CONDITIONAL GRANTS 200405 DEPARTMENT OF HEALTH NORTH WEST

CONDITIONAL GRANTS 2004/05 DEPARTMENT OF HEALTH NORTH WEST PROVINCE

Purpose To provide information on the Departmental Conditional Grants for the year 2004/05.

Data on trends in allocations, transfers and actual expenditure of the Departmental Conditional Grants and Capital Grants. 2002/03 2003/04 % CONDITIONAL GRANT'S NAME TOTAL BUDGET EXPENDITURE R'000 EXPENDIT URE ON BUDGET % TOTAL BUDGE T EXPENDITURE % EXPENDITURE ON BUDGET R'000 % Comprehensive HIV/AIDS 20, 419 21, 293 104. 28% 32, 891 31, 260 95. 04 Health Professions Training & Development 32, 898 28, 524 86. 70% 37, 144 37, 112 99. 91 8, 334 6, 513 78. 15% 14, 551 12, 196 83. 82 Hospital Revitalisation 64, 293 52, 824 82. 16% 71, 408 37, 981 53. 19 Integrated Nutrition 43, 965 43, 972 100. 02% 71, 967 63, 699 88. 51 0 0 1, 000 205 20. 50 34, 750 36, 446 104. 88% 35, 000 34, 859 99. 60 204, 659 189, 572 92. 63% 263, 961 217, 312 82. 33 Hospital Management & Quality Improvement Medico-Legal National Tertiary Service Total

Data on trends in allocations, transfers and actual expenditure of the Departmental Conditional Grants and Capital Grants. Grant’s Name 2004/05 Provincial Allocatio n R’ 000 Infrastructure 2004/05 Total Availa ble R’ 000 2004/05 Transfers from National R’ 000 2004/05 Actual Expen diture R’ 000 35 358 22 722 Health Professions Training & Development 46 351 44 903 Comprehensive HIV & AIDS 70 981 1 631 72 612 59 151 64 619 Hospital Management and Quality Improvement 12 713 2 355 15 068 12 713 9 407 Hospital Revitalisation 92 845 33 428 126 273 92 845 81 930 9 987 8 266 18 253 9 987 9 336 42 105 38 606 Integrated Nutrition National Tertiary Services 2004/05 Provincial Roll Overs R’ 000 42 105 Malaria and Cholera Prevention 3 400 2 336 Medico Legal Services 794 734 UN Funding for TB 317 TOTAL 310 340 50 191 360 531 298 510 274 593

Monitoring Capacity n n n The Department created a post of Conditional Grants Manager for monitoring all the Conditional Grants and the post was filled in November 2004. The Manager is responsible for monitoring expenditure of Conditional Grants and whether the expenditure complies with the conditions of the DORA and the approved business plans. The manager guides responsible programme managers in their day to day management of the grants. The Manager is responsible for drafting monthly and quarterly reports, in terms of the recommended reporting format, the performance of Conditional Grants. However, the financial management capacity at all levels still requires strengthening An audit of financial management competence conducted by a contracted independent firm, has revealed capacity gaps

Past year performance (2004/05)

Infrastructure Amount Total Budget R’ 000 35 358 Actual Expenditure R’ 000 22 722 % of Expenditure against the Budget 64. 26 Comment: n Projects planning took longer than expected, there were poor tender responses for other projects and there was also a delay in appointment of Consultants. n Relationship with DPW needs to be continuously strengthened

Health Professions Training & Development Amount Total Budget R’ 000 46 351 Actual Expenditure R’ 000 44 903 % of Expenditure against the Budget 96. 88 Comment: The expenditure under the grant has been satisfactory. Under expenditure mainly on personnel due to challenges of attracting personnel

Comprehensive HIV & AIDS Amount Total Budget R’ 000 72 612 Actual Expenditure R’ 000 64 619 % of Expenditure against the Budget 88. 99 Comment: n The funds under this grant are already committed per various sub-programmes. The activities took longer until the end of the financial year due to delays in the supply chain management for securing relevant Service Providers and finalising Service Level Agreements with appointed Service Providers. n An amount of R 11, 8 m was not transferred by national and has been requested to be rolled over. Of the total R 64 m spent, R 3 m was from equitable share.

Hospital Management and Quality Improvement Amount Total Budget R’ 000 15 068 Actual Expenditure R’ 000 9 407 % of Expenditure against the Budget 62. 43 Comment: n Of the 3 revitalisation hospital, 2 experience delays, thus impacting on the spending of the grant n Capacity at hospital level also needs strengthening n The Accreditation process of Hospitals will be funded and finalisation of installation of PAAB system in Hospitals will also be completed. n Due to the fact that the first hospital for Revitalisation has been completed (Swartruggens), funds will be utilized for implementing the cost center management project to the hospital and also continue with the existing site – Klerksdorp/Tshepong. n Treasury has approved the roll over.

Hospital Revitalisation Amount Total Budget R’ 000 126 273 Actual Expenditure R’ 000 81 930 % of Expenditure against the Budget 64. 88 Comment: n The tendering process for projects took longer than expected and implementing agents did not adhere to the programme. n Based on the fact that the Departments of Health and Public Works are working on a service level agreement and standard operating procedures, coupled with the full supply chain management delegations in place, the Department is in a better position to ensure that all committed funds are spent as planned. n Treasury has approved the roll over but kept the funds in the reserve fund. n Our relationship with DPW, as it strengthen, should have a positive impact

Integrated Nutrition Amount Total Budget R’ 000 18 253 Actual Expenditure R’ 000 9 336 % of Expenditure against the Budget 51. 15 Comment: n The first transfer of the programme was received three months later than scheduled and this impacted badly on the plans of the programme. n The expenditure was low due to a transition phase for the transfer of functions and responsibilities for the School Nutrition Fund to the Education department. n The Department of Health had to restructure its operations with special focus on an Integrated Nutrition programme. n The programme therefore started late during the financial thus impacting negatively on expenditure. n However the amount left is surrendered. Treasury has approved the roll over but kept the funds in the reserve fund.

National Tertiary Services Amount Total Budget R’ 000 42 105 Actual Expenditure R’ 000 38 606 % of Expenditure against the Budget 91. 69 Comment: n The expenditure for the grant is largely incurred from equitable share first and then journalised to the grant due to the nature of services rendered. However, the expenditure trend under the programme has been satisfactory. n The reason for the Department not utilising the remaining funds is because there has been delays in delivering equipments ordered for Hospitals offering tertiary services and the funds are however committed. n Treasury has approved the roll over.

Malaria and Cholera Prevention Amount Total Budget R’ 000 3 400 Actual Expenditure R’ 000 2 336 % of Expenditure against the Budget 68. 71 Comment: n Though a business plan was submitted, a clear demonstration of need was not elaborate given that this was a once off conditional grant n The activities under the programme have been moving slowly. n Most the activities under this special conditional grant also benefited from equitable share allocation. n Treasury has approved the roll over but kept the funds in the reserve fund.

Medico Legal Services Amount Total Budget R’ 000 794 Actual Expenditure R’ 000 734 % of Expenditure against the Budget 92. 44 Comment: n The expenditure under the grant has been satisfactory. n Success of managing this process also relies on good partnership with SAPS, DPW, etc.

Monthly Reports n Monthly reports have been regularly sent to the provincial Treasury and National Department of Health’s Office.

Conditional Grants business plans for the year 2005/06 n Business plans for all the grants have been sent to National Office and all have been approved. The province has already received transfers for April and May months from the National Office. Most of transfers only come in May.

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