1. GAUTENG: HEALTH CONDITIONAL GRANTS 7 June 2005

2. 2004-05 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

3. Budget allocation trends

4. Issue2003-042004-05 Transfers from National MonthlyMonthly Budget / Amount Transferred R1 676 760 000 R1 727 736 000 Spending Total Budget spent National Tertiary Service Grant

5. Issue2003-042004-05 Transfers from National MonthlyMonthly Budget / Amount Transferred R539 330 000 R560 778 000 Spending Total Budget spent Health Professions Training Grant

6. Issue2003-042004-05 Transfers from National QuarterlyQuarterly Budget / Amount Transferred R74 273 000 10 307 000 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

7. Issue2003-042004-05 Transfers from National QuarterlyQuarterly Budget / Amount Transferred R29 125 000 R20 776 000 * R15 582 000 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.

8. Issue2003-042004-05 Transfers from National QuarterlyMonthly Budget / Amount Transferred R64 288 000 R134 231 000 Spending Total Budget spent R134 million HIV/AIDS Grant There was an under-expenditure of R231 000 during 2004-05. This artificial and is mainly due to unprocessed journals at year- end.

9. Issue2003-042004-05 Transfers from National MonthlyMonthly Budget / Amount Transferred R87 939 000 R155 126 000 Spending Total Budget spent R61.2million Revitalisation Grant

10.  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

11. Issue2003-042004-05 Transfers from National QuarterlyQuarterly Budget / Amount Transferred R47 160 000 R66 458 000 Spending Total Budget spent R57.6million Provincial Infrastructure Grant

12. Infrastructure Grant  R8,8 million was not spent during 2004-05.  The whole amount was however committed during 2004-05 and expenditure will take place in 2005- 06.  A request was submitted to Gauteng Treasury for the roll-over of the full unspent amount.

13. Expenditure vs. Budget

14. Budget vs. expenditure

15. 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 2003-04  Will be further strengthened during 2005/6

16. 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

17. 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.

18. 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

19. Thank you