CONDITIONAL GRANTS 2004/05

1. CONDITIONAL GRANTS 2004/05 DEPARTMENT OF HEALTH NORTH WEST PROVINCE

2. Purpose To provide information on the Departmental Conditional Grants for the year 2004/05.

3. Data on trends in allocations, transfers and actual expenditure of the Departmental Conditional Grants and Capital Grants.

4. Data on trends in allocations, transfers and actual expenditure of the Departmental Conditional Grants and Capital Grants.

5. Monitoring Capacity • The Department created a post of Conditional Grants Manager for monitoring all the Conditional Grants and the post was filled in November 2004. • The Manager is responsible for monitoring expenditure of Conditional Grants and whether the expenditure complies with the conditions of the DORA and the approved business plans. • The manager guides responsible programme managers in their day to day management of the grants. • The Manager is responsible for drafting monthly and quarterly reports, in terms of the recommended reporting format, the performance of Conditional Grants. • However, the financial management capacity at all levels still requires strengthening • An audit of financial management competence conducted by a contracted independent firm, has revealed capacity gaps

6. Past year performance (2004/05)

7. Comment: Projects planning took longer than expected, there were poor tender responses for other projects and there was also a delay in appointment of Consultants. Relationship with DPW needs to be continuously strengthened Infrastructure

8. Comment: The expenditure under the grant has been satisfactory.Under expenditure mainly on personnel due to challenges of attracting personnel Health Professions Training & Development

9. Comment: The funds under this grant are already committed per various sub-programmes. The activities took longer until the end of the financial year due to delays in the supply chain management for securing relevant Service Providers and finalising Service Level Agreements with appointed Service Providers. An amount of R11,8m was not transferred by national and has been requested to be rolled over. Of the total R64m spent, R3m was from equitable share. Comprehensive HIV & AIDS

10. Comment: Of the 3 revitalisation hospital, 2 experience delays, thus thus impacting on the spending of the grant Capacity at hospital level also needs strengthening The Accreditation process of Hospitals will be funded and finalisation of installation of PAAB system in Hospitals will also be completed. Due to the fact that the first hospital for Revitalisation has been completed (Swartruggens), funds will be utilized for implementing the cost center management project to the hospital and also continue with the existing site – Klerksdorp/Tshepong. Treasury has approved the roll over. Hospital Management and Quality Improvement

11. Comment: The tendering process for projects took longer than expected and implementing agents did not adhere to the programme. Based on the fact that the Departments of Health and Public Works are working on a service level agreement and standard operating procedures, coupled with the full supply chain management delegations in place, the Department is in a better position to ensure that all committed funds are spent as planned. Treasury has approved the roll over but kept the funds in the reserve fund. Our relationship with DPW, as it strengthen, should have a positive impact Hospital Revitalisation

12. Comment: The first transfer of the programme was received three months later than scheduled and this impacted badly on the plans of the programme. The expenditure was low due to a transition phase for the transfer of functions and responsibilities for the School Nutrition Fund to the Education department. The Department of Health had to restructure its operations with special focus on an Integrated Nutrition programme. The programme therefore started late during the financial thus impacting negatively on expenditure. However the amount left is surrendered. Treasury has approved the roll over but kept the funds in the reserve fund. Integrated Nutrition

13. Comment: The expenditure for the grant is largely incurred from equitable share first and then journalised to the grant due to the nature of services rendered. However, the expenditure trend under the programme has been satisfactory. The reason for the Department not utilising the remaining funds is because there has been delays in delivering equipments ordered for Hospitals offering tertiary services and the funds are however committed. Treasury has approved the roll over. National Tertiary Services

14. Comment: Though a business plan was submitted, a clear demonstration of need was not elaborate given that this was a once off conditional grant The activities under the programme have been moving slowly. Most the activities under this special conditional grant also benefited from equitable share allocation. Treasury has approved the roll over but kept the funds in the reserve fund. Malaria and Cholera Prevention

15. Comment: The expenditure under the grant has been satisfactory. Success of managing this process also relies on good partnership with SAPS, DPW, etc. Medico Legal Services

16. Monthly Reports • Monthly reports have been regularly sent to the provincial Treasury and National Department of Health’s Office.

17. Conditional Grants business plans for the year 2005/06 • Business plans for all the grants have been sent to National Office and all have been approved. The province has already received transfers for April and May months from the National Office . Most of transfers only come in May.

18. CLOSURE