GAUTENG: HEALTH CONDITIONAL GRANTS 7 June 2005

Conditional Grants  National Tertiary Grant  Health Professions Training and Development Grant  Revitalisation Grant (Capital)  Provincial Infrastructure Grant (Capital)  HIV/AIDS Grant  Integrated Nutrition Grant  Hospital Quality and Management Improvement Grant

Budget allocation trends

Issue Transfers from National MonthlyMonthly Budget / Amount Transferred R R Spending Total Budget spent National Tertiary Service Grant

Issue Transfers from National MonthlyMonthly Budget / Amount Transferred R R Spending Total Budget spent Health Professions Training Grant

Issue Transfers from National QuarterlyQuarterly Budget / Amount Transferred R Spending Total Budget spent R9.8 million spent Integrated Nutrition Programme The Integrated Nutrition Programme was shifted to Education from 1 April 2004 thus the reduced allocation per head

Issue Transfers from National QuarterlyQuarterly Budget / Amount Transferred R R * R Spending Total Budget spent Hospital Management and Quality Improvement Grant *R5,194million was transferred by National department on the 31 March 2005 but accounted for in the books of Provincial department on the 1 st April 2005.

Issue Transfers from National QuarterlyMonthly Budget / Amount Transferred R R Spending Total Budget spent R134 million HIV/AIDS Grant There was an under-expenditure of R during This artificial and is mainly due to unprocessed journals at year- end.

Issue Transfers from National MonthlyMonthly Budget / Amount Transferred R R Spending Total Budget spent R61.2million Revitalisation Grant

 Approval was received from the National Department of Health to utilize R90 million of the Revitalisation grant for the New Pretoria Academic hospital.  A request for the roll-over of the full amount has been submitted to Gauteng Treasury

Issue Transfers from National QuarterlyQuarterly Budget / Amount Transferred R R Spending Total Budget spent R57.6million Provincial Infrastructure Grant

Infrastructure Grant  R8,8 million was not spent during  The whole amount was however committed during and expenditure will take place in  A request was submitted to Gauteng Treasury for the roll-over of the full unspent amount.

Expenditure vs. Budget

Budget vs. expenditure

Monitoring  Financial –Monitoring done on different management levels –Compliance with reporting requirements  Performance –Compliance with reporting requirements  No qualification from Auditor General on conditional grants for  Will be further strengthened during 2005/6

Reporting  Financial Reporting –Report done on template provided by National Treasury –Finalised and submitted every month on the dates stipulated by the DORA (15 th of each month)  Performance Report –Submitted quarterly as required  Other ad hoc

Local Government  Local Government (LG) provides Primary Health Care Services at LG clinics on an agency basis  Provincial health provides funding. –Cash subsidy by means of transfer payments –Pharmaceuticals –Payments for the Cost of Laboratory tests  Local Government reports monthly by means of a certificate.

Challenges  Accuracy and reliability of data  Allocations do not take cross border flow of patients into consideration  Range of eligible services provided at each institution exceed grant allocations –Complex nature of Gauteng, means that some services e.g. renal dialysis provided by some regional hospitals which are not funded –Psychiatric tertiary services not funded

Thank you