1. DEPARTMENT OF HEALTH AND SOCIAL DEVELOPMENT VOTE 07: HEALTH Third QUARTER Provincial Budget Review PRESENTED BY HONOURABLE Mme M.R.K SEGABUTLA MEMBER OF EXECUTIVE COUNCIL

2. HOSPITAL REVITALIZATION GRANT (HRG) 3 rd QUARTER EXPENDITURE TRENDS 2007/08-2009/10 2007/082008/092009/10 HRP COMPONENTBudget R’000 Actual R’000 %Budget R’000 Actual R’000 %Budget R’000 Actual R’000 % Infrastructure Development (ID) 129,20796,04974225,440108,28948186,442113,96661 Health Technology (HT)5,0005,5311116,0824,347727,189407,1527 Organizational Development (OD) 3,1502,944932,7002,288852,500378,62215 Quality Improvement (QI) 5,7505,651989,3187,481805,000616,78012 Project Office5,0944,594905,0003,075625,8002,52844 Roll Over 3,4895,427 TOTAL148,201114,76977252,029125,48051212,360117,89755,5

3. HOSPITAL REVITALIZATION GRANT (HRG) EXPENDITURE AS AT 31 DECEMBER 2009

4. HOSPITAL REVITALIZATION GRANT (HRG) HRP COMPONENT & HOSITAL SITES BUDGET (R’000)QUARTER 3 EXPENDITURE (R’000) PERCENTAGE (%) INFRASTRUCT URE Letaba 47,80631,24865 Thabamoopo 38,74928,93875 Maphutha Malatji 43,49434,01678 Thabazimbi 33,89312,77538 Dilokong 2,0001,11156 Nkhensani 3,0005,158172 Jane Furse 18,0006900.04 Musina 3,000290.009

5. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 LETABA HOSPITAL Budget 2009/10 (R’000) Expendi ture (R’000) % Spent Comments Contract B1 Demolish existing wards and Walkways, underground services, podiums… 80065882.2 Completed, final account paid. A saving of 142 recorded Contract B2 New Health Support, Dental Unit, Sub Acute… 1,12165358 Completed and occupied. Final account could be released due outstanding snag items. Contract B3 Administration, Visitors Waiting, Gate House… 10,99114,740134 Delayed due to slow performance by contractor. Project within the fast tracked HRP improvement plan Contract A1 Recreation and Residential Facilities 3,2921,56948 Completed and occupied. Final account not released due outstanding snag items Contract A2 Oncology Ward, Demolish existing nurse residence, new Orthotic & Prosthetic centre… 8,8032,25826 Delayed due to slow performance and contract terminated in February 2009. New contractor appointed in September 2009 under the fast tracked HRP improvement plan Contract A3 (a) New Maternity Ward and Walk Ways… 13,3918,32462 Contractor appointed in June 2009. Project progressing well and on track Contract A3 (b) New Boiler and Upgrade 3,2002,06365 Completed and commissioned. Final payment and training of boiler operators are still outstanding. Professional Fees and Disbursements 90070179 Proportional to work done so far. Saving of 142 in Contract B1 will be used to offset the anticipated over expenditure TOTAL47,80630,96665%

6. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 THABAMOOPO HOSPITAL Budget 2009/10 (R’000) Expen diture (R’000) % SpentComments Contract A1 Podiums, Sewer Reticulation, Storm Water, Internal Roads 30000.0 Final account could not be paid due to unattended storm damage repair Contract A2 Pharmacy, Female Acute, Sub-Acute, Chronic Ward, Security Ward… 7,0005,71182 Project delayed for 16 months due to slow performance and contract terminated in March 2009. New contractor appointed in September under the fast tracked HRP improvement plan Contract A3 Sewer, Roads, Storm water, building podiums, demolitions… 3,0002,57869 Delayed due to dependency on A2. Project attended to under HRP improvement plan Contract A4 Kitchen, Dining Hall, Bulk Store 10,5954,88846 Delayed due to dependency on A2. Project attended to under HRP improvement plan Contract A4 New Male Acute, Sub Acute, Chronic Wards… 10,3006,63958 Delayed due to dependency on A2. Project attended to under HRP improvement plan Contract B1 Water supply, reticulation, reservoir… 1,90000 Delayed due contractor and consultant conflict. Matter resolved and project back on track Contract B2 Administration, Admission, Mortuary… 2,0002,388118 Completed and final account due in December 2009 Contract B3 Workshop 3,142 100 Completed, occupied and final account paid Professional Fees and Disbursements 4,1003,59287 Proportional to progress on site TOTAL38,74928,93875%

7. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 MAPHUTHA MALATJIE HOSPITAL Budget 2009/10 (R’000) Expendit ure (R’000) % Spent Comments Contract A1 Administration, Gateway Clinic, Gate House… 5,0003,44167 Project delayed for 8 months due to slow performance. On track and completion rescheduled for end of September 2009. Contract B1 Paedriatic, Female & Male Wards upgrade, Theatre… 12,00012,324102 On track and progressing well Contract B2 Transport Offices, Linen Store, Kitchen Upgrade… 12,0008,30869 Delayed for 3 months due revision of designs whilst on site. Project attended to under HRP improvement plan Contract D New Access Road 4,5003,25572 Physical progress far exceeds financial progress. On track and progressing well Contract C New OPD, Casualty 6,9365,2120 Delayed due to dependency on A1. Award and site hand over due in October 2009 Professional Fees and Disbursements: Team P 3,0582,48681 Proportional to progress on site TOTAL43,49434,01678%

8. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 THABAZIMBI HOSPITAL Budget 2009/10 (R’000) Expendi ture (R’000) % Spent Comments Contract: Bulk Earthworks and Civil Works 14,00027619 Delayed for 7 months due to finalization of Environmental Impact Assessment (EIA). Contract: EMS, Gateway Clinic and Gate House 15,48311,99977 Contractor appointed in June 2009 hence no expenditure recorded. Project progressing well and on track Design: Various Buildings Main Hospital 4,4105007 On track TOTAL33,89312,77538%

9. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 DILOKONG HOSPITAL Budge t 2009/1 0 (R’000) Expend iture (R’000) % Spent Comments Transport Control2,0001,11256 On track Wards Final accounts on completed projects TOTAL2,0001,11256%

10. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 NKHENSANI HOSPITAL Budget 2009/10 (R’000) Expendi ture (R’000) % Spent Comments Gateway3,0005,158172 Project delayed for 10 months due to slow performance and contract terminated in January 2009. New contractor appointed in September under the fast tracked HRP improvement plan Step Down Project delayed for 18 months. Back on track under the HRP improvement plan and due for completion by end of October 2009 Final accounts on completed projects Final accounts long overdue. HRP improvement to address this matter TOTAL3,0005,158172%

11. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 MUSINA HOSPITAL Budget 2009/10 (R’000) Expenditure (R’000) % Spent Comments PRE-PLANNING & DESIGN3,00029.009Delayed due to site relocation. Back on track TOTAL3,000290.009%

12. HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3 JANE FURSE HOSPITAL Budget 2009/10 (R’000) Expendit ure (R’000) % Spent Comments Civil - Roads18,0006900.04 Tender advertised. Correct Theatre Correct OPD & Casualty Gateway Clinic Linen Bank TOTAL18,0006900.04%

13. CHALLENGES  Slow construction progress on site  Civil and building contracts delayed at Thabazimbi due to finalization of Environmental Impact Assessment (EIA)  Dependencies within sites have a ripple effect on all other projects due to follow  Musina site changes: from current hospital site, to 2 nd site and now ultimately to 3 rd site  Musina 3 rd Site confirmed in August 2009 but official allocation not yet attained  Determination of specifications and scope of work for corrective work at Jane Furse Hospital

14. VALUE OF RE-AWARDED PROJECTS ( Those that were terminated ) HospitalDescriptionConstruction Contract Value NkhensaniCompletion of Gate Way Clinic, Two Gate Houses, Library, ARV Clinic and Fencing R 4,187,243.94 LetabaConstruction of a New Gynecology Ward, Demolition of Existing Nurses Residence and Construction of Orthortotic and Prosthetic Centre R 35,000,000.00 ThabamoopoCompletion of Female Acute, Sub Acute and Chronic Ward R 9,038,384.21 ThabamoopoCompletion of Male Security WardR 3,086,088.20 ThabamoopoCompletion of Substance Abuse WardR 7,939,960.00 ThabamoopoCompletion of Hostels, Flats, Bachelor’s Flats, Halfway House, Pharmacy and Shelter (Kiosk) R 1,147,032.00 Total Construction Contract ValueR 60,398,708.35 Estimated Professional Fees and DisbursementsR 4,000,000.00 TOTALR 64,398,708.35

15. VALUE OF DELAYED PROJECTS ( progress dependent on the terminated projects) HospitalDescriptionConstruction Contract Value ThabamoopoFinalization of Earthworks for Phases 2 and 3 dependent on Completion of Hostels, Flats, Bachelor’s Flats, Halfway House, Pharmacy and Shelter (Kiosk) Contractor for Earthworks could not proceed with work since May 2009 R 3,836,543.65 LetabaPart of Contract A2-Construction of a New Gynecology Ward, Demolition of Existing Nurses Residence and Construction of Orthortotic and Prosthetic Centre dependent on Completion of Recreation and Residential Facilities, that is Contract A1 R 3,300,000.00 Total Value of Delayed ProjectsR 7,136,543.35 Total Value of Re-Awarded Projects (those that have been terminated)R 64,398,708.35 GRAND TOTAL (projected to be spent Sept 09- March 10) R 71,535,252.00

16. MONITORING AND EVALUATION: HRP IMPROVEMENT PLAN Performance Monitoring and Evaluation:  Resident clerks of works appointed to assist in ensuring performance of contractors per site on a daily basis.  Measurement of construction works to be undertaken and paid for twice per month  Projects monitored closely by DPW and professional teams; and Health PMU and professional teams

17. IN CONCLUSION The HRG below targeted Expenditure noted in all components An HRP Improvement Plan supported a Provincial level (Premier’s Office, Provincial Treasury, the Department and Implementing Agents) implemented as of September 2009 Dependencies and slow performance of contractors delayed expenditure plan Projected under spending R40,247due to the above stated reasons

18. Summary 4 th Quarter -31 March 2010