1. 2015/10/261 NATIONAL DEPARTMENT OF HEALTH PRESENTATION TO THE STANDING COMMITTEE ON APPROPRIATIONS 2009 MEDUIM TERM BUDGET POLICY STATEMENT (MTBPS) 30 October 2009

2. 2015/10/262 OUTLINE OF THE PRESENTATION: Introduction. New NHS priorities. 2009/2010 April – September Actual Expenditure results. Adjusted Estimates 2009/2010. MTEF Budget Proposals. Budget Pressures. Conclusion.

3. INTRODUCTION The Department of Health addresses the third Medium term priority pronounced by Cabinet namely : Improving health outcomes. In implementing the priority as set out, the Department has developed a new Ten Point Plan. 2015/10/263

4. NEW NHS PRIORITIES FOR 2009-2014 (i) Provision of strategic leadership and creation of a social compact for better health outcomes; (ii)Implementation of a National Health Insurance Plan; (iii) Improving Quality of Services; (iv) Overhauling the health care system and improve its management; (v) Improving Human Resources Management; (vi) Revitalization of physical infrastructure; (vii) Accelerated implementation of HIV and AIDS Plan and reduction of mortality due to TB and associated diseases; (viii) Mass mobilisation for better health for the population; (ix) Review of the Drug Policy; (x) Strengthening Research and Development

5. Review of Actual Expenditure for the National Department April – September 2009. PROGRAMMEOriginal Allocation Adjusted Appropriation April – September Exp. % Expenditure of Adjusted Appropriation. 1.Administration 236 596 260 437 133 779 51.4 2. Strategic Health Prog. 4 692 328 5 791 253 2 402 712 41.5 3. Health Planning & Monitoring 357 084 396 449 177 471 44.8 4. Health Human Resources Management & Development. 1 786 224 1 798 947 891 002 49.5 5. Health Services 9 898 865 10 086 099 5 206 603 51.6 6. International Relations, Health Trade & Product Regulation 86 997 90 247 45 370 50.3 TOTAL 17 058 094 18 423 459 8 856 937 48.1 5

6. Review of Actual Expenditure for the National Department April – September 2009. Economic classifications. Econ. Class Original Allocation Adjusted Appropriation April – September Exp. % Expenditure of Adjusted Appropriation. Compensation of Employees 299 901 329 132 160 342 48.7 Goods and Services 638 026 820 542 293 294 35.7 Transfers and Subsidies 16 091 839 17 247 364 8 397 583 48.7 Payments for Capital assets 28 328 26 421 5 712 21.6 TOTAL 17 058 094 18 423 459 8 856 937 48.1 6

7. APRIL – SEPTEMBER EXPENDITURE RESULTS. From the figures indicated, after the Adjusted appropriation allocations, the Department is at 48.1%. The 1.9% variance from the target of 50% as at end of September is influenced by additional funding as well as rolled over amounts. 2015/10/267

8. ADJUSTED ESTIMATES 2009/2010. The total increase for the Department amounts to R1,365 billion. Of the R1,365billion, an amount of R231,088 million refers to requested roll over funds for the 2008/09 financial year. That makes 17% of the increase. R160million is earmarked for the H1N1 Influenza pandemic. 8

9. ADJUSTED ESTIMATES 2009/2010. Additional funding received PRIORITY AREA H1N1 Influenza pandemic. ART – Comprehensive HIV&AIDS Care Management & Treatment. Countrywide measles & polio mass immunization campaign. 2010 World Cup Health preparation strategy grant. FUNDING in millions 160 000 900 000 20 000 30 000 9

10. ADJUSTED ESTIMATES 2009/2010. Additional funding received PRIRITY AREA General Salary adjustments: National Department. Public Entities: - National Health. Laboratory Services. - SA Medical Research Council. FUNDING in millions. 7 348 11 064 5 865 10

11. ADJUSTED ESTIMATES 2009/2010. Additional funding received. The Department deemed it critical to request National Treasury to hold the funding earmarked for provincial health departments for H1N1; ART and 2010 World cup at National level, to ensure that the funds are utilized for intended purposes. Procurement of goods and services will be done centrally in consultation with the provinces. 11

12. ADJUSTED ESTIMATES 2009/2010 The National Department shifted funds within programmes, mainly from Goods and services, after a thorough review and alignment as a result of the drive ( by the Finance Minister) to cut and save costs from travel & subsistence, conferencing as well as consultancy services. Identified funding was then moved to provide for new priority areas as per the new Ten Point Plan. 2015/10/2612

13. 13 MTEF BUDGET PROPOSALS. For the current MTEF budget bids process, the Department took a resolution, in order to stabilize the health sector, to focus on the following critical funding areas which are part of the ten point plan as well as for strengthening of the public health services: - Full funding of ALL OSD categories. - Fully funding of “warm bodies”: Compensation of Employees, to deal with the over expenditure. - Adequate funding of the ART programme. - Adequate funding of the Blood Services (SANBS) and the laboratory services (NHLS).

14. 14 MTEF BUDGET PROPOSALS. R million10/1110/1210/13 HIV/AIDS2,6003,1004,000 Doctor OSD 400 Health therapists OSD 500 550 600 Health stabilization and rescue plan (provinces) 1,5002,5003,000 EMS 2010 final preparations 267 0 0

15. SPECIAL NHC 28TH AUGUST15 MTEF BUDGET PROPOSALS. R million10/1110/1210/13 National Department various 192 194 150 TOTAL5,4596,7448,150

16. 16 BUDGET PRESSURES Ensuring full funding of ALL OSD categories and implementation. Adequate funding of the Comprehensive HIV&AIDS Treatment Plan. Funding of the Infrastructure. Payment and management of the Blood Services (SANBS) and the laboratory services (NHLS). Fully funding of “warm bodies”.( Personnel). Funding inflation related cost drivers. Clearing of Accruals from08/09.

17. 17 CONCLUSION The Budget proposals are preliminary and still to be discussed and finalized with the National Treasury. The Department is aware of the economic climate due to the melt down but has focused on the Ten Point Plan priorities. Provincial Health Departments also have to engage with their provincial treasuries for possible increase in their equitable share allocations.

18. 2015/10/2618 NATIONAL DEPARTMENT OF HEALTH THANK YOU.