Statement on health budget vote by Dr Nomafrench Mbombo
Today Minister Dr Nomafrench Mbombo delivered her budget vote speech in the Western Cape Provincial Parliament. The following statement sets out a summary of her address.
Introduction:
COVID-19 dramatically shifted the Western Cape Department of Health’s priorities and the way we work to ensure the health of our patients. It however did not change our mission to protect people who are at risk and safeguard the lives of our frontline staff.
Difficult decisions were made about which healthcare service can be safely continued, and which ones can be scaled back or temporarily halted as we scaled up our health platform to save lives. This led us to de-escalating services, resulting in backlogs in elective surgeries and some Primary Health Care services.
These will need to be addressed as a priority, with a particular focus on ensuring a recovery in our Mental Health services, as well as stepping up our fight against Tuberculosis.
The Western Cape’s health services:
The projected population of the Province in 2021 is just over 7 million of which 75 per cent is estimated to be uninsured. In fulfilling its Constitutional mandate to progressively realize the right to health care, the Department is committed to ensuring the provincial health system delivers high-quality care to all people of the province.
This includes preventive, promotive, curative, rehabilitative and palliative care services, which is provided across 591 service points, consisting of 467 primary health care service points, 53 hospitals and 49 Emergency Medical Services (EMS) stations. There are 33 districts, 5 regional, 2 central, 1 tertiary and 12 specialised hospitals. The Department also provides Emergency Medical Services (EMS) from 49 EMS stations and has 16 forensic pathology facilities.
Five key elements of the Western Cape’s health response:
- Innovation
Technology is a key enabler and disruptor in doing business unusual. We built public trust by having the core markers on a public-facing dashboard that gets updated daily. This has also inculcated the practice of being data and evidence led.
The dashboard innovation won national and continental awards, including:
• Silver Medallist- Next Generation Media Award for Technical Innovation. We competed with companies in the private sector such as Vodacom and SAB
• Finalist for the BCX digital innovation award; and
• Africa Tech Award Winner- Use of Technology in the Public Sector
The Western Cape Government Health’s Emergency Medical Services also became the first government institution in South Africa that is allowed to fly over national key points. This Drone Rescue Project was launched in December 2020.
This new innovation in healthcare was also seen with the Vector project, where diabetics who were at high risk during COVID-19 peak periods were pre-emptively identified, followed up daily and were fast-tracked and admitted at earliest signs of decompensation. This significantly reduced the mortality of diabetics from COVID-19.
Another key innovation was the delivery of chronic medication to residents in the Western Cape. More than 1,3 million medicine parcels were delivered to homes of chronic stable patients – this reduced their risk of travelling to health facilities.
Funds have been earmarked to continue this project in the coming financial year.
2. Public-Private Partnerships
The first lesson we learned from COVID -19 is that it does not discriminate. It knows no race, nationality, ethnicity or social standing. This is the reason why I called a meeting with the Private Hospitals and General Practitioners which led to the changing of Western Cape Private Health Licensing Regulation that enabled Private Hospitals to review their beds and prioritize COVID-19 beds. Western Cape was the first to complete the Public-Private Agreements on sharing critical beds using the same critical protocols. We are resolute in not creating binaries between Public and Private. This has led to fruitful working conditions and I am proud of the partnership.
3. Infrastructure
For the coming financial year, we have earmarked the following infrastructure projects:
- Klipfontein Hospital:
- The Tender for the Professional Service Providers has been advertised and is currently going through the various processes related to the tendering processes
- De Doorns Ambulance Station Replacement Facility, Project Completion date is on the 21 April 2021, thereafter, a commissioning period of approximately 2 months will take place before the facility is fully operational.
- Laingsburg Clinic - Upgrade and Additions, Phase 1 Sectional Completion was achieved on 08 December 2020 and is operational. Revised project completion of the whole project (Phase 1 & 2) is 25 March 2021.
- Victoria Hospital New Emergency Centre Phase project completion is anticipated for the14 July 2021
- Tygerberg Regional Hospital, the department is currently preparing the Clinical Brief
- Observatory Forensic Pathological Lab – Replacement, Current expected Project Completion date June 2021
- Helderberg Hospital; phase 3 – Project Completion has been reached /Phase 2 to be completed once decanting is done.
4. Human Resources
Staff safety remains the biggest concern for the Department, with the EMS being the most vulnerable.
70 cases ranging from robbery, assault, theft and intimidation occurred in 2020. In one month alone, July 11 cases were opened. This is amid a COVID pandemic! this is unacceptable and deserves to be condemned in the strongest and harshest terms.
Everyone is under immense pressure, feelings of compassion fatigue, burnout, stress, insomnia, anxiety and depression are real in our employees, many of us have lost colleagues and loved ones due to COVID-19. It is this reason that Mental Health is on the priority on the list of the Non-Covid services that will be recovered
5. Vaccination Drive
It is anticipated that we will be able to cover 50% of health care workers with the limited doses being received via the Sisonke Programme. We support equitable access to staff from across the service platform, from acute hospitals to EMS and Public Health Care (incl. Community Health Workers) both within WCGH and CoCT.
We are preparing to scale up vaccination during April to complete Phase 1 (the remaining 50% of health care workers), with expected delivery of enough Pfizer doses.
Clean audit:
The Western Cape Government Health has received clean audit findings for two consecutive years. And we are still the first department of Health to achieve this major feat.
The health budget allocation for the 2021/22 financial year is R 27.392 billion as indicated by Western Cape Provincial Treasury, this is a 0.43 increase from the second appropriation.
Budget allocations
From an economic classification point of view, this year’s budget allocation includes:
- Compensation of Employees – R15.616 billion
- Goods and services- R9.200 billion
- Transfers and subsidies – R1.593 billion
- And Payments for capital assets – R982.719 million
Conditional grant funding totals R6.971 billion which includes a COVID component allocation of R156.690 million.
Earmarked priority allocations include R1.124 billion for infrastructure including the Tygerberg hospital maintenance and capital program. Staff wellness programs, R5 million and home delivery of chronic medication R33 mil are new allocations for the current year.
Fight against Covid-19
- R832 million has been earmarked to provide R250 million to continue to invest in staff safety through the acquisition of PPE
- R250 million for surveillance and testing
- R332 million invested into the healthcare platform to continue the operations of Brackengate Hospital of Hope and Sonstraal for the year and to provide relief to the central, regional and district hospitals by allowing for COVID staff contracts to be extended in anticipation of the third wave.
- The province has also provided the department with R150 million for vaccine implementation and procurement.
Summary of budget allocations:
Programme 1: Administration is allocated R1.522 billion
Programme 2: District Health Services is allocated R11.166. billion.
Programme 3: Emergency Medical Services is allocated R1.208 billion,
Programme 4: Provincial Hospital Services is allocated R4,140 billion.
Programme 5: Central Hospital Services is allocated R7.309 billion,
Programme 6: Health Science and Training is allocated R360.579 million
Programme 7: Health Care Support is allocated R561.568
Programme 8: Health Facilities Management is allocated R 1.124 billion.
Media Enquiries:
Nomawethu Sbukwana Spokesperson for Western Cape Minister for Health, Dr Nomafrench Mbombo Cell: 083 893 5200 Email: Nomawethu.Sbukwana@westerncape.gov.za