Health Portfolio Committee Annual Report 2006-2007

1. Health Portfolio Committee Annual Report 2006-2007

2. Purpose and mandate • Provide cost-effective health laboratory services • Provide training for health science education • Support health research

3. NHLS Sites [PMG note: Diagram not included]

4. Head Office & NICD PMG note: Diagram not included]

5. Offices PMG note: Diagram not included]

6. NHLS Board CEO John Robertson Operations Corporate Surveillance Central Region Nontombi Mbelle Finance & Administration George Sentoo NICD Barry Schoub Coastal Region Sipho Mahlati Human Resources Harriet Kwinda NIOH Vacant Northern region Vacant Information Technology Stelios Michas National Cancer Registry Kwazulu Natal Nelly Mkhize Quality Assurance & Academic Affairs Martin Hale Structure

7. NHLS Services Primary Healthcare Clinics District Hospitals Regional Hospitals Tertiary Hospitals National Institute for Communicable Diseases National Institute for Occupational Health

8. NHLS Service Model Fee for Service Sole Provider Training Research

9. Facilities Laboratories 268 laboratories across nine provinces Personnel 5591 Total personnel 2029 Technologists and Technicians 181 Pathologists 197 Registrars

10. Financials

11. Highlights Unqualified Audit Opinion 2006/2007 Real Revenue Growth YOY - 18.2% KZN Integration successfully achieved Increased cash from R40m (2003) to R 296m ( 2007)

12. Emphasis of matter • Title deeds This emphasis of matter will appear again as we are still in the process of transferring titles in the name of the NHLS • Completeness of external research grant program This is a technical emphasis of matter which is unique to research organisations • Tender Regulations Tenders are advertised in the Government Gazette but adjudicated internally

13. Summary of Group Results

14. Summary of Cash flows

15. Financial Dimensions Income 0.3% Derived from teaching 2.0% Research grants 2.8% Derived from govt grants 90.5% Derived from fees 4.4% Other income  Expenditure 2.2% Teaching and Research 1.8% Occupational Health 5.0% Surveillance & Epidemiology 80.3% Laboratory Services 10.7% Administration

16. Tariff Development

17. Top 20 Tests – Rand Value

18. Top 20 Tests – Volume

19. Procurement The above excludes procurement from internationals

20. Laboratory Services Laboratory Expenditure by Province 2006/7

21. Provincial Spend and per Capita Spend

22. Human Resources

23. Human ResourcesOverview • Headcount: • March 2003: 3 509 • March 2004: 3 797 • March 2005: 3 880 • March 2006: 4 132 • March 2007: 5 591 • Payroll: • March 2003: R 489 971 million • March 2004: R 559 358 million • March 2005: R 584 932 million • March 2006: R 676 172 million • March 2007: R 859 830 million

24. Human ResourcesAchievements 2006 to 2007 • Successful transfer from KZN - 999 employees. • Final phase of the Broadband and remuneration and career management system • Successful recruitment drive visiting majority of universities

25. Workforce Profile

26. Workforce Profile

27. Workforce Profile

28. Workforce Profile

29. Workforce Profile

30. Workforce Profile

32. Training • Affiliated to 9 Medical Universities • Affiliated to 11 Universities of Technology • Successful signing of the umbrella agreement

33. Registrar appointments by year by discipline 2001 - 2007

34. Registrars in posts as at April 2007 by year of appointment by discipline 2001 - 2007

35. Graduates 2005-2007

36. Research

37. NHLS Research Trust 2001 NHLS Research Trust Capital R30m 2006 NHLS Research Trust Capital R80m 2007 NHLS Research Trust Capital R108m 2001 NHLS Research Trust Allocation R1.5m 2006 NHLS Research Trust Allocation R5m 2007 NHLS Research Trust Allocation R7m

38. Research 6 MRC units 1 NRF Centre of Excellence Cancer Registry 191 Scientists 392 Research publications annually

39. Publications DISCIPLINE 2003-2004 2004-2005 2005-2006 2006-2007

40. Publications UNIVERSITY 2003-2004 2004-2005 2005-2006 2006-2007

41. QA Division • Provision of Proficiency Testing Programmes • Protocols for evaluation of systems, methods and reagents • Implementation of Quality Standards to conform with international norms • Guidance with preparation for SANAS accreditation • Training of Auditors • Training of QA personnel • Monitoring effectiveness of the management of laboratories

42. GOALS of NHLS PROFICIENCY TESTING • To facilitate the implementation of appropriate procedures for all service laboratories and the harmonization of laboratory results • To provide analysis of performance data for users and management • Identify deficiencies with regard to the technical quality of results • Direct resources in an efficient manner order to correct such deficiencies

43. The Proficiency Testing Process

44. PT Programmes Currently Provided • Clinical Chemistry • General chemistry • Endocrinology • Therapeutic drugs • Blood Gas • Haematology • General Haematology • Differential and slide assessment • Coagulation • CD4

45. PT Programmes Currently Provided cont • Microbiology • Bacteriology • Mycology • Parasitology • TB microscopy and culture • Syphilis serology • HIV testing

46. Utility of PT Schemes in the context of the HIV and TB Pandemic • Establishing the diagnostic efficiency in: • A: Identifying infected individuals • B: Monitoring disease progress • C: Identifying opportunistic infections • D: Monitoring levels of toxicity of therapeutics • E: Monitoring effectiveness of treatment • F: Identification of opportunistic infections

47. Participating Laboratories By Scheme

48. Laboratory Accreditation

49. NICD

50. NATIONAL INSTITUTE FOR COMMUNICABLE DISEASE • Academic & training • Surveillance & monitoring of communicable diseases • Outbreak response & management • International • Communication & consultation • Research – applied & operational • Quality assurance & reference