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Budget Presentation. Northern Cape Province. Health Portfolio Committee – Monday 7 th June 2004. Vision. Our Vision is to provide excellent, holistic, people-centred and affordable health care in the Northern Cape. Mission.
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Budget Presentation Northern Cape Province Health Portfolio Committee – Monday 7th June 2004
Vision Our Vision is to provide excellent, holistic, people-centred and affordable health care in the Northern Cape
Mission We are committed to achieving our vision through a decentralized, accountable, accessible and constantly improving health care system within available resources. Our caring, multi-skilled effective personnel will use evidence-based, informative health care and maturing partnerships for the benefit of our clients and patients.
Deficit Analysis • Clearing of suspense account • Pharmaceuticals R 20’994 m • Works R 3’492 m • Backlog payments • Inflation • Food supplies • Fuel • Medicine • Laboratory
Inter-Provincial Equity • Correction to 17% of provincial equitable share including own revenue would add to the Health coffers: R 44’960 million
Health Sector Inflation • Adjustment after currency slide of December 2001 • National task team investigated impact on health budgets • Recommendation to Health & Treasury 10x10 • Stores & Livestock 22,7% • Equipment 29,2% • Prof & Spec 13,25% • NC Health Department recommended adjustment was never received: R 35 million
Improved Access to Services • Upgrading tertiary services at Kimberley Hospital R 36 million required • Upgrading secondary services at Gordonia Hospital R 14 million required • Equipping of district hospitals R 46 million required • Clinics R 2 million required
Emergency Medical Services • Ambulance equipment • Rescue equipment • Human resources • Amount Required: R 15 million
Other Pressures PRESSUREREQUIRED • Assistive devices R 2,500m • Nursing College R 10,000m • Maintenance R 9,000m • Health Promotion R 2,000m • Cross boundary flows R 21,000m
Free Health Care for the Disabled • Number of Disabled: 40’681 • Estimated 4.8% of population in Sept 2003 • Patient Day Equivalents (PDE): 9’904 • PDE = (in patient days) + (outpatient visits/3) • Cost per PDE: R 1’024 • Cost of treating disabled patients will require additional spending: R 10’180 million
Anti-Retroviral Treatment R 72’800 million • Current funding R14,0 million • Shortfall R58,8 million IMPLEMENTATION COST OF YEAR 1 (2004 / 2005) Strengthening R43’400 million Human Resources Training, etc. R29’400 million Drugs and Lab costs
Rural & Scarce Skill Allowance • Costed impact R35,8 million • Current fundingR12,4 million Shortfall R23,4 million
Programme 1:ADMINISTRATION • Office of the MEC • Management
Sub- programme 1.1: Office of the MEC Key Strategic Objectives • To provide strategic political leadership • To provide the administrative framework and support function to allow the MEC for Health to discharge his duties. • To support public accountability and participation.
Sub- Programme 1.2: Management Key Strategic Objectives • To develop a strategic plan for the department and maintain the strategic direction • To develop a financial plan for the department for the MTEF period • To maintain a system of effective management of all departmental assets
QUALITY ASSURANCE • Conducts regular quality audits and responds with quality improvement plans • Supports the fundamentals of Batho Pele • Recent Awards: • Premier’s Excellence Gold Award • Cecila Makiwane • Platinum
Programme 2:DISTRICT HEALTH SYSTEM • District Management • Priority Programmes • Support Services
Programme 2: District Health System District Priorities • The Districts remain the area of primary service delivery • Underlying strategies include: • Improving Access • Improving Quality • Ensuring minimum service package is available throughout
Other District Health challenges include: • To improve the nutritional status in the community • To ensure the retention of Health Professionals, esp. prof nurses • To raise the profile of mental health and substance abuse • To ensure a 2 crew per EMS vehicle • Ensure rational drug use of essential drug use at primary level • To render quality care to all mothers and babies
COMMUNICABLE DISEASES • HCBC coverage in all districts • HIV & AIDS: • 155 professionals trained in ART, 300 in opportunistic infections management • 116 VCT sites achieved and strategically placed • HIV Prevalence rate stable (the slight decline not yet significant) • TB undergoing review • Disease surveillance continues • Director Appointed • 5 Sites accredited for ART
MATERNAL, CHILD AND WOMEN’S HEALTH • Roll out of youth friendly services in 3 districts • Collaboration of the youth and adolescent programme with other youth structures • Implementation of IMCI at district level • Improvement of maternal and pediatric health care services • Establishment of a dedicated HIV and AIDS clinic at GDH for children
HEALTH PROMOTION • Launch of health promoting schools • Monitoring for compliance of the tobacco legislation • Monitoring of emerging diseases • Dissemination of the results of the youth risk behavioral survey
MENTAL HEALTH AND SUBSTANCE ABUSE • Psychiatric services are being integrated at PHC level • The establishment of psychiatric community based services in the province • Started with the training of Mental health care providers at facility level
REHABILIATION DISABILITY AND CHRONIC DISEASE • The Northern Cape has the greatest number of cataract surgery tours in the country • Assistive devices have been prioritized, to reduce waiting lists • Access to services for chronic diseases in remote areas continues to increase
INTEGRATED NUTRITION PROGRAMME • Vitamin A supplementation is being implemented according to National guidelines • Monitoring of menus at primary schools continues • Establishing of food gardens at clinics and schools will progress in collaboration with the Dept of Agriculture
ORAL HEALTH • Plans are underway to ensure the full package of primary oral health services is delivered to rural and remote areas • This includes projects to: • provide an appropriately trained and dedicated workforce • ensure that rehabilitative services are provided to edentulous patients
ENVIRONMENTAL HEALTH • Involvement in Port Control is increasing in Kimberley and Upington • Inspections are conducted at hazardous substance premises in compliance with legislation • Support is given for follow up of contacts of some communicable diseases patients e.g. hepatitis
PHARMACEUTICAL SERVICES • Monitoring of tracer drugs to ensure optimal levels at all facilities on a weekly basis • Use of stock cards in the absence of a computerized system • Training of pharmaceutical assistants • The implementation of the rural and scarce skills allowance for pharmacist
INFORMATION MANAGEMENT • A Ten Year Review has been completed internally • Bi-annual Indicator Reviews were implemented as management tools • KHC Nerve Centre supports Information Management at all Hospitals • Training of PHC nurses in the software continues (DHIS, STI module, TB module)
EMS Strategic Priorities • The establishment of a two-crew Ambulance in all the major centres (De Aar, Springbok, Kuruman, Upington and Jan Kempdorp). • Procurement of sufficient and appropriate vehicles to affect a 60% separation of Emergencies/Planned Patient Transport. • Implementation of the three year vehicle replacement plan
Programme 4:PROVINCIAL HOSPITAL • Kimberley Hospital
The Complex • Kimberley Hospital • West End Hospital • KHC Rehabilitation Centre Services • level 1, 2 and 3 services • 35 beds for private patients Twinning • Oxford-Radcliffe, England • Chicago, USA • France
Internal Medicine General Cardiology Dermatology Lipidiology Clinical Immuniology Clinical Hematology Intensive Care Burn Unit Colorectal Surgery General Surgery 11. Hepatobiliary Surgery Vascular Surgery Opthalmology Ear, Nose and Throat Neurosurgery 16. Orthopedic 17. Plastic & Reconstructive Surgery 18. Accident & Emergency 19. Neonatal ICU 20. Medical Oncology 21. Tertiary Oncology 22. Nephrology (Renal Dialysis) 23. Spinal Injury Management 24. Complex Radiology (CT Scan) Tertiary Services Package
KHC Objectives • Improving secondary hospital & outreach services • Developing specialist tertiary services • Valuing and respecting users of the services • Valuing and developing staff • Improving infrastructure and technology • Making best use of human and financial resources