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PRESENTATION TO THE SELECT COMMITTEE ON FINANCE 03 September 2008

3 VISION Health Service Excellence For All!

4 CONDITIONAL GRANTS

5 GRANTS Forensic Pathology Services Hospital Revitalisation Comprehensive HIV & AIDS National Tertiary Services Health Professions Training & Development Infrastructure Grant to Provinces

6 TRENDS IN ALLOCATION

7 TRENDS IN ALLOCATION (cont.) The total conditional grant allocation shows an annual growth of 35.3% The main contributors are; –The introduction of Forensic Pathology Services. –Hospital Revitalization –Infrastructure Grant to Provinces –National Tertiary Services –HIV & AIDS

8 CONDITIONAL GRANT SPENDING TRENDS 2006/07 & 2007/08

9 Hospital Revitalization –Withdrawal of Upington & De Aar Hospitals due to implementation of Peer Review –Slow progress on New Mental Health due to capacity of contractor Infrastructure Grant to Provinces Infrastructure –Late implementation of the infrastructure plan

10 CONDITIONAL GRANT SPENDING 30 JUNE 2008

11 CONDITIONAL GRANT SPENDING (cont.) Q1-2008/09 Department received 25% of allocated budget Spent 17% of total allocation at 30 June 2008 Experienced under expenditure on four grants; –Infrastructure Grant to Provinces –National Tertiary Services Grant –Health Professions Training & Development –Hospital Revitalisation

12 CAPITAL EXPENDITURE

13 CAPITAL EXPENDITURE Q1-2008/09

14 HOSPITAL REVITALISATION

15 BUDGET VS EXPENDITURE

16 PROF ZK MATTHEWS HOSPITAL Barkly West

17 ACHIEVEMENTS & CHALLENGES Achievements –Practical completion of the building infrastructure works –Procurement of health technology equipments –30% delivery of health technology equipment Challenges –Delay in finalization of minor outstanding works (snag list) –Delay in the delivery of health technology equipments

18 DE AAR HOSPITAL

19 ACHIEVEMENTS & CHALLENGES Achievements –Compilation of revised service package as per STP guidelines Challenges –Capacity challenge in HRP office

20 NEW MENTAL HEALTH HOSPITAL

21 ACHIEVEMENTS & CHALLENGES Achievements –Construction – 60% Challenges –Slow progress on site due to capacity of contractor

22 FORENSIC PATHOLOGY SERVICES

23 ACHIEVEMENTS ObjectiveIndicator Target 2008/09 Actual Q1DeviationReason for deviation Improve forensic pathology services Number of mortuaries being upgraded % of autopsies completed within 2days of arrival at the mortuary Increased fleet 11 70% % % - Process delayed: dispute Establish Employee Assistance Programme for workers at the mortuaries % of employees making use of the programme 100%50%(New programme) Ensure that all mortuary personnel are adequately trained Number of training sessions held per annum (formal) 20- 2(Building works disturbing work flow) impacts training

24 CHALLENGES ChallengesMeasures to overcome them  Extension of EAP to all forensic pathology officers because of large province.  Training of mortuary staff.  Increased distances to be travelled and thus increased overtime to be worked due to cancellation of undertakers’ contracts as a National directive. (Government Gazette of 20 July 2007: Regulation 636).  Arrange/design a referral system.  Training (In-house) deferred until building works is completed.  Training (formal) Awaiting accreditation from SAQA. (A National- driven training).  Prepare and submit amended business plan to accommodate additional staff.

25 CHALLENGES ChallengesMeasures to overcome them  Inadequate resources (human & capital) in the integrated North West and Northern Cape area (Moshwaweng and Pampierstad)  Delay in completion of building projects due to dispute with Implementing Agent.  Prepare and submit amended business plan to address resource shortfall.  Considering to re-negotiate with current contractor or discontinue

26 INFRASTRUCTURE GRANT TO PROVINCES

27 BUDGET VS EXPENDITURE

/08 PROJECTS Achievements –Construction – average 60% Challenges –Late inclusion of staff accommodation –Late decision on site allocation for Groblershoop maternity –Late start construction work at Dibeng

/09 PROJECTS Achievements –Commencement of earthworks for: –Hartswater –Olifantshoek –Pampierstad Challenges –Delay in the advertisement of tender- Hondeklipbaai –Delay in finalisation of service package for Pampierstad CHC

30 PROJECTS FUNDED THROUGH ROLL OVERS Achievements –Tenders awarded for: –Kimberley Hospital Lifts –Kimberley Hospital Boilers Challenges –Late submission of final account

31 COMPREHENSIVE HIV & AIDS

32 EXPENDITURE

33 ACHIEVEMENTS –6 CCMT dieticians / nutritionists were appointed –A successful HIV and AIDS consultative stakeholder conference was held to facilitate the development of the Provincial Strategic Plan –Calvinia ART Service point now fully operational due to appointment of a medical officer –5 Districts and 8 Local AIDS Councils established

34 ACHIEVEMENTS ART Programme 1 st Quarter 2008 –Total Assessed: 2,077 –On Treatment: 708

35 CHALLENGES & REMEDIAL ACTION Information management system slow and data received not up to date or reliable - Training on correct and effective management of data - Regular monthly meetings Delays in infrastructure refurbishment - Support Projects Office for infrastructure revitalization Minimal staff capacity at Provincial level Vacant Posts – 12 Filled Posts – 8 Advertised Posts – 7 Establish Step down Care in the Districts - Identify beds in district hospitals - Policy guidelines have been distributed for input

36 NATIONAL TERTIARY SERVICES

37 OUTPUTS

38 CHALLENGES & REMEDIAL ACTION Challenges –Specialist skills shortage (Dr’s & nurses) –Increased patient load –Referral pathways Remedial Actions –Posts advertised –Review of agreement with F/S & W/C and respective academic institutions –Streamline referral system –Strengthen outreach programme

39 HEALTH PROFESSIONS TRAINING & DEVELOPMENT

40 ACHIEVEMENTS Supported training of: oDoctors - 65 oRadiographers - 18 oPost-basic Nursing Programmes - 31 oClinical Psychologists - 5 oPharmacists - 2 oMedical Registrars – 4 oNursing students – 232 Two (2) medical students completed and are doing internship in 2008

41 CHALLENGES Full implementation of the Registrar programme Structured skills transfer programme in the regional hospital

42 MONITORING Each grant managed by member of senior management Monthly slot in senior management meetings for financial reports Quarterly slot in senior management meetings for output reports

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