CLUSTER: HOSPITAL SERVICES Presentation to Portfolio Committee on Health 3 April 2001

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CLUSTER HOSPITAL SERVICESPresentation to
Portfolio Committee on Health3 April 2001
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CLUSTER DIRECTORATESAND BUDGETS

• Cluster Manager . R 0.960 m
• Health Technology . R 1.508 m
• Facilities Planning . R 1.423 m
• Hospital Management . R 2.074 m
• Emergency Medical Services Disaster
• Management . R 0.606 m
• Radiation Control . R 5.994 m
• Total . R12.565 m
• Conditional Grants . R 5 341 bn

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HEALTH FACILITIES PLANNING
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Integrated Health Planning Framework (IHPF)
What is IHPF?

• Quantifies National Policy
• Updates existing National Planning Framework
• Integrates health planning
• 1. HR, finance, technology, quality
• 2. HSS, acute chronic care, PHC
• Dynamic tool
• Long term Planning

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IHPF (continued)
Activities

• Development of affordability cost model
• Conditional grants and other funding to be
  investigated
• Generic Provincial Strategic Plan

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Implementation of Hospital Revitalisation

• Components
• Land buildings
• Organisational development
• Health Technology / Equipment
• Quality of care

• Identifying pilot projects for Revitalisation
• Develop Business Plans
• Investigating World Bank funding
• Provincial allocations transferred and monitored

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OTHER ACTIVITIES
Conditional Grants

• Support rehabilitation of over 400 projects
• Assisting with commissioning of 3 Academic
  Hospitals (Durban, Umtata and Pretoria)

Continue to - Develop databases and combined
standards and guidelines for public and
private health facilities - Develop database,
standards and guidelines for mortuaries and
EMS - Develop planning and commissioning
guidelines
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HEALTH TECHNOLOGY (HT) POLICY
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HT - Policy Framework and Legislation
 

• HT Policy Framework- Approved by MINMEC in 02/01
• - Implementation to resume
• - HT System Development Programme to be declared
• - HT System Programme Major Projects
• HT Scoping Study
• HT Audit
• Essential HT Packages
• HT Legislation
• - To be finalised after the completion of HT
  policies
• - Develop strategy to close the present gap on
  critical equipment
• - Finalize Schedule of equipment for the CON

 
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HT- (HT Management Planning)

• HT Management Policy to be finalised
• - Meant to ensure equipment safety
• - Meant to reduce equipment downtime and
  disruption of
• service delivery
• - Equipment donor guidelines to be delivered
• - Staffing Norms to be finalised
• - HT Managers already trained for 7 provinces
• Organ Transplantation
• - Policy to be revised
• - Expert Committee to be put in place
• - Ongoing coordination of unrelated living donor
  transplants
• evaluation of requests for non-South
  Africans

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HT System - (Scoping Study)

•  
• Scoping Study to provide
• Analysis of RSA and International HT scenario
• A strategy for HT System development including
  phasing of the four subsystems
• Required resources (Rand, HR, Infrastructure)
• Legal Implications
• Evaluation and monitoring mechanisms including
  the time frames and indicators

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HT System - Essential Health Technology Packages
(EHTP)

• Integrated HT planning tool for
• (Essential Med equipment related Cost links
  to EDL
• and Essential HR)
• To be finalised for Maternal Child Health
• Development at MRC (NDoH WHO main funders)
• RSA piloting the Field-Testing for 25 countries
  
• (RSA, Mozambique, Namibia reps for the region)

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HT System HT Audit

• To identify equipment gaps, physical status,
  deployment etc
• HT audit guidelines produced
• Pilot audit in 2 provinces to be completed (NP
  EC)
• Completed Audits in 3 facilities (for EHTP
  field-testing)

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HOSPITAL MANAGEMENT

• Decentralization of Hospital Management

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HOSPITAL MANAGEMENT

• Equip managers with appropriate competencies
  skills
• Achieve competency framework agreements for all
  levels of hospital managers
• Device agreed role profiles for levels of
  management
• Capacity building for managers
• Business planning training in hospitals
• Information systems development
• Labour relations
• Cost centre training
• Orgnisational development

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HOSPITAL MANAGEMENT

• Facilitate implementation of decentralisation of
  hospital management
• Develop a Nationally agreed policy on
  decentralisation process
• Identify criteria for conferring decentralised
  status
• Develop an assessment/audit tool

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HOSPITAL MANAGEMENT

• Implementation of management systems structures
• Complete the implementation of cost centres in
  the pilot hospitals
• Support Provinces roll-out of cost centres
• Improve and support the efficiency of Hospital
  Boards
• Produce guidelines on the functioning of hospital
  and community boards

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HOSPITAL MANAGEMENT

• Improve the effective and appropriate spending of
  financial resources
• Improve the financial monitoring reporting
  mechanisms
• Business plans
• Monthly quarterly reports - intervention

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HOSPITAL MANAGEMENT

• STRATEGIC POLICY DIRECTIONS
• Building Financial Management Capacity
• Ensuring democratic Public Hospital governance
• Attainment of nationally agreed approach to
  decentralisation

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EMERGENCY MEDICAL SERVICES AND DISASTER
MANAGEMENT
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EMERGENCY MEDICAL SERVICES

• PROVINCIALISATION OF SERVICES
• Support the North West, Eastern Cape and Gauteng
  in their provincialisation process
• North West and Eastern Cape due to complete
  exercise in June 2001
• Gauteng unlikely to complete before year-end

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EMERGENCY MEDICAL SERVICES

• NORMS AND STANDARDS
• Include in National Planning Framework
• Develop costing models
• Regulations
• Pre-hospital emergency medical services
• In-hospital emergency centres

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DISASTER MANAGEMENT

• Policy and Guidelines for National and Provinces
• establish focal points in provinces
• develop contingency plans
• Resource Data Base
• resource support project
• health reaction teams

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DISASTER MANAGEMENT

• Red Cross Act
• community capacity enhancement program
• auxiliary body to Health in an emergency
• Training
• source appropriate training in district
  management
• establish development program for district
  management personnel

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RADIATION CONTROL
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PRIORITIES 2001

• Revise and broaden the quality Assurance
  programme to include CT and dental x-ray units
• Start a programme to license the use of
  industrial radio-frequency equipment
• Update the sale database and publish a 2001
  sourcebook of licensed electromedical equipment
• Investigate a regulatory fee structure
• Tighten control over Industrial Radiography -
  start re-registration process

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CONDITIONAL GRANTS
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Central Hospital
Provinces Budget Transf Expected Expend Variance
E. C 13,000 13,000 3,000 10,000
GP 1,492,868 1,492,868 1,492,868 0
WC 961,949 961,949 961,949 0
FS 237,538 237,538 237,538 0
KZN 406,645 406,645 406,645 0
Total 3,112,000 3,112,000 3,102,000 10,000
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Health Prof Training Research
Prov Budget Transf Expected Expend Variance
EC 52,830 52,830 52,830 0
MP 23,480 23,480 23,480 0
NC 23,480 23,480 23,480 0
NP 23,480 23,480 23,480 0
NW 23,480 23,480 23,480 0
GP 503,646 503,646 503,646 0
WC 292,326 292,326 292,326 0
FS 84,528 84,528 84,528 0
KZN 146,750 146,750 146,750 0
Total 1,174,000 1,174,000 1,174,000 0
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Hosp Reconstruction Rehab
Prov Budget Transf Expected Expend Variance
EC 84,000 84,000 40,000 44,000
MP 35,000 35,000 35,000 0
NC 8,500 8,500 7,000 1,500
NP 69,490 69,490 69,490 0
NW 40,000 40,000 36,710 3,290
GP 55,000 55,000 55,000 0
WC 28,362 28,362 28,362 0
FS 32,261 32,261 20,342 11,919
KZN 70,526 70,526 70,526 0
Total 423,139 423,139 362,430 60,709
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Red of Highly Spec Services
Prov Budget Transf Expected Expend Variance
EC 67,437 67,437 67,437 0
MP 56,169 56,169 56,169 O
NC 26,039 26,039 26,039 O
NP 75,481 75,481 75,481 0
NW 53,914 53,914 53,914 0
National 6,905 0 0 6,905
Total 285,945 279,040 279,040 6,905
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New Durban Academic Hospital
Province Budget Transfered Expected Expend Variance
KZN 273,000 273,000 273,000 0
Total 273,000 273,000 273,000 0
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Umtata Academic
Province Budget Transfered ExpectedExpend Variance
EC 111,855 111,855 111,855 0
Total 111,855 111,855 111,855 0
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