Finance Minister Trevor Manuel must outline a clear spending plan for addressing the state of the public healthcare system when he makes his Budget speech, consultancy Frost & Sullivan said on Tuesday.

"Although there are very specific items and issues that need addressing, we feel that the focus should be on improving the quality of care in the public sector, rather than trying to overregulate the private sector," said Peter Breitenbach, the head of Frost & Sullivan's African healthcare practice.

"Despite claims to the contrary, the state of the nation's health is worse now than it was 15 years ago," he said.

According to Breitenbach, while Health Minister Barbara Hogan's first few months as minister have been promising, government urgently needed to address the lack of capacity in healthcare services.

This meant increased spending on the recruitment and training of healthcare workers, and offering higher wages to retain key staff.

"As this also affects the private sector, Manuel should set aside funding for programmes in which government can engage with the private sector to address the need for skills."

Breitenbach said there was also a desperate need for improved provision of primary healthcare services.

"Government claims to have the largest ARV (antiretroviral) programme in the world, but there are still massive gaps in provision and this extends to maternal and child health, as well as infectious disease control and management," he said.

According to Frost & Sullivan, Manuel should also address issues of energy, water infrastructure, information and communication technologies (ICT) when he makes his budget speech in parliament on Wednesday.

Turning to Eskom, the consultancy said that while Manuel didn't need to announce any new contributions to the power-utility's expansion programme, it would like to see the minister deliver a very clear message that government would honour any of the utility's debts.

"In the current financial climate it's obviously going to be very difficult for government to invest large sums into Eskom's expansion programme," Frost & Sullivan energy industry manager Cornelis van der Waal said.

"However, with a stronger credit rating, Eskom will be able to obtain loans at a better rate."

It was therefore crucial for government to back them, as they would be key to delivering growth in South Africa.

Van der Waal said he would also like to see the introduction of a green energy tax linked to the sale of electricity.

"This could possible be as little as one cent per kWh, but could create a source of funding for green energy projects, with a specific focus on wind, biomass and solar applications."

With water security becoming an increasingly pressing issue, Frost & Sullivan said the minister needed to focus a portion of the planned infrastructure spend on water and wastewater service delivery.

"Significant ground has been claimed in the bid to ensure that South Africans have access to clean water and sanitation, however the water and wastewater sector is challenged by skill shortages and ageing water and wastewater infrastructure," said David Winter, the head of Frost & Sullivan's environmental technologies practice.

"Particularly at the municipal level, water and wastewater treatment plants are understaffed and poorly maintained," he said.

Winter recommended that there be focused budget spending on skills development and infrastructure improvement, particularly in the wastewater treatment sector.

According to Frost & Sullivan ICT industry analyst Lindsey McDonald, the government's recognition of the ICT industry as an enabler for the creation of new jobs and to stimulate economic development should be carried through in this year's budget.

During the course of last year, funds were allocated for the improvement of existing technology infrastructure, as well as for the installation of new networks.

In 2009, Manuel was expected to announce budgetary allocations for the deployment of network infrastructure at the local and provincial government level.

"Players in the market will also be eager to see further tax incentives, specifically within the SMME (small, medium and micro enterprises) environment," Mc Donald said.

"This is where a large degree of innovation occurs... Incentives for innovation and research & development are also important."

The 2010 World Cup was also likely to inform the budget, with additional allocations towards the technology requirements for the tournament, the consultancy said.