance
Compliance with agreed transfer schedules

10. Central Hospitals PURPOSE
To ensure collective planning of highly specialised services
To ensure that long term strategic planning is not disrupted by budgetary problems
To ensure that all citizens have equity of access to services and that there is reasonable distribution of services
To eliminate the need for one province to charge another for these services

11. Criteria for division
Based upon meeting 75% of operating expenditure of ten central hospitals:
Free State - Universitas
Gauteng - Chris Hani-Baragwanath, Johannesburg, Pretoria Academic & Garankuwa
KZN - King Edward & Wentworth
Western Cape- Groote Schuur, Tygerberg & Red Cross

12. Criteria for division
An allocation to Eastern Cape for Grahamstown high security psychiatry facility has been included for 2000/01

13. Rationale for funding through conditional grant
These Central Hospitals are national assets because of the types of services they deliver
Because of the nature of these services it can only be offered at certain institutions
Services must be accessible across provinces
Cannot be funded through equitable share

14. Past Performance

15. Actual Allocation

16. Health Professionals Training and Research PURPOSE
To support the training of all categories of health professionals and to support research
To compensate provinces for the additional service costs
To pursue the policy objective of shifting most teaching from central hospitals

17. Criteria for division
During 1998/99 the allocation was made on the basis of the number of final year medical students
10% of the grant was divided equally between provinces without a medical school
In following financial years, it was adjusted for inflation

18. Rationale for funding through conditional grant
Recruitment and selection of is not limited to geographical boundaries
The research component is not limited by provincial boundaries

19. Past Performance

20. Actual Allocation

21. Redistribution of specialised services PURPOSE
To improve equity of access to tertiary care
To reduce the number of people who have to be transferred
To build expertise, specialist training, clinical standards and morale
To build up facilities, resources and tertiary services in at least one hospital per province

22. Criteria for division
Owing to inequalities in provinces, the need for the service and the cost of establishing it is considered primarily in allocating funds
The population of the five provinces is used broadly to guide provincial allocations

23. Past Performance

24. Actual Allocation

25. Hospital Reconstruction and Rehabilitation(R&R) Purpose
To fund a major hospital R&R project in all provinces

26. Criteria for division
A major hospital facilities audit doen in 1995 indicated the need
An index was calculated which reflected the study as a backlog index for each province
This index forms the base for the division of funds
Restructure hospital sector

27. Rationale for funding through conditional grant
To achieve specific national objective of transformation of hospital sector requires national based funding
The equitable share distribution does not match the required fund distribution to achieve an equitable base in the health infrastructure
To develop and monitor infrastructure planning require conditionality on processes

28. Past Performance

29. Actual Allocation

30. Construction Durban Academic Hospital Pretoria Academic Hospital Umtata Academic Hospital
PURPOSE
To fund the construction and equipment of the Durban, Pretoria and the Umtata Academic Hospitals

31. Rationale for funding through conditional grant
These are some of the designated central hospitals which will deliver mostly tertiary and quaternary services

32. Past Performance

33. Actual Allocation

34. Primary School Nutrition Programme (PSNP) & Integrated Nutrition Programme (INP)
PURPOSE
Implemented in 1994
Focus include school feeding, nutrition education and health promotion
RDP allocation replaced by PSNP Conditional Grant in 1998/99 financial year

35. PURPOSE (cont)
On 30 April 1999 approval from DSE was obtained to use PSNP Conditional Grant allocation to create infrastructure for and fund recurrent expenditures of the INP.

36. Criteria for division
The INP/PSNP Conditional Grant Allocation replaced the RDP Allocation
Methodology for distribution to provinces was maintained
Projected population
Poverty gap figures

37. Rationale for funding through conditional grant
SA become signatory to the Rights of the Child in 1995
Government pledged itself to prioritise children’s issues
Initiated as a Presidential Lead Project of the RDP
Provided to ensure and facilitate the nutrition and social development of children
Funding through equitable share would not guarantee funding for this priority

38. Past Performance

39. Actual Allocation

40. National integrated plan for children and youth infected and affected by HIV/AIDS PURPOSE
Ensure access to appropriate and effective integrated system of prevention, care and support services for children infected and affected by HIV/AIDS

41. Criteria for division Principles
Areas (provinces) of highest prevalence
Priority provinces identified by Cabinet
Areas where poverty alleviation programmes are being implemented
Areas where the Integrated Nutrition Programme is implemented
Areas in need of social upliftment

42. Criteria for division
At the end of 1999 an audit was done on the readiness of the health & NGO sector to deliver home- community based care and support. This was used as basis for allocations as well as business plans submitted by provinces

43. Rationale for funding through conditional grant
HIV/AIDS is a Government priority. Should this become part of the equitable share, there is no guarantee that it will be used for the intended purpose
The National Department is not in a position to fund the Integrated Plan out of its annual budget.

44. Past Performance

45. Actual Allocation