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HEALTH PORTFOLIO COMMITTEE
7 March 2006
DEPARTMENT BUDGET AND STRATEGIC PLAN 2006/07
Acting Chairperson: Ms M Madumise (ANC)
Documents handed out
Presentation on Strategic Plan 2006/07-2008-09
Summary and Analysis of department of health budget 2006/07 [vote16]
Strategic plan 2006/07-2008/09
The Director General presented the Department’s strategic plan for 2006/07. He provided a progress report on all of its programmes and identified its key challenges and priorities. The Committee asked for clarity on the accessibility of the health care system and budget implications, whether or not the department’s budget was adequate to address poverty-related problems and the issue of long queues at clinics and hospitals.
Mr Thami Mseluku, Director General, briefed the Committee on the National Department of Health ‘s strategic Ten Point Plan 2004-2009, which included improving governance and management of the national health system and improving the quality of care while strengthening support services. He outlined the department's recent achievements and gave a progress report on each of its programmes dealing with Maternal, Child and Women’s Health, Youth and Adolescent Health, HIV & AIDS and STIs, Tuberculosis. Malaria, Non-communicable diseases, Human Resources for Health, Pharmaceuticals, Health Legislation, Health Financing, Hospitals and International Health Liason. Other achievements were stability in infant and under-five mortality, access to safe terminations had improved, a database for medicines prices was in place, a pricing committee had finalised proposals on dispensing fees which would be released for public comment on 9 March 2006. The ongoing hospital revitalization was in its fourth year and four hospitals had been completed in 2004/5 while 45 hospitals would enroll into the programme over the next three years. By September 2006 all hospital CEOs would have appropriate delegations and a training programme for those CEOs had commenced.
The Director-General noted the challenges as being the implementation of policies within resource constraints, implementation of policies within resource constraints, health resources for health challenges. The department acknowledged challenges in improving the quality of care as well as strengthening priority health programmes. The presentation outlined the key priorities for 2006/07 that included implementation of the Human Resources for Health plan, strengthening physical and the development and implementation of service transformation plans.
Dr A Luthuli (ANC) commented that in the previous engagement with the department on HIV/AIDS and TB, the department had promised to return to the Committee to speak directly on the issues. That had never happened.
The DG responded that indeed they had promised to return to the Committee but when they had made
follow ups, the Committee could not find a slot for a meeting with the department to present this.
Mr B Mashile (ANC) asked how long the process of reviewing capacity would last as indicated by the President in his State of the Nation Address. He further questioned the scope of work of the delegation of the CEOs placed at hospitals. What was the status of their qualifications? What implications did the budget have on the department’s programmes?
The DG answered that the issue of capacity had been under discussion for a long time and it did not arise as a response to what the President had said in his State of the Nation Address. The department worked at strengthening understanding and participation in the international training industry. On the question of CEOs, the Department needed not only to look at qualifications of CEOs but at their level and capacity to manage other matters in hospitals.
Ms M Matsemela (ANC) commented that there was no mention in the presentation of the outbreak of avian influenza (Bird Flu). She asked if there was any difference between Home Care Givers and Community Based Care Givers.
The DG indicated that the Department’s budget caters for emergencies and diseases such as Bird flu would fall under emergencies and would be covered by the budget for emergencies
The DG responded that the Cabinet had taken a decision few years back to integrate Community Care Givers and Home Based Givers and other support programmes into a single framework. The Department of Social Developed in conjunction with the DOH had integrated these support structures and referred to them as Community Based Givers because of the nature of services rendered to communities.
Mr A Madella (ANC) followed up on the question of Community Care Givers and their stipends. He asked whether or not there was a uniform stipend system for caregivers. He further posed a question around the re-opening of Nursing Colleges. He asked if it was possible for the Committee to be informed on all the colleges that were to be re-opened. This was important because parliamentarians were always in contact with communities and questions would always arise on the issue of colleges.
He continued that previous Annual Reports suggested that there were problems around qualifications of the Chief Financial Officers (CFOs) and their inability to provide strategic plans and other reports. Were there any measures taken to prevent the continuation of such problems.
The DG replied that stipends were already uniform in all provinces except in Kwazulu Natal which they were working on managing this so it was not increased as they were very high compared to other provinces. He also indicated that the Department sought to start with caregivers who worked on voluntary basis to avoid problems. Regarding re-opening Nursing Colleges, the DG said that there was a task team that was looking and identifying colleges that were going to be re-opened and what processes needed to be followed.
Ms C Dudley (ACDP) wanted to know if the Department’s budget catered for occurrences such as the recent power outages. She also asked if the Department was satisfied with the needs analysis in various provinces, as it was evident that other areas also struggled to maintain comprehensive needs analysis. Ms Dudley questioned the department’s strategy to intervene with regard to systems that were not on scratch. What was done to monitor and trace patients on AntiRetroviral treatment and if that that was incorporated in the budget.
The DG replied that recent power outages would have not impacted on hospitals as hospitals had back up systems such as generators even though power outages did alarm the Department as to the challenges that hospitals are faced with. However the Department hoped to look at other measures to assist during power cuts across provinces.
On the question of needs analysis, there were measures to do the needs-based and budget-based analysis because means would far supercede the actual capacity in terms of resources. He indicated that to ensure that systems were up to scratch, service providers as well as universities also needed to be actively involved in producing the quality of pharmocovigilance.
Dr R Rabinowitz asked if the Department had looked at the possibility of announcing AIDS as a notifiable disease. She sought clarity on the Alternative Healthcare Council that was going to be regulated but until now had not happened. She questioned when the African Traditional Medicines Bill was going to be implemented. She also asked what the Department was doing with administration costs of some Medical aid Schemes that seemed to escalate rapidly. Was there any legislation coming up to regulate Medical Aid Schemes and private hospitals? She requested the DG to communicate directly with the Committee via e-mails to inform them of activities and conferences that were going to address problems relating to healthcare.
The DG responded that identifying AIDS as a notifiable disease was a heated debate that the Department preferred not to respond to at that stage as it was also debated internationally. He said that the question of alternative healthcare council was discussed at various levels through certain processes and it was clear that there were delays in producing the required results. The major problem was that there were issues of expertise needed to speed up processes. The African Traditional Medicines Bill was on the Department’s table and they would be meeting with the drafters soon to finalise matters. He said that there was a lot of activity around the Bill and regulation of medicines and Medical Aid schemes. He hoped that at least by the end of 2006, the Department would be able to tell where the country was headed towards on these matters.
Mr Madella asked what impact would the department’s R 12 billion budget have on problems in hospitals such as long queues.
The DG said that the budget could assist in ensuring that there were enough pharmacists available in all hospitals. Other problems facing hospitals required proper management by officials at various hospitals. He further echoed that lack of personnel to manage issues such as long queues was a problem that could be addressed with the assistance of the budget and interventions by hospital officials.
The meeting was adjourned.
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