MPUMALANGA PROVINCE DEPARTMENT OF HEALTH AND SOCIAL SERVICES

MPUMALANGA PROVINCE DEPARTMENT OF HEALTH AND SOCIAL SERVICES BUDGET HEARING 5 APRIL 2005 1

Mpumalanga Provincial team Ø MEC PE Pasha Member of Executive Council Ø Mr. HE Verachia Head of Department Ø Mr. R Mnisi Chief Financial Officer Ø Dr. K Michael Chief Director: Hospital Services Ø Ms. G Mathebula Chief Director: Primary Health Care 2

Mpumalanga Provincial team Ø Mr. R Masilela Ø Ms. P Rousseau Ø Mr. J Mlangeni PA to the MEC PA to the HOD Deputy Director: Communications 3

Strategic Priorities for the National Health System (2004 -2009) identified the following major elements: Ø Improve governance and management of the NHS Ø Promote healthy lifestyles Ø Contribute toward to human dignity by improving quality of care Ø Improve management of Communicable diseases and non-communicable illness 4

Ø Strengthen Primary Health Care, EMS and Hospital Services delivery systems Ø Strengthen support services Ø Human Resource planning, development and management Ø Planning, budgeting, monitoring and evaluation Ø Prepare and implement legislation Ø Strengthen international relations 5

Key achievements for the Provincial Health Department 2004/2005 See handout 6

Vision A developed society in which all people have equitable access to quality, humane and integrated health and social services 7

Mission To provide and promote integrated quality health and social services in partnership with all stakeholders to ensure healthy lifestyles and reduce poverty in all communities in Mpumalanga. 8

Values Equity Honesty Dignity Transparency Honesty Integrity Accessibility Value of money Information Human Rights Collective Accountability Efficiency and Effectiveness 9

Provincial Priorities 1. Addressing Communicable Diseases 10

Provincial Priorities 11

Key priorities for the next 3 years 12

Improve governance and management of the Provincial Health System 13

Ø Establishment of Hospital Boards and Clinic Committees according to the National Health Act, Act no 61 of 2003. Ø Training of Hospital Board and Clinic Committee members. Ø Appointment of CEO’s at all provincial hospitals. Ø Strengthen training for Hospital managers. Ø Implement Departmental Communication strategy 14

Promote healthy lifestyles 15

Ø Community mobilisation to adopt healthy lifestyle practices through healthy eating habits and exercise. Ø Strengthen Health Promoting schools. Ø Strengthen Diabetes Awareness through expanding the Diabetes Support groups. Ø Strengthen the Household and Community component of IMCI. 16

Contribute towards human dignity by improving quality of care 17

Ø Strengthen community participation through Imbizo’s, community meetings and community structures e. g. DOTS and HBC groups. Ø Support multi-sectoral Victim Empowerment Programme. Ø Conduct patient satisfaction surveys at health facilities. Ø Establish adverse event reporting systems at all hospitals. Ø Ongoing clinical audits in line with National benchmarks. 18

Improve management of communicable diseases and non-communicable illness 19

Ø Empower Communicable Disease Control response teams. Ø Monitor immunization coverage for children under 1 year of age. Ø Empower health workers on the Integrated Management of Childhood Illnesses for children under 5 years. Ø Training of PHC nurses on early diagnosis and treatment of Malaria cases. Ø Accelerate the implementation of the Comprehensive plan for HIV and AIDS. 20

Ø Implement TB review recommendations including management of MDR TB Ø Strengthening of programmes on women and maternal health including screening for breast and cervical cancer. 21

Strengthen Primary Health Care, EMS and Hospital Services delivery systems 22

Ø Improve access to PHC by constructing additional facilities and providing additional mobile services in prioritised areas. Ø Increase delivery of PHC package at all service delivery points. Ø Reduce response times for EMS in urban and rural areas. Ø Prepare business cases for one additional revitalisation project per annum, including a business case for a provincial tertiary facility. 23

Strenghten Support services 24

Ø Implement a Health Technology Management System. Ø Monitor and strengthen radiation control in hospitals. Ø Monitor compliance with EDL guidelines. Ø Provision of a central Pharmaceutical Depot that complies with legislation. 25

Human resource planning, development and management 26

Ø Strengthen and develop a fully functional Health Sciences College. Ø Monitor implementation of the Departmental Human Resource Plan. Ø Monitor implementation and impact of Departmental Retention strategy. Ø Engage responsibility managers on PMDS compliance. 27

Planning, budgeting, monitoring and evaluation 28

Ø Monitor compliance with PFMA and supply chain management system. Ø Improve and strengthen the health information system and empower managers to utilise quality health information. Ø Establishment of monitoring and evaluation teams to monitor performance against set objectives and standards. 29

Prepare and implement legislation 30

Ø Develop and promulgate a Provincial Health Act Ø Monitor compliance with the Mental Health Care Act, Pharmacy Act and National Health Act. 31

Strenthen international relations 32

Ø Further develop the Lebombo Spatial Development Initiative, which is a collaborative programme between Swaziland, Mozambique and Mpumalanga in addressing communicable diseases in the region. Ø Jointly expand the collaborative project on health information systems with the Italian Corporation. Ø Develop and implement a doctor and specialist rotation system with the United Kingdom and Germany. 33

Brief description of the Budget with Trends 2002/03 – 2007/08 34

Department of Health and Social Services Health Component Expenditure R’ 000 Sources of revenue Equitable share Conditional Grants 2001/ 2002/2003/2004/ 2005/ 2006/ 20072008 1 285 511 1 489 433 1 821 474 2 035 407 2 183 565 2 466 932 2 655 194 174 050 198 713 320 352 338 975 296 893 365 035 399 777 10 370 10 540 2 152 196 2 384 922 Own Revenue Total Revenue R’ 000 Medium Term Estimates R’ 000 1 456 561 1 688 146 46 000 2 480 458 2 877 967 3 054 971 35

Department of Health and Social Services Health Component Budget 2004/2005 R’ 000 Equitable share Conditional Grants Total Preliminary Expenditure 2004/2005 R’ 000 Under/over R’ 000 Expenditure as % allocation 2 045 947 2 011 100 34 847 98, 3% 338 975 255 119 83 856 75, 3% 2 384 922 2 266 219 118 703 95, 1% 36

Department of Health and Social Services Health Component Expenditure R’ 000 Medium Term Estimates R’ 000 2001/ 2002/2003/2004/ 2005/ 2006/ 2007 1. Administration 111 015 120 729 176 035 216 141 155 022 160 723 204 783 2. District Health Services 885 855 1 021 266 1 092 551 1 109 784 1 231 086 1 397 771 1 465 557 46 729 90 625 92 549 120 393 130 024 Programmes 3. Emergency Medical Services 2007/2008 4. Provincial Hospital Services 224 546 232 951 269 611 353 125 382 764 456 759 464 439 5. Central Hospital 156 080 176 775 302 377 365 088 358 013 399 982 410 215 6. Health Sciences and Training 32 638 39 328 45 160 58 919 84 292 93 342 101 475 7. Health care Support services 12 664 24 696 15 427 22 765 33 594 40 840 43 229 8. Health Facilities Management 63 72 401 81 148 168 475 143 198 208 157 235 249 1 456 561 1 688 478 2 006 393 2 384 922 2 480 518 2 877 967 3 054 971 Total Revenue 37

Department of Health and Social Services Health Component Conditional Grant Health Financial Management Grant Expenditure R’ 000 2003/2004/2005 Medium Term Estimates R’ 000 2005/ 2006/ 2007/ 2008 39 975 44 323 52 042 2 844 2 008 Provincial Infrastructure Grant 29 171 40 553 Flood Construction Grant 11 016 6 677 National Tertiary Services Grant 41 796 48 527 42 224 44 757 46 995 Health Professional Training and Development Grant 46 575 42 083 54 363 57 081 Hospital Revitalisation Grant 65 944 88 423 57 018 101 032 117 071 13 081 13 735 Coroner Services Grant 1 000 Hospital Management and Quality Improvement Grant 20 273 28 990 12 340 Integrated Nutrition Programme Grant 67 183 15 053 9 581 HIV and AIDS Grant 34 550 65 661 81 392 107 479 112 853 338 975 296 893 356 665 399 777 Medico Legal Services Total 1 000 320 352 38

Department of Health and Social Services Health Component Budget 2004/2005 R’ 000 Health Financial Management Grant Preliminary Expenditure 2004/2005 R’ 000 Under/(over) R’ 000 2 008 1 676 332 40 553 18 129 22 424 6 677 6 286 391 National Tertiary Services Grant 48 527 46 467 2 060 Health Professional Training and Development Grant 42 083 0 Hospital Revitalisation Grant 88 423 51 699 36 724 1 000 728 272 Hospital Management and Quality Improvement Grant 28 990 21 538 7 452 Integrated Nutrition Programme Grant 15 053 13 402 1 651 HIV and AIDS Grant 65 661 53 111 12 550 338 975 255 119 83 856 Provincial Infrastructure Grant Flood Construction Grant Coroner Services Grant Total 39

Budgetary Trends The Mpumalanga Province had a budget of 2002/3 the budget was R 1, 688 billion and for 2003/4 the budget was R 2, 152 billion. For 2004/2005 the budget allocated was R 2, 385 billion The department provides in addition to the population of the province, health care services to patients from neighboring countries of Swaziland Mozambique 40

Budgetary Trends § The Departmental expenditure per capita for 2004/2005 was R 64, 87 § The allocation for the health component represents 21, 5% of the Provincial equitable share budget 41