Presentation to the Health Portfolio Committee

1. Presentation to the Health Portfolio Committee Presentation to Health Portfolio Committee Free State Department of Health 14 JUNE 2004

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

4. Strategic Plan • The departmental strategic plan is informed by • National strategic framework • Free State Development plan • Growing the economy and job creation • Sustainable Infrastructure • Investing in the development of people • Good governance • Safety and security • Departmental Strategic Position Statement

6. Achievements on Strategic Objective • Reduce burden of HIV/AIDS and TB • Community Home Based Care has been established in 85% of towns in the province. This implies that 74 towns in the Free State have Home Based Care access. • The Department commenced the plan to implement the Comprehensive HIV and AIDS plan. • The TB cure rate for new smear positive cases achieved was 67,3%. • DOTS has been implemented in 75% of health facilities • TB treatment interruption rate achieved is 8,2%. • The national World Aids day event was hosted on 1 December 2003 by the department. • Effective and Efficient Management of resources • All the resources allocated to Vote 5 during 2003/2004 were deployed to achieve the goals set out in the departmental strategic plan, and stayed within budget. • Quarterly reviews of the budget and performance against the strategic plan were conducted to ensure the achievements of goals and management of the budget. • 11 Managerial accountants were appointed to assist with financial management. • Functional District Health System • 2nd Provincial District Health System conference was hosted, preparing the department and municipalities to implement the DHXS from July 2004. • A total of 106 community development workers have been recruited from villages and farm areas in the Free State. • The under one immunization coverage improved to 83% • A new eye care centre was established at Mofumahadi Manapo Mopeli hospital

7. Achievements on Strategic Objective continue: • Effective Marketing and Communication of Health Services • The department supported by the HWO developed a Health promotion strategy. • A services marketing strategy was developed • Integrated communication strategy wad developed. • Developed and empowered personnel and stakeholders • As part of the Service Delivery Improvement Plan, officials were trained in the Performance Development and Management System. • 4 members of EMS personnel completed Advanced life support training. A further 25 staff members commenced advanced life support and intermediate life support training. • The department assisted the Central University of Technology to commence a diploma in Emergency care in 2004 • The department spent R 4 667 703 for the first phase of implementing salary parity for local government employed PHC health care workers to encourage them to stay in small towns. • A rural allowance and a scarce skills allowance to recruit and retain health professionals, was introduced from July 2003 at a cost of R18 034 099. • External bursaries were provided accoding to the priorities of the department to a total of about R11 million • iCAM awarded runner up prize for innovation in service delivery from CPSI of DPSA

8. Achievements on Strategic Objective continue: • Appropriate Infrastructure • Nine (9) new clinics were built at Steynsrus, Boshof, Thaba Nchu, Clarens, Vrede, Masilo, Kroonstad, Seisoville & Ladybrand. • The following six (6) clinics were upgraded: Bophelong and Tshepong in Welkom, Botshabelo Block B and D clinics, Thusong clinic in Bloemfontein and Qibing clinic at Wepener. • The revitalization projects at Boitumelo and Pelonomi Hospitals commenced and most contracts were awarded. • The Meditech Hospital information system was implemented at Boitumelo hospital. • The department successfully executed 11 hospital projects in the 2003/2004 financial year. • X-ray machines to a total value of R3 159 254, are being procured for Mohau, Katleho, Dr JS Moroka, Embekweni, Phekolong, Nketoana and Botshabelo hospitals. • The department is also procuring a new state of the art linear accelerator for cancer treatment to the value of R12 426 000 million and upgrading an existing linear accelerator to the value of R3 722 100. • Accessible and quality services at all levels • The remaining 18 of the 31 hospitals (58%) of the Free State Department of Health were added to the Council for Health Service Accreditation of Southern Africa (COHSASA) process. • Bongani and Nala Hospitals were awarded full accreditation by COHSASA • Dihlabeng hospital received intermediate accreditation • FSPC and Mafube Hospital achieved a focused survey • Implementation of the collocation PPP at Pelonomi and Universitas hospitals

9. Expenditure per Programme Expenditure 2003/2004

12. Expenditure 2003/2004 • Expenditure per Economic Classification

15. 2004/2005 Budget • The budget allocated to the Free State Health Department for the 2004/2005 financial year is R 2 730 596 000, which is 22% of the total of the provincial budget of R12,543 billion. • Health now has the 3rd largest budget after education and Social Development • This budget is R 138,16 million or 5,33% more than the budget allocated in the 2003/2004 financial year. The increase is nominal and does not take into consideration inflation. In real terms the increase is 0,83%. • In terms of the MTEF, the budget will increase to R 2 972 196 000 in 2005/2006 and R3 184 012 000 in 2006/2007. • The budget is composed of R1 913 519 000 from the equitable share, R733 857 000 from conditional grants and R83 220 000 from provincial own revenue. • R 1, 653,751 000 or 60,6% of the budget is set aside for compensation of employees. R 795, 000 000 (29%) will be used to procure goods and services. R 104, 829 000 (3,8%) is allocated for transfer payments mainly to municipalities. The budget for buildings and infrastructure is R 121 389 000 (4,4%) and for capital equipment is R55, 624 000 or 2% of the total budget.

16. Departmental Receipts

19. MTEF • An Overview

20. ALLOCATION

21. MTEF 2001-2007 GRAPH

23. Conditional Grants

26. Challenges for 2004/2005 • 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. • Poverty • Unemployment • Population density • Rural polulation • 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. • 24 hour Primary Health Care facilities are needed to enable treatment at the clinically appropriate level. • The difficulty of recruiting and retaining health professional in rural areas

27. Priorities for 2004/05 • Strengthening the Primary Health Care services. • Implement the core PHC package • Conduct an immunization campaign in July and a mop up campaign on August • Implement a healthy settings campaign • Implement school health service • Build clinics at Brandfort, Welkom, Winburg, Odendaalsrus, Bethulie and Wepener • Implementation of District Health System. • Transfer municipal health services to district municipalities • Take over PHC services from local municipalities and prepare for devolution • Further implement the EMS plan • Improvement of quality care in all facilities. • Ensure that all hospitals are accredited by COHSASA • Implement a clinical risk assessment system • Commission the new trauma unit at Pelonomj hospital • Implement Meditech HIS at Bongani hospital • Implement eye care and renal dialysis and psychiatric services at Mof M M hospital • Decisively dealing with HIV/ AIDS and other communicable diseases. • Establish one ARV site per district • Implement VCCT at all health facilities • Achieve TB cure rate of 75% • Efficient and effective management of resources including personnel. • Continue the implementation of the PFMA • Implement supply chain management • Develop a plan to take over medico legal mortuaries • Implement learnerships in Ancillary care, Pharmacy assistant, Auxillary nursing

28. Thank You