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CLUSTER: HOSPITAL SERVICES Presentation to Portfolio Committee on Health 3 April 2001. CLUSTER DIRECTORATES AND BUDGETS:. Cluster Manager ……. R 0.960 m Health Technology ……. R 1.508 m Facilities Planning ……. R 1.423 m Hospital Management ……. R 2.074 m
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CLUSTER: HOSPITAL SERVICESPresentation to Portfolio Committee on Health3 April 2001
CLUSTER DIRECTORATESAND BUDGETS: • Cluster Manager ……. R 0.960 m • Health Technology ……. R 1.508 m • Facilities Planning ……. R 1.423 m • Hospital Management ……. R 2.074 m • Emergency Medical Services & Disaster • Management ……. R 0.606 m • Radiation Control ……. R 5.994 m • Total ……. R12.565 m • Conditional Grants ……. R 5 341 bn
HEALTH FACILITIES PLANNING
Integrated Health Planning Framework (IHPF) What is IHPF? • Quantifies National Policy • Updates existing National Planning Framework • Integrates health planning: • 1. HR, finance, technology, quality • 2. HSS, acute & chronic care, PHC • Dynamic tool • Long term Planning
IHPF (continued) Activities • Development of affordability cost model • Conditional grants and other funding to be investigated • Generic Provincial Strategic Plan
Implementation of Hospital Revitalisation • Components • Land & buildings • Organisational development • Health Technology / Equipment • Quality of care • Identifying pilot projects for Revitalisation • Develop Business Plans • Investigating World Bank funding • Provincial allocations transferred and monitored
OTHER ACTIVITIES Conditional Grants • Support rehabilitation of over 400 projects • Assisting with commissioning of 3 Academic Hospitals (Durban, Umtata and Pretoria) Continue to - Develop databases and combined standards and guidelines for public and private health facilities - Develop database, standards and guidelines for mortuaries and EMS - Develop planning and commissioning guidelines
HT - Policy Framework and Legislation • HT Policy Framework- Approved by MINMEC in 02/01 • - Implementation to resume -HT System Development Programme to be declared - HT System Programme Major Projects • HT ‘Scoping Study’ • HT Audit • Essential HT Packages • HT Legislation - To be finalised after the completion of HT policies - Develop strategy to close the present gap on critical equipment - Finalize Schedule of equipment for the CON
HT- (HT Management & Planning) • HT Management Policy to be finalised - Meant to ensure equipment safety - Meant to reduce equipment downtime and disruption of service delivery - Equipment donor guidelines to be delivered - Staffing Norms to be finalised - HT Managers already trained for 7 provinces • Organ Transplantation - Policy to be revised - Expert Committee to be put in place - Ongoing coordination of unrelated living donor transplants & evaluation of requests for non-South Africans
HT System - (Scoping Study) Scoping Study to provide • Analysis of RSA and International HT scenario • A strategy for HT System development including phasing of the four subsystems • Required resources (Rand, HR, Infrastructure) • Legal Implications • Evaluation and monitoring mechanisms includingthe time frames and indicators
HT System - Essential Health Technology Packages (EHTP) • Integrated HT planning tool for (Essential Med equipment + related Cost & links to EDL and Essential HR) • To be finalised for Maternal & Child Health • Development at MRC (NDoH & WHO main funders) • RSA piloting the Field-Testing for 25 countries (RSA, Mozambique, Namibia reps for the region)
HT System – HT Audit • To identify equipment gaps, physical status, deployment etc • HT audit guidelines produced • Pilot audit in 2 provinces to be completed (NP & EC) • Completed Audits in 3 facilities (for EHTP field-testing)
HOSPITAL MANAGEMENT Decentralization of Hospital Management
HOSPITAL MANAGEMENT • Equip managers with appropriate competencies & skills • Achieve competency framework agreements for all levels of hospital managers • Device agreed role profiles for levels of management • Capacity building for managers • Business planning training in hospitals • Information systems development • Labour relations • Cost centre training • Orgnisational development
HOSPITAL MANAGEMENT • Facilitate implementation of decentralisation of hospital management • Develop a Nationally agreed policy on decentralisation process • Identify criteria for conferring decentralised status • Develop an assessment/audit tool
HOSPITAL MANAGEMENT • Implementation of management systems & structures • Complete the implementation of cost centres in the pilot hospitals • Support Provinces roll-out of cost centres • Improve and support the efficiency of Hospital Boards • Produce guidelines on the functioning of hospital and community boards
HOSPITAL MANAGEMENT • Improve the effective and appropriate spending of financial resources • Improve the financial monitoring & reporting mechanisms • Business plans • Monthly & quarterly reports - intervention
HOSPITAL MANAGEMENT • STRATEGIC POLICY DIRECTIONS • Building Financial Management Capacity • Ensuring democratic Public Hospital governance • Attainment of nationally agreed approach to decentralisation
EMERGENCY MEDICAL SERVICES • PROVINCIALISATION OF SERVICES • Support the North West, Eastern Cape and Gauteng in their provincialisation process • North West and Eastern Cape due to complete exercise in June 2001 • Gauteng unlikely to complete before year-end
EMERGENCY MEDICAL SERVICES • NORMS AND STANDARDS • Include in National Planning Framework • Develop costing models • Regulations • Pre-hospital emergency medical services • In-hospital emergency centres
DISASTER MANAGEMENT • Policy and Guidelines for National and Provinces • establish focal points in provinces • develop contingency plans • Resource Data Base • resource support project • health reaction teams
DISASTER MANAGEMENT • Red Cross Act • community capacity enhancement program • auxiliary body to Health in an emergency • Training • source appropriate training in district management • establish development program for district management personnel
PRIORITIES: 2001 • Revise and broaden the quality Assurance programme to include CT and dental x-ray units • Start a programme to license the use of industrial radio-frequency equipment • Update the sale database and publish a 2001 sourcebook of licensed electromedical equipment • Investigate a regulatory fee structure • Tighten control over Industrial Radiography - start re-registration process
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