Annual Report 2015/2016

Transcription

GAUTENG DEPARTMENT OF HEALTH
ANNUAL REPORT
2015/2016
Together, Moving Gauteng City Region Forward
HEALTH
Quick Search
Index of key sections that are of interest to readers.
Please use it for quick access to necessary information.
DISTRICT
HEALTH CARE
SERVICES
ADMINISTRATIVE
OVERVIEW
ABOUT THE
DEPARTMENT
AND
MANAGEMENT
MESSAGES
A performance report
outlining the
organisation of people
in the Department,
transformation, quality
priorities progress and
key technological
progress made.
Performance of the priority
health programmes
accessibility, treatment and
support provided at
primary health facilities
including reengineering
of the PHC system to make
it more effective.
Information about the
mandate, location and
messages from the MEC
and the accounting
officer on performance
of the department.
34-51
18-33
3-17
HEALTH CARE
SUPPORT
SERVICES
OVERVIEW
HOSPITAL AND
EMERGENCY
SERVICES
Performance of the
emergency medical
services, various
categories of hospital
efficiency and quality
starting with hospitals that
provide specialised,
tertiary care to quaternary
health care services.
52-64
A brief overview on
pharmaceutical, blood
and supply chain
management including
human resources capacity
development initiatives
and capital investments.
GOVERNANCE,
HUMAN AND
FINANCIAL
ACCOUNTABILITY
PATTERNS
A brief overview on risk
management, human
resources statistics,
financial statements
and legislation.
109-319
65-106
Primary Health Care
Gauteng Department
Service Delivery Platforms
JHB Metro
Ekurhuleni
WBOT
WBOT
176
CLINICS
Hopitals utilisation & bed
capacity
Tertiary & Quartenary Hopitals
Provincial or Regional Hospitals
District Hospitals
118
112
CLINICS
District Hospitals
2
Tshwane
WBOT
99
126
Sedibeng
WBOT
WBOT
84
CLINICS
1
Westrand
District Hospitals
CLINICS
Mental Hospital
3
2
District Hospitals
2
JHB Metro
Ekurhuleni
Tshwane
Westrand
Sedibeng
2
4
1
1
1
Rehabilitation Hospital 2
Central Hospitals
Helen Joseph
Hospital
Kalafong
Hospital
Chris Hani Baragwanath
Academic Hospital
Steve Biko
Academic Hospital
Hospital Bed Capacity
District Hospitals
52
CLINICS
3
Tertiary Hospitals
Tembisa
Hospital
46
Regional Hospitals
Oral & Dental Hospital
1
58
District Hospitals
4
Specialised Hospitals
TB Hospital
73
Tertiary Hospitals
Outpatients
Dr George Mukhari
Academic Hospital
Charlotte Maxeke Johannesburg
Academic Hospital
Inpatients
District Hospitals
District Hospitals
Tertiary Hospitals
Inpatients
Inpatients
Outpatients 678 662
Tertiary Hospitals
Beds
2737
Regional Hospitals
Beds
4725
Beds
2187
Central Hospitals
Beds
6183
Outpatients
724 596
Regional Hospitals
Outpatients 1 056 655
Central Hospitals
Outpatients 2 405 848
149 369
Regional Hospitals
Inpatients
270 437
110 960
Central Hospitals
Inpatients
22 387
Gauteng Department of Health
Service coverage
Integrated
School
Health
Programme
ISHP
Number of Households visited
Antenatal 1st visit before
20 weeks
Diabetes Screening
ARV
533 093
109 988
1 878 208
School Learners Screened
Facility Births
206 557
Hypertension Screening
3 217 460
188 194
Fully Immunised under 1
TB Screening
212 835
4 155 896
ARV
Initiated on ARVs
153 440*
*1 163 847 patients initiated on ARV treatment since program inception
HIV Testing
2 934 613
Assistive Devices Provision
61 349
Department of Health
Province of Gauteng
Vote No. 4
Annual Report
PR 222/2016
ISBN: 978-0-621-44720-0
Part A: General Information
Gauteng Provincial Government | Health | Annual Report 2015/2016
1. DEPARTMENT GENERAL INFORMATION
Physical address:
37 Pixley Ka Isaka Seme Street
Marshalltown
Johannesburg
2001
Postal address:
Private Bag X085
Marshalltown
2107
South Africa
Telephone number:
Email:
Website address:
Facebook:
Twitter:
Instagram:
011 355 3477
[email protected]
http://www.health.gpg.gov.za
Gauteng Provincial Health Department
@GautengHealth
@gautenghealth
3
TABLE OF CONTENTS
4
PART A: GENERAL INFORMATION
2
1.
DEPARTMENT GENERAL INFORMATION
3
2.
ABBREVIATIONS AND ACRONYMS
6
3.
FOREWORD BY THE MEC FOR HEALTH
8
4.
REPORT OF THE ACCOUNTING OFFICER
10
5.
STATEMENT OF RESPONSIBILITY AND CONFIRMATION OF THE ACCURACY
OF THE ANNUAL REPORT
16
6.
STRATEGIC OVERVIEW
17
7.
ORGANISATIONAL STRUCTURE
18
8.
ENTITIES REPORTING TO THE MEC
19
9.
LEGISLATIVE AND OTHER MANDATES
19
PART B: PERFORMANCE INFORMATION
20
1.
AUDITOR-GENERAL’S REPORT: PREDETERMINED OBJECTIVES
21
2.
OVERVIEW OF DEPARTMENTAL PERFORMANCE
22
3.
STRATEGIC OUTCOME-ORIENTATED GOALS
27
4.
PERFORMANCE INFORMATION BY PROGRAMME
28
5.
TRANSFER PAYMENTS
77
6.
CONDITIONAL GRANTS
78
7.
DONOR FUNDS
85
8.
CAPITAL INVESTMENT
92
PART C: GOVERNANCE
108
1.
INTRODUCTION
109
2.
RISK MANAGEMENT
109
3.
MINIMISING CONFLICT OF INTEREST
109
4.
CODE OF CONDUCT
109
5.
HEALTH SAFETY AND ENVIRONMENTAL ISSUES
109
6.
PORTFOLIO COMMITTEES
111
7.
SCOPA RESOLUTIONS
116
8.
PRIOR MODIFICATIONS TO AUDIT REPORTS
119
9.
INTERNAL CONTROL UNIT
120
10.
INTERNAL AUDIT AND AUDIT COMMITTEES
121
11.
AUDIT COMMITTEE REPORT
122
PART D: HUMAN RESOURCE MANAGEMENT
124
1.
INTRODUCTION
125
2.
OVERVIEW OF HUMAN RESOURCES
125
3.
HUMAN RESOURCES OVERSIGHT STATISTICS
126
PART E: FINANCIAL INFORMATION
156
1.
REPORT OF THE AUDITOR-GENERAL
158
2.
ANNUAL FINANCIAL STATEMENTS
163
PART F: MSD FINANCIAL INFORMATION
276
1.
REPORT OF THE ACCOUNTING OFFICER
278
2.
REPORT OF THE AUDITOR-GENERAL
284
3.
ANNUAL FINANCIAL STATEMENTS
288
ANNEXURES:
316
5
2. ABBREVIATIONS AND ACRONYMS
AARTO
Administrative Adjudication of Road Traffic Offence
EML
Essential Medicine List
AG
Auditor-General
EMTCT
Elimination of Mother to Child Transmission
A&E
Accident and Emergency
ENs
Enrolled Nurses
AET
Adult Education and Training
EOST
Emergency Obstetric Simulation Training
AIDS
Acquired Immune Deficiency Syndrome
EPI
Expanded Programme on Immunisation
ALOS
Average Length of Stay
EPWP
Expanded Public Works Programme
ANC
Antenatal Care
ES
Equitable Share
ART
Antiretroviral Treatment
ESMOE
Essential Steps in Managing Obstetric Emergencies
ARV
Anti Retroviral
ELL
Essential Laboratory List
Adolescent and Youth Friendly Services
EWP
Employee Wellness Programme
Basic Accounting System
ERM
Enterprise Risk Management
Broad-Based Black Economic Empowerment
EXCO
Executive Committee or Council
BFHI
Baby Friendly Hospital Initiative
FBO
Faith-Based Organisation
BLS
Basic Life Support
FDC
Fixed-Dose Combination (ARV Pill)
BUR
Bed Utilisation Rate
FP
Fertility Planning
CAD
Computer Aided Dispatch
FY
Financial Year
CARMMA
Campaign for Accelerated Reduction of Maternal
Mortality in Africa
GAS
Gauteng Audit Services
GBN
Gauteng Broad-band Network
CBO
Community-Based Organisation
GDF
Gauteng Department of Finance
CCMDD
Centralised Chronic Medicine Dispensing and
Distribution
GDoH
GIS
Geographic Information System
GPG
Gauteng Provincial Government
GSSC
Gauteng Shared Services Centre
HAART
Highly Active Antiretroviral Treatment
HAS
HIV, AIDS & Sexual Transmitted Infection
HAST
HIV, AIDS, STIs and TB
HBC
Home Based Care
HDI
Historically Disadvantaged Individual
HCT
HIV Counselling and Testing
HCWM
Healthcare Waste Management
HECP
Healthy Environment for Children Programme
HFM
Health Facilities Management
AYFS
BAS
BBBEE
6
CCMT
Comprehensive Care Management and Treatment
CDC
Communicable Disease Control
CEO
Chief Executive Officer
CFO
Chief Financial Officer
CMH
Charlotte Maxeke Hospital
CHBAH
Chris Hani Baragwanath Academic Hospital
CHC
Community Health Centre
CHW
Community Health Worker
CIP
Compulsory Induction Programme
CIPS
Chartered Institute of Procurement and Supply
CMR
Child Mortality Rate
COIDA
Compensation of Occupational Injuries and
Diseases Act
HFRG
Hospital Facility Revitalisation Grant
CPD
Continuing Professional Development
HBB
Helping Babies Breathe
DAC
Departmental Acquisition Council
HIV
Human Immunodeficiency Virus
DDG
Deputy Director General
HOD
Head of Department
Dr George Mukhari Academic Hospital
HPCSA
Health Professions Council of South Africa
District Health Information System
HPs
Health Promoters
District Health System
HPTDG
Health Professional Training and Development Grant
Department of Infrastructure Development
HPV
Human Papiloma Virus
DOH
Department of Health (National)
HR
Human Resources
DOL
Department of Labour
HWSETA
Health and Welfare Sector Education and Training
Authority
DMT
District Management Team
ICDM
Integrated Chronic Disease Management
DORA
Division of Revenue Act
ICSM
Integrated Clinical Service Management
DPSA
Department of Public Service and Administration
ICT
Information and Communication Technology
EAP
Employee Assistance Programme
ICU
Intensive Care Unit
ECDP
Early Childhood Development Centre Practitioners
IEC
Information, Education and Communication
ECC
Emergency Communication Centre
IGR
Inter-Governmental Relations
ECT
Emergency Care Training
IMU
Information Management Unit
EE
Employment Equity
ILS
Intermediate Life Support
EGK
Electronic Gate-Keeping
IMCI
Integrated Management of Childhood Illnesses
EHWP
Employee Health and Wellness Programme
EMIS
Education Management Information System
IMCI,CC
Integrated Management of Childhood Illnesses
Community Component
EML
Essential Medicines List
IMR
Infant Mortality Rate
EMS
Emergency Medical Services
INH
Isoniazid
DGMAH
DHIS
DHS
DID
IPT
Isoniazid Prophylaxis Therapy
PEP
Post-Exposure Prophylaxis
IRS
Integrated Reporting System
PEN
Pupils Enrolled Nurse
ISHP
Integrated School Health Programme
PFMA
Public Finance Management Act
IT
Information Technology
PIER
Public Information and Education Relations
IUD
Intra-Uterine Device
PIDS
Provincial Indicator Data Set
KMC
Kangaroo Mother Care
PHC
Primary Healthcare
KZN
KwaZulu-Natal
PLHIV
People Living with HIV
LAN
Local Area Network
PMTCT
Prevention of Mother-To-Child Transmission
LARC
Long Acting Reversible Contraceptives
POA
Programme of Action
LE
Life Esidimeni
PPP
Public Private Partnership
MBFI
Mother Baby Friendly Initiative
PPT
Planned Patient Transport
M&E
Monitoring and Evaluation
PTC
Pharmacy Therapeutic Committee
MDGs
Millennium Development Goals
QA
Quality Assurance
MDR-TB
Multi-Drug Resistant Tuberculosis
QIP
Quality Improvement Plan
MEC
Member of Executive Council
PSETA
Public Service Education and Training Authority
MIS
Management Information System
PWD
People with Disabilities
MMC
Medical Male Circumcision
RAF
Road Accident Fund
MMR
Maternal Mortality Rate
RMC
Risk Management Committee
MOA
Memorandum of Agreement
RR-TB
Rifampicin Resistant-TB
MOU
Memorandum of Understanding
RPL
Recognition of Prior Learning
MSD
Medical Supplies Depot
RWOPS
Remunerative Work Outside Public Service
MSM
Men who have Sex with Men
QA
Quality Assurance
MSSN
Management of Small and Sick New-Born
SADC
Southern African Development Community
MTCT
Mother-to-Child-Transmission
SAM
Severe Acute Malnutrition
MTEF
Medium-Term Expenditure Framework
SAHPRA
South Africa Health Product Regulatory Authority
NCDs
Non-Communicable Diseases
SAMEC
South African Malaria Elimination Committee
NCS
National Core Standards
SANBS
South African National Blood Service
NDoH
National Department of Health
SANC
South African Nursing Council
NDP
National Development Plan
SAPS
South African Police Service
NGO
Non-Governmental Organisation
SBCC
Social Behaviour Change Communication
NHA
National Health Act
SCM
Supply Chain Management
NHI
National Health Insurance
SDGs
Sustainable Development Goals
NHLS
National Health Laboratory Services
SDLP
Service Delivery Improvement Plan
NIOH
National Institute of Occupational Health
SLA
Service Level Agreement
NIMART
Nurse-Initiated Management of ART (ART)
SBH
Steve Biko Hospital
NIMDR
Nurse Initiated Multi-Drug Resistance
STGs
Standard Treatment Guidlines
NPC
National Pharmacovigilance Centre
STH
Soil Transmitted Helminths
NPO
Non-Profit Organisation
STI
Sexual Transmitted Infection
NOH
National Oral Health
SMS
Senior Management Service
NSDA
National Service Delivery Agreements
SOP
Standard Operating Procedure
NSP
National Strategic Plan on HIV, TB and STI
SRHR
Sexual Reproductive Health and Right
NRP
Neonatal Resuscitation Programme
SRM
Supply Relationship Management
NTSG
National Tertiary Services Grant
SVS
Stock Visibility System
OD
Organisational Design
TB
Tuberculosis
OHS
Occupational Health and Safety
TOR
Terms of Reference
OHSC
Office of Health Standards and Compliance
UJ
University of Johannesburg
OPD
Outpatient Department
UNICEF
United Nations Children’s Emergency Fund
OSD
Occupation-Specific Dispensation
UPFS
Uniform Patient Fees Schedule
OVC
Orphans and Vulnerable Children
WAN
Wide Area Network
PACS
Picture Archiving and Communication System
WASH
Water, Sanitation and Hygiene
PC
Primary Care
WBOT
Ward Based Outreach Teams
PEC
Patient Experience of Care
WHO
World Health Organisation
PCR
Polymerase Chain Reaction
WISN
Workload Indicator for Staffing Norm
PDE
Patient-Day Equivalent
XDR-TB
Extreme Drug Resistant Tuberculosis
7
3.
FOREWORD BY THE MEC FOR HEALTH
Infrastructure
8
The African National Congress-led government has
made signiÄcant strides since 1994 in improving the
quality of healthcare and ensuring that every citizen
has access to this fundamental right, as enshrined
in our Constitution. The Äfth administration of the
Gauteng Provincial Government has consolidated
many of these gains as it works towards the overall
improvement of the lives of our people. We have
continued to strive to accelerate social and economic
transformation in Gauteng. Improving health
outcomes remains at the top of our agenda and we
will ensure that patients are treated with dignity at all
times. Patients must be at the centre of what we do,
no matter the challenges we face. In doing this, the
Department has had to ensure that it works efÄciently
and effectively through all of its units and that each
person plays their necessary role in achieving our
collective vision.
Financials
When we came in to ofÄce in May 2014, the
Department was under administration – as per
Section 18 of the Public Finance Management Act. In
the 2014/2015 Änancial year, we received a qualiÄed
audit with matters of emphasis.
It is, therefore, heart-warming that the Department
has received an unqualiÄed audit opinion for the
2015/2016 Änancial year. This milestone points to the
hard work and dedication of the team, from all units in
the Department ranging from head ofÄce to hospitals,
district ofÄces, Emergency Medical Services (EMS)
and to the Medical Supplies Depot.
We recognise that this is a huge step forward and it
must be maintained. I know that the team is hard at
work, moving towards achieving a clean audit before
the end of the current term of ofÄce. We continue to
pay special attention to building the capacity of our
managers who are responsible for Änance, supply
chain and human resourses by providing on-the-job
training in collaboration with the South African Institute
of Chartered Accountant and other professional
bodies.
New infrastructure projects as well as continuous
maintenance are key factors in fulÄlling the mandate of
providing quality healthcare. The timeous implementation
of infrastructure projects is also an important part of
assessing our performance. As such, a number of
key projects were initiated and some completed in this
Änancial year. These include maintenance projects, the
commencement of the construction of new facilities and
refurbishments to existing facilities.
In addition to these projects, the Department procured
the Bronkhorstspruit District Hospital in December 2015.
The hospital has been operational since 27 December
2015 and boast 42 usable beds. The second phase will
concentrate on expanding and running the hospital as a
200-bed facility.
Transformation, Modernisation and
Reindustrialisation (TMR)
Gauteng has made signiÄcant inroads towards achieving
the goals of the Township Economy Revitalisation. The
Department identiÄed select categories and spent R289
million of our goods and services budget by procuring
from township enterprises. Furthermore, we invested
in buying produce such as dairy, meat and fresh or
processed vegetables for all our facilities from local black
farmers.
Emergency Medical Services (EMS) have contributed
to the development of township enterprises through the
support of repair and maintenance hubs in Winterveldt,
Katlehong, Soweto and Kagiso. To date, we have
repaired and refurbished 89 vehicles at a cost of
R3.5 million. Other township economy initiatives include
support for cooperatives such as the Mamelodi Kasi
Primary Cooperatives and the Reitiretse Car Wash.
In line with the TMR agenda, the Department has spent
R926 million on ARVs. Approximately R737 million of
this was spent on local companies producing ARVs in
different parts of the country, including Gauteng. This
also beneÄts our massive ART programme, currently the
biggest in the country. The Department will continue to
work and support emerging pharmaceutical companies
that pursue local production of active pharmaceutical
ingredients. The ANC-led government is Ärmly
committed to the vision of full industrial production for
the essential drug list and other items.
With regards to modernisation, the Department has
invested signiÄcantly in ICT hardware and is upgrading
LAN connectivity within facilities, to be able to store all
the Picture Archiving Communication System (PACS)
images/clinical data and share this data between
facilities. PACS is currently available at 13 of our
facilities. The Department connects the four central
hospitals to other hospitals in their cluster to enable
image-sharing through the network.
The modernisation journey started with the scanning
of approximately 381 000 patient records (16 million
pages) from the Old Natalspruit Hospital prior to
moving to the Thelle Mogoerane Hospital. The
scanning of patient records has also been done at the
Charlotte Maxeke Academic and Jubilee hospitals.
The modernisation road map has now clearly been
deÄned with three main objectives:
•
•
•
Improve Quality of Patient Care
Reduce Patient Waiting Times
Improve Revenue Collection
These all boil down to improving the quality of life for
our people. The use of the IdentiÄcation VeriÄcation
System (IVS) at the Chris Hani Baragwanath Academic
Hospital allows us to use patient ID numbers and
Änger prints to link to multiple databases, thus
ensuring accurate demographic information and the
correct classiÄcation of patients according to their
ability to pay for certain levels of care. IVS will be rolled
out to all hospitals by the end of the 2016/17 Änancial
year. The overall outcome will be a ‘Single View of the
Patient’, once all of the building blocks have been put
in place. Some of our other major innovations in the
modernisation of healthcare include:
•
•
The launch of the electronic Bed Management
System (eBMS) that allows us to better manage
the 27.7 million patients annually that present to
our facilities. It is linked with the EMS control room
where ambulances are dispatched and allows
medical staff to Åawlessly identify available beds
across each cluster.
15% to 30%. We are currently rolling out the app
to all 42 obstetrics vehicles across Gauteng.
•
The AITAHealth application for Community
Healthcare Workers (CHWs), currently used in
Tshwane, is being scaled up. This application
allows CHWs to better proÄle households and to
provide healthcare services at this level.
•
There are a number of other notable modernisation
projects such as Sense4Baby (monitoring of
pregnancy through mobile technology) and Hear
Sense (part of the school health programme).
This report comes with an acknowledgement of the
many achievements of the Department and conÄrms
that the future of healthcare in Gauteng is bright. It bears
testimony to how far we have gone as a dedicated,
caring and activist government. It is my hope that the
small steps that we are taking to improve the health
outcomes in Gauteng will continue to have the desired
impact on the Department.
Our goal is to serve and this often requires us to do
more with less and to understand when things do not
go as planned. This calls on us to empathise with people
at their most vulnerable and during difÄcult times. The
journey of a thousand miles began with one single
step that we took in 1994 and it continues as we work
towards the rollout of universal coverage through the
National Health Insurance.
Ms Qedani Dorothy Mahlangu
Gauteng MEC for Health
31 May 2016
RESPONSE is a mobile application for tracking and
dispatching ambulances. The app is live in parts
of Tshwane. Since it launch we have witnessed
ambulance response times come down between
9
4. REPORT OF THE
ACCOUNTING OFFICER
Our ever-expanding Ward Based Outreach Teams
(WBOTs) are providing healthcare support directly
to households, and have managed to have a wider
reach through increase in the number of teams.
Other innovative solutions aimed at improving patient
care management and overall patient experiences
included the design and implementation of daily patient
satisfaction tools, the electronic bed management
system and the roll-out of electronic health records.
4.1
Overview of Operations and
Results
The vision of the Gauteng Department of Health is:
“Daily we provide high-quality, efÄcient and accessible
healthcare to transform people’s lives.” In pursuance
of this vision, the Department developed a Strategic
Plan and an Annual Performance Plan for 2015/16 that
provides a roadmap towards the fulÄlment of healthcare
priorities.
10
The Gauteng City Region continues to have the
best Tuberculosis (TB) cure rates. We have also
succeeded to deliver the second-largest HIV and
AIDS programme in the country, including the biggest
roll-out of Antiretroviral Therapy (ART), with more than
700 000 people remaining on ART Care.
Prevention of Mother-to-Child vertical transmission
remains one of the success stories in our drive to
prevent Mother-to-Child-Transmission of HIV. Our
focus on strengthening efforts to curb childhood
preventable illnesses has also had tremendous
success in reducing deaths among children under
Äve years due to the provision of vaccines for
preventable conditions such as measles, pneumonia
and diarrhoea.
Furthermore, Medical Male Circumcision (MMC) is
a key HIV prevention programme, with more than
100 000 males circumcised in the Änancial year
under review. There have also been concerted efforts
to improve coverage of this and many other health
service interventions through partnerships with both
medical practitioners and development partners.
Efforts towards improving patient and community
experiences of the health facility, universal
coverage through the implementation of the
PHC reengineering programmes, chronic medicines
dispensing programmes that enable delivery closer
to homes of chronic patients were maintained.
The Department has managed to bring stability in its
management structure through the appointment of
staff in key positions such as Head of Clinical Branch
at Head OfÄce and CEOs for various hospitals.
In addition, employee wellness was supported
through various awareness creation initiatives. One of
the successes in this regard has been in the provision
of Änancial wellness interventions that have over the
years helped the Department to reduce the magnitude
of garnishee orders against employees.
The shortage of specialist nurses in high care and
midwifery remains a cause for concern. To address this
problem, the Department made available various funding
options for both staff and the public through the Health
Programme Development Grant, bursary schemes and
the skills levy grant, among other measures.
A conscious decision to celebrate the achievements
of institutions and staff has been adopted. As a result,
there is much more visibility and sharing of information
as regards international and national accolades that
are awarded to institutions and or staff throughout
the organisation. To mention a few, Prof. Luvhengo at
Charlotte Maxeke Academic Hospital was awarded an
International Swan-Morton Silver Scalpel SASSiT Award
for teaching excellence in research supervision, while
Dr. Pakula trained the Ärst fellow in Minimal Invasive
Surgery/Laparoscopy in 2015, making Dr George
Mukhari Academic Hospital a leading centre in the
training for minimal invasive surgery for the Training of
General Surgery Specialists.
A partnership recently formed with the South African
Institute of Chartered Accountants has also improved
the Department’s Änancial business processes.
A number of challenges remain which often affects
the ability of the Department to attain a gold
standard of service provision such as in the case
of Ideal Clinic and National Core Standards. These
challenges require that the Department strengthen
supervision, continously to improve the state of health
infrastructure. Quality improvement plans are being
rigorously monitored to ensure that performance on
Quality Core Standards improves.
4.2.
Overview of the Änancial results
of the department:
Departmental Receipts
Revenue collected in the 2015/2016 Änancial year
amounts to R479 million comprising of hospitals fees
of R339 million and other revenue of R139 million.
Hospital fees constitute about 71% while other
revenue sources makeup 29% of the total revenue.
The Department experienced a decline in revenue
collection of more than R44 million compared with
previous Änancial year. It also missed its revenue
collection target of R555 727 000 by R76 469 000 for
the Änancial year 2015/16.
2015/2016
Departmental
Receipts
Sale of goods and
services other than
capital assets
Transfers received
Fines, penalties and
forfeits
Interest, dividends and
rent on land
Financial transactions
in assets and liabilities
Total
2014/2015
Estimate
Actual
Amount
Collected
(Over)/Under
Collection
Estimate
Actual
Amount
Collected
(Over)/Under
Collection
R’000
R’000
R’000
R’000
R’000
R’000
527 770
433 650
94 120
497 896
451 636
46 260
-
-
-
-
-
-
50
56
(6)
47
52
(5)
1 216
939
277
1 147
397
750
26 691
44 651
(17 960)
25 420
71 966
(46 546)
555 727
479 296
76 431
524 510
524 046
459
The under-collection in revenue is attributed to multiple
factors such as the late implementation of annual
increment of Uniform Patient Fee Schedule (UPFS)
that was implemented after Äve months into the
Änancial year 2015/16. Delay in UPFS implementation
was due to prolonged stakeholder consultation.
Other revenue challenges encountered during the
year under review included payments delays by RAF
and Compensation Fund, with the latter institutions
delay caused by a newly implemented claims system.
Lastly, the late billing of patients by institutions remains
a concern. To address the problem, billing units of the
health institutions personnel are regularly trained and
attend capacity-building programmes!
Tariff Policy
Patient Fee tariff
The billing charges, paid by patients at health
institutions, are based on the UPFS tariffs for patients
using public hospitals. These tariffs are determined
by a steering committee consisting of the National
Department of Health and the nine provinces, and are
revised annually in accordance with section 7.3.1 of
the Treasury Regulations.
Patients accessing public institutions are classiÄed
into three main groups for the purposes of service fee
determination:
Full Paying: This category of patients is liable to pay
full UPFS fees for all services provided.
Subsidised and Exempted Patients: These
patients fall into six categories based on statutory
requirements: PH, PG, HG, H0, H1, H2 and H3. The
PG and HG categories are exempted from paying
fees due to speciÄc circumstances that are statutorybased, such as pregnancy and children under six
years of age. Patients in the H0 category receives
services free of charge only when they provide proof
of status, that is social pensioners. The H1, H2 and
H3 categories pay discounted fees that are expressed
as a percentage of the fees payable by full paying
patients.
11
Free Services: Free services are provided in line with
the national and provincial policies and the following
free services are provided by the Department:
•
•
•
•
•
•
•
•
•
•
•
Free health services for pregnant women and
children under the age of six (Notice 657 of 1994,
1 July 1994).
Free primary healthcare services (Notice 1514 of
1996, 17 October 1996).
Termination of pregnancy (Act 92 of 1996).
Social Pensioners (Act 81 of 1967 as amended by
Act 100 of 1998).
Medico Legal service for survivors of rape, assault and
post-mortem (Criminal Procedure Act 51 of 1977).
Donors (Human Tissue Act 63 of 1965).
Children who are committed to the care of a
children’s home, industrial school or foster parents
(Child Care Act 74 of 1983, Section 15).
Persons with Mental Disorders (Mental Health Act
18 of 1973).
Infectious, Formidable and/or NotiÄable Diseases
(National Health Act 61 of 2003).
Services to formally unemployed contributors
(Unemployment Insurance Act 63 of 2001).
Patients receiving HIV and AIDS treatment (Notice
1 of August 2006).
HOSPITALS
Meals and Crèches Fees Tariffs: The tariffs for
meals and crèches are reviewed and revised annually
in accordance with section 7.3.1 of the Treasury
Regulations. Tariffs adjustments are also negotiated
and agreed upon with employee organisation.
Other Tariffs: Other tariffs such as parking,
accommodation and so on are determined externally
involving relevant departments.
The Department has identiÄed other sources of
revenue such as advertisement on hospital/building
and charging market-related prices on visitor’s
parking lot to assist in the maximisation of revenue
collection. The Department continually engages
with state departments, medical schemes and other
provinces on the settlement of outstanding claims for
patients referred to Gauteng hospitals.
Patient Fees Debt
The hospitals have written off bad debts amounting
to R336 million for patient fees debtors as at the
end of March 2016. The amount of debts written off
increased from R228 million to R336 million during the
year under review.
BAD DEBTS WRITTEN OFF
R’000
12
Central Hospitals
203 432
Regional Hospitals
26 645
Tertiary Hospitals
82 401
District Hospitals
19 303
Dental Hospitals
3 569
Tuberculosis Hospitals
Psychiatric Hospitals
Other Specialised Hospitals
TOTAL
210
1 173
19
336 752
Bad debt is written off in accordance with the
Department’s write-off policy. Due to cost involved in
the follow-up of a debt, all debt that is less than R195
is not followed up and is written off after 90 days. The
outstanding patient debts from self-paying patients
that were handed over to the debt collector, often the
agreements are not honoured, leading to defaulter
payments.
Programme expenditure
2014/2015
Programme Name
2015/2016
Final
Appropriation
Actual
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Actual
Expenditure
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
Administration
566 467
565 081
1 386
808 126
807 358
768
District Health
Services
9 820 584
9 563 046
257 538
11 269 137
11 075 547
193 590
Emergency Medical
Services
933 348
847 561
85 787
999 572
940 319
59 253
Provincial Hospital
Services
6 100 656
5 987 314
113 342
6 518 398
6 432 065
86 333
Central and Tertiary
Hospitals
11 584 643
11 584 642
1
12 585 477
12 582 282
3 195
Health Sciences and
Training
870 779
861 931
8 848
938 929
938 834
95
Healthcare Support
Services
230 602
211 542
19 060
259 796
223 499
36 297
1 384 100
1 384 095
5
1 957 652
1 864 651
93 001
31 491 179
31 005 212
485 967
35 337 087
34 864 555
472 532
Health Facilities
Management
Total
The table above summarises the budget versus
actual expenditure as at 31 March 2016. The
Department spent 98% of the budget. There is a 2%
overall underspending of R472 532 million due to the
following:
•
•
R57 million for Conditional Grants could not
be spent in the 2015/2016 Änancial year,
the underspending occurred within the
Comprehensive HIV and AIDS, National Health
Insurance and EPWP Social Sector Incentive
grants.
Underspending was incurred within the Voted
Funds on goods and services due to payment
of the Medical Supplies Depot for accruals of
2014/2015 and surrender of the Voted Funds to
Provincial Treasury.
4.3
Virement/Rollovers
The year-end application for shifting and virement was
made to the Provincial Treasury to alleviate excess
expenditure on standard items within programmes
and sub-programmes. The application was guided
by Section 43 of the Public Finance Management Act
(PFMA) and Treasury regulation.
The shifting and virement was made on the
compensation of employees, goods and services,
transfer and subsidies and payment for capital assets
and economic classiÄcations.
The following main divisions were affected:
•
•
•
•
•
•
Administration
District Health Services
Provincial Hospital Services
Central and Tertiary Hospital Services
Health Sciences and Training
The Head of the Department approved the shifting
and recommended the application, which was
subsequently approved by Provincial Treasury.
The virement approved District Health Services,
Emergency Medical Services and Provincial Hospital
Services to reduce the overspending in Administration,
Central and Tertiary Hospital Services and Health
Sciences and Training programmes.
13
4.4
Unauthorised, fruitless and
wasteful expenditure and steps
taken to address and prevent a
recurrence
The Department did not record any Unauthorised
Expenditure during the period under review.
The value of the fruitless and wasteful expenditure
was R2.2 million. This was due to expired medication.
The Department, through its Medical Supplies Depot,
continues to ensure that the amount of expired stock
is maintained below the industry norm of 2% average
stock holding, with expired medication at 0.04% of
average stock holding for the 2015/2016 Änancial year.
Efforts to improve stock control are ongoing and
include adherence to minimum and maximum stock
levels, improvement of stock availability and improving
supplier’s lead times by imposing penalties for late
deliveries. As a result of this, supplier performance
signiÄcantly increased and this improved stock
management processes and prevented over-ordering
due to stock shortages that could lead to expiring
medication.
14
With regard to efforts to address increasing medicolegal matters, the Department has appointed two law
Ärms to conduct a legal audit of all litigation matters
from 2005 to date. The objective is to reduce costs,
minimise or reduce unnecessary litigation and identify
key factors that contribute to litigation cases.
4.5
Activities discontinued during the
2015/2016 Änancial year
The contract between the Department and Selby Park
Hospital was not renewed in the 2015/2016 Änancial
year and steps were taken to incorporate Selby Park
beds into existing facilities of the Department.
New/proposed activities
The Department will be implementing the test and
treat services, which differ from the previous guidelines
of treating patients with CD4 counts lower than 500.
This type of service will have cost and personnel
implications. The full cost implication for the province
is still being looked into.
No unsolicited proposals were accepted for the year
under review.
The Department submitted the 2015/16 Annual
Procurement Plan to Provincial Treasury and thus met
the deadline of 30 April 2015.
The Department advertised 25 tenders to establish
a departmental contract to ensure procurement of
quality medical equipment and products. We have
also strengthened contract management in the
Department in order the irregular expenditure. With
regard to the Preferential Procurement (PP) spend
targets, the Department met the provincial targets
on HDI and Youth. However, the Department did not
meet the provincial targets on Women and PWD.
In addition, we have efÄcient and effective Asset
Management systems as we have been maintaining
unqualiÄed audit opinions in the past four Änancial
years.
4.8
Public Private Partnerships (PPP)
The Department did not register or undertake any
PPP Project with National Treasury in accordance
with the Treasury Regulations 16 for the year under
review.
4.6
4.7
Gifts and donations in kind
received from non-related parties
The Department received various donations in kind,
including vehicles, computer equipment, ofÄce
furniture and other machinery.
4.9
Exemptions and deviations
received from the Provincial
Treasury
The Department received condonement in October
2015 from Provincial Treasury for not implementing
the increment of UPFS tariffs for 2015/2016.
The Gauteng Department of Health embarked on
a process to transfer healthcare services that were
provided by Life Esidimeni to save costs while not
compromising the standard of care.
4.10 Events after the reporting date
The Department launched an electronic Bed
Management System (eBMS) in the Steve Biko
cluster that enables medical staff to identify the
location of available beds before hospital admissions
is conÄrmed.
4.11 Acknowledgement or
appreciation
The Department wishes to thank ofÄcials and
management, including implementing partners for
their commitment towards improving healthcare
delivery in Gauteng.
4.12 Approval
The Annual Financial Statements set out on
pages 156 to 275 have been approved by the
Accounting OfÄcer.
15
Dr T.E. Selebano
Accounting Officer
31 May 2016
5. Statement of Responsibility
and Confirmation of the
Accuracy of the Annual
Report
The Accounting OfÄcer is responsible for establishing,
and implementing a system of internal control that
has been designed to provide reasonable assurance
as to the integrity and reliability of the performance
information, the human resources information and the
Annual Financial Statements.
To the best of my knowledge and belief, I conÄrm the
following:
The external auditors are engaged to express
an independent opinion on the Annual Financial
Statements.
All information and amounts disclosed throughout
the Annual Report are consistent. The Annual Report
is complete, accurate and free from any omissions.
The Annual Report has been prepared in accordance
with the guidelines on the Annual Report as issued by
National Treasury.
In my opinion, the Annual Report fairly reÅects the
operations, the performance information, the human
resources information and the Änancial affairs of the
department for the Änancial year ended 31 March
2016.
The Annual Financial Statements (Part E) have been
prepared in accordance with the modiÄed cash
standard and the relevant frameworks and guidelines
issued by the National Treasury.
The Accounting OfÄcer is responsible for the
preparation of the Annual Financial Statements and
for the judgements made in this information.
16
Sincerely,
Dr T.E. Selebano
Accounting Officer
31 May 2016
Vision
communicate our decision openly across the different
levels in the organisation. We do not lie to our patients
but tell them the truth.
Daily we provide high-quality, efÄcient and accessible
healthcare to transform people’s lives.
EfÄciency: We work efÄciently to optimise the scarce
resources to achieve more with less.
6. Strategic Overview
Mission
Create an effective public healthcare system in
Gauteng by ensuring we have the right people, skills,
systems and equipment to provide the care our
patients need to live healthy, quality lives.
Values
Patient focused: Everything we do should beneÄt
the patient. We want our patients to be our number
one priority in everything we do. All the decisions
we make and the actions we take should be driven
by our vision to provide high-quality, efÄcient and
accessible care to our patients – at both clinical and
non-clinical functions. We will articulate this value to
new employees through our induction programme.
Putting our patients Ärst does not mean that patients
get what they ask for, but that they receive what is in
their best interests.
Accountability: We take ownership of our
responsibilities and go above and beyond call of
duty and expect our colleagues to do the same to
achieve the best outcome for our patients. We aspire
to be an organisation in which employees take full
responsibility for their work, and we will provide them
with clear job descriptions, performance contracts
and consequence management to help them achieve
this. We praise and celebrate achievements when
colleagues go the extra mile. Role modelling is
essential to be embed in this value. Accountability is
also about making our colleagues responsible for their
work; we have the leadership strength and capabilities
to have the difÄcult and courageous conversations
with our teams.
We know that budgets are constrained and human
resources are few. We know that wasting resources
has a negative effect on our patients’ health. We will
focus relentlessly on improving efÄciency at every level
in every department.
Provincial
values:
Patriotism,
Integrity,
Purposefulness, Passionate, Accountability, Activism
The Department derives its mandate from the South
African Constitution, the National Health Act and
other legislation promulgated by Parliament.
The core mandate of the Department is to:
• Improve the health status of the population;
• Improve health services;
• Secure better value for money;
• Ensure effective organisation; and
• Provide integrated services and programmes
that promote and protect healthy, quality and
sustainable livelihoods for poor, vulnerable and
marginalised groups in society
In fulÄlling its mandate, the Department is guided by
legislation listed in the annexure at the end of this
report.
Transparency: We make decisions based on facts
and we are willing to explain them to those affected.
We want to be a transparent organisation, free of
internal politics and unnecessary bureaucracy. We will
17
7. Organisational Structure
Head of Department
Head OfÄce
CD: Information and
Technology
18
Chief of Operations
DDG: Human Resources
& OD
CD: Corporate Services
Chief Financial OfÄcer
DDG: Facility
Management
Dir: Health information
Management &
Technology
CD: Health Programs
CD: Human Resources
Management
CD: Legal & Corporate
Secretarial Services
CD: Financial
Accounting
CD: Infrastructure
Management
Dir: IT Risk Management
CD: Hospital Services
CD: Human Resources
Development
CD: Communication
CD: Supply Chain &
Asset Management
Dir Health Care Waste
Management
Dir: Information Systems
CD: District Management
CD: Policy, Strategic
Planning & Monitoring
CD: Risk Management
CD: Special Projects
Dir: IT Infrastructure
CD: Health Service
Support
CD: Budget & Revenue
CD: Infrastructure Project
Management
CD: Tuberculosis (TB)
CD: Health Economist &
Financing
Chief Engineer:
CD: Forensic & Medico
Legal
CD: EMS
CD: Pharmaceutical
Services
CD: HIV & AIDS
CD: Nursing Services
8. Entities Reporting to the MEC
The Department has no public entities that fall under
the control of the MEC except the Medical Supplies
Depot (MSD), which is a trading entity.
The performance of the MSD, in respect of
pharmaceutical services, is incorporated elsewhere in
this report.
The table below indicates entities that report to the MEC.
Name of Entity
Legislative Mandate
Financial Relationship
Nature of Operations
Medical Supplies
Depot (MSD)
Registered as ‘The Central
Medical Trading Account’
since 1 April 1992 under the
Exchequer Act, Act 1 of 1976.
The depot charges a levy
of 5% on stock supplied to
the Provincial Healthcare
Facilities.
The MSD is responsible for the supply
of essential medicines and disposable
sundry items to the Provincial Healthcare
Facilities in Gauteng.
9. Legislative and other Mandates
The Department derives its mandate from the South
African Constitution, the National Health Act and
other legislation promulgated by Parliament.
The core mandate of the Department is to:
• Improve the health status of the population;
• Improve health services;
• Secure better value for money;
• Ensure effective organisation; and
•
Provide integrated services and programmes
that promote and protect healthy, quality and
sustainable livelihoods for poor, vulnerable and
marginalised groups in society
In fulÄlling its mandate, the Department is guided by
legislation listed in the annexure at the end of this
report.
19
Part B: Performance Information
1. Auditor-General’s Report: Predetermined Objectives
The AGSA currently performs certain audit procedures
on performance information to provide reasonable
assurance in the form of an audit conclusion. The audit
conclusion on performance against predetermined
objectives is included in the report to management,
with material Ändings being reported under the
Predetermined Objectives heading in the report on
other legal and regulatory requirements section of the
auditor’s report.
Refer to page158 of the Report of the Auditor-General,
published as Part E: Financial Information.
21
2. Overview of Departmental Performance
2.1
Service Delivery Environment for
2015/16
The past Änancial year saw an acceleration of efforts
to expand coverage of health services across all
health programme interventions, improve access to
services beyond the traditional health service delivery
platforms and improve timeous delivery of care and
patient health outcomes. These services are extended
also to patients from neighbouring provinces.
In line with its mission, the Department delivered
primary healthcare services to an estimated
22 000 000 patients who visited clinics and
community healthcare centres: 4 071 067 children
below the age of Äve and 18 028 661 of them were
adults and children above Äve years. These primary
healthcare services comprise a wide range of services,
including both curative and preventative interventions,
with a complementary capacity for rehabilitative and
palliative care.
22
The goal of universal access to quality healthcare
services was boosted through the Department’s use
of 533 Ward Based Outreach Teams that provide
screening and referral services to 1 900 754 patients
within the comfort of their own homes. These patients
comprise 387 868 children and 1 512 886 adults.
Integrated School health-based services were
also provided by 69 school health teams and oral
hygienists. These teams provide health screening
services and refer learners for further healthcare
interventions should the need arise. A total of 187 870
pupils were screened during the year under review.
It is through this platform that immunisation services
aimed at preventing tetanus and diphtheria were also
provided to 49 368 pupils. In addition, oral health
preventative services were provided, allowing oral
hygienists to clean pupils’ teeth and place Ässure
sealants on the molars of 77 061 primary school
pupils in order to prevent tooth decay.
Access to affordable, essential medicines is a vital
component of an efÄcient healthcare system and to
demonstrate the commitment towards access to
medicines the Department runs a Chronic Medicines
Dispensing programme for stable patients on chronic
medication. To date, the programme has 171 medicine
pick-up points, 51% of which are in the public sector
with 114 926 patients enrolled.
In addition to services provided at primary healthcare level, the Department provided hospital services
to an estimated 1 777 018 patients at Out-Patient
Departments (OPDs) of specialised, district and
regional hospitals while 3 130 44 presented at OPDs
of tertiary and central hospitals.
The provision of maternal and child health services
and HIV and TB, including public health programmes,
remained a priority.
Efforts were made to ensure that services aimed at
preventing mortality and morbidity of key population
continue. As a result of these interventions, the
Department observed an improvement in attendance
of Antenatal Care before 20 weeks of gestation and a
decline in maternal deaths.
Preventative and curative services were also provided
to HIV and TB infected patients. To date, 2 934 613
clients of the planned 2 119 906 patients were tested
for HIV. To bolster prevention efforts, 197 852 306
of the 191 782 721 planned male condoms were
distributed and 7 642 078 of the 4 097 926 planned
female condoms. Futhermore, more than 2 million
people were reached using the PASOP platform
through various campaigns such as peer education,
door-to-door drives, community dialogues, and
information blitz. This was coupled with multimedia
campaigns on various platforms, covering a wider
audience.
Patients who test positive for HIV are immediately
enrolled on ART treatment. During the period under
review, 153 440 patients were placed on ART with
756 039 retained on care. Measures to retain patients
on care include follow-up visits, tracing patients
through their physical addresses and provision of
counselling and support through community support
groups.
2.2
Service Delivery Improvement Plan
The Department has completed a Service Delivery Improvement Plan to improve on key services that are service
delivery orientated. The tables below outlines the plan and its achievements to date.
Table 2.2.1: Main services and standards
Main services
BeneÄciaries
Current/actual
standard of service
Desired standard of
service
Actual achievement
Improving access to
obstetric ambulance
services
Mothers and new-born
babies
43 obstetric
ambulances dedicated
to obstetric emergency
care linked to delivery
of services to MOU’s
53 obstetric
ambulances per MOU
or part thereof based
on demand trend
10 fully-equipped
obstetric ambulances
were procured and put
in operation.
Mothers and new-born
babies
16% Basic Life
Support Care and
84%Intermediate
Life Support Care
Technicians
25% Emergency Care
Technicians (ECT)
50% Intermediate Life
Support (ILS), 25%
Basic Life Support
(BLS)
A signiÄcant increase of
number of Intermediate
Life Support Care and
Emergency Technicians
Care by at least 10%
combined
Improving access to
medicines for patients
who are stable on
chronic medicine
Patients who rely on
public health services
for their acute and
chronic medicine
supply and their
families
Medicines delivered
to 30 000 stable
chronic patients at
pick-up points closer to
patients’ residences
Medicines delivered
to 30 000 stable
chronic patients at
pick-up points closer to
patients residences
As at the end of
quarter four the
cumulative number of
patients enrolled on
the programme in the
province is 114 926
Antenatal Care
Services
Individual pregnant
women, partners,
men, fathers, couples,
grandparents and
communities
Antenatal services
provided to women
with a Ärst visit before
20 weeks at 43.7%
(quantity)
Antenatal care visits
before 20 weeks to
reach 70% at the end
of the cycle
54.9% of pregnant
women attended
antenatal care before
20 weeks of gestational
age
Table 2.2.2: Batho Pele arrangements with beneÄciaries
Current/actual
arrangements
Desired arrangements
Actual achievements
Courtesy
100% of obstetric emergency calls
answered within 30 seconds
100% of obstetric emergency calls answered within 30 seconds
in the Emergency Communication Centre (ECC)
Access
99% Improved Priority1 (One) response
time on Obstetric ambulances within 15
minutes
Of all the call volumes received, 20% on average were obstetric
calls. 78.8% of the P1 urban calls were serviced within
15 minutes after all information was received
Consultation
Three in various forms, which included legislature format on
Number of consultations with
stakeholders where obstetric ambulance broad EMS delivery concerns
related inputs were provided
23
Actual achievements
Professional
standard
Services provided by professionals
registered with a professional body in
accordance with their scope of practice
Services provided by the service provider (Pharmacy Direct),
the private pick-up points (for example, Medi-Rite, Clicks
pharmacies) and at the PHC facilities are all provided by
professionals registered with professional bodies and in
accordance with their scope of practice
Legal standard (if
applicable)
Chronic dispensing SOPS available
The SOPs have been Änalised
Consultation
Consultation with stakeholders
A total of 18 meetings during this quarter with various
stakeholders in all the districts to discuss the progress of the
programme
Access
60 pick-up point for chronic medicines
Medirite = 13, Clicks = 36, Private pharmacies = 14, NGO’s = 7,
Clinics and CHC’s = 94
Hospitals = 5,Private doctors = 2,Total = 171
Courtesy
Patients are sent SMS notiÄcation
reminding them of their pick-up dates
two days prior to collection
SMS sent to all 114 926 patient notifying them on their pick up
dates
Service standard
Current EML availability is at 84%
96% medicine availability
Value for money
Free service
It is a free service to the patient. Patients can decide on the
pick-up point to collect chronic medication closest to their
home/work and avoid travelling long distances
Patients will not have to travel long
distance
Human
Resources
24
The ratio of pharmacist to pharmacist
assistants must not exceed 1:3
No project manager has been appointed speciÄcally for this
project to date
Current/actual
arrangements
Actual achievements
Current/actual arrangements
Professional standard
All antenatal care services to
be provided in accordance
with maternity guidelines from
HPCSA and SANC Regulation
(legal standard)
All antenatal care services to
be provided in accordance with
Maternity Guidelines
All antenatal care services are
provided in accordance with
Maternity guidelines
Legal Standard
Provision of services by
registered professionals with
relevant bodies, for example
SANC, HPCSA (professional
standard)
Services provided by
professionals registered with a
professional body
Antenatal services are provided
by personnel registered with
professional bodies
Consultation
Community dialogues per
district
Community dialogues/
consultations conducted at
least once per year per district
(consultation)
Consultation held in one health
district
Access
Number of households where
pregnant women were referred
to facilities
5 269 households were visited
100% households visited by
by WBOT teams
WBOT teams where pregnant
women were referred to facilities
Courtesy
Provide information pertaining
to pregnancy and child
birth through dialogues,
MOMCONNECT and SBCC
materials/media/WBOT
(Information)
100% households visited by
WBOT teams where pregnancy
care was given
Provide information to
communities pertaining
to pregnancy and child
birth through dialogues,
MOMCONNECT and SBCC
materials/media
75% of pregnant women
received staged-messages
through MOMCONNECT during
pregnancy and one-year post
delivery
Table 2.2.3: Service delivery information tool
Current/actual information
tool
Desired information tool
Actual achievements
Information
20 Public Information and Education
Relations (PIER) campaigns on EMS
conducted with a total of 500 Ärst
responders equipped with skills to
handle most emergencies mostly in
informal settlements deemed high-risk
12 Public Information and Education Relations
(PIER) campaigns on EMS conducted with a
total of 414 Ärst responders equipped with skills
to handle most emergencies mostly in informal
settlements deemed high-risk
Sharing of the Annual Citizens
Report with communities
Number of Annual Citizens Report
distributed to communities
Report distributed via communications
department within the Gauteng Department of
Health
Pharmaceutical Services
Information is being provided to the
patients in one ofÄcial language
Posters and pamphlets for the CCMDD Tshwane
project already available in English, Afrikaans, Zulu
and Tswana
Table 2.2.4: Complaints mechanism
Current/actual complaints
mechanism
Desired complaints mechanism
Actual achievements
EMS complaints acknowledged
within 3 – 7 working days
90% EMS complaints acknowledged
within 3 – 7 working days
100% complaints are acknowledged within
3 – 7 days.
Consistent timeous delivery of
medicines
1 042 queries/complaints/information sharing –
received at the pharmacy direct call centre and
resolved within 48 hours
25
2.3
Organisational environment
The Department concluded the development and
internal approval of the organisational structure and
awaits endorsement from OfÄce of the Premier and
DPSA. In addition, processes to advocate for the
development of the Service Delivery Model, which
supports the organisational structure, have already
started. The Service Delivery Model process will
continue during the Ärst quarter of the new Änancial
year. In addition to strengthening human capital,
the Department was able to perform veriÄcation of
all new appointments, including Änancial suitability
and criminal record checks, which encompasses full
compliance with the E-DISCLOSURE.
In the past, the Department faced the challenge of
vacancies in the executive leadership portfolio. During
the year under review, various leadership vacancies
were Älled, and this included appointment of four
hospital CEOs, Deputy Director General: Clinical
Services and Chief Directors for Risk and Internal
Control.
26
One of the key strategic focus areas of the Department
is to improve excellence in the Non-Clinical Functions.
One such area is the Änance portfolio. To this end, the
Department partnered with the South African Institute
of Chartered Accountants to improve governance and
support implementation of sound business processes
within the Department. This partnership started in
January 2016.
2.4
Key Policy Developments and
Legislative Changes
During the year under review, the following legislations
and policies were introduced.
(a) The release of the White Paper on National Health
Insurance in December 2015.
The White Paper describes a three-phase process of
implementation over a 14-year period:
•
Phase 1 (Äve years – 2012/2013 to 2016/2017)
focused on strengthening the public health sector,
but also implementing key enablers such as the
OfÄce of Health Standards Compliance (OHSC).
• Phase 2 (Äve years – 2017/2018 to 2020/2021)
focused on registration of the population and the
creation of a transitional NHI Fund to purchase
non-specialist Primary Healthcare (PHC) services
from “certiÄed and accredited public and private
providers”, but also with some amendments to
the Medical Schemes Act.
• Phase 3 (four years - 2021/2022 to 2024/2025)
focused on bringing the NHI Fund into full
operation as a strategic purchaser and single
payer of comprehensive health services, including
specialist services that will require wide-ranging
legislative reforms.
(b) The Medicines and Related Substances
Amendment Act (14 of 2015) was passed by
Parliament and assented to by the President in
December 2015.
(c) During the year under review, new guidelines
on MTCT were released that had implications on
operations of the programme.
3. Strategic Outcome-Orientated Goals
3.1 Progress towards achievement of the 5-year targets and NDP goals
Goals
Indicator
Gauteng baseline
performance 2014/15
Gauteng actual
performance 2015/16
45 – in facility
(per 1 000 live births)
6.1 (per 1 000 live births)
36 – in facility
(per 1 000 live births)
15.5 (per 1 000 live
births)
142/100 000 live birth
125.32/100 000 live
birth (MaMMAS)
11.1/1 000 live births
12.7/1 000 live births
2%
546 (1.5%)
Total number of patients (adults and children) on
ART
559 363
754 456
Medical Male Circumcisions
Under-5 overall Mortality Rate (U5MR –
Improved health
per 1000 live births)
and well-being of
all citizens, with
Infant overall Mortality Rate (per 1 000 live births)
an emphasis on
children and women
Maternal Mortality Ratio (overall per 100 000 live
births)
Neonatal Mortality Rate <28 days, (per 1 000 live
births)
Mother-to-Child Transmission rate of HIV
<2 months of age
Reduced rate of
new infections and
burden of HIV &
AIDS and TB
132 095
247 999
Proportion of TB treatment success among all TB
cases
84.5%
87.1%
TB defaulter rate at the end of TB treatment
among all TB cases.
5.10%
5%
Percentage of HIV-TB co-infected patients who are
on ART on completion of TB treatment
67%
89.1%
Percentage of diagnosed MDR-TB patients who
are enrolled in a TB treatment programme
45%
86.6%
Increased equal and Primary healthcare utilisation rate
timely access to
PHC outreach team coverage
efÄcient and quality
healthcare services, Specialist Clinical Team Coverage
thereby preparing
for roll-out of NHI
Excellence in
our non-clinical
functions
Intake of medical students
Intake of pharmacy students
Intake of nursing students (professionals nurses)
Number of health departments receiving
unqualiÄed audit from Auditor-General
Excellence in
our non-clinical
functions
NHI pilot districts
1.8
1.7
130 teams
533 teams
1 of the 5 districts has
complete teams
4 of the 5 districts have
complete teams
517
650 (All three
universities’ intake)
Pharmacy assistants:
616
616
1 137
4 668
QualiÄed
UnqualiÄed
Tshwane district is
piloting the NHI since
2012
All Äve districts are
piloting the NHI. About
45% (170) of Äxed PHC
facilities are scoring
above 80% on the ideal
clinic dashboard
27
4. Performance Information
By Programme
the importance of Employment Equity Targets of 2%
for PWDs and 50% for women at senior management
level as mandated by the EE Act and Plan.
4.1
Gender and disability mainstreaming
Programme 1: Administration
Purpose of the programme
The purpose of this programme is to provide strategic
direction and leadership, to guide and support the
development of policy frameworks and guidelines
for priority programmes, to develop policies and
legislation on health-care provision, and to ensure that
norms and standards are followed in the course of
implementation.
List of sub-programmes
•
•
•
Human Resource Management.
Quality Assurance.
Information and Communication Technology.
Strategic objectives:
The following strategic objectives are relevant for
Programme 1:
•
•
28
•
Improved client satisfaction rates.
Improved achievement against national norms for
health professionals.
Employment equity and diversity management.
Human Resource Management
SigniÄcant Achievements
Employment Equity
For the Änancial year 2015/16 the Gauteng Department
of Health’s equity targets for women appointments
at senior levels and People With Disabilities (PWDs)
were 43% and 2% respectively. During the year under
review, the Department made 10 684 appointments,
7 915 of which were women. Additionally, of the
seven SMS level positions Älled, one was by a female
candidate.
By the end of March 2016, women appointments at
senior management level constituted 44.4% of senior
management within the Department. As regards
People With Disabilities, the Department had a total of
194 employees who self-reported having a disability.
The Department ensures that all adverts for posts
clearly state that only female candidates are invited
to apply. People With Disabilities are accepted as
walk-in applications and targeted recruitment adverts
expressly state that only people with disabilities are
invited to apply.
In the year under review, 36 roadshows and
18 workshops were conducted to raise awareness on
The Department participated in a month-long
Women’s Month Programme organised by the OfÄce
of the Premier at Constitution Hill. It used the platform
to provide a range of screening services for diabetes,
high blood pressure, cholesterol, HIV/AIDS, breast
and cervical cancer, oral health as well as promotion
of healthy lifestyle. In addition, it hosted a workshop
during the DPSA Women Management Week that
was attended by 39 women at senior management.
During the workshop, the 8 Principle Action Plan for
promoting women empowerment and gender equality
within the public service were discussed, including the
launch of a women’s forum at Sterkfontein Hospital.
Strategy to overcome areas of underperformance
Despite the progress made in increasing the
representation of women in senior management
positions, the Department needs to develop a strategy
to ensure that senior female managers who retire are
replaced by women so that there is progress.
It is a point of concern for the Department that fewer
People With Disabilities (PWD) have qualiÄcations
in health sciences, particularly in medicine and
nursing where there is a demand and this limits their
placements. Refurbishments to existing physical
infrastructure are being made to make it easy for
(PWD) to access the Department’s facilities.
A remedial plan has been developed to help facilitate
achievement of the employment equity targets. The
recruitment and selection policy and other Human
Resources policies are continually analysed to identify
barriers that could hamper the implementation of the
Employment Equity Act and Plan.
Quality Assurance
The Department, through its Provincial Inspectorate
Unit, continued with its National Core Standards
(NCS)
self-assessments
coordination
efforts
aimed at improving overall compliance of all health
establishments to prescribed quality standards.
Other interventions to support quality standards
performance included the establishment of Quality
Internal Assessment Teams that were devolved to the
districts to assist health facilities with compliance to
the prescripts and directives of the National Health
Core Standards and compliance with the ideal clinics
norms and standards.
SigniÄcant achievement in relation to the six priority areas
The highlights from current self-assessment results indicate the average overall performance scores as follows:
2013/14
2014/15
2015/16
Central
72%
76%
84%
Tertiary
68%
69%
76%
Regional
69%
69%
74%
District
71%
72%
72%
Hospitals
There has been an overall improvement in
performance across all levels of care in the past three
Änancial years. The best performing facilities are Steve
Biko Academic Hospital, Helen Joseph Hospital and
Rahima Moosa Mother and Child hospital, all with
scores above 80%.
There are continuing efforts to improve performance
of facilities where performance is not satisfactory
including development of QIPs.
2013/14
Six priority areas
2014/15
2015/16
Availability of medicines
74%
77%
80%
Cleanliness
61%
64%
73%
Patient safety
70%
70%
75%
Infection prevention and control
67%
69%
76%
Positive and caring attitude
73%
73%
76%
Waiting times
75%
76%
82%
There is overall improvement across all six priority
areas over the past three years with the biggest
improvements in staff attitudes, cleanliness of facilities
and infection prevention and control.
A special management mentoring regime has been
put in place as part of these hospitals’ QIPs to further
improve performance.
Patients’ complaints management system
During the year under review, the Department received
a total of 492 complaints and a large number of them
were related to patient care, waiting times, respect
and dignity, access to information, surgical backlogs,
medicines and medical supplies. Complaints about
patient care, waiting times and medicine availability
were the most common, while emergency care and
infection prevention had the least complaints.
To improve the overall experiences of the beneÄciaries
of the service, complaints were attended to promptly. In
total, 293 (60%) of the 492 complaints received during
the year under review were addressed, while 196 (67%)
of these were addressed within 25 working days.
Reduction of waiting times at Gauteng
Department of Health facilities
Apart from redress mechanisms in place, the
Department seeks to improve beneÄciaries’
experience of healthcare services through various
means such as the implementation of the Lean
Management Programme that aims, among other
things, to reduce patients’ waiting times at various
facilities. As at end of the Änancial year, hospitals
in the Chris Hani Baragwanath cluster, namely
Leratong Regional, Sebokeng Regional, Chris Hani
Baragwanath Academic and Kopanong District
hospitals, were part of the Lean Management
Programme. The programme was also extended
to pharmacy departments at Steve Biko Academic
Hospital, Charlotte Maxeke Academic Hospital and
Tembisa Tertiary Hospital.
Of the 30 reporting hospitals (four central, three
tertiary, nine regional, 10 district and four specialised),
21 (70%) complied with the provincial waiting times
benchmark of 120 minutes for their outpatients
departments from point of entry (patient registration)
to exit (pharmacy). Additionally, 22 hospitals (73%)
complied with the provincial benchmark for their
casualty departments from point of entry (patient
registration) to exit (pharmacy). Twenty-six out of 35
CHCs (74%) complied with the benchmark of 100
minutes from point of entry to exiting the facility.
From 2014/15 to 2015/16 Änancial year, the overall
improvements in the reduction in waiting time ranged
from 21% to 86% in facilities running the Lean
Management Programme.
29
Strategies to address areas of underperformance
Information and Communication
Technology
•
•
•
•
30
•
Awareness initiatives are implemented to
encourage patients to always provide feedback
and the Department has started with a pilot to
daily administer a questionnaire to obtain patients’
feedback about how they experience health
services in the province.
Strengthening the booking system by establishing
speciÄc appointment dates, times and retrieval
of patients’ Äles a day before patients are due for
appointments. The early retrieval of Äles leads to
shorter queues and signiÄcantly reduces patients’
waiting times. Furthermore, staff at facilities are
able to plan ahead for the expected patient load.
Capacity-building included training of courtesy
ofÄcers/queue marshals in effective queue
management. A total of 350 Community Healthcare
Workers were trained and 200 were designated as
courtesy ofÄcers and allocated to health facilities,
including hospitals, community health centres
and clinics within the Johannesburg, Sedibeng,
Ekurhuleni, Tshwane and West Rand districts.
Revising the duty roster of OPD and casualty
clinicians to start work as early as 8am (previously,
this was at 11.30am).
Conducting regular walkabouts and spot checks
by nurse managers, CEOs and staff members
from the Chief Directorate for Nursing and Quality
Assurance, speciÄcally at accidents emergency
units, OPDs, pharmacies, radiology departments
and theatres in order to identify challenges and
introduce potential countermeasures on the spot.
Additionally, improved relations between provincial
and hospital stakeholders have been enabled by
this process.
Modernisation of our health system is a journey
that is well under way. While we were of the belief
that we would be further along the road with the
digitisation of patient records, we are on track with the
modernisation of our public health services by 2019.
There are three main objectives of Modernisation:
• Improve Quality of Patient Care
• Reduce Patient Waiting Times
• Improve Revenue Collection
The overall outcome will be a Single View of the
Patient. This requires us to put several building blocks
in place: applications interfaces to have interoperability
of systems (PACS; Medicom, NHLS; RX etc.); single
source of patient demographic information (IVS);
digitisation of historical patient information for the
continuum of care; connectivity between and internally
within each facility; the required hardware; proÄcient
support staff to train and support the modernised
environments.
Progress was made with regards to the
implementation of the Gauteng Broadband Network
project to connect all health facilities to the network.
Patient Archiving Communications System (PACS)
mobile application, the Electronic Health Records
and the Bed Bureau Management System are among
other e-health-related solutions that the Department
is implementing. Budgetary constraints and other
legal challenges pertaining to ICT contracts remain a
concern.
To manage the cost for the delivery of ICT projects,
the Department will be reviewing the previous plan
for the delivery of some projects such as PACS.
Other avenues to support funding for ICT will also be
explored.
PERFORMANCE INDICATORS: PROGRAMME 1 – ADMINISTRATION
Strategic
objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
for 2015/16
(over/(under)
32/36
5
(27)
SCM tender processes for
the roll-out of the project took
longer than anticipated. The
project is being reviewed
by the Bid Adjudication
Committee (BAC) and
advertisement of the tender
will commence in the new
Änancial year.
Comment on deviation
Improve quality of patient services
Number of
hospitals
implementing
Lean Management
Project
5
Improve quality of and access to information systems in healthcare facilities
Number of
M-health
application
developed
0
2
2
0
The target was achieved with
the development of the AITA
Health application for WBOTs
and the development of the
response application for EMS.
Number of
hospitals with
PACS
6
19/36
8
(11)
This target has been
reviewed. The purchase of
a separate PACS system for
each facility is not required
and would be too costly
and result in unnecessary
expenditure. Each of the
four central hospitals has
a centrally located PACS
system and will be connected
to each facility in their cluster
that will allow for the sharing
of images between facilities.
Number of
hospitals with
scanned medical
records
5
32/36
5
(27)
R555 727 000
R479 000 000
(R76 727 000)
Target not achieved.
Scanning of patient records
is one element of creating
an electronic patient record.
This target will be amended
to reÅect the creation of the
single view of a patient record.
Currently, Äve hospitals scan
patient records, namely
Thelle Mogoerane, Charlotte
Maxeke, Edenvale, Tembisa
and Jubilee.
Improve revenue collection
Rand value of
revenue collected
#
Target not achieved. Late
implementation of the UPFS
tariffs which meant the
Department could not bill
using latest public service
tariffs.
The Department is exploring
other revenue sources
such as charging marketrelated fees for its residential
properties, parking and billing
companies that use health
facilities for advertising.
31
Strategic
objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
for 2015/16
(over/(under)
Establish accurate cost base for Gauteng health department budget
#
Percentage of
actual spend
against forecast
<2%
2%
0%
Target achieved. 98% of
overall budget spent. To put
control measures to ensure
that the Department does not
overspend or underspend its
budget
44%
43%
44.4%
1.4%
Target achieved. Of the
117 SMS positions, 52 are
women. The Department is
working towards complying
with the 50% employment
equity targets. There is a need
to also strengthen recruitment
strategies and ensure that
they are biased to female
candidates.
0.72%
2%
0.29%
(1.71%)
Nine new employees with
disabilities were recruited
and three employees with
disabilities were placed on
the Learnership Programme
during the year under review,
bringing the total number
of persons with disabilities
to 194.
Ensure equitable and diverse workforce
Percentage of
women in senior
management posts
Percentage of
People With
Disabilities
employed
by Gauteng
Department of
Health
32
Increase employee satisfaction
Percentage of
newly appointed
staff members
with veriÄed
qualiÄcations
#
40%
43%
3%
Target exceeded. All newly
targeted appointed staff
qualiÄcations were veriÄed.
Percentage of
grievance cases
resolved within 30
days
#
80%
80%
0%
Target achieved. The total
number of grievances lodged
in the year under review
was 127 and 102 of those
were resolved within 30
days. The remaining seven
cases were resolved within
acceptable timeframes.
Regular training on the
management of grievances
will be offered to managers.
Strategic
objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
for 2015/16
(over/(under)
Percentage of
misconduct cases
resolved within 90
days
#
90%
90%
0%
Percentage of
precautionary
suspensions
uplifted within 60
days
#
100%
79%
(23%)
Audit opinion from
Auditor-General
#
UnqualiÄed
UnqualiÄed
No deviation
Percentage of
hospitals with
broadband access
#
50%
99%
49%
The only facility to be
connected by GBN is Jubilee
Hospital. Target achieved, this
indicator is driven jointly with
the department of E-gov.
Percentage of Äxed
PHC facilities with
broadband access
#
1%
30%
29%
GBN, through the department
of E-gov, has connected 100
clinics in this Änancial year.
Target achieved. 707 of the
785 misconduct cases were
resolved within 90 days.
Progressive discipline was
applied instead of formal
discipline and, as a result,
more cases were Änalised on
time. Postponement delays
Änalisation of misconduct
cases within acceptable
timeframes. To address this
challenge, the merit of each
request for postponement
will be assessed to prevent
unnecessary case delays.
23 of 29 precautionary
suspensions uplifted within
60 days and only six of the
suspensions were uplifted
after 60 days.
UnqualiÄed Audit
Target achieved.
Changes to planned targets
There were no mid-year adjustments to the targets under Programme 1
Expenditure: Programme 1 – Administration
2014/15
SubProgramme
Name
Final
Appropriation
Actual
Expenditure
2015/16
(Over)/Under
Expenditure
Final
Appropriation
Actual
Expenditure
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
OfÄce of the
MEC
15 444
15 066
378
18 345
14 588
3 757
Management
551 023
550 015
1 008
789 781
792 770
(2 989)
The programme has spent within the target norm.
33
4.2
•
Programme 2: District Health
Services
•
The purpose of the programme is to provide
comprehensive Primary Healthcare (PHC) services,
district hospital services, and comprehensive HIV and
AIDS care and to deliver priority health programmes,
including the nutrition programme.
The District Health System is the vehicle for the
delivery of PHC. It encompasses a range of basic
health services, including health promotion, disease
prevention, curative care and rehabilitation. PHC
coupled with equitable access to decent housing,
clean water, sanitation, nutrition and education has
been shown to have a signiÄcant impact on health
and health outcomes.
•
•
•
•
•
•
34
District Health Management and PHC services.
District Hospitals.
HIV and AIDS, STIs and TB.
Maternal, Child and Women’s Health and Nutrition.
Disease Prevention and Control.
Forensic Pathology Services.
Strategic objectives
•
•
•
•
•
•
•
•
•
•
Reduce preventable causes of maternal deaths.
Reduce infant mortality.
Reduce child mortality.
Reduce malnutrition in children.
Reduce referrals for specialised psychiatric care.
Increase mobility among people with disabilities.
Reduce new HIV infections in youth and adults
through increased safe sex behaviours.
Reduce new HIV infections in babies.
Increase male circumcision among youth.
Reduce deaths from TB through effective treatment.
Districts
Teams established
Trained Team Leader
Number of wards
•
•
•
Reduce death from AIDS through appropriate
treatment, care and support for 80% of people
living with HIV (PLHIV).
Facilitate normal psychosocial development of
orphans and vulnerable children (OVC), including
children affected by AIDS.
Increase partnerships on HIV and AIDS.
Improve client satisfaction rate.
Increase level of efÄciency in PHC facilities.
Sub-programme 2.1: District Health
Management and PHC Services
SigniÄcant achievements
Integrated Chronic Disease Management
(ICDM)
Integrated Chronic Disease Management (ICDM)
model of care is implemented across all Äve districts,
albeit in an incongruent manner. The model supports
integrated prevention, treatment and care of chronic
patients at primary healthcare level (PHC) and
support self-managed care within the community.
During the year under review, 343 of the 369 Äxed
facilities implemented the Integrated Clinical Service
Management (ICSM). The West Rand District has
implemented the programme at all its facilities
while JHB-Metro has the least number of facilities
implementing ICSM.
Ward Based Outreach Teams (WBOTs)
Ward Based Outreach Teams (WBOTs) is one of
the PHC re-engineering strategy streams aimed at
providing preventative and promotion of health services
at community level through the use of 533 teams
comprising of 324 team leaders and 6012 CHWs.
These teams operated in 316 of the 508 targeted
wards. During the year under review, the coverage of
these outreach services reached 499 232 households.
In its efforts to improve coverage of these outreach
services, the Department also trained 324 Team
Leaders and 343 Community Health Workers (CHWs).
Johannesburg
Ekurhuleni
Tshwane
West
Rand
Sedibeng
Total
176
112
126
73
46
533
50
64
113
51
46
324
130
55
67
10
54
316
The table above shows the breakdown of WBOTs per district including the coverage of wards and number of
team leaders.
Expanded Public Works Programme (EPWP)
Efficiency Measures
The EPWP programme forms part of the decent
employment through inclusive economic growth
outcome of government that promotes decent work
and sustainable livelihoods, education, health; rural
development; food security and land reform and
the Äght against crime and corruption. During the
2015/16 Änancial year, the Department recruited
3 765 participants who were largely funded through
the EPWP voted funds while 415 of the total recruit’s
funding came through the incentive grant.
During the period under review, district hospitals
had a bed occupancy that was 15% lower than the
expected capacity. A total of 30 207 (65%) beds were
utilised for management of level 1 in-patient care
services instead of the expected 80% beds utilisation
norm. On average, patient length of stay was within
the norm at an estimated three days during the
Änancial year 2015/16. Anecdotal evidence seems to
suggest that this pattern of bed occupancy may be
due to the recently introduced ward based outreach
and Integrated Chronic Disease Management (ICDM)
programmes wherein patients are given medical care
within the conÄnes of their homes, thus reducing the
number of patients reliant on hospital care. A much
more rigorous evaluation is, however, needed to
qualify this hypothesis.
Strategies to overcome areas of underperformance
Although the number of WBOTs increased beyond
the planned output, there is still a need to appoint
and train additional team leaders. In absolute terms,
to cover 80% or 406 wards, the Department requires
a total of 619 WBOT leaders.
As regards the EPWP programme, whose current
challenges revolve around high attrition rate and
absenteeism among other issues, the Department
will be strengthening monitoring of participants
through the use of attendance registers. In addition,
motivations to address the revision of Minimum
Wage by National Department of Public Works will
be attended to. Minimising delays and expediting the
appointment of replacements for participants who
leave will also help in closing the gap.
Sub-programme 2.2: District Hospitals
District hospitals provide primarily level 1 in-patients
care services, delivered by general family practitioners
medical ofÄcers and family medicine specialists,
and include casualty and emergency care services.
District hospitals play a pivotal role in screening and
managing “off- street” access and refer to higher
levels of care only when appropriate. The referral
between the different levels is guided by protocols,
which provide practice guidelines.
Rehabilitation and therapeutic services
The Department provides rehabilitation services
aimed at promoting health and wellbeing, prevention
of disability, restoring integration and upholding
rights of vulnerable groups. These programmes
are undertaken in close cooperation with other
government departments, advocacy groups, NGOs
and Community-Based Organisations.
In support of poverty alleviation, various efforts were
put in place to improve Vocational Rehabilitation
services aimed at facilitating clients’ return to work
following a debilitating injury. Two hundred and
nine patients beneÄted from this programme in
the Ärst six months of implementation. Continued
education programmes were offered by Occupational
Therapy staff and several supportive guidelines were
developed. The Vocational rehab programme was
rolled out across the province. A screening tool to
assess patients’ ability to continue to drive after
becoming disabled was developed and will be rolled
out in the next Änancial year.
35
Prevention of secondary complications for wheelchair
users is of utmost importance and requires highly
skilled staff. To achieve this, wheelchair seating training
was provided to members of each district and 24 staff
members were trained. Early childhood intervention
remains a key focus area for rehabilitation services,
and the programme was rolled out to all facilities that
provide rehabilitation services.
Waiting lists for medical assistive devices were mostly
non-existent. By the end of the Änancial year, a total
of 61 349 devices was issued compared to 49 293 in
2014/15. This was mostly achieved by the additional
funding that was made available from central ofÄce
and also by strengthening recording systems.
36
There is a need to expedite SCM processes to
ensure the awarding of rehabilitation consumables
tender and advertising the rehabilitation equipment
tender. To address gaps in manual wheelchair
repairs services, which are currently not functional
in Johannesburg Metro, West Rand and Sedibeng
districts, the Department will expedite the renewal of
the service agreement with the existing manual repair
workshops for the coming year and start the process
for advertising a tender for the manual wheelchairs
maintenance and repairs services for 2017.
Radiography services
Radiology services are one of the key services
provided as part of the diagnostics health delivery by
ensuring provision of quality imaging and radiation
therapy services with the least amount of radiation risk
to the patient. Monitoring of Radiographic Equipment
during the year under review was conducted, as per
schedule, to ensure compliance with the National
Core Standards and Legal Compliance requirements
as per the Hazardous Substances Act 15 of 1973. As
part of modernisation and strengthening of radiology
services, the Department implemented digitisation of
diagnostic radiography departments by acquiring 6
full digital X-ray units, 1 conventional unit and 2 digital
imaging units radiology equipment at three CHC and
four districts hospitals.
The Department will ensure that there is a plan to
maintain existing radiology equipment to prevent
interruptions in service provision and improve
compliance of diagnostic radiography equipment. It
will also address stafÄng needs for radiology services
through continued bursary allocation, allocation of
community services radiographers and sessional
service provision by retired radiographers over and
above expediting the Älling of vacated posts.
Oral Health
The Department, during the year under review,
continued with the provision of oral health services
that beneÄted 40 774 children and 739 909 adults.
Key programmes implemented included the provision
of preventative and oral health promotion type of
services at schools, tooth brushing programmes to
31 112 clients and provision of dentures to 3 661.
Stakeholder engagements on oral health services
was done during the National Oral Health congress.
Furthermore, the Department implemented dental
assistants internship programme that will make dental
assistant graduates to acquire relevant skills. By the
end of the Änancial year, nine dental assistants
graduates had beneÄted from this programme.
On an annual basis, the Department receives
15 community service dentists who support the
provision of oral health services. The current challenge
is that dentists are expected to function with the
support of dental assistants on a daily basis and these
categories are currently in short supply. To close this gap,
the Department has started a learnership programme
for dental assistants. Challenges pertaining to storage
of dental consumables are being resolved after a
building was identiÄed at Tshwane District Hospital.
The building is currently undergoing refurbishments
and will improve accessibility by all users.
Sub-programme 2.3: HIV, AIDS, STIs
and TB
Summary of SigniÄcant Achievements
HIV Counselling and Testing (HCT)
During the year under review, the Department tested
3 273 089 patients. This level of performance was
made possible through the active involvement of 51
funded Non-ProÄt Organisations that engaged in
extensive social mobilisation and targeted hard-toreach areas and informal settlements in order to provide
communities an opportunity to access HCT services.
The launch of the PASOP communication strategy
has also increased awareness about the importance
of knowing one’s HIV status and encouraged partners
to protect each other. The PASOP communication
strategy and testing also focused on the key
populations, for example commercial sex worker,
males having sex with males (MSM), substance and
drug users who were counselled and tested by their
peers supported by health staff also contributed to
the increased uptake. Expansion of HCT services to
communities by PEPFAR funded NGOs and provision
of HCT in all the Nthirisano Community Indabas also
added to the achievement of the HCT uptake.
Medical Male Circumcision
Prevention of Mother-To-Child Transmission
An estimated 112 896 males were circumcised during
15/16 Änancial year and the target of 300 000 could
not be achieved. The number of facilities performing
MMC increased from 68 to 76 public health facilities,
Äve Non-Medical Sites and 19 Independent Private
General Practitioners contracted with the Department
and Developmental Partners with the aim of increasing
output. There is improved monthly reporting by
private providers due to strengthened public private
partnership.
The Prevention of Mother-to-Child transmission
programme is yielding positive outcomes. During the
year under review, only 1.5% of babies tested six
weeks after birth had a positive PCR result, less than
the 2% target. A key contributor to the success of the
PMTCT programme is the increasing rate of pregnant
women who are initiated on ARTs at antenatal clinics.
During the period under review, the Department
initiated 39 700 (91%) pregnant women who tested
HIV-positive on antiretroviral therapy, exceeding the
90% target.
Antiretroviral therapy
During the year under review, 149 367 adults and
4 073 children were initiated on antiretroviral
treatment. Since the inception of this initiative,
1 163 847 patients have been placed on antiretroviral
treatment. Further treatment support in the form of
antiretroviral prophylaxis was offered to 4 552 eligible
victims of sexual assault cases.
As part of its efforts to improve adherence and
ensure that all patients that test positive are placed
on treatment, the Department continues with its
treatment support programmes and more than
1 000 treatment adherence clubs were established.
As a result of these initiatives, a signiÄcant number
of patients on treatment were retained on care. The
Department had 750 230 of the 746 678 targeted
patients remaining on antiretroviral treatment at the
end of March 2016.
Tier
Antiretroviral
Therapy
Programme
Electronic
Register (ART Tier.Net) has been rolled out across
all Health Districts in Gauteng. This electronic
monitoring provides tools for Cohort Reporting and
early identiÄcation of potential defaulters. A total of
384 Gauteng health facilities are on ART Tier.Net
(T2) and 325 on Phase 6 Cohort Reporting with
dispatch Äles obtained quarterly. This intervention has
made great progress in ART Data Quality and clinical
management of patients.
Medical Male Circumcision (MMC) is another priority
intervention aimed at prevention of HIV and other
sexually transmitted infections. This intervention
forms part of HIV prevention programmes used in
combination with other barrier methods like condoms.
Condom Distribution in Prevention of HIV and
STI’s
In addition to MMC prevention services, the
Department distributed 198 383 706 male condoms
and 7 642 078 million female condoms to clients as
one of the preventative efforts in the Äght against HIV
infection in communities.
High Transmission Areas (HTA)
As part of HIV prevention, the HTA programme
focuses on high-risk areas such as Truck Stops,
Commercial Sex Worker Friendly and/or Special
Clinics, Key Populations Clinics like 1081 Clinic
in HatÄeld, Tshwane, to provide HIV prevention
messages and linkage to treatment, care and support
through peer-education programmes. As at the end
of the Änancial year, the sites had increased beyond
the 100 targeted sites to 139 with 621 peer educators
receiving a stipend.
Multi-Sectoral Approach on HIV/AIDS
Six sectors of the Gauteng AIDS Council reached
312 327 people with awareness and education
programmes and four million people through media.
A total of 3 666 people were reached through training
workshops. The sectors included men, sex workers,
LGBTI, women, sports and people living with HIV
(PLHIV). The PASOP AIDS campaign reached millions
of people through thought-provoking messages on
billboards, murals, and advertisements on radio and
in print as well as on various social media platforms.
The combined outputs of organisations working with
sex workers were 25 669 sex workers, including
15 642 reached through workshops. Donor support
also contributed to the programme’s performance.
37
The Metro and District AIDS Councils led by
Executive Mayors and Members of the Mayoral
Councils (MMCs) provided ward-based door-to-door
education supported by a provincial grant. Educators
reached more than seven million people through
3.7 million household visits in more than 70% of the
wards and made 254 680 referrals to local services for
poverty relief, healthcare, social and other services. In
addition, ward educators from Ward Based Outreach
Teams (WBOT) reached another 487 697 people.
The educators prioritise HIV prevention and support
the Ntirhisano Service Delivery task teams and war
rooms. Monitoring visits in wards conÄrmed high
follow-up of referrals.
Informal settlements, high-risk wards and high-risk
groups (key populations) are prioritised for education
that includes information, condoms and referrals.
The purpose is to increase safer sexual and social
behaviours plus effective utilisation of a wide range of
local services including healthcare.
Challenges
38
Young unmarried women have the highest rates of new
HIV infections. While the HIV infection rates in youth
15 to 24 years dropped rapidly between 2008 and
2012, analysis of trends shows increasing substance
abuse and increasing sex in exchange for living costs,
gifts or cash (transactional sex) in young women.
Unemployment, poverty and inequality are driving
social and sexual risks behaviours in young unmarried
women especially those with multiple partners.
Plans for 2016/17
The Gauteng AIDS Council, led by Premier David
Makhura, will review the Strategic Plan in 2016 to
inform the revised multi-sector plan for 2017 to 2021.
The national DREAMS plan, which is funded by the
United States President’s Emergency Plan for AIDS
Relief (PEPFAR), focus on reducing new HIV infections
in young women in two metros.
The outcomes of the combined education efforts are
being measured in 2016 through two large surveys
that were contracted by Gauteng Department of
Health through tenders in 2015. The surveys will
measure knowledge, social norms (attitudes), sexual
and social risk behaviours, exposure to interventions
with preferences, plus utilisation of local services:
health, poverty relief, social and other services. The
Human Sciences Research Council (HSRC) is also
conducting the national household survey on HIV
in 2016 that will add extensive information to the
provincial surveys. The results will become available
in 2017.
Poor data management and veriÄcation by subdistrict on HIV counselling and demand creation
remains a challenge in increasing the intake on
Medical Male Circumcision (MMC) and contracting
of private providers. New PCR testing guidelines are
not being reported correctly by facilities. Home-based
Care and Ward Based Outreach Teams engaged in
Change Management from 2015/16.
All of the sub-districts are required to perform a data
conduct data-clean up and vaildation for HCT.
As regards MMC, there is a plan to review MMC
demand creation to improve Winter 2016 MMC.
Outputs through better planning; Contracted GP’s
to assist with increasing MMC performance and
possible increase of GP’s and rigorous daily review of
data captured to be enforced.
Male condoms demand and supply issues have been
escalated to the National Department of Health for
contract management and oversight.
Summary of SigniÄcant Achievements
TB control programme
Tuberculosis remains a major cause of death
among HIV-positive people. To address the burden
of diseases due to TB, the Gauteng Department of
Health continued with the provision of preventative
therapy to HIV-positive patients who have not yet
contracted TB. By the end of the Änancial year, 68 684
households were visited for contact tracing and 2 385
children under Äve years were provided with Isoniazid
(INH) prophylaxis.
The implementation of the new 90-90-90 targets
to screen, test and treat at least 90% of the most
vulnerable populations to TB and TB/HIV co-infected
and ensure that 90% of those with TB are cured have
started to yield beneÄts, with TB incidence declining
from 375/100 000 in 2014/15 to 331/100 000 in
2015/16.
The roll-out of GenXpert diagnostic machines has
also made contributions to early TB diagnosis and
treatment in particular early diagnosis of MDR TB.
This diagnostic equipment has also helped expose
the increasing burden of drug resistant TB (DR-TB),
which may have contributed slightly to the decline in
patients with drug-sensitive TB.
A total of 4 155 896 patients were screened for
TB during the Änancial year under review. The
implementation of the new diagnostic technology, the
GenXpert is yielding positive results.
The number of cases diagnosed increased from
35 595 in 2014/15 to 49 661 in 2015/16.
Treatment outcomes
Out of 49 661 patients diagnosed with TB during the
year under review, 12 653 (25%) were new smear
positive cases. Of the total new smear positive cases,
10 971 (87.1%) were successfully treated while
619 (4.9%) defaulted from treatment compared to
841 cases who defaulted in 2014/15. The targets set
for the period under review were achieved and the
focus is currently on the new 90-90-90 targets.
Social mobilisation
Outreach activities continued at various targeted
areas including commemoration of the World STOP
TB Day at Dobsonville. The TB commemoration is a
worldwide call of action aimed at mobilising political
and social commitment to raise awareness about the
burden of TB and HIV. A total of 6 700 people were
reached at this event where there was also different
health services on offer.
TB/HIV collaboration
The total number of TB patients with known HIV
status increased from 37 357 (94%) in 2014/15
to 42 002 (95.9%) in 2015/16. An increased
TB/HIV co-infection total of 29 969 (68.4%) clients
were recorded for 2015/16 as compared to 21 919
(68%) in 2014/15. ART was provided to 25 455 (85%)
of the 29 969 clients, a slight improvement from the
83% enrolled on ART during 2014/15 Änancial year.
Multi Drug Resistant – TB (MDR – TB)
The number of MDR-TB inpatients increased from 1
007 in 2014/15 to 1 122 in 2015/16. Furthermore,
the implementation of the Decentralised and
Deinstitutionalised
Management
of
Multidrug
Resistant Tuberculosis (MDR-TB) for South Africa
resulted in a total of 2081 Rifampicin Resistant
(RR-TB) and MDR-TB cases of which 1 139 (54.7%)
were new cases in 2014/15 and increased in 2015/16
to a total of 2 669 with a record of 1 569 (58.7%) new
cases.
Drug Resistant TB
During 2015/16 467 doctors, nurses and allied
professionals were trained on MDR-TB. A total of 68
PHC nurses were trained on NIMDR TB training and
32 injection retired nurses were appointed to support
MDR TB clients for daily injections and general MDR
TB management and care within all districts in the
Änancial year on review.
This will go a long way towards ensuring that noninfectious MDR-TB patients resume productive lives
speedily. New strategies on tracing include EMOCHA
and MiLinc that are used to trace patients on diagnosis
and link them to care through tracing and following
them up in the communities.
Research
Clinical trials and operational research continued
within all districts to support the Department in
the management and care of TB. Bedaquiline is
currently piloted in two facilities: Sizwe TB and Helen
Joseph hospitals. To date, 230 patients are receiving
Bedaquiline in both sites. These are patients with
complications and pre-existing diseases and who
cannot receive injectable Drug Resistant TB drugs.
Sub-programme 2.4: Maternal, Child
and Women’s Health and Nutrition
Summary of signiÄcant achievements
Maternal and Newborn Health
Antenatal care coverage is at 106.5% (225 566)
with Ärst visit before 20 weeks reaching 55%
(122 205). The achievement may be attributable to
the implementation of the “Every Day is Antenatal
Care Day” campaign and involvement of WBOT to
encourage early health seeking behaviours and media
campaigns.
In-facility maternal mortality ratio reduced to 125 per
100 000 live births, lower than the target of 132 per
100 000 live births. The proportion of births attended
by skilled health personnel is 92.8%. The neonatal
mortality is 9.5 per 1 000 live births and in patient early
neonatal mortality were 9.3 per 1 000 live births.
Child Health and Integrated School Health
Programme
A total of 648 professional nurses and 15 doctors
were trained on Integrated Management of Childhood
Illnesses (IMCI) including Helping Babies Breath. A
total of 363 (99%) PHC facilities are implementing
the IMCI Strategy to promote proper management
of sick children by all clinicians. IMCI Update session
was conducted for 96 professional nurses, dieticians,
district clinical specialist teams, nursing college tutors
and university lecturers in collaboration with NDoH
and Regional Training Centre to improve clinical
skills. In addition, 70 clinicians, including paediatric
hospital managers, were trained on the Child Problem
IdentiÄcation Programme to strengthen infant and
child mortality audits and thus addressing and
preventing causes of infant and child mortality.
Child under Äve years pneumonia case fatality rates
remained at 1.9% lower than the planned target of
2.5% and child under Äve years diarrhoea case fatality
rates are maintained at 1.8% below the target of
3%. This is due to the high community awareness
39
on initial household management of diarrhoea with
Åuid replacement; importance of hand washing and
the involvement of WBOT to encourage early health
seeking behaviours and media campaigns.
During the year under review, 691 public schools were
visited by 69 school health teams for provision of
Integrated School Health Programme (ISHP) whereby
178 282 learners were screened for health problems
of which 35 587 were referred to health facilities with
various health problems for further management.
In addition, 39 483 learners were given their catchup TB immunisations in schools. TB screening was
conducted at targeted learners and 704 TB suspects
were referred to local PHC Facilities for appropriate
management.
About 50 208 Grade 4 girls were immunised with
Human Papilloma Virus vaccine (HPV) 2nd dose
during August and September 2015. HPV vaccine
coverage is at 68.3% (45 822).
Adolescent and Youth Health
40
The province has revived the Provincial Youth Health
Advisory Group, which convenes on a quarterly basis
with programme managers, youth and development
partners to discuss issues pertaining to Adolescent
and Youth Friendly Services (AYFS). The programme
trained nine Master Trainers to cascade training with
43 AYFS implementers trained on provision of SRHR
to young adult (youth). Annual Youth Health Summit
was convened in June (Youth Month) and was
attended by 300 young people.
Reproductive and Women’s Health
Various reproductive services were provided
during the year under review and included 15 083
Mammogram tests, sub-dermal implants insertion for
18 089 clients and other contraceptive methods. In
healthcare facilities, 5 077 female sterilisations/tubal
ligations were performed.
To ensure quality reproductive care services 27
professional nurses were trained on the insertion of
IUD and 431 professional nurses were trained on
Contraceptive and Fertility Planning (FP).
The cervical cancer screening coverage improved
in the past Änancial year to 45.1% (152 160).
This improvement is attributed to the increased
number of WBOT who conduct household health
education promoting attendance to PHC clinics.
There is still a need, however, to strengthen
household health education on pap smears through
WBOT and media campaigns and support Health
Districts to develop a social mobilisation plan on
cervical cancer. The Department opened a criminal
case against illegal termination of service providers
as a strategy to reduce maternal mortality due unsafe
abortion services. Health Districts are reporting
poor attendance of Family Planning (FP) services by
women and the strategy is to strengthen household
health education on FP by WBOT, media and support
Health Districts to develop a social mobilisation plan
on contraception.
Nutrition
Various nutrition-related strategies continued to be
implemented during the period under review to
reduce neonatal mortality and promote early initiation
of breast feeding. A total of 962 252 (58.1%) children
between one and Äve years of age have been given
Vitamin A. Ward Based Outreach Teams are now
able to administer Vitamin A during household visits.
A total of 53 (88.3%) of the 60 maternity facilities
maintained their UNICEF/WHO Mother and Baby
Friendly Hospitals Initiative (MBFI) accreditation status
and promotes exclusive breastfeeding practices. In
addition to the MBFI, Kangaroo Mother Care (KMC)
services are provided at 23 (88.4%) of the 26 targeted
hospitals. Training on proper classiÄcation of Severe
Acute Malnutrition (SAM) rate also continued during
the year under review.
Health promotion
A total of 391 awareness campaigns on all aspects
of healthy lifestyles were conducted. The reported
number of people screened for hypertension and
diabetes is 20 243. Health education and healthy
lifestyles activities, including physical exercises
and growing food gardens have reached a total of
1 011 452 people. The following components of a
healthy lifestyle were communicated:
•
•
The Health Promotion programme targets
individuals and groups of all ages in order to
increase their involvement in activities that
improve their lifestyles. It supports and assists all
priority programmes as organising and facilitating
in healthy lifestyle campaigns, events, community
development and health education activities.
Provision of Health Promotion in the country
is guided by the National Health Promotion
policy and 2015-2019 strategy and provides
clear guidelines on the roles and responsibilities
of health promoters (HPs) at all levels towards
achieving the objectives of the National Service
Delivery Agreements (NSDA), Sustainable
Development Goals (SDGs) and all other priority
health programmes such as NCD.
Healthy Lifestyles
The following activities have been conducted in different settings in an attempt to encourage healthy living
among communities.
Component
Physical activity
Overweight and obesity
Nutrition
Salt reduction
Total people reached
2014/15
Total people reached
2015/16
204 159
242 288
52 391
152 524
194 863
277 524
84 001
202 600
Tobacco
166 806
185 314
Alcohol
185 699
223 773
Safe sexual behaviour
206 252
339 226
1 094 171
1 699 668
TOTALS
Healthy lifestyles activities were conducted in schools
throughout the province with messages on all aspects
of healthy lifestyle.
Health education aimed at the prevention of early
childhood illnesses and maternal deaths
Healthy lifestyle activities were conducted in a total of
984 Early Childhood Development Centres (ECDC). A
total of 657 Early Childhood Development Practitioners
(ECDP) were trained on Integrated Management
of Children Illnesses Community Component (IMCI
CC). Furthermore, a total of 217 Early Childhood
Development Practitioners (ECDP) were trained on
the implementation of a healthy environment. Support
visits were conducted to a total of 117 ECDC during
the year of which 50 have food gardens.
Healthy lifestyle activities were also conducted in
several settings in the community such as community
service centres, churches, shopping malls and
informal settlements. A total of 783 of these activities
were conducted in these neighbourhoods.
A total of 401 campaigns were conducted during
the current Änancial year. These campaigns include
immunisation campaigns and mini-campaigns
conducted by Health Promoters in their clinics and
catchment areas. During these campaigns a total of
1 878 208 people were screened for diabetes and
3 217 460 for hypertension.
Women, Maternal and Youth Health Promotion
A total of 21 348 pregnant mothers were reached
with messages on Elimination of Mother to Child
Transmission, including education on the importance
of early booking for 3 236 pregnant mothers.
Education on family planning services was also
given to 21 803 people and 13 433 teenagers were
educated on teenage pregnancy. A total of 29 622
mothers and children were mobilised and educated
on the importance of immunisation. A total of 22 463
mothers were further educated on the importance of
exclusive breastfeeding.
Challenges and strategies for addressing areas
of under-performance
There is a need to increase capacity and recruit more
Health Promoters to increase coverage across the
province. Currently, there are 156 Health Promoters
(HPs) and 200 are needed to address demand for
services. The programme will also be engaging with
districts to review the reporting template to make it
more effective.
Sub-programme 2.5: Disease
Prevention and Control
Summary of signiÄcant achievements
Non-communicable diseases, geriatrics, and
eye-care
To date, 501 facilities are implementing Integrated
Clinical Service Management (ICSM). A total of 840
nurses have been trained on Primary Care (PC) 101
Guideline that is recommended for management of
Non-Communicable and Chronic Communicable
diseases.
A total of 3 217 460 hypertension patients were
screened and counselled during the year, exceeding
the set target of 58 000. A total number of 1 878 208
patients were screened and counselled for diabetes
during the year, also exceeding the planned target
of 58 000. The screening activities do help in early
detection and management to avoid complications at
a later stage.
41
Geriatrics
A total of 97 residential facilities for older persons
are provided with a doctor on a weekly basis. The
Gauteng Elder Abuse Strategy is being implemented
in all districts. Training on elder abuse and notiÄcation
was conducted in Tshwane, Sedibeng, JHB-Metro
and the West Rand District and awareness campaigns
on older persons abuse were also conducted in all
districts. A total of 224 nurses were trained on the
Elder Abuse Strategy. Training is ongoing until all
nurses are trained.
Long-Term domiciliary oxygen therapy
The Department provided home-based oxygen to a
total of 1 652 patients during the year under review.
Eye care
42
A total of 13 919 cataract operations were performed,
of which 13 682 were done in public facilities and
237 done in private facilities. The province achieved
the target of 1 300/million cataract surgery rate. A
total of 56 509 patients were seen by optometrists at
facilities and out of those, 28 563 received spectacles.
A total of 23 Eye Care Awareness campaigns were
held in all Äve districts during Eye Care Awareness
Month. During the eye care awareness campaigns,
3 436 people were screened and 1 334 of them were
referred for further management. Seven district-based
glaucoma awareness and screening campaigns were
held in all districts, 394 patients were screened and
235 patients were referred for further management.
A total of eight community radio stations held talk
shows on Eye Health, including additional six radio
talks during the eye care awareness during the
Glaucoma Awareness Week.
A total of six optometry bursary holders were
successfully placed in three districts to enhance
human resources to improve eye health services. At
the moment, the province has 51 full-time optometrists
in hospitals and districts.
In collaboration with African Vision, the Department
has managed to initiate an ongoing cataract surgery
project at Odi Hospital. The project is aimed at reducing
the cataract surgery waiting list at Dr George Mukhari
Academic and Odi hospitals. The Department also
signed a Memorandum of Understanding with Orbis
aimed at increasing cataract surgery performance at
Bheki Mlangeni District Hospital, thereby helping to
reduce the waiting time for surgery at nearby Chris
Hani Baragwanath Academic Hospital (CHBAH).
Training on the prevention and control of eye health
conditions at primary healthcare level was done for
51 Health Promoters (29) in the West Rand and 22 in
Johannesburg Health district.
Communicable disease control and surveillance
According to the International Health Regulations
reporting of NotiÄable Communicable Diseases is
mandatory. The target response and reporting period
is within 24 hours of the occurrence of the event.
All hospitals and clinics submit weekly surveillance
reports and 84% of reports were submitted on time.
The annual inÅuenza vaccinations has been conducted
in all districts focusing on vulnerable groups, for
example persons with chronic illnesses and pregnant
women and the province attained a coverage of 95%
meaning, 291 400 people received vaccinations.
South Africa is in the process of working to eliminate
malaria by 2018. Gauteng is not malaria endemic
area. However, the increased inÅux of people into
the province results in a few cases and, sometimes,
death.
Environmental health services
Within the reporting year 2015/16, 183 public health
facilities were inspected with respect to compliance
with portable water. One thousand seven hundred
and ninety (1 790) water samples were collected and
1 490 samples were found to be compliant. Also
within the same reporting period, 22 Water, Sanitation
and Hygiene (WASH) campaigns were conducted
and eight community trainings were done. In addition
to water samples testing, 1 006 food samples were
collected and analysed for bacteriological compliance.
The total of 461 food samples tested positive (+ve). The
samples that tested positive were found to have been
contaminated with toxins produced by enterotoxin
producing strains of Staphylococcus aureus. These
food samples were collected by municipalities and
analysed by National Health Laboratory Services
(NHLS). Chemical food samples collected were 361,
only 94 complied with the required standard.
Management of hazardous substances was carried
out in all health districts.
A total of hundred and six hazardous substance
dealers were inspected and ninety seven complied
with Hazardous Substances Act No. 15 of 1973 and
were issued with licences for a period of one year.
The programme Environmental Health has appointed
32 Environmental Health Practitioners who have
been placed in 30 public health hospitals to render
environmental health services. A provincial health travel
medicine clinic has been established at the corner of
Simmonds and Fox streets, the former Reserve Bank
building. A portion of medical equipment was donated
by Chris Hani Baragwanath Academic Hospital
(CHBAH). Vaccines and dry dispensary are available
and a travel clinic manager has been appointed.
Challenges and strategies to improve
areas of under-performance
Compliance with reporting deadlines is a challenge.
From April 2015 to March 2016 the City of Tshwane
has reported poorly regarding water and food samples.
A total of 32 Environmental Health Practitioners
have been appointed and placed in public health
facilities, but there is a lack of ofÄce equipment such
as computers, making it hard for them to function
effectively. The ofÄce is still waiting for IT to order 20
computers for Environmental Health Practitioners in
the hospitals.
Sub-programme 2.6: Forensic
Pathology Services
The purpose of Clinical Forensic Medical Service is to
support survivors of crime, particularly rape, domestic
violence and child abuse. In the process, the service
supports the judicial processes through collection of
evidence and functions as expert witnesses in the court
of law. The service also examines alleged perpetrators
of crime. Lastly, the service is also involved in taking
blood for alleged drunken driving and provision of
medical care to inmates in correctional centres.
The Gauteng Anti-Rape strategy was developed in
conjunction with all relevant stakeholders and the
leading Department was the Family Violence Child
Protection and Sexual Offences Unit (FCS) of the
SAPS.
Both Forensic Pathology and Clinical Forensic
Medical services play an important role in the overall
strategic objective of the government to create safer
communities and adopting zero tolerance for crime,
especially violent crime.
Summary of signiÄcant achievement
Our interventions signiÄcantly contribute in the
strategy to reduce trauma, which is among the top
cost drivers in the provision of health services. There
is currently a total of 24 forensic pathology services
operational in the province, six in the metros and four
on the West Rand and two in Sedibeng.
This sub-programme consists of Forensic Pathology
Service and Clinical Forensic Medical Service.
The purpose of Forensic Pathology Service is interalia investigation of the cause of any unnatural
death or sudden unexpected death, using scientiÄc
internationally accepted methods thereby assisting
South African Polica Service (SAPS) in the collection
of evidence and presentation thereof in a court of law.
The service is also required to keep statistics on trends
that can be used in prevention strategies for unnatural
causes of death that include trauma such as motor
vehicle accidents, violence, drowning, suicide and so
on. Through its joint service partnership with medical
universities, the service appoints medical doctors and
trains medical, legal and law enforcement practitioners
in the Äeld of forensic medicine.
43
Sub-programme 2.1: District Health Management and PHC Services
District Health Management and PHC Services
Actual
achievement
2014/15
Strategic
Objective
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
2015/16 (Over/
(Under)
28/32
0
Increase quality and access in PHC Facilities
27/35
Number of CHCs
that provide 24hour services
28/35
Target achieved. Staff was
appointed and equipment
procured to ensure quality
provision of services.
Expand ward based PHC outreach teams
44
Number of fully
Åedged Ward
Based Outreach
teams
388
300/508
533
233
Target achieved and exceeded.
The Department recruited and
trained more team leaders to
establish 145 additional teams
during the current Änancial
year. A total of 533 teams were
established to date.
Number of
districts piloting
NHI interventions
#
5
5
0
Target achieved. All Äve health
districts are piloting NHI
interventions to prepare the
province for NHI implementation.
Percentage of
Äxed PHC facilities
scoring above
80% on the ideal
clinic dashboard
#
5 (1.32%)
45%
43.7%
Target achieved. Facility managers
and supervisors are paying more
attention to improvement of quality
elements and maintenance of
those already achieved.
Patient experience
of care survey rate
#
100%
N/A
(100%)
Target not achieved. Specialised,
district, regional, tertiary hospitals
all conducted the PEC Survey in
July-August 2015. There is a need
to align the survey template with
the latest DHIS version is 1.4.
Patient experience
of care rate
#
68%
66.5%
(1.5%)
Target was not achieved but
patient experience rate improved
from 66.5% by 8.5%. About
seven out of 11 hospitals were
compliant. All the non-complaint
facilities are being supported and
full compliance will be achieved in
the coming Änancial year.
OHH registration
visit coverage
(annualised)
93.9%
70%
12.3%
(57.7%)
The existing teams did not have
sufÄcient team leaders and thus
coverage was compromised.
It is envisaged that the newly
appointed Enrolled Nurse Team
leaders will assist in improving
coverage in the near future.
Number of
districts with
District Clinical
Specialist Teams
(DCSTs)
5
5/5
5
0
Target achieved. Sedibeng district
has mitigated the shortage of
anaesthetists by employing
medical ofÄcers and supporting
them with anaesthetists in
surrounding health facilities.
Number of District
Mental Health
Teams established
#
1
0
(1)
Target not achieved. There was
no creation of posts for mental
health teams. Existing structures
were used.
# Previously not mentioned
Strategic
Objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
2015/16 (Over/
(Under)
PHC utilisation
rate
1.8
2.5
1.7
(0.8)
Target not achieved. PHC
utilisation is lower than the national
average. With the implementation
of WBOTS, more patients are
seen at community level instead
of clinics.
Complaints
résolution rate
#
90%
82.3%
(7.7%)
Target not achieved. There’s
a continuous push within the
Department to handle complaints
as they arise. In addition, health
facilities are encouraged to
be proactive in identifying and
addressing potential areas that
can cause patient dissatisfaction.
95.2%
80%
91.6%
11.6%
Target achieved. Efforts will be
made to educate patients to lodge
complaints while at the health
facilities so these can be attended
to promptly.
National Core
Standards selfassessment rate
136%
100%
82%
(18%)
Target not achieved. More focus
during the latter part of the year
shifted to preparing facilities to
audits and assessments of ideal
clinics.
Quality
improvement
plan after selfassessment rate
#
80%
80%
0
Target achieved. All facilities that
had been assessed developed
QIPs. To strengthen monitoring of
the QIPs.
Percentage
of hospitals
compliant with
all Extreme and
Vital Measures of
the National Core
Standards
0%
27%
(3 of 11)
0%
(27%)
Target not achieved. Impact of
external factors such as limitations
in Infrastructure (isolation
rooms), generators, emergency
equipment etc. Extreme measures
performance range from 69% to
89% and vital measures from 65%
to 79%.
Patient experience
of care survey rate
#
100%
100%
0
Patient experience
of care rate
#
75%
67%
(8%)
Target was not achieved, facilities
to improve on staff attitude,
patient safety and cleanliness
Average Length
of Stay
4.3 days
4 days
4.4 days
0.4
Target achieved. This might be
due to an increasing number of
patients being transferred to step
down beds in CHCs.
Inpatient Bed
Utilisation Rate.
60.6%
80%
65.8%
(14.2%)
Target not achieved. Beds
operated at 65% of capacity
possibly because patients were
transferred to step down beds in
CHCs.
Expenditure
per Patient Day
Equivalent (PDE)l
R2 386
R2 500
R2 450
R50
Target achieved. Within Target.
Transferring patients from District
Hospitals to step down beds in
CHCs has had a positive impact.
Budget for CHCs with step down
beds to be increased.
Complaints
resolution within
25 working days
rate
District Hospitals
Target achieved. To continue
supporting facilities with QIPs.
45
Strategic
Objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
2015/16 (Over/
(Under)
Complaints
resolution rate
Complaint
resolution within
25 working days
rate.
#
80%
89.6%
9.6%
Target achieved. Patients are
encouraged to lodge complaints
at the source of the incident to
speed up the resolution process.
98.5%
68%
99.3%
31.3%
Target exceeded. Complaints
posters to be displayed on walls
to assist patients on how to lodge
complaints.
Actual
achievement
2015/16
Deviation from
planned target
2015/16 (Over/
(Under)
HIV and AIDS, STI and TB control
Performance
indicator
Actual
achievement
2014/15
Planned
target
2015/16
Improve care and life expectancy for HIV positive people
Total clients
remaining of
ART
46
730 576
746 678
756 039
9 361
<1.5%
1,5%
0%
Target exceeded. Data mop up
conducted in the health facilities
in all districts. Adherence clubs
and follow-up of patients helped
minimise treatment defaulting.
Reduce mother to child transmission
Transmission
rate from
mother to child
1.3%
Target achieved. of the 33 388
babies born to HIV positive women
were tested for HIV around six
weeks postnatal, only 500 tested
HIV positive on a polymerase chain
reaction (PCR) test. Further efforts
are being made to address underreporting and data management.
Reduce incidents of new HIV infections & STI
Client tested for
HIV (incl ANC)
#
2 119 906
2 934 613
814 707
Target exceeded. Performance
attributed to participation of 51
NPO’s Contracted for Social
Mobilisation, PASOP Campaigns
PEPFAR Funded Development
Partners.
Male condom
distribution Rate
(Annualised)
#
191 782 721
197 852 306
6 069 585
Target exceeded despite supply
challenges with the National Tender.
Anecdotal evidence indicates that
there is increased demand for
Rebranded Scented Condoms.
Female condom
distribution Rate
(Annualised)
4 838 281
4 097 926
7 648 078
3 550 152
Target exceeded. Anecdotal
evidence indicates that there is
increased demand for Rebranded
Scented Condoms. Future efforts
to increase distribution and uptake
includes collaboration with tertiary
institutions.
HIV and AIDS, STI and TB control
Performance
indicator
Actual
achievement
2014/15
Planned
target
2015/16
Medical Male
Circumcision
performed –
Total
139 093
151 082
Actual
achievement
2015/16
112 794
Deviation from
planned target
2015/16 (Over/
(Under)
(38 288 )
Target not achieved. Observations
made on MMC trends seem to
suggest that highest uptake is
during winter months probably due
to cultural inÅuences and practical
reasons. Involvement of school
health programmes and youth
friendly services in the provision
of this service is anticipated to
yield better results. Strengthen
partnerships with medical
practitioners and traditional leaders
to improve uptake.
Increase opportunities for testing and screening for TB
30%
46.9%
16.9%
Target exceeded. Availability
of screening tools at all entry
points resulted in the screening
of 4 983 095 patients for TB
symptoms at PHC facilities. Target
will be revised to ensure optimal
screening.
85.7%
86%
87.1%
1.1%
Target achieved due to improved
patient monitoring and patient
education.
TB client lost to
follow up rate
#
<5%
5%
0%
Target achieved. A range of
initiatives are under way to improve
performance such as increased
patient monitoring, veriÄcation of
patient details and encouraging
patients to give correct contact
details.
TB client death
rate
#
<5%
4.4%
0.6%
Target achieved. There is a need to
intensify screening efforts across all
health facilities.
64.5%
70%
72%
2%
Target achieved. Facilities
intensiÄed use of Drug Resistant
TB algorithms. New strategies on
patient tracing include linking them
to care using mobile health platform
by partners using EMOCHA and
MiLinc systems.
#
50%
51%
1%
Target achieved. 51% of MDR-TB
patients successfully completed
treatment. New strategies on
patient tracing include linking them
to care using mobile health platform
by partners using EMOCHA and
MiLinc systems and use of retired
nurses to trace patients.
TB symptom
years and older
screened rate
#
Reduce mortality for people with TB
TB client
treatment
success rate
Combat MDR-TB
TMDR-TB
conÄrmed
treatment start
rate
MDR-TB
treatment
success rate
47
Oral Health, Rehabilitation and Mental Services
Performance
indicator
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
61 349
25 349
Target exceeded. Additional
resources were provided that
enabled the achievement of target.
77 061
23 561
The Department has made available
necessary resources such as
transport and portable equipment to
ensure that oral hygienists provide
services to school-going children
without fail. More than 77 000
molar and premolars were sealed to
protect from tooth decay.
Increase Mobility for People with Disability
49 293
Number of
assistive devices
issued
36 000
Increase level of efÄciency in PHC facilities
Number of Ässure
sealants placed
52 477
53 500
Increased level of efÄciency in PHC facilities in integrating mental health services
Percentage of PHC
facilities integrating
mental health
services
288 (74%)
85%
83%
(2%)
Target not achieved due to limited
recording of cases. Follow-ups and
monitoring will be done to ensure
completeness of reported Ägures.
Maternal, Child and Women’s Health and Nutrition
Performance
indicator
48
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
Reduce maternal morbidity and mortality due to pregnancy and childbirth
Antenatal visit
before 20 weeks
rate
48.6%
55%
55%
0%
Target achieved. Implementation
of the “Every Day is Antenatal Care
Day” campaign, media campaigns
and Involvement of WBOT to
encourage early health seeking
behaviours is contributing to
improvements.
Mother postnatal
visit within 6 days
rate
85.4%
87%
76.9%
(10.1%)
Target not achieved because of
external factors: high number of
deliveries from other provinces
and neighbouring countries. It
has also been observed that the
number of deliveries registered by
Home Affairs for Gauteng differs
signiÄcantly from the number of
birth certiÄcates issued.
Reduce perinatal and neonatal morbidity and mortality
Immunisation
coverage under
1 year
Measles 2nd dose
coverage
107.1%
90%
106.4%
16.5%
Target achieved due to daily
provision of immunisation services,
consistent availability of vaccines
and establishment of hospital
vaccination points.
#
90%
92%
2%
Target achieved. The Department
to continue to educate the public
about the New Measles Vaccine
Schedule at six and 12 months.
Focus will be on strengthening
defaulter tracing by increasing the
coverage of Ward Based Outreach
Teams (WBOTs).
Performance
indicator
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
DTaP-IPV/Hib 3 –
Measles 1st dose
dropout rate
#
<10%
(12.%)
2%
Child under 5
years diarrhoea
case fatality rate
2.9%
3.%
1.8%
1.2%
Target achieved due to Involvement
of WBOTs in increasing awareness
of household management of
diarrhoea which include Åuid
replacement and importance of
hand washing.
Child under 5
years pneumonia
case fatality rate
2.1%
2.5%
1.9%
0.6%
Target achieved through effective
implementation of both clinical and
household component of IMCI.
Child under 5
years severe acute
malnutrition case
fatality rate
9.3%
7%
7.5%
0.5%
Target achieved due to incorrect
clinical assessment, classiÄcation
and management of SAM.
#
10%
16.9%
6.9%
Target achieved. There are efforts
to collaborate with Development
partners and also increase
capacity of dedicated school
health nurses.
School Grade
1 screening
coverage
33.6%
40%
37.7%
(3.3.%)
Target not achieved but there is
improved coverage compared
to last year. There are efforts to
collaborate with Development
partners and also increase capacity
of dedicated school health nurses.
School Grade
8 screening
coverage
12%
20%
17.5%
(2.5%)
to previous Änancial year. There
are efforts to collaborate with
Development partners and also
increase capacity of dedicated
school health nurses.
Couple year
protection rate
32.1%
50%
42.5%
(7.5 %)
to previous Änancial year due to
the introduction of Long Acting
Reversible Contraceptives (LARC).
Collaborate with development
partners in increasing coverage of
LARC and voluntary sterilisation.
Cervical cancer
screening
coverage
43.6%
55%
45.1%
(9.9%)
to previous Änancial year. There
is a need, however, to Änalise
the national screening policy and
review data collection tools to
include women infected with HIV
because their statistics is currently
not considered even after they are
screened for cervical cancer.
School Grade R
screening
coverage
Target achieved. Continue to
educate primary and secondary
caregivers on the interpretation of
the road to health card and new
measles vaccines schedule.
49
Performance
indicator
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
56.5%
60%
58.8%
(1.2%)
improved coverage as compared
to previous Änancial year. Maximise
opportunities to increase Vitamin
A coverage through outreach,
WBOTs and Early Childhood
Development Centres (ECDs).
Human Papilloma
Virus Vaccine Ärst
dose coverage
#
87%
68.3%
(18.7%)
Target not achieved because
of limited capacity to roll out
the programme. Once delays
in downloading the data from
the National Electronic data
capturing tool are resolved,
reported performance on HPV
is 125.32/100 000 (MaMMAS)
expected to improve.
Maternal Mortality
in facility Ratio
(MMR)
112.6/100 000
live births
137/100 000
live births
125.32/
100 000
live births
(MaMMAS)
12/100 000
live births
Target achieved. Facilitate
alignment of data sources (DHIS
and MammAS) to ensure correct
reporting on the DHIS at facility
level.
#
13/1000
live births
9.5/1 000
live births
3.5/p 1 000
live births
Target achieved. There is
improved monitoring of labour and
childbirth, Neonatal Resuscitation
Programme (NRP) which includes
helping babies breath (HBB) and
management of small and sick
new born (MSSN).
1.3%
<2%
1.5%
0.5%
Target achieved. Fewer babies
tested HIV- positive because of
effective implementation of PMTCT
and revised treatment guidelines.
#
90%
92.4%
2.4%
Target achieved. Efforts to ensure
that all HIV-positive antenatal
clients are put on ART.
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
Number of NCD
educational
campaigns/
programmes
(cumulative)
#
84
391
307
Clients screened
for hypertension –
25 years and older
#
58 800
3 217 460
3 158 660
Target exceeded. Increased
community-based campaigns
resulting in increased referral to
facilities for screening.
Clients screened
for diabetes – 5
years and older
#
58 800
1 878 208
1 819 408
Target exceeded. Increased
communitybased campaigns
resulting in increased referrals to
facilities for screening.
Vitamin A
coverage 12-59
months
Inpatient early
neonatal death
rate
50
Reduce mother to child transmission
Infant 1st PCR test
positive around six
weeks rate
Antenatal client
initiated on ART
rate
Disease Prevention and Control
Performance
indicator
Target achieved. 391 NCD
educational campaigns conducted
Indicator and target not expressed
in the same manner. To improve
quality checks on plans.
Disease Prevention and Control
Performance
indicator
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation from
planned target
2015/16
Clients screened
for mental
disorders
#
2%
3.7%
1.7%
Target exceeded. Plans to increase
coverage by standardising
screening tools for use by all
facilities and providing continuous
in- service training.
Clients treated for
mental disorders
#
3%
0.1%
(2.9%)
Target not achieved. To strengthen
integration of mental health.
Cataract surgery
rate (uninsured
population)
1 127/mil
1300/mil
1 311/mill
11
Target achieved. Increased
performance in hospitals due
to high-level management
intervention with hospital senior
management to increase cataract
surgery operations.
1.4%j
<0.3%
1.4%
1.1%
Target not achieved. Late
presentation of patients to
health facilities. No free ChemoProphylaxis available for travellers
to endemic areas. Annual
malaria seminars conducted to
create awareness to all health
professionals. Availability of IV
Artesunate in hospitals. Ongoing
health promotion.
Malaria case
fatality rate
(annual)
Linking performance with budgets
51
Expenditure: Programme 2 – District Health Services
2014/15
Sub- Programme
Name
District Management
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
438 195
428 363
9 832
466 764
451 135
15 629
Community Health
Clinics
1 805 836
1 664 910
140 926
2 083 377
2 085 055
(1 678)
Community Health
Centres
1 329 667
1 329 667
-
1 540 994
1 503 927
37 067
Community-Based
Services
1 176 291
1 168 605
7 686
1 475 846
1 458 519
17 327
HIV/AIDS
2 790 532
2 709 860
80 672
3 086 733
3 002 814
83 919
47 759
42 109
5 650
49 239
48 712
527
Nutrition
Coroner Services
183 884
173 799
10 085
194 933
184 034
10 899
District Hospitals
2 048 420
2 045 733
2 687
2 371 251
2 341 351
29 900
4.3
Programme 3: Emergency
Medical Services
The purpose of the Emergency Medical Services
Programme (EMS) is to ensure rapid and effective
emergency medical care and transport as well as
efÄcient planned patient transport, in accordance with
provincial norms and standards.
Gauteng EMS has added additional Åeet in the
2015/16 Änancial year, by procuring 10 intensive
care unit ambulances, 10 obstetric ambulances,
10 planned patient transporters and 62 ambulances.
The Åeet has been branded according to NHI White
Paper, enhancing the corporate identity of EMS.
Interfacility transfer rate improved by approximately
17% in the Änancial year under review from 12% to
28.7%, which means there was more capacity to
service the calls emanating from facilities. Part of the
efÄciency gains was directly realised from improved
call answering time in the Emergency Communication
Centre (ECC) to ensure optimal access and availability.
52
Human resource recruitment in all categories of
emergency care ofÄcers, that is basic life support,
intermediate life support and advanced life
support, the provincialisation of West Rand and
centralisation of ECC in Sedibeng, has improved
operational efÄciencies in call taking and dispatch to
emergencies. Tetra radio has also been procured as
the communication medium for operational vehicles
and management.
Additional efforts to improve response times by
the Gauteng EMS include plans to restructure and
prioritise the location of EMS bases in line with call
dispatch location. The operational capacity, with
respect to stafÄng, will be intensiÄed through an
aggressive recruitment and scheduled training and
development. Fleet recapitalisation will continue in the
new Änancial year, with procurement of ambulances
and transporters. The ECC in the West Rand will be
centralised and live tracking of all EMS vehicles will be
rolled out to enhance call taking and dispatch by live
virtual location of vehicle.
The ECC Computer Aided Dispatch (CAD) will go on
tender for an updated and enhanced system that will
integrate all facets of EMS, that is CAD, bed bureau,
messaging and tracking. EMS ICT LAN,WAN and
telephones are being prioritised by the Department
for roll-out to all EMS bases within the province. The
referral system in Gauteng Health is currently under
review by EMS and relevant stakeholders to help limit
the movement of patients between facilities and ensure
that EMS focuses on core business of emergency
care, treatment and transportation. Gauteng EMS will
be reviewing the Memorandum of Agreement with
municipalities to realise economies of scale with the
provincialisation model.
Performance indicators: Programme 3 – Emergency Medical Services
Performance
indicator
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
2015/16
EMS P1 urban
response under 15
minutes rate
78.7%
85%
77.4%
(7.6%)
Target not achieved. There
has been slight improvements
in the PI response time,
compared to the previous
Änancial year. The deviation
is caused by classiÄcation
of rural and urban areas in
Gauteng, which leads to
wrong classiÄcation of calls
and delayed response time.
The current location of bases
are being reviewed and
realigned with demand trends.
EMS P1 rural
response under 40
minutes rate
84.8%
100%
84.5%
(15.5%)
Target not achieved. The
location of bases in line
with dispatch point will be
realigned to improve on
response times.
EMS inter – facility
transfer rate
#
12%
28.7%
16.7%
Target achieved, which
shows EMS facility calls
are increasing, restricting
resources to emergencies
outside health facilities.
53
Expenditure: Programme 3 – Emergency Medical Services
2014/15
Sub- Programme
Name
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
Emergency Transport
802 832
723 165
79 667
890 608
830 415
60 193
Planned Patient
Transport
130 516
124 396
6 120
108 964
109 904
(940)
4.4
Programme 4: Provincial Hospital
Services
To provide general and specialised hospital services
by general specialists through regional hospitals, TB
hospitals, psychiatric/mental hospitals, dental training
hospitals and other specialised hospitals.
•
•
•
•
General (regional) hospitals.
Tuberculosis hospitals.
Psychiatric hospitals.
Regional hospitals.
SigniÄcant achievements:
54
In the year 2015/16, the strengthening of healthcare
services across mother and child health was
prioritised and gains achieved were introduced across
other disciplines across the province. The hospitals
improved service delivery to meet increasing demand,
and implemented initiatives aimed at improving
the quality of services in alignment to the national
core standards. Notable service successes were
recorded at the following hospitals: Leratong, Thelle
Mogoerane and Rahima Moosa. The aforementioned
introduced one-stop shop gynaecological unit as a
strategy and are doing well in terms of diagnosing,
treating and performing of gynaecological operations
within acceptable time-frames.
Sebokeng Hospital opened its new adult ICU and
is continuing with renovations, while Rahima Moosa
Hospital established a milk bank. Thelle Mogoerane
Hospital has high technology electronic equipment
the radiology department is one example of this
in practice. The hospital is also in the process of
implementing a paperless system and has an
improved patient Äle tracking system for patients.
Inter-hospital relationships
The cluster hospitals framework with the leadership
from central hospitals supports all regional hospitals
and district health services. This allowed for increased
sharing and collaboration for better use of services,
resources and for the optimal allocation of skilled
staff along the four geographical areas. Coordination
of both primary and skilled specialised services was
enabled, which assisted in strengthening access and
prompt care across the regional hospitals.
Mental health specialised hospital services
Mental health specialised services focused on
prevention of mental illness and substance abuse.
These services include the early detection of
mental illness and substance abuse, treatment and
rehabilitation. The following are some of the key
achievements for the year under review:
•
•
•
•
•
•
Mental health awareness campaign in October
2015, reaching 3 000 people in Pretoria.
Mental health awareness campaign conducted in
all Äve districts and hospitals in speciÄc months.
Mental health awareness – Tara Hospital was
represented on the television show SHARE, which
discussed mental health issues at the hospital.
Appointment of the CEO of Sterkfontein.
Weskoppies received two new food trucks to
facilitate food delivery in compliance with National
Core Standards.
Mental health services screening and treatment
(new indicator) are provided at clinics and hospitals
(district, regional, tertiary and central), supported
by specialised mental health hospitals.
Performance indicators: Programme 4 – Provincial Hospital Services
Sub-programme: General (Regional) Hospitals2
Performance indicator
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation
from planned
target
100%
100%
100%
0%
Target achieved.
Quality improvement plan after
self-assessment rate
#
70%
100%
30%
Target achieved.
Percentage of hospitals
compliant with all extreme and
vital measures of the national
core standards
0%
33%
0%
33%
Impact of external
factors, for example
infrastructure (isolation
rooms), generators,
emergency equipment
and so on.
Comment on
deviation
2015/16
Increase level of efÄciency in hospitals
National Core Standard selfassessment rate
(3/9)
Ranges for extreme
measures: 58% to 96%
Ranges for vital
Patient experience of care
survey rate
#
100%
100%
0%
All nine Regional
Hospitals conducted
PEC surveys.
Patient experience of care rate
#
70%
69%
(1%)
5 days
4.8 days
5.2 days
(0.4 days)
Target achieved.
To strengthen bed
management and
discharge processes.
Inpatient Bed Utilisation Rate.
82.4%
80%
82.3%
2.3%
Target achieved.
Continue to monitor
performance.
Expenditure per Patient Day
Equivalent (PDE).
R2 304
R2 250
R2 462
R212
Target achieved.
Improve budget
projection to align with
projected expenditures.
#
86%
92.4%
6.4%
Target achieved.
Guidelines on
complaints
management to be
used at all times.
99.90%
80%
100.2%
20.2%
Target achieved. All
complaints received are
promptly resolved.
Complaints resolution rate
Complaint resolution within 25
working days rate.
2
Point estimates were not used for efÄciency indicators. Allowable range calculated from STD deviation was applied
55
Sub-programme: General (Regional) Hospitals2
Actual
achievement
2014/15
Planned
target
Actual
achievement
2015/16
2015/16
Deviation
from planned
target
Comment on
deviation
2015/16
Sub-programme: Specialised Hospitals
Strategic objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
achievement
2015/16
Deviation from
planned target
2015/16
Comment on deviation.
Increase level of EfÄciency in Hospitals (Tuberculosis)
Inpatient Bed Utilisation Rate
73.1%
75%
71.3%
3.7%
Target achieved. There
is currently redistribution
of TB beds across other
regional and tertiary
hospitals outside of
Sizwe.
Complaints resolution within 25
working days rate
100%
95%
95%
0%
Target achieved. Most
complaints received are
dealt with immediately
from the source of
origin.
Patient Experience of care Rate
#
68%
69%
1%
All specialised hospitals
conducted the surveys
and improved from
the previous results of
66.5% to 69%. Version
used not same as one
used by DHIS.
Increase quality of patients services
56
Expenditure: Programme 4 – Provincial Hospital Services
2014/15
Sub- Programme
Name
General (Regional)
Hospitals
Tuberculosis Hospitals
Psychiatric/Mental
Hospitals
Dental Training Hospitals
Other Specialised
Hospitals
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
4 239 187
4 241 858
-2 671
4 610 804
4 597 721
13 083
334 932
205 810
129 122
317 482
284 768
32 714
1 023 492
1 069 675
(46 183)
1 056 920
1 032 466
24 454
426 770
407 374
19 396
456 201
443 190
13 011
76 275
62 597
13 678
76 989
73 920
3 069
4.5
Programme 5: Tertiary and
Central Hospitals
Helen Joseph Hospital
•
Programme purpose
To provide highly specialised healthcare services,
platforms for training health workers, sites for research
and to serve as specialist referral centres for regional
hospitals and neighbouring provinces.
There are four central hospitals in Gauteng: Steve Biko
Academic, Dr George Mukhari Academic, Charlotte
Maxeke Johannesburg Academic and Chris Hani
Baragwanath Academic. In addition there are three
tertiary hospitals namely: Hellen Joseph, Kalafong and
Thembisa Hospitals.
•
•
SigniÄcant Achievements by Tertiary and
Central Hospitals
•
Various signiÄcant achievements at the Department’s
tertiary and central hospitals cut across ICT,
infrastructure and clinical training functions and are as
follows:
•
Tembisa Hospital
•
With regards to governance-related matters, a new
management team has been appointed at the hospital
to turn around services to ensure that it accelerates
processes towards operating as categorised by the
National Department of Health (DOH). A business plan
is developed in line with National Tertiary Services
Grant (NTSG) requirements.
•
Kalafong Hospital
•
•
•
•
•
•
KPTH has already acquired an MRI scanner and
Mammogram in the previous Änancial year 20152016 and is in the process of acquiring a 128 slice
CT scanner in Ärst quarter of 2016-2017.
A second laparascopic tower was acquired in
2015-2016.
The IT infrastructure and stafÄng of IT are being
addressed in preparation for a Picture Archiving
and Communication System (PACS) that is
planned to be procured in 2016-2017.
With assessment by the OfÄce of Health Standards
Compliance (OHSC) in February 2016, KPTH’s
score has improved an overall score of 64% of
2014 to 80%.
Various wards are being renovated in preparation
to increase Critical Care beds and modernise the
patient care systems.
There is an electronic Bed Management System
that is giving a real time bed situation.
•
•
Installation of the Magnetic Resonance Imaging (MRI)
unit in July 2015 for the Radiology department that
helped to reduce patient waiting times from seven
months to three days thus, signiÄcantly cutting back
the backlog from Charlotte Maxeke Johannesburg
Academic Hospital (CMJAH). Roll-out of the MRI
services to the other hospitals within the cluster
Procured
two
new
Tomosynthesis
Mammography units in radiology, thus improving
the rate of breast cancer screening and detection.
Introduction of PACS technology in various
patient consultation out-patient clinics and
wards. Reduced costs of printing X-Ray Älms by
introducing the X-Ray Paper Printer system by
average of 85% of initial expenditure.
As part of improving infrastructure, the Hospital
installed 21 new lifts throughout the whole hospital
including the residences.
Installation of the new generator and the changeover switch to reduce the kick-in phase to
generator power during power outages.
Conversion of diesel boiler to gas boiler therefore
saving on the cost of diesel.
Installation of CCTV security surveillance cameras
therefore improving security.
Expansion of clinical services by introducing
the wound specialist team providing service
seven days a week, second emergency theatre,
especially trauma cases, 24-hour acute renal
dialysis and eight-bedded medical high care unit.
Introduced projects aimed at reducing waiting
times for cataracts surgery, renal stones removal,
knee and hip replacement surgery and sonar
examinations, for example week-long Cataracts
Blitz, Stone Week and Move and Walk.
•
•
•
•
Clinical OUTREACH Programme providing
services to the patients in the Dr George Mukhari
Academic Hospital (DGMAH) cluster, especially in
Jubilee Hospital, thus minimising referrals and also
providing skills transfer to health professionals in
the district.
Establishment of the four Paediatric ICU Beds and
the Trauma Units (Ward 6) to provide muchneeded critical care in the DGMAH.
The implementation of the PACS/RIS System
that enhances the DGMAH healthcare delivery
platform, including research and training.
The District EPWP/Interns Programme and the
Tshwane Municipality EPWP deployees, give
support to various directorates, especially the
DGMAH Logistics and Admin Support Units.
57
Charlotte Maxeke Johannesburg Academic
Hospital
•
•
•
•
•
•
•
•
Performed Ärst immediate reconstructions
with free Åaps (Free TRAM or DIEP Åaps) – the
reconstruction was the Ärst in the hospital.
Implementation of the Information Management
Unit (IMU).
Cardiology unit recognised by the Premier as a
centre of excellence.
Electrophysiology lab (EP Lab) cost was
R12 million.
New theatre doors for main, cardiac and
orthopaedic theatres were installed.
Cataract surgery increased from 100 to 120 per
month.
Two Arthroplasty weeks conducted to reduce
waiting list, 15 hips and 20 knees.
Cleaners in the wards report to nursing department
to improve cleanliness.
•
•
•
Steve Biko Academic Hospital
•
•
58
•
•
•
•
•
Completion of a new 10-beded Neonatal ICU
facility, thereby increasing the Neonatal Unit from
29 beds to 39 beds.
Re-allocation of hospital beds and adding a new
20-bed short-stay ward, thereby relieving pressure
of patient load in the emergency unit. Creation
of a new 10-bed Trauma Short-Stay Unit, with
appointment of a Head of Clinical Unit for trauma
for the Ärst time ever.
Commissioning of a refurbished milk kitchen for
preparation and pasteurisation of donated breast
milk.
Commissioning of a brand new low dose whole
body diagnostic X-Ray (Lodox) machine.
Commissioning of a brand new 128-slice
Computerised Tomography (CT) scanner.
Implementation of an electronic Bed Management
System (e-BMS) that enables real-time on-line
information about availability of vacant beds in
all wards through the whole hospital, including
bed types by gender. This system promotes the
efÄcient use of hospital beds. The implementation
of the e-BMS in SBAH was a forerunner to
implementation of the system in the Äve other
acute hospitals in the SBAH Cluster.
Completion of the high-tech studio of the cabled
network hospital “radio station” that will enable
instantaneous communication with all staff
members and patients at all times on various
matters. This internal communication system,
when fully commissioned, will play a critical role
in cases where emergency evacuation of patients
and staff needs to be effected, to avoid disasters.
Implementation of new shift hours for all cleaners,
porters, linen workers and drivers to ensure
24-hour seven-days-per-week coverage of the
hospital, and thereby eliminating the previous use
of overtime in these functions.
New V-Block mega servers were installed, to
be utilised to house all interactive ICT systems
in SBAH and beyond (the whole SBAH Cluster,
including integrated HIS, PACS, RIS and electronic
patient records systems).
•
•
•
Development of the state-of-the-art training
centre with the modern life-saving equipment in
partnership with the private sector. The centre
boasts a well-resourced e-learning (24 computers)
area that will be connected to the Wits library to
assist both the under- and post-graduate students
with research. There is a simulation area (dry lab)
in keeping with modern teaching platforms. This
area will better prepare students for laparoscopic
procedures.
The hospital has a trauma unit that is the
busiest in the world, with a workload of around
5 000 severe trauma resuscitations and more than
60 000 other injured patients a year. It has close
links with CHBAH Burn Unit – the only one in the
country that manages both adults and children with
a theatre facility within the centre – which makes
up the other component of the Trauma Directorate.
The task of the trauma unit is to provide initial
emergency treatment, all the necessary surgical
operations in general, thoracic and vascular
surgery as well as intensive care, high care and
ward management to trauma victims.
It is the biggest undergraduate and postgraduate
teaching unit of the Department of Surgery of the
University of the Witwatersrand, and also provides
advanced trauma training through exchange
programmes with Spanish, Finnish, Greek, and
German medical and surgical organisations, as
well as the West African College of Surgeons and
Harvard University in Boston.
Challenges
The challenges that continue are infrastructure-related
and include human resources capacity and ineffective
systems for the collection of revenue.
Performance indicators: Programme 5 – Tertiary Hospital Services
Sub-programme: Tertiary Hospitals3
Performance
indicator
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
Deviation from
planned target
2015/16
2015/16
Increase level of EfÄciency in Hospitals
National Core
Standards selfassessment rate
100%
Quality
Improvement
Plan after selfassessment rate
#
100%
100%
0%
Target achieved. To monitor
implementation of the QIP.
100%
0%
Target achieved. To monitor
implementation of the QIP.
0%
(33%)
Impact of external factors
for example infrastructure
(isolation rooms), generators,
emergency equipment and
so on.
3/3
100%
3/3
Percentage of
hospitals compliant
with all extreme
and vital measures
of the national core
standards
0%
33%
(1/3)
Ranges for extreme
measures: 76% to 92%.
Ranges for vital measures:
64% to 77%.
Patient Experience
of care Survey
Rate
#
100%
100%
0%
All three tertiary hospitals
conducted the survey to
sustain the process.
Patient Experience
of Care Rate
#
75%
68.4%
(6.6)
Target not achieved,
supervision of facilities on
compliance, management
require strengthening
Average Length
of Stay
5.8 days
5.4 days
6.0 days
0.6 days
Inpatient Bed
Utilisation Rate
82.3%
82%
83.9%
1.9%
Target achieved. Target within
the allowable range.
Expenditure
per patient day
equivalent (PDE)
R2 409
R2 625
R2 583
R42
Target achieved. The deviation
is less than 2%. To continue
monitoring expenditure and
expedite functional business
units.
Complaint
Resolution rate
#
85.6%
98.1%
12.5%
Target achieved. On track to
be achieved once a complete
data has been received. To
strengthen education on
patients on how to lodge
complaints.
93.60%
68%
91.1%
23.1%
Target achieved. To strengthen
education on patients on how
to lodge complaints.
Complaint
Resolution within
25 working days
rate
3
Target achieved. Efforts will
be on strengthening bed
management and discharge
processes.
Point estimates were not used for EfÄciency indicators. Allowable range calculated from STD deviation was applied
59
Programme: Central Hospital Services
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
100%
100%
0%
Target Achieved. To
support monitoring of
QIPs.
100%
0%
Target achieved. To
support monitoring of
QIPs.
0%
(75%)
Deviation
from planned
target
2015/16
100%
after self-assessment rate
#
compliant with all extreme
and vital measures of the
national core standards
0%
(4/4)
100%
(4/4)
75%
(3/4)
Impact of external factors,
for example infrastructure
(isolation rooms),
generators, emergency
equipment and so on.
Ranges for extreme
measures: 75% to 89%.
Ranges for vital
Survey Rate
#
100%
100%
0%
Rate
#
75%
71.3%
(3.7%)
Central hospitals require
improvement of staff
attitude, patient care and
cleanliness.
#
6 days
7.9 days
1.9 days
Bed management and
discharge management
to be strengthened.
Inpatient Bed Utilisation
Rate
76.9%
80%
78%
2%
Target achieved. Within
allowable range.
Expenditure per Patient
Say Equivalent (PDE)
R3 507
R3 000
R3 500
R500
Target achieved.
Within allowable range
for this level of care.
Accumulated accruals
of the past years also
contributed.
#
80%
91.1%
11.1%
Target achieved. To
strengthen education on
patients on how to lodge
complaints.
96%
90%
93.7%
3.7%
Target achieved. Continue
to implement quality
improvement plan and
training on complaints
management.
60
Complaint Resolution rate
Complaint Resolution
within 25 working days
rate
Target achieved.
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
Deviation
from planned
target
2015/16
100%
100%
100%
0%
Target achieved
#
100%
100%
0%
Target achieved
0
100%
97%
3%
Not fully compliant.
Infection control under
extreme measures
affected the ability of the
hospital to achieve the
target.
Patient Experience of care
Survey Rate
#
100%
100%
0%
Target achieved.
Patient Experience of care
Rate
#
80%
75%
(5%)
Improvements on patients
safety and staff attitude
are required.
8.2 days
6 days
7.9 days
1.9 days
Patient stay is increased
due to the complex
nature of patient cases
handled at this level of
healthcare.
Rate
79.2%
80%
81%
1%
Target achieved.
The newly launched
electronic bed
management system has
improved inpatient bed
utilisation.
Expenditure per patient
day equivalent (PDE)
R4 301
R4 000
R4 466
R466
Target achieved.
Increased because
(ALOS) contributed
towards the costs of care.
#
85%
96.6%
11.6%
Target achieved.
106.5%
95%
97.2%
2.2%
Target achieved.
Complaint resolution rate
Complaint resolution within
25 working days rate
61
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
Deviation
from planned
target
2015/16
62
100%
78%
100%
12%
Target exceeded. Selfassessments were carried
out as planned.
#
100%
100%
0%
Target achieved. A QIP
was developed and is
being monitored.
0%
78%
65%
(13%)
Survey Rate
#
100%
100%
0%
Target achieved.
Rate
#
75%
67%
(8%)
Awaiting a revised tool,
current tool not userfriendly.
8.4 days
6.8 days
8.4 days
1.6 days
Improve bed
management and
Rate
78.9%
76%
74.8%
(1.2%)
Strengthen referral
system.
Day Equivalent (PDE)
R3 067
R3 500
R3 275
(R225)
Increase clinical services
and strengthen referral
systems.
#
92%
97.8%
5.8%
Target achieved.
91.8%
83%
93.1%
10.1%
Target achieved.
Assessments were done
by the OfÄce of Health
Standards Compliance.
Quality improvement has
been developed and there
is a need to strengthen
monitoring.
Charlotte Maxeke Johannesburg Academic Hospital
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
Deviation
from planned
target
2015/16
100%
100%
100%
0%
#
100%
0%
(100%)
0%
90%
Extremes –
87%
Extremes
- 3%
Vitals – 75%
Vitals- 25%
survey rate
#
100%
100%
0%
Target achieved.
rate
#
75%
68%
(7%)
Target not achieved. Need
to improve patient safety
and staff attitudes.
7.1 days
6.2 days
6.8 days
(0.6 days)
Rate
82.3%
85%
81.2%
3.8%
Target achieved
Target not achieved QIP
incomplete.
Impact of external factors
like generators that are
not checked regularly,
emergency equipment not
patient ready and so on.
Strengthen bed
management and
Target achieved. Patient
stays longer but bed
utilisation is low. Improve
bed management and
outpatient services to
align to utilisation targets.
R1 101
R3 000
R3 580
R580
Target achieved. Hospital
expenditure to be crosschecked. Continue to
monitor as costs are
inÅuenced by the rise in
various areas of service,
which are the higher price
of medication, laboratory
and blood services,
surgical consumables,
food and so on.
#
100%
92.7%
(7.3%)
Target not achieved. There
is an increased number in
complex complaints that
have resulted in serious
adverse events.
99.7%
96%
88%
(8%)
Complaints who are not
available for follow up are
one of the contributing
factors.
63
Actual
achievement
2014/15
Planned
target
Actual
achievement
Deviation from
planned target
2015/16
2015/16
2015/16
100%
100%
100%
0%
Target achieved.
#
100%
100%
0%
Target achieved.
0
100%
Extreme-84%
100%
Extremes:
100%
Vitals-84%
Extreme 16%
Vitals 6%
Vitals: 90%
Target not achieved. Impact
of external factors such
as generators that are not
checked regularly, emergency
equipment not patient ready
and so on.
Survey Rate
#
100%
100%
0
Target achieved.
Rate
#
75%
74.3%
(0.7%)
7.9 days
5.8 days
8.1 days
(2.3)
increased ALOS is due to
increased number of patients
admitted in medical wards with
severe disease. These patients
are already in advanced
stage of the disease and on
medications that can only be
given in a hospital setting.
Rate
77.7%
79%
77.7%
1.3%
Target achieved. Patient stays
longer in the hospitals yet
utilisation target is lower than
targeted. Improve utilisation of
services at the hospital to meet
the target.
R2 640
R3 101
R2 844
R257
Target achieved. Strengthen
monitoring of services aligned
to the target.
#
100%
78.4%
(21.6%)
Target not achieved. Due to
increased number of complex
complaints resulting in Serious
Adverse Events.
86.7%
75%
99.2%
24.2%
Target achieved.
64
Complaint Resolution
within 25 working days rate
Target not achieved
Improvement is needed
on patient safety and staff
attitudes.
Expenditure: Programme 5 – Central Hospital Services
2014/15
Sub- Programme Name
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
R’000
Expenditure
R’000
R’000
R’000
R’000
Central Hospitals
9 198 128
9 198 127
1
9 630 826
(436 980)
Provincial Tertiary Hospital Services
2 386 515
2 386 515
-
2 954 651
440 175
Actual
4.6
Programme 6: Health Sciences
and Training
The Health Sciences and Training Programme is
strategically positioned to plan, produce and manage
the education, training and development needs of the
Gauteng Department of Health (GDoH). It is designed
to comply with relevant legislative and policy mandates
at national, provincial and local level and to respond
to service transformation imperatives. Priorities
include support for the Service Transformation Plan,
Re-engineering of PHC, expansion of HIV and AIDS,
STI and TB programmes and implementation of NHI.
The Professional Development Directorate includes:
• Regional Training Centres
• Professional Development
• Bursary Section
• Professional Service Support
• Lebone College of Emergency Care
• Leadership Management and Skills Development
Directorate
• Employee Health and Wellness Programme
Directorate
Strategic objectives
•
•
•
•
•
Improve achievement of national norms for supply
of health professionals;
Improve compliance with legislative framework;
Respond to the GDoH staff education, training
and development needs;
Provide employee health and wellness to improve
productivity and staff morale; and
Contribute to the job-creation mandate through
targeted youth empowerment programmes.
Health Professionals Training & Development
Grant (HPTDG)
The Health Professionals Training and Development
Grant (HPTDG) is a special grant under DORA ACT
responsible for the training of health workers in
hospitals. An amount of R829 million was allocated
to cover the compensation of employees in training
during the Änancial year 2015/16 with special focus
on specialisation in clinical services.
In the year under review, 449 registrars, namely
doctors training to become specialists, were
remunerated through the grant. The training happens
in hospitals mainly under the supervision of Specialist
Consultants and Clinical Heads of Departments.
The students also register for Master of Medicine for
research, and the three universities are responsible
for their academic training while clinical training
happens in the Gauteng Health Platform. Some of
the specialisation and sub-specialisation happens
in Obstetrics & Gynaecology, Oncology, Internal
Medicine, Surgery, Neonatal Surgery, Cardiology,
and some few sub-specialities in Nephrology and
Paediatrics Oncology. The grant has also funded the
training of medical interns who are conducting clinical
training in hospitals as statutory requirements for the
completion of MBCHB.
About 71 super specialists are also covered by the
grant. The grant covers about 27 post-graduates in
nursing, psychiatry and other allied areas.
The Department has extended teaching and learning
platforms in other lower-level hospitals and in some
neighbouring provinces. This was done through the
rotation of registrars to nearby hospitals.
The rotation is done within the guidelines of the grant
and approved business plan by National Department
of Health and National Treasury as per the DORA ACT.
Professional Development
The main purpose of the programme is to plan,
produce and empower all categories of health
professionals, allied health and mid-level workers with
relevant health qualiÄcations and clinical skills required
to address the health needs of the province.
Education and training is made possible through
bursaries for qualifying external candidates pursuing
careers in health sciences full-time basis and to
qualifying staff members to improve performance
in functional areas. In 2015/16, 281 new bursaries
were awarded for different health sciences Äelds. To
this end, performance across all the key projects run
under professional development are as follows:
Continuous Professional Development (CPD)
Continuous professional development courses for
all health professionals were coordinated during the
year under review to train and build capacity in new
innovations, technology and clinical practice Äelds. A
total of 6 012 health professionals, allied and mid-level
workers have been trained in 2015/16.
Clinical Associates
During the period under review, six new bursaries were
awarded for clinical associates training, bringing the
total bursaries given to 42. Since the commencement
of the programme in 2012, 51 clinical associates were
recruited and 19 associates who were bursary holders
have been appointed in various district hospitals in
Gauteng and other provinces.
65
Bursary funding
In addition to the HPTDG, the Department provides
bursaries for the development of its internal staff and
Gauteng citizens. For the period under review, 281
new bursaries were offered, bringing the total number
of bursaries to 5 098 for both full-time and part-time
studies.
around Gauteng. Currently, 403 medical interns are
completing second year of studies at the end of
December 2016. In addition to medical internships,
65 pharmacists interns were placed in the accredited
pharmacies in the province and 100 are currently
performing community services. Sixty-seven foreign
health professionals were offered jobs and 30 have
successfully obtained their extensions of contracts.
Pharmacist Assistants Training
A total of 616 pharmacist assistants were recruited
since 2012 comprising of 220 employees and 396
external learners. From the 220 internal learners,
141 completed post-basic pharmacist assistants
training and have since returned back to the service
and 329 external recruits completed basic training.
Currently, 178 are on post-basic programme. There
are 61 pharmacist assistants waiting to start with
post-basic training.
Skills Development for Enrolled Nurses Working
in Maternity Units
66
HIV and AIDS Training
With regards to HIV training, a conditional grant funding
has been made available to support development of
personnel responsible for the delivery of HIV-related
services. Through this funding, 559 professional
nurses were trained and skilled to render the Nurse
Initiated Management of ARV Treatment (NIMART) for
all ARV Sites in the Districts and Hospitals. In addition,
14 073 Health & Allied Professionals and Lay Workers
were empowered in various Äelds of the CCMT
treatment, care and support.
During the year under review, 22 enrolled nurses
were put in training and will complete the six-month
programme in August 2016. The structure of the
course requires one-week contact session for theory
per month and three weeks of practicals in maternity
wards, which includes student accompaniment by a
tutor. This six-month skills programme for Enrolled
Nurses (ENs) working in the maternity setting has
been running since 30 July 2012 at Rahima Moosa
Nursing College.
Employee Health and Wellness Programme
(EHWP)
Cuban Medical Programme
During the year under review, 14 362 employees
accessed employee wellness services, namely
occupational health services, HCT and Psychosocial
services. Since the implementation of employee
Änancial wellness services, the Department has
observed a decline in garnishee orders over the years.
A total of 461 students are continuing to beneÄt
from the South African Medical Cuban Programme
implemented in line with the Bilateral Corporation
Agreement between South Africa and Cuba and is
based on a promotive and preventative model, which
is key in supporting the implementation of the NHI.
During the year under review, new student intakes of
112 were sent to Cuba to study medicine. This brings
to 466 the total number of students who left South
Africa to study medicine in Cuba since 2011/2012
Änancial year. Notwithstanding, this number has since
reduced to 461 for various reasons such as death,
inability to cope with studies, pregnancy and bad
behaviour.
Professional Service Support
Community service is a national mandate. During
the year under review, the Department successfully
placed 225 medical doctors and 430 allied health
professionals (occupational therapists, radiographers,
speech and hearing therapists, dieticians, clinical
psychologists, physiotherapists, and environmental
health practitioners) at accredited health institutions.
The two-year medical internship programme placed
429 medical interns in the accredited institutions
The purpose of the EHWP is to promote and ensure
sustained wellbeing of the GHD employees. This
Integrated Employee Wellness Programme responds
to work-related performance challenges and wellness
of employees and is designed to address HIV, AIDS,
TB and STIs in the workplace, Occupational Health
(Medicine and Nursing) and Employee Assistance
Programme.
To fully institutionalise implementation of the employee
satisfaction surveys, the Department will collaborate
with universities and other partners such as NIOH
to support with the design and development of
programmes based on the survey recommendations.
Nursing Education
During the year under review, the focus of nursing
education was to increase the number of nurses to
meet the health needs of the country and ensure that
all the critical nursing specialities gaps are closed.
Nurses are also encouraged to be actively involved
in operational research and the implementation of
recommendations. To this end, the current pool of
nurses under training is reÅected on the tables below:
Table 1: The composition of basic nursing training in 2015/16 appears in the table below:
NUMBER
CATEGORY
Professional Nurses: four-year degree
710
Professional Nurses: four-year diploma
3 070
Professional Nurses: bridging course
476
Enrolled Nurses: two-year course
95
Enrolled Nurses: exiting from four-year course
34
Enrolled Nursing Auxiliaries exiting from four-year course
44
Enrolled Nurses: Pupil Enrolled Nurse 2 one-year course
239
4 668
TOTAL
Table 2: Fields of study of specialist nurse graduates in 2015/16
NUMBER
CATEGORY
Primary Healthcare
148
Psychiatric Nursing
17
Child Nursing
39
Advanced Midwifery and Neonatology
93
Ophthalmic Nursing
22
Midwifery
139
Orthopaedic Nursing
0
Critical Care Nursing
46
Trauma and Emergency Nursing
26
Nephrology Nursing
12
Operating Theatre Nursing
39
Oncology Nursing
13
594
TOTAL
LEADERSHIP MANAGEMENT AND SKILLS
DEVELOPMENT
The Leadership Management and Skills Development
programme is charged with management and
leadership development as well as skills development
programmes for all staff. This includes generic skills
development for all staff, functional skills development
for non-clinical staff, management of the skills levy,
orientation and induction, including sourcing of
external funding from strategic partners such as the
HWSETA. This programme also markets its offerings
through its knowledge management unit that
champions the e-learning and other non-classroom
learning for the Department.
In the year under review, 13 352 staff members
attended various training programmes and 216
managers were enrolled on various management
development programmes. In addition, 686
managers/supervisors were trained on several
technical programmes including Änance for nonÄnancial managers, bringing the total staff trained to
902.
Futhermore, 10 141 staff members beneÄted
from various skills programmes, including Code
of Conduct, Staff Support Programme, Emotional
Intelligence and Customer Care. A total of
1 652 unemployed and employed youth were
accepted into Youth Development Programmes,
642 into learnerships and 1 010 into internships
while 657 participants were enrolled into various AET
learning areas.
67
Performance indicators: Programme 6 – Health Sciences and Training
Programme: Health Sciences and Training
Performance
indicator
Actual
achievement
2014/15
Planned target
2015/16
Actual
achievement
2015/16
Deviation
from planned
target
2015/16 (Over
(Under)
Improve achievement of national norms
Basic nurse
students
graduating
68
1 367
1 500
2 520
1 020
Target exceeded. Collaboration
with universities in moderating
student exams and support to
Tutors, remediation programmes
and peer education system
contributed to the observed
performance.
Intake of medicine
students annually
#
650
153
(497)
Target not achieved. The 650
is the total medical students
intake per annum in the
three universities in Gauteng
and 153 of this intake were
direct departmental bursary
beneÄciaries. The target and the
indicator will be revised to reÅect
number of students beneÄting
from GDOH speciÄc funding.
Number of new
medical students
enrolled annually
on the RSA-Cuban
medical
#
80
112
32
Target achieved due to improved
uptake of students and retention
in the programme as compared
to the previous years.
Percentage of
health facilities
conducting
employee
satisfaction surveys
#
54%
9%
(45%)
satisfaction survey was
conducted at 38 institutions. The
Department will explore avenues
to support the institutionalisation
of employee survey in the coming
years working with universities
and other partners.
Number of clinical
engineers on
training
50
50
50
0
Target achieved. Fifty clinical
engineers students were trained
by TUT on a short programme.
Number of
bursaries awarded
for Ärst year
medicine students
#
20
17
(3)
Target not achieved because not
all prospective applicants met the
university entrance requirements
for MBCHB. The three nonqualifying students were offered
funding in alternative health
sciences qualiÄcations.
Number of
bursaries awarded
for Ärst year nursing
students
#
1 000
960
(40)
Target not achieved because of
limited vacant funded posts. To
Änalise the review of a Standard
Operating Procedure which
guides the nursing colleges on
steps to take regarding nursing
students who exit the programme
before completion of their
studies.
Expenditure: Programme 6 – Health Sciences and Training
2014/15
Sub- Programme
Name
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
Nurse Training
Colleges
655 649
645 135
10 514
761 616
666 886
94 730
EMS Training
Colleges
38 059
27 811
10 248
39 584
28 381
11 203
121 031
132 717
(11 686)
78 053
180 373
(102 320)
56 040
56 268
(228)
59 678
63 194
(3 516)
Bursaries
Other Training
4.7
Programme 7: Healthcare
Support Services
The purpose of this programme is to provide nonclinical services, including laundry, food services and
medical supplies, to support hospitals and clinics in
an effective and efÄcient manner.
Strategic objective
The central objective of the programme is to increase
the efÄcacy of the supply chain management system.
Summary of the signiÄcant achievements
During the year under review, the Chief Directorate
Supply Chain and Asset Management put in place
effective control measures to reduce irregular
expenditure such as the full implementation of
the Bid Committee system and implementation of
the centralised contract management register. To
strengthen business processes, the unit implemented
a checklist that is being used by SCM practitioners to
ensure compliance with SCM policies and procedures.
As a result of these measures, the Department
observed a 20% decline in irregular expenditure
compared to the previous Änancial year (2014/15).
Lastly, the Department was able to comply with the
Annual Procurement Treasury submission deadlines.
With regard to Preferential Procurement (PP) spend
targets, the Department met the provincial targets on
HDI and youth. However, it did not meet the provincial
targets on women and People With Disabilities
because the industry is predominantly dominated by
able-bodied people and males.
With regards to asset management, the Department
maintained an unqualiÄed audit opinion for the
past four Änancial years. In its quest to improve the
skills and continuous professional development
of the supply chain practitioners, the Department
established a partnership with Chartered Institute of
Procurement and Supply (CIPS).
Future plans of the Department will be to ensure that
the Department’s procurement strategy is biased to
all designated groups.
Medicine availability
From the Essential Medicine List developed for use at
public healthcare institutions and facilities nationally,
the Gauteng Provincial Pharmacy and Therapeutics
Committee developed a Provincial Medicine
Formulary. It is the responsibility of Pharmaceutical
Services to ensure that medicines in the provincial
formulary are always available at healthcare institutions
and facilities. Globally, there is inconsistency in the
availability of the active pharmaceutical ingredient
required in manufacturing medicines. The Department
has been able to achieve and maintain an average
medicine availability of 97% for vital medicines and
96% for essential medicines. An important strategy
that has served as an early warning system to ensure
that all possible efforts are made to ameliorate
medicine shortages is the weekly stock availability
monitoring. Healthcare institutions and facilities
forward their reports to the central ofÄce which then
liaises with the depot to pro-actively source the muchneeded medicines.
69
Improved Medicine access to patients – Central
Chronic Medicine Dispensing and Distribution
programme (CCMDD)
Stock visibility systems for improved stock
management and reporting
Access to affordable, essential medicines is a
RX Solution inventory management system has been
implemented in all hospital and district pharmacies.
Pharmacy managers, pharmacy store managers
and 30 ICT staff members from the institutions were
trained to use the system. A dashboard has been
connected to this system at central hospitals. Tertiary
and regional hospitals will be connected in 2016/17.
At Dr George Mukhari Academic Hospital pharmacy
the dashboard has been automated such that their
medicines stock on hand can be viewed by contract
managers at the National Department of Health.
Other central hospitals will soon follow. The aim is to
provide timeous monitoring information at the level of
contract managers of possible medicine shortages so
that relevant interventions can be effected on time.
vital component of an efÄcient healthcare system,
particularly in our resource-constrained environment
with a high burden of disease. This programme assists
in improving patient waiting times at clinics and hospital
OPD pharmacies. Patients are given an opportunity to
choose an accredited medicine pick-up point nearest
to their residences where they can collect their
monthly repeat medicines instead of collecting from
their clinic or hospital. Such patients are monitored to
ensure that they consult with their hospital doctor or
clinic nurse once in six months. There is a screening
programme that assists in selecting patients who
RX Solution implementation
qualify to be in this programme. During the year under
review, a total of 114 926 patients were enrolled on
the CCMDD programme in Gauteng and 81 623
(71%) are from the Tshwane district. The service is
provided through the CCMDD programme. The
dispensing and distribution of medicines in Tshwane
70
is performed by a private service provider while in all
other districts the services are provided by provincial
district pharmacies.
While it started as a primary healthcare programme,
the CCMDD has evolved to include all district hospitals
in the Tshwane district. Negotiations are under way to
include the regional, tertiary, central and specialised
Stock Visibility System
Whereas the RX Solution dashboard is used at
hospital level, Stock Visibility System (SVS), which is
simpler, is used at primary healthcare clinics. The only
piece of equipment required is a cellphone. All clinics
in the Johannesburg Health District (110 in total) are
connected to the SVS, which enables managers to
centrally view stock levels of selected medicines. At
the moment only ARVs, TB medicines and vaccines
are part of the system.
The plan for 2016/17 is to:
a) Expand to more clinics in other districts in addition
to Johannesburg
hospitals patients onto the programme.
b) Include more medicines as part of the SVS
There are currently 171 pick-up points participating
Rational Medicines Use
in the programme. Fifty-one percent (51%) are in
The aim of any medicine management system is to
deliver the correct medicine to a patient who needs
that medicine in an appropriate dose required for the
clinical condition, for an adequate period of time at
the lowest cost to the patient and the community. To
conform to these criteria, prescribers should follow a
standard process of prescribing. Standard treatment
Guidelines (STGs) for adults, paediatrics and primary
healthcare are available and are continuously
updated so that prescribers have a reference point.
In November 2015, the latest primary healthcare
guidelines, together with their cellphone application,
were launched at Pretoria West Hospital. Pharmacists,
doctors and nurses were trained in signiÄcant changes
from the previous STGs.
the public sector. They include separate queues at
healthcare facilities and adherence clubs that are
accommodated within the healthcare facilities. Repeat
prescriptions for the elderly are delivered directly
to the respective old age homes and the elderly
are treated as priority patients. The Park Station
Dis-Chem pick-up point has been set up and is due
to start operating in the Ärst quarter of the 2016/2017
Änancial year. This pick-up point is strategically
located since Park Station is used by approximately
2-million commuters. Patients no longer need to take
time off work to collect their chronic medication.
Pharmacovigilance Decentralisation Project
There are instances where, even if medicines are
used rationally, may cause adverse reactions and
interactions. The early detection of these adverse
reactions is important. The Pharmacovigilance
programme assists in this early detection as
well as documenting an increase in frequency of
known adverse reactions. During the year under
review, the Department supported the National
Pharmacovigilance Centre (NPC) to conduct a project
to decentralise Adverse Drug Reaction reporting.
ABC/VEN
VEN analysis is a system of setting priorities for
purchasing medicines in which medicines are divided
according to their health impact into essential and
non-essential medicines. The prioritisation has been
completed and the ABC/VEN analysis started in the
last month of 2015/16. Meaningful results to inform
management decisions will be available as the
programme continues in 2016/17. Training on VEN
analysis was conducted for 100 pharmacy personnel
in the year under review.
Electronic Gate-Keeping (EGK)
During the year under review, the Department, through
the Lab and Blood services unit, rolled out EGK to an
additional 12 hospitals, bringing the total of hospitals
implementing EGK to 32. Since implementation of
the EGK system, the Department has observed a
1.5% reduction in the NHLS bill due to a decline in
unnecessary repeat tests.
Provincial Laboratory and Blood Users’
Committee
The Committee, in collaboration with the National
Health Laboratory Service (NHLS) Pathologists group,
has successfully completed the development and
approval of the reÅex testing policy. The anticipated
beneÄts of the policy is increased transparency on
NHLS billing. The Department was also able to resolve
all track care lab information system challenges
through active involvement of the committee. As a
result, turnaround time of lab results was improved.
South African National Blood Services
(SANBS)
Blood Wastage Reports
During the year under review, the unit increased efforts
to encourage clinicians on the proper management of
unused blood and timeous return of unused blood to
the blood bank. Draft guidelines have been developed
to assist institutions in minimising blood wastage, thus
curbing SANBS costs. The SLA review process was
completed in March 2016 and the SLA was signed on
the 29 March for distribution in April 2016.
Results turnaround times
During the year under review, the Department
experienced delays in processing cervical smears by
the NHLS. This delayed timeous clinical intervention,
increasing patients’ complaints, but these have since
been resolved.
71
Expenditure: Programme 7 – Healthcare Support Services
Performance indicators: Programme 7 – Healthcare Support Services
Healthcare Support Services
Strategic
objective
Actual
achievement
2014/15
Planned
target
2015/16
Actual
Deviation Comment on deviation
achievement
from
planned
2015/16
target
2015/16
Increase level of efÄciency in hospitals and PHC facilities
72
Percentage of
linen contract
awarded to women
cooperatives
100%
100%
100%
0%
Target achieved. All hospitals procure
their linen from the linen contract that
was awarded to 12 cooperatives. The
Department plans to increase the number
of cooperatives beneÄting from the
procurement in the coming Änancial year.
Percentage
of hospitals
procuring/buying
vegetables from
local farmers
100%
40%
60%
20%
Target achieved. Tender awarded to local
farmers. All vegetables are procured from
local farmers.
Percentage of
hospital procuring/
buying dairy
products from local
farmers
#
20%
N/A
N/A
The tender for dairy products was
awarded to distributors and not local
farmers because of existing contractual
obligations that only end in 2017.
1
Percentage of
hospital procuring/
buying bread from
small medium scale
bakeries
#
0%
N/A
N/A
Target achieved. The tender for dairy
products was awarded to distributors
and not local farmers because of existing
contractual obligations which only end in
2017.
Percentage health
institutions with
electronic SCM
system
#
80%
100%
20%
Target achieved. All intuitions are utilising
SAP Supply Relationship Management
(SRM) for their procurement.
Percentage of vital
medicine available
at health facilities
90%
90%
97%
7%
Target exceeded. Strategies implemented
successfully. The main strategy being
the weekly out-of-stock reporting from
institutions that serves as an early warning
system for timeous interventions.
Percentage of
EML available at
facilities.
79%
90%
96%
6%
Target exceeded. Strategies implemented
successfully. The main strategy being
the weekly out-of-stock reporting from
institutions that serves as an early warning
system for timeous interventions.
Percentage of
essential medicines
delivered directly to
health facilities
#
70%
70%
0%
Target achieved.
Number of patients
registered in the
Tshwane CCMDD
programme
#
60 000
81 623
21 623
Target exceeded. Voluntary participation
into the programme. The programme has
completed its second year and therefore
patients are more willing to be enrolled
Number of
patients enrolled
on centralized
chronic medicine
dispensing and
distribution
programme
#
60 000
114 926
54 926
Target not achieved. Uptake slower in all
other districts in Gauteng. Strategies to
improve uptake include the creation of
more awareness of the programme.
Healthcare Support Services
Deviation Comment on deviation
Actual
from
achievement
planned
2015/16
target
2015/16
Actual
achievement
2014/15
Planned
target
2015/16
Number of patients
registered with
remote automated
dispensing unit
#
50 000
0
(50 000)
Not reached. The remote automated
dispensing units have not as yet been
operationalised.
Percentage of
GeneXpert results
available within 48
hours
#
90%
91%
1%
Target achieved. Periodic reporting on
this indicator has enabled the NHLS
to develop appropriate intervention
measures.
Strategic
objective
Changes to planned targets
No changes were made to the targets.
Linking performance with budgets
Expenditure: Healthcare Support Services
2014/15
Sub- Programme
Name
Laundries
Food Supply Services
Medicine Trading
Account
2015/16
Final
Appropriation
Actual
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Actual
Expenditure
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
170 419
158 418
12 001
190 473
175 605
14 868
60 182
53 124
7 058
69 321
47 894
21 428
1
-
1
1
0
1
73
4.8
Programme 8: Health Facilities
Management
The purpose of this programme is to plan for, provide
and equip new facilities; to upgrade and rehabilitate
community health centres, clinics, and district,
provincial, specialised and academic hospitals and
other health-related facilities; and to undertake lifecycle management of immovable assets through
maintenance.
Strategic objective
Increased efÄciency of service implementation.
Sub-programmes of Infrastructure Management are:
Hospital Facility Revitalisation Grant (HFRG)
74
The purpose of HFRG is to:
• Help accelerate construction, maintenance,
upgrading and rehabilitation of new and
existing infrastructure in health, including health
technology, organisational design (OD) systems
and quality assurance (QA);
• Supplement expenditure on health infrastructure
delivered through public-private partnerships; and
• Enhance capacity to deliver health infrastructure.
Equitable Share (ES)
This is a voted fund used for both maintenance and
capital projects.
Extended Public Works Programme (EPWP)
The EPWP incentive is to expand work creation efforts
through the use of labour-intensive delivery methods
in the following identiÄed focus areas:
• Maintenance of buildings
• Landscaping and gardening projects
• General cleaning of hospitals
Except for EPWP, all funding sources are sub-divided
according to the type of infrastructure project which
are as follows:
• New or replaced infrastructure asset
• Upgrades and additions
• Renovation, rehabilitation and refurbishment
• Maintenance and repairs
Key achievements
In its efforts to support clinical care the Department
completed the refurbishment of wards and installation
of additional oxygen and vacuum points at Chris
Hani Baragwanath, Rahima Moosa, Leratong and
Carletonville hospitals.
Additional to the refurbishments, the Department
upgraded various service points, namely:
• Tembisa Hospital: upgrading of blood bank,
psychiatric ward and Ward 16
• Kopanong Hospital: upgrading of TB Wards
• Mamelodi Hospital: upgrading of blood bank
• Sterkfontein Hospital: upgrading of ward 16 to
increase bed capacity
• Charlotte Maxeke Johannesburg Academic
Hospital: refurbishment of staff residential facilities
• Far East Rand Hospital: upgrading of Ward 8 to
improve physical condition of the ward.
Further successes that prevented interruption of
service included the upgrade of Pretoria West Chiller
Plant.
Maintenance
Since the implementation of the e-maintenance
systems, the Department has observed faster
response time on maintenance requests by
institutions. The term contracts entered into with
Builders Warehouse have reduced the burden of
managing stores and minimised the risk of building
material loss.
In order to harmonise and improve accountability
and relations between the two Departments, there
is a need to enforce implementation of commitments
outlined in the Service Level Agreement (SLA).
In addition, the Department plans to improve its
operations efÄciency through:
•
•
Improved payment turn-around time for
contractors and professional service providers.
Finalise recruitment of built environment
specialists.
Performance indicators: Programme 8
Performance
indicator
Actual
achievement
2014/15
Planned
target
2015/16
Actual achievement
2015/16
Deviation
from
planned
target
2015/16
Increase level of EfÄciency in hospitals and PHC facilities
Proportion of P8
budget spent
on maintenance
(preventative and
scheduled)
84%
55%
55%
0%
The target was reached as
55% of the entire P8 budget
was spent on maintenance.
This is mainly due to
continued implementation
of E-maintenance, threeyear supplier contract
with Builders Warehouse
and term contracts with
contractors.
Number of
additional clinics
and community
health centre
constructed
0
1
0
(100)
Target not achieved and
construction is still at 56%
completion. The contracts
were terminated because
of poor performance
(Low quality of work) and
replacement contractor
had to be appointed. A
replacement contractor
has been appointed and
the facility is due to be
completed by March 2017.
Percentage of
capital work
projects Änished
on time
#
60%
75%
15%
Target exceeded. In future
we will ensure stringent
project monitoring to enable
achievement of planned
outputs within agreed time
frames.
Number of Health
facilities that
have undergone
major and minor
refurbishment
#
43
43 facilities were in various
stages of refurbishment
namely:
(0)
Target was reached as 43
facilities were in various
stages of completion.
Completion of refurbishment
projects last over multiple
years depending on the size
of projection and thus not
only completed projects
were considered.
Cancelled = 6 projects
Completed = 3 projects
(Kopanong TB, Tshwane
District Psych ward,
Khayalami Fence)
Construction = 8 projects
Design = 16 projects
Feasibility = 1 projects
IdentiÄed = 3 projects
Retention 3
Tender = 3 projects
Total = 43 projects
75
Performance
indicator
Actual
achievement
2014/15
Planned
target
2015/16
Actual achievement
2015/16
Deviation
from
planned
target
2015/16
#
1
The SLA was signed by
HoD from GDoH and GDID
and is being implemented
(0%)
The SLA was signed and
is being implemented.
The document will be
updated as and when
the need requires. Future
revision of the indicator is
recommended to ensure
relevance.
Number of
provincial
departments
of health that
have established
service level
agreements
into (SLAs) with
Departments of
Public Works
Performance indicators: Programme 8
Performance
indicator
Actual
achievement
2014/15
(in R’000’)
Expenditure on capital
projects.
R591 505
Planned
target
2015/16 (in
R’000’)
R642 997
Actual
achievement
2015/16
(in R’000’)
R673 734
Deviation
from planned
target
2015/16
(in R’000’)
(R30 737) Poor performance of contractor.
Delays in tender and appointment
of replacement contractor.
Poor quality contractors.
76
Expenditure on
maintenance projects.
R742 347
R1 262 402
R1 152 487
R109 915 Implementation of electromechanical projects took longer
than expected and impacted on
expenditure.
Health Facilities Management: Expenditure per sub-programme
Expenditure: Programme 8 – Health Facilities Management
2014/15
Sub- Programme
Name
Community Health
Facilities
Emerg Medical Rescue
Serv
Actual
2015/16
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
130 198
145 237
(15 040)
319 515
263 022
56 493
1 654
1 108
546
3 390
1 126
2 264
District Hospital
Services
226 767
209 253
17 514
298 291
299 793
(1 502)
Provincial Hospital
Services
488 814
464 429
24 385
573 518
545 898
27 620
Central Hospital
Services
379 399
398 392
(18 993)
509 193
511 780
(2 587)
Other Facilities
157 268
165 676
(8 407)
253 745
243 032
10 713
5. Transfer Payments
Transfer payments to public entities
Table 7.1: Transfer payments made to public entities 2015/16
Transfer payments to public entities
The table below reÅects the transfer payments made for the period 1 April 2015 to 31 March 2016
Name of
transferee
Type of organisation
Purpose for
which the
funds were
used
Did the dept.
comply with
s 38 (1) (j) of
the PFMA
Local
Government
Municipalities
PHC
Yes
Local
Government
Municipalities
HIV/AIDS
Yes
Local
Government
Municipalities
EMS
Yes
HWSETA
Departmental Agency
Learnerships
Yes
Universities
Higher Education
Institutions
Training of
Student
Nurses
Yes
Life Esidimeni
Private Enterprise
Psychiatric
Services
Yes
Mental Health
NPOs
NPOs
CommunityBased
Services
Yes
NPOs
CommunityBased
Services
Yes
NPOs
Meals for
Children at
Crèches
Yes
EPWP
NPOs
Nutrition NPOs
Witkoppen
Clinic
NPO
Community
Based
Services
Yes
Alexandra
Health Centre
NPO
Community
Based
Services
Yes
HIV/AIDS
NPOs
NPOs
Community
Based
Services
Yes
Service
BeneÄts
Yes
Households
Amount
transferred
(R’000)
Amount
spent by the
entity
270 013
270 013
57 366
57 168
330 063
329 846
17 919
17 919
1 824
1 824
198 726
198 725
101 403
102 837
Reasons for
the funds
unspent by
the entity
77
101 396
101 396
48 481
48 481
12 672
12 672
11 139
11 139
47 967
47 967
266 790
266 790
The table below reÅects the transfer payments which were budgeted for in the period 1 April 2015 to
31 March 2016, but no transfer payments were made.
Name of
transferee
Sefako Makgatho
Purpose for
which the funds
were to be used
Higher Education
Institution
Amount
budgeted for
Amount
transferred
(R’000)
(R’000)
333
Reasons why funds were not
transferred
65 Entity not registered on SAP, payment
made to accommodate accrual before
name change
6. Conditional Grants
The table/s below details the conditional grants and earmarked funds received during for the period
1 April 2015 to 31 March 2016.
Conditional Grant: Health Facility Revite Grant
Department who transferred the
grant
Purpose of the grant
To help accelerate construction, maintenance, upgrading and rehabilitation of new and
existing infrastructure in health including health technology, organisational development
systems and quality assurance; to enhance capacity to deliver health infrastructure.
Expected outputs of the grant
Complete planning for three facilities: Kalafong, Tambo Memorial, Sebokeng
Revitalisation
Complete design for Äve facilities: Jubilee, Yusuf Dadoo, Khayalami, Finetown, Lillian
Ngoyi
Complete construction at three facilities: CHBAH oxygen, Sebokeng completion of
works, CMJAH staff residences
Provide equipment for one facility: Thelle Mogoerane Hospital
Complete project and operationalised three facilities: Kopanong TB, Randgate Clinic,
Tembisa Psychiatric ward
No maintenance projects were planned on HFRG
Actual outputs achieved
Actual output at end of 2015/16 Änancial year:
Planning was completed at 0 facilities, but planning at Kalafong, Tambo Memorial and
Sebokeng hospitals progressed.
Design was completed for Lillian Ngoyi hospital and Finetown Clinic and they
progressed to Tender stage. Jubilee and Yusuf Dadoo hospitals remained in design
stage.
78
Construction was completed and the facility operationalised at CHBH, Kopanong and
Tembisa hospitals.
Sebokeng Completion of Works, CMJAH Nurses Residences, new Randgate Clinic and
additional works to Thelle Mogoerane Hospital remained in construction.
Equipment was provided for Thelle Mogoerane Hospital.
Sebokeng Completion of works, CMJAH staff residences.
Number of facilities equipped: Thelle Mogoerane Hospital
Number of facilities operationalised: 3 (Kopanong TB, Randgate Clinic, Tembisa
Psychiatric ward).
Number of facilities maintained: 0
Amount per amended DORA
R313 630
Amount received (R’000)
R313 630
Reasons if amount as per DORA
was not received
NIL
Amount spent by the department
(R’000)
R313 630
Reasons for the funds unspent by
the entity
Reasons for deviations on
performance
Targets could not be reached due to:
Late approval of planning documents.
Delays in procurement.
Lack of delegations.
Late payment of invoices.
Department who transferred the
grant
Measures taken to improve
performance
Re-enforce implementation of Service Level Agreement with GDID.
Improve planning of facilities by utilising additional resources appointed.
Identify and address reasons for late payments.
Improve approval processes by implementing delegations.
Improved Project Management principles.
Monitoring mechanism by the
receiving department
Monitoring mechanisms during planning are: project plans, submissions, monthly design
reviews and Änalisations, meetings.
Monitoring mechanisms during construction are monthly progress review reports and
meetings.
Expenditure is monitored monthly by preparation of variance report, conditional grant
report and IRM.
Conditional Grant: National Tertiary Services Grant
Department who transferred the grant
Ensure provision of tertiary health services for all South African citizens.
Compensate tertiary facilities for additional costs associated with provision of
these services.
Provision of designated central and national tertiary services in seven hospitals/
complexes as agreed between the province and the national Department of
Health (DoH).
All tertiary clinical services assigned in the YES list of the SLA with NDOH
were met. Patient data elements are regularly monitored in provision of tertiary
services.
R3 572 856
R3 572 856
Reasons if amount as per DORA was not
received
NIL
Amount spent by the department (R’000)
R3 570 498
Reasons for the funds unspent by the entity
The slow payment of the NHLS account is due to investigations in the billing
process that has contributed to underspending of R2 358.
Reasons for deviations on performance
N/A
Measures taken to improve performance
N/A
Monitoring mechanism by the receiving
department
Expenditure is monitored through monthly and quarterly Änancial reports.
79
Conditional Grant: Health Professions Training and Development Grant
Support provinces to fund service costs associated with training of health
science trainees on the public service
230 medical doctors produced
232 placed in community services
R829 604
R829 604
Reasons if amount as per DORA was not
received
NIL
R829 604
Monitoring mechanism by the receiving
department
Expenditure is monitored through monthly and quarterly Änancial reports.
Conditional Grant: Comprehensive HIV/AIDS Grant:
80
Support the implementation of the HIV, AIDS and TB National strategic
plan
Male condoms distribution: 232 879 020;
Female condom distribution: 4 097 924;
Interventions in HIV High Transmission Areas: 100;
Employment on Stipends of Lay Counsellors: 2 353;
Conduct HIV testing (incl. antenatal): 3 047 381;
Increase number of facilities offering Medical Male Circumcisions
(MMC): 100;
Conduct MMC (perform): 371 893;
Increase Sexual Assault Cases offered ARV prophylaxis: 6 200;
Antenatal clients initiated on ART: 43 000;
Babies PCR tested at six weeks: 39 000;
Increase number of facilities offering ART: 400;
Increase number of new patients started on ART treatment: 137 500;
Increase number of patients on ART remaining in care: 746,678;
Increase number of active home-based carers receiving stipends:
6 200;
Increase number of beneÄciaries served by home based carers:
300 000;
Increase number of HIV-positive clients screened for
TB: 330 000;
Increase number of HIV-positive clients started on IPT: 95 000;
Increase number of doctors trained on HIV/AIDS, TB, STIs and other
chronic diseases: 45;
Increase No of Nurses trained on HIV/AIDS, TB, STIs and other
chronic diseases: 3 216;
Increase No of Non-professional trained on HIV/AIDS, TB, STIs and
other chronic diseases: 4 720.
No of male condoms distributed 197 852 306
No of female condoms distributed 7 648 078
No of HTA intervention sites 139
No of active lay counsellors on stipend 2316
No of clients tested (including antenatal) 2 886 660
No of health facilities offering MMC 100
No of MMC performed 112 794
No of sexual assault cases offered ARV prophylaxis 5878
No of antenatal clients initiated on ART 41600
No of babies PCR tested at 6 weeks 35 868
No of facilities offering ART 400
No of new patients started on treatment 153 440
No of patients on ART remaining in care 756 039
No of active home-based carers receiving stipends 5803
No of beneÄciaries served by home-based carers 433 561
No of HIV-positive clients screened for TB 4 983 095
No of HIV-positive clients started on IPT 95,000 77, 810 [82%]
No of doctors trained on HIV/AIDS, TB, STIs and other chronic
diseases 123
No of nurses trained on HIV/AIDS, TB, STIs and other chronic
diseases 6511
No of non-professionals trained on HIV/AIDS, TB, STIs and other
chronic diseases 6165
R2 928 300
R2 928 300
Reasons if amount as per DORA was not received
NIL
R2 880 682
81
Deadlock at Finance Department and later long delays on creation
of all posts for personnel employment; function Human Resource
Management (generically) taken over by Finance Department, which
despite circulars from the National Treasury declaring “no moratorium
on posts creation for personnel employment on grants as that would
affect grant expenditure” did not assist in speeding up the processes.
Posts for personnel employment affected range from +508 Ward
Based Outreach Team Leaders (WBOTs) on HBC to District Medical
Male Circumcision (MMC) Roving Teams on MMC, to Integrated
School Health Teams and Food Service Assistants on PMTCT as
well as other Districts Operational Posts to increase Service Delivery
Capacity. [ a fraction of all these posts was approved in January 2016]
Appointment of Private GP’s to perform MMCs missed the 2015 winter
peak season.
Male condoms supply not meeting demand following change to new
national tender in July 2015.
Medical Male Circumcision (MMC) – Urban MMC low summer demand
and winter-only MMC myth affecting performance; Not all Public
Health Facilities offer MMC except referrals to developmental partners
and few available MMC Services thus reducing access and outputs;
few medical general practitioners contracted to increase capacity
joined the Department past the 2015 winter peak.
Where targets are achieved (on target), signiÄcant progress made
(+80%) and or targets exceeded (+100%) results are attributed to
Targeted SpeciÄc Interventions driven by use of Health Information
where gaps are identiÄed, root causes analysed per district, subdistrict and facility in technical support visits, thereby leading to
reviews, feedback and change in practices. (Thus Implementation
of Monitoring and Evaluation and or Use of Health Information for
Effective Management).
82
Male Condoms Availability – Escalated to national contract
management and National Condoms Line Management to intervene,
HIV/AIDS and STIs unit to continue to engage with suppliers to comply
with awarded tender.
MMC – To open more MMC sites through independent general
practitioners contracting and mobilise community for MMC access
intending to maximise outputs on 2016 winter peak.
Post creation issues escalated through HR to SMT, also shared with
NDOH.
Monitoring mechanism by the receiving department
The HAS directorate mandated every health district to hold quarterly
Änance and non-Änance performance reviews; while at provincial level
reviews are also held.
Central OfÄce HAS conducts ad-hoc need-driven support visits to
District Management Teams on Finance and Non-Finance.
Monthly Änance and non-Änance performance is engaged by the HAS
Unit Meeting.
Central OfÄce HAS director conducts ad-hoc need driven 1 on 1’s with
line spending clinical programmes on both Änance and non-Änance
performance.
Conditional Grant: National Health Insurance
Test innovations in health service delivery and provision for
implementing NHI, allowing for each district to interpret and design
innovations relevant to its speciÄc context; in line with the vision for
realising universal health coverage for all.
To undertake health system strengthening activities in identiÄed focus
areas.
To assess the effectiveness of interventions/activities undertaken in
the district; funded through this grant
Selected Municipal Ward Based Outreach Teams equipped to collect
relevant data from households.
Monitoring and evaluation including impact assessment of the
effectiveness of selected. Municipal Ward-Based Outreach Teams
undertaken.
Gaps identiÄed and addressed and SCM processes streamlined in
pilot districts.
Compliance with monitoring and evaluation of targets in operational
plans.
Uniform
1 600 skirts, 1 600 chino pants (male and female) and 1 600 golf
shirts (white and fawn) were delivered. The drimacs were not
delivered.
Kitbags
650 kitbags with consumables for use by community health workers
were delivered.
Lean Management
Lean institute rendered coaching sessions to improve supply chain
processes and all 48 sessions were conducted.
Queue Management system
Queue Management system was installed in three facilities to improve
patient’s experience of services rendered.
Deputy Director: NHI M&E is retained and is responsible for NHI M&E
and overall performance monitoring in the district.
R10 206
R10 206
NIL
Amount spent by the Department (R’000)
R7 040
Underspending is due delays in the supply chain processes, thus
affecting the delivery and payment of uniform, installation of queue
management system.
Suppliers who had limited capacity to fulÄl mandates.
Over-budgeting for queue management resulted in surplus funds on
activity.
Make follow-up with health processing centre for payments of
outstanding invoices.
Engage with suppliers to effect delivery of outstanding orders.
Expenditure is monitored through monthly and quarterly Änancial
reports.
83
Conditional Grant: Social Sector EPWP Incentives Grant for the Province – Department of
Health
National Department of Public Works
To incentivise Provincial Social Sector Departments identiÄed in
2015/16 Social sector EPWP log frame.
To increase job creation by focusing on the strengthening and expansion
of social sector programmes that have employment potential.
415 participants recruited and receiving stipend through EPWP.
150 facilities receiving services from EPWP workers.
A minimum of 415 beneÄciaries receiving training.
415 jobs created and poverty was alleviated.
In 150 facilities service delivery improved.
415 participants skilled in customer care.
R8 788
R8 788
N/A
R8 626
The grant expenditure is at 98% and the shortfall is due to the following
reasons: the programme purchased reÅector jackets instead of work
suits and equipment was purchased centrally under ICT budget.
84
Monthly expenditure reports and quarterly service reports.
Conditional Grant: EPWP Intergrated Grant for Province
The Expanded Public Works Programme (EPWP) is one element
within a broader government strategy to reduce poverty through
the alleviation and reduction of unemployment. The EPWP involves
creating work opportunities for unemployed persons, allowing them
to participate economically and contribute to the development of
their communities and the country as a whole.
128 beneÄciaries were employed during 2015/16 Änancial year in
various facilities.
128 beneÄciaries were employed during 2015/16 Änancial year in
various facilities.
R2 051
R2 051
R2 021
The R30 000 unspent was as a result of insufÄcient funds (shortfall)
to pay for the 128 beneÄciaries an amount of
R271 000 end of 31 October 2015.
On 1 November 2015 till 31 March 2016. All the 128 beneÄciaries
were transferred to GDID – EPWP and
were paid there.
Due to a shortfall in funds all 128 beneÄciaries were transferred to GDID.
Expenditure is monitored monthly by preparation of conditional grant
report and IRM.
Expenditure is monitored monthly by preparation of conditional grant
report and IRM.
7. Donor Funds
7.1
Donor Funds Received
Donor Fund 1
Name of donor
Bought from recreation funds
Full amount of the funding
R6 423.35 (HP printer)
Period of the commitment
None
Purpose of the funding
For ofÄce use at the hospital
Expected outputs
Amount received in current period (R’000)
R6 423.35 (HP printer)
Printers were bought to the value of R6 423.35
Reasons for the funds unspent
Printers were bought to the value of R6 423.35
Monitoring mechanism by the donor
None
Donor Fund 2
Name of donor
BHCC (Baragwanath Hospital Comforts Committee)
R5 058.18 (Industrial Zig Zag)
None
Donated by BHCC and Clinic Outreach for the hospital use
Expected outputs
For laundry
For laundry
R5 058.18 (ofÄce furniture)
Sewing machine to the value of R5 058.18 was donated for laundry
use
Sewing machine to the value of R5 058.18 was donated for laundry
use
None
Donor Fund 3
Name of donor
Rotary Club of HatÄeld
R474 000 (sims syringe)
None
Bought by Rotary Club
Expected outputs
Syringe drivers – vital tool for administering medicine.
Syringe drivers – vital tool for administering medicine.
R474 000 (medical equipment)
Syringe drivers to the value of R474 000 were donated
Syringe drivers to the value of R474 000 were donated
None
85
Donor Fund 4
Name of donor
Same foundation
R196 749 (comprehensive ventilator)
None
For patients purposes
Expected outputs
Provides critical care to patients with complex respiratory diseases
Comprehensive ventilator to the value of R196 749 was donated
None
Donor Fund 5
86
Name of donor
National Department of Health Revenue
R10 008 (laptops)
none
To assist the HR department with capturing data for the WISN project
Expected outputs
R10 008 (laptops)
Laptops were donated to the value of R10 008
None
Donor Fund 6
Name of donor
Same Foundation
None
For patients purposes
Expected outputs
Amount received in current period(R’000)
None
Donor Fund 7
Name of donor
National Department of Health Revenue
R10 008 (laptops)
None
Expected outputs
R10 008 (laptops)
None
Donor Fund 8
Name of donor
Dr Tshepo and Edzia Ngale
R2 359.90 (Sansui)
None
To staff and patient at Ward 39
Expected outputs
Entertainment to patients and staff
Entertainment to patients and staff
R2 359.90 (Sansui)
Sansui TV to the value of R2 359.90 was donated
Sansui TV to the value of R2 359.90 was donated
None
Donor Fund 9
Name of donor
Karodia Furniture
R1 500 (bed mattress)
None
For patients use
Expected outputs
For sleeping comfort of the patients
For sleeping comfort of the patients
R1 500 (mattress)
Mattress was donated to the value of R1 500
Mattress was donated to the value of R1 500
None
87
Donor Fund 10
Name of donor
Mr Alan Pullinger
R2 930 (domestic furniture & kitchen appliance)
None
For kitchen use
Expected outputs
For staff use
For staff use
R2 930 (domestic and kitchen)
Folding table and microwaves to the value of R2 930 were donated
Folding table and microwaves to the value of R2 930 were donated
None
Donor Fund 11
Name of donor
88
HiFi Corp
R56 999.60 (Hisense TV)
None
Donation to different ward in the Hospital
Expected outputs
For entertainment of patients and staff
For entertainment of patients and staff
R56 999 (Hisense TV)
Hisense TV were donated to the value of
R56 999.60
Hisense TV were donated to the value of
R56 999.60
None
Donor Fund 12
Name of donor
Recreation funds
R2 097 (LG DVD player and Aqua cooler)
None
For staff use and patients
Expected outputs
R2 097 (LG DVD player and aqua cooler)
DVD player and Aqua Cooler to the value of R2 097 were donated
DVD player and Aqua Cooler to the value of R2 097 were donated
None
Donor Fund 13
Name of donor
SA Medical and Thabile Trade (Pty)Ltd
R46 138.86 (colposcope and computer laser printer)
None
Donation to maternity and X-Ray dept
Expected outputs
Printer for printing purpose and colposcope to maternity ward
Printer for printing purpose and colposcope to maternity ward
R46 138.86 (colscope and computer laser printer)
Colscope and computer laser printer were donated to the value of
R46 138.86
Hisense TV were donated to the value of R56 999.60
None
Donor Fund 14
Name of donor
Hospital recreation fund
R3 211.68 (HP laser printer)
None
For ofÄce use
Expected outputs
For staff use
For staff use
R3 211.68 (HP laser printer)
HP laser printer to the value of R3 211.68 was donated
HP laser printer to the value of R3 211.68 was donated
None
Donor Fund 15
Name of donor
Cluster TB Control and Management
R95 080 (medical equipment and laptop)
None
For patient use
Expected outputs
Medical equipment for patient use daily and laptop for ofÄce daily
duties
Medical equipment for patient use daily and laptop for ofÄce daily
duties
R95 080 (medical equipment and laptop)
Medical equipment and laptop were donated to the value of R95 080
Medical equipment and Laptop were donated to the value of R95 080
None
89
Donor Fund 16
Name of donor
Johannes Jacobus
R300 (Defy microwave)
None
For Speech Therapy and Audiology Department
Expected outputs
For staff use
For staff use
Amount received in current period(R’000)
R300 (domestic and kitchen)
Microwave to the value of R300 was donated
Microwave to the value of R300 was donated
None
Donor Fund 17
90
Name of donor
Dr J.F. Deolinda
R3 000 (Sansui TV)
None
Donation was made to improve the quality of patients during their stay
at the hospital
Expected outputs
For entertainment of patients
For entertainment of patients
R3 000 (Sansui TV)
Sansui TV was donated to the value of R3 000
Sansui TV were donated to the value of R30 000
None
Donor Fund 18
Name of donor
Same Foundation
None
Donation was for the institution’s daily running
Expected outputs
For patients’ use
For patients’ use
Medical equipment was donated to the value of R503 813
Medical equipment was donated to the value of R503 813
None
Donor Fund 19
Name of donor
Same Foundation
R7 000 (Sansui Åat screen)
None
The donation is for the beneÄt of the hospital staff and was placed in
the doctors room
Expected outputs
For entertainment of staff
For entertainment of staff
R7 000 (Sansui Åat screen TV)
Sansui Åat screen TV was donated to the value of R7 000
Sansui Åat screen TV was donated to the value of R70 000
None
91
8. Capital Investment
Capital investment, maintenance and asset management plan
Progress on infrastructure projects is as follows:
a) Progress made on implementing the capital, investment and asset management plan.
Through the implementation of various capital and maintenance infrastructure projects, Programme 8 managed
to spend 67% of its total allocated budget.
b) Infrastructure projects which have been completed in the current year and the
progress in comparison to what was planned at the beginning of the year. Provide
reasons for material variances (2% variance).
92
Project name
Construction start
date
Planned
Construction end
date as at 1 April
2015
Actual or
new planned
Construction end
date as at 31 March
2016
Reason for
deviation
Thelle Mogoerane Hospital (New
Natalspruit Hospital)
Build new 760 Bed Regional
Hospital
01 November 2006
20 June 2014
31 October 2016
Additional
work identiÄed.
Delay in
payment of
invoices.
Renovations to psychiatric ward
and observation units
16 October 2012
29 July 2015
31 July 2016
Late payment
of invoices.
Tshwane District Hospital
External wet services contract
21 January 2016
20 January 2017
20 January 2017
No deviation
applicable.
Tembisa Hospital
New 24-hour Blood Bank
12 September 2013
31 May 2015
30 November 2015
Delay in Änal
completion.
Lengthy
approval
processes.
Sebokeng Hospital
Construction and/or Completion
of Pharmacy, ICU, Radiology,
Kit Store, Administration Block,
Physiotherapy, Waiting Areas,
Existing OPD, Renal and Gate
House for Sebokeng Hospital
11 November 2013
15 December 2015
31 May 2016
Lengthy
approval
processes.
Delay in
payment of
invoices.
Academic Hospital
Additional oxygen and vacuum
points
06 October 2015
31 July 2016
31 July 2016
No deviation
applicable.
Academic Hospital
Upgrading and renovation of the
existing psychiatric unit
09 November 2015
27 September 2016
27 September 2016
No deviation
applicable.
Randgate Clinic
Build new clinic
03 March 2015
11 November 2015
To be determined
Nonperformance
by contractor.
Termination of
contractor
Lengthy SCM
processes at
GDID.
Project name
Construction start
date
Planned
Construction end
date as at 1 April
2015
Actual or
new planned
Construction end
date as at 31 March
2016
Reason for
deviation
Bonalesedi Nursing College
Renovations and additions to
nursing college
04 September 2014
30 June 2016
30 June 2016
No deviation
applicable
Ga-Rankuwa Nursing College
Upgrading and renovations to
nursing college
25 May 2015
25 October 2016
25 October 2016
No deviation
applicable
Chris Hani Baragwanath Academic
Hospital
Renovations to psychiatric wards
06 October 2015
30 September 2016
30 September 2016
No deviation
applicable
Academic Hospital
Revitalisation of staff residences –
Blocks A, D & E
18 August 2014
30 April 2016
26 April 2016
No deviation
applicable
Thelle Mogoerane Hospital
(Natalspruit Hospital)
New staff residences to serve new
25 February 2015
31 August 2016
31 August 2016
No deviation
applicable
Refurbishment contracts 4A on
wards that are part of the ongoing
hospital refurbishment plan
06 May 2015
05 May 2016
05 May 2016
No deviation
applicable
New Kekana Gardens Clinic
New clinic
01 November 2015
30 September 2016
30 September 2016
No deviation
applicable
Kekanastad Clinic
Construction of new clinic
11 November 2015
31 October 2016
31 October 2016
No deviation
applicable
Khutsong South Ext2 Clinic
New Clinic
12 April 2016
28 February 2017
28 February 2017
No deviation
applicable
Pholosong Hospital
Step down ward
01 April 2015
31 March 2017
31 March 2017
No deviation
applicable
93
c) Infrastructure projects that are currently in progress (list projects) and when are they expected to
be completed
Unique Project name
Project
number
94
Stage
Construction start
date
Construction end
date
Retention
01 September 2007
31 July 2011
In progress
NA
NA
4
Bertha Gxowa Hospital
Build new 300-bed district hospital
8
Management of the grant
9
Thelle Mogoerane Hospital (New Natalspruit
Hospital)
Build new 760 bed regional hospital
Construction
76% – 99%
01 November 2006
31 October 2016
10
Hospital)
Equipment for the revitalisation project
Procurement
NA
NA
11
Bheki Mlangeni Hospital (Zola Hospital in
Jabulani)
New 300 bed district hospital
Retention
20 March 2009
31 May 2015
18
Additional oxygen and vacuum pump points in
neonatal and maternity wards
Completed
28 March 2014
31 December 2014
23
Renovations to psychiatric ward and observation
units
Construction
51% – 75%
16 October 2012
31 July 2016
26
Leratong Hospital
Additional oxygen and vacuum pump points in
neonatal and maternity wards
Retention
30 October 2012
30 September
2015
35
External wet services contract
Construction
1% – 25%
21 January 2016
20 January 2017
38
Tembisa Hospital
New 24-hour Blood Bank
Construction
76% – 99%
12 September 2013
30 November 2015
43
Discoverers CHC
Convert CHC into district hospital
Design
03 June 2016
03 June 2019
48
Kopanong Hospital
Renovations and refurbishments of wards to
accommodate TB beds
Completed
02 May 2012
17 March 2015
49
Lenasia South CHC
Convert CHC into district hospital
Design
01 June 2016
26 February 2017
51
Pretoria West Hospital
Upgrading of Chiller Plant
Retention
12 October 2012
04 September
2015
53
Carletonville Hospital
Additional oxygen and vacuum points
Retention
30 October 2012
30 April 2015
56
Sebokeng Hospital
Construction and/or Completion of pharmacy,
ICU, radiology, kit store, administration block,
physiotherapy, waiting areas, existing OPD, renal
and gate house for Sebokeng Hospital
Construction
76% – 99%
11 November 2013
31 May 2016
58
Renovations to oncology
Retention
31 July 2006
29 April 2011
63
Hospital
Construction
51% – 75%
06 October 2015
31 July 2016
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
64
Hospital
Upgrading and renovation of the existing
psychiatric unit
Construction
1% – 25%
09 November 2015
27 September
2016
71
Rahima Moosa Mother and Child Hospital
Completed
10 October 2012
31 March 2013
74
S G Lourens Nursing College
Refurbishment to nursing college
Design
Construction not
commenced
Construction not
commenced
75
Sterkfontein Hospital
Upgrading of Ward 16
Completed
17 January 2014
30 November 2015
224
Tshwane Rehabilitation Centre
Renovations and upgrading of facility
Design
01 November 2016
31 August 2018
227
Boikhutsong CDC
Replacement of existing clinic and upgrade to
new CDC
Tender
05 May 2016
17 April 2018
229
Randgate Clinic
Build new clinic
Construction
51% – 75%
03 March 2015
To be determined
230
Weskoppies Hospital
Replace north emergency power generator, LT
upgrade and street lighting.
Retention
28 June 2013
30 November 2014
248
Bonalesedi Nursing College
Renovations and additions to nursing college
Construction
76% – 99%
04 September 2014
30 June 2016
249
Upgrading and renovations to nursing college
Construction
51% – 75%
25 May 2015
25 October 2016
251
Tembisa Hospital
Retention
08 April 2014
09 October 2015
253
Construction
26% – 50%
06 October 2015
30 September
2016
412
Jubilee Hospital
Revitalisation
Design
Construction not
commenced
Construction not
commenced
413
Dr Yusuf Dadoo Hospital
Revitalisation
Design
Construction not
commenced
Construction not
commenced
414
Tambo Memorial Hospital
Revitalisation
Feasibility
Construction not
commenced
Construction not
commenced
415
Kalafong Hospital
Revitalisation
Feasibility
Construction not
commenced
Construction not
commenced
416
Sebokeng Hospital
Revitalisation
Feasibility
Construction not
commenced
Construction not
commenced
421
Kagiso CHC
Conversion of SAPS building into a CHC
Feasibility
Construction not
commenced
Construction not
commenced
425
Refurbishment of Oorkant, Susan Hof, Querani
and Strydom Hof Nurses Residences at Helen
Joseph
Design
01 September 2016
01 March 2018
426
Hospital
Revitalisation of Staff Residences – Blocks A, D
&E
Construction
76% – 99%
18 August 2014
26 April 2016
428
Critical repairs and refurbishment of staff
accommodation, walkways, neo-natal ICU and
labour ward.
Tender
01 April 2016
01 August 2018
95
Unique Project name
Project
number
96
Stage
Construction start
date
Construction end
date
Construction
26% – 50%
25 February 2015
31 August 2016
On hold
NA
NA
429
Thelle Mogoerane Hospital (Natalspruit Hospital)
New staff residences to serve new Thelle
Mogoerane Hospital
433
Daveyton FPS Mortuary
New mortuary
441
S G Lourens Nursing College
All maintenance activities
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
444
Johannesburg FPS Mortuary
New mortuary
Tender
05 April 2016
05 April 2019
445
Bronkhorstspruit FPS Mortuary
New mortuary
Tender
01 August 2016
01 October 2017
451
Far East Rand Hospital
Upgrade Wards 4 & 8
Completed
22 April 2013
19 November 2015
458
Khayalami Hospital
Complete refurbishment of the existing unused
hospital into a functional district hospital
On hold
Construction not
commenced
Construction not
commenced
499
Hospital
Refurbishment of electrical reticulation
Design
Construction not
commenced
Construction not
commenced
502
Bank of Lisbon Building
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
503
Finetown Clinic
Construction of new Finetown Clinic
Tender
02 May 2016
31 May 2017
535
ReÄlwe Clinic
Replace small clinic and upgrade to CHC
Design
Construction not
commenced
Construction not
commenced
536
K.T. Motubatse Clinic
Construction of additional consulting rooms
Design
Construction not
commenced
Construction not
commenced
557
Soshanguve Block JJ Clinic
Build new clinic
Cancelled
Construction not
commenced
Construction not
commenced
584
Mandisa Shiceka Clinic
Replace current clinic and upgrade to CDC
Design
01 June 2016
28 February 2018
586
Lillian Ngoyi
Construct new district hospital adjacent to
existing CHC
Tender
01 June 2016
TBA
683
Rayton Clinic
Additional consulting rooms
Cancelled
Construction not
commenced
Construction not
commenced
686
Ekangala
Five additional consulting rooms
Design
Construction not
commenced
Construction not
commenced
687
Medical Supply Depot
New medical supply depot
IdentiÄed
Construction not
commenced
Construction not
commenced
687
Auckland Park Medical Supply Depot
Maintenance
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
692
Temba CHC
Extension for twelve rooms, Äling room,
pharmacy and waiting area.
Design
Construction not
commenced
Construction not
commenced
717
Lebone College of Emergency Care
The conversion of the old maternity hospital into
an EMS training facility
NA
NA
NA
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
Tender
NA
NA
Construction
51% – 75%
06 May 2015
05 May 2016
IdentiÄed
Construction not
commenced
Construction not
commenced
719
Securing of Sites for Various Projects
Various sites
720
Refurbishment contracts 4A on wards that are
part of the ongoing hospital refurbishment plan
721
Additional works
722
South Rand Hospital
Conversion and renovation of old compound/
pharmacy
Tender
Construction not
commenced
Construction not
commenced
723
Heidelberg Hospital
Renovation to maternity, OPD & casualty and
new helipad
Design
Construction not
commenced
Construction not
commenced
729
Special projects
Various capital projects, of minor value and
managed by the Special Projects Directorate
Construction
76% – 99%
01 April 2015
31 March 2016
737
Magagula Heights Clinic
Procurement and installation of ±600m² Parkhome adjacent to the existing Magagula Heights
Clinic
Cancelled
Construction not
commenced
Construction not
commenced
739
Hospital)
Organisational development and quality
assurance activities associated with hospital
revitalisation projects
Completed
NA
NA
741
New Kekana Gardens Clinic
New clinic
Construction
1% – 25%
01 November 2015
30 September
2016
742
New Inner City CHC
New CHC
Feasibility
Construction not
commenced
Construction not
commenced
744
New Eersterust Clinic
Minor extension of recently built CHC
Tender
Construction not
commenced
Construction not
commenced
746
New Kanana Clinic
Feasibility
Construction not
commenced
Construction not
commenced
747
Dewagensdrift Clinic
Tender
Construction not
commenced
Construction not
commenced
750
New Bophelong (Tshwane District 3) Replaced by
new Atteridgeville CHC
Design
Construction not
commenced
Construction not
commenced
797
Pretoria North Clinic
Additions and rehabilitation
Design
Construction not
commenced
Construction not
commenced
813
Weskoppies Hospital
Condition assessment and refurbishment of
heritage buildings
Design
Construction not
commenced
Construction not
commenced
817
TB Infrastructure
Installation of TB Park homes
Tender
NA
NA
821
Bheki Mlangeni Hospital (New Zola/Jabulani
Hospital)
Organisational development and quality
assurance activities associated with hospital
revitalisation projects
Completed
NA
NA
97
Unique Project name
Project
number
98
Stage
Construction start
date
Construction end
date
1106
Electro-Mechanical Replacement Programme
Replacement of electro mechanical equipment at
various institutions
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
1125
Radio Communication System
Construction
26% – 50%
01 April 2015
31 March 2016
3300
Dark City CHC
Design
01 October 2016
01 October 2018
3322
Stanza Bopape Clinic
Feasibility
Construction not
commenced
Construction not
commenced
3340
Dilopye Clinic
Design
Construction not
commenced
Construction not
commenced
3342
Kekanastad Clinic
Construction
1% – 25%
11 November 2015
31 October 2016
3343
Ramotse Clinic
Design
01 September 2016
01 September
2017
3344
Refentse Clinic
Design
01 June 2016
06 December 2017
3361
Kgabo CHC
Design
Construction not
commenced
Construction not
commenced
3363
Phedisong 4 CHC
Design
01 October 2016
01 October 2017
3373
FSM (Ga-Rankuwa) Cluster Clinics and CHC’s
Minor Works
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4004
Ann Latsky Nursing College
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4019
Bona Lesedi College
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4038
Chris Hani Nursing College
Maintenance
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4040
Rahima Moosa Nursing College
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4069
Ekurhuleni Regional Health OfÄce
All Maintenance Activities
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4086
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4144
Lebone College of Emergency Care
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4145
Lebone EMS College
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4181
Nicol House
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
4232
Sedibeng Regional Health OfÄce
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4271
TMI boiler house
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4607
Tshwane District Clinics
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4608
Ekurhuleni District Clinics
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4609
Sedibeng District Clinics
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4610
Johannesburg District CHCs
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4611
West Rand District Clinics
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4613
Ekurhuleni District CHCs
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4615
Johannesburg District Clinics
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4617
Sedibeng District CHCs
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4619
Tshwane District CHCs
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4621
West Rand District CHCs
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4622
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4623
Carletonville hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4624
CMJAH
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4625
CHBAH
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4627
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
99
Unique Project name
Project
number
100
Stage
Construction start
date
Construction end
date
4628
Dr Yusuf Dadoo Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4630
Edenvale Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4631
Far East Rand Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4632
Heidelberg Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4633
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4634
Jubilee Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4635
Kalafong Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4636
Kopanong Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4637
Leratong Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4638
MEDUNSA Oral Health Centre
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4639
New Mamelodi Hospital
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4640
Hospital)
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4642
Odi Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4643
Old Germiston Hospital
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4644
Old Mamelodi Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4646
Pholosong Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4647
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
4648
Rahima Moosa Mother and Child Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4649
Sebokeng Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4650
Sizwe Tropical Diseases Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4651
South Rand Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4653
Sterkfontein Hospital
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4654
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4655
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4656
Tara H Moross Hospital
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4657
Tembisa Hospital
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4658
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4659
Weskoppies Hospital
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4661
Forensic Pathology Services and Mortuaries
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4662
Chris Hani Laundry
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4663
Dunswart Provincial Laundry
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4664
Johannesburg Provincial Laundry
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4665
Masakhane Cook freeze
Construction
26% – 50%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4666
Masakhane Laundry
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
101
Unique Project name
Project
number
102
Stage
Construction start
date
Construction end
date
4667
Tshwane District Pharmacies
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4668
Johannesburg District Pharmacies
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4671
West Rand District Pharmacies
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4674
Tshwane Rehabilitation Centre
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4682
Cullinan Care Rehabilitation Hospital
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4698
EPWP
Construction
76% – 99%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4699
Nizamiye Clinic
Upgrade of clinic
Design
Construction not
commenced
Construction not
commenced
4708
Cosmo City CHC
Construction of a new CHC
Design
Construction not
commenced
Construction not
commenced
4709
Various generator replacements
IdentiÄed
Construction not
commenced
Construction not
commenced
4718
Lehae CHC
Construction of a new CHC
Design
Construction not
commenced
Construction not
commenced
4727
Jubilee Hospital
Upgrade of gateway clinic
Cancelled
Construction not
commenced
Construction not
commenced
4729
Edenvale Hospital
TWO new wards, new linen bank, upgrade CCTV
system
IdentiÄed
Construction not
commenced
Construction not
commenced
4730
Lebone College
Health council upgrades
Design
01 June 2016
10 February 2018
4731
Ann Latsky Nursing College
New admin building, parking area
IdentiÄed
Construction not
commenced
Construction not
commenced
4732
Carletonville Hospital
Renovations
IdentiÄed
Construction not
commenced
Construction not
commenced
4733
South Rand Hospital
CCTV cameras
Cancelled
NA
NA
4735
Helipad, new oncology
Design
Construction not
commenced
Construction not
commenced
4736
Hall and archives
IdentiÄed
Construction not
commenced
Construction not
commenced
4737
Louis Botha Hospital
Repair and renovate
IdentiÄed
Construction not
commenced
Construction not
commenced
4738
Weskoppies Hospital
Storm water drainage, repairs and renovations
IdentiÄed
Construction not
commenced
Construction not
commenced
4738
Zola Clinic
Replace asbestos with bricks and upgrade
existing clinic to CHC
IdentiÄed
Construction not
commenced
Construction not
commenced
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
Design
11 November 2016
30 April 2018
4739
Chiawelo Clinic
Replace asbestos with brick and upgrade
existing clinic to CHC
4740
Johannesburg Health District
Stretford medico legal
Cancelled
NA
NA
4741
Dunswart laundry
IdentiÄed
Construction not
commenced
Construction not
commenced
4742
Small works-electrical, mechanical, building
IdentiÄed
Construction not
commenced
Construction not
commenced
4746
Khayalami Hospital
Fence
Completed
15 May 2015
12 October 2015
4747
Mamelodi Hospital
Blood bank
Completed
01 April 2015
31 August 2015
4748
Tembisa Hospital
Maternity theatre
Design
Construction not
commenced
Construction not
commenced
4750
Zola Clinic
Maintenance
Construction
51% – 75%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4751
Diepsloot Hospital
New hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4752
BraamÄscherville CHC
Construction of new CHC
IdentiÄed
Construction not
commenced
Construction not
commenced
4753
Randfontein Clinic
Replace small clinic and upgrade to CHC
Design
13 July 2016
01 March 2018
4754
Kokosi CHC
New CHC
Design
Construction not
commenced
Construction not
commenced
4755
Khutsong South Ext2 Clinic
New Clinic
Construction
1% – 25%
12 April 2016
28 February 2017
4756
Mayibuye clinic
Tender
01 June 2016
01 March 2017
4757
Greenspark Clinic
Newclinic
Tender
01 June 2016
01 March 2017
4758
Daveyton Hospital
New hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4759
Esangweni CHC
Cancelled
NA
NA
4760
Kwa-Thema Clinic
Design
Construction not
commenced
Construction not
commenced
4761
Daveyton Main Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4762
J Dumani CHC
Extensions of pharmacy store room
Design
Construction not
commenced
Construction not
commenced
4763
Phillip Moyo CHC
Extension and refurbishment of maternity unit
Design
Construction not
commenced
Construction not
commenced
4764
North Mead Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4765
Eldorado CHC
IdentiÄed
Construction not
commenced
Construction not
commenced
4766
Orange Farm Ext7 Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
103
Unique Project name
Project
number
104
Stage
Construction start
date
Construction end
date
4767
Hillbrow District Hospital
Conversion of CHC into District Hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4768
Wildebeestfontein (Orange Farm) Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4769
Moroka Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4770
Magagula clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4771
Sebokeng Zone 17 Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4772
Evaton West Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4773
Bophelong Ext Clinic
Tender
Construction not
commenced
Construction not
commenced
4774
Vischkuil Clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4775
Dr Helga Kuhn Clinic
Upgrade of existing clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4776
Usizolwethu Clinic
Upgrade of existing clinic
IdentiÄed
Construction not
commenced
Construction not
commenced
4795
Boitumelo Clinic
Tender
01 April 2016
01 November 2017
4797
Heidelberg hospital
Upgrading
Cancelled
Construction not
commenced
Construction not
commenced
4798
Acquisition of Hospital in Bronkhorstspruit area
IdentiÄed
Construction not
commenced
Construction not
commenced
4799
Diepkloof FPS
Design
Construction not
commenced
Construction not
commenced
4800
Additional works
IdentiÄed
Construction not
commenced
Construction not
commenced
4801
Diverse security installations
IdentiÄed
Construction not
commenced
Construction not
commenced
4802
Odi Hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4804
Academic Hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4805
Dr. George Mukhari Academic Hospital
IdentiÄed
Construction not
commenced
Construction not
commenced
4820
Steve Biko Academy Hospital
Widening of the access road
IdentiÄed
Construction not
commenced
Construction not
commenced
4809
Charlotte Maxeke EMS
Construction
1% – 25%
Construction not
commenced
Construction not
commenced
4811
Hospital
Sewer Reticulation
Design
Construction not
commenced
Construction not
commenced
4812
Tembisa Hospital
Installation of diesel tank
Design
Construction not
commenced
Construction not
commenced
4813
Tembisa Hospital
New store
Design
Construction not
commenced
Construction not
commenced
4814
Tembisa Hospital
Stretcher Bay
Design
Construction not
commenced
Construction not
commenced
Unique Project name
Project
number
Stage
Construction start
date
Construction end
date
Retention
TBC
TBC
4815
Tembisa Hospital
Ward 16
4816
Pholosong Hospital
Step down ward
Construction
51% – 75%
01 April 2015
31 March 2017
4817
Kopanong Hospital
Park homes
IdentiÄed
Construction not
commenced
Construction not
commenced
4818
Edenvale Hospital
Upgrade
Design
Construction not
commenced
Construction not
commenced
4819
Leratong Nurses Res
Upgrade
IdentiÄed
Construction not
commenced
Construction not
commenced
4822
Generator Monitoring System
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4828
Johannesburg Forensic Mortuary
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4833
Fochville EMS
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4834
Psychiatric Ward
IdentiÄed
Construction not
commenced
Construction not
commenced
4834
Cullinan EMS
Construction
1% – 25%
Various contracts
commencing on
different dates
Various contracts
ending on different
dates
4835
New Access Ramp
IdentiÄed
Construction not
commenced
Construction not
commenced
4835
Sebokeng EMS
Construction
1% – 25%
Construction not
commenced
Construction not
commenced
4836
Tshepiso Clinic
Upgrade
IdentiÄed
Construction not
commenced
Construction not
commenced
105
d. Plans to close down or down-grade any
current facilities
There are no plans to close down or down-grade any
current facilities.
e. Progress made on the maintenance of
infrastructure
In 2015/16 GDOH managed to spend R1 152 487 000
(91%) of the total maintenance allocation by continued
implementation of the E-maintenance, term contracts
and supplier’s contract with Builders Warehouse. The
reported under expenditure was mostly on the delivery
of electro-mechanical equipment where procurement
processes took longer than expected.
f. Developments relating to the above
that are expected to impact on the
Department’s current expenditure
The Department’s infrastructure continues to suffer
from a substantial maintenance backlog, resulting
in the deterioration of the value and functionality of
facilities. Addressing the maintenance backlog will
lead to increased expenditure budget requirements.
106
g. Details as to how asset holdings have
changed over the period under review,
including information on disposals,
scrapping and loss due to theft
With regard to immovable assets, no assets were
disposed of, scrapped or lost due to theft.
i. The current state of the Department’s
capital assets, for example what
percentage is in good, fair or bad
condition
In the User Asset Management Plan (UAMP) for
2015/16, 96% of the health assets occupied by the
GDOH were rated “fair” in terms of condition, 2%
were rated “good” and 2% were rated “poor”.
j. Major maintenance projects that have
been undertaken during the period under
review
Except for the normal day-to-day, statutory and
planned maintenance, the following major projects
were undertaken:
Tambo Memorial Hospital:
Burnt stores was refurbished and upgraded with Äre
detection system
CHBAH:
Accident and emergency renovation and upgrade
Heidelberg Hospital:
Renovation and refurbishment of burnt theatre
Jhb Laundry:
Refurbishment to burnt roof and structure
h. Measures taken to ensure that the
Department’s asset register remained
up-to-date during the period under
review
As of 2014/15, GDID is responsible for the
maintenance of the immovable asset register.
k. Progress made in addressing the maintenance backlog during the period under review,
The 2015/16 maintenance allocation has been fully spent. The measurement to determine if the backlog
maintenance has been addressed can only be done when an assessment of new conditions is concluded in
three years.
2015/16
Infrastructure
projects
Actual
2014/15
Final
Appropriation
Expenditure
(Over)/Under
Expenditure
Final
Appropriation
Expenditure
Actual
(Over)/Under
Expenditure
R’000
R’000
R’000
R’000
R’000
R’000
New and
replacement
assets
571 788
493 626
78 162
414 207
357 691
56 516
Existing
infrastructure
assets
1 333 611
1 331 431
2 180
914 259
982 684
(68 425)
231 876
228 910
2 966
157 296
173 125
(15 829)
86 228
85 629
599
124 045
65 409
58 636
1 015 507
1 016 892
(1 385)
632 918
744 150
(111 232)
1 015 507
1 016 892
(1 385)
632 918
744 150
(111 232)
Upgrades and
additions
Rehabilitation,
renovations and
refurbishments
Maintenance and
repairs
Infrastructure
transfer
Current
Capital
Total
889 892
1 905 399
808 165
1 825 057
81 727
80 342
695 548
1 328 466
596 225
1 340 375
99 323
(11 909)
107
Part C: Governance
1. Introduction
Fraud and Corruption
2. Risk Management
The Department of Health adopted Premier David
Makhura’s Anti-Corruption Strategy which conÄrms
the province’s zero tolerance stances toward fraud
and corruption. Furthermore, the Department has its
own Fraud Prevention Plan. Forensic investigations
continued to be offered by the shared Forensic
Investigating Unit at the Department of Treasury.
Eighteen cases were investigated with Änancial
implications of R935 520.47.
The Risk Management Policy, Strategy and
Implementation Plan during the year under review was
circulated to all employees as part of the awareness
strategy.
Various channels for reporting allegations of fraud and
corruption exist, and these are described in detail in
the Anti-Corruption Strategy and the Departmental
Fraud Prevention Plan.
The Risk Management strategy also acknowledged
the importance of creating an environment of
honesty and openness where adverse incidents and
emerging risks are identiÄed quickly and dealt with in
a positive and responsive way. Other aspects of the
strategy dealt with reducing risks to employees and
stakeholders.
An Investigation and Integrity Management Directorate
has been established and fraud and corruption is
reported anonymously via managers, walk-ins or
telephonically. A dedicated email address has also
been created for reporting purposes. ConÄdentiality is
maintained at all times.
The Gauteng Department of Health (GDoH) is
committed to good corporate governance in its
delivery of healthcare services to members of the
public. The Department assures taxpayers that
systems have been implemented to utilise state
resources effectively, efÄciently and economically.
Since the implementation of the strategy, the Risk
Management Unit has successfully conducted 14 risk
assessments and 16 risk awareness/training in both
central ofÄce and the institutions.
The Strategic Risk Assessment Register/Handbook
was also developed in collaboration with Gauteng
Provincial Treasury (ERM) focused on understanding
the risks that the Department faces, identifying the
causes and developing control measures.
During the year under review, the Department
established a Risk Management Committee (RMC)
and appointed ofÄcials, including an external
chairperson to chair all the committee activities. To
this end, RMC meetings have been held and key
resolutions/key outcomes of the committees have
resulted in signiÄcant changes in the governance of
the Department.
Scheduled RMC meetings took place on a quarterly
basis, three meetings were held and the outcome
was reported to the audit committee by the external
chairperson.
The Department has made signiÄcant strides in the
improvement of the risk culture within the organisation.
During the year under review, the Risk Management
Unit was also capacitated to ensure a stronger culture
of risk management by appointing one Assistant
Director and one Administrative OfÄcer. In addition,
Risk Management Managers were appointed in some
of the institutions.
3. Minimising Conflict of
Interest
The Department complied with the full disclosure of
senior managers by the 30th April 2016.
4. Code of Conduct
Awareness sessions on the Public Service Code
of Conduct as well as Ethics in the Workplace are
held on a continuous basis. The Department has an
Integrity Management Policy that is in the process of
being rolled out.
5. Health Safety and
Environmental Issues
The Directorate of Healthcare Waste and
Occupational Hygiene Risk Management is
responsible for managing safety and many other
related statutory requirements by ensuring that the
Department is in compliance.
The Occupational Health and Safety Act states, inter
alia, that the Department must:
•
•
•
Provide for the health and safety of persons at work;
Provide for the health and safety of persons in
connection with the use of plants and machinery;
Protect persons other than persons at work
against hazards to health and safety arising out of
or in connection with activities at work.
109
•
Healthcare Waste management entails the effective
monitoring, evaluation, information, research and
policy development and reporting systems for the
health-care waste provincial tender.
Nature of Health and Safety Issues
•
•
•
Section 16 (1) of the Occupational Health and
Safety Act states that every Chief Executive OfÄcer
shall, as far as is reasonably practicable, ensure
that the duties of his employees are properly
discharged, and the head of any department shall
be deemed to be the chief executive.
Section 16 (1), which applies to the HOD, assigns
these powers and functions by written delegation
to section 16 (2) appointees. In the GDoH these
are the respective hospital CEOs, district and
facility managers, as well as other undeÄned
managers.
Healthcare Waste Management is based on
technical expertise and reporting of service failures
as well as a need analysis and development of
standard operating procedures where legislation
does not speciÄcally address a process or
handling of a category of risk waste.
Challenges
110
There are limitations in consultation with the health and
safety units by stakeholders involved in infrastructurerelated projects. When facilities are upgraded or new
facilities are built, occupational health and safety
requirements are not put in place as a prerequisite
for approval of work practices by the appointed
contractors and thus may compromise the health and
safety of GDoH employees, patients, visitors and the
employees of any contractors on site.
Health Care Waste Management (HCWM)
Behavioural management is dealt with on a daily basis
as most segregation actions are behaviourally based.
No hazard identiÄcation risk assessments and
inspections will be conducted at facility level as
required by the Act;
If no hazard identiÄcation risk assessments are
conducted, the Department cannot identify dangers
to which employees and others may be exposed in
their working environment and no control procedures
can be introduced and managed;
Medical surveillance would be a fruitless and expensive
exercise as the potential hazards would be unknown;
This could undoubtedly lead to high absenteeism
and low productivity; and facilities are at risk of noncompliance with the national building regulations and
there is a direct impact on emergency preparedness,
including Äre and evacuation drills.
Major funding is required for training and development
of new strategies to address behavioural change or
management.
None or late payment of contracted service providers
directly affects services rendered (service suspensions)
and none collection leads to inconveniences such as
odour, infection, exposure risks for both employees
and patients and the broader public.
Non-compliant main storage areas affect the progress
with the rollout to the durable system and contribute
to unauthorised risk waste access. Waste that cannot
be secured may lead to the spread of infections and
other environmental pollution issues.
Improper management of the general waste stream
leads to incorrect separation practices and an
increase in the generation of risk waste, which
negatively affects audit Ändings and allocated budget
for the management of healthcare risk waste.
None or late payment of contractors negatively affects
services rendered by contracted parties.
Main storage area – provision and poor standard of
build storage areas.
Implementation of general waste recycling practices.
Effects
When 16 (2) delegations are not signed, health and
safety representatives cannot be appointed;
6. Portfolio Committees
The following tables highlight matters discussed during Portfolio Committee meetings
Date of the
Meeting
Matters raised
How matters were addressed
28 May
2015
1. Areas where
the 58% over
expenditure was
incurred.
The area that incurred 58.6% over expenditure in the third quarter is
programme 1 due to the following:
2. The progress with
regards to setting
realistic and
attainable targets.
The reviews of
the target on
the availability
of medication in
the facilities as it
should be at 100%.
•
Computer services – This is as a result of the Department investing in
Health Information systems to digitalise and integrate health systems in
the form of V Block in different facilities.
•
Communications – The over-expenditure is incurred due to payment
of accruals from previous Änancial year.
•
Machinery and Equipment – Over expenditure incurred due to
purchases of medical and allied equipment for the various hospitals as
a Ministerial Directive during 2014/15, the orders were placed in the
previous Änancial year. However delivery and the payment thereof only
took place in the current Änancial year.
•
The raw material used in the manufacturing of pharmaceuticals known
as the Active Pharmaceutical Ingredient (API) is in short supply globally.
This has an impact on the manufacturing of pharmaceutical supplies in
volumes that will adequately and appropriately meet the global demand.
South Africa is not spared from this worldwide phenomenon.
•
As per resolutions taken at the 2013 International Summit on medicine
shortage hosted by the International Pharmaceutical Federation in
Toronto, Canada, each country should establish a publicly accessible
means of providing information on shortages. In other words, there is an
acceptance of the fact that there are medicine shortages. South Africa
responded to this international resolution by setting up a relevant site on
the NDoH website.
•
3. The alignment
of the budget
spent against the
targets achieved as
evidence of value
•
for money.
•
Overall, the Department has performed at 74%, which is slightly below
the target of 75% in the third quarter. However, the underachieved
target of 1% is across standard items and is mainly due to:
½ Transfer payments; provincialisation of West Rand EMS and
Re-alignment of HIV/AIDS business plan.
Payments for capital assets were due to accelerated investment to
procure medical and allied equipment for various health facilities and
re-alignment of Health Facility Revitalisation Grant.
Efforts are also being made to improve on performance information
integrity to ensure that accurate performance is reported. Although the
Department has been setting ambitious targets all along with the aim of
ensuring that services have a greater coverage, there are engagements
internally to also ensure that these ambitions are further supported by
available resources and strategies.
111
Date of the
Meeting
Matters raised
27 June
2015
4. What is the target
that is achieved to
deliver essential
medicines to
“collection points”
outside the clinic
because 70% is
delivered to the
clinic?
(http://www.doh.gov.za/docs/EDP/NationalMedicineShortagesCatalogue.pdf)
where medicine shortages in this country were listed. A promise was made to
update this list regularly but unfortunately this was not the case. This country is still
experiencing medicine shortages as experienced globally.
•
It is desirable to set the target for the availability of vital and essential
medicines at 100%. However, in light of the global limited access to
the API, a target of continuous availability at 100% is neither achievable
nor realistic. It is for this reason that the Department agreed on a target
of 99% although even 99% is difÄcult to maintain constantly. A more
realistic target would have been 98%.
The National Department of Health has deÄned these indicators as sector indicators
5. Why is the
and prescribes how they should be reported by sector departments and this
Department not
prescription Änds expression in the annual performance plans of departments.
consistent in
reporting targets
like chronic
diseases (DM and
hypertension) and
mental health? (that
is, numbers versus
percentages)?
21 August
2015
6. Measure in place
to decrease fatality
resulting from
malaria
The following are the measures put in place:
•
112
•
•
7. Interventions in
conjunction with
WBOT’s team in
order to trace TB
patients who do
not pitch for followup appointment
Continuous training of the following categories:
½ Doctors and Nurses
½ Environmental Health Practitioners
½ Outbreak Response Teams
½ Infection Prevention and Control
½ Health Promoters
½ Clinic Managers
½ Seminars conducted for all healthcare categories and presentations
done by malaria experts
Public awareness during events, radio slots and one to one interviews
during door to door visits, with emphasis on early healthcare seeking
behaviour especially after visiting a malaria endemic area.
Pharmaceuticals currently in the process of implementing the use of
I.V. Artesunate in hospitals. This is a drug of choice for the treatment of
severe malaria.
The Community Health Worker (CHW) is given a note by the facility nurse to give to
a patient who fails to pitch for follow-up treatment. The CHW also emphasises the
importance of treatment adherence. If a patient continues not to return to the clinic,
the team leader visits the patient to offer counselling.
Date of the
Meeting
Matters raised
27 August
2015
8. Overcrowding
compromises
safety and
predisposes
individuals to
health risks,
for example
tuberculosis and
sexual assaults and
so on.
•
DCS continues to address overcrowding
•
Provide condoms and post-exposure prophylaxis for sexual assaults
•
Continue supply of respirators for staff to improve ventilation
•
DoH in partnership with DCS continue to implement interventions for
better health outcomes including:
•
Embracing and ensuring that the 2020 UNAIDS vision and targets are
achieved, that is:
½ Screen the population including key population groups (vulnerable,
underserved, at risk) for TB.
½ Diagnose and initiate treatment of all people screened for TB.
½ Treatment success started on treatment through affordable services,
promoting adherence and social support.
Through health districts, DoH continues to provide oversight and
support to DCS.
•
24 October
2015
EMS Human
Resources
•
Total number of EMS staff
½ Operation staff = 1431
½ Corporate staff = 71
•
Posts Älled Jan-June 2015:½ ALS 7
½ BLS 10
½ ILS 23 (5 serving notice)
Current Challenges
and Associated
Budget Shortfalls
Budget
•
•
•
•
•
•
•
Infrastructure:
Only one purpose
built provincial
EMS station
(Embalenhle,
Orange Farm).
HR: OSD
limitations for
Advanced
Life Support
Paramedics (ALS)
and Emergency
Communication
Centre agents.
Vehicle Procurement
Approval obtained for 92 vehicles; vehicles currently at convertors;
estimated delivery December 2015.
Creation of new posts
•
Recruitment ongoing; currently shortlisting operational posts;
appointments to follow.
½ NECET Policy
•
Consolidated submission of Migration Plan will be done by NCEMS to
TEC NHC.
Provincialisation
•
West Rand is imminent as MOA is signed.
Referral System
Provincialisation
model in Gauteng. • All Metros and Districts (EMS included) are operationalising the
PricewaterhouseCoopers draft policy, as speciÄc area of work.
Referral system in
PIER
Gauteng Health.
PIER-Public
Information
Awareness
Education and
Relations
Access – roads
and house
numbers.
•
First responder training in communities.
Access
•
Pick-up points
•
Engagement with roads and transport
113
Date of the
Meeting
Matters raised
13
November
2015
9. The capacitation of
Human Resources
Management so
as to comply with
Regulation 1 of
the Public Service
Regulations.
Over and above these posts, the Infrastructure Management Unit capacity was
improved through appointments and Älling of the following positions: Chief Engineer:
Civil Structural, Chief Architect: Infrastructure Planning, Chief Architect: Programme
Delivery, Chief Quantity Surveyor: Programme Delivery, Chief Engineer: Mechanical
Infrastructure Planning, Chief Engineer: Electrical Infrastructure Planning.
10. The proper strict
compliance
with the Supply
Chain Processes
and Treasury
Regulations
and contract
management
that will ensure
improved supplier
performance.
114
11. The capacitation
of management
of the hospitals
on dealing with
legal cases from
inception stages.
•
Deputy Director Contract Management has been appointed.
•
Supplier performance monitored.
•
Contract register has been developed, monitored and updated.
•
A conference was held in November 2015 aimed at assisting clinicians
and nurses and to ensure ofÄcials comply with legislation, regulations
and standing orders.
•
Logistics Management has introduced a checklist to ensure all relevant
documentation is received and attached on SAP/SRM prior to the
creation of purchase orders and the invitation of quotations are semicentralised within the Acquisition Management Unit.
•
Supply Chain Management policy has been compiled.
•
SCM has continued with on-the-job training to all SCM ofÄcials.
•
Contract management unit established, contract management policy
has been approved and Deputy Director Contract Management has
been appointed.
•
Supplier performance monitored.
•
Contract register has been developed, monitored and updated.
The Department’s legal services, in collaboration with SAE unit, will regularly engage
with health facilities through continued workshops and conferences in responding to
litigation symptoms and develop strategies.
With speciÄc reference to Obstetrics and Gynaecology, the MEC sent a letter
to all hospital CEOs instructing all institutions to report all SAE occurring in their
institutions during patient care to Legal Services and Serious Adverse Events Unit
within 24 hours so that they involve legal services to assist in dispatching appropriate
advise to the hospital management before patients are discharged.
Legal Services Unit and Serious adverse events are meeting management to
discuss cases that have been received from attorneys and which show no prospect
of being successfully defended. Once the hospital management agrees that there
was negligence in the care of the patient, an approval is sought on whether to
compensate monetarily or by offering free care to correct the damage concerned.
The attorneys are approached and requested to consider mediation instead of
approaching courts.
Furthermore, a new consent form has been circulated and currently piloted, which
is more detailed and seeks to avoid situations where patients are given insufÄcient
information in the process of obtaining an informed consent for operation, which
could lead to them to sue the hospital later.
18th
February
2016
12. What is the
progress on the
projects that
have incurred
overspending
by 58% on
Administration?
Machinery and equipment (medical and allied equipment) was purchased from
this responsibility for various institutions as a Ministerial Directive during 2014/15.
However, delivery and payment thereof took place during 2015/16 Änancial year.
In addition, expenditure was incurred on computer services budget items to digitalise
patients records and integrate health systems in the form of V-BLOCK.
Date of the
Meeting
18th March
2016
18 April
2016
19 May
2016
Matters raised
13. What are the
Department’s
plans to ensure
that GPF speeds
up the process
to increase
dedicated School
Health nurses?
The Department submitted all relevant and required documents to GPF, and awaits
a response and recommendation from GPF. Based on the recommendation, the
Department then will develop a plan.
14. Progress in
implementing the
Nursing Strategy
2013/2017
Progress is as follows:
• Appointment of the acting Chief Nursing OfÄcer
• Appointment of three Directors and a Deputy Director
• Designation of Nursing Coordinators in all districts
• Gauteng Nursing Leaders Forum established; this forum is where nurse
managers in charge of hospitals and other services meet
• Public and private sector
• Hospitals, districts, military and correctional services, SA Blood Services
and so on
• Steering Committee
• This committee consists of senior nurses from hospitals, district nursing
and nursing colleges
• They started to implement the Nursing Strategy in all establishments
• Upgrading of nurse manager posts
• All four central hospitals had appointed directors by 2013
• Deputy Directors in tertiary hospitals
• Launching of the Nursing Values “I CARE 4U”
• Awareness campaigns to all health establishments, both public and
private, nursing colleges to adopt the values
• Gauteng Nurses Leaders Forum
• Sharing of best practices
• Nursing leadership – discussions and training as a standing item
• Cluster meetings – sharing of ideas
• Four hospital clusters that refer to central hospitals
• Cluster hospitals, clinics and colleges
15. What is the
progress on the
projects that
have incurred
overspending
by 58% on
administration?
•
Funds were shifted to the programme to alleviate the excess
overspending; however spending was also exacerbated by the payment
of accruals. The Department envisages shifting funds during the yearend virement process to be within the allocated budget.
16. What is the target •
that is achieved to
deliver essential
•
medicines to
‘collection points’
•
outside the clinic
because 70% is
delivered to the
clinic?
The CCMDD programme in Tshwane: As of December 2015, 40% of
the patients collect their chronic medication parcels at private sector
pharmacies.
In May 2015, 22.13% of patients collected their medication from
collection points and this has improved by 17.87% 40%.
The Department continues to register private sector collection points.
•
17. The matter
•
concerning the
Outstanding
Contract: Ward 1
and 2 (Psychiatric)
The contractor abandoned site due to contractual issues.
We will be re-scoping the works to enable the appointment of
replacement contractor to complete the project.
115
Date of the
Meeting
Matters raised
18. Completion of
Works Ward 1
and 2:
•
•
•
20. Attending of other
repair works
identiÄed during
the visit
•
•
The Process to Complete the Works (abandoned contract) has
commenced as follows:
Within GDoH the compilation of the scope of work to complete the two
wards has commenced to complete an updated Request for Service
The Request for Service will be sent to GDID for implementation once all
internal processes are completed; the planned date is 27 May 2016.
Both GDoH and GDID are investigating an alternative procurement and
funding process to appoint contractor within a period shorter than a
normal tender process.
The status of disrepair and conditions were discussed with GDID to
effect the required corrective works.
7. Scopa Resolutions
The following tables highlights matters discussed during SCOPA sitting:
Dates of the
Meeting
Matters Raised
How The Matters Were Addressed
14th October
2015
The Department’s readiness to attain
an unqualiÄed audit opinion with no
matters under compliance of laws
and regulations and predetermined
objectives.
The Department has implemented a plan to address
the qualiÄcation of accrued Departmental Revenue. The
Plan focuses on addressing all issues with regards to the
completeness of the opening balance for 2014/2015 by
31 December 2014. It is also targeting to address all issues
regarding Accrued Departmental revenue for the 2014/2015
Änancial year by 30 April 2015.
With regards to no Matters under compliance with laws and
regulations and predetermined objectives the Department
is planning to clear all non-compliance areas by 2016. The
Department has reduced the areas of non-compliance from
36 in 2010/2011 to 10 areas in 2013/2014.
116
Has the Department or any other
institution within the provincial
government instituted a review of
systems and procedures to prevent
or minimise such unauthorised
expenditure? If yes please give
details? If not why not?
In an effort to prevent unauthorised expenditure in future, the
Department has taken the following steps:
Budget allocation letters were issued to institutions, indicating
accruals and commitments, and emphasising compliance with
the Public Finance Management Act (PFMA);
The Department also submitted the In Year Monitoring on a
monthly basis to Treasury on Budget Performance.
An institutional In-year monitoring process has been instituted
that provides cost centres with feedback on a monthly basis in
terms of expenditure trends.
Why was there insufÄcient appropriate
evidence to determine whether
any adjustment to the accrued
Departmental revenue stated
at R625 535 000 in the Financial
statements was necessary?
Regardless of assurances given to
the Committee previously, the matters
have recurred. Provide the Committee
with the following:
The Department has implemented the following:
•
Trainings, workshops and revenue forums were held
with all hospitals;
•
Patient classiÄcation manual policy amended and
implemented; a revenue process manual was
developed and implemented
Dates of the
Meeting
Matters Raised
What is being done to rectify the 87%
system down time experienced during
the year under review?
All institutions on MEDICOM are having software upgrades
from version 2 to version 12 and MEDICOM has been installed
at Bheki Mlangeni and Thelle Mogoerane hospitals. Further,
a project has commenced to capture all patient records
electronically by 31 March 2015.
Recapturing of lost/crashed and downtime data project
commenced in November 2013 and is in progress.
A plan and tracking tool have been developed to monitor
recapturing of lost/crashed and down time data.
Corrective measures in place to
minimise future lawsuits where
possible
There is a Litigation Strategy is place, which is aimed at
addressing challenges experienced in the litigation process
and to reduce the high medical negligent claims.
Department has a perpetual issue with
compliance with section 40(1) of the
Public Finance Management Act. What
action will the MEC take to rectify this
matter?
The Department has put measures in place to address this
problem. Recently, there have been cases of theft opened with
the police as well as unethical conduct and fraud on the part
of law Ärms. Risk Management is now brought on board to
assist with further internal investigation to probe the element
of enticing patients to pursue cases against the department.
These strategies seek to address among others consequent
management where there is non-compliance with norms and
standards, shortage of equipment.
The following is being implemented:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Strengthening the SCM function
Alignment of SCM to the National Treasury Supply
Chain Management Framework Act
Establishing a contract management unit
Implement SCM Demand management plans
Establish terms contracts for non negotiable goods
and services for healthcare support
Management accountability
Monitoring payment of suppliers within 30 days
Pre payment of accruals with an intention of clearing
them
Supplier reconciliations are done monthly- PWC
will be training institutions on the format of supplier
recons as performed at Central OfÄce;
BAS/Persal recons are done monthly;
Bank reconciliations are performed on a daily/
monthly basis
The General Ledger of the department is also
reconciled in conjunction with the Provincial
Treasury on daily basis.
Records are maintained and availed for audit
purposes on all the above reconciliations
There was a correction of error relating to prior year,
hence the restatement of corresponding Ägures.
The error emanated from building improvements
that were incorrectly capitalised to the cost of
Property Plant and Equipment when they should
have been expensed in the statement of Änancial
performance. Also, there was an error in the
presentation and disclosure of the cash Åow
statement.
117
Dates of the
Meeting
Matters Raised
Implementation of controls over
daily and monthly processing and
reconciliations.
Supplier reconciliations are done monthly- PWC will be
training institutions on the format of supplier recons as
performed at Head ofÄce.
BAS/MEDSAS recons are done monthly.
Bank reconciliations are performed on a daily/monthly basis.
Provide reasons why corresponding
Ägures for the Änancial year ending 31
March 2014 were restated?
The misstatements were as a result of irregular expenditure
that was incurred at the Department of Health level relating
to the Medical Supplies Depot which was erroneously not
disclosed in the annual Änancial statements of the Medical
Supplies Depot.
The General Ledger of the depot is also reconciled in
conjunction with the Provincial Treasury on a monthly basis.
Records are maintained and availed for audit purposes on all
the above reconciliations.
11 March 2016
Additional information on the
unauthorised expenditure 2011/12 and
2012/2013 FY on:
•
Outpatient Department (OPD)
and Expenditure per Patientday Equivalent (PDE)
•
Employee analysis
•
Accrual analysis and detail
breakdown of Unauthorised
expenditure per
118
•
•
•
The Expenditure per Patient-day Equivalent (PDE)
for Gauteng hospitals is consistently higher than
the target set out in the Gauteng Province APP.
The majority of hospitals in Gauteng have real
expenditure per PDE above the national average.
•
Consistent with its role, the highest Expenditure
PDE is for central hospitals.
•
The highest Expenditure per PDE was observed
during the 2012/2013.
•
The is a year on year increase in the Outpatient
department head count due to increased number of
patient treated at facilities.
Extract from SLA with
Municipalities for EMS services The Department did not conduct any investigations
with regards to the unauthorised expenditure due to the
Original Presentation
following:
•
Unauthorised Expenditure that was incurred with
regards to Compensation of Employees were in
relation to the implementation of the Occupation
SpeciÄc Dispensation that was negotiated through
the Bargaining Council to ensure the retention of
qualiÄed Professionals. The cost of implementation
exceeded the budget allocation. Due to this, the
Department did not do any investigation or followed
any process to hold ofÄcials responsible or to
recover any funds.
•
Unauthorised expenditure that was incurred with
regards to accruals was due to the pressure with
regards to ensuring the continuous rendering of
Healthcare services. It is difÄcult to determine
whether the Department is properly funded or not,
based on the fact that Gauteng services patients
from other provinces and outside of the country.
5 – 6 Maternity patients being treated in Gauteng
facilities is Foreign patients. Based on our country
being a democratic society as enshrined in the
Constitution, Healthcare is a right whether you
are a South African citizen or not. Under such
circumstances the likelihood on curbing over
expenditure on Goods and services seems remote.
Dates of the
Meeting
Matters Raised
The Department did not conduct any investigations
with regards to the unauthorised expenditure due to the
following:
There are cases that relate to over-expenditure during this
period under scrutiny that has been under investigations by
Special Investigations Unit (SIU). These asses were referred
under the Presidential Proclamation and therefore the
Department may not be privy to the status and outcome.
8. Prior Modifications to Audit Reports
Include a discussion on mechanisms put in place by
the Accounting OfÄcer to resolve the matters reported
by the AGSA in the previous Änancial year. This should
include all matters in the audit report and those noted
as important in the management report.
The discussion should be limited to all matters that
gave rise to a qualiÄcation, disclaimer, adverse opinion
and matters of non-compliance only. The Department
may include the information in a table as follows:
Nature of qualiÄcation,
disclaimer, adverse opinion
and matters of noncompliance
Financial
year in
which it
Ärst arose
Progress made in clearing/resolving the matter
Interest was not charged on
debts as required by treasury
regulation 11.5.1.
2013/2014
National Health has requested exemption for charging of interest for H0, H1
and H2 categories of patients.
The Department will commence with charging of interest to self-paying patients
(H3) effective immediately.
The process for implementation of charging of interest to be discussed with
Treasury for guidance and concurrence
Effective and appropriate steps 2013/2014
were not taken to collect all
money due, as required by
section 38(1)(c)(i) of the PFMA
and treasury regulation 11.2.1,
15.10.1.2(a) and 15.10.1.2(e).
The following measures to be implemented
• Centralisation of debt management for effective management and
collection
• MoUs to be concluded with all departments and Provinces
referring patients to GDOH
• Debt collecting company appointed for self-paying patients
• Public servants identiÄed from self-paying patients and
implementing persal deductions
• Monthly meetings to be held with all departments and provinces
owing GDOH to follow up on payments
• Payment plans signed with all funders
• Alexander forbes appointed for RAF claims collection
• Medikredit appointed for medical aid claims collections
EOH appointed for Injury on duty claims.
Goods and services of a
2013/2014
transaction value above R500
000 were procured without
inviting competitive bids, as
required by treasury regulation
16A6.1. Deviations were
approved by the accounting
ofÄcer even though it was not
impractical to invite competitive
bids, in contravention of
treasury regulation 16A6.4.
Management will ensure that control measures are implemented to comply
with Treasury Regulations and Instruction notes relating to deviations from the
normal procurement processes. Management will implement the following;
• Approval to be obtained from HOD
• Investigation of Irregular Expenditure
• Report to the Provincial Treasury
• Adjust the irregular expenditure amount in the AFS
• Consequence Management (If applicable)
• Ensure that bids are awarded within the validity period to avoid
extension of contracts.
119
120
Financial
year in
which it
Ärst arose
SufÄcient appropriate audit
evidence could not be
obtained that goods and
services with a transaction
value below R500 000
were procured by means of
obtaining the required price
quotations, as required by
treasury regulation 16A6.1
2013/2014
To ensure compliance with supply chain processes when procuring
consignment stock, the department will adjudicate and award the consignment
stock tender before 30 September 2016.
Financial
year in
which it
Ärst arose
Contractual obligations
and money owed by the
department were not settled
within 30 days, as required by
section 38(1)(f) of the PFMA
and treasury regulation 8.2.3.
2012/2013
The following will be implemented in order to ensure compliance;
• Daily Monitoring of Webcycles.
• CFO’s Änance and supply chain management forum to ensure
clearing of all the exceptions on time.
• Centralised point for submission of invoices.
• Monthly supplier reconciliations and following up on reconciling
items.
• Encouraging suppliers to move to E-invoicing.
• Creation of Purchase Orders for all items except those that meet
the deÄnition of sundry.
Finalisation of tender for consignment stock.
All supply chain payments to be paid via procure to pay and not through
sundry payment.
Effective steps were not taken 2013/2014
to prevent irregular and fruitless
and wasteful expenditure,
amounting to R493 155 000
and R7 433 000 respectively,
as disclosed in notes 26 and
27 of the annual Änancial
statements, as required by
section 38(1)(c)(ii) of the PFMA
and treasury regulation 9.1.1.
•
•
Improved controls and monitoring of stock
Payment within 30 days
9. Internal Control Unit
Internal Control (ICC) unit is responsible for coordinating the implementation of effective internal
control and compliance framework towards clean audit
and sound governance. Management is deemed to
own the controls and other lines of defence (including
internal control unit) to help ensure their application
and viability. We have developed an Internal Control
Policy as part of the compliance framework. This
policy sets out key internal control objectives and
principles for the Department as well as duties of the
Accounting Authority, Risk and Audit Committees,
Management and Staff, Risk Management and
Internal Control Unit, Internal Audit (Gauteng Audit
Services), External Audit (Auditor-General) and other
internal control units within the Department.
During the year under review, the Internal Control
Unit focused on audit issues, that is revenue and
contingent liability matters as reported by the AuditorGeneral in July 2015. An area of concern was the
Änancial/operational performance of the institutions
and instances of its PFMA non-compliance in relation
to old debts. Ensuring compliance is ongoing and is
closely monitored. All new debts will be compliant
with the requirements of the PFMA.
The Internal Control Unit continuously conducts
assessments and trains staff during the year and
recommendations are made to management at
the institutions to ensure ongoing compliance with
policies and procedures to achieve its goals.
10. Internal Audit and Audit Committees
•
½
The Department uses the services of a shared
provincial audit function, the Gauteng Audit
Services (GAS). GAS has completed the
following audits during the year under review
and management has developed action plans to
implement the recommendations.
½
½
½
Audits conducted during the 2015/2016 financial
year.
•
Risk and compliance
½ Compliance Audit on Occupational Health and
Safety at Thelle Mogoerane Regional Hospital
½ Internal Audit report: EMS
½ Revenue Management at Kalafong
½ Internal Audit Report: Litigation
½ Internal Audit Report: Risk Management
½ Internal Audit Report: Corporate
Governance
½ Review on the Implementation of National
Treasury: Cost Containment measures Q2
½ Follow-up Audit on AGSA Ändings at Helen
Joseph Hospital
½ Follow-up Audit on AGSA Ändings at Tambo
Memorial Hospital
½ Follow-up on Quality Assurance at Helen
Joseph Hospital
½
½
½
½
½
Follow-up on SigniÄcant Ändings for Q2 at
Asset Management Review at MSD
CertiÄcation of the 2015 management review
assessment tool (MPAT I.S) –Advisory only
Follow-up Audit on SigniÄcant Ändings
Q1(Edenvale
Hospital;
JHB
Regional
Pharmacy & Lillian Ngoyi CHC
Quality Assurance at Dr. Yusuf Dadoo Hospital
Financial Interim Statements Q2 at MSD
Financial Statement Q2-Advisory only
Follow-up on AGSA Ändings at Ekurhuleni
District
Follow-up Audit on AGSA Ändings at ODI
District Hospital
•
Computer Audits
½ Information Technology Governance Review
•
Performance Audit
Performance Audit on the Quality of Healthcare
Services at Dr George Mukhari Academic Hospital
Key activities and objectives of the audit committee
Attendance of audit committee meetings by audit
committee members (Tabular form)
The table below discloses relevant information on the audit committee members:
Cluster
03 Audit
Committee
Members
Name
QualiÄcations
Lungelwa
Sonqishe
•
Precious Sibiya
•
•
•
•
•
Japie du Plessis
•
•
Internal or If internal,
external position
in the
department
Date appointed
Date
Resigned
No. of Meetings
attended
B.Com. Accounting External
Science
MBA
CertiÄcate in
Governance
-
01 September 2010 Current
•
05 Ordinary
Meetings,
Chartered
Accountant (SA)
B. Accounting
Postgraduate
Diploma in
Accountancy
External
-
10 October 2014
•
05 Ordinary
Meetings,
National Diploma:
State Accounting
and Finance
Registered
Government
Auditor;
External
-
01 November 2015 Also
•
serve as a
Chairperson
of Cluster
02.
04 Ordinary
Meetings.
Current
121
11. Report of the Audit Committee – Cluster 03
We are pleased to present our report for the Änancial
year ended 31 March 2016.
Audit Committee and Attendance
The Audit Committee consists of the external Members
listed hereunder and is required to meet a minimum of
at least two times per annum as per provisions of the
Public Finance Management Act (PFMA). In terms of the
approved Terms of Reference (GPG Audit Committee
Charter), Äve meetings were held during the current
year, that is three meetings to consider the Quarterly
Performance Reporting (Änancial and non-Änancial)
and two meetings to review and discuss the Annual
Financial Statements and the Auditor-General of South
Africa’s (AGSA) Audit and Management Reports.
Non-Executive Members
Name of Member
Lungelwa Sonqishe
122
Number of Meetings
attended
05
Precious Sibiya
05
Japie du Plessis
04
Executive Members
In terms of the GPG Audit Committee Charter, ofÄcials
listed hereunder are obliged to attend meetings of the
Audit Committee:
Compulsory Attendees
Number of Meetings
Attended
Ephraim Selebano
(Accounting OfÄcer)
05
George Mahlangu
(Chief Financial OfÄcer)
03
Johann Strauss
(Chief Risk OfÄcer)
05
The Audit Committee noted that the Chief Financial
OfÄcer attended three (03) of the Äve (05) scheduled
Audit Committee meetings. Therefore, the Audit
Committee is satisÄed that the Department adhered to
the provisions of the GPG Audit Committee Charter in
relation to ensuring that there is proper representation
for the Chief Financial OfÄcer.
The Members of the Audit Committee met with the
Senior Management of the Department, Internal Audit
and Auditor-General collectively to address risks
and challenges facing the Department. A number of
in-committee meetings were held to address control
weaknesses and deviations within the Department.
Audit Committee Responsibility
The Audit Committee reports that it has complied
with its responsibilities arising from section 38(1)(a)
of the PFMA and Treasury Regulation 3.1.13. The
Audit Committee also reports that it has adopted
appropriate formal terms of reference as its Audit
Committee Charter, has regulated its affairs in
compliance with this Charter and has discharged all
its responsibilities as contained therein.
The effectiveness of internal control and Information
and Communication Technology (ICT) Governance
In line with the PFMA and the recommendations
from King III Report on Corporate Governance
requirements, Internal Audit provides the Audit
Committee and Management with assurance that
the internal controls are appropriate and effective.
This is achieved by means of the risk management
process, as well as the identiÄcation of corrective
actions and suggested enhancements to the
controls and processes. The Audit Committee has
observed that the overall control environment of the
Department has continued to improve during the
year under review. Some deÄciencies in the system
of internal control and deviations were reported in the
Internal Audit Reports. To improve the overall control
environment, the Department should put more effort
in implementing the agreed action plans to address
the previously reported audit Ändings.
The Audit Committee also reviewed the progress
with respect to the ICT Governance in line with the
ICT Framework issued by the Department of Public
Service and Administration. Although there were
some signiÄcant progress on the ICT internal control,
the Audit Committee report its dissatisfaction with
minimal progress made with the implementation of
the ICT Governance. This continued to be a high risk
for the Department.
The Audit Committee reports that the following most
signiÄcant issues within the Department should
receive ongoing attention for effective operational and
Änancial management:
• IT Governance
• Risk Management
• Stock management
• Revenue management
• Supply chain management
• Internal Audit
The Audit Committee is satisÄed that the Internal
Audit plan represents a clear alignment with the key
risks, has adequate information systems coverage,
and a good balance across the different categories
of audits, i.e. risk-based, mandatory, performance,
computer and follow-up audits.
The Audit Committee has noted considerable
improvement in the communication between the
Executive Management, the AGSA and the Internal
Audit Function, which has strengthened the Corporate
Governance initiatives within the Department.
The Audit Committee is satisÄed with the content
and quality of quarterly reports prepared and issued
by Internal Audit for the Department during the year
under review. The Audit Committee wishes to stress
that in order for the Internal Audit Function to operate
at optimal level as expected by the Audit Committee,
the shortage in human resources and skills should
be addressed. The Department has since appointed
a new Chief Audit Executive to give stability and
leadership in the department.
Risk Management
Progress on the Departmental risk management was
reported to the Audit Committee on a quarterly basis.
The Audit Committee is partially satisÄed that the actual
management of risk is receiving attention and that
there are still a lot of areas that require improvement
Management should take full responsibility for the
entire Enterprise Risk Management process. The
Audit Committee noted that the Risk Management
Committee meetings were not held regularly. The
Department has since appointed an independent
Chairperson of the Risk Management Committee to
assist the Department with capacitation, coaching
and improving the current risk management status.
Senior Management’s commitment remains vital for
the successful implementation of risk management to
improve the overall performance of the Department.
quality of Änancial and non-Änancial quarterly reports
prepared and submitted by the Accounting OfÄcer
of the Department during the year under review and
conÄrms that the reports were in compliance with the
statutory reporting framework.
Evaluation of Annual Financial
Statements
The Audit Committee has:
• Reviewed and discussed the audited Annual
Financial Statements to be included in the Annual
Report, with the AGSA and the Accounting OfÄcer;
• Reviewed the Audit Report of the AGSA;
• Reviewed the AGSA’s Management Report and
Management’s response thereto;
• Reviewed the Department’s compliance with legal
and regulatory provisions; and
• Reviewed signiÄcant adjustments resulting from
the audit.
The Audit Committee concurs with and accepts
the AGSA’s conclusions on the Annual Financial
Statements, and is of the opinion that the audited
Annual Financial Statements be accepted and read
together with the report of the AGSA.
One-on-One Meeting with the
Accounting OfÄcer
The Audit Committee has met with the Accounting
OfÄcer for the Department to address unresolved
issues.
One-on-One Meetings with the
Executive Authority
The Audit Committee has met with the Executive
Authority for the Department to apprise the MEC on
the performance of the Department.
Forensic Investigations
Auditor-General of South Africa
Investigations into alleged Änancial irregularities,
Änancial misconduct and fraud were completed
during the year under review. Various measures
were recommended, including taking action against
the identiÄed ofÄcials and this was in the process
of Änalisation. The recommendations are at various
stages of implementation.
The Audit Committee has met with the AGSA to
The quality of quarterly reports submitted in terms of
the PFMA and the Division of Revenue Act
The Audit Committee is satisÄed with the content and
ensure that there are no unresolved issues.
Ms. Lungelwa Sonqishe
Chairperson of the Audit Committee
Date: 31 July 2016
123
Section D: Human Resource Management
1. Introduction
The Gauteng Department of Health (GDoH) currently
had approximately 64 261 Älled positions by the end
of March 2016. This Ägure includes both full-time
and part-time employees. The projected demand in
the province is well over the amount allocated to Äll
the posts. To address nursing shortages, provincial
nursing colleges have doubled their intakes for
professional nurse training, with the re-opened two
colleges having been previously closed.
2. Overview of Human Resources
Human resource priorities for the year under review and the impact of these
Key Programmes
Impact
1. Health infrastructure
•
Hospital revitalisation and health technology
•
R829 604 000 HPTDG funding increase was distributed across the four clusters,
beneÄting from academic hospitals to district hospitals within the clusters.
•
532 health professionals are paid out of the R359 496 000 allocated for
compensation of employees.
•
More training equipment will be purchased from R41 482 000 allocated for the capital
and equipment budget.
•
Training of interns commenced in November 2014 and was completed in May 2015.
Interns were absorbed into posts.
•
The four major legs of Human Resources – labour relations, organisational
development, human resource development and human resources management –
were integrated for improvement of organisational performance.
•
By the end of the second quarter, the GDoH had trained 107 managers on various
management development programmes. 35 Managers were funded to attend the
Lean Management Conference. 19 Managers attended the Operational Health
Managers’ Conference
2. Creating the effective
organisation
3. Improve performance
against National Core
Standards
4. Youth Empowerment
5. Modernisation
•
By the end of the second quarter, the GDoH had trained 1 810 staff members in
various functional and generic skills programmes, including a new development
programme for the Secretariat, personal assistants and secretaries.
•
Emotional Intelligence and Customer Care Intervention Programme planned to
commence in November 2015 in order to improve patient experience
•
415 youth participated in learnerships. This includes clinical and non-clinical
learnerships such as Radiography, Nursing, and Pharmacist Assistant.
•
820 learners participated in various internship programmes. This includes Clinical and
Non-clinical Internships: Nursing, legal, ICT and general administration.
•
The Employee Self Service on leave management is now established and is being
used by all staff at Central OfÄce.
•
Planning around the roll-out of the Payroll CertiÄcate as part of the ESS System for
Central OfÄce has commenced
•
•
•
•
•
Increased number of registrars in intake with
Service Improvement Needs.
Improved coordination and management of
Training Grant from R811 million to R865 million.
Human Resource Planning
Completed the Organisational Structure and
ensued alignment of the structure to the Äve-year
strategy of the Department.
Addressed all the concerns in the Turnaround
Strategy, including management CoE Expenditure
and reduced utilisation of commuted overtime
and general overtime.
•
•
•
•
•
•
Appointed clinical engineers and raised funding for
their workplace experimental learning. Complied
with the Department of Labour and submitted a
Skills Plan and Employment Equity Plan.
SigniÄcantly reduced Auditor-General Findings in
Central OfÄce and in various institutions.
Filled posts in senior executive management and
hospital CEOs.
Implementation of WISN in the Districts was
completed.
Implementation of Employee Self Service on leave
management.
Completed the Staff Satisfaction Survey covering
more than 10% of the total staff complement.
125
Employee performance management;
During the year under review, there was signiÄcant
improvement in the timeous signing of Performance
Agreements by members of Senior Management
Services (SMS). We have managed to have 100%
compliance.
Highlight achievements and challenges faced by
the Department, as well as future human resource
plans /goals.
The biggest challenge is the retention of health
professionals. The Department still experiences a high
attrition rate of the health professionals despite the
introduction of Occupational SpeciÄc Dispensation.
The introduction of the OSD managed to reduce the
attrition just over a few years after its introduction but
private institutions have also improved their salary
structures, making it hard for the Department to retain
its health professionals seeking greener pastures.
3. Human Resources
Oversight Statistics
The tables below reÅects an overview of Human
Resources Patterns for the Änancial year 2015/16
3.1
Personnel related expenditure
The following tables summarises the Änal audited
personnel related expenditure by programme and by
salary bands. In particular, it provides an indication of
the following:
• amount spent on personnel
• amount spent on salaries, overtime, homeowner’s
allowances and medical aid.
Table 3.1.1: Personnel expenditure by programme for the period 1 April 2015 and 31 March 2016
Programme
Total
Personnel
Training Professional
Expenditure Expenditure Expenditure
and
Special
Services
(R’000)
126
1. Administration
2. District Health Services
3. Emergency Medical Services
4. Provincial Hospital Services
(R’000)
(R’000)
(R’000)
Personnel Employment
costs as
(b)
percent of
Total
Expenditure
(R’000)
807 358
324 030
3 431
26 301
40%
1882
11 075 547
5 799 772
12 230
10 824
52%
19330
940 319
388 834
31
0
41%
1621
6 432 065
4 722 697
616
24 017
73%
19841
12 582 282
8 584 959
914
37 190
68%
19179
6. Health Sciences and Training
938 834
675 562
6 310
149
72%
4135
7. Health Care Support
Services
223 499
140 147
31
0
63%
947
1 864 651
11 999
3 161
0
1%
33
5. Central Hospital Services
8. Health Facilities
Management
- HWSETA Accounts
0
*
0
Medsas Trading Account
0
*
0
59,22%
66 968
Total
34 864 555
20 648 000
26 724
98 481
Notes:
a. Financial data extracted from Basic Accounting System (BAS).
•Personnel numbers extracted from the PERSAL system
b. Employment = employees as 31 March 2015 on the PERSAL System.
c. Special function: amount written off.
d. Report compiled by the Directorate Management Accounting
e. Training expenditure is derived from level 4 SCOA item - Training and development
f. Professional Services is derived from revised level 4 SCOA item - CONS/PROF:BUSINESS&ADVISORY SERV and including Agency: Nursing staff, professional
staff, researcher, admin and support staff and personnel and labour
Table 3.1.2 Personnel costs by salary band for the period 1 April 2015 to 31 March 2016
Salary band
Personnel
expenditure
% of total
Personnel
costs
no of
employees
Average
Personnel
costs per
employee
(R’000)
Lower skilled (Levels 1-2)
(R’000)
895 130
4.4
7 118
125 755.8
Skilled (Levels 3-5)
4 955 433
24.1
27 670
179 090.5
Highly skilled production (Levels 6-8)
3 927 459
19.1
14 329
274 091.6
Highly skilled supervision (Levels 9-12)
6 041 720
29.4
12 262
492 719.0
Senior and top management (Levels 13-16)
2 158 028
10.5
99
21 798 262.6
418
0.0
4
104 500.0
Contract (Levels 1-2)
Contract (Level 3-5)
11 170
0.1
71
157 323.9
213 908
1.0
704
303 846.6
2 045 645
9.9
3 047
671 363.6
129 671
0.6
18
7 203 944.4
Periodical remuneration
172 931
0.8
722
239 516.6
Abnormal appointment
21 512
0.1
924
23 281.4
20 573 025
100
66 968
307 206.8
Total
Source: Vulindlela
Notes:
a. Number of employees in the table refers to a head count of current employees on Persal
b. Total personnel costs recorded in this table differ from those in Table 3.1.3 as the data sources differ (i.e., Basic Accounting System – BAS – and Vulindlela). The
BAS system does not cater for salary bands, but for expenditure per item
Table 3.1.3: Salaries, Overtime, Home Owners’ Allowance and Medical Aid by programme for the
period 1 April 2015 and 31 March 2016
Programme
Salaries
(R’000)
Total
HOA
HOA as Medical Medical
Salaries Overtime Overtime
Ass.
Ass. as % personnel
% of
(R’000)
as % of (R’000)
as % of
cost (R’000)
of
Personnel (R’000)
Personnel
Personnel
Personnel
costs
costs
costs
costs
1. Administration
303 082
94%
2 575
2. District Health
Services
5 088 821
88%
254 727
3. Emergency
Medical Services
329 695
85%
11 455
4. Provincial
Hospital Services
4 000 067
85%
375 999
5. Central
Hospitals Services
7 163 518
83%
896 868
6. Health Siences
and Training
607 421
90%
898
0%
7. Health Care
Support Services
108 504
77%
8 174
8. Health Facilities
Management
11 358
95%
14
- HWSETA
Accounts
Total
1%
6 805
11 568
4%
324 030
4% 194 641
3% 261 581
5%
5 799 771
3%
5%
29 632
8%
388 834
8% 153 006
3% 193 626
4%
4 722 697
10% 239 279
3% 285 293
3%
8 584 959
37 854
6%
29 390
4%
675 562
6%
10 630
8%
12 839
9%
140 147
0%
203
2%
425
4%
12 000
0%
0%
0
3% 824 354
4% 20 648 000
18 052
0,00%
17 612 466
127
85% 1 550 710
8% 660 470
2%
Notes:
a. Data extracted from Basic Accounting System (BAS).
b. Total Personnel Cost on this table differ form Table (2.2) as the data source differ (i.e. BAS and Vulindlela). BAS does not cater for salary bands, but expenditure
per item.
c. Salaries include all the compensation of employees items excluding overtime, houisng allowance and employer medical aid
Table 3.1.4: Salaries, Overtime, Home Owners’ Allowance and Medical Aid by salary band for the
period 1 April 2015 to 31 March 2016
Salary
bands
Salaries
Amount
Overtime
Salaries as
a % of
personnel
costs
(R’000)
Lower skilled
(Levels 1-2)
Amount
Home Owners
Allowance
Overtime
as
a % of
personnel
costs
(R’000)
Amount
HOA as
a % of
personnel
costs
(R’000)
Medical Aid
Amount
(R’000)
Medical
aid as
a % of
personnel
costs
(R’000)
573 776
60.7
11 990
1.3
82 396
8.7%
58 943
6.2%
Skilled
(Level 3-5)
3 332 317
92.3
83 634
2.3
327 907
9.1%
273 998
7.6%
Highly skilled
production
(Levels 6-8)
2 993 350
103.8
66 375
2.3
64 580
2.2%
175 359
6.1%
Highly skilled
supervision
(Levels 9-12)
5 941 874
91.2
893 356
13.7
127 218
2.0%
128 667
2.0%
Senior
and Top
management
(Levels
13 -16)
1 512 682
119.1
493 492
38.9
6 274
0.5%
14 932
1.2%
14 353 999
94.3
1 548 847
10%
608 375
4.0%
651 899
4.3%
Total
Source: Vulindlela
128
3.2
Employment and vacancies
The tables in this section summarise the position with regard to employment and vacancies.
The following tables summarise the number of posts in the establishment, the number of employees, the
vacancy rate and whether any staff are additional to the establishment.
The information is presented in terms of three key variables:
• programme
• salary band
• critical occupations (see deÄnition in notes below)
Departments have identiÄed critical occupations that need to be monitored. In terms of current regulations, it is
possible to create a post in the establishment that can be occupied by more than one employee. Therefore, the
vacancy rate reÅects the percentage of vacant posts.
Table 3.2.1: Employment and vacancies by programme as at 31 March 2016
Programme
Number
of posts on
approved
establishment
1. Health administration
Number of
posts Älled
Vacancy
Rate
Number of posts
Älled additional to
the establishment
1215
991
18.4%
0
21 706
19 029
12.3%
0
1688
1617
4.2%
0
4. Provincial health service
21 050
19 463
7.5%
0
5. Central hospital services
21 100
18 965
10.1%
0
6. Health sciences
5 336
4 073
23.7%
0
7. Healthcare support services
1 051
947
9.9%
0
53
33
37.7%
0
73 199
65 118
11.0%
0
2. District health services
3. Emergency medical services
8. Health facility management
Total
Notes:
a. Data was extracted from PERSAL (Establishment Report) as end March 2016
b. The Vacant posts include (1 frozen posts)
Table 3.2.2: Employment and vacancies by salary band as at 31 March 2016
Salary Band
Description
Number
of posts on
approved
establishment
1. Lower skilled (Levels 1 – 2)
Number of
posts Älled
Vacancy
Rate
Number of employees
additional to
the establishment
8 331
7 757
6.9%
0
2. Skilled (Levels 3 – 5)
30 394
26 971
11.3%
0
3. High skilled production
(Levels 6 – 8)
17 702
15 648
11.6%
0
4. Highly skilled supervision
(Levels 9 – 12)
16 629
14 632
12.0%
0
143
110
23.1%
0
73 199
65 118
11.0%
0
5. Senior management
(Levels 13 – 16)
Total
Note:
a. Data was extracted from PERSAL (Establishment Report) as end March 2016
b. The Vacant posts include (1 frozen posts)
129
Table 3.2.3 Employment and vacancies by critical occupations as at 31 March 2016
Critical occupation
Number
of posts on
approved
establishment
Number of
posts Älled
Vacancy
Rate
Number of
employees
additional to
the establishment
Dental practitioner
263
233
11.4%
0
Dental specialist
151
135
10.6%
0
Medical practitioner
2 656
2 249
15.3%
0
Medical practitioner (intern)
1 013
934
7.8%
0
Medical specialist
2 569
2 322
9.6%
0
Emergency care practitioner
1 583
1 511
4.5%
0
Pharmacist
584
504
13.7%
0
Pharmacist (intern)
99
74
25.3%
0
Professional nurse
15 992
14 160
11.5%
0
Staff nurse
7 901
6 952
12.0%
0
Nursing assistant
7 490
7 033
6.1%
0
Professional nurse (student)
4 614
3 401
26.3%
0
44 915
39 508
12.0%
0
Total
Note:
Data was extracted from PERSAL (Establishment Report) as end March 2016
This report reÅects the number of critical posts as they appear on the Establishment
3.3
130
Filling of Senior Management Service (SMS) Posts
The tables in this section provide information on employment and vacancies as they relate to members of the
Senior Management Service by salary level. It also provides information on advertising and Älling of SMS posts,
reasons for not complying with prescribed timeframes and disciplinary steps taken.
Table 3.3.1 SMS post information as at 31 March 2016
SMS Level
Total number
of funded SMS
posts
Total number
of SMS posts
Älled
% of SMS
posts Älled
Total number
of SMS posts
vacant
% of SMS
posts vacant
Director-General/Head of
Department
1
1
100%
0
0%
Salary Level 16
1
1
100%
0
0%
Salary Level 15
9
8
89%
1
11%
Salary Level 14
32
25
78%
7
22%
Salary Level 13
Total
89
75
84%
14
16%
132
110
83%
22
17%
Table 3.3.2 SMS post information as at 30 September 2016
SMS Level
Total number
of funded SMS
posts
Total number
of SMS posts
Älled
% of SMS
posts Älled
Total number
of SMS posts
vacant
% of SMS
posts vacant
Department
1
1
100%
0
0%
Salary Level 16
1
1
100%
0
0%
Salary Level 15
9
7
78%
2
22%
Salary Level 14
31
26
84%
5
16%
Salary Level 13
93
78
84%
15
16%
135
113
84%
22
16%
Total
Table 3.3.3 Advertising and filling of SMS posts for the period 1 April 2015 to 31 March 2016
SMS Level
Total number
of funded SMS
posts
Total number
of SMS posts
Älled
% of SMS
posts Älled
Total number
of SMS posts
vacant
% of SMS
posts vacant
Department
1
1
0
100%
0
Salary Level 16
1
1
0
100%
0
Salary Level 15
9
8
2
89%
1
Salary Level 14
32
25
7
78%
7
Salary Level 13
89
75
11
84%
14
132
110
20
83%
22
Total
Table 3.3.4 Reasons for not having complied with the filling of funded vacant SMS – Advertised within
6 months and filled within 12 months after becoming vacant for the period 1 April 2015 to
31 March 2016
Reasons for vacancies not advertised within six months
Most of the newly-vacated positions are advertised within six months of being vacated.
Reasons for vacancies not Älled within six months
The recruitment and retention of suitably qualiÄed employees/skills in critical positions is a serious challenge due to the skills not
readily being available and has an impact on the turnaround times.
Table 3.3.5 Disciplinary steps taken for not complying with the prescribed timeframes for filling SMS
posts within 12 months for the period 1 April 2015 to 31 March 2016
Reasons for vacancies not advertised within six months
The majority are advertised within six months. Some delays are due to reasons such as Financial constraints.
Reasons for vacancies not Älled within six months
Delay by line Manager to undertake the recruitment process.
Meeting of gender and disability targets.
Successful candidate being retained (counter offered) by their Department therefore prolonging the recruitment process and
having to head hunt or re advertise positions.
131
3.4
Job Evaluation
Within a nationally determined framework, an
executing authority may evaluate or re-evaluate
any job in his or her organisation. In terms of the
regulations, all vacancies on salary level 9 and higher
must be evaluated before they are Älled. The following
table summarises the number of jobs that were
evaluated during the year under review. The table also
provides statistics of the number of posts that were
upgraded or downgraded.
Table 3.4.1 Job Evaluation by Salary band for the period 1 April 2015 and 31 March 2016
Salary band
Lower skilled
(Levels 1-2)
132
Posts on
establishment
Number
of jobs
evaluated
% of jobs
evaluated
Posts upgraded
Posts downgraded
Number
Number
% of
posts
evaluated
% of posts
evaluated
8 161
0
0.0%
0
0.0%
0
0%
29 347
0
0.0%
0
0.0%
0
0%
Highly skilled
production
(Levels 6-8)
16 598
0
0.0%
0
0.0%
0
0%
Highly skilled
supervision
(Levels 9-12)
13 416
15
0.1%
0
0.0%
0
0%
Senior
management
Band A
90
6
6.7%
0
0.0%
0
0%
Senior
management
Band B
26
2
7.7%
0
0.0%
0
0%
Senior
management
Band C
6
1
16.7%
0
0.0%
0
0%
Senior
management
Band D
0
0
0.0%
0
0.0%
0
0%
Contract
(Levels 1-2)
4
0
0.0%
0
0.0%
0
0%
Contract
(Levels 3-5)
52
0
0.0%
0
0.0%
0
0%
Contract
(Levels 6-8)
708
0
0.0%
0
0.0%
0
0%
2 985
0
0.0%
0
0.0%
0
0%
Contract Band A
6
0
0.0%
0
0.0%
0
0%
Contract Band B
8
0
0.0%
0
0.0%
0
0%
Contract Band C
3
0
0.0%
0
0.0%
0
0%
Contract Band D
1
0
0.0%
0
0.0%
0
0%
71 411
24
31%
0
0
0
0.0%
Contract
(Levels 9-12)
Total
The following table provides a summary of the number
of employees whose positions were upgraded due to
their posts being upgraded. The number of employees
may differ from the number of posts upgraded since
not all employees are automatically absorbed into the
new posts and some of the posts upgraded might be
vacant.
Table 3.4.2 Profile of employees whose positions were upgraded due to their posts being upgraded
for the period 1 April 2015 to 31 March 2016
Gender
African
Asian
Female
0
Male
0
Total
0
Coloured
0
0
White
Total
0
0
0
0
0
0
0
0
0
Employees with a disability
The following table summarises the number of cases where remuneration bands exceeded the grade determined
by job evaluation. Reasons for the deviation are provided in each case.
Table 3.4.3 Employees with salary levels higher than those determined by job evaluation by occupation
for the period 1 April 2015 and 31 March 2016
Occupation
Number of
employees
Job evaluation
level
0
Remuneration level
0
Reasons for
deviation
0
0
Total number of employees whose salaries exceeded the level determined by job evaluation
0
Percentage of total employed
0
The following table summarises the beneÄciaries of the above in terms of race, gender, and disability.
133
Table 3.4.4 Profile of employees whose salary levels are higher than those determined by job
evaluation for the period 1 April 2015 to 31 March 2016
Gender
African
Asian
Coloured
White
Total
Female
0
0
0
0
0
Male
0
0
0
0
0
Total
0
0
0
0
0
Employees with a disability
Note:
If there were no cases where the salary levels were higher than those determined by job evaluation, keep the heading and replace the table with the following:
Total number of employees whose salaries exceeded the grades determine by job evaluation
0
3.5
rates indicate trends in the employment proÄle of
the Department. The following tables provide a
summary of turnover rates by salary band and critical
occupations (see deÄnition in notes below).
Employment Changes
This section provides information on changes in
employment during the Änancial year. Turnover
Table 3.5.1 Annual turnover rates by salary band for the period 1 April 2015 and 31 March 2016
Salary Band
Number of
employees
at the
beginning of
period – April
2015
Appointments
and Transfers
into the
Department
Terminations
and
transfers out
of the
Department
Turnover
rate
6 646
1 224
155
0.02
26 770
3 250
1 228
0.05
3. Highly skilled production (Levels 6 – 8)
13 780
1 052
1 320
0.10
4. Highly skilled supervision (Levels 9 – 12)
13 260
2 550
2 250
0.17
5. Senior management service Band A
71
3
5
0.07
5. Senior management service Band B
23
3
0.13
5. Senior management service Band C
5
1
0.20
5. Senior management service Band D
1
6. Contracts
Total
0.00
3 705
2 605
2 537
0.68
64 261
10 684
7 499
11.7%
Notes:
a. Data extracted from PERSAL
b. Number of Employees – as on the 1st April 2016
c. Appointments and Transfers into the Department – as from the 1st of April 2015 to the 31st of March 2016
d. Terminations and Transfers out of the Department – as from the 1st of April 2015 to the 31st of March 2016
134
Table 3.5.2 Annual turnover rates by critical occupation for the period 1 April 2015 to 31 March 2016
Critical occupation
Dental practitioner
Number of
employees at
the beginning
of period – April
2015
Appointments
and transfers
into the
department
299
Dental specialist
Terminations
and
transfers out
of the
department
55
Turnover
rate
44
14.7%
189
20
22
11.6%
2 582
1 211
916
35.5%
903
465
483
53.5%
Medical specialist
2 441
427
480
19.7%
Emergency care practitioner
1 427
212
72
5.0%
500
187
165
33.0%
Pharmacists
Pharmacists (intern)
411
345
412
100.2%
13 312
1 517
1 826
13.7%
Staff nurse
6 426
575
321
5.0%
Nursing assistant
6 394
830
223
3.5%
3 968
1 077
93
2.3%
38 852
6 921
5 057
13.0%
Professional nurse
Total
Source: PERSAL
Notes:
a. This only represent critical occupations
b. Number of employees as at 1 April 2015
c. Appointments and transfers into the department between 1 April 2015and 31 March 2016
d. Terminations and transfers out of the department between 1 April 2015 and 31 March 2016
The table below identiÄes the major reasons why staff have left the department.
Table 3.5.3 Reasons why staff left the department in the period 1 April 2015 to 31 March 2016
Termination Type (a)
Number
1. Death
% of Total
Resignation
278
3.7%
2. Resignation
2 806
37.4%
3. Expiry of contract
3 181
42.4%
4. Dismissal – operational changes
0.0%
5. Dismissal – misconduct
159
2.1%
6. Dismissal – inefÄciency
0.0%
7. Discharged due to ill-health
8. Retirement
9. Transfer to other Public Service departments
10. Other
Total
Total number of employees who left as a % of total employment
84
1.1%
979
13.1%
10
0.1%
2
0.0%
7 499
100.0%
11.6%
Source: PERSAL
Note:
Terminations as between 1 April 2015 and 31 March 2016
Table 3.5.4 Promotions by critical occupation for the period 1 April 2015 to 31 March 2016
Occupational Class (b)
Employees 1
April 2015
Promotions
to another
salary level
Salary level
promotions
as a % of
employees by
occupation
Dental practitioner
299
1
0.33%
Dental specialist
189
1
0.53%
2 582
14
0.54%
903
Progression to
another notch
within
a salary level
1
Notch
progression
as a
% of
employees by
occupation
0.33%
0.00%
11
0.00%
0.43%
0.00%
Medical specialist
2 441
28
1.15%
62
2.54%
Emergency care
practitioner
1 427
15
1.05%
7
0.49%
Pharmacists
500
5
1.00%
3
0.60%
Pharmacists (intern)
411
Professional nurse
0.00%
0.00%
13 312
83
0.62%
57
0.43%
Staff nurse
6 426
66
1.03%
10
0.16%
Nursing assistant
6 394
0.00%
0.00%
3 968
0.00%
0.00%
Total
38 852
213
0.55%
151
Notes:
Source: PERSAL
a. Promotions - as on the 1st of April 2015 to the 31st of March 2016
b. Number of Employees - as on the 1st of April 2015
0.39%
135
Table 3.5.5 Promotions by salary band for the period 1 April 2015 to 31 March 2016
Salary Band
Employees 1
April 2015
Promotions
to another
salary level
Salary bands
promotions
as a % of
employees
by salary
level
Progression
to
another
notch within
a salary level
Notch
progression
as a % of
employees
by salary
bands
6 650
601
9.0%
0
0.0%
26 820
257
1.0%
21
0.1%
3. Highly skilled production
(Levels 6 – 8)
14 484
167
1.2%
16
0.1%
4. Highly skilled supervision
(Levels 9 – 12)
16 191
98
0.6%
146
0.9%
116
5
4.3%
1
0.9%
64 261
1 128
1.8%
184
0.29%
(Levels 13 – 16)
Grand Total
Source: PERSAL
Notes:
a. Number of Employees - as on the 1st of April 2015
b. Promotions - as from the 1st of April 2015 to the 31st of March 2016
3.6 Employment Equity
Table 3.6.1 Total number of employees (including employees with disabilities) in each of the following
occupational categories as at 31 March 2016
Female
Total
Black
Coloured
Indian
3
4
80
7
63
3
6
72
6
165
1 845
54
450
2 349
866
1 782
91
488
2 361
1 023
6 599
3. Technicians and
Associate Professionals
2 851
47
57
2 955
155
17 585
512
417
18 514
1 279
22 903
4. Clerks
2 410
49
19
2 478
65
5 265
91
13
5 369
341
8 253
5. Service Workers and
Shop and Market Sales
Workers
2 463
23
14
2 500
69
13 981
134
19
14 134
172
16 875
0
2
3
7. Craft and Related
Trades Workers
8. Plant and Machine
Operators and
Assemblers
9. Elementary
Occupations
Grand Total
Employees with disabilities
1
1
Total
White
African
1. Legislators, Senior
OfÄcials and Managers
White
Indian
73
2. Professionals
136
African
Coloured
Total Black
Male
Occupational Category
395
8
2
405
8
33
33
3 938
55
4
3 997
71
7 408
158
3
7 569
87
11 724
13 976
239
550
14 765
1 241
46 117
989
946
48 052
2 910
66 968
65
7
72
19
72
9
2
83
20
194
Notes:
a. Data extracted from PERSAL as at end March 2016
b. Total number of employees as at the end of the reporting period (31 March 2016).This table counts current employees and not Älled posts.
446
Table 3.6.2 Total number of employees (including employees with disabilities) in each of the following
occupational bands as on 31 March 2016
5
5
4
Total (a)
White
Total
Black
Indian
African
White
Coloured
African
1. Top management
Coloured
Female
Total
Black
Male
(b)
Indian
Occupational Bands
4
9
49
1
2
52
6
31
2
2
35
6
99
3. Professionally qualiÄed and
experienced specialists
and mid-management
3 043
80
493
3 616
975
9 674
327
716
10 717
1 656
16 964
4. Skilled technical and
academically
qualiÄed workers, junior
management, supervisors
2 428
48
34
2 510
145
10 913
325
190
11 428
950
15 033
5. Semi-skilled and
discretionary decisionmaking
5 998
81
20
6 099
97
20 975
256
38
21 269
276
27 741
6. Unskilled and deÄned
decision making
2 453
29
1
2 483
18
4520
79
4 599
22
7 122
13 976
239
550
14 765
1 241
3 534
83
3
48 052
2 910
66 968
65
7
72
19
72
9
2
83
20
194
Total
Notes:
a. This table counts current employees and not Älled posts.
b. ClassiÄcation legend
1. Top Management
-: Deputy Director General and upwards, but excludes the MEC
2. Senior Management
-: Chief Directors and Directors
3. Professionally Qual.
-: Level 9 to 12 and professionals level 0, 13 and 14
4. Skilled technical and
-: Levels 6 to 8
5. Semi-skilled and disc.
-: Levels 3 to 5
6. Unskilled and
-: Levels 1 to 2
137
Table 3.6.3 Recruitment for the period 1 April 2015 to 31 March 2016
1.Top management
1
6
1
Total (a)
White
Indian
Coloured
African
White
Coloured
African
Female
Indian
Male
Occupational Bands (b)
1
7
3. Professionally qualiÄed and experienced
specialists and mid-management
944
22
134
294
2 047
73
253
500
4 267
4. Skilled technical and academically
qualiÄed workers, junior management, supervisors
226
5
10
29
1 159
43
91
273
1 836
5. Semi-skilled and discretionary decision-making
651
11
4
8
2 583
32
8
47
3 344
2
790
12
3
1 229
148
333
6 580
160
352
824
10 684
6. Unskilled and deÄned decision making
Total
415
7
2 242
45
1
2
Source: PERSAL
Notes:
a. Data extracted from PERSAL – as from 1st April 2015 to 31st March 2016
This table counts only the number of appointments and not transfers into the Department
1. Top Management
2. Senior Management -: Chief Directors and Directors
3. Professionally Qual. -: Level 9 to 12 and professionals level 0, 13 and 14
4. Skilled technical and -: Levels 6 to 8
5. Semi-skilled and disc. -: Levels 3 to 5
6. Unskilled and
-: Levels 1 to 2
3
Table 3.6.4 Promotions for the period 1 April 2015 to 31 March 2016
Total (a)
White
Total
Black
Indian
Coloured
African
White
Indian
Coloured
African
1.Top management
1
1
0
1
2
2
0
2
3. Professionally qualiÄed and experienced
specialists and mid-management
70
10
80
12
119
2
15
136
19
247
qualiÄed workers, junior management,
supervisors, foreman and
superintendents
63
1
64
1
98
3
6
107
11
183
5. Semi-skilled and discretionary decision
making
73
1
1
75
1
201
1
202
6. Unskilled and deÄned decision-making
252
1
253
2
339
5
344
2
601
Total
461
2
475
16
757
11
789
32
1 312
0
0
0
12
0
21
278
0
0
Notes:
a. Data extracted from PERSAL.
Table includes both level and notch promotions:
Level promotion = promotions from one salary level to another (Professional Nurse Grade 1 to Professional Nurse Grade 2 -i.e. level 6 to 7)
Notch promotion = promotion from one notch to another within the same salary level (i.e. pay progression).
1. Top Management
3. Professionally Qual. -: Level 9 to 12 and professionals level 0, 13 and 144. Skilled technical and -: Levels 6 to 8
5. Semi-skilled and disc. -: Levels 3 to 5
6. Unskilled and
-: Levels 1 to 2
Table 3.6.5 Terminations for the period 1 April 2015 to 31 March 2016
1.Top management
2
2
4
4
Total (a)
White
Total
Black
541
3 905
273
25
1350
64
69
1 483
336
2 117
3
364
11
872
24
2
898
34
1 307
72
2
81
1
82
1
157
145
1 714
329
4 083
172
289
4 544
912
7 499
4
2
6
6
2
14
259
5
9
353
8
4
Indian
2 075
5. Semi-skilled and discretionary
decision making
Coloured
218
qualiÄed workers, junior
management, supervisors
2
10
81
999
32
6
1776
133
70
3
290
17
1 537
0
2
849
Grand Total
1
4
3. Professionally qualiÄed and
experienced specialists and
mid-management
6. Unskilled and deÄned decisionmaking
African
Female
White
Indian
African
Total Black
Male
Coloured
138
Female
Total Black
Male
Source: PERSAL
Notes:
a. Data extracted from PERSAL
1. Top Management
3. Professionally Qual. -: Level 9 to 12 and professionals level 0, 13 and 14
4. Skilled technical and -: Levels 6 to 8
5. Semi-skilled and disc -: Levels 3 to 5
6. Unskilled and
-: Levels 1 to 2
Table 3.6.6 Disciplinary action for the period 1 April 2015 to 31 March 2016
333
3
6
342
10
410
4
6
420
13
Total
White
Total Black
Indian
Coloured
African
White
Indian
African
Disciplinary action
Total Black
Female
Coloured
Male
785
Note:
Data supplied by Labour Relations Management
Table 3.6.7 Skills development for the period 1 April 2015 to 31 March 2016
Total (a)
White
Total Black
Indian
Coloured
African
White
Total Black
African
1. Legislators, senior
ofÄcials and
managers
Indian
Female
Coloured
Male
Occupational
Category (b)
4
0
0
4
0
19
0
0
19
2
25
2. Professionals
605
16
21
642
41
1 005
8
16
1 029
26
1 738
3. Technicians
and associate
professionals
2 810
40
102
2 952
389
7 555
405
213
8 173
716
12 230
687
90
16
793
11
1 005
61
53
1 119
264
2 187
4. Clerks
5. Service workers and
shop and market
sales workers
7. Craft and related
trades workers
8. Plant and machine
operators and
assemblers
9. Elementary
occupations
Total
Employees with
disabilities
139
1 850
81
93
2 024
39
3 980
91
76
4 147
192
6 402
0
0
0
0
0
0
0
0
0
0
0
11
0
0
11
8
2
0
0
2
1
22
341
18
19
378
31
745
35
22
802
26
1 237
6 308
245
251
6 804
519
14 311
600
380
15 291
1 227
23 841
2
0
0
2
0
3
0
0
0
0
2
Note:
a. Data Supplied by Human Resource Development: Skills Development
Legislators, Senior
OfÄcials and
Managers:
OfÄcials responsible for determining and formulating policy and strategy, planning, directing and
coordinating the policies and activities of the organisation e.g CEOs, Senior Managers, College
Principals, etc.
Professionals:
Include ofÄcials whose main task require a high level of professional knowledge e.g. Clinical
Psychologists, Medical & Dental Practitioners, etc
Technicians
and Associate
Professionals:
This group includes occupations whose main tasks require technical knowledge and experience e.g.
Clinical Technologists, Industrial Technicians, Environmental Health
Clerks:
This group includes occupations whose tasks require the knowledge and experience necessary to
organise, store, compute and retrieve information e.g. Accounting Clerks, Stores OfÄcers, Administration
Clerks
Service Workers
and Shop and
Market Sales
Workers:
This group includes occupations whose main tasks require the knowledge and experience necessary to
provide personal and protective services e.g. Auxilairy Services OfÄcers (ward attendants), Emergency
Care Practitioners, FireÄghters, Food Services Aids, etc.
Craft and Related
Trades Workers:
This group includes occupations whose main tasks require the knowledge and experience of skilled
trades and handicrafts e.g. Clinical Photographers, plumbers, electricians, etc.
Plant and Machine
Operators and
Assemblers:
The main tasks of this occupational grouping involve the use of automated industrial machinery and
equipment
Elementary
Occupations:
This group covers occupations which require relatively low/elementary levels of knowledge and
experience necessary to perform mostly simple and routine tasks, involving the use of hand held tools
and in some cases considerable physical effort, and, with few exceptions, limited personal initiative and
judgement e.g. Cleaners, Groundsmen, etc.
3.7
Signing of Performance Agreements by SMS Members
All members of the SMS must conclude and sign performance agreements within speciÄc timeframes. The
information in Table 3.7.1 includes reasons for not complying within the prescribed timeframes and disciplinary
steps taken.
Table 3.7.1 Signing of Performance Agreements by SMS members as on 31 March 2016
SMS Level
140
Total number of
funded SMS posts
Director-General/Head
of Department:
Salary Level 16
0
Salary Level 15
1
Salary Level 14
7
Total number of
SMS members
Signed performance
agreements as % of
total number of SMS
members
Total number
of signed
performance
agreements
1
1
100%
7
7
100%
30
30
100%
Salary Level 13
14
78
77
99%
Total
22
116
115
99%
Table 3.7.2 Reasons for not having concluded Performance Agreements for all SMS members as at
31 March 2016
Signed
performance
agreements
as % of total
number of SMS
members
Total
number
of
funded
SMS
posts
Total
number
of SMS
members
Total
number
of signed
performance
agreements
Department: Salary Level 16
0
1
1
100%
Salary Level 15
1
7
7
100%
Salary Level 14
7
30
30
100%
14
78
77
99%
22
116
115
99%
SMS Level
Salary Level 13
Total
Reason for not having
concluded Performance
Agreements
One Senior manager was on
precautionary suspension.
Table 3.7.3 Disciplinary steps taken against SMS members for not having concluded Performance
Agreements as at 31 March 2016
Reasons
None
•
The reporting date in the heading of this table should be aligned with that of Table 3.7.1.
3.8
Performance Rewards
To encourage good performance, the Department has
granted the following performance rewards during
the year under review. The information is presented
in terms of race, gender, disability, salary bands and
critical occupations (see deÄnitions in notes below).
Table 3.8.1 Performance Rewards by Race, Gender and Disability for the period 1 April 2015 to
31 March 2016
Demographics
Number of
BeneÄciaries
Total
Employment
Percentage
of Total
Employment
29 916
45 204
66.20
216 222
7 228
African, male
8 503
13 329
63.80
61 301
7 209
Asian, female
348
903
38.50
2 492
7 161
Asian, male
178
497
35.80
1 281
7 197
Coloured, female
634
967
65.60
4 581
7 226
African, female
Coloured, male
White, female
Average
Cost per
BeneÄciary
(R)
139
231
60.20
999
7 187
1 408
2 757
51.10
10 096
7 170
451
1 036
43.50
3 135
6 951
41 577
64 924
424.7
300 107
7 218
White, male
TOTAL
Cost (R’000)
Table 3.8.2 Performance Rewards by salary band for personnel below Senior Management Service for
the period 1 April 2015 to 31 March 2016
Salary Band
Number of
BeneÄciaries
Total
Employment
Percentage
of Total
Employment
Cost (R’000)
Average
Cost per
BeneÄciary
(R)
141
4 978
7 122
69.90
36 000
7 232
18 230
27 741
65.70
131 758
7 228
Highly skilled production
(Levels 6-8)
9 980
15 033
66.40
71 807
7 195
Highly skilled supervision
(Levels 9-12)
8 389
15 028
55.80
60 531
7 216
Periodic remuneration
0
0.00
0
0
Abnormal appointment
0
0.00
0
0
Total
39 046
62 548
62%
275 092 247
7 045
Table 3.8.3 Performance Rewards by Critical Occupation for the period 1 April 2015 to 31 March 2016
Critical Occupations
Number of
BeneÄciaries
Total
Employment
Percentage
of Total
Employment
(%)
150
302
49.70
1 085
7 233
83
186
44.60
593
7 145
1101
1515
72.70
7940
7 212
Medical practitioners
675
2522
26.80
4 885
7 237
Medical specialists
588
2466
23.80
4 259
7 243
Nursing assistants
4844
6557
73.90
35 004
7 226
Dental practitioners
Dental specialists
Emergency services related
Pharmacists
Cost
(R’000)
Average
Cost per
BeneÄciary
(R)
269
792
73.88
1 948
7 242
Professional nurse
9405
13966
67.30
68 030
7 233
Staff nurses and pupil nurses
5047
11035
45.70
36 474
7 227
22 162
39 341
56.33
160 218
7 229
Total
Table 3.8.4 Performance related rewards (cash bonus), by salary band for Senior Management Service
for the period 1 April 2015 to 31 March 2016
BeneÄciary proÄle
Salary Band
Number
of
beneÄciaries
Cost
Number
of
employees
% of total
within
salary bands
Total Cost
(R’000)
142
Average
cost
per
employee
Total cost as
a % of the
total
personnel
expenditure
Band A
0
78
0
0
0
0
Band B
0
30
0
0
0
0
Band C
0
7
0
0
0
0
Band D
0
1
0
0
0
0
Total
0
116
0
0
0
0
3.9
Foreign Workers
The tables below summarise the employment of foreign nationals in the Department in terms of salary band and
major occupation.
Table 3.9.1 Foreign workers by salary band for the period 1 April 2015 to 31 March 2016
1 April 2015
Salary Band
Number
Lower skilled
31 March 2016
% of total
Number
% of total
Change
Number
% Change
19
2.11%
16
1.75%
-3
-25.0%
Highly skilled (Levels 6-8)
114
12.64%
117
12.80%
3
25.0%
(Levels 9-12)
349
38.69%
376
41.14%
27
225.0%
419
46.45%
404
44.20%
-15
-125.0%
1
0.11%
1
0.11%
0
0.0%
902
100.0%
914
100.0%
12
100.0%
Total
Source: PERSAL
Table 3.9.2 Foreign workers by major occupation for the period 1 April 2015 to 31 March 2016
1 April 2015
Major occupation
Number
31 March 2016
% of total
Number
Change
% of total
Number
% Change
Administrative ofÄce workers
9
1.0%
9
1.0%
0
0.0%
Elementary occupations
8
0.9%
6
0.7%
(2)
(16.7%)
Information technology personnel
1
0.1%
1
0.1%
0
0.0%
Professionals and managers
672
74.5%
670
73.3%
(2)
(16.7%)
Social natural technical and
medical sciences + supp
9
1.0%
11
1.2%
2
16.7%
Technicians and associated
professionals
203
22.5%
217
23.7%
14
116.7%
Total
902
100.0%
914
100.0%
12
100.0%
Source: PERSAL
3.10 Leave utilisation
The Public Service Commission has identiÄed the need for careful monitoring of sick leave within the public
service. The following tables provide an indication of the use of sick leave and disability leave. In both cases, the
estimated cost of the leave is also provided.
Table 3.10.1 Sick leave for the period 1 January 2015 to 31 December 2015
Salary Band
Total
Days
% Days with Number of % of Total Average Estimated
Total
Total number
Medical
Employees Employees
Days
Cost
number of
of
CertiÄcation using Sick using Sick
per
Employees days with
Leave
Leave
Employee
using Sick
medical
(R’000)
Leave
certiÄcation
1. Lower skilled
(Levels 1-2)
31 390
90.8%
4 702
15.0%
7
13 094
46031
28 487
2. Skilled
(Levels 3-5)
126 848
87.4%
19 411
15.3%
7
77 345
46031
110 882
3. Highly skilled
production
(Levels 6-8)
82 299
85.2%
11 912
14.5%
7
81 502
46031
70 107
4. Highly skilled
supervision
(Levels 9-12)
61 716
83.7%
9 305
15.1%
7
118 603
46031
51 678
5. Senior
management
(Levels 13-16)
4 263
75.8%
701
16.4%
6
16 279
46031
3 230
306 515
86.25%
46 031
76.3%
7
306 823
46 031
264 384
Grand Total
Notes:
a. Data extracted from Vulindlela.
b. Format of data is on calender and not Änancial year.
c. % days with medical certiÄcation refers to days that employees took as sick leave and were covered by a medical certiÄcate.
d. % number of employees using sick leave days refer to employees using sick leave against the total staff in the employ of the department as at the end of the
calender year.
e. Average days per employee = per annum/year.
143
Table 3.10.2 Disability leave (temporary and permanent) for the period 1 January 2015 to
31 December 2015
Average Days per
Employee
(b)
Total number of
days with medical
certiÄcation
Total number of
Employees using
Disability Leave
43.7%
137
19%
18
161
720
1 648
1 317
Skilled
(Levels 3-5)
11 308
59.9%
599
9%
26
1 037
6 777
11 308
1 317
Highly skilled
production
(Levels 6-8)
5 179
102.0%
330
6%
24
743
5 283
5 179
1 317
Highly skilled
supervision
(Levels 9-12)
5 617
197.5%
239
2%
20
865
11 096
5 617
1 317
428
433.2%
12
1%
103
896
1 854
428
1 317
24 180
106.4%
1317
36.3%
18
3 702
25 730
1 317
1 317
Senior
management
(Levels 13-16)
Grand Total
No of Employees
using
% of Total
Employees using
Disability Leave
1 648
Estimated Cost
(R’000)
Number of
Employees using
Disability Leave
Lower skilled
(Levels 1-2)
Total
Days
% Days with
Medical
CertiÄcation
Salary Band
Notes:
c. Average days per employee = per annum/year.
144
The table below summarises the utilisation of annual leave. The wage agreement concluded with trade unions
in the PSCBC in 2000 requires management of annual leave to prevent high levels of accrued leave being paid
at the time of termination of service.
Table 3.10.3 Annual Leave for the period 1 January 2015 to 31 December 2015
Salary Band
Total Days Taken
Number of
Employees using
annual leave
Average per
Employee per
day
125 591.11
6 369
19.7
591 742.42
26 597
22.2
342 212.27
15 053
22.7
305 262.69
13 838
22.1
Senior management (Levels 13-16)
TOTAL
37 565.60
1 583
23.7
1 402 374.09
63 440
22.1
Notes:
Number of Employees
as at 31 December 2014
Total number of capped
leave available at 31
December 2014
Number of Employees
taken capped leave
Average capped leave
per employee as at 31
December 2014
Total days of capped
leave taken
Salary Band
Average number of days
taken per employee
Table 3.10.4 Capped leave for the period 1 January 2015 to 31 December 2015
11
2.2
17
5
3 979
231
890
4.5
22
200
111 621
4 970
1 055
4.4
33
239
131 969
4 044
1 185
4.8
37
245
127 084
3 422
Grand Total
176
7.0
40
25
1 9814
492
3 317
4.6
30
714
394 467
13 159
Notes:
a. Data extracted from Vulindlela
b. Format of data is on calender and not Änancial year
The following table summarises payments made to employees as a result of leave that was not taken.
Table 3.10.5 Leave payouts for the period 1 April 2015 to 31 March 2016
Reason
Total amount
Number of
employees
Average
payment
per employee
(R)
(R’000)
Leave payout for 2014/15 due to non-utilisation of leave for the previous
cycle
n/a
n/a
n/a
145
Capped leave payouts on termination of service for 2015/16
81 596
2 438
33 468
Current leave payout on termination of service for 2015/16
18 044
1 546
11 671
118 785
5 435
21 856
Grand Total
Notes:
a. Data extracted from Vulindlela
b. Format of data is on calender and not Änancial year
3.11 HIV/AIDS & Health Promotion Programmes
Table 3.11.1 Steps taken to reduce the risk of occupational exposure
Units/categories of employees
identiÄed
to be at high risk of contracting HIV &
related diseases (if any)
Key steps taken to reduce the risk
•
Doctors
Policy approved and implemented for prophylaxis for accidental exposure to
blood borne pathogens
•
Nurses
Guidelines for prophylaxis for accidental exposure to blood borne pathogens
•
Laboratory workers
Protective clothing
•
Cleaners working in clinical areas
Survey on risk assessment
•
Laundry workers
Training of ofÄcers
•
Mortuary workers
Policy approved and implemented for prophylaxis for accidental exposure to
blood borne pathogens
•
Healthcare waste ofÄcers
A Directorate of Healthcare Waste & Occupational Hygiene Management has
been created to deal with Waste Management
Notes:
Data Supplied by Chief Directorate Human Resource Development Employee Wellness
Table 3.11.2 Details of Health Promotion and HIV/AIDS Programmes
Question
Yes
1. Has the Department designated a member of
the SMS to implement the provisions contained
in Part VI E of Chapter 1 of the Public Service
Regulations, 2001? If so, provide her/his name
and position.
2. Does the Department have a dedicated unit or
have you designated speciÄc staff members to
promote health and well being of your employees?
If so, indicate the number of employees who are
involved in this task and the annual budget that is
available for this purpose.
3. Has the department introduced an Employee
Assistance or Health Promotion Programme for
your employees? If so, indicate the key elements/
services of the programme.
4. Has the Department established (a) committee(s)
as contemplated in Part VI E.5 (e) of Chapter 1
of the Public Service Regulations, 2001? If so,
please provide the names of the members of
the committee and the stakeholder(s) that they
represent.
146
5. Has the Department reviewed the employment
policies and practices of your department to
ensure that these do not unfairly discriminate
against employees on the basis of their HIV
status? If so, list the employment policies/practices
so reviewed.
X
Employee Assistance Programme: Professional
Counselling, Trauma Management, Prevention of violence
in the Workplace, Stress and ConÅict Management,
Capacity Building on EAP Issues, Lifestyle Management.
Lifestyle Management, Absenteeism Management,
Managerial Consultancy, Pre Retirement Services,
Behavioural Risk Management Audit, Financial Wellness,
Debt Management Ongoing Monitoring and Evaluation,
and Report writing.
X
X
7. Does the Department encourage its employees to
undergo Voluntary Counseling and Testing? If so,
list the results that you have achieved.
X
10. Management of disclosure
11. Reduction of stigma and discrimination
12. HIV and TB Co-infection
13. Peer education
14. Training of the trainer
15. Empowerment of People With Disabilities
X
X
X
9. Training on HIV and AIDS issues conducted by HIV
and AIDS Workplace
Details, if yes
Due to a moratorium on posts the Department the
department has not designated a member of the SMS
to implement the provisions contained in Part VI E of
Chapter 1 of the Public Service Regulations, 2001
The Directorate Employee Wellness Programme is
responsible for promoting health and well-being of
employees. The total number of employees in the Unit is
17. The allocated budget is:
R8 000 000 from the equitable share and R6.5 million
from the HIV conditional Grant
6. Has the Department introduced measures to
protect HIV-positive employees or those perceived
to be HIV-positive from discrimination? If so, list
the key elements of these measures.
8. Has the Department developed measures/
indicators to monitor & evaluate the impact of your
employee Health and Wellness programme? If so,
list these measures/indicators.
No
X
X
X
X
X
X
X
X
EHWP Provincial Committee (40 members), Tshwane
EHWP Regional Committee, Ekurhuleni EHWP regional
Committee: Johannesburg Metro Regional Committee,
HIV and AIDS, STI and TB Provincial Committee, EAP,
and Occupational Health.
The Directorate Employee Wellness Programme is
responsible for reviewing the HIV and AIDS, STI and TB
Policy and Employee Health and Wellness Programme.
The department has introduced measures to protect
HIV – positive employees such as Capacity Building on
Reduction of Stigma and Discrimination. Policy on HIV
and AIDs, STI and TB Management.
3 Quarters of employees go for HCT and Phsical
Assessments every 6 months.
Increase the number of employees empowered in EHWP
Increase the no of employee wellness centre’s by 2 per
annum – currently 16 Reduction of Occupational Injuries
& Diseases by 10% (2009-2011),(Strategic Plan 20092014). Increase no of employees accessing EHWP).
Reduce the number of new HIV infections by 50%
(NSP 2012 – 2016).
Increase the no of employees who present themselves
for HCT.
Management of disclosure, Reduction of stigma and
discrimination, HIV and TB Co - infection.
Peer education.
Training of the trainer.
Empowerment of People With Disabilities
Mainstreaming of HIV and AIDS and TB management
Question
Yes
16. Maistreaming of HIV and AIDS and TB
management
X
X
X
17. Capacity-buiding on PMTCT
18. ARV provision
No
Details, if yes
Capacity-buiding on PMTCT
Capacity-building on Alzheimer/Dementia
Note:
Data Supplied by Chief Directorate: Human Resource Development – Employee Health and Wellness Programme: HIV, STI & TB Management
3.12 Labour Relations
Table 3.12.1 Collective agreements for the period 1 April 2015 to 31 March 2016
Subject Matter
Date
PSCBC Resolution 2 of 2015: Agreement on salary adjustments and improvements on
conditions of service in the Public Service for the period 2015/16 – 2017/18
20 May 2015
PSCBC Resolution 3 of 2015: Agreement on the review of the Government Employees
Medical Scheme (GEMS)
20 May 2015
PSCBC Resolution 4 of 2015: Agreement on the review of Annexure A of PSCBC Resolution
1 of 2007: Danger Allowance
20 May 2015
PSCBC Resolution 6 of 2015: Agreement on the review of the post retirement
20 May 2015
PSCBC Resolution 7 of 2015: Framework agreement for the establishment of a Government
Employees Housing Scheme (GEHS)
27 May 2015
PSCBC Resolution 8 of 2015: Amendment to PSCBC resolution 2 of 2015 for salary
adjustments and improvements on conditions of service in the public service for the period
2015/16 – 2017/18
26 June 2015
Gauteng Chamber of the PHSDSBC Resolution 2 of 2015: Payment of PMDS incentive
bonus and pay progression for the 2014/2015 cycle in the Gauteng Department of Health
30 November 2015
147
Note:
The following table summarises the outcome of disciplinary hearings conducted within the department for the
year under review.
Table 3.12.2 Misconduct and disciplinary hearings finalised for the period 1 April 2015 to
31 March 2016
Outcomes of disciplinary hearings
Number
% of total
4
0.6%
Verbal warning
125
20.3%
Written warning
211
34.3%
Final written warning
177
28.7%
30
4.9%
Fine
0
0.0%
Demotion
0
0.0%
Dismissal
42
6.8%
Correctional counselling
Suspended without pay
Not guilty
Case withdrawn
Total
9
1.5%
18
2.9%
616
100.0%
Note:
Table 3.12.3 Types of misconduct addressed at disciplinary hearings for the period 1 April 2015 to
31 March 2016
Type of misconduct (based on annexure A)
Number
% of total
46
5.9%
239
30.4%
53
6.8%
110
14.0%
22
2.8%
6
0.8%
93
11.8%
Desertion of post
Absenteeism
Negligence
Insubordination
Fraud and corruption
Dishonesty and misrepresentation
Theft
Dereliction of duty
Other
24
3.1%
174
22.2%
18
2.3%
785
100.0%
While on duty, conducts herself or himself in an improper, disgraceful and
unacceptable manner
Total
Source: Labour Relations Management
Note:
The ‘Other’ cases (203) include:
Poor performance
RWOPS
Assault
Alcohol abuse
Sexual harassment
Latecoming
Abscondment and unprocedural, unprotected strike
Table 3.12.4 Grievances logged for the period 1 April 2015 to 31 March 2016
148
Number of grievances resolved
Number of grievances not resolved
Total number of grievances lodged
Number
% of Total
96
75.6%
31
24.4%
127
100.0%
Notes:
a) Data supplied by Labour Relations Management
b) The above number of grievances lodged include:
Eight (8) Grievances were lodged directly with the PSC of which 6 are Änalised and two (2) awaiting closure by the PSC.
One (1) Grievance was lodged directly with the Public Protector, who referred it back to the Department. The investigation was Änalsed and awaiting Änal signature.
Table 3.12.5 Disputes logged with councils for the period 1 April 2015 to 31 March 2016
Number
% of Total
Number of disputes upheld
60
32.3%
Number of disputes pending
36
19.4%
186
51.6%
Total number of disputes lodged
Notes:
(a) Data supplied by Labour Relations Management & Development
(b) The total number of disputes lodged include:
- PHSDSBC cases
- PSCBC cases
- CCMA cases
(c) The 36 pending cases include seven cases waiting for awards.
(d) The 60 disputes upheld were 49 cases in favour of the Department and 11 cases in favour of the applicant.
(e) The 186 cases lodged include:
49 Cases deadlocked
22 Cases settled
19 Cases withdrawn
Table 3.12.6 Strike action for the period 1 April 2015 to 31 March 2016
Total number of person working days lost
598.75
Total cost (R’000) of working days lost
R184.44
Amount (R’000) recovered as a result of no work no pay
R184.44
Notes:
a. Data supplied by Labour Relations Management
b. The strike took place on the 23 April 2015.
Table 3.12.7 Precautionary suspensions for the period 1 April 2015 to 31 March 2016
Number of people suspended
29
Number of people whose suspension exceeded 30 days
21
Average number of days suspended
1 554
Cost (R’000) of suspensions
R3 036
3.13 Skills development
This section highlights the efforts of the department with regard to skills development.
Table 3.13.1 Training needs identified for the period 1 April 2015 to 31 March 2016
Occupational
Categories
Gender
1. Legislators, senior ofÄcials and
managers
2. Professionals
Number of
employees
as at 1 April
2015
Learnerships
Training needs at the start of the
reporting period
Skills
programmes
& other short
courses
Other
forms
of
training
Total
Female
78
0
60
0
60
Male
84
0
40
0
40
Female
3218
0
900
50
950
Male
3 196
0
700
30
730
3. Technicians and associate
professionals
Female
19 083
350
12 500
80
12 930
Male
2 966
150
1 900
50
2 100
4. Clerks
Female
5 249
0
3 500
0
3 500
Male
2 388
0
1 900
0
1 900
Female
13 641
0
8 000
0
8 000
Male
2 488
0
3 800
0
3 800
Female
2
100
18
0
118
5. Service workers and shop and
market sales workers
7. Craft and related trades workers
Male
1
50
12
0
62
8. Plant and machine operators and
assemblers
Female
33
0
0
0
0
Male
405
0
0
0
0
9. Elementary occupations
Female
7 480
100
600
0
700
Male
3 949
60
400
0
460
64 261
810
34 330
210
35 350
Total
Source: Directorate Human Resource Development: Skills Development
149
Notes
a. Data provided by the Directorate Human Resource Development: Skills Development
b. Number of employees is as at the beginning of the reporting period (i.e. April 2015) as required by the reporting guideline.
c. Learnerships, Skills Programmes and other forms of training are training needs identiÄed as per Workplace Skills Plan of 2014/2015
d. ClassiÄcation legend:
150
•
Legislators,
Senior
OfÄcials and
Managers:
OfÄcials responsible for determining and formulating policy and strategy, planning, directing and
coordinating the policies and activities of the organisation e.g CEOs, Senior Managers, College
Principals, tc.
•
Professionals:
Include ofÄcials whose main tasks require a high level of professional knowledge e.g. Clinical
•
Technicians
and Associate
Professionals:
This group includes occupations whose main tasks require technical knowledge and experience e.g.
Clinical Technologists, Industrial Technicians, Environmental Health OfÄcers, Professional Nurses, etc.
•
Clerks:
This group includes occupations whose tasks require the knowledge and experience necessary
to organise, store, compute and retrieve information e.g. Accounting Clerks, Stores OfÄcers,
Administration Clerks
•
Service
Workers and
Shop and
Market Sales
Workers:
This group includes occupations whose main tasks require the knowledge and experience necessary
to provide personal and protective services e.g. Auxilairy Services OfÄcers (ward attendants),
Emergency Care Practitioners, FireÄghters, Food Services Aids, etc.
•
This group includes occupations whose main tasks require the knowledge and experience of skilled
Craft and
Related Trades trades and handicrafts e.g. clinical photographers, plumbers, electricians, etc.
Workers:
•
The main tasks of this occupational grouping involve the use of automated industrial machinery and
Plant and
equipment e.g. drivers, tradesmans aides, etc.
Machine
Operators and
Assemblers:
•
Elementary
Occupations:
This group covers occupations which require relatively low/elementary levels of knowledge and
experience necessary to perform mostly simple and routine tasks, involving the use of hand held tools
and in some cases considerable physical effort, and, with few exceptions, limited personal initiative and
judgement e.g. cleaners, groundsmen, etc.
Table 3.13.2 Training provided for the period 1 April 2015 to 31 March 2016
Occupational
categories
Gender
1. Legislators, senior ofÄcials and managers
Female
Male
2. Professionals
Female
Male
3. Technicians and associate professionals
Female
4. Clerks
Male
5. Service workers and shop and market
sales workers
8. Plant and machine operators and
assemblers
Total
Training provided within the
reporting period
Total
Skills
Programmes
& other short
courses
Other
forms
of
training
21
0
84
4
0
4
3 218
1 055
0
1 055
683
0
683
8 494
0
8 889
78
3 196
21
395
Male
2 966
247
3 094
0
3 341
Female
5 249
1 383
0
1 383
2 388
804
0
804
13 641
4 339
0
4 339
2 488
2 063
0
2 063
Female
2
0
0
0
Male
1
0
0
0
33
3
0
3
Female
Female
Male
9. Elementary occupations
Learnerships
19 083
Male
7. Craft and related trades workers
Number of
employees
as at
1 April 2015
405
19
0
19
Female
7 480
828
0
828
Male
3 949
409
0
409
23 199
0
23 841
64 261
642
Source: Directorate Human Resource Development
Notes:
a. Data provided by the Directorate Human Resource Development
b. Number of employees is extracted from PERSAL as at the beginning of the reporting period (i.e April 2014) as required by the reporting guideline.
c. Learnerships, Skills Programmes and other forms of training is trainining provided as per Annual Training Report of 2015/2016.
d. ClassiÄcation legend.
151
Other training provided
•
Legislators, Senior OfÄcials
and Managers:
OfÄcials responsible for determining and formulating policy and strategy, planning,
directing and coordinating the policies and activities of the organisation e.g CEOs, Senior
Managers, College Principals, etc.
•
Professionals:
Include ofÄcials whose main task require a high level of professional knowledge e.g. Clinical
•
Technicians and Associate
Professionals:
This group includes occupations whose main tasks require technical knowledge and
experience e.g. Clinical Technologists, Industrial Technicians, Environmental Health
OfÄcers, Professional Nurses, etc.
•
Clerks:
This group includes occupations whose tasks require the knowledge and experience
necessary to organise, store, compute and retrieve information e.g. Accounting Clerks,
Stores OfÄcers, Administration Clerks
•
Service Workers and Shop
and Market Sales Workers:
This group includes occupations whose main tasks require the knowledge and
experience necessary to provide personal and protective services e.g. Auxiliary Services
OfÄcers (ward attendants), Emergency Care Practitioners, FireÄghters, Food Services
Aids, etc.
•
Craft and Related Trades
Workers:
This group includes occupations whose main tasks require the knowledge and
experience of skilled trades and handicrafts e.g. clinical photographers, plumbers,
electricians, etc.
•
Plant and Machine Operators The main tasks of this occupational grouping involve the use of automated industrial
and Assemblers:
machinery and equipment e.g. Drivers, tradesmans aides, etc.
•
Elementary Occupations:
This group covers occupations which require relatively low/elementary levels of
knowledge and experience necessary to perform mostly simple and routine tasks,
involving the use of hand held tools and in some cases considerable physical effort,
and, with few exceptions, limited personal initiative and judgement e.g. cleaners,
groundsmen, etc.
3.14 Injury on duty
152
The following tables provide basic information about injury on duty.
Table 3.14.1 Injury on duty for the period 1 April 2015 to 31 March 2016
Nature of injury on duty
Required basic medical attention only
Number
% of total
586
99.32%
Temporary total disablement
2
0.34%
Permanent disablement
0
0.00%
Fatal
2
0.34%
Total
590
100.00%
Source: Department of Finance
3.15 Utilisation of Consultants
The following tables provide information on the utilisation of consultants in the department. In terms of the Public
Service Regulations “consultant” means a natural or juristic person or a partnership who or which provides
in terms of a speciÄc contract on an ad hoc basis any of the following professional services to a department
against remuneration received from any source:
(a) The rendering of expert advice;
(b) The drafting of proposals for the execution of speciÄc tasks; and
(c) The execution of a speciÄc task which is of a technical or intellectual nature, but excludes an employee of a
department.
Table 3.15.1 Report on consultant appointments using appropriated funds for the period 1 April 2015
to 31 March 2016
Project Title
Total number of
consultants that
worked on the project
Duration:
Work Days
1. XJM Consultants
The supporting of the Änance division of the Medical
Supplies Depot for a period of 2 years including the contract
price adjustment due to the adding of value added tax (VAT).
2 years
Request for BAC approval to appoint a Consultant for the
Development of a Medical Device Assessment and Audit
Tool for the Gauteng Department of Health.
The process to appoint
the consultant is not
yet complete. The bid
evaluation has taken
place but other SCM
steps are still underway
12 months
BAC approval for Payment of Outstanding Claims by LTE
Consultants for the Mapping of Health Institutions near
Venues or the FIFA Confederations Cup.
1. LTE Consultants
4 months
Request for BAC approval of tender award –
Tender GT/GDH/116/2014 for the investigation of the “Loss
to Follow-up of Patients (LTFUP)” in anti-retroviral (ARV’s)
treatment in Gauteng for a period of 6 months.
KPMG Services (Pty) Ltd
Contract value
in Rand
5 060 232
950 000
4 084 000
Live Moya (Pty) Ltd
Request for BAC approval of tender award –
Tender GT/GDH/150/2014 for Mid – Term review of the
Gauteng Strategic Plan for HIV, TB and STI’s for 2012-2016.
153
6 months
1 563 311
4 months
1 026 696
Report on consultant appointments using appropriated funds for the period September to
December 2015
Project Title
Total number of
consultants that
Duration:
Work Days
Request for BAC approval to Extend the Scope of Services
for GDoH Lean Project which is being executed by Lean
Institute Africa under Purchase Order No. 4250471278.
Lean Institute Africa
3 months
Request for BAC approval to appoint BMGI Consultants
through section 10.5 of SCM Practice note no 3 of 2003 for
the purpose of undertaking a comprehensive Diagnostic of
Chris Hani Baragwanath Academic Hospital.
BMGI Consultants
12 weeks
Request for BAC approval to appoint two law Ärms to do
legal audit of all the departmental medico litigation matters
without going through competitive bidding process.
Ngcebesha Madlanga
Inc.; and Mdlulwa Nkuhlu
Inc.
10 months
Total number of projects
Total individual
consultants
Contract value
in Rand
1 420 000
13 000 000
1
59 162 880
Total duration:
Workdays
Total contract
value in Rand
13 months,
12 weeks
3
73 582 880
Report on consultant appointments using appropriated funds 2015/16 (January to March 2016)
154
Medical Supplies Depot:
Amendment of approval of extension of contract: XJM
Consultants to provide support to Änance division at Medical
Supplies Depot.
XJM Consultants
6 months
Total individual
consultants
Total duration:
Workdays
1
1
6 months
1 424 430
Total contract
value in Rand
1 424 430
Source: Directorate: Supply Chain Management
Table 3.15.2 Analysis of consultant appointments using appropriated funds, in terms of historically
disadvantaged individuals (HDIs) for the period 1 April 2015 to 31 March 2016
Project title
Percentage
ownership by HDI
groups
Percentage
management
by HDI groups
Request for BAC approval to Extend the Scope of Services
for GDOH Lean Project which is being executed by Lean
Institute Africa under Purchase Order No. 4250471278.
100%
100%
1
Request for BAC approval to appoint BMGI Consultants
through section 10.5 of SCM Practice note no 3 of 2003 for
the purpose of undertaking a comprehensive Diagnostic of
Chris Hani Baragwanath Academic Hospital.
100%
100%
1
Request for BAC approval to appoint two law Ärms to do
legal audit of all the departmental medico litigation matters
without going through competitive bidding process.
Ngcebesha Madlanga Inc.; and Mdlulwa Nkuhlu Inc.
100%
100%
2
Number of
consultants from HDI
groups that worked
on the project
Note:
58.14% of appropriated funds for goods and services were spent on black economic empowerment (BEE) companies.
Table 3.15.3 Report on consultant appointments using donor funds for the period 1 April 2015 to
31 March 2016
Project Title
Total number of consultants who
Duration (work days)
Donor and contract value in Rand
None
Total individual consultants
Total duration (work days)
Total contract value in Rand
None
Table 3.15.4 Analysis of consultant appointments using donor funds, in terms of Historically
Disadvantaged Individuals (HDIs) for the period 1 April 2015 and 31 March 2016
Project Title
Percentage
ownership by HDI
groups
Percentage
management by
HDI groups
Number of
Consultants
from HDI groups
that work on the
project
None
3.16 Severance Packages
Table 3.16.1 Granting of employee initiated severance packages for the period 1 April 2015 to
31 March 2016
Salary band
Number of
applications
received
Number of
applications
referred to the
MPSA
Number of
applications
supported by
MPSA
155
Number of
packages
approved by
department
0
0
0
0
0
0
0
0
Highly skilled production
(Levels 6-8)
0
0
0
0
(Levels 9-12)
0
0
0
0
0
0
0
0
Total
0
0
0
0
Department Of Health Vote 4
Appropriation Statement
for the year ended 31 March 2016
156
Part E: Financial Information
Financial Statements of
For the Year Ended 31 March 2016
Table of Contents
Report of the Auditor General
158
163
Notes to the Appropriation Statement
225
Statement of Financial Performance
228
Statement of Financial Position
229
Statement of Changes in Net Assets
230
Cash Flow Statement
231
Accounting Policies
232
Notes to the Annual Financial Statements
238
Annexures to the Annual Financial Statements
260
157
Report of the auditor-general to the Gauteng Provincial
Legislature on vote no. 4: Gauteng Department of Health
Report on the Änancial statements
Introduction
1.
I have audited the Änancial statements of the Gauteng Department of Health set out on pages 163 to 260,
which comprise the appropriation statement, the statement of Änancial position as at 31 March 2016, the
statement of Änancial performance, statement of changes in net assets and cash Åow statement for the
year then ended, as well as the notes, comprising a summary of signiÄcant accounting policies and other
explanatory information.
The accounting oɉcer’s responsibility for the Änancial statements
2.
The accounting oѝcer is responsible for the preparation and fair presentation of these Änancial statements
in accordance with the ModiÄed Cash Standard (MCS) prescribed by the National Treasury and the
requirements of the Public Finance Management Act of South Africa, 1999 (Act No.1 of 1999) (PFMA) and
the Division of Revenue Act of South Africa, 2015 (Act No. 1 of 2015) (DoRA), and for such internal control
as the accounting oѝcer determines is necessary to enable the preparation of Änancial statements that are
free from material misstatement, whether due to fraud or error.
Auditor-general’s responsibility
3.
My responsibility is to express an opinion on these Änancial statements based on my audit. I conducted my
audit in accordance with International Standards on Auditing. Those standards require that I comply with
ethical requirements, and plan and perform the audit to obtain reasonable assurance about whether the
Änancial statements are free from material misstatement.
4.
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures
in the Änancial statements. The procedures selected depend on the auditor’s judgement, including the
assessment of the risks of material misstatement of the Änancial statements, whether due to fraud or
error. In making those risk assessments, the auditor considers internal control relevant to the department’s
preparation and fair presentation of the Änancial statements in order to design audit procedures that are
appropriate in the circumstances, but not for the purpose of expressing an opinion on the eќectiveness of
the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies
used and the reasonableness of accounting estimates made by management, as well as evaluating the
overall presentation of the Änancial statements.
5.
I believe that the audit evidence I have obtained is suѝcient and appropriate to provide a basis for my audit
opinion.
158
Opinion
6.
In my opinion, the Änancial statements present fairly, in all material respects, the Änancial position of the
Gauteng Department of Health as at 31 March 2016 and its Änancial performance and cash Åows for the
year then ended, in accordance with MCS prescribed by the National Treasury and the requirements of
the PFMA and DoRA.
Emphasis of matters
7.
I draw attention to the matters below. My opinion is not modiÄed in respect of these matters.
SigniÄcant uncertainties
8.
With reference to note 20.1 to the Änancial statements, the department is the defendant in lawsuits as a
result of various claims relating to medical negligence, civil claims and breach of contract. The ultimate
outcome of these claims cannot presently be determined and no provision for any liability that may result
was made in the Änancial statements.
Restatement of corresponding Ägures
9.
As disclosed in note 34 to the Änancial statements, the corresponding Ägures for 31 March 2015 have been
restated as a result of an error discovered during 31 March 2016 in the Änancial statements of the Gauteng
Department of Health at, and for the year ended, 31 March 2015.
Payables
10. Payables which exceed the payment term of 30 days as required in treasury regulation 8.2.3 amount to
R1 201 597 000 as disclosed in note 22 to the Änancial statements. This amount, in turn, exceeds the voted
funds to be surrendered of R472 532 000 as per the statement of Änancial performance by R729 065 000.
Report on other legal and regulatory requirements
11. In accordance with the Public Audit Act of South Africa, 2004 (Act No. 25 of 2004) and the general notice
issued in terms thereof, I have a responsibility to report Ändings on the reported performance information
against predetermined objectives of selected programmes presented in the annual performance report,
compliance with legislation and internal control. The objective of my tests was to identify reportable Ändings
as described under each subheading but not to gather evidence to express assurance on these matters.
Accordingly, I do not express an opinion or conclusion on these matters.
Predetermined objectives
12. I performed procedures to obtain evidence about the usefulness and reliability of the reported performance
information of the following selected programmes presented in the annual performance report of the
department for the year ended 31 March 2016:
13. Programme 2: District health services on pages 32 to 51.
Programme 5: Tertiary and central hospital services on pages 57 to 64
14. I evaluated the usefulness of the reported performance information to determine whether it was presented in
accordance with the National Treasury’s annual reporting principles and whether the reported performance
was consistent with the planned programmes. I further performed tests to determine whether indicators
and targets were well deÄned, veriÄable, speciÄc, measurable, time bound and relevant, as required by the
National Treasury’s Framework for Managing Programme Performance Information (FMPPI).
15. I assessed the reliability of the reported performance information to determine whether it was valid, accurate
and complete.
16. The material Ändings in respect of the selected programmes are as follows:
Programme 2: District health services
Usefulness of reported performance information
Presentation of performance information
17. I was unable to obtain suѝcient appropriate audit evidence to support the reasons provided for the variance
between planned targets and actual achievements.
159
Measurability of indicators and targets
18. The processes and systems that produced the indicator should be veriÄable, as required by the FMPPI.
A total of 25% of indicators and targets were not veriÄable.
Reliability of reported performance information
19. The FMPPI requires auditees to have appropriate systems to collect, collate, verify and store performance
information to ensure reliable reporting of actual achievements against planned objectives, indicators and
targets. We were unable to obtain the information and explanations to satisfy ourselves as to the reliability
of the reported performance information. This was due to the fact that the auditee could not provide
suѝcient appropriate evidence in support of the reported performance information. In addition, the reported
performance information was not valid, accurate and complete when compared to the source information
or evidence provided.
Programme 5: Tertiary and central hospital services
Usefulness of reported performance information
Presentation of performance information
20. I was unable to obtain suѝcient appropriate audit evidence to support the reasons provided for the variance
between planned targets and actual achievements.
Additional matter
I draw attention to the following matter:
160
Achievement of planned targets
21. Refer to the annual performance report on pages 20 to 76 for information on the achievement of the
planned targets for the year. This information should be considered in the context of the material Ändings
on the usefulness and reliability of the reported performance information in paragraphs 16; 17; 18 and 19
of this report.
Compliance with legislation
22. I performed procedures to obtain evidence that the department had complied with applicable legislation
regarding Änancial matters, Änancial management and other related matters. My material Ändings on
compliance with speciÄc matters in key legislation, as set out in the general notice issued in terms of the
PAA, are as follows:
Procurement and contract management
23. Suѝcient appropriate audit evidence could not be obtained that goods and services with a transaction
value below R500 000 were procured by means of obtaining the required price quotations, as required by
treasury regulation 16A6.1.
24. Goods and services of a transaction value above R500 000 were procured without inviting competitive
bids, as required by treasury regulation 16A6.1. Deviations were approved by the accounting oѝcer even
though it was not impractical to invite competitive bids, in contravention of treasury regulation 16A6.4.
Expenditure management
25. Eќective steps were not taken to prevent irregular and fruitless and wasteful expenditure, amounting to
R493 155 000 and R7 433 000 respectively, as disclosed in notes 26 and 27 of the annual Änancial
statements, as required by section 38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1.
26. Contractual obligations and money owed by the department were not settled within 30 days, as required
by section 38(1)(f) of the PFMA and treasury regulation 8.2.3.
Revenue management
27. Eќective and appropriate steps were not taken to collect all money due, as required by section 38(1)(c)(i) of
the PFMA and treasury regulation 11.2.1, 15.10.1.2(a) and 15.10.1.2(e).
28. Interest was not charged on patient debts as required by treasury regulation 11.5.1.
Internal control
29. I considered internal control relevant to my audit of the Änancial statements, annual performance report
and compliance with legislation. The matters reported below are limited to the signiÄcant internal control
deÄciencies that resulted in the Ändings on the annual performance report and the Ändings on compliance
with legislation included in this report.
Leadership
30. The accounting oѝcer did not exercise adequate oversight responsibility to ensure complete and accurate
performance reporting. This resulted in material Ändings on the annual performance report and noncompliance with key laws and regulations.
Financial and performance management
31. Senior management did not ensure that suѝcient controls are in place to prepare accurate and complete
performance reports that are supported and evidenced by reliable information. In addition, there was a lack
monitoring controls to ensure compliance with laws and regulations including procurement and contract
management, expenditure management and revenue management.
Other reports
32. I draw attention to the following engagements that could potentially impact on the department’s Änancial,
performance and compliance related matters. My opinion is not modiÄed in respect of these engagements
that are either in progress or have been completed.
Performance audit on the management of pharmaceuticals
33. A performance audit on the management of pharmaceuticals was conducted at the national and
provincial departments of health. The objective was to determine whether patients received prescribed
pharmaceuticals in time. The performance audit focused on the following:
• Policy and planning for pharmaceuticals
• Procurement of pharmaceuticals
• Storage and safeguarding of pharmaceutical stock
• Distribution of pharmaceuticals to patients.
The outcomes of this performance audit will be included in a transversal report to be tabled in Parliament.
161
Investigations
34. Investigations based on the allegations of procurement irregularities, fraud, theft and negligence are being
performed by the department. Some of these investigations have been Änalised and others were still in
progress at the reporting date.
Johannesburg
31 July 2016
Johannesburg
31 July 2016
162
EMERGENCY MEDICAL SERVICES
PROVINCIAL HOSPITAL SERVICES
CENTRAL HOSPITAL SERVICES
HEALTH SCIENCES AND TRAINING
HEALTH CARE SUPPORT SERVICES
HEALTH FACILITIES MANAGEMENT
3
4
5
6
7
8
35 337 087
Departmental receipts
Actual amounts per Statement of Financial Performance Expenditure
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
Actual amounts per Statement of Financial Performance (Total Revenue)
Add:
1 957 652
259 796
912 929
12 034 408
6 726 998
1 086 491
11 615 587
743 226
R’000
Adjusted
Appropriation
Reconciliation with Statement of Financial Performance
TOTAL
ADMINISTRATION
DISTRICT HEALTH SERVICES
1
2
Programme
Voted funds and Direct charges
Appropriation per programme
98.7
31 491 179
1 384 100
230 602
870 779
11 584 643
6 100 656
933348
524 051
472 532
95.2
86.0
100.0
100.0
98.7
94.1
9 820 584
566 467
R’000
32 015 230
34 864 555
34 864 555
93 001
36 297
95
3 195
86 333
59 253
98.3
99.9
%
Expenditure
Final
as % of Änal Appropriation
appropriation
479 296
35 337 087
-
1 864 651
223499
938 834
12 582 282
6 432 065
940 319
193 590
768
R’000
Variance
35 816 383
259 796
1 957 652
26 000
-
938 929
551 069
-
6 518 398
12 585 477
(208 600)
999 572
(86 919)
11 075 547
807 358
808 126
11 269 137
64 900
(346 450)
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
Virement
31 005 212
31 005 212
1 384 095
211 542
861 931
11 584 642
5 987 314
847 561
9 563046
565 081
R’000
Actual
Expenditure
163
Goods and services
9 032
Catering: Departmental activities
234 353
Agency and support / outsourced services
2 329
146 701
Inventory: Fuel, oil and gas
Inventory: Learner and teacher support material
336 544
37 025
181 162
Inventory: Food and food supplies
Inventory: Clothing material and accessories
Fleet services (including government motor transport)
-
577 531
Contractors
Entertainment
30 510
1 407 228
36 954
255 349
Legal services
Laboratory services
Consultants: Business and advisory services
Computer services
91 725
5 210
Communication (G&S)
20 829
Bursaries: Employees
151 063
Audit costs: External
Minor assets
7 805
3 399 694
11 511 943
Social contributions
3 064
17 435 012
Salaries and wages
Advertising
20 834 706
Administrative fees
32 346 649
-
-
-
-
-
-
-
(18 905)
-
-
8 316
-
-
100
-
-
(5 993)
110
-
72 262
-
(31 568)
(31 568)
40 694
R’000
R’000
Compensation of employees
Shifting of
Funds
Adjusted
Appropriation
-
-
(1 600)
-
(9 000)
-
34 600
-
9 000
-
4 000
-
16 000
-
-
-
(20 000)
-
-
-
(6 000)
6 000
-
-
R’000
Virement
164
Current payments
Appropriation per economic classiÄcation
2 329
146 701
334 944
37 025
172 162
-
268 953
558 626
39 510
1 407 228
49 270
255 349
107 725
9 132
5 210
20 829
125 070
7 915
3 064
11 584 205
3 393 694
17 409 444
20 803 138
32 387 343
R’000
Final
Appropriation
2015/16
1 449
140 513
256 414
24 275
152 327
-
288 770
546 702
569 030
965 528
50 018
252 192
105 989
6 434
2 966
18 453
50 352
5 969
4 939
11 257 325
2 422 431
18 225 569
20 648 000
31 905 325
R’000
Actual
Expenditure
880
6 188
78 530
12 750
19 835
-
(19 817)
11 924
(529 520)
441 700
(748)
3 157
1 736
2 698
2 244
2 376
74 718
1 946
(1 875)
326 880
971 263
(816 125)
155 138
482 018
R’000
Variance
62.2
95.8
76.6
65.6
88.5
-
107.4
97.9
1 440.2
68.6
101.5
98.8
98.4
70.5
56.9
88.6
40.3
75.4
161.2
97.2
71.4
104.7
99.3
98.5
%
2 739
137 702
253 180
26 567
113 979
4
270 226
658 143
67 293
1 269 115
29 193
153 834
97 575
7 091
-
36 923
125 431
23 452
3 112
10 088 818
2 988 541
15 754 712
18 743 253
28 832 071
R’000
1 095
105 893
223 180
15 745
89 286
5
272 608
620 651
238 820
1 057 990
39 802
104 787
99 333
5 075
10
25 364
37 697
14 700
3 250
9 735 281
2 118 085
16 536 824
18 654 909
28 390 262
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
11 283
5 508
Operating payments
Venues and facilities
657 443
Municipal bank accounts
Departmental agencies and accounts
17 919
-
657 443
Municipalities
Municipal agencies and funds
657 443
Provinces and municipalities
1 457 653
-
Interest (Incl. interest on unitary payments (PPP))
Transfers and subsidies
-
Interest and rent on land
490
44 756
Training and development
Rental and hiring
32 334
1 978 486
Property payments
Travel and subsistence
126 883
Operating leases
48 773
125 799
Transport provided: Departmental activity
405 980
Consumable: Stationery, printing and oѝce supplies
35
Inventory: Other supplies
Consumable supplies
-
2 791 833
Inventory: Medicine
Medsas inventory interface
2 359 922
-
-
-
-
-
(51 882)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
205 684
(117 050)
-
R’000
R’000
45 447
Shifting of
Funds
Adjusted
Appropriation
Inventory: Medical supplies
Inventory: Materials and supplies
45 447
2 242 872
2 780 865
35
482 624
130 137
112 883
2 114 156
29 773
32 334
44 756
11 283
5 508
490
1 405 771
657 443
657 443
657 443
17 919
(216 652)
76 644
4 338
(14 000)
135 670
(19 000)
-
R’000
R’000
-
Final
Appropriation
2015/16
Virement
17 919
-
657 442
657 442
657 442
1 467 193
-
-
1 558
3 315
5 639
26 724
31 486
26 373
2 130 670
73 519
124 489
478 766
-
-
2 804 016
2 072 897
35 553
R’000
Actual
Expenditure
-
-
1
1
1
(61 422)
-
-
(1 068)
2 193
5 644
18 032
848
3 400
(16 514)
39 364
5 648
3 858
35
-
(23 151)
169 975
9 894
R’000
Variance
100.0
-
100.0
100.0
100.0
104.4
-
-
318.0
60.2
50.0
59.7
97.4
88.6
100.8
65.1
95.7
99.2
-
-
100.8
92.4
78.2
%
17 131
-
647 041
647 041
647 041
1 471 150
-
-
1 968
18 744
8 991
49 812
34 287
48 173
1 602 796
121 048
108 252
409 573
-
-
2 387 043
1 995 848
26 724
R’000
17 135
48
672 042
672 090
672 090
1 570 752
72
72
5 033
10 051
6 502
29 235
28 295
26 473
1 699 230
77 566
108 694
411 414
-
2
2 386 709
1 964 385
26 401
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
165
-
35 337 087
Biological assets
Land and sub-soil assets
Software and other intangible assets
Payment for ðnancial assets
-
-
-
-
-
Specialised military assets
-
11 188
-
11 188
-
-
11 188
-
(5 000)
(5 000)
(46 882)
-
659 596
-
Heritage assets
Other machinery and equipment
4 448
664 044
Transport equipment
868 741
Machinery and equipment
1 532 785
Payments for capital assets
Buildings
47 053
Other transfers to households
868 741
46 390
Buildings and other ðxed structures
93 443
Social beneÄts
686 984
1 864
17 919
R’000
R’000
Households
Non-proðt institutions
Higher education institutions
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
(35 900)
35 900
-
-
-
-
26 000
-
26 000
(26 000)
-
-
R’000
Virement
166
Departmental agencies (non-business entities)
35 337 087
-
-
-
-
-
-
634 884
40 348
675 232
868 741
868 741
1 543 973
73 053
41 390
114 443
614 102
1 864
17 919
R’000
Final
Appropriation
2015/16
34 864 555
10 848
-
-
-
-
-
554 635
141 566
696 201
784 988
784 988
1 481 189
179 497
87 293
266 790
523 218
1 824
17 919
R’000
Actual
Expenditure
472 532
(10 848)
-
-
-
-
-
80 249
(101 218)
(20 969)
83 753
83 753
62 784
(106 444)
(45 903)
(152 347)
90 884
40
-
R’000
Variance
98.7
-
-
-
-
-
-
87.4
350.9
103.1
90.4
90.4
95.9
245.7
210.9
233.1
85.2
97.9
100.0
%
31 491 179
-
-
-
-
-
482
773 149
41 008
814 157
373 319
373 319
1 187 958
105 195
40 677
145 872
659 324
1 782
17 131
R’000
31 005 212
12 699
-
-
-
-
248
578 341
73 956
652 297
378 954
378 954
1 031 499
133 329
95 495
228 824
652 703
-
17 135
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
Fleet services (including government motor transport)
Contractors
Legal services
Laboratory services
Computer services
Communication (G&S)
-
2 160
32
278
14 795
-
22 516
251 989
15 274
993
-
800
20 829
Minor assets
1 918
354 821
Goods and services
Advertising
73 017
1 377
297 753
Salaries and wages
Administrative fees
370 770
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
743 226
725 591
45
724 881
(45)
R’000
R’000
18 345
Shifting of
Funds
Adjusted
Appropriation
Current payments
2. MANAGEMENT
1. OFFICE OF THE MEC
Programme 1: ADMINISTRATION
383 821
1 377
1 918
29 000
-
993
31 274
251 989
26 516
23 795
278
32
2 160
-
16 000
4 000
9 000
-
-
73 017
-
297 753
-
800
370 770
-
20 829
754 591
29 000
-
808 126
64 900
-
18 345
792 770
35 855
R’000
R’000
29 045
Final
Appropriation
2015/16
Virement
-
2 778
223
141
61 798
-
26 301
248 146
31 102
1 408
64
18 453
516
2 351
3 140
420 386
39 534
284 496
324 030
744 416
807 358
792 770
14 588
R’000
Actual
Expenditure
-
(618)
(191)
137
(38 003)
-
215
3 843
172
(415)
(64)
2 376
284
(433)
(1 763)
(36 565)
33 483
13 257
46 740
10 175
768
(2 989)
3 757
R’000
Variance
-
128.6
696.9
50.7
259.7
-
99.2
98.5
99.5
141.8
-
88.6
64.5
122.6
228.0
109.5
54.1
95.5
87.4
98.7
100.4
100
79.5
%
-
1 590
555
515
10 543
-
24 500
129 549
15 387
415
-
20 561
616
4 716
1 861
248 076
37 944
266 556
304 500
552 576
566 467
551 023
15 444
R’000
2
1 524
598
1 312
26 948
304
36 466
76 490
17 264
484
(5)
23 976
318
3 643
2 236
212 420
35 789
266 052
301 841
514 261
565 081
550 015
15 066
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
167
57
-
Foreign governments and international organisations
Public corporations and private enterprises
Non-proÄt institutions
2 092
-
Households
-
2 092
120
Rental and hiring
-
220
152
2 068
Operating payments
6 729
2
3 227
Property payments
783
7 528
391
-
Operating leases
Consumable: Stationery, printing and oѝce supplies
Consumable supplies
Inventory: Medicine
481
52
50
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
R’000
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
168
2 092
-
-
-
-
-
-
2 092
-
120
220
152
2 068
6 729
2
3 227
783
7 528
391
-
481
57
52
50
R’000
Final
Appropriation
2015/16
4 288
-
-
-
-
-
-
4 288
-
740
725
67
3 431
6 520
25
4 648
1 468
4 918
445
144
754
61
1
18
R’000
Actual
Expenditure
(2 196)
-
-
-
-
-
-
(2 196)
-
(620)
(505)
85
(1 363)
209
(23)
(1 421)
(685)
2 610
(54)
(144)
(273)
(4)
51
32
R’000
Variance
205.0
-
-
-
-
-
-
205.0
-
616.7
329.5
44.1
165.9
96.9
1 250.0
144.0
187.5
65.3
113.8
-
156.8
107.0
1.9
36.0
%
2 000
-
-
-
-
-
-
2 000
-
6
529
37
3 396
10 687
-
5 831
7 765
7 728
847
-
182
39
58
163
R’000
2 158
-
-
-
-
-
-
2 158
-
4
591
44
1 052
6 884
41
4 913
4
4 571
655
-
1 754
195
43
109
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
-
743 226
Biological assets
Payment for Änancial assets
-
-
-
-
-
-
-
-
-
-
15 543
-
15 543
-
-
Heritage assets
Transport equipment
-
15 543
Buildings and other Äxed structures
-
-
R’000
R’000
2 092
Shifting of
Funds
Adjusted
Appropriation
Social beneÄts
57 681
-
2 092
51 443
35 900
808 126
-
-
64 900
-
-
-
-
-
-
-
-
-
15 543
-
-
-
35 900
35 900
807 358
973
-
-
-
50 358
7 323
57 681
51 443
35 900
2 717
1 571
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
768
(973)
-
-
-
-
-
(34 815)
28 577
(6 238)
-
(6 238)
(2 717)
521
R’000
Variance
99.9
-
-
-
-
-
-
324.0
20.4
112.1
-
112.1
-
75.1
%
566 467
-
-
-
-
-
-
8 031
3 860
11 891
-
11 891
-
2 000
R’000
565 081
6 471
-
-
-
-
-
36 689
5 502
42 191
-
42 191
204
1 954
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
169
13 649
-
Households
-
Biological assets
18 345
-
Total
-
475
-
Heritage assets
475
-
-
4 221
17 870
Current payments
Goods and services
R’000
Adjusted
Appropriation
(45)
-
-
-
-
-
-
(45)
-
(45)
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
45
-
-
-
-
-
45
-
45
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
170
Economic classiÄcation
Subprogramme: 1.1: OFFICE OF THE MEC
18 345
-
-
-
-
-
-
475
-
475
-
-
-
-
-
-
-
-
-
4 221
13 649
17 870
R’000
Final
Appropriation
2015/16
14 588
-
-
-
-
-
-
658
-
658
-
-
-
-
-
-
-
-
-
4 556
9 374
13 930
R’000
Actual
Expenditure
3 757
-
-
-
-
-
-
(183)
-
(183)
-
-
-
-
-
-
-
-
-
(335)
4 275
32 940
R’000
Variance
79.5
-
-
-
-
-
-
138.5
-
138.5
-
-
-
-
-
-
-
-
-
69
68.7
77.9
%
15 444
-
-
-
-
-
-
291
-
291
-
-
-
-
-
-
-
-
-
4 007
11 146
15 153
R’000
15 066
-
-
-
-
-
-
602
-
602
55
-
-
-
-
-
-
55
-
2 264
12 145
14 409
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
-
-
Biological assets
724 881
-
Total
-
15 068
-
15 068
Heritage assets
Households
2 092
-
-
2 092
350 600
Goods and services
357 121
707 721
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 1.2: MANAGEMENT
45
-
-
-
-
-
-
45
-
45
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
2 092
50 968
50 968
760 781
35 855
35 855
64 855
792 770
973
-
-
-
-
-
57 023
-
57 023
4 288
-
-
-
-
-
-
-
-
(2 989)
(973)
-
-
-
-
-
(6 055)
-
(6 055)
(2 196)
-
-
-
-
(2 196)
-
(36 230)
42 465
6 235
R’000
Variance
-
-
-
4 288
-
415 830
314 656
730 486
R’000
Actual
Expenditure
-
-
-
379 600
29 000
-
357 121
-
2 092
736 721
29 000
-
R’000
R’000
-
Final
Appropriation
2015/16
Virement
100.4
-
-
-
-
-
-
111.9
-
111.9
205.0
-
-
-
-
-
-
205.0
-
109.5
88.1
99.1
%
551 023
-
-
-
-
-
-
11 600
-
11 600
2 000
-
-
-
-
-
2 000
-
244 069
293 354
537 423
R’000
550 015
6 471
-
-
-
-
-
41 589
-
41 589
2 103
-
-
-
-
-
2 103
-
210 156
289 696
499 852
R’000
Actual
Expenditure
2014/15
Expenditure
Final
appropriation
171
1 474 746
3 086 733
4. COMMUNITY BASED SERVICES
5. HIV/AIDS
842 461
4 727 926
Goods and services
Computer services
Communication (G&S)
10 145
1 525
42 090
7 342
88 169
Minor assets
3 611
Advertising
404
5 094 169
Salaries and wages
Administrative fees
5 936 630
10 664 556
Current payments
Economic classiðcation
8 316
-
-
100
7
110
-
78 262
-
(31 568)
(31 568)
46 694
-
2 477 251
11 615 587
8. DISTRICT HOSPITALS
-
194 933
(1 100)
-
1 100
-
-
-
7. CORONER SERVICES
50 339
1 751 444
6. NUTRITION
2 113 377
3. COMMUNITY HEALTH CENTRES
466 764
R’000
R’000
2. COMMUNITY HEALTH CLINICS
1. DISTRICT MANAGEMENT
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
(50 000)
-
-
(291 000)
-
(55 450)
(55 450)
(346 450)
(346 450)
(106 000)
-
-
-
-
(210 450)
(30 000)
-
R’000
Virement
172
Sub programme
Programme 2: DISTRICT HEALTH SERVICES
18 461
1 525
42 090
7 442
38 176
3 721
404
4 515 188
842 461
5 007 151
5 849 612
10 364 800
11 269 137
2 371 251
194 933
49 239
3 086 733
1 475 846
1 540 994
2 083 377
466 764
R’000
Final
Appropriation
2015/16
9 307
437
38 347
4 554
26 449
2 153
234
4 406 612
753 774
5 045 998
5 799 772
10 206 384
11 075 547
2 341 351
184 034
48 712
3 002 814
1 458 519
1 503 927
2 085 055
451 135
R’000
Actual
Expenditure
9 154
1 088
3 743
2 888
11 727
1 568
170
108 576
88 687
(38 847)
49 840
158 416
193 590
29 900
10 899
527
83 919
17 327
37 067
(1 678)
15 629
R’000
Variance
50.4
28.7
91.1
61.2
69.3
57.9
57.9
97.6
89.5
100.8
99.1
98.5
98.3
98.7
94.4
98.9
97.3
98.8
97.6
100.1
96.7
%
Expenditure
as % of Änal
appropriation
904
381
39 574
5 659
48 029
16 285
325
3 695 109
804 042
4 385 283
5 189 325
8 884 434
9 820 584
2 048 420
183 884
47 759
2 790 532
1 176 291
1 329 667
1 805 836
438 195
R’000
751
329
35 712
3 821
14 999
8 572
184
3 613 482
644 602
4 519 328
5 163 930
8 777 412
9 563 046
2 045 733
173 799
42 109
2 709 860
1 168 605
1 329 667
1 664 910
428 363
R’000
Actual
Expenditure
2014/15
Final
Appropriation
4 836
11 577
74 219
67 676
Property payments
6 561
4 650
25 062
Operating payments
18 921
3 684
28 880
364 423
Operating leases
54 600
106 641
Consumable: Stationery, printing and oѝce
supplies
1 954 799
Consumable supplies
678 230
21 235
Inventory: Medicine
116
38 198
Fleet services (including government motor
transport)
55 302
378 505
-
-
-
-
-
-
-
-
-
215 634
(127 000)
-
-
-
-
-
-
-
(18 905)
-
-
R’000
R’000
676 475
Shifting of
Funds
Adjusted
Appropriation
Contractors
Legal services
Laboratory services
Sub programme
-
-
-
-
-
-
-
-
-
(171 000)
(70 000)
-
-
-
-
-
-
-
-
-
-
R’000
Virement
13 827
554
11 720
12 229
3 423
2 515
3 684
18 921
25 062
6 561
4 650
49 388
54 600
368 053
99 828
106 641
28 880
2 100 007
1 999 433
364 423
399 433
481 230
91
25
11 512
116
21 235
1 135
66 541
67 676
6 773
2 135
3 138
12 833
7 201
3 130
(3 630)
15 053
5 212
6 813
(100 574)
81 797
9 723
24 884
4 804
2 085
49 335
36 113
38 198
11 749
74 219
43 553
55 302
35 190
(40 889)
(5 300)
R’000
Variance
11 577
45 725
324 410
681 775
676 475
4 836
R’000
R’000
359 600
Actual
Expenditure
Final
Appropriation
2015/16
54.1
52.2
48.8
61.9
15.0
101.0
47.9
90.5
93.6
105.0
83.0
54.2
21.6
98.3
66.5
41.5
94.5
78.8
90.2
945.5
100.8
%
Expenditure
as % of Änal
appropriation
12 935
3 526
21 096
15 189
4 066
302 618
20 679
50 407
69 842
1 608 453
333 481
10 201
-
45 765
43 379
6 795
22 005
42 937
355 871
5 804
607 911
R’000
8 183
3 441
13 577
10 551
722
303 383
16 110
42 692
64 049
1 708 803
279 482
8 786
6
36 694
42 785
4 200
13 297
33 609
304 646
22 841
630 516
R’000
Actual
Expenditure
2014/15
Final
Appropriation
173
-
-
Heritage assets
Transport equipment
-
174 832
4 448
179 280
Buildings
-
179 280
-
11 434
Social beneÄts
11 434
Households
432 937
-
-
Foreign governments and international
organisations
327 380
327 380
Municipalities
-
327 380
771 751
50
-
188
-
188
-
-
188
-
-
-
(46 882)
-
-
-
-
-
-
-
(46 882)
-
-
R’000
R’000
Rental and hiring
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
174
Sub programme
-
175 020
4 448
179 468
-
-
179 468
-
11 434
11 434
386 055
-
-
-
-
327 380
327 380
327 380
724 869
-
50
R’000
Final
Appropriation
2015/16
-
126 548
63 633
190 181
-
-
190 181
69
24 360
24 429
324 493
-
-
-
-
327 379
327 379
327 379
676 301
-
361
R’000
Actual
Expenditure
-
48 472
(59 185)
(10 713)
-
-
(10 713)
(69)
(12 926)
(12 995)
61 562
-
-
-
-
1
1
1
48 568
-
(311)
R’000
Variance
-
72.3
1 430.6
106.0
-
-
106.0
-
213.0
213.7
84.1
-
-
-
-
100.0
100.0
100.0
93.3
-
722.0
%
Expenditure
as % of Änal
appropriation
-
181 443
7 406
188 849
14 150
14 150
202 999
445
14 357
14 802
407 629
-
-
-
-
310 720
310 720
310 720
733 151
-
992
R’000
-
72 563
34 526
107 089
13 554
13 554
120 643
45
23 738
23 783
328 990
-
-
-
-
310 721
310 721
310 721
663 494
-
741
R’000
Actual
Expenditure
2014/15
Final
Appropriation
R’000
R’000
-
11 615 587
Biological assets
-
-
-
-
-
Shifting of
Funds
Adjusted
Appropriation
Sub programme
(346 450)
-
-
-
-
-
R’000
Virement
(2 681)
2 681
11 075 547
11 269 137
193 590
-
-
-
R’000
R’000
R’000
Variance
Actual
Expenditure
Final
Appropriation
2015/16
98.3
-
-
-
-
-
%
Expenditure
as % of Änal
appropriation
9 820 584
-
-
-
-
-
R’000
9 563 046
1 497
-
-
-
-
R’000
Actual
Expenditure
2014/15
Final
Appropriation
175
-
organisations
-
Biological assets
466 764
-
Total
-
43 697
-
43 697
Heritage assets
Households
1 544
-
-
1 544
104 559
Goods and services
-
316 964
421 523
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
176
Subprogramme: 2.1: DISTRICT MANAGEMENT
466 764
-
-
-
-
-
-
43 697
-
43 697
1 544
-
-
-
-
-
-
1 544
-
104 559
316 964
421 523
R’000
Final
Appropriation
2015/16
451 135
794
-
-
-
-
-
45 811
-
45 811
2 181
-
-
-
2 181
-
110 256
292 093
402 349
R’000
Actual
Expenditure
15 629
(794)
-
-
-
-
-
(2 114)
-
(2 114)
(637)
-
-
-
-
-
-
(637)
-
(5 697)
24 871
19 174
R’000
Variance
96.7
-
-
-
-
-
-
104.8
-
104.8
141.3
-
-
-
-
-
-
141.3
-
105.4
92.2
95.5
%
Expenditure
as % of Änal
appropriation
438 195
-
-
-
-
-
-
37 717
-
37 717
1 476
-
-
-
-
-
1 476
-
60 916
338 086
399 002
R’000
Final
Appropriation
428 363
85
-
-
-
-
-
23 640
-
23 640
1 198
-
-
-
-
-
1 198
-
81 923
321 517
403 440
R’000
Actual
Expenditure
2014/15
-
-
Biological assets
2 113 377
-
Total
-
40 093
-
40 093
2 029
Heritage assets
Households
10 977
-
organisations
-
-
270 014
283 020
753 905
1 036 359
Goods and services
1 790 264
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 2.2: COMMUNITY HEALTH CLINICS
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(30 000)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(30 000)
-
(30 000)
(681)
4 354
33 067
33 067
681
2 085 055
40 093
40 093
2 083 377
(1 678)
-
-
-
-
7 026
-
7 026
(2 325)
(1 695)
-
-
2 029
-
-
-
-
-
-
-
1
12 672
-
-
-
270 013
270 014
(4 019)
-
8 698
(12 702)
(4 004)
R’000
Variance
10 977
287 039
-
715 207
723 905
283 020
1 764 268
1 049 061
1 760 264
1 036 359
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
100.1
-
-
-
-
-
-
82.5
-
82.5
214.6
115.4
-
-
-
-
100.0
101.4
-
98.8
101.2
100.2
%
Expenditure
as % of Änal
appropriation
1 805 836
-
-
-
-
-
-
26 439
-
26 439
4 000
9 000
-
-
-
-
256 424
269 424
-
482 867
1 027 106
1 509 973
R’000
1 664 910
181
-
-
-
-
-
10 451
-
10 451
5 642
7 436
-
-
-
-
256 425
269 503
-
450 160
934 615
1 384 775
R’000
Actual
Expenditure
2014/15
Final
Appropriation
177
-
organisations
-
Biological assets
1 751 444
-
Total
-
38 128
-
38 128
1 847
Heritage assets
Households
11 139
-
-
12 986
591 211
1 109 119
Goods and services
1 700 330
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(210 450)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(155 000)
(55 450)
(210 450)
R’000
Virement
178
Subprogramme: 2.3: COMMUNITY HEALTH CENTRES
1 540 994
-
-
-
-
-
-
38 128
-
38 128
1 847
11 139
-
-
-
-
-
12 986
-
436 211
1 053 669
1 489 880
R’000
Final
Appropriation
2015/16
1 503 927
536
-
-
-
-
-
31 975
-
31 975
6 082
11 139
-
-
-
-
-
17 221
-
421 474
1 032 721
1 454 195
R’000
Actual
Expenditure
37 067
(536)
-
-
-
-
-
6 153
-
6 153
(4 235)
-
-
-
-
-
-
(4 235)
-
14 737
20 948
35 685
R’000
Variance
97.6
-
-
-
-
-
-
83.9
-
83.9
329.3
100.0
-
-
-
-
-
132.6
-
96.6
98.0
97.6
%
Expenditure
as % of Änal
appropriation
1 329 667
-
-
-
-
-
-
19 160
-
19 160
3 749
65 153
-
-
-
-
68 902
-
360 470
881 135
1 241 605
R’000
1 329 667
318
-
-
-
-
-
15 282
-
15 282
6 969
63 666
-
-
-
-
-
70 635
-
308 623
934 809
1 243 432
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
1 474 746
-
Total
-
6 245
-
6 245
832
Heritage assets
Households
232 528
-
-
-
233 360
383 875
Goods and services
851 266
1 235 141
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 2.4: COMMUNITY BASED SERVICES
1 100
-
-
-
-
-
-
-
-
-
-
1 100
-
-
-
-
-
1 100
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(6)
2 607
20 022
20 022
6
1 458 519
832
6 245
6 245
1 475 846
-
17 327
-
-
-
-
(13 777)
-
(13 777)
(1 775)
29 395
204 233
-
-
-
-
-
-
-
27 620
-
11 345
(7 855)
3 490
R’000
Variance
233 628
-
-
-
-
206 840
372 530
383 875
-
859 121
851 266
234 460
1 231 651
1 235 141
-
-
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
98.8
-
-
-
-
-
-
320.6
-
320.6
313.3
87.4
-
-
-
-
-
88.2
-
97.0
100.9
99.7
%
Expenditure
as % of Änal
appropriation
1 176 291
-
-
-
-
-
-
36 622
-
36 622
795
201 211
-
-
-
-
-
202 006
-
313 645
624 018
937 663
R’000
1 168 605
-
-
-
-
-
-
8 418
-
8 418
2 401
149 143
-
-
-
-
-
151 544
-
279 668
728 975
1 008 643
R’000
Actual
Expenditure
2014/15
Final
Appropriation
179
R’000
-
organisations
-
Biological assets
3 086 733
-
Total
-
8 078
-
8 078
-
Heritage assets
Households
127 954
-
-
57 366
185 320
-
2 124 127
769 208
2 893 335
Goods and services
Current payments
Adjusted
Appropriation
-
-
-
-
-
-
-
188
-
188
-
(46 882)
-
-
-
-
-
(46 882)
-
78 262
(31 568)
46 694
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
180
Subprogramme: 2.5: HIV/AIDS
3 086 733
-
-
-
-
-
-
8 266
-
8 266
-
81 072
-
-
-
-
57 366
138 438
-
2 202 389
737 640
2 940 029
R’000
Final
Appropriation
2015/16
3 002 814
9
-
-
-
-
-
2 211
-
2 211
714
47 967
-
-
-
-
57 366
106 047
-
2 220 338
674 209
2 894 547
R’000
Actual
Expenditure
83 919
(9)
-
-
-
-
-
6 055
-
6 055
(714)
33 105
-
-
-
-
-
32 391
-
(17 949)
63 431
45 482
R’000
Variance
97.3
-
-
-
-
-
-
26.7
-
26.7
-
59.2
-
-
-
-
100.0
76.6
-
100.8
91.4
98.5
%
Expenditure
as % of Änal
appropriation
R’000
2 790 532
-
-
-
-
-
-
4 625
14 150
18 775
-
84 506
-
-
-
-
54 296
138 802
-
1 976 161
656 794
2 632 955
2 709 860
-
-
-
-
-
-
2 216
13 554
15 770
1 411
66 636
-
-
-
-
54 296
122 343
-
1 993 358
578 389
2 571 747
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
-
Heritage assets
Biological assets
50 339
-
Total
-
Households
50 339
-
organisations
-
50 339
-
-
-
-
Goods and services
-
-
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 2.6: NUTRITION
(1 100)
-
-
-
-
-
-
-
-
-
-
(1 100)
-
-
-
-
-
(1 100)
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
-
230
230
48 482
-
49 239
-
-
-
48 712
49 239
527
-
-
-
-
-
-
-
-
-
98.9
-
-
-
-
-
-
-
-
98.5
-
757
48 482
-
-
-
-
-
98.5
-
-
-
-
%
Expenditure
as % of Änal
appropriation
49 239
-
-
-
757
-
(230)
-
(230)
R’000
R’000
R’000
Variance
Actual
Expenditure
Final
Appropriation
2015/16
47 759
-
-
-
-
-
-
-
-
-
-
47 759
-
-
-
-
-
47 759
-
-
-
-
R’000
42 109
-
-
-
-
-
-
-
-
-
-
42 109
-
-
-
-
-
42 109
-
-
-
-
R’000
Actual
Expenditure
2014/15
Final
Appropriation
181
-
organisations
-
Biological assets
194 933
-
Total
-
6 139
-
6 139
Heritage assets
159
-
Households
-
159
29 371
159 264
Goods and services
188 635
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
182
Subprogramme: 2.7: CORONER SERVICES
194 933
-
-
-
-
-
-
6 139
-
6 139
159
-
-
-
-
-
-
159
-
29 371
159 264
188 635
R’000
Final
Appropriation
2015/16
184 034
34
-
-
-
-
-
11 930
-
11 930
757
-
-
-
-
-
-
757
-
28 343
142 970
171 313
R’000
Actual
Expenditure
10 899
(34)
-
-
-
-
-
(5 791)
-
(5 791)
(598)
-
-
-
-
-
-
(598)
-
1 028
16 294
17 322
R’000
Variance
94.4
-
-
-
-
-
-
194.3
-
194.3
476.1
-
-
-
-
-
-
476.1
-
96.5
89.8
90.8
%
Expenditure
as % of Änal
appropriation
183 884
-
-
-
-
-
-
20 434
-
20 434
150
-
-
-
-
-
-
150
-
28 859
134 441
163 300
R’000
173 799
58
-
-
-
-
-
13 717
-
13 717
81
-
-
-
-
-
-
81
-
27 982
131 961
159 943
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
2 477 251
-
Total
-
36 900
-
36 900
Heritage assets
Households
5 023
-
-
5 023
740 878
1 694 450
Goods and services
2 435 328
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 2.8: DISTRICT HOSPITALS
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(106 000)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(106 000)
-
(106 000)
45 165
621
2 341 351
36 900
2 371 251
29 900
(621)
-
-
-
-
-
(8 265)
-
(8 265)
45 165
-
-
36 900
-
-
-
-
-
-
-
(2 711)
-
-
7 734
-
-
-
-
-
-
(2 711)
-
96 644
(55 147)
41 497
R’000
Variance
5 023
7 734
-
538 234
634 878
5 023
2 287 831
1 749 597
2 329 328
1 694 450
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
98.7
-
-
-
-
-
-
122.4
-
122.4
154.0
-
-
-
-
-
-
154.0
-
84.8
103.3
98.2
%
Expenditure
as % of Änal
appropriation
2 048 420
-
-
-
-
-
-
43 852
-
43 852
4 632
-
-
-
-
-
4 632
-
472 191
1 527 745
1 999 936
R’000
2 045 733
855
-
-
-
-
-
33 365
-
33 365
6 081
-
-
-
-
-
6 081
-
471 768
1 533 664
2 005 432
R’000
Actual
Expenditure
2014/15
Final
Appropriation
183
R’000
R’000
1 086 491
249 850
Goods and services
113 510
transport)
2 100
10
6 500
1 916
5 000
60
865
6 471
50
Contractors
Legal services
Computer services
Communication (G&S)
4 098
73 831
1 012
351 879
Salaries and wages
Minor assets
425 710
Administrative fees
675 560
Current payments
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
136 964
2. PLANNED PATIENT TRANSPORT
-
949 527
1. EMERGENCY TRANSPORT
-
Shifting of
Funds
Adjusted
Appropriation
-
-
-
(9 000)
-
-
-
-
-
-
-
-
(42 000)
(6 000)
(3 019)
(9 019)
(51 019)
(86 919)
(28 000)
(58 919)
R’000
Virement
184
Sub programme
Programme 3: EMERGENCY MEDICAL SERVICES
2 100
10
6 500
104 510
1 916
5 000
60
865
6 471
50
4 098
1 012
207 850
67 831
348 860
416 691
624 541
999 572
108 964
890 608
R’000
Final
Appropriation
2015/16
699
8
3 067
93 063
303
1 420
50
-
4 304
27
1 864
1 120
177 544
61 111
327 723
388 834
566 378
940 319
109 904
830 415
R’000
Actual
Expenditure
1 401
2
3 433
11 447
1 613
3 580
10
865
2 167
23
2 234
(108)
30 306
6 720
21 137
27 857
58 163
59 253
(940)
60 193
R’000
Variance
33.3
80.0
47.2
89.0
15.8
28.4
83.3
-
66.5
54.0
45.5
110.7
85.4
90.1
93.9
93.3
90.7
94.1
100.9
93.2
%
Expenditure
as % of Änal
appropriation
5 000
10
5 000
67 118
1 500
4 000
-
-
4 000
10
7 973
712
199 235
58 697
281 046
339 743
538 978
933 348
130 516
802 832
R’000
1 894
6
1 488
66 085
541
2 638
324
-
6 487
2
147
616
136 808
51 677
279 233
330 910
467 718
847 561
124 396
723 165
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
330 063
-
330 063
Municipalities
330 063
-
332 063
-
20
450
Rental and hiring
763
1 001
43 812
6 000
supplies
12 000
3 398
Consumable supplies
27 000
3 000
Inventory: Medicine
Property payments
9 114
Operating leases
1 700
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
(19 000)
-
(14 000)
330 063
330 063
-
330 063
-
-
-
330 063
-
20
330 942
-
450
330 063
31
763
332 063
161
1 001
330 063
25 007
24 812
5 189
6 000
12 461
1 844
3 398
-
12 412
430
3 000
13 000
12 520
9 114
-
-
12 000
1 564
1 700
-
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
-
-
-
-
-
-
-
1 121
-
20
450
732
840
(195)
(412)
539
811
1 554
2 570
(3 406)
136
R’000
Variance
-
-
-
-
100.0
100.0
100.0
99.7
-
-
-
4.1
16.1
100.8
103.4
95.9
86.5
54.3
14.3
137.4
92.0
%
Expenditure
as % of Änal
appropriation
-
-
-
-
336 321
336 321
336 321
337 141
-
-
-
1 000
1 001
43 200
10 000
25 000
6 000
3 500
2 000
12 011
200
R’000
-
-
-
-
361 321
361 321
361 321
362 136
-
-
-
-
150
22 548
7 927
16 379
3 263
1 955
504
2 870
984
R’000
Actual
Expenditure
2014/15
Final
Appropriation
185
-
1 086 491
Biological assets
-
-
-
-
-
-
-
-
-
-
78 868
-
78 868
-
-
-
-
-
-
Heritage assets
Transport equipment
-
78 868
-
2 000
2 000
Social beneÄts
-
R’000
R’000
Households
Shifting of
Funds
Adjusted
Appropriation
(86 919)
-
-
-
-
-
-
(35 900)
-
(35 900)
-
(35 900)
-
-
-
-
R’000
Virement
186
999 572
-
-
-
-
-
-
42 968
-
42 968
-
42 968
-
2 000
2 000
-
R’000
Final
Appropriation
2015/16
940 319
39
-
-
-
-
-
7 041
35 919
42 960
-
42 960
-
879
879
-
R’000
Actual
Expenditure
59 253
(39)
-
-
-
-
-
35 927
(35 919)
8
-
8
-
1 121
1 121
-
R’000
Variance
94.1
-
-
-
-
-
-
16.4
-
100.0
-
100.0
-
44.0
44.0
-
%
Expenditure
as % of Änal
appropriation
933 348
-
-
-
-
-
-
29 687
27 542
57 229
-
57 229
81
739
820
-
R’000
847 561
38
-
-
-
-
-
2 197
15 472
17 669
-
17 669
80
735
815
-
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
949 527
-
Total
-
78 868
-
78 868
Heritage assets
1 000
-
Households
-
330 063
331 063
182 132
Goods and services
357 464
539 596
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 3.1: EMERGENCY TRANSPORT
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
(58 919)
-
-
-
-
-
-
(35 900)
-
(35 900)
-
-
-
-
-
-
-
-
(39)
330 063
724
42 960
42 960
39
830 415
330 063
1 000
42 968
42 968
890 608
-
60 193
-
-
-
-
8
-
8
276
-
-
-
-
-
-
276
-
23 892
330 787
144 240
168 132
(14 000)
36 056
59 948
-
312 389
R’000
Variance
331 063
456 629
516 577
348 445
(9 019)
(23 019)
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
93.2
-
-
-
-
-
-
100.0
-
100.0
72.4
-
-
-
-
-
100.0
99.9
-
85.8
89.7
88.4
%
Expenditure
as % of Änal
appropriation
802 832
-
-
-
-
-
-
57 229
-
57 229
680
-
-
-
-
-
336 321
337 001
-
133 917
274 685
408 602
R’000
723 165
38
-
-
-
-
-
17 669
-
17 669
691
-
-
-
-
-
361 321
362 012
-
80 641
262 805
343 446
R’000
Actual
Expenditure
2014/15
Final
Appropriation
187
R’000
-
organisations
-
Heritage assets
Biological assets
136 964
-
Total
-
1 000
-
Households
-
1 000
-
67 718
Goods and services
68 246
135 964
Current payments
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(28 000)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(28 000)
-
(28 000)
R’000
Virement
188
Subprogramme: 3.2: PLANNED PATIENT TRANSPORT
108 964
-
-
-
-
-
-
-
-
-
1 000
-
-
-
-
-
-
1 000
-
39 718
68 246
107 964
R’000
Final
Appropriation
2015/16
109 904
-
-
-
-
-
-
-
-
-
155
-
-
-
-
-
-
155
-
33 304
76 445
109 749
R’000
Actual
Expenditure
(940)
-
-
-
-
-
-
-
-
-
845
-
-
-
-
-
-
845
-
6 414
(8 199)
(1 785)
R’000
Variance
100.9
-
-
-
-
-
-
-
-
-
15.5
-
-
-
-
-
-
15.5
-
83.9
112.0
101.7
%
Expenditure
as % of Änal
appropriation
R’000
130 516
-
-
-
-
-
-
-
-
-
140
-
-
-
-
-
-
140
-
65 318
65 058
130 376
124 396
-
-
-
-
-
-
-
-
-
124
-
-
-
-
-
-
124
-
56 167
68 105
124 272
R’000
Actual
Expenditure
2014/15
Final
Appropriation
1 590 763
Goods and services
Legal services
Laboratory services
Computer services
Communication (G&S)
Minor assets
10 326
179 085
3 499
85
11 197
152
11 898
775
533 841
144
4 258 434
Salaries and wages
Advertising
4 792 275
Administrative fees
6 383 038
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
76 991
-
-
-
-
R’000
Shifting of
Funds
6 726 998
456 201
1 082 920
403 482
4 707 404
R’000
Adjusted
Appropriation
Current payments
5. OTHER SPECIALISED HOSPITALS
4. DENTAL TRAINING HOSPITALS
3. PSYCHIATRIC/MENTAL HOSPITAL
2. TUBERCULOSIS HOSPITALS
1. GENERAL HOSPITALS
Sub programme
Programme 4: PROVINCIAL HOSPITAL SERVICES
-
-
-
-
-
-
-
-
-
(182 600)
-
-
-
(182 600)
(208 600)
-
-
(886)
(2 491)
7 902
148
12 083
2 576
1 737
48 682
111 424
11 197
85
3 499
179 085
10 326
(101 098)
130 403
1 762
4
3 996
335
67
5 355
152
1 402 808
1 408 163
88 489
(18 911)
11 898
552 752
533 841
77
4 169 945
4 258 434
69 578
440
4 722 697
4 792 275
74 933
775
6 125 505
6 200 438
86 333
3 071
13 011
24 454
144
73 920
6 432 065
76 991
443 190
456 201
6 518 398
284 768
1 032 466
317 482
32 714
(26 000)
(86 000)
1 056 920
13 083
4 597 721
4 610 804
(96 600)
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
1 079.1
27.2
49.6
3 030.6
107.9
97.4
66.4
56.8
53.5
99.6
103.5
97.9
98.5
98.8
-
98.7
96.0
97.1
97.7
89.7
99.7
%
Expenditure
as % of Änal
appropriation
40 877
141 549
3 104
849
10 526
51
10 800
1 371
111
1 411 934
744 420
3 575 640
4 320 060
5 731 994
6 100 656
76 275
426 770
1 023 492
334 932
4 239 187
R’000
100 614
77 813
2 195
280
12 421
106
4 751
1 177
113
1 318 425
481 168
3 770 503
4 251 671
5 570 168
5 987 314
62 597
407 374
1 069 675
205 810
4 241 858
R’000
Actual
Expenditure
2014/15
Final
Appropriation
189
12 640
212 096
Operating leases
Property payments
2 137
2 537
705
19 538
supplies
76 782
Consumable supplies
35
Inventory: Other supplies
351 544
Inventory: Medicine
Medsas inventory interface
446 760
5 716
803
27 267
100 657
10 312
14 298
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
38 639
49 692
R’000
R’000
transport)
Entertainment
Sub programme
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
(155 000)
(26 000)
-
-
-
(1 600)
-
-
-
-
-
R’000
Virement
190
Contractors
2 537
2 137
705
212 096
12 640
19 538
76 782
35
-
196 544
420 760
5 716
803
27 267
99 057
10 312
14 298
-
49 692
38 639
R’000
Final
Appropriation
2015/16
617
863
694
253 407
11 029
21 422
92 065
-
-
179 046
419 689
5 761
682
28 471
89 076
7 846
9 812
-
58 005
37 818
R’000
Actual
Expenditure
1 920
1 274
11
(41 311)
1 611
(1 884)
(15 283)
35
-
17 498
1 071
(45)
121
(1 204)
9 981
2 466
4 486
-
(8 313)
821
R’000
Variance
24.3
40.4
98.4
119.5
87.3
109.6
119.9
-
-
91.1
99.7
100.8
84.9
104.4
89.9
76.1
68.6
-
116.7
97.9
%
Expenditure
as % of Änal
appropriation
1 259
2 013
296
130 861
10 445
16 456
97 889
-
-
288 075
400 312
5 841
443
43 489
78 517
5 757
12 444
1
54 316
46 650
R’000
413
1 272
3 102
207 123
6 177
18 414
87 204
-
2
175 382
414 032
4 437
146
28 318
62 915
3 516
3 612
2
48 190
52 657
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
Transport equipment
-
82 802
-
Buildings
-
82 802
7 111
Social beneÄts
7 111
Households
254 047
-
-
261 158
-
Interest (Incl. interest on unitary payments (PPP))
-
300
Rental and hiring
158
986
R’000
Adjusted
Appropriation
Sub programme
Operating payments
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
198 725
19 568
19 568
228 047
7 111
7 111
-
-
-
-
-
-
-
-
(26 000)
13 926
-
-
-
-
-
-
-
86 123
-
-
82 802
-
-
-
-
-
-
-
-
-
-
-
-
218 293
235 158
-
(26 000)
-
-
-
-
-
-
-
-
86 123
457
300
-
-
-
49
158
-
82 802
(12 457)
930
986
-
(13 926)
(3 321)
-
-
(3 321)
(12 457)
29 322
-
-
-
-
-
-
16 865
-
-
(157)
109
56
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
Virement
2015/16
-
104.0
-
-
104.0
-
275.2
275.2
87.1
-
-
-
-
-
-
92.8
-
-
152.3
31.0
94.3
%
Expenditure
as % of Änal
appropriation
2 000
111 057
500
500
111 557
-
5 410
5 410
251 695
-
-
-
-
-
-
257 105
-
-
470
5 200
1 962
R’000
Final
Appropriation
5 550
72 111
631
631
72 742
419
18 860
19 279
323 713
-
-
-
4
4
-
342 996
72
72
335
1 118
588
R’000
Actual
Expenditure
2014/15
191
-
6 726 998
Biological assets
-
-
-
-
-
-
-
Heritage assets
Sub programme
-
R’000
R’000
82 802
Shifting of
Funds
Adjusted
Appropriation
(208 600)
-
-
-
-
-
-
-
R’000
Virement
192
6 518 398
-
-
-
-
-
-
82 802
R’000
Final
Appropriation
2015/16
6 432 065
2 144
-
-
-
-
-
72 197
R’000
Actual
Expenditure
86 333
(2 144)
-
-
-
-
-
10 605
R’000
Variance
98.7
-
-
-
-
-
-
87.2
%
Expenditure
as % of Änal
appropriation
R’000
6 100 656
-
-
-
-
-
-
109 057
5 987 314
1 408
-
-
-
-
-
66 561
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
4 707 404
-
Total
-
53 406
-
53 406
Heritage assets
Households
3 532
-
-
3 532
1 200 759
Goods and services
3 449 707
4 650 466
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 4.1: GENERAL HOSPITALS
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(96 600)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(96 600)
-
(96 600)
70 159
-
53 406
-
1 834
4 597 721
4 610 804
-
-
13 083
(1 834)
-
-
-
-
-
(16 753)
-
(16 753)
70 159
-
-
53 406
-
-
-
(11 599)
-
-
-
15 131
-
-
-
-
3 532
-
-
-
-
-
(11 599)
-
(35 310)
78 579
43 269
R’000
Variance
-
15 131
-
1 139 469
1 104 159
3 532
4 510 597
3 371 128
4 553 866
3 449 707
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
99.7
-
-
-
-
-
-
131.4
-
131.4
428.4
-
-
-
-
-
-
428.4
-
103.2
97.7
99.0
%
Expenditure
as % of Änal
appropriation
4 239 187
-
-
-
-
-
-
85 874
-
85 874
3 276
-
-
-
-
-
3 276
-
1 099 854
3 050 183
4 150 037
R’000
4 241 858
1 157
-
-
-
-
-
53 880
-
53 880
13 477
-
-
-
-
-
13 477
-
1 129 008
3 044 336
4 173 344
R’000
Actual
Expenditure
2014/15
Final
Appropriation
193
-
organisations
-
Biological assets
Payment for Änancial assets
403 482
-
Total
-
10 064
-
10 064
Heritage assets
Households
441
-
-
441
200 937
Goods and services
192 040
392 977
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(86 000)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(86 000)
-
(86 000)
R’000
Virement
194
Subprogramme: 4.2: TUBERCULOSIS HOSPITALS
317 482
-
-
-
-
-
-
10 064
-
10 064
441
-
-
-
-
-
-
441
-
114 937
192 040
306 977
R’000
Final
Appropriation
2015/16
284 768
18
-
-
-
-
-
1 809
-
1 809
717
-
-
-
-
-
717
-
87 011
195 213
282 224
R’000
Actual
Expenditure
32 714
(18)
-
-
-
-
-
8 255
-
8 255
(276)
-
-
-
-
-
-
(276)
-
27 926
(3 173)
24 753
R’000
Variance
89.7
-
-
-
-
-
-
18.0
-
18.0
162.6
-
-
-
-
-
-
162.6
-
75.7
101.7
91.9
%
Expenditure
as % of Änal
appropriation
334 932
-
-
-
-
-
-
2 688
500
3 188
400
-
-
-
-
-
400
-
150 197
181 147
331 344
R’000
Final
Appropriation
205 810
60
-
-
-
-
-
1 875
360
2 235
460
-
-
-
-
-
460
72
47 626
155 357
203 055
R’000
Actual
Expenditure
2014/15
-
organisations
-
Biological assets
1 082 920
-
Total
-
6 766
Heritage assets
-
6 766
2 006
Households
254 047
-
-
256 053
123 866
Goods and services
-
696 235
820 101
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 4.3: PSYCHIATRIC/MENTAL HOSPITAL
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
(187)
822 409
702 529
119 880
201 674
198 725
2 949
8 196
8 196
187
1 032 466
820 101
696 235
123 866
230 053
228 047
2 006
6 766
6 766
1 056 920
(26 000)
-
-
-
-
-
-
-
-
-
-
(26 000)
-
-
-
-
-
(26 000)
-
-
-
-
24 454
-
-
-
-
(1 430)
-
(1 430)
(943)
29 322
-
-
-
-
-
28 379
-
3 986
(6 294)
(2 308)
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
97.7
-
-
-
-
-
-
121.1
-
121.1
147.0
87.1
-
-
-
-
-
87.7
-
96.8
100.9
100.3
%
Expenditure
as % of Änal
appropriation
1 023 492
-
-
-
-
-
-
7 535
-
7 535
962
251 695
-
-
-
-
-
252 657
-
99 933
663 367
763 300
R’000
1 069 675
123
-
-
-
-
-
5 856
-
5 856
4 048
323 713
-
-
-
4
-
327 765
-
96 999
638 932
735 931
R’000
Actual
Expenditure
2014/15
Final
Appropriation
195
-
organisations
-
Biological assets
456 201
-
Total
-
10 166
-
10 166
Heritage assets
896
-
Households
-
896
-
48 571
396 568
Goods and services
445 139
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
196
Subprogramme: 4.4: DENTAL TRAINING HOSPITALS
456 201
-
-
-
-
-
-
10 166
-
10 166
896
-
-
-
-
-
-
896
-
48 571
396 568
445 139
R’000
Final
Appropriation
2015/16
443 190
-
-
-
-
-
-
3 755
-
3 755
586
-
-
-
-
-
-
586
-
43 288
395 457
438 745
R’000
Actual
Expenditure
13 011
(104)
-
-
-
-
-
6 411
-
6 411
310
-
-
-
-
-
-
310
-
5 283
1 111
6 394
R’000
Variance
97.1
-
-
-
-
-
-
36.9
-
36.9
65.4
-
-
-
-
-
-
65.4
-
89.1
99.7
98.6
%
Expenditure
as % of Änal
appropriation
R’000
426 770
-
-
-
-
-
-
9 176
-
9 176
757
-
-
-
-
-
-
757
-
48 613
368 224
416 837
407 374
67
-
-
-
-
-
8 869
271
9 140
1 144
-
-
-
-
-
-
1 144
-
34 196
362 827
397 023
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
76 991
-
Total
-
2 400
-
2 400
Heritage assets
Households
236
-
-
236
16 630
Goods and services
57 725
-
74 355
Current payments
R’000
Adjusted
Appropriation
Subprogramme: 4.5: OTHER SPECIALISED HOSPITALS
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
R’000
71 530
58 370
13 160
185
-
R’000
74 355
57 725
16 630
236
-
-
-
1
-
-
73 920
2 204
2 400
-
-
-
76 991
185
2 204
236
2 400
-
Actual
Expenditure
Final
Appropriation
2015/16
3 071
-
-
-
-
-
196
-
196
51
-
-
-
-
-
-
51
-
3 470
(645)
2 825
R’000
Variance
96.0
-
-
-
-
-
-
91.8
-
91.8
78.4
-
-
-
-
-
-
78.4
-
79.1
101.1
96.2
%
Expenditure
as % of Änal
appropriation
76 275
-
-
-
-
-
-
5 784
-
5 784
15
-
-
-
-
-
15
-
13 337
57 139
70 476
R’000
62 597
1
-
-
-
-
-
1 631
-
1 631
150
-
-
-
-
-
150
-
10 596
50 219
60 815
R’000
Actual
Expenditure
2014/15
Final
Appropriation
197
R’000
R’000
1 721 366
3 374 153
Goods and services
801
606
127 132
493
152 149
Contractors
Legal services
551 668
Laboratory services
373
14 338
83
-
41 442
Computer services
Communication (G&S)
Minor assets
Advertising
65
6 639 678
Salaries and wages
Administrative fees
8 361 044
Current payments
-
-
-
-
-
-
-
-
-
(6 000)
-
-
(6 000)
-
-
-
(6 000)
12 034 408
11 735 197
-
2 954 651
2. PROVINCIAL TERTIARY HOSPITAL
SERVICES
-
9 079 757
1. CENTRAL HOSPITALS
-
Shifting of
Funds
Adjusted
Appropriation
34 600
-
-
-
-
-
-
-
-
30 000
-
-
486 600
-
64 469
64 469
551 069
551 069
-
551 069
R’000
Virement
198
Sub programme
Programme 5: CENTRAL HOSPITAL SERVICES
161 732
152 149
493
551 668
606
373
14 338
83
-
65 442
801
65
3 854 753
1 721 366
6 704 147
8 425 513
12 280 266
12 585 477
2 954 651
9 630 826
R’000
Final
Appropriation
2015/16
186 453
180 497
349 868
235 071
12 603
1 025
18 186
152
-
13 085
692
330
3 659 816
896 804
7 688 155
8 584 959
12 244 775
12 582 282
2 514 476
10 067 806
R’000
Actual
Expenditure
(24 721)
(28 348)
(349 375)
316 597
(11 997)
(652)
(3 848)
(69)
-
52 357
109
(265)
194 937
824 562
(984 008)
(159 446)
35 491
3 195
440 175
(436 980)
R’000
Variance
115.3
118.6
70 967.1
42.6
2 079.7
274.8
126.8
183.1
-
20.0
86.4
507.7
94.9
52.1
114.7
101.9
99.7
-
100.0
85.1
104.5
%
Expenditure
as % of Änal
appropriation
169 928
237 738
10 019
519 655
635
-
25 273
74
-
38 486
124
88
3 532 490
1 223 610
6 553 792
7 777 402
11 309 892
11 584 643
2 386 515
9 198 128
R’000
188 567
250 136
87 586
349 357
378
210
25 273
63
15
11 816
512
68
3 476 310
790 975
7 026 508
7 817 483
11 293 793
11 584 642
2 386 515
9 198 127
R’000
Actual
Expenditure
2014/15
Final
Appropriation
6 447
15 743
335 162
Property payments
-
Municipalities
Municipal agencies and funds
22 684
3 184
Operating payments
-
2 703
1 278
563
18 027
33 763
Operating leases
172 169
Consumable supplies
supplies
482 338
Inventory: Medicine
1 223 916
48 662
133 994
7 054
-
-
-
(5 000)
-
-
-
-
-
-
-
-
-
(9 950)
9 950
-
-
-
-
-
-
R’000
R’000
-
Shifting of
Funds
Adjusted
Appropriation
transport)
Entertainment
-
-
-
-
-
-
-
-
-
-
135 670
-
4 338
76 644
109 348
96 000
-
-
4 272
(518)
44 390
48 662
(1 273)
914
690
37 823
-
2 703
3 184
17 684
-
470
434 978
470 832
93
2 190
1 353
39 929
38 101
18 027
563
244 131
248 813
1 278
35 854
523 817
581 736
-
-
-
(20 139)
-
2 494
1 789
(75)
15 837
(1 828)
4 682
57 919
91 112
16 261
1 238 754
15 743
1 329 866
32 550
7 720
101 444
1 864
6 447
5 190
7 054
-
-
R’000
Variance
133 994
-
-
-
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
-
-
-
213.9
-
21.7
33.8
105.9
16.5
92.4
12.1
104.8
98.1
90.0
93.1
103.3
91.2
75.7
119.7
73.6
-
-
%
Expenditure
as % of Änal
appropriation
-
-
-
15 431
-
2 786
1 773
1 363
556
395 237
22 812
23 021
184 468
488 461
1 240 115
6 700
42 377
106 529
7 386
6 883
3
R’000
48
48
48
49 073
-
1 922
836
1 436
15
399 806
8 167
36 779
213 229
501 962
1 252 342
9 282
38 869
89 564
5 348
2 769
3
R’000
Actual
Expenditure
2014/15
Final
Appropriation
199
-
12 034 408
Biological assets
-
-
-
-
-
-
-
11 000
-
11 000
276 527
-
276 527
-
11 000
-
(5 000)
(5 000)
-
-
-
-
Heritage assets
Transport equipment
-
276 527
22 684
-
22 684
-
Social beneÄts
-
organisations
Households
-
-
R’000
R’000
-
Shifting of
Funds
Adjusted
Appropriation
551 069
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
200
12 585 477
-
-
-
-
-
-
287 527
-
287 527
-
287 527
-
17 684
17 684
-
-
-
-
-
R’000
Final
Appropriation
2015/16
12 582 282
3 557
-
-
-
-
-
285 282
10 845
296 127
-
296 127
999
36 824
37 823
-
-
-
-
-
R’000
Actual
Expenditure
3 195
(3 557)
-
-
-
-
-
2 245
(10 845)
(8 600)
-
(8 600)
(999)
(19 140)
(20 139)
-
-
-
-
-
R’000
Variance
100.0
-
-
-
-
-
-
99.2
-
103.0
-
103.0
-
208.2
213.9
-
-
-
-
-
%
Expenditure
as % of Änal
appropriation
11 584 643
-
-
-
-
-
-
259 120
200
259 320
-
259 320
-
15 431
15 431
-
-
-
-
-
R’000
11 584 642
2 476
-
-
-
-
-
233 252
6 048
239 300
-
239 300
1 517
47 508
49 025
-
-
-
-
-
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
9 079 757
-
Total
-
175 527
-
175 527
Heritage assets
20 032
-
Households
-
20 032
2 366 811
Goods and services
-
6 517 387
8 884 198
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 5.1: CENTRAL HOSPITALS
-
-
-
-
-
-
-
11 000
-
11 000
(5 000)
-
-
-
-
-
-
(5 000)
-
(6 000)
-
(6 000)
R’000
Shifting of
Funds
-
551 069
-
-
-
-
-
-
-
-
-
(3 186)
3 186
10 067 806
9 630 826
(436 980)
-
-
-
-
(26 233)
-
(26 233)
(16 376)
-
-
-
-
-
-
-
-
-
-
212 760
-
-
-
-
-
-
-
-
-
-
-
186 527
-
-
-
-
-
-
-
(16 376)
-
31 408
15 032
-
-
(188 868)
31 408
-
-
212 760
3 036 279
2 847 411
-
486 600
(202 317)
15 032
6 784 173
6 581 856
64 469
(391 185)
R’000
Variance
186 527
9 820 452
9 429 267
551 069
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
104.5
-
-
-
-
-
-
114.1
-
114.1
208.9
-
-
-
-
-
-
208.9
-
106.6
103.1
104.1
%
Expenditure
as % of Änal
appropriation
9 198 128
-
-
-
-
-
-
159 315
-
159 315
13 113
-
-
-
-
-
-
13 113
-
2 855 046
6 170 654
9 025 700
R’000
9 198 127
2 319
-
-
-
-
-
189 268
-
189 268
39 929
-
-
-
-
-
48
39 977
-
2 817 342
6 149 221
8 966 563
R’000
Actual
Expenditure
2014/15
Final
Appropriation
201
-
organisations
-
Biological assets
2 954 651
-
Total
-
101 000
-
101 000
Heritage assets
2 652
-
Households
-
2 652
-
1 007 342
Goods and services
1 843 657
R’000
2 850 999
Current payments
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
202
Adjusted
Appropriation
Subprogramme: 5.2: PROVINCIAL TERTIARY HOSPITAL SERVICES
2 954 651
-
-
-
-
-
-
101 000
-
101 000
2 652
-
-
-
-
-
-
2 652
-
1 007 342
1 843 657
2 850 999
R’000
Final
Appropriation
2015/16
2 514 476
371
-
-
-
-
83 367
-
83 367
6 415
-
-
-
-
-
-
6 415
-
623 537
1 800 786
2 424 323
R’000
Actual
Expenditure
440 175
(371)
-
-
-
-
-
17 633
-
17 633
(3 763)
-
-
-
-
-
-
(3 763)
-
383 805
42 871
426 676
R’000
Variance
85.1
-
-
-
-
-
-
82.5
-
82.5
241.9
-
-
-
-
-
-
241.9
-
61.9
97.7
85.0
%
Expenditure
as % of Änal
appropriation
R’000
2 386 515
-
-
-
-
-
-
100 005
-
100 005
2 318
-
-
-
-
-
-
2 318
-
677 444
1 606 748
2 284 192
2 386 515
157
-
-
-
-
-
50 032
-
50 032
9 096
-
-
-
-
-
-
9 096
-
658 968
1 668 262
2 327 230
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
912 929
662 001
115 833
55 553
Salaries and wages
Goods and services
Contractors
540
-
188
Legal services
512
1 572
Computer services
Communication (G&S)
262
5 210
-
1 076
Minor assets
300
Advertising
62
777 834
Administrative fees
833 387
Current payments
-
59 678
4. OTHER TRAINING
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
52 053
3. BURSARIES
-
39 584
-
R’000
R’000
761 614
Shifting of
Funds
Adjusted
Appropriation
2. EMS TRAINING COLLEGES
1. NURSE TRAINING COLLEGES
Sub programme
Programme 6: HEALTH SCIENCES AND TRAINING
118
938 834
728 829
675 562
582 589
92 973
53 267
38
353
2 902
938 929
833 387
777 834
662 001
115 833
55 553
62
300
1 076
5 210
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
26 000
8
70
165
388
512
188
540
144
63 194
1 375
180 373
78 053
59 678
-
26 000
262
28 381
39 584
-
1 572
2 308
666 886
761 614
-
152
(165)
118
504
197
-
723
300
24
2 286
22 860
79 412
102 272
104 558
95
(3 516)
(102 320)
11 203
94 728
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
Virement
2015/16
71.9
-
37.2
1.6
87.5
55.0
55.7
-
32.8
-
61.3
95.9
80.3
88.0
86.9
87.5
100.0
105.9
231.1
71.7
87.6
%
Expenditure
as % of Änal
appropriation
1 133
50
50
109
1 798
382
-
16 362
2 039
356
15
68 508
93 898
567 203
661 101
729 609
870 779
56 040
121 031
38 059
655 649
R’000
Final
Appropriation
498
507
12
4
1 305
206
-
1 388
701
244
33
48 093
92 551
561 481
654 032
702 125
861 931
56 268
132 717
27 811
645 135
R’000
Actual
Expenditure
2014/15
203
1 051
19 996
Operating leases
Property payments
-
67 588
30
400
7 649
Operating payments
1 995
7
3 635
supplies
152
2 819
Consumable supplies
905
Inventory: Medicine
902
1 410
52
61
2 109
2 513
transport)
145
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
R’000
Shifting of
Funds
Adjusted
Appropriation
-
26 000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
204
-
93 588
-
30
400
7 649
1 995
7
19 996
1 051
3 635
2 819
152
905
902
1 410
52
61
2 109
2 513
145
R’000
Final
Appropriation
2015/16
-
198 885
-
26
31
6 310
10 716
-
18 402
45
3 221
4 673
555
838
210
742
12
39
373
1 551
80
R’000
Actual
Expenditure
-
(105 297)
-
4
369
1 339
(8 721)
7
1 594
1 006
414
(1 854)
(403)
67
692
668
40
22
1 736
962
65
R’000
Variance
-
212.5
-
86.7
7.8
82.5
537.1
-
92.0
4.3
88.6
165.8
365.1
92.6
23.3
52.6
23.1
63.9
17.7
61.7
55.2
%
Expenditure
as % of Änal
appropriation
-
125 644
-
80
680
15 125
3 632
10
8 938
1 180
3 973
4 179
54
511
1 172
2 296
48
203
1 629
2 039
465
R’000
-
150 215
-
139
322
10 452
7 466
-
13 518
-
2 442
4 920
58
161
748
943
28
78
261
1 067
592
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
-
-
912 929
Biological assets
-
-
-
-
-
-
-
-
-
11 954
-
11 954
-
-
-
-
-
-
-
-
-
-
Heritage assets
Transport equipment
-
11 954
47 053
752
Social beneÄts
47 805
-
Households
-
1 864
organisations
17 919
-
R’000
R’000
17 919
Shifting of
Funds
Adjusted
Appropriation
-
26 000
-
-
-
-
-
-
-
-
-
-
-
26 000
-
26 000
(1 394)
4 155
1 394
938 834
11 954
938 929
95
-
-
-
-
7 799
(5 571)
2 228
9 726
-
-
2 228
(102 659)
5 571
9 726
11 954
-
175 712
73 053
(2 678)
(105 337)
-
40
-
-
11 954
3 430
752
-
-
-
-
-
-
-
179 142
1 824
1 864
-
-
17 919
17 919
-
73 805
-
17 919
17 919
-
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
100.0
-
-
-
-
-
-
34.8
-
81.4
-
81.4
240.5
456.1
242.7
-
-
-
97.9
100.0
100.0
%
Expenditure
as % of Änal
appropriation
870 779
-
-
-
-
-
-
15 526
-
15 526
-
15 526
104 669
2 062
106 731
-
-
-
1 782
17 131
17 131
R’000
861 931
790
-
-
-
-
-
4 648
4 153
8 801
-
8 801
131 064
2 020
133 084
-
-
-
-
17 131
17 131
R’000
Actual
Expenditure
2014/15
Final
Appropriation
205
-
organisations
-
Biological assets
761 614
-
Total
-
3 587
-
3 587
Heritage assets
752
-
Households
-
752
-
27 877
729 398
Goods and services
757 275
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
206
Subprogramme: 6.1: NURSE TRAINING COLLEGES
761 614
-
-
-
-
-
-
3 587
-
3 587
752
-
-
-
-
-
-
752
-
27 877
729 398
757 275
R’000
Final
Appropriation
2015/16
666 886
1 214
-
-
-
-
-
7 455
-
7 455
1 607
-
-
-
-
-
-
1 607
-
26 254
630 356
656 610
R’000
Actual
Expenditure
94 728
(1 214)
-
-
-
-
-
(3 868)
-
(3 868)
(855)
-
-
-
-
-
-
(855)
-
1 623
99 042
100 665
R’000
Variance
87.6
-
-
-
-
-
-
207.8
-
207.8
213.7
-
-
-
-
-
-
213.7
-
94.2
86.4
86.7
%
Expenditure
as % of Änal
appropriation
655 649
-
-
-
-
-
-
7 527
-
7 527
2 062
-
-
-
-
-
-
2 062
-
21 190
624 870
646 060
R’000
645 135
779
-
-
-
-
-
5 603
-
5 603
1 806
-
-
-
-
-
-
1 806
-
20 531
616 416
636 947
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
Households
-
Biological assets
39 584
-
Total
-
7 933
-
Heritage assets
7 933
-
-
12 375
Goods and services
-
19 276
31 651
Current payments
R’000
Adjusted
Appropriation
Subprogramme: 6.2: EMS TRAINING COLLEGES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
4 307
-
8 068
12 375
5 651
(180)
51
2 150
2 150
180
28 381
7 933
7 933
39 584
11 203
-
-
-
-
5 783
-
5 783
(51)
-
-
-
-
-
-
(51)
51
-
1 344
26 000
17 932
R’000
31 651
R’000
R’000
Variance
19 276
Actual
Expenditure
Final
Appropriation
2015/16
71.7
-
-
-
-
-
-
27.1
-
27.1
-
-
-
-
-
-
-
-
-
65.2
93.0
82.1
%
Expenditure
as % of Änal
appropriation
38 059
-
-
-
-
-
-
7 584
-
7 584
-
-
-
-
-
-
-
-
-
12 386
18 089
30 475
R’000
27 811
11
-
-
-
-
-
3 198
-
3 198
161
-
-
-
-
-
-
161
-
7 211
17 230
24 441
R’000
Actual
Expenditure
2014/15
Final
Appropriation
207
-
organisations
-
Heritage assets
Biological assets
52 053
-
Total
-
47 053
-
Households
-
47 053
5 000
Goods and services
-
5 000
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
26 000
-
-
-
-
-
-
-
-
-
26 000
-
-
-
-
-
-
26 000
-
-
-
-
R’000
Virement
208
Subprogramme: 6.3: BURSARIES
78 053
-
-
-
-
-
-
-
-
-
73 053
-
-
-
-
-
-
73 053
-
5 000
-
5 000
R’000
Final
Appropriation
2015/16
180 373
-
-
-
-
-
-
-
-
-
177 471
-
-
-
-
-
-
177 471
-
2 902
-
2 902
R’000
Actual
Expenditure
(102 320)
-
-
-
-
-
-
-
-
-
(104 418)
-
-
-
-
-
-
(104 418)
-
2 098
-
2 098
R’000
Variance
231.1
-
-
-
-
-
-
-
-
-
242.9
-
-
-
-
-
-
242.9
-
58.0
-
58.0
%
Expenditure
as % of Änal
appropriation
121 031
-
-
-
-
-
-
-
-
-
104 669
-
-
-
-
-
-
104 669
-
16 362
-
16 362
R’000
Final
Appropriation
132 717
-
-
-
-
-
-
-
-
-
131 117
-
-
-
-
-
-
131 117
-
1 391
209
1 600
R’000
Actual
Expenditure
2014/15
-
Households
-
-
Biological assets
59 678
-
Total
-
434
Heritage assets
434
-
-
1 864
17 919
-
organisations
-
10 301
Goods and services
19 783
29 160
39 461
Current payments
R’000
Adjusted
Appropriation
Subprogramme: 6.4: OTHER TRAINING
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
121
63 194
434
59 678
121
434
-
-
-
-
13
1 824
1 864
-
17 919
17 919
-
-
-
-
19 756
19 783
(5 742)
16 043
10 301
(3 516)
-
-
-
-
-
-
313
-
313
(13)
-
-
-
40
-
-
27
1 886
(3 856)
43 317
27 274
39 461
R’000
Variance
29 160
R’000
R’000
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
105.9
-
-
-
-
-
-
27.9
-
27.9
-
-
-
-
97.9
100.0
-
99.9
-
155.7
93.5
109.8
%
Expenditure
as % of Änal
appropriation
56 040
-
-
-
-
-
-
415
-
415
-
-
-
-
1 782
17 131
-
18 913
-
18 570
18 142
36 712
R’000
56 268
-
-
-
-
-
-
-
-
-
-
-
-
-
-
17 131
-
17 131
-
18 960
20 177
39 137
R’000
Actual
Expenditure
2014/15
Final
Appropriation
209
118 278
35 492
95 404
Salaries and wages
Goods and services
2 874
transport)
Inventory: Medicine
-
516
94
892
27 553
80
134
369
Contractors
625
Communication (G&S)
730
153 770
Minor assets
249 174
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
259 796
-
-
-
1
69 322
190 473
R’000
R’000
Current payments
3. MEDICINE TRADING ACCOUNT
2. FOOD SUPPLY SERVICES
1. LAUNDRIES
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
210
Sub programme
Programme 7: HEALTH CARE SUPPORT SERVICES
-
516
94
892
27 553
80
2 874
134
369
625
-
730
95 404
35 492
118 278
153 770
249 174
259 796
1
69 322
190 473
R’000
Final
Appropriation
2015/16
17
204
184
399
16 494
465
3 820
153
7
569
1
334
76 095
23 947
116 200
140 147
216 242
223 499
-
47 894
175 605
R’000
Actual
Expenditure
(17)
312
(90)
493
11 059
(385)
(946)
(19)
362
56
396
19 309
11 545
2 078
13 623
32 932
36 297
1
21 428
14 868
R’000
Variance
-
-
39.5
195.7
44.7
59.9
581.3
132.9
114.2
1.9
91.0
-
45.8
79.8
67.5
98.2
91.1
86.8
86.0
-
69.1
92.2
%
Expenditure
as % of Änal
appropriation
-
236
71
965
24 369
-
1 900
-
718
867
-
378
82 965
22 271
114 073
136 344
219 309
230 602
1
60 182
170 419
R’000
-
378
101
17
27 710
930
930
511
130
512
-
272
81 026
19 990
104 885
124 875
205 901
211 542
-
53 124
158 418
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
Transport equipment
10 305
-
10 305
-
10 305
317
-
Social beneÄts
-
organisations
317
-
Households
-
-
317
-
148
33
18 126
-
450
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
R’000
42 780
Shifting of
Funds
Adjusted
Appropriation
Operating payments
Property payments
Operating leases
supplies
Consumable supplies
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3 749
(4 349)
6 556
6 556
4 349
2 207
10 305
10 305
10 305
8 098
-
3 749
(329)
(329)
-
-
646
-
-
-
317
-
-
-
-
-
-
-
646
-
-
-
-
-
-
(329)
-
(498)
117
33
(274)
8 683
317
646
317
31
498
-
-
33
148
18 400
-
-
-
-
422
450
18 126
28
34 097
42 780
-
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
-
21.4
-
63.6
-
63.6
203.8
203.8
-
-
-
-
-
-
203.8
-
-
20.9
-
101.5
-
93.8
79.7
%
Expenditure
as % of Änal
appropriation
10 133
-
10 133
-
10 615
678
678
-
-
-
-
-
-
678
-
-
30
52
10 384
100
347
42 548
R’000
2 011
2 705
4 716
-
4 964
658
658
-
-
-
-
-
-
658
-
172
1
-
15 692
-
250
33 420
R’000
Actual
Expenditure
2014/15
Final
Appropriation
211
R’000
R’000
-
259 796
Biological assets
-
-
-
-
-
Heritage assets
-
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
R’000
Virement
212
259 796
-
-
-
-
-
-
R’000
Final
Appropriation
2015/16
223 499
55
-
-
-
-
-
R’000
Actual
Expenditure
36 297
(55)
-
-
-
-
-
R’000
Variance
-
86.0
-
-
-
-
-
-
%
Expenditure
as % of Änal
appropriation
230 602
-
-
-
-
-
482
R’000
211 542
19
-
-
-
-
248
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
190 473
-
Total
-
8 278
-
8 278
Heritage assets
243
-
Households
-
243
49 987
131 965
Goods and services
181 952
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 7.1: LAUNDRIES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
(55)
618
6 379
6 379
55
175 605
243
8 278
8 278
190 473
-
14 868
-
-
-
-
1 899
-
1 899
(375)
-
-
-
-
-
-
(375)
618
5 895
-
44 092
49 987
7 504
13 399
R’000
Variance
243
168 553
124 461
181 952
R’000
R’000
131 965
Actual
Expenditure
Final
Appropriation
2015/16
92.2
-
-
-
-
-
-
77.1
-
77.1
254.3
-
-
-
-
-
-
254.3
-
88.2
94.3
92.6
%
Expenditure
as % of Änal
appropriation
170 419
-
-
-
-
-
-
10 133
-
10 133
527
-
-
-
-
-
-
527
-
43 454
116 305
159 759
R’000
158 418
19
-
-
-
-
-
4 716
-
4 716
527
-
-
-
-
-
-
527
-
42 679
110 477
153 156
R’000
Actual
Expenditure
2014/15
Final
Appropriation
213
-
organisations
-
Biological assets
69 322
-
Total
-
2 027
-
2 027
Heritage assets
Households
74
-
-
-
45 416
Goods and services
74
21 805
67 221
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
214
Subprogramme: 7.2: FOOD SUPPLY SERVICES
69 322
-
-
-
-
-
-
2 027
-
2 027
74
-
-
-
-
-
-
74
-
45 416
21 805
67 221
R’000
Final
Appropriation
2015/16
47 894
-
-
-
-
-
-
177
-
177
28
-
-
-
-
-
28
-
32 003
15 686
47 689
R’000
Actual
Expenditure
21 428
-
-
-
-
-
-
1 850
-
1 850
46
-
-
-
-
-
-
46
-
13 413
6 119
19 532
R’000
Variance
69.1
-
-
-
-
-
-
8.7
-
8.7
37.8
-
-
-
-
-
-
37.8
-
70.5
71.9
70.9
%
Expenditure
as % of Änal
appropriation
60 182
-
-
-
-
-
482
-
-
482
151
-
-
-
-
-
151
-
39 510
20 039
59 549
R’000
53 124
-
-
-
-
-
248
-
-
248
131
-
-
-
-
-
131
-
38 347
14 398
52 745
R’000
Actual
Expenditure
2014/15
Final
Appropriation
1
organisations
Households
Heritage assets
Biological assets
Total
1
Goods and services
-
1
R’000
Adjusted
Appropriation
Current payments
Subprogramme: 7.3: MEDICINE TRADING ACCOUNT
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
-
1
-
-
-
1
-
-
-
-
1
-
1
1
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1
R’000
R’000
R’000
Variance
Actual
Expenditure
Final
Appropriation
2015/16
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
%
Expenditure
as % of Änal
appropriation
1
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1
-
1
R’000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Actual
Expenditure
2014/15
Final
Appropriation
215
555
transport)
2 051
Contractors
-
158
Communication (G&S)
Computer services
150
2 850
1 063 473
Goods and services
Minor assets
3 853
400
12 820
Salaries and wages
Advertising
16 673
Current payments
1 080 146
253 745
1 957 652
6. OTHER FACILITIES
-
509 193
5. CENTRAL HOSPITAL SERVICES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
573 518
-
298 291
-
4. PROVINCIAL HOSPITAL SERVICES
3 390
2. EMERGENCY MEDICAL RESCUE
SERVICES
-
3. DISTRICT HOSPITAL SERVICES
319 515
R’000
R’000
1. COMMUNITY HEALTH FACILITIES
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
216
Sub programme
Programme 8: HEALTH FACILITIES MANAGEMENT
555
-
2 051
-
158
150
2 850
400
1 063 473
3 853
12 820
16 673
1 080 146
1 957 652
253 745
509 193
573 518
298 291
3 390
319 515
R’000
Final
Appropriation
2015/16
-
-
2 021
-
23
-
(151)
333
1 060 797
1 536
10 463
11 999
1 072 796
1 864 651
243 032
511 780
545 898
299 793
1 126
263 022
R’000
Actual
Expenditure
555
-
30
-
135
150
3 001
67
2 676
2 317
2 357
4 674
7 350
93 001
10 713
(2 587)
27 620
(1 502)
2 264
56 493
R’000
Variance
-
-
98.5
-
14.6
-
-5.3
83.3
99.7
39.9
81.6
72.0
99.3
95.2
95.8
100.5
95.2
100.5
33.2
82.3
%
Expenditure
as % of Änal
appropriation
-
525
11 518
22 946
150
500
17 110
600
850 501
3 659
11 119
14 778
865 279
1 384 100
157 268
379 399
488 814
226 767
1 654
130 198
R’000
2
-
8 634
27 474
359
393
4 693
552
848 717
1 333
8 834
10 167
858 884
1 384 095
165 676
398 392
464 429
209 253
1 108
145 237
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
285
-
organisations
-
Rental and hiring
-
-
3 826
240
-
1 013 456
38 502
Operating payments
Property payments
Operating leases
supplies
1 000
-
Consumable supplies
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
R’000
-
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
15
-
-
-
3 161
3 826
-
153
240
1 020 370
1 013 456
285
1 683
1 000
-
705
-
-
32 499
-
-
285
-
-
-
-
38 502
(683)
-
-
-
-
-
-
-
-
-
(15)
-
-
-
-
665
87
-
(6 914)
6 003
(705)
-
-
-
R’000
R’000
R’000
Variance
R’000
Actual
Expenditure
Final
Appropriation
2015/16
Virement
-
-
-
-
-
-
-
-
-
-
-
82.6
63.8
-
100.7
84.4
-
168.3
-
-
-
-
%
Expenditure
as % of Änal
appropriation
-
-
-
-
-
-
-
-
500
-
-
6 133
350
45
738 927
33 067
320
6 300
9 000
2 500
-
10
R’000
-
-
-
-
-
-
22
-
3 953
20
13
2 904
536
45
746 868
30 729
283
5 982
13 366
1 868
30
13
R’000
Actual
Expenditure
2014/15
Final
Appropriation
217
-
1 957 652
Biological assets
-
-
-
-
-
-
-
-
8 765
-
-
-
-
-
-
Heritage assets
8 765
868 741
Buildings
868 741
877 506
Social beneÄts
-
R’000
R’000
Households
Shifting of
Funds
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
218
1 957 652
-
-
-
-
-
-
8 765
8 765
868 741
868 741
877 506
-
-
R’000
Final
Appropriation
2015/16
1 864 651
5
-
-
-
-
-
6 847
6 847
784 988
784 988
791 835
15
15
R’000
Actual
Expenditure
93 001
(5)
-
-
-
-
-
1 918
1 918
83 753
83 753
85 671
(15)
(15)
R’000
Variance
95.2
-
-
-
-
-
-
78.1
78.1
90.4
90.4
90.2
-
-
%
Expenditure
as % of Änal
appropriation
1 384 100
-
-
-
-
-
-
160 152
160 152
358 669
358 669
518 821
-
-
R’000
Final
Appropriation
1 384 095
-
-
-
-
-
-
160 420
160 420
364 769
364 769
525 189
22
22
R’000
Actual
Expenditure
2014/15
-
organisations
Households
-
Biological assets
319 515
-
Heritage assets
Total
-
151 896
-
-
151 896
-
-
167 619
-
167 619
R’000
Adjusted
Appropriation
Goods and services
Current payments
Subprogramme: 8.1: COMMUNITY HEALTH FACILITIES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
-
263 022
319 515
56 493
-
-
-
-
-
66 320
66 320
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(9 827)
85 576
-
-
151 896
177 446
167 619
-
-
-
-
(9 827)
85 576
177 446
167 619
R’000
-
R’000
R’000
Variance
151 896
Actual
Expenditure
Final
Appropriation
2015/16
82.3
-
-
-
-
-
-
-
56.3
56.3
-
-
-
-
-
-
-
-
-
105.9
-
105.9
%
Expenditure
as % of Änal
appropriation
130 198
-
-
-
-
-
-
-
54 709
54 709
-
-
-
-
-
-
-
-
-
75 489
-
75 489
R’000
Final
Appropriation
145 237
-
-
-
-
-
-
(2 815)
29 800
26 985
-
-
-
-
-
-
-
-
-
118 252
-
118 252
R’000
Actual
Expenditure
2014/15
219
-
organisations
Households
Heritage assets
Biological assets
3 390
-
Total
-
3 390
Goods and services
-
Current payments
R’000
3 390
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
220
Adjusted
Appropriation
Subprogramme: 8.2: EMERGENCY MEDICAL RESCUE SERVICES
3 390
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
3 390
-
3 390
R’000
Final
Appropriation
2015/16
1 126
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1 126
-
1 126
R’000
Actual
Expenditure
2 264
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
2 264
-
2 264
R’000
Variance
33.2
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
33.2
-
33.2
%
Expenditure
as % of Änal
appropriation
R’000
1 654
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1 654
-
1 654
1 108
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
1 108
-
1 108
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
-
Biological assets
298 291
-
Heritage assets
Total
-
128 469
128 469
Households
-
-
-
169 822
-
169 822
R’000
Adjusted
Appropriation
Goods and services
Current payments
Subprogramme: 8.3: DISTRICT HOSPITAL SERVICES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
117 735
299 793
128 469
298 291
(1 502)
-
-
-
-
-
-
-
10 734
10 734
117 735
128 469
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
(12 236)
-
-
-
-
-
182 058
169 822
-
-
-
-
(12 236)
182 058
169 822
R’000
R’000
R’000
Variance
Actual
Expenditure
Final
Appropriation
2015/16
100.5
-
-
-
-
-
-
-
91.6
91.6
-
-
-
-
-
-
-
-
-
107.2
-
107.2
%
Expenditure
as % of Änal
appropriation
226 767
-
-
-
-
-
-
12 222
39 355
51 577
-
-
-
-
-
-
-
-
175 190
-
175 190
R’000
Final
Appropriation
209 253
-
-
-
-
-
-
12 390
39 108
51 498
-
-
-
-
-
-
-
-
157 755
-
157 755
R’000
Actual
Expenditure
2014/15
221
-
organisations
Households
-
Biological assets
573 518
-
Total
-
8 000
Heritage assets
300 598
-
308 598
-
-
-
264 920
-
264 920
Goods and services
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
222
Subprogramme: 8.4: PROVINCIAL HOSPITAL SERVICES
573 518
-
-
-
-
-
-
8 000
300 598
308 598
-
-
-
-
-
-
-
-
-
264 920
-
264 920
R’000
Final
Appropriation
2015/16
545 898
-
-
-
-
-
-
6 547
273 736
280 283
-
-
-
-
-
-
-
-
-
265 615
-
265 615
R’000
Actual
Expenditure
27 620
-
-
-
-
-
-
1 453
26 862
28 315
-
-
-
-
-
-
-
-
-
(695)
-
(695)
R’000
Variance
95.2
-
-
-
-
-
-
81.8
91.1
90.8
-
-
-
-
-
-
-
-
-
100.3
-
100.3
%
Expenditure
as % of Änal
appropriation
488 814
-
-
-
-
-
-
90 510
147 076
237 586
-
-
-
-
-
-
-
-
-
251 228
-
251 228
R’000
464 429
-
-
-
-
-
-
93 063
140 006
233 069
-
-
-
-
-
-
-
-
-
231 360
-
231 360
R’000
Actual
Expenditure
2014/15
Final
Appropriation
-
organisations
Households
-
Biological assets
509 193
-
Heritage assets
Total
-
209 314
-
209 314
-
-
-
299 879
-
299 879
R’000
Adjusted
Appropriation
Goods and services
Current payments
Subprogramme: 8.5: CENTRAL HOSPITAL SERVICES
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
315 114
196 666
196 666
511 780
299 879
209 314
209 314
509 193
R’000
(2 587)
-
-
-
-
-
12 648
12 648
-
-
-
-
-
-
-
-
-
(15 235)
-
(15 235)
R’000
315 114
Variance
R’000
Actual
Expenditure
299 879
R’000
-
Final
Appropriation
2015/16
Virement
100.5
-
-
-
-
-
-
-
94.0
94.0
-
-
-
-
-
-
-
-
-
105.1
-
105.1
%
Expenditure
as % of Änal
appropriation
R’000
379 399
-
-
-
-
-
-
57 420
65 262
122 682
-
-
-
-
-
-
-
-
-
256 717
-
256 717
398 392
-
-
-
-
-
-
57 422
68 851
126 273
-
-
-
-
-
-
-
-
-
272 119
-
272 119
R’000
Actual
Expenditure
2014/15
Final
Appropriation
223
-
organisations
Households
-
Biological assets
253 745
-
Total
-
765
Heritage assets
78 464
-
-
79 229
-
-
157 843
16 673
174 516
Goods and services
Current payments
R’000
Adjusted
Appropriation
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Shifting of
Funds
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
R’000
Virement
224
Subprogramme: 8.6: OTHER FACILITIES
253 745
-
-
-
-
-
-
765
78 464
79 229
-
-
-
-
-
-
-
-
-
157 843
16 673
174 516
R’000
Final
Appropriation
2015/16
243 032
5
-
-
-
-
-
300
111 275
111 575
15
-
-
-
-
-
-
15
-
119 438
11 999
131 437
R’000
Actual
Expenditure
10 713
(5)
-
-
-
-
-
465
(32 811)
(32 346)
(15)
-
-
-
-
-
-
(15)
-
38 405
4 674
43 079
R’000
Variance
95.8
-
-
-
-
-
-
39.2
141.8
140.8
-
-
-
-
-
-
-
-
-
75.7
72.0
75.3
%
Expenditure
as % of Änal
appropriation
157 268
-
-
-
-
165 676
-
-
-
-
-
-
-
360
87 004
87 364
22
-
-
-
-
-
-
22
-
68 123
10 167
78 290
R’000
Actual
Expenditure
-
52 267
52 267
-
-
-
-
-
-
-
-
-
90 223
14 778
105 001
R’000
Final
Appropriation
2014/15
1
Detail of transfers and subsidies as per Appropriation Act (after
Virement):
Detail of these transactions can be viewed in the note on Transfers and subsidies and Annexure 1 (A-H) to the
2
Detail of speciÄcally and exclusively appropriated amounts voted (after
Virement):
Detail of these transactions can be viewed in note 1 (Annual Appropriation) to the Annual Financial Statements.
3
Detail on payments for Änancial assets
Detail of these transactions per programme can be viewed in the note to Payments for Änancial assets to the
4
Explanations of material variances from Amounts Voted (after virement):
4.1 Per programme:
Administration
Central Hospital Services
Health Sciences & Training
Final
Appropriation
Actual
Expenditure
Variance
Variance as
a%
of Final
Approp.
R’000
R’000
R’000
%
808 126
807 358
768
0
11 269 137
11 075 547
193 590
2
999 572
940 319
59 253
6
6 518 398
6 432 065
86 333
1
12 585 477
12 582 282
3 195
0
938 929
938 834
95
0
Health Care Support Services
259 796
223 499
36 297
14
1 957 652
1 864 651
93 001
5
35 337 087
34 864 555
472 532
1
Total
The overall expenditure of the department is at 99%.
Programme name: Health Care Support Services The under spending on this programme is due to delays
in the Älling of posts.
225
Per economic classiÄcation
Final
Appropriation
Actual
Expenditure
Variance
Variance as
a % of Final
Appropriation
R’000
R’000
R’000
%
20 803 138
20 648 000
155 138
0.7
Goods and services
11 584 205
11 257 325
326 880
2.8
657 443
657 442
1
0.0
Departmental agencies and
accounts
17 919
17 919
-
0.0
1 864
1 824
40
2.1
614 102
523 218
90 884
14.8
Households
114 443
266 790
(152 346)
(133.1)
868 741
784 988
83 753
9.6
675 232
696 201
(20 969)
(3.1)
-
10 848
(10 848)
(100.0)
Current payments
Payments for ðnancial assets
Non Proðt Institutions - The under expenditure is attributed to a reduced bed occupancy within mental health as
well as a revised HIV and AIDS conditional grant business plan.
Households - Over expenditure incurred due to an increased intake of the South African Cuban doctors programme
as well as an unforeseen increase in staќ resignations resulting in increased leave gratuity payments.
Buildings and other ðxed structures - Underspending incurred due to a delay in the approval of plans.
226
Payment for ðnancial assets – The expenditure relates to irrecoverable debts written oќ.
Per conditional grant
Final Appropriation
Actual Expenditure
Variance
Variance as a % of
Final Appropriation
R’000
R’000
R’000
%
Comprehensive HIV and AIDS Grant
2 928 300
2 880 682
47 618
2
National Tertiary Services Grant
3 572 856
3 570 498
2 358
0
Health Professional Training and
Development Grant
829 604
829 604
-
0
National Health Insurance Grant
10 206
7 040
3 166
31
2 051
2 021
30
1
313 630
313 630
-
0
8 788
8 626
162
2
7 665 435
7 612 101
53 334
1
EPWP Intergrated Grant for
Provinces
Health Facility Revitalisation Grant
Social Sector EPWP Incentive Grant
for Provinces
Total
National Health Insurance – the underspending is as a result of the delays by the service providers to deliver
on orders placed.
227
Note
2015/16
2014/15
R’000
R’000
REVENUE
Annual appropriation
1
35 337 087
31 491 179
Departmental revenue
2
479 296
524 051
35 816 383
32 015 230
TOTAL REVENUE
EXPENDITURE
Current expenditure
3
20 648 000
18 654 913
Goods and services
4
11 257 325
9 735 446
5
-
73
31 905 325
28 390 432
Total current expenditure
7
1 467 193
1 570 751
1 467 193
1 570 751
1 481 189
1 031 334
1 481 189
1 031 334
10 848
12 695
34 864 555
31 005 212
951 828
1 010 018
Voted funds
472 532
485 967
Annual appropriation
419 197
430 362
53 335
55 605
479 296
524 051
951 828
1 010 018
Total transfers and subsidies
Expenditure for capital assets
Tangible assets
228
8
Total expenditure for capital assets
Payments for ðnancial assets
6
TOTAL EXPENDITURE
SURPLUS FOR THE YEAR
Reconciliation of Net Surplus for the year
Conditional grants
SURPLUS FOR THE YEAR
2
as at 31 March 2016
Note
2015/16
2014/15
R’000
R’000
1 396 562
1 651 879
ASSETS
Current assets
Unauthorised expenditure
9
1 337 304
1 598 685
Cash and cash equivalents
10
1 448
2 512
Prepayments and advances
11
70
88
Receivables
12
57 740
50 594
54 000
54 000
54 000
54 000
1 450 562
1 705 879
1 373 014
1 632 635
817 172
830 607
Non-current assets
Investments
13
TOTAL ASSETS
LIABILITIES
Current liabilities
Voted funds to be surrendered to the Revenue Fund
14
Departmental revenue to be surrendered to the Revenue Fund
15
79 151
76 776
Bank overdraft
16
300 223
458 853
Payables
17
176 468
266 399
1 373 014
1 632 635
77 548
73 244
Capitalisation reserve
54 000
54 000
Recoverable revenue
23 548
19 244
TOTAL
77 548
73 244
TOTAL LIABILITIES
NET ASSETS
Represented by:
Closing balance of Payables was reduced by R19 244. Prior Year payables were overstated due to
misclassiÄcation of debt recoverable income and interest (entry was misinterpreted). It was classiÄed as a
payable instead of equity.
229
Statement of Changes in Net Assets
Note
2015/16
2014/15
R’000
R’000
Opening balance
54 000
54 000
Closing balance
54 000
54 000
19 244
10 932
Capitalisation Reserves
Recoverable revenue
Opening Balance
4 304
8 312
(17 846)
-
Debts Raised
22 150
8 312
Closing balance
23 548
19 244
TOTAL
77 548
73 244
Transfers
Debts recovered (included in departmental receipts)
The diσerence of R50 377 000 between the capital amount as disclosed by the Medical Supplies Depot
and the department as reñected in the ðnancial statements of the department is as a result of a cash
injection to increase stock holdings. The transaction was funded from the depot’s own proceeds. The
investment of R54 million is the initial capital outlay to the depot, no additional funds were transferred
by the department.
The prior year Recoverable Revenue has been included in the Statement of Changes in Net Assets.
230
Cash Flow Statement
Note
2015/16
2014/15
R’000
R’000
35 816 383
32 015 230
35 337 087
31 491 179
478 357
523 654
939
397
CASH FLOWS FROM OPERATING ACTIVITIES
Receipts
Annual appropriated funds received
Departmental revenue received
Interest received
1.1
2
2.3
Net decrease (increase) in working capital
Surrendered to Revenue Fund
Current payments
Interest paid
5
Payments for Änancial assets
Transfers and subsidies paid
164 322
95 789
(962 888)
(1 876 180)
(31 905 325)
(28 390 359)
-
(73)
(10 848)
(12 695)
(1 467 193)
(1 570 751)
18
1 634 451
260 961
8
(1 481 189)
(1 031 334)
(1 481 189)
(1 031 334)
Increase in net assets
4 304
-
Net cash ñows from ðnancing activities
4 304
-
Net increase in cash and cash equivalents
157 566
(770 373)
Net cash ñow available from operating activities
CASH FLOWS FROM INVESTING ACTIVITIES
Net cash ñows from investing activities
CASH FLOWS FROM FINANCING ACTIVITIES
Cash and cash equivalents at beginning of period
Cash and cash equivalents at end of period
19
(456 341)
314 032
(298 775)
(456 341)
231
Accounting Policies
Summary of signiÄcant accounting policies
The Änancial statements have been prepared in accordance with the following policies, which have been applied
consistently in all material aspects, unless otherwise indicated. Management has concluded that the Änancial
statements present fairly the department’s primary and secondary information.
The historical cost convention has been used, except where otherwise indicated. Management has used
assessments and estimates in preparing the annual Änancial statements. These are based on the best information
available at the time of preparation.
Where appropriate and meaningful, additional information has been disclosed to enhance the usefulness of the
Änancial statements and to comply with the statutory requirements of the Public Finance Management Act (PFMA),
Act 1 of 1999 (as amended by Act 29 of 1999), and the Treasury Regulations issued in terms of the PFMA and the
annual Division of Revenue Act.
1
Basis of preparation
The Änancial statements have been prepared in accordance with the ModiÄed Cash Standard.
2
Going concern
The Änancial statements have been prepared on a going concern basis based on the assumption that
funding is provided by National Government.
3
Presentation currency
Amounts have been presented in the currency of the South African Rand (R) which is also the functional
currency of the department.
4
Rounding
Unless otherwise stated Änancial Ägures have been rounded to the nearest one thousand Rand (R’000).
5
Comparative information
5.1
Prior period comparative information
Prior period comparative information has been presented in the current year’s Änancial statements. Where
necessary Ägures included in the prior period Änancial statements have been reclassiÄed to ensure that
the format in which the information is presented is consistent with the format of the current year’s Änancial
statements.
232
5.2
Current year comparison with budget
A comparison between the approved, Änal budget and actual amounts for each programme and
economic classiÄcation is included in the appropriation statement.
6
Revenue
6.1
Appropriated funds
Appropriated funds comprises of departmental allocations as well as direct charges against the revenue
fund (i.e. statutory appropriation).
Appropriated funds are recognised in the statement of Änancial performance on the date the
appropriation becomes eќective. Adjustments made in terms of the adjustments budget process are
recognised in the statement of Änancial performance on the date the adjustments become eќective.
The net amount of any appropriated funds due to/from the relevant revenue fund at the reporting date is
recognised as a payable/receivable in the statement of Änancial position.
Accounting Policies
6.2
Departmental revenue is recognised in the statement of Änancial performance when received and is
subsequently paid into the relevant revenue fund, unless stated otherwise.
Any amount owing to the relevant revenue fund at the reporting date is recognised as a payable in the
statement of Änancial position.
6.3
Accrued departmental revenue
Accruals in respect of departmental revenue (excluding tax revenue) are recorded in the notes to the
Änancial statements when:
it is probable that the economic beneÄts or service potential associated with the transaction will Åow to
the department; and the amount of revenue can be measured reliably.
The accrued revenue is measured at the fair value of the consideration receivable.
Accrued tax revenue (and related interest and/penalties) is measured at amounts receivable from
collecting agents.
7
Expenditure
7.1
7.1.1
Salaries and wages
7.1.2
Salaries and wages are recognised in the statement of Änancial performance on the date of payment.
Social contributions made by the department in respect of current employees are recognised in the
statement of Änancial performance on the date of payment.
Social contributions made by the department in respect of ex-employees are classiÄed as transfers to
households in the statement of Änancial performance on the date of payment.
7.2
Other expenditure
Other expenditure (such as goods and services, transfers and subsidies and payments for capital assets)
is recognised in the statement of Änancial performance on the date of payment. The expense is classiÄed
as a capital expense if the total consideration paid is more than the capitalisation threshold.
7.3
Accrued expenditure payable
Accrued expenditure payable is recorded in the notes to the Änancial statements when the goods are
received or, in the case of services, when they are rendered to the department or in the case of transfers
and subsidies when they are due and payable.
Accrued expenditure payable is measured at cost.
7.4
Leases
7.4.1
Operating leases
Operating lease payments made during the reporting period are recognised as current expenditure in the
The operating lease commitments are recorded in the notes to the Änancial statements.
233
Accounting Policies
7.4.2
Finance leases
Finance lease payments made during the reporting period are recognised as capital expenditure in the
The Änance lease commitments are recorded in the notes to the Änancial statements and are not
apportioned between the capital and interest portions.
Finance lease assets acquired at the end of the lease term are recorded and measured at the lower of:
•
cost, being the fair value of the asset; or
•
the sum of the minimum lease payments made, including any payments made to acquire ownership
at the end of the lease term, excluding interest.
8.
Aid Assistance
8.1
Aid assistance received
Aid assistance received in cash is recognised in the statement of Änancial performance when received.
In-kind aid assistance is recorded in the notes to the Änancial statements on the date of receipt and is
measured at fair value.
Aid assistance not spent for the intended purpose and any unutilised funds from aid assistance that are
required to be refunded to the donor are recognised as a payable in the statement of Änancial position.
8.2
Aid assistance paid
Aid assistance paid is recognised in the statement of Änancial performance on the date of payment. Aid
assistance payments made prior to the receipt of funds are recognised as a receivable in the statement of
Änancial position.
9.
Cash and cash equivalents are stated at cost in the statement of Änancial position.
Bank overdrafts are shown separately on the face of the statement of Änancial position as a current
liability.
234
for the purposes of the cash Åow statement, cash and cash equivalents comprise cash on hand, deposits
held, other short-term highly liquid investments and bank overdrafts.
10.
Prepayments and advances are recognised in the statement of Änancial position when the department
receives or disburses the cash.
Prepayments and advances are initially and subsequently measured at cost.
11.
Loans and receivables
Loans and receivables are recognised in the statement of Änancial position at cost plus accrued interest,
where interest is charged, less amounts already settled or written-oќ. Write-oќs are made according to
the department’s write-oќ policy.
12.
Investments
Investments are recognised in the statement of Änancial position at cost.
13.
Financial assets
Accounting Policies
13.1
Financial assets (not covered elsewhere)
A Änancial asset is recognised initially at its cost plus transaction costs that are directly attributable to the
acquisition or issue of the Änancial.
At the reporting date, a department shall measure its Änancial assets at cost, less amounts already settled
or written-oќ, except for recognised loans and receivables, which are measured at cost plus accrued
interest, where interest is charged, less amounts already settled or written-oќ.
13.2
Impairment of Änancial assets
Where there is an indication of impairment of a Änancial asset, an estimation of the reduction in the
recorded carrying value, to reÅect the best estimate of the amount of the future economic beneÄts
expected to be received from that asset, is recorded in the notes to the Änancial statements.
14.
Payables
Loans and payables are recognised in the statement of Änancial position at cost.
15
Capital Assets
15.1
Immovable capital assets
Immovable capital assets are initially recorded in the notes to the Änancial statements at cost. Immovable
capital assets acquired through a non-exchange transaction is measured at fair value as at the date of
acquisition.
Where the cost of immovable capital assets cannot be determined reliably, the immovable capital assets
are measured at R1 unless the fair value of the asset has been reliably estimated, in which case the fair
value is used.
All assets acquired prior to 1 April 2002 (or a later date as approved by the OAG) may be recorded at R1.
Immovable capital assets are subsequently carried at cost and are not subject to depreciation or
impairment.
Subsequent expenditure that is of a capital nature is added to the cost of the asset at the end of
the capital project unless the immovable asset is recorded by another department in which case the
completed project costs are transferred to that department.
15.2
Movable capital assets
Movable capital assets are initially recorded in the notes to the Änancial statements at cost. Movable
capital assets acquired through a non-exchange transaction is measured at fair value as at the date of
acquisition.
Where the cost of movable capital assets cannot be determined reliably, the movable capital assets are
measured at fair value and where fair value cannot be determined; the movable assets are measured at
R1.
Movable capital assets are subsequently carried at cost and are not subject to depreciation or
impairment.
Biological assets are subsequently carried at fair value. [Subsequent expenditure that is of a capital nature
is added to the cost of the asset at the end of the capital project unless the movable asset is recorded by
another department/entity in which case the completed project costs are transferred to that department.
235
Accounting Policies
15.3
Intangible assets
Intangible assets are initially recorded in the notes to the Änancial statements at cost. Intangible assets
acquired through a non-exchange transaction are measured at fair value as at the date of acquisition.
Internally generated intangible assets are recorded in the notes to the Änancial statements when the
department commences the development phase of the project.
Where the cost of intangible assets cannot be determined reliably, the intangible capital assets are
measured at fair value and where fair value cannot be determined; the intangible assets are measured at
R1.
Intangible assets are subsequently carried at cost and are not subject to depreciation or impairment.
Subsequent expenditure that is of a capital nature is added to the cost of the asset at the end of the
capital project unless the intangible asset is recorded by another department/entity in which case the
completed project costs are transferred to that department.
16.
Provisions and Contingents
16.1
Provisions
Provisions are recorded in the notes to the Änancial statements when there is a present legal or
constructive obligation to forfeit economic beneÄts as a result of events in the past and it is probable that
an outÅow of resources embodying economic beneÄts or service potential will be required to settle the
obligation and a reliable estimate of the obligation can be made. The provision is measured as the best
estimate of the funds required to settle the present obligation at the reporting date.
16.2
236
Contingent liabilities
Contingent liabilities are recorded in the notes to the Änancial statements when there is a possible
obligation that arises from past events, and whose existence will be conÄrmed only by the occurrence or
non-occurrence of one or more uncertain future events not within the control of the department or when
there is a present obligation that is not recognised because it is not probable that an outÅow of resources
will be required to settle the obligation or the amount of the obligation cannot be measured reliably.
16.3
Contingent assets
Contingent assets are recorded in the notes to the Änancial statements when a possible asset arises from
past events, and whose existence will be conÄrmed by the occurrence or non-occurrence of one or more
uncertain future events not within the control of the department.
16.4
Commitments
Commitments are recorded at cost in the notes to the Änancial statements when there is a contractual
arrangement or an approval by management in a manner that raises a valid expectation that the
department will discharge its responsibilities thereby incurring future expenditure that will result in the
outÅow of cash.
17.
Unauthorised expenditure is recognised in the statement of Änancial position until such time as the
expenditure is:
•
approved by the Provincial Legislature with funding and the related funds are received; or
•
approved by the Provincial Legislature without funding and is written oќ against the appropriation in
the statement of Änancial performance; or
•
transferred to receivables for recovery.
Unauthorised expenditure is measured at the amount of the conÄrmed unauthorised expenditure.
18.
Fruitless and wasteful expenditure
Fruitless and wasteful expenditure is recorded in the notes to the Änancial statements when conÄrmed.
The amount recorded is equal to the total value of the fruitless and or wasteful expenditure incurred.
Fruitless and wasteful expenditure is removed from the notes to the Änancial statements when it is
resolved or transferred to receivables for recovery.
Fruitless and wasteful expenditure receivables are measured at the amount that is expected to be
recoverable and are de-recognised when settled or subsequently written-oќ as irrecoverable.
Accounting Policies
19.
Irregular expenditure
Irregular expenditure is recorded in the notes to the Änancial statements when conÄrmed. The amount
recorded is equal to the value of the irregular expenditure incurred unless it is impracticable to determine,
in which case reasons therefor are provided in the note.
Irregular expenditure is removed from the note when it is either condoned by the relevant authority,
transferred to receivables for recovery or not condoned and is not recoverable.
Irregular expenditure receivables are measured at the amount that is expected to be recoverable and are
de-recognised when settled or subsequently written-oќ as irrecoverable.
20.
Changes in accounting policies, accounting estimates and errors
Changes in accounting policies that are aќected by management have been applied retrospectively
in accordance with MCS requirements, except to the extent that it is impracticable to determine the
period-speciÄc eќects or the cumulative eќect of the change in policy. In such instances the department
shall restate the opening balances of assets, liabilities and net assets for the earliest period for which
retrospective restatement is practicable.
Changes in accounting estimates are applied prospectively in accordance with MCS requirements.
Correction of errors is applied retrospectively in the period in which the error has occurred in accordance
with MCS requirements, except to the extent that it is impracticable to determine the period-speciÄc
eќects or the cumulative eќect of the error. In such cases the department shall restate the opening
balances of assets, liabilities and net assets for the earliest period for which retrospective restatement is
practicable.
21.
Events after the reporting date
Events after the reporting date that are classiÄed as adjusting events have been accounted for in the
Änancial statements. The events after the reporting date that are classiÄed as non-adjusting events after
the reporting date have been disclosed in the notes to the Änancial statements.
22
Capitalisation reserve
The capitalisation reserve comprises of Änancial assets and/or liabilities originating in a prior reporting
period but which are recognised in the statement of Änancial position for the Ärst time in the current
reporting period. Amounts are recognised in the capitalisation reserves when identiÄed in the current
period and are transferred to the Provincial Revenue Fund when the underlying asset is disposed and the
related funds are received.
23
Recoverable revenue
Amounts are recognised as recoverable revenue when a payment made in a previous Änancial year
becomes recoverable from a debtor in the current Änancial year. Amounts are either transferred to the
Provincial Revenue Fund when recovered or are transferred to the statement of Änancial performance
when written-oќ.
24
Related party transactions
A related party transaction is a transfer of resources, services or obligations between the reporting entity
and a related party. Related party transactions within the Minister’s portfolio are recorded in the notes to
the Änancial statements when the transaction is not at arm’s length.
Key management personnel are those persons having the authority and responsibility for planning,
directing and controlling the activities of the department. The number of individuals and their full
compensation is recorded in the notes to the Änancial statements.
25
Inventories (EɈective from 1 April 2017)
At the date of acquisition, inventories are recorded at cost in the Statement of Financial Performance.
Where inventories are acquired as part of a non-exchange transaction, the cost of inventory is its fair
value at the date of acquisition.
Inventories are measured at year end at weighted average cost.
237
1.
Annual Appropriation
1.1
Annual Appropriation
Included are funds appropriated in terms of the Appropriation Act (and the Adjustments Appropriation Act) for
Provincial Departments:
2015/16
Final Appropriation
Administration
Actual Funds
Received
Final
Appropriation
Appropriation
received
R’000
R’000
R’000
R’000
808 126
808 126
566 467
566 467
11 269 137
11 269 137
9 820 584
9 820 584
999 572
999 572
933 348
933 348
6 518 398
6 518 398
6 100 656
6 100 656
12 585 477
12 585 477
11 584 643
11 584 643
Health Sciences and Training
938 929
938 929
870 779
870 779
Health Care Support Service
259 796
259 796
230 602
230 602
1 957 652
1 957 652
1 384 100
1 384 100
35 337 087
35 337 087
31 491 179
31 491 179
2015/16
2014/15
R’000
R’000
7 665 435
7 717 049
Central Hospitals
Total
1.2
238
2014/15
Conditional grants
Total grants received
The department was scheduled to receive an amount of R7 665 435 billion but received an amount of R7 665 471 billion as a result of the roll-over of the NHI
Grant. The department spent an amount of R7 608 383 billion.
2.
Note
2015/16
2014/15
R’000
R’000
Sales of goods and services other than capital assets
2.1
433 650
451 636
Fines, penalties and forfeits
2.2
56
52
Interest, dividends and rent on land
2.3
939
397
Transactions in Änancial assets and liabilities
2.4
44 651
71 966
Total revenue collected
479 296
524 051
Departmental revenue collected
479 296
524 051
2.1
Sales of goods and services other than capital assets
2015/16
Sales of goods and services produced by the department
Sales by market establishment
Administrative fees
2014/15
R’000
R’000
431 396
450 433
36 852
20 045
3 912
3 965
390 632
426 423
2 254
1 203
433 650
451 636
2015/16
2014/15
R’000
R’000
Fines
56
52
Total
56
52
2015/16
2014/15
Other sales
Sales of scrap, waste and other used current goods
Total
2.2
2.3
Fines, penalties and forfeits
Interest, dividends and rent on land
R’000
R’000
Interest
939
397
Total
939
397
2.4
239
Transactions in Änancial assets and liabilities
Receivables
2015/16
2014/15
R’000
R’000
19 286
26 984
Other Receipts including Recoverable Revenue
25 365
44 982
Total
44 651
71 966
3.
3.1
Salaries and Wages
Basic salary
Performance award
Service Based
Compensative/circumstantial
Periodic payments
Other non-pensionable allowances
Total
2015/16
2014/15
R’000
R’000
13 322 403
12 121 365
312 013
278 825
16 662
17 868
1 801 624
1 655 315
170 861
142 091
2 602 006
2 321 363
18 225 569
16 536 827
Service based refers to long service awards. other Non-Pensionable Allowances represents amongst
others service bonus and housing allowances. The amount disclosed under Compensative/circumstantial
represents overtime paid to Health Professionals. Periodic payments refer to payments made to retired
doctors, session doctors and employees paid a once oσ salary related payment.
3.2
2015/16
2014/15
R’000
R’000
Pension
1 593 161
1 456 512
Medical
824 354
658 795
221
303
4 662
2 432
Employer contributions
240
UIF
Bargaining council
Insurance
Total
Total compensation of employees
Average number of employees
33
44
2 422 431
2 118 086
20 648 000
18 654 913
65 070
64 051
4.
Goods and services
Note
2015/16
2014/15
R’000
R’000
Administrative fees
4 936
3 249
Advertising
5 968
14 699
Minor assets
50 349
37 700
Bursaries (employees)
4.1
2 966
1 397
Catering
6 435
5 078
Communication
105 989
99 333
252 192
104 787
50 018
39 801
Laboratory services
965 528
1 057 990
Legal services
569 031
238 822
Contractors
343 020
385 435
Agency and support/outsourced services
492 454
507 990
-
4
4.3
18 453
23 977
152 328
89 287
Inventory
4.4
5 335 121
4 723 404
Consumables
4.5
603 251
520 105
90 240
77 562
2 113 950
1 699 236
Computer services
4.2
Entertainment
Audit cost – external
Fleet services
Operating leases
Property payments
4.6
Rental and hiring
Transport provided as part of the departmental activities
4.7
Other operating expenditure
Total
4.8
1 557
5 031
26 373
26 477
31 486
28 296
3 315
10 032
26 725
29 234
5 640
6 520
11 257 325
9 735 446
The amount disclosed under Rental and Hiring is for the once oɈ use of a facility. other operating expenditure relates to courier and laundry services. Property
Payments relates to the maintenance and utility payments for health facilities. The item Inventory relates to purchase of medication and medical supplies.
Consumables represent laboratory consumables. Agency and support/outsourced services represent amongst others waste removal, payments to nursing
agencies and security services. The amount disclosed under legal services includes amongst others settlement of Medico Legal claims.
4.1 Minor assets
2015/16
2014/15
R’000
R’000
Tangible assets
50 349
37 700
50 349
37 700
Total
50 349
37 700
241
4.2 Computer services
2015/16
2014/15
R’000
R’000
External computer service providers
252 192
104 787
Total
252 192
104 787
External Computer Service Providers include software licences for operating systems and specialized computer
services.
4.3
Audit cost – External
Regularity audits
Investigations
Total
4.4
2014/15
R’000
R’000
18 453
21 747
-
2 230
18 453
23 977
2015/16
2014/15
Inventory
R’000
R’000
24 275
15 747
Food and food supplies
247 940
223 181
Fuel, oil and gas
140 513
105 891
1 448
351
35 257
26 397
Medical supplies
1 971 892
1 964 383
Medicine
2 913 796
2 387 454
Total
5 335 121
4 723 404
2015/16
2014/15
Clothing material and accessories
Learning, teaching and support material
242
2015/16
Materials and supplies
4.5
Consumables
R’000
R’000
Consumable supplies
477 691
411 409
Uniform and clothing
76 843
64 893
Household supplies
349 877
299 226
420
293
8 165
8 308
Communication accessories
IT consumables
Other consumables
42 386
38 689
Stationery, printing and oѝce supplies
125 560
108 696
Total
603 251
520 105
4.6
Property payments
2015/16
2014/15
R’000
R’000
27 368
18 149
Property maintenance and repairs
1 021 697
765 196
Other
1 064 885
915 891
Total
2 113 950
1 699 236
Municipal services
The amount disclosed under other includes security services, cleaning and payments of water and
electricity.
4.7
2015/16
2014/15
R’000
R’000
27 897
25 735
3 589
2 561
31 486
28 296
2015/16
2014/15
R’000
R’000
275
486
Resettlement costs
1 237
1 541
Other
4 128
4 493
Total
5 640
6 520
2015/16
2014/15
R’000
R’000
-
73
Local
Foreign
Total
4.8
Other operating expenditure
Professional bodies, membership and subscription fees
5.
Interest paid
Total
6.
-
73
2015/16
2014/15
R’000
R’000
Payments for Änancial assets
Debts written oќ
10 848
12 695
Total
10 848
12 695
243
7.
Note
2015/16
R’000
R’000
36
657 442
672 042
Annex 1B
17 919
17 184
Higher Education Institutions
Annex 1C
1 824
1 782
Annex 1D
523 218
659 324
Households
Annex 1E
266 790
145 872
1 467 193
1 496 204
2015/16
2014/15
R’000
R’000
1 481 189
1 031 334
33
784 988
378 954
31.1
696 201
652 380
1 481 189
1 031 334
Voted funds
Total
Total
8.
Expenditure for capital assets
Note
Tangible assets
Machinery and equipment Cash
Total
8.1
244
Analysis of funds utilised to acquire capital assets – 2015/16
Tangible assets
Machinery and equipment Cash
Total
8.2
2014/15
R’000
R’000
1 481 189
1 481 189
784 988
784 988
696 201
696 201
1 481 189
1 481 189
Analysis of funds utilised to acquire capital assets – 2014/15
Voted funds
Total
R’000
R’000
1 031 334
1 031 334
378 954
378 954
652 380
652 380
1 031 334
1 031 334
Voted funds
Total
2015/16
2014/15
Tangible assets
Total
8.3 Finance lease expenditure included in Expenditure for capital assets
Tangible assets
127 907
83 861
Total
127 907
83 861
Finance leases represent cell phones, GG Vehicles and photo copy machines.
9.
9.1
Reconciliation of unauthorised expenditure
Note
Opening balance
Less: Amount condoned
Closing balance
2015/16
2014/15
R’000
R’000
1 598 685
1 598 685
(261 381)
-
1 337 304
1 598 685
Analysis of awaiting authorisation per economic classiðcation
Current
1 337 304
1 598 685
Total
1 337 304
1 598 685
9.2
Analysis of unauthorised expenditure awaiting authorisation per economic classiÄcation
2015/16
2014/15
R’000
R’000
Current
1 337 304
1 598 685
Total
1 337 304
1 598 685
2015/16
2014/15
R’000
R’000
Unauthorised expenditure relating to overspending of the vote or a main
division within a vote
1 337 304
1 598 685
Total
1 337 304
1 598 685
9.3
Analysis of unauthorised expenditure awaiting authorisation per type
The department did not incur any unauthorised expenditure in the Änancial year 2015/2016.
Subsequent to year end, an authorised expenditure amount of R1 350 260 000 was condoned with funding by SCOPA. The amount has not yet been approved
by the Premier.
10.
Bank related accounts
2015/16
2014/15
R’000
R’000
-
580
342
851
Cash on Hand
1 106
1 081
Total
1 448
2 512
2015/16
2014/15
R’000
R’000
70
88
Total
70
88
Cash receipts
11.
245
12.
Receivables
2015/16
Note
2014/15
Total
Total
R’000
R’000
R’000
R’000
4 871
4 871
771
771
Claims recoverable
12.1
Recoverable expenditure
12.2
505
505
994
994
Staќ receivable
12.3
45 238
45 238
43 623
43 623
Other receivable
12.4
7 126
7 126
5 206
5 206
57 740
57 740
50 594
50 594
2015/16
2014/15
R’000
R’000
Other Departments
4 871
771
Total
4 871
771
2015/16
2014/15
R’000
R’000
Total
StaɈ receivables represent salary related debts.
12.1 Claims recoverable
12.3
246
Recoverable expenditure
Disallowance Damages and Losses
505
994
Total
505
994
2015/16
2014/15
R’000
R’000
10 524
10 800
12.3
StaɈ receivable
Breach of contract
Employees
Ex-Employees
Suppliers
5 731
5 417
24 387
23 324
4 568
4 047
Fraud
28
34
Other
-
1
Total
45 238
43 623
12.4
Other receivables
2015/16
2014/15
R’000
R’000
Private Telephone
94
-
Salary: Disallowance Account
23
17
Salary: Deduction Disallowance
133
182
Salary: Tax Debt
370
853
Salary Reversal Control Account
6 506
4 154
Total
7 126
5 206
2015/16
2014/15
The comparative for private telephones is disclosed under payables.
12.5
Impairment of receivables
R’000
R’000
Estimate of impairment of receivables relating to staќ debts
11 679
7 771
Total
11 679
7 771
2015/16
2014/15
R’000
R’000
Investment in Medical Supplies Depot
54 000
54 000
Total
54 000
54 000
Total non-current
54 000
54 000
Opening balance
54 000
54 000
Closing balance
54 000
54 000
2015/16
2014/15
R’000
R’000
Opening balance
830 607
1 699 631
Transfer from statement of Änancial performance
472 532
485 967
Paid during the year
(485 967)
(1 354 991)
Closing balance
817 172
830 607
StaɈ debt that are older than 3 years have been impaired.
13.
Investments
Non-Current
Shares and other equity
Analysis of non-current investments
14.
Voted funds to be surrendered to the Revenue Fund
247
15.
Departmental revenue to be surrendered to the Revenue Fund
2015/16
Opening balance
Transfer from Statement of Financial Performance
Paid during the year
Closing balance
16.
2014/15
R’000
R’000
76 776
73 914
479 296
524 051
(476 921)
(521 189)
79 151
76 776
2015/16
2014/15
R’000
R’000
Bank Overdraft
First National Bank
Other bank related accounts
Total
251 561
352 502
48 662
106 351
300 223
458 853
Other bank related accounts represents the Bank Adjustment Account, Cheques Payable, Outstanding Payments and cancelled/reissued cheques.
17.
Payables – current
2015/16
2014/15
R’000
R’000
163 885
248 616
12 583
17 783
176 468
266 399
2015/16
2014/15
R’000
R’000
2 422
596
Private Telephone
-
59
Salary: Garnishee Orders
-
6
Salary: Income Tax
8 488
10 251
Salary: Pension Fund
1 078
1 210
477
477
-
4 933
Amounts owing to other entities
Other payables
Total
248
17.1
Other payables
Description
Salary ACB Recalls
Housing Loan Guarantees
Telephone Control Account
Sal: Bargaining Council
32
-
Other
22
251
Housing Key Deposits
Total
64
-
12 583
17 783
18.
Net cash Åow available from operating activities
2015/16
2014/15
R’000
R’000
Net surplus as per Statement of Financial Performance
951 828
1 010 018
Add back non cash/cash movements not deemed operating activities
682 623
(749 057)
(7 146)
(3 598)
18
172
261 381
–
(Increase) in receivables – current
Decrease in prepayments and advances
Decrease (Increase) in other current assets
Increase (Decrease) in payables – current
Expenditure on capital assets
(89 931)
99 215
1 481 189
1 031 334
(962 888)
(1 876 180)
1 634 451
260 961
Surrenders to Revenue Fund
Net cash Åow generated by operating activities
19.
Reconciliation of cash and cash equivalents for cash Åow purposes
Consolidated Paymaster General Account
Cash receipts
Cash on hand
Total
20.
Contingent liabilities and contingent assets
20.1
Contingent liabilities
2015/16
2014/15
R’000
R’000
(300 223)
(458 273)
342
851
1 106
1 081
(298 775)
(456 341)
249
Note
2015/16
2014/15
R’000
R’000
Nature of Contingency
Housing loan guarantees for employees
Annex
3A
56
176
Litigation Claims against the department
Annex
3B
16 533 542
13 103 894
19 972
2 738
16 553 570
13 106 808
2015/16
2014/15
R’000
R’000
27 621
28 479
Intergovernmental payables (unconÄrmed balances)
Total
Annex 5
20.2 Contingent assets
Claims against employees (Negative leave credits)
Claim against National Health Laboratory Services
1 559 392
1 559 392
Total
1 587 013
1 587 871
The amount of R1.6 billion disclosed as a contingent asset represents the possible debt by National Health Laboratory Services due to billing irregularities.
The department is awaiting a Änal resolution in this matter.
21.
Commitments
2015/16
R’000
R’000
Current expenditure
794 257
1 183 968
Approved and contracted
779 154
1 183 090
15 103
878
Capital expenditure
934 179
475 875
Approved and contracted
863 224
471 270
70 955
4 605
1 728 436
1 659 843
Approved but not yet contracted
Approved but not yet contracted
Total Commitments
Current: Longer than a year
1 121
Current: Shorter than a year
793 137
Capital: Longer than a year
360 700
Current: Shorter than a year
573 478
Total
1 728 436
22.
Accruals and payables not recognised
22.1
Accruals
Listed by economic classiÄcation
250
2014/15
Goods and services
Capital assets
Total
Listed by programme level
2015/16
2014/15
R’000
R’000
30 Days
30+days
Total
1 095 904
828 338
1 924 242
1 607 309
-
-
-
69 573
-
-
-
173 991
1 095 904
828 338
1 924 242
1 850 873
2015/16
2014/15
R’000
R’000
1. Administration
105 662
269 833
403 385
554 925
78 252
62 837
4. Provincial Hospitals
545 729
220 210
774 635
718 553
6. Health Training and Sciences
8 688
4 706
7. Health Care Support Services
7 891
3 978
8. Health Facilities Management
-
15 831
Total
1 924 242
1 850 873
22.2 Payables not recognised
2015/16
R’000
Listed by economic classiÄcation
Goods and services
Capital assets
30 Days
30+days
Total
1 560 477
946 551
2 507 028
22 713
728
23 441
63 762
254 318
318 080
1 646 952
1 201 597
2 848 549
2015/16
2014/15
R’000
R’000
1. Administration
879 086
-
236 232
-
74 663
-
4. Provincial Hospitals
345 323
-
771 083
-
6. Health Training and Sciences
6 600
-
7. Health Care Support Services
15 830
-
8. Health Facilities Management
519 732
-
2 848 549
-
Total
Listed by Programme Level
Total
251
The amount of R519 732 disclosed under Health Facilities Management represents accruals to Department of Infrastructure development
Accruals and Payables not recognised were in the previous years combined. A change in the ModiÄed cash standard in 2015/16 instructed that the two be
separated. Therefore, no comparative Ägures exist for Payables Not recognised.
Note
2015/16
2014/15
R’000
R’000
54 093
170 158
Included in the above totals are the following:
ConÄrmed balances with other departments
Annex 5
ConÄrmed balances with Medical Supplies Depot
Annex 5
Total
434 079
569 876
488 172
740 034
23.
Employee beneÄts
2015/16
2014/15
R’000
R’000
Leave entitlement
333 274
302 030
Service bonus (Thirteenth cheque)
510 722
461 950
Performance awards
312 521
281 149
Capped leave commitments
415 008
429 245
19 985
14 172
1 591 510
1 488 546
Long Term Service Awards
Total
The comparative of Long Term Service Awards has been included in this note.
24.
Lease commitments
24.1 Operating leases expenditure
2015/16
Buildings and other
Äxed structures
Not later than 1 year
4 585
4 585
Later than 1 year and not later than 5 years
1 914
1 914
Total lease commitments
6 499
6 499
Buildings and other
Äxed structures
Total
17 188
17 188
2014/15
252
Total
4 232
4 232
21 420
21 420
Machinery and
equipment
Total
81 424
81 424
Operating lease commitments relates to leasing of buildings by the department.
24.2
Finance leases expenditure**
2015/16
2014/15
50 282
50 282
131 706
131 706
Machinery and
equipment
Total
21 380
21 380
130 361
130 361
151 741
151 741
Finance lease commitments relates to leases of GG Vehicles
Cellphones and Photocopy machines
25.
2015/16
2014/15
R’000
R’000
Sale of goods and services other than capital assets
3 302 138
3 099 148
Total
3 302 138
3 099 148
2015/16
2014/15
25.1
Analysis of accrued departmental revenue
Opening balance
Less: amounts received
R’000
R’000
3 099 148
2 850 292
336 412
421 351
Add: amounts recognised
876 154
898 658
Less: amounts written-oќ/reversed as irrecoverable
336 752
228 451
3 302 138
3 099 148
Closing balance
The prior year balance has been restated to correct prior years’ misstatements. An amount of R8.4 million was lost as revenue that should have been received as
a result of the late implementation of the Uniform Patient Fees Structure (UPFS) which was only implemented in September 2015 instead of April 2015.
25.2 Accrued department revenue written oɈ
2015/16
2014/15
R’000
R’000
Patient Fees written oќ on the stand alone systems
336 752
228 434
Total
336 752
228 434
2015/16
2014/15
R’000
R’000
25.3 Impairment of accrued departmental revenue
Estimate of impairment of accrued departmental revenue
1 493 050
1 404 162
Total
1 493 050
1 404 162
The amount that has been impaired as accrued departmental revenue relates to self-paying patient debts that are older than 90 days.
26.
Irregular expenditure
26.1
Reconciliation of irregular expenditure
2015/16
2014/15
R’000
R’000
6 106 509
5 982 138
Add: Irregular expenditure - relating to prior year
334 779
124 371
Add: Irregular expenditure – relating to current year
493 155
Opening balance
Irregular expenditure awaiting condonation
6 934 443
6 106 509
Analysis of awaiting condonation per age classiðcation
Current year
493 155
124 371
Prior years
6 441 288
5 982 138
Total
6 934 443
6 106 509
253
26.2
Details of irregular expenditure – current year
Incident
Disciplinary steps taken/criminal
proceedings
2015/16
R’000
Deviation from normal tender procedures
18 130
30% Overtime
765
Three Quotations not obtained
46
Tenders (004/2015 &005/2015)
18 694
Ex post facto payments
25 198
Helicopter & Private ambulance hire
25 946
Sundry payments (2015/16)
404 376
Total
493 155
26.3
Prior period error
Prior period error
Note
2015/16
R’000
Irregular expenditure discovered in 2015/16 relating to 2014/2015
334 779
Total
334 779
27.
Fruitless and wasteful expenditure
27.1
Reconciliation of fruitless and wasteful expenditure
Opening balance
254
Fruitless and wasteful expenditure – relating to current year
Less: Amounts resolved
Closing balance
2015/16
2014/15
R’000
R’000
417 460
414 610
7 433
159 759
-
(156 909)
424 893
417 460
27.2 Analysis of awaiting resolution per economic classiÄcation
Current
424 893
417 460
Total
424 893
417 460
27.3
Analysis of Current year’s fruitless and wasteful expenditure
Incident
Disciplinary steps taken/criminal proceedings
2015/16
R’000
Expired medication
None
2 265
Infrastructure Development
5 168
Total
7 433
In the previous years, Litigations against the Department were disclosed as Fruitless and Wasteful expenditure, this practise has ceased.
28.
Payments made to Related Parties
2015/16
2014/15
R’000
R’000
Goods and services
2 960 352
2 398 578
Total
2 960 352
2 398 578
Year end balances arising from payments
Payables to related parties (Medical Supplies Depot)
434 079
569 876
Total
434 079
569 876
2015/16
2014/15
R’000
R’000
1
1 906
1 677
Level 15 to 16
6
9 388
9 645
Level 14 (incl. CFO if at a lower level)
18
16 525
19 078
Related Parties include Gauteng Departments:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Medical Supplies Depot
Oѝce of the Premier
Gauteng Legislature
Economic Development and entities
Education
Social Development
Local Government and Housing
Roads and Transport
Community Safety
Agriculture and Rural Development and entities
Sports, Arts, Culture and Recreation
Department of E Government
Provincial Treasury
G-Fleet
Infrastructure Development
29.
Key management personnel
No. of Individuals
Political oѝce bearers
Oѝcials:
-
Family members of key management personnel
Total
4
1 205
1 018
29
29 024
31 418
Included in salary levels 15 to 16 is the salary of the previous Head of Department who left the service on 30 April 2015. Disclosed as amounts paid to salary levels
15 to 16 is an arbitration award settled with the previous Head of Department.
30.
Provisions
Note
2015/16
2014/15
R’000
R’000
Litigation Claims against the Department
299 998
144 305
Performance Bonuses for 2008/2009 2009/2010 and 2010/2011
413 000
413 000
-
8 788
National Health Laboratory Services
OSD to Engineers
Total
9 274
722 272
9 274
575 367
255
30.1 Reconciliation of movement in provisions – 2015/16
Litigations
Performance
OSD
Total Provisions
Bonus
R’000
R’000
R’000
Opening balance
144 305
413 000
9 274
566 579
Increase in provision
204 300
-
-
204 300
Settlement of provision
(48 607)
-
-
(48 607)
Closing balance
299 998
413 000
9 274
722 272
During the Änancial year 2015/2016 the department had made a decision to settle invoices from 1 April 2015 whilst the matter is awaiting Änal resolution. There is
therefore no amount provided for in respect of NHLS. The amount owing to NHLS for the year 2015/2016 has been disclosed as an accrual.
30.2 Reconciliation of movement in provisions – 2014/15
Opening balance
Litigations
Performance
Bonus
NHLS
R’000
R’000
R’000
OSD
Total Provisions
R’000
43 185
413 000
328 513
9 274
793 972
Increase in provision
141 329
-
8 788
-
150 117
Settlement of provision
(40 209)
-
(328 513)
-
(368 722)
Closing balance
144 305
31.
413 000
8 788
9 274
575 367
Movable Tangible Capital Assets
Movement in Movable Tangible Capital Assets per Asset Register for the year ended 31 March 2016
Opening balance
Additions
Disposals
Closing Balance
R’000
R’000
R’000
R’000
4 088 983
649 165
(49 419)
4 688 729
Transport assets
343 095
43 200
(224)
386 071
Computer equipment
186 131
27 740
(1 143)
212 728
Furniture and oѝce equipment
113 792
18 952
(631)
132 113
256
Machinery and Equipment
3 445 966
559 273
(47 421)
3 957 818
Total Movable Tangible Capital Assets
4 088 983
649 165
(49 419)
4 688 729
40 179 Assets to the value of R14 000 000 are in a process of being veriÄed, as mass veriÄcation exercise will be taking place in 2016/2017 Änancial year.
31.1 Additions
Additions to Movable Tangible Capital Assets per Asset Register for the year ended 31 March 2016
Cash*
Non-cash**
(Capital Work in
Received
Progress current current, not paid
costs and
(Paid current
Änance lease
year, received
payments)
prior year)
R’000
R’000
R’000
R’000
R’000
696 201
3 931
(127 907)
76 940
649 165
Transport assets
Total
141 566
-
(98 758)
392
43 200
Computer equipment
18 333
116
-
9 291
27 740
Furniture and oѝce
equipment
17 575
23
-
1 354
18 952
Other machinery and
equipment
518 727
3 792
(29 149)
65 903
559 273
Total Additions to Movable
Tangible Capital Assets
696 201
3 931
(127 907)
76 940
649 165
31.2 Disposals
Disposals of Movable Tangible Capital Assets per Asset Register for the year ended 31 March 2016
Non-cash disposal
Total disposals
R’000
R’000
49 419
(49 419)
(224)
(224)
(1 143)
(1 143)
(631)
(631)
(47 421)
(47 421)
Total Disposal Of Movable Tangible Capital Assets
(49 419)
(49 419)
Transport assets
Computer equipment
a. Movement for 2014/15
Movement in Moveable Tangible Capital Assets per Asset Register for the year ended 31 March 2015
Opening balance
Additions
Disposals
Closing Balance
R’000
R’000
R’000
R’000
3 561 616
599 204
71 837
4 088 983
Transport assets
346 981
7 617
11 503
343 095
Computer equipment
167 316
21 028
2 213
186 131
101 494
13 567
1 269
113 792
2 945 826
556 992
56 852
3 445 966
Total Movable Tangible Capital Assets
3 561 616
599 204
71 837
4 088 983
257
b. Minor assets
Movement in Minor Assets per the Asset Register for the year ended 31 March 2016
Opening balance
Additions
Disposals
Total Minor Assets
Machinery and
equipment
Total
R’000
R’000
659 705
659 705
44 626
44 626
(5 868)
(5 868)
698 463
698 463
Movement in Minor Assets per the Asset Register for the year ended 31 March 2015
Intangible assets
Machinery and
equipment
Total
4
627 637
627 641
Additions
-
39 968
39 968
Disposals
4
(7 900)
(7 904)
Total Minor Assets
-
659 705
659 705
Machinery and
equipment
Total
R’000
R’000
Opening balance
31.3
Movable Assets Written OɈ
Movable Assets Written Oσ for the year ended 31 March 2015
258
Assets written oќ
32
32
Total Movable Assets Written OɈ
32
32
Opening balance
Closing Balance
R’000
R’000
Software
207 910
207 910
Total Intangible Capital Assets
207 910
910
32.
Intangible Capital Assets
Movement in Intangible Capital Assets per Asset Register for the year ended 31 March 2016
32.1 Movement for 2014/2015
Movement in Intangible Capital Assets per Asset Register for the year ended 31 March 2015
Opening balance
Closing Balance
R’000
R’000
Software
207 910
207 910
Total Intangible Capital Assets
207 910
207 910
33.
Immovable Tangible Capital Assets
Movement in Immovable Tangible Capital Assets per Asset Register for the year ended 31 March 2016
Opening balance
Closing Balance
R’000
R’000
Buildings and other Fixed Structures
3 284
3 284
Total Immovable Tangible Capital Assets
3 284
3 284
33.1
Movement for 2014/15
Movement in Immovable Tangible Capital Assets per Asset Register for the year ended 31 March 2015
Opening balance
Closing Balance
R’000
R’000
Buildings and other Fixed Structures
3 284
3 284
Total Immovable Tangible Capital Assets
3 284
3 284
33.2
Additions
Additions to Immovable Tangible Capital Assets as per Asset Register for the year ended 31 March 2016
Cash
(Capital Work in
Progress current
costs and Änance
lease payments)
Total
R’000
R’000
R’000
Building and other Fixed Structures
470 332
(470 332)
-
Other Fixed Structures
470 332
(470 332)
-
Total Additions to Immovable Tangible Capital Assets
470 332
(470 332)
-
34.
Prior Year Errors
34.1
Accrued Departmental Revenue Adjustment of Closing balance
Closing balance
(2 547 110)
Opening balance restated
Net EɈect
34.2
3 099 148
552 038
Other Payables and Statement of changes in Net assets
Other payables Opening Balance
37 027
Restated Opening Balance (Other payables)
(17 783)
Restated of opening balance- Statement of changes in equity
(19 244)
Net EɈect
-
Debt Receivable Income and Interest incorrectly disclosed as a payable not changes in net asset.
259
2 051
EPWP Integrated Grant to Prov
7 662 433
8 788
EPWP Social Sector Incentive
Grants
Total
7 204
National Health Insurance
3 572 856
313 630
National Tertiary Service
829 604
Hospital Facilities Revitalisation
Grants
2 928 300
Health Prof Training &
Development
Comprehensive HIV and AIDS
3 002
-
-
3 002
-
-
-
-
R’000
Roll
Overs
-
-
-
-
-
-
-
-
R’000
DORA
Adjustments
Grant Allocation
-
-
-
-
-
-
-
-
R’000
Other
Adjustments
7 665 435
2 051
8 788
10 206
3 572 856
313 630
829 604
2 928 300
R’000
Total
Available
260
R’000
Division of
Revenue Act/
Provincial
Grants
Statement of Conditional Grants received (Unaudited Schedule)
Name Of Department
35.
7 665 435
2 051
8 788
10 206
3 572 856
313 630
829 604
2 928 300
R’000
Amount
received
by
department
7 612 101
2 021
8 626
7 040
3 570 498
313 630
829 604
2 880 682
R’000
Amount
spent by
department
53 334
30
162
3 166
2 358
-
-
47 618
R’000
Under/
(Overspending)
Spent
99
98
69
100
100
100
98
%
% of
available
funds
spent by
department
7 717 049
2 010
14 475
10 281
3 493 891
752 700
811 114
2 632 578
R’000
7 661 433
2 010
12 866
5 660
3 493 853
752 700
811 114
2 583 230
R’000
Amount
spent by
department
2014/15
Division
of
Revenue
Act
59 687
20 310
11 501
11 601
6 713
City of Tshwane Metro
Ekurhuleni Metro
West Rand District
Council
39 792
City of Johannesburg
HIV and AIDS
(Provincial)
West Rand District
Council
Category C
143 250
Ekurhuleni Metro
111 416
Metro
Category A
Emergency Medical
Services
117 885
42 086
Ekurhuleni Metro
-
-
-
-
-
-
-
-
-
-
-
R’000
R’000
110 043
Roll
Overs
(77)
447
447
(696)
(23 875)
(207)
-
-
-
-
-
R’000
Adjustments
Grant Allocation
Division
of
Revenue
Act
Category A
Primary Health Care
Name of Municipality
6 636
12 048
11 948
19 614
15 917
143 043
59 687
111 416
117 885
42 086
110 043
Total
Available
-
19 614
12 048
6 636
-
15 917
11 948
-
59 687
-
111 416
143 043
-
42 085
-
110 043
117 885
R’000
-
-
-
-
-
-
-
-
-
-
-
%
Funds Re-allocations
Withheld
by National
Treasury
or National
Department
R’000
Actual
Transfer
Transfer
Statement of Conditional Grants and other Transfers paid to Municipalities (Unaudited Schedule)
36. Annexure 1A
6 636
12 048
11 948
19 614
15 917
143 043
59 687
111 416
117 885
42 085
110 043
R’000
Amount
received
by
municipality
6 636
12 048
11 948
19 614
15 917
143 043
59 687
111 416
117 885
42 085
110 043
R’000
Amount
spent by
municipality
Spent
-
100
100
100
100
100
100
100
100
100
100
%
% of
available
funds
spent by
municipality
6 376
11 086
10 923
19 288
37 789
136 040
56 683
105 809
111 952
39 967
104 505
R’000
Division
of
Revenue
Act
2014/15
261
262
Total
Sedibeng District
Council
Name of Municipality
681 327
-
-
R’000
R’000
7 043
Roll
Overs
Division
of
Revenue
Act
(23 884)
77
R’000
Adjustments
Grant Allocation
657 443
7 120
Total
Available
657 442
7 120
R’000
Actual
Transfer
-
-
R’000
-
-
%
Funds Re-allocations
Withheld
by National
Treasury
or National
Department
Transfer
Statement of Conditional Grants and other Transfers paid to Municipalities (Unaudited Schedule)
36. Annexure 1A (continued)
657 442
7 120
R’000
Amount
received
by
municipality
657 442
7 120
R’000
Amount
spent by
municipality
Spent
-
%
% of
available
funds
spent by
municipality
647 109
6 691
R’000
Division
of
Revenue
Act
2014/15
Adjusted
17 919
Total
17 919
R’000
Appro-priation
SABC
Health and Welfare Seta
Department/Agency/Account
-
-
-
17 919
R’000
17 919
R’000
R’000
Total
Available
Adjustments
Roll
Overs
TRANSFER ALLOCATION
STATEMENT OF TRANSFERS TO DEPARTMENTAL AGENCIES AND ACCOUNTS (UNAUDITED SCHEDULE)
ANNEXURE 1B
17 919
-
17 919
R’000
Actual
Transfer
100
%
% of
Available
funds
Transferred
TRANSFER
17 184
53
17 131
R’000
Appropriation
Act
2014/15
263
264
Adjusted
333
400
University of Limpopo
University of Pretoria
1 864
637
Total
494
University of Johannesburg
R’000
Appropriation
University of Witwatersrand
Name Of Higher Education Institution
-
-
-
-
-
R’000
Roll
Overs
-
-
-
-
-
R’000
Adjust-ments
Transfer Allocation
1 864
400
333
637
494
R’000
Total
Available
STATEMENT OF TRANSFERS TO HIGHER EDUCATION INSTITUTIONS (UNAUDITED SCHEDULE)
ANNEXURE 1C
Actual
1 824
393
66
821
544
R’000
Transfer
40
7
267
(184)
(50)
R’000
98
20
129
110
%
Amount
% of
(over)/under Available funds
transferred
Transferred
Transfer
1 782
400
222
637
523
R’000
Appro-priation
Act
2014/15
Adjusted
10 977
11 139
Community Health Clinics (Witkoppen Clinic)
Community Health Centres ( Alexandra Health Centre)
Total
CBS (Specialised Services NPOs & Rehabilitation)
614 102
1 444
103 386
49 239
Nutrition Provincial (NGO’s)
Community Based Services (EPWP NPOs)
81 072
128 798
Community Based Services (Mental Health NPOs)
HIV and AIDS (NGO’s)
228 047
R’000
Appropriation
Act
Subsidy Chronic PSYCH Care (Life Esidimeni)
Public Corporations
Non-ProÄt Institutions
103 386
1 444
-
-
614 102
11 139
10 977
49 239
81 072
128 798
-
228 047
-
-
-
R’000
-
R’000
R’000
Total
Available
-
Adjustments
Roll
Overs
Transfer Allocation
STATEMENT OF TRANSFERS TO NON-PROFIT INSTITUTIONS (UNAUDITED SCHEDULE)
ANNEXURE 1D
523 218
1 434
101 396
11 139
12 672
48 481
47 967
101 403
198 726
R’000
99
98
100
115
98
59
79
87
%
Actual
% of
Transfer Available funds
Transferred
Expenditure
659 324
1 370
89 739
65 153
9 000
47 759
84 506
110 102
251 695
R’000
Appropriation
Act
2014/15
265
Total
H/H Claims against State
H/H Bursaries( non-employee)
H/H Other Transfers
H/H Emp S/Ben: Leave Gratuity
H/H Employee S/Ben: Injury on duty
H/H Employee Social BeneÄts
Adjusted
114 444
-
73 053
36 669
4 722
R’000
Appropriation
Act
-
-
-
-
-
R’000
Roll
Overs
-
-
-
-
-
R’000
Adjust-ments
Transfer allocation
266
Households
STATEMENT OF TRANSFERS TO HOUSEHOLDS (UNAUDITED SCHEDULE)
ANNEXURE 1E
114 444
-
73 053
36 669
4 722
R’000
Total
Available
266 790
3 785
175 712
85 205
2 088
R’000
Actual
Transfer
-
-
241
232
44
%
% of
Available funds
Transferred
Expenditure
145 872
526
104 669
-
36 328
4 349
R’000
Appropriation
Act
2014/15
Total
Subtotal
Various individual donors
Received in kind
Subtotal
Various Individual Donors
Received in cash
Name of Organisation
123
115
35
Furniture and Oѝce Equipment
Other Machinery and Equipment
Pharmaceutical supplies
•
•
•
75 585
75 708
47 050
47 165
75 411
1 445
45 510
-
174
60
Various Items
Computer Equipment
•
123
-
R’000
R’000
115
2014/15
2015/16
•
Cash Received and utilized
Nature of Gift, Donation or Sponsorship
STATEMENT OF GIFTS, DONATIONS AND SPONSORSHIPS RECEIVED (UNAUDITED SCHEDULE)
ANNEXURE 1F
267
268
Total
FIRST RAND BANK (FNB)
Guarantor
institution
2
Guarantee in
respect of
housing
176
176
R’000
176
176
R’000
Original Opening balance
guaranteed
1 April 2015
capital
amount
(120)
(120)
R’000
during the
year
Guarantees
draw downs
-
-
R’000
Guarantees
repayments/
cancelled/
reduced/
released during
the year
-
-
R’000
Revaluations
STATEMENT OF FINANCIAL GUARANTEES ISSUED AS AT 31 MARCH 2016 – LOCAL (UNAUDITED SCHEDULE)
ANNEXURE 3A
56
56
R’000
31 March 2016
Closing balance
R’000
Guaranteed
interest for year
ended 31 March
2016
R’000
Realised
losses not
recoverable i.e.
claims paid out
3 755 040
64 712
581
3 820 333
10 079 281
1 502 408
9 729
1 508 092
4 384
13 103 894
Medico-Legal
Civil Claims
Total
OSD to Nurses
Premature termination of contracts
Vehicle Liability
Claims against the department
R’000
Liabilities
incurred during
the year
R’000
Nature of Liability
1 April 2015
Opening
Balance
STATEMENT OF CONTINGENT LIABILITIES AS AT 31 MARCH 2016 (UNAUDITED SCHEDULE)
ANNEXURE 3B
390 685
-
-
25
8 403
382 257
R’000
Liabilities paid/
cancelled/
reduced during
the year
-
-
-
-
-
-
R’000
Liabilities
recoverable
(Provide details
hereunder)
16 533 542
4 384
1 508 092
10 285
1 558 717
13 452 064
R’000
31 March 2016
Closing Balance
269
(95)
Western Cape: Department of Health (U3)
8
North West Department of Health and Social Development(Patient fees)
SA National Defence Force (Patient fees)
National Department of Justice (Patient Fees)
Gauteng Department of Infrastructure Development
58
-
Limpopo Department of Health and Social Development (Patient fees)
Eastern Cape Dept of Education (D5)
-
South African Police Services (Patient fees)
43
-
Department of Correctional Services (Patient fees)
National Department of Social Development (07)
-
89
Northern Cape Department of Health (H5)
Mpumalanga Department of Health & Social Services(Patient fees)
35
-
-
-
-
-
-
-
-
-
-
-
-
14
National Department of Correctional Services(95)
23
151
314
National Department of Health(20)
306
North West Health (3Y)
72
Gauteng Treasury (4G)
125
SA National Defence Force (W1)
Western Cape Provincial Parliament (U4)
947
Limpopo Department of Health and Social Development (P4)
81
22
(44)
290
Gauteng Education(K5)
31
199
R’000
31/03/2015
Gauteng Social Development(G5)
Mpumalanga: Department of Health (C5)
Department
R’000
31/03/2016
ConÄrmed balance outstanding
270
Government Entity
CLAIMS RECOVERABLE (UNAUDITED SCHEDULE)
ANNEXURE 4
-
-
-
10 508
2 664
329 931
51 942
18 799
40 146
5 572
-
-
-
-
-
-
-
-
-
-
-
-
R’000
31/03/2016
-
-
-
9 540
2 924
422 751
89 569
17 881
34 033
37 115
-
-
-
26
-
-
-
-
-
-
-
-
R’000
31/03/2015
UnconÄrmed balance outstanding
58
43
8
10 508
2 664
329 931
51 942
18 799
40 146
5 572
89
35
151
-
306
125
-
947
290
-
-
199
R’000
31/03/2016
Total
-
-
-
9 540
2 924
422 751
89 569
17 881
34 033
37 115
-
-
14
49
314
72
-
81
(44)
22
31
(95)
R’000
31/03/2015
27
KZN Department of Health (3K)
Patient Fees to the value of R 459 562 million is included on Annexure 4 but not reÅecting on BAS.
TOTAL
Other
Other Government Entities
2 496
-
2 496
28
Total
48
National: Department of Justice & Constitutional Development (12)
142
R’000
31/03/2016
31/03/2016
R’000
459 562
459 562
R’000
443
443
614 140
301
613 839
-
-
-
-
R’000
31/03/2015
31/03/2015
Department of Higher Education and Training (63)
Free State Department of Health (V5)
Government Entity
462 058
-
462 058
27
28
48
142
R’000
31/03/2016
Total
614 583
301
614 282
-
-
-
-
R’000
31/03/2015
271
Department of Women (65)
Kwazulu-Natal: Department of Health
National Treasury
National Department of Justice
6
12
-
105
-
-
Rural Development and Land reform
Eastern Cape Department of Health (D2)
137
3
281
16
512
208
-
-
Oѝce of the Premier
Mpumalanga: Department of Health
National Department of Defence Force
Limpopo: Department of Health (Q7)
Department of Justice and Constitutional Dev
8
59
South African Police Services (Social) (90)
North West: Department of Health
14
Free State: Department of Health (V5)
-
-
1 120
830
7
101 169
Government Printing
-
67 476
R’000
31/03/2015
Gauteng Department of Education
7
Gauteng Department of Infrastructure
52 527
Gauteng Oѝce of the Premier (G6)
Gauteng Department of Transport G-Fleet (K8)
Current
DEPARTMENTS
R’000
31/03/2016
272
Government Entity
INTER-GOVERNMENT PAYABLES (UNAUDITED SCHEDULE)
ANNEXURE 5
13
19 959
R’000
31/03/2016
-
-
-
-
-
-
-
-
-
1 054
-
-
-
-
1 684
R’000
31/03/2015
6
16
512
13
8
59
14
1 120
830
7
72 846
R’000
31/03/2016
Total
12
-
105
137
3
281
208
-
-
1 054
-
-
101 169
7
69 160
R’000
31/03/2015
434 079
434 079
488 172
Subtotal
Total Intergovernmental
54 093
21
R’000
31/03/2016
31/03/2016
R’000
19 972
153 043
153 043
173 015
R’000
170 158
569 876
569 876
740 034
2 738
-
-
2 738
-
R’000
31/03/2015
31/03/2015
Medical Supplies Depot (K7)
Current
OTHER GOVERNMENT ENTITY
Total Departments
Department of Water & Sanitation
Government Entity
669 001
594 936
594 936
74 065
21
R’000
31/03/2016
Total
742 772
569 876
569 876
172 896
-
R’000
31/03/2015
273
562 149
Closing balance
The adjustment Ägure of (R830 473) is the variance between Closing Inventory and Physical Inventory at the end of 2014/15.
Closing inventory after stock veriÄcation is R 627 132 for 2015/2016.
(634 784)
(2 265)
-
(Less): Issues
(Less): Disposals
Add: Additions Non-Cash
513 802
Add: Additions/Purchases - Cash
R’000
2015/16
(830 473)
Quantity
(Less): Adjustments to prior year balances
Note
1 515 869
274
Opening balance
Inventory [Per major category]
INVENTORY (UNAUDITED SCHEDULE)
ANNEXURE 6
Quantity
1 515 869
(375 981)
(2 468)
-
1 024 254
-
870 064
R’000
2014/15
Total
Building & other Fixed Structures
MOVEMENT IN CAPITAL WORK IN PROGRESS (UNAUDITED SCHEDULE)
ANNEXURE 7
1 972 332
470 332
470 332
1 502 000
1 502 000
1 972 332
Closing Balance
Current Year Capital WIP
Opening Balance
275
276
Part F: Medical Supply Depot
Financial Statements of
Gauteng Medical Supplies Depot
For the Year Ended 31 March 2016
Table of Contents
278
288
289
Statement of Net Assets
290
Statement of Cash Flows
291
Accounting Policies
294
Notes to the Änancial statements
299
Report of the Audit Committee- Cluster 03
313
Annexure - Legalisation
316
277
1. Report of the Accounting Oѝcer
The Accounting Oѝcer of the Gauteng Department of
Health hereby submits the annual report for the Gauteng
Medical Supplies Depot, to the Executive Authority of
the Gauteng Department of Health, and the Gauteng
Provincial Legislature of the Republic of South Africa.
1.
General review of the state of
aɈairs
The Medical Supplies Depot is responsible for the
supply of essential medicines to Provincial Health
Care Facilities in Gauteng. The Depot operates as
a trading entity and charges a levy of 5% on stock
issued to the Provincial Health Care Facilities.
The Depot procures essential medicines on contract
or quotations and either store these items at the
Depot or orders are placed with suppliers on behalf of
institutions for direct delivery to the various institutions.
Accurate usage of items, as well as money spent by
hospitals, can be obtained from the Medical Stock
Administration System (MEDSAS). The Economic
Order Quantity (EOQ) together with the First-EntryExpiry-First-Out, (FEEFO) system is applied to ensure
that correct stock levels are maintained.
278
The Depot prepares Änancial statements for each
Änancial period in accordance with the prescribed
practice (Statements of South African Generally
Recognised Accounting Practice-GRAP). The Änancial
statements are prepared and reported on accordingly.
The Medical Supplies Depot has a re-packing
function, where bulk medicine is repacked into patient
ready packs. The re-packing expenses are recovered
from the normal levy charged. Managers for each cost
centre were identiÄed and procedures to ensure the
completeness of stock requisitioning and receiving
were designed. It is possible to reconcile the relevant
cost centres with the records of the Änance section.
This further enhances the monitoring of expense
items through a budget process.
1.1
SigniÄcant events that have taken
place during the year
Improved supplier payments and
document management
The depot has witnessed signiÄcant improvements
in the payment of suppliers especially with the
direct deliveries. The improvements are attributed
to a number of measures introduced by both the
depot and the Gauteng Department of Health which
included quarterly meetings with suppliers intended
to smoothen communication between the two
parties. Furthermore, the department ring-fenced
a monthly average in the region of R250 million for
the payment of the depot’s suppliers. During the said
quarterly meetings, a number of payment challenges
have been resolved leading to improved receipt of
payment documents such as invoices, delivery notes
and annexure “A” also referred to as Proof of Delivery
documents (PODs).
These coupled with the follow-up centre which follows
up purchases orders, among other things have
resulted in signiÄcant increase in stock availability both
at the medical supplies depot and at the facilities.
Patient-ready packets now on contract
The depot’s Pre-pack unit has experienced a scale
down of production levels due to the fact that a
number of patient-ready packets are now included
in suppliers contracts. This and other changes within
the MSD have necessitated a deeper consideration
for the re-engineering process which commenced
with the Pre-pack and Contract units. Management in
consultation with labour unions have moved a number
of staќ from those aќected units to other units.
Implementation of the Provincial Medicine
Procurement Unit (PMPU)
The medical supplies depot also expanded on the
use of the PMPU to procure pharmaceuticals and
facilitate the direct delivery of medicines to health care
facilities in September 2013. The implementation of
this process has reduced the time that it takes from
ordering medication to the delivery of medication. It
also reduces the amount of times that stock needs to
be handled and thus reducing the risk of breakages
and expiry of stock. The implementation of this has led
to a higher number of direct deliveries made to health
care facilities and in turn reduced the distribution cost
incurred by the Medical supplies Depot. Currently,
approximately 70% of EML medicines are delivered
directly to healthcare institutions.
Establishment of Pharmaceutical
Procurement Committee (PPC)
During the 2013/14 Änancial year, the Medical
Supplies Depot established a Pharmaceutical
Procurement Committee. The committee was
established to ensure that there are proper controls
in place and transparency towards the procurement
of Pharmaceutical items that fall outside national and
provincial contracts. The PPC is also responsible for
ensuring that alternative medicines are sourced in
line with procurement process where suppliers are
unable to deliver stock due to stock shortages or the
unavailability of stock.
The PPC has introduced several control measures to
ensure that all procurement is in line with supply chain
regulations and that proper supporting documentation
is in place including regular reporting Through the PPC
the Medical supplies Depot have also moved towards
penalising suppliers for late delivery and for additional
expenses incurred when medicines have to be
sourced outside of the contract due to unavailability
of stock from contracted Suppliers.
•
Improved medicine procurement through the
tender system and determination of pack sizes to
be re-packed or purchase
ReÄning the provincial medicine formulary such
that non-EDL medicines allowed for use are not
greater than 20% of the total medicines used
Monitoring of expenditure on medicines using the
ABC analysis where A medicines are those that
consume 80% of the budget, B medicines 15%
of the budget and C medicines 5% of the budget.
On a quarterly basis, medicine utilisation review is
done focusing primarily on the A medicines.
•
•
Revival of the Provincial Pharmacy and
Therapeutics Committee (PPTC)
Spending Trends
The Provincial Pharmacy and Therapeutics Committee
has been revived. Through its subcommittees
(Formulary, Rationale medicine use, Safety & quality
and Procurement advisory subcommittees), it assists in:
• the standardisation of medicines used in
accordance with the Essential Drugs Programme
• the rationale utilisation of medicines aligned to
evidence-based medicine principles.
A summary of major spending trends indicates that
medicines price increased at a rate higher than
the consumer price index (CPI). This has the eќect
that revenue increases at a higher rate and has a
favourable inÅuence on the net proÄt of the Depot.
Cost containment measures were implemented which
further had a positive impact on the net proÄt.
Major accounts
Description
31 March 2016
Amount
Variance
From
Prior Year
31 March 2015
Amount
R
Variance
From
Prior Year
R
31 March 2014 Variance
From
Amount
Prior Year
R
31 March 2013
Amount
R
Revenue
2 984 248 189
10.99%
2 688 733 804
(7.57%)
2 908 789 812
(0.68)%
2 928 979 725
Cost of sales
2 842 329 263
11.85%
2 541 292 259
(8.04%)
2 763 338 474
(1.43)%
2 803 521 784
Expenditure:
Personnel
61 841 794
13.64%
54 417 818
3.66%
52 496 147
7.80%
48 684 146
Expenditure:
General
29 584 910
(18.98%)
36 517 781
(20.00%)
45 798 889
22.25%
37 463 148
Net proÄt
60 447 734
0.123%
60 373 292
28.00%
47 099 000
33.41%
35 302 769
Personnel expenses increased as more scarce skills
posts on the staќ establishment were Älled. A general
moratorium on the Älling of posts were in place for
other posts.
generated by the Depot. This also contributed in a
reduction of distribution cost. The distribution cost was
further reduced by the roll out of DDV procurement
through the PMPU.
The Depot management has however identiÄed areas
where career development constraints exist and where
risks identiÄed need to be addressed. The Depot
started with the training of pharmacist assistants to
address this. During the period under review a total
number of 15 pharmacist assistants were enrolled
for formal training. The proposed organisational
structure that was forwarded to our Head Oѝce has
been reviewed, amended and incorporated into the
Departmental organisational structure. UnÄlled posts
were frozen by the Department of Public Service and
Administration during the 2012/13 Änancial year.
2.
The movement of the procurement function of
non-Pharmaceutical items from the Depot to the
Department of Health had an impact on the revenue
Services rendered
The Medical Supplies Depot is responsible for the
eќective and eѝcient procurement, quality testing,
storage and distribution of essential medicines to
all the Provincial Health Care Facilities in Gauteng.
The Depot ensures that Essential Medicine List
(EML) medicines are available to our clients at all
times. This involves the evaluation of medicine for
tender purposes, participation in tender adjudication
meetings, procurement and distribution of these items,
as well as quality control of medicines distributed to
our institutions.
Quality control is carried out in a fully equipped
laboratory, where samples are tested from each batch
279
of medicines received. The Depot’s laboratory is the
only laboratory in South-Africa where the Ändings on
quality tests performed are also communicated to
other provinces.
TariɈ policy
The tariќ policy for the trading account was approved
on 1 April 1992 as per the Exchequer Act, Act No. 66
of 1975. Approval was granted for a Äve percent (5%)
levy on the average carrying value of stock issued to
customer hospitals.
Free Service
The Depot does not provide any free service. The
quality control of the medicines performed by
the laboratory on site is part of the administrative
expenses of the Depot, which are recovered as part
of the 5% levy charge.
3.
280
Capacity constraints
The Medical Supplies Depot delivers a vital service to
all the Health Care Institutions in Gauteng. Currently
the Medical Supplies Depot has 264 posts on the
approved staќ establishment, with 45 vacant. In
addition to the 45 vacant posts, there are 2 Senior
Managers that were on suspension during the
Änancial period under review
This can be demonstrated in the following two of our
key performance objectives:
•
•
KPI 1: “Availability” refers to a situation where the
stock on hand at the depot is suѝcient to meet
the demand created on MEDSAS in full.
KPI 2: “Service level” refers to how quickly the
MSD takes to issue stock, in full, on MEDSAS.
The measurement of this KPI is therefore timebased. This will ensure that orders are dispatched
to institutions as scheduled.
Systems for measuring the indicator ‘% of orders
supplied to institutions on Ärst requests’ were
strengthened, and the actual performance is
calculated according to the following deÄnition: ‘If
an order/request with varying quantities is fulÄlled
100% within one working day, then that order counts
towards the achieving of the target. If even one unit is
not captured as part of the request within one working
day, the order does not count as being fulÄlled’.
This is an extremely high standard to fulÄl, but it is
speciÄc, measurable and time-bound. Also, it holds
the Depot to higher standards – meeting orders within
one working day could have a life-saving impact at
the level of institutions. However, the more rigorous
monitoring system makes it appear that performance
is lower than planned.
A constraint to ensure eќective, economical and
eѝcient reporting exists in that information from
various systems needs to be manually collated.
Information from the following systems is used and
involves time-consuming reconciliation procedures to
enable compliance with Statements of SA GRAP for
disclosure purposes:
•
•
•
•
•
Basic Accounting System (BAS)
Personnel and Salary Administration System
(PERSAL)
Medical Stock Administration System (MEDSAS)
Asset Management System (ASSETWARE)
Manual systems to perform reconciliation
procedures and accrual based accounting
The Depot introduced a monthly Änancial reporting
tool and designed relevant guidelines for populating
the tool with all the various Änancial information from
the diќerent systems. This tool was introduced to
reduce the amount of time spent preparing Änancial
information and also ensuring that complete and
accurate Änancial information is maintained on a
monthly basis.
4.
Utilisation of donor funds
The Depot receives donation of Fluconazole
suspension, Fluconazole Injection and Fluconazole
tablets from PÄzer Laboratories for use by AIDS
patients with Oesophageal Candidiasis and
Cryptococcal Meningitis. This type of donor funding
is received on a continuous basis.
Tenofovir, Emtritabine and Efavirenz 300/200/600mg
tablets, the Äxed dose combination( three in one) were
donated from the global fund once oќ to assist in the
roll out of the Äxed dose combination(three in one) in
the Änancial year under review.
Please note that the Depot does not account for
the economic beneÄt received in the Statement of
Financial Performance, as the Depot is considered
to be only a conduit for hospitals and to control
the receipt of donations for the Department. The
donation is reÅected in the Änancial statements of the
Department.
The current market value of donations issued and
charged at a value of one-hundredth of one cent
(R0.0001) to all clients of the Depot. The total charge
to health institutions for donations received amounted
to under R10.
Below is the breakdown of donations received during the Änancial period.
ICN
Item Description
Supplied Quantity
by/
received
Arranged
by
181931183
Mebendazole 500mg Tablets; 1’s (in a bottle
of 150’s)
NDoH
5400
377.38
R2 037 852
180963203
Flucanazole Injection 2mg/ml;100ML
NDoH
4500
197.29
R887 805
181791499
Fluconazole Powder for oral Suspension
50mg/5ml; 35ml
NDoH
1200
203.32
R243 984
180962874
Fluconazole tablets 200mg; 28’S
NDoH
18000
2 352.25
R42 340 500
Current Market Total SEP
Value per Unit
Value
Single Exit
Price (SEP)
TOTAL
5.
Trading entities
The Medical Supplies Depot operates as a trading
entity, known as “The Central Medical Trading
Account” since 1 April 1992. The trading entity acts
as a shared supply chain for the procurement and
provisioning of pharmaceutical to the Department’s
Health Care Institutions in Gauteng.
A four year comparative analysis of major accounts is
disclosed under paragraph 1 above.
6.
Organisation to whom transfer
payments have been made
No transfer payment has been made by the Depot in
this Änancial year under review.
7.
Public/Private Partnership (PPP)
No Public Private Partnership has been entered into
by the Depot in this Änancial year.
The following non-core services have been outsourced
to the private sector which consist mostly of Black
Economic Empowerment companies:
•
•
•
•
•
Maintenance and support of the MEDSAS
computer system.
Distribution of stock to health care institutions.
Security of the property and vehicle access
control.
Maintenance, pest control and minor landscaping
of the garden at the Depot.
General maintenance contracts, such as lifts, air
conditioners, stand-by generator, Äre equipment
and access control mechanisms.
Refer to note 23 of the Änancial statements
commitments detail.
8.
Corporate governance
arrangements
R45 510 141
The following Änancial risks were prioritised:
•
•
•
•
•
A system was developed to reconcile creditors
and to ensure recovery and payment of over- or
under- payments made.
Debtors control was introduced to ensure that
revenue is collected timeously and outstanding
orders are cleared.
A reconciliation procedure was implemented
whereby hospitals reconcile stock received, with
charges on their accounting system (BAS) and
MEDSAS (Budget Expenditure Report).
The asset management system (ASSETWARE)
was maintained and all assets are recorded and
capitalised.
The Depot’s controls and operations are
evaluated together with the Audit Committee of
the Department of Health
The Depot utilises and follows the Fraud Prevention
Plan of the Department of Health.
Management uses risk assessments and reports of
both internal and external audit on a monthly basis in
order to identify areas for improvement of the operations
of the Depot. Updated reports made available are
being used to strengthen the implementation of
risk management and fraud prevention plans at the
Medical Supplies Depot. An updated risk assessment
for all operations at the Depot was completed in the
Änancial period under review.
9.
Discontinued activities
There were no discontinued operations during the
Änancial year under review.
10.
Inventories
The valuation method used by the Medical Supplies
Depot is the moving weighted average method as per
the MEDSAS:
Management, with the objective of safeguarding the
assets of the Depot and ensuring a high quality of
service delivery, performs an annual risk assessment.
281
Medicine and medically related items
Closing stock
31 March 2016
R
31 March 2015
R
31 March 2014
R
31 March 2013
R
311 096 708
218 910 037
239 434 577
164 252 270
31 March 2016
R
31 March 2015
R
31 March 2014
R
31 March 2013
R
13 273
14 616
15 646
27 584
2 568 494
561 395
5 254 573
2 648 327
Medicine and medically related items
Breakages
Expired stock
The reason for the high value of expired stock in the
prior year is attributable mainly to expired female
condoms that constituted R4.6 million of the expired
stock. In the prior years it was mainly attributable to the
Medical Supplies Depot receiving late communication
regarding regimen changes, for instance, for TB
treatment resulting in doctors not prescribing the
already stocked medicines.
282
•
•
•
Back orders were reduced
Warehouse management practices were improved
with the introduction of trolley consolidations,
streamlining of schedules for supervisors that
assists in eќective staќ utilisation.
Quality assurance processes were improved with
a complete overhaul of the standard operating
procedures.
11.
Events after the reporting date
The Depot has further introduced control measures
to deal with short dated stock that has an expiry date
of less than 18 Month. These measures include that
stock is accepted on condition that suppliers will
accept the return of any stock that has expired before
it was dispensed.
There were no signiÄcant events identiÄed by
management that may have a signiÄcant impact on
the entity’s Änancial position, its Änancial performance
or its cash Åows for the period ended 31 March 2016.
Control measures in place
12.
Whilst the long term solutions for ensuring eѝcient
and eќective stock management at the depot require
an appropriate infra-structure (new warehouse),
an integrated information system and adequate
workforce in terms of numbers and skills, the following
short term controls have been instituted:
•
•
•
•
•
Shelf marshals have been appointed to monitor
expiry dates and identifying items expiring in
6 months.
Stock on hand is Ärst issued before replacement
items are issued when regimens (treatment
protocols) are changed.
Improved communication and planning around
prescription treatment changes to avoid a
situation where the depot is having high volumes
of stock items that is not prescribed anymore and
ultimately expires.
Reviewing the list of items to be kept at the Depot.
Discuss regimen changes with National
Department of Health to align with current stock
levels
Information on predetermined
objectives
The Gauteng Department of Health and Social
Development’s Strategic Plan, 2009 to 2014 was
used as a basis for developing the Depot’s Operational
Plan. This approach ensured that the Depot’s
predetermined objectives are clearly aligned to those
of the Department as far as the Depot’s relevance to
the Department is concerned.
For the period under review, the Depot had a total
of seven (7) predetermined objectives which were
reported on quarterly. Each of the seven objectives
had at least one indicator whose measurement
variable inputs were collected either through the
current IT Systems in use such as MEDSAS or
collected manually or a combination of IT and manual
systems.
The key performance indicators per the strategic plan based on measurable objectives and our actual
achievement are reÅected in the table below:
No.
Measurable objective
Performance
Indicator
Indicator Description per approved
Operational Plan 2015/2016
ANNUAL PERFORMANCE
RESULTS
Target
Actual
Variance
Explanation to deviations
Reasons for variance
1
Increase available
of EML (vital and
essential) medicines
to 90% by the end of
March 2016
Percentage of
vital and essential
medicines available
at the medical
supplies depot
90%
93%
3%
The target was met. Interventions
were introduced, which included
the creation of a follow-up centre
on all orders placed with suppliers.
2
Ensure that 83% of
EML demander’s
orders are satisÄed in
full within 24 hrs
Percentage of EML
orders satisÄed in
full within 24hrs
83%
81%
(2%)
This was not achieved because
of the suppliers that were making
partial deliveries which were not
enough to cover all the outstanding
orders from the demanders.
3
Improved cost
containment
Percentage of
expired stock [not
exceeding 2%]
<2.00%
1.171%
4
Improved contract
compliance
Percentage of
invoices processed
for payment within
30 days
100%
77%
5
Ensure optimum
productivity for prepack Unit
Number of units
pre-packed by the
end of March 2016
1 500
000
1 173
613
6
Ensure Timely testing
of medicines by the
lab by the end of
March 2016
Percentage of
medicines tested
within 48 hrs by
the Laboratory by
the end of March
2016
95%
100%
5%
The target was met. There has
been an increase in the number of
pharmacists at the laboratory unit.
7
Provide logistical
support to the
warehouse, pre-pack
laboratory and other
departments within
the depot
Percentage of DID
projects by the end
of March 2016
70%
48%
(22%)
This target was not achieved. This
is due to sole reliance on DID to
execute all MSD projects.
13.
SCOPA Resolutions
There were resolutions adopted for the Medical
Supplies Depot (MSD) for the year ended 31 March
2016 and progress was provided to SCOPA on a
quarterly basis.
14.
Investigation
A forensic investigation by the Gauteng Forensic
services relating to prior period irregularities was
concluded during the year and oѝcials aќected were
deployed at various institutions within the department.
15.
(0.829%) The target was met. Interventions
were put in place in the warehouse
regarding receipt of stock from
suppliers.
(23%)
This target was not achieved.
This is due to delayed receipt of
payment vouchers from facilities as
proof of delivery of goods (PODs)
(326 387) This target was not achieved. This
is due to patient-ready packets
which were put on contract
necessitating the scaling down of
production at the Pre-pack unit of
the depot
mostly attributable to the back dated approval of
contract price increases by the National Department
of Health. This Ägure of R 1 186 415 has, however,
decreased signiÄcantly from prior periods (2015:
R1 650 509) due to the improved communication
and other control measures that were implemented
to address this.
16.
Approval
The Änancial statements set out on pages 288 to 312
have been approved by the Accounting Oѝcer.
Other
The Depot was still incurring a cost relating to price
increases not recovered from demanders. This is
DR T.E. SELEBANO
HEAD OF DEPARTMENT
283
Report of the auditor-general to the Gauteng Provincial
Legislature on Gauteng Medical Supplies Depot
Report on the Änancial statements
Introduction
1.
I have audited the Änancial statements of the Gauteng Medical Supplies Depot set out on pages 288 to
312, which comprise the statement of Änancial position as at 31 March 2016, the statement of Änancial
performance, statement of changes in net assets and cash Åow statement for the year then ended, as well
as the notes, comprising a summary of signiÄcant accounting policies and other explanatory information.
The accounting oɉcer’s responsibility for the Änancial statements
2.
The accounting oѝcer is responsible for the preparation and fair presentation of these Änancial statements in
accordance with the South African standards of Generally Recognised Accounting Practice (SA standards
of GRAP) and the requirements of the Public Finance Management Act of South Africa, 1999 (Act No.1 of
1999) (PFMA) and for such internal control as the accounting oѝcer determines is necessary to enable the
preparation of Änancial statements that are free from material misstatement, whether due to fraud or error.
Auditor-general’s responsibility
3.
My responsibility is to express an opinion on these Änancial statements based on my audit. I conducted
my audit in accordance with International Standards on Auditing. Those standards require that I comply
with ethical requirements, and plan and perform the audit to obtain reasonable assurance about whether
284
the Änancial statements are free from material misstatement.
4.
An audit involves performing procedures to obtain audit evidence about the amounts and disclosures
in the Änancial statements. The procedures selected depend on the auditor’s judgement, including the
assessment of the risks of material misstatement of the Änancial statements, whether due to fraud or
error. In making those risk assessments, the auditor considers internal control relevant to the entity’s
preparation and fair presentation of the Änancial statements in order to design audit procedures that are
appropriate in the circumstances, but not for the purpose of expressing an opinion on the eќectiveness of
the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies
used and the reasonableness of accounting estimates made by management, as well as evaluating the
overall presentation of the Änancial statements.
5.
I believe that the audit evidence I have obtained is suѝcient and appropriate to provide a basis for my audit
opinion.
Opinion
6.
In my opinion, the Änancial statements present fairly, in all material respects, the Änancial position of the
Gauteng Medical Supplies Depot as at 31 March 2016 and its Änancial performance and cash Åows for
the year then ended, in accordance with SA standards of GRAP and the requirements of the PFMA.
Report on other legal and regulatory requirements
7.
In accordance with the Public Audit Act of South Africa, 2004 (Act No. 25 of 2004) and the general notice
issued in terms thereof, I have a responsibility to report Ändings on the reported performance information
against predetermined objectives of selected programmes presented in the annual performance report,
compliance with legislation and internal control. The objective of my tests was to identify reportable Ändings
as described under each subheading but not to gather evidence to express assurance on these matters.
Accordingly, I do not express an opinion or conclusion on these matters.
Predetermined objectives
8.
I performed procedures to obtain evidence about the usefulness and reliability of the reported performance
information of the following selected programmes presented in the annual performance report of the
trading entity for the year ended 31 March 2016:
• Programme 7: Health care support services – Sub programme: Medical Supplies Depot Medicine trading
account on pages 69 to 73.
9.
I evaluated the usefulness of the reported performance information to determine whether it was presented in
accordance with the National Treasury’s annual reporting principles and whether the reported performance
was consistent with the planned programmes. I further performed tests to determine whether indicators
and targets were well deÄned, veriÄable, speciÄc, measurable, time bound and relevant, as required by the
National Treasury’s Framework for Managing Programme Performance Information (FMPPI).
10. I assessed the reliability of the reported performance information to determine whether it was valid,
accurate and complete.
11. I did not identify any material Ändings on the usefulness of the reported performance information for the
following programme:
• Programme 7: Health care support services – Sub programme: Medical Supplies Depot Medicine trading
account.
Additional matters
12. Although I did not raise any material Ändings on the usefulness and reliability of the reported performance
information for the selected programme, I draw attention to the following matters:
Achievement of planned targets
13. Refer to the annual performance report on pages 282 to 283 for information on the achievement of the
planned targets for the year.
Adjustment of material misstatements
14. I identiÄed material misstatements in the annual performance report submitted for auditing. These material
misstatements were on the reported performance information. As management subsequently corrected
the misstatements, I did not raise any material Ändings on the usefulness and reliability of the reported
performance information.
Compliance with legislation
15. I performed procedures to obtain evidence that the trading entity had complied with applicable legislation
regarding Änancial matters, Änancial management and other related matters. My material Ändings on
compliance with speciÄc matters in key legislation, as set out in the general notice issued in terms of the
PAA, are as follows:
285
Procurement and contract management
16. Goods and services of a transaction value above R500 000 were procured without inviting competitive
bids, as required by treasury regulations 16A6.1. Deviations were approved by the accounting oѝcer even
though it was not impractical to invite competitive bids, in contravention of treasury regulation 16A6.4
Expenditure management
17. Eќective steps were not taken to prevent irregular expenditure, amounting to R31 069 239 as disclosed in
note 19 of the AFS, as required by section 38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1.
18. Contractual obligations and money owed by the trading entity were not settled within 30 days, as required
by section 38(1)(f) of the PFMA and treasury regulation 8.2.3.
Internal control
19. I considered internal control relevant to my audit of the Änancial statements, annual performance report
and compliance with legislation. The matters reported below are limited to the signiÄcant internal control
deÄciencies that resulted in the Ändings on the annual performance report and the Ändings on compliance
with legislation included in this report.
Leadership
20. The accounting oѝcer did not exercise adequate oversight responsibility regarding performance reporting
and compliance with laws monitoring. This resulted in material amendment on the annual performance
report and material audit Ändings non-compliance with laws and regulations.
286
Other reports
21. I draw attention to the following engagements that could potentially impact on the trading entity’s Änancial,
performance and compliance related matters. My opinion is not modiÄed in respect of these engagements
that are either in progress or have been completed.
Investigations
22. Investigation into allegations that certain oѝcials were involved in a syndicate that may be engaging in illicit
activities was still progress.
23. Investigation into theft of stock and tampering with vehicle tracker system was started on 8 July 2014
and completed on 14 December 2015 and the suspect was found guilty. The suspect appealed the
decision and the result of his appeal was to be received by the end of July 2016 from Central Oѝce Legal
department.
Johannesburg
31 July 2016
287
Statement of Financial Position – Medical Supplies Depot
as at 31 March 2016
Note
31 March
31 March
2016
2015
R
R
12 188 572
6 207 303
ASSETS
Non-current assets
Property, plant and equipment
2
12 182 615
6 198 200
Intangible assets
3
5 957
9 103
760 214 785
811 338 851
4
311 096 708
218 910 037
Trade and other receivables from exchange transactions
5
444 031 632
586 561 010
6
5 086 445
5 867 804
772 403 357
817 546 154
363 646 963
303 115 436
104 376 790
104 376 790
259 270 173
198 738 646
335 445
596 446
335 445
596 446
408 420 949
513 834 272
Current assets
Inventories
Total assets
NET ASSETS AND LIABILITIES
Net assets
Capital and reserves
288
Medsas capital account
7
Accumulated surplus
Non-current liabilities
Financial lease obligation
8
Current liabilities
Leave pay accrual
9
3 106 741
3 528 897
Trade and other payables from exchange transactions
10
405 076 927
509 877 089
Finance lease obligation
8
237 281
428 286
772 403 357
817 546 154
Total net assets and liabilities
Statement of Financial Performance – Medical Supplies Depot
Note
31 March
31 March
2016
2015
R
R
Revenue from exchange transactions
11
2 984 248 189
2 688 733 804
Cost of sales
23
(2 842 329 263)
(2 541 292 259)
141 918 926
147 441 545
Gross proðt
Other income
11
149 770
118 980
Revenue from non exchange transactions
11
6 708 385
1 811 318
Operating expenditure
12
(91 426 704)
(90 935 599)
(4 871 807)
(10 371 292)
(78 088 880)
(74 612 158)
Other expenses
(8 466 017)
(5 952 149)
Operating surplus before interest and tax
57 350 377
58 436 244
Distribution cost
Administrative expenses
Finance income
13
3 173 221
2 045 937
Finance cost
13
(75 864)
(108 889)
60 447 734
60 373 292
-
-
60 447 734
60 373 292
60 447 734
60 373 292
Surplus before taxation
289
Taxation
14
Surplus for the period
Other comprehensive income, net of taxation
Total comprehensive income attributable to:
Statement of Changes in Net Assets – Medical Supplies Depot
Balance at 31 March 2014
MEDSAS Capital
Account
Accumulated
Surplus
Total
R
R
R
104 376 790
137 922 863
242 299 653
-
60 373 292
60 373 292
104 376 790
198 296 155
302 672 945
-
442 491
442 491
104 376 790
198 738 646
303 115 436
-
60 447 734
60 447 734
Initial recognition of owned assets
-
83 793
83 793
104 376 790
259 270 173
363 646 963
Balance at 31 March 2015 as previously stated
Correction of prior period error
Balance at 31 March 2015 restated
Balance at 31 March 2016
290
Statement of Cash Flow – Medical Supplies Depot
Note
31 March
31 March
2016
2015
R
R
Cash ñows from operating activities
Cash generated from / (utilised in) operations
15
6 476 865
(12 263 420)
Finance income
13
3 173 221
2 045 937
Finance costs
13
(75 864)
(108 889)
9 574 222
(10 326 372)
(10 434 653)
(847 235)
531 078
-
(9 903 575)
(847 235)
(452 006)
165 224
Net cash (outñow) / inñows from ðnancing activities
(452 006)
165 224
Decrease in cash and cash equivalents
(781 359)
(11 008 383)
Cash and cash equivalents at the beginning of the year
5 867 804
16 876 187
Cash and cash equivalents at the end of the year
5 086 445
5 867 804
Net cash generated from / (utilised in) operating activities
Cash ñows from investing activities
Purchase of property, plant and equipment
2
Proceeds on disposal of property, plant and equipment
Net cash outñow from investing activities
Cash ñows from ðnancing activities
(Repayment of) / Increase in Änance lease liability
8
291
Accounting Policies – Medical Supplies Depot
1.1
Basis of preparation
These Änancial statements were prepared in
accordance with the standards of Generally
Recognised Accounting Practices (GRAP) issued
by the Accounting Standards Board in accordance
with the Public Finance Management Act, 1999 (Act
No.1 of 1999) as amended by the Public Finance
Management Amendment Act (Act No. 29 of 1999).
1.2
Presentation currency
The Änancial statements are presented in South African
Rand, which is the functional currency of the entity.
1.3
Rounding
Unless otherwise stated, all Änancial Ägures have
been rounded to the nearest Rand (R).
1.4
Going concern assumption
The annual Änancial statements were prepared on a
going concern basis, which assumes that the entity
will continue to operate as a going concern for at least
the next 12 months.
1.5
292
Prior year comparatives
Where necessary, comparative Ägures have been
reclassiÄed to conform to changes in presentation in
the current year.
1.6
SigniÄcant judgements and
estimates
The use of judgment, estimates and assumptions is
inherent to the process of preparing annual Änancial
statements. These judgements, estimates and
assumptions aќect the amounts presented in the
annual Änancial statements. Uncertainties about
these estimates and assumptions could result in
outcomes that require a material adjustment to the
carrying amount of the relevant asset or liability in
future periods.
Änancial impact of each of those potential outcomes.
Management then assigns a weighting factor to each
of these outcomes based on the probability that the
outcome will materialise in future. The factor is then
applied to each of the potential outcomes and the
factored outcomes are then added together to arrive
at the weighted average value of the provisions.
Depreciation and amortisation
Depreciation and amortisation recognised on
property, plant and equipment is determined with
reference to the useful lives and residual values of the
underlying items. The useful lives and residual values
of assets are based on management’s estimation of
the asset’s condition, expected condition at the end
of the period of use, its current use, expected future
use and the entity’s expectations about the availability
of Änance to replace the asset at the end of its useful
life. In evaluating the how, the condition, and use of
the asset inform the useful life and residual value.
Management considers the impact of technology and
minimum service requirements of the assets.
Fair value determination of property, plant
and equipment (excluding heritage assets)
In determining the fair value of property, plant and
equipment the entity applies a valuation methodology
to determine the fair value based on any one of, or a
combination of the following factors:
•
•
•
•
The market related selling price of the item; or
The material composition of the item; or
The item’s special features which include design,
appendages and improvements; or
The item’s condition with regards to whether it is
broken, in a poor, fair, good or excellent condition.
Inventory
Inventories that qualify for recognition must initially be
stated at cost. Where inventories are acquired at no
cost, or for nominal consideration, their cost shall be
their fair value at the date of acquisition.
Provisions
All inventory items at year-end are stated using the
weighted average cost.
Provisions are measured as the present value of
the estimated future outÅows required to settle
the obligation. In the process of determining the
best estimate of the amounts that will be required
in future to settle the provision management
considers the weighted average probability of the
potential outcomes of the provisions raised. This
measurement entails determining what the diќerent
potential outcomes are for a provision as well as the
In testing for, and determining the value-in-use of nonÄnancial assets, management is required to rely on the
use of estimates about the asset’s ability to continue
to generate cash Åows (in the case of cash-generating
assets). For non-cash-generating assets, estimates
are made regarding the depreciated replacement
cost, restoration cost, or service units of the asset,
depending on the nature of the impairment and the
availability of information.
1.7
Financial instruments
Initial recognition
The entity recognises a Änancial asset or a Änancial
liability in its Statement of Financial Position when,
and only when, the entity becomes a party to the
contractual provisions of the instrument. This is
achieved through the application of trade date
accounting.
Upon initial recognition the entity classiÄes Änancial
instruments or their component parts as Änancial
liabilities or Änancial assets in conformity with the
substance of the contractual arrangement and to the
extent that the instrument satisÄes the deÄnitions of
a Änancial liability or a Änancial asset, in accordance
with the standards of GRAP on Financial instruments GRAP 104.
Trade and other receivables
Trade and other receivables are initially recognised
at fair value plus transaction costs that are directly
attributable to the acquisition and subsequently
stated at amortised cost, using the eќective interest
rate method.
Cash and cash equivalents are measured at amortised
cost using the eќective interest rate method.
Cash includes cash on hand and cash with banks.
Cash equivalents are short-term highly liquid
investments that are held with registered banking
institutions with maturities of three months or less and
are subject to an insigniÄcant risk of change in value.
For the purposes of the Cash Flow Statement, cash
and cash equivalents comprise cash on hand and
deposits held on call with banks.
Trade and other payables
Trade payables are initially measured at fair value
plus transaction costs that are directly attributable
to the acquisition and are subsequently measured
at amortised cost using the eќective interest rate
method.
Gains and losses
A gain or loss arising from a change in the fair value
of a Änancial asset or Änancial liability measured at fair
value is recognised in surplus or deÄcit.
For Änancial assets and Änancial liabilities measured at
amortised cost or cost, a gain or loss is recognised in
surplus or deÄcit when the Änancial asset or Änancial
liability is derecognised or impaired or through the
amortisation process.
OɈ-setting
The entity does not oќset Änancial assets and Änancial
liabilities in the Statement of Financial Position unless
a legal right of set-oќ exists and the parties intend to
settle on a net basis.
Impairments
All Änancial assets measured at amortised cost are
subject to an impairment review. The entity assesses
at the end of each reporting period whether there is
any objective evidence that a Änancial asset or group
of Änancial assets is impaired.
If there is objective evidence that an impairment loss
on Änancial assets measured at amortised cost has
been incurred, the amount of the loss is measured as
the diќerence between the asset‘s carrying amount
and the present value of estimated future cash Åows
(excluding future credit losses that have not been
incurred) discounted at the Änancial asset‘s original
eќective interest rate (that is the eќective interest
rate computed at initial recognition). The carrying
amount of the asset is reduced through the use of
an allowance account. The amount of the loss is
recognised in surplus or deÄcit.
1.8
Inventories
Initial recognition and measurement
Inventories are initially recognised at cost. Cost refers
to the purchase price, plus taxes, transport costs and
any other costs in bringing the inventories to their
current location and condition.
Subsequent measurement
Inventories will be measured at the lower of cost and
the net realisable value. Inventories are stated on a
weighted average moving basis with the same cost
formula being used for all inventories having a similar
nature and use at the entity.
Redundant and slow-moving inventories are identiÄed
and written down from cost to net realisable value
with regard to their estimated economic or realisable
values. The amount of any reversal of any write-down
of inventories arising from an increase in net realisable
value is recognised as a reduction of inventories
recognised as an expense in the period in which the
reversal occurs.
Derecognition
The carrying amount of inventories is recognised as
an expense in the period that the inventory was sold,
distributed, written oќ or consumed, unless that cost
qualiÄes for capitalisation to the cost of another asset.
293
1.9
Property, plant and equipment
The cost of an item of property, plant and equipment is
the purchase price and other costs directly attributable
to bring the asset to the location and condition
necessary for it to be capable of operating in the
manner intended by the entity. Trade discounts and
rebates are deducted in arriving at the cost at which
the asset is recognised. The cost also includes the
estimated costs of dismantling and removing the asset.
Items of property, plant and equipment are initially
recognised as assets on acquisition date and are initially
recorded at cost where acquired through exchange
transactions. However, when items of property, plant
and equipment are acquired through non-exchange
transactions, those items are initially measured at their
fair values as at the date of acquisition.
Asset classiÄcation
Subsequent to initial recognition, items of property,
plant and equipment are measured at cost less
accumulated depreciation and impairment losses.
Depreciation
Depreciation is calculated on the depreciable amount,
using the straight-line method over the estimated
useful lives of the assets. Components of assets that
are signiÄcant in relation to the whole asset and that
have diќerent useful lives are depreciated separately.
The depreciable amount is determined after taking into
account an assets’ residual value, where applicable.
The assets’ residual values, useful lives and
depreciation methods are reviewed at each Änancial
year-end and adjusted prospectively, if appropriate.
The annual depreciation rates are based on the
following estimated asset useful lives:
Average useful lives (Years)
Motor vehicles
-
Cars, minibuses, trucks
Plant and equipment
294
Air-conditioning
3-5
4-7
Medical equipment
1 - 16
Telephone system
5-6
Audio Visual
1 - 18
Domestic Equipment
1 - 16
Lab Equipment
1 - 19
Security Equipment
3 - 20
Vehicles
7 - 19
Warehouse Equipment
1 - 16
Workshop and tools
3 - 19
Oѝce furniture
-
Kitchen Appliances
3 - 19
Oѝce equipment
3 - 17
Computer equipment
1 - 18
Impairment
The entity tests for impairment where there is
an indication that an asset may be impaired. An
assessment of whether there is an indication of
possible impairment is done at each reporting date.
Where the carrying amount of an item of property,
plant and equipment is greater than the estimated
recoverable amount (or recoverable service amount),
it is written down immediately to its recoverable
amount (or recoverable service amount) and an
impairment loss is charged to the Statement of
Financial Performance.
Intangible assets are subsequently carried at cost less
accumulated amortisation and impairments.
Where items of property, plant and equipment have
been impaired, the carrying value is adjusted by the
impairment loss, which is recognised as an expense
in the Statement of Financial Performance in the
period that the impairment is identiÄed.
An impairment is reversed only to the extent that
the asset’s carrying amount does not exceed the
carrying amount that would have been determined
had no impairment been recognised. A reversal of the
impairment is recognised in the Statement of Financial
Performance.
Derecognition
Items of property, plant and equipment are
derecognised when the asset is disposed of or when
there are no further economic beneÄts or service
potential expected from the use of the asset. The gain
or loss arising on the disposal or retirement of an item
of property, plant and equipment is determined as
the diќerence between the sales proceeds and the
carrying value and is recognised in the Statement of
Financial Performance.
1.10 Intangible Assets
An intangible asset is an identiÄable non-monetary
asset without physical substance. The entity
recognises an intangible asset in its Statement
of Financial Position only when it is probable that
the expected future economic beneÄts or service
potential that are attributable to the asset will Åow to
the entity and the cost or fair value of the asset can be
measured reliably.
The cost of an intangible asset is amortised over
the useful life where that useful life is Änite. The
amortisation expense on intangible assets with Änite
lives is recognised in the Statement of Financial
Performance in the expense category consistent with
the function of the intangible asset.
Intangible assets with indeÄnite useful lives are not
amortised, but are tested for impairment annually,
either individually or at the cash generating unit level.
The assessment of indeÄnite life is reviewed annually
to determine whether the indeÄnite life assumption
continues to be supportable. If not, the change
in useful life from indeÄnite to Änite is made on a
prospective basis.
Amortisation and impairment
Amortisation is charged to write-oќ the cost of
intangible assets over their estimated useful lives
using the straight-line method.
The annual amortisation rates are based on the
following estimated average asset lives:
Intangible Asset
Average Useful Life
Computer Software
3-5 years
The amortisation period, the amortisation method and
residual value for intangible assets with Änite useful
lives are reviewed at each reporting date and any
changes are recognised as a change in accounting
estimate in the Statement of Financial Performance.
Impairments
The entity tests intangible assets with Änite useful lives
for impairment where there is an indication that an
asset may be impaired. An assessment of whether
there is an indication of possible impairment is
performed at each reporting date. Where the carrying
amount of an item of an intangible asset is greater than
the estimated recoverable amount (or recoverable
service amount), it is written down immediately to its
recoverable amount (or recoverable service amount)
and an impairment loss is charged to the Statement
of Financial Performance.
Intangible assets are initially recognised at cost.
Derecognition
Where an intangible asset is acquired by the entity
for no or nominal consideration (i.e. a non-exchange
transaction), the cost is deemed to be equal to the fair
value of that asset on the date acquired.
Intangible assets are derecognised when the asset is
disposed of or when there are no further economic
beneÄts or service potential expected from the asset.
The gain or loss arising on the disposal or retirement
295
of an intangible asset is determined as the diќerence
between the sales proceeds and the carrying value
and is recognised in the Statement of Financial
Performance.
1.11 Leases
The entity as lessee in an operating lease
Assets subject to operating leases, that is those
leases where substantially all of the risks and rewards
of ownership are not transferred to the lessee through
the lease, are not recognised in the Statement of
Financial Position. The operating lease expense is
recognised over the course of the lease arrangement.
The lease expense recognised for operating leases is
charged to the Statement of Financial Performance on
a straight-line basis over the term of the relevant lease.
To the extent that the straight-lined lease payments
diќer from the actual lease payments the diќerence
is recognised in the Statement of Financial Position
as either lease payments in advance (operating lease
asset) or lease payments payable (operating lease
liability) as the case may be. This resulting asset and /
or liability is measured as the undiscounted diќerence
between the straight-line lease payments and the
contractual lease payments.
296
The operating lease liability is derecognised when the
entity’s obligation to settle the liability is extinguished.
The operating lease asset is derecognised when the
entity no longer anticipates economic beneÄts to Åow
from the asset.
payments between the capital and interest portion of
the liability is eќected through the application of the
eќective interest method.
The Änance charges resulting from the Änance lease
are expensed, through the Statement of Financial
Performance, as they accrue. The Änance cost accrual
is determined using the eќective interest method.
The Änance lease liabilities are derecognised when the
entity’s obligation to settle the liability is extinguished.
The assets capitalised under the Änance lease are
derecognised when the entity no longer expects any
economic beneÄts or service potential to Åow from
the asset.
1.12 Revenue from exchange
transactions
Revenue is recognised by the entity for goods sold,
the value of which approximates the consideration
received or receivable, excluding indirect taxes,
rebates and discounts.
Revenue is only recognised when all of the following
criteria are satisÄed:
•
•
•
The entity as lessee in a Änance lease
Leases are classiÄed as Änance leases where
substantially all the risks and rewards associated
with ownership of an asset are transferred to the
entity through the lease agreement. Assets subject
to Änance leases are recognised in the Statement of
Financial Position at the inception of the lease, as is
the corresponding Änance lease liability.
Assets subject to a Änance lease, as recognised in
the Statement of Financial Position, are measured (at
initial recognition) at the lower of the fair value of the
assets and the present value of the future minimum
lease payments. Subsequent to initial recognition
these capitalised assets are depreciated over the
contract term.
The Änance lease liability recognised at initial
recognition is measured at the present value of the
future minimum lease payments. Subsequent to initial
recognition this liability is carried at amortised cost,
with the lease payments being set oќ against the
capital and accrued interest. The allocation of the lease
The entity retains neither continuing managerial
involvement to the degree usually associated with
ownership nor eќective control over the goods sold;
The amount of revenue can be measured reliably;
and
It is probable that the economic beneÄts or
service potential associated with the transaction
will Åow to the entity and the costs incurred or to
be incurred in respect of the transaction can be
measured reliably.
1.13 Revenue from non-exchange
transactions Gifts and donations,
including goods in-kind
Gifts and donations, including goods in kind, shall
be recognised as income in the period it is received
provided that all of the following conditions have been
satisÄed:
•
•
•
•
The amounts of the donations, gifts, goods-inkind and penalties can be measured reliably.
There is an existing signed contract with the
supplier that includes a paragraph on penalties;
It is probable that the economic beneÄts comprising
of the donation will Åow to the entity; and
The amounts of the donations, gifts, goods-inkind and penalties can be measured reliably.
Gauteng Medical Supplies does not account for
the economic beneÄt received in the Statement of
Financial Performance, as the depot is considered
to be only a conduit for hospitals and to control the
receipt of donations for the Department.
1.14 Borrowing costs
Borrowing costs directly attributable to the
acquisition, construction or production of qualifying
assets are capitalised to the cost of that asset unless
it is inappropriate to do so. The entity ceases the
capitalisation of borrowing costs when substantially all
the activities to prepare the asset for its intended use
or sale are complete. It is considered inappropriate to
capitalise borrowing costs where the link between the
funds borrowed and the capital asset acquired cannot
be adequately established. Borrowing costs incurred
other than on qualifying assets are recognised as an
expense in the Statement of Financial Performance
when incurred.
1.15 Irregular expenditure
Irregular expenditure is recognised as expenditure
in the Statement of Financial Performance. If the
expenditure is not condoned by the relevant authority,
it is treated as an asset until recovered or written oќ
as irrecoverable.
1.17 Employee BeneÄts
Short-term employee beneÄts
Short term employee beneÄts encompasses all those
beneÄts that become payable in the short term, that
is within a Änancial year or within 12 months after the
Änancial year. Therefore, short term employee beneÄts
include remuneration, compensated absences and
bonuses.
Short-term employee beneÄts are recognised in
the Statement of Financial Performance as services
rendered, except for non-accumulating beneÄts,
which are recognised when the speciÄc event occurs.
These short-term employee beneÄts are measured at
their undiscounted costs in the period the employee
renders the related service or the speciÄc event
occurs.
Retirement beneÄt costs
“Fruitless and wasteful expenditure is deÄned as
expenditure that was made in vain and would have
been avoided had reasonable care been exercised,
therefore:
The Depot provides retirement beneÄts for its
employees through a deÄned beneÄt plan for
government employees. These beneÄts are funded by
both employer and employee contributions. Employer
contributions to the fund are expensed when money
is paid to the fund. No provision or beneÄt accounting
is disclosed for retirement beneÄts in the Änancial
statements as the obligation and plan assets is the
responsibility of the multi-employer Government
Employee Pension Fund resorting under the control
of National Treasury.
•
1.18 Events after reporting date
1.16 Fruitless and wasteful expenditure
•
It must be recovered from a responsible oѝcial (a
debtor account should be raised); or
The Vote (If responsibility cannot be determined).
Such expenditure is treated as expenditure in the
Statement of Financial Performance and where
recovered, it is subsequently accounted for as
revenue in the Statement of Financial Performance.
Due to nature of business at the MSD (where expired
stock and stock breakages is inherent to the business
of MSD), expired and stock breakages will only be
recognised as fruitless and wasteful expenditure if their
total value is higher than 2% of average stock holding.
Qualitative consideration would also be considered to
disclose fruitless and wasteful expenditure.”
Recovery of irregular and fruitless and wasteful
expenditure
The recovery of unauthorised, irregular, fruitless
and wasteful expenditure is based on legislated
procedures, and is recognised when the recovery
thereof from the responsible oѝcials is probable.
The recovery of unauthorised, irregular, fruitless and
wasteful expenditure is treated as other receivables.
Revenue from non exchange transactions – sale of
goods
Two types of events can be identiÄed:
•
•
those that provide evidence of conditions that
existed at the reporting date (adjusting events
after the reporting date); and
those that are indicative of conditions that arose
after the reporting date (non-adjusting events after
the reporting date).
The entity will adjust the amounts recognised in the
Änancial statements to reÅect adjusting events after
the reporting date once the event occurred.
The entity will disclose the nature of the event and
estimate its Änancial eќect or a statement that such
estimate cannot be made in respect of all material
non-adjusting events, where non-disclosure could
inÅuence the economic decisions of users taken on
the basis of the Änancial statements.
297
1.19
Related Parties
The entity has processes and controls in place to aid
in the identiÄcation of related parties. A related party is
a person or an entity with the ability to control or jointly
control the other party, or exercise signiÄcant inÅuence
over the other party, or vice versa, or an entity that is
subject to common control, or joint control. Related
party relationships where control exists are disclosed
regardless of whether any transactions took place
between the parties during the reporting period.
Where transactions occurred between the entity any
one or more related parties, and those transactions
were not within:
•
•
298
normal supplier and/or client/recipient relationships
on terms and conditions no more or less favourable
than those which it is reasonable to expect the
entity to have adopted if dealing with that individual
entity or person in the same circumstances; and
terms and conditions within the normal operating
parameters established by the reporting entity’s
legal mandate.
“Further details about those transactions are disclosed
in the notes to the Änancial statements.
Information about such transactions is disclosed in
the Änancial statements.”
1.20 Standards, amendments to
standards and interpretations
issued not yet eɈective.
The following Standards of GRAP and / or
amendments thereto have been issued by the
Accounting Standards Board, but will only become
eќective in future periods or have not been given an
eќective date by the Minister of Finance. The entity
has not early-adopted any of these new Standards
or amendments thereto, but has referred to them
for guidance in the development of accounting
policies in accordance with GRAP 3 as read with
Directive 5:
Standard name and number
EɈective date( if applicable)
GRAP 20 - Related Party Disclosures
Approved and not yet eќective
GRAP 32 - Service Concession Arrangements: Grantor
GRAP 108 - Statutory Receivables
GRAP 109 - Accounting by Principles and Agents
Property, Plant and Equipment
25 737
554 900
12 182 615
(97 032)
(486 325)
(19 186 075)
122 769
1 041 225
31 368 690
Cell phones
251 226
(374 314)
625 540
277 937
(14 979)
Oѝce equipment
11 627 715
(18 699 750)
30 327 465
292 916
9 949 754
26 163 351
1 693 211
189 231
829 053
674 927
24 470 140
13 372 529
6 656 683
1 169 342
-
(10 625)
(4 566 605)
10 625
508 619
4 430 303
Cost
(3 946 592)
Carrying value at
end of the year
(10 175 928)
5 735 947
2016
Accumulated
depreciation
20 125 682
10 625
4 455 211
Cost
Motor vehicles - G-Fleet
Leased Assets
Plant and equipment
Oѝce furniture
Äxtures and Ättings
Computer equipment
Owned assets
2.
2015
(19 965 151)
(695 072)
(80 458)
(523 723)
(90 891)
(19 270 079)
(10 135 349)
(5 146 491)
(10 625)
(3 977 614)
Accumulated
depreciation
6 198 200
998 139
108 773
305 330
584 036
5 200 061
3 237 180
1 510 192
-
452 689
Carrying value at
end of the year
Notes to the Financial Statements – Medical Supplies Depot
299
496 132
10 518 445
108 773
998 139
6 198 200
Oѝce equipment
Cell phones
203 216
584 036
305 330
292 916
10 022 313
5 200 061
Leased Assets
9 589 615
3 237 180
Plant and equipment
185 099
-
247 599
1 510 192
-
452 689
Oѝce furniture
Fixtures and Ättings
Computer equipment
Owned assets
Additions
(5 313 106)
(1 148 118)
(66 462)
(406 729)
(674 927)
(4 164 988)
(2 836 462)
(1 105 835)
-
(222 691)
Disposals/
Impairment
300
Carrying value at
beginning of the year
2016 - Reconciliation of Property Plant & Equipment
4 731 772
657 136
63 714
406 729
186 693
4 074 636
2 766 811
1 095 577
-
212 248
(3 952 696)
(448 389)
(80 288)
(257 320)
(110 781)
(3 504 307)
(2 807 390)
(515 691)
-
(181 226)
Accumulated
Depreciation Charge
depreciation on
disposals/ impairment
12 182 615
554 900
25 737
251 226
277 937
11 627 715
9 949 754
1 169 342
-
508 619
Carrying value at end
of the year
Cell phones
Oѝce equipment
Leased Assets
131 282
806 209
847 234
46 069
8 722 400
-
674 927
686 204
578 178
61 957
41 025
4 678 545
8 036 196
Plant and equipment
28 799
-
12 226
2 229 820
-
1 127 831
Additions
Oѝce furniture
Äxtures and Ättings
Computer equipment
Owned assets
Carrying value at
beginning of the year
2015 - Reconciliation of Property Plant & Equipment
185 536
1 131 952
1 155 814
(1 219 356)
-
(185 536)
946 416
(946 416)
(1 131 952)
6 888
-
23 862
-
(10 658)
16 974
(76 746)
(3 307 892)
(494 274)
(68 578)
(272 848)
(152 848)
(2 813 618)
(1 437 595)
(748 427)
-
(627 596)
Accumulated
Depreciation Charge
depreciation on
disposals/ impairment
(87 404)
Disposals/
Impairment
6 198 200
998 139
108 773
305 330
584 036
5 200 061
3 237 180
1 510 192
-
452 689
Carrying value at end
of the year
301
3.
31 March
31 March
2016
2015
R
R
9 103
16 314
(3 146)
(7 211)
5 957
9 103
94 081 150
103 327 575
Intangible Assets
Computer software
Carrying value at the beginning of the year
Amortisation charge for the period
4.
Inventories
Trading stock
-
1 046 193
216 387 194
114 038 761
628 364
497 508
311 096 708
218 910 037
Pre-pack stock
ARV
Operational stock
The valuation method used by the Depot was the weighted average
moving basis based on cost price. There was no impairment of inventory
raised at 31 March 2016 (2015: Nil). Management has assessed
impairment at year end individually and based on this assessment no
impairment of inventory has been raised (2015: Nil).
13 273
14 616
2 568 494
561 395
568 965
210 484
3 150 731
786 495
Trade receivables
434 079 220
579 168 617
Other receivables
9 952 412
7 392 393
444 031 632
586 561 010
Breakages
302
Expired stock
Inventory Count variance
No write down of inventory to net realisable value was required during
the period under review.
5.
Trade and other receivables rrom Exchange
Transactions
(Refer to note 16 for fair values)
Trade receivables are non-interest bearing and are generally repayable
between 30 and 90 days. There were amounts older than 90 days as
at year end, management has assessed trade receivables individually
and collectively and has come to the conclusion that there is no reason
to believe that these amounts will not be recovered within 90 days after
year end hence no impairment of trade receivables was recognised for
the year ended March 2016 (2015: R Nil). These accounts have not
been discounted due to the fact that normal trading terms had not been
violated during the period under review.
As at 31 March 2016, the age analysis of trade receivables that
were due but not impaired is as follows:
< 30 days
381 947 401
392 306 947
> 30 days
52 131 819
186 861 670
434 079 220
579 168 617
Total
6.
31 March
31 March
2016
2015
R
R
Cash And Cash Equivalents
5 084 945
Bank balance
Petty cash
5 866 304
1 500
1 500
5 086 445
5 867 804
Cash and cash equivalents earn interest at Åoating rates based on daily
bank deposit rates. The Änance income is recognised in the Statement
of Financial Performance.
7.
MEDSAS Capital Account
MEDSAS capital account
104 376 790
104 376 790
Capital is used for the operating expenses of the Depot and for the
purchasing of inventory. The Gauteng Department of Health provided
the initial capital of R54 000 000 after Treasury approval was obtained.
The capital was increased by R26 000 000 in 2007, after obtaining
Treasury approval, by transferring from the accumulated surplus and an
additional transfer of R24 376 790 in 2009.
8.
Finance Lease Obligations
Minimum lease payments
Within 1 year
378 947
546 841
Within the 2nd to 5th year
455 468
751 872
834 415
1 298 713
(261 689)
(273 980)
572 726
1 024 733
Within 1 year
237 281
428 286
Within the 2nd to 5th year
335 445
596 446
572 726
1 024 732
(237 281)
(428 286)
335 445
596 446
Balance at the beginning of the year
3 528 897
3 161 078
Net accrual raised during the year
(422 156)
367 819
Balance at the end of the year
3 106 741
3 528 897
Less: Future Änance charges
Present value of lease obligations
The present value of lease obligations can be analysed as follows:
Less: Current portion
Obligations under Änance leases are secured by the lessor’s title to the
leased asset. Finance leases bear interest at an average rate of 9%.
9.
Leave Accrual
A leave accrual is recognised for leave due to employees at year end. The accrual for leave is calculated by
multiplying the number of leave days due to each employee by a daily rate based on the total cost to the company.
The accrual is expected to be realised within 12 months of the reporting date.
303
10.
31 March
31 March
2016
2015
R
R
Trade And Other Payables From Exchange
Transactions
398 301 315
503 606 755
6 775 612
6 270 334
405 076 927
509 877 089
< 30 days
122 094 161
315 639 045
> 30 days
276 207 154
187 967 710
Total
398 301 315
503 606 755
2 984 248 189
2 688 733 804
6 708 385
1 811 318
149 770
118 980
2 991 106 344
2 690 664 102
Distribution cost:
4 871 807
10 371 292
Fees for distribution costs
4 372 121
9 747 680
499 686
623 612
Administrative expenses:
78 088 880
74 612 158
Staќ Costs
56 634 454
49 628 364
5 207 340
4 789 454
Communication
414 088
384 901
Maintenance and repairs
419 424
2 009 564
Stationery and printing
730 469
1 114 866
7 215 296
9 610 392
406 099
251 817
1 759 424
1 674 184
-
140 510
5 302 286
5 008 106
Trade payables
Sundry creditors
Trade payables are non-interest bearing and are generally repayable
within 30 days. These accounts have not been discounted due to the
fact that the eќect of discounting is not signiÄcant.
As at 31 March 2016, the age analysis of trade payables that were due
but not impaired is as follows:
11.
Revenue And Other Income
Revenue from exchange transactions - sale of goods
Revenue from non exchange transactions - sale of goods
Other income
304
12.
Operating Expenditure
Rental of vehicles
Contribution to deÄned beneÄt plan
Other administrative expenses
Fees for services:
Lease rentals of equipment
Audit fees
Technical
Security
12.
31 March
31 March
2016
2015
R
R
Operating Expenditure (continued)
Other expenses:
8 466 017
5 952 149
Depreciation owned assets
3 504 308
2 813 618
Depreciation leased assets
448 389
494 275
3 146
7 211
External training
79 928
136 499
Scrapping of property, plant and equipment
93 100
63 542
Stock price adjustments not recovered
1 186 415
1 650 509
Inventory written oќ
3 150 731
786 495
91 426 704
90 935 599
75 864
108 889
3 173 221
2 045 937
Amortisation of intangible assets
Total operating expenditure
13.
Finance Cost And Finance Income
Finance cost:
Capitalised Änance leases
Finance income:
Bank balance
14.
305
Taxation
No provision has been made for taxation as the Depot is exempt from
income taxation in terms of section 10 (1) of the South African Income
Tax Act No.58 of 1962.
15.
Cash Generated From/ (Utilised In)
Operations
Operating surplus Before Interest and Tax
Depreciation on property, plant and equipment
Amortisation of intangible assets
Net movement in leave pay accrual
Gain on the disposal of property, plant and equipment
Property, plant and equipment scrapped
Prior period error
57 350 377
58 436 244
3 952 697
3 307 893
3 146
7 211
(422 156)
367 819
(42 844)
-
93 100
63 542
-
442 491
3 150 731
786 495
64 085 051
63 411 695
(Increase)/Decrease in inventories
(95 337 402)
19 738 045
Decrease/(Increase) in trade and other receivables
142 529 378
(305 344 126)
(104 800 162)
209 930 966
(57 608 186)
(75 675 115)
Inventory written oќ
Operating surplus before changes in working capital
Movement in working capital
(Decrease)/Increase in trade and other payables
31 March
31 March
2016
2015
R
R
6 476 865
16.
(12 263 420)
Risk Management
General
The main risks faced by the trading entity are interest rate risk, credit risks and liquidity risks. The Depot has
developed a comprehensive risk strategy in terms of Treasury Regulation 28.1 in order to monitor and control
these risks. The risk management process relating to each of these risks is discussed under the headings below.
Interest rate risk
The entity is not exposed to signiÄcant interest rate risk as there is no internal funding other than cash and Änance
leases. The following table set out the carrying amount, by maturity, of the entity’s Änancial instruments exposed to
interest rate risk:
31 March 2016
Within 1 year
Within 2 - 5 years
Total
5 086 445
-
5 086 445
237 281
335 445
572 726
Trade receivables
434 079 220
-
434 079 220
Trade payables
398 301 315
-
398 301 315
5 867 804
-
5 867 804
428 286
596 446
1 024 732
Trade receivables
579 168 617
-
579 168 617
Trade payables
503 606 755
-
503 606 755
Finance lease obligations
31 March 2015
306
The entity’s Änancial instruments are linked to the South African prime rate.
The following table demonstrates the sensitivity to a reasonable possible change in interest rates, with all other
variables held constant of the entity’s surplus before taxation:
Increase in EɈects on surplus
interest rate by:
before taxation
31 March 2016
R
1%
50 864
1%
(5 727)
Trade receivables
1%
4 340 792
Trade payables
1%
(3 983 013)
1%
58 678
1%
(10 247)
Trade receivables
1%
5 791 686
Trade payables
1%
(5 036 068)
31 March 2015
Credit Risk
Financial assets, which potentially subject the Depot to the risk of non-performance by counter parties, consist
mainly of cash and accounts receivable, consisting of trade receivables and staќ debtors. Trade accounts
receivable consist of a small consumer base. The Depot limits its treasury counter-party exposure by only dealing
with well-established Änancial institutions approved by National Treasury. Trade debtors – The Gauteng Department
of Health is eќectively the only client of the Depot, although deliveries occur to various health institutions.
16.
Risk Management (continued)
Credit risk (continued)
Credit risk with regards to receivables is managed as follows:
‘Trade debtors – A monthly claim is compiled of all issues from the Depot to health institutions and of payments
aќected to suppliers for direct deliveries. This claim is normally paid within a week by Central Oѝce as the Depot
follows-up strongly on outstanding monies to ensure that there is money available to release a weekly run of
payments to suppliers.
‘Staќ debtors – Section 17, 30 and 38 of the Public Service Act indicate that any overpayment or wrongly
granted remuneration to staќ irrespective of whose fault it is may be recovered from the employee. There are
built-in control measures in Persal to limit overpayments and adjustments have a three-tier approval process.
The employee applies or provides approved documents, a practitioner records the transaction on Persal, a senior
reviews the transaction on Persal and a third person is required to approve the transaction. With death, retirement
or resignation there is a prescribed debt form that needs to be completed and is forwarded with the pension
withdrawal form (Z102) to the National Department of Finance (Pension Oѝce) where the staќ debt is recovered
before payment to the employee or employee beneÄciaries occur. Where the debt recovered is inadequate the
Gauteng Shared Service Center’s debt recovery section recovers outstanding monies.
Financial assets and liabilities exposed to credit risk at the reporting date were as follows:
31 March 2016
31 March 2015
Trade and other receivables (less than 3 months)
434 079 220
579 168 617
Cash and cash equivalents (less than 3 months)
5 086 445
5 867 804
335 445
596 446
Finance lease obligation - long term (2 to 5 years)
Finance lease obligation - short term (less than 1 year)
Trade and other payables ( Less than 3 months)
237 281
428 286
405 076 927
509 877 089
Liquidity Risk
The Depot maintains a large amount of inventory, the maximum turnover period for the inventory kept however is
twelve weeks or three months.
Liquidity risk is managed as follows:
Proper stock management processes are in place where stock is ordered based on economic order quantities.
The maximum turnover period of stock kept at the Depot is three months. At least a monthly exercise is done to
identify slow moving items and a memo is issued to health institutions every six months with an inventory list of the
items as a reminder that the stock is available.
Currency Risk
The Depot does not transact with any supplier or customer outside the South African borders and this risk is
therefore not directly applicable. However, this risk arises as suppliers purchase raw material from international
suppliers which is subject to foreign exchange rate Åuctuations. Suppliers therefore request, through an application
to either National Treasury (State Tender Board) or the GSSC, for a price adjustment based on the Åuctuation of
foreign exchange rates.
307
16.
Risk Management (continued)
Fair values
At 31 March 2016, the carrying values of cash and cash equivalents, trade and other receivables and trade and
other payables approximate the fair values due to short term maturities of these assets and liabilities as disclosed
below:31 March 2016
31 March 2015
Financial Assets
Carrying Amount
5 086 445
5 867 804
444 031 632
586 561 010
5 086 445
5 867 804
444 031 632
586 561 010
405 076 927
509 877 089
572 726
1 024 732
405 076 927
509 877 089
572 726
1 024 732
405 076 927
509 877 089
572 726
1 024 732
(5 086 445)
(5 867 804)
Net debt
400 563 208
505 034 017
Equity/capital
363 646 963
303 115 436
36 916 245
201 918 581
9%
39,98%
Fair Value
Financial Liabilities
Carrying Amount
Finance lease obligation
Fair Value
308
Capital Management
The primary objective of the entity’s capital management is to ensure that
it maintains a strong credit rating and healthy ratios in order to support
its business and maximise value.
Trade and other payables from exchange
transactions
Finance obligations
Less: cash and cash equivalents
Capital and net debt
Gearing ratio
17.
Contingent Liabilities
There were no contingent liabilities outstanding as at 31 March 2016 (2015: Nil)
18.
31 March
31 March
2016
2015
R
R
Fruitless And Wasteful Expenditure
25 742 325
25 742 325
Current year fruitless and wasteful expenditure*
-
-
Condoned or written oќ by relevant authority
-
-
Transfer to receivables for recovery-not condoned
-
-
25 742 325
25 742 325
Expired stock
-
-
Breakages
-
-
To be condoned at 31 March 2017
-
-
Current year expenditure
-
25 742 325
Awaiting to be condoned
-
25 742 325
Opening Balance
Closing Balance
Analysis awaiting condonation per age analysis:
Current year
Prior years
*Expired and broken inventory expenses in the prior year did not exceed
2% of the average inventory on hand, However in the period under
review broken and expired stock exceeded 2% of the average inventory
on hand.
19.
309
Irregular Expenditure
1 277 614 241
1 233 231 879
24 216 899
44 382 362
6 852 340
-
Condoned or written oќ by relevant authority
-
-
Transfer to receivables for recovery-not condoned
-
-
Irregular Expenditure Awaiting condonement
-
-
1 308 683 480
1 277 614 241
-
-
641 298
-
Opening Balance
Current year Irregular expenditure**
Prior Year Incurred in the Current Financial Year**
Closing Balance
Analysis awaiting condonation per age analysis:
Current year
Less than 3 quotations
Invalid tax clearance certiÄcates
Expired tax clearance certiÄcates
7 725 930
11 836 565
-
No invitation of competitive bids
4 013 106
-
Prior year incurred in the current Änancial year**
6 852 340
-
31 069 239
-
No tax clearance certiÄcates
To be condoned at 31 March 2017
31 March
31 March
2016
2015
R
R
Prior years
Opening balance
-
1 233 231 879
Less than 3 quotations
-
4 002 330
Invalid tax clearance certiÄcates
-
12 996 045
No tax clearance certiÄcates
-
11 949 445
Expired tax clearance certiÄcates
-
259 399
No invitation of competitive bids
-
15 175 143
Awaiting to be condoned
-
1 277 614 241
**The above irregular expenditure relates to non-compliance with supply chain management policies for a number of national, provincial and Departmental contracts.
20.
Key Management Personnel Emoluments
The key performance areas of the post of a Depot Manager was reviewed when the Medicines and Related
Substances Control Act came into eќect on 1 July 2005. In an attempt to strengthen pharmaceutical services in
the province and the key performance areas of the Depot manager, a decision was made to use the post of Chief
Director: Clinical Support Services on a pro-rata basis with the post of the Depot manager. This split is a time basis
of 50:50. The expense related to the compensation of this post is not part of the Depot but funded in full by the
Gauteng Department of Health. No loan, proÄt sharing or schemes available to key personnel and all personnel of
the Depot are not considered as oѝce holders as deÄned in the Public Service Act.
310
31 March
31 March
2016
2015
R
R
Director Administration: Mr J M Smidt
518 506
Salary
Bonuses and performance payments
Expense allowance
Pension Contribution
491 475
43 209
40 956
235 056
222 802
67 406
63 892
864 177
819 125
518 506
491 475
Director Pharmaceutical Services: Mr S. Choma
Salary
Bonuses and performance payments
Expense allowance
Pension Contribution
43 209
40 956
235 056
222 802
67 406
63 892
864 177
819 125
21.
31 March
31 March
2016
2015
R
R
Operating Lease/ Contract Arrangements
At the reporting date the Depot had outstanding commitments under
non-cancellable operating leases and/or contracts, which fall due as
follows:
Operating leases - equipment and motor vehicles
Minimum lease payments due
Within 1 year
Within 2 to 5 years
118 476
140 080
-
118 476
118 476
258 556
The lease agreements are not renewable at the end of the lease term
and the Depot does not have the option to acquire the equipment and
motor vehicles. The lease agreements do not impose any restrictions.
The lease agreements’ escalation rate is 0%.
22.
Related Party Transactions And Balances
The medical Supplies Depot is a trading entity under the control of the
Gauteng Department of Health. All transactions with the Department of
Health are considered to be related party transactions and are at arm’s
length.
Name of related party
Relationship
Controlling
entity
Fellow
Department
Department of Infrastructure Development
Related party balances
Gauteng Department of Health - Receivables
434 079 220
579 168 617
2 984 248 189
2 688 733 804
2 842 141 132
2 560 698 861
188 131
(7 113 929)
Gauteng Department of Health - Sales
Other Related Party Transactions
The building currently occupied by the Depot is owned by the
Department of Infrastructure Development. Market related rentals for the
buildings occupied amount to R9 300 000 per year.
23.
Cost Of Sales
Actual cost of sales prior to adjustments
Other Adjustments
Prior Year Accruals
Cost of sales as reported
-
(12 292 673)
2 842 329 263
2 541 292 259
311
24.
31 March
31 March
2016
2015
R
R
Commitments
Approved, contracted and not provided for in the statement of Änancial
position
2 973 801
832 067
-
1 674 432
- Security
2 754 953
7 945 370
- Distribution services
8 606 243
-
14 334 997
10 451 869
11 518 137
7 524 627
2 816 860
2 927 242
- Cleaning services
- Accounting services
Time distribution of commitments that are approved, contracted and not
provided for in the statement of Änancial position
< 1 year
1 - 2 years
3 - 5 years
25.
-
-
14 334 997
10 451 869
Events After Reporting Date
There have been no events identiÄed after 31 March 2016 that may have a material impact on the entity’s Änancial
position, Änancial performance or its cash Åows for the year then ended.
312
26.
Correction of Prior Period Error
While preparing Änancial statements of the entity for the period ended 31 March 2016, management identiÄed that
there were outstanding proof of deliveries (PoDs) with related Rx and DDV accruals that were not accounted for in
the prior years, but have come through to MSD in 2015/16 Änancial year. Due to that these accruals were noted in
the current year - 2015/16 Änancial year, they therefore represented a prior period error, which must be accounted
for retrospectively in the Änancial statements. Consequently, MSD has adjusted all comparative amounts presented
in the current period's Änancial statements such that the source documentation and Änancial statements agree
to each other at the reporting date. Management determined that the total trade payables, trade receivables and
accumulated surplus for the year ended 2014/15 were understated by R8 849 826, R9 292 317 and R442 491
respectively.
Financial statement extract of the entity appear as follows after the retrospective correction of prior period error
disclosing all aќected account balance categories.
Account categories
Balance at
the beginning
of the year
as previously
stated
Correction of
prior period
error
Restated
balance at the
beginning of
the year
494 756 929
8 849 826
503 606 755
Trade receivables
569 876 300
9 292 317
579 168 617
Accumulated Surplus
198 296 155
442 491
198 738 646
Trade payables
Report of the Audit Committee – Cluster 03
Medical Supply Depot
We are pleased to present our report for the Änancial year ended 31 March 2016.
Audit Committee and Attendance
The Audit Committee consists of the external Members listed hereunder and is required to meet a minimum
of at least two times per annum as per provisions of the Public Finance Management Act (PFMA). In terms of
the approved Terms of Reference (GPG Audit Committee Charter), Äve meetings were held during the current
year, i.e. three meetings to consider the Quarterly Performance Reporting (Änancial and non-Änancial) and two
meetings to review and discuss the Annual Financial Statements and the Auditor-General of South Africa’s
(AGSA) Audit and Management Reports.
Non-Executive Members
Name of Member
Number of Meetings Attended
Lungelwa Sonqishe
05
Precious Sibiya
05
Japie du Plessis
04
Executive Members
In terms of the GPG Audit Committee Charter, oѝcials listed hereunder are obliged to attend meetings of the
Audit Committee:
Compulsory Attendees
Number of Meetings Attended
Nocawe Thipa (Acting CEO)
03
Johann Strauss (Acting CFO & Chief Risk Oѝcer)
05
The Audit Committee noted that the Accounting Oѝcer and Chief Financial Oѝcer attended three (03) of the Äve
(05) scheduled Audit Committee meetings. Therefore, the Audit Committee is satisÄed that the Entity adhered
to the provisions of the GPG Audit Committee Charter in relation to ensuring that there is proper representation
for the Accounting Oѝcer and Chief Financial Oѝcer.
The Members of the Audit Committee met with the Senior Management of the Entity, Internal Audit and AuditorGeneral collectively to address risks and challenges facing the Entity. A number of in-committee meetings were
held to address control weaknesses and deviations within the Entity.
Audit Committee Responsibility
The Audit Committee reports that it has complied with its responsibilities arising from section 38(1)(a) of the
PFMA and Treasury Regulation 3.1.13. The Audit Committee also reports that it has adopted appropriate formal
terms of reference as its Audit Committee Charter, has regulated its aќairs in compliance with this Charter and
has discharged all its responsibilities as contained therein.
The eќectiveness of internal control and Information and Communication Technology (ICT) Governance
In line with the PFMA and the recommendations from King III Report on Corporate Governance requirements,
Internal Audit provides the Audit Committee and Management with assurance that the internal controls are
appropriate and eќective. This is achieved by means of the risk management process, as well as the identiÄcation
of corrective actions and suggested enhancements to the controls and processes. The Audit Committee has
observed that the overall control environment of the Entity has continued to improve during the year under
review. Some deÄciencies in the system of internal control and deviations were reported in the Internal Audit
Reports pertaining to inventory management, asset management and inappropriate Änance management
system. To improve the overall control environment, the Entity should put more eќort in implementing the agreed
action plans to address the previously reported audit Ändings.
313
The Audit Committee also reviewed the progress with respect to the ICT Governance in line with the ICT
Framework issued by the Department of Public Service and Administration. Although there were some signiÄcant
progress on the ICT internal control, the Audit Committee report its dissatisfaction with minimal progress made
with the implementation of the ICT Governance. This continued to be a high risk for the Entity. Internal Audit
The Audit Committee is satisÄed that the Internal Audit plan represents a clear alignment with the key risks, has
adequate information systems coverage, and a good balance across the diќerent categories of audits, i.e. riskbased, mandatory, performance, computer and follow-up audits.
The Audit Committee has noted considerable improvement in the communication between the Executive
Management, the AGSA and the Internal Audit Function, which has strengthened the Corporate Governance
initiatives within the Entity.
The Audit Committee is satisÄed with the content and quality of quarterly reports prepared and issued by
Internal Audit for the Entity during the year under review. The Audit Committee wishes to stress that in order
for the Internal Audit Function to operate at optimal level as expected by the Audit Committee, the shortage
in human resources and skills should be addressed. The Department has since appointed a new Chief Audit
Executive to give stability and leadership.
Risk Management
Progress on the risk management was reported to the Audit Committee on a quarterly basis. The Audit
Committee is partially satisÄed that the actual management of risk is receiving attention because of the lack of
implementation of risk action plans. Areas for improvement include inventory management and ICT governance.
Management should take full responsibility for the entire Enterprise Risk Management process should ensure
that the Risk Management Committee is functional to improve the overall performance of the Entity.
Forensic Investigations
314
Investigations into alleged Änancial irregularities, Änancial misconduct and fraud were completed during the year
under review. Various measures were recommended, including taking action against the identiÄed oѝcials and
this was in the process of Änalisation. The recommendations are at various stages of implementation.
The quality of quarterly reports submitted in terms of the PFMA and the Division of Revenue Act
The Audit Committee is satisÄed with the content and quality of Änancial and non-Änancial quarterly reports
prepared and submitted by the Accounting Oѝcer of the Entity during the year under review and conÄrms that
the reports were in compliance with the statutory reporting framework.
Evaluation of Annual Financial Statements
The Audit Committee has:
•
•
•
•
•
Reviewed and discussed the audited Annual Financial Statements to be included in the Annual Report, with
the AGSA and the Accounting Oѝcer;
Reviewed the Audit Report of the AGSA;
Reviewed the AGSA’s Management Report and Management’s response thereto;
Reviewed the Entity’s compliance with legal and regulatory provisions; and
Reviewed signiÄcant adjustments resulting from the audit.
The Audit Committee concurs with and accepts the AGSA’s conclusions on the Annual Financial Statements,
and is of the opinion that the audited Annual Financial Statements be accepted and read together with the
report of the AGSA.
One-on-One Meeting with the Accounting Oɉcer
The Audit Committee has met with the Accounting Oѝcer for the Entity to address unresolved issues.
One-on-One Meetings with the Executive Authority
The Audit Committee has met with the Executive Authority for the Entity to apprise the MEC on the performance
of the Entity.
Auditor-General of South Africa
The Audit Committee has met with the AGSA to ensure that there are no unresolved issues.
Ms. Lungelwa Sonqishe
Chairperson of the Audit Committee
Date: 31 July 2016
315
Gauteng Provincial Department Health Vote 4
• Merchandise Marks Act, 17 of 1941
Provides for the covering and marking of merchandise, and incidental matters.
• State Liability Act, 20 of 1957
Provides for the circumstances under which the state attracts legal liability.
• Conventional Penalties Act, 15 of 1962
Provides for the enforceability of penal provisions in contracts
• Medicines and Related Substances Act, 101 of 1965 (as amended in 1997)
Provides for the registration of medicines and other medicinal products to ensure their safety. The Act also
provides for transparency in the pricing of medicines.
• Foodstuќs, Cosmetics and Disinfectants Act, 54 of 1972
Provides for the regulation of foodstuќ s, cosmetics and disinfectants, in particular, safety and quality
standards that must be complied with by manufacturers, importers and persons selling the products
concerned.
• Occupational Diseases in Mines and Works Act, 78 of 1973
Provides for medical examinations on persons suspected of having contracted occupational diseases
especially in mines and for compensation in respect of those diseases.
• Hazardous Substances Act, 15 of 1973
Provides for the control of hazardous substances, in particular those emitting radiation.
• International Health Regulations Act, 28 of 1974
316
Provides for the adoption of resolutions adopted at the World Health Assembly.
• Pharmacy Act, 53 of 1974
Provides for the regulation of the pharmacy profession, including community service by pharmacists.
• Health Professions Act, 56 of 1974
Provides for the regulation of health professions, in particular, medical practitioners, dentists, psychologists
and other related health professions, including community service by these professionals.
• Nursing Act, 33 of 2005
Provides for the regulation of the nursing profession.
• Patents Act, 57 of 1978
Provides for the protection of inventions including gadgets and chemical processes.
• Dental Technicians Act, 19 of 1979
Provides for the regulation of dental technicians and for the establishment of a council to regulate the
profession.
• Allied Health Professions Act, 63 of 1982
Provides for the regulation of health practitioners, like chiropractors and homeopaths, and for the
establishment of a council to regulate these professions.
• Child Care Act, 74 of 1983
Provides for the protection of the rights and wellbeing of children.
• Control of Access to Public Premises and Vehicles Act, 53 of 1985
Provides for the regulation of individuals entering government premises, and incidental matters.
• SA Medical Research Council Act, 58 of 1991
Provides for the establishment of the SA Medical Research Council and its role in relation to research, in
particular, health research.
• Occupational Health and Safety Act, 85 of 1993
Provides requirements that employers must comply with in order to create a safe working environment for
employees in the workplace.
• Trade Marks Act, 194 of 1993
Provides for the registration, certiÄcation and a collective of trademarks and matters incidental thereto.
• Designs Act, 195 of 1993
Provides for the registration of designs and matters incidental thereto.
• Public Service Act, Proclamation 103 of 1994
Provides for the administration of the public service in its national and provincial spheres, and empowers
the Minister to appoint and dismiss oѝcials.
• Choice on Termination of Pregnancy Act, 92 of 1996
Provides a legal framework for termination of pregnancies based on choice under certain circumstances.
• Public Service Commission Act, 46 of 1997
Provides for the ampliÄcation of the constitutional principle of accountable governance, and incidental
matters
• Basic Conditions of Employment Act, 75 of 1997
Provides for the minimum conditions of employment that employers must comply with in their workplaces.
• Intergovernmental Fiscal Relations Act, 97 of 1997
Provides for the harmonization of Änancial relations between the various spheres of government, and
incidental matters
• State Information Technology Act, 88 of 1998
Provides for the creation and administration of an institution responsible for the state’s information
technology system.
• Competition Act, 89 of 1998
Provides for the regulation of permissible competitive behaviour, regulation of mergers of companies and
matters related thereto.
• Copyright Act, 98 of 1998
Provides for the protection of intellectual property of a literary, artistic or musical nature that is reduced to
writing.
• Sterilization Act, 44 of 1998
Provides for the right to sterilization; to determine the circumstances under which sterilization may be
performed and, in particular, the circumstances under which sterilization may be performed on persons
incapable of consenting or incompetent to consent due to mental disability.
• Employment Equity Act, 55 of 1998
Provides for the measures that must be put into operation in the workplace in order to eliminate
discrimination and promote aѝrmative action.
317
• Skills Development Act, 97 of 1998
Provides for the measures that employers are required to take to improve the levels of skill of employees in
workplaces.
• Medical Schemes Act, 131 of 1998
Provides for the regulation of the medical schemes industry to ensure consonance with national health
objectives.
• Public Finance Management Act, 1 of 1999
Provides for the administration of state funds by functionaries, their responsibilities and incidental matters.
• Tobacco Products Control Amendment Act, 12 of 1999
Provides for the control of tobacco products, prohibition of smoking in public places and regulation of
advertisements of tobacco products as well as sponsoring of events by the tobacco industry.
• Promotion of Access to Information Act, 2 of 2000
AmpliÄes the constitutional provision pertaining to accessing information under the control of various
bodies.
• Promotion of Administrative Justice Act, 3 of 2000
AmpliÄes the constitutional provisions pertaining to administrative law by codifying it.
• Promotion of Equality and the Prevention of Unfair Discrimination Act, 4 of 2000
Provides for the further ampliÄcation of the constitutional principles of equality and elimination of unfair
discrimination.
318
• Preferential Procurement Policy Framework Act, 5 of 2000
Provides for the implementation of the policy on preferential procurement pertaining to historically
disadvantaged entrepreneurs.
• Protected Disclosures Act, 26 of 2000
Provides for the protection of whistle-blowers in the Äght against corruption.
• National Health Laboratory Service Act, 37 of 2000
Provides for a statutory body that provides laboratory services to the public health sector.
• Council for Medical Schemes Levy Act, 58 of 2000
Provides for a legal framework for the council to charge medical schemes certain fees.
• Mental Health Care Act, 17 of 2002
Provides a legal framework for mental health and in particular the admission and discharge of patients in
mental health institutions with emphasis on the human rights of mental patients.
• Unemployment Insurance Contributions Act, 4 of 2002
Provides for the statutory deductions that employers are required to make on the salaries of employees.
• The Division of Revenue Act, 7 of 2003
Provides for the manner in which revenue generated may be disbursed.
• Broad Based Black Economic Empowerment Act, 53 of 2003
Provides for the promotion of black economic empowerment in the manner that the state awards contracts
for services to be rendered, and incidental matters.
• The National Health Act, 61 of 2003
Provides for regulation of national health and promotes uniformity in respect of health services across the
nation.
• Intergovernmental Relations Framework Act, 13 of 2005
Provides for formalisation of relations between (and within) the three spheres of government through
facilitating coordination in the implementation of policy and the establishment of intergovernmental
structures.
• SpeciÄc provincial health legislation
- National legislation and policy are further supported by the following provincial legislation
- The Hospital Ordinance Act, 1958 (as amended in 1999)
- The Gauteng District Health Services Act, 2000
- The Gauteng Ambulance Services Act, 2002.
• Other policy imperatives guiding the work of the Department include the following:
- Strategic priorities for the National Health System
- Provincial government’s Äve-year strategic programme of action
- Gauteng Äve-year strategic plan for health
- The Provincial Growth and Development Strategy
- The Gauteng Global City Region Strategy.
319
PR 222/2016
ISBN: 978-0-621-44720-0

Annual Report 2015/2016

Transcription

Similar documents

I`m helping to end MS by participating in the 2016 Jayman BUILT MS

The Board of Directors of Qatar Fuel (WOQOD) is pleased to invite

2016 MW Alliance Raffle - Manitowish Waters Alliance LTD

Annonce S1

Print PDF - TheBayNet.com

Rush Hour Rewards can save you money Join us for

waiver guidelines jakarta incident

2016 Winter Newsletter

Please join us on Facebook: www.facebook.com/einsteinaward

Flyer! - Cruzzin` Dreams