Provincial Budgets and Expenditure as at 30 June 2009 (2009/10 Financial Year) [Section 32 of PFMA] Select Committee on Finance and Appropriations National Council of Provinces Presented by: Intergovernmental Relations National Treasury 18 September 2009

Key highlights (1) The presentation covers provincial spending as at 30 June 2009 (first quarter) Based on Section 40(4) PFMA reports (IYM) submitted by PTs Published in Government Gazette on 30 July 2009 Press Release published on 14 August 2009 Health at 28.3% of total provincial budgets 7 provinces projecting to overspend their health budgets (EC – R727.9m, KZN – R486m, LP – R478.9m, MP – R350.3m) Capital - Provinces spent R1.6bn or 21.2% which is 39.5% compared to the same period in 2008/09 Spending against budgets on health conditional grants is 19.3% excluding schedule 4 grants

Health (1) Spending at R20.9bn or 25.4% against R82.4bn main budget 7 provinces projecting to overspend their main budgets EC – R727.9m, KZN – R486m, LP – R478.9m, MP – R350.3m Increase of R3.8bn or 22.2% compared to the previous year Low rate of health spending in FS (22.1%) and LP (22.2%) EC (28.3%) and MP (27.9%) reflects the highest rate of spending in health Health Personnel spending at R11.4bn or 24.7% (R46bn main budget) Goods and Services spending at R7bn or 27.9% of R25.2bn budget Projected overspending of R1.3bn in 6 provinces KZN – R518.9m, MP – R336.1m, LP – R278.3m, FS – R159.3m Capital spending at R1.6bn or 21.2% of R7.8bn budget Increase of 39.5% compared to spending over the same period last year Low rate of capital spending in NC (14.2%) and LP (15.2%) NW, KZN (both at 30.6%) and MP (26.5%) reflects the highest rate of capital spending in health

Health (2)

Health: Programme Analyses Programme 2: Provincial District Health Services Spending at R8.4bn or 24.9% of R33.9bn main budget Projected over-expenditure of R1.4bn in 6 provinces LP – R408.7m, KZN – R369.1m, EC – R360.1m Lowest rate of spending in GP (21.4%) and NC (22.2%) Highest in EC (29.4%) and MP (29.3%) Programme 4: Provincial Hospital Services Spending at R4.8bn or 25.8% of R18.6bn main budget Projected over-expenditure of R873.9m in 6 provinces EC – R429.2m, KZN – R243.9m Lowest rate of spending in WC (18.7%) and NC (22.5%) Highest in EC (30.6%) and KZN (28.2%) Programme 5: Central Hospital Services Spending at R3.2bn or 28.9% of R11bn main budget Projected over-expenditure of R515.8m in 4 provinces KZN – R369.1m, WC – R65.8m, MP – R46.9m Lowest rate of spending in NW (17.2%) and LP (22.2%) Highest in WC (32.6%) and KZN (31.3%)

Health: District Services

Health: Hospital Services

Health: Central Hospital Services

Health: Personnel

Health: Goods and Services

Health: Capital Capital spending at R1.6bn or 21.2% of R7.8bn budget Increase of 39.5% compared to spending over the same period last year Low rate of capital spending in NC (14.2%) and LP (15.2%) NW, KZN (both at 30.6%) and MP (26.5%) reflects the highest rate of capital spending in health

Conditional Grants

Conditional Grants: Outcomes Health – 2008/09 Free Sate problems with ART roll out. KZN overspent, however in the previous year, R100 million was withheld and reallocated to other provinces Two contractors in Western Cape went bankrupt, hence the delay – unspent funds to be rolled over

Conditional Grants: Outcomes Health – 2008/09 Poor performance by contractors in Mpumalanga R171 million to be rolled over in Western Cape, due to project delays experienced in Mitchell’s plain and Khayelitsha hospital

Conditional Grants The total conditional grant allocation is R49.3bn (including Schedule 4 and 8 grants) with health making up the bulk at R15.6bn Specific health grants that show low rates of spending include: Health Disaster Response (Cholera) (2.1%) Hospital Revitalisation (18.7%) Comprehensive HIV and AIDS (19%)

HIV and AIDS

Hospital Revitalisation

Conditional Grants – Spending Rates

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