Eastern Cape Department of Health Budget, 2005/06 Financial Year

1. Eastern Cape Department of Health Budget, 2005/06 Financial Year Presented to the National Portfolio Committee of Health Cape Town, 5 April 2005 L. BOYA (MR.) SUPERINTENDENT GENERAL FOR HEALTH, EASTERN CAPE PROVINCE

2. INDEX

3. INDEX, continued

4. OVERVIEW • Continue to strengthen the provincial health system, in particular the district health system, improve the service delivery model to align with the above strategic objective. • Strengthening of clinical governance and systems for community participation • Emphasize on norms and standards in care, staffing, resourcing and funding • Use of activity based budgeting • Provincial fiscal environment and its impact on health services • Deepening and sharpening the turnaround strategy.

5. POLICY MANDATES • The Department derives its mandates and is informed by the following:- • the priorities identified by National Department of Health, the Batho Pele principles, the Eastern Cape Provincial Strategic Plan, the Youth Development Programme and the Gender Programme. • the Strategic Position Statement where affordability and sustainability guide the planning and implementation process • SMT Programme of action adopted by the Department and the 2005/06 MEC’s Policy speech.

6. POLICY MANDATES (CONTINUED) • The Strategic and Operational Plans are also aligned to the Eastern Cape Provincial Growth and Development Plan (PGDP) with the following specific deliverables: • halting, managing and improving health outcomes for HIV/AIDS and TB by 2014. • reducing by ⅔ the under five infant and child mortality rate by 2014. • reducing by ¾ maternal mortality rate in 2014.

7. POLICY MANDATES (CONTINUED) • increasing infrastructure and human resources development • strengthening research development initiatives in the Eastern Cape Province for better health services • halting and beginning to reverse the spread of Tuberculosis

8. MAJOR HEALTH CHALLENGES • In-equitable development and access of health services affecting mostly, the North Eastern part of the Eastern Cape Province:- -in-equitable development is characterized by lack of infrastructure and information technology in the Northern Eastern part of the Province, -lack of access, implies, long distances and poor transportation to health facilities especially in the North Eastern part of the Province, -shortage and to some extent un-available drugs, medicine, equipment, and human-resources is a major challenge in the Province, • Poor quality of our health institutions.

9. MAJOR HEALTH CHALLENGES, continued • Poor quality of health care. • Un-even and underdeveloped community participation and partnerships • Improving compliance in all sectors of the Eastern Cape Department of Health. • Improving communication within the Department. • Ensuring effectiveness and efficiency and achievements of health outcomes through judicious employment of resources. • Lack of long-term planning. • Underdeveloped information and monitoring and evaluation systems.

10. MAJOR HEALTH CHALLENGES, continued • Improving overall organisational performance management. • Successful implementation of the Comprehensive Treatment Management and Care including ARV’s. • Improving health outcomes especially in the four priority programmes. • Re-aligning the service delivery model to the district health system approach.

11. MAJOR HEALTH CHALLENGES, continued • Improving and strengthening the referral system • Improving emergency medical services and patient transport • Improving safety in the health institutions. • Shortage of professional, managerial and technical skills • Still high vacancy rate in spite of continuous attempts to fill posts • Lack of accommodation making it difficult to retain staff in rural areas

12. KEY FOCUS AREAS / PRIORITIES FOR 2005/06 F/Y In addressing the above challenges, the Department focus on the Following:- • Strengthening the service delivery platform especially for PHC through determination and enforcement of minimum norms and standards, setting correct baselines, and benchmarking. • Revitilisation of health institutions • Strengthening Quality Assurance Systems • Promote Partnerships and Public Participation

13. KEY FOCUS AREAS / PRIORITIES FOR 2005/06 F/Y,continued • Ensure compliance across all sectors • Effective communication and branding of the department, institutions and programmes • Improving and re-engineering business processes for long term sustainable quality health care delivery. • Long range planning towards a quality public health system • Strengthening information systems towards more effective monitoring and evaluation.

14. KEY FOCUS AREAS / PRIORITIES FOR 2005/06 F/Y • Improvement overall organizational performance through intensification of Performance Management Development Systems (PMDS) • Implementation and rollout of the Comprehensive Treatment Plan including ARV. • Strengthening the maternal and child health programme • Improve TB cure rate

15. KEY FOCUS AREAS / PRIORITIES FOR 2005/06 F/Y • Improving access to health care by developing the district health system and the delivery of the PHC Package • Addressing inequity in service provision throughout the province • Improving emergency and patient transport system • Improving capacity and access to regional and tertiary services in the province. • Provide ongoing training and skills development for health workers • Implement programmes for attraction and retention of essential human resource skills

16. Budget Trends

17. Trendsinspending

18. Trends by EconomicClassification

19. % Growth in nominal and real terms

20. TRANSFERS 2005/06

21. CONDITIONAL GRANTS 2005/06

22. EXPENDITURE AMOUNT PER CAPITA Source IGFR, 2004 National Treasury

23. PRG 1: ADMINISTRATION

24. HEALTH OUTPUT MEASURES - PROGRAMME 1 • Formulation and facilitation of implementation various policies, i.e. • Demand management, Logistic management, Management of fleet • Management of equipment, General administration service • Implementation of programmes • Attraction and retention of essential human resources • Ongoing provision of training and skill development • Decentralisation of HR, Finance, Procurement and Asset through Corporate Service Centres

25. PROGRAMME 2: DISTRICT HEALTH SERVICES • Aim : • To develop and support District Health Services in the Eastern Cape • Key objectives: • To improve access to PHC through the implementation of DHS policy • To reduce morbidity and mortality through the implantation of maternal, child and women’s health • To strengthen prevention / treatment of HIV/AIDS and Sexually Transmitted Infections • Tuberculosis programmes • To decrease communicable and non-communicable diseases • Improve provision of district hospital services

26. PRG 2: DISTRICT HEALTH SERVICES

27. PRG 2: DISTRICT HEALTH SERVICES, continued

28. HEALTH OUTPUT MEASURES - PROGRAMME 2

29. HEALTH OUTPUT MEASURES - PROGRAMME 2, continued

30. PROGRAMME 3: EMERGENCY MEDICAL SERVICES • Aim: • To render efficient and effective emergency medical services to all the inhabitants of the Province of the Eastern Cape. • Key objectives • Provision of pre-hospital emergency care • Transportation of the sick and injured

31. PRG 3: EMERGENCY MEDICAL SERVICES

32. HEALTH OUTPUT MEASURES - PROGRAMME3

33. PROGRAMME 4: PROVINCIAL HOSPITAL SERVICES • Aim: • To provide cost effective, good quality, high level specialised services to the people of the Eastern Cape in collaboration with the Health Sciences Faculties. • Key objectives: • Plan, develop and deliver hospital services • Reclassify and right size hospitals i.e. Provincial Hospitals • Redistribute beds equitably across the Province • Strengthening of Hospital management systems-financial controls, efficiency and quality.

34. PRG 4: PROVINCIAL HOSPITAL SERVICES

35. HEALTH OUTPUT MEASURES; PROGRAMME 4

36. PROGRAMME 6: HEALTH SCIENCES AND TRAINING • Aim: • To provide training of all Health Professionals in the Province of the Eastern Cape. • Key Objectives: • To implement programmes for attraction and retention of essential human resource skills through: • Creation of ECDOH pool of health personnel through bursary, internship and learnership programmes (succession planning) • Increased exposure of health science students to EC rural Health Services • Active Recruitment of Graduates • To provide ongoing training and skills development for health workers, ensuring appropriate skills to impact on health status of people in EC province through: • Staff Growth and Learning with implementation of Workplace Skills Plan and District Health Management and Leadership programmes • Compliance with HPCSA standards of Continuing Professional Development (CPD) and internship accreditation • Compliance with SANC Acts and Regulations • To improve staff morale through: • Implementation of results-driven Performance Management & Development System • Career Development Planning • Academic & Service Support

37. PRG 6: HEALTH SCIENCES AND TRAINING

38. PROGRAMME 7: HEALTH CARE SUPPORT SERVICES: • Aim: • To render specialised clinical orthotic and prosthetic services. • Key Objectives: • Improve access to Health care for persons with disability • Facilitate recruitment of medical orthotists and prothetiasts (MOP’s ) from outside the country.

39. PRG 7: HEALTH CARE SUPPORT

40. HEALTH OUTPUT MEASURES - PROGRAMME 7

41. PROGRAMME 8: HEALTH FACILITIESDEVELOPMENT AND MAINTENANCE • Aim: • To improve access to Health care services by providing new health facilities, upgrading and maintaining existing facilities • Objectives • To improve access to Health Care services by providing new Health facilities, upgrading and maintenance existing facilities.

42. PRG 8: HEALTH FACILITIES, DEVELOPMENT &MAINTENANCE

43. HEALTH OUTPUT MEASURES: PROGRAMME 8

44. CONCLUSION • Consolidation and deepening of the turn around strategy. • Continue to build capacity for delivery and strengthen the service delivery platform • Make greater improvements in quality of care • Austerity measures will continue to impact on ability to fulfill our mandate • We remain committed and willing to serve

45. THANK YOU