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Department of Health

Department of Health. Presentation to the Select Committee on Finance on 3 May 2006. Conditional Grants. National Tertiary Services Grant Health Professions Training Grant Revitalisation Grant (Capital) Provincial Infrastructure Grant (Capital) HIV/AIDS Grant

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Department of Health

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  1. Department of Health Presentation to the Select Committee on Finance on 3 May 2006

  2. Conditional Grants • National Tertiary Services Grant • Health Professions Training Grant • Revitalisation Grant (Capital) • Provincial Infrastructure Grant (Capital) • HIV/AIDS Grant • Integrated Nutrition Grant • Hospital Management and Quality Improvement Grant • Forensic Pathology Services Grant

  3. Expenditure Trends

  4. Allocation, Transfers & Expenditure

  5. Allocation, Transfers & Expenditure

  6. Allocation, Transfers & Expenditure

  7. Allocation, Transfers & Expenditure

  8. Allocation, Transfers & Expenditure • Expenditure on 3 grants is at 100% - National Tertiary Services; Health Professions Training & Development and HIV/AIDS. • Integrated Nutrition Programme – R9,9m of the R11,3m allocated budget has been spent i.e.87%. Delay by supplier to supply invoice for payment. • Hospital Management & Quality – expenditure amounted to R8m which is 44% of allocated budget. Initial business plan submitted to National Health but was not accepted as Department had to rework it. Second business plan was approved on the 29th November 2005. This was too late for some projects to be implemented.

  9. Allocation, Transfers & Expenditure • Revitalisation – The full allocation was spent • Provincial Infrastructure – R18,5m of the R74m allocation was transferred to the department. Expenditure for the year amounted to R74m. R55,5m was withheld by National Treasury because other departments did not comply with the conditions of the grant, although Health complied.

  10. Allocation, Transfers & Expenditure • Forensic Pathology – expenditure on this grant amounted to R7,9m which constitutes 41% of allocated budget. • Appointment of personnel delayed • Certain equipment was not delivered in time. • Allocation only approved in December 2005

  11. Capital Expenditure

  12. Capital Expenditure - Continued • R55,6 million was spent on equipment costing less than R5000.00 • R19,5 million was spent at the New Pretoria Academic Hospital. R19,3 million of this relate to medical and allied equipment. • This amount is classified as Goods and Services

  13. Achievements 2005/06 • Pharmacy project – Upgrade of pharmacies at the following hospitals has been completed to meet new legislative requirements • Kopanong Hospital • Edenvale Hospital • Coronation Hospital • Weskoppies Hospital • Pholosong Hospital • Waste Management – Medical waste areas have beem upgraded to comply with Provincial and National Health Care Waste Management Regulations

  14. Achievements 2005/06 • Tshwane District Hospital (Old Pretoria Academic Hospital) - Master plan completed • New Pretoria Academic Hospital – Hospital commissioned during February and March 2006. • Chris Hani Baragwanath Hospital - Project Implementation Plan for Phase 3 approved and construction is proceeding to schedule. • Sebokeng Hospital – New revitalisation approved project • Natalspruit Hospital - bulk site-works was awarded in April 2006 and contractor on site

  15. Achievements 2005/06 • Zola District Hospital - The relocation of the hospital has been agreed to and the hospital will now be erected on a site in Jabulani. Contractor will be on site in June 2006 • Daveyton Hospital - Contractor will be on site in June 2006. • Lilian Ngoyi District Hospital - Contractor is expected on site in September 2006.

  16. Achievements 2005/06 • Weskoppies Hospital - 2 new wards completed and operational • Kalafong Hospital – Upgrade of theatres completed and operational • Soshanguve Block L – Officially opened in March 2006 • Helen Joseph Hospital - The project to establish the breast clinic at Helen Joseph Hospital as a centre of excellence has been completed and is operational. • Period contracts in place in 85% of institutions • Anti Retroviral Therapy (ART) - 33 Sites are operational. Special Project initiated to facilitate roll out of ART to additional sites.

  17. Monitoring Capacity • Two initiatives were implemented by DPTR&W and Health to fast track delivery of projects - • Appointment of Project Management Resource Groups (PMRG) by the Department of Public Transport, Roads and Works (DPTR&W) to increase capacity on site in order to manage and expedite capital projects. • Appointment of dedicated project managers by GDoH for each Revitalisation project in order to strengthen the capacity to manage and expedite revitalisation projects

  18. Monitoring Capacity • The planning cycle of projects was reduced from 27 to 20 months • Flagship projects were identified which merited special attention by both Departments. • Closer cooperation and communication with institutional Facility Management Units has been implemented in respect of planning to finalise user requirements before a brief, requirements and schedule of accommodation is conveyed to DPTR&W. • This has reduced the need for subsequent amendment of design briefs which was often a cause of delays

  19. Monitoring Capacity • Projects were planned to tender documentation stage that could be initiated at short notice if cash flow trends demanded expedited expenditure. • Projects were initiated to exceed the budgeted amount in order to allow for delays or under expenditure. A target budget for 2006/07 has already been agreed. Projects for the 2006 / 2007 financial year have already been conveyed to DPTR&W.

  20. Monitoring • Financial • Monitoring done on different management levels • Compliance with reporting requirements • Performance • Compliance with reporting requirements • No qualification from Auditor General on conditional grants for 2004-05 • Will be further strengthened during 2006/7. A post dedicated on the level of Deputy Director was created for the control of conditional grants in the Branch reporting to the CFO.

  21. Reporting • Financial Reporting • Report done on template provided by National Treasury • Finalised and submitted every month on the dates stipulated by the DORA (15th of each month) • Performance Report • Submitted quarterly as required • Other ad hoc

  22. Service Level Agreements

  23. Challenges • Accuracy and reliability of data • Allocations do not take cross border flow of patients into consideration • Range of eligible services provided at each institution exceed grant allocations • Complex nature of Gauteng, means that some services e.g. renal dialysis provided by some regional hospitals which are not funded • Psychiatric tertiary services not funded

  24. Challenges • Allocation for Revitilisation Grant for 2006/7 amounts to R307million. • Projected expenditure for this 2006/7 year is R600million • Increase in monitoring capacity • Approval on nine Revitalisation projects • Projected cash flow is major challenge

  25. Thank you

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