STANDING COMMITTEE ON APPROPRIATIONS

1. STANDING COMMITTEE ON APPROPRIATIONS NATIONAL HEALTH GRANT PREPAREDNESS 8 March 2013

2. NATIONAL HEALTH GRANT • The National Grant Consist of two components: • Health Facility Revitalisation Grant • National Health Insurance Grant • These two components split into • Direct Provincial Allocations • In-Direct National Allocation (Grant In-Kind)

3. NHI-CG: Allocations and Preparedness

4. Contents • Background • Grant Framework Conditions • Allocations split between the Components • Preparedness • District piloting • Central Hospitals • GP Contracting

5. NHI-CG: Background • Underperformance in current 2013/14 cycle; • Revision DORA framework to adjust the purpose, focus activities and funding allocations to Provinces • Gives NDOH stronger and more direct control; • Impact on programme of work to be undertaken at National and pilot site levels; • Influences allocations across sites • Schedule 6A • Grant split into 2 components • Direct = District piloting • Indirect/In-kind = GPs contracting and central hospitals work

6. DORA 2013/14 Grant Framework (NHI) • Purpose • To undertake the development and implementation of a GPs contracting framework; • To enhance capacity to deliver Infrastructure in Health; • To support central hospitals in strengthening Health information systems; • To test various reimbursement systems at central hospitals • Outputs (deliverables) • Development and implementation of GPs contracting model; • A model for strengthening information and management systems for central hospitals; • A tool for central hospital reimbursement mechanisms; • Strengthened resource and administrative management systems and capacity of the central hospitals; • Improved central hospitals performance

7. DORA 2013/14 Conditions (NHI) • Work must be undertaken in all 10 central hospitals; • Funding from this grant will remain at the National Department of Health on the basis of the SLA(s) and utilized as per the approved cash flow • Payments will be made according to verified invoices or advance payments in line with approved Programme Implementation Plans from the service providers; • Monthly installments which may be altered at the discretion of the National Treasury based on invoices paid/due • DOH must establish a National Technical Task Teams (NTTT) • Plan, implement, monitor and evaluate all projects for coordinating and overseeing the work on central hospitals

8. NHI-CG Allocations Split

9. Level of Preparedness: Direct Component • The District business plan template has been revised, approved and formally communicated to all Provinces • Pilot Districts are in the process of drafting new, re-focused business plans for 2013/14 • Majority of districts have submitted draft plans on which National has given guidance and support • Target date for final submissions is 29th March 2013 • All indications are that Provinces will meet deadline on or before this date • Department is finalising M&E plan for 2013/14 • Will be ready prior to start of new FY

10. Level of Preparedness: In-Direct Component – Central Hospitals • Department has established a NTTT on Central Hospitals (DRGs) • First meeting held on 4th March 2013 • PIP and Roadmap being drafted • Key activities, resource schedule and outputs • Target date for final plan is 29th March 2013 • Rapid assessment tool for HIS at Central Hospitals • Intervention plans to improve systems performance and readiness

11. Level of Preparedness: In-Direct Component – GPs contracting • Minister currently undertaking road shows in pilot districts to mobilise doctors to participate in contracting activities • Department has created a Technical Specialist Unit for GPs contracting • Head of Unit appointed • GPs contract implementation protocol is being finalised • Finalisation of SLAs for PDOH & GPs at an advanced stage • Department will soon publish an advert for expression of interest from GPs • Database on state of readiness of each facility within Pilot districts finalised

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