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Provincial Budgets and Expenditure Review: 2003/04 – 2009/10 Chapter 3: Health

Provincial Budgets and Expenditure Review: 2003/04 – 2009/10 Chapter 3: Health. 17 October 2007. Health spending outcome 2006/07. Provincial health expenditure and budget trends, 2003/04 to 2009/10. Provincial health expenditure and budget trends, 2003/04 to 2009/10.

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Provincial Budgets and Expenditure Review: 2003/04 – 2009/10 Chapter 3: Health

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  1. Provincial Budgets and Expenditure Review: 2003/04 – 2009/10Chapter 3: Health 17 October 2007

  2. Health spending outcome 2006/07

  3. Provincial health expenditure and budget trends, 2003/04 to 2009/10

  4. Provincial health expenditure and budget trends, 2003/04 to 2009/10 • By 2009/10, total expenditure to be almost double that of 2003/04 • Functional classifications – strong growth in most areas, esp. HIV & Aids • Strong growth in hospitals budgets (4% real) • Between 2003/04 –2009/10 real growth will exceed 8% annually in NC, MP, NW & LMP

  5. Under-spending on Conditional Grants • Under-spending on conditional grants 3,5% (pre-audited), compared to provinces overall overspending of -0,7% • Under expenditure most prevalent in Forensic Pathology Grant (43,7%) and Hospital Revitalisation Grant (8,1%). • Rollover request for R570m received (about 47% for Forensic Pathology) • Hospital Revitalisation Task Team in place to strengthen programme and improve performance

  6. Primary health care (PHC) per sub-programme • Spending on PHC to grow sharply over next 3 years (real annual growth 8%) • By 2010 expenditure will be double that of 2003/04

  7. Primary Health Care (PHC) visits per province • Despite increase in funding, number of visits have leveled off at 102 million over the past 2 years, suggesting that demand may be leveling off • Utilization rate is lowest in GT and KZN and highest in WC • Low supervision rate of nurse-run clinics in WC, NC and MP may be misleading due to incomplete data

  8. PHC Expenditure - District

  9. Provincial emergency medical services expenditure, 2003/04 to 2009/10 • Additional R863m added over next 3 years as part of rolling out new EMS model • Expenditure to grow to R3,2b by 2009/10, almost double that of 2005/06

  10. Provincial HIV and Aids expenditure, 2001/02 to 2007/08 • Provinces budgeted R2,4 billion in 2006/07 (excluding conditional grant funds) growing to R3,9 billion in 2009/10 (28,8% real annual growth) • Conditional grant funding grows from R416m in 2003/04 to R2,7b in 2009/10 (30,4% real annual growth) • 264 423 patients currently on ARV treatment at 313 treatment sites – expect close to 300 000 by end of financial year. Could reach 600 000 by 2009/10

  11. HIV & AIDS, TB Performance indicators 2006/07 • Progress with HIV & Aids & TB noted, but still much to do • Despite most health centres stocking Nevirapine, only 62,5% of tested patients receive it, with large variations between provinces • TB cure rate very low at 53%, with large variations between provinces

  12. Hospital funding 2003/04 – 2009/10 • Real growth of 4% from 2003/04 – 2009/10 • Spending on TB hospitals grows strongly as sector deals with MDR-TB • Almost all categories show strong real growth, but central hospitals growth remains flat (may be distorted by WC reclassification of expenditure) • Continuous cycle of under budgeting and over expenditure in central hospitals

  13. Trends in scarce health professionals • Health sector personnel numbers increased by 31,710 over past 3 years • Compensation of employees budget to grow 10,6% annually over next 3 years to 2009/10, allowing sector to fill medical and administrative posts • Sector plans to recruit further 30,000 employees over next 5 years

  14. Conclusion • 2006/07 budget showed 13,9% nominal growth. • Particular strong growth in HIV & Aids & TB, Primary Health Care, Emergency Medical Services and infrastructure • Human Resources strategy bearing fruit –gains are visible in increasing numbers of health personnel, numbers of persons on Aids treatment, shorter ambulance response times and many facilities undergoing capital improvements. • However, improvement in health outcomes not yet sufficient

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