presentation to the select committee on finance and appropriations 1 st quarter spending on...

Presentation to the Select Committee on Finance and

Appropriations

1st quarter spending on Conditional Grants18 September 2009

Summary of Conditional Grants

GRANT NAME

2009/10 Budget

R'000

Comprehensive HIV and Aids Grant 880 659

Forensic Pathology Services 134 538

Health Professional Training and Development 222 425

Hospital Revitalisation 449 558

National Tertiary Services 983 948

Infrastructure grant to provinces 359 717

Total 3 030 845

2009/10 Conditional Grant Transfers &1stquarter Expenditure

• HPTD and HRG spending low at the end of Q1, but have since picked up by the end of August 2009;

• FPS Grant over-hitting the target due to infrastructure funds redirected by NDoH

GRANT NAME R'000

2009/10 Budget

Transfers received

Q1Actual Expenditure

% spent

Comprehensive HIV and Aids Grant 880 659 384 550 184 268 20.9%

Forensic Pathology Services 134 538 67 270 46 113 34.3%

Health Professional Training and Development 222 425 92 675 19 180 8.6%

Hospital Revitalisation 449 558 206 113 46 254 10.3%

National Tertiary Services 983 948 409 980 270 378 27.5%

Infrastructure grant to provinces 359 717 180 000 94 823 26.4%

Total 3 030 845 1 340 588 661 016 21.8%

Comprehensive HIV and AIDS Grant

2009/10 Actual % Projections

R'000 Budget 1st Quarter Spent Q2 - Q4 Outcome Under/ (Over)

HIV & AIDS CONDITIONAL GRANT 880 659 184 268 20.9% 696 391 880 659 -

Compensation of employees 232 156 42 632 18.4% 189 524 232 156 -

Goods and services 648 458 141 636 21.8% 506 822 648 458 -

Households 45 - - 45 45 -

Comprehensive HIV and AIDS Grant Shortfall

• Indicators point to need for upscaling of ART in KZN, at estimated costs of R580m

R '000 Audited Outcome Main Budget Adjusted Budget

Estimated actual

Medium-term estimates

2005/06 2006/07 2007/08 2008/09 2009/10 2010/11

KZN HIV and AIDS Budget 528,093 703,970 1,058,570 1,190,243 1,337,696 1,265,019 1,462,886 1,696,990

Comprehensive HIV and AIDS Grant 251,468 344,304 466,922 629,694 757,213 757,213 880,659 1,013,082

KZN TOP UP on HIV/AIDS 276,625 359,666 591,648 560,549 580,483 507,806 582,227 683,908

Comprehensive HIV and AIDS Grant Q1 service delivery

Performance Indicators 2008/09 2009/10 Actual Targets Q1 ActualNumber of hospitals accredited as ART service points 60 62 61

Number of fixed PHC facilities accredited as ART service points 26 39 33

Percent of accredited ART service points with nutritional services 100% 100% 100%

Number ART assessment first visit 133 603 158 000 35 500

Number of HIV patients medically eligible for ART on waiting list 7 297 2 000 600

Number of registered ART patients - ART start 70 278 95 772 23 943

Number of registered ART patients total 225 863 315 772 243 943

Number of CD4 tests done 742 778 1 010 820 225 820

Proportion of CD4 turn-around > 6 days 0% 0% 0%

Number of HIV viral load done 343 979 418 528 95 632

No. of fixed PHC facilities drawing blood for CD4 testing 602 602

Percent of fixed PHC facilities drawing blood for CD4 testing 100% 100% 100%

Any ARV drug stock out at ART service points 0% 0% 0%

Number of STI treated new episode among ART patients 24 287 7 100 2 000

Number of in-patient days of patients on ART 234 630

HAST programmes 09/10PROGRAMMES CONDITIONAL GRANT

R'000EQUITABLE SHARE R'000

TOTAL BUDGET

Anti-Retroviral Therapy (ART)

880 659 59 153 939 812

Home-based Care (HBC) - 95 149 95 149

High Transmission Area (HTA)

- 10 484 10 484

Post-Exposure Prophylaxis (NOPEP)

- 18 911 18 911

(PMTCT) - 112 848 112 848

Programme Management (PM)

- 40 587 40 587

Step Down Care (SDC) - 75 990 75 990

Voluntary Counselling & Testing (VCT)

- 162 047 162 047

Post-Exposure Prophylaxis Occupational (OPEP)

- 4 292 4 292

Sexually Transmitted Infections (STI)

- 2 140 2 140

Tuberculosis (TB) - 626 626

TOTAL 880 659 582 227 1 462 886

Forensic Pathology Services 2009/10 Actual % Projections

R'000 Budget 1st Quarter Spent Q2 - Q4 Outcome Under/(Over)

FORENSIC PATHOLOGY SERVICES 134 538 46 113 34.3% 88 425 134 538 -



Provinces and municipalities 77 40 51.9% 37 77 -

Households 16 9 56.3% 7 16 -

Buildings and other fixed structures 30 000 22 767 75.9% 7 233 30 000 -

Machinery and equipment 14 962 2 528 16.9% 12 434 14 962 -

Forensic Pathology Services Q1 service delivery

Performance indicator Annual Target Actual Q1 Reason for deviation

No of posts filled against establishment 14 7Awaiting approval for creation and filling of posts

No of SAIOH courses completed 0 0Moratorium on training & budget constraints

No of Quarterly district meetings held 8 2

Number of data capturers appointed 0 0Approval to yet obtained from MANCO

No of Facility Level Posts filled 540 540Awaiting approval for finalisation of the FPS structure

No of mortuary facilities supplied with appropriate goods & services 40 40

No of upgraded functional Mortuaries 12 6Budgetary constraints, some projects were placed on hold

No of Radio Campaigns conducted 0 0

Budgetary constraints & present infrastructure cannot cope with demand

Forensic Pathology Services detailed infrastructure spending

FORENSIC PATHOLOGY GRANT BUDGET R'000 Q1 Actual R'000

2009/10 Appropriation 134 538 46 113

of which: Buildings and Fixed structures 30 000 22 767

Coroner new facilities 20 367

Coroner new facilities Provincial Infrastructure 2 400

Forensic Pathology Services projected shortfall

ACTUAL PROJECTED

Financial Year 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12

Budget( R'000) 52655 128269 40000 30000 28117 28117

Expenditure(R'000) 19046 24797 52503 142250 116536 48511

Surplus/ Deficit 33 609 103 472 (12 503) (112 250) (88 419) (20 394)

Forensic Pathology Services detailed infrastructure (1)

MortuarySize (M1-

M6)

Renovation or new build

% CompleteNotes

Estcourt M1 New 60% Good progress. Superstructure complete. Roofing complete. Installation of fittings and finishes in progress.

Dundee M2 New 21% Piled foundations complete. Subsoil services complete. Superstructure in advanced stage of completion.

Greytown M1 New 30% Behind schedule. Contractor placed on terms. Catch-up plan being implemented. Contractor confident that they will complete within contract period.

Gale Street M6 Upgrade 82% In progress. Behind schedule. Contractor placed on terms.

Richards Bay M4 Upgrade 99% Pre-Final delivery 10 July 2009. Minor snags.

Newcastle M3 Upgrade 0% Site handed over 8 June 2009.

Madadeni M1 New 27% Good progress. Superstructure complete. Roof 80% complete.

Port Shepstone M3 Upgrade 0% Site handed over 8 July.

Eshowe M3 New 35% Slightly behind schedule. Catch-up plan being implemented. Unexpected soil conditions encountered. Superstructure 50% complete.


MortuarySize (M1-M6)


% Complete

Notes

Nkandla M2 New 0% Project placed on hold due to lack of funding.

Vryheid M2 New 0% Project placed on hold due to lack of funding.

Ulundi M2 New 0% Project placed on hold due to lack of funding.

Nongoma M2 New 0% Project placed on hold due to lack of funding.

Paulpietersburg M1 New 0% Project placed on hold due to lack of funding.

Mosvold Hospital M1 New admin block

0% Project placed on hold due to lack of funding.

Mseleni Hospital M1 New admin block


Manguzi Hospital M1 New admin block


Forensic Pathology Services detailed infrastructure (3)Mortuary

Size (M1-M6)


% Complete

Notes

Ladysmith M3 New 0% Project placed on hold due to lack of funding.

Bergville M1 New 0% Project placed on hold due to lack of funding.

Nquthu M2 New 0% Project placed on hold due to lack of funding.

Msinga / Tugela Ferry M2 New 0% Project placed on hold due to lack of funding.

Dannhouser M1 New 0% Project placed on hold due to lack of funding.

Ixopo M1 New 0% Project placed on hold due to lack of funding.

Bulwer M1 New 0% Project placed on hold due to lack of funding.

Stanger M3 Upgrade Offices 0% Project placed on hold due to lack of funding.

Phoenix M6 New 0% Tenders have closed. Adjudication complete, recommend award being processed. Project cancelled due to lack of funding.

Pongola M1 New 5% Foundation trenches complete. Behind schedule. Project being recommended for cancellation due to poor performance by contractor. Project will not go out to re-tender due to lack of funding.

Umzimkulu M1 Upgrade 0% Project placed on hold due to lack of funding.


Holding Facility CapacityRenovation or

new build

% Comple

tion

Notes

Maphumulo 48 New 0% Project placed on hold due to lack of funding.

Howick 18 New 0% Project placed on hold due to lack of funding.

Mooi River 6 New 0% Project placed on hold due to lack of funding.

Richmond 6 New 0% Project placed on hold due to lack of funding.

Camperdown 12 New 0% Project placed on hold due to lack of funding.

Utrecht 12 New 0% Project placed on hold due to lack of funding.

Health Professionals Training & Development spending



HEALTH PROFESSIONAL TRAINING GRANT 222 425 15 913 7.2% 203 245 219 158 -

Compensation of employees 119 691 - 0.0% 116 424 116 424 -


Machinery and equipment 2000 - - 2000 2000 -

Health Professionals Training and Development Q1 Service delivery

Performance indicator Annual Target Actual Q1

No & composition of health sciences students (undergrad) 6 900 6 999

No & composition of health sciences students (postgrad) 945

Expanded specialist & teaching infrastructure 1 Resource Centre Work in progress

Health Professionals Training & Development Registrar by discipline

Disciplines Number

Anaesthetics 79

Paediatrics 111

ENT 7

Internal medicine 75

Ophthalmology 15

General Surgery 87

Orthopaedics 43

Obstetrics & Gynae 48

Disciplines Number

Neurology 11

Cardiothoractic Surg. 6

Dermatology 15

Psychiatry 23

Radiology 29

Urology 23

TOTAL 572

Health Professionals Training and Development Q1 Student numbers

Qualification Level Student total at 1 June 09

Doctors by thesis 56

Doctors predoctoral 9

Honours 25

Masters by coursework 803

Masters by thesis 48

Occasional 5

Postgraduate diplomas 164

Undergraduate professional 1074

TOTAL 2184

Health Professionals Training and Development nurses enrolled Total of 5199

Health Professionals Training and Development nurses enrolled (2)

Hospital Revitalisation Grant 2009/10 Actual % Projections


REVITALISATION GRANT 449 558 46 254 10.3% 403 304 449 558 -

Compensation of employees 4 091 835 20.4% 3 256 4 091 -




Hospital Revitalisation detailed infrastructure

HOSPITAL REVITALISATION GRANT BUDGET R'000 Q1 Actual R'000

2009/10 Appropriation 449 558 71663


Dist Hosp Upgrade H/Revital 32 694

Dist Hosp Rehabilitation H/Revital (110)

Dist Hos New Facilities H/Revital 8 311

G/Hosp New Facilitiies H/Revital 172

Tb Hosp New Facilities H/Revital 2599

Psych Hos New Facilities H/Revital 73

Other/S: H/Revit Proj Manag 1300

Other/S: H/Revit Organi Dev 1216

Hospital Revitalisation Q1 spending by institution

Institution

Infrastructure Health Technology Grant Mngmt Quality Improvement Organisational Dev Year Total

Budget Q1 Budget Q1 Budget Q1 Budget Q1 Budget Q1 BudgetExpenses

Q1% spent

King George V 122 925 25 295 55 800 6 604 - - 500 - 6 670 34 185 895 31 933 0.2

Empangeni 69 660 3 137 5 600 4 833 - - 1 000 - 18 393 457 94 653 8 427 0.1

Pixley Ka Seme 45 625 - - - - - - - - - 45 625 - -

Hlabisa 48 660 1 188 500 118 - - 500 - 4 302 208 53 962 1 515 0.0

Rietvlei 40 146 2 033 1 500 554 - - 500 - 4 302 222 46 448 2 809 0.1

Madadeni 6 500 - - - - - - - - - 6 500 - -

Edendale 8 000 272 - - - - - - - - 8 000 272 0.0

J Dube 2 425 - - - - - - - - - 2 425 - -

Total343 941 31 925 63 400 12 109 6 050 1 321 2 500 - 33 667 921 449 558 46 277 0.4

National Tertiary Services 2009/10 Actual % Projections


NATIONAL TERTIARY SERVICES GRANT 983 948 270 378 27.5% 713 570 983 948 -



Provinces and municipalities 5 6 120.0% (1) 5 -

Universities and technikons - 28 - (28) - -

Households 383 71 18.5% 312 383 -


National Tertiary Services Q1 spending

Main Actual % Projection

Institution name budget 1st quarterspent to

date Q2 - Q4 Year-endOver/under

Inkosi Albert Luthuli central Hsp 416 999 108 750 26.1% 308 249 416 999 -

Grey's Hospital 334 300 79 368 23.7% 254 932 334 300 -

Ngwelezane Hospital 41 350 10 766 26.0% 30 584 41 350 -

Lower Umfolozi War Memorial 41 350 5 856 14.2% 35 494 41 350 -

HOCF Prov Hsp Devt / MTS (Oncology equip) 149 949 65 550 43.7% 84 399 149 949 -

Total 983 948 270 290 27.5% 713 658 983 948 -

Infrastructure Grant to Provinces



PROVINCIAL INFRASTRUCTURE GRANT 359717 94823 26.4% 264894 359717 -

Goods and services 212 203 7 0.0% 212 196 212 203 -


Infrastructure Grant to Provinces detailed infrastructure

INFRASTRUCTURE GRANT TO PROVINCES BUDGET R'000 Q1 Actual R'000

2009/10 Appropriation 359 717 94 823


Clinics Replace Prov Infr 16079

Clinics:Upgrade Prov Infr 4454

Clinics: Maintenance Prov Infr 11961

Chc New Facilities Prov Infrstr 11924

Chc Rehabilitation Prov Infrstr 152

Dist Hosp Replace Prov Infr 26858

Dist Hosp Upgrade Prov Infr 650

Dist Hosp Rehab Prov Infr 6289

Dist Hosp Maintenance Prov Infr 7367

G/Hosp Rehab Prov Infr 273

G/Hosp Replace Prov Infr 3329

G/Hosp Upgrade Prov Infr 501

Total Provincial Hosp Serv 3142

Othr/S Rehab Prov Infr (Cg) 1346

Othr/S N/Fac Prov Infr (Cg) 396

Total Other Serv 96

Summary Expenditure Trends Q1(1)

• Department spent R661 million of allocated Conditional Grant budget of R3.03 billion budget, or 21% of budget;

• Spending on Hospital Revitalisation and Health Professionals Training and Development Grants recorded low expenditure of 10.3% and 8.6%;

• Low expenditure on Revitalisation grant due to technical problems with tenders at both Hlabisa and Lower Mfolozi hospitals. This has been resolved;

• HPTD in line with projections for 1st quarter, in line with historic slow spending trend;

Summary Expenditure Trends (2)

• Spending on HIV and AIDS at 20.9% also slightly below target due to a slow start at the beginning of the year;

• Department’s conditional grant expenditure is on target for Q1 in respect of Infrastructure Grant to Provinces, Forensic Pathology and National Tertiary Services Grants;

• Department projects to fully spend grants by year-end

Summary Expenditure as at end August 2009

GRANT NAME R'000

Total Available Actual

Expenditure

Percentage should be spent)

42%)

Comprehensive HIV and Aids Grant 880 659 369 488 42%

Forensic Pathology Services 134 538 68 198 51%

Health Professional Training and Development 222 425 93 058 42%

Hospital Revitalisation 449 558 71 663 16%

National Tertiary Services 983 948 509 865 52%

Infrastructure grant to provinces 359 717 138 653 39%

Total 3 030 845 1 250 925 41%

presentation to the select committee on finance and appropriations 1 st quarter spending on...

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