PORTFOLIO COMMITTEE ON HEALTH
PROGRESS REPORT: QUARTER 2 & 3
ANNUAL PERFORMANCE PLAN
2014/15
NATIONAL DEPARTMENT OF
HEALTH
18 MARCH 2015
Purpose
Present Progress Report (Quarter Two & Three 2014/15 &
April to December 2014) on the Annual Performance Plan
2014/15. The report is presented by the following programmes:
1.
2.
3.
4.
5.
Programme 1 : Administration
Programme 2: Health Planning and Systems Enablement
Programme 3: HIV & AIDS, TB and MCWH
Programme 4: PHC Services
Programme 5: Hospitals, Tertiary Services and Workforce
Development
6. Programme 6: Health Regulation and Compliance
Management
Medium Term Strategic Framework
(MTSF) 2014-2019
The Department Annual Performance Plan is designed to deliver on
the MTSF commitments, namely:
Sub-outcome 1: Universal Health coverage progressively achieved through
implementation of National Health Insurance
Sub-outcome 2: Improved quality of health care
Sub-outcome 3. Implement the re-engineering of Primary Health Care
Sub-outcome 4: Reduced health care costs
Sub-outcome 5: Improved human resources for health
Sub-outcome 6: Improved health management and leadership
Sub-outcome 7: Improved health facility planning and infrastructure delivery
Sub-outcome 8: HIV & AIDS and Tuberculosis prevented and successfully managed
Sub-outcome 9: Maternal, infant and child mortality reduced
Sub-outcome 10 : Efficient Health Management Information System developed and
implemented for improved decision making
Progress Rating
1. Green = target has been achieved, exceeded, almost been achieved or is likely to
be achieved by the stipulated times .
2. Amber =Target could possibly be achieved by the stipulated time or substantial
progress has been made towards meeting the target.
3. Red= No substantial progress towards meeting the target
4. Blue= System for measuring the indicator not yet in place.
Source: Department of Performance Monitoring, 22 October 2014
Progress Report
PROGRAMME 1 : ADMINISTRATION
Programme 1: Administration
Strategic
Objective
Ensure effective
financial
management and
accountability by
improving audit
outcomes
Indicator
Audit opinion from
Auditor-General
Annual Target
Unqualified
Audit Opinion
Audit opinion from
3 Unqualified audit
Auditor-General for opinions
Provincial
Departments of
Health
Number of provinces 9
that submit reports
against defined set
of non-negotiable
items on a monthly
basis
Actual performance
Financial Improvement
Plan drafted
Provinces of Eastern Cape,
Free State, Gauteng
submitted Financial
Improvement Plans
9 provinces submitted
signed off reports
Overall
Progress
Programme 1: Administration
Strategic Objective
Develop and implement the
ICT Governance framework
by focusing on the business
continuity plan (BCP)
inclusive of a disaster
recovery plan (DRP)
Indicator
Develop and
Implement
Business
Continuity Plan
inclusive of a
disaster recovery
plan.
Provide support for effective Develop an
communication by
integrated
developing an integrated
communication
communication strategy and strategy and
implementation plan
implementation
plan
Annual Target
Actual performance
ICT continuity plan The ICT service
inclusive of a ICT
continuity plan
disaster recovery
approved.
plan (DRP) finalized
and approved.
Communication
Strategy finalized
and approved
Integrated
Communication
Strategy finalised and
approved.
Progress
Rating
Programme 1: Administration
Strategic Objective
Indicator
Target
Actual
performance
Ensure efficient and
responsive Human Resource
Services through the
implementation of efficient
recruitment processes and
responsive Human Resource
support programme
Average Turnaround
times for recruitment
processes.
Six monthly target:
Q3: 58% of
Average recruitment
vacant posts
process: turnaround time
were filled
will be 4 months
within 5 months
Provide support for effective
communication by developing
an integrated communication
strategy and implementation
plan
Develop and ImplementQ3 Target:
Various
Employee wellness
employee
Implementation of HIV &
programme that
AIDS and TB Management wellness and
comply with Public
health activities
Pillar
Service Regulations
were performed
(PSR) and Employee
Three EHW
Annual Target:
Health and Wellness
Pillars
All 4 EHW Pillars for
Strategic Framework.
improved employee well implemented up
to December
being and productivity
2014
implemented
Annual Target:
turnaround time will be 4
months
Overall
Progress
Programme 1: Administration
Strategic Objective
Indicator
Annual Target
Facilitate and coordinate
Planning guidelines for 9 Provincial
evidence based planning for all Provincial Annual
APPs
levels of the health care
Performance Plan
developed
system, aligned to the health (APPs) developed and according to
sector’s 10
implemented
guidelines
point plan and negotiated
Total number of
9 Provincial
service delivery agreement.
Provincial APPs
APPs reviewed
reviewed and
and feedback
feedback provided
provided
Establishment of fora for
Number of fora for
1 National and 9
consultation of stakeholders consultation
Provincial fora
on identified legislation,
established
established
regulations and policy
processes
Actual performance
Draft framework
prepared
All Provincial APPs were
reviewed and feedback
was provided
Linked to NHI processes;
will be reported in
Quarter4
Progress
Rating
Addressing Challenges: Programme 1
Poor response in the submission plans to address AG findings
are addressed during Provincial Financial Bilateral Review visits
with provinces
Progress Report
PROGRAMME 2 : HEALTH PLANNING AND
SYSTEMS ENABLEMENT
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Achieve Universal
Health Coverage
through the phased
implementation of the
National Health
Insurance(NHI
implementation of
the National Health
Insurance (NHI).
Indicator
Legislation for
NHI.
Annual /Quarter Three
Target
Annual Target:
Draft NHI Bill gazetted
for public consultation
Actual performance
Progress
Rating
The drafting of the NHI Bill
can only be undertaken
once the White Paper on NHI
is approved by Cabinet.
Draft White paper has been
prepared
Piloting of NHI in Annual Target :10 NHI pilot districts across the country:selected districts
Q3 Target:
M&E meetings held in 7 of
across the
Monitoring and
the 10 districts
country.
evaluation performance
meetings and site visits
for quarter 3 conducted
for all 10 NHI pilot sites
Q3 Target:
Consolidated quarter 3
performance report for
2014/15 prepared
Consolidated quarter 3
report prepared and
submitted in January 2015
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Achieve Universal Health Establishment of
Coverage through the
the National Health
phased implementation of Insurance Fund
the National Health
Insurance(NHI
implementation of
the National Health
Insurance (NHI).
Annual
Actual
performance
Phase 1 of the implementation The Draft
of NHI initiated through:
Conceptual Paper
Creation of a Project
on creation of
Management team established the NHI Fund has
and various activities for the
been prepared
"shadow process" of the NHI
Fund initiated
Funding Modality for the
National Health Insurance Fund
including budget reallocation
for the district primary health
care (PHC) personal health
services developed
Progress
Rating
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Revise and legislate
methodology for the
determination of the
Regulate health care in the
dispensing fee.
private sector by
establishing National
Pricing Commission and
legislating methodologies
for calculating fees.
Annual/Quarter
Three Target
Q3 target:
Data analysis on the
data from dispensing
practitioners across
the country
Annual Target:
Systematic survey for
the dispensing fee
completed for 2015/16
cycle
Actual performance
Recommendations on
Final Dispensing Fee
for Pharmacist
submitted for approval
Progress
Rating
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic
Objective
Indicator
Target
Actual performance
Implement a
Revise and
Annual Target:
Q2:Dispensing fee for
transparent pricing legislate
Systematic survey for the
persons licensed in terms of
system for
methodology for dispensing fee completed for Section 22C1a was published
medicines
the determination 2014/15 cycle
in September 2014 for a three
of the logistics
months comment
fee.
Q3: Legislation on data fees
has presided over logistics
fees in the implementation
order
Publish revised
Q2:Publication of the draft
Q2: On 08 July 2014,
SEP adjustment 2015/2016 Annual SEP
comments on the SEP
methodology
Adjustment gazette, calling Adjustment were invited from
for comments from
interested stakeholders .
stakeholders
Industry requested more time
Q3 : Review and analysis of to consider technical aspects
comments and data
that will influence their
calculated fir the final
comments
2015/2016 Annual Adjustment
Price
Annual Target:
Implementation of the
gazette 2014/15 Annual Price
Adjustment.
Progress
Rating
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Improve Management
and control of
pharmaceutical
services
Indicator
Target
Actual
performance
Percentage of the PHC Q2:Review 60% of PHC
Q2: 80%
Essential Medicines List EML/STG
(EML) and Standard
Q3 : Review 90% of PHC Q3: 93%
treatment Guidelines
EML/STG
(STGs) reviewed
Annual Target:
Review 100% Primary
Healthcare EML/STG &
publish 2014 edition
Percentage of the
Hospital Level
Paediatric Essential
Medicines List (EML)
and Standard treatment
Guidelines (STGs)
reviewed
Q2: 11%
Q2: Review 10% of
Hospital Level Paediatric
EML/STG
Q3: 11%
Q3: Review 15% of
Hospital Level Paediatric
EML/STG
Annual Target:
Review 20% Hospital
Level Paediatric EML/STG
Percentage of the
Q2: Review 35% of
Hospital Level Adult
Hospital Level Adult
Essential Medicines List EML/STG
(EML) and Standard
Q3: Review 45% of
treatment Guidelines
Hospital Level Adult
(STGs) reviewed
EML/STG
Annual Target:
Review 50% of Hospital
Level Adult EML/STG
Q2: 27%
Q3: 26%
Overall
Progress
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Target
Actual performance
Improve Management
and control of
pharmaceutical
services
Number of
medicines review
reports approved
by the NELMC for
inclusion in the
tertiary EML
Q2: Complete 3 medicine
Q2: 7
reviews
Q3: 7
Q3: Complete 3 medicine
reviews
Annual : Complete 12
medicine reviews for Tertiary
Level & update list
Central chronic
medicine dispensing
and distribution.
Number of
Districts
implementing
centralised
chronic medicine
dispensing &
distribution
Develop and
implement a
revenue retention
model
Q2: 40% of facilities in 10 NHI Q2: 57% of facilities
districts
Q3:60% of facilities in 10 NHI Q3: 61% of facilities in
districts
all pilot NHI districts
Strengthen revenue
collection by
incentivizing central
hospital to increase
their revenue
collection
Annual Target:
Implemented in all 10 NHI pilot
districts
Q2: Comparative analysis of
Q2:A Comparative
the two retention models
analysis presented to
Q3: Present the findings to the the CFOF
CFOF and NT/PT
Q3: Draft revenue
Annual Target:
retention model
Draft hybrid revenue retention document distributed
model developed
for comments of CFOs
Overall
Progress
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Annual Target
Business
architecture for a
National Integrated
Patient Based
Information System
developed.
Concept paper for
the establishment of
Establish a National Health Functional Health
the National Health
Research Observatory.
Research Observatory
Observatory
approved
Develop a complete
Develop Business and
System design for a
Enterprise architecture for National Integrated
eHealth.
Patient based
information system
Actual performance
Progress made with the
reference
implementation of
architecture in the 700
facilities project
Draft concept paper on
NHRO developed by the
National Health
Research Committee
Progress
Rating
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Develop and implement an Develop and
integrated monitoring and
implement
evaluation plan aligned
Integrated
to health outcomes and
monitoring and
outputs contained in the
evaluation plan.
Health Sector Strategy
Establish a coordinated
Develop and
disease surveillance system implement a
for Notifiable Medical
strategy and plan
conditions (NMC).
for the integration
of disease
surveillance
systems for NMC.
Annual
Target
Actual performance
Monitoring and Draft M&E Plan.
evaluation plan
for health
developed.
Draft strategy To be reported at the end of Q4
for the
integration of
disease
surveillance
systems for
NMC developed.
Overall
Progres
s
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Monitor HIV prevalence
Indicator
Annual
National HIV
Antenatal
Prevalence
Survey.
Annual
Target
Actual performance
2013 National The 2013 National Antenatal Sentinel
Antenatal
HIV Survey dataset has been finalised
Sentinel HIV
and analyzed.
and Herpes
Simplex Type 2
prevalence in
South Africa
Overall
Progress
Programme 2: National Health Insurance,
Health Planning and Systems Enablement
Strategic Objective
Indicator
Annual
Target
Actual performance
Domestication of
international treaties and
Implementation of
multilateral cooperation on
areas of mutual and
measurable benefit
Implement
International
treaties and
multilateral
frameworks.
International
treaties and
multilateral
frameworks
implemented
Q2: Nine international activities
undertaken under International
Treaties and frameworks
implementation
Q3: Nil activities reported
Implementation of bilateral
cooperation on areas of
mutual and measurable
benefit.
Number of
Bilateral
projects
implemented.
Two strategic Q2: Six activities were pursued within
bilateral
the ambit of bilateral projects
projects
Q3: Six activities
implemented
Progres
s Rating
Addressing Challenges: Programme 2
•The drafting of the NHI Bill and consequential gazetting can only be undertaken once the
White Paper on NHI is approved by Cabinet. Discussions have been initiated with the
National Treasury regarding the finalization of the White Paper on NHI and its submission
to Cabinet.
•The establishment of fora are linked to the processes to be pronounced in terms of the
White Paper for NHI.
•The gazette introducing the finalised logistics fee legislations was withdrawn due to
contestation by the logistics providers.
•The review of SEP Adjustment formula were not introduced yet. This is ensure industry
stakeholders have more time to consider technical aspects that would inform their
submissions
•The completion of reviews of the Essential Medicines List has been affected by two vacant
positions of a Pharmaceutical Policy Specialist and Senior Pharmaceutical Policy
Specialist. In addition, nominations were received late for the appointment of members to
the Paediatric Expert Review Committee.
Progress Report
PROGRAMME 3 : HIV AND AIDS,
TUBERCULOSIS , MATERNAL, CHILD AND
WOMEN’S HEALTH
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Target
Actual
performance
To scale up combination Number of HIV test
of prevention
client 15-49 years
interventions
to reduce new infections
Number of Medical
Male circumcisions
performed
Q2: 2 500 000
Q3: 2 500 000
Annual: 10 million
Q2: 2,147.654
Q3: 1,999,932
6,039,722 (April-Dec)
Q2: 250 000
Q3: 250 000
Annual: 1 million
Q2: 206,066
Q3: 68,810
419, 519 (April-Dec)
Increase the numbers of Total clients
HIV positive people who remaining on ART
are managed so that they (TROA) at the end of
do not contract
the month
opportunistic infections TB/HIV co-infected
especially TB and who
client initiated on
receive antiretroviral
ART rate
therapy when needed.
Q2: 2 600 000
Q3: 2 800 000
Annual: 3 000 000
Q2: 2,872,162
Q3: 2,904.153
2,904, 153 (AprilDec)
Q2: 70%
Q3: 71.4%
Q2: 60%
Q3: 64%
Annual: 64%
Progress
Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Improve the effectiveness and
efficiency of the routine TB control
programme to increase the
identification of TB patients; to
ensure that these take and
complete their treatment
of Tuberculosis
To improve the functioning of the
MDR-TB control programme
including earlier initiation and
decentralised treatment
Indicator
Target
Actual
performanc
e
TB new client treatment
success rate
Annual, Q2 & Q3 : Q2:79.2
82%
Q3:80.9%
TB (new pulmonary)
treatment defaulter rate
Annual, Q2 & Q3:
6%
Number of trained TB
tracing coordinators
Q2: 5.8%
Q3: 6%
Q2: 6
Q3: 7
Annual: 25
TB Death Rate
Annual, Q2 & Q3:
6%
Number of professional
Q2:5
nurses trained to initiate
Q3: 7
MDR-TB treatment
Annual : 25
Number of hospitals
Q2: 10
assessed according to the Q3: 15
Treatment Criteria
Annual: 50
Q2: 0
Q3: 0
96 (Apr-Dec)
Q2: 5.5%
Q3: 6%
Q2:3
Q3 :372
TB MDR confirmed
treatment initiation rate
Q2: 67.5%
Q3: 67.0%
Q2: 58%
Q3:59%
Annual: 60%
TB MDR treatment success Q2: 46%
rate
Q3: 48%
Annual: 42%
Q2: 5
Q3: 0
(Apr-Dec)
Q2: 47.1
Q3: 41.0%
Progress
Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Ensure that all correctional services Percentage of correctional
facilities have appropriate services
services centres conducting
and that inmates all have access to TB routine TB screening
and HIV diagnosis and treatment
Number of Correctional
services and care
Services Management areas
with risk assessments
undertaken
Target
Q2: 35%
Q3: 45%
Annual: 50%
Q2: 5
Q3: 5
Annual:20
Actual
perform
ance
Q2: 56%
Q3: 100%
Q2: 0
Q3: 0
Progress
Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Target
st
Actual performance
Q2: 54.9%
Q3: 54.7%
53.3% 9 (Apr-Dec)
Q2: 74.9%
Q3: 76.0%
74.6% (Apr-Dec)
Q2: 141.2
Q3: 127.5
137.4 per 100 000
(April to Dec)
Q2: 10.7 per1000 Q2: 12.5
Q3: 14.1
Live Births
13.3 per 1000 live
Q3: 10.3
births (Apr-Dec)
Annual: 10 per
1000 Live Births
Annual , Q2 and Q2: 58.4%
Q3:55%
Q3 : 55%
Annual , Q2 and Q2: 61.1%
Q3: 50.7%
Q3: 60%
54.3% (Apr-Dec)
To reduce the maternal Antenatal 1 visit before 20
Q2: 60%
mortality ratio to under weeks rate
Q3: 63%
100 per 100 000 live
Annual:65%
births.
Mother postnatal visit within 6 Q2: 77%
days rate
Q3: 78%
Annual:80%
Maternal mortality in facility
Annual: 100 per
ratio (annualised)
100 000 live
births (annual)
To reduce the
Inpatient Neonatal death rate
neonatal mortality rate (annualized)
to under 6 per 1000
live births.
To improve access to Couple year protection rate
sexual and
reproductive health
Cervical cancer screening
services by expanding coverage
the availability of
contraceptives.
HPV 1st dose coverage
Annual: 70%
91.7%
Progress
Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
Expand the PMTCT
coverage to
pregnant women by
ensuring all HIV
positive Antenatal
clients are placed
on ARVs and
reducing the
positivity rate to
below 1%.
Indicator
Target
Antenatal client initiated Q2: 93%
on ART rate.
Q3: 93%
Annual: 93%
Infant 1st PCR test
Annual &Q3:
positive around 6 weeks 1.8%
rate.
Actual
performance
Q2: 90.2
Q3: 95.6%
89.9% (Apr- Dec)
Q2: 1.4%
Q3: 1.6%
1.5% (Apr – Dec)
Progress
Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic Objective
Indicator
Target
Actual performance
Child under 5 years diarrhoea Annual, Q2& Q3: Q2: 3.0
3.5% (1 775/45 880) Q3: 3.1%
To reduce under-five case fatality rate
3.3% (Jan-Dec)
mortality rate to less
Annual , Q2& Q3: Q2: 9.9%
than 23 per 1,000 live Child under 5 years severe
Q3: 11.6%
8%
births by promoting acute malnutrition case
11.2% (Jan-Dec)
fatality rate
early childhood
Confirmed measles case
Annual, Q2 & Q3: 0.9 per 1, 000, 000
development
incidence per million total
<5/1,000,000
population
Immunisation coverage under Annual, Q2 & Q3: Q2: 88.2%
Q3: 87.0%
1 year (annualised)
90%
87.1% (Jan-Dec)
To contribute to
Q2: 8.8%
health and wellbeing DTaP-IPV/Hib 3 - Measles 1st Annual , Q2& Q3:
Q3: 3.5%
dose drop-out rate
7%
of learners by
4.7% (Jan-Dec)
screening for health
barriers to learning
Measles 2nd dose coverage
Annual, Q2 & Q3: Q2: 88.2
Q3: 82.3%
(annualised)
82%
81.2% (Jan-Dec)
Progres
s Rating
Programme 3: HIV and AIDS, TB and
Maternal Child and Women’s Health
Strategic
Objective
To contribute to
health and
wellbeing of
learners by
screening for
health barriers to
learning
Indicator
Quarter Three
Target
Actual
performance
School Grade 1
screening coverage
(annualised)
Annual, Q2& Q3:
28%
Q2: 22.0%
Q3:12,0%
School Grade 8
screening coverage
(annualised)
Annual, Q2 & Q3:
12%
26.7% (April-Dec)
Q2: 11.5
Q3: 1.5%
9.4% (April-Dec)
Progress
Rating
Addressing Challenges: Programme 3
•Demand for male medical circumcision services seem to have declined. Data
from partners are being streamlined into DHIS.
•With regard to couple year protection rate, the Department has introduced
implants which has improved uptake substantively
•The process to rectify the data on HIV testing 15-49 years is underway. Data from
partners is being streamlined into NDoH DHIS
•Performance on some TB indicators were affected by delays in finalization of
Global Funidng contracts, Service Level Agreements and the subsequent late
disbursements of funds to sub sub-recipients. The sub-recipients are calso
implementing catch-up plans on training of TB tracing coordinators in the fourth
quarter.
•Low screening coverages among learners were as a result of the second round
of Human Papiloma Virus immunisation campaign conducted from 29 September
and 31 October 2014. All school nurses were assigned to administer HPV
immunisation.
Progress Report
PROGRAMME 4 : PRIMARY HEALTH CARE
SERVICES
Programme 4: Primary Health Care
Services
Strategic Objective
Improve district
governance and
strengthen management
and leadership of the
district health system.
Indicator
Annual Target
Clinic Committees
are part of the
Ideal Clinic
Monitoring and evaluation Manual, which is
system developed.
being finalized
Number of primary
health care facilities
with functional clinic
committees/ district
hospital boards.
Implementation plan
approved.
Number of districts with
uniform management
structures for primary
health care facilities.
Uniform management
structures for PHC
facilities approved and
resources secured.
Establish an intersectoral Establish National
forum that will plan and Health Commission.
oversee the
implementation of
interventions across all
sectors.
Actual
performance
Draft 8 of DHS
strategy
developed. The
manual is being
finalised following
the stakeholders
consultation
Final draft
Key government
departments, civil society Framework for
and other key stakeholders addressing Social
Determinants of
consulted on the
Health submitted
establishment of the
for approval
intersectoral forum.
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic Objective
Improve access to
community based
PHC services and
quality of services at
primary health care
facilities.
Indicator
Target
Actual performance
The draft report on the
work for ideal clinic
realisation has been
submitted to the D-G. Of
the 509 facilities which
have conducted self
assessments, 20 facilities
scored 80% and more.
Q2 :1300 functional Q2: 1409
WBPHCOTs
Q3:1400 functional Q3: 1343
WBPHCOTs
Number of primary
Annual:
health care clinics in the Roll out plan
52 districts that qualify approved and
as Ideal Clinics.
resourced.
Number of functional
WBPHCOTs
Annual: 1500
A submission prepared to
Ensure that the Port Number of Ports of Entry Annual:
Health services are that are compliant with 20 ports of entry designate ports of entry
rendered in line with the International Health compliant with the
the International
Regulations
International
Health Regulations
Health Regulations
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic
Objective
Indicator
Improve
Number of
environmental
municipalities that
health services in all meet environmental
52 districts and
health norms and
metropolitan
standards in executing
municipalities in the their environmental
country.
health functions.
Ensure compliance
with Health Waste
management
regulations.
Annual Target
Environmental
Health strategy
developed
Actual
performance
Draft Environmental
Health strategy
developed
Health Care waste
Final Health Care
management
management
regulations finalised regulations
incorporating comments
prepared
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic
Objective
Indicator
Annual Target
Actual performance
Eliminate Malaria by
2018, so that there
is zero local cases
of malaria in South
Africa
Reduce the local
0.3 malaria cases per Q2: 0.03 (355 confirmed
transmission of malaria 1000 population at risk. local cases)
cases to 0 per 1000
Q3: 0.16 (1567
population at risk
confirmed local cases)
Number of malaria
3 malaria endemic
To be reported at the
endemic districts
districts reporting
end of Q4
reporting malaria
malaria cases within 24
cases within 24 hours hours of diagnosis.
of diagnosis
Improve South
Africa’s response
with regard to
Influenza prevention
and control
Number of high risk
population covered by
the seasonal influenza
vaccination
750 000 high risk
818908 high risk
individuals covered
individuals vaccinated
with seasonal influenza
vaccination.
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic Objective
Reduce risk factors
and improve
management for
Non-Communicable
Diseases (NCDS) by
implementing the
Strategic Plan for
NCDs 2012-2017
Indicator
Target
% reduction in obesity Annual: 65% obese
in men and women
women
Annual:31% obese
men
Number of people
Q2 150, 000
counseled and
screened for high blood Q3: 400 000
pressure
Annual: 500 000
Number of people
Q2: 150 000
counseled and
screened for raised
Q3: 400 000
blood glucose levels
Annual: 500 000
Actual performance
Survey indicator
Survey indicator
Q2: 132 036
Q3: 140 146
Q2: 100 278
Q3 :108 476
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic
Objective
Improve access
to and quality
of mental
health services
in South Africa
Indicator
Percentage
people
screened for
mental
disorders
Annual Target
Actual performance
Information system and baseline Included as part of the
established
Comprehensive PHC
Register
25 % of 16.5% (prevalence)
people screened and tested for
mental disorders
Percentage of Information system and baseline
people treated established
for mental
disorders
25 % of 16.5% (prevalence)
people screened and tested for
mental disorders
Survey indicator
Included as part of the
Comprehensive PHC
Register
Survey indicator
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic
Objective
Indicator
Improve access to Number of Districts
disability and
implementing the
rehabilitation
framework and
services through model for
the
rehabilitation
implementation of services
the framework
Cataract Surgery
and model for
rehabilitation and Rate
disability services
Annual Target
Actual
performance
Model approved and Draft model
costed
developed
1 500 operations per To be reported at
million un-insured
the end of Q4
population
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic Objective
Ensure access to and
efficient effective
delivery of quality
Emergency Medical
Services (EMS).
Indicator
Annual Target
Actual performance
Number of provinces that are Draft EMS
compliant with the EMS
Regulations
regulations.
developed.
Regulations published
for public comment on
24 July 2014.
Review EMS Response Time
monitoring system.
Review of EMS response
times finalised in
September 2014
Review prehospital EMS
response times
indicators and
finalise
definitions.
Progress
Rating
Programme 4: Primary Health Care
Services
Strategic
Objective
To improve
Forensic
Chemistry
Laboratory
turnaround times
for blood,
alcoholic,
toxicology and
food samples.
Indicator
Annual Target
Actual performance
Median waiting time
for blood alcohol
results.
Baseline
established.
Q2:5.6 months average for newly
received samples in 3 FCLs
Q3: 6.7 months for all 3 FCLs
Turnaround times of
toxicology tests and
reports.
Baseline
established.
Q2:7.6 months average for newly
received samples at 3 FCLs
Q3: 10.2 months for all 3 FCLs
Turnaround times of
food products tests
and reports.
Baseline
established.
Turnaround times of
food products tests
and reports.
Baseline
established: 120
days for nonperishables
Q2: Perishable average for 2 FCLs
- 16 days
Q3: 10 days
Q2: Non-perishables for average for
2 FCLs - 193
Q3: 314 days
Progress
Rating
Addressing Challenges: Programme 4
•The development of an implementation plan for the Ideal Clinic Realisation
and Maintenance (ICRM) is part the Operational Phakisa. The provinces are
at different stages of establishing Permanent Teams for Ideal Clinics
Realization and Maintenance. Training of the teams has commenced in the
NHI pilot districts and this training will be extended to all 52 districts in the
country starting in the first quarter of 2015/16 financial year. Web based
monitoring software for ICRM is being rolled out to all clinics in the country
•The establishment of the national Health Commission is pending as it is
closely linked to the NHI processes.
•Campaign data on people counseled and screened for high blood pressure
and raised blood glucose levels will be collected and reported by provinces in
the fourth quarter this will improve current figures.
Progress Report
PROGRAMME 5 : HOSPITALS, TERTIARY
SERVICES AND WORKFORCE DEVELOPMENT
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic Objective
Indicator
Increase capacity of central
No. of central hospital
hospitals to strengthen local
with reformed
decision making and
management and
accountability to facilitate semi- governance structures as
autonomy of 10 central
per the prescripts.
hospitals.
Ensure equitable access to
tertiary service through
implementation of the National
Tertiary services plan.
Ensure quality health care by
improving compliance with
National Core Standards at all
Central, Tertiary, Regional and
Specialised.
Target
Annual : 0
Actual
performance
draft policy on
governance for
central
hospitals
submitted for
review by
Legal Services
Four (4) of the
Number of gazetted
Annual: 2 gazetted
17 gazetted
hospitals providing the full tertiary hospitals
hospitals
package of Tertiary1
providing the full
Services.
package of Tertiary providing full
package of
1 services.
tertiary 1
services
Six monthly =1
% compliance with
100% compliance
Inspection
extreme and vital
with extreme and
ongoing in Q4
measures of the National vital measures of the by OHSC
Core Standards all Central, National Core
Tertiary, Regional and
Standards in 5
Specialised Hospitals.
Central Hospitals.
Progress
Rating
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic
Objective
Indicator
Annual Target
Actual performance
Develop health
workforce
staffing norms
and standards
Develop guidelines
for HRH norms and
standards using the
WISN methodology
Guidelines for implementing
HRH norms and standards at
Primary Health Care
facilities developed
Ensure that the
number,
distribution,
quality and
standard of
health facilities
are in
compliance with
norms and
standards
Number of RTC's
established
Draft guidelines
for PHC- HR
norms and
standards
available
3 RTCs
established
4 RTCs established and
functional in Mpumalanga,
Limpopo, Gauteng and North
West
Progress
Rating
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic Objective
Indicator
Annual
Target
Actual
performance
Improve quality of
Nursing training and
practice by ensuring that
all Nursing colleges are
accredited to offer the
new Nursing
qualification
Number of
public nursing
colleges
accredited to
offer the new
nursing
qualification
5 public
nursing
colleges
accredited to
offer the new
nursing
qualification
0 public nursing
colleges
accredited as
consultation and
discussions on
accreditation still
ongoing
Progress
Rating
Programme 5: Hospitals, Tertiary
Services and Workforce Development
Strategic Objective
Improve quality of health
infrastructure in South
Africa by ensuring all new
health facilities are
compliant with health
facility norms and
standards.
Indicator
Percentage of facilities
that comply with
gazetted infrastructure
Norms & Standards.
Annual Target
100% from date
of gazetting.
Actual
performance
Five CHCs in
Mpumalanga and
three Hospitals
have been reviewed
during the clinical
briefing phase in
line with gazetted
norms and
standards
Progress
Rating
Addressing Challenges: Programme 5
•A joint submission to initiate engagement and support from Ministers of
Health and Higher Education regarding NDoH and Nursing Council role is
being discussed with DHET.
• The
OHSC has prioritized to conduct unannounced inspections in in
Central Hospitals namely Steve Biko, Charlotte MaXeke, Inkosi Albert
Luthuli, Universitas, Groote Schuur and Tygerburg Hospitals before the
end of fourth quarter of 2014/15 to assess compliance with the National
Core Standards
Progress Report
PROGRAMME 6 : HEALTH REGULATION AND
COMPLIANCE MANAGEMENT
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Regulate Complementary
and Alternative Medicines
(CAMS), Medical Devices,
Invitro Diagnostics and
African Traditional
Medicines in South Africa.
Indicator
Regulate Complementary
and Alternative Medicines
(CAMS), Medical Devices,
Invitro Diagnostics and
African Traditional
Medicines.
Annual Target
CAMS for
Oncology,
Cardiovascular
Diseases,
HIV/AIDS and
Diabetes
Regulated.
Actual
performance
MCC published
Guidelines on
Medical Devices &
IVDs.
CAMS Regulations:
published new
definition
MCC publish
guidelines on
Vitamins and
Minerals.
Ten CAMS
applications under
review
Progress
Rating
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Improve the efficiency
of the Regulator
through restructuring
by establishing South
African Health Product
Regulation Authority
(SAHPRA) as a public
entity.
Strengthen food safety
through expanding
testing capabilities for
adulterants
(colourants, protein,
and allergens
Indicator
Establish
SAHPRA as a
public entity.
Annual Target
Actual performance
Medicines and Bill going through
Related
parliamentary
Substances
processes. Public
Amendment Bill hearings of the
drafted
Portfolio Committee on
Health on proposed
Amendment Bill
completed
Develop and
Consultations Consultations ongoing
establish MOUs and two draft
to establish the extent
with food testing MOUs with
of the capacity and
institutions to
testing
capabilities to conduct
enable testing
institutions
testing of food
for adulterants in
samples.
food products
Progres
s Rating
Programme 6: Health regulations
and Compliance Management
Strategic
Objective
Indicator
Quarter
Three Target
Improve
Percentage of
67% of all
registration of
prioritised medicines
prioritised
response times for (antiretroviral,
medicines
antiretroviral,
oncology, TB medicines registered
oncology, TB
and vaccines)
within 22
medicines and
registered within 22
months (NCEs)
vaccines used to Months for New
and 15 months
treat high burden Chemical Entities
(multisource
diseases.
(NCEs), and 15 months medicines).
for multisource
medicines.
Actual performance
0% of all priorities registered as per
set target.
NCEs: Biological(1)=21 months,
TB(1)=17months, Family
Planning(1)=49 months
Other(10)=average 24 months (range
14-62)
Generics: ARV(7)=average 38 months
(range 18-56); Oncology(11)=average
39 months (range 23-58);
Others(123)=55 months (range 14 112)
Progress
Rating
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Improve oversight and
Corporate Governance
practices by reviewing
the Governance
Framework and
Implementation Plan
biennially.
Indicator
Six monthly /
Annual Target
Actual
performance
Develop and
Annual:
Draft Governance
Implement
Approved Governance Framework and
Governance
Framework and
Implementation Plan
Framework and
Implementation Plan.
Implementation Plan
for Public Entities and
Statutory Councils.
Functional governance Six monthly :Public
Governance and
structures
entities governance Compliance report
established.
and compliance
produced
report produced
Annual:
Fully constituted
Boards/ Councils for
health entities and
statutory councils of
the Department
Traditional Health
Practitioners Act
reviewed
(Annual)
Proposed
amendments to the
Traditional Health
Practitioners Act.
Progress
Rating
Programme 6: Health regulations
and Compliance Management
Strategic
Objective
Enhance governance
and management by
establishing all
committees at the
CCOD/MBOD.
Establish
occupational health
services within the
public health
system.
Indicator
Audit opinion from the
Auditor-General for
CCOD.
Number of provinces
with occupational
health services within
their facilities.
Annual Target
Actual
performance
Governance structures 2 Audit & Risk
enhanced to improve
Committee
audit outcome.
meetings; 1 Risk
Committee meeting
convened
687 workers/exEstablishment of one
workers seen at
occupational health
Carletonville site in
service in one health
Gauteng;
facility in each of
624 workers/exEastern Cape and
workers seen at the
Gauteng provinces.
Mthatha site in
Eastern Cape
Progress
Rating
Programme 6: Health regulations
and Compliance Management
Strategic Objective
Indicator
Provide for coordinated
Establish National Public
disease and injury
Health Institutes of South
surveillance and research Africa (NAPHISA).
by establishing National
Public Health Institute of
South Africa (NAPHISA).
Annual Target
Conceptual
framework and
Business case for
NAPHISA approved.
Actual
performance
Conceptual
framework and
business case
currently with
Task Team on
NHLS
Progress
Rating
Programme 6: Health regulations
and Compliance Management
Strategic Objective
To monitor the existence of and
progress on annual and regular plans
that addresses breaches of quality,
safety and compliance in all public
sector establishments addresses
breaches of quality, safety and
compliance in all public sector
establishments.
To improve the acceptability, quality and
safety of health services by increasing
user and community feedback and
involvement.
Indicator
Quarter
Three &
Annual
Target
Actual
performan
ce
Percentage of Health
Establishments that have
developed an annual
Quality Improvement Plan
based on OHSC
inspections
Q3: 44%
64% for
Annual : 45% provinces of
GP, NW &
WC
Patient satisfaction
surveys rate.
70% (Annual) Nil reported
Patient satisfaction rate
Determine
Baseline
(Annual)
National
survey tool
and
database
piloted
Progress
Rating
Addressing Challenges: Programme 6
Provincial communication regarding inconsistent report
submissions by provinces on health facilities’ Quality
Improvement Plans.
2014/15: QUARTER 2 FINANCIAL REPORT
NDOH’S POSITION AS AT
30 SEPTEMBER 2014
As at the end of September 2014, the total spent for the National Department of Health was R16.212 billion
out of a budget of R33.955 billion, which represents 47.75% of the total budget.
Analysis of expenditure
Compensation of Employees expenditure is R304.543 million and 50.99% of the budget of R597.203 million
was spend.
Goods and Services expenditure is R425.637 million and 30.04% of the budget of R1 416.874 million. The
main reasons for the underspending can be ascribed to:
•
•
•
•
Indirect grant for National Health Insurance
WHO membership fees of approximately R20 million will be processed during the third quarter.
No expenditure for the South African Demographic Survey which has an allocated budget of R30 million
is reflected yet.
The Human Papilloma Virus Vaccinations is planned to be administered in the second and the fourth
quarters of the financial year. The expenditure is currently R16.616 million or 8.31% of the budget of R
200 million.
NDOH’S POSITION AS AT
30 SEPTEMBER 2014
Transfer payments’ expenditure is R15.369 billion and represents 49.71% of the budget of
R30.916 billion.
Capital expenditure is R113.186 million which is 11.04% of the budget of R1 025.035
million. The underspending is mainly due to:
• Invoices not received for the capital infrastructure projects.
• Procurement of specialized laboratory equipment is a very timely process.
Summary of Expenditure per
Programme
Subprogramme
Original Budget
R'000
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
ADMINISTRATION
399 721
206 531
193 190
51.67%
NATIONAL HEALTH INSURANCE,
HEALTH PLANNING & SYSTEM
ENABLEMENT
621 252
113 042
508 210
18.20%
HIV & AIDS, TB, MATERNAL & CHILD
HEALTH
13 049 923
6 345 479
6 704 444
48.62%
PRIMARY HEALTH CARE SERVICES
93 515
44 999
48 516
48.12%
18 925 780
9 100 851
9 824 929
48.09%
865 284
401 332
463 952
46.38%
HOSPITALS, TERTIARY HEALTH
SERVICES & HUMAN RESOURCE
DEVELOPMENT
HEALTH REGULATION & COMPLIANCE
MANAGEMENT
TOTAL
33 955 475
16 212 234
17 743 241
47.75%
Summary of Expenditure per
Economic Classification
Economic Classification
Original Budget
R'000
Compensation of Employees
Actual Expenditure
as on 30
September 2014
Funds
Available
R'000
R'000
% Spent
597 203
304 543
292 660
50.99%
1 416 874
425 637
991 237
30.04%
30 916 363
15 368 651
15 547 712
49.71%
Capital
1 025 035
113 186
911 849
11.04%
Losses
-
217
(217)
TOTAL
33 955 475
16 212 234
17 743 241
Goods and Services
Transfers
47.75%
Programme 1: Administration
Per Subprogramme
Subprogramme
Original Budget
R'000
Actual Expenditure
as on 30
September 2014
Funds
Available
R'000
R'000
% Spent
MINISTRY
31 046
13 630
17 416
43.90%
MANAGEMENT
26 458
9 918
16 540
37.49%
CORPORATE SERVICES
184 647
88 708
95 939
48.04%
OFFICE ACCOMMODATION
105 825
67 415
38 410
63.70%
FINANCIAL MANAGEMENT
51 745
26 860
24 885
51.91%
399 721
206 531
193 190
51.67%
TOTAL
Programme 1: Administration
per Economic Classification
Economic Classification
Original Budget
R'000
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
Compensation of Employees
161 600
82 419
79 181
51.00%
Goods and Services
230 830
121 912
108 918
52.81%
Transfers
1 397
1 000
397
71.58%
Capital
5 894
1 068
4 826
18.12%
132
(132)
206 531
193 190
Losses
TOTAL
399 721
51.67%
Programme 1
Reasons for variances
• Invoices amounting to R 23.017 million for property payments (water, electricity
and rent) for the 2013/14 financial year were processed during 2014/15.
• The invoices received from the Auditor-General is much higher than estimated.
• Several long-serving officials retired recently, which increased the transfer
payments to households.
Programme 2: National Health Insurance,
Health Planning and System Enablement
Per Subprogramme
Subprogramme
Original Budget
R'000
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
OFFICE OF THE DDG
2 989
19
2 970
0.64%
TECHNICAL POLICY & PLANNING
HEALTH INFORMATION
MANAGEMENT, MONITORING &
EVALUATION
2 084
671
1 413
32.20%
53 725
12 767
40 958
23.76%
SECTOR-WIDE PROCUREMENT
HEALTH FINANCING & NATIONAL
HEALTH INSURANCE
INTERNATIONAL HEALTH &
DEVELOPMENT
22 987
14 235
8 752
61.93%
487 210
56 726
430 484
11.64%
52 257
28 624
23 633
54.78%
TOTAL
621 252
113 042
508 210
18.20%
Programme 2: National Health Insurance,
Health Planning and System Enablement
Per Economic Classification
Economic Classification
Original Budget
R'000
Compensation of Employees
Goods and Services
Transfers
Capital
Funds
Available
R'000
R'000
% Spent
67 193
43 304
23 889
64.45%
476 637
40 896
435 741
8.58%
75 000
28 086
46 914
37.45%
2 422
740
1 682
30.55%
16
(16)
Losses
TOTAL
Actual Expenditure
as on 30
September 2014
621 252
113 042
508 210
18.20%
Programme 2: National Health Insurance,
Health Planning and System Enablement
Reasons for variances
• The budget for compensation of employees is exceeded due to the appointment of a
Health Attaché in Cuba and accompanying administrative officials.
• This budget is further exceeding due to the upgrading of Assistant Directors and Deputy
Directors.
• It was anticipated that 600 General Practitioners would participate in the National Health
Insurance Project, but only 130 could be contracted. This results in very slow spending
on the indirect National Health Insurance grant.
• WHO membership fees will be processed during third quarter of the financial year.
• The post of DDG is currently vacant.
• The SA Health and Demographic Survey is not progressing as anticipated.
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Per Subprogramme
Subprogramme
Original Budget
R'000
OFFICE OF THE DDG
HIV & AIDS
TUBERCULOSIS
WOMEN'S MATERNAL &
REPODUCTIVE HEALTH
CHILD, YOUTH & SCHOOL HEALTH
TOTAL
Actual Expenditure
as on 30
September 2014
Funds
Available
R'000
R'000
% Spent
3 609
2 073
1 536
57.44%
12 784 418
6 301 536
6 482 882
49.29%
26 442
10 655
15 787
40.30%
17 058
6 106
10 952
35.80%
218 396
25 109
193 287
11.50%
13 049 923
6 345 479
6 704 444
48.62%
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Per Economic Classification
Economic Classification
Original Budget
R'000
Compensation of Employees
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
64 404
33 587
30 817
52.15%
468 712
160 781
307 931
34.30%
12 515 080
6 150 839
6 364 241
49.15%
Capital
1 727
258
1 469
14.94%
Losses
-
14
(14)
TOTAL
13 049 923
6 345 479
6 704 444
Goods and Services
Transfers
48.62%
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Reasons for variances
• The vaccinations for the Human Papilloma Virus is scheduled for September to
October 2014 and February to March 2015. For this reason only R16.616
million is reflecting against the budget of R 200 million.
• The budget for compensation of employees is exceeded due to the upgrading
of Assistant Directors and Deputy Directors.
Programme 4: Primary Health Care Services
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
Original Budget
Actual Expenditure as
on 30 September 2014
Funds Available
R'000
R'000
R'000
% Spent
3 007
1 309
1 698
43.53%
DISTRICT SERVICES &
ENVIRONMENTAL HEALTH
25 762
12 445
13 317
48.31%
COMMUNICABLE DISEASES
13 553
7 910
5 643
58.36%
NON-COMMUNICABLE DISEASES
25 718
11 706
14 012
45.52%
HEALTH PROMOTION & NUTRITION
21 768
8 207
13 561
37.70%
3 707
3 422
285
92.31%
93 515
44 999
48 516
48.12%
VIOLENCE, TRAUMA & EMS
TOTAL
Programme 4: Primary Health Care
Services
Per Economic Classification
Economic Classification
Original Budget
R'000
Actual
Expenditure as on
30 September
2014
Funds
Available
R'000
R'000
% Spent
Compensation of Employees
50 567
27 948
22 619
55.27%
Goods and Services
37 036
13 930
23 106
37.61%
Transfers
4 438
2 448
1 990
55.16%
Capital
1 474
645
829
43.76%
Losses
-
28
(28)
TOTAL
93 515
44 999
48 516
48.12%
Programme 4: Primary Health Care
Services
Reasons for variances
• The 2014/15 Compensation of Employee budget does not include the
officials of the Directorate: Malaria as well as some officials of the
Directorate:
Violence, Trauma and EMS, which resulted in the
overspending.
• The budget for compensation of employees is further exceeding due to the
upgrading of Assistant- and Deputy Directors.
• The transfer of the Port Health Services to NDoH is delayed, therefore less
expenditure has been incurred.
• Other projects are also delayed, such as PC 101 training, workshops and
road shows on malaria and printing of stroke pamphlets and IEC materials.
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Per Subprogramme
Subprogramme
Original Budget
R'000
OFFICE OF THE DDG
HEALTH FACILITIES INFRASTRUCTURE MANAGEMENT
TERTIARY HEALTH CARE PLANNING
& POLICY
HOSPITAL MANAGEMENT
HUMAN RESOURCES FOR HEALTH
NURSING SERVICES
FORENSIC CHEMISTRY
LABORATORIES
TOTAL
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
3 570
1 909
1 661
53.47%
6 275 300
2 772 644
3 502 656
44.18%
10 171 405
5 085 968
5 085 437
50.00%
5 426
2 282
3 144
42.06%
2 344 652
1 190 317
1 154 335
50.77%
2 531
1 700
831
67.17%
122 896
46 031
76 865
37.46%
18 925 780
9 100 851
9 824 929
48.09%
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Per Economic Classification
Economic Classification
Original Budget
R'000
Compensation of Employees
Actual
Expenditure as on
30 September
2014
R'000
Funds
Available
% Spent
R'000
104 722
50 830
53 892
48.54%
81 224
56 982
24 242
70.15%
17 730 004
8 884 133
8 845 871
50.11%
Capital
1 009 830
108 879
900 951
10.78%
Losses
-
27
(27)
TOTAL
18 925 780
9 100 851
9 824 929
Goods and Services
Transfers
48.09%
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Reasons for variances
• Payments amounting to R108.280 million of the budget of R979.862 million
for the indirect grant for Health Facilities Infrastructure were processed.
Invoices amounting to R33.153 million were paid for goods and services,
resulting in the high expenditure rate.
• The Forensic Chemistry Laboratories advertised ten tenders for the
procurement of specialized laboratory equipment. Eight of the ten tenders
were awarded during the second quarter. Expenditure expected in the 3rd and
4th quarters.
Programme 6: Health Regulation and
Compliance Management
Per Subprogramme
Subprogramme
Original Budget
R'000
Actual Expenditure
as on 30 September
2014
Funds
Available
R'000
R'000
% Spent
OFFICE OF THE DDG
4 127
2 067
2 060
50.08%
FOOD CONTROL
PHARMACEUTICAL TRADE &
PRODUCT REGULATION
7 512
3 513
3 999
46.77%
96 248
45 334
50 914
47.10%
592 532
303 572
288 960
51.23%
108 953
25 491
83 462
23.40%
55 912
21 355
34 557
38.19%
865 284
401 332
463 952
46.38%
PUBLIC ENTITIES MANAGEMENT
OFFICE OF STANDARDS
COMPLIANCE
COMPENSATION COMMISSIONER
FOR OCCUPATIONAL DISEASES &
OCCUPATIONAL HEALTH
TOTAL
Programme 6: Health Regulation and
Compliance Management
Per Economic Classification
Economic Classification
Original Budget
R'000
Actual Expenditure
as on 30
September 2014
Funds
Available
R'000
R'000
% Spent
Compensation of Employees
148 717
66 455
82 262
44.69%
Goods and Services
122 435
31 136
91 299
25.43%
Transfers
590 444
302 145
288 299
51.17%
Capital
3 688
1 596
2 092
43.28%
Losses
-
-
-
TOTAL
865 284
401 332
463 952
46.38%
Programme 6: Health Regulation and
Compliance Management
Reasons for variances
•
An emergency transfer payment was made to Sierra Leone for a mobile clinic
with respect to the Ebola outbreak.
•
The Board for the Office of Health Standards Compliance was established on
4 June 2014, only now can servers, software, office accommodation, etc. be
procured.
HEALTH SECTOR: CONDITIONAL GRANTS
2014/15: QUARTER 2 CONDITIONAL GRANTS
EXPENDITURE
Introduction
 As at end Q2 aggregate CG spending at 44.6% or R13.4 bn
against total original budget of R30.1 bn
 increased spending of 0.2% or R1.2 bn compared to the same
period in the previous year (44.4% or R12.2 bn)
 however, overall spending is below the straight line norm of
50.0%
 Main contributors to under spending are:
• NHI spending 24.4%
• Health Facility Revitalization Grant spending 36.7%
• Comprehensive HIV/AIDS spending 42.9%
 Grants spending within the norm:
NTSG and HPTDG spent 49.7% and 49.4% respectively
OVERALL EXPENDITURE PER GRANT
(Schedule 4 and 5 grants)
Health Professions Training and
Development Grant
National Tertiary Services Grant
Comprehensive HIV and AIDS
Health Facility Revitalisation Grant
National Health Insurance
National Health Grant (Schedule 6)
Grant Name
HPV Vaccine
Health Facility Revite Grant
NHI-Indirect Grant
TOTAL
Original
Budget
% Spent of
Budget Commitments Expenditure Available Budget
R'000
R'000
R'000
R'000
16 616
168 217
8%
200 000
15 167
141 402
444 782
23%
604 862
18 678
20 046
346 610
5%
395 000
28 344
1 199 862
62 189
178 064
959 609
15%
OVERALL EXPENDITURE PER
PROVINCE
BUDGET
Grant Name
Original
Budget
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
EXPENDITURE
Expenditure
Budget
Available
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
R'000
%
Not Transferred
R'000
R'000
%
R'000
R'000
Eastern Cape
3 041 349
1 517 553
100.0%
1 342 362
1 698 987
44.1%
1 342 362
88.5%
175 191
Free State
2 343 498
1 177 704
100.0%
988 037
1 355 461
42.2%
971 593
82.5%
206 111
Gauteng
7 615 616
3 818 778
100.0%
3 444 735
4 170 881
45.2%
3 444 735
90.2%
374 043
Kwazulu-Natal
6 223 725
3 070 138
100.0%
2 917 749
3 305 976
46.9%
3 070 136
100.0%
2
Limpopo
1 891 938
937 198
100.0%
630 391
1 261 547
33.3%
480 129
51.2%
457 069
Mpumalanga
1 361 749
669 974
100.0%
532 865
828 884
39.1%
564 381
84.2%
105 593
Northern Cape
1 146 641
581 981
100.0%
563 250
583 391
49.1%
581 981
100.0%
-
North West
1 771 909
897 318
100.0%
819 554
952 355
46.3%
868 638
96.8%
28 680
Western Cape
4 714 901
2 317 339
100.0%
2 184 356
2 530 545
46.3%
2 184 356
94.3%
132 983
30 111 326
14 987 983
100.0%
13 423 299
16 688 027
44.6%
13 508 311
90.1%
1 479 672
TOTAL
%
% of
Transfers
Received
R'000
EASTERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
199 874
103 516
100.0%
86 825
113 049
43.4%
86 825
83.9%
16 691
National Tertiary Services Grant
786 007
393 004
100.0%
389 450
396 557
49.5%
389 450
99.1%
3 554
1 449 237
718 617
100.0%
643 021
806 216
44.4%
643 021
89.5%
75 596
599 231
299 616
100.0%
221 561
377 670
37.0%
221 561
73.9%
78 055
7 000
2 800
100.0%
1 505
5 495
21.5%
1 505
53.8%
1 295
3 041 349
1 517 553
100.0%
1 342 362
1 698 987
44.1%
1 342 362
88.5%
175 191
Comprehensive HIV and AIDS Grant
Health Facility Revitalisation Grant
National Health Insurance Grant
TOTAL
VARIANCES – EASTERN CAPE (1)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HPTDG
• CoE budget overstated and is
to be moved to Goods and
Services for WSU reimbursement
• Misallocation of expenditure
paid under Grant instead of ES
• CoE budget to be corrected
during adjustments budget
HIV/ AIDS • PERSAL link codes challenge
• NGO contracts expired and
requiring new contracts
• HCW’s uniforms not
implemented
• Slow initiation of procurement
processes for machinery and
equipment
• Journals for correcting
misallocated expenditure
• CoE database "clean up”
project underway
•New NGO individual contracts
in progress
• Demand process for desktops
and laptops have begun
VARIANCES – EASTERN CAPE (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Delays in the recruitment of
professional
•Slow progress due to new
system being implemented in
the previous months
• Late submission of invoices
and none processing of some
invoices due to change
• A recommendation to readvertise has
been initiated and engaged the
National Office for assistance
• Urge CDC to speed up
implementation of the new adopted
service delivery model
• Emphasize submission of invoices by
Service Providers on prescribed time
NHI
• Management challenges at
the pilot district on
implementation of key
objectives of BP
• NHI responsibility to be shifted to
District Health GM and OR Tambo
District Manager to manage
implementation
FREE STATE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
146 419
79 864
100.0%
76 686
69 733
52.4%
76 686
96.0%
3 178
National Tertiary Services Grant
898 091
449 046
100.0%
454 992
443 099
50.7%
446 588
99.5%
2 458
Comprehensive HIV and AIDS Grant
843 026
421 512
100.0%
239 044
603 982
28.4%
230 470
54.7%
191 042
Health Facility Revitalisation Grant
448 962
224 482
100.0%
217 189
231 773
48.4%
217 149
96.7%
7 333
7 000
2 800
100.0%
126
6 874
1.8%
700
25.0%
2 100
2 343 498
1 177 704
100.0%
988 037
1 355 461
42.2%
971 593
82.5%
206 111
National Health Insurance Grant
TOTAL
VARIANCES – FREE STATE
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HIV/ AIDS
• Delays in procurement
processes
• Outstanding NHLS and Depot
payments
• Expenditure acceleration plan
is being implemented
• Invoices to be processed in
October
NHI
• Post of Monitoring and
Evaluation not yet filled
• The district Manager is
advised to appoint an acting
Dep Director until post is filled
• IT to speed up process of
upgrading data lines
•Journalise the procurement of
trailers
• IT unit to start upgrading data
lines as per BP and will
journalise the grant
GAUTENG
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
811 114
405 558
100.0%
405 684
405 430
50.0%
405 684
100.0%
(126)
National Tertiary Services Grant
3 493 891
1 746 946
100.0%
1 675 512
1 818 379
48.0%
1 675 512
95.9%
71 434
Comprehensive HIV and AIDS Grant
2 632 578
1 327 957
100.0%
1 188 993
1 443 585
45.2%
1 188 993
89.5%
138 964
671 033
335 517
100.0%
170 793
500 240
25.5%
170 793
50.9%
164 724
7 000
2 800
100.0%
3 753
3 247
53.6%
3 753
134.0%
(953)
7 615 616
3 818 778
100.0%
3 444 735
4 170 881
45.2%
3 444 735
90.2%
374 043
Health Facility Revitalisation Grant
National Health Insurance Grant
TOTAL
VARIANCES – GAUTENG
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HIV/ AIDS
• Delays in delivery of goods
especially condoms
• Follow up with suppliers and
NDoH to fast track delivery
HFRG
• All projects transferred to DID
for implementation and hand
over period slowed
• Slow approval of projects
• Follow up and constant
monitoring of DID to fast track
spending
• Reallocation of budgets
between under spending and
over spending projects
• Follow up to done to ensure
speedy approval
KWAZULU-NATAL
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
292 837
146 418
100.0%
146 418
146 419
50.0%
146 418
100.0%
National Tertiary Services Grant
1 496 427
748 214
100.0%
793 324
703 103
53.0%
748 212
100.0%
Comprehensive HIV and AIDS Grant
3 257 992
1 588 668
100.0%
1 423 223
1 834 769
43.7%
1 588 668
100.0%
-
Health Facility Revitalisation Grant
1 162 469
581 238
100.0%
551 979
610 490
47.5%
581 238
100.0%
-
14 000
5 600
100.0%
2 805
11 195
20.0%
5 600
100.0%
-
6 223 725
3 070 138
100.0%
2 917 749
3 305 976
46.9%
3 070 136
100.0%
National Health Insurance Grant
TOTAL
-
2
2
VARIANCES – KWAZULU NATAL
GRANT
REASONS FOR
VARIANCES
REMEDIAL STEPS
HIV/ AIDS
• Program outputs are below
the planned targets
• Acceleration Plan to be
finalised in October 2014
• Await finalization of plans
to increase CD4 count to
500 and cost implications
NHI
• Delays in the finalization of
SCM processs
• Follow up on SCM
interventions to improve
expenditure
LIMPOPO
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
116 206
58 104
100.0%
44 696
71 510
38.5%
30 271
52.1%
27 833
National Tertiary Services Grant
323 158
161 579
100.0%
153 597
169 561
47.5%
103 255
63.9%
58 324
Comprehensive HIV and AIDS Grant
978 132
480 993
100.0%
336 628
641 504
34.4%
259 645
54.0%
221 348
Health Facility Revitalisation Grant
467 442
233 722
100.0%
92 718
374 724
19.8%
85 179
36.4%
148 543
7 000
2 800
100.0%
2 752
4 248
39.3%
1 779
63.5%
1 021
1 891 938
937 198
100.0%
630 391
1 261 547
33.3%
480 129
51.2%
457 069
National Health Insurance Grant
TOTAL
VARIANCES – LIMPOPO (1)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HPTDG
• PERSAL linkages challenge
• Bursaries payments
challenge
• Correct the link codes for
officials paid under grant
• Requested revision of BP
from NDoH
HIV/
AIDS
• Outstanding medicine
invoices and journalising of
expenditure
• Follow up the invoices for
payments
VARIANCES – LIMPOPO (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Non performing service
providers
• Delay in the finalisation of
retention projects
• Delays in approval of BP for
soft components. The delay were
due to the realignment of
activities within the Health
Technology components
• IDT are resolving SCM
issues
• Enforce robust performance
clause of SLA with service
providers and some
contractors are terminated
• BP subsequently approved
on 02 September and 04
August for Health Technology
NHI
• Awaiting delivery for WBOT
household profiling kits and
forms from Government printers
• Follow up with suppliers
and ensuring adherence of
delivery deadlines
MPUMALANGA
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
95 288
50 288
100.0%
31 666
63 622
33.2%
40 644
80.8%
9 644
National Tertiary Services Grant
97 116
48 558
100.0%
33 182
63 934
34.2%
40 465
83.3%
8 093
Comprehensive HIV and AIDS Grant
818 836
396 572
100.0%
416 639
402 197
50.9%
396 572
100.0%
-
Health Facility Revitalisation Grant
343 509
171 756
100.0%
50 140
293 369
14.6%
85 000
49.5%
86 756
7 000
2 800
100.0%
1 238
5 762
17.7%
1 700
60.7%
1 100
1 361 749
669 974
100.0%
532 865
828 884
39.1%
564 381
84.2%
105 593
National Health Insurance Grant
TOTAL
VARIANCES – MPUMALANGA
GRANT
REASONS FOR VARIANCES REMEDIAL STEPS
HPTDG
• Change in grant purpose
and a revised Business Plan
has been approved by NDoH
• The approval of the revised
Business Plan will expedite
expenditure
NTSG
• Use of Equitable Share
instead of Grant
• Journals to correct expenditure
HIV/ AIDS • Spending within norm
• None
HFRG
• Non receiving of final
accounts for complemented
projects from DPW
• Monthly final accounts meeting
held to track progress and unlock
bottlenecks
NHI
• Incorrect linkage of officials
• Delays with specification for
impact assessments
• Officials to be correctly linked
• Finalisation the appointment of
service provider to conduct impact
assessments
NORTHERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
76 697
44 482
100.0%
58 708
17 989
76.5%
44 482
100.0%
-
National Tertiary Services Grant
298 727
149 364
100.0%
176 680
122 047
59.1%
149 364
100.0%
-
Comprehensive HIV and AIDS Grant
342 789
174 621
100.0%
144 725
198 064
42.2%
174 621
100.0%
-
Health Facility Revitalisation Grant
421 428
210 714
100.0%
180 849
240 579
42.9%
210 714
100.0%
-
7 000
2 800
100.0%
2 288
4 712
32.7%
2 800
100.0%
-
1 146 641
581 981
100.0%
563 250
583 391
49.1%
581 981
100.0%
-
National Health Insurance Grant
TOTAL
VARIANCES – NORTHERN CAPE (1)
GRANT
REASONS FOR VARIANCES REMEDIAL STEPS
HPTDG &
NTSG
• Spending above norm
• To journalise excess expenditure
to Equitable Share
• Strict monitoring of expenditure
to avoid over expenditure
HIV/ AIDS
• PERSAL linkages challenge
• Department in a process of
correcting alignment of PERSAL
linkages between the Grant and
Equitable Share
• Rollover requested of R14.3
mil for procurement of capital
medical and office equipment
• Awaiting rollover request
approval from the Provincial
Treasury and NDoH
VARIANCES – NORTHERN CAPE (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Delay in the appointment of
service provider at Port Nolloth
• Kagung clinic termination of
contractor
• Slow progress on Mental Health
project
• Refurbishment, standby
generators and fence installation
commitments of R27 mil
• A rollover request of R29.7 mil
has been submitted to
Provincial Treasury and NDoH
• A workshop was held to
monitor Mental Health
construction progress
NHI
• Delays in the implementation of
business plan
• Close monitoring of
expenditure to avoid under
expenditure
NORTH WEST
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
104 586
52 296
100.0%
55 819
48 767
53.4%
43 580
83.3%
8 716
National Tertiary Services Grant
237 264
118 632
100.0%
107 347
129 917
45.2%
98 860
83.3%
19 772
Comprehensive HIV and AIDS Grant
936 938
480 528
100.0%
458 101
478 837
48.9%
480 528
100.0%
-
Health Facility Revitalisation Grant
486 121
243 062
100.0%
197 146
288 975
40.6%
242 870
99.9%
7 000
2 800
100.0%
1 141
5 859
16.3%
2 800
100.0%
-
1 771 909
897 318
100.0%
819 554
952 355
46.3%
868 638
96.8%
28 680
National Health Insurance Grant
TOTAL
192
VARIANCES – NORTH WEST
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
NTSG
• Invoices could not be paid on time due
to unavailability of system
• Expenditure to reflect in the
next quarter
HFRG
• Health technology equipment tender
has been awarded and awaiting
deliveries
• Infrastructure commitments of R91 mil
is at advance payment stage
• Follow up with service
providers to deliver tendered
goods
• Expedite the payments of
commitments
NHI
• Delays in the training of M&E and
impact assessment
• Some procurement could not be done
due to SCM challenges
• Finalise the registration of
service provider
• Approval to do a close bid
has be requested from HoD
WESTERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget
Received
%
R'000
% of
Transfers
Received
%
Not Transferred
R'000
Health Professions Training and
Development Grant
478 767
239 382
100.0%
239 382
239 385
50.0%
239 382
100.0%
-
National Tertiary Services Grant
2 537 554
1 268 777
100.0%
1 264 704
1 272 850
49.8%
1 264 704
99.7%
4 073
Comprehensive HIV and AIDS Grant
1 051 794
486 486
100.0%
435 800
615 994
41.4%
435 800
89.6%
50 686
639 786
319 894
100.0%
242 967
396 819
38.0%
242 967
76.0%
76 927
7 000
2 800
100.0%
1 503
5 497
21.5%
1 503
53.7%
1 297
4 714 901
2 317 339
100.0%
2 184 356
2 530 545
46.3%
2 184 356
94.3%
132 983
Health Facility Revitalisation Grant
National Health Insurance Grant
TOTAL
VARIANCES - WESTERN CAPE (1)
GRANT
REASONS FOR VARIANCES
HIV/ AIDS • August ART drugs and lab claims of
R4.5 mil City of Cape Town was not
paid in September, but will be paid in
October
• Within Goods commitments (+-R54
mil) did not materialised into
expenditure
• 81 posts vacant still to be filled
REMEDIAL STEPS
• Interacting with
municipalities to speed-up
claiming processes
• Regular contact with
suppliers to deliver goods
especially condoms (R40
mil)
• HR within districts busy
filling posts
VARIANCES - WESTERN CAPE (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Paarl Hospital: psychiatric unit – delays in
tender process and site handover 15 October
• District CDC 6- delays with tender
adjudication
• GF Jooste; New Hospital- waiting for
outcome of cabinet submission
• Vredenburg: Phase 2B – legal dispute which
delay the appointment of sub-contractors
• Tygerberg: New Hospital – feasibility study
still to be completed
• This will be
corrected in the
adjustment
estimate, with
reallocation of
budgets and
movement of
projects
NHI
• Late commencement of projects and
procurement process took longer with other
projects
• Expenditure will
reflect in the next
quarter
Key Overall Interventions
 Emphasize the effective and efficient management of SCM
processes
 Improvement in the alignment of captured budget with
Business and Operational Plans to avoid misallocations
 Conduct expenditure reviews especially for NHI, HFRG
and HIV/AIDS
2014/15: QUARTER 3 FINANCIAL REPORT
As at the end of December 2014, the total spent for the National Department of
Health was R24,906 billion of a budget of R33,900 billion, which represents 73.47%
of the total budget.
Analysis of expenditure
Compensation of Employees expenditure is R453,648 million and 75,03% of the
budget of R604,633 million was spend.
Goods and Services expenditure is R676,672 million and 42,06% of the budget of
R1,608 billion. The main reasons for the underspending can be ascribed to:
• The take-up of Health Practitioners at the pilot sites for National Health Insurance
is very slow. An under-expenditure on the NHI Indirect Grant is projected.
• R30 million is allocated in the 2014/15 budget allocation for specifically the SA
Demographic Health Survey. It is anticipated that ±R10 million will be spent
during this year.
• R181,5 million is allocated for current expenditure on the Health Facilities
Revitalization indirect grant. An under-expenditure is expected.
• TB World Day expenditure is on target at 75,7% and the event is going to take
place during March 2015.
Transfer payments:
billion.
Expenditure is R23,632 billion against a budget of R31,198
Capital expenditure is R142,381 million which is 29,12% of the budget of
R488,962 million. The underspending is mainly due to:
•
•
•
•
•
The procurement of six servers for the IT Unit took longer than anticipated.
R10,5 million is allocated to procure industrial fridges for the Human
Papilloma Virus vaccines in the provinces.
The spending on the Health Facilities Revitalization indirect grant is slow and
an under-expenditure is expected.
Specialized laboratory equipment was ordered and delivery is expected during
March 2015.
R9,77 million was received in the Adjustments Budget to upgrade the IT
system in anticipation of the establishment of SAPHRA during 2015.
Summary of Expenditure per Programme
Subprogramme
ADMINISTRATION
NATIONAL HEALTH INSURANCE,
HEALTH PLANNING & SYSTEM
ENABLEMENT
HIV & AIDS, TB, MATERNAL &
CHILD HEALTH
PRIMARY HEALTH CARE
SERVICES
HOSPITALS, TERTIARY HEALTH
SERVICES & HUMAN RESOURCE
DEVELOPMENT
HEALTH REGULATION &
COMPLIANCE MANAGEMENT
TOTAL
Original
Budget
R'000
399 721
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
399 721
302 591
Funds
Available
% Spent
R'000
97 130
75,70%
621 252
628 156
211 886
416 270
33,73%
13 049 923
13 049 923
10 084 379
2 965 544
77,28%
93 515
111 345
76 048
35 297
68,30%
18 925 780
18 810 607
13 621 600
5 189 007
72,41%
865 284
33 955 475
900 818
33 900 570
609 890
24 906 394
290 928
8 994 176
67,70%
73,47%
Summary of Expenditure per
Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
Adjusted
Budget
R'000
597 203
1 406 374
30 916 363
1 035 535
33 955 475
R0'00
604 633
1 608 666
31 198 309
488 962
33 900 570
Actual
Expenditure as
on 31
December 2014
R'000
453 648
676 672
23 632 816
142 381
877
24 906 394
Funds
Available
R'000
150 985
931 994
7 565 493
346 581
(877)
8 994 176
% Spent
75,03%
42,06%
75,75%
29,12%
73,47%
Programme 1: Administration
Per Subprogramme
Subprogramme
MINISTRY
MANAGEMENT
CORPORATE SERVICES
OFFICE ACCOMMODATION
FINANCIAL MANAGEMENT
TOTAL
Original
Budget
R'000
31 046
26 458
184 647
105 825
51 745
399 721
Adjusted
Budget
R0'00
31 046
26 458
184 647
105 825
51 745
399 721
Actual
Expenditure as
on 31
December 2014
R'000
20 872
15 131
131 382
97 737
37 469
302 591
Funds
Available
R'000
10 174
11 327
53 265
8 088
14 276
97 130
% Spent
67,23%
57,19%
71,15%
92,36%
72,41%
75,70%
Programme 1: Administration
per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
R'000
161 600
230 830
1 397
5 894
399 721
Adjusted
Budget
R0'00
161 600
230 714
1 397
6 010
399 721
Actual
Expenditure as
on 31
December 2014
R'000
122 508
176 344
1 922
1 657
160
302 591
Funds
Available
R'000
39 092
54 370
(525)
4 353
(160)
97 130
% Spent
75,81%
76,43%
137,58%
27,57%
75,70%
Programme 1
Reasons for variances
Transfer payments:
Leave gratuity payments. This will be adjusted by means of virement at the end of
the financial year due to retirements and payment of benefits.
Capital payments:
The procurement of servers were finalized and is it expected that the invoices will be
received during February 2015.
Programme 2: National Health Insurance,
Health Planning and System Enablement
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
TECHNICAL POLICY & PLANNING
HEALTH INFORMATION
MANAGEMENT, MONITORING &
EVALUATION
SECTOR-WIDE PROCUREMENT
HEALTH FINANCING & NATIONAL
HEALTH INSURANCE
INTERNATIONAL HEALTH &
DEVELOPMENT
TOTAL
Original
Budget
R'000
2 989
2 084
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
1 647
202
3 426
994
Funds
Available
% Spent
R'000
1 445
2 432
12,26%
29,01%
53 725
22 987
60 629
22 987
30 254
19 637
30 375
3 350
49,90%
85,43%
487 210
487 210
97 771
389 439
20,07%
52 257
621 252
52 257
628 156
63 028
211 886
(10 771)
416 270
120,61%
33,73%
Programme 2: National Health Insurance,
Health Planning and System Enablement
Per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
R'000
67 193
476 637
75 000
2 422
621 252
Adjusted
Budget
R0'00
67 193
483 541
75 000
2 422
628 156
Actual
Expenditure as
on 31
December 2014
R'000
64 314
85 905
60 739
872
56
211 886
Funds
Available
R'000
2 879
397 636
14 261
1 550
(56)
416 270
% Spent
95,72%
17,77%
80,99%
36,00%
33,73%
Programme 2: National Health Insurance,
Health Planning and System Enablement
Reasons for variances
Compensation of employees:
Budget pressure due to appointment of a Health Attaché in Cuba and support
staff.
Goods and Services:
•The recruitment of the Health Practitioners at the NHI pilot hospitals is
slower than anticipated.
•The expenditure towards the SA Health & Demographic Survey will be ±R10
million. R30 million was received as a special allocation for this purpose.
Transfers and Subsidies
Payment of leave gratuity, which increased the transfers to households.
Capital expenditure
The procurement of the ICD10 browser is in the final stages and will be
finalized before mid February 2015.
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
HIV & AIDS
TUBERCULOSIS
WOMEN'S MATERNAL &
REPODUCTIVE HEALTH
CHILD, YOUTH & SCHOOL
HEALTH
TOTAL
Original
Budget
R'000
3 609
12 784 418
26 442
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
3 609
3 173
12 784 418
10 003 352
26 442
14 147
Funds
Available
% Spent
R'000
436
2 781 066
12 295
87,92%
78,25%
53,50%
17 058
17 058
9 857
7 201
57,79%
218 396
13 049 923
218 396
13 049 923
53 850
10 084 379
164 546
2 965 544
24,66%
77,28%
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
R'000
64 404
458 212
12 515 080
12 227
13 049 923
Adjusted
Budget
R0'00
64 404
458 212
12 515 080
12 227
13 049 923
Actual
Expenditure as
on 31
December 2014
R'000
49 203
246 238
9 787 943
438
557
10 084 379
Funds
Available
R'000
15 201
211 974
2 727 137
11 789
(557)
2 965 544
% Spent
76,40%
53,74%
78,21%
3,58%
77,28%
Programme 3: HIV and AIDS,
Tuberculosis, Maternal and Child Health
Reasons for variances
Goods and services:
• Doses of the Human Papilloma Virus Vaccinations are administered during
September to October and February to March annually. Vaccines to the value of
R71m will be procured during the 4th quarter for last-mentioned dosages, but an
overall underspending is anticipated.
• Printing of birth registers and Maternity Case Records and the Family Planning
Campaign will be paid during February and March 2014.
• Expenditure for the TB World Day events will flow during March 2015.
Payments for capital assets:
Fridges for the Human Papilloma Virus Vaccines are still to be procured as the tender
is due for award.
Programme 4: Primary Health Care Services
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
DISTRICT SERVICES &
ENVIRONMENTAL HEALTH
COMMUNICABLE DISEASES
NON-COMMUNICABLE DISEASES
HEALTH PROMOTION &
NUTRITION
VIOLENCE, TRAUMA & EMS
TOTAL
Original
Budget
R'000
3 007
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
3 007
2 058
Funds
Available
% Spent
R'000
949
68,44%
25 762
13 553
23 674
31 298
21 780
16 897
1 894
14 401
92,00%
53,99%
25 718
25 718
18 191
7 527
70,73%
21 768
3 707
93 515
21 768
5 880
111 345
11 914
5 208
76 048
9 854
672
35 297
54,73%
88,57%
68,30%
Programme 4: Primary Health Care
Services
Per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
R'000
50 567
37 036
4 438
1 474
93 515
Adjusted
Budget
R0'00
52 740
49 685
7 446
1 474
111 345
Actual
Expenditure as
on 31
December 2014
R'000
42 479
24 650
5 152
3 737
30
76 048
Funds
Available
R'000
10 261
25 035
2 294
(2 263)
(30)
35 297
% Spent
80,54%
49,61%
69,19%
253,53%
68,30%
Programme 4: Primary Health Care
Services
Reasons for variances
Compensation of employees:
Appointment of 25 Environmental Health Practitioners to assist with Port Health has put
pressure on this budget..
Goods and services:
• The project on Regulatory Impact Assessment on the Control of Marketing Alcohol
Beverages Bill is not finalized yet.
• The audit to determine Baseline Data for the control of Hypertension and Diabetes will
commence in 4th quarter.
• The DDT Survey to the value of R 500 000 will commence in January 2015.
Transfers and subsidies:
• The SLA for the transfer of funds to the National Kidney Foundation is not finalized.
• National Treasury granted approval to increase the transfer to SACENDU.
Payments for capital assets:
Scanners were procured to manage the risk of the Ebola Virus at certain ports of entry.
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
HEALTH FACILITIES INFRASTRUCTURE MANAGEMENT
TERTIARY HEALTH CARE
PLANNING & POLICY
HOSPITAL MANAGEMENT
HUMAN RESOURCES FOR
HEALTH
NURSING SERVICES
FORENSIC CHEMISTRY
LABORATORIES
TOTAL
Original
Budget
R'000
3 570
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
3 570
3 295
Funds
Available
% Spent
R'000
275
92,30%
6 275 300
6 162 300
4 134 959
2 027 341
67,10%
10 171 405
5 426
10 171 405
5 426
7 629 145
3 499
2 542 260
1 927
75,01%
64,49%
2 344 652
2 531
2 342 479
2 531
1 780 932
2 090
561 547
441
76,03%
82,58%
122 896
18 925 780
122 896
18 810 607
67 680
13 621 600
55 216
5 189 007
55,07%
72,41%
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
Adjusted
Budget
R'000
104 722
81 224
17 730 004
1 009 830
18 925 780
R0'00
102 549
262 683
17 992 004
453 371
18 810 607
Actual
Expenditure as
on 31
December 2014
R'000
75 423
90 423
13 322 643
133 070
41
13 621 600
Funds
Available
R'000
27 126
172 260
4 669 361
320 301
(41)
5 189 007
% Spent
73,55%
34,42%
74,05%
29,35%
72,41%
Programme 5: Hospital, Tertiary Services
and Human Resource Development
Reasons for variances
Payments for capital assets:
• Tenders for specialized laboratory equipment were awarded. It is expected that
invoices will be received during March 2015.
• Expenditure on Infrastructure Grant will gain momentum with the finalisation
and award in construction of Siloam hospital as well as refurbishment of Nursing
Colleges etc.
Programme 6: Health Regulation
and Compliance Management
Per Subprogramme
Subprogramme
OFFICE OF THE DDG
FOOD CONTROL
PHARMACEUTICAL TRADE &
PRODUCT REGULATION
PUBLIC ENTITIES MANAGEMENT
OFFICE OF STANDARDS
COMPLIANCE
COMPENSATION
COMMISSIONER FOR
OCCUPATIONAL DISEASES &
OCCUPATIONAL HEALTH
TOTAL
Original
Budget
R'000
4 127
7 512
Actual
Expenditure as
Adjusted
on 31
Budget
December 2014
R0'00
R'000
4 127
3 069
7 512
5 273
Funds
Available
% Spent
R'000
1 058
2 239
74,36%
70,19%
96 248
121 748
72 554
49 194
59,59%
592 532
609 470
456 666
152 804
74,93%
108 953
102 049
41 173
60 876
40,35%
55 912
865 284
55 912
900 818
31 155
609 890
24 757
290 928
55,72%
67,70%
Programme 6: Health Regulation
and Compliance Management
Per Economic Classification
Economic Classification
Compensation of Employees
Goods and Services
Transfers
Capital
Losses
TOTAL
Original
Budget
R'000
148 717
122 435
590 444
3 688
865 284
Adjusted
Budget
R0'00
156 147
123 831
607 382
13 458
900 818
Actual
Expenditure as
on 31
December 2014
R'000
99 721
53 112
454 417
2 607
33
609 890
Funds
Available
R'000
56 426
70 719
152 965
10 851
(33)
290 928
% Spent
63,86%
42,89%
74,82%
19,37%
67,70%
Programme 6: Health Regulation
and Compliance Management
Reasons for variances
Compensation of Employees:
• The recruitment of officials for the OHSC is taking longer than expected.
• Additional funds were received during the Adjustments Budget to appoint
officials for SAPHRA.
Goods and services:
Additional funds of R8,3 million were received during the Adjustments Budget for
SAPHRA.
Capital Expenditure:
R9,7 million was received during the Adjustments Budget to upgrade the IT
system in anticipation of the SAPHRA establishment during 2015.
HEALTH SECTOR: CONDITIONAL GRANTS
2014/15: QUARTER 3 CONDITIONAL GRANTS
EXPENDITURE
Introduction
 As at end Q3 aggregate CG spending at 68.5% or R21.1 bn
against total adjusted budget of R30.8 bn
 increased spending of 2.2% or R2.4 bn compared to the same
period in the previous year (66.3% or R18.7 bn)
 however, overall spending is below the straight line norm of
75.0%
 Main contributors to under spending are:
• NHI spending 33.2%
• Health Facility Revitalization Grant spending 57.7%
• Comprehensive HIV/AIDS spending 67.8%
 Grants spending within the norm:
 HPTDG and NTSG spent 77.9% and 73.6% respectively
OVERALL EXPENDITURE PER GRANT
(Schedule 4 and 5 grants)
BUDGET
Grant Name
Original
Budget
R'000
Health Professions
Training and
Development Grant
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
Transfers
per % of
Payment
Schedule
R'000
EXPENDITURE
Expenditure
%
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
% of
Not
Transfers Transferred
Received
%
R'000
%
R'000
2 321 788
-
1 386
2 323 174
1 766 248
100.0%
1 808 639
514 535
77.9%
1 745 523
98.8%
20 725
National Tertiary
Services Grant
10 168 235
-
22 823
10 191 058
7 626 176
100.0%
7 503 549
2 687 509
73.6%
7 383 180
96.8%
242 996
Comprehensive HIV
and AIDS Grant
12 311 322
-
38 603
12 349 925
9 255 607
100.0%
8 372 589
3 977 336
67.8%
8 545 952
92.3%
709 655
Health Facility
Revitalisation Grant
5 239 981
262 000
331 086
5 833 067
3 929 992
100.0%
3 363 372
2 469 695
57.7%
3 237 403
82.4%
692 589
70 000
6 956
11 648
88 604
49 000
100.0%
29 427
59 177
33.2%
43 709
89.2%
5 291
30 111 326
268 956
405 546
30 785 828
22 627 023
100.0%
21 077 576
9 708 252
68.5%
20 955 767
92.6%
1 671 256
National Health
Insurance Grant
TOTAL
Health Professions Training and
Development Grant
Province
Original
Budget
R'000
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
Eastern Cape
199 874
-
Free State
146 419
-
Gauteng
811 114
Kwazulu-Natal
Limpopo
R'000
R'000
%
EXPENDITURE
PROVINCIAL TRANSFERS
Expenditure Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
R'000
R'000
%
R'000
%
R'000
201 260
153 474
100.0%
144 434
56 826
71.8%
144 434
94.1%
9 040
-
146 419
119 797
100.0%
113 183
33 236
77.3%
115 948
96.8%
3 849
-
-
811 114
608 337
100.0%
663 209
147 905
81.8%
663 209
109.0%
(54 872)
292 837
-
-
292 837
219 627
100.0%
220 466
72 371
75.3%
219 627
100.0%
-
116 206
-
-
116 206
87 156
100.0%
97 837
18 369
84.2%
55 808
64.0%
31 348
Mpumalanga
95 288
-
-
95 288
81 288
100.0%
54 017
41 271
56.7%
58 644
72.1%
22 644
Northern Cape
76 697
-
-
76 697
59 052
100.0%
75 577
1 120
98.5%
59 052
100.0%
-
North West
104 586
-
-
104 586
78 444
100.0%
80 843
23 743
77.3%
69 728
88.9%
8 716
Western Cape
478 767
-
-
478 767
359 073
100.0%
359 073
119 694
75.0%
359 073
100.0%
-
2 321 788
-
2 323 174
1 766 248
100.0%
1 808 639
514 535
77.9%
1 745 523
98.8%
20 725
TOTAL
1 386
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
1 386
National Tertiary Services Grant
Province
Original
Budget
R'000
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
Eastern Cape
786 007
-
Free State
898 091
-
Gauteng
3 493 891
Kwazulu-Natal
R'000
R'000
%
EXPENDITURE
PROVINCIAL TRANSFERS
Expenditure Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
R'000
R'000
%
R'000
%
R'000
796 341
589 505
100.0%
584 779
211 562
73.4%
584 779
99.2%
4 726
-
898 091
673 568
100.0%
692 595
205 496
77.1%
673 569
100.0%
(1)
-
-
3 493 891
2 620 418
100.0%
2 407 710
1 086 181
68.9%
2 407 710
91.9%
212 708
1 496 427
-
-
1 496 427
1 122 320
100.0%
1 209 136
287 291
80.8%
1 122 318
100.0%
2
323 158
-
7 556
330 714
242 369
100.0%
250 032
80 682
75.6%
253 969
104.8%
(11 600)
Mpumalanga
97 116
-
4 933
102 049
72 837
100.0%
48 485
53 564
47.5%
57 558
79.0%
15 279
Northern Cape
298 727
-
-
298 727
224 045
100.0%
240 732
57 995
80.6%
224 046
100.0%
(1)
North West
237 264
-
-
237 264
177 948
100.0%
169 025
68 239
71.2%
158 176
88.9%
19 772
2 537 554
-
-
2 537 554
1 903 166
100.0%
1 901 055
636 499
74.9%
1 901 055
99.9%
2 111
10 168 235
-
10 191 058
7 626 176
100.0%
7 503 549
2 687 509
73.6%
7 383 180
96.8%
242 996
Limpopo
Western Cape
TOTAL
10 334
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
22 823
Comprehensive HIV and AIDS
Province
Original
Budget
R'000
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
EXPENDITURE
PROVINCIAL TRANSFERS
Expenditure Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
R'000
R'000
%
R'000
1 449 237
1 085 658
100.0%
1 012 429
848 076
632 270
100.0%
R'000
%
R'000
%
R'000
436 808
69.9%
1 012 429
93.3%
73 229
559 141
288 935
65.9%
560 563
88.7%
71 707
181 455
1 449 237
-
Free State
843 026
-
Gauteng
2 632 578
-
-
2 632 578
1 982 730
100.0%
1 801 275
831 303
68.4%
1 801 275
90.8%
Kwazulu-Natal
3 257 992
-
-
3 257 992
2 430 435
100.0%
2 099 361
1 158 631
64.4%
2 430 435
100.0%
Limpopo
978 132
-
998 502
748 482
100.0%
618 470
380 032
61.9%
471 847
63.0%
Mpumalanga
818 836
-
818 836
617 114
100.0%
594 300
224 536
72.6%
617 114
100.0%
-
Northern Cape
342 789
-
355 972
262 155
100.0%
267 895
88 077
75.3%
262 155
100.0%
-
North West
936 938
-
-
936 938
726 954
100.0%
674 346
262 592
72.0%
644 762
88.7%
82 192
1 051 794
-
-
1 051 794
769 809
100.0%
745 372
306 422
70.9%
745 372
96.8%
24 437
12 311 322
-
12 349 925
9 255 607
100.0%
8 372 589
3 977 336
67.8%
8 545 952
92.3%
709 655
Eastern Cape
Western Cape
TOTAL
-
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
5 050
20 370
13 183
38 603
276 635
Health Facility Revitalisation Grant
Province
Original
Budget
R'000
Eastern Cape
599 231
Free State
448 962
Gauteng
671 033
Kwazulu-Natal
1 162 469
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
-
18 000
200 000
R'000
-
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
R'000
%
Expenditure
EXPENDITURE
PROVINCIAL TRANSFERS
Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
R'000
R'000
%
R'000
%
R'000
599 231
449 424
100.0%
422 093
177 138
70.4%
422 093
93.9%
27 331
136 489
603 451
336 723
100.0%
316 606
286 845
52.5%
316 856
94.1%
19 867
81 667
752 700
503 275
100.0%
323 700
429 000
43.0%
323 700
64.3%
179 575
1 362 469
871 852
100.0%
756 546
605 923
55.5%
871 852
100.0%
468 672
350 582
100.0%
342 469
126 203
73.1%
114 184
32.6%
236 398
343 509
257 633
100.0%
123 709
219 800
36.0%
135 000
52.4%
122 633
-
Limpopo
467 442
-
Mpumalanga
343 509
-
Northern Cape
421 428
30 000
13 482
464 910
316 071
100.0%
319 659
145 251
68.8%
316 071
100.0%
North West
486 121
14 000
17 156
517 277
364 592
100.0%
385 343
131 934
74.5%
364 400
99.9%
192
Western Cape
639 786
81 062
720 848
479 840
100.0%
373 247
347 601
51.8%
373 247
77.8%
106 593
331 086
5 833 067
3 929 992
100.0%
3 363 372
2 469 695
57.7%
3 237 403
82.4%
692 589
TOTAL
5 239 981
262 000
1 230
-
-
-
National Health Insurance
Province
Original
Budget
R'000
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
Eastern Cape
7 000
-
Free State
7 000
-
Gauteng
7 000
-
14 000
Limpopo
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
R'000
%
R'000
R'000
%
R'000
%
R'000
8 049
4 900
100.0%
1 551
6 498
19.3%
1 551
31.7%
3 349
7 000
4 900
100.0%
1 919
5 081
27.4%
1 911
39.0%
2 989
3 281
10 281
4 900
100.0%
3 949
6 332
38.4%
3 949
80.6%
951
-
5 848
19 848
9 800
100.0%
5 587
14 261
28.1%
15 648
159.7%
(5 848)
7 000
-
700
7 700
4 900
100.0%
4 399
3 301
57.1%
4 226
86.2%
674
Mpumalanga
7 000
-
770
7 770
4 900
100.0%
1 999
5 771
25.7%
2 700
55.1%
2 200
Northern Cape
7 000
-
-
7 000
4 900
100.0%
3 016
3 984
43.1%
4 900
100.0%
-
North West
7 000
-
-
7 000
4 900
100.0%
3 083
3 917
44.0%
4 900
100.0%
-
Western Cape
7 000
6 956
-
13 956
4 900
100.0%
3 924
10 032
28.1%
3 924
80.1%
976
70 000
6 956
88 604
49 000
100.0%
29 427
59 177
33.2%
43 709
89.2%
5 291
Kwazulu-Natal
TOTAL
1 049
R'000
EXPENDITURE
PROVINCIAL TRANSFERS
Expenditure Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
-
11 648
National Health Grant (Schedule 6)
Original
Budget % Spent of
Budget CommitmentsExpenditure Available Budget
Grant Name
R'000
R'000
R'000 R'000 R'000
HPV Vaccine
200 000
60 069
40 930 99 001
20%
Health Facility Revitalisation Grant
604 862
52 132 194 862 357 868
32%
National Health Insurance-Indirect Grant 388 044 334 267
35 213 18 564
9%
Total
1 192 906 446 468 271 006 475 432
23%
OVERALL EXPENDITURE PER
PROVINCE
Grant Name
Original
Budget
R'000
BUDGET
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
NATIONAL TRANSFERS
Actual
Transfers
Transfers
per % of
Payment
Schedule
EXPENDITURE
PROVINCIAL TRANSFERS
Expenditure Budget
% Spent of Transfers
% of
Not
Available
Budget Received
Transfers Transferred
Received
R'000
R'000
%
R'000
12 769
3 054 118
2 282 961
100.0%
2 165 286
141 539
2 503 037
1 767 258
100.0%
84 948
7 700 564
5 719 660
5 848
6 429 573
R'000
%
R'000
%
R'000
888 832
70.9%
2 165 286
94.8%
117 675
1 683 444
819 593
67.3%
1 668 847
94.4%
98 411
100.0%
5 199 843
2 500 721
67.5%
5 199 843
90.9%
519 817
4 654 034
100.0%
4 291 096
2 138 477
66.7%
4 659 880
100.1%
(5 846)
Eastern Cape
3 041 349
Free State
2 343 498
Gauteng
7 615 616
Kwazulu-Natal
6 223 725
Limpopo
1 891 938
-
29 856
1 921 794
1 433 489
100.0%
1 313 207
608 587
68.3%
900 034
62.8%
533 455
Mpumalanga
1 361 749
-
5 703
1 367 452
1 033 772
100.0%
822 510
544 942
60.1%
871 016
84.3%
162 756
Northern Cape
1 146 641
30 000
26 665
1 203 306
866 223
100.0%
906 879
296 427
75.4%
866 224
100.0%
(1)
North West
1 771 909
14 000
17 156
1 803 065
1 352 838
100.0%
1 312 640
490 425
72.8%
1 241 966
91.8%
110 872
Western Cape
4 714 901
6 956
81 062
4 802 919
3 516 788
100.0%
3 382 671
1 420 248
70.4%
3 382 671
96.2%
134 117
30 111 326
268 956
405 546
30 785 828
22 627 023
100.0%
21 077 576
9 708 252
68.5%
20 955 767
92.6%
1 671 256
TOTAL
18 000
200 000
EASTERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
199 874
-
1 386
201 260
153 474
100.0%
144 434
56 826
71.8%
144 434
94.1%
9 040
National Tertiary Services Grant
786 007
-
10 334
796 341
589 505
100.0%
584 779
211 562
73.4%
584 779
99.2%
4 726
Comprehensive HIV and AIDS Grant
1 449 237
-
-
1 449 237
1 085 658
100.0%
1 012 429
436 808
69.9%
1 012 429
93.3%
73 229
Health Facility Revitalisation Grant
599 231
-
-
599 231
449 424
100.0%
422 093
177 138
70.4%
422 093
93.9%
27 331
7 000
-
1 049
8 049
4 900
100.0%
1 551
6 498
19.3%
1 551
31.7%
3 349
3 041 349
-
12 769
3 054 118
2 282 961
100.0%
2 165 286
888 832
70.9%
2 165 286
94.8%
117 675
National Health Insurance Grant
TOTAL
VARIANCES – EASTERN CAPE (1)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HPTDG
• PERSAL linkages challenge
• CoE database clean up project is
underway to correct the anomaly
NTSG
• Procurement challenges on
CAPEX especially medical
and allied equipment
• Bid processes are being fast
tracked for medical and allied
equipment
HIV/ AIDS • NGO contracts expired and
requiring new contracts
• HCW’s uniforms not
implemented
• Slow initiation of
procurement processes for
machinery and equipment
• NGO individual contracts
concluded
• Payments for new NGOS
underway
• Participate in National Treasury
uniform tender
• Demand process for desktops
and laptops undertaken
VARIANCES – EASTERN CAPE (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Slow progress due to new system
being implemented in the previous
months
• Late submission of invoices and
none processing of some invoices
• WSUhas recovered and the
implementation of the new
adopted service delivery model is
progressing satisfactory
• Emphasize submission of
invoices by Service Providers on
prescribed time
NHI
• Journal for CoE not processed due
to December downtime
• Challenge in the implementation of
key objectives of BP
• Delays with tender process for
purchase of assistive devices for use
by WBOT
• Journal to be processed in
January
• Reprioritisation of BP objectives
and identification of quick wins has
been completed as part of
adjustment process
• Follow up on SCM process
FREE STATE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
146 419
-
-
146 419
119 797
100.0%
113 183
33 236
77.3%
115 948
96.8%
3 849
National Tertiary Services Grant
898 091
-
-
898 091
673 568
100.0%
692 595
205 496
77.1%
673 569
100.0%
(1)
Comprehensive HIV and AIDS Grant
843 026
-
5 050
848 076
632 270
100.0%
559 141
288 935
65.9%
560 563
88.7%
71 707
Health Facility Revitalisation Grant
448 962
136 489
603 451
336 723
100.0%
316 606
286 845
52.5%
316 856
94.1%
19 867
7 000
4 900
100.0%
1 919
5 081
27.4%
1 911
39.0%
2 989
2 503 037
1 767 258
100.0%
1 683 444
819 593
67.3%
1 668 847
94.4%
98 411
National Health Insurance Grant
TOTAL
7 000
2 343 498
18 000
18 000
141 539
VARIANCES – FREE STATE
GRANT
REASONS FOR VARIANCES
HIV/ AIDS • Delays in procurement processes
REMEDIAL STEPS
• Expenditure acceleration
plan is being implemented
HFRG
• Awaiting approval for funds shifts to
procure medical equipment
• Current commitments for
medical equipment amount
to R43 mil and expenditure
to improve
NHI
• Post of Monitoring and Evaluation
not yet filled
• IT unit to start upgrading data lines
as per BP and will journalise the
grant
• Filling of the post in
progress
• Journals to be processed
in the next quarter
GAUTENG
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
811 114
-
-
811 114
608 337
100.0%
663 209
147 905
81.8%
663 209
109.0%
(54 872)
National Tertiary Services Grant
3 493 891
-
-
3 493 891
2 620 418
100.0%
2 407 710
1 086 181
68.9%
2 407 710
91.9%
212 708
Comprehensive HIV and AIDS Grant
2 632 578
-
-
2 632 578
1 982 730
100.0%
1 801 275
831 303
68.4%
1 801 275
90.8%
181 455
Health Facility Revitalisation Grant
671 033
-
81 667
752 700
503 275
100.0%
323 700
429 000
43.0%
323 700
64.3%
179 575
7 000
-
3 281
10 281
4 900
100.0%
3 949
6 332
38.4%
3 949
80.6%
951
7 615 616
-
84 948
7 700 564
5 719 660
100.0%
5 199 843
2 500 721
67.5%
5 199 843
90.9%
519 817
National Health Insurance Grant
TOTAL
VARIANCES – GAUTENG
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
NTSG
• Institutions using Equitable Share
instead of grant
• Journals to be processed
to correct expenditure
HIV/ AIDS • Delays in procurement processes
• Follow ups are being
made with SCM
HFRG
• Under performance of contractors
at Tembisa blood bank, Leratong and
PTA West Hospitals
• Terminated contractors not replaced
• Follow up and constant
monitoring of contractors
and DID to fast track
spending
NHI
• Delay in the procurement of
machinery and equipment
• Liaise with relevant
stakeholders to expedite the
procurement processes
KWAZULU-NATAL
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
292 837
-
-
292 837
219 627
100.0%
220 466
72 371
75.3%
219 627
100.0%
National Tertiary Services Grant
1 496 427
-
-
1 496 427
1 122 320
100.0%
1 209 136
287 291
80.8%
1 122 318
100.0%
Comprehensive HIV and AIDS Grant
3 257 992
-
-
3 257 992
2 430 435
100.0%
2 099 361
1 158 631
64.4%
2 430 435
100.0%
-
Health Facility Revitalisation Grant
1 162 469
-
1 362 469
871 852
100.0%
756 546
605 923
55.5%
871 852
100.0%
-
5 848
19 848
9 800
100.0%
5 587
14 261
28.1%
15 648
159.7%
(5 848)
5 848
6 429 573
4 654 034
100.0%
4 291 096
2 138 477
66.7%
4 659 880
100.1%
(5 846)
National Health Insurance Grant
TOTAL
14 000
6 223 725
200 000
200 000
2
VARIANCES – KWAZULU NATAL
GRANT
REASONS FOR VARIANCES
HIV/ AIDS • Unpaid outstanding invoices for
NHLS
REMEDIAL STEPS
• Effect payments for NHLS
in the next quarter
HFRG
• Expenditure below the guide due to • Journals to be made in the
forced closure of the month
next quarter
NHI
• Delays with specification for impact • Research on impact
assessments
assessments to be finalised
and fast track appointment
of service provider
LIMPOPO
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
116 206
-
-
116 206
87 156
100.0%
97 837
18 369
84.2%
55 808
64.0%
31 348
National Tertiary Services Grant
323 158
-
7 556
330 714
242 369
100.0%
250 032
80 682
75.6%
253 969
104.8%
(11 600)
Comprehensive HIV and AIDS Grant
978 132
-
20 370
998 502
748 482
100.0%
618 470
380 032
61.9%
471 847
63.0%
276 635
Health Facility Revitalisation Grant
467 442
-
1 230
468 672
350 582
100.0%
342 469
126 203
73.1%
114 184
32.6%
236 398
7 000
-
700
7 700
4 900
100.0%
4 399
3 301
57.1%
4 226
86.2%
674
1 891 938
-
29 856
1 921 794
1 433 489
100.0%
1 313 207
608 587
68.3%
900 034
62.8%
533 455
National Health Insurance Grant
TOTAL
VARIANCES – LIMPOPO
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HPTDG,
NTSG &
HFRG
• Spending within norm
• None
HIV/ AIDS
• 200 data capturers not yet finalised
• Delays in training due SCM
challenges
• R6 mil HIV and AIDS test kits in the
process of being settled
• Procurement of IT equipment for
tier.net still in process (R2.2 mil)
• Fast-track the appointment
process for data capturers
• Fast-track procurement of
training venues through SCM
• Follow up with SCM for the
procurement of IT equipment
NHI
• Awaiting delivery for WBOT
household profiling kits and forms
from Government printers
• Follow up with suppliers and
ensuring adherence of delivery
deadlines
MPUMALANGA
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
95 288
-
-
95 288
81 288
100.0%
54 017
41 271
56.7%
58 644
72.1%
22 644
National Tertiary Services Grant
97 116
-
4 933
102 049
72 837
100.0%
48 485
53 564
47.5%
57 558
79.0%
15 279
Comprehensive HIV and AIDS Grant
818 836
-
-
818 836
617 114
100.0%
594 300
224 536
72.6%
617 114
100.0%
-
Health Facility Revitalisation Grant
343 509
-
-
343 509
257 633
100.0%
123 709
219 800
36.0%
135 000
52.4%
122 633
7 000
-
770
7 770
4 900
100.0%
1 999
5 771
25.7%
2 700
55.1%
2 200
1 361 749
-
5 703
1 367 452
1 033 772
100.0%
822 510
544 942
60.1%
871 016
84.3%
162 756
National Health Insurance Grant
TOTAL
VARIANCES – MPUMALANGA
GRANT
REASONS FOR VARIANCES REMEDIAL STEPS
HPTDG
• Outstanding accounts from
UP still not processed
• Payments to be effected in the
next quarter
NTSG
• PERSAL linkages challenge
• Use of ES instead of Grant
• Officials to be correctly linked
• Journals to correct expenditure
HIV/ AIDS • Spending within norm
• None
HFRG
• Non receiving of final
accounts for complemented
projects from DPW
• Monthly final accounts meeting
held to track progress and unlock
bottlenecks
NHI
• Incorrect linkage of officials
• Officials to be correctly linked and
and tender for equipment was expenditure will be closely
advertised in November
monitored
NORTHERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
76 697
-
-
76 697
59 052
100.0%
75 577
1 120
98.5%
59 052
100.0%
National Tertiary Services Grant
298 727
-
-
298 727
224 045
100.0%
240 732
57 995
80.6%
224 046
100.0%
Comprehensive HIV and AIDS Grant
342 789
-
13 183
355 972
262 155
100.0%
267 895
88 077
75.3%
262 155
100.0%
-
Health Facility Revitalisation Grant
421 428
13 482
464 910
316 071
100.0%
319 659
145 251
68.8%
316 071
100.0%
-
7 000
4 900
100.0%
3 016
3 984
43.1%
4 900
100.0%
-
1 203 306
866 223
100.0%
906 879
296 427
75.4%
866 224
100.0%
National Health Insurance Grant
TOTAL
7 000
1 146 641
30 000
30 000
26 665
(1)
(1)
VARIANCES – NORTHERN CAPE
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HPTDG &
NTSG
• Spending above norm
• To journalise excess expenditure
to ES
HIV/ AIDS
• Spending within norm
• None
HFRG
• Slow progress of the mental
health project
• Workshop held to discuss
mental health construction
challenge and interventions
NHI
• Delays in the implementation
of business plan and vacancy
of NHI coordinator
• Close monitoring of expenditure
to avoid under expenditure
• Acting official appointed in Nov
2014 as NHI coordinator
NORTH WEST
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
104 586
-
-
104 586
78 444
100.0%
80 843
23 743
77.3%
69 728
88.9%
8 716
National Tertiary Services Grant
237 264
-
-
237 264
177 948
100.0%
169 025
68 239
71.2%
158 176
88.9%
19 772
Comprehensive HIV and AIDS Grant
936 938
-
-
936 938
726 954
100.0%
674 346
262 592
72.0%
644 762
88.7%
82 192
Health Facility Revitalisation Grant
486 121
517 277
364 592
100.0%
385 343
131 934
74.5%
364 400
99.9%
192
7 000
4 900
100.0%
3 083
3 917
44.0%
4 900
100.0%
-
1 803 065
1 352 838
100.0%
1 312 640
490 425
72.8%
1 241 966
91.8%
National Health Insurance Grant
TOTAL
7 000
1 771 909
14 000
14 000
17 156
17 156
110 872
VARIANCES – NORTH WEST
GRANT
REASONS FOR VARIANCES
HPTDG,
• Spending within norm
HIV/ AIDS
& HFRG
REMEDIAL STEPS
• None
NTSG
• Waiting for delivery of equipment
ordered
• Follow up with Service
Providers to deliver
NHI
• Slow implementation of activities of • Fast-tracking activities
the business plan
and SCM follow up
WESTERN CAPE
BUDGET
Grant Name
Original
Budget
R'000
NATIONAL TRANSFERS
National
Provincial Adjusted
Adjustments Roll-overs Budget
R'000
R'000
R'000
Actual
Transfers
R'000
Transfers
per % of
Payment
Schedule
%
EXPENDITURE
Expenditure
R'000
Budget
Available
R'000
PROVINCIAL TRANSFERS
% Spent of Transfers
Budget Received
%
R'000
% of
Transfers
Received
%
Not
Transferred
R'000
Health Professions Training and
Development Grant
478 767
-
-
478 767
359 073
100.0%
359 073
119 694
75.0%
359 073
100.0%
-
National Tertiary Services Grant
2 537 554
-
-
2 537 554
1 903 166
100.0%
1 901 055
636 499
74.9%
1 901 055
99.9%
2 111
Comprehensive HIV and AIDS Grant
1 051 794
-
-
1 051 794
769 809
100.0%
745 372
306 422
70.9%
745 372
96.8%
24 437
Health Facility Revitalisation Grant
639 786
-
720 848
479 840
100.0%
373 247
347 601
51.8%
373 247
77.8%
106 593
13 956
4 900
100.0%
3 924
10 032
28.1%
3 924
80.1%
976
4 802 919
3 516 788
100.0%
3 382 671
1 420 248
70.4%
3 382 671
96.2%
134 117
National Health Insurance Grant
TOTAL
7 000
6 956
4 714 901
6 956
81 062
81 062
VARIANCES - WESTERN CAPE (1)
GRANT
REASONS FOR VARIANCES
HIV/ AIDS • Fewer payments were made within
Goods and Services than anticipated,
however, commitments of R62 mil for
condoms recorded at end December
• Outstanding municipalities ARV labs
and drugs claims for October, November
and December amounting to R15,8 mil
will be processed in January 2015
REMEDIAL STEPS
• Regular contact
with condoms
suppliers to deliver
goods
• Interacting with
municipalities to
speed-up claiming
processes
VARIANCES - WESTERN CAPE (2)
GRANT
REASONS FOR VARIANCES
REMEDIAL STEPS
HFRG
• Vredenburg Phase 2B – contract cancelled
and process to appoint new contractor on hold
as current contractor disputing process
• Asanda clinic- new clinic- ongoing strike
action is causing delays.
• Mfuleni CHC and Delft CHC – works
reclassified and moved to scheduled
maintenance
• The issues are
addressed in
different forums
• Unspent budget
allocations
Vredenburg will be
requested to be
rolled over
NHI
• 11 of 13 activities have been implemented
and expenditure is slightly lower than budget
• Expenditure is
being accelerated
to ensure 100% jn
March
Key Overall Interventions
 Effective and efficient management of Procurement Plans
 Proper budget alignment with Business and Operational
Plans
 Strengthen monitoring and evaluation of grants spending
with more emphasis on NHI, HIV/AIDS and HFRG.