1. Public Hearing on Performance of Hospital Revitalisation Programme Grant April – September 2010 Department of Health Western Cape 20 October 2010

2. Content Financial performance of HRP Grant budget for first two quarters of 2010/11 Performance and monitoring of HRP Grant in 2010/11 Coordination of HRP projects Performance of contractors and consultants Reporting and coordination between WCDOH and WCDT&PW Capacity to implement the Hospital Revitalisation Grant programme

3. Financial performance of HRP Grant budget for first two quarters of 2010/11

4. Expenditure per project vs budget First and Second Quarters 2010/11 ProjectAnnual Budget (R)Spent (R)% Spent George Hospital46,895,00015,095,00032 Khayelitsha Hospital194,741,000112,107,00058 Mitchell’s Plain Hospital124,113,00034,368,00028 Paarl Hospital134,044,00077,901,00058 Tygerberg Hospital2,000,00000 Valkenberg Hospital8,000,0003,292,00041 Vredenburg Hospital21,543,0009,755,00045 Worcester Hospital43,718,00016,596,00038 HRP Unit5,500,0002,922,00053 Grand Total580,554,000272,036,00047

5. Performance per project per component First and Second Quarters 2010/11 ProjectInfrastructure (%) Health Technology (%) OD & QA (%) Overall Performance (%) George Hospital4616632 Khayelitsha Hospital58N/A5258 Mitchell’s Plain Hospital 27N/A3628 Paarl Hospital68153358 Tygerberg HospitalN/A 00 Valkenberg Hospital41N/A 41 Vredenburg Hospital4883745 Worcester Hospital44184938

6. George Hospital Infrastructure Progressing well – finishing and snagging time-consuming Planning for NHLS and Emergency Centre being finalised Organisational Development Progressing well

7. George Hospital (cont) Quality Assurance Progressing well Health Technology Delays in roll-out of digital radiology impacts on expenditure Orders placed – awaiting delivery (expenditure will improve in next quarter)

8. George Hospital (cont)

9. Khayelitsha Hospital Infrastructure Contractor advised that project will be completed six months ahead of schedule – expenditure will exceed budget Organisational Development Progressing well

10. Khayelitsha Hospital (cont) Quality Assurance Client/staff satisfaction surveys still to be undertaken Health Technology No budget provision for 2010/11 – will be addressed during adjustment budget Equipment list being finalised Commissioning planned – 1 September 2011

11. Khayelitsha Hospital (cont)

12. Mitchell’s Plain Hospital Infrastructure Progressing well – expenditure will improve in next two quarters Contractor indicated that project potentially four months ahead of schedule Organisational Development Progress slow Appointment of Facility Project Manager will assist in addressing delays

13. Mitchell’s Plain Hospital (cont) Quality Assurance Client/staff satisfaction surveys still to be undertaken Health Technology No budgetary provision for 2010/11 Equipment list being reviewed

14. Mitchell’s Plain Hospital (cont)

15. Paarl Hospital Infrastructure Progressing well Organisational Development Progressing well Quality Assurance Progressing well Health Technology Progressing very well

16. Paarl Hospital (cont)

17. Tygerberg Hospital Infrastructure No provision for 2010/11 Organisational Development Awaiting formal approval of 2010/11 Project Implementation Plan Quality Assurance No provision for 2010/11 Health Technology No provision for 2010/11

18. Tygerberg Hospital (cont)

19. Valkenberg Hospital Infrastructure Emergency repairs to historic admin building Planning of replacement facility Health Technology No provision for 2010/11 Equipment list to be developed

20. Valkenberg Hospital (cont)

21. Vredenburg Hospital Infrastructure Phase 1B – Practical completion achieved on 22 April 2010 Phase 2A – Slight delay Phase 2B – In planning Organisational Development Asset Care Centre is being rolled out which will improve spending

22. Vredenburg Hospital (cont) Quality Assurance Surveys planned to be undertaken later in year Health Technology Delayed due to infrastructure

23. Vredenburg Hospital (cont)

24. Worcester Hospital Infrastructure Phase 3 – in retention Phase 4 – under construction, slightly behind New DMC – final account Phase 5 – in inception Organisational Development Progressing well

25. Worcester Hospital (cont) Quality Assurance Quality Assurance Manager appointed which will lead to improved spending Health Technology Delays in roll-out of digital radiology impacts on expenditure

26. Worcester Hospital (cont)

27. HRP Unit General Expenditure on track Key positions in process of being filled

28. Performance and monitoring of HRP Grant in 2010/11 (excluding roll-over)

29. Projected performance per project vs budget for 2010/11 (excl R42.774 million roll-over) ProjectAnnual Budget (R) Projected expenditure (R) Projected % Spent George Hospital46,895,00041,030,00091 Khayelitsha Hospital194,741,000249,923,000128 Mitchell’s Plain Hospital124,113,00094,844,00076 Paarl Hospital134,044,000135,247,000101 Tygerberg Hospital2,000,00000 Valkenberg Hospital8,000,0005,872,00073 Vredenburg Hospital21,543,00020,951,00097 Worcester Hospital43,718,00043,870,000100 HRP Unit5,500,000 100 Grand Total580,554,000597,237,000103

30. Projected performance for 2010/11 BudgetR 580,534,000 Predicted over-expenditureR 16,703,000 Roll-over (to be confirmed) R 42,774,000 Predicted under-expenditure (roll-over included) R 26,071,000

31. Monitoring Monitoring is ongoing Compliance with DORA and HRP Project Implementation Manual Alignment with Project Implementation Plans Reasons for deviations and addressing where possible Alignment with DOH Strategic Plan Continuous communication with all roleplayers Monthly reports to NHRP Quarterly reports to NHRP Annual reports In-year Monitoring Report (IYM) Infrastructure Reporting Model (IRM)

32. Coordination of HRP projects

33. Projects Regular site visitsRegular site visits Orientation of hospital staff on siteOrientation of hospital staff on site Monthly project site meetings (DTPW, DoH, Contractor and Consultants)Monthly project site meetings (DTPW, DoH, Contractor and Consultants) Project Commissioning MeetingsProject Commissioning Meetings Regular Committee meetings for each of HRP componentsRegular Committee meetings for each of HRP components Facility Project Manager appointed at each of the HRP projects (Mitchell’s Plain in process)Facility Project Manager appointed at each of the HRP projects (Mitchell’s Plain in process)

34. Coordination of HRP projects (cont) Programme Monthly Health Programme Progress Control Meetings (DTPW, DoH and Treasury)Monthly Health Programme Progress Control Meetings (DTPW, DoH and Treasury) Quarterly HRP Provincial Steering Committee MeetingsQuarterly HRP Provincial Steering Committee Meetings Daily informal contact between roleplayersDaily informal contact between roleplayers Monitoring by Treasury and National HRP with reportsMonitoring by Treasury and National HRP with reports Monthly HRP Project Management MeetingsMonthly HRP Project Management Meetings

35. Performance of contractors and consultants

36. Contractors The contractors are appointed and managed by the implementing agent (WCDT&PW)The contractors are appointed and managed by the implementing agent (WCDT&PW)Consultants The consultants are appointed and managed by the implementing agent (WCDT&PW)The consultants are appointed and managed by the implementing agent (WCDT&PW)

37. Reporting and coordination between WCDOH and WCDT&PW

38. Working in accordance to signed Service Delivery Agreement, IPMP, IPIP as prescribed by DORAWorking in accordance to signed Service Delivery Agreement, IPMP, IPIP as prescribed by DORA Continuous liaison and coordination between HRP Facility Project Manager and WCDT&PW Project LeaderContinuous liaison and coordination between HRP Facility Project Manager and WCDT&PW Project Leader Continuous liaison and coordination between WCDT&PW and HRP Programme ManagerContinuous liaison and coordination between WCDT&PW and HRP Programme Manager Continuous liaison between Chief Directorate: Infrastructure Management and Chief Directorate: Public WorksContinuous liaison between Chief Directorate: Infrastructure Management and Chief Directorate: Public Works

39. Capacity to implement the Hospital Revitalisation Grant programme

40. New Chief Directorate: Infrastructure ManagementNew Chief Directorate: Infrastructure Management Small HRP unit with substantial vacancy rate in senior posts (currently being addressed)Small HRP unit with substantial vacancy rate in senior posts (currently being addressed) Good progress shown in spite of vacanciesGood progress shown in spite of vacancies

41. Current HRP Unit – Current organogram Positions filled Filling in processPositions vacant

42. Capacity to implement the Hospital Revitalisation Grant programme Future HRP projectsFuture HRP projects –Tygerberg Hospital (possible PPP) –Brooklyn Chest Hospital (operational narrative and schedules of accommodation) –GF Jooste Hospital (business case being developed) –Helderberg Hospital (business case approved) –Mossel Bay Hospital (business case approved) –Victoria Hospital (business case approved)

43. Thank you DankieEnkosi