FREE STATE PROVINCIAL GOVERNMENT DEPARTMENT OF HEALTH

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FREE STATE PROVINCIAL GOVERNMENTDEPARTMENT OF
HEALTH

• PORTFOLIO COMMITTEE ON HEALTH
• BUDGET HEARINGS
• APRIL 2001

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VISION STATEMENT

• A healthy and self reliant Free State community
• MISSION STATEMENT
• The Free State Department of Health
• provides a quality comprehensive health care
  services to the Free State community
• optimally utilises health care resources to
  provide a caring and compassionate service
• endeavours to empower and develop all personnel
  to the best of their potential

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STRATEGIC THEMES

• THEME 1 PROMOTING THE WELL BEING OF ALL THE
• PEOPLE
• THEME 2 MEETING COMMUNITY DEMANDS
• THEME 3 RENDER QUALITY COMPREHENSIVE
• AND AFFORDABLE HEALTH
  SERVICES AT ALL
• LEVELS OF CARE
• THEME 4 EMPOWERING AND DEVELOPING ALL PERSONNEL
• AND THE RELEVANT
  STAKEHOLDERS
• THEME 5 TRANSFORMING HEALTH SERVICES TOWARDS
• PRIMARY HEALTH CARE
  FOUNDED ON DISTRICT
• HEALTH SYSTEM
• THEME 6 IMPROVING THE MANAGEMENT OF HEALTH
• SERVICES

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KEY STRATEGIC OBJECTIVES FROM THE STRATEGIC PLAN

• STRATEGIC THEME 1
• PROMOTING THE WELL BEING OF ALL THE PEOPLE
• Implement an integrated health promotion
  strategy through an inter-sectoral approach
• Increased interventions in HIV/AIDS
• Voluntary Counseling and Testing
• Mother to child transmission
• Home-based care
• Ensure improved management of Tuberculosis
• Implement and maintain a system for improved
  rural health
• Ensure the development and rendering of
  Environmental Health Services
• Ensure the implementation of an Integrated
  Nutrition Programme
• Ensure services are accessible to people with
  disabilities
• Ensure services are accessible to personnel

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STRATEGIC THEME 2 MEETING COMMUNITY DEMANDS

• Cultivate an Organisational Culture that is
  characterised by staff that are
• Proud of being health workers
• Enjoy working for the department
• Caring for colleagues and the clients
• Improve Customer Satisfaction at all levels of
  service

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STRATEGIC THEME 3 RENDER QUALITY
COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES AT
ALL LEVELS OF CARE

• Render comprehensive health care services at the
  most appropriate level
• Improve quality and efficiency of services
  rendered
• Render affordable and equitable services

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STRATEGIC THEME 4 EMPOWERING AND DEVELOPING ALL
PERSONNEL AND THE RELEVANT STAKEHOLDERS

• Training in line with service needs
• Implement Interactive Distance Education and
  Learning
• Implement ,review, maintain and monitor the
  induction programme
• Ensure availability of health professionals
• Develop and implement intervention strategies to
  address the impact of HIV/AIDS on health
  personnel
• Empower the community (Hospital Boards and
  College Councils)

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STRATEGIC THEME 5TRANSFORMING HEALTH SERVICES
TOWARDS PRIMARY HEALTH CARE FOUNDED ON DISTRICT
HEALTH SYSTEM

• Implement District Health Authorities in line
  with the Provincial Health Act (Act 8 of 1999)
• Implement District Health System in line with
  District Health Plan per district
• Ensure an extended access to 24 hour health
  services in all districts
• Ensure and render comprehensive maternal services
  to rural communities
• Restructure and re-organise integrated
  psychiatric and mental health services according
  to the Mental Health Bill

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STRATEGIC THEME 6IMPROVING THE MANAGEMENT OF
HEALTH SERVICES

• Access to and use of management information
• Effective Financial Management
• Develop and maintain Human Resource Plan
• Public Private Partnership
• Strategic Planning
• Ensure sensitivity for gender issues
• International co-operation
• Implementation of the PFMA
• Service Level Agreements (Municipalities)
• Loss of cohesion in Top Management
• Rationalisation of services

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FINANCIAL RESULTS

• 1997/1998 - R 141 MILLION OVER EXP - 9.28
• (BUDGET R 1,518 BILLION)
• 1998/1999 - R 98 MILLION OVER EXP - 5.95
• (BUDGET R 1,646 BILLION)
• 1999/2000 - R 135 MILLION UNDER EXP - 7.83
• (BUDGET R 1,724
  BILLION)
• 2000/2001 - R 60,3 MILLION UNDER EXP - 3.28
• BUDGET R 1,833 BILLION

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BUDGET AND MTEF

• BUDGET 2001/2002 - R 1,880 BILLION
• MTEF 2002/2003 - R 1,985 BILLION
• MTEF 2003/2004 - R2,099 BILLION

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REVENUE
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HOSPITAL AND OTHER CLINICAL SERVICES

• Policy decisions that will be implemented this
  year
• Implementation of EDL
• Strategic Physical Facilities Plan
• Policy decisions intended for the MTEF period
• Performance Agreements with Hospitals
• Implement District Health System together with
  local government in line with management plan
  and legislation
• Significant problems and constraints faced in
  achieving key objectives
• Improve staff morale and attitudes
• Lack of specific skills - Bio-Engineering
• The impact and usefulness of conditional grants
• Support Outreach Programme
• Issues relevant from National policy perspective
• Quality Assurance and Accreditation for all
  hospitals using COHSASA Programme
• Recommendations
• Improved equity and access

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PRIMARY HEALTH CARE PROGRAMMES

• Policy decisions that will be implemented this
  year
• High dose of Vit. A to woman after delivery
• Feeding of learners at identified schools
• Policy decisions intended for the MTEF period
• Develop and implement provincial guidelines,
  capacity building strategies,monitoring tools and
  Health Promotion Programs for all Primary Health
  Care programs
• Significant problems and constraints faced in
  achieving key objectives
• The burden of HIV/AIDS and TB epidemics divert
  funds and other resources needed for
  transformation
• The impact and usefulness of conditional grants
• Grants for Integrated Nutrition Program utilised
  appropriately
• Squezze of Central Hospital Grant.
• Issues relevant from National policy perspective
• Develop and implement Primary Health Care
  packages for clinics
• Estimated HIV/AIDS impact
• Prevalence of HIV remained the same as 1999
  survey - plateau phase has been reached
• Recommendations
• Funding need to reflect the impact of the twin
  epidemics of HIV/AIDS and TB

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TEACHING AND TRAINING

• Policy decisions that will be implemented this
  year
• Strategic areas of training
• Adult Basic Education and Training programmes
• Pharmaceutical services Assistant Pharmacists
• Radiographic servicesSupplementary Radiographers
• Nursing services Assistant nurses on
  supernumerary to be trained as professional
  nurses
• Bursaries
• Education and training of all health professional
• Award bursaries to meet the needs of the
  Department
• Training in line with Skills Development Act
• Development of skills according to the needs of
  the Department

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PSYCHIATRIC AND MENTAL HEALTH SERVICES

• Policy decisions that will be implemented this
  year
• District Psychiatric services
• bed capacity at specific levels of care
• Policy decisions intended for the MTEF period
• Restructure District Psychiatric Services
• Significant problems and constraints faced in
  achieving key objectives
• To appoint and retain Psychiatrists at Regional
  complexes
• Recommendations
• Restructure psychiatric services

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TB SERVICES

• Policy decisions that will be implemented this
  year
• Improve management of TB statistics
• Improve DOTS to decrease defaulter rate
• Policy decisions intended for the MTEF period
• Training of community doctors to manage TB
• Hospitalisation of TB patients in district
  hospitals
• Significant problems and constraints faced in
  achieving key objectives
• Financial and personnel constraints where
  additional beds need to be established
• Issues relevant from National policy perspective
• Coordination with HIV/AIDS program to decrease
  the impact on the TB program

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EMERGENCY MEDICAL SERVICE

• Policy decisions that will be implemented this
  year
• Maintain a quality Provincial Emergency Medical
  Service
• Establish a Provincial Commuter Service (patient
  transport)
• Policy decisions intended for the MTEF period
• All patient transport to be accommodated within
  EMS sub-directorate
• Training of 20 of staff to an advanced level
• Significant problems and constraints faced in
  achieving key objectives
• Severe staff shortage if Conditions of
  Employment Act is implemented and the total staff
  establishment is not filled
• Issues relevant from National policy perspective
• Provincialisation of Emergency Medical Service
  (EMS)
• Recommendations
• Guidelines for EMS regarding personnel, equipment
  and vehicles to be developed and implemented

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SUPPORT SERVICES

• Policy decisions that will be implemented this
  year
• Implement Antifraud and Corruption system
• Implement Monitoring and Evaluation system
• Policy decisions intended for the MTEF period
• Implement Transport and Fleet management policy
• Unlocking resources within private sector for
  public sector delivery
• Issues relevant from National policy perspective
• Implement Antifraud and Corruption system
• Implement PFMA
• Implement Administrative Justice and Promotion of
  Access to Information legislation as well as
  Employment Equity Plan
• Ensure Batho Pele culture and attitude change

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PERSONNEL

• Shortage of key staff
• All health and related professions and
  specialists
• Development and implementation of staffing norms
  consistent with a strategic plan
• Provincial Human Resource Plan
• Critical problem areas involving Human Resource
  issues requiring urgent attention from
  government as a whole
• Implement Departmental Performance Management
  System
• Current rewards and incentives system is still
  protected by collective agreements.
• Training staff in new performance management
  system

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KEY HEALTH PROBLEMS

• Trends
• HIV/ AIDS is stabilising
• Health service interventions
• Establishment of Health Promotion strategies
• Promotion of advanced midwifery training
• Establishment of Disease Outbreak Response Teams
  in every district
• Implementation of Step-down facilities and
  Home-based care
• Establishment of Victim support Centres and
  training
• Implementation of Cervical Screening Programs in
  collaboration with CANSA
• Building capacity to manage HIV/AIDS patients at
  Primary Health Care level
• Dissemination of information to the community
  using the media