Budget Speech Vote 7 for the Department of Health 2023/24. Speech Delivered By Limpopo Health MEC, Dr Phophi Ramathuba at the Limpopo Provincial Legislature, Lebowakgomo, Tuesday, 18 April 2023.
Hon. Speaker and Deputy Speaker;
Hon. Premier Chupu Stanley Mathabatha;
Colleagues in the Executive Council;
Hon. Chief Whip and Chair of chairs;
The Chairperson of the Portfolio Committee on Health Hon. Simon Mathe;
Leader of the official opposition;
Hon. Members of the Provincial Legislature (MPLs);
Director General of the Province and all HODs;
Leaders of the religious community;
Invited guests,
ladies and gentlemen.
Ndi Matsheloni; Avuxeni; Thobela; Goeie more; Silotjhile; Good morning!
The curtain is surely closing on this 6th Administration.
Honourable Speaker, we come from a dark financial and administrative period, wherein we could not even appoint critical personnel like nurses, doctors, pharmacists etc. on a permanent basis. We could not procure necessary life-saving devices, and our workers were denied tools of trade. We want to thank Team Bophelong for their resilience and endurance in ensuring that the Department is kept afloat.
We have stabilized our financial outlook and set the department on an upward trajectory. This budget will cement
the strides we have made over the years and further ignite hope for the future.
There is no doubt that this was the most challenging term for the healthcare sector. This will go down in the annals of history as an administration that was largely disrupted by the COVID-19 pandemic.
Our healthcare system was tested and stretched to the maximum. It was during this period that the resilience of our public health system was demonstrated. It was during this period that the patriotism and commitment of our public healthcare workers was demonstrated.
The COVID-19 pandemic was a sad and devastating occurrence but also pushed us into finding innovative and creative ways in the continuous rendering of healthcare services. It thrust us, like all sectors into the 4th industrial revolution where the use of technology was up-scaled. The Department has had to find new ways of doing things. Staff training and development was increasingly delivered online. Recruitment is also automated and continues to improve on the turnaround time.
Honorable speaker;
As we continue on the previous commitment of accelerating service delivery to the rural arears using technology, the last outstanding CT Scan was installed and commissioned at Sekhukhune district, ST Ritas Hospital and handed over by both the Minister of Health Dr. Joe Phaahla and the Premier, Chupu Stanley Mathabatha.
Honourable Speaker, breast cancer is currently number two leading cause of death amongst cancers in women. We have lost so many lives as a result of breast cancer due to late diagnosis.
Honourable speaker, we are pleased to report to this legislature that technology has once more made it possible for us to deliver on our commitment of procuring mammograms and installing them in all our five districts, with units in Tshilidzini, Letaba, Mokopane,
St Ritas and Mankweng hospitals.
While we do not have radiologists stationed in some of these facilities, it is through technology that even those women in the rural areas can access this life-saving service.
Honourable Speaker, we are currently operating with one Magnetic Resonance Imaging (MRI) machine stationed at Pietersburg Tertiary and Academic Hospital. This has posed a major challenge regarding turnaround time for patients requiring this service. Teaching and training of both radiologists and radiographers has been difficult hence in addition two more MRI will be procured this financial year, one for Pietersburg hospital and another one for Mankweng hospital, bringing the total to three (03).
One of the setbacks on service delivery by COVID-19, especially the lockdown period was compromising other healthcare services which resulted in amongst others surgical backlogs. This led us into finding new ways of addressing the surgical backlogs. What started as a catch-up strategy following the COVID-19 lockdown period, is now a unique and highly successful Rural Health Matters campaign which is a legacy.
Since its inception, the campaign has seen over 6000 patients benefitting from a variety of surgical procedures ranging from orthopaedic, urogynecology, paediatric surgery, ophthalmology, maxillofacial surgery, gynaecology, amongst others.
This campaign has changed the face of healthcare in the far-flung, rural parts of our Province.
The Rural Health Matters is made possible through the dedication of depart- ment’s own specialists and other health professionals, who embark on district surgical outreach every 6 weeks. These professionals are joined by volunteer specialists from other provinces and private sector.
These are indeed our real “Thuma mina” brigades. Allow us, Honourable Speaker, to single out Professor Steve Matshidze from the University of Free State, a son of the soil, who has consistently over the years mobilised without failure a team of orthopaedic surgeons to join him during this outreach programme. He has since its inception performed at over 1600 orthopaedic operations of which about 200 are hip and knee replacements. Some of these operations can cost one patient up to R250 000.00 in private facilities hence we must jealously guard against abuse of this project which might lead to collapse.
Honourable Members;
COVID-19 exposed our inefficiencies in the management of the healthcare system. The World Health Organisation defines health as a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.
This means that we must start doing things differently by reverting to basics and focusing on primary healthcare as our first step.
We have declared the year ahead as the year of Primary Healthcare. This declaration is not a mere slogan or a rhetoric without significance. This declaration is a living commitment to build on our existing capacity to prevent disease, prolong life and promote a healthy lifestyle among the people of Limpopo.
We have our fingers firmly on the pulse. We are able to feel the vibrations of life. At the heart of our rejuvenated approach to primary healthcare is the provisioning of a 24-hour service at most of our primary healthcare facilities.
We are remodelling our clinics and healthcare centres to be reliable, dependable and attractive first points of entry for those in need of primary healthcare. We want our people to believe and have confidence in their local clinics and healthcare centres.
Through this approach, we aim to broaden access to quality primary healthcare, reduce the cost of medical care – most importantly, we aim to alleviate the burden on our hospitals.
Hospitals should only deal with serious emergencies and complicated procedures. This will make the entire healthcare value chain to be effective and responsive.
It is in this context that we are purposefully building capacity in our local clinics and healthcare centres.
This capacity includes the improvement of infrastructure, recruitment of more nurses, and adequate supply of medicines especially children vaccines.
Primary Health Care (PHC) is the first level of contact between the community and the formal health system. It is the foundation upon which the entire health system relies on for improved health outcomes.
In preparation for this deliberate effort to strengthen the base of the health system, the Limpopo Department of Health has during the last half of the 2022/23 financial year embarked on several initiatives to ensure that service delivery at Primary Health Care is optimized.
To this end, we have since appointed 20 additional suitably qualified and competent PHC facility managers.
The Department has introduced a competency-based recruitment process to identify suitable candidates with the capacity to take PHC to the new heights. In this financial year, a further 52 posts of OPMs will be advertised to increase capacity in the largest platform of the health system. We invite all young professional nurses to take up the challenge- be on the lookout for an advert soon.
Another progressive move was to convene a nine-day seminal capacity-building training and workshop of all Operational Managers (OPMs) including those in acting capacity from PHC facilities in all districts.
The training was designed to address service delivery improvement, minimize adverse events that leads to medico-legal cases, and close monitoring of medicine stock availability through the Stock Visibility System (SVS).
The workshop would not have been complete without empowering them on governance and information management improvement in their respective clinics in an effort to realize a clean audit outcome and ultimately improved patient outcomes.
Tools of trade to facilitate communication and efficiency in management that comes with access to telephonic, internet and virtual platforms were issued.
This will also aid referral of patients and soliciting of medical advice from higher levels of care.
Honorable Speaker, the Honorable Premier was spot on during SOPA debate when he said the department was at an advanced stage in activating a number of earmarked clinics to operate 24 hours, a programme which was previously disrupted by COVID-19.
2023/24 being the year of primary health care means we will be hard at work insuring successful rollout of 24 hour services. This we will do in collaboration with our traditional leaders, Unions, community members and other stakeholders.
Honorable speaker
Currently, only 50 clinics are operating fixed 24hours services, followed by a further 57 providing 24hour coverage on an on-call system.
We are therefore committing to this august house to work towards doubling the number of clinics rendering 24hour services. At the end of this financial year, we must be able to register around 229 clinics operating either on-call or straight shift 24hour coverage.
In order to achieve this objective, we obviously require qualified, dedicated and passionate adequate staff. To date, the recent recruitment drive brought in an additional 278 Professional Nurses with midwifery on a permanent basis to some of those clinics earmarked for 24 hour services. Another 300 professional nurses will be recruited in this financial year to further improve the pool of PHC staff. This will go a long way towards strengthening and enabling efficient service delivery across the various platforms of PHC such as the fixed clinics, mobile outreach services (mobile clinics), integrated school health services and community outreach services (CHW/CCGs).
Honorable Members; change is painful and unfortunately for transformation to takeoff there must be changes, for primary health care to improve and function better, the health department of 2010 must be dismantled. The Department is focusing on rearranging the management of primary health care services, wherein mobile clinics, community healthcare workers and fixed clinics will be managed by an operational manager stationed at a fixed clinic within the geographic area. This will enable the operational manager to oversee mobile services resulting in resources maximally utilized by effective allocation. A cluster of these clinics will be accountable to the local area manager. Clinics within a certain municipal area will be managed and supervised by their district hospitals. Consultations regarding this matter are underway. We hope the implementation will improve service deliv- ery and response time. A pipe-burst or blocked toilet at a clinic in Moutse area will have to be fixed by a plumber at Philadelphia hospital not to wait for a plumber from Sekhukhune district offices, which by the way their offices are here in Lebowakgomo.
The Geographic Service Area model which will define levels of healthcare from community healthcare worker to tertiary health services will assist in integration of healthcare services. The main focus being on preventative healthcare services, mainly communicable and non-communicable diseases which are responsible for premature death. While we have seen a reduction in mother-to-child HIV transmission from to 0,59, we are concerned about our failure to achieve the 90-90-90 targets, especially the second and the third 90. The recent reports suggesting that there is an increase in new infection amongst young women and a girl child. Working with sister departments, civil society and business under the umbrella of Limpopo AIDS Council led by Honorable Premier, we commit towards reduction of new HIV infections, increasing number of people tested for both TB and HIV, increase people initiated on ARVs and finally reduce the viral load of those infected.
Honorable speaker;
The World Health Organization judges the functionality of a healthcare system by its low maternal and under-five mortality. It gives us pleasure to report that our maternal mortality has decreased from 93/100 000 deliveries in April 2022 to 75/100 000 in February 2023. This is an improvement after a regression that was registered
in 2020/21/22 financial years due to COVID-19. The reduction was made possible by our obstetrics response teams which came up with initiatives focusing on capacity building of our clinicians. While attitude of staff is still a challenge within the depart- ment especially when it comes to maternal healthcare services. We must take time to celebrate and appreciate those who goes beyond their call of duty. It is against this background that we invited our professional nurse, a midwife sister Tshililo Mphaphuli who distinguished herself during an emergency when her clinic which does not operate 24 hours was closed and a woman in labor arrived. Sister Mphaphuli, like Florence Nightingale, did not ask any questions, instead focused on the emergency at hand which was to deliver the baby, little did she know that not one, not two, not three but four heads will pop-out from the perineum.
Honorable Members, meet our own “Cicilia Makiwane”.
Honourable Speaker;
An effective, responsive healthcare system means we must have a reliable emergency medical services vehicles.
The Honourable Premier Stanley Mathabatha administration has consistently insisted on a minimum of 50 ambulances annually owing to financial constraints to ensure that the fleet does not collapse.
It is my distinct pleasure to inform this august house that this Department as indicated earlier has made tremendous strides in the management of its
finances such that it has become possible to reprioritize within our budget allocation an amount of R500 million to augment R50 million earmarked funding provided by the provincial treasury as presented by MEC Hon. Seaparo Sekoati.
Honourable Speaker;
We therefore commit for the first time in the history of our province, in a single financial year, since the dawn of democracy that we shall procure 500 Emergency Medical Services vehicles. This will simply mean that
each crew will be allocated its own ambulance which will result in accountability and proper care, therefore response time will improve and lives will be prolonged and preserved.
Honourable Speaker, the Health Professional Council of South Africa is busy with the restructuring of the profession, as we speak, basic ambulance assistance course has been faced out, so is the ambulance emergency assistant. As a province we are working with different institutions of higher learning towards partnership of new curriculum, however, as a department we are proud of some of our personnel amongst the EMS whom whenever there is a disaster in the province they always respond without failure.
Our rescue mission team continue to make us proud. Last year, during the KZN floods they were amongst the first to respond to the call by the President to go on a rescue mission. When disaster hit both Turkey and Syria, and the ambassador made a plea for assistance, our selfless warriors did not hesitate- once more they volunteered and were in the midst of that dangerous situation. They did that all in the name of serving humanity.
Honourable Members, allow me to present our heroic team comprising of Robert Masubelele, Vicky Shipalane, Nicholas Nekhumbe, and Louis Markram.
Honourable speaker;
Essential medicines are defined by the World Health Organisation as medicines that satisfy the priority health needs of the population. People should have access to these medications at all times.
As part of strengthening primary healthcare essential medication availability becomes central. We have seen major improvements in terms of stock availability in our facilities, however more efforts are put in place to address the shortfall. We have seen stability in key programmes amongst others chilhood vaccines, antiretroviral and anti-TB medicines that are being tracked continuosly for availability in our facilities.
To sustain the stability and improve in other programmes an amount of R1.849 Billion has been allocated just for medicine and a further R217 million towards dry dispensary.
Honourable Speaker
Continue the fight against malaria
Limpopo remains prone to malaria epidemics and it has been reported in the past, malaria cases are remaining at lower levels, with 1 745 cases and 24
deaths reported in 2022/23, even though one death is too many. Just to remind the august house where we are coming from, in the 2017/18 financial year we recorded 18 977 and 160 deaths. We are confident that the numbers will continue to plummet until we record zero malaria related death.
Measles Outbreak
Limpopo province regrets being the leading province in the prevalence of measles despite fully implementing the Extended Programme on
Immunization without charge. Of the 1095 suspected cases, 347 were confirmed laboratory and 347 completed their isolation period. The positive news is that since the outbreak healthcare workers managed all cases well, hence we registered zero death. The unfortunate situation is that only 20 out of three hundred and forty-seven were fully vaccinated translating to only 5,76%.
As with COVID-19, the department responded swiftly by conducting and completing measles vaccination campaign for children aged 6 months to 59 months. The campaign covered 74% of the target population hence we registered zero death. We have now decided as of the beginning of April 2023 to extend the vaccination to the 5-15 years’ age group who are currently predominantly affected. This will be done at schools, fixed health facilities, mobile clinics as well as within the communities in collaboration with the Department of Basic Education and other stakeholders.
Honorable Speaker,
Once again, our savings came in handy because this vaccination program is made possible by the current 867 COVID-19 contractual vaccination employees whom as the department we have decided to extend their contract for the sole purpose of assisting in this vaccination.
Cholera
The department has taken note of the cholera outbreak in other parts of the country and our outbreak response team is ready and has a plan in place.
We will be working closely with our municipalities, as is customary, to do regular water testing and all other modes of surveillance.
Health is one of those sectors that are inherently labor intensive, therefore the structure must address the core business of the department.
We come from a painful past with a structure that was bloated at the top with no foot soldiers, for example, we reported in this august house previously that this department spends 76 percent of its budget on the compensation of employees, leaving us with a mere 24 percent for goods and services, including capital spending while at the same time with serious shortages on critical personnel like nurses, doctors etc. we want to report to you honorable members that unpopular decisions were taken, painfully so, which resulted in us reducing Compensation of Employees.
The structure has been reorganized from eight (08) DDGs for example to only four (04) DDGs. Similar work was done on other managerial categories.
The department has submitted to the Office of the Premier a proposed structure for the district which continues on this trend of removing duplications of functions and fostering efficiency. For example, where there would have been a deputy manager HIV testing, deputy manager ARVs, and deputy manager condom distribution. Even in finance, splitting of orders is not allowed, so it is in law where splitting of charges is not allowed. These are highly paid managers who will be best suited in managing some of our facilities at primary healthcare level and hospitals.
Consultations with relevant stakeholders will continue, however for the sake of the health of the people of this province this work cannot be postponed any further.
The department’s increasing improvement in management of the personnel budget has resulted in treasury and Office the Premier approving 1426 posts which were filled within a space of 4 months, amongst which there were doctors, psychologists and various types of specialists.
Management of Medico-Legal Matters
The war against the medico-legal problem continues. An interesting development in this area is the Noyila case in the Eastern Cape where the judge ordered that the Department of Health must provide some of the service that are required by the successful applicant instead of the department being required to pay a huge amount for future medical care. Although the judgment is under appeal, it is worth noting due to its seminal impact.
Following engagements with the Auditor General of South Africa, benchmarking and consultations the Department has halved its medico-legal to R7 billion by changing accounting methods. The campaign continued with the launch of first of a series of conferences on medico-legal matters that aimed at identifying root causes of the problem with a view to prevention of new cases as well as cascading the management of cases to the lower level of management. A programme of District visits has been developed and will be rolled-out.
During the course of 2022/23 the Department appointed 03 Heads of Clinical Department, 2 Heads of Clinical Unit and 23 medical specialists. The province currently has 124 registrars (doctors training to be specialists).
Honourable Speaker,
We are proud to announce that finally the contractor has been appointed by the National Department of Health to resume the construction of the long-awaited Limpopo Academic and Central hospital as pronounced by both the minister of finance and the Premier.
This facility will require highly specialised professionals since we will be expected to render services amongst others organ transplant hence the department has embarked on a four-year strategy to prepare for those skills.
To this end, the province plans on building up on this numbers to have 240 local registrars by 2025. In addition, the department will send supernumerary registrars to other universities to augment the number of specialists that will be required in the central hospital.
Forensic pathology
We have observed a rise in the number of unnatural deaths in the province and the majority of those cases are attributed to the behaviour of members of the society particularly road traffic accidents and interpersonal violence. We had a total of 5473 deceased persons that were subjected to medico-legal investigation through Forensic Pathology Services, this is 219 more than the previous year.
The service is experiencing pressure as a result of this rise in number of cases that is not proportional to the available resources and this will be considered as an area of priority. As a result, Forensic Pathology Services have been overstretched but have managed to render services under those difficult circumstances.
This service continues to excel in the delivery of autopsies in high volume incidents within relatively short periods.
Honourable members we must remember while forensic pathologist might not be too visible and amongst the most celebrated of our health professionals, they are our voices and they are our advocates when we cease to exist, but needs justice.
Today we celebrate the head of Forensic pathology department Dr. Thakadu Mamashela, the man who throw his diary and gets to work whenever the needs arises. We will continue to provide them with the necessary resources and personal care focusing on debriefing.
Infrastucture
Honourable Speaker;
Health infrastructure is one of the building blocks and critical pillars for healthcare delivery and it is a specialized kind of infrastructure, hence as a department we also spent time building capacity internally towards realization of this objective.
The department during the year under review has completed the following projects:
Pietersburg hospital ward –F was repurposed into an ICU; the ward is 17 beds with the state of art technology.
The Mankweng hospital has completed the maintenance and refurbishment of the following section: theatres, OPD, Thuthuzela and ICU. All this is made with the sole purpose of making sure that our patients are treated in a place that is safe and preserve their dignity.
We have handed over State-of-the-Art maternity ward in FH Odendaal hospital, with a theatre and work is in progress to complete neonatal and paediatric wards. At the end of the day, we want to have a maternal and child healthcare centre of excellence.
Nursing colleges are also not left behind, to date the department completed the refurbishment of Giyani Nursing college resident block D.
This comes at the right time now that the department has received accreditation to train professional nurses on a new curriculum, the first group of 118 students have already started with the training.
Repairs and maintenance at WF Knobel Hospital: Male & Female Wards, Storm Damaged Staff Houses, Laundry, Stores & Kitchen while Male & Female ward, Houses 1,2, 3 & 9 have been completed.
Major Repairs and Maintenance were also completed at Zava and Mudimeli clinics. Enviroloo maintenance and repairs were completed at 142 facilities. Due to the aggressive nature of water in the province, there was a need by the department to attend to the water softening plants at the facilities.
As part of preparation for 24 hour services, we have prioritized the security at our facilities by upgrading our fences.
To this end, upgrades were completed at 16 facilities, namely: Kgapane Hospital, Hoedspruit EMS, Mudimeli Clinic, Letaba Hospital, Sehlale Clinic, Blydrift Clinic, Mamabolo Clinic, Thomo Clinic, Warmbaths Hospital, Van Velden Hospital, Relela Clinic, Thohoyandou Nursing College, Thlogotlou Clinic, Marishane Clinic, Seobi Dikgale, Ellisras Hospital.
Pharmaceutical units required extra room for storage and the following prefabs were delivered at 12 facilities, namely:
Ellisras Hospital, George Masebe Hospital, Witpoort Hospital, Kgapane Hospital, Van Velden Hospital, Letaba Hospital, Malamulele Hospital, Messina Hospital, Botlokwa Hospital, Helene Franz Hospital, Zebediela Hospital, Helene Franz Hospital Gateway Clinic.
As the country, and indeed the province, continue to grapple with the effects of loadshedding, the department has invested in the procurement of standby generators to curtail the impact on our facilities.
The Limpopo Department of Health has delivered generators for installation (connected and stationed) to 7 facilities, namely:
Messina hospital, Evuxakene hospital, Jane Furse hospital, Blouberg CHC, Witpoort Hospital, Dr CN Phatudi Hospital, and Duiwelskoof CHC.
All the generators are new, and upgrades were conducted to some existing generators.
19 mobile generators were procured, out of the nineteen, seventeen have been delivered and are stationed at Provincial Head Office. They are mobile and will be dispatched to facilities as and when required.
One has since been dispatched to Dr. CN Phatudi Hospital, another one dispatched to Seshego Pharmaceutical depot.
Another 01 generator will be permanently installed at Mokopane Hospital, while the other one will be permanently installed at FH Odendaal hospital.
The department is looking into alternatives energy supplies i.e. the supply of inventors in facilities. Heat pumps for the boiling of water of which the department has done energy workload study to determine the sizes of batteries to be installed. The project will be rolled out in few facilities as a pilot project.
Following the pronouncement of the premier on the installation of solar panels, the department will conduct all preliminary works and await guidance from the Provincial Treasury and Office of the Premier.
We are pleased to announce to this House that engagements on finding alternative energy supply has begun. The department has met with the new Minister of Electricity on how best we can spare our healthcare facilities from the challenges of loadshedding.
Revenue collection
Honourable speaker
The Department has prioritised revenue collection as the only alternative source to augment its budget deficit over this Medium Term Expenditure Framework. Through the implementation of the Revenue Enhancement Strategy and continuous support from the Provincial Treasury, we are pleased to report to this august house that the Department managed to surpass the third quarter revenue targets of R193 791 Million.
Honourable Speaker, there is currently a public perception that health services are free for all who visit our health facilities, leading to huge outstanding amount. This is incorrect as patients are categorized in terms of affordability. Members of the communities that fall within the paying categories including those with medical aids, are urged to pay for the health services they receive in our health facilities as this will contribute to the funding of the health services in the province. The public is however informed that services are still free at primary healthcare facilities such as clinics, mobile clinics, gateway clinics and health-centres. We call on all our communities to visit these facilities for their wellbeing. Free services have also been extended for all COVID-19 related and Mental health services at hospital level for low income group, unemployed and those that are not members of medical schemes.
Honourable Speaker;
This financial year should allow us the platform to continue to build an efficient, effective, comprehensive and inclusive healthcare system capable of delivering on the promises we made to the people of Limpopo. We will do this guided by the oath and promise to meet the electoral, constitutional and legislative mandates given to us by the people of our province.
This budget should propel us to new heights of service delivery. It should resonate with the expectations of the people of Limpopo and assist in meeting their health needs.
Honorable Speaker,
Budget Speech: 2023 – Budget Breakdown: Vote 07: Health
The 2023/24 overall budget for Health vote has increased by 4.6% from the 2022/23 Main
Appropriation and increased by 0.8% from the Adjusted Appropriation. Within this allocation, Equitable share grows by 7.1% from main appropriation whereas conditional grants decreases by 6.4%.
The increase in Equitable Share is towards stabilizing the baseline from previous MTEFs reduction. Equitable Share increase by 3.7 % from the 2022/23 adjusted allocation whereas conditional grants decrease by 11.7 % from the 2022/23 adjusted allocation. The decrease in the Conditional Grants is due to discontinuation of Covid-19 funding. Covid-19 activities will be rendered within the total allocated budget of the Department. In monetary terms, the total budget increases from the budget of R23.6 billion in 2022/23 to R23.8 billion in 2023/24. The total allocation increase by an average of 3.5% over the Medium-Term Expenditure Framework.
Honourable speaker, I am therefore honoured and indeed privileged to table to this noble house the budget for Health-Vote 7, for the year 2023/24 to the value of R23.8 billion, which consists of R19.6 billion equitable share, R3.9 billion conditional grants and R210.5 million own revenues.
Honorable speaker, the budget has been allocated to fund the following key priorities of the Department:
- Strengthening District Health Services (Primary Healthcare) and district hospital delivery systems: R12.6 billion. This shows an increase of 6.9% from 2022/23. This as a backbone of health delivery system and is therefore allocated 52.9% of the total budget of the department. The budget of this priority grows by an average of 4.8% over the Medium Term Expenditure Framework (MTEF).
- R2.9 billion has been allocated for Regional, Tuberculosis and Psychiatric hospitals.
This allocation is important for the provision of specialized health services not primarily rendered in district hospital services as well as primary health care.
- Malaria Control services are allocated R73. million in equitable share. Furthermore, an amount of R65.2 million has been allocated within the conditional grant framework in order to prevent and control malaria in the affected areas of this Province.
- Comprehensive HIV and AIDS programme funding including TB services has been provided at R1.9 billion.
- R1.3 billion has been set aside for the running of Emergency Medical Services in the Province. Included in this allocation is an amount to purchase 500 ambulances.
- Tertiary services in the Province, has been provided for at R2.1 billion. These services continue to be provided in Pietersburg and Mankweng Tertiary hospitals.
- An amount of R851.6 million has been allocated to Health Infrastructure Programme. This allocation will be used mainly for hospital revitalization, clinics building and upgrades as well as buildings and equipment maintenance.
- An amount of R97.3 million has been set aside for the training of health professionals as part of our commitment to reduce vacancy rate in these categories. This amount covers medical students in the Republic of Cuba, Limpopo Medical School, Nursing students and other Medical Schools in the country.
- Honorable speaker, in order to maintain the stock level at our clinics, health centres and hospitals across the province, R1.8 billion medicine allocation has been provided.
This includes amount of R 642.2 million for the provision of antiretroviral drugs to HIV positive patients and new intake, and R240 million for Vaccines to reduce infant and child mortality.
I remain eternally grateful for the continued support and confidence I receive from the Honourable Premier in the execution of my responsibilities.
The Premier is also central in guiding us to spend our budget allocation efficiently and within the prescripts of the Public Finance Management Act.
A special thanks goes to the portfolio committee on health for their robust, frank and constructive engagements and continuous oversight.
We also want to take this opportunity to thank the Standing Committee on Public Accounts for ensuring that the work we do is within the proper legal and constitutional framework.
Gratitude to our Acting-HOD Dr. Mutheiwana Dombo and all those who put in the effort to ensure that our loyalty to this government and the people of Limpopo remains intact and unquestionable.
Let me conclude by drawing from an astute revolutionary, the former President of Burkina Faso, A Pan-Africanist, Thomas Sankara, who said:
“You cannot carry out fundamental change without a certain amount of madness. In this case, it comes from nonconformity, the courage to turn your back on the old formulas, the courage to invent the future. Besides, it took the madmen of yesterday for us to be able to act with extreme clarity today. I want to be one of those madmen.”
I thank you!
Summary of the 2023/24 Medium Term Expenditure Framework: Health-Vote 07
Summary per Funding Source Adjusted Medium-term estimates appropriation
R thousand 2022/23 2023/24 2024/25 2025/26
- Equitable share: 18,944,593 19,634,942 20,013,048 20,837,343
- Conditional grant: 4,447,366 3,926,774 3,960,919 4,138,368
- Departmental receipts: 201,637 210,508 220,612 232,160
- Total: 23,593,596 23,772,224 24,194,579 25,207,871
Summary per Programme Adjusted Medium-term estimates appropriation
R thousand 2022/23 2023/24 2024/25 2025/26
1. Administration: 297,902 303,688 305,727 319,421
2. District Health Services: 15,367,693 15,459,783 16,058,761 16,704,181
3. Emergency Madical Services: 994,571 1,303,667 1,088,841 1,121,774
4. Provincial Hospital Services: 2,801,286 2,913,703 2,976,605 3,089,959
5. Central Hospital Services: 2,091,901 2,105,014 2,155,384 2,249,790
6. Health Sciences And Training: 713,654 683,946 662,447 707,967
7. Health Care Support Services: 228,222 150,786 157,057 164,095
8. Health Facilities Management: 1,098,367 851,637 89,757 850,684
Total: 23,593,596 23,772,224 24,194,579 25,207,871
Summary Per Economic Classification Adjusted Medium-term estimatesappropriation
R thousand 2022/23 2023/24 2024/25 2025/26
- Compensation of employees: 16,602,161 16,447,701 16,713,903 17,093,312
- Goods and services: 5,907,714 6,142,321 6,605,194 7,177,700
- Provinces and municipalities: 1,688 2,049 2,167 2,263
- Departmental agencies and accounts: 20,000 25,000 26,120
- Households: 262,328 231,202 192,440 200,971
- Buildings and other fixed structures: 371,230 307,182 306,858 320,605
- Machinery and equipment: 448,475 621,769 349,017 386,900
- Total: 23,593,596 23,772,224 24,194,579 25,207,871
