NATIONAL DEPARTMENT OF HEALTH

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NATIONAL DEPARTMENT OF HEALTH

• PRESENTATION TO THE STANDING COMMITTEE ON
  APPROPRIATIONS 2009 MEDUIM TERM BUDGET POLICY
  STATEMENT (MTBPS)
• 30 October 2009

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OUTLINE OF THE PRESENTATION

• Introduction.
• New NHS priorities.
• 2009/2010 April September Actual Expenditure
  results.
• Adjusted Estimates 2009/2010.
• MTEF Budget Proposals.
• Budget Pressures.
• Conclusion.

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INTRODUCTION

• The Department of Health addresses the third
  Medium term priority pronounced by Cabinet namely
  
• Improving health outcomes.
• In implementing the priority as set out, the
  Department has developed a new Ten Point Plan.

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NEW NHS PRIORITIES FOR 2009-2014

• (i) Provision of strategic leadership and
  creation of a social compact for better health
  outcomes
• (ii) Implementation of a National Health
  Insurance Plan
• (iii) Improving Quality of Services
• (iv) Overhauling the health care system and
  improve its management
• (v) Improving Human Resources Management
• (vi) Revitalization of physical infrastructure
• (vii) Accelerated implementation of HIV and AIDS
  Plan and reduction of mortality due to TB and
  associated diseases
• (viii) Mass mobilisation for better health for
  the population
• (ix) Review of the Drug Policy
• (x) Strengthening Research and Development

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Review of Actual Expenditure for the National
Department April September 2009.
PROGRAMME Original Allocation Adjusted Appropriation April September Exp. Expenditure of Adjusted Appropriation.
1.Administration 236 596 260 437 133 779 51.4
2. Strategic Health Prog. 4 692 328 5 791 253 2 402 712 41.5
3. Health Planning Monitoring 357 084 396 449 177 471 44.8
4. Health Human Resources Management Development. 1 786 224 1 798 947 891 002 49.5
5. Health Services 9 898 865 10 086 099 5 206 603 51.6
6. International Relations, Health Trade Product Regulation 86 997 90 247 45 370 50.3
TOTAL 17 058 094 18 423 459 8 856 937 48.1
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Review of Actual Expenditure for the National
Department April September 2009.Economic
classifications.
Econ. Class Original Allocation Adjusted Appropriation April September Exp. Expenditure of Adjusted Appropriation.
Compensation of Employees 299 901 329 132 160 342 48.7
Goods and Services 638 026 820 542 293 294 35.7
Transfers and Subsidies 16 091 839 17 247 364 8 397 583 48.7
Payments for Capital assets 28 328 26 421 5 712 21.6
TOTAL 17 058 094 18 423 459 8 856 937 48.1
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APRIL SEPTEMBER EXPENDITURE RESULTS.

• From the figures indicated, after the Adjusted
  appropriation allocations, the Department is at
  48.1.
• The 1.9 variance from the target of 50 as at
  end of September is influenced by additional
  funding as well as rolled over amounts.

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ADJUSTED ESTIMATES 2009/2010.

• The total increase for the Department amounts to
  R1,365 billion.
• Of the R1,365billion, an amount of R231,088
  million refers to requested roll over funds for
  the 2008/09 financial year. That makes 17 of the
  increase.
• R160million is earmarked for the H1N1 Influenza
  pandemic.

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ADJUSTED ESTIMATES 2009/2010. Additional funding
received

• PRIORITY AREA

• FUNDING in millions

• H1N1 Influenza pandemic.
• ART Comprehensive HIVAIDS Care Management
  Treatment.
• Countrywide measles polio mass immunization
  campaign.
• 2010 World Cup Health preparation strategy grant.

• 160 000
• 900 000
• 20 000
• 30 000

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ADJUSTED ESTIMATES 2009/2010. Additional funding
received

• PRIRITY AREA

• FUNDING in millions.

• General Salary adjustments
• National Department.
• Public Entities
• - National Health.
• Laboratory Services.
• - SA Medical Research
• Council.

• 7 348
• 11 064
• 5 865

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ADJUSTED ESTIMATES 2009/2010. Additional funding
received.

• The Department deemed it critical to request
  National Treasury to hold the funding earmarked
  for provincial health departments for H1N1 ART
  and 2010 World cup at National level, to ensure
  that the funds are utilized for intended
  purposes.
• Procurement of goods and services will be done
  centrally in consultation with the provinces.

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ADJUSTED ESTIMATES 2009/2010

• The National Department shifted funds within
  programmes, mainly from Goods and services, after
  a thorough review and alignment as a result of
  the drive ( by the Finance Minister) to cut and
  save costs from travel subsistence,
  conferencing as well as consultancy services.
• Identified funding was then moved to provide for
  new priority areas as per the new Ten Point Plan.

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MTEF BUDGET PROPOSALS.

• For the current MTEF budget bids process, the
  Department took a resolution, in order to
  stabilize the health sector, to focus on the
  following critical funding areas which are part
  of the ten point plan as well as for
  strengthening of the public health services
• - Full funding of ALL OSD categories.
• Fully funding of warm bodies Compensation
• of Employees, to deal with the over
  expenditure.
• - Adequate funding of the ART programme.
• - Adequate funding of the Blood Services
• (SANBS) and the laboratory services (NHLS).

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MTEF BUDGET PROPOSALS.
R million 10/11 10/12 10/13
HIV/AIDS 2,600 3,100 4,000
Doctor OSD 400 400 400
Health therapists OSD 500 550 600
Health stabilization and rescue plan (provinces) 1,500 2,500 3,000
EMS 2010 final preparations 267 0 0
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MTEF BUDGET PROPOSALS.
R million 10/11 10/12 10/13
National Department various 192 194 150
TOTAL 5,459 6,744 8,150

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BUDGET PRESSURES

• Ensuring full funding of ALL OSD categories and
  implementation.
• Adequate funding of the Comprehensive HIVAIDS
  Treatment Plan.
• Funding of the Infrastructure.
• Payment and management of the Blood Services
  (SANBS) and the laboratory services (NHLS).
• Fully funding of warm bodies.( Personnel).
• Funding inflation related cost drivers.
• Clearing of Accruals from08/09.

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CONCLUSION

• The Budget proposals are preliminary and still to
  be discussed and finalized with the National
  Treasury.
• The Department is aware of the economic climate
  due to the melt down but has focused on the Ten
  Point Plan priorities.
• Provincial Health Departments also have to engage
  with their provincial treasuries for possible
  increase in their equitable share allocations.

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NATIONAL DEPARTMENT OF HEALTH

• THANK YOU.