provincial budgets and expenditure 07/08 as at 31 december 2007

1

Provincial Budgets and Expenditure 07/08 as at 31 December 2007

SCOF (NCOP) Hearings-Health

National Treasury

February 2008

2

Health: summary

• Dec 07 – 9 months of financial year; benchmark 75% spending• Spending at R45.3bn or 74.4% against R60.8bn adjusted budget

– Seven provinces projecting to overspend by R1.8bn (KZN, GP, LP, EC, WC, NC, FS) while MP and NW projecting to underspend by R282.4m

– Q2 Sept showed R1.4b over-spend proj before – Increase of R6.6bn or 17.0% compared to the previous year – Low rate of health spending in NW (66.8%) and MP (68.0%) – KZN (79.7%) and LP (78.2%) reflects the highest rate of spending

in health• Health personnel spending at R25.2bn or 76.1% (R33.1bn adjusted

budget)– Six provinces projecting to overspend by R1.1bn (KZN, EC, LP,

GP, WC, FS)– Three provinces projecting to underspend by R64.1m

• NPNC spending at R16.4bn or 75.8% of R21.6bn adjusted budget

3

Adjustment budget

2007/08

Main appro-priation

Total Adjust-mentsAdjusted appro-

priation

EC 8,142,743 (74,046) 8,068,697FS 3,643,438 100,962 3,744,400GT 12,052,282 393,348 12,445,630KZN 13,412,815 512,613 13,925,428LIM 6,096,010 (109,404) 5,986,606MPU 3,594,674 122,962 3,717,636NC 1,459,941 120,052 1,579,993NW 3,754,518 162,110 3,916,628WC 7,095,173 332,132 7,427,305TOTAL 59,251,594 1,560,729 60,812,323

4

Health

Table : Provincial Health Expenditure as at 31 December 2007

Eastern Cape 8 068 697 8 234 187 5 914 378 73.3% -165 490 – -2.1% 27.1% 34.4% 5 070 075 16.7%

Free State 3 744 400 3 822 851 2 818 720 75.3% -78 451 – -2.1% 28.7% 38.0% 2 498 786 12.8%

Gauteng 12 445 630 12 763 930 8 993 231 72.3% -318 300 – -2.6% 31.6% 43.8% 8 135 710 10.5%

Kw aZulu-Natal 13 925 428 14 572 383 11 097 261 79.7% -646 955 – -4.6% 33.3% 42.6% 8 574 768 29.4%

Limpopo 5 986 606 6 276 360 4 682 632 78.2% -289 754 – -4.8% 25.7% 33.8% 4 029 675 16.2%

Mpumalanga 3 717 636 3 685 190 2 529 325 68.0% – 32 446 0.9% 22.0% 29.4% 2 161 865 17.0%

Northern Cape 1 579 993 1 703 204 1 184 353 75.0% -123 211 – -7.8% 27.8% 37.8% 1 021 753 15.9%

North West 3 916 628 3 666 628 2 616 450 66.8% – 250 000 6.4% 23.7% 34.1% 2 463 051 6.2%

Western Cape 7 427 305 7 561 837 5 433 293 73.2% -134 532 – -1.8% 35.1% 46.1% 4 730 212 14.9%

Total 60 812 323 62 286 570 45 269 643 74.4% -1 756 693 282 446 -2.4% 29.4% 39.0% 38 685 895 17.0%

% share of Health to

total provincial

expenditure

% share of Health to

total Social serv

expenditure

2006/07: Pre-audited

outcome as at 31

December 2006

Year-on-year

growth

Actual payments

as % of adjusted budget

(Over) Under

% (Over) / under of adjusted budget

R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

5

Health Personnel

Table : Provincial Personnel Expenditure: Health as at 31 December 2007

Eastern Cape 4 171 711 4 521 002 3 300 143 79.1% -349 291 – -8.4% 23.8% 55.8% 2 873 188 14.9%

Free State 2 251 816 2 264 171 1 706 420 75.8% -12 355 – -0.5% 28.6% 60.5% 1 505 126 13.4%

Gauteng 6 213 280 6 312 581 4 580 963 73.7% -99 301 – -1.6% 33.0% 50.9% 3 994 376 14.7%

Kw aZulu-Natal 7 913 564 8 282 240 6 239 004 78.8% -368 676 – -4.7% 32.3% 56.2% 4 908 627 27.1%

Limpopo 3 709 544 3 918 931 2 973 366 80.2% -209 387 – -5.6% 24.9% 63.5% 2 365 586 25.7%

Mpumalanga 2 031 153 2 018 855 1 428 241 70.3% – 12 298 0.6% 20.7% 56.5% 1 162 682 22.8%

Northern Cape 794 513 787 735 583 211 73.4% – 6 778 0.9% 24.5% 49.2% 462 339 26.1%

North West 1 996 435 1 951 435 1 421 293 71.2% – 45 000 2.3% 22.7% 54.3% 1 417 471 0.3%

Western Cape 4 055 297 4 113 568 2 986 797 73.7% -58 271 – -1.4% 36.2% 55.0% 2 529 041 18.1%

Total 33 137 313 34 170 518 25 219 438 76.1% -1 097 281 64 076 -3.1% 28.4% 55.7% 21 218 436 18.9%

% share of Health

Personnel to total

personnel expenditure

% share of Health

personnel to total Health

expenditure


outcome as at 31

December 2006

Year-on-year

growth

Actual payments


(Over) Under


R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

6

Health Non-Personnel, Non-Capital

Table : Provincial Non-Personnel, Non-Capital Expenditure: Health as at 31 December 2007

Eastern Cape 3 058 458 2 858 818 1 985 186 64.9% – 199 640 6.5% 9.1% 33.6% 1 841 956 7.8%

Free State 1 200 114 1 228 267 908 600 75.7% -28 153 – -2.3% 9.3% 32.2% 843 629 7.7%

Gauteng 5 035 637 5 181 216 3 737 754 74.2% -145 579 – -2.9% 13.1% 41.6% 3 411 020 9.6%

Kw aZulu-Natal 4 623 001 4 951 415 3 973 065 85.9% -328 414 – -7.1% 11.9% 35.8% 3 007 878 32.1%

Limpopo 1 671 667 1 782 034 1 307 862 78.2% -110 367 – -6.6% 7.2% 27.9% 1 198 537 9.1%

Mpumalanga 1 297 235 1 303 228 956 835 73.8% -5 993 – -0.5% 8.3% 37.8% 815 804 17.3%

Northern Cape 475 052 627 059 461 420 97.1% -152 007 – -32.0% 10.8% 39.0% 372 734 23.8%

North West 1 408 240 1 332 667 924 112 65.6% – 75 573 5.4% 8.4% 35.3% 859 226 7.6%

Western Cape 2 859 165 2 935 426 2 129 256 74.5% -76 261 – -2.7% 13.8% 39.2% 1 911 345 11.4%

Total 21 628 569 22 200 130 16 384 090 75.8% -846 774 275 213 -2.6% 10.6% 36.2% 14 262 129 14.9%

% share of NPNC to

total provincial

expenditure

% share of NPNC to

total Health expenditure


outcome as at 31

December 2006

Year-on-year

growth

Actual payments


(Over) Under


R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

7

Capital Assets

Table : Provincial Capital Expenditure: Health as at 31 December 2007

Eastern Cape 838 528 854 367 629 049 75.0% -15 839 – -1.9% 38.1% 10.6% 354 931 77.2%

Free State 292 470 330 413 203 700 69.6% -37 943 – -13.0% 20.0% 7.2% 150 031 35.8%

Gauteng 1 196 713 1 270 133 674 514 56.4% -73 420 – -6.1% 41.2% 7.5% 730 314 -7.6%

Kw aZulu-Natal 1 388 863 1 338 728 885 192 63.7% – 50 135 3.6% 28.8% 8.0% 658 263 34.5%

Limpopo 605 395 575 395 401 404 66.3% – 30 000 5.0% 40.3% 8.6% 465 552 -13.8%

Mpumalanga 389 248 363 107 144 249 37.1% – 26 141 6.7% 17.1% 5.7% 183 379 -21.3%

Northern Cape 310 428 288 410 139 722 45.0% – 22 018 7.1% 34.8% 11.8% 186 680 -25.2%

North West 511 953 382 526 271 045 52.9% – 129 427 25.3% 30.6% 10.4% 186 354 45.4%

Western Cape 512 843 512 843 317 240 61.9% – – 0.0% 25.6% 5.8% 289 826 9.5%

Total 6 046 441 5 915 922 3 666 115 60.6% -127 202 257 721 2.2% 31.2% 8.1% 3 205 330 14.4%

R thousand

Adjusted budget

Actual payments


Under

Actual payments as

at 31 December

2007

% share of Health

Capital to total

Capital expenditure

Projected outcome (Over)

Year-on-year growth


outcome as at 31

December 2006

% share of Capital to

total Health expenditure


8

Capital Assets

• Health capital spending at R3.7bn or 60.6% – Increase of 14.4% compared to spending for the same

period last year

– Three provinces projecting to overspend by R127.2m while the remaining provinces projecting under expenditure of R257.7m

– Low rate of health capital spending in MP (37.1%) and NC (45.0%)

– EC (75.0%) and FS (69.6%) reflects the highest rate of capital spending in health

9

Health (3)Programme Analyses

• Prog 2: Provincial District Health Services– Spending at R18.7bn or 75.0% of R25.0bn adjusted budget– Lowest rate of spending in NW (64.9%) and GP (69.1%) and

highest in KZN (83.2%) and LP (78.0%)

• Prog 4: Provincial Hospital Services– Spending at R10.9bn or 75.0% of R14.5bn adjusted budget– Lowest rate of spending in MP (68.2%) and NW (68.5%) and

highest in LP (83.5%) and NC (79.6%)

• Prog 5: Central Hospital Services– Spending at R7.0bn or 77.7% of R9.0bn adjusted budget– Lowest rate of spending in NW (61.7%) and MP (73.7%) and

highest in KZN (84.8%) and FS (79.6%)

10

Health (4)District health services

Table : Provincial District Health Services Expenditure (Programme 2) as at 31 December 2007

Eastern Cape 3 627 219 3 621 654 2 707 232 74.6% – 5 565 0.2% 12.4% 45.8% 2 272 694 19.1%

Free State 1 380 495 1 377 879 1 002 401 72.6% – 2 616 0.2% 10.2% 35.6% 916 510 9.4%

Gauteng 3 208 385 3 208 385 2 215 743 69.1% – – 0.0% 7.8% 24.6% 1 796 277 23.4%

Kw aZulu-Natal 6 375 856 6 834 483 5 304 657 83.2% -458 627 – -7.2% 15.9% 47.8% 3 994 492 32.8%

Limpopo 3 178 007 3 344 007 2 477 745 78.0% -166 000 – -5.2% 13.6% 52.9% 2 026 440 22.3%

Mpumalanga 1 929 133 1 924 884 1 371 375 71.1% – 4 249 0.2% 11.9% 54.2% 1 121 946 22.2%

Northern Cape 720 448 708 111 515 989 71.6% – 12 337 1.7% 12.1% 43.6% 370 723 39.2%

North West 1 897 098 1 737 098 1 231 490 64.9% – 160 000 8.4% 11.2% 47.1% 1 307 911 -5.8%

Western Cape 2 671 734 2 743 457 1 920 759 71.9% -71 723 – -2.7% 12.4% 35.4% 1 415 932 35.7%

Total 24 988 375 25 499 958 18 747 391 75.0% -696 350 184 767 -2.0% 12.2% 41.4% 15 222 925 23.2%

% share of DHS to total provincial

expenditure

% share of DHS to total

Health expenditure


outcome as at 31

December 2006

Year-on-year

growth

Actual payments


(Over) Under


R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

11

Health (5)Hospital services

Table : Provincial Hospital Services Expenditure (Programme 4) as at 31 December 2007

Eastern Cape 2 773 393 2 773 393 1 919 258 69.2% – – 0.0% 8.8% 32.5% 1 649 596 16.3%

Free State 951 159 987 636 747 021 78.5% -36 477 – -3.8% 7.6% 26.5% 701 102 6.5%

Gauteng 3 146 071 3 220 674 2 348 275 74.6% -74 603 – -2.4% 8.3% 26.1% 2 141 767 9.6%

Kw aZulu-Natal 3 614 550 3 766 286 2 860 200 79.1% -151 736 – -4.2% 8.6% 25.8% 2 279 232 25.5%

Limpopo 798 070 856 824 666 724 83.5% -58 754 – -7.4% 3.7% 14.2% 536 463 24.3%

Mpumalanga 534 887 531 722 364 575 68.2% – 3 165 0.6% 3.2% 14.4% 265 806 37.2%

Northern Cape 376 952 399 864 300 163 79.6% -22 912 – -6.1% 7.1% 25.3% 251 685 19.3%

North West 1 024 337 994 337 702 104 68.5% – 30 000 2.9% 6.4% 26.8% 597 461 17.5%

Western Cape 1 273 956 1 302 589 964 009 75.7% -28 633 – -2.2% 6.2% 17.7% 1 038 826 -7.2%

Total 14 493 375 14 833 325 10 872 329 75.0% -373 115 33 165 -2.3% 7.1% 24.0% 9 461 938 14.9%

% share of PHS to total provincial

expenditure

% share of PHS to total

Health expenditure


outcome as at 31

December 2006

Year-on-year

growth

Actual payments


(Over) Under


R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

12

Health (6)Central hospital services

Table : Central Hospital Services Expenditure (Programme 5) as at 31 December 2007

Free State 677 324 708 061 539 161 79.6% -30 737 – -4.5% 5.5% 19.1% 440 429 22.4%

Gauteng 3 689 268 3 932 008 2 876 114 78.0% -242 740 – -6.6% 10.1% 32.0% 2 804 546 2.6%

Kw aZulu-Natal 1 285 717 1 371 313 1 090 236 84.8% -85 596 – -6.7% 3.3% 9.8% 888 158 22.8%

Limpopo 524 700 549 700 409 445 78.0% -25 000 – -4.8% 2.3% 8.7% 349 423 17.2%

Mpumalanga 445 213 443 354 328 137 73.7% – 1 859 0.4% 2.9% 13.0% 341 757 0.0%

North West 81 409 81 409 50 212 61.7% – – 0.0% 0.5% 1.9% 42 645 17.7%

Western Cape 2 321 806 2 352 455 1 719 627 74.1% -30 649 – -1.3% 11.1% 31.6% 1 625 098 5.8%

Total 9 025 437 9 438 300 7 012 932 77.7% -414 722 1 859 -4.6% 4.6% 15.5% 6 492 056 8.0%

% share of CHS to total provincial

expenditure

% share of CHS to total

Health expenditure


outcome as at 31

December 2006

Year-on-year

growth

Actual payments


(Over) Under


R thousand

Adjusted budget

Projected outcome

Actual payments as

at 31 December

2007

13

Health Grants (1)Comprehensive HIV and Aids Grant

• Objective (Schedule 5 Grant):– To enable the health sector to develop an effective

response to HIV and Aids– Support implementation of the National Operational

Plan for Comprehensive HIV and Aids Treatment and Care

• First Nine Months Expenditure:– Health spent R1.6bn or 77.6% of the R2.0bn adjusted

allocation – Highest spending: NC 89.8% and KZN 87.8%– Lowest spending: FS 66.1% and WC 67.5%

• Service Delivery Outcome:– Department / Sector to respond

14

HIV and AIDS grant (Dec07)

COMPREHENSIVE HIV AND AIDS

Province

R thousandEastern Cape 233,204 193,147 82.8%Free State 153,646 101,627 66.1%Gauteng 399,604 292,006 73.1%KwaZulu-Natal 466,922 410,060 87.8%Limpopo 200,578 146,024 72.8%Mpumalanga 121,190 101,535 83.8%Northern Cape 74,091 66,514 89.8%North West 156,429 109,802 70.2%Western Cape 200,559 135,305 67.5%Total 2,006,223 1,556,020 77.6%

Total available% Actual

payments of total available

Provincial actual

payments

15

Health Grants (4)Hospital Revitalisation Grant

• Objective (Schedule 5 Grant):– To provide funding to enable provinces to plan, manage,

modernise, rationalise and transform the infrastructure, health technology, monitoring and evaluation of hospitals in line with national policy objectives

First Nine Months Expenditure:– Health spent R1.3bn or 59.5% of the R2.2bn adjusted allocation – 66.8% of national allocation transferred– Highest spending: WC 85.7% and NW 74.0%– Lowest spending: MP 29.0% and KZN 42.5% – Forecasted under-expenditure of R90 million, MP R11.7 million, NC R78

million


16

Hospital Revitalisation

Province

R thousandEastern Cape 246,750 156,200 63.3% 246,750 - Free State 90,419 64,219 71.0% 90,419 - Gauteng 567,052 327,177 57.7% 567,052 - KwaZulu-Natal 360,194 153,114 42.5% 360,194 - Limpopo 148,172 107,538 72.6% 148,172 - Mpumalanga 107,843 31,302 29.0% 96,102 11,741 Northern Cape 251,448 133,344 53.0% 172,966 78,482 North West 209,166 154,791 74.0% 209,166 - Western Cape 195,715 167,777 85.7% 195,715 - Total 2,176,759 1,295,462 59.5% 2,086,536 90,223

Preliminary (over)/under

Total available% Actual

payments of total available

Preliminary outcome for

financial year

Provincial actual

payments

17

Health Grants (2)Forensic Pathology Services Grant

• Objective (Schedule 5 Grant):– To provide for the transitional activities required to transfer the

Medico-Legal Mortuaries from SAPS to Health– To initiate the development and provision of a comprehensive

Forensic Pathology Service to ensure impartial professional evidence for the criminal justice system concerning death due to unnatural causes

• First Nine Months Expenditure:– Health spent R370.8m or 45.9% of the R808.3m adjusted

allocation – Only 60.9% of national allocation transferred– Highest spending: FS 84.8% and NC 73.4%– Lowest spending: MP 29.1% and KZN 32.2%


18

Forensic pathology

Province

R thousandEastern Cape 119,704 60,987 50.9% 68,135 51,569 Free State 41,713 35,382 84.8% 41,713 - Gauteng 92,428 56,269 60.9% 92,428 - KwaZulu-Natal 247,285 79,648 32.2% 247,285 - Limpopo 42,743 25,013 58.5% 42,743 - Mpumalanga 70,964 20,621 29.1% 60,246 10,718 Northern Cape 36,519 26,808 73.4% 40,797 (4,278) North West 36,235 15,407 42.5% 36,235 - Western Cape 120,706 50,689 42.0% 120,706 - Total 808,297 370,824 45.9% 750,288 58,009


Provincial actual

payments

% Actual payments of

total available


financial yearTotal available

19

National Tertiary Services grant

NATIONAL TERTIARY SERVICES

Province

R thousandEastern Cape 428,912 243,318 56.7% 420,912 8,000 Free State 480,945 392,981 81.7% 480,945 - Gauteng 1,959,399 1,469,547 75.0% 1,959,399 - KwaZulu-Natal 789,578 659,712 83.6% 789,578 - Limpopo 79,649 47,449 59.6% 79,649 - Mpumalanga 54,995 27,866 50.7% 54,995 - Northern Cape 110,775 794 0.7% 110,775 - North West 81,409 51,566 63.3% 81,409 - Western Cape 1,335,544 1,001,655 75.0% 1,335,544 - Total 5,321,206 3,894,888 73.2% 5,313,206 8,000


Total availableProvincial

actual payments

% Actual payments of

total available


financial year

20

Health Grants (5)National Tertiary Services Grant

• Objective (Schedule 4 Grant):– To compensate provinces for the supra-provincial nature of

tertiary services provision and spill over effects– To provide strategic funding to enable provinces to plan.

modernise. rationalise and transform the tertiary hospital service delivery platform in line with national policy objectives including improving access and equity

• First Nine Months Expenditure:– Spending of this grants is subsumed in the spending of a range

of programmes and therefore no reporting is required– However, spent R3.9bn or 73.2% of the R5.3bn allocation – Transfers received amounted to 75.0% of national allocation– Highest spending: KZN 83.6% and FS 81.7%– Lowest spending: NC 0.7% and MP 50.7%


21

Health Grants (3)Health Professions Training and Development Grant

• Objective (Schedule 4 Grant):– Support provinces to fund costs associated with training of health

professionals– Development and recruitment of medical specialists in under-served

provinces– Support and strengthen undergraduate and post graduate teaching and

training processes in health facilities– Enable shifting of teaching activities from central hospital to regional and

district hospitals• First Nine Months Expenditure:

– Spending of this grants is subsumed in the spending of a range of programmes and therefore no reporting is required

– However, spent R1.2bn or 72.6% of the R1.6bn allocation – Transfers received amounted to 75.0% of national allocation– Highest spending: FS 96.6% and KZN 77.7%– Lowest spending: NC 3.5% and EC 59.1%


22

Conclusion

• Over-spending (KZN, NC,Lim) and under-spending provinces (NW, Mpum)

• R1.7 b over-exp projection end Dec

• Under-spending on Hospital Revit (NC, KZN) and forensic pathology (KZN, MP) grants

• NC: Problem journalising NTSG,HPTD

• Capital under-spending already projected in 5 provinces

provincial budgets and expenditure 07/08 as at 31 december 2007

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