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PRESENTATION OF THE NATIONAL DEPARTMENT OF HEALTH’S ANNUAL REPORT FOR 2005/06PORTFOLIO COMMITTEE ON HEALTH CAPE TOWN 29 MAY 2007

1.FLOW OF PRESENTATION • VISION & MISSION • LEGISLATIVE MANDATES • KEY PRIORITIES OF THE NATIONAL HEALTH SYSTEM (NHS) FOR 2004-2009 • SUMMARY OF ACHIEVEMENTS & CHALLENGES PER BUDGET PROGRAMME, COMPARING PROGRESS BETWEEN 2004/05 AND 2005/06 • BUDGET AND EXPENDITURE REPORT • KEY PRIORITIES AS REFLECTED IN THE NDOH STRATEGIC PLANS FOR 2006/07-2008/09 AND 2007/08-2009/10 • CONCLUSIONS

2. VISION & MISSION VISION • AN ACCESSIBLE, CARING AND HIGH QUALITY HEALTH SYSTEM MISSION • TO IMPROVE HEALTH STATUS THROUGH PREVENTION OF ILLNESS & DISEASE AND THROUGH THE PROMOTION OF HEALTHY LIFESTYLES AND TO CONSISTENTLY IMPROVE THE HEALTH CARE DELIVERY SYSTEM BY FOCUSING ON ACCESS, EQUITY, EFFICIENCY, QUALITY AND SUSTAINABILITY

3.LEGISLATIVE MANDATES • 51 ACTS MENTIONED IN THE NDOH ANNUAL REPORT 2005/06 INCLUDING: • THE CONSTITUTION OF THE REPUBLIC • NATIONAL HEALTH ACT OF 2003 • PUBLIC FINANCE MANAGEMENT ACT OF 1999 • NURSING ACT OF 2005 • MEDICINES & RELATED SUBSTANCES ACT • MEDICAL SCHEMES ACT OF 1998 • TOBACCO PRODUCTS CONTROL AMENDMENT ACT OF 1999

4. BUDGET PROGRAMME STRUCTURE OF THENDOH IN 2005/06 • PROGRAMME 1: ADMINISTRATION • PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES • PROGRAMME 3: HEALTH SERVICE DELIVERY • PROGRAMME 4: HUMAN RESOURCES • NB. BUDGET PROGRAMME STRUCTURE CHANGED BETWEEN 2004/05 AND 2005/06, WITH PROGRAMMES SUCH AS DISTRICTS AND DEVELOPMENT AND HIER MOVING FROM PROGRAMME 2 TO PROGRAMME 3

5. KEY NHS PRIORITIES FOR 2004-2009 1. IMPROVE GOVERNANCE & MANAGEMENT OF THE NHS 2. PROMOTE HEALTHY LIFESTYLES 3. CONTRIBUTE TOWARDS HUMAN DIGNITY BY IMPROVING QUALITY OF CARE 4. IMPROVE MANAGEMENT OF COMMUNICABLE & NON-COMMUNICABLE DISEASES 5. STRENGTHEN PHC, EMS AND HOSPITAL SERVICE DELIVERY SYSTEMS 6. STRENGTHEN SUPPORT SERVICES 7. HUMAN RESOURCE PLANNING, MANAGEMENT AND DEVELOPMENT 8. PLANNING, BUDGETING AND MONITORING & EVALUATION 9. PREPARATION AND IMPLEMENTATION OF LEGISLATION 10. STRENGTHEN INTERNATIONAL RELATIONS

6. SUMMARY OF ACHIEVEMENTS 6.1. PROGRAMME 1: ADMINISTRATION

6. SUMMARY OF ACHIEVEMENTS6.2. PROGRAMME 2: STRATEGIC HEALTH PROGRAMMES

6. SUMMARY OF ACHIEVEMENTS 6.3. PROGRAMME 3: HEALTH SERVICE DELIVERY

6. SUMMARY OF ACHIEVEMENTS 6.4. PROGRAMME 4: HUMAN RESOURCES MANAGEMENT

7. CHALLENGES • POVERTY, UNEMPLOYMENT, LOW EDUCATION LEVELS, POOR TRANSPORT INFRASTRUCTURE, SOCIAL COHESION ISSUES • TRIPLE BURDEN OF DISEASE (COMMUNICABLE, NON-COMMUNICABLE, INJURIES AND TRAUMA) • LACK OF SUFFICIENT & SKILLED HUMAN RESOURCES FOR HEALTH (CLINICAL & MANAGEMENT LEVEL) • POOR HEALTH INFRASTRUCTURE • COMMUNITY MOBILISATION, PATIENT ADHERENCE ISSUES

8. BUDGET, EXPENDITURE AND AUDIT OUTCOMES FOR 2005/06MR. F.G. MULLER (CFO)

8.1.NATIONAL DEPARTMENT OF HEALTH

8.4.NATIONAL DEPARTMENT OF HEALTH AUDIT OUTCOMES 1. Qualification – DORA Reasons: • Payments made prior to approval of Business plans • Difference between total amounts of Business Plans and DORA applications • Late and non submission of monthly financial reports

8.4. NATIONAL DEPARTMENT OF HEALTH 1. Qualification – DORA (cont.) • Late and non submission of quarterly reports • Quarterly visits to provinces not always conducted • Appointment of monitoring staff happened late in the financial year.

8.5.NATIONAL DEPARTMENT OF HEALTH 2. Matters of Emphasis • Audit Committee – non functional • Internal Audit – ineffective • National Environmental Management Act – non compliance, report not done • Supply Chain Management Unit – not fully operational.

9.KEY NHS PRIORITIES FOR 2006/07 & 2007/089 9.1.DEVELOP PROVINCIAL SERVICE TRANSFORMATION PLANS; 9.2. STRENGTHEN HUMAN RESOURCES; 9.3. IMPROVE QUALITY OF CARE; 9.4. STRENGTHEN INFRASTRUCTURE; 9.5. STRENGTHEN PRIORITY HEALTH PROGRAMMES (HEALTHY LIFESTYLES, HIV PREVENTION, TB CRISIS MANAGEMENT, MCWH&N)

10. CONCLUSION • DESPITE MANY CHALLENGES THE DOH HAS SEEN PROGRESS IN HEALTH SERVICE DELIVERY IN 2005/06 (AND IN 2006/07) • WITH GUIDANCE FROM THE MINISTER AND DEPUTY MINISTER NDOH WILL WORK HARD TO ENSURE ACHIEVEMENT OF 2007/08 TARGETS • HOWEVER, CHANGES IN THE SOCIAL CONTEXTS IN WHICH OUR PEOPLE LIVE AND ADEQUATE RESOURCE AVAILABILITY FOR THE HEALTH SYSTEM (HUMAN RESOURCES & FINANCES) ARE KEY TO THE SUCCESSFUL IMPLEMENTATION OF THIS PLAN; • INTERSECTORAL COLLABORATION ACROSS GOVERNMENT AND WITH KEY STAKEHOLDERS ARE CRUCIAL; • ONCE THE MINISTER HAS TABLED THE ANNUAL REPORT FOR 2006/07 IN PARLIAMENT IN SEPTEMBER 2007, THE NATIONAL DOH WILL RETURN TO PRESENT IT TO THE PORTFOLIO COMMITTEE.

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