1. THE OVERVIEW OF THE HEALTH SECTOR IN SOUTH AFRICA
PRESENTATION TO THE PORTFOLIO COMMITTEE ON HEALTH
02 JUNE 2014
LINDOKUHLE NGOMANE
THE OVERVIEW OF THE HEALTH SECTOR IN SOUTH AFRICA

2. Legislative Mandate – Oversight Current Status of the Health Sector
Presentation Outline
Background
Legislative Mandate – Oversight
Current Status of the Health Sector
Mandate of the Department
Department’s Core Functions
Entities Supporting the Department
National Policy Priorities
Financial Controls
Key issues

3. Committees of Parliament facilitate the:
BACKGROUND
Parliament conducts its constitutional obligations through the work of Committees.
Committees of Parliament facilitate the:
passing of legislation
approve annual departmental budgets
conduct oversight over departments falling within their portfolio

4. LEGAL FRAMEWORK - OVERSIGHT
SA oversight legislative framework comprises of the Constitution, PFMA & the Money Bills Act
Constitution
Mandates Parliament or legislative organs of state to scrutinise & oversee Executive actions to ensure accountability
Oversight mandate: Sections 55, 92 , 114 & 133
Oversight processes: Sections 213, 214 & 215
Public Finance Management Act (PFMA)
Passed to regulate the financial management of both the national and provincial spheres of government
Objective is to ensure transparency, accountability & sound management of the revenue, expenditure, assets & liabilities of all public institutions
Section 27 (1): The Minister must table the annual budget for a financial year in the NA before the start of the financial year
Section 27 (4): requires dpt. to submit to Parliament measurable objectives for each main programme in the department’s Budget Vote

5. Current status of the Health sector
South Africa has two types of health care systems
Public and private health systems
The private health system is costly and used mostly by middle to high income individuals and families
The public health care system is under pressure to deliver services to about 80% of the population

6. challenges facing the public health sector
The specific challenges faced by the health sector includes:
increasing demand for health services related to the complex and changing disease profile of the country
a greatly increased burden of disease (Prevention and treatment of HIV/AIDS and MDR-TB)
significant areas of weakness in health system management
Numerous barriers still exist in relation to quality and access to healthcare

7. challenges facing the health sector.....
Availability of health personnel in the public sector
The health system appears to be under‐performing with its given level of expenditure
Distribution of financing & spending
Leadership & innovation

8. MANDATE of the department
The legislative mandate of the Department is derived from the Constitution, the National Health Act, 61 of 2003 and other pieces of legislation passed by Parliament
Critical are the following sections and schedules of the Constitution:
Section 27(1)(a); Section 27(3); Section 28(1)(c); Schedule 4
The national government and provinces are given certain constitutional competencies to perform certain functions at the spheres.
In some cases there are concurrent functions that both spheres of government have constitutional competency (schedule 4).

9. Core functions of the department
The health sector is responsible for the achievement of Outcome 2 of govt’s programme of action: “a long and healthy life for all South Africans”
The following key objectives of the Department are to:
Improve life expectancy
Reduce maternal and child mortality
Combat HIV and AIDS and decreasing the burden of diseases from tuberculosis
Improve the efficiency of public health

10. ENTITIES SUPPORTING THE DEPARTMENT

11. National policy Priorities
The health sector is also guided by the:
National Development Plan (NDP) 2030
State of the Nation Address (SONA)
Negotiated Service Delivery Agreement (NSDA)
Health sector’s 10 Point Plan

12. Financial controlS within the sector
The Department had received an unqualified audit opinion for the past five years.
The previous Committee observed that there is improvement in the manner in which financial and predetermined objectives are managed.
The AG noted that unauthorised, irregular, fruitless and wasteful expenditure remains an area of concern for the health sector.

13. Financials controls (cont....)
Audit outcomes of the health sector
Unqualified with findings
Qualified with findings
Adverse/Disclaimed with findings
The audit findings for the Health sector have shown little improvement over the last three years.
The number of disclaimers has however reduced to one remaining province (Limpopo).

14. Key issues
In order to enhance its performance the sector is aiming at:
Fast-tracking the implementation of a National Health Insurance scheme.
Strengthening the fight against HIV and TB, non-communicable diseases, as well as injury and violence.
Improving human-resource management at state hospitals and strengthening co-ordination between the public and private health sector.
Deploying "health teams" to communities and schools.
Regulating costs to make health care affordable to all.
Increasing life expectancy from 60 years to 70 years in 2030 (NDP 2030).

15. Thank You
THANK YOU