PURPOSE OF HOSPITAL REVITALISATION PROGRAM

1. Mpumalanga Department of Health Brief for National Portfolio Committee on Health, Hospital Revitalization Programme Presented by: Hon MEC Dr RC Mkasi 29 August 2012

2. PURPOSE OF HOSPITAL REVITALISATION PROGRAM GRANT OVERVIEW • As per the Division of Revenue Act of 2012,, the purpose of the Hospital Revitalisation & Provincial Infrastructure Grants is as follows: • To provide funding to enable provinces to plan, manage, modernise, rationalise and transform the infrastructure, health technology, monitoring and evaluation of health facilities in line with national policy objectives • To transform hospital management and improve quality of care in line with national policy • The vision of Hospital Revitalisation Program is to modernize all hospitals within the country, Hospital Revitalisation Program is a 25 year national program • In line with the Ten Point Plan Strategic Framework document of the Health Department, the Revitalisation of Hospital Services includes: • Updating the National Infrastructure Planning Framework • Improving the condition of health Facilities • Improving the condition of equipment • Decentralization of health facility management • Rationalisation of highly specialised services

3. 1. Data on trends in allocations, transfers and actual expenditure of Hospital Revitalisation grant of the department of health: Mpumalanga. • Allocation for 2011/12 financial year • HOSPITAL REVITALISATION GRANT budget allocated was • R 356 557 million

4. (b) Data on trends in transfers and expenditure 2011\12 Total Amount Received as at 31March 2012 is R 365 557 000.00 Actual expenditure: as at 31 March 2012 is R 296 889 467.20. - 83 % Under-expenditure R 59 667 532.80 Committed under-expenditure R 57 667 532.80 Roll-over approved R 59 571 000.00

5. (b) Data on trends in transfers and expenditure 2012\13 Budget Allocation 2012\13 R 300 000 000.00 Total Amount Received as at 30 June 2012 is R 31 740 000.00 Actual expenditure: as at 30 June 2012 is R 31 957 576.98 at 17%

6. 2.Department’s monitoring capacity thus far, for the financial year 2012\13. • 90% of the HRP post structure has been filled • Director Filled-01\04\2009 • Infrastructure Manager- Filled • HT Manager -Filled • QA\OD Manager Filled-01\08\2009 • M&E Manager –Filled 01\08\2012 • Site project managers -Filled 2x 01\08\2009 • Assistant Director Finance-Vacant from 01\08\2012 • Site Electrical Engineering Technicians 3x Technicians appointed 01\09\2009 • Secretary Filled-01\06\2009 • Administrative officer Filled-01\09\2009 • State Accountants x2 finalizing appointment by 01\10\2012

7. Cont: • Hospital Revitalisation Monitoring and Evaluation Practices on a continuous basis • Infrastructure norms and standards are a national competency under revision by CSIR • Compliance to norms and standards is implemented through a defined process in the Division of Revenue Act for all projects as follows:- • Business Case, • Health Brief, • Operational Narrative and • Designs • Initial Project Implementation Plan and • Annual Project Implementation Plan appraisal and approval is done by National Department of Health prior to implementation

8. Cont: • Hospital Revitalisation Monitoring and Evaluation Practices on a continuous basis • The Department of Public Works,Roads and Transport is an implementing agent for Infrastructure delivery,IDT is implementing agent for Rob Ferreira Hospital • Technical support unit appointed by National Treasury/Health-IDIP-Resident Engineer-PMSU appointed by NDoH • Monthly grant management meetings led by HoD • Monthly Project Management meetings with NDoH, PDoH,DPWR&T and Provincial Treasury • Conducting quarterly reviews for project progress reporting

9. 2. Cont: • Submission of reports totalling to 17 to the National Department of Health • -12 Monthly reports • -4 Quarterly reports • -Annual report • SITE VISITS • Monthly Site visits by the HRP Unit • National Treasury visits • Support visits National Department of Health

10. 2. Cont: • Political Visits • -Premier • -Portfolio Committee • -MEC & HOD • Monthly Steering committee meetings • Monthly Site and technical meetings with consultants • Monthly inter departmental( Health, Public Works & IDT) meetings

11. 2. Cont: • Reasons for under-expenditure • Poor performance of nominated Implementing agent(IDT),with lack of technical capacity and proper project management skills which has resulted in huge cost overruns • Inadequate expertise of professional teams which resulted in inaccurate bills of quantities and insufficient designs • Poor performance of contractors with good CIDB grading, which led contracts to be terminated, contractors contesting termination thus delaying appointment of new contractors therefore funds were not spent

12. 2. Cont: • Reasons for under-expenditure • Unforeseen site conditions which caused delays in some projects(huge underground rocks in Rob Ferreira hospital delaying progress in two major projects)in spite of a Geo-Tech assessment • Inclement weather conditions, floods and storm damages which caused delays in progress

13. 2. Cont: • Measures to improve programme management and spending • Joint collaboration with National Department of Health to form a governance committee and termination of existing contract with IDT,DPWR&T to take over from IDT • Strengthening of the unit with two state accountants for fast tracking procurement of equipment • Centralisation of health technology management for procurement of equipments • Blacklisting of poorly performing service providers

14. 2. Cont: • Measures to improve programme management and spending • Appointment of new contractors with a proven capacity to deliver big projects • Strengthen inter departmental partnership with implementing agent • Strengthen capacity of the infrastructure unit(appointment of Resident Engineer and other built environment professionals) • Appointment of a Resident Engineers for supervision of civil\structural projects

15. Progress on projects under implementation

16. Projects under planning

17. THANK YOU