The Standing Committee on Health were briefed on the Western Cape Department of Health 2021/22 Adjusted Budget. After deliberations, it adopted its Committee Report approving Vote 6:Health in the Western Cape Adjustment Appropriation Bill.
Members asked how much has been made available in the budget to address nursing and medical emergency services at the Khayelitsha Hospital and the number of nurses employed there; the reasons for budget cuts in building infrastructure and the type of facilities affected by this; and the R100m Covid-19 activities related to staff facilities and why these were not implemented timeously. They asked if the Department has engaged with Provincial Treasury for more funds seeing that this money is coming from national government and rollovers; the reasons for the reduction in the health facility management budget and what projects would be affected by this; why R74.5m was shifted from vaccine programme and if this meant the Western Cape vaccination programme is failing; and asked for an update on Cape Town Convention Centre (CTICC) vaccination site.
Western Cape Health MEC Nomafrench Mbombo, in her introductory, remarks, informed the Committee that for 2021/22 the Department was given R27 billion and now R798m has been added. This took the budget to R28.9 billion. Funding came from the equitable share. This adjusted budget comes at a time when the whole country has challenges due to fiscal constraints. The budget has taken into cognisance the wage agreement shortfall and the new Omicron variant, prioritising Covid-19 and non-Covid-19 cases that are coming back to haunt us such as mental health which competes with trauma and chronic cases. In some hospitals she visited, the situation is calmer in terms of Covid-19 admissions.
Dr Keith Cloete, Health HOD, explained the R790m adjusted budget is made up of two sources of funding: R100m rollover funding approved by Provincial Treasury and R620m for the wage agreement adjustment of salaries for all department employees. The Western Cape Department of Health (WCDH) was concerned about over-expenditure before the adjusted budget came, but now the department has got a chance to balance the books. The wage money is to buffer salary increases. The rollover money would be used for covering the Covid-19 response until March 2022, including everything required for the fourth wave. The adjusted budget in their estimations would help cover funding pressures identified during the year and assist to meet all service obligations.
Ms R Windvogel (ANC) asked if WCDH engaged with Provincial Treasury to add more funds seeing that this money is coming from national government and from rollovers. She asked for the reasons for the reduction in the health facility management budget and what projects would be affected by this.
Dr Cloete replied they had engagements with Provincial Treasury on the rollovers. Since the Department has a good standing with Provincial Treasury, it was given the R101m it requested from rollovers. The big engagement with Treasury was on the shortfall for employees and they got that from the national allocation.
Mr Simon Kay, CFO & Head of Corporate Services: WCDH, stated Provincial Treasury did not provide more because WCDH had savings from the previous Covid-19 allocation which they asked for and used in the current year to fund the fourth wave response. When WCDH asked for the R211m from Provincial Treasury, it was given the money. The Omicron variant was announced after the allocation, and Provincial Treasury indicated if WCDH needs further funding similar to what happened last year, it would find the money for the Omicron variant.
On facilities management, Mr Kay replied that because maintenance requirements have been impacted by Covid-19, no expenditure was incurred for maintenance and capital projects. The recommendation is that it is better to surrender the funds in the adjusted budget to be earmarked for the next time when WCDH would be given the money. That is a timing difference that does not include the funding allocated for the Klipfontein project where the professional service providers (PSPs) have not been appointed and it is being re-advertised. Nothing has yet been awarded. So that money cannot be spent.
Ms A Bans (ANC) asked for a breakdown of the following items: 2020/21 funding wage agreement, Presidential Youth Initiative and assistant nurses. She asked the reason for the budget cuts in building structures and the type of facilities that would be affected by this. She asked for details of the R100m Covid-19 activities related to staff facilities and why these were not implemented timeously.
Mr Kay replied that funding from the Presidential Youth Initiative has been used to renew contracts for the Covid-19 and vaccine response until 31 March 2022. Additional money that came to Administration Programme from rollovers is for centrally-held Covid-19 funds primarily for PPE and testing. CoE funds sit in a different programme. Facilities are properly managed in Programmes 2, 4 and 5.
Mr R Allen (DA) commended WCDH for the budget increase it received under trying circumstances.
Ms Windvogel asked how much has been made available in the budget to address nursing and medical emergency services at Khayelitsha Hospital, and the number of nurses employed there.
Dr Cloete replied that nursing and medical emergency adjustments were made to solve the case pressure felt at Khayelitsha Hospital such as psychiatric and trauma cases. The cases are not only Covid-19. Costs including the number of nurses in Khayelitsha Hospital would be sent in writing to the Committee.
Ms Bans asked for clarity on the R74.5m shifted from the vaccine programme and if this meant the Western Cape vaccination programme is failing. She asked for an update on the CTICC vaccination site and costs.
Dr Cloete replied that CTICC after an agreement with WCDH decided to close the vaccine site formally.
Mr Kay explained that R150m was allocated to the Administration Programme for flexibility because they did not know the shape the vaccine programme would take. The budget was shifted from the Administration Programme to where the expenditure has actually happened such as the Cape Town Convention Centre (CTICC) and Athlone stadium vaccination sites. A lot of expenditure has been incurred in metro and rural health services to support the vaccine rollout programme.
Committee Report on Western Cape DoH 2021/22 Adjusted Budget
The Chairperson tabled the Committee Report.
Ms L Botha (DA) proposed the Committee support the vote; Mr Allen seconded the motion.
Ms Windvogel expressed a minority view not to support the vote.
Mr Allen moved for the adoption of the report; Ms Bans seconded the motion.
The report was adopted with no amendments.
The Committee resolved to ask for clarity from the Department on the unspent R74.5m meant for the Western Cape vaccine programme and for funds shifted to Athlone Stadium, CTICC and other programmes.
The meeting was adjourned.
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