Select Committee on Finance National Council of Provinces Presented by: National Treasury

1. Health services: Preliminary Outcome of Conditional Grants & Capital Expenditure as at 31 March 2007(2006/07 Financial Year) Select Committee on Finance National Council of Provinces Presented by: National Treasury 11 May 2007

2. Key priorities for 2006 MTEF Health • Hospital Revitalisation • Forensic pathology • Recruit health professionals (including CHWs); • Expand Emergency Medical Services, implement new national ambulance service model; • Primary health care, • Modernise tertiary services.

3. Health (1) • Spending at R53,6bn or 100,6% against R53,3bn adjusted budget • Four provinces (FS, GP, LP and NC) overspent their adj budgets • Preliminary overspending of R328,2m (GP – R372,2m) • Increase of R6,6bn or 14,0% compared to the previous year • Low rate of health spending in NW (96,2%) and EC (98,2%) • NC (107,0%) and LP (104,8%) reflects the highest rate of spending in health • Health Personnel spending at R28,8bn or 99,5% (R28,9bn adjusted budget) • NPNC spending at R20,2bn or 104,2% of R19,4bn adjusted budget • Preliminary overspending of R806,3m (GP – R329,7m) • Capital spending at R4,7bn or 93,1% • Increase of 21,4% compared to audited spending • Low rate of capital spending in KZN (84,6%) and NC (85,2%) • LP (111,8%) and FS (104,2%) reflects the highest rate of capital spending in health

4. Health (2)

5. Health: Programme Analyses • Programme 2: Provincial District Health Services • Spending at R21,1bn or 99,0% of R21,3bn adjusted budget • Lowest rate of spending in NW (94,7%) and WC (96,6%) • Highest in LP (105,3%) and NC (101,3%) • Programme 4: Provincial Hospital Services • Spending at R13,0bn or 102,1% of R12,8bn adjusted budget • Lowest rate of spending in LP (98,1%) and MP (98,8%) • Highest in NC (111,0%) and FS (110,1%) • Programme 5: Central Hospital Services • Spending at R8,7bn or 106,4% of R8,2bn adjusted budget • Preliminary over-expenditure of R522,9m (GP – R412,9m) • Lowest rate of spending in NW (99,5%) and WC (100,2%) • Highest in GP (112,2%) and FS (106,2%)

6. Health: District Services

7. Health: Hospital Services

8. Health: Central Hospital Services

9. Health: Personnel

10. Health: Capital

11. Health: Non-personnel Non-capital

12. Payments for Capital Assets (Health) • Health capital spending at R4,7bn or 93,1% • Increase of 21,4% compared to audited outcome ast year • Preliminary underspending of R343,4m • Low rate of health capital spending in KZN (84,6%) and NC (85,2%) • LP (111,8%) and FS (104,1%) reflects the highest rate of capital spending in health

13. Health: Capital

14. Monthly Expenditure: Payments for Capital Assets

15. Proposed Dates for CG QPRs • National departments administering conditional grants are required to table QPRs (including both financial and non-financial information) with the SCOF in the NCOP at the end of each quarter in line with the requirements of the DoRA, Grant Frameworks and Treasury Regulation 5.3 • Departments are required to provide the NT with copies of the reports tabled at SCOF in NCOP • The quarterly reports for each quarter should be submitted to the NT by the dates provided

16. Health GrantsComprehensive HIV and Aids Grant • Objective (Schedule 5 Grant): • To enable the health sector to develop an effective response to HIV and Aids • Support implementation of the National Operational Plan for Comprehensive HIV and Aids Treatment and Care • 4th Quarter Expenditure: • Health spent R1,7bn or 103,1% of the R1,7bn adjusted allocation (includes provincial roll-overs) • Transfers received amounted to 100,0% of national allocation • Highest spending: EC (121,0%) and LP (112,9%) • Lowest spending: NC (91,3%) and NW (96,0%) • Service Delivery Outcome: • Department / Sector to respond

17. CG: performance (non-financial) reporting

18. HIV/AIDS

19. Health GrantsHospital Revitalisation Grant • Objective (Schedule 5 Grant): • To provide funding to enable provinces to plan, manage, modernise, rationalise and transform the infrastructure, health technology, monitoring and evaluation of hospitals in line with national policy objectives • To transform hospital management and improve quality of care in line with national policy • 4th Quarter Expenditure: • Health spent R1,6bn or 88,7% of the R1,8bn adjusted allocation (including provincial roll-overs) • Transfers received amounted to 100,0% of national allocation • Highest spending: LP (346,2%) and EC (108,1%) • Lowest spending: KZN (69,9%) and NC (72,2%) • Service Delivery Outcome: • Department / Sector to respond

20. Hospital Revitalisation

21. Health GrantsForensic Pathology Services Grant • Objective (Schedule 5 Grant): • To provide for the transitional activities required to transfer the Medico-Legal Mortuaries from SAPS to Health • To initiate the development and provision of a comprehensive Forensic Pathology Service to ensure impartial professional evidence for the criminal justice system concerning death due to unnatural causes • 4th Quarter Expenditure: • Health spent R342,0m or 55,4% of the R616,9m adjusted allocation (including provincial roll-overs) • Transfers received amounted to 100,0% of national allocation • Highest spending: LP (108,6%) and GP (78,7%) • Lowest spending: KZN (39,8%) and NW (41,7%) • Service Delivery Outcome: • Department / Sector to respond

22. Forensic pathology

23. Health GrantsNational Tertiary Services Grant • Objective (Schedule 4 Grant): • To compensate provinces for the supra-provincial nature of tertiary services provision and spill over effects • To provide strategic funding to enable provinces to plan, modernise, rationalise and transform the tertiary hospital service delivery platform in line with national policy objectives including improving access and equity • 4th Quarter Expenditure: • Spending of this grants is subsumed in the spending of a range of programmes and therefore no reporting is required • However, spent R5,0bn or 99,4% of the R5,0bn adjusted allocation (including provincial roll-overs) • Transfers received amounted to 100,0% of national allocation • Highest spending: LP (100,2%) • Lowest spending: EC (92,2%) and MP (98,2%) • Service Delivery Outcome: • Department / Sector to respond

24. National tertiary services grant

25. Health GrantsHealth Professions Training and Development Grant • Objectives (Schedule 4 Grant): • Support provinces to fund costs associated with training of health professionals • Development and recruitment of medical specialists in under-served provinces • Support and strengthen undergraduate and post graduate teaching and training processes in health facilities • Enable shifting of teaching activities from central hospital to regional and district hospitals • 4th Quarter Expenditure: • Spending of this grants is subsumed in the spending of a range of programmes and therefore no reporting is required • However, spent R1,5bn or 100,2% of the R1,5bn adjusted allocation (including provincial roll-overs) • Transfers received amounted to 100,0% of national allocation • Highest spending: LP (104,5%) and EC (100,9%) • Lowest spending: MP (96,2%) Service Delivery Outcome: • Department / Sector to respond

26. Health professions training grant