Select Committee on Finance National Council of Provinces Health services: Preliminary Outcome of Conditional Grants & Capital Expenditure as at 31 March 2007 (2006/07 Financial Year) Select Committee on Finance National Council of Provinces Presented by: National Treasury 11 May 2007

Key priorities for 2006 MTEF Health Hospital Revitalisation Forensic pathology Recruit health professionals (including CHWs); Expand Emergency Medical Services, implement new national ambulance service model; Primary health care, Modernise tertiary services.

Health (1) Spending at R53,6bn or 100,6% against R53,3bn adjusted budget Four provinces (FS, GP, LP and NC) overspent their adj budgets Preliminary overspending of R328,2m (GP – R372,2m) Increase of R6,6bn or 14,0% compared to the previous year Low rate of health spending in NW (96,2%) and EC (98,2%) NC (107,0%) and LP (104,8%) reflects the highest rate of spending in health Health Personnel spending at R28,8bn or 99,5% (R28,9bn adjusted budget) NPNC spending at R20,2bn or 104,2% of R19,4bn adjusted budget Preliminary overspending of R806,3m (GP – R329,7m) Capital spending at R4,7bn or 93,1% Increase of 21,4% compared to audited spending Low rate of capital spending in KZN (84,6%) and NC (85,2%) LP (111,8%) and FS (104,2%) reflects the highest rate of capital spending in health

Health (2)

Health: Programme Analyses Programme 2: Provincial District Health Services Spending at R21,1bn or 99,0% of R21,3bn adjusted budget Lowest rate of spending in NW (94,7%) and WC (96,6%) Highest in LP (105,3%) and NC (101,3%) Programme 4: Provincial Hospital Services Spending at R13,0bn or 102,1% of R12,8bn adjusted budget Lowest rate of spending in LP (98,1%) and MP (98,8%) Highest in NC (111,0%) and FS (110,1%) Programme 5: Central Hospital Services Spending at R8,7bn or 106,4% of R8,2bn adjusted budget Preliminary over-expenditure of R522,9m (GP – R412,9m) Lowest rate of spending in NW (99,5%) and WC (100,2%) Highest in GP (112,2%) and FS (106,2%)

Health: District Services

Health: Hospital Services

Health: Central Hospital Services

Health: Personnel

Health: Capital

Health: Non-personnel Non-capital

Payments for Capital Assets (Health) Health capital spending at R4,7bn or 93,1% Increase of 21,4% compared to audited outcome ast year Preliminary underspending of R343,4m Low rate of health capital spending in KZN (84,6%) and NC (85,2%) LP (111,8%) and FS (104,1%) reflects the highest rate of capital spending in health

Health: Capital

Monthly Expenditure: Payments for Capital Assets

Proposed Dates for CG QPRs National departments administering conditional grants are required to table QPRs (including both financial and non-financial information) with the SCOF in the NCOP at the end of each quarter in line with the requirements of the DoRA, Grant Frameworks and Treasury Regulation 5.3 Departments are required to provide the NT with copies of the reports tabled at SCOF in NCOP The quarterly reports for each quarter should be submitted to the NT by the dates provided

Health Grants Comprehensive HIV and Aids Grant Objective (Schedule 5 Grant): To enable the health sector to develop an effective response to HIV and Aids Support implementation of the National Operational Plan for Comprehensive HIV and Aids Treatment and Care 4th Quarter Expenditure: Health spent R1,7bn or 103,1% of the R1,7bn adjusted allocation (includes provincial roll-overs) Transfers received amounted to 100,0% of national allocation Highest spending: EC (121,0%) and LP (112,9%) Lowest spending: NC (91,3%) and NW (96,0%) Service Delivery Outcome: Department / Sector to respond

CG: performance (non-financial) reporting

HIV/AIDS

Health Grants Hospital Revitalisation Grant Objective (Schedule 5 Grant): To provide funding to enable provinces to plan, manage, modernise, rationalise and transform the infrastructure, health technology, monitoring and evaluation of hospitals in line with national policy objectives To transform hospital management and improve quality of care in line with national policy 4th Quarter Expenditure: Health spent R1,6bn or 88,7% of the R1,8bn adjusted allocation (including provincial roll-overs) Transfers received amounted to 100,0% of national allocation Highest spending: LP (346,2%) and EC (108,1%) Lowest spending: KZN (69,9%) and NC (72,2%) Service Delivery Outcome: Department / Sector to respond

Hospital Revitalisation

Health Grants Forensic Pathology Services Grant Objective (Schedule 5 Grant): To provide for the transitional activities required to transfer the Medico-Legal Mortuaries from SAPS to Health To initiate the development and provision of a comprehensive Forensic Pathology Service to ensure impartial professional evidence for the criminal justice system concerning death due to unnatural causes 4th Quarter Expenditure: Health spent R342,0m or 55,4% of the R616,9m adjusted allocation (including provincial roll-overs) Transfers received amounted to 100,0% of national allocation Highest spending: LP (108,6%) and GP (78,7%) Lowest spending: KZN (39,8%) and NW (41,7%) Service Delivery Outcome: Department / Sector to respond

Forensic pathology

Health Grants National Tertiary Services Grant Objective (Schedule 4 Grant): To compensate provinces for the supra-provincial nature of tertiary services provision and spill over effects To provide strategic funding to enable provinces to plan, modernise, rationalise and transform the tertiary hospital service delivery platform in line with national policy objectives including improving access and equity 4th Quarter Expenditure: Spending of this grants is subsumed in the spending of a range of programmes and therefore no reporting is required However, spent R5,0bn or 99,4% of the R5,0bn adjusted allocation (including provincial roll-overs) Transfers received amounted to 100,0% of national allocation Highest spending: LP (100,2%) Lowest spending: EC (92,2%) and MP (98,2%) Service Delivery Outcome: Department / Sector to respond

National tertiary services grant

Health Grants Health Professions Training and Development Grant Objectives (Schedule 4 Grant): Support provinces to fund costs associated with training of health professionals Development and recruitment of medical specialists in under-served provinces Support and strengthen undergraduate and post graduate teaching and training processes in health facilities Enable shifting of teaching activities from central hospital to regional and district hospitals 4th Quarter Expenditure: Spending of this grants is subsumed in the spending of a range of programmes and therefore no reporting is required However, spent R1,5bn or 100,2% of the R1,5bn adjusted allocation (including provincial roll-overs) Transfers received amounted to 100,0% of national allocation Highest spending: LP (104,5%) and EC (100,9%) Lowest spending: MP (96,2%) Service Delivery Outcome: Department / Sector to respond

Health professions training grant