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NATIONAL DEPARTMENT OF HEALTH

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NATIONAL DEPARTMENT OF HEALTH PRESENTATION ON THE FFC RECOMMENDATIONS ON THE DIVISION OF REVENUE 2011/12 17 AUGUST 2010 * Introduction. The Department has been ... – PowerPoint PPT presentation

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Title: NATIONAL DEPARTMENT OF HEALTH


1
NATIONAL DEPARTMENT OF HEALTH
  • PRESENTATION ON THE FFC RECOMMENDATIONS ON THE
    DIVISION OF REVENUE 2011/12
  • 17 AUGUST 2010

2
Introduction.
  • The Department has been requested to comment on
    the Division of Revenue Bill and the FFC
    recommendations.
  • Noting that the aim of the Department of Health
    is
  • - To promote the health of all people in South
    Africa through an accessible, caring and high
    quality health system based on the primary health
    care approach.

3
Introduction continued.
  • The Department will also comment on
  • Whether sections of the Bill can be reworded or
    deleted as appropriate provision already exists
    in other legislation,
  • Whether objects and the body of the Bill should
    be amended to accommodate or reflect the
    governments priorities or whether these should
    be included in the conditional grants frameworks
    and
  • Whether the Bill should be amended to better
    accommodate and compliment the outcomes approach,
    and what these changes should be.

4
The Four Main Health Outputs
  • Noting that the Health Department strives to
    achieve the following outputs, based on
    Governments outcome number two a long and
    health live of all South Africans of the Service
    Delivery Agreement
  • - Improving Life Expectancy.
  • Reducing Maternal Mortality Rates and
  • Child Mortality Rates.
  • - Combating HIVAIDS and TB.
  • - Enhancing Health Systems Effectiveness.

5
Division Of Revenue Act (DORA).
  • Department manages 5 conditional grants.
  • Conditional Grants have been part of the health
    system since its inception in 1998
  • Health conditional grants account for /- 95
    of total NDoH budget.

6
The FIVE conditional grant allocations are
  • HIV and AIDS ( Schedule 5)
  • Forensic Pathology Services ( Schedule 5)
  • Hospital Revitalization ( Schedule 5)
  • National Tertiary Services ( Schedule 4)
  • Health Professions Training Dev ( Schedule 4)
  • Schedule 4 Allocations to provinces and
    municipalities to supplement the funding of
    programmes or functions funded from provincial or
    municipal budgets.
  • Schedule 5 Specific purpose allocations to
    provinces.

7
Comprehensive HIV and AIDS Conditional Grant
  • Purpose of the grant
  • Enables the health sector to develop an effective
    response to HIV AIDS.
  • Supports prevention programmes, VCT, PMTCT, PEP,
    HCBC, Step Down Care
  • Subsidizes funding for ARV treatment.
  • Allocation criteria
  • Antenatal HIV prevalence.
  • Estimated share of AIDS cases.
  • Populations post-demarcation.

8
Forensic Pathology Services Grant
  • Purpose of the grant
  • Assists with the transfer of medico-legal
    mortuaries from SAPS to the health sector.
  • To provide a comprehensive forensic pathology
    service for the criminal justice system.
  • Allocation criteria
  • In accordance with the National project Plan, as
    modified for demarcation and inflation.

9
Hospital Revitalization Grant
  • Purpose of the grant
  • Plays a key role in transforming and modernizing
    infrastructure, health technology, equipment
    Monitoring and Evaluation in hospitals.
  • Funds upgrading and replacement of hospital
    infrastructure - focuses mainly on projects
    where entire hospital is upgraded.
  • Also supports management development initiatives
    including personnel, procurement delegations and
    financial management capacity.

10
Hospital Revitalization.
  • Allocation criteria
  • Based on projected cash flow figures for approved
    projects over MTEF period.
  • Includes expenditure on infrastructure, health
    technology, organisational development quality
    improvement
  • Project based allocation approach is aligned with
    equity based approach over long term.

11
National Tertiary Services Grant.
  • Purpose of the grant
  • Aims to provide strategic funding to enable
    provinces to plan, modernize and transform
    services in tertiary hospitals.
  • 26 hospitals/complexes of hospitals are funded.
  • Western Cape and Gauteng receive the largest
    proportion of the grants these provinces provide
    the highest proportion of tertiary services.
  • Allocation criteria
  • Cost of designated tertiary services
  • as determined by the costing and the
  • review of the NTSG.

12
The Health Professions Training and Development
Grant
  • The grant is under review for integration with
    the Department of Higher Education.
  • Problems identified
  • Training of specialists and sub specialists takes
    place public sector academic hospitals and
    primary centers.
  • Currently 1687 registrars post are unfilled.
  • The review will address infrastructure,
    governance, financing and operational issues.

13
CONDITIONAL GRANTS MTEF ALLOCATION
Conditional Grants 2010/11 R'000 2011/12 R'000 2012/13 R'000
Comprehensive HIV and AIDS Grant 6,011,757 7,432,962 8,764,610
Forensic Pathology Services Grant 556,962 590,380 619,899
Health Professions Training and Development Grant 1,865,387 1,977,310 2,076,176
Hospital Revitalization Grant 4,020,667 4,172,292 4,380,907
National Tertiary Services Grant 7,398,000 7,798,878 8,188,822
Total 19,852,773 21,971,822 24,030,414
14
Comments on the Bill
  • The Department agrees with the provisions
    regarding the duties of transferring national
    officer in respect of Schedule 4 allocation
    ( chapter 3 Part 2, clause 9).
  • Schedule 4 specifying allocations to provinces
    to supplement the funding of programmes or
    functions funded from provincial budgets
  • An amendment is proposed regarding Chapter 3,
    Part 3, under the clause on withholding of funds,
    clause 16 (c) (2). The two grants should not be
    exempted from withholding of funds.

15
Comments on the Bill continued
  • The transferring national officer , as part of
    the oversight authority towards implementation
    and ensuring achievement of the health outcomes,
    should have the authority to withhold funds if
    they are not utilized for intended purposes or
    there is under performance.
  • This would give the transferring national officer
    the opportunity to intervene timeously.

16
Comments on the Bill continued
  • Related amendments to the framework will be
    submitted to the National Treasury related to the
    two grants ( National Tertiary Services and the
    Health Professional Training Development
    grants).
  • The amendments are related to development of
    business plans as a prerequisite for transferring
    funds by the transferring national officer to the
    receiving provincial officer, in line with
    Chapter 3, part 2, clause 10 (a) (iii).

17
Comments on the Bill continued
  • Concerns have been raised by some provincial
    receiving officers related to timeous transfers
    from the Provincial Revenue Fund to the
    provincial departments due to cash flow
    challenges.
  • It is proposed that a clause be included in the
    Bill to protect or ensure prompt transfers to the
    receiving officers from the Provincial Revenue
    Fund once received from the transferring national
    officer.

18
Comments on the FFC Recommendations.
  • In line with Chapter 3 of the FFC, related to the
    performance of the grants, the Department intends
    ensuring clear role clarification between the
    national and provincial level with regard to
    oversight, accountability, responsibility and
    control of the grants, in line with the
    priorities in the Service Delivery Agreement.
  • This will be included in the framework of all the
    conditional grants.

19
Comments on the FFC Recommendations.
  • The Department agrees with the recommendations
    under Chapter 3, paragraph 7.3, related to the
    transparency in the allocations of the grants,
    that in some cases, targeted allocations to the
    challenges, and not equitable share formula
    allocation, should be applied.
  • All the recommendations in Chapter 3 are agreed
    with and supported.

20
Comments on the FFC Recommendations.
  • Noting that Chapter 4 is more related to
    Municipal Revenue matters, the Health Department
    would like some of the recommendations to be
    applied to hospitals with regard to patient fees
    revenue collection and management.
  • It is proposed that a uniform revenue retention
    strategy be developed for the Health sector, as
    an incentive for collection of due patient fees.

21
In conclusion
  • The Department acknowledges the work done by the
    FFC and the equitable share formula for the
    allocations to provinces.
  • The recommendations related to the reform of the
    Local Government equitable share formula are also
    noted, with special reference to the data
    availability challenges. The Health Department
    shares the same challenges, however appreciates
    that some work with Treasury, is currently
    underway to determine a possible specific formula
    for the public health sector, to address the
    health demographics and work load per province
    and or hospital.
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