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NATIONAL DEPARTMENT OF HEALTH PRESENTATION TO THE SELECT COMMITTEE ON SOCIAL SERVICES 24 May 2002. Brief Explantion of the New Grant Framework for Tertiary Services and the Health Professionals Training and Development. Thabo Sibeko Chief Director Hospital Services. Need for Change.
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NATIONAL DEPARTMENT OF HEALTH PRESENTATION TO THE SELECT COMMITTEE ON SOCIAL SERVICES 24 May 2002 BUDGET PRESENTATION
Brief Explantion of the New Grant Framework for Tertiary Services and the Health Professionals Training and Development Thabo Sibeko Chief Director Hospital Services BUDGET PRESENTATION
Need for Change • Central Hospitals and Health Professionals Training and Research Grant Frameworks flawed • Redistributive Grant inadequate • Review undertaken to examine the location, and volume of Tertiary Services provided in SA (all nine provinces) BUDGET PRESENTATION
Data • 529 specialised service units • 62 hospitals in all 9 provinces • Major effort by provinces to complete additional data collection yielded significant benefits BUDGET PRESENTATION
National Tertiary Services • Based on the review of HSS the following policy findings were observed: • All provinces provide a significant level of Tertiary Services, however: • Some provinces have low provision, low access and low funding requirements (Mpu, NW and NP) • Some provinces provide significant level of Tertiary services but receive no funding (EC, NC) • Some provinces provide significant level of Tertiary services but receive less funding than is required to deliver these services (KZN, FS) • Some provinces provide significant level of Tertiary services but receive more funding than is required to provide these services (GP, WC) BUDGET PRESENTATION
National Tertiary Services • New framework funds all provinces for the tertiary services they provide based on the volume of services they provide and the costs incurred in providing these services • attempts to address the policy findings mentioned earlier • The NTS grant replaces the CHG, RTS and HPTR grants • Full costs of NTS exceed the envelope of what was allocated for the CHG and RTS by R280m • Hence, drew down from HPTR grant. BUDGET PRESENTATION
National Tertiary Services PURPOSE • To fund national tertiary services • To ensure equitable access by all South Africans to basic tertiary health care • To ensure nationally coordinated planning for tertiary services BUDGET PRESENTATION
HPTD • R280m less in value (to fund NTS) • Original HPTR allocations and criteria retained but proportionately reduced for all provinces • Development funds added (R227m over 5 years), • which seeks to strengthen Level II services in Provinces without medical schools by funding additional registrar and medical specialist posts to bring all provices up to the national per capita level BUDGET PRESENTATION
CONDITIONAL GRANTS (HOSPITAL GRANTS) BUDGET PRESENTATION
Old New Central hospitals and National tertiary services RHSS Health professional Health professional training & research training & development Pretoria Academic Pretoria Academic Hospital reconstruction & Hospital Revitalization rehabilitation Hospital Mx & Quality Improvement LIST OF OLD & NEW GRANTS LIST OF OLD & NEW GRANTS BUDGET PRESENTATION
Notes • Service Agreements for NTSG and HPTD prepared • Business plans for other grants are developed and approved • Expenditure according to business plan /service agreements • Progress against action plan • List of indicators pertaining to expenditure vs cash flow • RDP and INP indicators BUDGET PRESENTATION
Notes (Cont…) • Provincial heads of health submit monthly and quarterly financial reports • Certificates signed by Provincial Accounting Officer at the end of the financial year. • Provincial liaison and technical support visits • Regular meetings per financial year between national and provinces BUDGET PRESENTATION
Payment Schedule • National Tertiary Services and HPT &D-monthly transfers • Hospital revitalization ,Pretoria Academic- quarterly advances • and Hosp Mx & Quality Improvement- 3 advance installments BUDGET PRESENTATION
Payment Schedule • National Tertiary Services and HPT &D-monthly transfers • Hospital revitalization ,Pretoria Academic- quarterly advances • and Hosp Mx & Quality Improvement- 3 advance installments BUDGET PRESENTATION
NTSG BUDGET PRESENTATION
Hospital Mx & Quality Improvement BUDGET PRESENTATION
HPT & D BUDGET PRESENTATION
Hospital Revitalization BUDGET PRESENTATION
PROVINCIAL HEALTH BUDGETS 2002/03 Portfolio Committee on Health 24 May 2002 BUDGET PRESENTATION
Expenditure 2001/02 BUDGET PRESENTATION
Expenditure on conditional grants BUDGET PRESENTATION
PROVINCIAL PER CAPITA SPENDING (excl CGs) 1600 1400 1200 1000 Series1 800 Series2 600 400 200 0 Eastern Cape Free State Gauteng KwaZulu- Mpumalanga Northern Northern North West Western Total Natal Cape Province Cape BUDGET PRESENTATION