1. National Department of Health Presentation to the Standing Committee on Appropriations Public Hearings on the Adjustments Appropriation Bill
05 November 2010

2. CONTENTS Adjustment Budget. Expenditure as at 30 September
Conditional Grants.
Conclusion.

3. The budget for NDOH will be adjusted from R21,5 billion to R21,6 billion due to increase of R164,5 million.
The National Department of Health agree with proclamation of the Adjustments Appropriation Bill.
Adjustment Budget

4. Adjustment Budget Cont…
An amount of R49,8 million was for funds rolled over for the following:
R11 million for the installation of information technology infrastructure in the newly refurbished Civitas Building.
R3,2 million for FIFA World Cup unspent funds. The funds are however committed.
R17 million on Hospital Revitalization for improved programme management (R12 million ) and Health Technology and management Audits (R5m).

5. Adjustment Budget Roll over Cont…
Tuberculosis Day Event for R1,2 million.
H1N1 Influenza Vaccines R4,4 million.
Audit of primary health care facilities for the amount of R5 million.
District Health Information systems for the amount of R8 million.

6. Adjustment Budget Additional Allocations.
Salary and Housing Allowance increase for R9,7 million based on the new wage agreement.
Unforeseeable and Unavoidable Expenditure to the amount of R105 million:
Comprehensive HIV and AIDS Grant , R40 million.
National: Distribution of Condoms, R60 million.
Medicines Control Council (MCC) to Support its turnaround strategy , mainly on staffing and to address backlogs in medicines registration, R5 million.

7. Adjusted Estimates of National Expenditure
Programme R,000
Main Appropriation
Roll-Overs
Unforeseeable/Unavoidable
Virements and Shifts
Other Adjustements
Total Adjustements
Adjusted Appropriation
Administration
264,834
11,000
3,600
2,700
17,300
282,134
Strategic Health Programme
7,294,902
5,624
100,000
1,100
106,724
7,401,626
Health Planning and Monitoring
406,933
3,203
1,000
3,500
7,703
414,636
Health Human Resources Management and Development
1,897,051
500
1,897,551
Health services
11,528,757
30,000
-3,600
1,900
28,300
11,557,057
International Relations, Health Trade and product Regulation
104,508
5,000
-1,000
4,000
108,508
GRAND TOTAL
21,496,985
49,827
105,000
9,700
164,527
21,661,512

8. CURRENT EXPENDITURE AS AT 30 SEPTEMBER 2010
Target as at September 50%
Actual is at 49,30%
The improvement of condition of service (salary increase) will only reflect in November

9. Programme 1: Administration
ECONOMIC CLASSIFICATION
BUDGET
R'000
ACTUAL EXPENDITURE
VARIANCE
EXPENDITURE IN PERCENTAGES
Current Payments
257,677
106,162
151,515
41.20%
Compensation of Employees
111,709
50,031
61,678
44.79%
Goods and Services
145,968
56,131
89,837
38.45%
Transfers and Subsidies
370
535
(165)
144.59%
Capital Payments
6,787
2,081
4,706
30.66%
GRAND TOTAL
264,834
108,778
156,056
41.07%

10. Programme 2: Strategic Health Programme
ECONOMIC CLASSIFICATION
BUDGET R'000
ACTUAL EXPENDITURE R'000
VARIANCE R'000
EXPENDITURE IN PERCENTAGES
Current Payments
441,323
184,807
256,516
41.88%
Compensation of Employees
89,483
40,876
48,607
45.68%
Goods and Services
351,840
143,931
207,909
40.91%
Transfers and Subsisdies
6,837,256
3,314,021
3,523,235
48.47%
Capital Payments
16,323
2,878
13,445
17.63%
GRAND TOTAL
7,294,902
3,501,706
3,793,196
48.00%

11. Programme 3: Health Planning and Monitoring
ECONOMIC CLASSIFICATION
BUDGET R'000
ACTUAL EXPENDITURE R'000
VARIANCE
R'000
EXPENDITURE IN PERCENTAGES
Current Payments
126,027
45,891
80,136
36.41%
Compensation of Employees
64,647
29,138
35,509
45.07%
Goods and Services
61,380
16,753
44,627
27.29%
Transfers and Subsisdies
277,839
135,264
142,575
48.68%
Capital Payments
3,067
2,944
123
95.99%
GRAND TOTAL
406,933
184,099
222,834
45.24%

12. Programme 4: Health Human Resources Management and Development
ECONOMIC CLASSIFICATION
BUDGET
R'000
ACTUAL EXPENDITURE R'000
VARIANCE
EXPENDITURE IN PERCENTAGES
Current Payments
31,137
14,654
16,483
47.06%
Compensation of Employees
17,211
7,265
9,946
42.21%
Goods and Services
13,926
7,389
6,537
53.06%
Transfers and Subsidies
1,865,387
955,328
910,059
51.21%
Capital Payments
527 59
468
11.20%
GRAND TOTAL
1,897,051
970,041
927,010
51.13%

13. Programme 5: Health Services
ECONOMIC CLASSIFICATION
BUDGET R'000
ACTUAL EXPENDITURE
R'000
VARIANCE R'000
EXPENDITURE IN PERCENTAGES
Current Payments
103,103
30,405
72,698
29.49%
Compensation of Employees
43,900
20,267
23,633
46.17%
Goods and Services
59,203
10,138
49,065
17.12%
Transfers and Subsidies
11,422,419
5,774,903
5,647,516
50.56%
Capital Payments
3,235
1471
1,764
45.47%
GRAND TOTAL
11,528,757
5,806,779
5,721,978
50.37%

14. EXPENDITURE IN PERCENTAGES
Programme 6: International Relations, Health Trade and product Regulation
ECONOMIC CLASSIFICATION
BUDGET
R'000
ACTUAL EXPENDITURE R'000
VARIANCE
EXPENDITURE IN PERCENTAGES
Current Payments
103,732
27,483
76,249
26.49%
Compensation of Employees
42,754
18,636
24,118
43.59%
Goods and Services
60,978
8,847
52,131
14.51%
Transfers and Subsidies
100
(100)
Capital Payments
776 62
714
7.99%
GRAND TOTAL
104,508
27,645
76,863
26.45%

15. Expenditure Summary per Programme
BUDGET
R'000
ACTUAL EXPENDITURE R'000
VARIANCE
EXPENDITURE IN PERCENTAGES
Administration
264,834
108,778
156,056
41.07%
Strategic Health Programme
7,294,902
3,501,706
3,793,196
48.00%
Health Planning and Monitoring
406,933
184,099
222,834
45.24%
Health Human Resources Management and Development
1,897,051
970,041
927,010
51.13%
Health services
11,528,757
5,806,779
5,721,978
50.37%
Internation Relations, Health Trade and product Regulation
104,508
27,645
76,863
26.45%
GRAND TOTAL
21,496,985
10,599,048
10,897,937
49.30%

16. Expenditure Summary per Economic Classification
BUDGET
R'000
ACTUAL EXPENDITURE R'000
VARIANCE
EXPENDITURE IN PERCENTAGES
Current Payments
1,062,999
409,402
653,597
38.51%
Compensation of Employees
369,704
166,213
203,491
44.96%
Goods and Services
693,295
243,189
450,106
35.08%
Transfers and Subsidies
20,403,271
10,180,151
10,223,120
49.89%
Capital Payments
30,715
9,495
21,220
30.91%
GRAND TOTAL
21,496,985
10,599,048
10,897,937
49.30%

17. Analysis of Expenditure.
The target of expenditure for end of September was 50%, the NDOH achieved 49,30%.
There was under spending of 1,7 % which was attributed to:
Compensation of Employees (COE) delay in finalizing wage agreement. The expenditure will pick up at end of Nov. as the matter is now finalized.
Accruals amounting to R30m are still to be paid. This should influence the actual expenditure percentage positively, once paid.
Capital expenditure funding is being reviewed to address the turnaround strategy for the current IT challenges in the Department.

18. CONDITIONAL GRANTS REPORT
30 SEPTEMBER 2010

19. COMPREHENSIVE HIV AND AIDS
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
690,940
335,546
278,308
48.6%
40.3%
412,632
Free State
433,583
216,792
147,905
50.0%
34.1% -
Gauteng
1,277,683
636,536
614,154
49.8%
48.1%
KwaZulu-Natal
1,498,811
694,371
548,336
46.3%
36.6%
Limpopo
514,896
257,448
250,505
48.7%
557,804
(42,908)
Mpumalanga
383,646
183,831
173,329
47.9%
45.2%
390,147
(6,501)
Northern Cape
182,306
107,426
66,893
58.9%
36.7%
North West
475,838
237,918
186,731
39.2%
478,809
(2,971)
Western Cape
554,054
284,365
219,248
51.3%
39.6%
Total
6,011,757
2,954,233
2,485,409
49.1%
41.3%
5,651,505
360,252

20. FORENSIC PATHOLOGY SERVICES
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
69,345
39,750
25,622
57.3%
36.9%
43,723
Free State
37,218
16,405
14,052
44.1%
37.8% -
Gauteng
92,421
47,478
38,454
51.4%
41.6%
KwaZulu-Natal
152,406
76,202
94,590
50.0%
62.1%
Limpopo
39,913
20,500
19,751
49.5%
43,113
(3,200)
Mpumalanga
50,107
24,459
15,597
48.8%
31.1%
50,277
(170)
Northern Cape
22,868
12,500
9,289
54.7%
40.6%
21,209
1,659
North West
26,433
13,216
10,712
40.5%
Western Cape
66,251
35,788
45,036
54.0%
68.0%
73,653
(7,402)
Total
556,962
286,298
273,103
49.0%
522,352
34,610

21. HEALTH PROFESSIONS TRAINING AND DEVELOPMENT
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
160,444
80,220
22,296
50.0%
13.9%
138,148
Free State
117,400
58,698
63,402
54.0% -
Gauteng
651,701
325,848
325,849
KwaZulu-Natal
235,771
117,882
101,267
43.0%
Limpopo
94,085
62,280
59,142
66.2%
62.9%
99,925
(5,840)
Mpumalanga
76,149
46,500
32,863
61.1%
43.2%
77,550
(1,401)
Northern Cape
61,802
29,882
20,022
48.4%
32.4%
North West
83,324
41,664
37,448
44.9%
83,899
(575)
Western Cape
384,711
192,354
Total
1,865,387
955,328
854,643
51.2%
45.8%
1,735,055
130,332

22. HOSPITAL REVITALIZATION
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
360,660
195,115
88,746
54.1%
24.6%
271,914
Free State
378,426
200,558
62,860
53.0%
16.6%
245,589
132,837
Gauteng
798,609
435,606
391,395
54.5%
49.0% -
KwaZulu-Natal
500,815
179,834
100,813
35.9%
20.1%
300,815
200,000
Limpopo
323,425
159,093
88,713
49.2%
27.4%
346,582
(23,157)
Mpumalanga
331,657
190,095
166,568
57.3%
50.2%
371,875
(40,218)
Northern Cape
420,218
176,741
122,147
42.1%
29.1%
350,061
70,157
North West
326,303
216,182
193,508
66.3%
59.3%
376,303
(50,000)
Western Cape
580,554
320,053
271,955
55.1%
46.8%
608,287
(27,733)
Total
4,020,667
2,073,277
1,486,705
51.6%
37.0%
3,486,867
533,800

23. INTERVENTIONS FOR THE REVITE GRANT.
Projected R542 million under expenditure including provincial roll overs has been confirmed with the provinces.
Business plans have been revised and the funds are being redirected for other projects within the same framework.
Treasury is being consulted regarding provinces which show projected over expenditure to receive additional funding from the projected under expenditure.

24. NATIONAL TERTIARY SERVICES
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
557,137
278,568
324,251
50.0%
58.2%
232,886
Free State
659,469
329,736
292,750
44.4% -
Gauteng
2,561,154
1,280,580
KwaZulu-Natal
1,102,585
551,292
503,681
45.7%
Limpopo
257,314
128,658
123,139
47.9%
278,757
(21,443)
Mpumalanga
91,879
45,942
28,940
31.5%
Northern Cape
225,948
112,974
86,226
38.2%
North West
179,280
89,640
54,383
30.3%
Western Cape
1,763,234
881,616
Total
7,398,000
3,699,006
3,575,566
48.3%
7,186,557
211,443

25. SUMMARY OF HEALTH CG GRANTS
Province
Division of Revenue Act, 2010 (Act No. 1 of 2010)
Payment Schedule: Year to date
Received by province: Year to date
Provincial actual payments
% Transferred of national allocation
% Actual payments of total available
Projected outcome for financial year
Projected (over)/under
R thousand
Eastern Cape
1,838,526
929,199
739,223
50.5%
40.2%
1,099,303
Free State
1,626,096
822,189
580,969
50.6%
35.7%
1,493,259
132,837
Gauteng
5,381,568
2,726,048
2,650,432
50.7%
49.3% -
KwaZulu-Natal
3,490,388
1,619,581
1,348,687
46.4%
38.6%
3,290,388
200,000
Limpopo
1,229,633
627,979
541,250
51.1%
44.0%
1,326,181
(96,548)
Mpumalanga
933,438
490,827
417,297
52.6%
44.7%
981,728
(48,290)
Northern Cape
913,142
439,523
304,577
48.1%
33.4%
841,326
71,816
North West
1,091,178
598,620
482,782
54.9%
44.2%
1,144,724
(53,546)
Western Cape
3,348,804
1,714,176
1,610,209
51.2%
3,383,939
(35,135)
Total
19,852,773
9,968,142
8,675,426
50.2%
43.7%
18,582,336
1,270,437

26. Management and Monitoring of Conditional Grants
Monthly meetings are being held within the Department with the DG and the grant managers to review progress made and to advise and suggest for interventions where applicable.
More work still needs to be done at grant level to monitor performance and the grant indicators in terms of the approved business plans.
Relevant DDGs are urged to ensure quality of reports submitted on the performance of the grants.

27. Conclusion.
The challenge for NDOH is ensuring that the 91% grant funds achieve objectives, targets and goals intended. ( part of performance measurement)