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Eastern Cape Department of Health Budget, 2005/06 Financial Year Presented to the National Portfolio Committee of Health Cape Town, 5 April 2005 L. BOYA (MR.) SUPERINTENDENT GENERAL FOR HEALTH, EASTERN CAPE PROVINCE

Eastern Cape Department of Health Budget, 2005/06 Financial Year

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Eastern Cape Department of Health Budget, 2005/06 Financial Year. Presented to the National Portfolio Committee of Health Cape Town, 5 April 2005 L. BOYA (MR.) SUPERINTENDENT GENERAL FOR HEALTH, EASTERN CAPE PROVINCE. INDEX. INDEX, continued. OVERVIEW. - PowerPoint PPT Presentation

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Page 1: Eastern Cape Department of Health Budget, 2005/06 Financial Year

Eastern Cape Department of Health Budget, 2005/06

Financial YearPresented to the National Portfolio

Committee of Health Cape Town, 5 April 2005

L. BOYA (MR.) SUPERINTENDENT GENERAL FOR HEALTH, EASTERN CAPE PROVINCE

Page 2: Eastern Cape Department of Health Budget, 2005/06 Financial Year

2

INDEXTopic PageOverviewPolicy mandatesMajor Health ChallengesKey focus areas for 2005/06 Financial YearBudget FiguresTrends in SpendingTrend by Economic ClassificationGrowth in nominal and real termsTransfersConditional Grants

45812161718192021

Page 3: Eastern Cape Department of Health Budget, 2005/06 Financial Year

3

INDEX, continuedTopic PageExpenditure Amount Per CapitaProgram 1: Health AdministrationProgram 2: District Health ServicesProgram 3: Emergency Medical ServicesProgram 4: Provincial Health ServicesProgram 6: Health Sciences and TrainingProgram 7: Health Care SupportProgram 8: Health Facilities Development & MaintenanceConclusion

222325303336384144

Page 4: Eastern Cape Department of Health Budget, 2005/06 Financial Year

4

OVERVIEW

• Continue to strengthen the provincial health system, in particular the district health system, improve the service delivery model to align with the above strategic objective.

• Strengthening of clinical governance and systems for community participation

• Emphasize on norms and standards in care, staffing, resourcing and funding

• Use of activity based budgeting• Provincial fiscal environment and its impact on

health services• Deepening and sharpening the turnaround

strategy.

Page 5: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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POLICY MANDATES

• The Department derives its mandates and is informed by the following:- – the priorities identified by National Department of

Health, the Batho Pele principles, the Eastern Cape Provincial Strategic Plan, the Youth Development Programme and the Gender Programme.

– the Strategic Position Statement where affordability and sustainability guide the planning and implementation process

– SMT Programme of action adopted by the Department and the 2005/06 MEC’s Policy speech.

Page 6: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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POLICY MANDATES (CONTINUED)

• The Strategic and Operational Plans are also aligned to the Eastern Cape Provincial Growth and Development Plan (PGDP) with the following specific deliverables:– halting, managing and improving health

outcomes for HIV/AIDS and TB by 2014.– reducing by ⅔ the under five infant and child

mortality rate by 2014.– reducing by ¾ maternal mortality rate in

2014.

Page 7: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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POLICY MANDATES (CONTINUED)

– increasing infrastructure and human resources development

– strengthening research development initiatives in the Eastern Cape Province for better health services

– halting and beginning to reverse the spread of Tuberculosis

Page 8: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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MAJOR HEALTH CHALLENGES

• In-equitable development and access of health services affecting mostly, the North Eastern part of the Eastern Cape Province:--in-equitable development is characterized by lack of infrastructure and

information technology in the Northern Eastern part of the Province,-lack of access, implies, long distances and poor transportation to

health facilities especially in the North Eastern part of the Province, -shortage and to some extent un-available drugs, medicine, equipment,

and human-resources is a major challenge in the Province,

• Poor quality of our health institutions.

Page 9: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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MAJOR HEALTH CHALLENGES, continued

• Poor quality of health care.• Un-even and underdeveloped community

participation and partnerships • Improving compliance in all sectors of the Eastern

Cape Department of Health.• Improving communication within the Department.• Ensuring effectiveness and efficiency and

achievements of health outcomes through judicious employment of resources.

• Lack of long-term planning.• Underdeveloped information and monitoring and

evaluation systems.

Page 10: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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MAJOR HEALTH CHALLENGES, continued

• Improving overall organisational performance management.

• Successful implementation of the Comprehensive Treatment Management and Care including ARV’s.

• Improving health outcomes especially in the four priority programmes.

• Re-aligning the service delivery model to the district health system approach.

Page 11: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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MAJOR HEALTH CHALLENGES, continued

• Improving and strengthening the referral system• Improving emergency medical services and patient

transport• Improving safety in the health institutions.• Shortage of professional, managerial and technical skills• Still high vacancy rate in spite of continuous attempts to

fill posts• Lack of accommodation making it difficult to retain staff

in rural areas

Page 12: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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KEY FOCUS AREAS / PRIORITIES FOR

2005/06 F/YIn addressing the above challenges, the

Department focus on the Following:-• Strengthening the service delivery platform

especially for PHC through determination and enforcement of minimum norms and standards, setting correct baselines, and benchmarking.

• Revitilisation of health institutions• Strengthening Quality Assurance Systems• Promote Partnerships and Public Participation

Page 13: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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KEY FOCUS AREAS / PRIORITIES FOR 2005/06

F/Y,continued• Ensure compliance across all sectors

• Effective communication and branding of the department, institutions and programmes

• Improving and re-engineering business processes for long term sustainable quality health care delivery.

• Long range planning towards a quality public health system

• Strengthening information systems towards more effective monitoring and evaluation.

Page 14: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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KEY FOCUS AREAS / PRIORITIES FOR 2005/06

F/Y• Improvement overall organizational

performance through intensification of Performance Management Development Systems (PMDS)

• Implementation and rollout of the Comprehensive Treatment Plan including ARV.

• Strengthening the maternal and child health programme

• Improve TB cure rate

Page 15: Eastern Cape Department of Health Budget, 2005/06 Financial Year

15

KEY FOCUS AREAS / PRIORITIES FOR 2005/06

F/Y• Improving access to health care by

developing the district health system and the delivery of the PHC Package

• Addressing inequity in service provision throughout the province

• Improving emergency and patient transport system

• Improving capacity and access to regional and tertiary services in the province.

• Provide ongoing training and skills development for health workers

• Implement programmes for attraction and retention of essential human resource skills

Page 16: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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Budget Trends

Budget 2003/04 2004/05 2005/06

R'000 R'000 R'000

Equitable Share 4,478,263 4,272,980 5,183,164

Conditional Grants 592,080 628,286 848,172

Other: Treasury Reserve 276,000  

Own Revenue 41,543 44,000 56,455

  5,111,886 5,221,266 6,087,791

Total Expenditure 5,243,012 5,172,977  

  -131,126 48,289  

Page 17: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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Trends in spending

Programme Audited 2001/02

Program %

Audited2002/03

Program %

Audited 2003/04

Program %

Budget2004/05

Program %

Budget2005/06

Program %

Health Administration 168,947 4.34% 191,694 4.92% 215,110 5.53% 286,582 7.36% 295,052 7.58%

District Health Services 2,124,752 54.59% 2,247,675 57.74% 2,518,346 64.70% 2,367,902 60.83% 2,794,563 71.79%

Emergency Medical Services 87,314 2.24% 128,464 3.30% 194,488 5.00% 151,389 3.89% 186,846 4.80%

Provincial Hospital Services 1,237,957 31.80% 1,531,892 39.36% 1,764,282 45.33% 1,795,285 46.12% 1,850,037 47.53%

Central Hospitals - - - - -

Health Sciences and Training 76,756 1.97% 96,124 2.47% 122,884 3.16% 137,393 3.53% 337,245 8.66%

Health Care Support Services 6,765 0.17% 9,168 0.24% 23,027 0.59% 16,607 0.43% 45,806 1.18%

Health Facilities Dev & Maint 189,962 4.88% 288,212 7.40% 404,875 10.40% 466,108 11.97% 578,242 14.86%

Special Functions - 13 - -

TOTAL 3,892,453 4,493,242 5,243,012 5,221,266 6,087,791

Page 18: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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Trends by Economic Classification

Economic Classification 2001/02 2002/03 2003/04 2004/05 2005/06

  R'000 R'000 R'000 R'000 R'000

Compensation of Employees 2,429,383 2,490,865 2,815,673 3,087,550 3,308,547

Goods and Services 942,248 1,048,669 1,225,405 1,137,148 1,608,486

Transfers and Subsidies to 502,179 690,056 735,594 551,985 651,089

Payments for Capital Assets 18,643 263,652 466,340 444,583 519,669

           

TOTAL 3,892,453 4,493,242 5,243,012 5,221,266 6,087,791

Page 19: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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% Growth in nominal and real terms

GROWTH 2002/03 2003/04 2004/05 2005/06

% Increase year on year in nominal terms 15.43 16.69 (0.41) 16.60

Value of budget in Nominal Terms 4,493,242 5,243,012 5,221,266 6,087,791

% increase year on year in Real Terms2 8.29 6.76 (6.76) 11.79

Value of budget in Real Terms2 4,215,049 4,796,900 4,888,826 5,836,808

Page 20: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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TRANSFERS 2005/06AGENCY R’000

Local Government 218,133

Provincially Aided Hospitals 86,608

Life Care 49,860

Nutrition 26,316

NGO’s for AIDS 75,813

SANTA’s 66,793

HPTD Grant 127,566

TOTAL 651,089

Page 21: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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CONDITIONAL GRANTS 2005/06

Conditional Grants

2004/05 R’000

2005/06R’000

% Increase (Decreas

e)

National tertiary services 272,036 353,022 29.77

Health Profession’s training & research 97,464 127,566 30.88

HIV/AIDS 98,970 159,005 60.65

Hospital revitalization 116,354 157,732 35.56

Integrated Nutrition Programme 23,933 26,313 9.94

Hospital Management Improvement 19,529 24,531 25.61

Total 628,286 848,172 34.99

Page 22: Eastern Cape Department of Health Budget, 2005/06 Financial Year

22Source IGFR, 2004 National Treasury

EXPENDITURE AMOUNT PER CAPITA

Page 23: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 1: ADMINISTRATIONProgram 1: Administration

2004_05 2005_06 2006_07

2007_08

Office of the MEC 5,211

4,362

4,530

4,802

Management

255,375

290,690

259,631

275,62

9

Total

260,586

295,052

264,161

280,43

1

Compensation of Employees

62,334

92,653

94,363

94,725

Goods and Services

188,252

188,415

156,682

166,68

5

Transfers  

242

251

263

Capital (Assets)

10,000

13,742

12,865

18,758

Total

260,586

295,052

264,161

280,43

1

Page 24: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES - PROGRAMME 1• Formulation and facilitation of implementation

various policies, i.e.– Demand management, Logistic management,

Management of fleet– Management of equipment, General

administration service• Implementation of programmes

– Attraction and retention of essential human resources

• Ongoing provision of training and skill development

• Decentralisation of HR, Finance, Procurement and Asset through Corporate Service Centres

Page 25: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PROGRAMME 2: DISTRICT HEALTH SERVICES• Aim :

– To develop and support District Health Services in the Eastern Cape

• Key objectives:– To improve access to PHC through the

implementation of DHS policy– To reduce morbidity and mortality through the

implantation of maternal, child and women’s health

– To strengthen prevention / treatment of HIV/AIDS and Sexually Transmitted Infections

– Tuberculosis programmes– To decrease communicable and non-

communicable diseases– Improve provision of district hospital services

Page 26: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 2: DISTRICT HEALTH SERVICES

Program 2: District Health Services 2004_05 2005_06

2006_07 2007_08

2.1 District Management

85,324

140,000

143,988

149,397

2.2 Community Health Clinics

721,396

771,488

781,486

827,646

2.3 Community Health Centres

331,097

315,869

320,751

339,996

2.4 Community Based Services

53,120

57,668

50,017

53,018

2.5 Other Community Services

9,120

8,464

8,869

9,401

2.6 HIV/Aids

131,970

177,580

237,543

249,420

2.7 Nutrition

23,933

26,316

- -

2.8 Coroner Services

-

-

- -

Page 27: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 2: DISTRICT HEALTH SERVICES, continued

2.9 District Hospitals

1,328,142 1,297,178 1,440,106 1,591,822

Total

2,684,102 2,794,563 2,982,760 3,220,700

Compensation of Employees

1,835,804 1,760,079 1,842,831 1,952,810

Goods and Services

466,736 591,853 681,317 784,846

Transfers

367,391 422,171 436,515 459,842

Capital (Assets)

14,171 20,460 22,097 23,202

Total

2,684,102 2,794,563 2,982,760 3,220,700

Page 28: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES - PROGRAMME 2Objective Target

Increase access to Comprehensive Care Treatment and Support programme for people infected and affected by HIV AIDS

Total of 65 Sites to provide ART

Ensure accessibility to VCT services

113 Fixed PHC facilities accredited

Improve number of TB patients treated according to MTDP

80% of TB patients have DOT supporters

Increase number of facilities implementing IMCI strategy

60% of facilities to implement IMCI

Increase number of facilities providing ANC

92%

Page 29: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES - PROGRAMME

2, continuedObjective Target

Nutrition: Contribute to food security

30 Clinic Gardens

Disease Prevention and Control:Reduce morbidity and mortality rate in traditional circumcision

80%

Page 30: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PROGRAMME 3: EMERGENCY MEDICAL

SERVICES• Aim:

– To render efficient and effective emergency medical services to all the inhabitants of the Province of the Eastern Cape.

• Key objectives– Provision of pre-hospital emergency

care– Transportation of the sick and injured

Page 31: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 3: EMERGENCY MEDICAL SERVICESProgram 3:

Emergency Medical Services 2004_05

2005_06 2006_07

2007_08

3.1 Emergency Transport

33,487

132,531

126,366

133,166

3.2 Planned Patience Transport

31,878

54,315

55,814

59,163

Total 65,365

186,846

182,180

192,329

Compensation of Employees

8,327

117,669

117,147

124,176

Goods and Services 57,038

68,670

64,507

67,600

Transfers   507

526

553

Capital (Assets)        

Total 65,365

186,846

182,180

192,329

Page 32: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES - PROGRAMME 3Objective TargetFill vacant posts to reduce single crew ambulances

Fill 10% of the 49% vacancies

Develop Mount Ayliff into a fully fledged Metro Centre

70% completion

Improve monitoring of response times by introducing Vehicle Management/Plotter system

20 Minutes Urban45 Minutes Rural

Page 33: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PROGRAMME 4: PROVINCIAL HOSPITAL

SERVICES• Aim: – To provide cost effective, good quality, high level

specialised services to the people of the Eastern Cape in collaboration with the Health Sciences Faculties.

• Key objectives:– Plan, develop and deliver hospital services– Reclassify and right size hospitals i.e. Provincial

Hospitals– Redistribute beds equitably across the Province– Strengthening of Hospital management systems-

financial controls, efficiency and quality.

Page 34: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 4: PROVINCIAL HOSPITAL SERVICES

Program 4: Provincial Hospital Services

2004_05

2005_06

2006_07

2007_08

4.1 General (Regional ) Hospital

1,459,0

23

1,524,9

61

1,657,7

06

1,875,6

88

4.2 TB. Hospitals 51,287

96,279

120,818

139,276

4.3 Psychiatric/ Mental Hospital

192,934

228,797

240,573

255,007

4.4 Chronic Hospital        

4.5 Dental Training Hospital        

4.6 Other Specialised Hospital        

Total

1,703,244

1,850,037

2,019,097

2,269,971

Compensation of Employees

1,043,8

80

1,164,6

67

1,221,2

03

1,294,4

75

Goods and Services

500,613

571,400

655,119

813,325

Transfers

148,751

100,245

124,932

143,436

Capital (Assets)

10,000

13,725

17,843

18,735

Total

1,703,2

44

1,850,0

37

2,019,0

97

2,269,9

71

Page 35: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES; PROGRAMME 4

Objective Target

To develop guiding document for service delivery plan needs to be linked to modernization of tertiary services

Hospital complexes complying with national standards in provision of tertiary services and efficiency indicators

Implementation of referral system

Complexes and hospitals implementing referral system

Establishment of additional 85 beds for Psychiatric services across the province

100%

Establish 2nd MDR TB Centre 20%

Page 36: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PROGRAMME 6: HEALTH SCIENCES AND

TRAINING• Aim:

– To provide training of all Health Professionals in the Province of the Eastern Cape.• Key Objectives:• To implement programmes for attraction and retention of essential

human resource skills through:– Creation of ECDOH pool of health personnel through bursary, internship and

learnership programmes (succession planning) – Increased exposure of health science students to EC rural Health Services – Active Recruitment of Graduates

• To provide ongoing training and skills development for health workers, ensuring appropriate skills to impact on health status of people in EC province through:– Staff Growth and Learning with implementation of Workplace Skills Plan and

District Health Management and Leadership programmes – Compliance with HPCSA standards of Continuing Professional Development (CPD)

and internship accreditation – Compliance with SANC Acts and Regulations

• To improve staff morale through:– Implementation of results-driven Performance Management & Development

System – Career Development Planning– Academic & Service Support

Page 37: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 6: HEALTH SCIENCES AND TRAINING

Program 6: Health Sciences & Training 2004_05 2005_06 2006_07 2007_08

6.1 Nursing Training College

154,857

170,679

180,728

190,041

6.2 EMS Training College

1,000

1,000 1,300

1,365

6.3 Bursaries

7,669

38,000

43,245

45,407

6.4 Primary Health Care Training  

-

-

-

6.5 Training Other  

127,566

127,566

133,944

Total

163,526

337,245

352,839

370,757

Compensation of Employees

152,350

164,908

170,101

180,307

Goods and Services

11,176

4,445

54,834

56,151

Transfers  

127,892

127,904

134,299

Capital (Assets)        

Total

163,526

337,245

352,839

370,757

Page 38: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PROGRAMME 7: HEALTH CARE SUPPORT

SERVICES:• Aim:

– To render specialised clinical orthotic and prosthetic services.

• Key Objectives:– Improve access to Health care for

persons with disability– Facilitate recruitment of medical

orthotists and prothetiasts (MOP’s ) from outside the country.

Page 39: Eastern Cape Department of Health Budget, 2005/06 Financial Year

39

PRG 7: HEALTH CARE SUPPORT

Program 7: Health Care Support 2004_05 2005_06 2006_07 2007_08

7.1 Laundries        

7.2 Engineering        

7.3 Forensic Services        

7.4 Orth and Prosthetic Services

21,607

45,806

39,608

40,906

7.5 Medicine Trading Account        

Total 1,607 45,806

39,608

40,906

Compensation of Employees 8,300

8,571

7,933

8,409

Goods and Services

13,307

33,703

31,641

32,462

Transfers  

32

34

35

Capital (Assets)   3,500  

Total 21,607

45,806

39,608

40,906

Page 40: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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HEALTH OUTPUT MEASURES - PROGRAMME 7Objective Target

To improve staff level by recruitment of O&P Staff and training of students

6 trained students

To provide wheelchairs and hearing aids and assistive devices

60% of persons with disability supplied with devices

Page 41: Eastern Cape Department of Health Budget, 2005/06 Financial Year

41

PROGRAMME 8: HEALTH FACILITIES

DEVELOPMENT AND MAINTENANCE• Aim:

– To improve access to Health care services by providing new health facilities, upgrading and maintaining existing facilities

• Objectives– To improve access to Health Care

services by providing new Health facilities, upgrading and maintenance existing facilities.

Page 42: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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PRG 8: HEALTH FACILITIES, DEVELOPMENT &MAINTENANCE

Program 8: Health Facilities Development & Maintenance 2004_05 2005_06 2006_07 2007_08

8.1 Community Health Facilities

142,000

122,413

193,601

215,395

8.2 Emergency Medical Rescue Services

-

-

-

-

8.3 District Hospital Services

257,614

392,329

389,816

411,550

8.4 Provincial Hospital Services

112,250

63,500

193,866

215,672

8.5 Central Hospital Services        

8.6 Other Facilities        

Total

511,864

578,242

777,283

842,617

Compensation of Employees        

Goods and Services

8,796

110,000

63,805

77,255

Transfers        

Capital (Assets)

503,068

468,242

713,478

765,362

Total

511,864

578,242

777,283

842,617

Page 43: Eastern Cape Department of Health Budget, 2005/06 Financial Year

43

HEALTH OUTPUT MEASURES: PROGRAMME 8

Objective TargetTo improve access to health care services by providing new health facilities and equipment

5 new clinics

Upgrade/replace clinics 36 facilitiesRevitalise hospitals, upgrade and maintain existing facilities

8 hospitals

Revitalization of Hospitals (through the conditional grant)

5 hospitals

Page 44: Eastern Cape Department of Health Budget, 2005/06 Financial Year

44

CONCLUSION

• Consolidation and deepening of the turn around strategy.

• Continue to build capacity for delivery and strengthen the service delivery platform

• Make greater improvements in quality of care

• Austerity measures will continue to impact on ability to fulfill our mandate

• We remain committed and willing to serve

Page 45: Eastern Cape Department of Health Budget, 2005/06 Financial Year

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