National Department of Health Response to the MTBPS 2002

1
National Department of Health Response to the
MTBPS 2002

• Dr. A Ntsaluba
• Director-General Health

2
Overall Assessment

• On the whole, the MTBPS 2002 reasonably positive.
• There are substantial increases proposed to
  Social Services spending over the coming MTEF
• Genuine attempt by the National Treasury to link
  the budget process to policy priorities
• Still needs more effort
• It is important to recognise the benefits of
  improved social services for the health sector.

3
Health Sector Assessment

• Substantial increases projected for the health
  sector
• Growth over the MTEF of above 10
• Increased spending targeted at priority and
  pressure points
• HIV/AIDS R3.3b over the MTEF
• Personnel R2.25b over the MTEF
• Infrastructure - R770m over the MTEF
• General Health Sector adjustment R1.2b over MTEF

4
Health Sector Assessment

• Whilst there are substantial increases
• Not all that was asked for was allocated
• Not all areas addressed
• Selective prioritisation by National Treasury,
  pre-empts some policy making that only the sector
  is able to best decide upon.

5
Health Pressures and Priorities

• Following main proposals tabled to National
  Treasury
• Health Inflation
• General adjustment in the light of higher than
  expected health/medical inflation
• Exchange rate
• Fall in CPI
• Wage drift

6
Health Pressures and Priorities

• HIV/AIDS
• Revision of the enhanced response
• Roll-out of MTCT
• Provision of PEP for survivors of sexual assault
• Personnel
• Community Service
• Rural and scarce skills allowances
• mid-level workers

7
Health Pressures and Priorities

• Health Infrastructure
• Increased spending on revitalisation
• Increased funding required for sustaining health
  infrastructure
• Health technology/equipment

8
Summary of Requests for 02/03

• The sum total of additional funds to be made
  available to the Health Sector is summarised as
  follows
• Health Inflation - R1.1b
• Conditional Grants - R300m
• Health Infrastructure - R3m
• Total Additional - R1.4b

9
Summary of Requests for 03/04
10
Funds Allocated by Treasury
11
Concerns

• Majority of funds are channelled through the
  equitable share
• This is correct but raises some very strong
  concerns
• Firstly, structure of the formula means that
  targeted increases for the Health Sector not
  possible
• Secondly, equitable share disproportionately
  biases poorer provinces, hence, areas where
  strongest health intervention is required

12
Improved working relationship with National
Treasury

• The improved working relationship between
  National Health and National Treasury is very
  positive,
• Bears some appreciation for health sector
  pressures and priorities
• There are three Health/Treasury Technical teams
• HIV/AIDS
• Personnel
• Infrastructure

13
Conclusion

• Positive signs
• Sustained forward movement
• However,
• Interaction at provincial level between Health
  and Treasury needs to ensure that funds reach the
  priorities they are intended for.