1. PRESENTATION ON CONDITIONAL GRANTS TO THE SELECT COMMITTEE ON APPROPRIATIONS NORTH WEST DEPARTMENT OF HEALTH 08 AUGUST 2012 1

2. OUTLINE OF PRESENTATION HIV/AIDS Grant NTSG HPTDG HOSPITAL REVITALISATION Grant INFRASTRUCTURE Grant

3. HIV AND AIDS CONDITIONAL GRANT PERFORMANCE 2011/12 AND 2012/13

4. 2011/12 Expenditure Per SCOA Item 4 Item Budget (R’000) Expenditure (R’000) Budget Bal. (R’000) % Spent Compensation of Employees 110,81884,82825,99076.55 Goods & Services362,266347,48614,78095.92 Machinery & Equipment 6,6264,7231,90371.27 Non Profit Inst.119,727119,421 30699.74 Total599,437556,45842,97992.83

5. Comments Fourth Quarter 2011/12 Expenditure: The expenditure reflects a picture after the implementation of the recovery plan which was a consultative process between the province and NDoH. The spending pattern prior to that was characterised by challenges which included many suppliers of ARVs and Condoms not registered within the provincial data base thus affecting timeous processing of payments.

6. 2012/13 First Quarter Expenditure Per SCOA Item 6 Item Budget (R’000)Expenditure (R’000) % Spent Compensation of Employees 116,55916,91514.52 Goods & Services425,42043,30010.18 Machinery & Equipment 3,22500 Non Profit Inst.140,00017,72512.66 Total685,20477,94011.38

7. Comments First Quarter 2012/13 Expenditure. The first quarter of the current financial year experienced challenges of delayed loading of the budget in the system which is a reason for the current variance in the expenditure. The HIV & AIDS Management programme commenced the financial year with ensuring effective implementation of the HIV & AIDS Grant decentralisation process through conducting districts road shows for orientation of management on the conditional grant. The districts are presently spending on activities as planned in their respective business plans which will reflect an improved expenditure level in the second quarter. 7

8. National Tertiary Services Grant (NTSG) 8

9. Budget and expenditure Issues The NTSG does not fund all tertiary services in the province, some are funded through the equitable share (particularly newly introduced tertiary services ). Budget items which are funded through the NTSG are: compensation of employees (including OSD), goods and services, QIP, Capital and Modernisation of Tertiary Services.

10. Expenditure on NTSG 2011/12 ….. HOSPITALSALLOCATED BUDGETPERCENTAGE SPENT KLERKSDORP/ TSHEPONG 125,782,364100% JOB SHIMANKANA TABANE 38,637,241100% MAFIKENG PROVINCIAL HOSPITAL 29,860,395100%

11. Expenditure on NTSG 2012/13 for 1 st Qrt HOSPITALSALLOCATED BUDGET (R’000) PERCENTAGE SPENT KLERKSDORP/ TSHEPONG 143 00016% JOB SHIMANKANA TABANE 37 00015% MAFIKENG PROVINCIAL HOSPITAL 31 76514%

12. Budget and expenditure Issues Reasons for under-expenditure - Health technology procurement still in process (the procurement will be finalised within the current financial year). - Challenges experienced with the loading of the budget and revised scoa codes (the challenge has now been resolved).

13. HEALTH PROFFESSIONALS TRAINING AND DEVELOPMENT GRANT (HPTDG)

14. Expenditure on HPTDG 2011/12 HOSPITALSALLOCATED BUDGETPERCENTAGE SPENT KLERKSDORP/ TSHEPONG R51 083 800100% JOB SHIMANKANA TABANE R20 726 334100% MAFIKENG PROVINCIAL HOSPITAL R16 512 866100%

15. Expenditure on HPTDG 1 st Qrt. Of 2012/13 HOSPITALSBUDGET SPENTPERCENTAGE SPENT KLERKSDORP/ TSHEPONG R9 714 21818% JOB SHIMANKANA TABANE R2 751 85813% MAFIKENG PROVINCIAL HOSPITAL R291 2502%

16. Comments on the under-expenditure…. Reason for under-expenditure: Challenges experienced with the loading of the budget and revised scoa codes (the challenge has now been resolved). The process of journalising what ever expenditure incurred through the equitable share is currently being journalised to the conditional grant, particularly for Mafikeng Provincial Hospital.

17. PLANNING SERVICES CONDITIONAL GRANTS

18. Expenditure Report 2011/12 NAME OF THE GRANT ALLOCATED BUDGET (R’000) EXPENDITUREPERCENTAGE Hospital Revitalization R370 074R362 962 853.6598.08% Health Infrastructure R145 572R136 695 036.0193.90% TotalR515 646R499 657 889.6696.90%

19. Expenditure Report 2012/13 NAME OF THE GRANT ALLOCATED BUDGET (R’000) EXPENDITUR E PERCENT AGE AVAILABLE BUDGET Hospital Revitalization R423 127R123 391 288.00 29.16%R299 735 712.00 Health Infrastructure R112 790R6 382 763.005.66%R106 407 237.00 Nursing Colleges R8 680R0.000%R8 680 TotalR544 597R129 774 051.00 23.83%R414 822 949.00

20. Budget inputs The Department will be constructing 6 Replacement Clinics this year (Buxton, Tweelingspan, Moshana, Lekgopung, Mosweu and Madiba a Makgabana). The Department will be constructing 3 New Community Health Centre this year (Mathibestadt, Maquassi Hills, Jouberton and Sekhing) to meet the growing demands of our facilities. The Department will also be renovating and extending Mmabatho and Excelsius Nursing Colleges from 600 to 1200 students. Four Nursing schools will be replaced (Stegman, Witrand, Thusong and Taung) over MTEF period. Job Shimankana Tabane (JST) Hospital, Witrand Hospital, Boitekong CHC will be renovated and extended to meet the growing demands on our facilities.

21. Health Infrastructure Challenges The Department to date have backlog of R2 billion rands on renovations, upgrades and maintenance of our facilities. The Department also have backlog of about R1,8 billion towards health facility gaps relating to service delivery. The Department is also expected to implement NHI and as such R800 million is required to raise most of our facilities to the required standards. The Department only have about R654 million for 2013/14, R681 million for 2014/15 and possible R710 million for 2015/16 which indicates over-commitment on the available budget.

22. THANK YOU