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SA: Norman Mabasa: Address by the Limpopo Health MEC, at the Provincial Budget Vote for the Department of Health, Limpopo Legislative Chamber, Lebowakgomo (23/04/2013)

23rd April 2013

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Honourable Speaker, Rudolph Phala
Honourable Deputy Speaker, Joyce Mashamba
Honourable Premier, Cassell Mathale
Honourable Members of the Legislature and NCOP
Members of the Executive Council
Executive Mayors and Mayors of local municipalities
Provincial Commissioner of the Public Service Commission, Matome Mawasha; and other leaders of Chapter Nine and Ten Institutions
Director General, Ms Rachel Molepo-Modipa
Heads of Departments
Leaders of Opposition Parties
Traditional leaders
Former MPs and MPLs
Leadership of various religious formations
Leadership of Labour and Business; women, community and the youth
Members of the media
Distinguished guests, comrades, and friends
The People of Limpopo
Honourable Speaker

It is indeed an honour and distinct privilege for me to present the 2013/14 Budget Vote (7) of the Department of Health to this august House for consideration.

Honourable Speaker

I thought it appropriate to begin this presentation by refreshing our minds with facts we are very much familiar with, yet facts so important to rehearse because they, at least for now, impress upon our conscious minds the framework and objective reality within which the Department of Health (DoH) functions as it strives to remain true to its mandate to deliver healthcare to the people of this Province, Limpopo.

Of course it is public knowledge that this department has been placed under administration intervention in terms of Section 100(1)(b) of the Constitution of the Republic of South Africa. In terms of this intervention the National Department of Health (NDoH) has taken over the following functions:

 

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  • Financial management and budget control
  • Procurement management
  • Human resource management (reviewing the organisational structure)
  • Pharmaceutical supplies management
  • Infrastructure management
  • Information technology management

Notwithstanding significant progress recorded under the current institutional arrangements, some serious challenges still remain to be addressed. This august house will remember that in its sitting on 12 March 2013 we attempted to get approval for the second adjustments appropriation to make additional funds available for medicines and medical supplies. This was an indication that we indeed had challenges.

This is an assertion which is well corroborated by the Progress Report on Administration: Department of Health, by the Health Administrator and Head of Department of dated 19 March 2013, which states: “The department experienced shortage of some medicines due to shortage of funds. During the last three months or quarter of 2011/12 financial year, some of the suppliers of Pharmaceuticals put on hold the accounts of non-payment of accounts. This resulted in the province depleting the buffer stock at the Pharmaceutical depot and also depleted the six weeks stock holdings at all outlets.

Between April to November 2012, stock availability increased to about 80%, however the department ran out of funds and as a result could not place orders in December 2012 and January 2013. The result was that by February 2013 the stock availability went down to 44%.

The reason for shortage of funds were two folds; firstly there were accruals to the value of R122’526’110, from the 2011/12 financial year. The budget for the 2012/13 financial year was R553’905’000, that meant only R431’379’000 was available for spending. The expenditure for 2011/12 according to BAS was R485’457’000. Secondly the budget itself at R553’905’000 is about half of what is needed in the department to satisfy the needs for medicines in the province.”

To mention some of the success achieved and for which we are very grateful to the NDoH Intervention Team: 55 unemployed undergraduate interns were deployed in finance and revenue, SCM and assets, and ICT management. Austerity measures are in place on approvals of payments for overtime work and subsistence and travel.

A procurement reform project (which also includes KwaZulu-Natal and Eastern Cape) is at a design stage, and is aimed at, among other goals, addressing unauthorised, irregular as well as fruitless and wasteful expenditure due to non-compliance with Supply Chain Regulations.

As part of the procurement reform project the department is working on increasing transversal contracts to minimise quotation based procurement and acquisition of goods and services. Progress achieved in this regard includes repairs of hospital boilers and procurement of autoclaves for hospitals. A project allocated R88m to repair boilers in 19 hospitals is progressing well. The National Department of Health has also provided funding of R50m for 52 autoclaves in hospitals.

On the infrastructure programme, the NDoH technical infrastructure Team is monitoring existing construction projects. Infrastructure management received R10 million in the form of conditional grants to appoint new personnel and improve the overall management of infrastructure projects in the department. The project for the doctors’ accommodation, which consists of 112 units, has been completed and the property handed over to the department, with the involvement of public works.

Having highlighted the successes achieved, it is only fair to mention the challenges that still confront the department under the current administration intervention:
Adequate funding for compensation of employees remains a challenge for the department. However this should not overshadow the fact that the department increased its staff complement with 1’288 health professionals and support personnel, including 625 contractual appointments and 19 transfers into the department, during the 2012/13 financial year.

Honourable Speaker
Our 2013/14 budget presentation almost coincides with the National Minister’s announcement of the change-over to Fixed Dose Combination (FDC) Anti-retrovirals which will be used in the first line treatment of HIV positive persons, effective 01 April 2013. In preparation for the roll out of FDC our Pharmaceutical Depot placed initial orders in three batches of 15’960, 18’060 and 18’800 batch quantities respectively during February 2013.

Deliveries are already in progress and allocations to hospitals are planned to be shared with facilities per location. An estimated total of 13’000 new patients per quarter, including pregnant women and patients with CD4 count less than 350 will be initiated on FDC. As far as prevention of mother to child transmission is concerned, 6’000 patients per quarter will benefit from FDC.

Honourable Speaker
With the aim of enriching departmental planning political oversight embarked on a series of visits to all the hospitals in the province which aim to solicit first-hand observations about prevailing challenges. Together with the administration team from Vhembe District, we rounded all the hospitals in Vhembe in February 2013 (with Donald Frazer Hospital showcasing a generally well managed facility which is still in good condition relative to its old age, while on the other hand Louis Trichardt Memorial Hospital is an example of a deteriorating facility with serious infrastructure challenges).

The picture with each of the other hospitals in the District would fall somewhere between the two extremes. We envisage that the remainder of the hospitals in the Province shall have been rounded by 30 June 2013. I would like to thank the Acting District Executive Manager of Vhembe, Mr Robert Sirwali, for the support during the visits and also to ask other District Executive Managers to emulate this example when their respective turns come.

Honourable Speaker
Distinguished guests

In all important respects, this Budget resonates with the recently announced National Development Plan. It also acknowledges pronouncements by the President of South Africa, Mr Jacob Zuma, in his 2013 State of the National address, particularly when he said: “We should put South Africa first. All of us have a patriotic duty and responsibility to build and promote our country.”

This is the same sentiment shared by Minister of Finance Mr Pravin Gordhan during his Budget Speech presentation. Putting our people first is not something new to government because we already have Eight (8) Batho Pele Principles to guide us to deliver quality services to our people.

It is in this context that we believe that ‘putting South Africa first’ is to us as a Department, primarily, ‘putting the people of Limpopo first’, especially those who need medical care as we are custodians of public healthcare services. We also recognise the need to work together with other departments and stakeholders to ensure that quality services are delivered to our people.

Honourable Speaker
During our budget presentation last year we mentioned the low life expectancy of the South Africans, which was at 53, 5 years 57, 2 respectively for men and women.
It is our pleasure today to report that life expectancy has increased to 60 years for all South Africans, which is a good sign that some of the healthy lifestyle practices that the department promotes and advocates are making a positive impact. We also highlighted the need for the department to change from a curative to a preventative kind of healthcare system based on the principle of healthy living and preservation of health.

The fact that according to Statistics South Africa’s 2011 Report the population of Limpopo has increased from 4.9 million to 5.4 million presents to the Department a need to increase its services to cater for a growing population and improve the efficiency of its service delivery pipelines.

Honourable Speaker

The delivery of public healthcare services is guided by the Ten Point Plan and the four outputs of the Negotiated Service Delivery Agreement (NSDA), namely, increasing life expectancy, decreasing maternal and child mortality rates, combating HIV & AIDS, and, decreasing the burden of disease from tuberculosis, as well as strengthening health system effectiveness.

Healthcare delivery is also guided by the six Ministerial Priorities, namely, patient safety, waiting times, cleanliness, staff attitudes, availability of medicines and consumables and infection control.

Honourable Speaker

I am mentioning these factors because they play a very significant role in our continuing endeavours to improve the department’s operations towards achieving the key strategic priority of A Healthy Life for All South Africans as outlined in the 2009 election manifesto. The successes I make reference to elsewhere in this presentation are a testimony to this.

Not so many months ago, the department has been in the news spotlight for all the wrong reasons. Still fresh upon the minds of many might be the situations reported regarding George Masebe hospital and Mankweng hospital, which, according to the report of the ministerial investigative team, were a manifestation of leadership challenges that have blown off the lid. The report further indicates that managers in these facilities could not take decision promptly on issues that affect the running of the hospitals and the well-being of patients in facilities.

Honourable Speaker
Steps have been taken to address management challenges in hospitals by appointing chief executive officers (CEOs) in a significant number of hospitals. I would like to take this opportunity to welcome the recently appointed 12 CEOs of the following hospitals: Polokwane, Mokopane, Tshilidzini, Philadelphia, Hayani, Thabamoopo, Elim, Dilokong, Helene Franz, Zebediela, Seshego and St Ritas
More candidates have been interviewed for CEO positions and appointments are still being processed.

Honourable Speaker

The following services were identified as non-negotiable budget items for the department:

  • Infection control and cleaning
  • Medical Supplies including Dry Dispensary
  • Medicines
  • Medical Waste
  • Laboratory Services: National Health Laboratory Services
  • Food Services and Relevant Supplies
  • Security Services
  • Laundry Services
  • Essential Equipment and Maintenances of Equipment
  • Infrastructure Maintenances
  • Children Vaccines
  • HIV and AIDS including TB

Subsequent to the presentation of last year’s budget, compensation of employees was also added to the list. A legitimate expectation therefore exists that the department should be seen to be ensuring that these non-negotiable items are fully funded. I must also mention that these items have been costed nationally in order to provide an indicative budget for each province. Unfortunately we must face the sad fact that the department’s allocation has a shortfall in the region of R650 million towards the funding of these non-negotiables.

Honourable Speaker,

During last year’s budget vote presentation we announced the Primary Health Care re-engineering process – a road map pointing towards the maximisation of the use of clinics and health centres in the province. This financial year we will continue to pursue the re-engineering of primary health care, focusing on the following three streams: District-based clinical specialist support teams; School-based Primary Health Care services; and Municipal Ward-based Primary Health Care.

The Department has appointed an integrated team of district clinical specialists who are based in the districts. The role of these teams is to provide clinical support and oversight to primary health care services in order to address high levels of maternal and child mortality and to improve health outcomes.

Plans are in place to establish Municipal Ward-Based Primary Health Care teams, responsible for a defined number of families. These teams will facilitate community involvement and participation, and will implement appropriate interventions to address health problems.

The department continues to make a humble call to the people of Limpopo to make use of the Primary Healthcare Centres as the first contact centres to ensure that cases which need to be addressed by the Community Health Centres and Primary Healthcare Centres are fully attended to while deserving ones are referred to the hospital.

During the previous financial year 120 facilities were assessed for compliance against the six priorities of the core standards for Primary Healthcare, and the plan for this financial is to assess the same number of facilities. We assessed 6 district hospitals during the previous year, and we intend assessing all 30 hospitals in the current financial year.

As far as the regional hospitals are concerned we assessed five of them in 2012/13 financial year and we have planned to assess five again in the current financial year, while with the specialised hospitals we managed to assess three of them and we have planned to assess the same number during the current financial year. We have also planned to assess the two tertiary hospitals in this financial year. We have also put in place a plan to address complaints within 25 working days.

Infrastructure Development

Honourable Speaker
Distinguished members

Infrastructure development remains vital to us as it should go a long way in mitigating aging and dilapidating infrastructure that has not been maintained over decades.

With the aim of ensuring that PHCs ease the burden on the hospitals and also take services closer to the intended people we are happy to announce that during 2012/13 financial year we completed the building and upgrading of fifteen (15) clinics, namely, Selepe, Mpheni, Nchabeleng, Shivulani, Lebowakgomo Unit B, Matsotsosela, Sterkstroom, Sereni, Lambani, Pudiyakgopa, Burgericht, Relela, Toitskraal, William Eadie, and Kutama.

This brings to 58 the total number of clinics built and upgraded over the past 5 years (i.e. from 2008/09 to 2012/13). Surely nothing can send a better message than the completion of these clinics that the department, indeed, puts ‘people first’. We expect that this will significantly reduce the long queues at the hospitals as people can still get quality healthcare services from the clinics. It will also greatly complement the department’s plans to increase the number of facilities offering 24-hour services.

The department has planned to complete twelve (12) clinics in the current financial year to accelerate primary health care re-engineering. The clinics expected to be completed by the end of the financial year are Mamone, Shotong, Midoroni, Loloka, Smashersblock, Soetfontein, Marulaneng, Vlakplaas, Phalaborwa Busstop, Shigalo, Muyexe and Rooiberg.

Honourable Speaker,

During the previous financial year we made mention of the department’s inability to recruit health professionals especially medical officers due to lack of suitable accommodation in hospitals. Shortage of staff remains a fundamental problem.

The department will therefore continue to pay particular attention to recruitment and retention of health professionals, through various strategies including addressing accommodation needs.

We made a commitment that the problems surrounding shortage of accommodation and professionals would receive urgent attention. Indeed they got the attention they deserved, and it is our pleasure to announce that the department has completed 162 units in four facilities, which are broken down in this fashion:

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  • Sterpark Polokwane: 112 units made up of single and family units
  • Thabazimbi hospital: 20 bachelor flats
  • Matlala hospital: 10 bedrooms
  • Mecklenburg hospital: 10 bedrooms
  • Zebediela hospital: 10 bedrooms

This strategic decision of the department to provide residence for professionals is also a way of retaining their indispensable services in the province. As part of Infrastructure Development planning, in particular staff accommodation, units are planned to be completed in the current financial year in ten (10) hospitals, namely, WF Knobel, Voortrekker, Malamulele, Makhado, Donald Frazier, Letaba, Kgapane, Dilokong, Jane Furse, Philadelphia.

In addition, plans are in place to complete in this financial year two emergency medical services (EMS) stations in WF Knobel and Siloam hospitals respectively.

Honourable Speaker,

We have noted the general outcry that our response to emergency cases takes longer than 40 minutes which is the target standard for rural areas. The construction of these two facilities is expected to improve services coverage and responsiveness to cases of emergency.

Honourable Speaker
Despite the financial challenges we were also able to complete the OPD, Casualty, Administration block at Thabazimbi hospital.

In order to strengthen service delivery and also make it easy for staff to execute their work properly we have planned to complete the following infrastructure projects during this financial year:

  • Maternity, Theatre, Wards, Laboratory, Kitchen, Linen bank and Transport control (Thabazimbi hospital)
  • Maternity ward, Victim empowerment center (Letaba Hospital)
  • Transport control unit (Thabamoopo Hospital)

HIV and AIDS

Honourable Speaker,

During his address at the launch of the HIV/AIDS awareness strategy for the construction industry on 21 October 2002 former President Rolihlahla Nelson Mandela characterised HIV/ AIDS as is not just a disease, but a human right's issue even worse that a war.

The response to the concern raised in the above observation is the ANC’s dictum “Working together we can do more”, which requires of us to mobilise the whole of society in order to win the war against HIV and AIDS including other related diseases.

We will continue our HIV campaigns during the current financial year in order to keep the message alive.

Honourable Speaker

During the State of the Province address Premier Honourable Cassel Mathale expressed government’s appreciation on the fact that there is improvement in the management of HIV and AIDS in the province. “We have increased the number of antiretroviral treatment (ART) sites to 493 by the end of December 2012. The total number of patients registered on the ART programme has substantially increased in this financial year. We are also pleased by the increased number of pregnant women who test for HIV at our healthcare facilities. We are intensifying our efforts of fighting the spread of HIV and AIDS, whilst also curbing the number of new infections. We have made significant strides in increasing the number of facilities which provide comprehensive HIV and AIDS treatment and support in the province.”

Indeed there is improvement in this regard, we are happy to announce that the Antenatal HIV prevalence in the province in 2011 has, in comparison to other years, increased at a decreasing rate of 0, 2% from 21, 9% to 22, 1%. A real decrease is within sight as the department intensifies its campaigns.

While two districts had decreased HIV prevalence and the other two had slight increase of prevalence, Waterberg District had a huge increase of HIV prevalence of 4, 2% (from 26, 1% in 2010 to 30, 3% in 2011). This is the first time a district in Limpopo registers HIV prevalence of 30%.

The department has already put measures in place to manage this prevalence downwards, which include door to door campaigns, farm campaigns, campaigns in mining communities, squatter camps campaigns and campaigns at social gatherings.
To ensure that everyone know their status on HIV and TB, HIV counselling and testing including the Intensified Case Finding campaigns were conducted, from which 720’288 people were counselled and 695’611 were tested, out of whom 71’666 tested positive for HIV; 57’475 people were screened for TB and 3’575 were diagnosed for TB.

For this year, we have plans to engage in a massive HCT and ICF campaigns with a target of 1’392’678 testing for HIV and screening for TB.

As already alluded to, the department is also planning to put all newly diagnosed patients, qualifying pregnant women and breastfeeding mothers on a fixed dose combination drug consisting of three ARV drugs, viz. Tenofovir, emtricitabine and effavirenz. This treatment has started on the first of April 2013.

Regarding the prevention of mother to child transmission of HIV, we are working hard to eliminate the transmission by 2015, as required for the attainment of the millennium development goals. The transmission is currently at 2, 8%, an improvement of 1, 4% in a year. The prevalence among the age group 15-24 years is 13, 6% while the requirement is that we should be at 15% in 2015. (The Province is ahead of the performance target).

The department would like to thank the traditional leaders and health practitioners for the good working relations in achieving the targets for medical male circumcisions, in which regard we outshined all other provinces. (Unlike in other provinces, all males in Limpopo go through counselling and testing before initiation).

Malaria

During the past financial year, incidents of malaria have been at their lowest level in Limpopo since the malaria outbreaks experienced in the year 2000. During the 2012/13 financial year, 1’372 malaria cases were notified in Limpopo, compared to the 3’269 and 4’525 cases reported in the previous two financial years. This success can be attributed to the continuous efforts in the fight against malaria by the department, with the main malaria control intervention being the Indoor Residual Spraying Programme.

This programme is aimed at reducing malaria transmission, through the spraying of dwellings in the malaria-affected communities. The department managed to spray 1’137’686 structures in the financial year (against a target of 990’000). The department remains committed to the fight against malaria, with the ultimate goal of eliminating malaria transmission in the province. This will however require on-going investment in the programme, to sustain the current gains.

Reduction of Infant and Child mortality rate

Honourable Speaker

The department is committed to reducing Infant and Child mortality rate through the implementation of Integrated Management of Childhood Illnesses (IMCI).The programme is implemented in all Primary Health Care facilities, with 387 facilities achieving 60% saturation and 291 implementing House Hold Community Component of IMCI.

Training of professional nurses on IMCI will continue with the aim of increasing facilities with 60% saturation to 100%. Immunisation coverage is at 96.6% and this coverage will continue to increase as we will be conducting two rounds of measles and Polio campaigns in April, May and June 2013.

The Limpopo Initiative for new-born care will continue to be implemented in all hospitals with the aim of reducing facility neonatal mortality rate from 13.1 in 2012/13 to 12.9 in 2013/14.

The department has launched the Integrated School Health Programme in Vhembe district as it is one of the NHI pilot sites. The National Department of Health purchased three mobile trucks for the following services: Dental, eye care and physical examination.

The service is implemented with the Department of Education to support and facilitate learning through identifying and addressing health barriers to learning and also support the school community in creating a safe and secure environment for teaching and learning. To date 2’507 of 3’931 quintile 1 and quintile 2 schools have received school health services.

Maternal Health

Honourable Speaker

Maternal mortality continues to be a challenge as it remains high at 159.07 per 100’000 live births as indicated in the Ninth Interim report on the Confidential Enquiries into Maternal Deaths in South Africa.

The department is committed in implementing the recommendations of the Saving Mothers’ Report with the special focus on improving the skills of professional health care providers in Essential Steps In the Management of Obstetric Emergencies, and the management of pregnant women with HIV and AIDS and TB which continues to be a priority, as the conditions are major contributory factors to maternal morbidity and mortality.

We also launched the Campaign on Accelerated Reduction of Maternal and Child Mortality in Africa on 16 October 2013 with the aim of involving all stake holders in the fight to reduce maternal and child mortality in the province.

Contraception services are number one pillar of Safe Motherhood and one of the key strategies to reduce maternal mortality. The services are implemented in all our facilities in the province with the introduction of Intra Uterine Device as a method of contraception, and we urge our communities to utilise this method of contraception to prevent unplanned and high risk pregnancies.

Environmental Health

Honourable Speaker

We have put in place safety measures to ensure that lives of the community is in a safe environment to eliminate potential health hazards and risks that may impact adversely on the Limpopo community. This will be done in line with Ministerial priorities as outlined:

  • We will continue to have Health Care Risk Waste managed effectively in all our facilities in terms of the HCRW standards and guidelines to ensure 100 percent compliance.
  • In terms of Infection Control and Cleaning we envisage to improve practices by reducing Nosocomial infection rate by five percent and Neonatal Nosocomial infection rate by three percent respectively in the 2013 – 2014 financial year.

Human Resource Development

Honourable Speaker

As already alluded to, and despite the financial constraints during 2012/13 financial year, we managed to increase personnel by 1’288 persons, among which are 16 medical specialists, registrar, 104 medical officers, 133 medical officers (community service), 79 medical officers (interns), 12 dentists, 19 dentists (community service), 169 professional nurses, 112 professional nurses (community service), 1 lecturer (nursing), 29 staff nurses, 88 nursing assistants, 31 pharmacists, 70 pharmacists (community service), 53 pharmacists (interns), 266 allied health professionals, 27 allied assistants, eight EMS practitioners, and 68 support personnel.

For this financial year we intend to strengthen our work force through the grant-funded vacancies, which we are confident will add value to the department. The vacancy rate remains a serious challenge to the department.

National Health Insurance

Honourable Speaker

In 2012/13 we reported that the Minister of Health had announced that Vhembe District was selected as one of the ten (10) districts to pilot the National Health Insurance (NHI) on the basis of predetermined criteria, namely demographics, socio-economic including income levels and social determinants of health, health profiles, health delivery performance and health service management.

The NHI is a health financing model to assist countries to achieve universal coverage, i.e. by ensuring that all of its citizens are able to access high quality care anywhere in the country regardless of their ability to pay for needed services.

The intended objectives include reducing high maternal and child mortality through district-based health interventions; strengthening the performance of the public health system in readiness for the full roll-out of NHI; assess whether the health service package, the PHC teams and a strengthened referral system will improve access to quality health services, particularly in the rural and previously disadvantaged areas of the country; assess the feasibility, acceptability, effectiveness and affordability of innovative ways of engaging private sector resources for public purpose; examine the extent to which communities are protected from financial risks of accessing needed care by introducing a district mechanism of funding for health services and test the ability of the districts to assume greater responsibilities associated with the purchaser-provider split required under NHI.

Honourable Speaker

For 2012/13, the Province has been allocated R11,5m from NHI conditional grant towards the implementation of NHI activities. I am therefore pleased to report that we worked with the key stakeholders to market and promote awareness about the NHI, and that Facility Improvement Teams (FITs) were launched in June 2012 to assess the status of health infrastructure and make proposals for the necessary improvements.

The bulk of office equipment and essential medical equipment have been delivered; School Health was launched on 1 March 2013 and three mobile care vehicles have been received from national health to enhance service delivery to schools and PHC settings in Vhembe pilot District.

The Provincial Project Manager has been appointed and assumed duties on 1 February 2013. This has brought about an additional institutional capacity to strengthen project management capabilities in the province.

Working within the context of the approved 2013/14 NHI Business Plan, the key performance areas include contracting of about 40 private General Practitioners (GPs) to support our PHC facilities; training of pharmacy assistants to support district based clinical specialists and health outreach teams; enhancing capacity for district planning, implementation, monitoring and evaluation as well as piloting an integrated referral system in the pilot district. We will enhance the communication strategy to continually market the NHI, promote good governance and effective stakeholder participation.

It is anticipated that field-testing innovative interventions will yield best practices which can be rolled out to other districts across the province.

2013/14 Budget vote summary and financial projections

Vote 07: Health

The 2013/14 overall budget for Health vote has increased by an average 2.1%.
Equitable Share grows by 2.8%, Own Revenue increases by 3.4% and with a 5% reduction in Conditional Grants. In monetary terms, the total budget indicates a slight growth from R12.8 billion this financial year to R13 billion in 2013/14. Infrastructure budget however has reduced by an average of 25% to R457 million. This Infrastructure allocation will be used mainly for the Hospital Revitalisation Programme, the building and upgrading of clinics, nursing schools and emergency medical services’ stations.

Honourable speaker

The budget has been channelled to fund the following key priorities:

  • Strengthening District Health Services (Primary Healthcare) and district hospital delivery systems: R6.4 million.
  • R508 million has been set aside for the running of Emergency Medical Services in the province
  • In an effort to improve the provision of tertiary services in the Province, an amount of R1.1 billion has been provided for this programme, comprising the Polokwane/Mankweng hospitals complex.
  • An amount of R64 million has been set aside for Expanded Public Works Programme
  • Bursaries for health professionals: R110million. (R30 million of this amount is funded from the Health Professional Training Grant.)
  • R45.6 million has been provided for TB/MDR (Multi Drug Resistant) service programmes in the Province.
  • Comprehensive HIV and AIDS: The budget for this priority has been increased by R94million to R861 million. This is an increase of 12.3% from the 2012/13 budget of R767million.
  • Medicine has been allocated R620 million, R275 million for Antiretroviral drugs and R120 million for Vaccines to reduce infant and child mortality.
  • R457million has been allocated to the Health Facility Revitalisation Programme.
  • An amount of R89 million has been provided to prevent and control malaria in the affected areas of this Province.

Honourable speaker

Funding for the health services is still a challenge, with the operational activities of the Provincial and District offices, hospitals and clinics being materially underfunded; these include amounts payable for municipal services, electricity supply, security, transport and maintenance of equipment and infrastructure.

The allocated funds do not fully address the healthcare needs of the people of this Province and we therefore propose a consolidated effort to address this challenge. This department will however put more efforts in providing value for money in the utilisation of this budget.

Revenue collection

The department is targeting to collect R120 million in the 2013/14 financial year. This is 3.4% growth from the current target of R116 million. We will put more efforts to achieve this target as we know that this will contribute to the funding of the health services in the province.

We therefore urge the community to pay for the health services they receive in our health facilities as this will ultimately be for their own benefit. Services, however, remain free at all primary healthcare facilities such as clinics, health centers and mobile clinics.

Honourable speaker

I am therefore honoured and indeed privileged to table to this august house the budget for Health-Vote 7, for the 2013/14 financial year, to the total of value of R13 billion which consists of R11.1 billion equitable share, R1.7 billion conditional grants and R120 million of own receipts.

Conclusion

Honourable Speaker

Let me take this opportunity to thank the departmental officials for the good work they are performing for the department from the grounds men and women to the Head of the Department. I also want to thank my family for the support and understanding throughout the tight time-schedule within which I work. Let me also thank my colleagues from the Legislature for their support.

Thank you

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