Presentation to the Health Portfolio Committee

1. Presentation to the Health Portfolio Committee Presentation to Health Portfolio Committee Free State Department of Health 15 APRIL 2003

2. Vision:A Healthy and self-reliant Free State community. Mission: - Provide a quality, accessible and comprehensive Health Care Services to the Free State community. - Optimally utilises health care resources to provide a caring and compassionate services. - Endeavours to empower and develop all personnel and stakeholders to the best of their potential.

3. Corporate Goals 7. Accessible and quality services at all levels 2. Effective and efficient management of resources 1. Reduce burden of HIV/AIDS and TB A Healthy and self-reliant Free State community 4. Effective marketing and communication of Health Services. 3. Functional District Health System 6. Appropriate infrastructure 5. Developed and empowered personnel and stakeholders

4. Achievements on Strategic Objective • Reduce burden of HIV/AIDS and TB • Develop Home Based Care and step down facilities in all districts in the Free State within 3years. • Manage 95% of HIV/AIDS and Tuberculosis (TB) patients at Level1 facilities within 3 years. • Reduce prevalence of HIV/AIDS by 1% per year over the next 3 years. • Increase Tuberculosis cure rate of the new Tuberculosis cases to 85% within 3 years. • Effective and Efficient Management of resources • Implement Public Finance Management Act (Act 1 of 1999 as amended by Act 29 of 1999) according to the Treasury regulations within 3 years. • Improve the morale of staff within 3 years. • Develop and implement an asset management and maintenance and replacement system (facilities, equipment and Information Technology) within 3 years. • Functional District Health System • Implement District Health System according to legislation within 3 years. • Develop functions in line with legislation within 3 years

5. Achievements on Strategic Objective continue: • Effective Marketing and Communication of Health Services • Develop and implement a services market plan within 3 years. • Develop and implement an integrated, comprehensive communications strategy within 3 years. • Developed and empowered personnel and stakeholders • Ensure all occupational classes of staff are trained in line with service needs within 3 years. • Ensure availability of health professionals at appropriate service delivery levels within 3 years. • Train and empower stakeholders within 3 years. • Appropriate Infrastructure • Implement revitalisation of hospitals according to approved plans within 3 years. • Implement clinic building and upgrading plans. • Implement an electronic health information system at all levels of care within 3 years. • Accessible and quality services at all levels • Accredit 12 institutions (2 at Academic Health Services Complex, 5 regional hospitals and 5 district hospital) by Council for Health service Accreditation of Southern Africa (COHSASA) within 3 years. • Reduce the incidence of medico-legal incidents by 50% within 3 years. • Provide 100% access to 24-hours services within Local Municipality Area within 3 years.

6. STRATEGIC PLAN • 10 POINT PLAN • FREE STATE DEVELOPMENT PLAN • PROVINCIAL STRATEGIC POSITION STATEMENT • INFORMATION/DATA • NATIONAL AND PROVINCIAL HEALTH AND OTHER LEGISLATION • NATIONAL AND PROVINCIAL POLICIES

8. Expenditure per Programme Expenditure 2002/2003

9. Programmes Budget 2002/2003 Actual Expenditure 2002/2003 Under (Over) Expenditure 2002/2003 % Health Administration 96,626 93,549 3,077 96.82 District Health Services 857,073 853,223 3,851 99.55 Regional and Specialised Hospitals 628,064 623,309 4,755 99.24 Central Hospital Services 421,145 419,661 1,484 99.65 Health Sciences 47,636 45,302 2,334 95.10 Health Care Support Services 31,651 27,053 4,598 85.47 Health Facilities and Capital Stock 113,263 71,509 41,754 63.14 Supernumerary Staff 64,484 64,256 227 99.65 Internal Charges (20,776) (17,760) (3,016) 85.48 Authorised Losses 0 1,373 (1,373) 0 Totals 2,239,166 2,181,475 57,691 97.42

11. Expenditure 2002/2003 • Expenditure per Standard Items

12. Programmes Budget 2002/2003 Actual Expenditure 2002/2003 Under (Over) Expenditure 2002/2003 % Personnel Expenditure 1,380,805 1,372,917 7,888 99.43 Administrative Expenditure 62,719 63,825 (1,106) 101.76 Stores & Livestock 347,633 353,708 (6,075) 101.75 Equipment 108,200 88,560 19,640 81,85 Land and Buildings 134 30 104 22.39 Professional and Specialised Services 230,663 191,690 38,973 83,10 Transfer Payments 109,006 109,006 0 100 Miscellaneous 6 1,739 (1,733) 0 Totals 2,239,166 2,184,389 54,777 97,42

14. Departmental Receipts

15. Revenue items R thousand Revenue generated 1999/00 2000/01 2001/02 2002/03 Projected Projected Projected 2003/04 2004/05 2005/06 Patient fees Other 30,531 8,860 41,019 10,103 49,350 14,073 51,908 12,154 56,842 5,230 59,692 5,297 62,646 5,345 Total 39,391 51,122 63,423 64,062 62,072 64,989 67,991

17. MTEF • An Overview

18. 2002/2003 2003/2004 ‘000 2004/2005 ‘000 2005/2006 ‘000 Final Totals for the Health Vote 2,239,166 2,474,912 2,719,741 2,935,227 - Equitable Share 1,756,936 1,752,970 1,886,180 2,037,240 - Own Revenue - 75,798 83,220 85,410 - Conditional grants 482,230 646,144 750,341 812,577 ALLOCATION

19. MTEF 2000-2006 GRAPH

21. Conditional Grants

22. Allocated Budget 2002/2003 ‘000 Actual Expenditure 2002/2003 ‘000 Allocated Budget 2003/2004 ‘000 MTEF 2004/2005 ‘000 MTEF 2005/2006 ‘000 - Totals - Conditional grants 630,293 630,293 646,144 750,341 812,577 - National Tertiary services Grant 292,145 292,145 336,501 384,165 432,116 - Professional Training Dev 90,552 90,552 90,061 93,643 92,517 - PSNP 40,543 40,543 47,817 56,200 61,588 Hospital Rehabilitation 29,500 26,733 50,356 52,370 54,466 - HIV/AIDS 18,6570 18,657 30,144 40,843 42,621 - Provincial Conditional Grant 35,000 35,000 45,000 75,000 78,600 - Infrastructure Grant 32,876 25,511 28,390 35,065 37,276 - Infrastructure Grant (Floods) 50,687 19,265 5,145 0 0 - Hospital Management Improvement Grant 11,333 11,333 12,730 13,055 13,393

24. Addressing Equity

25. Equity • At provincial level, The Department motivates its needs to the Provincial Budget Management Committee. • The Department received 18.5% of equitable share and 22.3% of total revenue including conditional grants. • This compares to the 23.3% average of Provincial Health Departments in the country. • Two percent (2%) of the budget on Academic hospital level and Provincial hospital level were shifted to Primary Health Care Services. • An equity review is done on an annual basis and informs process towards intra-provincial equity. • All districts are undergoing DHER to look at intra-district equity • District funding funds the district plans approved by the PHA and managed amongst others through S L A • The burden of inflation to the Health sector has a huge impact,especially on replacement of equipment and medical consumables, and therefore equity.

26. Achievements • SUMMARY OF THE ACHIEVEMENTS OF THE MEC DELIVERABLES FOR 2002/03

27. Challenges • The mission of the Free State Provincial Government is: • Enhancing economic development and job creation. • Providing and facilitating sustainable infrastructure development. • Investing in the development of people of the Province. • Ensure a safe and secure environment. • To support these, the thrust on the Free State Department of Health remain: • Strengthening the Primary Health Care services. • Implementation of district Health System. • Improvement of quality care in all facilities. • Decisively dealing with HIV/ AIDS and other communicable diseases. • Efficient and effective management of resources including personnel.

28. Challenges: continue • External and Internal factors affecting Health Care delivery within the province: • The poor socio-economic status of the majority of the Free State population poses major challenges to the delivery of appropriate health care services. • Cross border flow and inappropriate self referrals affect the health budget. • HIV/ AIDS epidemic requires sustainable and effective intervention if significant cost implications are to be managed. • The District Health system should form the foundation for the delivery of health care. • A monitoring mechanism is required, to ensure that public health resources are aligned with Primary Health Care priorities. • 24 hour Primary Health Care facilities are needed to enable treatment at the clinically appropriate level. • Completion of the transformation of Emergency Medical Services and Patient transport system to support referral systems. • Current Human Resources policy needs to be reviewed. • Marketing of health services • Provision of quality health care

29. Thank You