Limpopo Intervention- Section 100 (1) (b) Ms VM Rennie 16 September 2014
Background • The following challenges were identified, as communicated in the Media Statement: Joint Ministerial Team on Limpopo Section 100 Intervention of 19 January 2012: • Poor asset management; • R400 million in irregular expenditure of goods and services (mostly medical equipment) in contravention of SCM regulations. This was not included in the financial statements submitted to the Auditor-General last year; • R427 million in assets with no supporting documents; • The Department projected that it will overspend its budget by R461 million.
Background • Limpopo Provincial Department of Health was placed under administration in terms of section 100 (1)(b) of the Constitution of the Republic of South Africa (Act no. 108 of 1996) in December 2011. • In terms of the communiqué between the Minister of Health and the MEC for Health the National Department of Health was to take over the following functions: • Financial Management and Budget Control • Procurement Management • Human Resource Management (reviewing the organizational structure) • Pharmaceutical Supplies Management • Infrastructure Management • Information Technology Management
Background The administration team undertook a diagnostic review during the Diagnostic Phase, the main aim of which was to understand the underlying causes that might have led to poor financial management and to stabilize cash flow. The next phase, the Recovery Phase, aimed to restore Departmental operations systemically and develop a continuity and sustainability plan with the ultimate goal of recovering core functions, focusing on key performance areas. Specific intervention projects have also been identified and are being implemented. For purposes of long-term sustainability, the projects have been incorporated and included into the Department’s Annual Performance Plan (APP) for the current financial year (2013/14).
Key Interventions • Head-counts with Persal clean-up • Review and implementation of a new Organisational Structure • Introduction of SCM policies and procedures • Review of decentralized financial model • Appointment of key personnel • Investigation of cases of corruption and implementation of disciplinary measures • Address shortage of medicines and key consumables
Section 100 (1) (b) – Achievements The following are the key achievements that Section 100(1)(b) has delivered: • Brought an end to reckless contracting and spending by the Departments under Administration thus leading to improved cash flow situation; • Key officials were trained on leadership and SCM • Has assisted the Department to fill certain key positions • Reviewed certain material contracts and developed a new sourcing strategy; • Certain cases were referred to the Department of Public Service and Administration, Special Investigating Unit and PricewaterhouseCoopers for further investigation;
Section 100 (1) (b) – Achievements • Centralised the payment verification process in order address the weaknesses identified by the intervention team. • Few of audit findings were resolved between FY2011/12 and FY2012/13. • Persal clean up reduced number of vacant posts from 62 430 to 38 000 • Intervention team brought interns to support record management at facility level • The Intervention Team engaged other Government entities in order to address system related challenges such as the unavailability of BAS. • Provided access to resources that the department would not have under normal circumstances e.g. fixing of boilers and autoclaves • Key officials were also seconded to the department • The contract of PwC was extended until end of July 2014 in order to support the Department throughout the audit.
Medicine and Surgical Availability • Pharmaceutical and Surgical supplies have remained stable at 86% and 62% availability respectively, against a target of 95% • Average stock availability has been at 76% • Vaccine availability has improved from 82% to 100% (12 of 12 vaccines) • ARV stock availability provincially is at 90% • FDC (Fixed dose combination) roll out is in progress. • The Direct deliveries project is being implemented in a phased in approach.
Section 100 (1) (b) – Challenges: Incomplete Projects • Record Management Improvement in conjunction with the Office of The Premier. • Supply Chain Reform Projects including: Security, Laundry, Catering, Health Care Waste, Medical Equipment and Maintenance and Coal; • Asset Management Project: PWC-Rakoma (major problems resolved) • The filling of key posts in finance including the CFO • Macrostructure/ Organogram and its implementation • Change Management and Team Building • Development of a culture of accountability and consequences for poor performance • Review of the district leadership structures and performance • Skills audit of all key managerial and leadership posts in the department • Appropriate deployment of key executives at corporate and district level • The review and audit of the ICT infrastructure and the filling of Key posts in ICT including the GITTO and Health Information Management i.e. PHIS, key posts, etc • Improvement of the system for procurement and distribution of Medicine
Conclusion. On the whole, Section 100 Interventions have assisted the LDoH to put systems in place to strengthen compliance with laws and implement strategies/plans to improve services delivery; Not withstanding the existence of incomplete projects and all factors considered, the Department believes it can manage on its own with support from the National Health Department on an ongoing basis going forward.
MPUMALANGA HEALTH DEPARTMENT • The Department has been put under curatorship by the province and this is not a national intervention. • The incumbent HOD is on suspension. • Currently there is an Acting HOD. National Health has indicated the anomaly in the appointment of the current Acting HOD due to the fact that the incumbent was appointed by NDoH as a project coordinator for the NHI project in the province. • Most of the Top management is on suspension. No Deputy Director Generals in place except for the CFO. • Support from National Health is on ad-hoc basis ( e.g Infrastructure programme)