1. Presentation to the National Health Portfolio Committee
Presented by Dr H N Manzini;
HoD – Health & Social Development; 16th March 2005

2. Presentation to the Portfolio Committee
Limpopo Department of Health and Social Development

3. Mandates
The Departmental operations are guided by the following Mandates.
- Applicable National & Provincial Legislations
National Ten Points Plan
Provincial Strategic Priorities
Health Core Functions
The Strategic Plan is based on these principles.

4. National Ten Points Plan
Improve Governance and management of the NHS
Promote healthy lifestyles
Contribute towards human dignity by improving quality of care
Improve the management of communicable and non-communicable illnesses
Strengthen Primary Health care, EMS and Hospital service delivery systems
Strengthen support services
Human Resource Planning, Development and Management
Planning, Budgeting and Monitoring and Evaluation
Prepare and implement legislation
Strengthen International Relations

5. Provincial Priorities
TB/STD/HIV/AIDS & other communicable diseases
Maternal, Child, Women, Youth & Adolescence Health
Integrated Poverty Alleviation
Health Promotion
District Health Development & Primary Health Care
implementation
Hospital Revitalisation
Health Planning, Logistics & Support Services
Quality of Care
Mental, Chronic, Disabilities & Geriatric Health
Communication, Collaboration & Community Participation
Development of a Medical School

6. Core Functions
Formulate and implement provincial health policies, norms, standards and legislation   
Provide regional and specialised hospital services as well as academic Health Services, where relevant.
Render and co-ordinate Medical Emergency Services (including ambulance service)
Render health services to the detained, arrested, charged.
Screen applications for licensing and inspection of private facilities.
Quality control of all health services and facilities.
Inter-provincial and inter sectoral co-ordination and collaboration.
Co-ordinate the funding and financial management (budgetary process) of the district health services

7. Core Functions
Provide technical and logistical support to health districts.
Render specific provincial services programmes, e.g. TB programme.
Provide non-personal health services.
Provide and maintain equipment, vehicles and health care services.
Effective consultation on health matters at the community level.
Provide occupational health services.
Research on, and planning, co-ordination, monitoring and evaluation of health services rendered in the Province.
Ensure that functions delegated by the National level are carried out.
Render Medico-legal services.

8. Strategic Priorities and Objectives 2004/05
Section A
Strategic Priorities and Objectives 2004/05

9. Programme 1: Health Administration
PRIORITIES
Improve governance and the management of the Provincial Health System (PHS)
Strengthen admin support services
Human resource planning development and management
Planning, budgeting and monitoring and evaluation
Prepare & implement legislation
Implementation of fraud prevention and risk management plan;
Management of records and information systems

10. Strategic Objectives and Targets
In the next five years Provincial Health Legislation will be aligned to the National Health Legislation.
Achieve full implementation of supply chain management policy the end of 2005/06
Outsourcing of the following: Renal dialysis, Concession of hospitals, Staff accommodation, Laundry services and EMS on a PPP basis by the end 2006/07.

11. Continue… Payment of creditors within 30 days by 2005/06
100% of staff must have signed PI’s by 2005/06
Development of a full HR Strategy in the next by the end of 2005/06
Approved organizational structures for the Department during 2005/06
All institutions to have Governance Structures by 2005/06

12. Continue…
100% of all institutions in the Department have effective Risk management policies and practices by 2005/06
Accurate information available and disseminated to correct stakeholders at all times by 2005/06
100% compliance with National Archives guidelines by 2005/06

13. Programme 2: District Health Services
PRIORITIES
Integrated Primary Health Care
District Health Services and Devolution
Communicable Disease Control
Malaria programme
HIV & AIDS, STIs & TB
Decentralization of Hospital Management
Strengthening of Partnerships with NPOs

14. Strategic Objectives and Targets
100% provision of comprehensive primary health care package at all PHC facilities by 2006/07
100% access to primary health care services by 2007/08;
All designated PHC Facilities to render 24 hrs service by 2007/08
100% implementation of devolution strategy by by 2005/06
Service Level Agreement will be signed with District Municipalities for provision of Primary Health Care Services by 2005/06

15. Continue…
95% immunization coverage of children under 1year by 2007/08.
>1% reduction mortality and morbidity through rapid response to outbreaks of diseases by 2006/07
Reduce Malaria incidence by 10 % per year.

16. Continue…
85 % Access to Provision of comprehensive HIV&AIDS, care, treatment, management and support including ARV’s and nutritional supplements by 2007/08
Cure rate of new smear positive TB cases at first attempt increased to 85% by 2006/07
Strengthen partnership with EU on PDPHC, HIV&AIDS by formalising LSAs with NPOs by 2005/06

17. Programme 3: Emergency Medical Services.
PRIORITIES
HR development
Improve access to EMS services
STRATEGIC OBJECTIVES AND TARGETS
Outsourcing of Emergency Medical services Fleet by 2006/07

18. Programme 4: Provincial Hospitals Services.
PRIORITIES
Revitalization of Hospitals.
Implementation of Secondary Hospital Package.
Decentralisation of Hospital management
Specialised Hospital Services.
Accreditation of facilities for teaching purposes.

19. STRATEGIC OBJECTIVES AND TARGETS
100% full decentralized Hospital Management by 2006/07
Complete Revitalisation Projects by 2007/08
100% transformed nursing services by 2007/08
100% revenue collection targets achieved by 2005/06

20. Programme 5:Central Hospitals - Provincial Tertiary Services.
PRIORITIES
Revitalization of Hospitals
Implementation of Tertiary Hospital Package
Decentralisation of Hospital management
Accreditation of facilities for teaching purposes
Development of a medical school.

21. STRATEGIC OBJECTIVES AND TARGETS
Reduce ALOS to 5% by 2007/08.
Usable bed utilization rate increased to 84% by 2007/08.
Reduce patient waiting time to 1hr by 2007/08.
Complete consolidation of developing tertiary services package (MTS) by 2006/07;
Fast –track and consolidate efforts to develop Academic Departments to support the Limpopo University Medical School between 2005/06 – 2007/08 (budgets & other resources)

22. Programme 6: Health Sciences and Training.
PRIORITIES
Conduct research in nursing
Train mid level workers
Train nurses
Provide bursaries
Train Emergency Care Practitioners

23. STRATEGIC OBJECTIVES AND TARGETS
100% operational post basic diploma nursing program by 2006/07
80% student intake from rural and nodal communities by 2007/08.
Initiate and improve partnerships with institutions of higher learning and other relevant institutions by end of 2006/07

24. Programme 7: Health Care Support Services.
PRIORITIES
Supply of medicines to health facilities
Monitor rational utilisation of drugs;
Inspectorate Services.

25. STRATEGIC OBJECTIVES AND TARGETS
Increase drug availability at the depot, hospitals, health centers and clinics to 95% by 2007/08.
Pharmaceutical programme managed in line with national policy on an ongoing basis.

26. Programme 8: Health Facilities Management
PRIORITIES
Upgrade and Building of PHC facilities
Hospital revitalisation
Maintenance of Health Facilities

27. STRATEGIC OBJECTIVES AND TARGETS
Built 100 clinics in the next five years at the rate of 20 clinics per year
All PHC facilities have clean water and sanitation by 2007/08
All PHC facilities fully electrified by 2008/09

28. MTEF Budget & Expenditure Trends
Section B
MTEF Budget
&
Expenditure Trends

29. New Equitable Share Formula
The growth in the provincial equitable share primarily caters for the three-year wage agreement for public servants and further adjustments to the remuneration of educators.
It also provides for funding of the primary health function in non-metropolitan municipalities, strengthening of school based education, and the expansion of developmental welfare services.
The division of the equitable share allocation among provinces is done through an objective redistributive formula.
The formula is reviewed and updated annually and takes recommendations of the Financial and Fiscal Commission into account.
A broad-ranging review of the formula has been undertaken for the 2005 / 06 and MTEF.

30. New Equitable Share Formula cont..
The formula consists of 4 main and 2 minor components
Education = 51 % and uses census data for the school age cohort and official estimates of school enrolment weighted equally.
Health = 26 % is based on estimated number of people with and without medical aid coverage and weighted at a 1 : 4 ratio.
Institutional = 5 % allocated equally across provinces to cover core provincial administration costs.
Basic = 14 % is calculated on the basis of the population share of each province.
Poverty = 3 % reinforces the redistributive basis.
Economic = 1 % to cater for provincial revenue raising powers that have not changed

31. Limpopo Provincial Equitable Share Allocations – over the MTEF

32. MTEF Budget 2005/06 to 2007/08

33. MTEF Budget 2005/06 to 2007/08
There is concern for Non PE in the outer years.
As can be seen the allocation for Non PE reduces in the 2006/07 year by R m with once off costs of R65.2 m from the previous year.
The 2007/08 year shown an increase above the previous year of R m that leaves a almost no growth in the budget for Non PE for two years running.
The rest of the budget is ring fenced and cannot be rerouted to fund Non Personnel Expenditure.
The allocation for the purchase of drugs does show real growth and these funds are ring fenced.

34. Summary of Conditional Grant Allocation

35. MTEF Budget 2005/06 to 2007/08

36. MTEF Budget 2005/06 to 2007/08- Health Budget Allocation per Programme

37. MTEF Budget 2005/06 to 2007/08- Health Budget Allocation per Programme
The increase in the Personnel Budget is intended for the filling of critical vacant positions in both Clinical and Administration posts
Clinical Posts Other
2005 / R 62.7m 424 R 22.9m
2006 / R 49.3m 481 R 46.4m
2007 / R 38.1m 351 R 34.1m

38. Departmental Revenue Collection 2001 /02 - 2004/05 & Budget 2005/06
2000/01
Actual
2001/02
2002/03
2003/04
2004/05
Budget
2005/06
MTEF
Revenue Targets
50 037
57 209
56 990
60 409
60 000
63 911
Received
48,703
58,022
59,011
58,267
64 974
Estimated
N / a
There will be an increase in the UPFS (Uniform Patient Fee Structure) Rates with effect from 1 April 2005 onwards. This is the first increase since 2003 / 04 and averages out at a 8% increase. The increase is applicable to paying patients and does not effect the free patients who remain un effected.
Other departmental tariffs will also be adjusted upwards.

39. Expenditure Trends: 1995/96 – 2003/04 2004/05 Estimated and MTEF Budget

40. Personnel v/s Non-Personnel trends

41. The End
‘Working as A Team has potential to assist in rolling back the frontiers of Ill – health and Poverty globally’