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KwaZulu-Natal Department of Health Conditional Grants and Capital Expenditure Presentation to the Standing Committee on Finance 11 May 2007. Expenditure on Conditional Grants. Challenges. Comprehensive HIV and AIDS Grant: Scarcity of health professionals
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KwaZulu-Natal Department of HealthConditionalGrants and Capital ExpenditurePresentation to the Standing Committee on Finance11 May 2007
Challenges • Comprehensive HIV and AIDS Grant: • Scarcity of health professionals • Patients enrolled at 76,000 by March 2007 against a target for the year of 55,160 • Inadequate infrastructure • Need for nutritional support to address co-infections and prevent MDR-TB • Health Professionals Training and Development Grant: • Scarcity of suitably qualified health professionals • Inadequate infrastructure and equipment
Challenges (Contd..) • Hospital Revitalization Grant: • Allocation includes R 88.9million originally earmarked for release back to National Department of Health. • Release did not materialize due to delays in gazetting • If amount of R 88.9million is excluded, expenditure to date improves to 99% of the total adjusted allocation of R 228.39million. • The amount of R 88.9million resulted from a rollover of R112.5m from the 05/06 FY due to the appeals that delayed the commencement of the King George V Hospital project, with the project commencing in earnest during the first quarter of the 2006/07 financial year • A rollover amounting to R91.761m has been requested for 06/07 • The Department is to receive support from National Treasury under the IDIP programme, which is expected to address the challenges which led to rollovers through improved infrastructure planning • Reduced funding of infrastructure under Revitalization remains a challenge • Appeals on tenders are out of DOH and DOW control – they are escalated to the Provincial Treasury • Currently a number of bids for medical equipment are under appeal
Challenges (Contd..) • Forensic Pathology Services Grant: • Delays in claims from SAPS in respect of the three months to June 2006, prior to takeover of the service by the Department. • Delays in submission of claims by Department of Works. • Scarcity of suitably qualified health professionals • Availability of land for mortuary upgrade programme • Delays on infrastructure projects • National Tertiary Services Grant: • Slow pace in expansion of services due to scarcity of health professionals • Slow pace of infrastructure delivery • Increase in burden of disease, cases requiring complex surgery and co-morbidities
Challenges (Contd..) • Provincial Infrastructure Grant: • Previously had problems with pace of infrastructure roll out with Dept of Works • Certain projects fast-tracked through engagement of third parties (e.g. Ithala, IDT) • Relations improved with new management at Dept of Works • Both Depts working on new ways to address infrastructure requirements of the Province, currently estimated at R7bn
Capital Spending • Actual spending of R938.213m or 85% of amount allocated of R1.109bn • Variance due to under spending in machinery and equipment as a result of: • Appeals against bid awards • Delays in certain construction projects (e.g. mortuary upgrade programme) • Spending in buildings and other fixed structures exceeded budget by R35.749m • Capacity for infrastructure rollout improved