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Presentation to the National Health Portfolio Committee. Presented by Dr H N Manzini; HoD – Health & Social Development; 16 th March 2005. Presentation to the Portfolio Committee. Limpopo Department of Health and Social Development. Mandates.
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Presentation to the National Health Portfolio Committee Presented by Dr H N Manzini; HoD – Health & Social Development; 16th March 2005
Presentation to the Portfolio Committee Limpopo Department of Health and Social Development
Mandates The Departmental operations are guided by the following Mandates. - Applicable National & Provincial Legislations • National Ten Points Plan • Provincial Strategic Priorities • Health Core Functions The Strategic Plan is based on these principles.
National Ten Points Plan • Improve Governance and management of the NHS • Promote healthy lifestyles • Contribute towards human dignity by improving quality of care • Improve the management of communicable and non-communicable illnesses • Strengthen Primary Health care, EMS and Hospital service delivery systems • Strengthen support services • Human Resource Planning, Development and Management • Planning, Budgeting and Monitoring and Evaluation • Prepare and implement legislation • Strengthen International Relations
Provincial Priorities • TB/STD/HIV/AIDS & other communicable diseases • Maternal, Child, Women, Youth & Adolescence Health • Integrated Poverty Alleviation • Health Promotion • District Health Development & Primary Health Care implementation • Hospital Revitalisation • Health Planning, Logistics & Support Services • Quality of Care • Mental, Chronic, Disabilities & Geriatric Health • Communication, Collaboration & Community Participation • Development of a Medical School
Core Functions • Formulate and implement provincial health policies, norms, standards and legislation • Provide regional and specialised hospital services as well as academic Health Services, where relevant. • Render and co-ordinate Medical Emergency Services (including ambulance service) • Render health services to the detained, arrested, charged. • Screen applications for licensing and inspection of private facilities. • Quality control of all health services and facilities. • Inter-provincial and inter sectoral co-ordination and collaboration. • Co-ordinate the funding and financial management (budgetary process) of the district health services
Core Functions • Provide technical and logistical support to health districts. • Render specific provincial services programmes, e.g. TB programme. • Provide non-personal health services. • Provide and maintain equipment, vehicles and health care services. • Effective consultation on health matters at the community level. • Provide occupational health services. • Research on, and planning, co-ordination, monitoring and evaluation of health services rendered in the Province. • Ensure that functions delegated by the National level are carried out. • Render Medico-legal services.
Section A Strategic Priorities and Objectives 2004/05
Programme 1: Health Administration PRIORITIES • Improve governance and the management of the Provincial Health System (PHS) • Strengthen admin support services • Human resource planning development and management • Planning, budgeting and monitoring and evaluation • Prepare & implement legislation • Implementation of fraud prevention and risk management plan; • Management of records and information systems
Strategic Objectives and Targets • In the next five years Provincial Health Legislation will be aligned to the National Health Legislation. • Achieve full implementation of supply chain management policy the end of 2005/06 • Outsourcing of the following: Renal dialysis, Concession of hospitals, Staff accommodation, Laundry services and EMS on a PPP basis by the end 2006/07.
Continue… • Payment of creditors within 30 days by 2005/06 • 100% of staff must have signed PI’s by 2005/06 • Development of a full HR Strategy in the next by the end of 2005/06 • Approved organizational structures for the Department during 2005/06 • All institutions to have Governance Structures by 2005/06
Continue… • 100% of all institutions in the Department have effective Risk management policies and practices by 2005/06 • Accurate information available and disseminated to correct stakeholders at all times by 2005/06 • 100% compliance with National Archives guidelines by 2005/06
Programme 2:District Health Services PRIORITIES • Integrated Primary Health Care • District Health Services and Devolution • Communicable Disease Control • Malaria programme • HIV & AIDS, STIs & TB • Decentralization of Hospital Management • Strengthening of Partnerships with NPOs
Strategic Objectives and Targets • 100% provision of comprehensive primary health care package at all PHC facilities by 2006/07 • 100% access to primary health care services by 2007/08; • All designated PHC Facilities to render 24 hrs service by 2007/08 • 100% implementation of devolution strategy by by 2005/06 • Service Level Agreement will be signed with District Municipalities for provision of Primary Health Care Services by 2005/06
Continue… • 95% immunization coverage of children under 1year by 2007/08. • >1% reduction mortality and morbidity through rapid response to outbreaks of diseases by 2006/07 • Reduce Malaria incidence by 10 % per year.
Continue… • 85 % Access to Provision of comprehensive HIV&AIDS, care, treatment, management and support including ARV’s and nutritional supplements by 2007/08 Cure rate of new smear positive TB cases at first attempt increased to 85% by 2006/07 • Strengthen partnership with EU on PDPHC, HIV&AIDS by formalising LSAs with NPOs by 2005/06
Programme 3: Emergency Medical Services. PRIORITIES • HR development • Improve access to EMS services STRATEGIC OBJECTIVES AND TARGETS • Outsourcing of Emergency Medical services Fleet by 2006/07
Programme 4: Provincial Hospitals Services. PRIORITIES • Revitalization of Hospitals. • Implementation of Secondary Hospital Package. • Decentralisation of Hospital management • Specialised Hospital Services. • Accreditation of facilities for teaching purposes.
STRATEGIC OBJECTIVES AND TARGETS • 100% full decentralized Hospital Management by 2006/07 • Complete Revitalisation Projects by 2007/08 • 100% transformed nursing services by 2007/08 • 100% revenue collection targets achieved by 2005/06
Programme 5:Central Hospitals - Provincial Tertiary Services. PRIORITIES • Revitalization of Hospitals • Implementation of Tertiary Hospital Package • Decentralisation of Hospital management • Accreditation of facilities for teaching purposes • Development of a medical school.
STRATEGIC OBJECTIVES AND TARGETS • Reduce ALOS to 5% by 2007/08. • Usable bed utilization rate increased to 84% by 2007/08. • Reduce patient waiting time to 1hr by 2007/08. • Complete consolidation of developing tertiary services package (MTS) by 2006/07; • Fast –track and consolidate efforts to develop Academic Departments to support the Limpopo University Medical School between 2005/06 – 2007/08 (budgets & other resources)
Programme 6: Health Sciences and Training. PRIORITIES • Conduct research in nursing • Train mid level workers • Train nurses • Provide bursaries • Train Emergency Care Practitioners
STRATEGIC OBJECTIVES AND TARGETS • 100% operational post basic diploma nursing program by 2006/07 • 80% student intake from rural and nodal communities by 2007/08. • Initiate and improve partnerships with institutions of higher learning and other relevant institutions by end of 2006/07
Programme 7: Health Care Support Services. PRIORITIES • Supply of medicines to health facilities • Monitor rational utilisation of drugs; • Inspectorate Services.
STRATEGIC OBJECTIVES AND TARGETS • Increase drug availability at the depot, hospitals, health centers and clinics to 95% by 2007/08. • Pharmaceutical programme managed in line with national policy on an ongoing basis.
Programme 8: Health Facilities Management PRIORITIES • Upgrade and Building of PHC facilities • Hospital revitalisation • Maintenance of Health Facilities
STRATEGIC OBJECTIVES AND TARGETS • Built 100 clinics in the next five years at the rate of 20 clinics per year • All PHC facilities have clean water and sanitation by 2007/08 • All PHC facilities fully electrified by 2008/09
Section B MTEF Budget & Expenditure Trends
New Equitable Share Formula • The growth in the provincial equitable share primarily caters for the three-year wage agreement for public servants and further adjustments to the remuneration of educators. • It also provides for funding of the primary health function in non-metropolitan municipalities, strengthening of school based education, and the expansion of developmental welfare services. • The division of the equitable share allocation among provinces is done through an objective redistributive formula. • The formula is reviewed and updated annually and takes recommendations of the Financial and Fiscal Commission into account. • A broad-ranging review of the formula has been undertaken for the 2005 / 06 and MTEF.
New Equitable Share Formula cont.. The formula consists of 4 main and 2 minor components • Education = 51 % and uses census data for the school age cohort and official estimates of school enrolment weighted equally. • Health = 26 % is based on estimated number of people with and without medical aid coverage and weighted at a 1 : 4 ratio. • Institutional = 5 % allocated equally across provinces to cover core provincial administration costs. • Basic = 14 % is calculated on the basis of the population share of each province. • Poverty = 3 % reinforces the redistributive basis. • Economic = 1 % to cater for provincial revenue raising powers that have not changed
Limpopo Provincial Equitable Share Allocations – over the MTEF
MTEF Budget 2005/06 to 2007/08 • There is concern for Non PE in the outer years. • As can be seen the allocation for Non PE reduces in the 2006/07 year by R 70.299 m with once off costs of R65.2 m from the previous year. • The 2007/08 year shown an increase above the previous year of R 6.803 m that leaves a almost no growth in the budget for Non PE for two years running. • The rest of the budget is ring fenced and cannot be rerouted to fund Non Personnel Expenditure. • The allocation for the purchase of drugs does show real growth and these funds are ring fenced.
MTEF Budget 2005/06 to 2007/08- HealthBudget Allocation per Programme
MTEF Budget 2005/06 to 2007/08- HealthBudget Allocation per Programme • The increase in the Personnel Budget is intended for the filling of critical vacant positions in both Clinical and Administration posts Clinical Posts Other • 2005 / 06 270 R 62.7m 424 R 22.9m • 2006 / 07 444 R 49.3m 481 R 46.4m • 2007 / 08 358 R 38.1m 351 R 34.1m
Departmental Revenue Collection2001 /02 - 2004/05 & Budget 2005/06
Expenditure Trends: 1995/96 – 2003/042004/05 Estimated and MTEF Budget
The End ‘Working as A Team has potential to assist in rolling back the frontiers of Ill – health and Poverty globally’