STANDING COMMITTEE ON APPROPRIATIONS

NATIONAL HEALTH GRANT PREPAREDNESS8 March 2013

1

NATIONAL HEALTH GRANT

• The National Grant Consist of two components:– Health Facility Revitalisation Grant– National Health Insurance Grant– These two components split into

• Direct Provincial Allocations• In-Direct National Allocation (Grant In-Kind)

2

REFORM OF INFRASTRUCTURE GRANTS AND PREPAREDNESS

3

Why Grant Reform?

• The following where the cost driver of grants reform:– HRG and NCSG are Schedule 5 while HIG is Schedule4– Challenges on project planning

• Hospitals under HIG never peer reviewed• HIG does not provide HT in most provinces• HIG does not address organisational development• Change of project scope of work

– Budget re-allocation from one project to another or among provinces

– Compliance with DORA conditions– AG audit frameworks separately even though the

implementation is done jointly– Write to NT every time there is a shift from one grant to another

4

Why Grant Reform?

– Advantage of one Infrastructure Grant:• Three Grants (HRG, HIG and NCSG) will be treated as

components in 2013/14 • Provinces are allowed to shift money from one component to

another and projects re-gazetting will be done once a quarter through NT

• Flexibility to move funds from poor performing project to performing project within the province and within the given envelop

• AG will focus on one set of conditional grant framework- easy to comply

• Easy to manage by both national and provincial department of health

• Available resources can be utilised as one team

5

NATIONAL HEALTH GRANT

6

NATIONAL HEALTH GRANT

7

NATIONAL HEALTH GRANT

8

9

INFRASTRUCTURE

LEVEL OF PREPAREDNESS TO IMPLEMENT PROVINCIAL DIRECT ALLOCATION AND

NATIONAL “IN-KIND” ALLOCATION

10

National Department of HealthInfrastructure Unit

Grant Management Structure

11

• Somerset East Nursing School and Settlers Nursing school, new schools in 14-15 and 15-16 for two new nursing colleges in EC

• Manapo Nursing College in FS-• SG Lourens Nursing College, Garankuwa Nursing College in GP• Thohoyandou Nursing College in LP• Three Nursing Colleges in MP-• Tswaragano Nursing College in NC• Taung Nursing School ; Mmabotho Nursing College in NW

• 5 new Clinics in EC under HIG• 7 new Clinics in FS under HIG• 5 new Clinics in PM under HIG• 5 new Clinics (in NW under HIG• Replacement of Tshilidzini hospital ; Elim Hospital in LP under HIG.• In-Loco Supervision.• GPs OA: (10 in NC, 70 in KZN and 30 each in other provinces)

• Two additional hospitals in EC under HRG• New district Hosp in Shoshanguve GP under HRG• Siloam Hospital in LP under HRG• In-Loco site supervision

12

Schematic Concept of contracting options, of various In-Kind funded Projects by NDoH

Hospital revitalization in some NHI districts

Building of new clinics in some NHI districts

Nursing Colleges and Schools Revitalization

GPs Operational Accommodations

Project Management

• Two additional hospitals in EC In NHI District, • -One New district Hospital in Shoshanguve in GP In NHI

District• Siloam Hospital in LP in NHI District, • Replacement of Tshilidzini hospital and Elim Hospital

in LP, NHI District,

• 5 new Clinics in EC• 7 new Clinics in FS• 5 new Clinics in MP• 5 new Clinics in NW

• Somer Set East Nursing School and Settlars Nursing school, new schools in 14-15 and 15-16 for two new nursing colleges. In EC

• Manapo Nursing College in FS• SG Lourens Nursing College, Garankuwa Nursing College in GP• Thohoyandou Nursing College in LP• Three Nursing Colleges, new projects in MP-• Tswaragano Nursing College , new projects in NC• Taung Nursing School ; Mmabotho Nursing College ; new projects in NW

Project Professional Service Provider per

hospital using the Kahylitsha district

hospital design

Contractors

Project Professional Service Provider, using

prototype clinic design per province or one for all

Contractors

Project Management

Alternatively, design and build

contract/s for new ones

One Project Management

Project Professional Service Provider per

nursing college or school

Contractors

Project Management

Resident Engineers and Clerks of Works appointed for projects at construction stage, depending on

the size, nature and level of supervision

Existing project structure in the

provinces

In-Loco Supervision of HIG

and NC grant funded projects

in provinces

In-Loco Supervision of HRG funded projects

in provinces

Alternatively, design and build

contract/s for new ones

All projects at construction stage in HRG, HIG and NC&S

The PMs making sure the installations are properly

done to the suppliers specification

Project Management

Suppliers

• 10 in NC• 70 in KZN• All other provinces 30

each

13

Thank youThank you

www.doh.gov.zawww.doh.gov.za

14