1. PRESENTATION TO THE SELECT COMMITTEE ON SOCIAL SERVICES
ANNUAL PERFORMANCE PLAN AND BUDGET 2011/ /14

2. 1. VISION AND MISSION VISION MISSION
Long and healthy life for all South Africans
MISSION
To improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the health care delivery system by focusing on access, equity, efficiency, quality and sustainability.

3. HEALTH SECTORS PLAN 2011/12 TO 2013/14
Government adopted an outcome-based approach to service delivery
The Health sector is responsible for the achievement of Outcome 2 : A long and healthy life for all South Africans
Four Identified outputs:
Output 1 : Increasing Life Expectancy
Output 2 : Decreasing Maternal and Child mortality
Output 3 : Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis
Output 4 : Strengthening Health System Effectiveness

4. Health Sector 10 point Plan
Interrelationship across the Health Sector Negotiated Service Delivery Agreement, the 10 Point Plan and the National Health Insurance
Health Sector 10 point Plan
A LONG & HEALTHY
LIFE FOR ALL
SOUTH AFRICANS
NSDA
NHI
Defined Targets
Defined
Timeframes & critical
milestones
Secret

5. INCREASED LIFE EXPECTANCY
STRENGTHENING HEALTH SYSTEM EFFECTIVENESS
IMPROVED
ACCESS TO
HUMAN
RESOURCES
FOR
HEALTH
INTER -
SECTORAL
ACTION
SOCIAL
DETERMI
NANTS OF
QUALITY OF
SERVICES
NATIONAL
INSURANCE
IMPACT
OUTCOMES
OUTPUT
FINANCIAL
MANAGE
MENT
INPUTS
PRIMARY
CARE
ORIENTED
SERVICE
DELIVERY
INFORMA
TION
ACCESSS TO
FACILITIES
HEALTH SECTOR NSDA
Reduced Maternal and Child mortality rates
Reduce burden from HIV&AIDS and TB (Mortality and Morbidity)
Reduce burden from non-communicable diseases
Reduce burden from violence and injury
Primary Health Care Oriented Service Delivery
Improved quality of services
Improved Human Resources for Health
Improved access to Health Facilities
Improved financial manage-ment
National Health Insurance
Health Informa - tion
Inter -sectoral action for social de -terminants of Health

6. IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
SCALE UP THE COMBINATION OF PREVENTION
INTERVENTIONS TO REDUCE NEW HIV INFECTIONS
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Scaling up condom distribution, with 1 billion male condoms distributed annually during 2011/ /14, and 6 million female condoms distributed annually during 2013/14
Increase the number of Medical Male Circumcisions to during 2011/12 and annually during 2012/13 and 2013/14
Increase the HCT uptake rate from 80% to 90% in 2013/14

7. IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVE THE QUALITY OF LIFE OF PEOPLE LIVING WITH HIV &AIDS BY PROVIDING AN APPROPRIATE PACKAGE OF CARE, TREATMENTS AND SUPPORT
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Increasing the number of new patients initiated on Antiretroviral Therapy (ART) to between to annually during 2011/ /14
Increasing the proportion of PHC facilities implementing nutritional intervention for People living with HIV and AIDS and TB from 77% in 2010/11 to 88% in 2013/14

8. REDUCE INFANT, CHILD AND YOUTH MORBIDITY AND MORTALITY
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
REDUCE INFANT, CHILD AND YOUTH MORBIDITY AND MORTALITY
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Maintain the percentage of children under 1-year of age fully immunised at 95% throughout the MTEF period
Maintain the measles immunisation coverage rate of 95 % throughout the MTEF period
Increasing the number of sub-districts implementing school health services from 100 to 150 in 2011/12 , 200 in 2012/13 and 232 in 2013/14
Implementing programmes in secondary schools to address youth risk behaviour with a focus on life skill based HIV and AIDS education in 60 Sub Districts during 2011/12 and 100 Sub Districts during 2012/13
Increasing the Vitamin Supplementation coverage among children 12 to 59 Months from 38% in 2010/11 to 45% in 2013/14

9. TO REDUCE MATERNAL MORTALITY
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
TO REDUCE MATERNAL MORTALITY
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Maintain ante – natal coverage rate of 100 % throughout the MTEF period
Increasing the antenatal coverage before 20 weeks from 37% in 2010/11 to 60% in 2013/14
Increasing the proportion of deliveries taking place in health facilities under the supervision of trained personnel from 88% in 2010/11 to 95% in 2013/14
Increasing the proportion of designated health facilities providing Choice on Termination of Pregnancy (CTOP) from 40% in 2010/11 to 55% in 2013/14;
Increasing the percentage of mothers and babies who receive post-natal care within 6 days of delivery from 40% in 2010/11 to 80% in 2013/14;

10. IMPROVED ACCESS TO REPRODUCTIVE HEALTH
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED ACCESS TO REPRODUCTIVE HEALTH
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Increasing the cervical cancer screening coverage from 50% in 2010/11 to 56% by 2013/14
Increasing the couple year protection rate from 32% in 2010/11 to 37 % by 2013/14

11. EXPAND PMTCT COVERAGE TO PREGNANT WOMEN
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
EXPAND PMTCT COVERAGE TO PREGNANT WOMEN
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
100% of pregnant woman to be tested for HIV
Increasing the antenatal clients initiated on HAART rate from 87% in 2011/12 to 100% in 2013/14
Decreasing the percentage of babies testing PCR positive 6 weeks after birth from 10% in 2011/12 to 6.5% in 2013/14
Increasing the uptake rate for HIV Positive antenatal clients on AZT for any period before labour from 86% in 2011/12 to 100% in 2013/14

12. TO REDUCE THE BURDEN OF DISEASE OF TUBERCULOSIS
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
TO REDUCE THE BURDEN OF DISEASE OF TUBERCULOSIS
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Increasing the TB cure rate from 70 % in 2009 to 85% in 2013/14.
Reducing the TB treatment defaulter rate from 7% in 2010/11 to 5% (or less) in 2013/14

13. COMBATING TB AND HIV BY REDUCING THE CO-INFECTION BURDEN
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
COMBATING TB AND HIV BY REDUCING
THE CO-INFECTION BURDEN
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Increasing the percentage of HIV positive patients screened for TB from 70% in 2011/12 to 100% in 2013/14
Increasing the percentage of TB patients tested for HIV from 80% in 2011/12 to 100% in 2013/14
Increasing the percentage of TB/HIV co-infected patients receiving Cotrimoxazole Prophylaxis Therapy from 90% in 2011/12 to 100% in 2013/14
Increasing the number of HIV positive patients receiving Isoniazid Preventative Therapy (IPT) from in 2011/12 to in 2013/14

14. IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
REDUCE THE BURDEN OF DISEASE FROM
COMMUNICABLE AND NON – COMMUNICABLE DISEASES
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Decreasing the incidence of malaria from 0,62 per 1000 population at risk in 2010/11 to 0.54 per 1000 population at risk in 2013/14;
Chronic care whether from communicable or non-communicable causes will be aligned and a single chronic care model will be rolled out to 3 districts in 2011/12
The number of districts implementing the long term care model for diabetes and hypertension will be increased to 52 by 2013/14
The integrated Health Promotion Policy and Strategy with an implementation plan will be finalised during 2011/12
To strengthen the quality of Environmental Health Services , norms and Standards will be developed during 2011/12

15. RE- ENGINEERING OF PRIMARY HEALTH CARE
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
RE- ENGINEERING OF PRIMARY HEALTH CARE
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Implementation of community based services in each district by establishing Family Health Teams ; 54 in 2011/12, 100 in 2012/13 and 250 in 2013/14
Complete the comprehensive audit of Primary Level Services inclusive of District Hospitals by March 2011/12
Improve community participation to strengthen the governance of the District Health System,
Increase number of District Health Councils established from 43 in 2010/11 to 52 in 2012/13
Increase the percentage of functional committees established for PHC facilities to 60 % in 2013/14
Improve access to primary health care services, with an increased utilisation rate of 3 visits by 2013/14
Improve health outcomes through ensuring that 52 Districts Health Plans are used for planning, budgeting, monitoring ,reporting and improved programme implementation by providing more direct support to the District Management Teams

16. ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Develop and implement a national infrastructure plan in conjunction with provincial infrastructure units
Develop a set of Health Infrastructure norms and standards for all levels of care
Establish an Infrastructure Project Management information system
Finalisation of the Health Care Technology strategy
Finalisation of the essential equipment lists for primary health care in 2011/12 and for secondary and tertiary health care in 2012/13

17. ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
ACCELERATE THE DELIVERY OF HEALTH INFRASTRUCTURE
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Accelerating the delivery of health infrastructure through Public Private Partnerships (PPPs)
All five tertiary hospitals should complete the feasibility study by March These are:
Nelson Mandela Academic (Eastern Cape);
Chris Hani Baragwanath (Gauteng);
Dr. George Mukhari (Gauteng);
Limpopo Academic (Limpopo);
King Edward VIII (KwaZulu-Natal);
Funding will be provided to hospitals through the hospital revitalization grant :
41 Hospitals will be under construction
25 Hospitals will be in the planning phase

18. IMPROVED HEALTH WORKFORCE PLANNING, MANAGEMENT AND DEVELOPEMNT
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED HEALTH WORKFORCE PLANNING,
MANAGEMENT AND DEVELOPEMNT
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Finalising the revised Health Workforce Plan responsive to service delivery platforms by the end of 2011/12
Strategy for Rural Health workforce developed by the end of 2011/12
Norms and Standards for Health Workforce for Primary and Secondary Health Care developed
Integrate Community Health Workers into the formal Health System

19. IMPROVED HEALTH CARE FINANCING
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVED HEALTH CARE FINANCING
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
Work in preparation for the implementation of NHI will continue. Specific outputs for 2011/12 include:
Finalization of the NHI policy and legislative framework
NHI Pilot Sites established
Funding model developed

20. IMPROVE THE QUALITY OF HEALTH SERVICES
IMPLEMENTATION OF THE HEALTH SECTOR’S RESPONSE DURING 2011/12 – 2013/14
IMPROVE THE QUALITY OF HEALTH SERVICES
KEY STRATEGIC INTERVENTIONS DURING 2011/ /14 WILL INCLUDE:
In 2011/12 new policies related to the legislative amendment governing the establishment and functioning of the Office of Health Standards Compliance and relevant regulation will be finalised
The Office of Health Standards Compliance as a national certification body will be established by March 2012
Patient satisfaction will be monitored and a patient satisfaction surveys will be conducted in 60 % of public hospitals during 2011/12 , in 90% during 2012/13 and 100% during 2013/14
20% (800) of the 4,333 public health facilities will be assessed for compliance with the 6 priorities of the core standards. This figure grows to 40% in 2012/13 and to 70% by 2013/14;

21. RESOURCE ENVELOPE FOR IMPLEMENTING OF THE NATIONAL DOH PLANS FOR 2010/11-2012/13

22. INTRODUCTION
During the Medium Term Framework ( MTEF) budget process, the Health Department requested additional funding for both National and Provincial departments for the amount of R19,9 billion for the three year MTEF period.
Cabinet and National Treasury approved an amount of R18,1 billion made up of R3,4billion for National Health and R14,6 billion for the provincial health departments for earmarked funds additional to the equitable share baseline.

23. EXPENDITURE TRENDS
The Department’s expenditure grew from R13.6 billion in 2007/08 to R23.1 billion in 2010/11 at an average annual rate of 19.4 percent.
Over the Medium Term period, expenditure is expected to grow to R30.1 billion, at an average annual rate of 9.2 percent.
The increase in both periods is driven largely by transfers to provinces for the conditional grants, with the main increase being on the HIV and AIDS and the Revitalization of Hospitals grants, while the National Tertiary Services grant (NTSG) increased significantly in the MTEF period.
The Forensic Pathology Services grant will be phased out in the 2012/13 financial year and has therefore been included in the provincial equitable share allocations.

24. MEDIUM TERM ALLOCATION FOR 2011/12 – 2013/14
The Budget includes new allocations of R442 million for 2011/12, R692 million for 2012/13 and R2.2 billion for 2013/14.

25. MEDIUM TERM ALLOCATION FOR 2011/12 – 2013/14
R3 million, R5 million and R7 million for the Health Systems Trust to support health systems research activities including the annual health review and district health barometer
R2 million per year to publish standardised annual health statistics in the new annual health statistics publication to facilitate performance auditing and better inform the public and health service providers
R5 million, R6 million and R7 million for the Compensation Commissioner for Occupational Diseases to address backlogs in compensation, improve systems and address problems identified in audit reports
R60 million in 2011/12 and 2012/13, R60 million and R1.4 billion for the HIV and AIDS conditional grant for the rapidly growing treatment programme and to strengthen prevention programmes including R60 million per annum for male circumcision

26. MEDIUM TERM ALLOCATION FOR 2011/12 – 2013/14
R10 million per year to forensic chemistry laboratories to purchase equipment and appoint staff to address backlogs R10 million to the South Africa Health Products and Regulatory Authority to establish itself and to deal with the medicine registration backlogs. This is a once off payment, based on the understanding that SAHPRA will generate and retain its own revenue going forward.
R30 million in 2011/12, and R30 million in 2012/13 and 2013/14 to progressively increase the distribution of condoms
R9 million, R5 million and R5 million to nursing colleges to plan and coordinate the second phase of upgrading, recapitalising and maintaining nursing colleges following the infrastructure audit

27. MEDIUM TERM ALLOCATION FOR 2011/12 – 2013/14
The expenditure below is towards preparatory work for NHI.
R10 million, R20 million and R10 million to Office of Standards Compliance and Quality Assurance to establish itself and to support its inspectorate, certificate of compliance and ombudsman functions
R21 million, R17 million and R13 million for infrastructure management and private public partnerships to build up capacity in the department to oversee the hospital revitalisation projects and to support planning and transaction advisor cost for large private public partnership projects
R5 million, R7 million, and R9 million for health technology to support provincial upgrading of engineering workshops and equipment audits and to develop equipment packages and systems for health technology
R5 million per year for National Health Insurance to support development work and projects including the ministerial advisory committee

28. MEDIUM TERM ALLOCATION FOR 2011/12 – 2013/14
Expenditure towards preparatory work for NHI continue .....
R4 million in 2011/12 and 2012/13 and R5 million in 2013/14 to develop improved hospital tariff schedules for use by provinces and the Road Accident Fund, including improved uniform patient fee structure, Road Accident Fund reimbursement and tariff structure, and developing diagnosis related groups system.
R5 million per year for health information systems to support national workgroup investigations of new patient based IT system and to propose next steps in IT infrastructure to support the district health information system
R2 million, R3 million and R4 million to monitor and support provinces in order to stabilise provincial finances and improve audit outcomes
R250 million, R500 million and R750 million for the national tertiary services conditional grant to support public hospitals to achieve norms and standards partly in preparation for the National Health Insurance and to implement standards and guidelines of the Office of Standards Compliance and Quality Assurance, as well as to address differential costs of doctor occupation specific dispensation

29. ADDITIONAL FUNDS ALLOCATED TO THE BASELINE FOR THE NATIONAL DEPARTMENT
PRIORITY FOCUS AREA
11/12
R’000
12/13
13/14
Increased distribution of condoms
30,000
Improved conditions of service
13,000
15,000
16,000
Quality Office of Standards Compliance: Support for inspectorate and accreditation function
10,000
20,000
Forensic chemistry laboratories: Equipment and filling of posts
Oversight of hospital revitalization projects
Health technology: Equipment packages and systems
5,000
7,000
9,000
Public private partnership (PPP) projects: Planning and transactional advisor costs
11,000
3,000

30. ADDITIONAL FUNDS ALLOCATED TO BASELINE
PRIORITY FOCUS AREA
11/12
R’000
12/13
13/14
Nursing colleges: Planning and coordination of upgrading and recapitalization project
9,000
5,000
National Health Insurance: Ministerial advisory committee
National workgroup investigations of patient based information technology system
Revenue management: Improved hospital tariff schedules
4,000
South African Health Products Regulatory Authority: Establishment and capacity to deal with medicines registration backlogs
10,000 -
Health Systems Trust
3,000
7,000
CCOD
6,000
Unit to support provincial finance
2,000
HIV and Aids Conditional grants
60,000
1,400,000
National Tertiary Services conditional grant to support public hospitals
250,000
500,000
750,000
 TOTAL
442,000
692,000
2,276,000

31. PROGRAMME ALLOCATIONS FOR 2011/12-2013/14
PROGRAMMES
R’ million
10/11
11/12
12/13
13/14
Administration
282
326
325
344
Health Planning and Systems Enablement
125
161
178
190
HIV&AIDS, TB and Maternal, Child and Women’s Health
6,669
8,027
9,377
11,188
Primary Health Care Services
700
730
143
150
Hospital Tertiary Services and Workforce Development
13,947
15,963
17,016
17,664
Regulations and Compliance Management
496
525
572
601
Total Budget Allocated
22,219
25,732
27,611
30,137

32. ECONOMIC CLASSIFICATIONS ALLOCATIONS FOR 2012/13 TO 2013/14
10/11
11/12
12/13
13/14
Compensation of Employees
385
424
465
492
Goods and Services
755
785
795
830
Total Transfers & Subsidies
21,034
24,489
26,316
28,778
Payment of Capital Assets 45 33 35 37
Payment of Financial Assets -
Total
22,219
25,732
27,611
30,137

33. CONDITIONAL GRANTS ALLOCATIONS 2011/12-2013/14
Schedule
2011/12
R'000
2012/13
2013/14
Health Infrastructure Grant 4
1,701,856
1,820,981
1,921,134
Health professions and Development Training
1,977,310
2,076,176
2,190,366
National Tertiary Services
8,048,878
8,688,822
9,389,207
Comprehensive HIV and Aids 5
7,492,962
8,824,610
10,606,664
Forensic Pathology Services
590,380 -
Hospital Revitalization Grant
4,136,290
4,335,908
4,067,859
Total
23,947,676
25,746,497
28,175,230

34. CONDITIONAL GRANTS ALLOCATIONS 2011/12-2013/14
Schedule 4 grants: specifying allocations to provinces to supplement the funding of programmes or functions funded from provincial budgets;
Transfer payments cannot be withheld based on non performance or compliance, however, the new Division of Revenue Grant allows a 5% withholding while interventions are put in place.
Grants included are:
- National Tertiary Services,
- Health Professions Training and Development
- Forensic Pathology Services.

35. CONDITIONAL GRANTS ALLOCATIONS 2011/12 - 2013/14
Schedule 5 : specifying specific-purpose allocations to provinces.
Grants included are:
- HIV and AIDS grant and the Revitalization of
Hospital grant.
Schedule 5 grants may be withheld for non performance and or compliance. Interventions must also be put in place for compliance.

36. ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS) SUMMARY PROV
ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS) SUMMARY PROV. ALLOCATED.
Provinces
2011/12
2012/13
2013/14
Total
R'000
Eastern Cape
522,450
675,521
702,753
1,900,724
Free State
106,872
178,564
202,144
487,580
Gauteng
745,872
1,035,179
1,158,860
2,939,911
KwaZulu-Natal
299,766
494,481
534,869
1,329,116
Limpopo
258,841
470,219
594,336
1,323,396
Mpumalanga
239,498
455,859
502,401
1,197,758
Northern Cape
88,317
160,461
189,891
438,669
North West
196,090
373,169
450,116
1,019,375
Western Cape
228,820
350,550
452,977
1,032,347
2,686,526
4,194,003
4,788,347
11,668,876

37. CONDITIONAL GRANTS COMPREHENSIVE HIV & AIDS
Province
2010/11
Budget
2011/12 Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape
691,940
864,173
1,014,134
1,222,480
Free State
437,583
530,440
621,824
750,788
Gauteng
1,281,683
1,620,673
1,934,057
2,294,326
KwaZulu-Natal
1,518,811
1,889,427
2,246,099
2,675,081
Limpopo
515,896
624,909
733,963
884,146
Mpumalanga
387,646
490,366
578,087
694,264
Northern Cape
186,306
212,923
247,228
301,557
North West
476,838
599,437
705,969
848,533
Western Cape
555,054
660,614
743,249
935,489
TOTALS
6,051,757
7,492,962
8,824,610
10,606,664

38. CONDITIONAL GRANTS FORENSIC PATHOLOGY SERVICES
Province
2010/11
Budget
2011/12
Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape
69,345
73,506 -
Free State
37,218
39,451
Gauteng
92,421
97,966
KwaZulu-Natal
152,406
161,550
Limpopo
39,913
42,308
Mpumalanga
50,107
53,114
Northern Cape
22,868
24,240
North West
26,433
28,019
Western Cape
66,251
70,226
TOTALS
556,962
590,380

39. CONDITIONAL GRANTS HEALTH PROFESSIONS TRAINING AND DEVELOPMENT
Province
2010/11
Budget
2011/12
Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape
160,444
170,071
178,730
188,560
Free State
117,400
124,444
130,930
138,131
Gauteng
651,701
690,803
725,310
765,202
KwaZulu-Natal
235,771
249,917
261,860
276,262
Limpopo
94,085
99,730
103,913
109,628
Mpumalanga
76,149
80,718
85,208
89,894
Northern Cape
61,802
65,510
68,583
72,356
North West
83,324
88,323
93,522
98,666
Western Cape
384,711
407,794
428,120
451,667
TOTALS
1,865,387
1,977,310
2,076,176
2,190,366

40. CONDITIONAL GRANTS HOSPITAL REVITALIZATION
Province
2010/11
Budget
2011/12
Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape
360,660
382,048
402,678
387,104
Free State
378,426
417,883
438,140
412,172
Gauteng
798,609
801,965
828,552
760,206
KwaZulu-Natal
500,815
547,698
566,605
533,432
Limpopo
323,425
371,672
392,410
369,152
Mpumalanga
331,657
356,557
378,014
355,081
Northern Cape
420,218
406,892
427,263
401,940
North West
326,303
370,074
401,150
377,375
Western Cape
580,554
481,501
501,096
471,397
TOTALS
4,020,667
4,136,290
4,335,908
4,067,859

41. CONDITIONAL GRANTS NATIONAL TERTIARY SERVICES
Province
2010/11
Budget
2011/12
Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape
557,137
609,327
660,693
698,110
Free State
659,469
715,204
769,964
800,000
Gauteng
2,561,154
2,759,968
2,933,361
3,100,895
KwaZulu-Natal
1,102,585
1,201,831
1,303,824
1,408,053
Limpopo
257,316
267,314
277,314
287,314
Mpumalanga
91,879
105,970
120,270
Northern Cape
225,948
235,948
245,948
255,948
North West
179,280
194,280
209,280
224,280
Western Cape
1,763,232
1,973,127
2,182,468
2,494,337
TOTALS
7,398,000
8,048,878
8,688,822
9,389,207

42. CONDITIONAL GRANTS HEALTH INFRASTRUCTURE GRANT
Province
2010/11
Budget
2011/12
Allocation
2012/13
Forward Estimates
2013/14
Forward Estimates
R'000
Eastern Cape -
299,754
327,673
345,695
Free State
129,621
141,911
149,716
Gauteng
142,694
157,434
166,093
KwaZulu-Natal
358,471
393,367
415,002
Limpopo
270,802
267,888
282,622
Mpumalanga
146,368
143,383
151,269
Northern Cape
89,501
98,258
103,662
North West
145,466
159,656
168,437
Western Cape
119,179
131,411
138,638
TOTALS
1,701,856
1,820,981
1,921,134

43. ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS) ALLOCATED DIRECTLY TO PROVINCES.
R million
11/12
12/13
13/14
Health technology 20 30 40
Nursing colleges upgrading and maintenance 32
OSD doctor Annexure A top-up
110
119
126
OSD therapeutic top-up
363
426
449
Maternal and child health
228
501
700
Personnel and goods stabilization
522
1,073
1,444
HIV: ARV 350 threshold  -
500

44. ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS) ALLOCATED DIRECTLY TO PROVINCES.
R million
11/12
12/13
13/14
Registrars esp paed, obs and critical posts
100
200
300
Family health team pilots/models
400
700
Public hospital norms and standards
240
486
532
Policy priorities subtotal
1,715
3,767
4,823
Improvements in conditions of service
1,556 
1,556
Forensic pathology shift into PES
620
654
Total
3,271
5,943
7,033

45. COMMENTS ON ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS)
EC: Allocated only for:
Allocated funds for OSD for doctors and health therapeutics and medical registrars in obstetrics and pediatrics.
Recapitalizing nursing college; etc.
Improvements in Conditions of Service
FS: Allocated only for:
All priorities have combine amount which is R20,6m ,R53,4m and R73,5 for three years
R 86,2 m, R87,7 & R89,4 m for Improvement in condition of service (ICS)
GP: Allocated only for:
all OSD and recapitalization of nursing colleges
Improvements in Conditions of Service for Housing allowance carry through costs
Policy adjustment: includes family health teams and PHC re-engineering and public hospital norms and standards.

46. COMMENTS ON ADDITIONAL PRIORITY FOCUS AREAS (EARMARKED FUNDS)
KZN, MP, NC, NW and WC :Allocated funding for all priorities identified
Total Allocated Funds Earmarked are R3,2 billion, R5,9 billion,& R7 billion for 2011/12,2012/13 &2013/14 respectively. Provinces allocated R2,6 billion, R4,1 billion & R2,3 billion.
Not ALL the earmarked funds have been allocated to the Health Departments. An amount of R4,7 billion remains unallocated. It is assumed that National Treasury allocated the funds to the provincial Treasuries.

47. CONCLUSION
National DoH Annual Performance Plan 2011/ /14 reflects interventions to improve health service delivery and improve health outcomes for all South Africans.
A sector wide plan will be produced by end of May 2011, which will reflect the contribution of the entire sector - National and 9 Provincial DoHs - to the achievement of the Health Sector NSDA outcomes