Department of Health’s response on FFC’s recommendations 11th June 2008

Issues to be addressed Fiscal performance of community health clinics – sub program. Infrastructure for primary healthcare and health outcomes

Key findings in PHC The Department of Health concurs with FFC’s assertion on Primary Health Care (PHC). True average growth of PHC financing per provinces have been varying over the years. Acknowledges the difficulties in aggregating budget and expenditure in clinics. Provincial departmental budget votes publishes allocations to hospitals but not on clinics.

What is the next step?? Embarked on a “great plains project” aimed at developing cost centers throughout provinces. This project is aimed at ensuring that health facilities can manage their own budgets (not a budget for a clinic to be managed by a hospital) Project has started with tertiary hospitals in all provinces and next two years regional hospitals will be included. Need to include as many hospitals as soon as possible and further the clinics DHER’s reflect that expenditure per capita has been increasing in many districts (above R300 which is a national average)

Infrastructure for PHC and health outcomes Department of Health have seen and heard over the media and through our consultative processes some complaints about the quality of PHC services. Need to engage FFC on the findings of the two options proposed

What has been done Undertaking the “Benefit Incidence Analysis study” Explore treatment seeking behaviour in any detail as existing data from household survey both 2003 and 2006 do not provide an answer. To gain a better understanding of public experiences and perceptions of public sector health services and about what is required to promote equitable benefit incidence. Furthermore, BIA will help in understanding the factors influencing this distribution of health care benefits and ways in which equitable benefit incidence can be promoted

What has been done Proposals on the development of National Health Insurance (NHI) have been discussed with National Treasury which seek to achieve universal coverage. Department of Health have realised that Hospital Revitalization program must include even the clinics that are referring patients to the hospital.

Infrastructure Grant Matter must be discussed with provincial treasuries, as provincial Departments of Health have no say on “how much must be allocated to them for clinic building and revitalization”

The Department of Health will engage FFC regarding these recommendations.