Budget Speech for the Department of Health 2012/13 delivered by Limpopo Health MEC, Dr. Norman Mabasa at the Provincial Legislature, Lebowakgomo

Honourable Speaker & Deputy Speaker of the Provincial Legislature
Honourable Premier, Mr Cassel Mathale
Honourable Members of the Executive Council (MECs)
Honourable Members of the Legislature (MPLs)
Executive Mayors and mayors present here
Director General
HOD for Health, Mme Daisy Mafubelu and other HODs
Leaders of different political parties and formations
Stalwarts and veterans of our movement
Esteemed majesties
Leadership of the Trade Union Movement
Representatives of the Non-governmental organisations
Heads of institutions
Members of the media
Comrades and friends
Ladies and gentlemen.

Honourable Speaker, it is indeed an honour and a distinct privilege for me to present the 2012/13 Budget Vote (7) of the Department of Health to this August House for consideration.

When presenting the health-budget speech a year ago we made a point that “our country is facing a quadruple burden of diseases consisting of HIV and AIDS; Communicable diseases; Non-Communicable diseases mainly related to lifestyle; and Violence and Injury”.

The consequence of this is the high levels of mortality and morbidity, yet some if not many of these diseases can be prevented. These we said conscious of the fact that the ANC-led government has identified health as one of the priority areas that do not only needs urgent attention but requires all of us irrespective of our political persuasion to work together in developing a “Long and healthy life for all our people”.

Honourable Speaker, we must therefore spare no effort in ensuring that the goal of providing quality, affordable, accessible and more sustainable health care delivery to all our people is achieved.

We have a responsibility to do everything that has to be done to make sure that our people receive the best possible health care at both private and especially at public health facilities in the province to mitigate the effects of illnesses that often lead to death and the reduction in life expectancy.

In 2009, Statistics South Africa estimated the life expectancy of South Africans to be 53,5 years for males and 57,2 for females. In order for us to improve the life expectancy of our people from the current estimated age to 60 years of age, we really have to take tough decisions including the need to move swiftly from curative health system to a preventative health care system based on the principle of healthy living and the preservation of health.

During this financial year we will, with a deliberate and added sense of urgency do the following:

• step-up vaccinations
• enhance our capacity to control infectious diseases
• re-introduce family planning delivery
• recognise tobacco use as a health hazard
• ensure decline in deaths from coronary heart diseases and stroke.
  

We are therefore calling upon all of us to work together in partnership to reach the goal of improving the health profile of all South Africans and in particular the people of Limpopo.

I trust that we will all rally behind the dictum, Unity in action: Working together to build a long and healthy life for all.

Honourable Speaker, One of the very best ways of achieving health outcomes is to advocate for primary health care, particularly in a rural province as our own, the province of Limpopo. Primary health care (PHC) should be made the first-line of call in terms of health care delivery, something that suddenly appears ‘foreign’ to most people in the province the majority of whom are poor.

To demonstrate this point, allow me to repeat after the Director General (DG) of the World Health Organisation Dr. Margaret Chan who had this to say about primary health care: “primary health care is a people-centred approach to health that makes prevention as important as cure. As part of this preventive approach, it tackles the root causes of ill health, also in non-health sectors, thus offering an upstream attack on threats to health”.

Honourable Speaker, the statistics that come out of out-patient departments in all hospitals shows that our people do not consult at clinics but prefer a hospital as though is a first point of call in health delivery thus creating a serious service delivery challenges at hospitals including but not limited to long queues; patients taking too long to receive treatment or even medication.

Although we have implemented about 75% of the entire package at all 443 Primary Health Care (PHC) facilities in the province with a record of 409 0875 patients received treatment at these facilities, we are not convinced that our clinics are utilised to their full potential. More still needs to be done. In this regard, we will during this financial year develop a strategy, referred to as PHC re-engineering process – a road map that will point us towards the maximum use of clinics and health centres in the province.

Salient features of this strategy includes amongst others the following:

• increasing the number of clinics offering a 24hour service from 64 to 75
• increasing the number on-call system facilities from 357 to 368
• enhancement of clinic visitation by Medical doctors, health professionals and allied health workers to PHC facilities on structured basis
• supply of quality equipment and required medicines to clinics
• recruitment, training and re-training of retired professional nurses and community health workers.

We are confident that the re-engineering process will assist a great deal in ensuring that prevention of diseases is taken a notch higher while on the other hand giving impetus to the management of sicknesses at municipal ward level. These we will do with full knowledge that “primary health care approach is the most efficient, fair and cost effective to organise health system. It can prevent much of the disease burden, and it can also prevent people with minor complaints from flooding the emergency wards of hospitals”, as Dr. Margaret Chan observed

Let me pause to thank all companies like Anglo-American, Palabora Mining Company, Eskom, Polokwane Smelters and so forth for the donation of clinics and health care-related equipment to communities in the province. Their contribution and investment in health is an indication that they recognise that health is the very foundation of productivity and prosperity.

HIV and AIDS

Honourable Speaker, we are here today not only to find ways to solve our immediate health challenges but to build a future for ourselves and for generations to come. We are here to talk about an issue that is central to that future and that is the issue of health care, the universal access to quality and affordable public health care for all our people. To contribute to vision for health 2030 that “we envisage South Africa has a life expectancy rate of at least 70 years for men and women”.

This can only be achieved if we could ensure that the next generation is free of HIV; the quadruple burden of diseases has been radically reduced; maternal; infant and child mortality is drastically reduced while at the same time we work tirelessly in improving health systems effectiveness.

In the year 2000, the leading causes of morbidity in terms of disability-adjusted life years lost were HIV/AIDS (31%), interpersonal violence (7%), Tuberculosis (4%), Road traffic injury (3%) and Diarrhoeal diseases (29%). In this regard we acknowledge that the challenge of HIV and AIDS, unwanted teenage pregnancies coupled with back street abortions remains the greatest health and social ‘headaches’ in our province thus contributing to the high numbers of maternal, infant and child mortality.

Statistics reveals that South Africa is leading the world in the global HIV burden; hence we are taking the responsibility as a nation to roll-back this reality. We are implementing the HCT campaign which, we are firmly convinced that it is paying dividends. However there are still pockets of resistance from some among us as fuelled by among others discrimination and the stigmatisation of the virus. The consequences of stigma and discrimination are wide-ranging and manifest themselves differently across communities and individuals. In most cases stigma not only makes it more difficult for people trying to come to terms with HIV and manage their illness on a personal level, but it also interferes with attempts such as the HCT campaign to fight the AIDS pandemic.

The stigma associated with HIV has a potential to deter us from taking fast, effective and appropriate action against the epidemic, whilst on a personal level it can make individuals reluctant to access HIV testing, treatment and care even though it is offered free of charge. In the words of the UN Secretary-General Ban Ki Moon “stigma remains the single most important barrier to public action. It is the main reason why too many people are afraid to see a doctor to determine whether they have the disease, or to seek treatment if so. It help make AIDS the silent killer, because people fear the social disgrace of speaking about it, or taking easily available precautions. Stigma is a chief reason why the AIDS epidemic continues to devastate societies around the world”.

Honourable Speaker I was shocked to read a front-page story authored by Nyambeni Mandiwana of the Capricorn Voice newspaper with a headline title “We Don’t Want to know our status”. In this article Mandiwana wrote “Students fear being tested for HIV and AIDS, knowing their status will in all probability be positive in asking the students why they were reluctant to be tested, many said they fear “what they already know”.

A 22 year old student said she was scared to get tested, given her involvement in sexual activities saying “the MEC’s plans are good, but sorry, I am too scared. I have already been around and if I test positive, I might die of heart attack”, she said. (Capricorn Voice 28 Feb 2012).

Despite all this challenges and the fact that our province account 21,6% of people living with HIV and AIDS we have managed to test 100 892 people through the HCT campaign in farms, institutions of higher learning, prisons, taxi ranks and all other such strategically placed public events in the province. We will continue to do so, as we believe one new infection is one too many. Our target this financial year is to test over 300 000 people as part of the overall “know your health status campaign”. The next stop should the grounds of the Limpopo provincial legislature and I hope honourable members will take the lead in this regard.

Honourable Speaker, prevention is better than cure and as a result we will continue to use biomedical HIV prevention methods, including but not limited to the following:

• widespread distribution of 105 million male condoms and at least 630,000 female condoms (also known as Femidoms)
• intensify the Male Medical Circumcision (MMC)
• enhance testing and treatment for sexually transmitted illnesses (STIs)
• provision of Anti-retroviral therapy/treatment
• implementation of Post Exposure Prophylaxis (PEP),
• prevention of mother-to-child transmission (PMTCT).

The proper and consistent use of condoms will assist us not only as barrier contraceptives but also to reduce the risk of contracting STI’s such as syphilis, gonorrhoea and HIV, including the rocketing incidents of unwanted or unintended pregnancies which is rife in this province particularly among the youth. On the other hand we are determined to intensify the medical male circumcision campaign to reach all men young and old in the province in an endeavour to reduce the rate new HIV infections.

Although male circumcision is seasonal in our province we have reached 41 375 people through public health facilities and a record 31 000 in initiation schools during the 2011/12 financial year. United in action with all traditional leaders in the province we are confident that during this financial year we will increase the figure to reach about 50 000 men in our facilities and perhaps 40 000 through the ‘rite of passage’ at initiation schools.

HIV Treatment & Prevention

Honourable Speaker, the management and treatment of HIV and AIDS through among others anti-retroviral therapy is as important as the prevention of new infections. Lifelong Anti-retroviral treatment saves lives as huge reductions in rates of deaths and suffering has been achieved the world over, including the reduction of HIV transmission at population level. I am pleased to report that during the last financial year we have managed to initiate about 35 545 new patients on lifelong ART which brings the figure to 131 954 people on ART in the province with more than 85% treatment adherence since its inception in 2004.

However, many patients are in need of treatment. This year we are targeting to initiate no less than 46 000 qualifying patients with a CD4 count of 350 and below on Lifelong ART. This has to be done without fail if we are to manage HIV and AIDS epidemic in the province. We count on you, Honourable members for your support not only at the level of making people aware but also as health ambassadors.

Maternal Health

Similarly, we have a responsibility to prevent mother-to-child transmission in order to reduce the rate of infants born of HIV positive mothers. We have in the past managed to arrest the rate of MTCT below 5% as required, however we are worried that there is a slight increase from 5.0% to 5.1%. The consequence of which is that the zero maternal HIV vertical transmission cannot be reached unless drastic action is taken.

Part of the reason why we find ourselves in this predicament can be attributed to the non-provision of the necessary prophylaxis to HIV positive pregnant mothers due to late bookings, home deliveries and the refusal to test for HIV during pregnancy. In this regard, we will from now henceforth intensify efforts to prevent new infections; improve timeliness and continuity of Ante-natal care (ANC) and improves quality of PMTCT services at all our facilities. These can only be achieved if all pregnant mothers check-in to our facilities early enough in pregnancy stage.

Honourable Speaker, we will further strengthen our public education efforts to teach people about the use of clinics and equally I would like to challenge all members of this august house to consider encouraging pregnant mothers to consult clinics at every opportune moment we get, including during constituency work. These will assist us on the road to reduce both maternal, infant and child mortality.

Immunisation Drive

Honourable Speaker, the value of immunisation cannot be over-stated as it helps to fortify the immune system against agents thus helping to fight or prevent infections. Immunisation forms an important part of health care delivery and for that reason we will spare no effort in ensuring that immunisation from birth is provided at all our facilities. To this end, we exceeded the national immunisation coverage by 3,9% as we are now standing firmly on 93,9%. We have started with the massive immunisation drive and we will continue to extent our coverage that includes the provision of measles; pneumococcal and rotavirus vaccinations. Special vaccination will also be embarked upon to prevent diseases such as PCV 13 (an extra dose of the pneumococcal conjugate vaccines) and N1H1 influenza.The message is clear and unambiguous: Don’t wait. Vaccinate!

Non-communicable Diseases (NCD’s)

Honourable Speaker health is by definition “a state of complete physical, mental and social well-being, and not merely the absence or disease or infirmity”. If it is true, which I have no doubt in my mind that it is true, it must then follow that we do the best we can as individuals and a collective to ensure that no part of our health well-being is neglected.

In this regard, allow me to state a point that non-communicable diseases – better known as lifestyle diseases, principally cardiovascular diseases; diabetes; cancers and chronic respiratory diseases, are the leading causes of preventable morbidity and disability. Statistics suggests that throughout the world non-communicable diseases accounts for 60% of global deaths and it is estimated that in 2030 NCD’s will contribute about 75% deaths globally unless something drastic happens to change the situation around.

First, we need to recognise that the challenges of obesity; lack of exercise (physical inactivity); unhealthy diets including excessive salt intake; tobacco use and harmful use of alcohol are serious health hazards. Secondly, we need to take serious action in order to prevent our people from suffering from non-communicable diseases by reducing the exposure to this health hazards.

During this financial year we will step-up public campaigns against alcohol and tobacco use, advocate for the reduction of salt intake, promote public awareness about diet and physical activity. We therefore welcome the efforts by the Minister of Health to regulate and subsequently ensure bans on alcohol advertising, promotion and sponsorship. We further applaud Minister Aaron Motsoaledi for taking a decisive unpopular stance in the introduction of a legislative framework to regulate salt intake and salt content of food – a move aimed at reducing the rate of people suffering from NCD’s.

Over and above these national initiatives, we are determined to strengthen the capacity of the health care system based on the primary health care model to ensure early detection and services for people at high risk of heart attacks; strokes and curable cancers. We will continue to strengthen our “know your health status campaign” by providing free health tests at all strategic locations in the province including farms, taxi ranks, shopping malls and so forth. We will further encourage corporates, government departments and entities including the Limpopo Provincial Legislature to set aside at least an hour once a week for physical activity.

We have introduced a “Hlasela Mafutha -Thuba Mokhaba” health walk and aerobics sessions and members of staff at both our departments are benefitting from this initiative. I must say, service delivery is not compromised during the health walk. Let us remain united in the fight against non-communicable diseases while at the same time taking personal responsibility in the reduction of salt intake and fatty foods in our households. This will assist us not only to fight and or prevent non-communicable diseases but also in the building of healthy communities.

Tuberculosis (TB)

Honourable Speaker, tomorrow (24/March) our province will join many people the world over in celebrating the World TB day under the banner “Stop TB in my lifetime”. These we will do to raise awareness about the epidemic of and to communicate our efforts to eliminate the prevalence of TB among our people. We will also take a moment to reflect on the achievements we recorded in the fight against TB while acknowledging challenges that we faced during the previous year as we endeavour to eliminate TB.

We are confident that this year, we will increase the TB cure rate from the record 70.3% we achieved during the 2011/12 financial year to 85%. These will only be achieved if we strengthen our TB screening initiatives particularly among people who are at high risk; improve our case finding and contact tracing campaigns with the aim of detecting new infections and to curb the defaulter rate. We will continue with our door-to-door campaigns and embark on TB road shows to educate people about dangers of TB including how to manage and control.

Our message is clear: TB is curable – Lufhiha-lua-alafhea!

Malaria

The outbreak of Malaria also remains a cause for concern in the health sector and in particular the Limpopo province as this also accounts for many deaths in the province yet is preventable. In the 2011/12 financial year we lost 18 people due to Malaria, however our interventions assisted us a great deal in saving lives that could have otherwise been lost out of 2 891 cases we received in the same period.

In January alone (this year), we handled about 659 Malaria cases which amounts to a slight decline compared to the same time the previous year. This is an indication that our preventive interventions are beginning to bear fruits. We are fully prepared to deal effectively with malaria cases as all our facilities in the province are equipped with malaria diagnostic test kits and provide treatment to those who are tested positive. As a preventive intervention, our malaria teams will continue to comb all affected and high risk areas to raise awareness and conduct spraying exercise in the community and households.

To this end, we have managed to spray 910 769 houses in the province and we would like confirm to our people that malaria is curable particularly when diagnosed early. I am happy to announce that the Limpopo province successfully hosted the Southern African Development Community (SADC) Malaria day in Bungeni village near Giyani in 2011 and over 10 000 people attended the event and shared their experiences with Ministers of health in the region.

Infrastructure Development

Honourable Speaker, one of the reasons why we have been unsuccessful in recruiting health workers particularly medical officers is the challenge of lack of suitable accommodation particularly in rural hospitals. We are convinced that by the end of this financial year, the challenge of staff accommodation will be a thing of the past as most of our infrastructure development projects in relation to staff accommodation will be finalised.

Although the completions of these are at different stages ranging from 25% to 95% we are confident that all will be duly completed during this financial year. Similarly, the construction of the new theatres at Elim and Mokopane hospitals and the building of new OPDs, casualties and pharmacies at Philadelphia hospital, Voortrekker Hospital and Mucklenburg hospital are at an advanced stage at 63% and 42% and on schedule. Elim hospital is almost done and due for opening soon.

However construction at some sites is at a complete halt thus delaying progress as contractors are off-site citing non-payment as the main reason for abandoning ship. We are hopeful that the allocation for the hospital revitalisation grant for the 2012/13 financial year will assist us to complete these projects. We have to make difficult choices on how to best allocate resources for infrastructure development for health.

National Health Insurance

Honourable Speaker, despite all this challenges and the difficult choices we have to make on how best to fund health infrastructure and health care in general, we remain resolute in providing the most efficient, affordable and quality health care to our people. The pilot project of the National Health Insurance (NHI) provides us with yet another opportunity to excel in the provision of health care services to our people as we believe that indeed “health is a human right”. In this regard we will make sure that we improve all our facilities in the province to meet the minimum requirements for the implementation of the National Health Insurance (NHI).

I am sure Honourable members would recall that during the introduction of the NHI framework, the Minister of Health announced that in the year 2012 “we will start piloting the NHI to help us finalise how the service benefits will be designed, how the population will be covered and how the services will be delivered”. I am therefore pleased to announce that the Vhembe district in our province has been selected as one of the ten (10) pilot sites for the implementation of the NHI. I must say we worked very hard to ensure that we pass the audit conducted by the National health department with the aim of selecting pilot sites. These include the re-engineered PHC streams; basic infrastructure, compliance with standards, appropriate management levels. We are ready…! We are ready!

We will further ensure that all our facilities are NHI compliant going forward so that when the full implementation of the kicks we are able to roll-out. To this end, we will make sure as agreed at the National Health Council that funding to the following non-negotiables are protected against under-funding from this financial year onwards. The non-negotiables include the following: infection control; medicines and medical suppliers (incl. dispensary); cleaning materials and services; essential equipment and maintenance; laboratory services (NHLS); Blood supply and services (SANBS); children’s vaccines; food services and relevant supplies; child health services (incl. neonatal & perinatal); maternal and reproductive health services; full complement of ward-based primary health outreach teams; district specialist teams, infrastructure maintenance; HIV & AIDS; TB and security services.

Honourable Speaker, let me re-state it for emphasis…We are ready… We are ready. During the Provincial Budget Speech, Honourable Masondo said “The freedom of our people from disease is one of the priorities of the ANC-led government, and has become a societal priority”.

Human Resource Management

Honourable Speaker, in his State of the Nation Address 2011, His Excellency President Jacob Gedleyihlekisa Zuma has announced the establishment of a medical school in the province located at the University of Limpopo. We believe that this initiative will assist us in developing the necessary capacity and o produce the requisite skills to deal with burden of diseases going forward. I am happy to report that we have been working tirelessly, with the University of Limpopo since the announcement to make sure that this dream is realised.

To this end, we have managed to secure accreditations in 19 fields of study out of the 20 applied for, safe for nuclear medicine as we were found wanting on “lack of equipment, consumables and staff”.  We have noted the comments and recommendations by the Health Professional Council of South Africa (HPCSA) and we will do all we can to correct this anomaly so that we get accredited on nuclear medicines in the near future. We want to thank all members of team led by Professor A.J Mbokazi, the Deputy Dean: Polokwane Campus for the job well sometimes behind the scenes to make sure that we get accredited.

Honourale Speaker, we are confident that through this school will not only produce the required numbers of highly skilled health professionals but also attract specialists and academics in health to our province. If we succeed in doing so, then we will be able to improve the quality of care even in specialist areas in district areas and surrounding health centres and clinics, as well as improving the planning, management and monitoring of district services.

However, the shortage of health professionals particularly medical officers remains a challenge and a serious cause for concern to all of us in the health sector. We must develop a pool of medical officers and deploy them to the most rural areas of the province according to need. In this regard, we continue to encourage young people to study medicine and other such related fields in health with our support in the form of study loans and or bursaries. We also offer deserving students, the Cuban scholarship to enable them to study medicine in Cuba.

During this financial year our province was allocated 10 Cuban scholarships, however we only managed to send 9 students to Cuba as the tenth student pulled out at the last minute. I am pleased to report that this initiative is bearing fruits and the impact is felt in our hospitals particularly hospitals that are located in rural areas. This year 29 recipients of the Cuban scholarship fund are back in the country for their last leg of studies in South African universities. They will be joined by an additional 33 medical students who also studied in Cuba that brings to total number of students due to complete to 62. If they all complete, as I am convinced that they will; we will have an addition of 62 qualified doctors in our facilities in 2013.

We wish them all the best in their studies. I hope they will serve as an inspiration to others to complete their studies on record time, especially the 100 new aspirant medical students who are due to be enrolled in the Cuban scholarship programme this year.
Accelerate training of nurses

Honourable Speaker, similarly the shortage of nurses remains a challenge and therefore we need to accelerate the production of appropriately qualified and skilled nurses without delay. This is urgent.

The PHC re-engineering strategy requires us to develop these skills as primary health care includes promotive and preventive components, which are key activities of public health. In this regard we need to accelerate the production of appropriately skilled nurses who will be deployed in all our facilities to lead and effectively deal with primary health care teams consisting of professional nurse, staff nurse and community health workers.

We are producing about 450 professional nurses per annum, 250 of whom are produced by the Limpopo College of nursing yet the need is still enormous. In this regard, we are working tirelessly to establish additional two campuses in the Sekhukhune and Waterberg districts while revitalising all the existing nursing college campuses in the province. We are confident that with the management teams already in place to facilitate the critical issue of accreditation, the council will this year accredit us accordingly so that the training can commence in earnest.

We agree with the National Development Plan on promoting health that “prioritising the training of more mid-wives and distributing them to appropriate levels in the health system could have an immediate positive impact on maternal, neonatal and child health, which would reduce maternal and child mortality”.

Health Budget Vote 7 (Tabling)

Honourable Speaker, in tabling the provincial budget speech the MEC for Provincial Treasury, Hon. David Masondo has announced an increased allocation of the Department of Health from R11.5 billion to R11.9 billion for the 2012/13 financial year. He said “the department enjoys a high share of the provincial budget at 26% due to the number of priorities outlined within the department, which include the implementation of the National Insurance scheme, the fight against HIV-AIDS, TB, malaria and cholera as well as the recruitment and increasing of the number of professionals through building more nursing colleges”.

Honourable Speaker, I am privileged to table Health budget vote 7 for the 2012/13 financial year to this honourable house for consideration.

These we do Honourable Speaker conscious of the fact that these are public funds that needs to be utilised for the purposes intended for. We therefore commit that we will not only spend this budget wisely but also account for every rand while ensuring that wasteful, fruitless and unauthorised expenditure is eliminated. We will do everything to make sure that all assets in our trust on behalf of the people of Limpopo are safely and jealously guarded against any form of misuse, mismanagement, fraud and corruption.

In this regard, we welcome the announcement by the Minister of Finance, Hon. Pravin Gorhdan who said “we will review the competencies and capabilities required to perform the procurement functions and as said by the President, there will be strict vetting of all the procurement officers to be appointed”.

Conclusion

Honourable Speaker, we have been allocated a budget that gives effect to Vision for Health 2030 in which we envisage that South Africa has an improved life expectancy of at least 70 years for males and females. We will make sure that health promotion and wellness is strengthened among our people as it remain the most critical component of prevention and the management of lifestyle diseases that account for too many deaths.

There is clear evidence that preventive interventions work and that improved access to quality and affordable public health care can reduce the burden of morbidity, disability and premature mortality.
Unfortunately, many of us, when we think about weight loss, exercise and living healthy lifestyle, we think like Mike Twain who once said “The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not”.

Let us stop focusing on negatives for we believe that the real joy and benefit of good health comes from focusing on the possibilities of health, what we gain through living well.
Now is the time and season for action. Now is the time to deliver on health care.

I thank you.

Summary: Budget Vote 7 – Health

The overall budget for Health vote has increase by an average 2.4%. Equitable share grows by 0.9%, 1.4% conditional grants and 5.6% own revenue. In monetary terms this means a growth from R11.6 billion this financial year to R11.9 billion in 2012/13. Infrastructure budget however has been reduced by 39% to R566 million. This allocation will be used mainly for hospital revitalisation programme, clinics building and upgrades, EMS stations and extension of TB wards.

Allocations

• Strengthening District Health Services (Primary Healthcare) and district hospital delivery systems: R5.7 billion. This shows an additional R490 million from the current budget of R5.2 billion
• R520 million has been set aside for the running of Emergency Medical Services in the province
• In an effort to improve the provision of tertiary services in the Province, an amount of R1 billion has been provided for this programme.
• An amount of R67 million has been set aside for Expanded Public Works Programme
• Bursaries for health professionals: R105 million.
• R85 million has been provided for TB/MDR service programme in the province.
• Comprehensive HIV and AIDS: The budget for this priority has been increased by R88 million to R713 million. This is an increase of 14% from the current budget of R624 million.
• Medicine has been allocated R464 million
• R107 million has been provided for Vaccines to reduce infant and child mortality:
• R301 million has been allocated to the Hospital Revitalisation Programme.
• The provision of accommodation to health professionals plays a critical role in their retention to this province. An amount of R58 million has therefore been provided for this.
• An amount of R88 million has been provided to prevent and control malaria in the affected areas of this province.

Medium term expenditure framework: Health vote 7

Breakdown of the 2012/13 Medium Term Expenditure Framework