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Gauteng Provincial Government | Health | Annual Report 2012/2013
Annual Report 2012/13In terms of the Public Finance Management Act Rule 9.4 (1) of the Gauteng Legislature
Standing Rules August 2009
PR 222/2013
ISBN: 978-0-621-42072-2
1
2
Part A:
GENERAL INFORMATION
3
1. DEPARTMENT GENERAL INFORMATION
Physical address: 37 Sauer Street
Johannesburg
2001
Postal address: Private Bag X085
Marshalltown
2107
South Africa
Telephone number: 011 355 3503
Twitter: @GautengHealth
Facebook Gauteng Provincial Health
Department
Website address: http://www.health.gpg.gov.za
Gauteng Provincial Government | Health | Annual Report 2012/2013
TABLE OF CONTENTSPART A: GENERAL INFORMATION 21. DEPARTMENT GENERAL INFORMATION 32. LIST OF ABBREVIATIONS/ACRONYMS 6 3. STRATEGIC OVERVIEW 83.1. Vision 83.2. Mission 83.3. Values 83.4. Strategic outcome orientated goals 8 4. LEGISLATIVE AND OTHER MANDATES 8 5. ORGANISATIONAL STRUCTURE 96. ENTITIES REPORTING TO THE MEC 10FOREWORD BY THE MEC FOR HEALTH 11OVERVIEW OF THE ACCOUNTING OFFICER 12PART B: PERFORMANCE INFORMATION 161. STATEMENT OF RESPONSIBILITY FOR PERFORMANCE INFORMATION 172. AUDITOR GENERAL’S REPORT: PREDETERMINED OBJECTIVES 183. OVERVIEW OF DEPARTMENTAL PERFORMANCE 193.1 Service delivery environment for 2012/2013 193.2 Service Delivery Improvement Plan 213.3 Organisational environment 233.4 Key policy developments and legislative changes 244. STRATEGIC OUTCOME ORIENTED GOALS 245 PERFORMANCE INFORMATION BY PROGRAMME 255.1 PROGRAMME 1: ADMINISTRATION 25 PHARMACEUTICAL SERVICES 25 EMPLOYMENT EQUITY 27 QUALITY ASSURANCE 27 INFORMATION AND COMMUNICATION TECHNOLOGY 305.2 PROGRAMME 2: DISTRICT HEALTH SERVICES 38SUB-PROGRAMME 2.1: DISTRICT HEALTH MANAGEMENT AND PHC SERVICES 38SUB-PROGRAMME 2.2: DISTRICT HOSPITALS 40SUB-PROGRAMME 2.3: HIV AND AIDS, STIs AND TB 40SUB-PROGRAMME 2.4: MATERNAL, CHILD AND WOMEN’S HEALTH AND NUTRITION 44SUB-PROGRAMME 2.5: DISEASE PREVENTION AND CONTROL 47SUB-PROGRAMME 2.6: FORENSIC PATHOLOGY SERVICES 495.3 PROGRAMME 3: EMERGENCY MEDICAL SERVICES 745.4 PROGRAMME 4: PROVINCIAL HOSPITAL SERVICES 77 TUBERCULOSIS HOSPITALS 77 PSYCHIATRIC HOSPITALS 77 ORAL AND DENTAL HEALTH CENTRES 785.5 PROGRAMME 5: CENTRAL HOSPITAL SERVICES 84 STEVE BIKO ACADEMIC HOSPITAL 88 DR GEORGE MUKHARI HOSPITAL 92 CHARLOTTE MAXEKE JOHANNESBURG ACADEMIC HOSPITAL 93 CHRIS HANI BARAGWANATH ACADEMIC HOSPITAL 955.6 PROGRAMME 6: HEALTH SCIENCES AND TRAINING 97
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.7 PROGRAMME 7: HEALTH CARE SUPPORT SERVICES 1085.8 PROGRAMME 8: HEALTH FACILITIES MANAGEMENT 1126 SUMMARY OF FINANCIAL INFORMATION 1186.1. Departmental receipts 1186.2. Programme Expenditure 1206.3. Transfer payments, excluding public entities 1216.4. Transfer payments to Public Entities 1236.5. Conditional grants and earmarked funds received 1246.6. Donor Funds 1366.7 Capital Investment, maintenance and asset management plan 1456.8 Disposal of assets 1486.9 Reconciliations 1506.10 Achievements in asset management 151PART C: GOVERNANCE 1521. INTRODUCTION 1542. RISK MANAGEMENT 1543. FRAUD AND CORRUPTION 1544. MINIMISING CONFLICT OF INTEREST 1555. CODE OF CONDUCT 1556. HEALTH SAFETY AND ENVIRONMENTAL ISSUES 1557. INTERNAL CONTROL UNIT 156REPORT OF THE AUDIT COMMITTEE 157PART D: HUMAN RESOURCE MANAGEMENT 1601. LEGISLATION THAT GOVERNS HR MANAGEMENT 1622. INTRODUCTION 1623. HUMAN RESOURCE OVERSIGHT STATISTICS 1643.1. Personnel related expenditure 1643.2. Employment and Vacancies 1693.3. Job Evaluation 1713.4. Employment changes 1733.5 Employment Equity 1763.6. Performance Rewards 1823.7. Foreign Workers 1843.8. Leave utilisation 1853.9. HIV and AIDS & Health Promotion Programmes 1873.10. Labour Relations 1903.11. Skills Development 1923.12. Injury on duty 1943.13. Utilisation of consultants 194PART E: FINANCIAL INFORMATION 1961. REPORT OF THE ACCOUNTING OFFICER 1982. ACCOUNTING OFFICER’S STATEMENT OF RESPONSIBILITY 2223. REPORT OF THE AUDITOR GENERAL 2234. ANNUAL FINANCIAL STATEMENTS 230MEDICAL SUPPLIES DEPOT 329 ANNEXURES 384 LEGISLATION 384 GOALS AND STRATEGIC OBJECTIVES 2009-14 389
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Gauteng Provincial Government | Health | Annual Report 2012/2013
2. ABBREVIATIONS AND ACRONYMSAG Auditor-General
A&E Accident and emergency
AIDS Acquired immune defi ciency
syndrome
ALOS Average length of stay
ANC Antenatal care
ART Antiretroviral treatment
BAS Basic Accounting System
BBBEE Broad-based black economic
empowerment
BFHI Baby Friendly Hospital Initiative
BLS Basic life support
BUR Bed utilisation rate
CARMMA Campaign for Accelerated
Reduction of Maternal
Mortality in Africa
CBO Community-based organisation
CEO Chief executive offi cer
CFO Chief fi nancial offi cer
CHC Community health centre
CHW Community health worker
CMR Child mortality rate
CPD Continuing professional
development
DAC Departmental Acquisition Council
DHIS District Health Information System
DHS District Health System
DID Department of Infrastructure
Development
DOH Department of Health (national)
DPSA Department of Public Service and
Administration
EAP Employee assistance programme
EE Employment equity
EML Essential Medicines List
EMS Emergency medical services
EPI Expanded Programme on
Immunisation
EPWP Expanded Public Works
Programme
ESMOE Essential Steps in Managing
Obstetric Emergencies
EXCO Executive committee or council
FBO Faith-based organisation
FDC Fixed-dose combination (ARV pill)
FY Financial year
GAS Gauteng Audit Services
GIS Geographic information system
GPG Gauteng Provincial Government
GSSC Gauteng Shared Services Centre
HAART Highly active antiretroviral
treatment
HAST HIV, AIDS, STIs and TB
HCT HIV counselling and testing
HFM Health Facilities Management
HIV Human immunodefi ciency virus
HOD Head of department
HR Human resources
HWSETA Health and Welfare Sector
Education and Training
Authority
ICT Information and communication
technology
ICU Intensive care unit
IEC Information, education and
communication
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Gauteng Provincial Government | Health | Annual Report 2012/2013
ILS Intermediate life support
IMCI Integrated Management of
Childhood Illnesses
IMR Infant mortality rate
IPT Isoniazid prophylaxis
IT Information technology
M&E Monitoring and evaluation
MDGs Millennium Development Goals
MDR-TB Multi-drug resistant tuberculosis
MEC Member of Executive Council
MIS Management information system
MMC Medical male circumcision
MMR Maternal mortality rate
MOU Memorandum of understanding
MSD Medical Supplies Depot
MSM Men who have sex with men
MTEF Medium-Term Expenditure
Framework
NCDs Non-communicable diseases
NGO Non-governmental organisation
NHI National Health Insurance
NHLS National Health Laboratory Services
NIMART Nurse-initiated management of ART
NPO Non-profi t organisation
NSP National Strategic Plan on HIV, TB
and STI
OPD Outpatient department
OSD Occupation-specifi c dispensation
OVC Orphans and vulnerable children
PDE Patient-day equivalent
PEP Post-exposure prophylaxis
PFMA Public Finance Management Act
PHC Primary health care
PLHIV People living with HIV
PMTCT Prevention of mother-to-child
transmission
POA Programme of action
PPP Public-private partnership
PTC Pharmacy Therapeutic Committee
PSETA Public Service Education and
Training Authority
PWD People with disabilities
RAF Road Accident Fund
RWOPS Remunerative work outside public
service
QA Quality assurance
SADC Southern African Development
Community
SANBS South African National Blood
Service
SAPS South African Police Service
SLA Service-level agreement
TB Tuberculosis
TOR Terms of reference
XDR-TB Extensively drug resistant
tuberculosis
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Gauteng Provincial Government | Health | Annual Report 2012/2013
3. STRATEGIC OVERVIEW
3.1. Vision
To be the best provider of quality health services to
the people in Gauteng.
3.2. Mission
To provide excellent, integrated health services in
partnership with stakeholders and to contribute
towards the reduced burden of disease in all
communities in Gauteng.
3.3. Values
• Batho Pele principles.
• Excellence.
• Integrity.
• Humility.
• Selflessness.
• Respect.
• Social justice.
I care, I serve, I belong.
3.4. Strategic outcome-orientated goals
The strategic goals of the Gauteng Department of
Health (GDoH) are:
• Improved health and wellbeing with an
emphasis on vulnerable groups.
• Reduction in the rate of new HIV infections
by 50% in youth, adults and babies, and
reduction in the number of deaths from TB
and AIDS by 20%.
• Increased effi ciency of service implemen-
tation.
• Human capital management and develop-
ment for better health outcomes.
• Organisational excellence.
4. LEGISLATIVE AND OTHER MANDATES
The GDoH 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.
• Provide integrated services and pro-
grammes that promote and protect healthy,
quality and sustainable livelihoods of poor,
vulnerable and marginalised groups in
society
In fulfi lling its mandate, the GDoH is guided by
legislation listed in the annexure at the end of this
report. 8
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.
ORG
ANIS
ATIO
NAL
STR
UCT
URE
MEC
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9
Gauteng Provincial Government | Health | Annual Report 2012/2013
6. ENTITIES REPORTING TO THE MEC
The only public entity that falls under the control of the MEC for Health is the Medical Supplies Depot (MSD)
which is a trading entity. The performance of the MSD in respect of the performance of pharmaceutical
services forms part of this report. The table below provides details of the MSD.
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 No 1
of 1976.
The MSD 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 provincial
healthcare facilities in
Gauteng.
10
Gauteng Provincial Government | Health | Annual Report 2012/2013
Foreword by the MEC for HealthGauteng MEC for Health, Mr AHM Papo’s Foreword to the 2012/13 Annual ReportDuring the year under review, the delivery of health services was guided by the Turnaround Strategy which was extensively consulted on, adopted by the Gauteng Executive Council and subsequently launched for implementation in July 2012.
The interventions contained in the Turnaround Strategy included strengthening fi nancial management, Supply Chain Management, and human resource management at central offi ce, district offi ces and facility level.
The Turnaround Strategy will continue to be implemented until the end of the current term of offi ce. In order to strengthen fi nancial management at all levels, budget allocations are informed by service packages. The Department also linked these allocations to health priorities and main outcomes.
These interventions, among others, will ensure organisational stability and an institutionalised culture of fi scal discipline. We will also continue to manage irregular expenditure in order to fi nally eliminate accruals.
Notable progress has been made regarding transforming Supply Chain Management in the department and the containment of accruals. While the Department was faced with challenges as alluded to above, service delivery was not compromised as indicated by many of the service and health outcomes contained in this Annual Report.
In the year under review, four of our hospitals were reclassifi ed as Central hospitals and three as Tertiary hospitals. This change has required aligning service packages provided at these hospitals with new mandates. Within the general approach of the Turnaround Strategy, the fi lling of key vacancies in Health Districts and Central Offi ce contributed towards organisational stability.
This has put the Department on a sound footing to consolidate the Turnaround Strategy into concrete programmes that will guide the Department as we approache the end of the term. We have prioritised delivery of quality health services and continue to direct resources in pursuit of this objective.
We have continued to focus on the social determinants of health in order to deal with some of the causes of diseases currently over burdening the health system. We have also put various measures to strengthen Primary Health Care.
Mr A.H.M Papo
MEC for Gauteng Department of Health
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Overview of the Accounting Offi cerThe year under review saw an acceleration of
efforts to improve health system effi ciency within
the Gauteng Department of Health (GDoH).
The department intensifi ed efforts to foster an
organisational culture of fi scal discipline and fi nd
innovative ways to improve the patient experience
of healthcare services. We continued to implement
the Turnaround Strategy, the ultimate goal of which
is to bring about stability and improve service
delivery.
Major strides have been made in the implementation
of fi nancial reforms and, as a result, budget
allocations are being made according to health
priorities. A cost analysis of service packages was
nearing completion at the end of the year and it will
inform future budget processes. The department is
fi nalising the establishment of a Health Processing
Centre to ensure compliance with the injunction
to pay suppliers within 30 days. Thanks to the
commitment of our staff as a whole and our
stakeholders, we are confi dent that the department
is moving in the right direction.
In the light of our commitment to providing quality
healthcare services to the people of Gauteng, we
have made concerted efforts to shift resources
progressively towards primary healthcare (PHC). We
have also brought services closer to communities
through the expansion of ward-based outreach
teams which are now functioning in 49 municipal
wards alongside school health teams and district
health specialist teams. In the period under review,
the number of visits to healthcare institutions grew
substantially. PHC facilities saw more than two
million more patients than in the previous year,
while outpatient departments at the province’s
regional hospitals treated 1.8 million more patients
than in 2011/12 and outpatient visits at central
hospitals increased by two million.
The Ministry of Health is preparing to introduce
National Health Insurance (NHI) as a way to
improve access to healthcare for all who require
it thus achieving universal coverage. The changes
that this will involve are being tested and fi ne-tuned
through NHI pilot districts. In Gauteng, Tshwane is
the designated NHI pilot district and it will provide
valuable information about the requirements of NHI
in the rest of the province. While the Tshwane pilot
project got off to a slow start and spent only part of
its allocated funding, it gained momentum over the
course of the year.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Improving life expectancy and reducing mortality
and morbidity through prevention and management
of communicable and non-communicable diseases
has remained uppermost in our minds. Evidence
of this can be found in the investments made in
the past year in capital infrastructure and service
delivery. In order to improve diagnosis of TB,
including drug-resistant forms of TB, we have
expanded the availability of GeneXpert machines
to an additional seven institutions. Along with
improved diagnosis of TB we have seen sustained
progress in TB treatment outcomes.
Gauteng has been a strong contributor to South
Africa’s HIV success story. In 2011/12, residents
of Gauteng continued to flock in their millions for
HIV testing. Although the antiretroviral treatment
(ART) programme continued to grow, the rate of
expansion was slower than planned. By the end of
the year 693 136 adults and 41 172 children were
receiving ART.
High rates of maternal mortality have been a
serious concern for South Africa as a whole, and
Gauteng is no exception. Throughout 2012/13, the
department sustained a concerted effort to reduce
maternal mortality through training of health
workers and following internationally recognised
approaches to managing obstetric emergencies.
The results of this effort will only be known when
the Independent Committee of Enquiry on Maternal
Mortality publishes its three-yearly Saving Mothers
report in 2014/15.
The department has also made headway in
the prevention childhood diseases. There was
improved coverage by immunisation programmes.
Notable achievements included further progress in
preventing HIV transmission from mother to child.
We continue to explore various social platforms
for communicating healthcare messages aimed at
preventing ill-health and promoting appropriate use
of health services. We are also engaged in exploring
the use of technology to improve healthcare
delivery.
The department is sensitive to the concerns of
our communities about the quality of service they
receive at our institutions. We continue to conduct
client satisfaction surveys to measure the quality
of care from the patient’s perspective and we have
created platforms for communities to provide
feedback without fear of being prejudiced. In
addition to this, teams of inspectors from the GDoH
and National Department of Health have begun to
assess our institutions against national standards
and provide an objective report on the strengths
and weaknesses of service provision.
An area of serious concern to both patients and
health professionals in recent years has been
inadequate availability of medicines in many
hospitals and clinics. Problems encountered were
partly due to the Department's delay in processing
payments and at times inability of suppliers
to meet demands. The department has been
working relentlessly to ensure optimal availability
of medicines at all times. We strive to achieve a
100% availability of all medicines on the Essential
Medicines list in the Medical Supplies Depot (MSD)
We believe that 2012/13 was a critical turning point
in respect of this element of care. In the previous
year, the availability of essential medicines dropped
to an average of 64% but by the end of 2012/13
this fi gure had improved to 76%. This improvement
was due to re-engineering of business processes at
the Medical Supplies Depot and stronger fi nancial
management under the Turnaround Strategy. The
department accepts that further improvement in
this area remains critical to good care.
We continue to partner with various stakeholders
to improve provision of healthcare services and we
strive continually to strengthen the professional
expertise and skills of our staff through a range of
training programmes and bursaries. Our growing
investment in human resources development
attests to our commitment to improving the quality
of healthcare.
While the demand for services continues to grow,
13
Gauteng Provincial Government | Health | Annual Report 2012/2013
the department’s resources are not infi nite. The
need to ensure that available resources are used
effi ciently and in a manner calculated to improve
health outcomes, cannot be overemphasised.
The department acknowledges that adequate
provision of health services to all who need it is
a huge responsibility – we thus require the full
cooperation and participation of our partners in the
sector and the people to whom we provide services.
We appreciate community members who use health
facilities appropriately and access health services
at the correct level of care We value the continued
contribution of community health workers and
civil society organisations that participate in the
delivery of healthcare. We are cognisant of the
contribution of countless healthcare workers, of
their often heroic efforts to save lives and of the
ground-breaking work done in our own institutions.
This continues to inspire us to strive to be the best
provider of quality healthcare services.
Ndoda Biyela
(ACTING) ACCOUNTING OFFICER
GAUTENG DEPARTMENT OF HEALTH
14
Gauteng Provincial Government | Health | Annual Report 2012/2013
15
16
Part B:
PERFORMANCE INFORMATION
17
1. STATEMENT OF RESPONSIBILITY FOR PERFORMANCE INFORMATION
In my opinion, the performance information contained in this report fairly reflects the performance
information of the department for the fi nancial year ended 31 March 2013.
Ndoda Biyela
(ACTING) ACCOUNTING OFFICER
GAUTENG DEPARTMENT OF HEALTH
31 May 2013
Gauteng Provincial Government | Health | Annual Report 2012/2013
2. AUDITOR-GENERAL'S REPORT PREDETERMINED OBJECTIVES
See Part E of this report (Financial Information) for
the full Report of the Auditor-General. No assurance
were provided on predetemined objectives.
18
Gauteng Provincial Government | Health | Annual Report 2012/2013
3. OVERVIEW OF DEPARTMENTAL PERFORMANCE
3.1 Service delivery environment for 2012/13
The GDoH remains committed to the National goal
of a long and healthy life for all South Africans. It
continues to implement a number of interventions
aimed at increasing life expectancy, with an
emphasis on reducing infant, child and maternal
mortality rates, reducing new HIV infections and
managing the impact of AIDS, reducing the burden
of disease from TB and improving health system
effectiveness.
The Departmental Turnaround Strategy is designed
to address major challenges and areas of concern.
It covers eight focal areas, namely: fi nancial
management, human resources, district health
services, hospital management, medico-legal
services, health information, communication and
social mobilisation, and health infrastructure. This
strategy guided numerous interventions during the
course of 2012/13.
Gains from implementation of the Turnaround
Strategy are beginning to emerge. Budget reforms
have been implemented and the Department has
been able to keep expenditure within budget. For
the fi rst time in many years, expenditure on the
compensation of employees has been within budget.
Long-standing issues in relation to Remunerated
Work Outside the Public Service (RWOPS) and
overtime are being addressed through a range of
initiatives. A new procure-to-pay process has been
established to minimise incidents of fraudulent
transactions and possible collusion by offi cials with
suppliers. A supply chain management charter has
also been developed. The Department had verifi ed
77% of targeted employees by the end of January
2013.
Key achievements and challenges in relation to
health service delivery are outlined below.
Health system effectiveness
The demand for primary healthcare (PHC) services
grew substantially during the year under review. The
total number of visits to PHC facilities exceeded
the projected fi gure by more than two million and
amounted to more than 23 million visits. In addition,
1 853 400 patients attended out-patient Departments
(OPDs) at regional hospitals and 2 597 531 were seen
at OPDs at central hospitals.
The Department remains focused on strengthening
primary prevention of diseases through health
promotion and by encouraging communities to
attend PHC facilities for preventive care.
In order to improve the working and patient care
environment, various infrastructure projects have
been undertaken. Equipment such as generators,
chillers, boilers and autoclaves has been replaced.
This should not only improve the patient experience
but also contribute to better infection control and
patient safety. Where possible, the Department
utilised the services of small and medium
enterprises for infrastructure contracts.
Health services are provided through a combination
of community-based outreach programmes and
facility-based care involving hospitals, Community
Health Centres (CHCs), and fi xed and mobile clinics.
There is a continuous effort to improve access
to care by increasing the number of healthcare
facilities, extending hours of service and attending
to soft issues which may discourage people from
using health services.
The Department provides comprehensive PHC care
services in all its CHCs. It offers 24-hour services
at 26 of the 32 CHCs. Ward-based community
health outreach teams are active in 49 municipal
wards. They ensure that households are visited
and services are offered to frail people in their
homes. PHC care has been further enhanced by
19
Gauteng Provincial Government | Health | Annual Report 2012/2013
ensuring that each CHC has a resident doctor and a
specialist family physician. Every health district has
a core specialist team, comprising obstetricians
and paediatricians, to provide guidance to staff at
CHCs and clinics within the district.
The Department provides extensive training to
existing personnel and offers bursaries to members
of the public wishing to study for occupations in
which there are critical staff shortages. A total of
4 397 students were awarded bursaries in targeted
areas of need during 2012/13.
Reducing maternal and child mortality
The provision of maternal and child health
interventions remains a key priority. The Department
provides 24-hour maternity services in all CHCs
and hospitals. During 2012/13, a total of 211 144
deliveries took place in our facilities, an increase of
7 279 on the previous year. Staff received training
in approaches designed to reduce maternal and
infant mortality, such as Essential Steps in the
Management of Obstetric Emergencies (ESMOE).
Signifi cant progress has been made in relation
to screening for cervical cancer among women
aged 30 years and older. Presently about 44% of
eligible women are being screened in accordance
with guidelines. The target is to increase screening
coverage to 70% by 2019/20 fi nancial year.
The Department took a number of measures aimed
at improving child survival rates. It achieved Mother
and Baby Friendly accreditation for an additional
fi ve institutions, bringing the total to 48 facilities.
These facilities assist mothers to breast feed
(which contributes to good nutrition and infant
survival) and educate them about the advantages
of breastfeeding. All fi xed PHC facilities implement
Integrated Management of Childhood Illnesses,
an approach advocated by the World Health
Organisation (WHO) for the early detection and
effective treatment of common health problems
among pre-school children.
Immunisation services are provided daily by
all clinics and some hospitals in Gauteng. The
immunisation coverage rate for various vaccine-
preventable infections has consistently been
maintained above 90%. In addition, there is constant
surveillance in respect of various diseases, including
polio. All cases of acute flaccid paralysis (AFP),
which might be due to polio, have been investigated
to rule out polio.
An additional preventive intervention is the
provision of vitamin A supplements to children
aged 6-11months and Gauteng managed to cover
more than 90% of eligible children.
Dedicated health services for teenagers and young
adults were strengthened and the number of youth
friendly services was increased to 121 facilities.
The oral health programme provided several
thousand children with fi ssure sealants to conserve
their teeth and involved 151 000 children in its
tooth-brushing projects. Other health promotion
programmes for children included education in
correct hand-washing technique – which benefi ted
104 103 learners from 138 schools – and healthy
living programmes which reached 706 schools. A
total of 111 schools in Gauteng have now been WHO-
accredited as health promoting schools. More than
700 child minders and 150 community members
received training on how they could contribute to
the management of childhood diseases.
The Department provided a total of 43 251 assistive
devices – such as wheelchairs and hearing aids –
to persons with disabilities, including children. In so
doing, the Department exceeded its target by 10 251
devices.
Combating HIV and AIDS
There has been a further notable reduction in HIV
transmission from mother to child. During the year
under review, 2.4% of babies tested HIV-positive
when tested at six weeks of age, compared to
3.6% in 2011/12. All babies born to women with
20
Gauteng Provincial Government | Health | Annual Report 2012/2013
HIV should receive the antiretroviral drug (ARV),
nevirapine, within 72 hours of birth and 95.5% of
babies actually received nevirapine.
During the course of the year, the Department
expanded its accredited services for antiretroviral
treatment (ART) from 359 to 364 sites. A total
of 693 136 adults and 41 172 children were on
treatment by the end of the financial year.
The number of facilities providing Medical Male
circumcision (MMC) increased substantially, from 43
to 60 sites. Other measures to reduce the incidence
of HIV included the work done in the community and
individual homes by non-profi t organisations with
support from the Department. Community-based
programmes benefi ted 933 059 individuals in high
risk groups and ward-based education initiatives
reached over six million residents.
Reducing the burden of disease from TB
During the reporting year, a total of 50 461 TB
cases were diagnosed in Gauteng and the affected
individuals commenced treatment. Evidence from
sputum smears that tested positive for TB over
two months was 83.4%, providing an indication that
patients were responding well to treatment. There
has been sustained progress in TB outcomes, and
the cure rate for pulmonary TB reached 82.4% in the
reporting year. The Department treated 794 cases
of multidrug-resistant TB (MDR-TB), constituting
1.6% of all TB cases. Seven additional hospitals
acquired GeneXpert diagnostic equipment, which
delivers TB test results – including the diagnosis
of drug-resistance – within a matter of hours. The
Department also provides the drug isoniazid to HIV-
positive patients to prevent them acquiring TB. This
intervention benefi ted 96 800 people living with HIV
in 2012/13.
External factors impacting on GDoH provision of healthcare
Service delivery in Gauteng is affected by various
environmental factors, including cross-border
utilisation of services and high rates of migration
into the province. Both of these factors increase
the size of the population served and impact on
expenditure on the health care system in Gauteng.
The fact that a fair proportion of the population
is transient and unstable present healthcare
challenges. For example, it is diffi cult to follow up
patients on TB treatment and ART.
There is still a tendency for service users to
bypass PHC facilities because of perceptions that
they receive better care in hospitals which offer
specialist services. Furthermore, cultural and
socio-economic factors still play a role in utilisation
of services. For example, such factors appear to
deter women from making their fi rst antenatal
care visits early (before 20 weeks) and mothers
from bringing children to clinics for HIV testing
and vitamin A supplementation. The attitudes of
administrative and professional staff also influence
patients’ decisions to avoid health services entirely
or choose some over others.
3.2 Service Delivery Improvement Plan
The Department has completed a service delivery
improvement plan. The tables below summarise
key components of the plan and achievements to
date.
21
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 1: Main services provided and standards
Main services Actual customers Potential
customers
Standard of
service
Actual
achievement
Complaints
response system.
Dissatisfi ed or
aggrieved patients
and members of
the public.
Public, patients,
patients’ relatives
and other
interested bodies.
95% of complaints
received to be
resolved within 25
working days.
95.4% resolution
rate within
specifi ed time
limit.
Table 2: Consultation arrangements with customers
Type of arrangement Actual customers Potential customers Actual achievements
Annual open days at
hospitals and clinics
in order to consult
with and inform
communities about the
Patients’ Rights Charter,
Batho Pele Principles
and the departmental
toll-free hotline for
complaints about poor
service.
Patients, healthcare
users, members
of the public, other
stakeholders and
interested parties.
Patients and other
healthcare service
users.
Open days held.
Awareness raised as
shown by the increased
number of complaints
received and managed.
Table 3: Service delivery access strategy
Access strategy Actual achievements
Establish toll-free complaints line operating
24 hours a day, seven days a week. Appoint
complaints offi cials at various institutions and
display contact details on posters in frontline
service areas. Conduct client satisfaction surveys
annually to measure patients’ perceptions of care
they receive.
Strategy implemented successfully with high
utilisation of the complaints system.
Client satisfaction survey showed that 67,4%
hospital users were satisfi ed with the care they
received.
Conduct awareness campaigns through
community radio stations to promote the toll-
free hotline and inform the public about the
departmental complaints response system.
Strategy achieved high utilisation of the system
and a high proportion of complaints were resolved
to the user’s satisfaction.
Table 4: Service information tool
Types of information tool Actual achievements
Information tools comprise posters on complaints
procedure, leaflets with the complaints number
and booklets guiding patients on procedure to be
used when a complaint is lodged.
Information tools are displayed in service areas at
all healthcare facilities. The attention of patients
and members of the public is drawn to these
information items.
22
Gauteng Provincial Government | Health | Annual Report 2012/2013
Types of information tool Actual achievements
Posters on the Batho Pele Principles and the
Patients’ Rights Charter and “know your services
rights” are placed at all institutions.
The number of complaints received from patients
and the public increased from 3 100 in 2011/12 to
6 750 in 2012/13.
Table 5: Complaints mechanism
Complaints mechanism Actual achievements
There is a toll-free complaints hotline.
Quality assurance/customer care units exist at
the central and district offi ces and at all health
facilities.
Complaints management guidelines are available
to staff to guide them on how to deal with
complaints and utilise redress mechanisms.
Attended to more than 350 complaints per month.
More than 95% are investigated and fi nalised
within 25 working days to satisfaction of most
patients.
Complaints are dealt with effectively at all levels
of care.
A user-friendly complaints form has been
developed. A procedure for walk-in complaints is
in place. There is a dedicated e-mail address for
complaints.
Implemented and functional.
3.3 Organisational environment
In December 2011, a Memorandum of Agreement
(MOA) between the Premier, the Minister of Health
and Treasury was signed. The obligations of the
province, in terms of this agreement, included
strengthening budget planning and implementation,
recovering debts owed to the province and
developing a comprehensive Turnaround Strategy.
The Health Turnaround Strategy 2012-14
was developed with the involvement of staff,
management, the National Department of Health
(NDOH), National Treasury, Provincial Treasury,
stakeholders, and the Gauteng Executive Council.
It was approved by the Gauteng Executive Council
on 4 July 2012. The strategy addresses eight
areas: fi nance and fi nancial management; human
resources; the district health system and PHC;
hospital management; the health information
system and health information management;
medico-legal services, communication and
infrastructure.
In December 2012, the Executive Council resolved
that the GDoH would be placed under administrative
curatorship in terms of section 18 of the Public
Finance Management Act (PFMA). In terms of this
section, the Gauteng Provincial Treasury would
intervene to assist the Department to put in place
systems and build capacity for effi cient, effective
and transparent fi nancial management.
A new MEC for Health, Mr Hope Papo, was appointed
in July 2012 and a permanent Chief Financial
Offi cer assumed duty in September 2012. The
Head of Department, Dr Nomonde Xundu, resigned
in October 2012. The CFO, Mr Ndoda Biyela, acted
as HOD for the remainder of the fi nancial year.
23
Gauteng Provincial Government | Health | Annual Report 2012/2013
3.4 Key policy developments and legislative changes
During the year under review, there were no major
changes in legislation and policies affecting
the operations of the Department. However, the
following developments were noteworthy:
• In March 2012, the DOH identifi ed Tshwane
district as one of the 10 National Health
Insurance (NHI) pilot sites. As a consequence
the Tshwane district received an NHI conditional
grant for the fi nancial year under review, as did
the four central hospitals in Gauteng.
• An amendment to the National Health Act
during 2012/13 changed the categorisation of
hospitals. Three of Gauteng’s regional hospitals
– Helen Joseph, Tembisa and Kalafong – were
redefi ned as tertiary hospitals.
• In addition, two policy decisions taken during
2012/13 will affect the Department going
forward:
• Central hospitals are to become a national
responsibility.
• Fixed dose combination ARVs will be introduced.
The decision to place all central hospitals under
the authority of the NDOH will affect four hospitals
in Gauteng. Preparations for this will continue
throughout 2013/14 as there will be implications
for planning, budgeting and ensuring seamless
service delivery from clinic to central hospital level.
At the end of 2012/13, the NDOH announced that
the fi xed dose combination (FDC) ARV would be
introduced from 1 April 2013. The once-a-day, single
ARV tablet contains a combination of three ARVs:
tenofovir, efavirenz and emtricitabine. Initially, it will
be given to newly diagnosed HIV-positive persons,
TB/HIV co-infected and all HIV positive pregnant
women and breast-feeding mothers regardless of
their CD4 count. It is expected that the FDC will
improve and strengthen adherence to treatment by
reducing the pill burden.
4. STRATEGIC OUTCOME ORIENTED GOALS
Strategic goals of the Department
• Improved health and wellbeing with an empha-
sis on vulnerable groups.
• Reduction in the rate of new HIV infections by
50% in youth, adults and babies in Gauteng, and
reduction in deaths from TB and AIDS by 20%.
• Increased effi ciency of service implementation.
• Human capital management and development
for better health outcomes.
• Organisational excellence.
Goals of the National Negotiated Service Delivery Agreement of the DOH
• Increase life expectancy.
• Decrease maternal and child mortality.
• Combat HIV and AIDS and decrease the burden
of disease from TB.
• Improve health system effectiveness.24
Gauteng Provincial Government | Health | Annual Report 2012/2013
5. PERFORMANCE INFORMATION BY PROGRAMME
5.1 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 healthcare provision, and
to ensure that norms and standards are followed in
the course of implementation.
List of sub-programmes
• Pharmaceutical Services.
• Human Resource Management.
• Quality Assurance.
• Information and Communication Technology.
• Risk Management.
Strategic objectives
The following strategic objectives are relevant for
Programme 1:
• Improve client satisfaction rate.
• Improve achievement of national norms in
terms of the ratio of health professionals to
population.
• Improve employment equity and strengthen di-
versity management.
Pharmaceutical Services Sub-programme
The Pharmaceutical Services Sub-programme
strives to ensure the provision and rational use of
essential medicines by suitably qualifi ed personnel
from pharmacies that are compliant with pharmacy
legislation and good pharmacy practice.
In order to monitor adherence to the National
Standard Treatment Guidelines, the unit facilitated
the strengthening of Pharmacy and Therapeutics
Committees (PTCs) at all institutions and in all
districts. The Provincial PTC was revived with four
sub-committees each focusing on a specifi ed area:
the formulary, rational medicine use, procurement
and safety and quality.
The Provincial PTC developed a new formulary and
removed from the formulary most non-contract
medicines and those that are not on the Essential
Medicines List (EML). This will reduce the high
costs related to the use of non-contract items and
facilitate uniform and rational use of medicines by
prescribers and dispensers. The committee also
created a mechanism to report adverse medicine
reactions.
The unit trained 38 pharmacy interns and 71
community service pharmacists completed their
service in our pharmacies. In order to train more
pharmacists’ assistants in preparation for PHC re-
engineering, the unit obtained authorisation from
the South African Pharmacy Council to change
the tutor: learner ratio from 1:3 to 1:5. This allowed
the Department to train 248 pharmacist assistants
who should be ready in two years to be deployed to
PHC facilities.
The provincial Medical Supplies Depot will be
empowered to submit accurate estimates of
medicine requirements to the DOH for purposes of
preparing national medicine tenders.
Pharmacy managers and drug controllers from
the central and tertiary hospitals received training
on fi nancial management, the Division of Revenue
Act (DORA) and the use of the National Tertiary
Services Grant (NTSG). Medicines constitute one
of the largest items in the goods and services
budget and it is therefore important for pharmacy
managers to be skilled in budget management.
Training was also provided on the new TB guidelines
and the roll out of the ARV FDC pill.
25
Gauteng Provincial Government | Health | Annual Report 2012/2013
To improve adherence to good pharmacy practice
and relevant legislation, all standard operating
procedures for pharmaceutical services were
reviewed and circulated to facilities. In response
to the National Core Standards for Health
Establishments, a protocol for safe administration
of medication to patients was developed and
approved. This protocol is specifi cally designed
to minimise prescribing, dispensing and
administration errors.
The re-engineering of business processes at
the Medical Supplies Depot (MSD) resulted in
an improvement in the percentage of essential
medicines available at facilities and the depot from
an average of 64% in March 2012 to 76% by the end
of the fi nancial year.
Laboratory and Blood Services Sub-programme
The following initiatives were taken during 2012/13
to promote the rational utilisation of laboratory
services.
Electronic gate-keeping
Electronic gate-keeping is an automated system
for requesting and approving diagnostic tests.
It has in-built features for ensuring the rational
use of tests. Following the successful piloting
of electronic gate-keeping (EGK) at Chris Hani
Baragwanath Academic Hospital, the system was
extended to an additional 19 hospitals from April
2012. These hospitals are listed below.
Table 5.1: List of hospitals implementing electronic gate-keeping
Chris Hani Baragwanath Academic Hospital Far East Rand Hospital
Charlotte Maxeke Academic Hospital Pholosong Hospital
Steve Biko Academic Hospital Tambo Memorial Hospital
Dr George Mukhari Hospital Tembisa Hospital
Kalafong Hospital Leratong Hospital
Mamelodi Hospital Natalspruit Hospital
Jubilee Hospital Kopanong Hospital
Helen Joseph Hospital Bertha Gxowa Hospital
Edenvale Hospital South Rand Hospital
Rahima Moosa Hospital Sebokeng Hospital
Improved control of accounts for laboratory services
All newly commissioned health facilities must
process applications for accounts with the National
Health Laboratory Service (NHLS) through the
Clinical Support Services unit to ensure that all
facilities are verifi ed by the Health Information
Directorate.
Service Level Agreements with SA National Blood Services (SANBS) and NHLS
There was a thorough review of the service level
agreement between the Department and NHLS.
The terms and conditions of the current agreement
were extended until 30 June 2013. Copies of
the agreement that governs the department’s
relationship with SANBS were distributed to
departmental facilities.
26
Gauteng Provincial Government | Health | Annual Report 2012/2013
Human Resource Management Sub-programme
Employment Equity
The Department undertook a road show to all
institutions to communicate employment equity
targets and raise awareness of the signifi cance
of the Employment Equity Act. Human resource
policies are regularly analysed to identify barriers
to implementation of the Act. The department’s
Skills Development Plan was developed in such a
way that it addresses skills gaps and ensures that
designated groups (in terms of Employment Equity
Act. 55 of 1998) are prioritised at all levels. The
plan also seeks to ensure continuous learning and
development.
For the fi nancial year 2012/13, the GDoH set a
target of 47% for female appointments at senior
management level and achieved 35.8% by the end
of March 2013. Three women were appointed to
senior management posts despite the moratorium
on recruitment that applied for a portion of the
fi nancial year. There is a high demand in the market
for senior female managers and resignations tend
to counterbalance appointments as senior women
in the Department move on to new opportunities.
Gender and disability mainstreaming
The Department continues to mainstream
provisions on gender, opportunities for people
with disabilities and opportunities for youth in
programme planning and implementation.
There has been a steady growth in the recruitment
of people with disabilities and the total number
stood at 458 at the end of the fi nancial year. The
moratorium on appointments also affected the
recruitment of people with disabilities. In addition,
most appointments in the Department comprise
health professionals and there are few people with
disabilities who have qualifi cations in medicine and
nursing.
The Department continues to source curricula vitae
of people with disabilities and include them in a
database. Heads of institutions are encouraged
to consider this database when recruiting staff for
relevant positions.
The Department continues to improve infrastructure
to accommodate people with disabilities and there
are workshops to sensitise staff to the needs of
their colleagues with disabilities and assist them to
provide support in a respectful manner.
Quality Assurance Sub-programme
The Department is committed to providing the
best quality of care to patients and users of its
health services and to meeting their service
expectations and needs. The Quality Assurance
Directorate coordinates quality assurance activities
in the province, promotes patient-centred care and
monitors the compliance of public health facilities
with norms and standards for service delivery.
Patients complaints management system
The Department complaints system responds to
complaints from patients and other members of
the public received at healthcare facilities and the
central offi ce as well as through the departmental
complaints hotline. Complaints are also channelled
through the call centres run by the Offi ce of the
Premier and the Presidency.
A total of 6 874 complaints were received by the
hotline and call centres during 2012/13 and 6 560
were resolved. Of these, 95, 4% were resolved within
25 working days. The Department ensures that
complainants are informed about the outcome of
their complaints.
The swift resolution of a high proportion of
complaints was assisted by the appointment of
dedicated complaints managers to respond to
complaints referred from the Premier’s Offi ce
and Presidential call centre. The Department has
also held workshops to strengthen the capacity
27
Gauteng Provincial Government | Health | Annual Report 2012/2013
of complaints managers in facilities to respond
effectively to complaints. Various communication
methods were used to create public awareness
of complaints mechanisms, including community
radio stations and posters in frontline service areas
at all institutions.
Special attention has been paid to the swift
investigation of serious adverse events. These
are unforeseen and untoward accidents involving
patients (and occasionally other members of the
public) in our health facilities that may lead to
serious injury, permanent damage or even death.
The Department has appointed a multidisciplinary
Serious Adverse Events Management Committee
at central offi ce. This committee ensures the
investigation of all serious adverse events and has
conducted workshops throughout the province to
make certain that facilities use a new reporting tool
for serious adverse events.
A total of 518 serious adverse events were reported
in 2012/13 and 390 were resolved, with affected
patients and/or families receiving redress where
appropriate. The 75,3 % resolution rate was about
30% better than in the previous fi nancial year. The
unresolved cases comprise those that have major
legal implications and those that can be dealt
with more appropriately by the Health Professions
Council of South Africa, to which they are referred.
Serious adverse events can be mitigated through
the practice of clinical audits. This involves the
comparison of current practice with models of
good practice and continual improvement in the
quality of clinical care. A total of 17 hospitals out
of 32 have implemented the clinical audit system
and this has assisted in the development of quality
improvement plans.
There are still challenges in relation to good
complaints management, including:
• Under-reporting by health facilities of cases in-
volving serious breaches of norms and stand-
ards.
• Prank calls by members of the public to the
complaints hotline.
Assessments reveal that there has been a gradual
improvement in terms of compliance with the
National Core Standards for Health Establishments.
Highlights from the assessments are provided
below. In all cases the results of self-assessments
undertaken by facilities in 2011/12 are compared
with the post-baseline assessments (performed by
provincial and national inspectors) in 2012/13.
• The four central hospitals – Steve Biko, Char-
lotte Maxeke, Dr George Mukhari and Chris Hani
Baragwanath academic hospitals – achieved an
overall average compliance score of 47.5 % in
the 2011/12 self-assessment and overall scores
ranging from 70% to 80 % in 2012/13.
• Regional and tertiary hospitals improved from
an overall average of 67% in 2011/12 to 72% in
2012/13.
• District hospitals increased compliance from an
overall average of 62.3% in 2011/12 to 73.5 %
in 2012/13.
The progress in district hospitals may be attributable
to the establishment of the facility improvement
team model in these hospitals and their use of the
national quality improvement plan. In Sedibeng,
hospitals followed the strategy of identifying and
addressing problem areas where “quick wins” were
possible.
More generally, inspectors from the Quality
Assurance Directorate discuss gaps identifi ed
during assessments with institutions. They
encourage the formulation of quality improvement
plans and monitor the implementation of these
plans.
28
Gauteng Provincial Government | Health | Annual Report 2012/2013
Achievements in relation to the six priority areas
Within the National Core Standards for Health
Establishments, six national priority areas have
been identifi ed for urgent improvement. These
areas are:
• Improving values and attitudes of staff of healthcare establishments.
• Cleanliness of hospitals and clinics.• Reducing waiting times and queues.• Keeping patients safe and providing reliable
care.• Preventing the transmission of infections within
hospitals and clinics.• Making sure medicines, supplies and equipment
are available.
In Gauteng, quality improvement teams have been established in all districts to focus on achieving progress in these priority areas. Details of progress in some areas are provided below.
Infection prevention and control
The Department has introduced specifi c measures to improve infection control in public hospitals and there has been a measurable reduction in certain hospital-acquired infections.
The Department has a provincial Infection Prevention and Control (IPC) manager who works with a team of retired nurses to conduct inspections in neonatal and maternity wards. They compile weekly dashboard reports that serve as an early warning system of potential outbreaks of hospital-acquired infections.
The rollout of the Best Care Always (BCA) project reduced certain hospital-acquired infections substantially. BCA is a joint venture of the national DOH and the private health sector and it has been implemented in 28 provincial hospitals. The project focuses on ventilator-associated pneumonia, infection at surgical sites and bloodstream infections associated with catheter use. The following reductions in infection have been
observed between February 2010 and March 2013:
• Ventilator-associated infections have dropped
from affecting 30% of hospitals to 20%.
• Surgical site infections are down dramatically.
At the start of the project they were experienced
at 27% of hospitals and by March 2013 the
fi gure was down to 5%.
• Catheter-associated bloodstream infections
have been reduced from occurring at 30% of
hospitals to 25%.
The number of outbreaks of disease within
provincial hospitals has been reduced from 63%
of hospitals in 2010 to 18.8% in March 2013. Strict
adherence to simple infection-control measures,
such as health professionals using the Betasan
hand disinfectant gel, makes a critical difference.
Improved cleanliness in the health institutions
There is an improvement in compliance with the
cleanliness standards specifi ed in the National Core
Standards. The province-wide score has improve:
in 2011/12 the average score of institutions on
cleanliness indicators was 50% and it increased
to 65 % in 2012/13. However, this still represents a
high level of non-compliance.
The following measures were taken to improve the
cleanliness of health facilities:
• A group of 152 cleaners from hospitals, district
health services and central offi ce, received
training on the cleanliness requirements of the
National Core Standards to ensure that they
understood what was expected of them.
• Special processes have been adopted to resolve
bottlenecks in the procurement system thus
improving the availability of cleaning equipment
and supplies.
• The Department formed a partnership with
private companies to sponsor training for
cleaners. This resulted in more than 300
cleaners receiving training that followed a
corporate cleaning model.
29
Gauteng Provincial Government | Health | Annual Report 2012/2013
Waiting times at health facilities
The Quality Assurance Directorate has developed
provincial benchmarks for waiting times in
out-patient departments (OPDs), accident and
emergency service areas, and pharmacies. Training
of queue marshals has been strengthened.
Continuous monitoring and evaluation of waiting
times has been implemented in all facilities.
There have been some improvements against
benchmarks:
• 75% – 80% of CHCs achieved the prescribed
provincial benchmark of 160 minutes from en-
try to exit of facility.
• 70% to 75% of hospitals achieved the prescribed
provincial benchmarks for waiting times at
out-patients departments, casualty, X-ray ser-
vices and pharmacies.
However, the results have been uneven. There has
been a marked reduction in waiting times at all
district hospitals and some clinics. However, two of
the central hospitals and all tertiary hospitals have
been unable to improve waiting times.
Strategies to address areas of underperformance
Proper queue management has been introduced
through appointment and training of queue
marshals. Fast queues have been established for
particular categories of patients. Signage is being
improved to direct patients to relevant service areas
and to fast queues.
There is training at all facilities to address staff
attitudes and to improve communication between
staff and end-users and their relatives. Private
partners are involved in this type of training. The
client satisfaction survey conducted annually
by the Department showed that clients saw an
improvement in staff attitudes especially at hospital
level. Overall 70% of healthcare users were satisfi ed
with the manner in which staff interacted with them.
This means that three out of every 10 patients is
still dissatisfi ed, indicating that challenges remain.
The Department identifi ed a leadership gap
in nursing management and established the
Provincial Nurse Leaders’ Forum. Members include
senior nurse managers from public and private
sector health institutions, nursing colleges and
universities. The focus is on understanding how to
inspire and execute best practice among nursing
staff at institutions.
Information and Communication Technology Sub-programme
The Department has an urgent need to upgrade
ailing ICT infrastructure which was mostly installed
more than 10 years ago. The ICT Directorate
developed an ICT strategy which is aligned with the
departmental business plan and also developed
individual implementation plans for different
functions, such as information management,
institutional arrangements and information
systems.
Data management
The DHIS Notifi able Medical Conditions (NMC)
Patient Module was designed and put into effect.
The Department completed a pilot project to
capture active surveillance data and interface
it with the intranet GIS. In a second phase of the
pilot project, MDR-TB cases were mapped as they
were confi rmed. Information offi cers were trained
to capture geo-coordinate data of MDR-TB cases at
Sizwe Hospital.
Records management
In 2012/13 the Department established 11 record
centres at central offi ce. A records management
policy is being developed together with a fi le
plan that will be sent to the National Archives for
approval. Other signifi cant achievements included:
• The design and implementation of a records dis-
posal programme.
• The drafting and approval of guidelines on the
preservation of patient records.
• The disposal of non-archival records.
30
Gauteng Provincial Government | Health | Annual Report 2012/2013
• The establishment of an active and effective
Health Records and Archives Forum.
• The introduction by all hospitals of a tool to
monitor the recording, sorting and fi ling of pa-
tient fi les.
ICT enterprise management
In terms of ICT security, the Department has rolled
out Symantec End Point Protection to 90% of its
sites. This provides protection against malicious
codes with the potential to crash systems. Other
important interventions included the roll-out of the
patch management system, adoption of security
procedures and policies, and raising awareness
among end-users of acceptable computer use.
Help desk services were also provided to all internal
clients.
ICT infrastructure
The backbone or foundation of ICT is the
infrastructure through which systems are
implemented. A project to transform ICT in the
GDoH started with the upgrade of infrastructure
at the central offi ce and Pretoria West Hospital
and included the upgrade of data lines in some
central hospitals and central offi ce. The ageing
infrastructure at the central offi ce was replaced in
the course of 2012/13 and the server was upgraded
to an appropriate standard for the volume and type
of business it is required to support.
Risk Management Sub-programme
A detailed report on risk management appears in
Part C: Governance.
31
Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 1 - Administration
Strategic objectives:
• Improved client satisfaction rates.
• Improved achievement against national norms for health professionals.
• Employment equity and diversity management.
Programme1: Administration
Strategic objective
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviation
Improved client satisfaction rate
Client
satisfaction
rate
69% 70% 67.5% (2.5%) Sustained
efforts are
required
from CEOs
of hospitals
to ensure
that results
from client
satisfaction
surveys are
utilised to
improve
service
provision.
Improved achievement of national norms
Medical
offi cers (22.6)
per 100 000
people
26.3 22 23.9 1.9 The target
of 22 was
exceeded. This
is due to an
accelerated
recruitment
drive. Salary
packages
of medical
offi cers have
improved.
32
Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme1: Administration
Strategic objective
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviation
Professional
nurses (87)
per 100 000
people
109 105 103.8 (1.2) Appointments
were
constrained
by available
budgets.
Pharmacists
(3) per 100 000
people
4.2 8 7.1 (0.9) There was
signifi cant
improvement.
Employment equity and diversity management
Percentage
of women
in senior
management
41% 47% 35.8% (11.2%) Posts at senior
management
level are
currently
fi lled. When
vacancies
occur, female
candidates will
be prioritised.
Percentage of
people with
disabilities
0.5% 1.5% 0.8% (0.7%) Only critical
clinical posts
were being
fi lled and few
people with
disabilities
work in these
occupations.
33
Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme 1: Administration
Performance indicator
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviations
Client
satisfaction
rate
69% 70% 67.5% (2.5%) Sustained
efforts are
required
from CEOs
of hospitals
to ensure
that results
from client
satisfaction
surveys are
utilised to
improve
service
provision.
Number of
CHCs with
waiting times
below agreed
benchmark
(35)
25 26 26 0 Trained
120 queue
marshals and
this improved
queue
management.
Number of
hospitals with
waiting times
below agreed
benchmark for
OPD (26)
18.5 18 19 1 Queue
marshals have
been trained to
improve queue
management.
Number of
hospitals with
waiting times
below agreed
benchmark for
casualty (26)
19.5 18 20 2 Exceeded
target. Work
will continue to
build capacity
of all staff
members to
contribute to
reduction of
waiting times.
34
Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme 1: Administration
Performance indicator
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviations
Number of
hospitals, with
waiting times
below agreed
benchmark for
pharmacy (26)
18 18 20 2 Exceeded
target. More
effort has
been devoted
to training
of queue
marshals.
Number of
hospitals
assessed
against the
National Core
Standards
# 25 25 0 There were
joint audits
conducted by
province and
national offi ce.
Capacity of
inspectors to
conduct audits
has improved.
Number of
CHCs assessed
against the
National Core
Standards
# 28 31 3 Target
achieved due
to improved
capacity of
inspectors.
Number
of clinics
assessed
against the
National Core
Standards
# 251 251 0 Achieved due
to improved
capacity of
inspectors.
Percentage
of women
in senior
management
(349)
41% 47% 35.8% (11.2%) Posts at senior
management
level are
currently
fi lled. When
vacancies
occur, female
candidates will
be prioritised.
# Indicator did not have baseline
35
Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme 1: Administration
Performance indicator
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviations
Percentage of
people with
disabilities
0.5% 1.5% 0.8% (0.7%) Only critical
clinical
posts were
advertised and
fi lled and there
are few people
with disabilities
in these
occupations.
Percentage
increase
in revenue
collection
3.4% 10% 12% 2% Revenue target
exceeded
because of
improved
processes and
liaison with
funders of
medical care.
Medical
offi cers per
100 000 people
26.3 22 23.9 1.9 The target
of 22 was
exceeded. This
is due to an
accelerated
recruitment
drive. Salary
packages
of medical
offi cers have
improved.
Professional
nurses per
100 000
109.0 105 103.8 (1.2) Appointments
were
constrained
by available
budgets.
Pharmacists
per 100 000
people
4.2 8 7.1 (0.9) There was a
signifi cant
improvement.
36
Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme 1: Administration
Performance indicator
Actual achievement
2011/12
Planned target2012/13
Actual achievement
2012/13
Deviation from planned target
for 2012/13
Comment on deviations
Vacancy rate
for professional
nurses
8% 6% 8.7% (2.7) Appointments
were
constrained
by available
budgets.
Vacancy rate
for doctors
14% <20% 17.33% 2.67% Vacancy rate
was kept low
because of the
recruitment
drive for
clinicians.
Vacancy rate
for medical
specialists
9% <20% 11.03% 8.97% Vacancy rate
was kept low
because of the
recruitment
drive for
clinicians.
Vacancy
rate for
pharmacists
14% 20% 16.6% 3.4 Retention of
pharmacists
meant the
vacancies for
pharmacists
were reduced.
Expenditure: Programme 1 – Administration
2012/2013 2011/2012
Budget sub-
programme
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
Offi ce of the
MEC 16 482 11 519 4 963 13 518 11 033 2 485
Management:
Health 666 965 489 843 177 122 494 076 432 200 61 876
Management:
Social
Development - - - 165 525 156 871 8 654
District
management - - - 169 475 152 301 17 174
Total 683 447 501 362 182 085 842 594 752 405 90 189
37
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.2 Programme 2: District Health Services
Purpose of the programme
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 which encompasses a range
of basic health services and includes 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 signifi cant
impact on health and health outcomes.
List of sub-programmes
• District health management and PHC services.
• District hospitals.
• Maternal, child and women’s health and nutri-
tion
• HIV, AIDS, STIs and TB.
• Disease prevention and control.
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 disabili-
ties.
• 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 treat-
ment.
• 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), includ-
ing children affected by AIDS.
• Increase partnerships on HIV and AIDS.
• Improve client satisfaction rate.
• Increase level of effi ciency in PHC facilities.
Sub-programme 2.1 District Health Management and PHC Services
Improving quality and effi ciency of PHC services
The GDoH comprises fi ve health districts: three
correspond to the metropolitan areas of Ekurhuleni,
Johannesburg and Tshwane and two to the district
councils of Sedibeng and West Rand. Each health
district is further organised into sub-districts, in
line with the administrative demarcations of the
municipalities. The number of sub-districts in each
health district is indicated below:
• Ekurhuleni: three sub-districts.
• Johannesburg: seven sub-districts.
• Tshwane: seven sub-districts.
• Sedibeng: three sub-districts.
• West Rand: four sub-districts.
Facilities offering PHC services within a health sub-
district include community health centres (CHCs),
community day centres, fi xed clinics, satellite clinics
and mobile clinics. In addition, district hospitals
provide the fi rst level of in-patient care. Some PHC
services extend beyond the walls of health facilities
into the community – for example, the ward-based
PHC outreach services and school health services.
At most PHC facilities, specially trained professional
nurses provide the bulk of curative health services
with the support of a medical offi cer to whom they
refer appropriate cases. Support services such as
investigative radiology and pathology are available
at district hospitals and some CHCs.
38
Gauteng Provincial Government | Health | Annual Report 2012/2013
Re-engineering of PHC through three service
streams
PHC re-engineering was designed to strengthen PHC
services and help improve performance in terms of
the Millennium Development Goals. The strategy
consists of three streams which are calculated to
show rapid results in terms of promoting health,
preventing disease and reducing mortality. These
streams are: district clinical specialist teams, ward-
based PHC outreach teams, and the integrated
school health programme.
District clinical specialist teams
Each district clinical specialist team consists of an
obstetrician, a family physician, an anaesthetist,
a paediatrician, who is supported by a paediatric
medical offi cer, and nurses with specialist PHC,
advanced midwifery and paediatric expertise.
Specialist teams exist in all Gauteng health districts
although some districts do not yet have the full
complement of team members.
The GDoH appointed additional specialists in three
districts:
• A medical offi cer in obstetrics and gynaecology
was added in Johannesburg.
• A specialist and a medical offi cer in obstetrics
and gynaecology and a paediatrics specialist
were added in the West Rand.
• A specialist family physician and medical offi cer
were included in the Sedibeng team.
Training was undertaken to provide additional
advanced midwives, PHC nurses and paediatric
nurses to assist specialist teams.
Ward-based PHC outreach teams
Each ward-based PHC outreach team comprises
a team leader (who is a professional nurse), an
enrolled nurse, and six to eight community health
workers (CHWs). These teams are linked to the PHC
facilities serving the municipal wards in which they
operate. A total of 49 teams had been established
by the end of 2012/13. Sedibeng with 15 teams,
has the largest number. Ekurhuleni, Tshwane
and the West Rand each have nine teams while
Johannesburg has seven.
A total of 2 058 CHWs have been trained to deliver
the services envisaged in the PHC re-engineering
strategy and 29 professional nurses have been
trained as team leaders. Funding for this preparation
was provided by development partners. There are
plans to train an additional 27 professional nurses
as team leaders.
Integrated school health services
The Department has partnered with provincial
departments of education and social development
to provide integrated school health services.
Each school health team consists of a professional
nurse, an auxiliary nurse and a health promoter, and
is supported by an optometrist, an oral hygienist
and a dental assistant. There were 50 school health
teams in place at the end of 2012/13. There is a
need for 59 additional teams to reach all schools
serving residents in the two lowest income quintiles.
The target date for achieving this level of resourcing
is the end of 2013/14.
During the year, 225 877 learners were screened
for various conditions. Of these, 14 212 fell into
schools serving the poorest 40% of the population.
Improving access to PHC services
The overall headcount of patients at PHC facilities
in Gauteng increased from 22 711 585 in 2011/12 to
23 063 294 in 2012/13. The increase in visits can be
attributed to the ward-based outreach teams who
encourage community members to seek healthcare
where necessary.
Extended hours of operation at PHC facilities also
contributed to increased utilisation of services. In
the year under review, 26 out of 32 CHCs provided
24-hour services and 112 out of 317 clinics had
extended hours of operation. These clinics remained
open until 18h00 during the week and functioned
between 7h30 and 13h00 during weekends.
39
Gauteng Provincial Government | Health | Annual Report 2012/2013
Rehabilitation and therapeutic services
The purpose of the rehabilitation and therapeutic
services is to ensure appropriate services to prevent
disability and restore the integration of people with
disability in the community. Such services are
offered in collaboration with other government
departments and disability organisations.
The Department provided 43 251 assistive devices,
such as wheelchairs and hearing aids, to assist the
reintegration of people with disabilities into their
communities. This exceeded the target of 33 000
assistive devices for the year.
The Vocational Rehabilitation Project prepares
adult patients, who have suffered an injury or illness
that resulted in a permanent disability, to regain full
employment within the open labour market. During
the year under review the vocational rehabilitation
team developed and promoted a screening tool to
facilitate referral of potential rehabilitation clients
to the central hospitals for full assessment.
The interdepartmental Early Childhood Intervention
Project aims to ensure that vulnerable children
have access to rehabilitation services as early as
possible. A parental information brochure about
children between the ages of 0 – 3 months was
developed with the aim of educating parents on
the expected milestones. The Offi ce of the Premier
is the custodian of the project. During 2012/13, a
total of 13 hospitals and two districts participated
actively in the project.
Sub-programme 2.2 District Hospitals
District hospitals saw a higher number of patients
at their outpatient departments than in the
previous fi nancial year. Outpatient visits and patient
admissions amounted to slightly more patient-day
equivalents than projected. The average length of
stay for inpatients was within the acceptable range.
Use of district hospital beds needs to increase in
order to achieve effi cient use of resources.
Sub-programme 2.3 HIV, AIDS, STIs and TB
HIV counselling and testing
There is a sustained commitment to increasing HIV
counselling and testing and in 2012/13 a total of
3 863 419 people were offered counselling for HIV
testing and 3 697 292 people underwent testing.
The fact that 93% of people counselled opted
to test is testimony to the improved standard of
counselling among lay counsellors.
Prevention of mother-to-child transmission
The HIV transmission rate from mothers living
with HIV to their babies reduced once more. Only
2.4% of babies tested at the age of six weeks were
HIV positive, compared to 3.6% in 2011/12. This
is partly due to a 3% increase in pregnant women
receiving long-term antiretroviral therapy (ART) and
a higher proportion of babies receiving nevirapine
within 72 hours of birth.
Antiretroviral therapy
The provision of ART to eligible individuals is one
of the most critical interventions for achieving the
department’s objective of reducing deaths from
AIDS. At the end of the year under review, there were
693 136 adults and 41 172 children receiving ART
in Gauteng.
40
Gauteng Provincial Government | Health | Annual Report 2012/2013
The Department increased the number of facilities
providing ART from 359 to 364. This means ART is
now available at 90.3% of all public health facilities.
The capacity of facilities to expand the ART
programme was underpinned by the training of an
additional 5 582 nurses to initiate and manage ART.
During the year, a special information management
system, known as 3 TIER (TIER.NET), was extended
to all districts in order to improve the quality of data
available on the ART programme.
Medical male circumcision
Medical Male Circumcision (MMC) is a component of
reproductive health services and the HIV prevention
programme. The Department increased the number of MMC sites substantially in 2012/13, from 43 to 60. Although the desired target for MMC was not met there was a large increase in the number of procedures performed, from 51 205 in 2011/12 to 94 059 in 2012/13. The support of development partners was crucial to this achievement. Output on MMC was affected by limited space at health facilities and a shortage of staff.
Home and community-based care
The department funded 234 Non-Profi t Organisations (NPOs) to provide home and community-based care services. These organisations included 27 hospices that provide palliative care. In all, 80 577 people received care through these CHBC services during 2012/13. The programme is delivered by 7 081 active home-based carers, 6 555 of whom receive stipends. The number of home visits conducted by home-based carers in 2012/13 was 164 243, exceeding the target of 100 000 visits.
High transmission areas
A total of 63 locations have been identified as high transmission areas for HIV and these areas form a focus for peer education and condom distribution. A total of 131 972 200 male condoms and 2 368 915 female condoms were distributed across the province in 2012/13, from health
facilities and other distribution points.
Strategies for addressing underperformance
The district health information system (DHIS) does
not capture data from external partners, such as
business organisations and NGOs, and therefore
reporting on the number of individuals tested for
HIV in the province is not complete. Arrangements
will be made to add external partners as DHIS
reporting units.
Despite the increase in the number of individuals on
ART, this aspect of the programme has experienced
challenges. Limited support from some local
authorities, coupled with shortage of space in some
clinics, affected expansion of the ART programme.
While the department aimed to provide ART at 403
facilities in 2012/13, this was possible at only 364
facilities. Plans are underway to bring all health
services under the provincial authority and this will
speed up processes to ensure that all facilities offer
ART services.
Data collection and reporting remain a challenge,
as data submission from facilities is often delayed
and this results in under-reporting. The introduction
of the 3TIER system in all clinics will improve data
quality going forward and the employment of
additional data capturers should improve the flow
of information.
A matter of considerable concern is the high
number of clients lost to follow-up after ART is
initiated. The task of tracing these patients is made
more diffi cult when incorrect residential addresses
have been provided by patients. The involvement of
home-based caregivers in the follow-up of patients
may improve our success rate.
There were problems with condom availability at
health facilities during the year. This was because
suppliers who were awarded the national tender to
provide condoms had limited stocks of condoms
available and national DoH had a limited supply of
female condoms.
41
Gauteng Provincial Government | Health | Annual Report 2012/2013
The Gauteng AIDS Council adopted the Gauteng
Strategic and Implementation Plans for HIV, TB and
STIs for 2012 to 2016. This includes a campaign
strategy and a draft fi ve-year plan. The plan is multi-
sectoral, involving all departments of government
and key sectors of civil society plus service NGOs.
Community education programmes met or
exceeded very large targets for 2012/13:
• Ward educators reached six million people
through door-to-door education.
• Community organisations communicated with
seven million people.
• Peer educators reached 933 059 people in high
risk settings.
Behavioural outcomes of HIV prevention
campaigns
The National Communication Survey (NCS) involves
a large representative sample of young people
and adults from across South Africa. It measures
patterns of belief and behaviour related to HIV
prevention. Provincial results of the survey are
available and the 2012 survey showed the following
outcomes for Gauteng province:
• Levels of knowledge of HIV prevention and
treatment for HIV and TB are high. There is very
high access to media in Gauteng and mass
media interventions on HIV reach 98% of youth.
• The highest use of condoms the last time they
had sex was reported by teenagers (80%).
Condom use declines with age.
• The practice of multiple sex partners continues
and is highest amongst young males of 20 to
25 years. One in four survey participants in this
group reported having more than one partner.
Females have fewer sex partners. Many men
with more than one sex partner still do not use
condoms.
• Since the mass HIV testing campaign started in
2010, 66% of adults have tested for HIV.
• Half of all men are already circumcised.
There are slightly more men who have been
medically circumcised than those undergoing
the traditional method. Men are willing to
circumcise and there is high demand for the
medical service.
• Young women aged 15 to 29 years have the
highest risk of new HIV infections. The NCS
points to the need for prevention programmes
to increase regular condom use among young
single women and their male partners.
• About half of young women have sex partners
who are fi ve or more years older than they
are. Older men tend to have younger partners.
Women in unequal relationships are less likely
to be able to insist on regular condom use. Sex
is often associated with partners who provide
benefi ts, including status, gifts or favours.
• Community programmes are quite extensive
but not visible enough to the public. Media
interventions need to be focused on all youth,
including educated and middle class youth.
Better use of social media is a priority.
Tuberculosis and HIV
Before the HIV pandemic, the incidence of TB
was declining. However, over the last 10 years TB
incidence has increased by 400%. TB is the number
one killer among HIV-positive populations. The high
prevalence of HIV is fuelling the TB epidemic and
more than 70% of TB patients are also living with
HIV.
Certain populations are at higher risk of TB
infection. These high-risk groups include healthcare
workers, mine workers, prisoners, prison offi cers
and household contacts of confi rmed TB cases.
In addition, certain groups have a greater chance
of progressing from TB infection to TB disease.
These include children, people living with HIV,
diabetics, smokers, people with silicosis, alcohol
and substance abusers and people who are
malnourished.
The department has adopted the new strategy
outlined in the Strategic Plan for HIV, TB and STI
2012-2016. Objectives of the plan are to:
• Reduce the TB case notifi cation rate by 50% by
2016.
42
Gauteng Provincial Government | Health | Annual Report 2012/2013
• Reduce the TB mortality rate by 50% by 2016.
• Reduce the psychosocial impact of HIV and
AIDS and TB on individuals, families and
communities.
• Reduce stigma and discrimination.
• Increase the TB treatment success rate to 90%
by 2016.
Overview and performance of TB programme
During the year under review, a total of 367 086
people attending PHC facilities and outpatient
departments of hospitals (including patients known
to be HIV-positive) were screened for TB. Laboratory
tests confi rmed that 50 461 of these had active TB
and treatment was initiated. The number of new TB
patients is lower than in the previous year and this may
be due to the successful implementation of Isoniazid
prophylaxis, which reduces new TB infections among
PLHIV and children under the age of fi ve years who
are household contacts of TB patients. Isoniazid
prophylaxis was provided to 98 801 PLHIV, exceeding
the target of 80 000.
At the end of six months of treatment, 18 492 out
of 22 669 smear positive patients (82.4%) were
cured. This cure rate exceeded the target of 82%.
There was also a reduction in the rate of patients
defaulting on treatment before completion. This
contributed to the increased cure rate and also
reduced the risk of drug-resistant TB developing.
Only 1 092 patients defaulted on their treatment.
This translates to a defaulter rate of 4.8%, which is
below the target of 5%.
Multidrug-resistant TB continues to be a problem.
It is imperative that patients have their sputum
collected at the end of two months of treatment to
ensure that they are responding to the drugs and
have converted to smear negative. During 2012/13
the two-month smear conversion rate was 83.4%,
slightly exceeding the target of 82%.
Where TB patients are living with HIV it is important
to manage the two conditions in an integrated way.
More than 88% of TB patients were counselled and
tested for HIV in the year under review and 71%
tested HIV positive. More than half of these (54%)
were initiated on ART.
MDR-TB often develops in patients who fail to
complete their initial TB treatment. In total, 794
new cases of MDR-TB were confi rmed in 2012/13.
This number translated to 1.57% of all TB patients,
which is within the national limit of 2.5%.
The GeneXpert technology, which diagnoses TB
(including drug-resistant TB) within hours, has been
expanded from fi ve to 12 hospitals. The advantage
is that patients know their results within 48 hours
and treatment can then be initiated, unlike in the
past where patients were lost to the system whilst
waiting weeks for test results.
Patients who become resistant to the drugs used to
treat MDR-TB have developed XDR-TB. The number
of newly diagnosed patients with XDR-TB was 19, a
signifi cant decrease from 37 in 2011/12. Treatment
support and adherence contributed to this reduction
as did the decentralised management of MDR-TB.
The department has initiated talks with the Hospice
Palliative Care Association, which will assist with
treating drug-resistant patients in their homes. The
department has also commenced with creating
isolation wards for the treatment of MDR-TB in
district hospitals. This will allow patients to undergo
treatment close to home and will overcome the
problem of patients absconding while being treated
at Sizwe Hospital. The current default rate at Sizwe
Hospital stands at 21%.
With the help of the University Research Corporation
(URC), the TB programme expanded its capacity
to respond to TB by providing appropriate training
to various categories of internal and external
stakeholders, including 466 nurses, 60 traditional
healers, fi ve laboratory technicians, 72 doctors, and
74 other individuals in diverse occupations.
43
Gauteng Provincial Government | Health | Annual Report 2012/2013
Intersectoral collaboration
The department has commenced meetings with
mining companies as the extremely high incidence
of TB on the mines. Effective management of TB
in the mining industry would go a long way to
reducing new infections and TB-related deaths in
the province.
The Aurum Health Institute opened a new clinical
trial facility at Tembisa Hospital. This centre will
conduct research on the prevention and treatment
of HIV and TB.
International relations
The department received delegates from the
Chinese government and the Democratic Republic
of Congo to learn from our best practices. The
NHLS was one of the places they visited.
Strategies to address underperformance
The turnaround time for sputum test results was
unsatisfactory: only 71% of results were delivered
within the specifi ed time and this was far below
the target of 90%. The underperformance was
attributed to instability within the NHLS. To address
this problem, more facilities will be equipped with
GeneXpert machines which produce results within
a few hours.
Sub-programme 2.4: Maternal, Child and Women’s Health and Nutrition
Maternal and newborn health
The achievment of targets relating to antenatal care
attendance before 20 weeks’ gestation remains a
major challenge. Only 37.8% of pregnant women
“book” (make their fi rst antenatal visit) during this
crucial stage for effective prenatal care.
The number of deliveries in facilities increased
slightly from 203 865 last year to 211 144 in
2012/13. This might reflect normal population
growth or indicate that more individuals perceive
the benefi ts of delivering babies in a health facility
with the attention of a skilled health worker.
Initiatives to reduce maternal mortality included
training of clinicians on Essential Steps in the
Management of Obstetric Emergencies (ESMOE). A
total of 188 doctors and 203 nurses were trained on
the management of obstetric emergencies during
2012/13. In addition, nurses were trained to use
early warning charts and implement the “Five Hs”
(a key component of Saving Mothers report and
the Campaign for the Accelerated Reduction of
Maternal Mortality in South Africa).
There was an observable improvement in coverage
of postnatal care for mother and baby within six
weeks of birth. Coverage for mothers increased
from 60% to 85% and for babies from 60% to 86.6%
during the reporting year.
Vitamin A supplementation for babies aged 6-11
months remained above target.
Child health
The programme on Integrated Management of
Childhood Illnesses is followed in 100% of facilities
that provide child health services.
During the National School Health Week 22
schools were visited. A total of 1 318 learners were
screened and 498 referred to appropriate services
for assistance with learning problems, poor vision,
hearing diffi culties, oral health problems and other
conditions.
Adolescent and youth health
The number of Youth-Friendly Services increased
from 117 to 121 in 2012/13 with the addition of four
facilities in the Sedibeng and Johannesburg health
districts. The percentage of babies born in health
facilities to mothers under 18 years dropped from
5.6% to 4.8% during the year. This fi gure is used as
a proxy for the teenage pregnancy rate.
44
Gauteng Provincial Government | Health | Annual Report 2012/2013
Expanded Programme on Immunisation
The coverage rate for routine immunisation against
various vaccine-preventable conditions was
maintained above 90% of children in the relevant
age group during the fi nancial year. For instance:
coverage for full immunisation of babies under
one year was 107.9%; coverage for the fi rst dose
of measles vaccine was 111.6%; coverage for the
pneumococcal vaccine third dose was 109.3%;
and rotavirus vaccine second dose coverage was
112.4%. Coverage can exceed 100% when the
actual number of children immunised exceeds the
estimated number in that age group in the province.
Cross-border flows of patients and migration into
the province may be the reasons behind this.
The national health department conducted training
on effective vaccine management during the third
quarter of the year and this training was cascaded
to all districts.
Disease surveillance was carried out throughout
the year, with 89% of weekly surveillance reports
submitted during 2012. The department will
continue to strive for 100% reporting.
Surveillance for acute flaccid paralysis – which
must be investigated to rule out polio – was above
target. Traditional healers are being trained and
the participation of relevant community groups is
being sought to ensure that proper stool samples
are obtained for testing.
Women’s health, including reproductive health
The number of hospitals providing mammograms
for breast cancer screening has increased slightly
from six to seven. Collectively they performed
14 753 mammograms during 2012/13.
The number of screening procedures performed for
cervical cancer was 116 100, representing 44.1% of
the target group comprising women 30 years and
older.
In terms of contraceptive use, the woman-year
protection rate was 26.9% and the couple-year
protection rate was 28.3%. In order to support the
goals of universal access to contraceptives and
choice in terms of method of contraception, 49
master trainers were trained in the insertion of the
intrauterine contraceptive device.
Nutrition and hospital food services
Mother Baby Friendly health facilities play an
important role in infant nutrition because of the
support they provide for breastfeeding. The number
of GDoH facilities accredited as Mother Baby
Friendly increased from 38 to 44 during 2012/13.
This means that 73% of maternity facilities in the
province are now accredited and the aim for the
coming year is to accredit another six facilities.
Orientation and capacity building on nutrition
assessment, care and support was conducted with
the assistance of the Programme for Advancing
Technology on Health (PATH). Participants
comprised 73 district and facility managers and
members of the paediatric clinical specialist teams
in the districts.
Training of professional healthcare professionals
in the area of nutrition has yielded positive results:
correct classifi cation of severe malnutrition has
contributed to a lower number of cases in children
under the age of fi ve years.
Food service audits were conducted in 20 health
facilities.
The department increased the number of early
childhood centres funded from 831 to 929 with
a corresponding increase in the number of
benefi ciaries from 37 342 to 44 160.
Healthy lifestyles
A total of 296 health promoters and CHWs received
training on subjects ranging from childhood cancer
and the Integrated Management of Childhood
Illnesses to malaria and tobacco control legislation.
45
Gauteng Provincial Government | Health | Annual Report 2012/2013
During the year, 557 health promotion events and campaigns took place. Usually they combined educational activities with screening for hypertension, diabetes and HIV.
The department established 271 walking clubs in 2012/13. Members of existing support groups for non-communicable diseases and older persons played a leading role in stimulating community interest in walking clubs. Additional healthy lifestyle activities took place at 1 293 venues – work places, service centres, luncheon clubs and youth clubs. A total of 95 health promoters were trained to assist with the organisation of Golden Games, an initiative of the Department of Social Development which aims to keep older people physically active.
Other health promotion activities during included a door-to-door awareness drive on paraffi n safety which focused on informal settlements and hostel residents in the West Rand district, and a TB and STI awareness event conducted for students at Monash University.
Health promotion in schools
Learners from 706 schools received education on various aspects of healthy lifestyles, including the dangers of smoking, drugs and substance abuse, prevention of pregnancy, medical male circumcision, healthy eating and physical activity.
In partnership with Awuzwe Communications, demonstrations were conducted on correct hand washing techniques. These reached about 104 103 learners from 138 schools in the province and 5 492 hand washing bags were distributed to participating schools. Similar campaigns were conducted for children in crèches and informal food vendors.
In collaboration with the Gauteng Department of Education (GDE), a number of health promoting schools (HPS) activities were conducted. These included advocacy sessions on HPSs in 582 schools and 197 assessments for accreditation of schools as HPS. A total of 111 schools met the WHO criteria
and were awarded HPS certifi cates.
Health promotion in clinics
Health education activities, mostly focused on
health lifestyles, were conducted in 775 clinics. A
Move for Health campaign was run and included
talks on the benefi ts of exercise and a fun walk
in which more than 5 000 community members
participated. A special effort was made to include
pregnant women in the campaign. A school holiday
programme benefi ted 320 learners. Exhibitions on
nutrition, TB and healthy lifestyles were displayed
in clinics.
Health promotion at crèches and early learning
centres
Activities on healthy lifestyles were conducted at
597 crèches. A total of 95 facilities participated in
the Healthy Baby & Growth Monitoring Initiative, in
partnership with Johnson & Johnson. More than
705 child minders and 156 community members
received training on the community component of
the Integrated Management of Childhood Illnesses.
Health promotion on maternal and women’s health
Awareness campaigns on breast cancer and
cervical cancer were conducted in Ekurhuleni
and the West Rand and benefi ted 1 324 women,
including some older women. A door-to-door
initiative to promote early booking for antenatal
care reached a total of 566 men and women in
Magagula Heights, Ekurhuleni.
Strategies for addressing areas of underperformance
There is a continued loss of health promoters as
they opt for careers in nursing. This turnover affects
performance and the department is offering health
promoters avenues for improving their career
prospects within the fi eld of health promotion.
Gauteng was responsible for an initiative to produce
an induction manual in health promotion and
introductory training for health promoters. Funding
was sought from the Japanese International
Cooperation Agency (JICA) and at this point the national health department became involved.
46
Gauteng Provincial Government | Health | Annual Report 2012/2013
The intention is to expand the project so that the training will eventually culminate in an NQF level 4 qualifi cation for health promoters.
Some schools were reluctant to give health promoters time to conduct healthy lifestyles activities but discussions have resulted in a number of these schools agreeing to accommodate health promotion after 13h00.
Health promotion programmes were sometimes constrained by a shortage of vehicles. This issue is being addressed through the departmental Turnaround Strategy.
There are areas of advocacy where health promotion has had a minimal response. These include the promotion of vitamin A supplementation, early attendance of antenatal clinics and follow-up HIV testing of babies born to mothers living with HIV. The plan is to seek the collaboration of faith-based organisations in these advocacy initiatives.
Sub-programme 2.5: Disease Prevention and Control
Non-communicable diseases, geriatric care and eye care
The West Rand district is participating in a pilot project on the Integrated Chronic Diseases Care Model, which is an initiative of the national health department. Fifteen facilities are involved in the pilot which aims to improve chronic diseases management. The Bertha Gxowa District Hospital is participating in a National Cancer Registry pilot project. All cancer cases are systematically entered into the cancer register which will help track incidence and types of cancer and this information will inform programme planning.
Inspections took place at 32 old age homes and health reports were issued for re-registration of
these homes.
A total of 323 doctors and nurses participated
in training on national protocols and guidelines
for a variety of chronic conditions: rheumatic
fever, rheumatic heart disease, chronic kidney
disease, chronic renal dialysis, cancer detection at
community level and obstructive sleep apnoea.
A public-private partnership resulted in a
successful World Sight Day event held in Dhlamini
Multi-purpose Hall in the Johannesburg region.
A total of 361 people were screened, 187 pairs
of spectacles were issued and 130 people were
referred for further management. There were 26
district-level awareness campaigns and events
in Eye Care Awareness Month during which 2 814
people were screened for eye problems, 187 pairs
of spectacles were issued and 944 people were
referred for further management. In addition,
eye care outreach services benefited 30 old age
homes and 200 pairs of spectacles were provided to residents of these homes.
The department employed three optometry bursary holders at district facilities.
Partnerships were forged with the Brian Holden Vision Institute for the purpose of improving eye care services in the Johannesburg District and with African Vision in order to increase capacity for cataract surgery.
A total of 35 new chronic disease support groups were established in various districts: 11 for people with diabetes, 14 for people with epilepsy, nine focusing on hypertension and one dealing with cancer. Campaigns were held in the districts to mark World Diabetes Day, World Older Persons Abuse Day, World Sight Day, World Glaucoma Day and World Kidney Day.
In terms of primary prevention of diseases, a total of 19 997 men over the age of 45 were screened for the prostate-specifi c antigen, a predictor of prostate cancer. Of those screened, 2 543 were found to have raised levels of the antigen and were
referred to appropriate management.
47
Gauteng Provincial Government | Health | Annual Report 2012/2013
Strategies for addressing areas of underperformance
The department has allocated a specifi c budget
for cataract surgery and has accelerated the fi lling
of posts for ophthalmologists. The department
continues to provide bursaries to students in the
fi eld of optometry.
Oral health services
A dental examination card is now being attached to
the Road to Health Chart that is opened for every
young child attending PHC facilities. This system
ensures that children who present themselves for
immunisation also receive a dental examination.
Oral health promotion is integrated into school
health programmes and is generously supported by
private sector donors. As a result, 151 000 learners
were involved in tooth-brushing initiatives.
Mental health and substance abuse services
PHC facilities serve as the entry point for mental
healthcare. In order to improve capacity in these
facilities for assessing, diagnosing and treating
common mental health disorders, 138 nurses and
74 medical doctors received relevant training. In the
year under review, 74% of PHC facilities were able to
provide mental health services.
At 107 CHCs and clinics there are multidisciplinary
teams for the provision of out-patient mental
healthcare to adults and children referred to these
facilities. Some of these clinics and CHCs facilitate
support groups for individuals with mental health
and substance abuse problems.
Non-governmental organisations (NGOs) are
licensed by the department to provide day care
and residential care to individuals with severe
psychiatric disability and profound intellectual
disability. A total of 4 681 persons were assisted
in this way by NGOs, some of which also received
funding from the department. These services are
an alternative to inpatient hospital care.
Services to prevent and reduce the harm of
illicit drugs are provided at district level, while
general hospitals provide emergency and acute
detoxifi cation services for substance abuse. The
use of drugs often causes or compounds mental
illness and PHC services provide community
management for persons with the dual diagnosis
of mental illness and substance abuse.
Communicable Diseases Control and Surveillance
All communicable disease outbreaks were reported
and responded to within 24 hours. The province
had only one case of imported cholera during the
year and there was no transmission beyond this
patient. This containment of cholera is mainly due
to consistent monitoring of water by Environmental
Health Services.
The Provincial Surveillance Task Team meets
regularly to ensure maintenance of systems for
tracking specifi ed communicable diseases and
containing their spread. A successful campaign to
prevent influenza saw the immunisation of more
than 30 580 pregnant women and 26 000 children
under the age of fi ve years. The department utilised
more than 99% of vaccines available.
Malaria deaths continued to be a matter of concern.
Since Gauteng is not a malaria-endemic area, levels
of public awareness are not suffi ciently high. All
reported malaria deaths in Gauteng were audited.
Provincial surveillance guidelines have been
implemented and are in the process of being
revised. These assist communicable disease
control coordinators and surveillance offi cers in
the early detection and containment of outbreaks.
Progress was made on developing a module on
notifi able medical conditions for the DHIS and it will
be put into effect in 2013/14.
Strategies to address areas of under-performance
Audits of malaria deaths have revealed that late
treatment is a major contributor to the high malaria
fatality rate. In order to address this, malaria alert
48
Gauteng Provincial Government | Health | Annual Report 2012/2013
posters and malaria treatment guidelines were
distributed to all facilities in the province to create
awareness and improve disease management.
There is also ongoing training of doctors and
nurses.
Social mobilisation campaigns were conducted
targeting travellers returning from malaria-endemic
areas and focusing on areas in Gauteng where
malaria deaths had previously occurred. Messages
focused on early recognition of malaria symptoms
and encouraging people with these symptoms to
seek early treatment. The intention is to collaborate
with taxi associations servicing relevant routes.
Environmental and Port Health Services
In 2012/13, environmental health offi cers inspected
172 public health facilities to establish whether
they had safe potable water and 223 facilities to
establish whether they met sanitation standards.
Municipal environmental health offi cers collected
2 235 samples which were analysed by the NHLS
to establish whether they complied with food
safety requirements. Only 36 food samples failed
to comply: they were contaminated with toxins
produced by strains of staphylococcus aureus.
A total of 41 dealers in hazardous substances were
inspected and those complying with the Hazardous
Substances Act were granted licences for a period
of one year.
More than 18 396 aircraft from malaria-endemic
countries that landed at OR Tambo and Lanseria
international airports were disinsected according
to the International Health Regulations of 2005. A
total of 7 662 aircraft from yellow fever-endemic
countries were also disinfected. During 2012/13
permission was granted for 783 air ambulance
flights to transport sick passengers into the country.
All these flights complied with International Health
Regulations.
The department received an award from the
National Institute of Communicable Diseases for
the successful Viral Watch Programme at the OR
Tambo International Airport Clinic. This programme
tracks trends in various agents that cause upper
respiratory tract infections.
Consistent application of the national yellow
fever guidelines in respect of visiting heads of
state, government ministers and diplomats is a
matter that continues to require attention. The
national Department of Health is managing these
challenges in collaboration with the Department of
International Relations and Cooperation.
Sub-programme 2.6 Forensic Pathology Services
The Forensic Pathology Service undertook
infrastructural upgrading projects at seven of
the province’s 11 forensic mortuaries. This not
only improved the working environment but also
ensured compliance with occupational health and
safety requirements.
Working with the Development Bank of Southern
Africa and the Department of Infrastructure
Development, the department fi nalised projects
briefs related to the building of three new forensic
mortuaries in Johannesburg, Daveyton and
Bronkhorstspruit.
Stakeholder meetings were held at regional level
with the South African Police Service (SAPS),
hospitals and undertakers to address operational
challenges.
During the 2012 16 Days of Activism against
Violence against Women and Children the
department opened a dedicated clinic for survivors
of violence at the main PHC facility in Daveyton,
Ekurhuleni. Permission has been granted to
establish three similar structures for the treatment
of survivors of violence in Sedibeng, Johannesburg
and West Rand District.
49
Gauteng Provincial Government | Health | Annual Report 2012/2013
In an effort to strengthen clinical forensic services
a meeting was held with the Nursing Council and
national DoH about the recognition of a specialty in
forensic nursing. Subsequently, Gauteng province
hosted a Forensic Nurses Forum with a view to
launching the Forensic Nurses Association.
Strategies to address areas of under-performance
The budget does not fully support the approved
staff establishment for clinical forensic services
and the resulting vacancies mean that the required
24-hour service is not always available. This will be
discussed with senior management.
Gauteng has the highest number of unnatural
deaths in South Africa. The department has
prioritised implementation of the National Strategic
Framework for Prevention of Non-natural Deaths. It
remains the only province reporting on preventive
activities in this regard. Implementation of the
strategy demands a multi-sectoral approach and
the department has secured the collaboration
of the departments of Community Safety, Social
Development, Education, Local Government and
SAPS, as well as certain community structures.
50
Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 2 – District Health 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 disabili-
ties.
• 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 treat-
ment.
• 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), includ-
ing children affected by AIDS.
• Increase partnerships on HIV and AIDS.
• Improve client satisfaction rate.
• Increase level of effi ciency in PHC facilities.
Sub-programme: District Health Management and PHC Services
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Improved health and wellbeing with an emphasis on vulnerable groups
Maternal
mortality rate
(MMR)
145/100 000
live births
160/100 000
live births
117.3/100 000
live births
42.7/100 000
live births
The fi gure for actual
achievement is an
estimate from DHIS
as the applicable
Saving Mothers
report with offi cial
data will only be
available in 2014/15.
Infant mortality
rate (IMR:34 per
1 000)
6.4/1000 live
births
30/1000 live
births
5/1000
live births
(25)/1000
live births
These are estimates
from DHIS. Data
integrity needs to be
addressed.
Mortality rate
(CMR: 43 per
1 000)
2.4/1000 live
births
25/1000 live
births
3.7/1000
live births
(21.3)/1000
live births
These are estimates
from DHIS. Data
integrity needs to be
addressed.
51
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Severe
malnutrition:
under 5 years
incidence
(0.27)
2.8 % 3.5% 2.5% (1%) Target exceeded
due to ongoing
training of health
professionals,
community
mobilisation and
surveillance.
Incidence of
hypertension
0.5% No target 0.3% n/a Health promotion
will be intensifi ed
to encourage
self-monitoring by
members of the
public.
Incidence of
type 2 diabetes
(2.7%)
0.3% 2.7% 0.2% 2.5% Rate of type 2
diabetes was
lower than
target but social
mobilisation needs
to be strengthened
to encourage
screening, promote
healthy lifestyles
and strengthen
treatment
adherence.
Reduce deaths
from TB and
AIDS by 20%
5.7% 6% 5.4% (0.6) Timely provision of
TB treatment and
ART.
70% of people
who require
ART are on
treatment
600 284 992 000
(70%)
734 308 (257 692) The failure to initiate
the targeted number
on ART points to a
need to strengthen
the continuum of
care.
52
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Medical Male
circumcision
among Gauteng
youth
51 205 138 841 94 059 (44 782) Challenges
in relation to
infrastructure and
appointment of staff
limited capacity to
perform MMC in
clinics.
Reduce deaths from TB through effective TB treatment
Cure rate 61% 82% 82.4% 0.4% Effective DOTS
support by CHWs
working with PHC
outreach teams,
availability of drugs
and well-functioning
laboratory system
contributed to the
achievement.
Reduce new HIV infections in babies
Transmission
rate
3.6% <5% 2.4% (2.6%) Result is based on
test conducted at six
weeks of age. More
pregnant women are
on ART and most
babies are receiving
nevirapine within 72
hours of birth.
Reduce death from AIDS through appropriate treatment, care and support for 80% of people living
with HIV (by 2016)
Total number
of adults and
children on ART
(cumulative)
600 284 992 000 734 308 (257 692) The failure to initiate
the targeted number
on ART points to a
need to strengthen
the continuum of
care.
53
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Improved client satisfaction rate
Client
satisfaction
rate for district
hospitals
65% 85% 66% (19%) Not achieved.
Challenges existed
in meeting National
Core Standards,
especially in relation
to cleanliness,
waiting times and
staff attitudes.
Increased level of effi ciency in PHC facilities
Total patient
headcount
(19.6 million)
22 711 585 21 000 000 23 063 294 2 063 294 Annual target of 21
million exceeded. A
contributory factor
may be the number
of patients seen in
their homes by ward-
based outreach
teams.
Utilisation rate:
PHC
(1.8 million)
2.0 2.5 2.0 (0.5) Many PHC patients
are still being treated
at higher levels of
care and renewed
efforts are needed
to redirect patients
to the appropriate
facility.
Utilisation rate:
PHC under 5
years
(4 million)
2 2.5 4.2 (0.5) Many PHC patients
are still being treated
at higher levels of
care and renewed
efforts are needed
to redirect patients
to the appropriate
facility.
Supervision rate
80%
86.5% 95% 90.7% (4.3%) Transport challenges
have obstructed
scheduled monthly
supervisory visits to
some facilities.
54
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Provincial PHC
expenditure per
head
(R 265.35)
R110 R225 R132.36 (R92.64) An increase in
patients, beyond the
targeted fi gure, led
to lower expenditure
per patient seen.
% complaints
resolved within
25 days
(100%)
100% 100% 94% (6%) The fi gure for
actual performance
is based on joint
audits conducted
by provincial and
national department
Increased level of effi ciency in district hospitals
Average length
of stay
( 3.5days)
3.5 days 3.0 days 3.2 days 0.2 days The condition of
each patient is
assessed at regular
intervals. Most
health conditions
treated at level 1
hospitals do not
require prolonged
treatment.
Caesarean
section rate
(16%)
22% <15% 21.2% (6.2%) Obstetrical
complications due
to late presentation
and HIV epidemic
increase caesarean
sections.
Bed utilisation
rate
(75%)
64% 75% 66.3% (8.7%) Level 1 cases are
still treated at
hospitals offering
higher levels of care
and not referred
back to district
hospitals.
55
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Expenditure
per patient-day
equivalent
(1 600)
R1 811 R1 250 R2 031.98 R781.98 Expenditure
substantially above
target may be due
to an increase in
surgery performed
at district hospitals.
Some district
hospitals are
assisting tertiary
hospitals with
caesarean sections
and this increases
costs.
Patient-day
equivalents -
Total
(825 000)
870 728 813 200 885 094 71 894 PDEs were
slightly higher
than projected.
Secondary and
tertiary hospitals
should continue
re-directing patients
to district hospitals
where appropriate.
OPD headcount
- Total
(870 950)
696 782 833 971 739 783 (94 188) The number
of outpatients
seen at district
hospitals was below
projection. However,
the PHC headcount
was higher than
projected and
regional hospital
OPDs also had more
visits than expected.
Patients may be
selecting these
facilities.
56
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Improved health and wellbeing with an emphasis on vulnerable groups
Number of
assistive
devices
provided
(31 092)
45 635 33 000 43251 10 251 A dedicated central
budget for assistive
devices augmented
facility budgets.
Number of
CHCs with 24-
hour access
as a percentage
of total number
of CHCs
25 32 26 (6) Financial constraints
have impeded
expansion of 24-
hour services. Only
one CHC was added
to those already
offering 24-hour
access.
Number of
fully trained
community
health workers
(cumulative)
0 3 000 2 058 (942) Insuffi cient funding
resulted in training
shortfall.
Number of
ward-based
outreach teams
established
(cumulative)
22 32 49 17 The target was
substantially
exceeded. The
intervention is
supported by the
Extended Public
Works Programme.
Professional
nurse clinical
workload (PHC)
31.7
consultations/
day
40
consultations/
day
32.9
consultations/
day
(7.1)
consultations/
day
PHC re-engineering
should improve
health system
effi ciency and
achieve a more
strongly nurse-driven
model.
57
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Doctor clinical
workload (PHC)
35.7
consultations/
day
30
consultations/
day
36.6
consultations/
day
6.6
consultations/
day
Workload of doctors
has increased as
a result of doctors
conducting outreach
to smaller clinics
that do not have a
permanent doctor
on site.
Provincial PHC
expenditure
per uninsured
person
R294 R400 R366 R34 There has been
an increase in
spending on PHC
per uninsured
resident which
reflects stronger
prioritisation of PHC.
PHC total
headcount
22 711 585 21 000 000 23 063 294 2 063 294 The number of
patient visits to PHC
facilities exceeded
the projection by
more than two
million.
PHC total
headcount
under 5 years
4 202 126 4 300 000 4 145 897 (154 103) Some patients may
still be choosing
hospital OPDs rather
than CHCs and
clinics. Ward-based
outreach teams
may be attending to
some problems in
the community.
Utilisation rate
- PHC
2.0 visits/
uninsured
resident
2.5 visits/
uninsured
resident
2.0 visits/
uninsured
resident
(0.5) visits/
uninsured
resident
On average, patients
visit facilities twice
a year which was
slightly less often
than expected.
Utilisation rate:
PHC under 5
years
4.2 visits/child 5.0 visits/
child
4.2 visits/child (0.8) visits/
child
Average number of
visits for children
under the age of fi ve
was slightly lower
than expected.
58
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Health Management and PHC Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Percentage
of fi xed PHC
facilities with
a monthly
supervisory visit
86.5% 95% 90.7% (4.3%) Cost containment
measures impacted
on availability
of transport for
supervisory visits.
This concern has
been addressed
and sub-district
management teams
will be strengthened
in 2013/14.
Expenditure per
PHC headcount
R110 R225 R 132.36 (R92.64) The increase in total
number of visits
contributed to low
expenditure per visit.
Finite resources
were stretched
to attend to more
patients.
Percentage
of complaints
of users of
PHC services
resolved within
60 days
100% 100% 94% (6%) The number of
complaints received
from patients and
public increased
from 3 100 in
2011/12 to 6 750 in
2012/13.
CHCs with a
resident doctor
rate
100% 100% 100% 0 All CHCs have a
resident medical
offi cer and a family
physician.
Number of
PHC facilities
assessed for
compliance
against the
National Core
Standards
72 72 282 210 There were joint
audits conducted
by provincial and
national health
departments.
59
Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: District Hospitals
District Hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Caesarean
section rate
22% 15% 21.2% 6.2% Some district
hospitals perform
caesarean sections
on behalf of
neighbouring
central and regional
hospitals.
Separations -
total
166 388 180 078 179 871 (207) Within projected
range.
Patient-day
equivalents -
total
870 728 813 200 885 094 71 894 Slightly higher PDEs
than the projected.
OPD
headcounts -
total
696 782 833 971 739783 (94 188) The number of
outpatients seen at
district hospitals was
below projection.
However, the PHC
headcount was
higher than projected
and regional hospital
OPDs also had more
visits than expected.
Patients may be
selecting these
facilities.
Average length
of stay
3.5 days 3.0 days 3.2 days 0.2 days Patients are assessed
at regular intervals
and discharged when
appropriate. The type
of conditions treated
at level 1 hospitals
do not usually require
prolonged treatment.
Bed utilisation rate
64% 75% 66.3% (8.7) Level 1 cases are still treated at hospitals offering higher levels of care and not referred back to district hospitals.
60
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Expenditure per patient-day equivalent (PDE)
R1 811 R1 250 R2 031.98 R781.98 Expenditure per patient-day exceeded projections. This could be due to the low bed utilisation and/or the increase in surgery (including caesarian sections) performed at district hospitals.
Percentage of complaints of users of district hospital services resolved within 25 days
100% 100% 87.4% (12.6%) Some complex complaints require more than 25 working days to resolve.
Percentage of District hospitals with Mortality and Morbidity meetings every month
10/10 10/10 10/10 0 The holding of mortality and morbidity meetings is encouraged and supported through meetings and workshops with clinical managers. The district clinical specialist teams have contributed to the practice of regular mortality and morbidity meetings.
District hospitals Patient Satisfaction rate
65% 85% 66% (19%) Hospitals experience challenges in meeting National Core Standards on cleanliness, waiting times and staff attitudes.
61
Gauteng Provincial Government | Health | Annual Report 2012/2013
District Hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Number
of district
hospitals
assessed for
compliance
against the 6
priorities of the
National Core
Standards
10 5 9 4 Improved capacity of inspectors enabled them to undertake more audits. There was joint auditing by provincial and national inspectors.
62
Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: Oral Health and Rehabilitation Services
Oral Health and Rehabilitation Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/2013
Comment on deviation
Number of
assistive
devices issued
45 635 33 000 43 251 10 251 There was a
dedicated central
budget for assistive
devices that
supplemented facility
budgets.
Number of
fi ssure sealants
placed
54 242 52 500 52 769 269 Performance was
within range of target.
Number of
dentures
delivered to
pensioners
5 690 5 500 6 906 1 406 The availability of
students in oral
health centres and
improvement in
pensioners’ grants
contributed to better
access to this service.
Number
of schools
learners on
tooth brushing
programmes
134 391 130 000 151 000 21 000 Target achieved
due to generous
donations of tooth
brushes and pastes
by private companies.
63
Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: HIV, AIDS, STIs and TB
HIV, AIDS, STIs and TB
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Number of people in high risk groups reached with peer education
555 479 700 000 933 059 233 059 Target achieved due to high output from peer educators.
Number of people reached with ward-based education
2 765 487 6 000 000 6 090 898 90 898 Target achieved due to increased implementation of ward-based outreach teams.
Number of CBO members reached with education and support
4 193 563 5 000 000 8 891825 3 891 825 Target substantially exceeded due to increased partnerships with community organisations that provided implementation capacity.
Numbers reached with media
6 438 000 6 000 000 7 281 848 1 281 848 Target achieved due to increased visibility of AIDS campaigns.
Number of civil society leaders trained on multi-sectoral AIDS programme
7 340 10 000 9 268 (732) Service contract delays impacted on the ability to achieve the target.
Number of government (GPG and municipal) managers trained on multi-sectoral programme
0 600 294 (306) Service contract delays impacted on the ability to achieve the target. Training will be completed during Q1 of 2013/14.
Number of people acccesing HCT
# 3 000 000 3 863 419 863 419 All health facilities offer HCT
64
Gauteng Provincial Government | Health | Annual Report 2012/2013
HIV, AIDS, STIs and TB
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Percentage of clients tested for HIV to those counselled (excl antenatal)
95.8% 95% 95.7% 0.7% Good quality pre-test counselling resulted in high uptake of testing.
Number of male condoms distributed
77 383 000 214 000 000 131 972 200 (82 027 800) The data includes data from DHIS (44 747 556) and data other sources (87 224 644). Limited stocks of condoms from suppliers impacted on the achievement of the target.
Number of female condoms distributed
600 834 2 782 000 2 368 915 (413 085) Limited national supply of female condoms.
Number of males circumcised
51 205 138 841 94 059 (44 782) The number of male circumcisions improved compared to the previous year.
Transmission rate from mother to child
3.6% <5% 2.4% 2.6% Improved PMTCT implementation.
Number of ART sites accredited
359 403 364 (39) Expansion was limited by infrastructural factors.
ARV drug Stock out rate
3.3% 0 6.1% (6.1%)Suppliers of drugs did not meet the demand.
Total number of adults on ART
564 520 942 000 693 136 (248 864) The failure to initiate targeted number on ART points to need to strengthen continuum of care.
# Indicator did not have baseline
65
Gauteng Provincial Government | Health | Annual Report 2012/2013
HIV, AIDS, STIs and TB
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Total number of children on ART
35 764 50 000 41 172 (828) The department is performing relatively well in identifying children requiring ART.
Male condom distribution rate
7.9 12 10.3 (1.7) Low stock from suppliers had an impact on distribution rate.
New smear-positive defaulter rate
5.7% 5.0% 4.80 0.2% Intensifi ed defaulter tracing led to fewer TB patients defaulting on treatment.
HCT testing rate
93% 95% 93.1% (1.9%) Good quality of pre-test counselling secured high uptake of testing.
PTB two-month smear conversion rate
82% 80% 83.4% 3.4% High sputum testing rate due to good monitoring of patients and education on importance of sputum assessments at two months.
Percentage of HIV-TB co-infected patients placed on ART
75% 45% 54.80% 9.8% More ART sites opened. Trained staff, availability of drugs, and TB patients knowing their HIV status contributed to achievement of target.
New smear-positive PTB cure rate
81.3% 82% 83.10% 1.1% Effective directly observed treatment support by CHW helped improve cure rate.
66
Gauteng Provincial Government | Health | Annual Report 2012/2013
HIV, AIDS, STIs and TB
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Smear result turn-around time under 48 hours
80% 82% 71% (11%) High staff turnover at some of the laboratories resulted in longer turn-around times.
Sub-programme: Maternal, Child and Women’s Health and Nutrition
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Number of facilities with maternity services newly certifi ed as BFHI
9 5 6 1 Target achieved due to commitment by management, training of healthcare providers and community participation.
Percentage of fi xed PHC facilities implementing IMCI
98.8% 98% 100% 2% Target achieved due to commitment by management and training of healthcare providers.
Vitamin A coverage 6-11 months
109.5% 90% 100.7% 10.7% Community mobilisation was sustained and there was good attendance at well-baby clinics.
Vitamin A coverage new (post partum mothers)
100.4% 90% 87.5% (2.5%) There was a minimal decline in postnatal coverage.
Antenatal clients initiated on AZT during antenatal care
78.7% 100% 78% (22%) Women with low haemoglobin are not given AZT.
67
Gauteng Provincial Government | Health | Annual Report 2012/2013
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Antenatal clients Nevirapine uptake
54.6% 80% 52.3% (27.7%) Women on ART do not require single dose nevirapine.
Baby nevirapine uptake
98.4% 100% 95.5% (4.5%) The gap between target and performance is partly due to babies dying before receiving nevirapine.
Antenatal clients initiated on HAART rate
80.5% 80% 83% 3% Nurses have been trained to initiate ART and treatment can commence on site.
Severe malnutrition under 5 years incidence
2.8% <3.5% 2.5% (1%) Target exceeded due to ongoing training, community mobilisation and surveillance.
Number (rate) of deliveries in health facility
203 865 220 000 211 144 (8 856) Deliveries increased by 7 279 compared to the previous fi nancial year.
Immunisation coverage under 1 year
114.6% 90% 107.9% 17.9% Training on effective vaccine management occurred in all districts. Coverage can exceed 100% of the estimated number of children when there is rapid migration or use of services by residents of other provinces.
68
Gauteng Provincial Government | Health | Annual Report 2012/2013
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Vitamin A coverage 12-59 months
47.7% 50% 46.32% (3.68%) Children in this age group are not regular clinic attendees unless sick. Coverage can be improved by training early childhood development centre managers.
Measles 1st dose under 1 year coverage
113.9% 90% 111.6% 21.6% All surveillance reporting units were visited twice this year. Under-performing units were visited more frequently. Coverage can exceed 100% of the estimated number of children when there is rapid migration or use of services by residents of other provinces.
Pneumococcal PCV 3rd dose coverage
102.8% 90% 109. 3% 19.3% Adequate vaccine stocks were available throughout the year. Coverage can exceed 100% of the estimated number of children when there is rapid migration or use of services by residents of other provinces.
69
Gauteng Provincial Government | Health | Annual Report 2012/2013
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Rotavirus (RV) 2nd dose coverage
111.8% 90% 112.4% 22.4% Personnel have been made aware of need to adhere strictly to the immunisation schedule for this vaccine. Coverage can exceed 100% of the estimated number of children when there is rapid migration or use of services by residents of other provinces.
Diarrhoea incidences under 5 years
5% <1.3% 4.1% 2.8% Hand washing practices still not adequate. An interdepartmental committee will be set up to consider socio-economic determinants of health. Awareness on the use of zinc will be promoted.
Pneumonia incidence under 5 years
4.7% <5% 3.7% 1.3% Target achieved.
Cervical cancer screening coverage
45% 56% 44.1% (11.9%) Target not achieved. The GDoH is three years into a 10-year cycle which should conclude with 70% of eligible women receiving screening.
Antenatal visits before 20 weeks’ rate
34.6% 40% 37.8% (2.2%) The target was not achieved in spite of social mobilisation activities.
70
Gauteng Provincial Government | Health | Annual Report 2012/2013
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Baby tested PCR positive six weeks after birth as a propotion of babies tested at six weeks
4.1% <5% 2.4% 2.6% There is a sustained reduction in mother-to-child transmission of HIV.
Couple-year protection rate
26.1% 45% 28.3% (16.7%) Data will be interrogated and if necessary programme adjustments will be made to achieve higher coverage.
Public Health Facilities Maternal mortality rate
145/100 000 live births
160/100 000 live births
117.3/100 000 live births
42.7/100 000 live births
The actual performance fi gure is an estimate derived from DHIS data. The offi cial fi gure will only become available when the next Saving Mothers report is published in 2014/15.
Delivery rate for women under 18 years
5.6% 6.5% 4.8% 1.7% Health promotion activities have contributed to the reduction in young mothers. There is a strong partnership between the departments of Health, Education and Social Development and support from development partners.
Public Health Facilities Infant mortality (under 1) rate
30/1000 live births
5.0/1000 live births
(25)/1000 live births
These are estimates from the DHIS. Data integrity needs to be addressed.
71
Gauteng Provincial Government | Health | Annual Report 2012/2013
Maternal, Child and Women’s Health and Nutrition
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Public Health Facilities Child mortality (under 5) rate
25/1000 live births
3.7/1000 live births
(21.3)/1000 live births
These are estimates from the DHIS. Data integrity needs to be addressed.
Malaria case fatality rate
1.3% <0.4% 1.1% 0.7% Cases imported from malaria- endemic areas present late at facilities and this often results in complications and deaths.
Cholera fatality rate
0% <1% 0.0 0 There is regular testing of tap and river water.
Cataract surgery rate
1 268/million 13 430/million
11 4 33/million (1 997) Target not achieved due to lack of dedicated cataract surgery budget in hospitals. Ring-fenced budget introduced in 2013/14.
72
Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 2 – District Health Services
2012/2013 2011/2012
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
District
management 529 506 512 335 17 171 318 577 434 769 (116 192)
Community
health clinics 1 970 362 1 884 133 86 229 1 477 412 1 439 244 38 168
Community
health centres 1 103 078 1 184 942 (81 864) 1 049 815 1 065 918 (16 103)
Community-
based services 978 352 919 224 59 128 748 767 823 889 (75 122)
HIV and AIDS 2 262 327 2 134 361 127 966 1 912 390 1 727 578 184 812
Nutrition 50 342 49 411 931 41 948 32 192 9 756
Coroner
services 147 971 126 423 21 548 144 905 129 981 14 924
District
hospitals 1 740 546 1 745 127 (4 581) 1 546 458 1 585 610 (39 152)
Total 8 782 484 8 555 956 226 528 7 240 272 7 239 181 1 091
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.3 Programme 3: Emergency Medical Services
Purpose of the programme
The purpose of the Emergency Medical Services
Programme (EMS) is to ensure rapid and effective
emergency medical care and transport as well as
effi cient planned patient transport, in accordance
with provincial norms and standards.
Developments during 2012/13
During 2012/13 EMS increased the vehicle fleet by
28 ambulances and six vehicles for planned patient
transport.
Response times remained a challenge in 2012/13.
However, the recapitalisation plan currently
being rolled out will address some of the existing
defi ciencies. The plan is briefly described below
under strategies to address underperformance.
Five ambulance bases in the province were
renovated and upgraded: two in Tshwane, two in
Johannesburg and one on the West Rand. This has
gone a long way to improving the accommodation
of EMS staff in the province.
EMS was at the forefront of service provision at the
2013 Africa Cup of Nations Soccer Tournament in
January and February 2013. Emergency services
were provided with a modest grant of R3 million from
the national health department. The tournament
was incident-free and declared successful.
The department has completed the process of
resuming direct management of Sedibeng EMS.
Strategies for addressing areas of underperformance
In terms of the recapitalisation plan, the department
will be procuring an additional 120 ambulances, 20
which will be dedicated to obstetric emergencies.
This will boost the total of number of dedicated
obstetric ambulances to 36 and strengthen efforts
to reduce maternal and neonatal deaths.
Other improvements that will be prioritised are:
reducing turn-around times for vehicle repairs and
maintenance; improving systems in the emergency
control centre; training more emergency care
practitioners; reducing time spent by ambulances
at hospitals; and operating across municipal
boundaries. Effective tracking devices will be
installed to monitor the fleet.
The department will foster relationships with
municipalities and ensure better reporting,
monitoring and evaluation in terms of the service
level agreement between the province and various
municipalities. 74
Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 3 – Emergency Medical Services
Emergency Medical Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Rostered
ambulances per
10 000 people
0.02 0.05 0.023/1000
population
(0.027) The department
will procure 120
ambulances,
including 20 for
obstetric care, as
part of the EMS
recapitalisation
project. Other issues
impacting on systems
effectiveness will be
addressed.
Priority 1 calls
with a response
time <15
minutes in an
urban area
33% 70% 52% (18%) Shortages of
ambulances and staff
continue to impact
negatively on the
achievement of the
target. Incomplete
data remains a
challenge.
Priority 1 calls
with a response
time of <40
minutes in rural
areas
100% 100% 95% (5%) The indicator reflects
the situation in
Metsweding, the only
rural sub-district.
Progress has been
made on raising
performance above
95%.
All calls with
a response
time within 60
minutes
93% 85% 77% (8%) Shortage of
ambulances and
staff members have
impacted on the
achievement of the
target.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 3 – Emergency Medical Services
2012/2013 2011/2012
Final appropriation
Actualexpenditure
(Over)/under
expenditure
Final appropriation
Actualexpenditure
(Over)/under
expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Emergency
transport
859 869 916 241 (56 372) 692 104 557 465 134 639
Planned
patient
transport
199 415 230 990 (31 575) 95 566 139 079 43 513
Total 1 059 284 1 147 231 (87 947) 787 670 696 544 91 126
76
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.4 Programme 4: Provincial Hospital Services
Programme purpose
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.
List of sub-programmes
• General (Regional) Hospitals.
• Tuberculosis Hospitals.
• Psychiatric hospitals.
Increased effi ciency in hospitals
Effi ciency gains by regional hospitals may be
attributed to hospitals rationalising some services.
These hospitals function as complexes within
the referral clusters and frequent support visits
are provided to them by central offi ce managers.
Out-patient headcounts have declined and this
appears to be due to down-referral of patients with
chronic conditions to clinics for repeat medication.
The lower headcounts have been associated with
reduced out-patient waiting times.
In 2012/13 there was an improvement in the general
cleanliness of hospitals in accordance with quality
of care priorities identifi ed by the Minister of Health.
Cluster meetings, headed by central hospitals, are
held at least once every two months to ensure that
services across levels of care are seamless. All
hospitals have effi cient complaints management
systems in place. Tembisa Hospital in Ekurhuleni
and Edenvale Hospital in Johannesburg received
awards from the national health department for
excellent waste management.
Some hospitals still experience high numbers of
inpatients in medical wards. The average cost per
patient-day equivalent remains high across regional
hospitals. This may be due to price increases for
medication, laboratory and blood services, surgical
consumables and food.
Reduction in maternal and child mortality
All hospitals are required to have maternal
mobidity and mortality committee meetings These
committees meet regularly to discuss matters
related to maternal and child mortality, including
ways to improve the quality of maternal and child
health care. Infection control measures have been
strengthened at all hospitals.
Strategies to address areas of under-performance
Overcrowding continues to occur at regional
hospitals in Johannesburg, West Rand and
Ekurhuleni. The completion of the Jabulani/Zola
Hospital and commissioning of Natalspruit Hospital
will relieve this situation to some extend. In addition,
there are plans to activate beds at Discoverers and
Lenasia South CHCs as they are converted into
district hospitals. There is also a long-term plan
to revitalise other hospitals to ensure that they
function optimally.
Tuberculosis Hospitals
Sizwe Hospital is designated as the only specialized
hospital in Gauteng for treatment of MDR-TB
and XDR-TB. It serves as the province’s central
refaral centre for outpatients requiring drugs for
the treatment of drug-resistant forms of TB. The
province is moving towards a more decentralised
model of managing drug-resistant TB.
Psychiatric Hospitals
This programme provides specialised inpatient and
outpatient services for adults and children with
mental illness or profound intellectual disability.
These services are provided at psychiatric units
in general hospitals and in specialised psychiatric
hospitals. The department provides forensic
psychiatric services to adults and adolescents
referred through the Criminal Procedures Act.
The department also has a contract with Life
Esidimeni to provide services for older persons with
chronic psychiatric disability or severe intellectual
disability who cannot be managed at home or by
77
Gauteng Provincial Government | Health | Annual Report 2012/2013
NGOs. A total of 2 260 beds in fi ve facilities are
made available through this arrangement, which
helps to improve bed utilisation at the department’s
specialised psychiatric hospitals.
Oral and Dental Health Centres
Training of oral health professionals and service
delivery at the University of Pretoria Oral Health
Centre was strengthened by additional upgrading
of facilities and equipment and good management.
At Medunsa Oral Health Centre the second
phase of the digitisation of the maxillofacial and
oral radiology unit got underway. Cabling was
completed and some screens had been installed in
clinical areas by the end of the fi nancial year.
At Wits Oral Health Centre heads of department
were appointed for orthodontics and the
clinical units, oral medicine and periodontology,
maxillofacial and oral surgery. The HPCSA
accredited a postgraduate specialist programme
in oral medicine and periodontology. The Wits Oral
Health School hosted the International Association
of Dental Research 2012 conference and Prof
Veerasamy Yengopalwas inaugurated president of
IADR South African division.
A total of 970 patients, mainly children and people
with special needs, received treatment under general
anaesthesia. There were outreach services to more
than 30 schools and more than 2 500 patients
were seen for oral health promotion, preventive and
corrective care.
78
Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 4 - Provincial Hospitals
Sub-programme: General (Regional) Hospitals
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Caesarean
section rate
30% 18% 32% 14% Denominator does
not account for
normal vertex
deliveries. Regional
hospitals serve as
referral centres
for complicated
caesarean section
cases.
Separations-
Total
443 854 546 016 453 399 (92 617) Law seperations
could be attributed
to improved level
of care, down
referral and effective
clustering
Patient-day
equivalents
(PDEs)-Total
2 650 397 3 383 058 2 609 924 (773 134) PDEs slightly lower
than previous
fi nancial year.
Out-patient
headcount-Total
2 022 677 1 700 000 1 853 400 153 400 Slightly above target
because some
patients continue
to bypass district
hospitals and present
at regional hospitals.
Anecdotal evidence
shows that patients
prefer to be seen and
treated by specialists
Average length
of stay
4.8 days 4.8 days 4.1 days (0.7) days Within range.
Improvement
attributed to better
case management.
Bed utilisation
rate
79% 86% 80% (6%) Minimal deviation.
Indicator also
points to good case
management of level
2 bates
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: General (Regional) Hospitals
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Expenditure
per patient day
equivalent (PDE)
R1 748 R1 128 R1 964 R836 Expenditure
is affected by
price increases
in medication,
laboratory and blood
services, surgical
consumables,
salaries and food.
Percentage
of complaints
of users of
the hospitals
services
resolved within
25 days
98.7% 95% 90% 5% There are complex
cases that take longer
than 25 working
days to resolve.
Many of these are
serious complaints
sometimes involving
adverse events.
Percentage
of regional
hospitals
with Monthly
Mortality and
Morbidity
meetings
100% 100% 100% 0% Target achieved.
Workshops were
conducted with
CEOs on mandatory
reporting on mortality
and morbidity. Quality
improvement plans
based on discussions
at these meetings are
instituted.
Regional
Hospitals
Patient
satisfaction rate
(percentage
of users of
services at
the hospital
satisfi ed with
the services
received)
69.7% 85% 67% 18% Training to address
staff attitudes and
improve patient
experiences is being
planned together with
private partners.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: General (Regional) Hospitals
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/2013
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Number
of regional
hospitals
assessed for
compliance with
the six priorities
of the National
Core Standards
11 6 9 3 Target exceeded
due to improved
capacity of inspectors
conducting audits
and joint auditing
by provincial and
national inspectors.
Sub-programme: Specialised Hospitals (Tuberculosis)
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Average length
of stay in Sizwe
Infectious
Disease
Hospital
120 days 120 days 104.0 days (16) days The nature of
treatment for drug-
resistant TB requires
protracted hospital
admission.
Bed occupancy
rate (BOR)
in Sizwe
Infectious
Disease
Hospital
75% 60% 55% (5%) More patients are
now treated for
drug-resistant TB
while residing in the
community, in line
with the national
policy. Optimal
utilisation of surplus
beds to be explored.
Expenditure
per patient-
day equivalent
(PDE) in Sizwe
Infectious
Disease
Hospital
R1 700 R1 750 R2 177 (R 427) Expenditure is
affected by price
rises for items such
as medication,
laboratory
services, surgical
consumables and
food.
81
Gauteng Provincial Government | Health | Annual Report 2012/2013
Sub-programme: Specialised Hospitals (Psychiatric)
Performance Indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/2013
Comment on deviation
Number of
dedicated acute
beds for adults
at designated
psychiatric
units in general
hospitals
419 480 419 (61) The annual target
was not achieved
mainly due to delays
in infrastructure
projects.
Number of
contracted
(life Esidimeni)
beds utilised for
chronic users
(Alos >1 year
as a % of total
beds)
79% 60% 80% (20%) The annual target
was not achieved.
The number of
chronic patients
requiring full-time
care is increasing.
There are few NGOs
that provide such
services. Families
experience diffi culties
managing patients at
home.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 4 – Provincial Hospitals
2012/2013 2011/2012
Final appropriation
Actualexpenditure
(Over)/under
expenditure
Final appropriation
Actualexpenditure
(Over)/under
expenditure
R’000 R’000 R’000 R’000 R’000 R’000
General hospitals 4 826 251 5 150 556 (324 305) 3 885 242 4 666 316 (781 074)
Tuberculosis
hospital 350 003 156 715 193 288 300 468 136 029 164 439
Psychiatric/
mental
healthcare
hospitals 956 038 893 466 62 572 723 777 785 378 (61 601)
Dental training
hospitals 355 284 329 030 26 254 305 108 293 615 11 493
Other specialised
hospitals 59 320 52 673 6 647 45 350 46 761 (1 411)
Total 6 546 896 6 582 440 (35 544) 5 259 945 5 928 099 (668 154)
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.5 Programme 5: Central Hospital Services
Programme purpose
To provide highly specialised healthcare services,
platforms for the training of health workers, sites
for research, and to serve as specialist referral
centres for regional, tertiary hospitals as well as
neighbouring provinces and SADC .
There are four central hospitals in Gauteng: Steve
Biko Academic Hospital, Dr George Mukhari
Hospital, Charlotte Maxeke Johannesburg
Academic Hospital and Chris Hani Baragwanath
Academic Hospital.
Strengthening health system effectiveness
For the 2012/13 fi nancial year, hospital effi ciency
indicators such as bed occupancy rate and average
length of stay for central hospitals were within
set targets, except at Dr George Mukhari Hospital
where bed occupancy remained low throughout the
year. Caesarean section rates remained high at all
central hospitals. This may be attributed to the fact
that central hospitals deal with complicated cases
that have been refared.
By structuring the relationship between referring
institutions the department has ensured that
patients benefi t from a well-functioning referral
system. Dr George Mukhari Hospital received a
donation from Royal Bafokeng Holdings to build a
burns unit. The project was in the planning phase
in 2012/13 and the process was progressing well.
Reducing maternal and child mortality
The four central hospitals hold regular maternal
morbidity and mortality meetings to reduce deaths
related to pregnancy and childbirth. Infection
control is well managed in these hospitals.
The high burden of disease and trauma remains a
challenge for central hospitals. There is always a
demand for acute surgery and this results in longer
waiting times for elective surgery. The department
is constantly exploring ways to reduce the elective
surgery backlog. Central hospitals resources
continue to be severely stretched since they treat
large numbers of patients from Gauteng and
beyond while serving as teaching platforms. Cost
containment measures are in place at all central
hospitals.
Strategies to overcome areas of under
performance
The challenges experienced by hospitals are
systems related. The Turnaround Strategy of the
department prioritises hospitals as an area of
intervention. Support systems for infrastructure
maintenance and capital projects have been
introduced at various hospitals and these also serve
to improve the functionality of electromechanical
equipment. Quality improvement programmes to
enhance patient experiences have been developed
and processes have been introduced to address
medico-legal issues arising in hospitals.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 5 – Central Hospital Services
Central Hospital Services
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Average length
of stay
5.4 days 6.4 days 5.3 days 1.1 days The shorter length
of stay can be
attributed to
improved case
management in
hospitals.
Caesarean
section rate
42% 40% 41% 1% Caesarean sections
are within range of
target.
Bed utilisation
rate
74% 80.5% 77% (3.5%) Bed utilisation has
increased in the
last year. It was still
slightly below target
due to careful case
management.
Expenditure
per patient
day equivalent
(PDE)
R1 748 R1 744 R2 950 R1 206 Expenditure is
affected by price
rises for items such
as medication,
laboratory and blood
services, surgical
consumables,
salaries and food.
Patient-day
equivalents
2 561 461 2 497 823 2 615 032 117 209 Actual numbers
exceeded the target
and last year’s fi gure.
Central hospitals
in Gauteng receive
referrals from
within the country
and across the SA
borders.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Central Hospital Services
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
OPD
headcount-
total
2 603 663 2 813 215 2 597 531 (215 684) Actual performance
was lower than
projected and
lower than previous
year. This is due
to improved down
refferals to lower
levels of care.
Separations
total
306 966 277 917 318 805 40 888 Number of
separations is
consistent with
the high number of
patients referred to
level 3 hospitals from
within SA and SADC.
Programme: Central Hospital Services
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement 2011/2012
Planned target
2012/2013
Actual achievement2012/2013
Deviation from planned
target 2012/2013
Comment on deviation
Client
satisfaction rate
(Percentage of
users of service
at the hospital
satisfi ed with
the services
received)
80% 85% 67% (18%) Central hospitals
are not complying
with aspects of
the National Core
Standards such
as cleanliness,
waiting times and
staff attitudes.
Hospital governance
structures will be
involved when
assessments on
core standards are
conducted.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Programme: Central Hospital Services
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement 2011/2012
Planned target
2012/2013
Actual achievement2012/2013
Deviation from planned
target 2012/2013
Comment on deviation
Percentage
of complaints
of users of
the hospital
services
resolved within
25 days
95.7% 95% 87.7% (7.3%) Target not achieved.
However, workshops
conducted at the
CEOs’ Forum dealt
with mandatory
reporting on
complaints
and addressing
complaints
mechanisms in
quality improvement
plans.
Monthly
mortality and
morbidity
meetings
100% 100% 100% 0% Target achieved.
Workshops
during the CEOs’
Forum dealt with
mandatory reporting
on morbidity and
mortality and
incorporation
of this in quality
improvement
initiatives.
Hospitals
assessed for
compliance
against the six
priorities of the
National Core
Standards
Yes Yes Yes None There were joint
audits at all central
hospitals conducted
by provincial
and national
inspectors. Capacity
of inspectors to
undertake audits has
improved.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 5 – Central Hospital Services
2012/2013 2011/2012
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
Central
hospital
services 7 599 859 7 799 913 (233 054) 6 778 355 7 131 562 (353 207)Total 7 566 859 7 799 913 (233 054) 6 778 355 7 131 562 (353 207)
Performance indicators: Steve Biko Academic Hospital
Steve Biko Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Caesarean
section rate
59% 40% 62% 22% Caesarean section
rate exceeded limit
substantially. This
was due to the high
rate of obstetric
emergencies. Better
risk identifi cation
is needed during
antenatal care.
Hospital provides
obstetric services
only for complicated
maternity cases.
Normal deliveries are
handled in the nearby
Tshwane district
hospital, Mamelodi
and in Stanza Bopape
CHC
Separations-
total
41 897 60 000 42 270 (17 730) Separations are
slightly higher than in
the previous year.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Steve Biko Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Patient day
equivalent-
total
428 318 39 000 387 293 348 293 The target was hugely
exceeded. The target
clearly needs to be
revised.
OPD headcount-
total
601 403 710 000 478 075 (231 925) Even though the
active reffering
of patients is
implemented, still
having inapropriate
(level of care and
catchment area)
patients coming to
hospital
Average length
of stay
5.3 days 6 days 5.5 days (0.5) days Management and
processing of
patients improved,
resulting in quicker
discharges. Limited
theatre time due to
nursing shortages
extends length of stay
for some patients.
Bed utilisation
rate
76% 85% 77% (8%) The sharp drop in bed
occupancy over the
festive season affects
the average for the
year.
Expenditure
per patient day
equivalent (PDE)
R3 300 R3 200 R3 899 (R 699) Cost per PDE is
affected by high cost
of healthcare due to
medical inflation and
salaries of health
professionals on
occupation-specifi c
dispensation.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Steve Biko Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Percentage
of complaints
of users of
the hospital
services
resolved within
25 days
96.2% 95% 97% 2% Target achieved due
to adequate numbers
of fully trained and
dedicated complaints
personnel.
Monthly
Mortality and
Morbidity
meetings
Yes Yes Yes 0% Target achieved
due to continuous
support meetings
and individualised
workshops with all
clinical managers.
Percentage of
users of service
at the hospital
satisfi ed with
the services
received
(Hospital patient
satisfaction
rate)
# 85% 67% (18%) Not achieved due
to challenges in
compliance with
National Core
Standards in areas of
cleanliness, waiting
times and staff
attitudes.
Hospitals
assessed for
compliance
against the six
priorities of the
National Core
Standards
# Yes Yes None There were joint
audits conducted
by provincial and
national inspectors.
Capacity of
inspectors to perform
audits has improved.
# Indicator did not have baseline
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Dr George Mukhari Hospita Dr George Mukhari Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Caesarean
section rate
42% 41% 35% 6% High rate of normal
vaginal deliveries
due to large number
of “walk-in” (non-
referred) patients.
Separations-
total
50 163 51 882 55 512 3 630 Hospital is located
in an area where
there are no regional
hospitals. It therefore
sees a high number
of patients and a
mixture of level 2 and
3 patients.
Patient day
equivalent-
total
492 163 586 987 534 716 (52 571) Underperformance
in terms of
projection was due
to insuffi cient ICU
beds and shortages
of equipment and
consumables.
OPD headcount-
total
288 153 358 754 348 646 10 108 Target achieved and
utilisation of OPD is
increasing. Systems
are to be in place to
maintain this.
Average length
of stay
7.8 days 5.5 days 7.3 days (1.8 days) Patients are staying
longer than expected
because of long
waiting times for
surgical procedures
due to shortages of
consumables and
insuffi cient ICU beds.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Dr George Mukhari Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Bed utilisation
rate
68% 74% 72% (2%) Insuffi cient ICU
beds and shortage
of equipment and
consumables.
Expenditure
per patient- day
equivalent (PDE)
R2 518 R1 877 R2 456 R579 Cost per PDE is
higher than target
due to payments of
accrued debts and an
unrealistic target.
Percentage
of complaints
of users of
the hospital
services
resolved within
25 days
96% 95% 97% 2% Target achieved due
to adequate skilled,
trained and dedicated
complaints personnel.
Monthly
Mortality and
Morbidity
meetings
Yes Yes Yes 0 Target achieved
due to continuous
support meetings and
workshops with all
clinical managers.
Percentage of
users of service
at the hospital
satisfi ed with
the services
received
(Hospital patient
satisfaction
rate)
# 85% 67% (18%) Not achieved due
to challenges in
complying with
National Core
Standards in respect
of cleanliness, waiting
times and staff
attitudes.
Hospitals
assessed for
compliance
against the six
priorities of the
National Core
Standards
# Yes Yes 0 Target achieved
due to effi ciency of
inspectors and joint
audits by provincial
and national
inspectors.
# Indicator did not have baseline
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Charlotte Maxeke Johannesburg Academic Hospital
Charlotte Maxeke Johannesburg Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Caesarean
section rate
50% 46% 51% 4.9% The caesarean
section rate is higher
than the target as the
hospital treats a high
number of unbooked
cases.
Separations-
total
72 457 50 724 92 517 41 793 Separations were
higher than in the
previous fi nancial
year and well over
projection.
Patient day
equivalent-
total
779 068 781 774 781 843 (4 112) Target achieved.
OPD headcount-
total
1 218 727 1 265 897 1 225 775 (40 122) Actual fi gure within
acceptable range of
target. Hospital will
strive to maintain
these volumes of
patients at OPD.
Average length
of stay (ALOS)
5.0 days 7 days 3.9 days 3.1 days A revised formula
has been adopted for
calculation of ALOS
and this is the main
reason for deviation
from the target.
Bed utilisation
rate
83% 87% 83% (4.2%) Rate is only slightly
lower than target
due to increase in
refferals from cluster
hospitals and inter-
provincial hospital
transfer
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Charlotte Maxeke Johannesburg Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Expenditure
per patient day
equivalent (PDE)
R2 565 R2 172 R2 640 R 468 Deviation due to
need to clear billings
accrued from
previous fi nanciajl
year.
Percentage
of complaints
of users of
the hospital
services
resolved within
25 days
95.7% 95% 97% 2% Target exceeded
due to skilled, fully
trained and dedicated
complaints personnel
and an increase
in complaints
managers. Also
assisted by a
workshop for CEOs
on compliance
with complaints
standards.
Monthly
Mortality and
Morbidity
meetings
Yes Yes Yes 0 Target achieved due
to continuous support
and workshops
with all institutional
clinical managers.
Percentage of
users of service
at the hospital
satisfi ed with
the services
received
(Hospital patient
satisfaction
rate)
# 85% 67% (18%) Not achieved due
to challenges in
meeting National
Core Standards
particularly in relation
to cleanliness, waiting
times and staff
attitudes.
Hospitals
assessed for
compliance
against the six
priorities of the
National Core
Standards
# Yes Yes 0 Target achieved
as inspectors now
conduct audits
effi ciently and there
have been joint audits
by national and
provincial inspectors.
# Indicator did not have baseline
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Chris Hani Baragwanath Academic Hospital
Chris Hani Baragwanath Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Caesarean
section rate
36% 33% 36% 3% The fi gures reflect
the high proportion of
complex cases dealt
with and attendance
to unbooked
emergencies.
Separations-
total
142 449 115 311 128 506 13 195 Separations slightly
lower than previous
year but still above
projection.
Patient day
equivalent-
total
861 911 739 062 911 180 172 118 There were more
than 100 000 more
admissions in
2012/13 than in the
previous year.
OPD headcount-
total
495 380 478 564 545 035 66 471 Hospital still attends
to level 1 and 2
patients who have
bypassed facilities
offering lower levels
of care.
Average length
of stay (ALOS)
4.8 days 5.8 days 5.5 days 0.3 days Observed ALOS
is slightly shorter
than target and
can be attributed
to improved case
management.
Bed utilisation
rate
72% 78.7% 77% (1.7) Slightly below target
due to improved case
management.
Expenditure
per patient day
equivalent (PDE)
R 2 822 R1 917 R3 101 (R1 184) Expenditure was
higher than the target
throughout the year.
This suggests a need
to review expenditure
target.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Chris Hani Baragwanath Academic Hospital
Strategic objectives: Increased level of effi ciency in hospitals
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Percentage
of complaints
of users of
the hospital
services
resolved within
25 days
96% 95% 97% (2%) Target achieved due
to adequate skilled,
trained and dedicated
complaints personnel.
Monthly
Mortality and
Morbidity
meetings
Yes Yes Yes 0 Target achieved
due to continuous
support meetings and
workshops with all
clinical managers.
Percentage of
users of service
at the hospital
satisfi ed with
the services
received
(Hospital patient
satisfaction
rate)
# 85% 67% 18% Not achieved due
to challenges in
meeting National
Core Standards
particularly in respect
of cleanliness, waiting
times and staff
attitudes.
Hospitals
assessed for
compliance
against the six
priorities of the
National Core
Standards
# yes Yes 0 Target achieved as
both national and
provincial inspectors
participated in such
audits and achieved
effi ciency in their
operations.
# Indicator did not have baseline
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.6 Programme 6: Health Sciences and Training
Purpose
The Health Sciences and Training Programme
is strategically positioned to plan, produce and
manage the education, training and development
needs of the department. It is designed to comply
with relevant legislative and policy imperatives 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 the HIV,
AIDS, STI and TB programmes and the development
of NHI.
List of sub-programmes
• Professional Development.
• Leadership Management and Skills Develop-
ment.
• Employee Health and Wellness Programme.
Strategic objectives
• Improve achievement of national norms for sup-
ply of health professionals.
• Improve compliance with legislative framework.
Professional Development Sub-programme
Nursing education
The department trains various categories of nurses
in accordance with the legislative framework
of the South African Nursing Council and the
National Human Resources for Health Strategy.
The department provides mandatory community
service placements for graduates with four-year
diplomas and degrees which cover general nursing,
psychiatric and community nursing and midwifery.
The intake of nurses annually is informed by the
targets in the performance plan. Appropriate
numbers are accepted in various categories of
nursing (including the category of mid-level enrolled
nurses) for the range of services offered in the
province.
The sub-programme supports and co-ordinates the
activities of six nursing colleges and ensures that
they meet the requirements of the South African
Nursing Council. Hospitals and clinics in the
province provide a platform for experiential learning
for nursing students from all these colleges.
During the year under review, the number of nursing
students in training in all courses and at all levels of
training was 6 327. The total intake during 2012/13
was 1 341.
A total of 2 327 nurses graduated in various
categories. These graduates comprised:
• Basic training graduates: 1 729.
• Post-basic training graduates: 598.
A total of 696 professional nurses were placed in
health institutions for community service.
The composition of basic nursing training graduates
in 2012/13 appears in the table below.
Table 7: Composition of 2012/13 basic nursing
graduates
Category Number
Professional nurses: four-year degree 114
Professional nurses: four-year diploma 651
Professional nurses: bridging course 169
Enrolled nurses: two-year course 617
Enrolled nurses: exiting from four-year
course 78
Enrolled nursing auxiliaries: exiting
from four-year course 100
TOTAL 1 729
The training of specialist nurses is informed by
the strategic priorities and needs analysis of the
province. Output increased slightly from 588 in
2011 to 598 in 2012. In response to the need for
advanced midwives, the number of graduates for
this programme was 79 in 2012 and the number of
critical care nursing graduates was 72.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
The nature of post-basic clinical training provided to
professional nurses is indicated in the table below.
Table 8: Fields of study of post-basic nursing
graduates in 2012/13
Field of study Number
Primary healthcare 137
Psychiatric nursing 17
Child nursing 52
Ophthalmic nursing 17
Advanced midwifery and neonatology 79
Midwifery 120
Orthopaedic nursing 21
Critical care nursing 72
Trauma and emergency nursing 23
Nephrology nursing 14
Operating theatre nursing 38
Oncology nursing 8
TOTAL 598
While the provincial nursing colleges produce the
largest number of nurses in the province, there are
quite a number of private sector nursing schools
in Gauteng. Thirteen private nursing schools have
entered into agreements with the department and
place their students in various Gauteng hospitals
for clinical experiential learning. The benefi t to the
department has been that some graduates from
these schools seek employment in provincial health
establishments.
Nursing as a career of choice was marketed through
career exhibitions, open days and visits to schools
throughout the year. By providing prospective
candidates with information about the selection
criteria they are able to make an informed decision
about applying for training.
The Minister of Health launched the National
Strategy for Nursing Education and Practice in
March 2013. Nursing colleges are developing a
provincial implementation plan for the nursing
education component.
Professional development
Professional development entails education,
training and development of all health
professionals, allied health professionals and mid-
level workers for hospitals, district health facilities
and health programmes. The directorate also
attends to job creation and career progression
through the management of clinical learnerships
and internships. Substantial formal employment
is created each year through the placement of
medical interns, community service professionals
and bursary benefi ciaries in the province’s health
facilities.
Bursaries
Through its bursary section the department
aims to produce, recruit and retain skilled staff
in occupations for which it has a high need.
Bursaries are awarded to full-time students not in
the employ of the department (“external” students)
and part-time students already working for the
department. Where possible the department
seeks to assist young people with good academic
performance from disadvantaged environments
gain qualifi cations in the health sciences.
The bursary fund complies with the PFMA and
Treasury Regulations and supports the national
Human Resources for Health Strategy. Bursary
funding is determined by service priorities. Bursary
benefi ciaries are contractually bound to serve the
department for a period equivalent to the period of
funded study.
During 2012/13 a total of 390 new bursaries were
provided, 242 for full-time courses and 148 for part-
time studies. The following are areas of scarce
skills that were identifi ed by the department for full-
time study: medicine, podiatry, pharmacy, dietetics,
physiotherapy, clinical engineering, speech and
hearing therapy, occupational therapy, medical
physics, oral hygiene, clinical technology, diagnostic
radiography and clinical associates.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
The following part-time courses were funded
through the bursary fund: post graduate nursing
(BCur, honours and master’s degrees, nursing
education, nursing management, midwifery and
psychiatric nursing), master’s in public health,
post-graduate diploma in HIV and AIDS and the
diploma in occupational health. In the areas of
management and administrative support the
following were funded: graduate and post graduate
degrees in information technology, human resource
management, public administration, labour law and
BCom.
With 4 161 bursaries being maintained from earlier
years, the intake for 2012/13 brought the number of
bursary benefi ciaries to 4 397.
Cuban medical programme
Through the 1996 bilateral cooperation agreement
between South Africa and Cuba, the department
has participated in programmes to train medical
students in Cuba. In 2011 and 2012 a group of
20 students from Gauteng were among the 80
receiving scholarships for Cuban study. A larger
group of 90 from Gauteng was recruited at the
end of 2012, bringing the total number awarded
scholarships from this province to 110. However,
four students have returned from Cuba due to
illness or pregnancy.
Professional services support
Community service is a statutory requirement for
health professionals. During 2012 the department
placed 220 medical doctors and 448 allied health
professionals in community service positions.
In compliance with the HPCSA regulations, 417
medical interns were placed in 13 accredited
health institutions in Gauteng for the fi rst year
of medical internship and 398 medical interns
completed their second year of internship. All these
health professionals are formally employed in the
services and contribute to the job creation agenda
of government.
Continuing professional development
Short clinical courses conducted for health
professionals are informed by strategic service
priorities and an analysis of training needs. These
courses are accredited for continuing professional
development (CPD) points which enable health
professionals to maintain registration. A total of
1 306 health professionals, including doctors,
participated in clinical short courses.
Eleven clinical technologists and two medical
orthotics and prosthetics interns completed a
one-year internship in central hospitals and at
the Orthopaedic Workshop in Tambo Memorial
Hospital.
Mid-level workers
The production of the mid-level workers is informed
by the national human resource strategy, the need
to address critical shortages of skills in the services
and the human resources component of the
department’s Turnaround Strategy.
Clinical associates:
A total of 49 clinical associates in all years of
study received bursaries during 2012/13. Of these,
13 graduated at the end of 2012. These clinical
associates were placed in various district hospitals
under the supervision of family physicians. They
play a signifi cant role in relieving the pressures on
services arising from a shortage of doctors. Their
scope of practice is determined by the HPCSA.
Pharmacist assistants:
In 2012/13, a total of 616 learners were in training
or recruited for training as pharmacist assistants.
Of these, 220 were employees from hospitals within
the department. A group of 45 learners completed
their courses during the year, 34 at basic level and
11 at post-basic level. The number of learners
actually undergoing training in 2012/13 was 416,
while a further 155 were waiting to commence
training pending the registration of pharmacist
tutors by the Pharmacy Council.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
The training of pharmacist assistants is an integral
part of the Turnaround Strategy. It is also an
important aspect of the re-engineering of PHC and
the expansion of the HIV and AIDS programme
Enrolled nurses working in maternity settings:
In-service training of the enrolled nurses working in
maternity settings commenced at the end of July
and 19 enrolled nurses completed the training in
January 2013. Two new groups were to commence
training before the end of April 2013. It is envisaged
that this training will improve the quality of services
in midwifery units and contribute to the reduction in
maternal and neonatal deaths.
Health Professions Training and Development Grant
The Health Professions Training and Development
Grant (HPTDG) is an allocation from the National
Treasury that supplements the provincial health
budget in all academic hospitals and faculties of
health sciences. It is aimed at sustaining a quality
teaching platform for health professionals.
The HPTDG’s purpose and overall policy direction in
2012/13 was to:
• Assist provinces to fund service costs associat-
ed with training of health science trainees.
• Establish clinical teaching and training capacity
in provinces that lack this capacity.
• Co-fund the expansion of undergraduate medi-
cal education in 2012 and in subsequent years
until 2025.
The HPDTG is essentially a top-up grant for service
costs related to training. It also benefi ts district
hospitals and PHC services in instances where
teaching and learning are shifted from tertiary
institutions to these services.
In 2012/13 the grant amounted to R725 310 000.
It is governed by the Division of Revenue Act which
requires monthly and quarterly reporting on its
utilisation. The entire amount allocated to Gauteng
was used in 2012/13.
In the year under review, a total of 22 438 students
in medicine, nursing and allied health professions
were enrolled in Gauteng’s institutions of higher
learning. These comprised 17 426 undergraduates
and 5 012 post-graduates. An estimated 15 000 of
these students used the department’s experiential
learning platform which is supported partially by
the HPTDG.
Gauteng institutions of higher learning produced
4 180 graduates in the health sciences in 2012/13.
Of these, 2 579 completed under-graduate degrees
while 1 601 earned post-graduate qualifi cations.
Table 9: Breakdown of health sciences graduates
from Gauteng institutions 2012/13
Field of study Number
Medicine (including specialists) 948
Nursing 2 060
Allied health professions 601
Other 534
Doctoral degrees 37
TOTAL 4 180
While graduates in medicine and allied health
professions are allocated to various provinces
for internships and community service, nearly all
nursing graduates have attended provincial nursing
colleges and take up employment in GDoH facilities.
Regional training centres
Training in the regional training centres is informed
by the National Strategic Plan for HIV, STI and
TB 2012-2016, the National 10-Point Plan, the
Negotiated Service Delivery Agreement (NSDA),
and the Provincial HIV/AIDS Strategy and related
operational plan.
The regional training centres have been created in
terms of a nationally driven project to expand the
learning and development platform by utilising
internal knowledge and expertise while drawing
on best practice approaches both nationally and
internationally. The project’s core strategic function
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Gauteng Provincial Government | Health | Annual Report 2012/2013
is to strengthen the HIV and AIDS programme but
the centres also serve as broader training and development platforms for hospitals, districts and priority health programmes. The centres are funded by the national conditional grant for HIV and AIDS.
In the year under review, 10 546 health professionals, mid-level workers and community health workers participated in skills-building courses to equip them for service priorities in the prevention and management of HIV, STIs, and TB. These included 1 195 professional nurses who were trained to initiate antiretroviral treatment. Their training underpinned the further expansion of the ART programme. In addition, 9 351 doctors, nurses, pharmacists, social workers and pharmacist assistants as well as lay counsellors (including traditional healers) received training in other aspects of treatment and care of people with HIV, STIs and TB, as well as prevention of these infections.
Lebone College of Emergency Care
The college provided experiential learning for 22 critical care assistants, 20 of whom successfully completed their training. In addition, 11 emergency care technician (ECT) students were found to be competent and were registered with HPCSA.
A total of 90 students were enrolled in their fi rst year of study at the college, bringing the total number of ECT students to 108. By the end of 2012/13 there were 66 graduates awaiting employment in public sector emergency medical services in Gauteng
The year also saw the enrolment of 24 students in the ambulance emergency assistance (AEA) course. Continuing professional development (CPD) in the form of training in basic life support was offered to 62 nursing and EMS personnel. Monthly continuing medical education sessions were conducted at the college and decentralised training centres for 702 doctors, nurses, allied health professionals and emergency service personnel.
Refresher courses were run for 67 basic ambulance
assistants and six ambulance emergency
assistants.
A total of 831 health professionals successfully
completed continuing medical and professional
education in emergency medical care.
Leadership, Management and Skills Development Sub-programme
The directorate delivering this sub-programme
focuses on the imperatives of ensuring health
system effectiveness and job-creation. It complies
with the key provisions of the Skills Development
Act, the National Skills Development Strategy III,
and the Skills Development Levies Act, working
closely with relevant sector education and training
authorities.
In order to strengthen compliance with the
Promotion of Access to Information Act (PAIA),
the Directorate is currently building capacity for
knowledge management in the department.
The directorate provides education, training and
skills development to all levels of management and
builds capacity among various categories of staff
through skills programmes. This includes the ABET
programme for less skilled categories of employees
and youth development programmes organised in
collaboration with various strategic partners.
The directorate accessed donor funding from
strategic partners for selected skills programmes,
including youth development programmes. Youth
development programmes included learnerships,
internships, career expos and initiatives like the
annual “take a girl child to work” event.
A total of 875 managers participated in various
management and leadership development
programmes including executive coaching in 2012.
An executive coaching programme was completed
by the CEOs and executive teams of nine hospitals.
A variety of other skills development initiatives
benefi ted 6 067 staff members who attended
various skills programmes.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
In accordance with provisions of the Turnaround
Strategy, 2 416 employees in relevant positions
attended code of conduct training. The ABET
programme admitted 963 employees.
Learnership programmes accommodated
297 young people while 1 690 participated in
internships. The department is not in a position to
guarantee employment to all learners and interns
who are trained. At least 2 137 school-goers were
reached through career expos aimed at providing
information and marketing health sciences.
Employee Health and Wellness Programme
The Employee Health and Wellness Programme
(EHWP) is informed by the Constitution of South
Africa of 1996, the Labour Relations Act, the
Occupational Health and Safety Act, and the
Compensation of Occupational Injuries and
Disease Act. It is also guided by National Strategic
Plan for HIV, STI and TB 2012-2016, policies of the
Department of Public Service and Administration
and strategic service delivery objectives of the
department.
The core business of the programme is to provide
an integrated health and wellness service to more
than 63 000 employees across the province. In
2012/13 the number of employees who accessed
EHWP services was 12 712. The nature of EHWP
services is described below.
Occupational health services
In 2012/13, occupational health services were
utilised by 4 198 employees. There were 31 reported
cases of occupational TB. Three of these resulted
in death while all other cases were successfully
treated. The total number of occupational injuries
and diseases reported to the Compensation
Commissioner was 583. Occupational health
services include medical surveillance, vaccination
programmes, case management and prophylaxis
for biological exposure. The department has
17 employee wellness centres which offer
family planning, PHC services, chronic disease
management and occupational health services.
A medical surveillance policy was developed
in 2012/13 as well as an occupational health
handbook for managers.
HIV, STIs and TB
Workplace services for HIV and AIDS, STIs and TB
were accessed by 5 862 employees, of these 663
employees requested HCT and 10 tested positive
and were referred for further management.
Employee Assistance Programme
The Employee Assistance Programme (EAP)
responded to requests from 2 652 employees
requiring counselling and trauma debriefi ng. Most
of these (1 677) accessed these services through
an external service provider while 975 utilised
internal services through trained EAP coordinators.
Financial wellness programmes reduced garnishee
orders applicable to departmental staff from 39 000
to 36 000. The pre-retirement counselling service
benefi ts employees preparing for retirement.
A substance abuse protocol was put into effect.
However, only fi ve employees were referred for
rehabilitation through the department’s EAP
programme.
Capacity-building in EHWP
In the year under review, 11 289 employees were
trained in HIV and TB management. This included 6 727
trained in reduction of stigma, mainstreaming of HIV
and AIDS, basic counselling skills, peer education
and management of disclosure. In addition, 4
562 staff members participated in prevention
programmes on health awareness days. HCT drives
and campaigns continued at provincial, regional and
district level. EHWP coordinators and peer educators
actively involved themselves in educating their peers.
Posters and pamphlets were developed, produced
and distributed to institutions.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
As part of the Turnaround Strategy, an action plan
was developed for improving staff morale as well
as a programme for rewarding employees who are
star performers.
A total of 4 419 employees were trained in prevention
of violence in the workplace, resilience building,
fi nancial wellness, pre-retirement preparation
and substance abuse management. In the area
of occupational health, 571 employees received
training in the management of occupational injuries
and diseases
Strategies for addressing areas of under
performance
The National Qualifi cations Framework Act, the
amended Higher Education Act and the Nursing
Act require that nursing education, which is mainly
a function of provincial health departments, be
transferred to jurisdiction of the Department of
Higher Education and Training. A collaborative
approach will be required to manage this change.
Capacity and resources need to be supplemented
in order to achieve increased production of health
professionals. The department has explored various
ways to maximise resources – collaboration with
other departments, training of mid-level workers
and expansion of experiential platforms by including
regional hospitals and district health services.
However, there are still insuffi cient experiential
learning sites for certain categories of students,
such as nurses and pharmacist assistants. This
limitation affects the numbers accepted for
training. It is possible that better use could be made
of existing experiential learning facilities by training
over weekends, public holidays and on a 24-hour
basis. However, there still would be signifi cant cost
implications.
A long standing challenge is that of placement of
nursing graduates. In 2012/13 the department
absorbed enrolled nurses who completed their
training in various institutions in order to facilitate
better service delivery. A plan is being devised to
place enrolled nurses who are due to complete
training in August and December 2013.
The department’s bursary funds assists some
4 500 individuals but its ability to employ and
retain benefi ciaries is limited, even though many
possess scarce skills which the department needs.
This compromises the return on investment in
bursaries. The HRH strategy and plan must be
more closely aligned with the projected demand
for health professionals. In 2012/13 nearly 70
emergency care technicians could not be absorbed
upon completion of their studies. They are likely to
be lost to the private sector.
Yet, when measured against service demands –
rather than budgeted posts – the number of health
professionals being produced is inadequate. The
amount allocated in the HPTDG must be reviewed
and policy decisions taken on recruitment and
retention, particularly in respect of some disciplines.
The relatively high staff turnover in the department
results in training backlogs. A policy is being
developed to address this.
The Employee Health and Wellness Programme
has been constrained by a lack of dedicated posts
for programme coordinators at institution level and
by fi nancial allocations. Training in occupational
health and safety will be prioritised in the new
fi nancial year.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 6 – Health Sciences and Training
Health Sciences and Training
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Number of
basic medical
graduates
550 600 517 (83) The number is
dependent on
university enrolment.
Number of fi rst
year medical
interns placed in
the services
403 400 422 22 Target exceeded
because Pholosong
Hospital was
accredited and
accepted nine
medical Interns in
January 2013 and
Sebokeng Hospital
had both budget and
an urgent need of
medical interns.
Number of
community
service doctors
placed in the
services
206 200 205 5 Target exceeded.
Number of
community
service dentists
placed
11 20 4 (16) Target not achieved
due to the retention
of community service
dentists from the
previous year and
need to prioritise
bursary holders in
post-fi lling.
Number
of medical
specialist
graduates
180 120 164 44 Target exceeded.
Number of allied
community
service
professionals
placed for in the
services
449 350 365 15 Target exceeded.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Health Sciences and Training
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Number of
pharmacy
interns placed
35 30 6 (24) Target not met due to
diffi culty in attracting
pharmacists. The
department will work
with the Pharmacy
Council to devise
ways to attract more
pharmacists to the
public sector.
Number of
community
service
pharmacists
placed
49 60 52 (8) Diffi culty in attracting
pharmacists as they
are in high demand
and competitive with
private sector
Number
of nursing
community
service placed
in the service
644 1 231 696 (535) Target not met.
Although the intake
for four-year courses
in 2009 was 1 311,
poor academic
performance of
students led to
low output of
graduates. Colleges
are addressing the
problem through
academic support
programmes.
Number of mid-
level workers
produced
(clinical
associates,
enrolled nurses,
emergency care
technicians,
pharmacist
assistant
graduates)
1 140 855 819 (36) Target not achieved
as there are limited
tutors for pharmacist
assistant training.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Health Sciences and Training
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned target
2012/13
Comment on deviation
Number
of youth
completing
internships
1 926 1 000 1 690 690 Additional
sponsorship was
received from
strategic partners.
Number
of youth
completing
learnerships
652 500 297 (203) Insuffi cient funding
was received from the
Health and Welfare
Sector Education and
Training Authority
(HWSETA).
Intake of
nursing
students
1 676 2 280 1 341 939 Target revised
downward due to
fi nancial constraints.
Plans are underway
to ensure nurses are
trained and absorbed.
Students with
bursaries from
the province
4 166 4 341 4 397 56 Target exceeded. The
bursaries were widely
advertised at career
expos and through
community radio
stations.
Basic nursing
students
graduating
1 785 1 712 1 729 17 Target exceeded.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 6 – Health Sciences and Training
2012/13 2011/12
Final
appropriati on
Actual
expenditure
(Over)/under
expenditure
Final
appropriati on
Actual
expenditure
(Over)/under
expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Nurse
training
colleges 691 617 689 133 2 484 666 168 648 885 17 283EMS
training
colleges 38 141 24 371 13 770 26 913 20 074 6 839Bursaries 50 815 43 575 7 240 30 000 32 138 (2 138)Other
training 61 351 49 983 11 368 42 941 24 992 17 949Total 841 924 807 070 34 854 766 022 726 089 39 933
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.7 Programme 7: Healthcare Support Services
Purpose
The purpose of this programme is to provide non-
clinical services, including laundry, food services
and medical supplies, to support hospitals and
clinics in an effective and effi cient manner.
Strategic objective
The central objective is to increase the effi cacy of
the supply chain management system.
Summary of signifi cant achievements
The achievements of this programme focus on
improvements in supply chain management,
including implementation of the broad-based black
economic empowerment (BBBEE) strategy.
The Preferential Procurement Policy Framework
Act (PPPFA) requires that government departments
award contracts to BBBEE companies. During the
year under review, 56% of the total value of items
procured was channelled to BEE companies,
against a target of 70%.
The PPPFA also requires that government
departments procure goods and services from
enterprises owned by women. In 2012/13, 24%
of the total value of the department’s contracts
was awarded to businesses owned by women,
exceeding the target of 15%.
The department continues to acquire linen from 12
cooperatives owned by women and it encouraged
all health institutions to procure linen from these
cooperatives. In 2012/13 19 out of 31 institutions
were conducting business with the cooperatives.
Strategies to address areas of underperformance
Challenges during the year included suppliers
not delivering critical items, such as medication
and food, due to non-payment resulting from the
adverse cash flow situation. Financial assistance
was provided by the Offi ce of the Premier, Provincial
Treasury, national Department of Health and
National Treasury.
Supply of clean linen was under pressure due to the
poor condition of laundry machinery at Masakhane
and Dunswart laundries. Tenders were awarded for
replacing laundry machinery at four major laundries.
The completion date was the end of March 2013.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 7 – Healthcare Support Services
Healthcare Support Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
BBBEE spend
as a % of total
procurement
budget
70% 70% 56% (14%) Not all vendors are
submitting their
BBBEE certifi cates for
verifi cation and they
are not complying
with the requirement
of the BBBEE score
card.
Number of
hospitals
procuring
goods through
cooperatives
25 19 31 12 Target exceeded.
Additional
hospitals began to
procure linen from
cooperatives.
Percentage of
procurement
awarded to
women-owned
enterprises
30% 15% 24% 9% Target achieved
by ensuring that
suppliers have
signifi cant female
participation if not
owned outright by
women.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Healthcare Support Services
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target2012/13
Comment on deviation
Percentage of
EDL available at
facilities
64% 98% 76% (22%) The target has not
been achieved.
Reasons include
operational and
fi nancial issues,
poor supplier
performance and
inadequate contract
management.
However, the situation
in 2012/13 showed
an improvement on
the previous year.
The re-engineering
of processes at the
Medical Supplies
Depot is continuing to
improve effi ciencies
and to highlight areas
of concern on the part
of institutions.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 7 – Healthcare Support Services
2012/2013 2011/2012
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
Laundries 161 853 152 113 9 746 139 460 141 187 (1 727)
Food supply
services 37 967 44 280 (6 313) 29 765 32 351 (2 586)
Medicine
trading
account 1 150 (149) 1 145 (144)
Total 199 821 196 544 3 277 169 226 173 687 (4 461)
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Gauteng Provincial Government | Health | Annual Report 2012/2013
5.8 Programme 8: Health Facilities Management
Purpose
The purpose of this programme is to plan, 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 life-cycle management of immovable assets through maintenance.
List of sub-programmes
• Capital Programme.• Maintenance Programme.• Special Projects.
Strategic objectives
• To increase effi ciency of service implementa-tion.
• To increase effi ciency in PHC facilities and hos-pitals.
• Signifi cant developments during 2012/13 in-cluded the following:
• The department delegated the power to ap-prove contracts up to the value of R1 million to the CEOs of central hospitals in order facilitate proper maintenance at these hospitals.
• A joint collaboration committee was established to expedite the NHI pilot project in Tshwane Dis-trict. This committee comprises a representa-tive from this programme and one each from Gauteng DID, Tshwane District and the national DOH.
Additional areas of progress are presented below.
Capital projects completed
The new Bertha Gxowa Hospital was offi cially opened on the 29 November 2012 with the OPD, admissions and pharmacy departments functional. Functionality was limited until after August when the fi re-stopping was completed and a certifi cate of occupation could be issued. The hospital
subsequently became fully functional.
Another infrastructural improvement was the
widening of the access road to the new Natalspruit
Hospital.
Upgrading and renovations
A number of projects for refurbishing hospitals and
nurses homes have been completed, including:
• Renovation and refurbishment of TB wards.
• Upgrading and renovation of the nurses’ resi-
dence at South Rand Hospital.
In addition, refurbishment of nurses’ residences
reached works completion at Chris Hani
Baragwanath Academic Hospital, Helen Joseph
Hospital, Sebokeng Hospital and Bonalesedi
Nursing College.
Electrical reticulation was completed at 10
institutions, the upgrade of autoclaves at 26
institutions, the upgrade of chillers at 15 institutions,
the upgrade of generators at 17 institutions and
steam reticulation at three institutions.
The main air-conditioning plant for the theatres
at Leratong Hospital was installed as were air-
conditioners in the Folateng wards at Sebokeng
Hospital.
Renovations of the bulk storage and dispensary
buildings at Hillbrow Pharmacy were accomplished
along with the construction of a pre-pack cold room
at the West Rand Pharmacy.
Additional oxygen and vacuum points were installed
at Edenvale Hospital, Dr George Mukhari Hospital
and Rahima Moosa Hospital.
In order to improve hygiene and safety for
employees and patients, healthcare waste storage
facilities were constructed at various institutions.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Projects in construction
Among projects still under construction are the new
Natalspruit Hospital and Zola/Jabulani Hospital
which were projected to reach works completion in
quarter 1 and quarter 2 of 2013/14 respectively.
The fi rst quarter of 2013/14 was also expected to
see completion of works at residences at Charlotte
Maxeke Hospital, Leratong Hospital, Tembisa
Hospital, Natalspruit Hospital and Lebone College.
Other projects that commenced during the year
under review included:
• Construction of additional oxygen and vacuum
points at seven hospitals.
• The upgrade of chiller plants at Pretoria West
Hospital, Kalafong Hospital and Bonalesedi
Nursing College.
• Renovation and refurbishment of the TB ward at
Tshwane District Hospital.
• Renovation and refurbishment at Ann Latsky
Nursing College.
• Renovation and refurbishment of the psychiat-
ric ward at Tambo Memorial Hospital.
• Refurbishment of theatres at Helen Joseph
Hospital.
In addition electrical reticulation was in progress
at three institutions. Boilers were being installed
at seven institutions and were under manufacture
for another 14 institutions. The installation of lifts
at seven institutions was in progress, while 15
institutions were awaiting delivery of new lifts.
Generators were being installed at four institutions
and another two hospitals were awaiting the
delivery of new generators.
Projects in planning
Planning of the new Randgate Clinic was completed
and contractors were to be appointed early in
2013/14.
The Development Bank of Southern Africa (DBSA)
was appointed as the implementing agent for the
emergency repair and refurbishment at Chris Hani
Baragwanath Academic Hospital, the development
of new forensic pathology facilities in Johannesburg
and Bronkhorstspruit, and the revitalisation and re-
opening of Khayalami Hospital in Kempton Park. In
addition, DBSA was tasked with the conversion of
Discoverers CHC and Lenasia South CHC to district
hospitals. The project briefs for these conversions
were approved and tenders were advertised in
March 2013.
Strategy to overcome areas of under performance
Various steps will be taken to ensure effi cient
and effective management of projects. The
department will ensure that project management
personnel have appropriate technical knowledge
and will augment the staff complement. Lengthy
approval processes and slow payment to service
providers has long been a bone of contention. The
department has sought to address these through
delegation of authority to facility level, in some
instances, and introduction of shorter processes
within the provincial departments of health, fi nance
and infrastructure development.
In addition the department will enter into a service
level agreement with Gauteng DID to facilitate
accountability.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Performance indicators: Programme 8 – Health Facilities Management
Health Facilities Management
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Percentage
completed
(Completion and
commissioning
of Zola/Jabulani
Hospital)
80% 100% 98% 2% Delays in the payment
of contractors
impacted on the
project. Practical
completion was
expected during
quarter 1 of 2013/14,
with fi nal completion
in quarter 2.
Percentage
completed
(Completion of
new Natalspruit
Hospital)
80% 100% 97% 3% Construction of the
new Natalspruit
Hospital reached
practical completion
on 28 February 2013.
Works completion
is anticipated on 31
May 2013 with fi nal
completion on 30
June 2013.
Percentage
completed
(Equipment for
new Natalspruit
Hospital)
10% 100% 28% 72% As the hospital was
not completed to
schedule, equipment
could not be delivered
to an incomplete
facility for security
reasons.
Percentage
completed
(Planning for
construction of
Randgate Clinic)
0% 100% 100% 0% Planning was
completed.
Construction will
commence in
2013/14.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Health Facilities Management
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Percentage
completed
(Equipment for
Zola/Jabulani
Hospital and
gateway clinic)
10% 100% 35% 65% As the hospital was
not completed to
schedule, equipment
could not be delivered
to an incomplete
facility for security
reasons.
Percentage
completed
(Planning for
revitalisation
of Jubilee
Hospital)
0% 100% 0% 100% Planning depended
on approval of
business case by
DOH. Preliminary
approval was given
in January 2013,
but was withdrawn
in February 2013.
Further advice
from the national
department is
awaited.
Percentage
completed
(Planning for
revitalisation of
Dr Yusuf Dadoo
Hospital)
0% 100% 0% 100% Planning depended
on approval of
business case by
DOH. Preliminary
approval was given
in January 2013,
but was withdrawn
in February 2013.
Further advice
from the national
department is
awaited.
115
Gauteng Provincial Government | Health | Annual Report 2012/2013
Health Facilities Management
Performance indicator
Actual achievement
2011/12
Planned target
2012/13
Actual achievement
2012/13
Deviation from planned
target 2012/13
Comment on deviation
Percentage
completed
(Planning for
revitalisation
of Tambo
Memorial
Hospital)
0% 100% 0% 100% Planning depended
on approval of
business case by
DOH. Preliminary
approval was given
in January 2013,
but was withdrawn
in February 2013.
Further advice
from the national
department is
awaited.
Percentage
completed
(Planning for
revitalisation
of Sebokeng
Hospital)
0% 100% 0% 100% Planning depended
on approval of
business case by
DOH. Preliminary
approval was given
in January 2013,
but was withdrawn
in February 2013.
Further advice
from the national
department is
awaited.
Percentage
completed
(Planning for
revitalisation
of Kalafong
Hospital)
0% 100% 0% 100% Planning depended
on approval of
business case by
DOH. Preliminary
approval was given
in January 2013,
but was withdrawn
in February 2013.
Further advice
from the national
department is
awaited.
116
Gauteng Provincial Government | Health | Annual Report 2012/2013
Expenditure: Programme 8 – Health Facilities Management
2012/2013 2011/2012
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
Community
health
facilities 106 325 101 168 5 157 56 842 100 989 (44 147)
Emergency
medical
rescue
services 939 19 344 (18 405) 34 020 2 870 31 150
District
hospital
services 368 159 271 852 96 307 623 136 529 011 94 125
Provincial
hospital
services 636 813 505 784 131 029 726 635 349 398 377 237
Central
hospital
services 257 904 212 039 45 865 311 090 225 152 85 938
Other
facilities 140 739 134 482 6 257 126 026 110 846 15 180
Total 1 510 879 1 243 831 267 048 1 877 749 1 318 266 559 483
117
Gauteng Provincial Government | Health | Annual Report 2012/2013
6. SUMMARY OF FINANCIAL INFORMATION
6.1. Departmental receipts
The table below reflects the department’s revenue collection for 2011/12 and the year under review. There was an increase of R53 million or 12% in revenue collected in 2012/13 compared to the previous year. Revenue collection also exceeded
the 2012/13 target of R472 million by R35 million. The generation of more than half a billion rand in own revenue is a considerable achievement which benefi ts both the province and the department.
The main source of revenue is patient fees which constituted 80% of total revenue.
The department has a working relationship with Gauteng Provincial Treasury on revenue-related matters. Agency fees on outsourced services are funded by the Provincial Treasury. This is an incentive to the department to increase revenue
collection.
Table 10: GDoH revenue collection 2012/13 and 2011/12
2012/13 2011/12
Departmental
receipts
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
Sale of goods and
services other than
capital assets 423 269 474 153 (50 884) 452 112 398 072 54 040
Transfers received 37 0 37 275 55l6 (281)
Fines, penalties
and forfeits 40 2 38 24 13 (11)
Interest, dividends
and rent on land 975 1 257 (282) 595 487 108
Sale of capital
assets 0 0 0 0 0 0
Financial
transactions
in assets and
liabilities 47 230 31 529 15 701 36 508 54 933 (18 425)
Total 471 551 506 941 (35 390) 489 514 454 061 35 453
The increase in revenue collection has been
achieved despite serious challenges relating to
patient administration systems. Effective liaison
with healthcare funders has contributed to better
revenue collection. Major success factors have
been the outsourcing of the submission of claims
to the Road Accident Fund (RAF) and the electronic
submission of claims to external funders.
Currently the claims process involves extracting
data from patient administration systems and
having this converted by MediKredit into an
acceptable electronic format before submitting
it to medical schemes. A live interface would be
ideal as it would be more effi cient and eliminate
rejections. Patients classifi ed as paying patients
are charged according to the Uniform Patient
118
Gauteng Provincial Government | Health | Annual Report 2012/2013
Fees Schedule which is revised annually at the
beginning of the fi nancial hear. For 2012/13 patient
tariffs were adjusted upward by 5.5%. For other
sources of revenue – parking fees and payment
for accommodation – the amounts payable are
determined outside the department by relevant
government structures.
The following healthcare services are free to
patients who are not members of medical schemes
or whose treatment is not paid for by the employer:
• Health services for pregnant women and chil-
dren under the age of six years (Notice 657 of
1 July 1994).
• Primary healthcare services (Notice 1514 of 17
October 1996).
• Termination of pregnancy (Choice on Termina-
tion of Pregnancy Act 92 of 1996).
• Services to social pensioners. (Aged Persons
Act 81 of 1967 as amended by Act 100 of 1998).
• Medico-legal services for survivors of rape and
assault and post mortem examinations (Crimi-
nal Procedures Act 51 of 1977).
• Organ and tissue donors (Human Tissue Act 63
of 1965).
• Children who are committed to a children’s
home, industrial school or foster parents (Child
Care Act 74 of 1983).
• Persons with mental disorders (Mental Health
Act 18 of 1973).
• Individuals with infectious, formidable and/or
notifi able diseases (National Health Act 61 of
2003).
• Services to those formally recognised as un-
employed (Unemployment Insurance Act 63 of
2001).
An estimated 80% of patients receive services free
of charge while only 20% pay a full or subsidised
fee. The actual cost of providing free services is not
available as the health information system is not
geared to producing this data.
The department has entered into an agreement
with nine medical schemes to participate in
their designated service provider networks for
the provision of prescribed minimum benefi ts
(PMBs) to their members. The Medical Schemes
Act requires medical schemes to cover PMBs
even when the members’ benefi ts in terms of the
rules of the scheme have been exhausted. Good
working relationships with medical schemes serve
to facilitate the settlement of claims. Payments
from medical schemes amounted to R94 million in
2012/13.
The appointment of Alexander Forbes to provide
supporting documents on RAF claims resulted in
increased payments from the RAF. The total amount
of revenue from RAF claims was R 155 million in
2012/13. Management of these claims requires
some legal knowledge as well as a thorough
understanding of the Road Accident Fund Act. The
volume of RAF claims is driven by the sheer number
of road accidents and the fact that most of injured
people are admitted to public facilities.
The service level agreement with Alexander Forbes
was managed closely until it expired in July 2012.
Part of the service provider’s role was to provide
training to hospital employees on the requirements
of the RAF.
During 2012/13 amounts owed by patients that
were not collectable were written off after attempts
had been made to recover them. The total value of
these irrecoverable debts was R 198 million.
Better business processes in health facilities
contributed to improved revenue collection. Training
combined with utilisation of Patient Classifi cation
Guidelines and the standard operating procedure
manual contributed signifi cantly to the success.
Guidelines have also been drafted on the
management of foreign patients visiting public
hospitals for medical treatment. These will be
implemented during 2013/14.
The department purchased new servers for
seven hospitals for the operation of the patient
119
Gauteng Provincial Government | Health | Annual Report 2012/2013
management system, Medicom. Installation will
take place in 2013/14 and this will reduce down time
and loss of data on patients because of IT system
failure. The most up to date version of Medicom
will be installed and this will facilitate storage of
comprehensive and accurate patient information
required for billing purposes.
The department plans to outsource some services
where in-facility skills and capacity are still not
adequate. This will apply to case managers for the
four central and three tertiary hospitals within the
department.
6.2 Programme expenditure
Table 11: GDoH expenditure by budget programme 2012/13 and 2011/12
2012/13 2011/12
Programme nameFinal
appropriation
Actual
expenditure
(Over)/under
expenditure
Final
appropriat-ion
Actual
expenditure
(Over)/under
expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Administration 683 447 501 362 182 085 842 594 752 405 90 189
District Health
Services 8 782 484 8 555 956 226 528 7 240 272 7 239 181 1 091
Emergency
Medical Services 1 059 284 1 147 231 (87 947) 787 670 696 544 91 126
Provincial
Hospital Services 6 546 896 6 582 440 (35 544) 5 259 945 5 928 099 (668 154)
Central Hospital
Services 7 566 859 7 799 913 (233 054) 6 778 355 7 131 562 (353 207)
Health Sciences
and Training 841 924 807 070 34 854 766 022 726 089 39 933
Healthcare
Support Services 199 821 196 544 3 277 169 226 173 687 (4 461)
Health Facilities
Management 1 510 879 243 831 267 048 1 877 749 1 318 266 559 483
Social Welfare
Services - - - 1 888 430 1 834 046 54 384
Development &
Research - - - 209 651 190 285 19 366
TOTAL 27 191 594 26 834 347 357 247 25 819 914 25 990 164 (170 250)
120
Gauteng Provincial Government | Health | Annual Report 2012/2013
6.3. Transfer payments excluding public entities
The table below reflects the transfer payments made for the period 1 April 2012 to 31 March 2013.
Table 12: Transfer payments 2012/13
Name of transferee
Purpose for
which the
funds were
used
Compliance
with s 38
(1) (j) of the
PFMA
Amount
transferred
(R’000)
Amount
spent by the
entity
Reasons for the funds
unspent by the entity
City of Johannesburg Metro Primary
healthcare
No contract 184 032 184 032 Transferred funds
were fully spent
City of Tshwane Metro Primary
healthcare
No contract 49 348 49 348
Ekurhuleni Metro Primary
healthcare
No contract 190 627 190 627
West Rand District Council Primary
healthcare
No contract 0 0
Sedibeng District Council Primary
healthcare
No contract 0 0
City of Johannesburg Metro Emergency
medical
services
Contract 192 867 192 867
City of Tshwane Metro Emergency
Medical
Services
Contract 61 504 61 504 13 010 under-spent as
the municipal fi nancial
year ends at the end
of June. A request
for roll-over was
submitted to Treasury
Ekurhuleni Metro Emergency
Medical
Services
- 229 534 229 534 Transferred funds
were fully spent
West Rand District Emergency
Medical
Services
Contract 48 887 48 887 Transferred funds
were fully spent
Sedibeng District Emergency
Medical
Services
- 44 235 44 235 R19 082 under-spent
due to provincial-
isation of EMS as from
1 September 2012
City of Johannesburg Metro HIV and AIDS Contract 14 582 14 582 Transferred funds
were fully spentCity of Tshwane Metro HIV and AIDS Contract 28 254 28 254
Ekurhuleni Metro HIV and AIDS Contract 20 868 20 868
West Rand District Council HIV and AIDS Contract 8 813 8 813
Sedibeng District Council HIV and AIDS Contract 9 974 9 974
121
Gauteng Provincial Government | Health | Annual Report 2012/2013
The table below reflects the transfer payments which were budgeted for in the period 1 April 2012 to 31
March 2013, but no transfer payments were made.
Table 13: Budgeted transfer payments that were not paid 2012/13
Name of transferee Purpose for which
the funds were to
be used
Amount budgeted
for
(R’000)
Amount
transferred
(R’000)
Reasons why
funds were not
transferred
Ekurhuleni Metro HIV and AIDS 9 988 0 Payments made
under wrong
allocations. A
Transfer Unit has
been established to
monitor payments
from 2013/14
West Rand District HIV and AIDS 5 783 0 Payments made
under wrong
allocations. A
Transfer Unit has
been established to
monitor payments
from 2013/14
Sedibeng District
Council
HIV and AIDS 6 069 0 Payments made
under wrong
allocations. A
Transfer Unit has
been established to
monitor payments
from 2013/14
University of
Johannesburg
540 0 Payments made
under wrong
allocations. A
Transfer Unit has
been established to
monitor payments
from 2013/14
University of
Limpopo
181 0 Payments made
under wrong
allocations. A
Transfer Unit has
been established to
monitor payments
from 2013/14
122
Gauteng Provincial Government | Health | Annual Report 2012/2013
6.4. Transfer payments to public entities
Table 14: Transfer payments made to public entities 2012/13
Name of public
entity
Services rendered
by the public entity
Amount
transferred to the
public entity
Amount spent by
the public entity
Achievements of
the public entity
Health and Welfare
SETA
Implementation of
Skills Development
Act, utilising
employers’
contributions for
skills development
and work-based
training
28 238 28 238 297 learnerships
implemented
123
Gauteng Provincial Government | Health | Annual Report 2012/2013
6.5 Conditional grants and earmarked funds received
The tables below describe the conditional grants and earmarked funds received by the department
Table 15: Health Professions Training and Development Grant
Department that transferred grant: National Department of Health
Purpose of the grant Assist provinces to cover costs associated with
providing a public service training platform for
students in the health sciences.
Establish new clinical teaching and training
capacity for public service platform in earmarked
provinces (Northern Cape, North West, Limpopo,
Mpumalanga, Eastern Cape).
Co-fund implementation of the National Human
Resources for Health Strategy in relation to the
expansion of undergraduate medical education
from 2012-2025.
Expected outputs of the grant All provinces will measure performance against the
National Human Resources for Health Strategy by
monitoring:
• Number of undergraduate health sciences
trainees utilising the public health service
platform, by category, training institution
and province.
• Number of postgraduate health sciences
trainees (excluding registrars) utilising the
public health service platform, by category,
training institution and province.
• Number of registrars trained on the public
health service platform, per discipline and
per training institution in province.
• Number of community service health
professionals utilising the public service
training platform.
• Number of other health science trainees
supervised during training on the public
health service platform as per statuary
requirements (for example, interns).
124
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred grant: National Department of Health
Actual outputs achieved • 22 438 students in all health sciences
disciplines enrolled in Gauteng’s institutions
of higher learning:
- 17 426 undergraduates are utilising
public sector platform.
- 5 012 post-graduate students are using
this platform.
• 739 fi rst and second year medical interns.
• 1 350 community service health
professionals.
• 1 193 registrars in training on the service
platform.
• 1 085 fi eld posts for registrars.
• 1 029 fi eld post for specialists.
Amount per amended DORA R725 310
Amount received (R’000) R725 310
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R725 310
Reasons for the funds unspent by the entity Funds entirely spent
Monitoring mechanism by the receiving
department
Monitor expenditure trends using BAS monthly
reports.
Produce fi nancial and non-fi nancial performance
evaluation reports which are shared with Treasury.
Undertake two national monitoring support visits.
Follow up and implementation of corrective
measures for underperforming institutions.
Table 16: National Tertiary Services Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Ensure provision of tertiary health services for all
South African citizens.
Compensate tertiary facilities for the costs
associated with providing these services to
patients including those from across boundaries/
borders.
Expected outputs of the grant Provision of designated central and national
tertiary services in 22 hospitals/complexes as
agreed between the province and the national DOH.
125
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Actual outputs achieved Total number of inpatient days: 1 348 346.
Number of inpatient days at individual hospitals:
Charlotte Maxeke Johannesburg Academic
Hospital: 240 068.
Chris Hani Baragwanath Academic Hospital:
340 007.
Dr George Mukhari Hospital: 336 659.
Steve Biko Academic Hospital: 233 333.
Helen Joseph Hospital: 62 443.
Kalafong Hospital: 135 836.
Amount per amended DORA R3 044 567
Amount received (R’000) R3 044 567
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R3 044 526
Reasons for the funds unspent by the entity Full amount spent
Monitoring mechanism by the receiving
department
Information offi cers at facilities collect information
monthly’ as per SLA and “YES” list, and collate
it quarterly. Discrepancies are identifi ed and
corrected.
Collated information from the individual facility
is then forwarded to the provincial information
offi cer who compiles a provincial report which is
sent to the Programme Manager: Hopsital Services
for coordination of signatures of relevant chief
directors, the CFO and HOD. The fi nal copy is then
sent to national health department and other
relevant stake holders.
126
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 17: Nati onal Health Insurance Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Test innovations necessary for implementing
National Health Insurance.
Undertake health system strengthening initiatives
and support selected pilot districts in implementing
identifi ed service delivery interventions.
Strengthen resource management of selected
central hospitals.
Expected outputs of the grant A framework that:
Enhances managerial autonomy, delegation of
functions and accountability in districts and health
facilities.
Provides for a scalable model, including the
required institutional arrangements, for a district
health authority (DHA) as the NHI contracting
agency.
Tests how health service management and
administration and relate to the functions and
responsibilities of DHAs.
Provides models for contracting private providers
that include innovative arrangements for
harnessing private sector resources at PHC level.
Provides for a rational referral system based on a
re-engineered PHC platform with a particular focus
on rural and previously disadvantaged areas.
Provides a model for revenue collection and a
management model for identifi ed central hospitals.
Actual outputs achieved • Procurement of medical equipment for
CHCs and clinics.
• Contracting of 11 general practitioners
where the need was identifi ed.
• Contracting of 49 CHWs to support ward-
based outreach teams.
• Full district specialist team appointed.
Amount per amended DORA R31 500
Amount received (R’000) R31 500
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R8 062
127
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Reasons for the funds unspent by the entity An amount of R23 435 could not be spent by the
department due late approval of the business plan
which resulted in:
Non-fi lling of case managers’ posts.
Delays in procurement of medical equipment.
Delays in contracting of NGOs which caused late
processing of CHWs’ payments.
The department applied for a rollover of
R12 026 which had not been approved by
Provincial Treasury at the time of compiling this
report. Equipment was purchased but not yet
delivered.
Monitoring mechanism by the receiving
department
Steering committee that meets on a weekly basis.
Performance reviews are conducted.
M&E reports are compiled.
Table 18: Comprehensive HIV and AIDS Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Enable the health sector to develop an effective
response to HIV and AIDS, including universal
access to HCT.
Support the implementation of the National
Operational Plan for comprehensive HIV and AIDS
treatment and care.
Subsidise funding for antiretroviral treatment
programme.
128
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Expected outputs of the grant • Renovation/expansion of health facilities
offering ART services.
• New patients started on ART.
• Total number of patients on ART remaining
in care.
• Benefi ciaries served by home-based carers.
• Active home-based carers receiving
stipends.
• Male condoms distributed.
• Female condoms distributed.
• High transmission area intervention sites
• ANC clients initiated on life-long ART.
• Babies tested for HIV at six weeks.
• HIV-positive clients screened for TB.
• HIV-positive patients started on isoniazid
prophylaxis.
• Active lay counsellors on stipends.
• Clients receiving pre-test counselling on
HCT (including ANC).
• Clients tested for HIV (including ANC).
• Health facilities offering MMC services.
• MMC procedures performed.
• Sexual assault cases offered ARV
prophylaxis.
• Step Down Care (SDC) facilities/units
• Doctors and professional nurses trained
in management of HIV, AIDS, STIs, TB and
chronic diseases.
129
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Actual outputs achieved • 364 fi xed public health facilities offering
ART services.
• 133 983 new patients started on ART.
• 714 308 patients in total remaining on ART.
• 80 577 benefi ciaries served by home-based
carers.
• 6 555 active home-based carers receiving
stipends.
• 131 972 200 male condoms distributed.
• 2 368 915 female condoms distributed.
• 14 736 ANC clients initiated on life-long
ART.
• 52 728 babies tested for HIV at six weeks.
• 244 784 HIV-positive clients screened for
TB.
• 1 644 active lay counsellors on stipends.
• 3 863 419 clients received pre-test counsel-
ling (including ANC).
• 3 697 292 clients tested for HIV (including
ANC).
• 60 health facilities offering MMC services.
• 94 159 medical male circumcisions per-
formed.
• 4 817 sexual assault cases offered ARV
prophylaxis.
• 18 SDC facilities/units.
• 5 991 doctors and professional nurses
trained on HIV, AIDS, STIs, TB and chronic
diseases.
Amount per amended DORA R1 901 293
Amount received (R’000) R1 901 293
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R1 901 293
Reasons for the funds unspent by the entity Full amount spent
130
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Monitoring mechanism by the receiving
department
Data is collected as per the reporting format of the
DORA: monthly fi nancial reports and quarterly non-
fi nancial reports. Data is collected at facilities, sent
to sub-district offi ces, then to district offi ce and
fi nally to the central offi ce. There it is verifi ed by
the HIS Directorate before forwarding to the HAST
Directorate.
Indicators per sub-programme are compared
against targets in the business plan to identify
deviations. If targets are not achieved, reasons are
sought and corrective action is taken.
Table 19: Nursing Colleges Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Supplement provincial funding of health
infrastructure (including provision of equipment
and furniture) to accelerate provision.
Ensure proper maintenance of infrastructure for
nursing colleges and schools.
Expected outputs of the grant Number of nursing colleges and schools planned,
designed, constructed, operationalized and
maintained.
Number of work opportunities created.
Actual outputs achieved One nursing college at 92% construction.
One nursing college at 80% planning.
One nursing college at 75% planning.
One nursing college at 68% planning.
Amount per amended DORA R12 480
Amount received (R’000) R12 480
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R7 701
Reasons for the funds unspent by the entity Delays in appointment of contractors led to late
payment of service providers.
Poor performance by service providers.
Lengthy process for approval of documents.
Monitoring mechanism by the receiving
department
Monitoring mechanisms during planning are:
project plans, submissions, monthly design reviews
and fi nalisations and meetings.
Monitoring mechanisms during construction are:
monthly progress review reports and meetings.
131
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 20: Health Infrastructure Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Supplement provincial funding of health
infrastructure to address backlogs and accelerate
provision of health facilities.
Ensure proper life cycle maintenance of provincial
healthcare infrastructure.
Expected outputs of the grant Number of health facilities, planned, designed,
constructed, operationalised and maintained.
Number of work opportunities created.
Actual outputs achieved Number of facilities designed and planned: 34.
Number of facilities in construction: 18.
Number of facilities operationalised: 57.
Number of facilities maintained: 2.
Amount per amended DORA R110 361
Amount received (R’000) R110 361
Reasons if amount as per DORA was not received Amount received per DORA
Amount spent by the department (R’000) R98 513
Reasons for the funds unspent by the entity Delays in appointment of contractors led to late
payment of service providers.
Poor performance by service providers.
Lengthy process for approval of documents.
Monitoring mechanism by the receiving
department
Monitoring mechanisms during planning are:
project plans, submissions, monthly design reviews
and fi nalisations and meetings.
Monitoring mechanisms during construction are:
monthly progress review reports and meetings.
132
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 21: Hospital Revitalisation Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Provide funding to enable provinces to plan,
manage, modernise, rationalise and transform
health infrastructure, health technology, and
monitoring and evaluation of the health facilities in
line with national policy objectives.
Supplement expenditure on health infrastructure
delivered through public-private partnerships.
Expected outputs of the grant Number of hospitals upgraded, rebuilt and fully
commissioned.
Actual outputs achieved New Natalspruit Hospital reached 97% completion.
New Zola/Jabulani Hospital reached 98%
completion.
Access road for new Natalspruit Hospital was
completed.
Electro-mechanical replacement programme was
implemented.
Nine facilities were maintained.
Amount per amended DORA R792 439
Amount received (R’000) R792 439
Reasons if amount as per DORA was not received Amount received as per DORA.
Amount spent by the department (R’000) R572 080
Reasons for the funds unspent by the entity The department could not fully utilise the amount
appropriated due to poor designs and project
management which lead to changes in scope,
variation orders and extension of time.
Delays in appointment of contractors led to late
payment of service providers.
Poor performance by service providers.
Lengthy process for approval of documents.
Monitoring mechanism by the receiving
department
Monitoring mechanisms during planning are:
project plans, submissions, monthly design reviews
and fi nalisations and meetings.
Monitoring mechanisms during construction are:
monthly progress review reports and meetings.
133
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 22: EPWP Integrated Grant
Department that transferred the grant: National Department of Public Works
Purpose of the grant Provide an incentive to provincial departments to
expand work creation efforts through the use of
labour-intensive delivery methods in the following
focus areas:
- Road maintenance and the maintenance of
buildings.
- Low traffi c volume roads and rural roads.
- Other economic and social infrastructure.
- Tourism and cultural industries.
- Sustainable land-based livelihoods.
Expected outputs of the grant Increase in number of people employed and
receiving income through the EPWP.
Increase in average duration of the work
opportunities created.
Increase in income per EPWP benefi ciary.
Actual outputs achieved None
Amount per amended DORA R1 000
Amount received (R’000) R1 000
Reasons if amount as per DORA was not received Amount received as per DORA
Amount spent by the department (R’000) 0
Reasons for the funds unspent by the entity The projects earmarked for implementation did not
progress and were moved to the next fi nancial year.
Monitoring mechanism by the receiving
department
None
Table 23: EPWP Incentive Grant for the Social Sector
Department that transferred the grant: National Department of Public Works
Purpose of the grant Provide an incentive to provincial social sector
departments identifi ed in the 2012 Social Sector
EPWP Log-frame to increase job creation by
focusing on strengthening and expanding
programmes that have employment potential.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Public Works
Expected outputs of the grant Increase in number of people employed and
receiving income through the EPWP.
Increase in duration of the work opportunities
created.
Increase in number of households and
benefi ciaries to which services are provided.
Increase in income per EPWP benefi ciary.
Actual outputs achieved 1 540 jobs were created.
1 540 contracts were extended by 230 days.
1 019 148 households benefi ted.
855 005 clients were seen.
Income increased from R63.18 per day (R1 264 per
month) to R66.34 per day (R1 326 per month).
Amount per amended DORA R29 072
Amount received (R’000) R29 072
Reasons if amount as per DORA was not received Amount received as per DORA
Amount spent by the department (R’000) R28 727
Reasons for the funds unspent by the entity Under-spent by 2% due to disqualifi cation of NGO
identifi ed for the grant because of mismanagement
of funds and two NGOs submitting their claim
forms late for the fourth quarter.
Monitoring mechanism by the receiving
department
Monthly reports of expenditure against budgeted
allocation are submitted through HOD to
Department of Public Works.
Table 24: African Cup of Nations Grant
Department that transferred the grant: National Department of Health
Purpose of the grant Provide health and medical services for the African
cup of Nations.
Expected outputs of the grant EMS at venues used in African Cup of Nations.
Actual outputs achieved Number of doctors: 0.
Number of nurses: 0.
Number of paramedics: 97.
Number of emergency care practitioners: 502.
Number of ambulances: 14.
Number of response vehicles: 6.
Number of disaster buses: 4.
Number of golf carts or equivalent: 2.
Number of port health practitioners: 0.
Number of forensic pathology services: 0.
Command and control function: 8 per day.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Department that transferred the grant: National Department of Health
Amount per amended DORA R3 000
Amount received (R’000) R3 000
Reasons if amount as per DORA was not received Amount received as per DORA.
Amount spent by the department (R’000) None
Reasons for the funds unspent by the entity R3 000
Monitoring mechanism by the receiving
department
These were based on the operational and
implementation plan
6.6. Donor funds
Donor assistance includes both cash and in-kind contributions. There is a need for substantial
improvement in reporting on donor assistance as institutions have provided insuffi cient information. All
fi gures for donor funding must correspond with the amounts disclosed in the annual fi nancial statement
and the following information must be provided:
• The name of the donor.
• The amount received in the current reporting period.
• The purpose of donor funding.
• Outputs achieved.
• Specifi cation whether the donation was in cash or kind.
• Amount spent from donor funds.
• Monitoring/reporting to the donor.
• Reasons for any unspent funds and an indication whether surplus funds will be returned to the
donor.
Table 25: Donor funds made in cash 2012/13
Name of donor: Various donors
Full amount of the funding R202 740.00
Period of the commitment Indefi nite
Purpose of the funding Provide and ensure necessary equipment/ furniture
at institution
Expected outputs Excellence in providing required services
Actual outputs achieved Indefi ned
Amount received in current period (R’000) Equipment (various) was donated
Amount spent by department (R’000) No cash received
Reasons for the funds unspent N/A
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
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Tables 26 (a – w): Donor funds made In-kind/assets 2012/13
a) Name of donor: Bracing Air Trading Project
Full amount of the funding R4 950.00
Period of the commitment Indefi nite
Purpose of the funding To promote effi cient healthcare services in the
West Rand Region
Expected outputs Determine early detection of the haemoglobin
levels in the blood of patients
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Equipment (various) was donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
b) Name of donor: DDP Valuers and Airports Company South Africa
Full amount of the funding R115 000.00
Period of the commitment Indefi nite
Purpose of the funding Ensure institution is equipped with the necessary
equipment for patients
Expected outputs Ensure patients are consulted with equipment in
good working condition
Actual outputs achieved Equipment becomes the department's
responsibility after acceptance of donation
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Equipment (various) was donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
c) Name of donor: National Department of Health
Full amount of the funding R247 199.26
Period of the commitment N/A
Purpose of the funding To support and roll out the implementation of HIV
register
Expected outputs N/A
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Computer equipment was received
Reasons for the funds unspent No cash received
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c) Name of donor: National Department of Health
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
d) Name of donor: Ms Ephonia Sophie Nkosi
Full amount of the funding R3 500.00
Period of the commitment Indefi nite
Purpose of the funding Provide education resources to institution
Expected outputs Ensure institution is equipped with required
resources
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Television was donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
e) Name of donor: Abbott Laboratories
Full amount of the funding R66 000.00
Period of the commitment N/A
Purpose of the funding Ensure correct ergonomics for staff and patients
Expected outputs Ensure institution is equipped with furniture
required
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Chairs were donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
f) Name of donor: Aspen Pharmacies, Wendy Braun, Natal Lowes, Dr Naicker & Ellen
Full amount of the funding R220 288.56
Period of the commitment Indefi nite
Purpose of the funding Ensure accurate and correct results for relevant
medical tests of patients
Expected outputs Obtain the necessary test results for patient
diagnosis
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Medical equipment donated
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f) Name of donor: Aspen Pharmacies, Wendy Braun, Natal Lowes, Dr Naicker & Ellen
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
g) Name of donor: Ms Simone Samuels & Dolly Marcus
Full amount of the funding R599.94
Period of the commitment Indefi nite
Purpose of the funding Provide warmth in wards
Expected outputs Ensure that wards are at correct temperatures for
patients
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Equipment (heaters) were donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
h) Name of donor: Welchallyn, Logan Medical & Surgical and Tal
Full amount of the funding R631 115.21
Period of the commitment Indefi nite
Purpose of the funding Ensure effi cient and professional service provided
by the institution
Expected outputs Ensure working tools for staff at institution
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Equipment / furniture was donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
i) Name of donor: University of Pretoria
Full amount of the funding R11 571.00
Period of the commitment Indefi nite
Purpose of the funding Repair of 30 chairs
Expected outputs Ensure comfortable ergonomics for patients and
staff
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Repair service was donated
Reasons for the funds unspent No cash received
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i) Name of donor: University of Pretoria
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
j) Name of donor: Makro and Globir Medical Supplier
Full amount of the funding R251 396.99
Period of the commitment Indefi nite
Purpose of the funding Used for the relaxation of muscles
Expected outputs Ensure use of high-frequency electromagnetic
currents as a form of physical or occupational
therapy and in surgical procedures.
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Diathermy equipment was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
k) Name of donor: Carefusion
Full amount of the funding R32 800.00
Period of the commitment Indefi nite
Purpose of the funding Ensure effi cient and professional service provided
by the institution
Expected outputs Ensure working tools for staff at institution
Actual outputs achieved Undefi ned
Amount received in current period (R’000) N/A
Amount spent by the department (R’000) Equipment/ Furniture (various) was donated
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
l) Name of donor: Techblitz Communication
Full amount of the funding R3 100.00
Period of the commitment Indefi nite
Purpose of the funding Ensure working audio visual equipment at
institution
Expected outputs Provide institution with the necessary audio visual
equipment needed for staff, patients
Actual outputs achieved Undefi ned
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l) Name of donor: Techblitz Communication
Amount received in current period (R’000) Equipment was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
m) Name of donor: Professional Orthopaedics and Isigidi Trading
Full amount of the funding R18 000.00
Period of the commitment Indefi nite
Purpose of the funding Used for the relaxation of muscles
Expected outputs Ensure use of high-frequency electromagnetic
currents as a form of physical or occupational
therapy and in surgical procedures
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Diathermy equipment was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
n) Name of donor: Game Stores
Full amount of the funding R2 219.00
Period of the commitment N/A
Purpose of the funding Used to store medicine with minimum
temperature requirements
Expected outputs Ensure longer life for medicines required to be
stored at below room temperature
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Refrigerators were donated, not funds
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
o) Name of donor: University of North West and Drager
Full amount of the funding R425 291.77
Period of the commitment Indefi nite
Purpose of the funding Used to care for premature babies in a neonatal
intensive care unit
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o) Name of donor: University of North West and Drager
Expected outputs Ensure maximum care and monitor growth of
premature babies
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Incubators were donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
p) Name of donor: PSA
Full amount of the funding R3 998.00
Period of the commitment Indefi nite
Purpose of the funding Ensure working computer equipment for
institution to perform required daily tasks
Expected outputs Obtain and provide accurate and relevant
information to Central Offi ce
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Equipment was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
q) Name of donor: Vitalaire
Full amount of the funding R 1 708.86
Period of the commitment N/A
Purpose of the funding To assist in faxing scripts for patients
Expected outputs Ensure correct and accurate information for
patients
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Fax machines / Printers were donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
r) Name of donor: Randfontein District Municipality
Full amount of the funding R34 200.00
Period of the commitment Indefi nite
Purpose of the funding Weighing of patients
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r) Name of donor: Randfontein District Municipality
Expected outputs Ensure correct weight for patients requiring
treatment
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Bathroom scales were donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
s) Name of donor: Aurum Institute for Health Research and TB Free
Full amount of the funding R165 541.49
Period of the commitment Indefi nite
Purpose of the funding Health research and TB Free road shows
Expected outputs Ensure communities are educated in the
prevention / treatment of TB
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Two cars were donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
t) Name of donor: Welch Allyn, GEO Cloud, Samsung, Makro and Furniture City
Full amount of the funding R383 581.91
Period of the commitment Indefi nite
Purpose of the funding Ensure institution is equipped with the necessary
tools
Expected outputs Ensure availability of relevant equipment and
furniture for job requirements
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Equipment / furniture was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
u) Name of donor: National Department of Health
Full amount of the funding R72 000.00
Period of the commitment N/A
Purpose of the funding Improve healthcare waste management
Expected outputs Ensure appropriate storage for placentas and other
anatomical HCW in certain facilities
Actual outputs achieved Undefi ned
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u) Name of donor: National Department of Health
Amount received in current period (R’000) Equipment (Freezers) were donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
v) Name of donor: Hifi Corporation
Full amount of the funding R2 469.98
Period of the commitment N/A
Purpose of the funding Improve healthcare waste management
Expected outputs Ensure institution is equipped with resources
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Audio visual equipment was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
w) Name of donor: Old Mutual
Full amount of the funding R620.00
Period of the commitment Indefi nite
Purpose of the funding Ensure institution is equipped with utensils
Expected outputs Ensure patients receive warm food
Actual outputs achieved Undefi ned
Amount received in current period (R’000) Microwave Oven was donated
Amount spent by the department (R’000) N/A
Reasons for the funds unspent No cash received
Monitoring mechanism by the donor Equipment becomes the department's
responsibility after acceptance of donation
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6.7 Capital investment, maintenance and asset management plan
Through the implementation of various capital and maintenance infrastructure projects, Programme 8
(Health Facilities Management) spent 82% of its allocated budget.
Table 27: Infrastructure projects completed 2012/13
Project name Planned date for completion
Actual date of completion
Reasons for variance
Bertha Gxowa Hospital New 300-bed district hospital
1 July 2011 31 August 2012 On 29 November 2011, the Bertha
Gxowa Hospital was offi cially opened.
Only the outpatients department,
admissions and pharmacy were
functional because the certifi cate
of occupation could not be issued
before completion of fi re-stopping.
Fire-stopping was completed in
August 2012 and the certifi cate was
issued, enabling the hospital to be fully
functional.
Leratong Hospital
Replacement of the main air-conditioning
8 July 2010 5 March 2013 Insuffi cient budget in early years of the
project. Shutting down all theatres for a
period of eight weeks was challenging
as services had to continue.
South Rand Hospital Upgrading and renovations to nurses’ residence
31 August 2012 31 August 2012 The project was completed on time.
Replacement of generators: Helen Joseph Hospital, Sterkfontein Hospital, Tambo Memorial Hospital, Carletonville Hospital, Chris Hani Baragwanath Academic Hospital, South Rand Hospital, Tshwane District Hospital, Lenasia South CHC, Zola CHC, Chiawelo CHC, Lillian Ngoyi CHC, Mofolo CHC
22 December 2011 26 October 2012 Procurement of service providers took
longer than expected.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Project name Planned date for completion
Actual date of completion
Reasons for variance
Johannesburg
Laundry
Replacement of
laundry equipment
18 November 2011 20 June 2012 Procurement of service providers took
longer than expected.
Table 28: Infrastructure projects that are currently in progress
Institution Description Planned completion date
Natalspruit Hospital New 760-bed regional hospital 30 June 2013
Zola Hospital (in Jabulani) New 300-bed district hospital and gateway clinic in Jabulani
16 August 2013
Jubilee Hospital Planning of construction: revitalisation of regional hospital
31 March 2014
Dr Yusuf Dadoo Hospital Planning of construction: revitalisation of regional hospital
31 March 2014
Tambo Memorial Hospital Planning of construction: revitalisation of regional hospital
31 March 2014
Kalafong Hospital Planning of construction: revitalisation of regional hospital
31 March 2014
Sebokeng Hospital Planning of construction: revitalisation of regional hospital
31 March 2014
Chris Hani Baragwanath Academic Hospital
Emergency repairs and refurbishment
31 July 2016
Khayalami Hospital Complete refurbishment of the unused hospital for use as a district hospital
30 November 2017
Helen Joseph Hospital Renovations to psychiatric ward and observation units
30 November 2013
Pretoria West Hospital Upgrading of main air-conditioning chiller plant
30 September 2013
Charlotte Maxeke Johannesburg Academic Hospital
Upgrading and renovation of the psychiatric unit
30 November 2014
Kopanong Hospital Renovation of wards 1 and 2 and psychiatric ward
31 March 2014
Randgate Clinic New clinic 30 September 2014
Tembisa Hospital Renovations and refurbishments to psychiatric wards
30 June 2014
Tambo Memorial Hospital Renovations and refurbishments to psychiatric wards
30 September 2013
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Institution Description Planned completion date
Chris Hani Baragwanath Academic Hospital
Renovations and refurbishments to psychiatric wards and observation units
30 June 2014
Helen Joseph Hospital Upgrading and renovation of four nurses’ and doctors’ residences
30 November 2013
Charlotte Maxeke Johannesburg Academic Hospital
Renovations of doctors’ quarters and staff residences
31 June 2016
Phase 1Charlotte Maxeke , Sebokeng, Leratong, Tembisa and Natalspruit hospitals and Lebone and Bonalesedi colleges
Rapid refurbishment of nurses’ residences
15 May 2013
Phase 2Chris Hani Baragwanath Academic and Dr George Mukari hospitals
Rapid refurbishment of nurses’ residences
30 November 2013
S G Lourens Nursing College Refurbishment of nursing college 27 March 2015
Bonalesedi Nursing College Renovations and additions to nursing college
30 March 2014
Ga-Rankuwa Nursing College Upgrading and renovations to nursing college
27 March 2015
Ann Latsky Nursing College Completion of Phase 2A: upgrading and renovations to nursing college
30 November 2013
Discoverers CHC Convert CHC into district hospital
15 August 2016
Lenasia South CHC Convert CHC into district hospital
31 October 2016
Sterkfontein Hospital Upgrading of psychiatric ward 31 January 2014
Boikutsong CHC Planning for building of new clinic
30 April 2014
Johannesburg FPS Mortuary Either upgrading of existing mortuary or building of new mortuary (depending on site selection)
31 May 2016
Bronkhorstspruit FPS Mortuary Building of new mortuary (possibly together with new EMS facility)
31 May 2016
Finetown Clinic New build 31 May 2015
Project 274 Various institutions Replacement of lifts and boilers 31 March 2014
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Gauteng Provincial Government | Health | Annual Report 2012/2013
The old Germiston Hospital will be demolished.
CEOs of central hospitals were delegated the
authority to approve maintenance projects up to
the value of R1 million. Projects at institutional
level that were valued at less than R500 000
were implemented on the basis of obtaining
three quotations. In accordance with Treasury
Regulations, projects valued at more than R500 000
followed the normal tendering process.
General maintenance of facilities in GDoH has been
mostly unsatisfactory due to capacity challenges.
However, through the Infrastructure Development
Improvement Plan (IDIP), GDID embarked on a
process of appointing new staff with much needed
technical expertise. As GDoH has also instituted a
process to capacitate district offi ces and facility
management units in hospitals, it is envisaged that
maintenance of facilities will improve in the longer
term.
As part of the Turnaround Strategy, the following
tertiary and central hospitals were prioritised:
• Steve Biko Academic Hospital.
• Dr George Mukhari Hospital.
• Charlotte Maxeke Johannesburg Academic
Hospital.
• Chris Hani Baragwanath Academic Hospital.
• Kalafong Hospital.
• Tembisa Hospital.
• Helen Joseph Hospital.
From October 2012 the Infrastructure Directorate
implemented a short term project to improve
maintenance at institutional level. Each prioritised
hospital was allocated a project manager who
visited the hospital weekly and monitored
maintenance and work in progress. Challenges
identifi ed during these visits were discussed at
provincial level and escalated for HOD intervention.
The substantial maintenance backlog continues
to result in the deterioration of the value of assets
and functionality of facilities. Addressing the
maintenance backlog will require an increased
budget.
6.8 Disposal of assets
The asset disposal plan defi nes the assets that can
be considered unsuitable or in excess of service
delivery needs and takes into account the options
of transferring these assets for alternative use or
making them available for rental or sale. All assets
identifi ed in the disposal plan should be disposed of.
An explanation must be given for any such assets
not disposed of. The method, frequency and timing
of disposal , as set out in the disposal plan, must
be followed. Disposal of movable assets should be
done on a quarterly basis and when the need arises.
Transaction
All asset disposals require approval by the
Accounting Offi cer unless the function has been
delegated to CEOs of institutions.
Movable assets will be disposed each fi nancial year
under the following circumstances:
• The asset is obsolete.
• The cost of repairing or maintaining the asset
exceeds the replacement cost.
• Performance of the asset fails to meet opera-
tional requirements.
• The asset has been damaged beyond repair.
Regulations require that disposal of movable
assets must be at market-related value or by tender
or auction, whichever is most advantageous to
the state, unless determined otherwise by the
relevant treasury. They also require that any sale
of immovable state property be at market-related
value, unless the relevant treasury approves
otherwise.
All institutions must ensure that they have (or
have access to) a disposal committee to deal with
disposal of assets.
Where computer equipment is to be disposed of,
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Gauteng Provincial Government | Health | Annual Report 2012/2013
the relevant department of education should be
approached to make arrangements for free transfer
of such assets to educational institutions. Before
disposal of computer hardware, the hard disks have
to be formatted and forensically sanitised to ensure
data cannot be extracted.
All equipment is disposed of in accordance with
sound environmental practice.
All assets disposed of should be recorded in the
disposals register.
• The cash received must be recorded
• The disposal register should record a clear refer-
ence to source documentation.
Non-traceable assets should be written off after
investigation and removed from the asset register.
Proper approval for the write-off must be obtained.
Any losses or discrepancies which appear to result
from criminal action must be reported to the SAPS.
Table 29: Value of assets disposed of 2012/13
Output 2012/2013
Intangible assets 0
Transport assets 3 516 615.80
Other machinery and
equipment 8 573 857.89
Computer equipment 926 180.57
Offi ce furniture and
equipment 369 251.77
Total R13 385 906.09
Because of the department has well-formulated
guidelines for asset disposal, it is able to provide
correct and accurate information and fi nancials.
Measures were taken during the year under review
to ensure that the department’s asset register
remained up to date. All assets must be recorded
in the asset register and asset management
system in accordance with the specifi cations in
Treasury guidelines. The information captured
must include non-fi nancial data on acquisition,
identity, accountability, performance and disposal,
in addition to detailed fi nancial data.
Classifi cation of assets should be directly linked
and conform to the classifi cations within the Annual
Financial Statement disclosure notes.
All assets must be recorded in the asset register,
regardless of the funding source, whether they are
cash or non-cash (found, donated, transferred). Any
and all costs incurred in the process of deploying
an asset within the Department in a working
state, such as confi guration, delivery, installation,
commissioning or other similar costs, must be
included in the overall cost of the asset.
The asset register and asset management system
must allow asset data to be;
• Updated as transactions and events occur.
• Regularly reconciled with acquisition, disposal
and transfer data and the general ledger.
• Readily available to asset managers, preferably
online, for review.
All the information in the asset register must be
safeguarded. No unauthorised changes must be
allowed. Reconciliations between the asset register
and the accounting records (general ledger) must
be done on a monthly basis.
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6.9 Reconciliations
Reconciliation involves a physical asset count
as well as reconciling the asset register and
accounting system. Assets that are procured and
received must be bar-coded and reported to central
offi ce on a weekly basis. A fi le for reconciliation
must be submitted to central offi ce no later than
the tenth day of each month.
Table 30: Breakdown of departmental assets by type and condition
Asset
category
Conditions description
Very
good
% Good % Fair % Poor % Very
poor
% Total %
Intangible assets - - - - - - - - - - - -
Transport assets 63 0.2 469 0.3 1122 0.2 6 0.1 110 0.5 1770 0.2
Other machinery and equipment 15 844 56.9 50 457 30.7 221 178 35.0 2 068 28.7 9 517 42.1 299 064 35.1
Computer equipment 2 877 10.3 15 489 9.4 29 659 4.7 678 9.4 3 485 15.4 52 188 6.1
Offi ce furniture and equipment 9 077 32.6 97 897 59.6 379 549 60.1 4 462 61.9 9 475 41.9 500 460 58.6
Total 27 861 100 164 312 100 631 508 100 7 214 100 22 587 100 853 482 100
None of the department’s immovable assets were
disposed of, scrapped or lost due to theft during
2012/13..
The User Asset Management Plan (UAMP) for
2012/13, rated the condition of 43% of immovable
assets occupied by the GDoH as good to excellent
and 57% as fair. These fi gures do not take into
account electrical and plumbing systems that are
in a poor to very poor state in many health facilities.
This situation is being addressed through the
Electro-Mechanical Replacement Programme and
the following projects were completed in 2012/13:
• Electrical reticulation at 10 institutions.
• Steam reticulation at three institutions.
• Upgrade of autoclaves at 26 institutions.
• Upgrade of chillers at 15 institutions.
The maintenance backlog has increased due to
limited supplier expertise and availability of material
and/or equipment. Supplier diversifi cation is being
considered as remedy.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 31: Expenditure on infrastructure projects 2012/13
2012/2013 2011/2012
Infrastructure
projects
Final
appropriation
R’000
Actual
expenditure
R’000
(Over)/under
expenditure
R’000
Final
appropriation
R’000
Actual
expenditure
R’000
(Over)/under
expenditure
R’000
New and
replacement
assets 738 320 508 359 229 961 1 248 068 596 395 651 673
Existing infra-
structure assets 743 102 672 981 70 121 682 481 538 516 143 965
Upgrades and
additions 96 564 32 357 64 207 213 759 69 044 144 715
Rehabilitation,
renovation and
refurbishment 160 042 34 048 125 994 46 507 - 46 507
Maintenance and
repairs 468 496 606 576 (138 080) 422 215 469 472 (47 257)
Infrastructure
transfer 1 481 422 1 181 340 300 082 1 930 559 1 134 911 795 638
Current 486 496 606 576 (120 080) 422 215 469 472 (47 257)
Capital 994 926 574 764 420 162 1 508 334 665 439 842 895
Total 1 481 422 1 181 340 300 082 1 930 549 1 134 911 795 638
6.10 Achievements in asset management
Monthly reconciliations of the asset register and the
Basic Accounting System (BAS) were submitted to
Treasury before the required deadline. The amounts
involved in reconciliation are indicated in Table 32.
The Asset Management Directorate has achieved
an unqualifi ed audit for two consecutive years
and was approached by the health departments of
Mpumalanga and KwaZulu-Natal for guidance on
achieving similar results. It also received requests
from Treasury to assist another department and
to use the GDoH Asset Management Policy and
Procedure Manual for benchmarking purposes.
Table 32: Reconciliations between BAS and asset register 2012/13
Capital items (R’millions) Minor items (R’millions)
Additions R414 623 R33 477
Disposals R13 385 -
Transfers (GDoH to Social
Development) R92 517 R69 108
Donations R29 616 R7 416
151
152
Part C
GOVERNANCE
153
Governance
Gauteng Provincial Government | Health | Annual Report 2012/2013
1. Introduction
Commitment to maintaining the highest standards
of governance is fundamental to the management
of public fi nances and resources. Tax payers and the
broader public want assurance that the department
has good governance structures in place to utilise
state resources effectively and economically.
2. Risk management
Effective risk management is necessary for the
department to ensure competent strategic decision
making and to conduct of effi cient, effective and
robust business processes. It is essential for
the realisation of the department’s strategic and
operational objectives. Sound management of risk
enables the department to anticipate and respond
to changes in the health environment, and make
informed decisions under conditions of uncertainty.
These decisions impact on the quality of service
delivery.
Strategy development
The department developed a risk management
strategy during the year under review. This focused
on understanding the risks that the department
faces, identifying the causes and developing
control measures. The strategy also acknowledged
the important of creating an environment of
honesty and openness where adverse incidents
are identifi ed quickly and dealt with in a positive
and responsive way. Other aspects of the strategy
dealt with reducing risks to employees and
stakeholders, managing them or transferring them,
as appropriate.
The strategy focus on mitigating risks relating to
the following areas:
• The National Health Council’s top 10 prior-
ities.
• The Gauteng Health Turnaround Strategy.
• Cash flow management.
• Human resources.
• Information and communication technol-
ogy.
• Infrastructure.
• Financial management.
• Risks related to internal and external audit
queries and areas of non-compliance.
Progress in addressing risks
The department’s cash flow position has improved
during the year under review. The department has
considerably decreased its overspending as well
as unauthorised expenditure. Targets in this regard
were developed as part of the Turnaround Strategy
and they were monitored regularly. The fi ve
pillars of the turnaround strategy were: strategic
leadership and a desirable organisational culture;
environmental controls for good governance;
communication and social mobilisation; human
resource management and development; health
infrastructure development and rehabilitation.
Mandate committees were established for high
risk areas. Compensation of employees remained
within the allocated budget and measures were
put into place to reduce expenditure on overtime.
Critical positions were fi lled. Risk assessments
were conducted for infrastructure management
and information and communication technology
and progress was monitored.
3. Fraud and corruption
The following activities were undertaken during
2012/13 with a view to eliminating fraud and
corruption:
• The department developed and implemented a
gift policy to address the common practice of
companies offering gifts as a courtesy to cli-
ents.
• Four offi cials attended the DPSA‘s anti-corrup-
tion training programme.
• Offi cials who attend the induction programme,
154
Gauteng Provincial Government | Health | Annual Report 2012/2013
tha tis offered on a monthly basis, are intro-
duced to the culture and ethos of the depart-
ment.
• There are awareness-raising activities on fraud
prevention and whistle blowing.
• The department conducted 17 training sessions
on ethics and fraud prevention.
Posters promoting the reporting of fraud and
corruption to the Public Service Commission’s
hotline were displayed in all institutions and
on the department’s intranet. Offi cials are also
encouraged to report fraud and corruption to the
risk management unit. Cases reported are referred
by the offi ce of the Public Service Commission
for investigation which is undertaken by Gauteng
Forensic Services.
4. Minimising conflict of interest
The Department has put a process in place whereby
all offi cials are requested to complete a declaration
of interest form on a yearly basis to minimize
conflict of interest. Awareness around conflict
of interest is raised at orientation and induction
sessions as well as training session on the code of
conduct.
Where conflict of interest has been identifi ed,
disciplinary action is taken.
Financial Disclosures were submitted by 90 SMS
members and these were submitted to the Public
Service Commission (PSC).
There were only three (3) SMS members who didn’t
submit as they were on suspension at the time and
have since been dismissed.
Staff on salary levels 1 to 12, including Supply
Chain employees and staff who were translated to
Occupational Specifi c Dispensations (OSDs) are all
required to submit annual Declarations of Interest,
declaring where the employees or their spouses
have business interest with the Department or
any other Department within the Public Service, or
where the employee is performing Remunerative
Work Outside the Public Service (RWOPS).The
system was introduced in the 2012/ 2013 fi nancial
year with varying degrees of compliance. The
monitoring and control measures have been
strengthened to ensure 100% compliance in the
coming fi nancial year.
A vetting plan has been approved and agreed with
the State Security Agency for implementation in the
2013/2014 fi nancial period
5. Code of conduct
The department conducted two training sessions
per institution on the code of conduct during the
fi nancial year. Awareness is also raised during
induction sessions.
Disciplinary procedures are followed where the
code of conduct is breached
6. Health, safety and environmental issues
Occupational health safety structures within
the department were established to address
occupational, health and environmental health
challenges as well as statutory requirements
applicable to these programmes. Occupational
health safety matters are managed within the
context of occupational health safety act. Internal
audits and risk assessments are done and where
occupational health and safety risks are identifi ed,
mitigation plans are put in place to address these.
In addition, the employee health and wellness
challenges is catered for through a range of
programmes as provided for in the DPSA policy for
155
intergrated policy for employee health and wellness.
All employee challenges and needs are addressed
through various committees and referral systems
within the department. Whilst environmental
health and related matters aim is to facilitate
legal compliance to environmental requirements
such as environmental pollution control within the
department.
7. Internal Control Unit
The Internal Control Unit assisted management to
improve the internal control environment through
the following activities:
• The development and implementation of a
monthly key control monitoring tool for all insti-
tutions. This is used to evaluate the effective-
ness of key controls and provide feedback to
management on areas requiring improvement
• Quarterly assessment of overall compliance
with internal controls to provide feedback to
management of weaknesses in the control en-
vironment.
• The establishment and coordination of an Audit
Action Plan Progress Review Committee that
meets on a monthly basis with all relevant of-
fi cials to evaluate progress made on the audit
action plan and to make recommendations for
improvement of audit outcomes.
• Coordination of internal and external audit pro-
cesses and quality assurance of all audit related
submissions.
• Regular training and awareness sessions with
regard to internal control and audit processes to
ensure improvement in the internal control envi-
ronment and the audit outcome.
Gauteng Provincial Government | Health | Annual Report 2012/2013
156
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
REPORT OF THE AUDIT COMMITTEE – CLUSTER 03for the year ended 31 March 2013.
Gauteng Department of Health
We are pleased to present our report for the fi nancial
year ended 31 March 2013
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), fi ve meetings were
held during the current year, i.e. three meetings for
Quarterly Performance Reporting (fi nancial and
non-fi nancial) and two meetings to review and
discuss the Annual Financial Statements and the
Auditor General Report.
Composition of the Audit Committee and Attendance:
The Audit Committee consists of the external
members listed hereunder and is required to meet
a minimum of at least three 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), fi ve
meetings were held during the current year, i.e.3
meetings for Quarterly Performance Reporting
(fi nancial and non-fi nancial) and two meetings to
review and discuss the Annual Financial Statements
and the Auditor-General Report.
Non-Executive Members:
Name of Member Number of Meetings Attended
Lungelwa Sonqishe
(Chairperson)
05
Mandla Ncube
(Member)
05
Nkateko Mabaso
(Member)
05
Executive Members:
In terms of the GPG Audit Committee Charter, the
Offi cials listed hereunder are obliged to attend the
meetings of the Audit Committee:
Compulsory Attendees Number of Meetings
Attended
N Biyela (Acting Head of
Department)
04
Abey Marokoane (Acting
Chief Financial Offi cer)
05
Johann Strauss (Acting
Chief Risk Offi cer)
05
The Audit Committee noted that the Acting Head of
Department did not attend one meeting. However
a letter of apology was tendered with a duly
authorised representative attending on his behalf.
Therefore, the Audit Committee is satisfi ed that the
Department adhered to the provisions of the GPG
Audit Committee Charter.
The Members of the Audit Committee met with the
Senior Management of the Department and Internal
Audit, collectively to address risks and challenges
facing the Departments. A number of in-committee
meetings were held to address control weaknesses
and conflicts with 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
The Audit Committee has observed that the overall
control environment has continued to improve
during the year under review. However, there
are still some concerns with the level of internal
controls within the Department where evidence of
157
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
REPORT OF THE AUDIT COMMITTEE – CLUSTER 03for the year ended 31 March 2013.
lapses of effective monitoring and enforcement by
Management were observed.
During the year under review, several defi ciencies in
the system of internal control and deviations were
reported by the Auditor-General South Africa. In
certain instances, the matters reported previously
have not been fully and satisfactorily addressed.
The quality of in year management and monthly / quarterly reports submitted in terms of the PFMA and the Division of Revenue Act
The Audit Committee is satisfi ed with the content
and quality of monthly and quarterly reports
prepared and issued by the Accounting Offi cer of
the Department during the year under review, in
compliance with the statutory reporting framework.
The managing of performance information needs
to be improved upon.
Evaluation of Financial Statements
The Audit Committee has:
• reviewed and discussed the audited Annual Fi-
nancial Statements to be included in the An-
nual Report, with the Auditor-General and the
Accounting Offi cer;
• reviewed the Auditor-General’s management re-
port and Management’s response thereto;
• reviewed the Department’s compliance with le-
gal and regulatory provisions; and
• reviewed signifi cant adjustments resulting from
the audit.
The Audit Committee concurs with and accepts
the Auditor-General’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 Auditor-
General.
Internal Audit
The Audit Committee is satisfi ed that the Internal
Audit plans addresses a clear alignment with
the major risks, adequate information systems
coverage, a good balance between different
categories of audits, i.e. risk-based, mandatory,
performance and follow-up audits and involvement
and support by Management of the plans.
The Audit Committee has noted considerable
improvement in the communication between the
Executive Management, the Auditor General and
the Internal Audit Function, which has strengthened
the Corporate Governance initiatives.
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, it requires
more capacity and skills. This is being addressed
and corrective action is being implemented.
Risk Management
Progress on Departmental risk management was
reported to the Audit Committee on a quarterly
basis. The Audit Committee is not satisfi ed that the
actual management of risk is receiving attention
and the implementation of the Risk Management
process requires a lot more commitment from
Management.
Forensic Investigations
The Audit Committee is not satisfi ed that the
forensic investigations are properly reported with
age-analysis of all reported issues indicated. Details
of results in respect of investigations conducted as
a result of calls through the fraud hotline were not
provided to the Committee.
158
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
REPORT OF THE AUDIT COMMITTEE – CLUSTER 03for the year ended 31 March 2013.
One-on-One Meetings with the Accounting Offi cer
The Audit Committee has met with the Accounting
Offi cer 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 appraise him on the
performance of the Department.
Auditor-General South Africa
The Audit Committee has met with the Offi ce of the
Auditor-General South Africa to ensure that there
are no unresolved issues.
Lungelwa Sonqishe
CHAIRPERSON OF THE AUDIT COMMITTEE
159
160
Part D:
HUMAN RESOURCE
161
Human Resource
Gauteng Provincial Government | Health | Annual Report 2012/2013
1. Legislation governing HR management The following legislation guides human
resources management in the department:
• The Constitution of the Republic of
South Africa 108 of 1996
• Public Service Regulation of 2001
as amended
• Employment Equity Act. 55 of 1998
• Treasury Regulations of 2001
• Public Service Act 103. Of 1994 as
Amended
• Skills Development Act. 97 Of 1998
• Basic Conditions of Employment Act.
75 of 1997
• Labour Relations Act. 66 of 1995
• All Collective Bargaining Resolutions
agreed upon at the Public Service Co
ordinating Bargaining Council and
Public Health and Social Develop-
ment Sector Bargaining Council
Other key strategic and policy documents
that inform the management of HR in the
health sector are:
• The National Ten Point Plan.
• 12 National Outcomes.
• NHI Green Paper.
• National Human Resources for
Health Strategic Plan.
• DPSA Manual on Organisational De-
sign.
• Negotiated Service Delivery Agree-
ment: Four Health Outcomes.
• Re-engineering of Primary Health-
Care.
• Modernization of Tertiary Services.
• Directive specifying which changes
to organisational structure must be
consulted with the Minister for Pub-
lic Service and Administration prior
to approval by executive authority.
• Policy approved by the Minister of
Public Service and Administration on
national co-ordination of entire occu-
pational categories or certain post
levels, including occupation-specifi c
dispensations.
2. IntroductionThe vision of the Human Resources
Management and Organisational
Development Division is to provide effi cient,
effective and responsive human resources
for the public health sector in Gauteng.
At end of 2012/13, the total number of
employees in the department was 63 659.
This fi gure includes 40 628 health
professionals. The breakdown of
professional employees was as follows:
• Doctors – 5 404
• Dentists – 453
• Nurses – 30 252
• Allied health professionals – 4 042
• Pharmacists – 477
The department prioritised the recruitment of clinical and clinical support staff over administrative and general support Staff. This approach ensured a constant supply of critical clinical staff. However, it also impacted negatively on the supply of general support staff. At the end of the fi nancial year, the total number of health administrative and general support staff was 22 741. This number excludes senior and middle management. In 2013/14 there should be a balance in appointments in order to ensure adequate support for the clinical professional staff.
The department introduced new systems and
improved existing processes for managing
the budget allocated to compensation of
employees. Ineffi ciencies were identifi ed
(for example, the management of overtime
and commuted overtime, and utilisation of
162
Gauteng Provincial Government | Health | Annual Report 2012/2013
provisions on remunerative work outside the
public sector [RWOPS]) and existing policies,
guidelines, operating procedures and control
systems were analysed and reviewed. The
changes resulting from these reviews were
at different stages of development as the
year ended.
The Human Resources Plan for 2012/13
was reviewed and amended in line with the
Turnaround Strategy’s cost containment
measures.
Between July and March the post fi lling
process was expedited and the following
senior management positions were fi lled:
• Chief Financial Offi cer.
• Chief Director: ICT.
• Chief Director: Health Economics.
• Chief Director: Infrastructure
Management.
• Chief Director: District Health
Services.
• Chief executive offi cers for the four
central hospitals.
The departmental HR plan is informed by
the National Human Resources for Health
Plan (HRH) that seeks to strengthen the
entire health system in South Africa. The
GDoH is a labour intensive organisation and
the shortage of skilled health professionals
is a matter of concern. The HR strategy is
developed in the context of preparing the
public health system for the introduction
of National Health Insurance. In the light of
these priorities and in accordance with the
GDoH Turnaround Strategy, the main focus
during 2012/13 was:
• Rationalisation of the staff establish-
ment to manage expenditure on em-
ployees while sustaining good quality
health services.
• Accelerate the fi lling of vacant fund-
ed posts in key health professions
(for example, professional nurses,
doctors, pharmacists, and pharma-
cist assistants).
• Increase productivity and accounta-
bility through effective performance
management.
• Tightening management of overtime
and RWOPS in order to secure best
value for the department.
• Aligning human resource plans with
the strategic direction of the depart-
ment.
The development of a clear human resource
plan assists the department’s managers
to approach HR more strategically, in
alignment with health targets such as the
achievement of the Millennium Development
Goals and the strengthening of the district
health system. The departmental plan is
also informed by the Integrated Health
Planning Framework (IHPF) and the Service
Transformation Plan (STP).
Improved access to human resources has been identifi ed in the national Performance Plan 2012/13 – 2013/14 as a key factor in improving health system effectiveness. This plan identifi es the following as key policy issues that give shape to HR planning:
• Re-engineered model of PHC. • Population-oriented service delivery.• Multi-disciplinary district PHC and
specialist teams.• Ensure expert clinical support for
frontline of healthcare provision: placing doctors at district level.
• Improving maternal and child health-care and TB and HIV services at all levels of the health system.
• Strengthening health facility man-agement for all levels of care.
• Improving working conditions of the health workforce.
• Revitalising infrastructure at all lev-els of care.
163
Gauteng Provincial Government | Health | Annual Report 2012/2013
The following policies were amended to
comply with resolutions and directives from
the DPSA:
• Recruitment and Selection Policy.
• Special Leave Policy.
• Management of Study Leave Policy.
The most signifi cant achievement of the
year was averting over-expenditure on
compensation of employees by means of
stringent monitoring of all appointments
– despite the challenges related to the
budget allocation and the shortage of health
professionals.
Challenges faced by the department
The demerger between the department
of Health and Social Development and
the migration of the functions back to
the department from the Department of
Finance were some of the major challenges
faced during the year. Another was the
rationalisation of the system of placing
personnel closer to the point of service.
There were a number of fi nancial challenges
arising from items that were not fully covered
by the budget. These included the increase
in the compensation of employees and the
retention of consultants to deal with HR
matters arising from ill-health of employees
and disciplinary matters.
Goals and future HR plans
The department needs to address the slow
appointment of employees with clinical
support skills in the new fi nancial year.
There is also a need to appoint key support
staff in human resources, infrastructure
management, fi nance and ICT. There needs
to be an intensifi ed focus on strengthening
PHC through community outreach teams
that have access to appropriate clinical
support.
3. Human resource oversight statisticsUnless stated otherwise, the human
resource oversight statistics tables contain
data from the PERSAL system as at the end
of March 2013.
3.1 Personnel-related expenditure
The following four tables summarise the
fi nal audited personnel-related expenditure
by programme and by salary band. In
particular, they provide an indication of the
following:
• The amount spent on personnel.
• The amounts spent on salaries, over-
time, home-owner’s allowances and
medical aid.
164
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 3.1.1: Personnel expenditure by programme 2012/213
ProgrammeTotal
expenditure (R’000)
Personnel expenditure
(R’000)
Training expenditure
(R’000)
Professional & special services (R’000)
Personnel cost as
% of total expenditure
Average personnel cost per
employee (R’000)
Employment
1.Administration 501 362 241 566 13 293 48 896 48% 92 306 2 617
2.District Health
Services 8 555 956 4 243 315 5 095 7 751 50% 252 608 16 798
3.Emergency
Medical
Services 1 147 231 262 330 32 0 23% 179 310 1 463
4.Provincial
Hospital
Services 6 582 440 4 584 209 532 12 932 70% 250 846 18 275
5.Central
Hospital
Services 7 799 913 5 096 361 584 8 397 65% 277 293 18 379
6.Health
Sciences and
Training 807 070 686 496 5 336 1 85% 134 029 5 122
7.Healthcare
Support
Services 196 544 120 031 0 0 61% 124 643 963
8.Health
Facilities
Management 1 243 831 10 234 3 529 407 1% 243 667 42
HWSETA
Accounts 106 0 3 103 0 0% 0 0
Total 26 834 339 15 244 542 31 504 78 384 56.81% 239 472 63 659
Notes:
a. Financial data extracted from Basic Accounting System (BAS).b. Personnel numbers extracted from the PERSAL system.c. Employment: employees as at 31 March 2013 on the PERSAL System.
165
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 3.1.2 Personnel costs by salary band 2012/13
Salary BandPersonnel
Expenditure (R’000)
% of total personnel
cost
no of employees
Average personnel cost per employee
(R’000)
Lower skilled (Levels 1-2) 940,691 6.2 6 744 139,485.6
Skilled (Level 3-5) 3,540,460 23.2 27 293 129,720.4
Highly skilled production (Levels 6-8) 2,687,674 17.6 11 980 224,346.7
Highly skilled supervision (Levels 9-12) 5,121,372 33.6 12 068 424,376.2
Senior and Top management (levels 13-16) 1,201,004 7.9 81 14,827,209.9
Contract (Levels 1-2) 2,106 0.0 31 67,935.5
Contract (Level 3-5) 37,636 0.2 243 154,880.7
Contract (Levels 6-8) 169,692 1.1 796 213,180.9
Contract (Levels 9-12) 1,336,840 8.8 2 366 565,021.1
Contract (levels 13-16) 59,771 0.4 10 5,977,100.0
Periodical Remuneration 111,225 0.7 891 124,831.6
Abnormal Appointment 36,069 0.2 1 599 22,557.2
Total 15,244,540 100 64 102 237,816.9
Notes:a) Data extracted from Vulindlela.
b) Number of employees refers to a head count of current employees on PERSAL.
166
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 3.1.3 Salaries, overtime pay, home-owner’s allowance and medical aid costs by programme
2012/13
Prog
ram
me
Sala
ries
(R’0
00)
Sala
riesa
s %
of p
erso
n-el
co
st
Ove
rtim
e (R
’000
)
Ove
rtim
e as
% o
f pe
rson
nel c
ost
HO
A (R
’000
)
HO
A as
% o
f pe
rson
nel c
ost
Med
ical
aid
. (R
’000
)
Med
ical
aid
as
% o
f pe
rson
nel c
ost
Tota
l per
sonn
el
cost
(R’0
00)
Administration 226 204 94% 3 139 1% 4 276 2% 7 947 3% 241 566
District Health
Services 3 678 369 87% 224 160 5% 144 898 3% 195 886 5% 4 243 315
Emergency
Medical Services 220 602 84% 4 859 2% 14 111 5% 22 757 9% 262 330
Provincial Hospital
Services 3 812 703 83% 434 259 9% 152 259 3% 184 698 4% 4 584 209
Central Hospitals
Services 4 232 128 83% 550 412 11% 147 970 3% 165 851 3% 5 096 361
Health Sciences
and Training 599 263 87% 660 0% 45 510 7% 41 062 6% 686 496
Healthcare
Support Services 90 205 75% 11 324 9% 9 278 8% 9 223 8% 120 031
Health Facilities
Management 9 698 95% 0 0% 172 2% 364 4% 10 234
Total 12 869 172 84% 1 228 813 8% 518 474 3% 627 788 4% 15 244 542
Notes:a) Data extracted from Basic Accounting System (BAS).b) Total personnel cost differs from Table 3.4.3 as the data sources differ (BAS and Vulindlela).c) Salaries include all compensation of employees except overtime, housing allowance, and employer’s contribution to medical
aid.
167
Gauteng Provincial Government | Health | Annual Report 2012/2013
Table 3.1.4: Salaries, overtime pay, home-owner’s allowance and medical aid by salary band: 2012/13
Salary BandsSalaries Overtime
Home Owners Allowance Medical Aid
Amount (R’000)
Salaries as a % of personnel
costs
Amount (R’000)
Overtime as a % of personnel
costs
Amount (R’000)
HOA as a % of
personnel costs
Amount (R’000)
Medical aid as a % of
personnel costs
Lower skilled (Levels 1-2) 640 174 67.7 15402 1.6 86 263 9.1% 61 654 6.5%
Skilled (Level 3-5) 2 444 106 67.7 72 177 2.0 246 332 6.8% 266 846 7.4%
Highly skilled production (Levels 6-8) 2 108 560 73.1 63 080 2.2 107 285 3.7% 151 829 5.3%
Highly skilled supervision (Levels 9-12) 3 904 563 59.9 80 0675 12.3 73 882 1.1% 136 133 2.1%
Senior and Top Management (levels 13-16) 831 539 65.5 277 478 21.9 4 712 0.4% 11 287 0.9%
Total 9 928 942 65.2 1 228 812 8% 518 474 3.4% 627 749 4.1%Notes:a. Data extracted from Vulindlela.b. All totals on this table differ from Table 3.1.3 as the data sources differ. BAS vs Vulindlela).BAS does not cater for salary bands.c. Senior and top management who are not health professionals do not qualify for overtime. However, 21.9% of this salary band
comprise medical SMS and heads of clinical departments and units.168
Gauteng Provincial Government | Health | Annual Report 2012/2013
3.2 Employment and vacancies
The tables in this section summarise the
position with regard to employment and
vacancies - covering the number of posts on
the establishment, the number of employees,
the vacancy rate, and whether there are any
staff members who are additional to the
establishment.
This information is presented in terms of
three key variables:• Programme.
• Salary band.
• Critical occupations.
The department has identifi ed critical
occupations that need to be monitored. In
terms of current regulations, it is possible to
create a post on the establishment that can
be occupied by more than one employee.
Therefore, the vacancy rate reflects the
percentage of posts that are not fi lled.
Unfunded vacant posts
In order to manage and correctly monitor
the budget for compensation of employees,
specifi c measures were put in place to
prevent over-expenditure.. The process
involved the clean-up of the Personnel and
Salaries (PERSAL) system by abolishing
unfunded posts and freezing vacant funded
posts. The latter will only be fi lled only when
there are funds available.
Although the department was compelled
to take drastic cost containment measures
on the fi lling of vacant funded posts, steps
were also taken to ensure continuation of
critical and essential services. Post-fi lling
was focused on the appointment of staff in
critical health professional categories and
critical support categories.
Tables below (3.2.1 – 3.2.3) also reflect
posts that are additional to the staff
establishment. These additional posts are
made of:
• Health professionals performing
community service: doctors, nurses
and allied professionals.
• Contract personnel in administra-
tion, nursing (retired nurses) and
support categories.
• Interns in medical and allied profes-
sions.
Table 3.2.1: Employment and vacancies by programme 2012/13
Programme Number of posts on approved
establishment
Number of posts
fi lled
Vacancy rate
Number of posts fi lled additional
to the establishment
Administration 1 261 890 24.3% 64
District Health Services 17 898 15 591 9.0% 696
Emergency Medical Services 1 528 1 457 4.6% 1
Provincial Hospital Services 19 277 16 874 7.6% 941
Central Hospital Services 19 764 17 090 8.6% 967
Health Sciences and Training 5 605 4 874 9.9% 176
Healthcare Support Services 1 029 956 6.6% 5
Health Facilities Management 39 34 12.8% -
Total 66 401 57 766 8.7% 2 850
Notes:a. Data was extracted from PERSAL (Establishment Report) as at end March 2013.
b. The vacant posts include 14 frozen posts and nine posts that were approved in principle.
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Table 3.2.2: Employment and vacancies by salary band 2012/13
Salary Band Number of posts on approved
establishment
Number of posts
fi lled
Vacancy rate
Number of employees
additional to the establishment
Lower skilled (Level 1 - 2) 7 908 7 436 5.8% 14
Skilled (Level 3 - 5) 27 278 25 233 6.6% 252
Highly skilled production (Level 6 - 8) 15 757 12 546 10.5% 1 557
Highly skilled supervision (Level 9 - 12) 15 328 12 459 12.0% 1 025
Senior management (Level 13 - 16) 130 92 27.7% 2
Total 66 401 57 766 8.7% 2 850Notes:
a. Data was extracted from PERSAL (Establishment Report) as at end March 2013.
Table 3.2.3: Employment and vacancies by critical occupations 2012/13
Critical occupation Number of posts on approved
establishment
Number of posts fi lled
Vacancy rate Number of employees additional
to the establishment
Dental practitioner 224 187 12.1% 10
Dental specialist 135 112 14.1% 4
Medical practitioner 2 264 1 565 21.9% 203
Medical practitioner (intern) 953 227 12.6% 606
Medical specialist 2 459 2 078 14.4% 26
Emergency care practitioner 1 432 1 360 5.0% 0
Pharmacist 479 351 17.5% 44
Pharmacist (intern) 79 9 27.8% 48
Professional nurse 14 411 11 612 9.6% 1 417
Staff nurse 5 972 5 689 4.3% 26
Nursing assistant 7 186 6 904 3.9% 5
Professional nurse (student) 4 742 4 188 11.5% 10
Total 40 336 34 282 7.0% 2 399Notes:a. Data was extracted from PERSAL (Establishment Report) as at end March 2013.b. This report reflects the number of critical posts as they appear on the establishment.
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3.3 Job evaluation
Within a nationally determined framework,
executing authorities may evaluate or re-
evaluate any job in their organisations. In
terms of the regulations, all vacancies on
salary levels 9 and higher must be evaluated
before they are fi lled. Many posts have
been evaluated through the process of
national co-ordination and the results are
communicated to departments through the
ministerial directives. The following tables
summarise the number of jobs that were
evaluated during the year under review
and indicates the number of posts that
were upgraded or downgraded. As Table
3.3.1 indicates, there was only one network
controller post that was evaluated for the
department.in 2012/13.
Table 3.3.1: Job evaluation by salary band 2012/13
Salary band Posts onestablish-
ment
Number of jobs
evaluated
% of jobs evaluated
Posts upgraded Posts downgraded
Number % of posts
evaluated
Number % of posts
evaluated
Lower skilled (L 1-2) 7 902 0 0.0% 0 0.0% 0 0.0%
Skilled (L 3-5) 27 182 0 0.0% 0 0.0% 0 0.0%
Highly skilled production (L 6-8) 15 134 1 0.0% 0 0.0% 0 0.0%
Highly skilled supervision (L9-12) 12 871 0 0.0% 0 0.0% 0 0.0%
Senior management Band A 84 0 0.0% 0 0.0% 0 0.0%
Senior management Band B 22 0 0.0% 0 0.0% 0 0.0%
Senior management Band C 8 0 0.0% 0 0.0% 0 0.0%
Senior management Band D 2 0 0.0% 0 0.0% 0 0.0%
Contract (L 1-2) 6 0 0.0% 0 0.0% 0 0.0%
Contract (L 3-5) 96 0 0.0% 0 0.0% 0 0.0%
Contract (L 6-8) 623 0 0.0% 0 0.0% 0 0.0%
Contract (L 9-12) 2 457 0 0.0% 0 0.0% 0 0.0%
Contract Band A 4 0 0.0% 0 0.0% 0 0.0%
Contract Band B 7 0 0.0% 0 0.0% 0 0.0%
Contract Band C 3 0 0.0% 0 0.0% 0 0.0%
Contract Band D 0 0 0.0% 0 0.0% 0 0.0%
Total 66 401 1 0.0% 0 0.0% 0 0.0%Notes:
a. Number of posts is based on the establishment report as at the end of March 2013.b. The above mentioned post has been evaluated and confi rmed to be in the correct level. It was not upgraded.c Due to national coordination most of the jobs are evaluated nationally by DPSA.
d. All OSD post cannot be evaluated.
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Table 3.3.2 provides a summary of the number of employees whose positions were upgraded due
to their post being upgraded. The number of employees benefi ting might differ from the number of
posts upgraded since not all employees are automatically absorbed into the new posts and some of
the upgraded posts could be vacant.
Table 3.3.2: Profi le of employees whose positions were upgraded due to their posts being upgraded
2012/13
Benefi ciary 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 0 0 0 0 0Notes:
a. There were no upgraded or downgraded posts.
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 3.3.3: Employees with salary levels higher than those determined by job evaluation of occupation
2012/13
Occupation Number of employees
Job evaluation
level
Remuneration level
Reasons for deviation
None 0 0 0 0
Percentage of total employed N/A
Table 3.3.4 summarises the benefi ciaries of the above in terms of race, gender, and disability.
Benefi ciary 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 0 0 0 0 0
Total number of employees whose
remuneration exceeded the grade determined
by job evaluation in 2012/2013
NONE
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3.4 Employment changes
This section provides information on changes in employment over the fi nancial year. Turnover rates
provide an indication of trends in the employment profi le of the department. The following tables provide a
summary of turnover rates by salary band and critical occupations.
Table 3.4.1: Annual turnover rates by salary band 2012/13
Salary Band
Number of employees April 2012
Appointments and transfers
into the department
Terminations and transfers
out of the department
Turnover rate (%)
Lower skilled (Level 1 - 2) 6 744 336 251 0.04
Skilled (Level 3 - 5) 27 293 1 258 857 0.03
Highly skilled production (Level 6 - 8) 11 980 738 878 0.07
Highly skilled supervision (Level
9 - 12) 14 558 1 410 1 421 0.10
Senior management service (Band
A) 60 3 3 0.05
Senior management service (Band
B) 19 2 10 0.53
Senior management service (Band
C) 1 0 6 6.00
Senior management service (Band
D) 1 0 3 3.00
Contracts 3 446 2 624 1 656 0.48
Total 64 102 6 371 5 085 7.9Notes:a. Data extracted from PERSAL.b. Number of employees - as on 1 April 2012.c. Appointments and transfers into the department between 1 April 2012 and 31 March 2013.
d. Terminations and transfers out of the department between 1 April 2012 and 31 March 2013.
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Table 3.4.2: Annual turnover rates by critical occupation 2012/13
Critical occupation Number of employees at the beginning
of period - April 2012
Appointments and Transfers
into the Department
Terminations and
transfers out of the
Department
Turnover rate
Dental Practitioner 284 50 43 15.1%
Dental Specialist 169 27 19 11.2%
Medical Practitioner 2 139 951 498 23.3%
Medical Practitioner (Intern) 845 492 258 30.5%
Medical Specialist 2 420 356 288 12.9%
Emergency care practitioner 1 340 202 35 2.6%
Pharmacists 430 125 116 27.0%
Pharmacists (Intern) 47 224 56 119.1%
Professional Nurse 12 363 918 1 106 8.9%
Staff Nurse 5 705 74 166 2.9%
Nursing Assistant 6 871 267 207 3.0%
Professional Nurse (Student) 5 313 737 106 2.0%
Total 37 926 4 423 2 898 7.6%Notesa. Data extracted from PERSAL.b. This table only represents critical occupations.c. Number of employees as on the 1 April 2012d. Appointments and transfers into the department between 1 April 2012 and 31 March 2013.e. Terminations and transfers out of the department between 1 April 2012 and 31 March 2013.
The table 3.4.3 provides reasons for staff leaving
the department.
The function of terminating employment is
being transferred from the GDF to institutions is
underway. This also decentralises the processing
of pensions and improves the turnaround time on
receipt of pension benefi ts. Improvements have
already been evident with the waiting period for
retirement benefi ts reduced from more than 90
days to less than 30 days.
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Table 3.4.3: Reasons for staff leaving the department 2012/13
Termination type (a) Number% of total
resignations
Death 272 5.3%Resignation 1 985 39.0%Expiry of contract 1 880 37.0%Dismissal - operational changes 0 0.0%Dismissal – misconduct 109 2.1%Dismissal – ineffi ciency 0 0.0%Discharged due to ill-health 38 0.7%Retirement 789 15.5%Transfer to another public service department 12 0.2%Other 0 0.0%Total 5 085 100.0%
Total number of employees who left as a % of total employment 7.9%
Notes:a. Data extracted from PERSAL.
b. Terminations between 1 April 2012 and 31 March 2013.
Table 3.4.4: Promotions by critical occupation
Occupational Class (b) Employees as at 01 April
2012
Promotionsto anothersalary level
Salary level promotions
as a % of Employees by
occupation
Progression to
another notch within a salary level
Notch progression
as a % of
Employees by occupation
Dental Practitioner 284 0 0.00% 1 0.35%
Dental Specialist 169 0 0.00% 0 0.00%
Medical Practitioner 2139 0 0.00% 22 1.03%
Medical Practitioner
(Intern) 845 0 0.00% 0 0.00%
Medical Specialist 2 420 8 0.36% 5 0.22%
Emergency care
practitioner 1 340 0 0.00% 0 0.00%
Pharmacists 430 0 0.00% 1 0.23%
Pharmacists (Intern) 47 0 0.00% 0 0.00%
Professional Nurse 12 363 6 0.05% 2 0.02%
Staff Nurse 5 705 1 0.02% 1 0.02%
Nursing Assistant 6 871 0 0.00% 0 0.00%
Professional Nurse
(Student) 5 313 0 0.00% 0 0.00%
Total 37 926 15 0.04% 32 0.08%Notes:a. Data extracted from PERSAL.b. Promotions between 1 April 2012 and 31 March 2013.c. Number of employees as on 1 April 2012.
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Table 3.4.5 Promotions by salary band: 2012/2013
Salary band Employees
1 April 2012
Promotionsto anothersalary level
Salary band promotions
as a % of employees in salary level
Progression to another
notch within a salary level
Notch progression
as a % of employees in salary bands
Lower skilled (Level 1 - 2) 6 775 7 0.1% 0 0.0%
Skilled (Level 3 - 5) 27 536 47 0.2% 1 0.0%
Highly skilled production
(Level 6 - 8) 12 776 19 0.1% 1 0.0%
Highly skilled supervision
(Level 9 - 12) 16 924 20 0.1% 31 0.2%
Senior management
(Level 13 - 16) 91 2 2.2% 0 0.0%
Total 64 102 95 0.1% 33 0.05%Notes:a. Data extracted from PERSAL.b. Number of employees as on 1 April 2012.
c. Promotions between 1 April 2012 and 31 March 2013.
3.5 Employment Equity
Table 3.5.1: Total number of employees (including employees with disabilities) as at 31 March 2013 by
occupational category
Occupational category Male Female
TotalA C I W A C I W
Legislators, senior offi cials
and managers 106 8 4 8 80 6 7 13 232
Professionals 1 625 41 432 875 1449 67 441 913 5 843
Technicians and associate
professionals 2 572 40 51 1 83 16 910 557 342 1 392 22 047
Clerks 2 287 55 17 91 5 143 103 16 426 8 138
Service workers and shop
and market sales workers 2336 25 16 74 12 865 184 22 226 15 748
Craft and related trades
workers 1 0 0 0 1 0 0 2 4
Plant and machine
operators and assemblers 366 9 2 11 37 0 0 0 425
Elementary occupations 3 520 51 7 93 7 267 166 6 112 11 222
Grand Total 12 813 229 529 1 335 43 752 1 083 834 3 084 63 659
Employees with
disabilities 27 1 0 12 26 4 1 6 77
Notes:a. Data extracted from PERSAL as at end March 2013b. Total number of employees is as at the end of the reporting period (31 March 2013).This table counts current employees and
not fi lled posts.
c. Abbreviations: A=African, C=coloured, I=Indian, W=white.
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Table 3.5.2 Total number of employees (including employees with disabilities) as at 31 March 2013 by
occupational band
Occupational band Male Female Total
A C I W A C I W
Top management 4 1 5
Senior management 43 1 3 7 20 3 3 4 84
Professionally qualifi ed,
experienced specialists
and mid-management 2 930 75 475 1 019 9 708 325 637 1 641 16 810
Skilled technical and
academically qualifi ed
workers, junior
management, and
supervisors 2 215 52 31 163 9 558 370 151 1 061 13 601
Semi-skilled and
discretionary decision-
making 5 427 70 19 107 20 403 300 40 354 26 720
Unskilled and defi ned
decision-making 2 194 31 1 39 4 062 85 3 24 6 439
Total 12 813 229 529 1 335 43 752 1 083 834 3 084 63 659
Employees with
disabilities 27 1 12 26 4 1 6 77The existing fi gure were wrong so I added up again – think its fi neNotes:a. This table counts current employees and not fi lled posts.b. Abbreviations: A=African, C=coloured, I=Indian, W=white.c. Classifi cation legend: Top management: Deputy director-general and upwards, but excludes the MEC. Senior management: Chief director and director. Professionally qualifi ed, mid-management: Level 9 to 12 and professionals level 0, 13 and 14. Skilled technical, junior management and supervisory: Levels 6 to 8. Semi-skilled, discretionary decisions: Levels 3 to 5. Unskilled, defi ned decisions: Levels 1 to 2.
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Table 3.5.3: Recruitment 2012/13
Occupational band
Male Female
TotalA C I W A C I W
Top management 1 1
Senior management 3 5 8
Professionally
qualifi ed, experienced
specialists and mid-
management 590 16 97 230 996 37 181 357 2 504
Skilled technical
and academically
qualifi ed workers,
junior management,
and supervisors 187 5 4 22 702 48 50 286 1 304
Semi-skilled and
discretionary
decision-making 326 5 6 12 1 094 21 15 40 1 519
Unskilled and defi ned
decision-making 135 1 1 2 244 383
Total 1 242 27 108 266 3 041 106 246 683 5 719
Employees with
disabilities 1 Notes:a. Data extracted from PERSAL for period from1 April 2012 to 31 March 2013.b. This table counts only the number of appointments and excludes transfers into the department.c. Abbreviations: A=African, C=coloured, I=Indian, W=white.d. Classifi cation legend: Top management: Deputy director-general and upwards, but excludes the MEC. Senior management: Chief director and director. Professionally qualifi ed, mid-management: Level 9 to 12 and professionals level 0, 13 and 14. Skilled technical, junior management and supervisory: Levels 6 to 8. Semi-skilled, discretionary decisions: Levels 3 to 5.
Unskilled, defi ned decisions: Levels 1 to 2.
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Table 3.5.4: Promotions: 2012/13
Occupational band Male Female Total
A C I W A C I W
Top management 1 1
Senior management 1 1
Professionally qualifi ed and experienced specialists and mid-management
15 4 6 13 1 7 5 51
Skilled technical and academically qualifi ed workers, junior management, supervisors
5 15 20
Semi -skilled and discretionary decision-making 18 30 48
Unskilled and defi ned decision-making 2 5 7
Total 42 0 4 6 63 1 7 5 128
Employees with disabilities 0
Notes:a. Data extracted from PERSAL for the period 1 April 2012 to 31 March 2013.b. Table includes both level and notch promotions. Level promotion = promotion from one salary level to another (For example,
Professional Nurse Grade 1 [Level 6] to Professional Nurse Grade 2 [Level 7]). Notch promotion = promotion or pay progression from one notch to another within the same salary level.
c. Classifi cation legend: Top management: Deputy director-general and upwards, but excludes the MEC. Senior management: Chief director and director. Professionally qualifi ed, mid-management: Level 9 to 12 and professionals level 0, 13 and 14. Skilled technical, junior management and supervisory: Levels 6 to 8. Semi-skilled, discretionary decisions: Levels 3 to 5. Unskilled, defi ned decisions: Levels 1 to 2.
d. Abbreviations: A=African, C=coloured, I=Indian, W=white.
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Table 3.5.5: Terminations: 2012/13
Occupational band Male Female Total
A C I W A C I W
Top management 3 1 5 1 10
Senior management 3 2 1 6
Professionally qualifi ed, experienced specialists and mid-management 481 13 85 182 1 063 36 119 277 2 256
Skilled technical and academically qualifi ed workers, junior management, and supervisors 195 8 12 22 738 39 43 330 1 387
Semi-skilled and discretionary decision-making 282 8 1 10 795 26 5 31 1 158
Unskilled and defi ned decision-making 91 1 1 9 156 5 1 4 268
Total 1 055 30 100 228 2 754 106 169 643 5 085
Employees with disabilities 3 2 1 1 7
Notes:
a. Data extracted from PERSAL.
b. Abbreviations: A=African, C=coloured, I=Indian, W=white.
c. Classifi cation legend:
Top management: Deputy director-general and upwards, but excludes the MEC.
Senior management: Chief director and director.
Professionally qualifi ed, mid-management: Level 9 to 12 and professionals level 0, 13 and 14.
Skilled technical, junior management and supervisory: Levels 6 to 8.
Semi-skilled, discretionary decisions: Levels 3 to 5.
Unskilled, defi ned decisions: Levels 1 to 2.
Management of discipline has improved immensely
due to training. Most disciplinary cases in 2012/13
2012/13 were fi nalised on time. Disciplinary cases
related mainly to absenteeism and theft. High
profi le cases involving senior management were
appropriately managed
The department managed to fi nalise all grievances
lodged through the Public Service Commission.
Most of employees’ grievances related to
recruitment and selection processes and the
majority were resolved. Most of employee disputes
concerned unfair dismissal, promotions and unfair
disciplinary action.
Table 3.5.6: Number of employees involved in disciplinary actions 2012/13
Male Female Total
A C I Total
black
W A C I Total
black
W
342 10 4 356 7 445 10 2 457 28 848Notes:
a. Data extracted from PERSAL.
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Table 3.5.7: Skills development: 2012/2013
Occupational category
Male Female Total
A C I Totalblack
W A C I Totalblack
W
Legislators, senior offi cials & managers 61 1 0 62 0 111 4 1 116 0 178
Professionals 61 9 13 83 10 88 17 5 110 4 207
Technicians & associate professionals 1 006 57 99 1 162 336 3 862 102 97 4 061 618 6 177
Clerks 2 005 191 35 2 231 89 4 867 228 199 5 294 991 8 605
Service workers, shop & market sales workers 411 58 51 520 7 901 68 37 1 006 115 1 648
Craft and related trades workers 0 0 0 0 0 0 0 0 0 0 0
Plant and machine operators and assemblers 67 3 9 79 16 2 1 6 9 1 105
Elementary occupations 71 0 11 82 5 161 21 17 199 26 312
Total 3 682 319 218 4 219 463 9 992 441 362 10 795 1 755 17 232
Employees with disabilities 0 0 0 0 0 1 0 1 2 0 2
Notes:a. Abbreviations: A=African, C=coloured, I=Indian, W=white.b. Classifi cation legend: Legislators, senior offi cials and managers: Offi cials responsible for determining and formulating policy and strategy, planning,
directing and coordinating policies and activities of organisation. Professionals: Include offi cials whose main tasks require a high level of professional knowledge. Technicians and associate professionals: This group includes employees whose main tasks require technical knowledge and
experience. Clerks: This group includes occupations whose tasks require the knowledge and experience necessary to organise, store,
compute and retrieve information. Service workers, shop and market sales workers: This group includes employees whose main tasks require knowledge and
experience necessary to provide personal and protective services. Craft and related trades workers: This comprises employees whose main tasks require knowledge and experience of skilled
trades and handicrafts. Plant and machine operators and assemblers: The main tasks of these employees involve the use of automated industrial
machinery and equipment. Elementary occupations: This group covers occupations which require relatively low levels of knowledge and experience
required to perform mostly simple and routine tasks, involving use of hand held tools and in some cases considerable physical
effort. With few exceptions, their work requires limited personal initiative and judgment.
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3.6 Performance rewards
To encourage good performance, the department granted performance rewards to selected employees, as
indicated in the following four tables. The information is presented in terms of race, gender, and disability,
salary bands and critical occupations
Table 3.6.1: Performance rewards by race, gender and disability 2012/13
Race and gender
Benefi ciary profi le Cost
Number of
benefi ciaries
Number of
employees
% of total within
group Cost (R’000)
Average cost
per employee
African male 78 42 036 0.2% 455 5 833
Indian male 11 11 893 0.1% 67 6 091
Coloured male 1 802 0.1% 6 6 000
White male 1 482 0.2% 6 6 000
African female 2 1 031 0.2% 11 5 500
Indian female 0 212 0.0% 0 0
Coloured female 3 2 967 0.1% 17 5 667
White female 0 1 146 0.0% 0 0
Total 96 60 569 0.2% 562 5 854Notes:
a. Data extracted from Vulindlela as at 31 March 2013.
Table 3.6.2: Performance rewards by salary band for personnel below senior management service
2012/13
Salary band
Benefi ciary profi le Cost
Number of benefi ciaries
Number of employees
% of total within salary bands
Total cost (R’000)
Average cost per
employee
Cost as a % of total personnel
expenditure
Unskilled (Levels
1-2) 9 8 738 0.1 51 5 667 0.0%
Skilled (Levels
3-5) 37 25 196 0.1 209 5 649 0.1%
Highly skilled
production
(Levels 6-8) 22 12 520 0.2 123 5 591 0.1%
Highly skilled
supervision
(Levels 9-12) 26 12 958 0.2 162 6 231 0.1%
Periodical
remuneration 0 908 0 0 0 0.0%
Abnormal
appointment 0 1 741 0 0 0 0.0%
Total 94 62 061 0.2 545 5 798 0.4%Notes:a. Data extracted from Vulindlelaas at 31 March 2013.
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Table 3.6.3: Performance rewards by critical occupation 2012/13
Critical Occupation
Benefi ciaries Cost
Number of benefi ciaries
Number of employees
% of total within
occupation
Total cost (R’000)
Average cost per employee
Dental practitioner 0 230 0 0 0
Dental specialist 0 99 0 0 0
EMS practitioner 1 1 360 0.1 0 6 000
Medical practitioners 2 2 956 0.1 12 6 000
Medical specialist 1 1 801 0.1 6 6 000
Nursing assistant 5 6 522 0.1 28 5 600
Pharmacist 3 987 0.3 17 5 667
Professional nurse 25 11 610 0.2 150 6 000
Staff nurse 14 5 779 0.2 79 5 643
Total 51 31 344 0.2 292 5 725Notes:
a. Data extracted from Vulindlela as at 31 March 2013.
Table 3.6.4: Performance related rewards by salary band for senior management service: 2012/13
Salary Band
Benefi ciary profi le Cost
Number of benefi ciaries
Number of employees
% of total within salary bands
Total cost (R’000)
Average cost per
employee
Total cost as % of total
personnel expenditure
Band A 0 66 0 0 0 0
Band B 0 25 0 0 0 0
Band C 0 3 0 0 0 0
Band D 0 0 0 0 0 0
Total 0 94 0 0 0 0
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3.7 Foreign workers
The tables below summarise the employment of foreign nationals in the department in terms of salary
band and major occupation.
Table 3.7.1 Foreign workers by salary band : 2012/2013
Salary Band 1 April 2012 31 March 2013 Change
Number
% of
total Number
% of
total Number
%
Change
Lower skilled 15 2.2% 17 2.4% 2 8.7%
Highly skilled (Level 6-8) 67 9.7% 73 10.2% 6 26.1%
Highly skilled supervision (Level 9-12) 309 44.7% 307 43.0% -2 -8.7%
Contract (Level 9-12) 300 43.4% 317 44.4% 17 73.9%
Contract (Level 13-16) 0 0.0% 0 0.0% 0 0.0%
Total 691 100.0% 714 100.0% 23 100.0%Notes:
Data extracted from Vulindlela – 31st March 2013
Table 3.7.2 Foreign workers by major occupation: 2012/2013
Major occupation 1 April 2012 31 March 2013 Change
Number % of
total
Number % of total Number % Change
Administrative offi ce workers 16 2.1% 12 1.6% (4) 30.8%
Elementary occupations 15 2.0% 6 0.8% (9) 69.2%
Information technology personnel 2 0.3% 2 0.3% 0 0.0%
Professionals and managers 708 94.7% 553 75.2% (155) 1192.3%
Social natural technical and medical
sciences+supp 1 0.1% 1 0.1% 0 0.0%
Technicians and associated
professionals 6 0.8% 161 21.9% 155 (1192.3%)
Total 748 100.0% 735 100.0% (13) 100.0%
Notes:
a. Data extracted from Persal
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3.8 Leave utilisation
The Public Service Commission has identifi ed a 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 3.8.1: Sick leave 2012
Salary Band Total days % days with
medical certifi cate
Number of employees using sick
leave
% of total employees using sick
leave
Average days per
employee for year
Estimated cost
(R’000)
Unskilled (Levels 1-2) 37 566 92.7% 5 466 12.3% 7 9 516
Skilled (Levels 3-5) 124 489 90.2% 18 837 42.5% 7 43 062
Highly skilled production
(Levels 6-8) 71 810 85.9% 10 799 24.4% 7 41 766
Highly skilled & supervisory
(Levels 9-12) 55 997 85.1% 8 684 19.6% 6 68 640
Senior management (Levels
13-16) 3 290 77.0% 541 1.2% 6 10 339
Total 293 151 88.34% 44 327 100.0% 7 173 323Notes:a. Data extracted from Vulindlela.b. Data is available for calendar year and not fi nancial year.
Table 3.8.2: Disability leave (temporary and permanent) 2012
Salary band Totaldays
% Days with
medical certifi cate
Number of employees
using disability
leave
% of total employees
using disability
leave
Average days per
employee per year
Estimated cost
(R’000)
Lower skilled (Levels 1-2) 376 100.0% 38 15.8 10 93
Skilled (Levels 3-5) 1 639 100.0% 92 38.3 18 592
Highly skilled production
(Levels 6-8) 836 100.0% 69 28.8 12 475
Highly skilled and
supervisory (Levels 9-12) 742 100.0% 37 15.4 20 900
Senior management (Levels
13-16) 15 100.0% 4 1.7 4 53
Total 3 608 100.0% 240 100.0 15 2 113Notes:a. Data extracted from Vulindlela.b. Data is presented for calendar year and not fi nancial year.
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The table below summarises the utilisation of annual leave. The wage agreement concluded with trade
unions in the Public Sector Collective Bargaining Chamber in 2000 requires management of annual leave
to prevent high levels of accrued leave being paid at the time of termination of service.
Table 3.8.3: Annual leave 2012
Salary Band Total days taken
Number of employees
using annual leave
Average days per employee
per year
Lower skilled (Levels 1-2) 157 402 7 851 20
Skilled (Levels 3-5) 552 798 26 337 21
Highly skilled production (Levels 6-8) 281 612 14 314 20
Highly skilled and supervisory (Levels 9-12) 272 513 13 325 20
Senior management (Levels 13-16) 27 112 1 298 21
Total 1 291 436 63 125 20Notes:a. Data extracted from Vulindlela.
b. Data is presented for the calendar and not fi nancial year.
Table 3.8.4 Capped leave 2012
Salary band Total days of capped leave
taken
Number of employees
using capped leave
Average number of days taken
per employee
Average capped leave per employee
as at 31 December
2012
Lower skilled (Levels 1-2) 187 46 4 46
Skilled (Levels 3-5) 1 315 320 4 320
Highly skilled production (Levels 6-8) 1 231 260 5 260
Highly skilled and supervisory (Levels
9-12) 1 531 318 5 318
Senior management (Levels 13-16) 197 33 6 33
Total 4 461 977 5 977
Notes:a. Data extracted from Vulindlela.b. Data is presented by calendar year and not fi nancial year.
c. Number of employees refers to those with capped leave between 1 January 2012 and 31 December 2012.
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The following table summarises payments made to employees as a result of leave that was not taken.
Table 3.8.5 Leave pay-outs: 2012
Reason Total amount
(R’000)
Number of
employees
Average
payment
per employee
(R’000)
Leave payout for 2011/12 due to non-utilisation of leave
for the previous cycle - - -
Capped leave payouts on termination of service for
2012/13 39 766 53 40 7 447
Current leave payout on termination of service for
2012/13 146 945 154
Total 39 912 6 285 6 350Notes:a. Data extracted from Vulindlela.b. Data is presented by calendar year and not fi nancial year.
c. Number of employees refers to those with capped leave between 1 January 2012 and 31 December 2012.
3.9 HIV and AIDS and Health Promotion Programmes
Table 3.9.1: Steps taken to reduce the risk of occupational exposure 2012/13
Categories of employees considered at high risk of contracting HIV and related diseases
Key steps taken to reduce the risk
Doctors Policy approved and implemented for prophylaxis for accidental exposure to blood-borne pathogens.
Nurses Guidelines in place for prophylaxis for accidental exposure to blood borne pathogens.
Laboratory workers Protective clothing provided.
Cleaners working in clinical areas Survey undertaken to assess risk.
Laundry workers Training provided for offi cers.
Mortuary workers A Directorate of Health Care Waste & Occupational Hygiene Management has been created.
Healthcare waste offi cers
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Table 3.9.2: Details of Health Promotion and HIV/AIDS Programmes 2012/13
Question Yes No Details, if 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.
X
2. Does the department have a dedicated
unit or designated staff members to
promote health and wellbeing 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.
X
The relevant unit is the EHWP Directorate
consisting of the following units: HIV &
AIDS and TB Management (4 posts); EAP (4
posts); and Occupational Health (7 posts).
The budget allocated from the equitable
share was R6.4 million for 2011/12 and
R5.3 million for 2013/2014. There was
no allocation from the HIV and AIDS
Conditional Grant.
3. Has the department introduced an
employee assistance or health promotion
programme for its employees? If so,
indicate the key elements/services of the
programme.
X
The department has developed an
integrated workplace health and wellness
programme for employees. It comprises
HIV and AIDS and TB management, EAP
and occupational health. The EAP provides
psychosocial support to employees,
including: individual and group counselling,
fi nancial and debt management, trauma
counselling, conflict management,
resilience training and pre-retirement
courses.
4. Has the department established a
committee 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.
X
There are provincial, regional and
institutional committees in place. These are
under the leadership of the Acting Director:
Wellness Programme. The provincial
committee comprises:
Departmental representatives: Ms D
Mopedi, Ms G Gemell, Ms N Mdumbe,
Ms P Koetsi, Ms Ms B Mathebula, Ms K
Tembani, Ms E Molefe, Ms N . Ngxabi.
Union representatives are: Mr R Lawrence,
Mr S Motlhabane, Mr. J Mashala and
additional representatives of all recognised
trade unions (PSA, NEHAWU, HOSPERSA,
NUPSAW & DENOSA).
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Question Yes No Details, if yes
5. Has the department reviewed its
employment policies and practices
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
The HIV and AIDS Workplace policy and
the Recruitment and Selection policy
have been ratifi ed and implemented. The
Employment Equity statement is clear on
no discrimination.
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.
X
HIV and AIDS prevention and awareness
programmes have been implemented.
Treatment, care and support is available
in the department. Social mobilisation
programmes are also undertaken.
7. Does the department encourage its
employees to undergo voluntary counselling
and testing? If so, list the results that you
have achieved.
X
As part of the HCT programme the
department encourages employees
undergoing voluntary testing. Due to the
confi dential nature of the process, it is
diffi cult to measure achievements. However
staff members have presented themselves
in large numbers for testing in recent
years. During the 2013 Condom Week,
398 personnel members underwent HCT,
eye testing, and glucose and hypertension
testing.
8. Has the department developed measures/
indicators to monitor & evaluate the impact
of your health promotion programme? If so,
list these measures/indicators.
X
Indicators have been developed and are
monitored quarterly. They include the
number of institutions engaging in healthy
lifestyle, nutrition, food gardening and
physical activity programmes, the number
of personnel who disclosed their HIV status,
and the number of personnel on ARVs.
Quarterly reports are also available from the
Directorate Integrated EHWP. Indicators for
measuring the impact of EHWP services are
as follows: number of employees accessing
EHWP services, number of employee
wellness centres established, number of
employees undergoing training on EHWP
and reduction of occupational injuries and
disease.
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Question Yes No Details, if yes
Number of employees undergoing training
on HIV and AIDS issues conducted by HIV
and AIDS workplace programmes.
Number trained on:
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.
X
The total number of employees who
attended training in the year under review
was 4 076.
The detailed breakdown of attendance on
different topics:
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:
Capacity building on PMTCT:
3.10 Labour Relations
Table 3.10.1: Collective agreements 2012/13
Subject matter Date
PSCBC Resolution 1 of 2012 (Wage agreement) 31/07/2012
PSCBC Resolution 3 of 2012 (Closing of pension redress project) 03/19/2012
PHSDSBC Resolution 1 of 2012 (OSD for engineers etc) 29/11/2012
PHSDSBC Resolution 2 of 2012 (Offi ce space) 29/11/2012
Table 3.10.2: Misconduct and disciplinary hearings fi nalised 2012/13
Outcomes of disciplinary hearings Number % of total
Correctional counselling 25 3.1%
Verbal warning 93 11.5%
Written warning 263 32.5%
Final written warning 380 47.0%
Suspended without pay 0 0.0%
Fine 0 0.0%
Demotion 0 0.0%
Dismissal 28 3.5%
Not guilty 7 0.9%
Case withdrawn 12 1.5%
Total 808 100.0%
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Table 3.10.3: Types of misconduct addressed at disciplinary hearings 2012/13
Type of misconduct (based on annexure A) Number % of total
HR and procurement irregularities 14 1.7%
Absenteeism 258 30.4%
Negligence 34 4.0%
Insubordination 74 8.7%
Fraud and corruption 26 3.1%
Dishonesty and misrepresentation 9 1.1%
Theft 138 16.3%
Dereliction of duty 85 10.0%
Other 188 22.2%
Intimidation and incitement 22 2.6%
Total 848 100.0%Notes:
a. The 188 cases under “Other” include: 1. Misuse of state vehicles and damage of state property (22). 2. Assault (16). 3. Abscondment (5) 4. Unauthorised RWOPS (22). 4. Late coming (74). 5. Poor performance (49).b. The above total of 848 includes 40 cases pending at the end of the fi nancial year.
Table 3.10.4: Grievances lodged 2012/13
Number % of total
Number of grievances resolved 430 97.7%
Number of grievances not resolved 10 2.3%
Total number of grievances lodged 440 100.0%
Table 3.10.5: Disputes lodged 2012/13
Number % of total
Number of disputes upheld 94 59.1%
Number of disputes pending 65 40.9%
Total number of disputes lodged 159 100.0%Notes:
a. The pending cases include those:
1. Awaiting arbitration awards.
2. Arbitration which are in progress.
3. Awaiting dates for arbitration.
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Table 3.10.6: Strike actions 2012/13
Total number of person working days lost 57
Total cost of working days lost (R’000) 23 157
Amount recovered as a result of no work no pay (R’000) 23 157
Table 3.10.7: Precautionary suspensions 2012/13
Number of people suspended 12
Number of people whose suspension exceeded 30 days 12
Average number of days suspended 185
Cost of suspensions (R’000) 3 231
3.11 Skills development
Table 3.11.1 Training needs identifi ed 2012/13
Occupational category Gender
Number of employees
as at 1 April 2012
Learnerships
Training needs at the start of the reporting period
Skills programmes & other short
courses
Other forms of training
Total
Legislators, Senior Offi cials
and Managers
Female 112 0 100 0 100
Male 116 0 80 0 80
Professionals Female 2 813 0 785 0 785
Male 3 043 0 474 0 474
Technicians and associate
professionals
Female 18 893 350 5 229 0 5 229
Male 2 701 150 796 0 796
Clerks Female 5 905 0 2 305 0 2 305
Male 2 548 0 1 260 0 1 260
Service workers and shop
and market sales workers
Female 13 541 0 1 805 0 1 805
Male 2 394 0 1 405 0 1 405
Craft and related trades
workers
Female 3 0 2 0 2
Male 1 0 1 0 1
Plant and machine
operators and assemblers
Female 38 0 20 0 20
Male 412 0 200 0 200
Elementary occupations Female 7 801 0 605 0 605
Male 3 781 0 220 0 220
Total 64 102 500 15 287 0 15 287Notes:a. Number of employees is as at the beginning of the reporting period (i.e. April 2012) as required by the reporting guideline.b. Learnerships, Skills Programmes and other forms of training are trainining needs identifi ed as per Workplace Skills Plan of
2012/ 2013c. Classifi cation legend: Legislators, senior offi cials and managers: Offi cials responsible for determining and formulating policy and strategy, planning,
directing and coordinating policies and activities of organisation. Professionals: Include offi cials whose main tasks require a high level of professional knowledge. Technicians and associate professionals: This group includes employees whose main tasks require technical knowledge and
experience.
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Clerks: This group includes occupations whose tasks require the knowledge and experience necessary to organise, store, compute and retrieve information.
Service workers, shop and market sales workers: This group includes employees whose main tasks require knowledge and experience necessary to provide personal and protective services.
Craft and related trades workers: This comprises employees whose main tasks require knowledge and experience of skilled trades and handicrafts.
Plant and machine operators and assemblers: The main tasks of these employees involve the use of automated industrial machinery and equipment.
Elementary occupations: This group covers occupations which require relatively low levels of knowledge and experience required to perform mostly simple and routine tasks, involving use of hand held tools and in some cases considerable physical effort. With few exceptions, their work requires limited personal initiative and judgment.
Table 3.11.2: Training provided for the period 2012/13
Occupational category Gender
Number of employees
as at 1 April 2012
Learner-ships
Training provided within the reporting period
Skills programmes & other short
courses
Other forms of training
Total
Legislators, senior offi cials and managers
Female 112 0 116 0 100
Male116 0 62 0 80
Professionals Female 2 813 0 114 0 785
Male 3 043 0 93 0 474
Technicians and associate Ppofessionals
Female 18 893 191 4 679 0 5 229
Male 2 701 106 1 498 0 796
Clerks Female 5 905 0 6 285 0 2 305
Male 2 548 0 2 320 0 1 260
Service workers and shop and market sales workers
Female 13 541 0 1 121 0 1 805
Male 2 394 0 527 0 1 405
Craft and related trades workers
Female 3 0 0 0 2
Male 1 0 0 0 1
Plant and machine operators and assemblers
Female 38 0 10 0 20
Male 412 0 95 0 200
Elementary occupations
Female 7 801 0 225 0 605
Male3 781 0 87 0 220
Total 64 102 297 17 232 0 15 287Notes:a. Number of employees is extracted from PERSAL as at the beginning of the reporting period (April 2012) as required by the
reporting guideline.b. Learnerships, skills programmes and other forms of trainingare per narrative section of Annual Training Report of 2012/13.c. Classifi cation legend: Legislators, senior offi cials and managers: Offi cials responsible for determining and formulating policy and strategy, planning,
directing and coordinating policies and activities of organisation. Professionals: Include offi cials whose main tasks require a high level of professional knowledge. Technicians and associate professionals: This group includes employees whose main tasks require technical knowledge and
experience. Clerks: This group includes occupations whose tasks require the knowledge and experience necessary to organise, store,
compute and retrieve information. Service workers, shop and market sales workers: This group includes employees whose main tasks require knowledge and
experience necessary to provide personal and protective services. Craft and related trades workers: This comprises employees whose main tasks require knowledge and experience of skilled
trades and handicrafts. Plant and machine operators and assemblers: The main tasks of these employees involve the use of automated industrial
machinery and equipment. Elementary occupations: This group covers occupations which require relatively low levels of knowledge and experience
required to perform mostly simple and routine tasks, involving use of hand held tools and in some cases considerable physical
effort. With few exceptions, their work requires limited personal initiative and judgment.
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3.12 Injury on duty
Table 3.12.1: Injury on duty 2012/13
Nature of injury on duty Number % of total
Required basic medical attention only 500 99.60%
Temporary total disablement 2 0.40%
Permanent disablement 0 0.00%
Fatal 0 0.00%
Total 502 100.00%
3.13 Utilisation of consultants
Table 3.13.1: Report on consultant appointments using appropriated funds 2012/13
Project title Total number of
consultants that worked
on the project
Duration work days
Contract value
(Rands)
Renewal of the Oracle licence for the support and
maintenance of patient information systems databases
(Medicom, ECIS, SMS and HER)
1 (Oracle) 12 months R3 419 208.73
Notes:
a. All projects approved during the reporting period.
Table 3.13.2: Analysis of consultant appointments using appropriated funds, in terms of historically
disadvantaged individuals 2012/13
Project Title Percentage ownership by HDI groups
Percentage management
by HDI groups
Number of consultants
from HDI groups that work on the
project
Renewal of the Oracle licence for the support and
maintenance of patient information systems databases
(Medicom, ECIS, SMS and HER)
1% 1% 1
Notes:b. 55% of appropriated funds for goods and services were spent on BEE companies.
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195
196
Part E:
FINANCIAL INFORMATION
197
Financial Information
TABLE OF CONTENTS
REPORT OF THE ACCOUNTING OFFICER 198ACCOUNTING OFFICER'S STATEMENT OF RESPONSIBILITY 222REPORT OF THE AUDITOR GENERAL 223APPROPRIATION STATEMENT 230NOTES TO THE APPROPRIATION STATEMENT 263STATEMENT OF FINANCIAL PERFORMANCE 265STATEMENT OF FINANCIAL POSITION 266STATEMENT OF CHANGES IN NET ASSETS 267CASH FLOW STATEMENT 268ACCOUNTING POLICIES 269NOTES TO THE ANNUAL FINANCIAL STATEMENTS 278DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTS 294ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTS 308
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REPORT OF THE ACCOUNTING OFFICERfor the year ended 31 March 2013.
1. General review of the state of fi nancial affairs
1.1 Vision To be the best provider of quality health
services to the people in Gauteng.
1.2 MissionTo provide excellent, integrated health
services in partnership with stakeholders
and to contribute towards the reduced
burden of disease in all communities in
Gauteng.
1.3 Important policy decisions affecting the departmentThe following signifi cant policy
developments during 2012/13 will affect the
work of the department in future years:
Memorandum of Agreement (MOA) with
National Government and Turnaround
Strategy
In December 2011, a Memorandum of
Agreement (MOA) between the Premier and
the National Ministers of Health and Finance
was signed.
The obligations of the province included
strengthening budget planning and
implementation, recovering debts owed
to the province and the development of a
comprehensive Turnaround Strategy. The
MOA remained in effect for the duration of
2012/13, and implementation was monitored
through weekly and monthly meetings of the
Technical Task Team, consisting of GDoH,
Gauteng Treasury, Gauteng Department of
Infrastructure Development, the Offi ce of
the Premier, the national DOH and National
Treasury.
The Turnaround Strategy 2012-14 was
developed with the involvement of staff,
management, the National Department
of Health, National Treasury, Provincial
Treasury, stakeholders, and the Gauteng
Executive Council, and was approved by the
Executive Council on 4 July 2012.
The Turnaround Strategy seeks to address
the following eight key areas:
1. Financial management.
2. Human resource management.
3. District health services.
4. Hospital management.
5. Communication and social
mobilisation.
6. Infrastructure and maintenance.
7. Information management.
8. Litigation management.
The Turnaround Strategy will continue to be
implemented for the remainder of the period
of the 2013 Medium Term Expenditure
Framework (MTEF).
As part of the Turnaround Strategy, the
department is implementing fi nancial
management interventions that will ensure
organisational stability and an institutional
culture of fi scal discipline. The department
continue to manage irregular expenditure in
order to eliminate accruals. Commitment
by all categories of staff to ensuing that
the Turnaround Strategy permeates all our
programmes will ensure that the department
delivers on its mandate.
Good progress is being made with stabilising
the department and implementing far-
reaching changes, particularly with regard
to fi nancial management, supply chain
management, the Medical Supplies Depot
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REPORT OF THE ACCOUNTING OFFICERfor the year ended 31 March 2013.
and human resources. However, the scale
of the problems faced by the department
in previous years means that the process
of restoring service levels, improving
effi ciencies and building improved systems
for quality service delivery will continue into
2013/14.
The department will continue to face severe
budget constraints in 2013/14. However, in
spite of these constraints, we are committed
to delivering quality health services and
achieving the health outcomes in the
Negotiated Service Delivery Agreement and
the Gauteng Programme of Action. We will
achieve this by doing things more effi ciently,
working smarter, and implementing cost
containment measures to ensure that
resources are focused on core service
delivery.
As a result, the majority of targets in the
Annual Performance Plan continue to
increase in line with the MTEF targets.
In addition, certain “targets”’ (projections
of demand for services), such as PHC
headcounts and the number of outpatients
at hospitals, continue to increase over the
MTEF because the reality is that demand for
services in Gauteng continues to increase,
in spite of a restricted resource envelope.
Our challenge is to continue to ensure
quality services even as the demand for
services increases. We are confi dent that
the Turnaround Strategy maps out a way to
do this, and the dedication and energy of our
health workers is the engine that will drive
implementation of the strategy.
Administrative curatorship (Section 18)
In December 2012, the Executive Council
of the Gauteng Provincial Government
resolved that the Department of Health
would be placed under administrative curatorship as per Section 18 of the Public Finance Management Act (PFMA). Invoking Section 18 of the PFMA will assist the department to achieve its mandate and to comply with the PFMA. In terms of this section, the Gauteng Provincial Treasury has appointed a consortium, consisting of Price Waterhouse Coopers, EOH and Ngubane and Co, that will assist the Department to put in place systems and build capacity for effi cient, effective and transparent fi nancial management. Specifi c areas that require the consortium’s assistance have been identifi ed.
• Finance: Financial mismanagement, defi cits and inadequate systems all point to a poor control environment, a general lack of adequate super-vision and fi scal discipline, which unfortunately severely impairs the department’s ability to deliver servic-es as expected. Problems in supply chain management are also sympto-matic of a poor control environment, ill-discipline, inadequate systems and poorly skilled human resources.
• Accenture has also been deployed as per National Treasury’s advice to assist the department with budget reforms. The team is in the process of developing a budget monitoring tool which will be useful for man-agement to review budgeting and spending trends.
• Hospital services: Overall manage-ment, accountability and structures that allow for interventions to be measured, monitored and improved upon are needed throughout the end-to-end management of health-care facilities where the service
delivery is the key objective.
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• Leadership and culture: Weaknesses
in this area have left the department
disoriented in the strategic sense,
and service delivery staff experience
lack of certainty and a weakened
sense of direction as a result.
• Human resources: While it is true
that properly skilled and effectively
managed human resources are the
most important investment for good
service delivery, organisational per-
formance (or effectiveness) is also
critically allied to strategy execution,
which can be enhanced by effective
programme management.
Fixed-dose combination (FDC) ARVs
At the end of 2012/13, the national
Department of Health announced that, with
effect from 1 April 2013, implementation
of the Fixed Dose Combination (FDC) ARV
would be rolled out for treatment of AIDS.
The once-a-day, single ARV tablet contains
a combination of three ARVs – tenofovir,
efavirenz and emtricitabine. Initially, it is
being given to newly diagnosed HIV positive
persons with CD4 counts lower than 350
and to all HIV positive pregnant women
and breast-feeding mothers regardless of
their CD 4 count. It is expected that FDC
will improve and strengthen adherence to
treatment by reducing the pill burden.
1.4 Important strategic issues facing the department A new MEC for Health was appointed in
July 2012, and a permanent Chief Financial
Offi cer (CFO) assumed duty in October 2012.
The Head of Department left the department
in October 2012, and the Chief Financial
Offi cer acted as Head of Department for the
remainder of the fi nancial year.
The department continued with the cost-
saving measures introduced in 2011/12.
Despite cost-saving measures having been
achieved to some extent, the department
continued to experience some resource
constraints. However, these resource
constraints were less severe in the reporting
period compared with previous fi nancial
years. During 2012/13, the department
settled accruals to the value of R4.2 billion
while ensuring that current year payments
were also made.
The department also settled accruals
relating to the Gauteng Medical Supplies
Depot in the fi rst quarter of the fi nancial
year which made possible the restoration
of pharmaceutical services at the depot.
The department made consistent payments
to the Medical Supplies Depot throughout
the 2012/13 fi nancial year. Some medicine
shortages were still experienced at the
Medical Supplies Depot during the year but
these could mainly be attributed to lead
times of suppliers between production of
drugs and deliveries.
The merger between the GDoH and the
Department of Social Development was
reversed with effect from 1 April 2012.
The GDoH therefore became a standalone
department with effect from the same
date. During the process of separating
the departments a formal agreement was
reached that accruals to the value of R63
million would be paid by the GDoH on behalf
of the Department of Social Development
during 2012/13. This amount was duly paid.
A process to convert debt balances and
other relevant asset and liability accounts of
the two departments was undertaken. There
were certain assets that were procured
while the departments were merged and a
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process to transfer assets took place with
appropriate recording in both asset registers.
In terms of reporting on prior year balances,
GDoH disclosed all prior year balances on
behalf of both departments while Social
Development disclosed zero prior year
balances.
The department continued to work with the
Provincial Treasury in making cash available
to pay suppliers. There has been acceleration
in paying suppliers as a result of which the
department is disclosing lower accruals for
the fi nancial year 2012/13 in comparison to
previous fi nancial years.
To ensure that only valid invoices of the
previous fi nancial years are paid, the
department has implemented a prepayment
audit process where each invoice relating
to previous fi nancial years is validated for
authenticity and only released for payment
once validated as correct.
Three senior managers were charged with
fraud and corruption. The disciplinary cases
were fi nalised in February 2013 with a
dismissal sanction for all three. Two of the
senior managers have declared a dispute
at the Bargaining Council, alleging unfair
dismissal. These cases are in progress.
The Identifi cation Verifi cation Solution (IVS)
Project, which involves verifying employees
against the population register and the pay-
roll, was launched on 13 February 2013. The
project is driven by Gauteng Department of
Finance (GDF) in partnership with the GDoH.
Central offi ce was the fi rst institution to be
verifi ed on the 25 and 26 February 2013
followed by the four central hospitals. As the
fi nancial year closed, the department was
busy with verifying personnel from central
offi ce and the four central hospitals who had
been on vacation or sick leave. The roll out to
the tertiary, regional, district and specialised
hospitals was due to follow in the new
fi nancial year. The whole department,
including the district health services,
nursing colleges and the laundries, is to be
completed within the 2013/14 fi nancial year.
The ICT and Revenue sections are in the
process of upgrading Medicom to the
latest version, EM 12.x. The upgrade will
be implemented at all institutions which
were previously running on MEDICOM. The
maintenance and support of EM 12.x will
form part of the upgrade and will extend
for a period of three years. A submission
has been made to BAC for approval of the
project. It should be noted that the two new
hospitals (Zola and Natalspruit) will form
part of the EM 12.x implementation.
1.5 Priorities of the department The programme and service priorities of
the GDoH are guided by the international,
national and provincial policies and
strategies listed below.
The Millennium Development Goals and
improving health outcomes
Goal 1: Eradicate extreme poverty and
hunger.
Goal 3: Promote gender equality and
empower women.
Goal 4: Reduce child mortality.
Goal 5: Improve maternal health.
Goal 6: Combat HIV and AIDS, malaria and
other diseases.
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The outcomes in the Negotiated Service
Delivery Agreement between the President
and the Minister of Health
1. Increased life expectancy.
2. Decreased maternal, infant and child
mortality.
3. Combating HIV and AIDS and
decreasing the burden of disease
from tuberculosis.
4. Improving health systems
effectiveness.
The 10-Point Plan of the national
Department of Health
• Provision of strategic leadership and
creation of social compact for better
health outcomes.
• Implementation of National Health
Insurance (NHI) as a pilot project.
• Improving the quality of health ser-
vices.
• Overhauling the healthcare system
and improving its management.
• Improved human resources planning
development and management.
• Revitalisation of infrastructure.
• Accelerated implementation of the
HIV and AIDS strategic plan and the
increased focus on TB and other
communicable diseases.
• Mass mobilisation for the better
health for the population.
• Review of drug policy.
• Strengthening research and develop-
ment.
Gauteng provincial strategic priorities
2009-14
• Quality basic education.
• Long and healthy life for all.
• All people are and feel safe.
• Decent employment.
• Sustainable human settlements.
• Effective local government system.
• Fair and inclusive citizenship.
Objectives of the Turnaround Strategy for
Health 2012-14
• More effective utilisation of available
resources by the department.
• The clearing of debt and accruals.
• Delivery within allocated budgets.
• Improvement of health outcomes.
• Entrenchment of the desired
organisational culture and enhanced
internal discipline. throughout the
organization.
• Improved public and partner
confi dence.
National health priorities, including NHI
pilot initiative and the non-negotiable
priorities
The African Cup of Nations
From 19 January to 12 February 2013 South
Africa hosted the Orange African Cup of
Nations. The tournament was played in fi ve
cities, with Gauteng hosting the opening
and closing ceremonies. In terms of the
mandate, the national Department of Health
and the South African Local Organising
Committee (SALOC) made commitments to
provide health and medical services for the
games. The GDoH was obliged to provide
certain health and medical services in terms
of guarantees provided by the Minister of
Health.
The department, together with the host
city, provided comprehensive medical
services for the CAF delegation, VIPs, teams’
delegates, match offi cials and spectators.
The department was also responsible
for the provision of health and medical
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services to foreign and local spectators,
media, sponsors, offi cials, administrators
and the small business sector servicing
the spectators at the respective venues.
As a result, EMS personnel, vehicles and
equipment were deployed in the following
areas during the duration of the tournament.
• Competition areas at stadiums.
• VIP medical centres at stadiums.
• Training grounds.
• Team base camps.
• Airports.
The games were a success and the
department played a role in this through the
following:
• Hospitals were placed on standby for
treatment of government VIPs and
spectators and for mass casualty
situations should they have arisen.
• Environmental health offi cers
provided appropriate accreditation
of all appropriate Orange Cup of
Nations venues.
• A provincial communicable disease
outbreak response team was
established and placed on standby
during the tournament.
• Health promotion was provided at
identifi ed hot spots.
• Port health services were provided at
all international airports on a 24-hour
basis.
• Forensic pathology services were
placed on standby as part of the
precautions for disaster management
(in case of mass deaths and victim
identifi cation requirements).
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1.6 Spending trends and general review of fi nancial affairsTable A: Departmental expenditure by budget programme
Programme
Final appropriation
2012/13R’000
Expenditure 31March
2013R’000
PercentageSpent
VarianceR’000
Administration 683 447 501 362 73% 182 085
District Health Services 8 782 484 8 555 956 97% 226 528
Emergency Medical Services 1 059 284 1 147 231 108% (87 947)
Provincial Hospital Services 6 546 896 6 582 440 101% (35 544)
Central Hospitals 7 566 859 7 799 913 103% (233 054)
Health Sciences and Training 841 924 807 070 96% 34 854
Health Care Support Services 199 821 196 544 98% 3 277
Health Facilities Management 1 510 879 1 243 831 82% 267 048
Total 27 191 594 26 834 347 99% 357 247
The table above summarises the budget
versus actual amount spent as at 31 March
2013. The department spent 99% of the
budget which implies that the department
is within budget. However, the department
reported over-spending on two programmes:
• Emergency Medical Services: over-
spent by 8%. The over-expenditure
is due to the payment of accruals for
goods and services and transfers to
municipalities. The provincialisation
of Sedibeng District with effect from
1 September 2012 also contributed
to overspending on compensation of
employees.
• Central Hospitals: overspent by 3%.
The main contributors to over-ex-
penditure on this programme are
goods and services as a result of the
payment of accruals and payments
to households arising from injury and
deaths on duty and unplanned resig-
nations.
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Table B: Expenditure by economic classifi cation
Economic classifi cation
Final appropriation
2012/13R’000
Expenditure 31 March
2013R’000
Percentagespent
VarianceR’000
Compensation of employees 15 278 812 15 244 542 100% 34 270
Goods and services 8 380 580 8 625 127 103% (244 547)
Interest and rent on land 0 981 0% (981)
Provinces and municipalities 964 285 1 083 525 112% (119 240)
Departmental agencies and accounts 28 286 28 267 100% 19
Universities and technikons 1 500 500 33% 1 000
Non-profi t institutions 916 785 817 505 89% 99 280
Households 83 731 86 713 104% (2 982)
Buildings and other fi xed structure 848 689 528 282 62% 320 407
Machinery and equipment 688 926 413 182 60% 275 744
Payment of fi nancial assets 0 5 723 0% (5 723)
Total 27 191 594 26 834 347 99% 357 247
From the table above it is evident that the
categories Goods and services, Transfers
to provinces and municipalities and
Households exceeded the allocated budget.
The main reason for the overspending was
payment of the previous year’s accruals in
2012/13. Over-expenditure in relation to
Households was attributable to the payment
for injury and deaths on duty and unplanned
resignations.
The under-spending on items may be
explained as follows: Under-spending on
Universities and technikons was due to
actual student intake which was less than
what was projected by the department. In
respect of NPOs, the under-spending was as
a result of late submission of claims by the
municipalities.
The overall under-spending on buildings
and other fi xed structures was due to slow
performance on infrastructure grants
– delays in appointment of contractors
by the implementing agent resulted in
projects not being completed as planned
and late processing of invoices. The delays
in completion of infrastructure projects
resulted in unavailability of storage space for
medical equipment and therefore spending
against budget was only 60%.
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Table C: Department’s spending trends over the past fi ve years
Year
Annual
appropriation
R’000
Actual
R’000
Over/under
expenditure
R’000
2008/9 16 649 946 17 421 818 (771 872)
2009/10 19 144 154 20 272 357 (1 128 203)
2010/11 22 568 438 22 380 182 188 256
2011/12 25 819 914 25 990 164 (170 250)
2012/13 27 191 594 26 834 347 357 257
The table above depicts the growth in the department’s spending by R11 billion from 2008/9 to 2012/13.
This is the result of an increase in the price of medical commodities as well as cost of living adjustments.
Table D: Non-negotiable items
Actual
expenditure
R’000
Infection control and cleaning 287 065
Medical supplies including dry dispensary 1 131 245
Medicines 1 122 517
Medical waste 101 896
Laboratory services: National Health Laboratory Services (NHLS) 1 239 164
Blood supply and services 535 230
Food services 195 358
Security services 278 186
Laundry services 30 071
Essential equipment and maintenance of equipment 296 790
Infrastructure maintenance 711 348
Children’s vaccines 53 283
HIV & AIDS programme 878 309
Total 6 859 462
The table above provides the spending
on non-negotiable items. The top cost
drivers among the non-negotiable items
are medicines, laboratory services, medical
supplies, the HIV and AIDS programme and
infrastructure maintenance.
Virement
An application for 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
PFMA and Treasury Regulation 6.3.
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Virement was made only in relation to the
compensation of employees and goods
and services economic classifi cations. The
following main divisions were affected:
• Administration.
• District Health Services.
• Provincial Hospital Services.
• Central Hospital Services.
• Health Sciences and Training.
• Healthcare Support Services.
The Acting Chief Financial Offi cer of the
department recommended the application
which was subsequently approved by the
Provincial Treasury.
The main reasons for unauthorised
expenditure incurred by the department
related to payment of accruals from the
previous fi nancial years which included
transfers to municipalities. The department
will continue to implement cost-saving
measures which started in 2012/13 during
the 2013/14 fi nancial year.
2. Services rendered by the department
• Strategic management and support
services are provided at all levels of
the department, that is, provincial, re-
gional and district levels.
• Primary healthcare services are de-
livered through the district health
system. A network of provincial clin-
ics and community health centres
provide ambulatory care adminis-
tered by doctors, nurses and other
professionals. In some areas local
authorities are subsidised to render
care at clinics.
• Emergency medical services and
planned patient transport are provid-
ed throughout the province.
• Secondary healthcare services are
provided through regional hospitals
that offer outpatient and inpatient
care at general specialist level and
tertiary care at three tertiary hospi-
tals.
• Specialised healthcare services pro-
vide inpatient care for psychiatric and
infectious diseases. Some tuberculo-
sis and chronic psychiatric services
are provided on an outsourced basis.
• Inpatient and outpatient academ-
ic healthcare services are provided
through four central hospitals and
three dental hospitals, with teaching
also taking place at other service lev-
els.
• Health sciences faculties and nurs-
ing colleges provide training for fu-
ture healthcare professionals.
These services are supported through
human resource development, management
and health support systems such as
laundries, facilities management, food
services and medicine supply services.
3. Tariff policy
The department applies the Uniform Patient
Fee Structure (UPFS) as its tariff policy.
The UPFS manual is reviewed annually as
per provision of Treasury Regulation 7. In
addition the department charges fees for
other revenue items and reviews the fees
schedule annually in consultation with
the Provincial Treasury as per Treasury
Regulation 7.
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4. Free services
H1 patients do not pay for services rendered
by the department as per government policy.
A full schedule of services provided free of
charge to specifi c categories of people in
accordance with legislation appears on page
119 of this report.
5. Inventories
• Inventory management has become
the function of supply chain manage-
ment (SCM) and falls under the Re-
porting: Sub-directorate. A policy on
inventory management was adopted
and rolled out to all health institu-
tions .
• A road show on inventory manage-
ment was undertaken for the districts
in February 2013 to inform SCM offi -
cials of the annual stocktake and the
need to include counting stock at
wards, clinics and open pharmacies.
SCM offi cials were notifi ed that the
counting of stock at wards must be
done by the sister in charge and a TPH 42 form must be used only for reporting on the description of the item and the quantity on hand as at the last day of March. The weighted average cost was done by stores.
• A meeting took place between EMS and Internal Control and Risk Man-agement in respect of inventory management pertaining to the stock in the ambulances and the method that was agreed to be used during stock-take.
• Stock-take certifi cates are consoli-dated at central offi ce and reported to Provincial Treasury for the depart-ment.
6. Capacity constraints
The department is currently engaged in a restructuring process to strengthen the management of hospitals and health districts in line with the national Human Resources for Health Strategy, the Re-engineering Primary Healthcare Services and the departmental Turnaround Strategy. Organisational structures are being aligned with national Department of Health structures.
There has been consultation with relevant parties on the rationalisation of the staff establishment, in accordance with the principle of decentralisation. Human Resource Management was compelled to take serious cost containment measures on the fi lling of vacant posts and has demonstrated commitment in the implementation of these measures. Statutory posts for community service and internships for graduating health professionals remain a challenge.
The challenges experienced by the department in retaining health professionals are being addressed as a priority. Good progress has been made in the appointment of medical specialists and practitioners. There has been accelerated fi lling of health professional posts through regular institutional post-fi lling planning meetings based on costed human resource plans, which are monitored by dedicated HR practitioners. All vacant unfunded posts were frozen.
The department is implementing the national DOH process of developing staffi ng norms for all categories of staff. This is being piloted in the Tshwane Health District as part of the preparation for implementation of NHI.
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There has been tighter management of remunerative work outside the public service (RWOPS) and overtime to align with service delivery needs and budget allocation. Overtime in excess of 30% must be motivated to the Head of Department.
There is close monitoring of attendance, leave and absenteeism. Disciplinary action is being taken where there are transgressions.
Most of senior positions vacant for a period of time, such as Chief Financial Offi cer, Head of Infrastructure, Health Economist, Chief Director for District Health and the Chief Director for Information and Communication Technology, have been fi lled. The appointment of chief executive offi cers (CEOs) for the four central hospitals and the pending appointment of CEOs for other levels of hospitals will strengthen the management of systems.
These appointments are accompanied by delegation of authority and performance management agreements (PMA) aligned with the National Service Delivery Agreement (NDSA). The fi lling of these posts is having a positive impact on service delivery and
planned programmes.
7. Utilisation of donor funding
The department receives donations from diverse donors for utilisation on various activities which might have not been provided for in the budget and to supplement the available resources. Donations are received in cash and kind and are used for purposes as specifi ed by the donor. Donations are managed in accordance with Treasury Regulations and the PFMA. Donations received in cash during 2012/13 amounted to R203 000. Donations in kind included medical supplies, computer equipment, vehicles and other machinery.
8. Trading entities and public entities
The Medical Supplies Depot is a trading entity of the department which is responsible for the supply of essential medicines and disposable sundry items to provincial healthcare facilities. The depot charges a levy of fi ve percent (5%) on stock issued to provincial facilities. The Annual Financial Statements of the Medical Supplies Depot along with the Accounting Offi cer’s Report, Audit Committee Report and the Report of the Auditor-General, is contained elsewhere in this annual report. These reports provide comparative information, describe new developments at the depot and include
information on losses and guarantees.
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9. Organisations to which transfer payments have been made Table E: Transfers to municipalities for delivery of PHC services
Municipality BudgetR’000
Total expenditure R’000
Ekurhuleni 168 117 190 627
City of Johannesburg 142 960 184 032
City of Tshwane 67 546 49 348
Total 378 623 424 007
Table F: Transfers to municipalities for delivery of emergency medical services
Municipality Budget
R’000
Total expenditure R’000
Sedibeng District Municipality 63 317 44235
West Rand District Municipality 49 675 48887
Ekurhuleni 178 830 229 534
City of Johannesburg 127 264 192 867
City of Tshwane 74 514 61504
Total 493 600 577 027
Table G: Transfers to departmental agencies and accounts
Agency Budget
R’000
Actual transfer
R’000
Health & Welfare SETA 28 238 28 238
SABC 0 29
Total 28 238 28 267
Table H: Transfer to universities and technikons
Institution Budget
R’000
Actual transfer
R’000
University of Johannesburg 540 0
University of Witwatersrand 434 302
University of Pretoria 345 198
University of Limpopo 181 0
Total 1 500 500
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Table J: Transfers to non-governmental and community-based organisations
Institution Budget R’000 Total expenditure R’000
Psychiatric/mental health 285 519 241 843
Community-based services 266 498 221 924
HIV and AIDS 196 153 199 388
Nutrition 49 379 48 856
Witkoppen Clinic 8 125 5 063
Alexander Health Centre 45 580 39 655
Phillip Moyo 24 110 17 907
District management 41 421 27 360
Management 0 15 121
Total 916 785 817 504
10. Public-private partnerships
Public-private partnership (PPP)
infrastructure projects for the GDoH are
implemented through a agreement, signed
on the 5 May 2010, which is referred to as
the Joint Implementation Agreement (JIA).
The agreement involves the following role
players:
• Development Bank of Southern
Africa (DBSA).
• Department of National Treasury
(PPP Unit).
• National Department of Health
(DOH).
• Gauteng Department of Health
(GDOH).
The following are Ministerial Flagship
projects in Gauteng:
• Chris Hani Baragwanath Academic
Hospital.
• Dr George Mukhari Academic
Hospital.
These projects are governed by the Joint
Implementation Committee (JIC) with
shared responsibilities between DBSA,
National Treasury – PPP Unit, national DOH
and GDOH.
Previously GDoH was mandated to lead the
PPP projects. This function has now been
taken over by the Infrastructure Unit of the
national health department. Currently, there
is no funding or budget for these projects
from the GDoH.
See disclosure note on PPPs for details in
this regard.
11. Corporate governance arrangements
The Audit Committee continued to provide
valuable and effective support and oversight
to the department in relation to performance
management, fi nancial management, risk
management and accountability during the
2012/13 fi nancial year.
The Audit Committee was established
in 2001 and was fully functional during
2012/13. Quarterly reviews of fi nancial and
non-fi nancial performance were held as
well as meetings to review the department’s
Annual Financial Statements, management
letter and audit report. The department
is incorporated in Cluster 3 of the Audit
Committee.
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The Gauteng Audit Services (GAS) of
the Gauteng Department of Finance
provide internal audit services for the
department. Internal audit plans, based on
the departmental risk assessment, were
developed by GAS to ensure compliance
with the PFMA and Treasury Regulations.
These plans were approved by the Audit
Committee, which exercises oversight of the
activities of GAS. All internal audits planned
for the year under review were completed
and all audit fi ndings and recommendations
and management action plans were
regularly monitored for implementation
with the assistance of the departmental risk
management unit.
The departmental Bid Adjudication
Committee (BAC) fulfi ls its role very
adequately in enabling the accounting offi cer
to ensure that procurement is fair, equitable,
transparent, competitive and cost effective.
It meets on average once a week and
deals with all cases involving procurement
in excess of delegated limits, including
requests for information (RFI), requests for
proposals (RFP), and cases where it is in the
best interests of the department to deviate,
within prescribed limits, from normal
procurement procedures.
The Audit Action Plan Progress Review
Committee (AAPPRC) was established for
the purpose of monitoring progress on the
implementation of action plans relating to
audit qualifi cations and other audit report
and management letter outcomes for the
2011/12 audit. It further focused on key
areas of non-compliance and performance
information. The AAPPRC consist of offi cials
from the GDoH, Gauteng Department of
Finance, Internal Audit, Gauteng Treasury
and the Offi ce of the Auditor-General. The
review of audit action plans through the
AAPPRC was expanded at institutional level
during 2012/13.
A Risk Management Committee was
established to provide oversight of all
aspects of the risk management process
within the department in accordance with
the Gauteng Provincial Government Risk
Management Framework.
Chapter III of the Hospitals Ordinance, 1956
(Ord.14 of 1958) (Which year was it?), as
amended, provides for the establishment
of hospital boards by the MEC for Health,
and prescribes the rights, powers, duties
and functions of the boards. Nursing
colleges under control of the department
were established in terms of Chapter IIA
of the abovementioned ordinance. Each
college is governed by a council which has
defi ned duties and powers of oversight and
control, particularly in relation to the funds
and accounts administered in the name
of the college council. Other governance
structures are described elsewhere in this
annual report.
12. Code of conduct and management of conflicts of interest
The Code of Conduct for Public Servants, as
contained in the Public Service Regulations,
and the Batho Pele Principles are well communicated to staff. Specifi c codes of conduct also exist, for example, for members of the BAC. Members of the BAC and bid evaluation committees sign a declaration of interest before each meeting. The Code of Conduct for Supply Chain Managers was also communicated to staff.
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Interests are declared annually by members of senior management, as required by law. All staff members, including supply chain management staff, are aware of the need to declare interests and potential conflict of interest whenever they become aware of these, as required by Regulation 16A8.3(a) of the Treasury Regulations. The department now requires all staff members to complete a form to declare their interests on an annual basis in order to strengthen controls in this area.
The department has clear policies with regard to remunerative work outside of the public service (RWOPS). This is communicated during induction of new employees as well
as through circulars.
The department has started vetting key
offi cials in the department and a vetting plan
has been approved by the State Security
Agency for full implementation in the
2013/14 fi nancial year.
13. Safety, health and environmental Issues
The department has continued to create
a healthy working environment for its
employees by ensuring good work ethics
and discipline through progressive human
resource development and management
practices.
While numerous challenges still confront
institutions regarding compliance with some
aspects of environmental and occupational
health and safety management, the
department has succeeded in establishing
active occupational health and safety
committees in most Institutions. The
development of an Environmental
Management Plan has been initiated and is
nearing completion. This will be rolled out to
Institutions on approval.
The department has, on its staff
establishment, environmental health
offi cers to ensure delivery of environmental
programmes as defi ned in the new National
Health Act as well as to coordinate the
activities of local and metro governments to
ensure compliance with legislated functions.
The environmental health programme also
focuses on environmental health conditions
at all health facilities, ensuring safe food
supply to staff and patients.
14. Discontinued activities/activities to be discontinued
A number of infrastructure projects
were halted in 2012/13 and certain
local government clinics in the City of
Johannesburg stopped providing extended
services. Apart from these projects,
described below, no major activities were
discontinued or will be discontinued.
However, there will be normal shifts of focus
within programmes and adjustments due to
budget changes.
Construction of new Boitumelo Clinic,
Bophelong Clinic, Magagula Heights Clinic,
Braamfi scherville Clinic, Randfontein Clinic
and Heidelberg Clinic
These clinics were identifi ed for construction
and GDID was requested to appoint
professional service providers to develop
designs. GDID subsequently appointed Tau
Pride. Tau Pride prepared the designs, which
were halted as Tau Pride initiated a legal
dispute with GDID. Until the legal matter is
resolved, GDID cannot appoint other service
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providers and the projects cannot progress.
It was decided to put the projects on hold
until GDID and Tau Pride resolve the legal
dispute. In 2012/13 a total of R13 264 000
was allocated for these projects, but in view
of the lack of progress the 2012/13 Adjusted
Budget was reduced to zero. Although the
current clinics are functional, the buildings
are dilapidated and new facilities will greatly
improve service delivery to the communities.
Renovation and refurbishment of wards to
accommodate TB beds at Dr Yusuf Dadoo
Hospital
In 2009 six hospitals were identifi ed for possible revitalisation and professional service providers were appointed to do a complete assessment of the institutions. Business cases were prepared, presenting three possible options for revitalisation of each institution. These business cases await approval from DOH. As these projects have major fi nancial implications, implementation will have to be prioritised. The six identifi ed hospitals were:
• Dr Yusuf Dadoo Hospital.• Sebokeng Hospital.• Tambo Memorial Hospital.• Dr George Mukhari Hospital.• Jubilee Hospital.• Kalafong Hospital.
Renovation and refurbishment of wards to
accommodate TB beds at old Germiston
Hospital
On 29 November 2011, the new Bertha Gxowa Hospital was opened. The new hospital was intended to replace the old Germiston Hospital but not all the services could be accommodated in the new facility and the TB wards had to remain in the old hospital. The estimated cost of renovating
and refurbishing the TB wards in the Germiston Hospital was R138 million. As it was uncertain whether the old facility should be renovated or demolished completely, the project was put on hold, awaiting a decision on the hospital’s future. An amount of R30 261 000 was allocated in the 2013/14 budget for the possible demolition. TB services are continuing, but patient care would improve if better infrastructure could
be provided.
The Zola/Jabulani and Natalspruit hospitals
are still work in progress.
Conversion of SAPS Building for Kagiso
CHC
In June 2012 GDOH requested GDID to
appoint professional service providers for
the conversion of part of the SAPS building
in Kagiso into a CHC. The SAPS building is
centrally located in the community which
makes it an ideal site for a CHC. Service
providers developed a design according to
the scope provided by GDoH, but the design
could not fi t on the available site. The project
was put on hold pending a decision on
whether to reduce the scope of the design or
request SAPS to vacate the building, making
it completely available for construction
of a CHC. In 2012/13 a total of R750 000
was allocated to this project, but this was
increased to R900 000 in the 2012/13
Adjusted Budget. As there is currently only
a clinic in Kagiso, services will be greatly
enhanced by the construction of a new CHC.
Extended hours
Due to fi nancial constraints, the department
experienced challenges in paying staff
the overtime required to render extended
services. Twenty-six local government
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clinics in the City of Johannesburg stopped
operating for extended hours in 2012/13.
This is likely to have affected access to
services for some patients. An additional
10 provincial clinics began to offer extended
hours during the course of the year which
has helped to mitigate the impact of
curtailing services at the local government
clinics.
15. New/proposed activities
Fixed-dose combination ARVs
From 1 April 2013, the department will
implement the revised approach to ART
featuring fi xed-dose combination (FDC)
ARVs, in line with the national DOH ARV
tender. This is not a “new” activity, but a
revised approach to ART that will improve
and strengthen adherence to treatment. The
costs will be covered by the HIV and AIDS
conditional grant.
New maternal and obstetric unit
The department opened a new maternal
and obstetric unit at Ethafeni in Ekurhuleni
during 2012/13. This will help to reduce the
load at Tembisa Hospital. When the MOU is
fully functional, Tembisa will be able to focus
on the more complicated deliveries while
routine cases can be dealt with at Ethafeni.
16. Asset management
The Asset Management Directorate has
maintained its momentum and continues
to achieve favourable results from all
stakeholders.
The directorate is currently leasing the Asset
Ware Management system from TAT I-Chain
which assists in monitoring and maintaining
the asset register which is updated and kept
correct and accurate by the directorate’s
staff.
Areas such as existence, completeness,
valuation, cut off, classifi cation, rights and
ownership of tangible assets were taken
into account by the asset management
staff. Assets bought in 2012/13 were
updated daily on the register and submitted
to Treasury. Quality checks were done by
the data capturing supervisor on an ongoing
basis.
The Asset Management Policy and
Procedure Manual, which includes
numerous guidelines, was reviewed, updated
and implemented across the department.
All parties are monitored and are strictly
adhering to the following:
• Compliance in respect of
reconciliations.
• Compliance in respect of journals.
• Compliance in respect of theft and
losses of departmental assets.
The above functions have been centralised
at central offi ce and are monitored
and managed strictly in order to
maintain consistency when dealing with
misallocations. Journals are submitted
to the necessary data capturing teams in
order to maintain a correct and accurate
asset register for the department. Staff
members who are well trained in the areas
of reconciliation and journal processing
ensure correctness and accuracy.
A theft/ loss control offi cer monitors
departmental assets and ensures that lost
and stolen assets are reported to SAPS as
well as all relevant parties. Investigations are
carried out and reported to the Accounting
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Offi cer in order to obtain permission to establish liability before writing off or removing the assets from the asset register.
Experienced teams from central offi ce assist institutions with the physical verifi cation and reporting of assets.
17. Events after the reporting date
An amount of R286 million was owing to the Medical Supplies Depot at 31 March 2013. This was settled during the fi rst quarter of the 2013/14 fi nancial year.
18. Information on predetermined objectives
Data collection and reporting on performance are governed by the District Health Information Management Policy, the data flow policy and a number of standard operating procedures which guide reporting and data validation. Data informing progress made with the predetermined objectives is largely collected at facility level and fed into the District Health Information System (DHIS).
Data is fi rst captured at facility level using paper-based registers and summarised using the PHC summary sheets before DHIS capturing can commence. The DHIS is the largest provider of performance data. Other performance data, in particular information on TB management, is from the ETR.net information system. Each level of reporting – health facilities, sub-districts and districts – is provided with sign-off sheets to ensure verifi cation of the correctness of the data that is sent to the next reporting level.
Programme performance data, once captured on the DHIS, is uploaded at the
provincial offi ce where another level of verifi cation takes place. The inbuilt validation checks in the DHIS help in improving the data received from districts. The department has also introduced physical data validation tools which are implemented on-site to assess the level of completeness and accuracy of the reported data. These self-assessments are conducted on a quarterly or six-monthly basis by district teams. A data validation assessment reporting tool has been developed to track progress on validation exercises and will be utilised in the new fi nancial year. However, there are still challenges in terms of capacity for verifi cation of data.
The department has produced a guide on performance reviews which provides information on the schedule and the scope of performance reviews. In accordance with this guide, the department held three performance review sessions where detailed discussions on areas of non-performance took place and plans to address these were compiled. The department will strengthen the monitoring of implementation of these plans in the new fi nancial year.
As part of the medium to long-term solution to data challenges, the department has developed a proposal for a comprehensive electronic health information management system which will address record keeping and provide detailed information that can be used for planning and informing management and oversight bodies on the department’s performance.
19. SCOPA resolutions
The department did not receive any SCOPA resolutions for the fi nancial year under review.
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20. Prior modifi cations to audit reports
Nature of qualifi cation, disclaimer, adverse opinion and matters of non-compliance
Financial year in
which it fi rst arose
Progress made in clearing/resolving the matter
I was unable to obtain suffi cient appropriate
audit evidence for departmental revenue
amounting to R453 505 000 (2010-11:
R438 979 000) as disclosed in note 1 to
the fi nancial statements due to inadequate
record keeping, ineffective computerised
information systems and failure to update
patient fee tariffs. I was unable to confi rm
the departmental revenue by alternative
means. Consequently, I was unable to
obtain suffi cient appropriate audit evidence
to satisfy myself as to the completeness,
classifi cation, accuracy, measurement,
occurrence and cut-off of departmental
revenue.
2009/10 • The classifi cation policy was re-
vised to cater for patients who
present themselves at public
facilities without required doc-
uments.
• The department conducted
training and improved on pro-
cesses to comply with the re-
quired portfolio of evidence re-
quired in patient classifi cation
of self-paying patients.
• The system problem remains,
but there is a plan to address in-
formation technology and infor-
mation systems in the province
in 2013/14. The issue of differ-
ent fi gures was resolved and
the Basic Accounting System
now balances with the stan-
dalone Patient Administration
System. Monitoring is under-
taken monthly and involves rec-
onciling the two systems. Insti-
tutions are submitting reports
monthly as a control measure.
• The issue of Uniform Patient
Fee Schedule of tariffs was re-
solved and updates are done at
the beginning of each fi nancial
year. Tariffs for 2012/13 and
2013/14 were up to date.
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Nature of qualifi cation, disclaimer, adverse opinion and matters of non-compliance
Financial year in
which it fi rst arose
Progress made in clearing/resolving the matter
I was unable to obtain suffi cient
appropriate audit evidence for receivables
for departmental revenue and provision for
bad debts amounting to R2 025 279 000
(2010-11: R1 535 700 000) and
R932 951 000 (2010-11: R648 353 000),
respectively as disclosed in notes 27 and
27.1 to the fi nancial statements. I was
unable to confi rm the receivables from
departmental revenue and provision for bad
debts by alternative means. Consequently, I
was unable to obtain suffi cient appropriate
audit evidence to satisfy myself as to the
existence, completeness, valuation, cut-off,
classifi cation and rights and ownership of
receivables for departmental revenue and
the provision for bad debts.
2009/10 • The department has devel-
oped a manual document to
cater for patients who present
themselves at Gauteng public
facilities without the required
identifi cation information for
classifi cation. The GPF is used
in cases where a patient cannot
furnish required information.
This information is then pre-
sented by patients in subse-
quent visits to the hospital.
• Ongoing training is provided
to hospital admission offi cials
to assist them to comply with
departmental policies. The ap-
pointment of case managers in
certain hospitals has improved
the quality of mandates and re-
ferral documents by funders.
• Further rollout of the case man-
agement system to other hos-
pitals will provide the required
skills and capacity.
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Nature of qualifi cation, disclaimer, adverse opinion and matters of non-compliance
Financial year in
which it fi rst arose
Progress made in clearing/resolving the matter
I was unable to obtain suffi cient appropriate
audit evidence for leave entitlement and
capped leave commitments amounting to
R1 032 722 000 (2010-11: R1 049 987 000)
as disclosed in note 25 to the fi nancial
statements due to inadequate system of
internal controls over all leave records on
which I could rely for the purpose of my
audit. I was unable to confi rm the leave
entitlement and capped leave commitments
by alternative means. Consequently, I was
unable to obtain suffi cient appropriate
audit evidence to satisfy myself as to the
completeness, valuation, existence, cut-off,
classifi cation and rights and obligations
of leave entitlement and capped leave
commitments.
2008/09 • The department implemented
several measures to strength-
en leave management, ensure
that this fi nding was properly
addressed and that the leave
entitlement was properly dis-
closed. This has had satisfacto-
ry results as reflected in the fact
that this fi nding does not repeat
in the 2012/13 audit.
The department did not have an adequate
system of internal controls in place for the
identifi cation and recognition of irregular
expenditure. There were no satisfactory
audit procedures that I could perform
to obtain reasonable assurance that
all irregular expenditure was recorded.
Consequently, I was unable to obtain
suffi cient appropriate audit evidence to
satisfy myself as to the completeness of
irregular expenditure of R1 115 884 000
as disclosed in note 28 to the fi nancial
statements.
2011/12 • The department implemented
several measures to strength-
en the reporting and identifi -
cation of irregular expenditure
to ensure that this fi nding was
properly addressed and that the
irregular expenditure was prop-
erly disclosed. These measures
have had satisfactory results
as reflected in the fact that this
fi nding does not repeat in the
2012/13 audit.
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21. Exemptions and deviations received from the National Treasury
There were no exemptions and deviations
received from National Treasury during the
year under review.
22. Quarterly fi nancial statements
In terms of the Offi ce of the Accountant-
General Instruction Note 1 of 2012/2013,
issued by the National Treasury, departments
were required to compile and submit interim
fi nancial statements (IFS) within 30 days
of the periods ending 30 June 2012, 30
September 2012, 31 December 2012 and 31
March 2013.
The Financial Accounting Unit of the
Provincial Accounting Services Branch in
Provincial Treasury conducts reviews of the
quarterly fi nancial statements in order to
identify issues of concern to be addressed
before the year-end fi nancial statements.
The primary purposes of the review by
Provincial Treasury are to:
• Improve the fi nancial reporting pro-
cess by constructing recommenda-
tions based on an analytical review
of the data.
• Ensure that the correct template has
been used as issued by Treasury.
• Identify any recognition, measure-
ment and disclosure errors in the fi -
nancial statements template.
• Ascertain whether the department
is ready for the purpose of fi nal AFS
preparation.
• Ensure compliance with National
Treasury preparation guidelines.
• Ensure correct classifi cation,
accuracy and reliability of information
presented.
For the fi nancial year 2012/13, the
department complied with the requirements
for submission of interim fi nancial
statements for each of the prescribed
quarters.
The analysis of the quarterly fi nancial
statements by Provincial Treasury suggested
that the department has an effi cient system
of internal control in place and is able to
report on all transactions. Matters that were
emphasised by the Provincial Treasury after
review of the IFS are addressed internally in
the department.
After the fi nancial statements for the period
ending 30 September 2012, the Auditor-
General also conducted an interim audit and
fi ndings presented to the department noted
shortcomings in the following areas:
• Understatement of commitments.
• Accruals and payments exceeding
the 30-day payment term required by
legislation.
• Operating and fi nance lease commit-
ments.
• Receivables for departmental reve-
nue.
• Irregular expenditure.
• Impairments/provision for doubtful
accounts.
• Movable tangible capital assets.
• Minor assets.
• Inventory.
These matters were responded to by
the department and addressed during
the compilation of the Annual Financial
Statements of the department.
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23. Other matters
Unauthorised expenditure
An amount of R4.5 billion has been condoned
by the Gauteng Provincial Legislature for
unauthorised expenditure incurred during
the fi nancial years 2007/8, 2008/9, 2009/10
and 2010/11. Unauthorised expenditure
amounting to R261 million was not approved
by the Gauteng Provincial Legislature for
the fi nancial years 2008/9, 2009/10 and
2010/11.
24. Approval
The Annual Financial Statements set out on
pages 230 to 328 have been approved by the
Accounting Offi cer.
Ndoda Biyela
(ACTING) ACCOUNTING OFFICER
GAUTENG DEPARTMENT OF HEALTH
31 MAY 2013
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Department of Health Vote 4
Statement of Responsibility for the Annual
Financial Statements for the year ended 31
March 2013
The Accounting Offi cer is responsible for the
preparation of the department’s annual fi nancial
statements and for the judgements made in this
information.
The Accounting Offi cer is responsible for
establishing, and implementing a system of internal
control designed to provide reasonable assurance
as to the integrity and reliability of the annual
fi nancial statements
In my opinion, the fi nancial statements fairly
reflects the operations of the department for the
fi nancial year ended 31 March 2013
The external auditors are engaged to express an
independent opinion on the AFS of the department.
The Department of Health AFS for the year ended
31 March 2013 have been examined by the external
auditors and their report is presented on page 230.
The Annual Financial Statements of the Department
set out on page 230 to page 328 have been approved
Ndoda Biyela
(ACTING) ACCOUNTING OFFICER
GAUTENG DEPARTMENT OF HEALTH
31 MAY 2013
ACCOUNTING OFFICER’S STATEMENT OF RESPONSIBILITYfor the year ended 31 March 2013.
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REPORT OF THE AUDITOR-GENERAL.
Department of Health Vote 4
REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG LEGISLATURE ON VOTE NO. 4: GAUTENG DEPARTMENT OF HEALTH
Introduction1. I have audited the fi nancial statements of
the Gauteng Department of Health, set out
on pages 230 to 328, which comprise the
appropriation statement, the statement
of fi nancial position as at 31 March 2013,
the statement of fi nancial performance,
statement of changes in net assets and
the cash flow statement for the year
then ended, and the notes, comprising a
summary of signifi cant accounting policies
and other explanatory information.
Accounting offi cer’s responsibility for the fi nancial statements2. The accounting offi cer is responsible
for the preparation of these fi nancial
statements in accordance with the
Departmental Financial Reporting
Framework prescribed by National Treasury
and the requirements of the Public Finance
Management Act, 1999 (Act No.1 of 1999)
(PFMA), and for such internal control as the
accounting offi cer determines necessary
to enable the preparation of fi nancial
statements that are free from material
misstatement, whether due to fraud or
error.
Auditor-General’s responsibility3. My responsibility is to express an opinion
on these fi nancial statements based on my
audit. I conducted my audit in accordance
with the Public Audit Act of South Africa,
2004 Act No. 25 of 2004) (PAA), the
General Notice issued in terms thereof and
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 fi nancial statements are
free from material misstatement.
4. An audit involves performing procedures
to obtain audit evidence about the
amounts and disclosures in the fi nancial
statements. The procedures selected
depend on the auditor’s judgement,
including the assessment of the risks of
material misstatement of the fi nancial
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 fi nancial statements in
order to design audit procedures that are
appropriate in the circumstances, but not
for the purpose of expressing an opinion
on the effectiveness 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
fi nancial statements.
5. I believe that the audit evidence I have
obtained is suffi cient and appropriate to
provide a basis for my audit opinion.
Basis for qualifi ed opinion
Departmental revenue 6. I was unable to obtain suffi cient
appropriate audit evidence for departmental
revenue amounting to R506 939 000
(2011-12: R453 505 000) as disclosed in
note 2 to the fi nancial statements due to
inadequate record keeping and ineffective
computerised information systems.
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REPORT OF THE AUDITOR-GENERAL
6. Departmental revenue (continued) I was unable to confi rm the departmental
revenue by alternative means.
Consequently, I was unable to determine
whether any adjustment to the fi nancial
statements was necessary.
Receivables for departmental revenue7. I was unable to obtain suffi cient
appropriate audit evidence for
receivables for departmental revenue
amounting R 2 438 694 000 (2011-12:
R2 025 279 000), as disclosed in note
27.1 to the financial statements due
to material weaknesses identified in
the receivables management system,
inadequate record keeping and
ineffective computerised information
systems. I was unable to confirm the
receivables from departmental revenue
by alternative means. Consequently, I
was unable to determine whether any
adjustment to the financial statements
was necessary.
Contingent liabilities 8. I was unable to obtain suffi cient
appropriate audit evidence for claims
against the department amounting to
R 2 725 656 000 (2011-12: R1 636 427 000)
as disclosed in note 22.1 to the fi nancial
statements, as the department had an
inadequate system of internal controls in
place for the identifi cation and recognition
of contingent liabilities in accordance with
Chapter 8 of the Departmental Financial
Reporting Framework prescribed by
National Treasury. I was unable to confi rm
the contingent liabilities by alternative
means. Consequently, I was unable to
determine whether any adjustment to the
fi nancial statements was necessary.
Provisions 9. The department did not recognise legal
claims as provisions where the outcome
of the claim is probable in accordance with
Chapter 8 of the Departmental Financial
Reporting Framework prescribed by
National Treasury. The department had a
number of claims instituted against them which should have been accounted for as provisions. I was unable to confi rm the provisions by alternative means. Consequently, I was unable to determine whether any adjustment to the fi nancial statements was necessary.
Qualifi ed opinion10. In my opinion, except for the possible
effects of the matters described in the Basis for qualified opinion paragraphs, the financial statements present fairly, in all material respects, the financial position of the Gauteng Department of Health as at 31 March 2013 and its financial performance and cash flows for the year then ended, in accordance with the Departmental Financial Reporting Framework prescribed by National Treasury and the requirements of the PFMA.
Emphasis of matters11. I draw attention to the matters below. My
opinion is not modifi ed in respect of these
matters.
Restatement of corresponding fi gures 12. As disclosed in note 25 to the fi nancial
statements, the corresponding fi gures for
31 March 2012 have been restated as a
result of an error discovered during the year
ended 31 March 2013.
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REPORT OF THE AUDITOR-GENERAL
Material impairment13. As disclosed in note 34 to the fi nancial
statements, potential irrecoverrable debts
relating to staff and patient debtors to the
amount of R1 133 353 000
(2011-12: R 994 176 000) were provided for
as a result of poor debt collection.
Material losses14. As disclosed in note 27.2 to the fi nancial
statements, material losses to the amount
of R198 434 000 (2011-12: R127 592 000)
were incurred as a result of a write-off of
irrecoverable patient debtors.
Material under spending of the budget15. As disclosed in the appropriation statement
and accounting offi cer’s report, the
department has materially underspent
the budget on Programme 1: Health
Administration - R182 085 000, Programme
2: District Health Services
– R226 528 000, Programme 6: Health
Sciences and Training - R34 854 000,
Programme 7: Health Care Support
Services – R3 277 000 and Programme 8:
Health Facilities Management –
R267 048 000. The total underspending of
these programmes amounted to
R713 792 000. As a consequence, the
department did not achieve its objectives of
the above mentioned programmes.
Additional matters I draw attention to the matters below. My
opinion is not modifi ed in respect of these
matters:
Financial reporting framework16. The fi nancial reporting framework
prescribed by the National Treasury and
applied by the department is a compliance
framework. The wording of my opinion
on a compliance framework should
reflect that the fi nancial statements have
been prepared in accordance with this
framework and not that they “present
fairly”. Section 20(2)(a) of the PAA, however,
requires me to express an opinion on
the fair presentation of the fi nancial
statements. The wording of my opinion
therefore reflects this requirement.
Signifi cant transactions17. As disclosed in the accounting offi cer’s
report, the Executive Council of the
Gauteng Provicial Government resolved
that the department will be placed under
Administrative Curatorship as per section
18 of the PFMA.
18. The Gauteng Department of Health and Social Development demerged
1 April 2012 and the two departments operated separately as Gauteng Department of Health and Gauteng Department of Social Development from
1 April 2012.
19. As disclosed in note 22.1 contingent liabilities, note 23 commitments, note 24 accruals and note 34.2 provision for liabilities to the fi nancial statements, the department is exposed to liabilities and potential liabilities of R 8 143 242 000. This represents 29% of the annual appropriation for 2013-14.
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REPORT OF THE AUDITOR-GENERAL
Unaudited supplementary schedules20. The supplementary information set out on
pages 308 to 328 does not form part of the
fi nancial statements and is presented as
additional information. I have not audited
these schedules and, accordingly, I do not
express an opinion thereon.
REPORT ON OTHER LEGAL AND REGULATORY REQUIREMENTS
21. In accordance with the PAA and the General
Notice issued in terms thereof, I report the
following fi ndings relevant to performance
against predetermined objectives,
compliance with laws and regulations and
internal control, but not for the purpose of
expressing an opinion.
Predetermined objectives22. I performed procedures to obtain evidence
about the usefulness and reliability of the
information in the annual performance
report as set out on pages 16 to 151 of the
annual report.
23. The reported performance against
predetermined objectives was evaluated
against the overall criteria of usefulness
and reliability. The usefulness of
information in the annual performance
report relates to whether it is presented
in accordance with the National Treasury
annual reporting principles and whether the
reported performance is consistent with
the planned objectives. The usefulness
of information further relates to whether
indicators and targets are measurable (i.e.
well defi ned, verifi able, specifi c, measurable
and time bound) and relevant as required
by the National Treasury Framework
for managing programme performance
information (FMPPI).
The reliability of the information in respect
of the selected programmes is assessed
to determine whether it adequately reflects
the facts (i.e. whether it is valid, accurate
and complete).
24. The material fi ndings are as follows:
Reliability of informationValidity, accuracy and completeness
25. The National Treasury FMPPI requires
that institutions should have appropriate
systems to collect, collate, verify and
store performance information to ensure
valid, accurate and complete reporting
of actual achievements against planned
objectives, indicators and targets.
Signifi cantly important targets with respect
to programme 2 District Health service
are materially misstated. This was due
to the lack of frequent review of validity
of reported achievements against source
documentation.
26. The National Treasury FMPPI requires
that it must be possible to validate the
processes and systems that produce the
indicator. A total of 24% of the indicators
were not verifi able in that valid processes
that produce the information on actual
performance did not exist. This was due
to the lack of key controls in the relevant
systems of collection, collation, verifi cation,
and storage of actual performance
information.
Additional matterI draw attention to the following matter below.
This matter does not have an impact on the
predetermined objective audit fi ndings reported
above.
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REPORT OF THE AUDITOR-GENERAL
Achievement of planned targets27. Of the total number of 203 targets planned
for the year, 107 of targets were not achieved during the year under review. This represents 53% of total planned targets that were not achieved during the year under review. This was mainly due to underspending of the budget.
Compliance with laws and regulations28. I performed procedures to obtain evidence
that the department has complied with applicable laws and regulations regarding fi nancial matters, fi nancial management and other related matters. My fi ndings on material non-compliance with specifi c matters in key applicable laws and regulations as set out in the General Notice issued in terms of the PAA are as follows:
Annual fi nancial statements29. The fi nancial statements submitted for
auditing were prepared in accordance with the Departmental Financial Reporting Framework prescribed by National Treasury, however material misstatements were identifi ed by the auditors in the submitted fi nancial statements and were subsequently corrected which is in contravention of section 40(1) (a) of the PFMA. The uncorrected material misstatements and supporting records that could not be provided resulted in the fi nancial statements receiving a qualifi cation of audit opinion.
Expenditure management30. The accounting offi cer did not take
effective steps to prevent unauthorised expenditure (note 11.1: R6 095 207 000), irregular expenditure (note 28.1: R5 748 235 000) and fruitless and wasteful expenditure (note 29.1: R408 050 000), as required by section 38(1)(c)(ii) of the PFMA and Treasury regulation(TR)9.1.1.
31. Contractual obligations and money owed by the department were not settled within 30 days or an agreed period, as required by section 38(1)(f) of the PFMA and TR8.2.3.
Revenue management32. The accounting offi cer did not ensure that
appropriate processes were developed and implemented to provide for the identifi cation , collection, recording, reconciliation and safeguarding of information about revenue, as required by TR7.2.1.
33. The accounting offi cer did not take effective and appropriate steps to recover all debts due prior to the debts being written off as required by section 38(1)(c)(i) of the PFMA and TR11.2.1, TR15.10.1.2(a), TR15.10.1.2(e) and TR11.4.1.
34. Bad debtors were written off that did not comply with the requirements of the department’s write-off policy, as required by TR11.4.2.
Budgets35. The accounting offi cer did not ensure that
all expenditure was made in accordance with the purpose of the department’s budget, as required by section 39(1)(a) of the PFMA.
Procurement and contract management36. Goods and services with a transaction
value below R500 000 were procured without obtaining the required price quotations, as required by TR16A6.1.
37. Goods and services of a transaction value above R500 000 were procured without inviting competitive bids, as required by TR16A6.1. Deviations were approved by the accounting offi cer even though it was not impractical to invite competitive bids, in contravention of TR16A6.4.
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REPORT OF THE AUDITOR-GENERAL
38. Contracts were extended or modifi ed without the approval of a properly delegated offi cial as required by TR8.2.
Human resource management and compensation39. Job descriptions were not specifi c for all
posts in which appointments were made in the current year, as required by Public Service Regulation (PSR) 1/III/I.1.
40. Employees were appointed without following a proper process to verify the claims made in their applications in contravention of PSR 1/VII/D.8.
41. Persons in charge at pay points did not always certify that the employees receiving payment were entitled thereto as required by TR8.3.4.
42. An organisational structure was not in place that is based on the department’s strategic plan as required by PSR 1/III/B.2(a).
Internal control43. I considered internal control relevant to
my audit of the fi nancial statements, the annual performance report and compliance with laws and regulations. The matters reported below under the fundamentals of internal control are limited to the signifi cant defi ciencies that resulted in the basis for qualifi ed opinion, the fi ndings on the annual performance report and the fi ndings on compliance with laws and regulations included in this report.
Leadership44. There was no formal code of ethics in
the department and many instances of management override and numerous cases of fraud and theft are being investigated as indicated under the “other reports” section of this report.
45. The accounting offi cer did not adequately implement documented policies and procedures to guide the effectiveness of the operations of the department and as a result instances of non compliance with the applicable laws and regulations were identifi ed as detailed under the reporting on compliance with laws and regulations section of this report.
46. An action plan was developed to address internal and external audit fi ndings and adherence to the plan was monitored on a monthly basis by the appropriate level of management, however the action plan was not implemented timorously and key prior year fi ndings there for re-occurred during the current year audit.
47. The accounting offi cer did not approve an Information Technology (IT) governance framework that supports and enables the business, delivers value and improves performance.
Financial and performance management48. The fi nancial statements were subject
to material amendments resulting from the audit as a result of inadequate review for completeness and accuracy prior to submission for audit.
49. The accounting offi cer did not always implement proper record keeping in a timely manner to ensure that complete, relevant and accurate information was accessible and available to support fi nancial and performance reporting.
50. The accounting offi cer did not implement controls over daily and monthly processing and reconciling of transactions.
51. The accounting offi cer did not always review and monitor compliance with applicable laws and regulations.
228
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
REPORT OF THE AUDITOR-GENERAL
52. The accounting offi cer did not design and implement formal controls over IT systems to ensure the reliability of the systems and the availability, accuracy and protection of information.
Governance53. The accounting offi cer did not implement
appropriate risk management activities to ensure that adequate risk assessments, including consideration of IT risks that impacts departmental revenue and fraud prevention, are conducted and that a risk strategy to address the risks was adequately developed and monitored.
OTHER REPORTSInvestigations54. There are investigations in progress relating
to procurement irregularities, fraud, theft, negligence and the investigations were ongoing at reporting date.
55. Investigations were conducted by independent consulting fi rms on request by the accounting offi cer. The investigations were initiated based on allegations of possible corruption and mismanagement at the department. The investigations were concluded and irregularities were reported to the accounting offi cer.
Performance auditsUse of Consultants56. A performance audit on the Use of
Consultants was conducted. The audit focused on the economic, effi cient and effective use of consultants at the provincial department. The management report was issued during this year.
Performance audit on the readiness of government to report on its performance57. A performance audit was conducted on the
Readiness of Government to report on its performance. The focus of the audit is on how government institutions are guided and assisted to report on their performance, as
well as the systems and processes that they
have put in place. The management report
was issued during this year.
Johannesburg
31 July 2013
229
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Appr
opria
tion
per p
rogr
amm
e
2012
/201
320
11/1
2
APPR
OPR
IATI
ON
ST
ATEM
ENT
Ad
just
ed
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of
fi nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
1. A
dmin
istr
atio
n
Curr
ent p
aym
ent
723,
842
-(5
9,00
0)66
4,84
247
1,73
119
3,11
171
%80
8,96
5 71
7,82
3
Tran
sfer
s an
d su
bsid
ies
2,10
0-
-2,
100
16,1
36(1
4,03
6)76
8.4%
7,1
36
6,04
3
Paym
ent f
or c
apita
l ass
ets
16,5
05-
-16
,505
12,7
613,
744
77.3
%26
,493
2
8,49
3
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-
734
(734
)-
- 4
6
742,
447
-(5
9,00
0)68
3,44
750
1,36
218
2,08
5-
842,
594
752
,405
2. D
istr
ict H
ealth
Ser
vice
s
Curr
ent p
aym
ent
7,59
8,10
8-
(44,
000)
7,55
4,10
87,
415,
385
138,
723
98.2
%6,
317,
185
6,68
8,29
2
Tran
sfer
s an
d su
bsid
ies
1,11
4,43
0-
-1,
114,
430
1,08
0,39
434
,036
96.9
%76
2,31
9
473
,202
Paym
ent f
or c
apita
l ass
ets
113,
946
--
113,
946
58,9
9054
,956
51.8
%16
0,76
8
77
,194
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-1,
187
(1,1
87)
- -
4
93
8,82
6,48
4-
(44,
000)
8,78
2,48
48,
555,
956
226,
528
-7,
240,
272
7,23
9,18
1
3. E
mer
genc
y M
edic
al
Serv
ices
Curr
ent p
aym
ent
535,
810
--
535,
810
556,
692
(20,
882)
103.
9% 3
72,7
44
39
7,64
9
Tran
sfer
s an
d su
bsid
ies
494,
074
--
494,
074
577,
474
(83,
400)
116.
9%
3
72,1
70
283
,101
Paym
ent f
or c
apita
l ass
ets
29,4
00-
-29
,400
13,0
6316
,337
44.4
%42
,756
15,
784
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-2
(2)
- -
1
0
1,05
9,28
4-
-1,
059,
284
1,14
7,23
1(8
7,94
7)-
7
87,6
70
696
,544
230
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Appr
opria
tion
per p
rogr
amm
e
2012
/201
320
11/1
2
APPR
OPR
IATI
ON
ST
ATEM
ENT
Ad
just
ed
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of
fi nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
4. P
rovi
ncia
l Hos
pita
l
Serv
ices
Curr
ent p
aym
ent
5,95
3,23
9-
152,
369
6,10
5,60
86,
248,
011
(142
,403
)10
2.3%
4,9
21,5
805,
674,
147
Tran
sfer
s an
d su
bsid
ies
298,
198
--
298,
198
255,
714
42,4
8485
.8%
1
99,8
40
1
83,9
84
Paym
ent f
or c
apita
l ass
ets
143,
090
--
143,
090
76,9
4466
,146
53.8
%
138
,525
69,
177
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-1,
771
(1,7
71)
-
-
791
6,39
4,52
7-
152,
369
6,54
6,89
66,
582,
440
(35,
544)
-5,
259,
945
5,92
8,09
9
5. C
entr
al H
ospi
tal S
ervi
ces
Curr
ent p
aym
ent
7,26
0,45
4-
-7.
260,
454
7,61
3,64
4(3
53,1
90)
104,
9%
6
,652
,455
7,
018,
157
Tran
sfer
s an
d su
bsid
ies
18,8
29-
-18
,829
21,0
08(2
,179
)11
1,6%
6,9
00
15,3
33
Paym
ent f
or c
apita
l ass
ets
287,
576
--
287,
576
163,
639
(123
,937
)56
,9%
1
19,0
00
96,3
39
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-.1,
622
(1,6
22)
-
-
1,
733
7,56
6,85
9-
-7,
566,
859
7,79
9,91
3(2
33,0
54)
-6,
778,
355
7,1
31,5
62
6. H
ealth
Sci
ence
s an
d
Trai
ning
Curr
ent p
aym
ent
816,
682
-(4
9,36
9)76
7,31
373
2,86
134
,452
95,5
%
720
,626
.6
91,8
54
231
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Appr
opria
tion
per p
rogr
amm
e
2012
/201
320
11/1
2
APPR
OPR
IATI
ON
ST
ATEM
ENT
Ad
just
ed
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of
fi nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Tran
sfer
s an
d su
bsid
ies
66,6
82-
-66
,682
65,2
961,
386
97,9
%
34
,997
27,
552
Paym
ent f
or c
apita
l ass
ets
7,92
9-
-7,
929
8,54
9(6
20)
107,
8%
10
,399
6
,566
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-36
4(3
64)
-
-
117
891,
293
-(4
9,36
9)84
1,92
480
7,07
034
,854
- 7
66,0
22
726,
089
7. H
ealth
Car
e Su
ppor
t
Serv
ices
Curr
ent p
aym
ent
195,
864
--
195,
864
194,
173
1,69
199
,1%
1
65,3
65
16
9,97
9
Tran
sfer
s an
d su
bsid
ies
274
--
274
276
(2)
100,
7%
261
333
Paym
ent f
or c
apita
l ass
ets
3,68
3-
-3,
683
2,05
21,
631
55,7
%
3
,600
3
,344
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-43
(43)
-
-
31
199,
821
--
199,
821
196,
544
3,27
7-
169
,226
17
3,68
7
8.H
ealth
Fac
ilitie
s
Man
agem
ent
Curr
ent p
aym
ent
575,
393
--
575,
393
638,
152
(62,
759)
110,
9%
736
,907
5
66,3
82
Tran
sfer
s an
d su
bsid
ies
--
--
211
(211
)-
-
21
Paym
ent f
or c
apita
l ass
ets
935,
486
--
935,
486
605,
468
330,
018
64.7
%
1,1
40,8
42
7
51,8
63
1,51
0,87
9-
-1,
510,
879
1,24
3,83
126
7,04
81,
877,
749
1,31
8,26
6
232
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Appr
opria
tion
per p
rogr
amm
e
2012
/201
320
11/1
2
APPR
OPR
IATI
ON
ST
ATEM
ENT
Ad
just
ed
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of
fi nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
9. S
ocia
l Wel
fare
Ser
vice
s
Curr
ent p
aym
ent
--
--
--
-
6
35,9
36
636
,707
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
1,17
2,18
9
1
,118
,752
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 8
0,30
5 78
,539
Paym
ent f
or fi
nanc
ial a
sset
s-
--
--
--
-
48
--
--
--
-1,
888,
430
1
,834
,046
10.D
evel
opm
ent &
Res
earc
h
Curr
ent p
aym
ent
--
--
--
-13
7,93
4 12
4,37
9
Tran
sfer
s an
d su
bsid
ies
--
--
--
-71
,645
65
,804
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 7
2 65
Paym
ent o
r fi n
anci
al a
sset
s-
--
--
--
- 3
7
--
--
--
-20
9,65
1 1
90,2
85
Subt
otal
27,1
91,5
94-
-27
,191
,594
26,8
34,3
4735
7,24
798
.7%
25,8
19,9
1425
,990
,164
TOTA
L27
,191
,594
--
27,1
91,5
9426
,834
,347
357,
247
98.7
%25
,819
,914
25,9
90,1
64
233
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Rec
onci
liatio
n w
ith s
tate
men
t of fi
nan
cial
per
form
ance
Dep
artm
enta
l rec
eipt
s 50
6,93
9-
--
453,
505
-
Aid
assi
stan
ce
- -
--
676
-
Actu
al a
mou
nts
per s
tate
men
t of fi
nan
cial
per
form
ance
(tot
al re
venu
e)27
,698
,533
--
-26
,274
,095
-
Actu
al a
mou
nts
per s
tate
men
t of fi
nan
cial
per
form
ance
(tot
al e
xpen
ditu
re)
-26
,834
,347
--
25,9
90,1
6425
,990
,164
234
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Appr
opria
tion
per e
cono
mic
cla
ssifi
catio
n
2012
/201
320
11/1
2
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
e
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
15,2
78,8
12-
-15
,278
,812
15,2
44,5
4234
,270
99.8
%
14,1
37,4
27
14,
882,
194
Goo
ds a
nd s
ervi
ces
8,38
0,58
0-
-8,
380,
580
8,62
5,12
7(2
44,5
47)
102.
9%
7
,330
,238
7
,798
,991
Inte
rest
and
rent
on
land
--
--
981
(981
)-
-
4,1
84
Tran
sfer
s &
sub
sidi
es
Pro
vinc
es &
mun
icip
aliti
es
964,
285
--
964,
285
1,08
3,52
5(1
19,2
40)
112.
4% 6
63,0
60
404
,090
Dep
artm
enta
l age
ncie
s &
acc
ount
s 28
,286
--
28,2
8628
,267
1999
.9%
13
,182
2
Uni
vers
ities
& T
echn
ikon
s 1,
500
--
1,50
050
01,
000
33,3
%
1
,162
910
Non
-pro
fi t In
stitu
tions
916,
785
--
916,
785
817,
505
99,2
8089
.2%
1,90
1,33
21,
697,
856
Hou
seho
lds
83,7
31-
-83
,731
86,7
13(2
.982
)10
3.6%
48,
880
71,2
69
Paym
ents
for c
apita
l ass
ets
Build
ings
& o
ther
fi xe
d
stru
ctur
es
848,
689
--
848,
689
528,
282
320,
407
62.2
% 8
86,5
88
674
,354
Mac
hine
ry &
equ
ipm
ent
688,
926
--
688,
926
413,
182
275,
744
60.0
% 8
37,9
76
452
,887
Soft
war
e an
d ot
her
inta
ngib
le a
sset
s -
--
--
--
69
122
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-5,
723
(5,7
23)
--
3,30
5
TOTA
L27
,191
,594
--
27,1
91,5
9426
,834
,347
357,
247
98.7
%25
,819
,914
25,9
90,1
64
235
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
1 –
Adm
inis
tratio
n
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Ad
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
1.1
Offi
ce o
f the
MEC
Curr
ent p
aym
ent
16,2
32-
-16
,232
11,0
815,
151
68.3
%
13
,273
10
,566
Paym
ent f
or c
apita
l ass
ets
250
--
250
438
(188
)17
5.2%
2
45
4
67
1.2.
Man
agem
ent (
Hea
lth)
Curr
ent p
aym
ent
707,
610
-(5
9,00
0)64
8,61
046
0,65
018
7,96
071
.0%
4
76,3
21
4
15,7
29
Tran
sfer
s an
d su
bsid
ies
2,10
0-
-2,
100
16,1
36(1
4,03
6)76
8.4%
2,0
00
777
Paym
ent f
or c
apita
l ass
ets
16,2
55-
-16
,255
12,3
233,
932
75.8
%
15
,755
1
5,66
1
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-73
4(7
34)
-
-
33
Tota
l
1.3.
Man
agem
ent (
Soci
al
Deve
lopm
ent)
Curr
ent p
aym
ent
--
--
--
-15
6,71
614
8,02
3
Tran
sfer
s an
d su
bsid
ies
--
--
--
-5,
041
5,01
2
Paym
ent f
or c
apita
l ass
ets
--
--
--
-3,
768
3,83
6
1.4.
Dist
rict m
anag
emen
t
Curr
ent p
aym
ent
--
--
--
-
162
,655
143
,505
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
95
254
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
6
,725
8
,529
Paym
ent f
or fi
nanc
ial a
sset
s -
--
--
--
-
13
Tota
l 74
2,44
7-
(59,
000)
683,
447
501,
362
182,
085
73.4
%
842
,594
752
,405
236
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il per
Pro
gram
me
1 –
Adm
inis
tratio
n
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Prog
ram
me
1 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
292,
851
-(4
8,00
0)24
4,85
124
1,56
63,
285
98.7
%
399
,539
416
,963
Goo
ds a
nd s
ervi
ces
430,
991
-(1
1,00
0)41
9,99
122
9,79
319
0,19
854
.7%
4
07,3
94
3
00,2
22
Inte
rest
and
rent
on
land
-
--
-37
1(3
71)
-
-
63
9
Tran
sfer
s an
d su
bsid
ies
to:
Non
-pro
fi t in
stitu
tions
-
--
-15
,132
(15,
132)
--
-
Hou
seho
lds
2,10
0-
-2,
100
998
1,10
247
.5%
7,2
95
6,0
42
Dep
artm
enta
l Age
ncie
s an
d
Acco
unts
--
--
7(7
)-
--
Paym
ent f
or c
apita
l ass
ets
Mac
hine
ry &
equ
ipm
ent
16,5
05-
-16
,505
12,7
613,
744
77.3
%
28
,297
28
,423
Soft
war
e an
d O
ther
Ass
ets
--
--
--
-69
70
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-73
4(7
34)
--
46
742,
447
-(5
9,00
0)68
3,44
750
1,36
218
2,08
573
.4%
842,
594
752,
405
237
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
2 –
Dis
trict
Hea
lth S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
2.1.
Dist
rict M
anag
emen
t
Cur
rent
pay
men
t 55
2,40
9(2
6,00
0)(4
4,00
0)48
2,40
946
6,13
816
,271
96.6
%
308
,358
356
,129
Tra
nsfe
rs a
nd s
ubsi
dies
42
,897
--
42,8
9729
,179
13,7
1868
.0%
1,2
17
57,2
41
Pay
men
t for
cap
ital a
sset
s 4,
200
--
4,20
016
,594
(12,
394)
395.
1%
9
,002
21
,288
Pay
men
t for
fi na
ncia
l ass
ets
--
--
424
(424
)-
-
1
11
2.2
Com
mun
ity H
ealth
Clin
ics
Cur
rent
pay
men
t 1,
568,
457
--
1,56
8,45
71,
444,
765
123,
692
92.1
%
1
,210
,903
1
,357
,255
Tra
nsfe
rs a
nd s
ubsi
dies
38
9,55
2-
-38
9,55
243
1,62
9(4
2,07
7)11
0.8%
2
61,9
25
80,2
35
Pay
men
t for
cap
ital a
sset
s 12
,353
--
12,3
537,
484
4,86
960
.6%
4,5
84
1,6
58
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-25
5(2
55)
--
96
2.3
Com
mun
ity H
ealth
Cent
res
Cur
rent
pay
men
t 96
8,23
948
,000
-1,
016,
239
1,11
6,06
8(9
9,82
9)10
9.8%
9
71,7
45
1,0
13,4
95
Tra
nsfe
rs a
nd s
ubsi
dies
72
,853
--
72,8
5360
,179
12,6
7482
.6%
55,8
92
47,4
27
Pay
men
t for
cap
ital a
sset
s 13
,986
--
13,9
868,
613
5,37
361
.6%
22,1
78
4,9
03
Paym
ent f
or fi
nanc
ials
ass
ets
--
--
82(8
2)-
- 93
238
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
2.4
Com
mun
ity B
ased
Serv
ices
Curr
ent p
aym
ent
694,
269
14,2
99-
708,
568
694,
226
14,3
4298
%
55
6,52
1 6
94,6
57
Tran
sfer
s an
d su
bsid
ies
267,
909
--
267,
909
223,
494
44,4
1583
.4%
19
0,46
0 12
6,16
9
Paym
ent f
or c
apita
l ass
ets
1,87
5-
-1,
875
1,50
437
180
.2%
1
,786
3,06
3
2.5.
HIV
and
AID
S
Curr
ent p
aym
ent
1,92
9,14
2-
-1,
929,
142
1,84
7,95
081
,192
95.8
% 1
,672
,206
1
,589
,280
Tran
sfer
s an
d su
bsid
ies
289,
380
--
289,
380
282,
853
6,52
797
,7%
2
00,7
40
1
28,1
58
Paym
ent f
or c
apita
l ass
ets
43,8
05-
-43
,805
3,55
840
,247
8.1%
3
9,44
4
10,1
40
2.6.
Nut
ritio
n
Curr
ent p
aym
ent
2,46
3(1
,500
)-
963
417
546
43.3
%2,
330
1,0
69
Tran
sfer
s an
d su
bsid
ies
49,3
79-
-49
,379
48,9
9438
599
.2%
39,
618
31,0
97
Paym
ent f
or c
apita
l ass
ets
--
--
--
- -
26
2.7.
Coro
ner s
ervi
ces
Curr
ent p
aym
ent
160,
150
(15,
000)
-14
5,15
012
4,23
320
,917
85.6
%
104,
440
1
16,2
33
Tran
sfer
s an
d su
bsid
ies
196
--
196
254
(58)
129.
6%10
0 3
8
Paym
ent f
or c
apita
l ass
ets
2,62
5-
-2,
625
1,92
869
773
.4%
40,3
65
13,
699
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-8
(8)
-
-
11
239
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
2.8.
Dist
rict h
ospi
tals
Cur
rent
pay
men
t 1,
722,
979
(19,
799)
-1,
703,
180
1,72
1,58
8(1
8,40
8)10
1.1%
1,4
90,6
82
1,5
60,1
74
Tra
nsfe
rs a
nd s
ubsi
dies
2,
264
--
2,26
43,
812
(1,5
48)
168.
4%
12,
367
2
,837
Pay
men
t for
cap
ital a
sset
s35
,102
--
35,1
0219
,309
15,7
9355
.0%
43,4
0922
,417
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-41
8(4
18)
--
182
Tota
l8,
826,
484
-(4
4,00
0)8,
782,
484
8,55
5,95
622
6,52
897
.4%
7,24
0,27
27,
239,
181
240
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
2 –
Dis
trict
Hea
lth S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Econ
omic
cla
ssifi
catio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
4,29
4,73
7-
(44,
000)
4,25
0,73
74,
243,
315
7,42
299
.8%
3,5
97,9
74
3,90
8,95
8
Goo
ds a
nd s
ervi
ces
3,30
3,37
1-
-3,
303,
371
3,17
2,07
113
1,30
096
.0%
2,71
9,21
1 2,
778,
099
Inte
rest
and
rent
on
land
-
--
--
--
- 1,
234
Tran
sfer
s an
d su
bsid
ies
to:
Prov
ince
s &
mun
icip
aliti
es
470,
685
--
470,
685
506,
498
(35,
813)
107.
6%29
0,89
0 12
1,24
4
Dep
artm
enta
l age
ncie
s &
acco
unts
-
--
-10
(10)
- -
2
Non
-pro
fi t in
stitu
tions
63
1,26
6-
-63
1,26
656
0,41
770
,849
88.8
%46
5,32
9 34
2,65
7
hous
ehol
ds12
,479
--
12,4
7913
,468
(989
)10
7.9%
6,10
09,
301
Paym
ent f
or c
apita
l ass
ets
Build
ings
& o
ther
fi xe
d
stru
ctur
es
31,3
40-
-31
,340
1,50
929
,831
4.8%
46,2
44
8,17
1
Mac
hine
ry &
equ
ipm
ent
82,6
06-
-82
,606
57,4
8125
,125
69.6
% 1
14,5
24
69,0
23
Paym
ent f
or fi
nanc
ial a
sset
s-
- -
-1,
187
(1,1
87)
- -
492
TOTA
LS8,
826,
484
-(4
4,00
0)8,
782,
484
8,55
5,95
622
6,52
897
.4%
7,24
0,27
27,
239,
181
241
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
3 –
Em
erge
ncy
Med
ical
Ser
vice
s
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
e
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
3.1
Emer
genc
y Tr
ansp
ort
Curr
ent p
aym
ent
336,
442
--
336,
442
325,
772
10,6
7096
.8%
2
77,1
78
2
58,6
26
Tran
sfer
s an
d su
bsid
ies
494,
027
--
494,
027
577,
404
(83,
377)
116.
9%
372
,170
283
,045
Paym
ent f
or c
apita
l ass
ets
29,4
00-
-29
,400
13,0
6316
,337
44.4
%
42
,756
15
,784
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-2
(2)
-
-
10
3.2
Plan
ned
Patie
nt
Tran
spor
t
Curr
ent p
aym
ent
199,
368
--
199,
368
230,
920
(31,
552)
115.
8%
95
,566
139
,023
Tran
sfer
s an
d su
bsid
ies
47-
-47
70(2
3)14
8.9%
-
56
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
- -
Tota
l1,
059,
284
--
1,05
9,28
41,
147,
231
(87,
947)
108.
3%78
7,67
069
6,54
4
242
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
3 –
Em
erge
ncy
Med
ical
Ser
vice
s
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Prog
ram
me
3 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
plo y
ees
253,
509
--
253,
509
262,
330
(8,8
21)
103.
5%
249
,855
22
9,34
4
Goo
ds a
nd s
ervi
ces
282,
301
--
282,
301
294,
362
(12,
061)
104.
3%
122
,889
16
8,30
5
Tran
sfer
s &
sub
sidi
es to
Prov
ince
s &
mun
icip
aliti
es
493,
600
--
493,
600
577,
027
(83,
427)
116.
9%
372
,170
28
2,84
6
Hou
seho
lds
474
--
474
447
2794
.3%
-
255
Paym
ent f
or c
apita
l ass
ets
Build
ings
& o
ther
fi xe
d
stru
ctur
es
--
--
--
4,0
00
-
Mac
hine
ry &
equ
ipm
ent
29,4
00-
-29
,400
13,0
6316
,337
44.4
%
38
,756
15
,784
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-2
(2)
--
10
Tota
l1,
059,
284
--
1,05
9,28
41,
147,
231
(87,
947)
108.
3%78
7,67
069
6,54
4
243
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
4 –
Pro
vinc
ial H
ospi
tal S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
4.1
Gen
eral
Hos
pita
ls
Curr
ent p
aym
ent
4,58
9,05
512
,794
151,
889
4,75
3,73
85,
071,
449
(317
,711
)10
6.7%
3,8
20,8
95
4,6
02,1
75
Tran
sfer
s an
d su
bsid
ies
10,3
51-
-10
,351
10,6
42(2
91)
102.
8%
4
,554
8
,561
Paym
ent f
or c
apita
l ass
ets
62,1
62-
-62
,162
67,0
87(4
,925
)10
7.9%
59,7
93
54,8
55
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-1,
378
(1,3
78)
-
-
725
4.2
Tube
rcul
osis
Hos
pita
ls
Curr
ent p
aym
ent
288,
794
--
288,
794
156,
117
132,
677
54.1
%
242
,174
133
,301
Tran
sfer
s an
d su
bsid
ies
255
--
255
148
107
58.0
%
243
260
Paym
ent f
or c
apita
l ass
ets
60,9
54-
-60
,954
367
60,5
870.
6%
58
,051
2
,464
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-83
(83)
-
- 4
4.3
Psyc
hiat
ric/
Men
tal
Hos
pita
ls
Curr
ent p
aym
ent
676,
537
(12,
794)
- 6
63,7
4364
5,17
318
,570
97.2
%
522
,704
605
,200
Tran
sfer
s an
d su
bsid
ies
286,
846
--
286,
846
243,
691
43,1
5585
.0%
1
94,8
67
1
73,3
67
Paym
ent f
or c
apita
l ass
ets
5,44
9-
-5,
449
4,39
71,
052
80.7
%
6
,206
6
,758
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-20
5(2
05)
-
-
53
244
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
2012
/201
320
11/1
2
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
4.4
Oth
er S
peci
aliz
ed
Hos
pita
ls
Curr
ent p
aym
ent
53,8
29-
-53
,829
52,4
151,
414
97.4
%
40
,161
44
,901
Tran
sfer
s an
d su
bsid
ies
54-
-54
54-
100.
0%
11
656
Paym
ent f
or c
apita
l ass
ets
5,43
7-
-5,
437
200
5,23
73.
7%
5
,178
1
,204
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-4
(4)
-
-
-
4.5.
Dent
al T
rain
ing
Hos
pita
ls
Curr
ent p
aym
ent
345,
024
-48
034
5,50
432
2,85
722
,647
93.4
%
295
,646
288
,570
Tran
sfer
s an
d su
bsid
ies
692
--
692
1,17
9(4
87)
170.
4%
165
1
,140
Paym
ent f
or c
apita
l ass
ets
9,08
8-
-9,
088
4,89
34,
195
53.8
%
9
,297
3
,896
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-10
1(1
01)
-
- 9
Tota
l6,
394,
527
-15
2,36
96,
546,
896
6,58
2,44
0(3
5,54
4)10
0.5%
5,25
9,94
55,
928,
099
245
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
4 –
Pro
vinc
ial H
ospi
tal S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Prog
ram
me
4 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
plo y
ees
4,42
7,67
4-
141,
369
4,56
9,04
34,
584,
209
(15,
166)
100.
3%
3
,804
,704
4,
215,
479
Goo
ds a
nd s
ervi
ces
1,52
5,56
5-
11,0
001,
536,
565
1,66
3,54
1(1
26,9
76)
108.
3%
1
,116
,876
1,
458,
216
Inte
rest
and
rent
on
land
-
--
-26
1(2
61)
- -
453
Tran
sfer
s &
sub
sidi
es to
Dep
artm
enta
l Age
ncie
s an
d Ac
coun
ts
--
--
4(4
)-
--
Non
-pro
fi t in
stitu
tions
28
5,51
9-
-28
5,51
924
1,84
343
,676
84.7
%
194
,040
17
2,25
5
Hou
seho
lds
12,6
79-
-12
,679
13,8
67(1
,188
)10
9.4%
5,8
00
11,7
30
Paym
ent f
or c
apita
l ass
ets
Build
ings
& o
ther
fi xe
d st
ruct
ures
38
,850
--
38,8
501
38,8
490.
0%
37
,000
86
6
Mac
hine
ry &
equ
ipm
ent
104,
240
--
104,
240
76,9
4327
,297
73.8
%
101
,525
68
,258
Soft
war
e &
othe
r int
angi
ble
asse
ts-
--
--
--
-
52
Paym
ent f
or fi
nanc
ial a
sset
s-
1,77
1(1
,771
)
-
79
0
Tota
l 6,
394,
527
-15
2,36
96,
546,
896
6,58
2,44
0(3
5,54
4)10
0.5%
5,25
9,94
55,
928,
099
246
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
5 –
Cen
tral H
ospi
tals
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
5.1
Cent
ral H
ospi
tal S
ervi
ces
Curr
ent p
aym
ent
7,26
0,45
4-
-7,
260,
454
7,61
3,64
4(3
53,1
90)
105%
6,6
52,4
55
7,0
18,1
57
Tran
sfer
s an
d su
bsid
ies
18,8
29-
-18
,829
21,0
08(2
,179
)11
2%
6,9
00
15
,333
Paym
ent f
or c
apita
l ass
ets
287,
576
--
287,
576
163,
639
123,
937
57%
11
9,00
0
96,
339
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-1,
622
(1,6
22)
-
-
1,
733
Tota
l 7,
566,
859
--
7,56
6,85
97,
799,
913
(233
,054
)10
3%
6
,778
,355
7,1
31,5
62
247
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
5 –
Cen
tral H
ospi
tals
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Econ
omic
cla
ssifi
catio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
5,13
0,27
1-
-5,
130,
271
5,09
6,36
133
,910
99%
4,73
3,96
64,
753,
470
Goo
ds a
nd s
ervi
ces
2,13
0,18
3-
-2,
130,
183
2,51
6,93
4(3
86,7
51)
118%
1,91
8,48
92,
263,
260
Inte
rest
and
rent
on
land
--
--
349
(349
)-
-1,
427
Tran
sfer
s an
d su
bsid
ies
to:
Hou
seho
lds
18,8
29-
-18
,829
21,0
08(2
,179
)11
2%6,
900
15,3
33
Mac
hine
ry a
nd e
quip
men
t28
7,57
6-
-28
7,57
616
3,63
912
3,93
757
%11
9,00
096
,339
Paym
ents
for fi
nan
cial
ass
ets
--
--
1,62
2(1
,622
)-
-
1,73
3
Tota
l7,
566,
859
--
7,56
6,85
97,
799,
913
(233
,054
)10
3%6,
778,
355
7,13
1,56
2
248
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
6 –
Hea
lth S
cien
ces
and
Trai
ning
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
6.1
Nur
sing
Tra
inin
g Co
llege
s
Curr
ent p
aym
ent
737,
537
-(4
8,23
3)68
9,30
468
2,44
26,
862
99%
6
62,0
25
6
42,5
87
Tran
sfer
s an
d su
bsid
ies
748
--
748
1,23
1(4
83)
165%
6
53
1,0
49
Paym
ent f
or c
apita
l ass
ets
1,56
5-
-1,
565
5,11
6(3
,551
)32
7%
3
,490
5
,212
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-34
4(3
44)
-
-
37
6.2.
EMS
Trai
ning
Col
lege
s
Curr
ent p
aym
ent
34,9
87(1
,698
)(1
,136
)32
,153
21,0
3011
,123
65%
20,3
62
18,7
78
Tran
sfer
s an
d su
bsid
ies
--
--
2(2
)-
-
17
Paym
ent f
or c
apita
l ass
ets
5,98
8-
-5,
988
3,33
02,
658
56%
6,5
51
1,2
79
Paym
ent f
or fi
nanc
ial a
sset
s-
--
-9
(9)
--
-
6.3.
BUR
SAR
IES
Curr
ent p
aym
ent
14,7
01-
-14
,701
8,28
46,
417
56%
10,0
00
6,6
52
Tran
sfer
s an
d su
bsid
ies
36,1
14-
-36
,114
35,2
9182
398
%
20
,000
25
,486
6.4.
Oth
er T
rain
ing
Curr
ent p
aym
ent
29,4
571,
698
-31
,155
21,1
0510
,050
68%
28,2
39
23,8
37
Tran
sfer
s an
d su
bsid
ies
29,8
20-
-29
,820
28,7
721,
048
97%
14,3
44
1,0
00
Paym
ent f
or c
apita
l ass
ets
376
--
376
103
273
27%
3
58
75
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-11
(11)
-
-
80
Tota
l89
1,29
3-
(49,
369)
841,
924
807,
070
34,8
5496
% 7
66,0
22 7
26,0
89
249
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
6 –
Hea
lth T
rain
ing
and
Scie
nces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Prog
ram
me
6 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
735,
857
-(4
9,36
9)68
6,48
868
6,49
6(8
)10
0%66
7,79
664
6,18
6
Goo
ds a
nd s
ervi
ces
80,8
25-
-80
,825
46,3
6534
,460
57%
52,8
3045
,419
Inte
rest
and
rent
on
land
--
--
--
--
249
Tran
sfer
s an
d su
bsid
ies
to:
Dep
artm
enta
l age
ncie
s an
d ac
coun
ts28
,286
--
28,2
8628
,239
4710
0%13
,182
-
Uni
vers
ities
and
tech
niko
ns1,
500
--
1,50
050
010
0033
.3%
1,16
291
0
Hou
seho
lds
36,8
96-
-36
,896
36,5
5833
899
%20
,653
26,6
43
Paym
ent
for fi
nan
cial
as
sets
Mac
hine
ry a
nd e
quip
men
t7,
929
--
7,92
98,
548
(619
)10
8%10
,399
6,56
5
Paym
ent
for fi
nan
cial
ass
ets
--
--
364
(364
)-
-11
7
Tota
l89
1,29
3-
(49,
369)
841,
924
807,
070
34,8
5496
%76
6,02
272
6,08
9
250
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
7 –
Hea
lth C
are
Supp
ort S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
7.1
Laun
drie
s
Curr
ent p
aym
ent
158,
021
--
158,
021
149,
876
8,14
595
% 1
35,7
15
137
,586
Tran
sfer
s an
d su
bsid
ies
210
--
210
266
(56)
127%
200
2
90
Paym
ent f
or c
apita
l ass
ets
3,62
2-
-3,
622
1,94
81,
674
54%
3,
545
3,2
84
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-23
(23)
-
- 27
7.2.
Food
Sup
ply
Serv
ices
Curr
ent p
aym
ent
37,8
42-
-37
,842
44,1
47(6
,305
)11
7% 2
9,64
9
32,2
49
Tran
sfer
s an
d su
bsid
ies
64-
-64
1054
16%
61
42
Paym
ent f
or c
apita
l ass
ets
61-
-61
104
(43)
171%
55
60
Paym
ent f
or fi
nanc
ial a
sset
s -
--
-20
(20)
-
-
4
7.3.
Med
icin
e Tr
adin
g Ac
coun
t
Curr
ent p
aym
ent
1-
-1
150
(149
)15
000.
0%
1
144
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
1
Tota
l19
9,82
1-
-19
9,82
119
6,54
43,
278
98.4
%16
9,22
617
3,68
7
251
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
7 –
Hea
lth C
are
Supp
ort S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Prog
ram
me
7 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
plo y
ees
130,
282
--
130,
282
120,
031
10,2
5192
%11
5,54
212
1,50
7
Goo
ds a
nd s
ervi
ces
65,5
82-
-65
,582
74,1
42(8
,560
)11
3%49
,823
48,3
67
Inte
rest
and
rent
on
land
--
--
--
--
106
Tran
sfer
s an
d su
bsid
ies
to:
Hou
seho
lds
274
--
274
276
(2)
101%
261
332
Mac
hine
ry a
nd e
quip
men
t3,
683
--
3,68
32,
052
1,63
156
%3,
600
3,34
4
Paym
ent
for
capi
tal a
sset
s-
--
-43
(43)
-
- 31
Tota
l19
9,82
1-
-19
9,82
119
6,54
43,
277
98%
169,
226
173,
687
252
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
8 –
Hea
lth F
acilit
y M
anag
emen
t
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Ap
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
8.1.
Com
mun
ity H
ealth
F a
cilit
ies
Curr
ent p
aym
ent
91,0
58-
-91
,058
81,1
429,
916
89%
56,8
42
100,
865
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
-
-
Paym
ent f
or c
apita
l ass
ets
15,2
67-
-15
,267
20,0
26(4
,759
)13
1%
-
1
24
8.2.
Emer
genc
y M
edic
al
Res
cue
Serv
ices
Curr
ent p
aym
ent
217
--
217
13,3
37(1
3,12
0)61
46.1
%
34
,020
2
,870
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
-
-
Paym
ent f
or c
apita
l ass
ets
722
--
722
5,16
9(4
,447
)71
6%-
-
8.3.
Dist
rict H
ospi
tal
Serv
ices
Curr
ent p
aym
ent
86,0
66-
-86
,066
85,1
41(9
25)
99%
63,9
72
1
11,3
12
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
-
-
Paym
ent f
or c
apita
l ass
ets
282,
093
--
282,
093
186,
711
95,3
8266
%
559
,164
417
,699
Paym
ent f
or fi
nanc
ial a
sset
s -
--
--
--
-
-
8.4.
Prov
inci
al H
ospi
tal
Serv
ices
Curr
ent p
aym
ent
150,
198
--
150,
198
192,
896
(42,
698)
128%
3
08,6
12
1
18,1
45
253
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Ap
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Paym
ent f
or c
apita
l ass
ets
486,
615
--
486,
615
312,
888
173,
727
64%
4
18,0
23
2
31,2
53
8.5.
Cent
ral H
ospi
tal
Serv
ices
Curr
ent p
aym
ent
127,
002
--
127,
002
157,
717
(30,
715)
124%
147,
935
131,
275
Paym
ent f
or c
apita
l ass
ets
130,
902
--
130,
902
54,3
2276
,580
42%
163,
155
93,8
77
8.6
Oth
er F
acili
ties
Curr
ent p
aym
ent
120,
852
--
120,
852
107,
919
12,9
3389
%12
5,52
610
1,91
5
Tran
sfer
s an
d su
bsid
ies
--
--
211
(211
)-
-21
Paym
ent f
or c
apita
l ass
ets
19,8
87-
-19
,887
26,3
52(6
,465
)13
3%50
08,
910
Tota
l1,
510,
879
--
1,51
0,87
91,
243,
831
267,
048
82%
1,87
7,74
91,
318,
266
254
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
8 –
Hea
lth F
acilit
y M
anag
emen
t
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Prog
ram
me
8 pe
r Eco
nom
ic
clas
sifi c
atio
nAd
just
edAp
prop
riatio
nSh
iftin
g of
Fu
nds
Vire
men
tFi
nal
Appr
opria
tion
Actu
alEx
pend
iture
Varia
nce
Expe
nditu
reas
% o
f fi n
al
appr
opria
tion
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
Curr
ent p
aym
ents
Com
pens
atio
n of
em
plo y
ees
13,6
31-
-13
,631
10,2
343,
397
75%
12,2
7711
,166
Goo
ds a
nd s
ervi
ces
561,
762
--
561,
762
627,
919
(66,
157)
112%
724,
630
555,
205
Inte
rest
and
Ren
t on
land
--
--
--
--
10
Tran
sfer
s an
d su
bsid
ies
to:
Hou
seho
lds
--
--
91(9
1)-
-21
Non
-Pro
fi t In
stitu
tions
--
--
113
(113
)-
--
Dep
artm
enta
l Age
ncie
s an
d Ac
coun
ts
--
--
7(7
)-
--
Paym
ent
for c
apita
l ass
ets
Build
ings
and
oth
er fi
xed
stru
ctur
es77
8,49
9-
-77
8,49
952
6,77
225
1,72
760
.2%
722,
144
590,
617
Mac
hine
ry a
nd e
quip
men
t15
6,98
7-
-15
6,98
778
,695
78,2
9253
.6%
418,
698
161,
247
Tota
l1,
510,
879
--
1,51
0,87
91,
243,
831
267,
048
82%
1,87
7,74
91,
318,
266
255
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il Per
Pro
gram
me
9 –
Soc
ial W
elfa
re S
ervi
ces
For t
he y
ear e
nded
31
Mar
ch 2
013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
9.1
Prof
essi
onal
and
Ad
min
istr
ativ
e Su
ppor
t
Curr
ent p
aym
ent
--
--
--
-
6
,008
5
,127
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
30
92
Paym
ent f
or fi
nanc
ial a
sset
s-
--
--
--
-
1
9.2
Subs
tanc
e Ab
use,
Pr
even
tion
& R
ehab
ilita
tion
Curr
ent p
aym
ent
--
--
--
-
37
,932
33
,253
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
44
,439
39
,931
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
18
4
172
Paym
ent f
or fi
nanc
ial a
sset
s -
--
--
--
-16
9.3
Care
& S
ervi
ce to
old
er
pers
ons
Curr
ent p
aym
ent
--
--
--
-
43
,444
45
,543
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
155
,392
151
,081
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
51
,823
58
,178
9.4
Crim
e, P
reve
ntio
n &
Supp
ort
Curr
ent p
aym
ent
--
--
--
-
64
,948
56
,998
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
72
,994
64
,800
Paym
ent f
or c
apita
l ass
ets
--
--
--
-
15
,000
1
,155
256
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
2012
/13
2011
/12
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
R’0
00
9.5
Serv
ice
To P
erso
ns W
ith
Disa
bilit
y
Curr
ent p
aym
ent
--
--
--
- 2
7,90
4 19
,922
Tran
sfer
s an
d su
bsid
ies
--
--
--
- 7
8,52
9 8
6,14
5
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 6
69
6
99
9.6
Child
Car
e &
Pro
tect
ion
Serv
Curr
ent p
aym
ent
--
--
--
- 4
40,9
47
467,
649
Tran
sfer
s an
d su
bsid
ies
--
--
--
-45
0,51
7 41
4,95
5
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 1
2,58
4 1
8,22
5
Paym
ent f
or fi
nanc
ial a
sset
s-
--
--
--
-
31
9.7
Vi
ctim
Em
pow
erm
ent
Curr
ent p
aym
ent
--
--
--
-8,
511
5
,962
Tran
sfer
s an
d su
bsid
ies
--
--
--
- 3
7,06
8 3
4,49
4
Paym
ent f
or c
apita
l ass
ets
--
--
--
- -
3
9.8
HIV
and
AID
S
Curr
ent p
aym
ent
--
--
--
- 6
,242
2
,253
Tran
sfer
s an
d su
bsid
ies
--
--
--
-23
5,19
8 2
30,3
57
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 1
5 15
9.9
Care
and
Sup
port
Se
rvic
es
to F
amili
es
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
98
,052
96
,989
Tot
al
--
--
--
-1,
888,
430
1,83
4,04
6
257
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Prog
ram
me
9 p
er E
cono
mic
cl
assi
fi cat
ion
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
Curr
ent p
aym
ents
Com
pens
atio
n of
em
plo y
ees
--
--
--
-42
7,52
0 46
2,92
7
Goo
ds a
nd s
ervi
ces
--
--
--
-20
9,41
6 1
73,7
12
Inte
rest
and
rent
on
land
-
--
--
--
- 6
6
Tran
sfer
s &
sub
sidi
es
Non
-pro
fi t in
stitu
tions
-
--
--
--
1,17
0,34
41,
117,
278
Hou
seho
lds
--
--
--
-1,
845
1,4
75
Paym
ent f
or c
apita
l ass
ets
Build
ings
& o
ther
fi xe
d st
ruct
ures
-
--
--
--
77,
200
74,
700
Mac
hine
ry &
equ
ipm
ent
--
--
--
-
3,1
05
3,8
39
Soft
war
e &
othe
r int
angi
ble
asse
ts
--
--
--
-
-
-
Paym
ent f
or fi
nanc
ial a
sset
s-
--
--
--
- 49
Tota
l-
--
--
--
1,88
8,43
01,
834,
046
258
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
Deta
ils p
er s
ub –
prog
ram
me
10.1
Pro
fess
iona
l and
Ad
min
istr
ativ
e Su
ppor
t
Curr
ent p
aym
ent
--
--
--
- 2
,920
3,
187
Tran
sfer
s an
d su
bsid
ies
--
--
--
- -
53
Paym
ent f
or c
apita
l ass
ets
--
--
--
-66
6
5
Paym
ent f
or F
inan
cial
Ass
ets
--
--
--
--
30
10.2
You
th D
evel
opm
ent
Curr
ent p
aym
ent
--
--
--
-7,
961
1,4
78
Tran
sfer
s an
d su
bsid
ies
--
--
--
- 6
,389
6,
625
10.3
.Sus
tain
able
Liv
elih
ood
Curr
ent p
aym
ent
--
--
--
-22
,643
19
,399
Tran
sfer
s an
d su
bsid
ies
--
--
--
-65
,256
59
,067
10.4
Inst
itutio
nal C
apac
ity
Build
ing
& S
uppo
rt
Curr
ent p
aym
ent
--
--
--
- 9
8,61
0 9
6,83
5
Tran
sfer
s an
d su
bsid
ies
--
--
--
-
- 59
Paym
ent f
or c
apita
l ass
ets
--
--
--
- 6
-
10.5
Res
earc
h an
d De
mog
raph
y
Curr
ent p
aym
ent
--
--
--
- 2
,891
2,
262
Tran
sfer
s an
d su
bsid
ies
--
--
--
- -
-
Tota
l-
--
--
--
209,
651
190,
284
259
Department of Health Vote 4APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Deta
il pe
r sub
-pro
gram
me
Adju
sted
Appr
opria
tion
Shift
ing
of
Fund
sVi
rem
ent
Fina
lAp
prop
riatio
nAc
tual
Expe
nditu
reVa
rianc
eEx
pend
iture
as %
of fi
nal
ap
prop
riatio
n
Fina
lAp
prop
riatio
nAc
tual
expe
nditu
re
10.6
Pop
ulat
ion
Capa
city
De
velo
pmen
t & A
dvoc
acy
Curr
ent p
aym
ent
--
--
--
- 2
,909
1,
218
Tran
sfer
s an
d su
bsid
ies
--
--
--
- -
-
Tota
l-
--
--
--
209,
651
190,
285
Prog
ram
me
10 P
er E
cono
mic
cl
assi
fi cat
ion
Curr
ent p
aym
ents
Com
pens
atio
n of
em
ploy
ees
--
--
--
- 1
28,2
54
116,
194
Goo
ds a
nd s
ervi
ces
--
--
--
-9,
680
8,1
86
Inte
rest
and
rent
on
land
--
--
--
--
-
Tran
sfer
s &
sub
sidi
es
Non
-pro
fi t in
stitu
tions
--
--
--
-71
,619
65,6
66
Hou
seho
lds
--
--
--
-26
137
Paym
ent f
or c
apita
l ass
ets
Mac
hine
ry &
equ
ipm
ent
--
--
--
-72
65
Paym
ents
for F
inan
cial
As
sets
--
--
--
--
37
Tota
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--
--
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209,
651
190,
285
260
Department of Health Vote 4
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NOTES TO THE APPROPRIATION STATEMENTfor the year ended 31 March 2013.
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, disclosure notes
and Annexure 1 (A-G) to the Annual Financial Statements.
2. Detail of specifi cally 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 fi nancial assets
Detail of these transactions per programme can be viewed in the note on Payments for fi nancial
assets to the Annual Financial Statements.
4. Explanations of material variances from Amounts Voted (after Virement):
4.1 Per ProgrammeFinal
Appropriation
Actual
ExpenditureVariance
Variance as
a % of Final
Appropriation
Programme Name R’000 R’000 R’000
Administration 683,447 501,362 182,085 27
District Health Services 8,782,484 8,555,956 226,528 3
Emergency Medical Services 1,059,284 1,147,231 (87,947) (8)
Provincial Hospital Services 6,546,896 6,582,440 (35,544) (1)
Central Hospital Services 7,566,859 7,799,913 (233,054) (3)
Health Sciences and Training 841,924 807,070 34,854 4
Health Care Support Services 199,821 196,544 3,277 2
Health Facilities Management 1,510,879 1,243,831 267,048 18
TOTAL 27,191,594 26,834,347 357,247 1
The table above summarises the budget versus actual amount spent as at 31 March 2013. The
department spent 99% of the budget which implies that the department is within budget. However,
the department is reporting over-spending on three programmes which are:
• Emergency Medical Services at 8%
• Provincial Hospital Services at 1%
• Central Hospital Services at 3%
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NOTES TO THE APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Programme 1: Administration
The under-expenditure is attributed to the non-fi lling of funded posts due to a moratorium on
administrative posts, restructuring and reallocation of personnel to District Health Services with the
aim of re-engineering of Primary Health Care. In addition the NHI funding allocated to strengthening
revenue collection could not be utilized fully due to delays in the approval of the business plan.
Programme 2: District Health Services
The under- spending on District Health Services is as a result of delays in the procurement of park-
homes for the HIV and AIDS programme. Furthermore, the funding which was set aside during
the adjustment budget for the new Zola hospital which could not be utilised due to delays in the
appointment of support staff.
Programme 3: Emergency Medical Services
The over-expenditure is due to payment of accruals for goods & services and transfers to
municipalities. The Provincilisation of Sedibeng district with effect from 1st September 2012 also
contributed to overspending on compensation of employees.
Programme 4: Provincial Hospital Services
The programme is within the allocated budget.
Programme 5: Central Hospital Services
The main contributors to the over-expenditure on this programme are goods & services as a result
of the payment of previous year’s accruals and households which emanated from injury on duty,
unplanned resignation and deaths.
Programme 6: Health Sciences and Training
The under-spending on this programme is attributed to the non- payment of invoices for training.
During the adjustment budget the department received an additional allocation of R8 million for
bursaries. This funding could not be fully utilised as this was appropriated at the beginning of the
academic year. Another contributing factor to the under-spending is the actual university student
intake (1 341) was less than what was projected (2 280) by the department.
Programme 7: Health Care Support Services
The programme is within the allocated budget.
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NOTES TO THE APPROPRIATION STATEMENTfor the year ended 31 March 2013.
Programme 8: Health Facilities Management
The under-spending is attributed to conditional grant funding not fully utilised due to poor design
and project management which resulted in scope changes, variation orders, cost escalations
and extension of time. Furthermore the factors mentioned led to delays in the appointment of
contractors by the implementing agent. Delays in the completion of projects which resulted in
the unavailability of storage space for medical equipment, hence the deferment of procurement
processes for machinery and equipment.
4.2. Per Economic classifi cation Final Appropriation
Actual Expenditure
Variance Variance as a % of Final
Appropriation
R’000 R’000 R’000 R’000
Current Payments 23,659,392 23,870,650 (211,258) (1)
Compensation of employees 15,278,812 15,244,542 34,270 0
Goods and services 8,380,580 8,625,127 (244,547) (3)
Interest and rent on land - 981 (981) (100)
Transfers & subsidies 1,994,587 2,016,510 (21,923) (1)
Provinces and municipalities 964,285 1,083,525 (119,240) (12)
Departmental agencies and
accounts 28,286 28,267 19 0
Universities and technikons 1,500 500 1,000 67
Non profi t organisation 916,785 817,504 99,281 11
Households 83,731 86,713 (2,982) (4)
Payments for capital assets 1,537,615 941,464 596,151 39
Building and other fi xed structures 848,689 528,282 320,407 38
Machinery and equipment 688,926 413,182 275,744 40
Payments for fi nancial assets - 5,723 (5,723) (100)
TOTAL 27,191,594 26,834,347 357,247 1
From the table above it is evident that the Goods & Services, Transfers to Provinces & Municipalities
and Households exceeded the allocated budget. The main reason for the overspending is due to
the payment of previous year’s accruals in 2012/2013. Over-expenditure in households is attributed
to the payment of injury on duty, unplanned resignations and deaths. The under-spending items
may be explained as follows: Universities and Technikons are due to actual student intake which
was less than what was projected by the department. NPIs: the under spending is as a result of
late submission of claims by the Municipalities The overall under-spending on buildings and other
fi xed structures is due to slow performance on Infrastructure Grants - delays in appointment of
contractors by the implementing agent resulted in projects not completed as planned and the
late processing of invoices. The delays in completion of infrastructure projects resulted in an
unavailability of storage space for medical equipment, hence, the spending is at 60%.
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NOTES TO THE APPROPRIATION STATEMENTfor the year ended 31 March 2013.
4.3 Per conditional grant Final Appropriation
Actual Expenditure
Variance Variance as a % of Final
Appropriation
R’000 R’000 R’000 R’000
National Tertiary Services Grant 3,044,567 3,044,526 41 0
Comprehensive HIV and AIDS
Grant 1,901,293 1,901,293 - 0
Hospital Revitalisation Grant 795,439 572,080 223,359 28
Health Professions Training
&Development Grant 725,310 725,310 - 0
Health Infrastructure Grant 110,361 98,513 11,848 11
Nat Health Insurance Grant 31,500 8,062 23,438 74
Nursing Colleges & Schools 12,480 7,701 4,779 38
EPWP Incentive Grant for the
Social Sector (Health) 29,072 28,727 345 1
AFCON Grant 3,000 3,000 - 0
EPWP Public Works Integrated
Grnt 1,000 0 1,000 0
TOTAL 6,654,022 6,389,212 264,810 4
264
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STATEMENT OF FINANCIAL PERFORMANCEfor the year ended 31 March 2013.
Note 2012/13 2011/12
R’000 R’000
REVENUE
Annual appropriation 1 27,191,594 25,819,914
Departmental revenue 2 506,939 453,505
Aid assistance 3 - 676
TOTAL REVENUE 27,698,533 26,274,095
EXPENDITURE
Current expenditure
Compensation of employees 4 15,244,542 14,882,194
Goods and services 5 8,625,127 7,798,991
Interest and rent on land 6 981 4,184
Total current expenditure 23,870,650 22, 685,369
Transfers and subsidies
Transfers and subsidies 9 2,016,510 2,174,127
Total transfers and subsidies 2,016,510 2,174,127
Expenditure for capital assets
Tangible capital assets 10 941,464 1,127,242
Software and other intangible assets 10 - 121
Total expenditure for capital assets 941,464 1,127,363
Payments for fi nancial assets 7 5,723 3,305
TOTAL EXPENDITURE 26,834,347 25,990,164
SURPLUS FOR THE YEAR 864,186 283,931
Reconciliation of Surplus for the year
Voted funds 357,247 (170,250)
Annual appropriation 92,437 (170,250)
Conditional grants 264,810 -
Departmental revenue 2 506,939 453,505
Aid assistance 3 - 676
SURPLUS FOR THE YEAR 864,186 283,931
265
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STATEMENT OF FINANCIAL POSITIONas at 31 March 2013.
POSITION Note 2012/13 2011/12
R’000 R’000ASSETS
Current assets 6,184,943 5,839,760
Unauthorised expenditure 11 6,095,207 5,770,734
Cash and cash equivalents 12 25,410 1,129
Prepayments and advances 13 109 221
Receivables 14 64,217 67,676
Non-current assets 54,000 54,000
Investments 15 54,000 54,000
TOTAL ASSETS 6,238,943 5,893,760
LIABILITIES
Current liabilities 6,184,943 5,839,760
Voted funds to be surrendered to the Revenue Fund 16 2,113,891 2,092,553
Departmental revenue and NRF Receipts to be
surrendered to the Revenue Fund
17 76,770 74,700
Bank overdraft 18 3,777,932 2,660,499
Payables 19 216,350 1,011,332
Aid assistance unutilised 3 - 676
TOTAL LIABILITIES 6,184,943 5,839,760
NET ASSETS 54,000 54,000
Represented by:
Capitalisation reserve 54,000 54,000
TOTAL 54,000 54,000
266
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STATEMENT OF CHANGES IN NET ASSETSfor the year ended 31 March 2013.
NET ASSETS Note 2012/13 2011/12
R’000 R’000
Capitalisation Reserves
Opening balance 54,000 54,000
Closing balance 54,000 54,000
TOTAL 54,000 54,000
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Department of Health Vote 4CASHFLOW STATEMENTfor the year ended 31 March 2013.
CASH FLOW Note 2012/13 2011/12
R’000 R’000
CASH FLOWS FROM OPERATING ACTIVITIES
Receipts 27,698,533 26,274,095
Annual appropriated funds received 1.1 27,191,594 25,819,914
Departmental revenue received 2 506,939 453,505
Aid assistance received 3 - 676
Net increase in working capital (1,115,984) (711,316)
Surrendered to Revenue Fund (1,165,928) (637,250)
Current payments (23,546,176) (21,659,583)
Payments for fi nancial assets (5,723) (3,305)
Transfers and subsidies paid (2,016,510) (2,174,127)
Net cash fl ow available from operating activities 20 (151,688) 1,088,514
CASH FLOWS FROM INVESTING ACTIVITIES
Payments for capital assets 10 (941,464) (1,127,363)
Net cash fl ows from investing activities (941,464) (1,127,363)
Net increase/(decrease) in cash and cash equivalents (1,093,152) (38,849)
Cash and cash equivalents at beginning of period (2,659,370) (2,620,521)
Cash and cash equivalents at end of period 21 (3,752,522) (2,659,370)
268
Department of Health Vote 4ACCOUNTING POLICIESfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
The Financial Statements have been prepared in accordance with the following policies, which
have been applied consistently in all material aspects, unless otherwise indicated. However, where
appropriate and meaningful, additional information has been disclosed to enhance the usefulness
of the Financial Statements and to comply with the statutory requirements of the Public Finance
Management Act, Act 1 of 1999 (as amended by Act 29 of 1999), and the Treasury Regulations
issued in terms of the Act and the Division of Revenue Act, Act 1 of 2010.
1. Presentation of the Financial Statements1.1 Basis of preparation
The fi nancial statements have been prepared on a modifi ed cash basis of accounting.
Under this basis, the effects of transactions and other events are recognised in the fi nancial records
when the resulting cash is received or paid. The “modifi cation” results from the recognition of certain
near-cash balances in the fi nancial statements as well as the revaluation of foreign investments and
loans and the recognition of resulting revaluation gains and losses.
In addition supplementary information is provided in the disclosure notes to the fi nancial statements
where it is deemed to be useful to the users of the fi nancial statements.
1.2 Presentation currency
All amounts have been presented in the currency of the South African Rand (R) which is also the
functional currency of the department.
1.3 Rounding
Unless otherwise stated all fi nancial fi gures have been rounded to the nearest one thousand Rand
(R’000).
1.4 Comparative fi gures
Prior period comparative information has been presented in the current year’s fi nancial statements.
Where necessary fi gures included in the prior period fi nancial statements have been reclassifi ed to
ensure that the format in which the information is presented is consistent with the format of the
current year’s fi nancial statements.
1.5 Comparative fi gures - Appropriation Statement
A comparison between actual amounts and fi nal appropriation per major classifi cation of expenditure
is included in the Appropriation Statement.
2. Revenue2.1 Appropriated funds
Appropriated funds comprises of departmental allocations as well as direct charges against revenue
fund.
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Appropriated funds are recognised in the fi nancial records on the date the appropriation becomes
effective. Adjustments made in terms of the adjustments budget process are recognised in the
fi nancial records on the date the adjustments become effective.
Unexpended appropriated funds are surrendered to the Provincial Revenue Fund. Any amounts
owing to the Provincial Revenue Fund at the end of the fi nancial year are recognised as payable in
the statement of fi nancial position.
Any amount due from the Provincial Revenue Fund at the end of the fi nancial year is recognised as
a receivable in the statement of fi nancial position.
2.2 Departmental revenue
All departmental revenue is recognised in the statement of fi nancial performance when received
and is subsequently paid into the Provincial Revenue Fund, unless stated otherwise.
Any amount owing to the Provincial Revenue Fund at the end if the fi nancial year is recognised as a
payable in the statement of fi nancial position.
No accrual is made for amounts receivable from the last receipt date to the end of the reporting
period. These amounts are however disclosed in the disclosure notes to the annual fi nancial
statements.
2.3 Direct Exchequer receipts
All direct exchequer receipts are recognised in the statement of fi nancial performance when the
cash is received and is subsequently paid into the Provincial Revenue Fund, unless stated otherwise.
Any amount owing to the Provincial Revenue Funds at the end of the fi nancial year is recognised as
a payable in the statement of fi nancial position.
2.4 Direct Exchequer payments
All direct exchequer payments are recognised in the statement of fi nancial performance when fi nal
authorisation for payment is effected on the system (by no later than 31 March of each year).
2.5 Aid assistance
Aids assistance is recognised as revenue when received
All in-kind aid assistance is disclosed at fair value on the date of receipt in the annexures to the
Annual Financial Statements
The cash payments made during the year relating to aid assistance projects are recognised as
expenditure in the statement of fi nancial performance when fi nal authorisation for payments is
effected on the system (by no later than 31 March of each year)
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The value of the assistance expensed prior to the receipt of funds is recognised as a receivable in
the statement of fi nancial position.
Inappropriately expensed amounts using aid assistance and any unutilised amounts are recognised as payables in the statement of fi nancial position.
3. Expenditure3.1 Compensation of employees
3.1.1 Salaries and wages
Salaries and wages are expensed in the statement of fi nancial performance when the fi nal authorisation for payment is effected on the system (by no later than 31 March of each year).
Other employee benefi ts that give rise to a present legal or constructive obligation are disclosed in the disclosure notes to the fi nancial statements at its face value and are not recognised in the statement of fi nancial performance or position.
Employee costs are capitalised to the cost of a capital project when an employee spends more than 50% of his/her time on the project. These payments form part of expenditure for capital assets in the statement of fi nancial performance.
3.1.2 Social contributions
Employer contributions to post employment benefi t plans in respect of current employees are expensed in the statement of fi nancial performance when the fi nal authorisation for payment is effected on the system (by no later than 31 March of each year).
No provision is made for retirement benefi ts in the fi nancial statements of the department. Any potential liabilities are disclosed in the fi nancial statements of the National Revenue Fund and not in the fi nancial statements of the employer department.
Employer contributions made by the department for certain of its ex-employees (such as medical benefi ts) are classifi ed as transfers to households in the statement of fi nancial performance.
3.2 Goods and services
Payments made during the year for goods and/or services are recognised as an expense in the statement of fi nancial performance when the fi nal authorisation for payment is effected on the system (by no later than 31 March of each year).
The expense is classifi ed as capital if the goods and/or services were acquired for a capital project or if the total purchase price exceeds the capitalisation threshold (currently R5, 000). All other expenditures are classifi ed as current.
Rental paid for the use of buildings or other fi xed structures is classifi ed as goods and services
and not as rent on land.
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3.3 Interest and rent on land
Interest and rental payments are recognised as an expense in the statement of fi nancial performance
when the fi nal authorisation for payment is effected on the system (by no later than 31 March of
each year). This item excludes rental for the use of buildings or other fi xed structures. If it is not
possible to distinguish between payment for the use of land and the fi xed structures on it, the whole
amount should be recorded under goods and services.
3.4 Payments for fi nancial assets
Debts are written off when identifi ed as irrecoverable. Debts written-off are limited to the amount
of savings and/or underspending of appropriated funds. The write off occurs at year-end or when
funds are available. No provision is made for irrecoverable amounts but an estimate is included in
the disclosure notes to the fi nancial statements.
All other losses are recognised when authorisation has been granted for the recognition thereof.
3.5 Transfers and subsidies
Transfers and subsidies are recognised as an expense when the fi nal authorisation for payment is
effected on the system (by no later than 31 March of each year).
3.6 Unauthorised expenditure
When confi rmed unauthorised expenditure is recognised as an asset in the statement of fi nancial
position until such time as the expenditure is either approved by the relevant authority, recovered
from the responsible person or written off as irrecoverable in the statement of fi nancial performance.
Unauthorised expenditure approved with funding is derecognised from the statement of fi nancial
position when the unauthorised expenditure is approved and the related funds are received.
Where the amount is approved without funding it is recognised as expenditure in the statement of
fi nancial performance on the date stipulated in the Act.
3.7 Fruitless and wasteful expenditure
Fruitless and wasteful expenditure is recognised as expenditure in the statement of fi nancial
performance according to the nature of the payment and not as a separate line item on the face of
the statement. If the expenditure is recoverable it is treated as an asset until it is recovered from the
responsible person or written off as irrecoverable in the statement of fi nancial performance.
3.8 Irregular expenditure
Irregular expenditure is recognised as expenditure in the statement of fi nancial performance. If the
expenditure is not condoned by the relevant authority it is treated as an asset until it is recovered or
written off as irrecoverable.
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4. Assets4.1 Cash and cash equivalents
Cash and cash equivalents are carried in the statement of fi nancial position at cost.
Bank overdrafts are shown separately on the face of the statement of fi nancial position.
For the purposes of the cash flow statement, cash and cash equivalents comprise cash on hand,
deposits held, other short-term highly liquid investments and bank overdrafts.
4.2 Other fi nancial assets
Other fi nancial assets are carried in the statement of fi nancial position at cost.
4.3 Prepayments and advances
Amounts prepaid or advanced are recognised in the statement of fi nancial position when the
payments are made and are derecognised as and when the goods/services are received or the
funds are utilised.
Prepayments and advances outstanding at the end of the year are carried in the statement of
fi nancial position at cost.
4.4 Receivables
Receivables included in the statement of fi nancial position arise from cash payments made that
are recoverable from another party (including departmental employees) and are derecognised upon
recovery or write-off.
Receivables outstanding at year-end are carried in the statement of fi nancial position at cost plus
any accrued interest. Amounts that are potentially irrecoverable are included in the disclosure notes.
4.5 Investments
Capitalised investments are shown at cost in the statement of fi nancial position.
Investments are tested for an impairment loss whenever events or changes in circumstances
indicate that the investment may be impaired. Any impairment loss is included in the disclosure
notes.
4.6 Loans
Loans are recognised in the statement of fi nancial position when the cash is paid to the benefi ciary.
Loans that are outstanding at year-end are carried in the statement of fi nancial position at cost plus
accrued interest.
Amounts that are potentially irrecoverable are included in the disclosure notes.
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4.7 Inventory
Inventories that qualify for recognition must be initially reflected 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.
All inventory items at year-end are reflected using the weighted average cost.
4.8 Capital assets
4.8.1 Movable assets
Initial recognition
A capital asset is recorded in the asset register on receipt of the item at cost. Cost of an asset
is defi ned as the total cost of acquisition. Where the cost cannot be determined accurately, the
movable capital asset is stated at fair value. Where fair value cannot be determined, the capital
asset is included in the asset register at R1.
All assets acquired prior to 1 April 2002 are included in the register R1.
Subsequent recognition
Subsequent expenditure of a capital nature is recorded in the statement of fi nancial performance
as “expenditure for capital assets” and is capitalised in the asset register of the department on
completion of the project.
Repairs and maintenance is expensed as current “goods and services” in the statement of fi nancial
performance.
4.8.2 Immovable assets
Initial recognition
A capital asset is recorded on receipt of the item at cost. Cost of an asset is defi ned as the total
cost of acquisition. Where the cost cannot be determined accurately, the immovable capital asset
is stated at R1 unless the fair value for the asset has been reliably estimated.
Subsequent recognition
Work-in-progress of a capital nature is recorded in the statement of fi nancial performance as
“expenditure for capital assets”. On completion, the total cost of the project is included in the asset
register of the department that is accountable for the asset.
Repairs and maintenance is expensed as current “goods and services” in the statement of fi nancial
performance.
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4.8.3 Intangible assets
Initial recognition
An intangible asset is recorded in the asset register on receipt of the item at cost. Cost of an
intangible asset is defi ned as the total cost of acquisition. Where the cost cannot be determined
accurately, the intangible asset is stated at fair value. Where fair value cannot be determined, the
intangible asset is included in the asset register at R1.
Subsequent expenditure
Subsequent expenditure of a capital nature is recorded in the statement of fi nancial performance as
“expenditure for capital asset” and is capitalised in the asset register of the department.
Maintenance is expensed as current “goods and services” in the statement of fi nancial performance.
5. Liabilities5.1 Payables
Recognised payables mainly comprise of amounts owing to other governmental entities. These
payables are carried at cost in the statement of fi nancial position.
5.2 Contingent liabilities
Contingent liabilities are included in the disclosure notes to the fi nancial statements when it is
possible that economic benefi ts will flow from the department, or when an outflow of economic
benefi ts or service potential is probable but cannot be measured reliably.
5.3 Contingent assets
Contingent assets are included in the disclosure notes to the fi nancial statements when it is probable
that an inflow of economic benefi ts will flow to the entity.
5.4 Commitments
Commitments are not recognised in the statement of fi nancial position as a liability or as expenditure
in the statement of fi nancial performance but are included in the disclosure notes.
5.5 Accruals
Accruals are not recognised in the statement of fi nancial position as a liability or as expenditure in
the statement of fi nancial performance but are included in the disclosure notes.
5.6 Employee benefi ts
Short-term employee benefi ts that give rise to a present legal or constructive obligation are
disclosed in the disclosure notes to the fi nancial statements. These amounts are not recognised in
the statement of fi nancial performance or the statement of fi nancial position.
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5.7 Lease commitments
Finance lease
Finance leases are not recognised as assets and liabilities in the statement of fi nancial position.
Finance lease payments are recognised as a capital expense in the statement of fi nancial
performance and are not apportioned between the capital and the interest portions. The total
fi nance lease payment is disclosed in the disclosure notes to the fi nancial statements.
Operating lease
Operating lease payments are recognised as an expense in the statement of fi nancial performance.
The operating lease commitments are disclosed in the disclosure notes to the fi nancial statements.
5.8 Impairment
The department tests for impairment where there is an indication that a receivable, loan or investment
may be impaired. An assessment of whether there is an indication of possible impairment is done
at each reporting date. An estimate is made for doubtful loans and receivables based on a review
of all outstanding amounts at year-end. Impairments on investments are calculated as being the
difference between the carrying amount and the present value of the expected future cash flows /
service potential flowing from the instrument.
5.9 Provisions
Provisions are disclosed when there is a present legal or constructive obligation to forfeit economic
benefi ts as a result of events in the past and it is probable that an outflow of resources embodying
economic benefi ts will be required to settle the obligation and a reliable estimate of the obligation
can be made.
6. Receivables for departmental revenue
Receivables for departmental revenue are disclosed in the disclosure notes to the annual fi nancial
statements. These receivables are written off when identifi ed as irrecoverable and are disclosed
separately.
7. Net Assets7.1 Capitalisation reserve
The capitalisation reserve comprises of fi nancial assets and/or liabilities originating in a prior
reporting period but which are recognised in the statement of fi nancial position for the fi rst time in
the current reporting period. Amounts are recognised in the capitalisation reserves when identifi ed
in the current period and are transferred to the Provincial Revenue Fund when the underlying asset
is disposed and the related funds are received.
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7.2 Recoverable revenue
Amounts are recognised as recoverable revenue when a payment made in a previous fi nancial year
becomes recoverable from a debtor in the current fi nancial year. Amounts are either transferred
to the Provincial Revenue Fund when recovered or are transferred to the statement of fi nancial
performance when written-off.
8. Related party transactions
Specifi c information with regards to related party transactions is included in the disclosure notes.
9. Key management personnel
Compensation paid to key management personnel including their family members where relevant,
is included in the disclosure notes.
10. Public Private Partnerships
A description of the PPP arrangement, the contract fees and current and capital expenditure relating
to the PPP arrangement is included in the disclosure notes.
277
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Gauteng Provincial Government | Health | Annual Report 2012/2013
1. An nual Appropriation 1.1 Appropriation
ProgrammeFinal
Appropriation
Actual Funds Received 2012/13
Funds not received/not
requested
Appropriation Received
2011/2012
R’000 R’000 R’000 R’000
Administration 683,447 683,447 - 842,594
District Health Services 8,782,484 8,782,484 - 7,240,272
Emergency Medical Services 1,059,284 1,059,284 - 787,670
Provincial Hospital Services 6,546,896 6,546,896 - 5,259,945
Central Hospitals 7,566,859 7,566,859 - 6,778,355
Health Sciences and Training 841,924 841,924 - 766,022
Health Care Support Service 199,821 199,821 - 169,226
Health Facilities Management 1,510,879 1,510,879 - 1,877,749
Social Welfare Services - - - 1,888,430
Development and Research - - - 209,651
Total 27,191,594 27,191,594 - 25,819,914
1.2 Conditional grants
2012/13 2011/12
Note R’000 R’000
Total grants received 39 6,654,022 6,199,217
Provincial grants included in Total Grants received - 142,694
Total 6,654,022 6,341,911
The department did not receive any provincial grants during the 2012/2013 fi nancial year
2. Departmental revenue
Sales of goods and services other than capital assets 2.1 474,156 398,072
Fines, penalties and forfeits 2.2 3 13
Interest, dividends and rent on land 2.3 1,255 487
Transactions in fi nancial assets and liabilities 2.4 31,525 54,933
Total revenue collected 506,939 453,505
Departmental revenue collected 506,939 453,505
2.1 Sales of goods and services other than capital assets
Sales of goods and services produced by the department 472,533 396,264
Sales by market establishment 13,080 392,642
Administrative fees 2,966 3,622
Other Sales 456,487 -
278
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Note 2012/13 2011/12
R’000 R’000
Sales of scrap, waste and other used current goods 1,623 1,808
Total 474,156 398,072
The comparative of the revenue item in Note 2.1 Other Sales is included under Sales by Market
Establishment. The reclassifi cation is as a result of SCOA changes.
2.2 Fines, penalties and forfeits
Fines 3 13
Total 3 13
2.3 Interest, dividends and rent on land
Interest 1,255 487
Total 1,255 487
2.4 Transactions in fi nancial assets and liabilities
Loans and advances 6 1
Receivables 22,001 31,256
Stale cheques written back 421 515
Other Receipts including Recoverable Revenue 9,097 23,161
Total 31,525 54,933
3. Aid assistance 3.1 Aid assistance received in cash from other sources
Local
Opening Balance 676 -
Surrendered (676) 676
Closing Balance 0 676
279
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
4. Compensation of employees4.1 Salaries and Wages
Note 2012/13 2011/12
R’000 R’000
Basic salary 9,928,941 9,592,928
Performance award 636 198,849
Service Based 766,271 719,310
Compensative/circumstantial 1,293,297 908,166
Periodic payments 108,823 104,410
Other non-pensionable allowances 1,313,285 1,564,421Total 13,411,253 13,088,084
4.2 Social contributions
Employer contributions
Pension 1,203,417 1,168,966
Medical 627,789 622,820
UIF 172 289
Bargaining council 1,851 1,906
Insurance 60 129
Total 1,833,289 1,794,110
Total compensation of employees 15,244,542 14,882,194
Average number of employees 63,360 65,546
The average number of employees disclosed during 2011/2012 included employees of the
Department of Social Development. The Department of Health is a stand-alone department
with effect from 1 April 2012.
280
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
5. Goods and services
Note 2012/13 2011/12
R’000 R’000
Administrative fees 3,178 4,469
Advertising 13,672 13,047
Assets less then R5,000 5.1 25,791 40,589
Bursaries (employees) 9,503 8,404
Catering 3,354 8,963
Communication 79,537 109,962
Computer services 5.2 75,807 99,629
Consultants, contractors and agency/outsourced services 5.3 1,993,616 1,853,124
Entertainment 242 66
Audit cost – external 5.4 28,583 19,952
Fleet services 95,535 11
Inventory 5.5 4,473,726 4,166,459
Housing 11 -
Operating leases 81,277 76,891
Property payments 5.6 1,312,556 1,149,199
Rental and hiring 1,537 -
Transport provided as part of the departmental activities 157,191 89,477
Travel and subsistence 5.7 194,475 69,757
Venues and facilities 5,146 15,402
Training and staff development 28,484 28,273
Other operating expenditure 5.8 41,906 45,317
Total 8,625,127 7,798,991
Other operating expenditure includes an amount of R35 million in respect of learnerships.
281
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.1 A ssets less than R5,000
Note 2012/13 2011/12
R’000 R’000
Tangible assets 5 25,791 40,589
Machinery and equipment 25,791 40,589
Total 25,791 40,589
5.2 Computer services
SITA computer services 46 -
External computer service providers 75,761 99,629
Total 75,807 99,629
5.3 Consultants, contractors and agency/outsourced services
Business and advisory services 50,701 74,349
Infrastructure and planning 132,828 -
Laboratory services 1,249,751 1,210,037
Legal costs 144,460 68,472
Contractors 189,182 187,706
Agency and support/outsourced services 226,694 312,560
Total 1,993,616 1,853,124
The amount of R189 million disclosed under contractors represents payments made in respect
of blood and blood products. The amount of R185 706 as disclosed in the 2011/2012 Annual
Report of the department for contractors is incorrectly disclosed as a result of a printing error.
The correct amount is R187 706 million.
5.4 Audit cost – External
Regularity audits 17,499 19,750
Performance audits - 1
Investigations 11,084 -
Other audits - 201
Total 28,583 19,952
282
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.5 I nventory
Note 2012/13 2011/12
R’000 R’000
Learning and teaching support material 5 1,330 748
Food and food supplies 184,748 215,979
Fuel, oil and gas 85,450 157,044
Other consumables 340,309 314,644
Materials and supplies 20,506 155
Stationery and printing 82,001 66,405
Medical supplies 1,766,582 2,066,011
Medicine 1,992,800 1,345,473
Total 4,473,726 4,166,459
5.6 Property payments
Municipal services 499,009 304,515
Property maintenance and repairs 578,279 602,281
Other 235,268 242,403
Total 1,312,556 1,149,199
Other represents laundry services, cleaning services safeguarding and security amongst other
items.
5.7 Travel and subsistence
Local 193,656 69,332
Foreign 819 425
Total 194,475 69,757
Included in the amount of R194 million is an amount of R174 million in respect of G Fleet
Services.
283
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
5.8 O ther operating expenditure
Note 2012/13 2011/12
R’000 R’000
Learnerships 5 35,368 25,803
Professional bodies, membership and subscription fees 171 150
Resettlement costs 1,148 5,338
Gifts - 1
Other 5,219 14,025
Total 41,906 45,317
The amount of R5.2 million disclosed as Other represents courier and delivery services.
6. Interest and rent on land
Interest paid 6 981 4,184
Total 981 4,184
7. Payments for fi nancial assets
Debts written off 7 5,723 3,305
Total 5,723 3,305
8. Debts written off
Nature of debts written off
Bad debts written off in respect of staff debt 5,723 3,305
Total debt written off 5,723 3,305
284
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
9. T ransfers and subsidies
Note 2012/13 2011/12
R’000 R’000
Provinces and municipalities 39, 40, Annex
1A, Annex 1B 1,083,525 404,090
Departmental agencies and accounts Annex 1C 28,267 2
Universities and technikons Annex 1D 500 909
Non-profi t institutions Annex 1G 817,504 1,697,856
Households Annex 1H 86,714 71,270Total 2,016,510 2,174,127
Included in the amount of R1, 083 billion representing transfers to Provinces and Municipalities
is an amount of R535 million relating to previous fi nancial years but paid in 2012/2013.
10. Expenditure for capital assets
Tangible assets 941,464 1,127,242
Buildings and other fi xed structures 37 528,282 674,355
Machinery and equipment 35 413,182 452,887
Software and other intangible assets - 121
Computer software 36 - 121
Total 941,464 1,127,363
10.1 Analysis of funds utilised to acquire capital assets – 2012/13
Voted Funds Aid
Assistance
Total
Tangible assets 941,464 - 941,464
Buildings and other fi xed structures 528,282 - 528,282
Machinery and equipment 413,182 - 413,182
Total 941,464 - 941,464
10.2 Analysis of funds utilised to acquire capital assets – 2011/12
Voted Funds Aid
Assistance
Total
Tangible assets 1,127,242 - 1,127,242
Buildings and other fi xed structures 674,355 - 674,355
Machinery and equipment 452,887 - 452,887
Software and other intangible assets 121 - 121
Computer software 121 - 121
Total 1,127,363 - 1,127,363
285
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
11. Unauthorised expenditure11.1 Reconciliation of unauthorised expenditure
Note 2012/13 2011/12
R’000 R’000
Opening balance 5,770,734 4,744,948
Unauthorised expenditure – discovered in current year 324,474 1,025,786
Less: Amounts approved by Parliament/Legislature with
funding (1) -
Unauthorised expenditure awaiting authorisation /
written off 6,095,207 5,770,734
Total 6,095,207 5,770,734
286
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
11.2 Analysis of unauthorised expenditure awaiting authorisation per economic classifi cation
Note 2012/13 2011/12
R’000 R’000
Capital - -
Current 6,095,207 5,770,734
Total 6,095,207 5,770,734
11.3 Analysis of unauthorised expenditure awaiting authorisation per type
Unauthorised expenditure relating to overspending of the
vote or a main division within a vote 6,095,207 5,770,734
Total 6,095,207 5,770,734
11.4 Details of unauthorised expenditure – current year
Incident Disciplinary steps taken/criminal proceedings
2012/13
R’000
Overspending of the main divisions
within the vote None 324,474
Total 324,474
An amount of R4.5 billion relating to unauthorized expenditure for the fi nancial years
2007/2008, 2008/2009, 2009/2010 and 2010/2011 was condoned by the Gauteng Provincial
Legislature on the 15th of May 2013 as per the Second Unauthorized Expenditure Act No. 2 of
2013. By the 31st of March 2013, the amount condoned in respect of unauthorized expenditure
was not effected in the bank account of the Department of Health. An amount of R261 million
was not approved by the Gauteng Provincial Legislature relating to 2008/2009, 2009/2010 and
2010/2011 fi nancial years.
287
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
12. Cash and cash equivalents
Note 2012/13 2011/12
R’000 R’000
Consolidated Paymaster General Account 24,361 -
Cash receipts 20 92
Disbursements 3 -
Cash on hand 1,026 1,037
Total 25,410 1,129
13. Prepayments and advances
Travel and subsistence 56 168
Advances paid to other entities (Provincial) 53 53
Total 109 221
14. Receivables
2012/13 2011/12
Note R’000 R’000 R’000 R’000
Less than one year
One to three years
Older than three years
Total Total
Claims recoverable 14.1 6,671 - - 6,671 9,146
Recoverable
expenditure
14.2
11,211 - - 11,211 12,592
Staff debt 14.3 13,613 (4,214) 29,109 38,508 40,248
Other debtors 14.4 7,827 7,827 5,690
Total 39,322 (4,214) 29,109 64,217 67,676
14.1 C laims recoverable
Note 2012/13 2011/12
R’000 R’000
Provincial Departments 6,671 9,146
Total 6,671 9,146
Included in other debtors is an amount of R370 000 for debts with credit balances. The Provincial
Departments indicated above relates to Provincial Departments in Gauteng.
288
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
14.2 Recoverable expenditure (disallowance accounts)
Note 2012/13 2011/12
R’000 R’000
Disallowance Damages and Losses 1,223 3,633
Disallowance Miscellaneous 9,883 8,860
Disallowance Payment Fraud: CA 105 99
Total 11,211 12,592
14.3 Staff debt
Breach of Contract 7,191 6,319
Employee 5,037 5,177
Ex Employee 51,146 52,272
Supplier 3,935 4,960
State Guarantee 138 107
GG Accident - 31
Fraud 44 50
Travel and Subsistence - (4)
Other (28,983) (28,664)
Total 38,508 40,248
The amount of (R28 983 million) includes Receivable Interest, Receivable Income and debts
with credit balances for an amount of R370 000.
14.4 Other debtors
Private Telephone - 40
Salary Disallowance Account 1 -
Salary Deduction Disallowance 204 101
Sal: Recoverable 687 1,766
Salary: Tax Debt 62 -
Salary Bargaining Council 2 -
Salary Reversal Control Account 6,769 3,760
Sal: Medical Aid - 22
Telephone Erroneous Interface Account 93 -
Sal: Fin Other Institutions 7 -
Sal: Deduction Parking 1 1
Sal: Offi cial Unions 1 -
Total 7,827 5,690
289
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
15. Investments
Note 2012/13 2011/12
R’000 R’000
Non-Current
Shares and other equity
Investment in Medical Supplies Depot 54,000 54,000
Total 54,000 54,000
Total non-current 54,000 54,000
Analysis of non current investments
Opening balance 54,000 54,000
Closing balance 54,000 54,000
The difference of R50, 377 million between the capital amount as disclosed by the Medical
Supplies Depot and the Department of Health as refl ected in the fi nancial statements 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.
16. Voted funds to be surrendered to the Revenue Fund
Opening balance 2,092,553 1,418,246
Transfer from statement of fi nancial performance 357,247 (170,250)
Add: Unauthorised expenditure for current year 324,474 1,025,786
Paid during the year (660,383) (181,229)
Closing balance 2,113,891 2,092,553
The unauthorised amount disclosed is as per the main division of the Vote. The amount of R661
million disclosed as paid during the year represents surrender of unspent funds for 2011/2012
paid during the 2012/2013 fi nancial year.
290
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
17. Departmental revenue to be surrendered to the Revenue Fund
Note 2012/13 2011/12
R’000 R’000
Opening balance 74,700 77,216
Transfer from Statement of Financial Performance 506,939 453,505
Paid during the year (504,869) (456,021)
Closing balance 76,770 74,700
The amount of (R504 869 million) comprises of an amount of (R429 612) million for current
year’s revenue paid over and an amount of (R75 257) for the month of March 2012 which was
paid over in the fi nancial year 2012/2013.
18. Bank Overdraft
Consolidated Paymaster General Account 3,777,932 2,660,499
Total 3,777,932 2,660,499
19. Payables – current
Amounts owing to other entities
202,649 996,064
Clearing accounts 19.1 - 10,731
Other payables 19.2 13,701 4,537
Total 216,350 1,011,332
The amount of R203 million disclosed as amounts owing to other entities is the amount that
was still payable to the Medical Supplies Depot as at 31 March 2013. This amount was settled
to the Medical Supplies Depot during the fi rst quarter of the fi nancial year 2013/2014. An
amount of R70 million relating to the fi nancial year 2012/2013 only interfaced in April 2013.
291
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
19.1 Clearing accounts
Note 2012/13 2011/12
21 R’000 R’000
Description
Telephone Control Account - 10,731
Total - 10,731
19.2 Other payables
Description
Salary ACB Recalls 3,482 1,627
Private Telephone 77 -
Salary: Garnishee Orders 13 -
Salary: Income Tax 1,426 1,669
Salary: Pension Fund 7 249
Housing Loan Guarantees 551 436
Salary Disallowance - 3
Other Payables 8,145 553
Total 13,701 4,537
• Other Payables includes the following:
• Sal: Bargaining Councils: CL
• Housing Key Deposits: CL
• Sal: Insurance Deductions: CL
• Sal: Offi cial Unions
292
Department of Health Vote 4NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
20. N et cash flow available from operating activities
Note 2012/13 2011/12
R’000 R’000
Net surplus/(defi cit) as per Statement of Financial
Performance 864,186 283,931
Add back non cash/cash movements not deemed
operating activities (1,015,874) 804,583
decrease in receivables – current 3,459 (6,539)
decrease in prepayments and advances 112 1,315
decrease in other current assets 1 -
(decrease) in payables – current (794,982) 319,694
Expenditure on Capital Assets 941,464 1,127,363
Surrenders to Revenue Fund (1,165,928) (637,250)
Net cash fl ow generated by operating activities (151,688) 1,088,514
21. Reconciliation of cash and cash equivalents for cash flow purposes
Consolidated Paymaster General account (3,753,571) (2,660,499)
Cash receipts 20 92
Disbursements 3 -
Cash on hand 1,026 1,037
Total (3,752,522) (2,659,370)
293
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
These amounts are not recognised in the Annual Financial Statements and are disclosed to
enhance the usefulness of the Annual Financial Statements.
22. Contingent liabilities and contingent assets22.1 Contingent liabilities
Note 2012/13 2011/12
25 R’000 R’000
Liable to Nature
Housing loan guarantees Employees Annex 3A 1,857 4,645
Claims against the department Annex 3B 2,725,656 1,636,427
Other departments (interdepartmental unconfi rmed
balances)
Annex 5
94 4,009
Total 2,727,607 1,645,081
Claims against the department represent mainly Medico Legal claims. The amount disclosed
under.
22.2 Contingent assets
Nature of contingent asset
Claims against suppliers - 396,028
Claim against employees (Negative Leave Credits) 24,652 5
Total 24,652 396,033
The amount of R24.6 million represents leave over grant to employees.
23. Commitments
Current expenditure
Approved and contracted 103,526 1,217,020
103,526 1,217,020
Capital expenditure
Approved and contracted 1,603,575 1,259,961
Approved but not yet contracted 210,278 -
1,813,853 1,259,961
Total Commitments 1,917,379 2,476,981
A total of R1 882 billion relating to commitments was older than a year.
294
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
24. Accruals
Listed by economic classifi cation 2012/13 2011/12
R’000 R’000
30 Days 30+ Days Total Total
Goods and services 357,767 1,175,655 1,533,422 2,844,601
Transfers and subsidies - 9,764 9,764 503,319
Capital assets - 20,317 20,317 10,347
Other 13,661 - 13,661 -
Total 371,428 1,205,736 1,577,164 3,358,267
Listed by programme level
1. Administration 238,672 206,943
2. District Health Services 282,888 806,909
3. Emergency Medical Services 63,669 133,158
4. Provincial Hospitals 387,017 1,023,869
5. Central Hospital Services 564,362 928,034
6. Health Sciences and Training 28,668 28,530
7. Health Care Support Services 4,207 7,369
8. Health Facilities Management 7,681 135,354
9 + 10 Social Development - 88,101
Total 1,577,164 3,358,267
Confi rmed balances with other departments 117,897 151,082
Confi rmed balances with other government
entities 285,762 854,474
Total 403,659 1,005,556
The amount of R118 million disclosed as confi rmed balances with other departments
represents amounts owing to the Gauteng Department of Finance, Department of Infrastructure
Development and G Fleet. The amount of R203 million disclosed as amounts owing to other
entities is the amount that was still payable to the Medical Supplies Depot as at 31 March
2013. This amount was settled to the Medical Supplies Depot during the fi rst quarter of the
fi nancial year 2013/2014. The accruals of 2011/2012 have been restated from R2.8 billion to
R3.3 billion after a review by the department.
295
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
25. Employee benefi ts
Note 2012/13 2011/12
R’000 R’000
Leave entitlement 596,908 448,825
Service bonus (Thirteenth cheque) 391,925 384,738
Performance awards 229,182 211,994
Capped leave commitments 458,451 486,144
Total 1,676,466 1,531,701
The leave entitlement has been reduced by an amount of R11.0 million relating to leave taken
during the fi nancial year 2012/2013 but not captured on Persal as at 31 March 2013.
26. Lease commitments26.1 Operating leases expenditure
2012/13
Buildings and other fi xed
structures Total
Not later than 1 year 23,588 23,588
Later than 1 year and not later
than 5 years 33,200 33,200
Later than fi ve years - -
Total lease commitments 56,788 56,788
2011/12
Buildings and other fi xed
structures Total
Not later than 1 year 12,439 12,439
Later than 1 year and not later
than 5 years 16,884 16,884
Total lease commitments 29,324 29,324
296
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
26.2 Finance leases expenditure**
2012/13 Machinery and equipment Total
Not later than 1 year 27,887 27,887
Later than 1 year and not later
than 5 years 22,479 22,479
Later than fi ve years - -
Total lease commitments 50,366 50,366
2011/12 Machinery and equipment Total
Not later than 1 year 39,947 39,947
Later than 1 year and not later
than 5 years 10,782 10,782
Later than fi ve years 113 113
Total lease commitments 50,842 50,842
LESS: fi nance costs 3,154 3,154
Total present value of lease
liabilities 47,688 47,688
This note excludes leases relating to public private partnership as they are separately disclosed
to note no.39.
Finance costs relating to fi nance leases are included in the capital cost of fi nance leases. This
is as a result of a policy change by National Treasury.
27. Receivables for departmental revenue
Note 2012/13 2011/12
R’000 R’000
Sales of goods and services other than capital assets 1,334,450 1,200,952
Total 1,334,450 1,200,952
The amount of R1.3 billion represents Patient Fees.
297
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
27.1 Analysis of receivables for departmental revenue
Note 2012/13 2011/12
R’000 R’000
Opening balance 2,025,279 1,535,700
Less: amounts received 324,173 332,884
Add: amounts recognised 936,022 950,055
Less: amounts written-off/reversed as irrecoverable 198,434 127,592
Closing balance 2,438,694 2,025,279
Provision for bad debts 1,104,244 933,951
An amount of R1, 104 billion has been provided for in respect of patient debt older than 3
months.
27.2 Receivables for department revenue written off
Patient Fees written off on the standalone systems 198,434 127,592
Total 198,434 127,592
Patient Fees written off represents patient debt older than 90 days.
28. Irregular expenditure28.1 Reconciliation of irregular expenditure
Opening balance 4,473,257 3,417,647
Add: Irregular expenditure – relating to prior year 372,633 -
Add: Irregular expenditure – relating to current year 1,141,557 1,115,884
Less: Amounts condoned (239,212) (60,274)
Less: Amounts recoverable (not condoned) - -
Less: Amounts not recoverable (not condoned) - -
Irregular expenditure awaiting condonation 5,748,235 4,473,257
Analysis of awaiting condonation per age classifi cation
Current year 902,345 1,115,884
Prior years 4,845,890 3,417,647
Total 5,748,235 4,533,531
298
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
28.2 Details of irregular expenditure – current year
Incident Disciplinary steps taken/criminal proceedings
2012/13R’000
BAC approvals (condonement) of request for
ex post facto approvals
None
58,877
BAC approvals of deviation from normal
tender and procurement procedures
Pending investigations
99,697
Extensions of the period term contracts Pending investigations 80,638
Security Services Pending investigations 199,908
Request for Quotations Pending investigations 10,558
Unsolicited Bids 2012/2013 Pending investigations 476,675
Overtime claims exceeding 30% Pending investigations 9,991
Unsolicited Bids 2011/2012 None 348,380
Nursing Services outsourced from agencies
on an ad hoc basis
Disciplinary actions in progress
19,087
Irregular contracts extended on a month to
month basis
None
66,317
Infrastructure irregularities None 119,809
Irregular Expenditure Note reported to BAC in
209/10, 2010/11 and 2011/12
None
24,253
Total 1,514,190
28.3 Details of irregular expenditure condoned
Incident Condoned by (condoning authority)
2012/13R’000
Condonement of ex post facto approvals BAC (58,877)
Approvals of deviations from normal tender
and procurement procedures BAC (99,697)
Extensions of the period terms contracts BAC (80,638)
Total (239,212)
For all amounts disclosed as condoned, the condoning authority was the Departmental Bid
Adjudication Committee (DBAC).
299
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
29. Fruitless and wasteful expenditure29.1 Reconciliation of fruitless and wasteful expenditure
Note 2012/13 2011/12
R’000 R’000
Opening balance 387,293 231,871
Fruitless and wasteful expenditure – relating to prior year 41,345 -
Fruitless and wasteful expenditure – relating to current
year 145,967 155,422
Less: Amounts resolved (166,555) -
Fruitless and wasteful expenditure awaiting resolution 408,050 387,293
30. Analysis of awaiting resolution per economic classifi cation
Current 408,050 30,586
Capital - 218,815
Total 408,050 249,401
31. Analysis of Current year’s fruitless and wasteful expenditure
Incident Disciplinary steps taken/criminal
proceedings
2012/13
R’000
Expired medication None 8,394
Interest on late payments None 7,630
Disposal of other inventory None 504
Legal Claims against the Department None 125,212
Other None 201
Rent None 134
Penalties/interest relating to
infrastructure(DID)
None
3,892
Total 145,967
32. Related party transactions
Note 2012/13 2011/12
R’000 R’000
Payments made
Goods and services 3,493,235 2,377,382
Total 3,493,235 2,377,382
Year end balances arising from revenue/payments
Payables to related parties 202,649 946,119
Total 202,649 946,119
300
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
The related party transactions relates to the Medical Supplies Depot, a trading entity of the
department. Included in the amount of R3.4 billion paid to the Medical Supplies Depot during the
2012/2013 fi nancial year is an amount of R946 million relating to the previous fi nancial year.
Other related parties include the following Gauteng Departments:
• Offi ce of the Premier
• Legislature
• Economic Development and Trading Entities
• Education
• Social Development
• Local Government and Housing
• Roads and Transport
• Community Safety
• Agriculture and Rural Development
• Sports, Arts, Culture and Recreation
• Finance
• Provincial Treasury
• Infrastructure Development
33. Key Management Personnel
No. Of
Individuals
2012/13 2011/12
R’000 R’000
Political offi ce bearers (provide detail below) 2 1,737 1,560
Offi cials:
Level 15 to 16 5 3,906 8,552
Level 14 (incl. CFO if at a lower level) 21 17,730 19,185
Family members of key management personnel 8 1,579 3,345
Total 36 24,952 32,642
Any guarantees issued to Senior Management by the department are disclosed in Note 29.
Included under political offi ce bearers is the salary of the previous MEC. The current MEC
assumed duty in July 2012. The post of Head of Department has been vacant since November
2012. The Chief Financial Offi cer assumed duty in October 2012. The Chief Financial Offi cer
acted as Head of Department from November 2012 to March 2013.
301
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
34. Provisions
Note 2012/13 2011/12
R’000 R’000
34.1 Provisions for Receivables
Staff Debtors 29,109 61,225
Other Debtors 1,104,244 932,951
Total 1,133,353 994,176
34.2 Provisions for Liabilities
Premature termination of Contracts 1,508,092 1,508,092
Performance Bonuses (2008/9/,2009/10 and 2010/11) 413,000 306,038
Total 1,921,092 1,814,130
An amount of R29,109 million has been provided for in respect of staff debt older than 3 years
and an amount of R1,104 billion has been provided for in respect of patient debt older than 3
months.
35. Movable Tangible Capital Assets
MOVEMENT IN MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR
ENDED 31 MARCH 2013
Opening balance
Curr Year Adjust-
ments to prior year balances
Additions Disposals Closing Balance
R’000 R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 3,236,671 (267,793) 382,295 105,903 3,245,270
Transport assets 267,186 (7,439) 12,525 4,394 267,878
Computer equipment 177,120 (12,824) 35,442 56,806 142,932
Furniture and offi ce equipment 365,071 (260,270) 6,223 17,483 93,541
Other machinery and equipment 2,427,294 12,740 328,106 27,220 2,740,920
TOTAL MOVABLE TANGIBLE CAPITAL ASSETS 3,236,671 (267,793) 382,295 105,903 3,245,270
302
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
35.1 Additions
ADDITIONS TO MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR
ENDED 31 MARCH 2013
Cash Non-cash (Capital Work in Progress current costs and fi nance lease payments)
Received current, not paid
(Paid current year, received prior year)
Total
R’000 R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 414,623 29,616 (61,211) (733) 382,295
Transport assets 41,325 9,366 (31,524) (6,642) 12,525
Computer equipment 32,956 1,995 - 491 35,442
Furniture and offi ce equipment 6,028 466 - (271) 6,223
Other machinery and equipment 334,314 17,790 (29,687) 5,689 328,106
TOTAL ADDITIONS TO MOVABLE TANGIBLE CAPITAL ASSETS 414,623 29,616 (61,211) (733) 382,295
35.2 Disposals
DISPOSALS OF MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR
ENDED 31 MARCH 2013
Transfer out
or destroyed
or scrapped
Total
disposals
R’000 R’000
MACHINERY AND EQUIPMENT 105,903 105,903
Transport assets 4,394 4,394
Computer equipment 56,806 56,806
Furniture and offi ce equipment 17,483 17,483
Other machinery and equipment 27,220 27,220
TOTAL DISPOSAL OF MOVABLE TANGIBLE CAPITAL ASSETS 105,903 105,903
303
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
35.3 Movement for 2011/12
MOVEMENT IN MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR
ENDED 31 MARCH 2012
Opening balance
Additions Disposals Closing balance
R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 2,852,217 426,139 41,685 3,236,671Transport assets 245,029 22,665 508 267,186
Computer equipment 166,936 16,153 5,969 177,120
Furniture and offi ce equipment 353,637 13,539 2,105 365,071
Other machinery and equipment 2,086,615 373,782 33,103 2,427,294
TOTAL MOVABLE TANGIBLE
ASSETS 2,852,217 426,139 41,685 3,236,671
35.4 Minor assets
MOVEMENT IN MINOR ASSETS PER THE ASSET REGISTER FOR THE YEAR ENDED AS AT 31
MARCH 2013
Intangible assets
Machinery and
equipment
Total
R’000 R’000 R’000
Opening balance 4 448,530 448,534
Curr Year Adjustments to Prior Year balances - 189,027 189,027
Additions - 33,477 33,477
Disposals - 75,253 75,253
TOTAL MINOR ASSETS 4 595,781 595,785
Number of R1 minor assets - 12,471 12,471
Number of minor assets at cost - 430,066 430,066
TOTAL NUMBER OF MINOR ASSETS - 442,537 442,537
304
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
MOVEMENT IN MINOR ASSETS PER THE ASSET REGISTER FOR THE YEAR ENDED AS AT 31
MARCH 2012
Intangible assets
Machinery and
equipment
Total
R’000 R’000 R’000
Opening balance 4 416,412 416,416
Additions - 40,587 40,587
Disposals - 8,469 8,469
TOTAL MINOR ASSETS 4 448,530 448,534
35.5 Movable assets written off
MOVABLE ASSETS WRITTEN OFF FOR THE YEAR ENDED AS AT 31 MARCH 2013
Specialised military assets
Intangible assets
Heritage assets
Machinery and
equipment
Biological assets
Total
R’000 R’000 R’000 R’000 R’000 R’000
Assets written off - - - 325 - 325
TOTAL MOVABLE ASSETS WRITTEN OFF - - - 325 - 325
36. Intangible Capital Assets
Opening balance
AdditionsClosing Balance
R’000 R’000 R’000
COMPUTER SOFTWARE 236,475 162 236,637
TOTAL INTANGIBLE CAPITAL ASSETS 236,475 162 236,637
36.1 Disposals
Transfer out
or destroyed
or scrapped
Total
disposals
R’000 R’000
COMPUTER SOFTWARE 28,916 28,916
TOTAL DISPOSALS OF INTANGIBLE CAPITAL ASSETS 28,916 28,916
305
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
36.2 Movement for 2011/12
Opening
balance
Disposal Closing
balance
R’000 R’000 R’000
COMPUTER SOFTWARE 236,637 28,916 207,721
TOTAL INTANGIBLE CAPITAL ASSETS 236,637 28,916 207,721
37. Immovable Tangible Capital Assets (Movement for 2012/2013)
Movement in immovable tangible capital assets per asset register for the year ended 31 March
2013
Opening
balance
Closing
Balance
R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES 4,006,508 4,006,508
Non-residential buildings 1,851,011 1,851,011
Other fi xed structures 2,155,497 2,155,497
TOTAL IMMOVABLE TANGIBLE CAPITAL ASSETS 4,006,508 4,006,508
38. Additions to immovable tangible capital assets per asset register for the year ended 31 March 2013
Cash (Capital Work in Progress
current costs and
fi nance lease payments)
Total
R’000 R’000 R’000
BUILDING AND OTHER FIXED STRUCTURES 457,386 (457,386) -
Other fi xed structures 457,386 (457,386) -
TOTAL ADDITIONS TO IMMOVABLE TANGIBLE
CAPITAL ASSETS 457,386 (457,386) -
306
Department of Health Vote 4DISCLOSURE NOTES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
38.1 Movement in immovable tangible capital assets per asset register for the year ended 31 March 2012 (Movement for 2011/2012)
Cash Additions Total
R’000 R’000 R’000
BUILDING AND OTHER FIXED STRUCTURES 3,971,762 34,746 4,006,508
Non-residential buildings 1,851,011 - 1,851,011
Other fi xed structures 2,120,751 34,746 2,155,497
TOTAL IMMOVABLE TANGIBLE CAPITAL ASSETS 3,971,762 34,746 4,006,508
Immovable assets valued at R1
Immovable assets valued at R1 in the asset register as at 31 march 2013
Buildings and other fi xed structures
Heritage Assets Total
R 1 Immovable assets 0.33 - 0.33
TOTAL 0.33 - 0.33
The department has disclosed 330 items (immovable assets) valued at R1 (R330).
307
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
39.
STAT
EMEN
T O
F CO
NDI
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NAL
GRA
NTS
REC
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ANT
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by
depa
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depa
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Und
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(Ove
rspe
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% o
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s
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sion
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Amou
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98,5
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nsic
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holo
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Serv
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--
--
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lege
s G
rant
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--
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EPW
P In
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Gra
nt
for t
he S
ocia
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tor
(Hea
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29,0
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--
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40
EPW
P In
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ocia
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-
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Nat
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l Hea
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ranc
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rant
31,5
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--
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8,06
223
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26-
-
308
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
NAM
E O
F
DEPA
RTM
ENT
GR
ANT
ALLO
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SPEN
T20
11/1
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Divi
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of
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rs
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A
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er
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depa
rtm
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Und
er /
(Ove
rspe
ndin
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% o
f
avai
labl
e
fund
s
spen
t by
depa
rtm
ent
Divi
sion
of
Rev
enue
Act
Amou
nt
spen
t by
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ent
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(100
)-
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--
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022
6,65
4,02
26,
389,
212
263,
948
-6,
133,
235
6,12
7,63
5
309
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
40.
STAT
EMEN
T O
F CO
NDI
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NAL
GRA
NTS
PAI
D TO
MU
NIC
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ITIE
S
ANN
EXU
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F CO
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ANTS
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MU
NIC
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ALLO
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sion
of
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Rol
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rsAd
just
men
ts
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l
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labl
e
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al
Tran
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Fund
s
With
held
Re-
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catio
ns
by N
atio
nal
Trea
sury
or N
atio
nal
Depa
rtm
ent
Amou
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rece
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by
mun
icip
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nt
spen
t by
mun
icip
ality
% o
f ava
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s
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mun
icip
ality
Divi
sion
of
Rev
enue
Act
R’0
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’000
R’0
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00R
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ary
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City
of T
shw
ane
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ro33
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--
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CATE
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0
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905
Emer
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y M
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--
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867
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City
of T
shw
ane
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ro49
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--
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etro
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178,
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229,
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--
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229,
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4
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and
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(Pro
vinc
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City
of J
ohan
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31-
14,2
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82-
-
City
of T
shw
ane
Met
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-9,
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9,90
828
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--
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--
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rule
ni M
etro
--
9,98
89,
988
20,8
68-
-20
,868
20,8
68-
-
310
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
NAM
E O
F
MU
NIC
IPAL
ITY
GR
ANT
ALLO
CATI
ON
TRAN
SFER
SPEN
T20
11/1
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of
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enue
Act
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l Ove
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just
men
ts
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l
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labl
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al
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s
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held
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atio
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or N
atio
nal
Depa
rtm
ent
Amou
nt
rece
ived
by
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icip
ality
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nt
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mun
icip
ality
% o
f ava
ilabl
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s
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mun
icip
ality
Divi
sion
of
Rev
enue
Act
R’0
00R
’000
R’0
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’000
R’0
00%
R’0
00R
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%R
’000
Wes
t Ran
d D
istr
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Coun
cil
--
5,78
35,
783
8,81
3-
-8,
813
8,81
3-
-
Sedi
beng
Dis
tric
t
Coun
cil
--
6,06
96,
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9,97
4-
-9,
974
9,97
4-
-
Cate
gory
C
Wes
t Ran
d D
istr
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Coun
cil
33,1
17-
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5849
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48,8
87-
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48,8
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94
Sedi
beng
Dis
tric
t
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cil
36,4
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26,8
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44,2
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31,5
40
Tota
l60
2,35
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361,
932
964,
285
1,08
3,52
5-
-1,
083,
525
1,08
3,52
5-
563,
060
311
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
41. TRANSFER OF FUNCTIONS41.1 Statement of Financial Position
Note
Bal per dept 2011/12
AFS before transfer
Functions per dept
2011/12 Bal after transfer
(transferred)
2011/12 2011/12 2011/12
R’000 R’000 R’000
ASSETS
Current Assets 5,840,436 (11,630) 5,828,806
Unauthorised expenditure 11 5,770,734 - 5,770,734
Cash and cash equivalents 12 1,129 (77) 1,052
Prepayments and advances 13 221 (37) 184
Receivables 14 67,676 (11,516) 56,160
Aid assistance receivable 3 676 - 676
Non-Current Assets 5,400 - 5,400
Investments 5,400 - 5,400
TOTAL ASSETS 5,845,836 (11,630) 5,834,206
LIABILITIES
Current Liabilities 15,839,760 - 15,839,760
Voted funds to be surrendered to the Revenue Fund 16 2,092,553 - 2,092,553
Departmental revenue and NRF Receipts to be surrendered to the Revenue Fund 17 74,700 - 74,700
Bank overdraft 18 2,660,499 - 2,660,499
Payables 19 11,011,332 11,011,332
Aid assistance repayable 3 - - -
Aid assistance unutilised 676 - 676
TOTAL LIABILITIES 15,839,760 - 15,839,760
NET ASSETS (9,993,924) (11,630) (10,005,554)
312
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
41.2 Disclosure Notes
Bal per dept 2011/12
AFS before transfer
Functions per dept
(transferred) 2011/12 Bal after transfer
2011/12 2011/12 2011/12
R’000 R’000 R’000
Contingent liabilities 22.1 3,459,211 (2,522) 3,456,689
Contingent assets 22.2 396,033 (396,033) -
Commitments 23 2,476,981 (121,192) 2,355,789
Accurals 24 2,827,177 - 2,827,177
Employee benefi ts 25 1,629,454 (83,761) 1,545,693
Lease commitments - operating lease 26.1 29,324 - 29,324
Lease commitments - fi nance lease 26.2 47,688 (6,437) 41,251
Receivables for departmental revenue 27 1,200,952 - 1,200,952
Irregular expenditure 28 4,533,531 - 4,533,531
Fruitless and wasteful expenditure 29 387,293 - 387,293
Impairment and other provisions 34 994,176 (24,749) 969,427
Movable tangible capital assets 35 3,236,671 (105,903) 3,130,768
Immovable tangible capital assets 37 406,508 - 406,508
Intangible capital assets 36 236,637 - 236,637 313
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
BST
ATEM
ENT
OF
TRAN
SFER
S TO
DEP
ARTM
ENTA
L AG
ENCI
ES A
ND
ACCO
UN
TS
DEPA
RTM
ENT/
AG
ENCY
/ AC
COU
NT
TRAN
SFER
ALL
OCA
TIO
NTR
ANSF
ER20
11/1
2
Adju
sted
Appr
opria
tion
Rol
l Ove
rsAd
just
men
tsTo
tal
Avai
labl
eAc
tual
Tr
ansf
er
% o
f Av
aila
ble
fund
s Tr
ansf
erre
d
Appr
opria
tion
Act
R’0
00R
’000
R’0
00R
’000
R’0
00%
R’0
00
Hea
lth a
nd W
elfa
re S
eta
15,1
03-
13,1
3528
,238
28,2
3810
0%13
,182
SABC
--
--
29-
-
Tota
l15
,103
-13
,135
28,2
3828
,267
-13
,182
314
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
CST
ATEM
ENT
OF
TRAN
SFER
S TO
UN
IVER
SITI
ES A
ND
TECH
NIK
ON
S
UN
IVER
SITY
/TEC
HN
IKO
N
TRAN
SFER
ALL
OCA
TIO
NTR
ANSF
ER20
11/1
2
Adju
sted
Ap
prop
riatio
nR
oll O
vers
Adju
stm
ents
Tota
l Av
aila
ble
Actu
al
Tran
sfer
Amou
nt n
ot
tran
sfer
red
% o
f Av
aila
ble
fund
s Tr
ansf
erre
d
Appr
opria
tion
Act
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
%R
’000
Uni
vers
ity o
f Witw
ater
sran
d43
4-
-43
430
213
244
%33
7
Uni
vers
ity o
f Joh
anne
sbur
g54
0-
-54
0-
540
-41
8
Uni
vers
ity o
f Lim
popo
181
--
181
-18
1-
140
Uni
vers
ity o
f Pre
toria
345
--
345
198
147
74%
267
Tota
l1,
500
--
1,50
050
01,
000
-1,
162
315
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
DST
ATEM
ENT
OF
TRAN
SFER
S TO
NO
N-P
ROFI
T IN
STIT
UTI
ON
S
NO
N-P
RO
FIT
INST
ITU
TIO
NS
TRAN
SFER
ALL
OCA
TIO
NEX
PEN
DITU
RE
2011
/12
Adju
sted
Ap
prop
-ria
tion
Act
Rol
l ove
rsAd
just
-men
tsTo
tal
Avai
labl
eAc
tual
Tr
ansf
er%
of
Avai
labl
e fu
nds
tran
sfer
red
Appr
o-pr
iatio
n Ac
t
R’0
00R
’000
R’0
00R
’000
R’0
00%
R’0
00
Men
tal H
ealth
20
3,74
2-
81,7
7728
5,51
924
1,84
385
%27
9,04
0
Com
mun
ity B
ased
Ser
vice
s 19
5,30
1-
71,1
9726
6,49
822
1,92
483
% 1
79,7
40
HIV
and
AID
S (P
rovi
ncia
l) 17
6,50
919
,644
196,
153
199,
388
102%
159,
350
Nut
ritio
n 40
,824
-8,
555
49,3
7948
,856
99%
38,
880
Com
mun
ity H
ealth
Clin
ics
(Ale
xand
ra H
ealth
Car
e
Cent
re)
45,5
80-
-45
,580
39,6
5562
%40
,700
Com
mun
ity H
ealth
Clin
ics(
Phi
llip
Moy
o)12
,406
-11
,704
24,1
1017
,907
87%
11,
704
Com
mun
ity H
ealth
Clin
ics
(Witk
oppe
n)
7,00
0-
1,12
58,
125
5,06
374
%6,
000
Subs
tanc
e Ab
use,
Pre
vent
& R
ehab
-
--
--
-44
,118
Care
& S
ervi
ce T
o O
lder
Per
sons
-
--
--
-15
0,25
3
Crim
e Pr
even
tion
& Su
ppor
t -
--
--
- 6
6,84
0
Serv
ice
To P
erso
ns W
ith D
isab
ility
--
--
--
75,5
33
Child
Car
e &
Prot
ectio
n Se
rvic
es-
--
--
-46
7,41
1
Vict
im E
mpo
wer
men
t -
--
--
- 3
0,40
4
HIV
and
AID
S (S
ocia
l) -
--
--
-22
2,99
6
Care
& S
uppo
rt S
ervi
ces
To F
amili
es
--
--
--
103,
000
Yout
h de
velo
pmen
t -
--
--
- 6
,363
Dis
tric
t Man
agem
ent
--
41,4
2141
,421
27,3
6066
%63
,756
Man
agem
ent
--
--
15,1
21-
-
316
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
NO
N-P
RO
FIT
INST
ITU
TIO
NS
TRAN
SFER
ALL
OCA
TIO
NEX
PEN
DITU
RE
2011
/12
Adju
sted
Ap
prop
-ria
tion
Act
Rol
l ove
rsAd
just
-men
tsTo
tal
Avai
labl
eAc
tual
Tr
ansf
er%
of
Avai
labl
e fu
nds
tran
sfer
red
Appr
o-pr
iatio
n Ac
t
R’0
00R
’000
R’0
00R
’000
R’0
00%
R’0
00
Scho
ol s
uppo
rt
--
--
--
-
Dir
Met
swed
ing
c-
--
--
--
Dis
tric
t Man
agem
ent
11,4
23-
(11,
423)
-34
--
Man
agem
ent
--
--
10-
-
Nut
ritio
n -
--
-10
4-
-
Oth
er fa
cilit
ies
--
--
29-
-
NPI
Don
atio
ns a
nd G
ifts
NPI
--
--
--
-
HIV
and
AID
S Pr
ovin
cial
--
--
97-
-
Nut
ritio
n-
--
-29
--
Oth
er fa
cilit
ies
--
--
84-
-
Tota
l69
2,78
5-
224,
000
916,
785
817,
504
89%
1,94
6,08
8
317
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
EST
ATEM
ENT
OF
TRAN
SFER
S TO
HO
USE
HO
LDS
HO
USE
HO
LDS
TRAN
SFER
ALL
OCA
TIO
NEX
PEN
DITU
RE
2011
/12
Adju
sted
Ap
prop
riatio
n Ac
t
Rol
l Ove
rsAd
just
-men
tsTo
tal
Avai
labl
eAc
tual
Tr
ansf
er%
of
Avai
labl
e fu
nds
Tran
sfer
red
Appr
o-pr
iatio
n Ac
t
R’0
00R
’000
R’0
00R
’000
R’0
00%
R’0
00
Tran
sfer
s
H/H
em
ploy
ee S
ocia
l ben
efi t
22,5
22-
24,9
1747
,439
49,7
4410
5 2
1,74
9
Burs
arie
s no
n em
ploy
ee
28,1
14-
8,00
036
,114
36,3
1110
126
,700
Clai
ms
agai
nst s
tate
hou
seho
lds
116
-62
178
617
347
109
H/H
Don
atio
ns &
Gift
s (C
ash)
-
--
-18
- 1
46
Pack
et M
oney
Hou
seho
lds
(Cas
h)
--
--
24-
911
Tota
l50
,752
-32
,979
83,7
3186
,714
104
49,6
15
318
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
FST
ATEM
ENT
OF
GIF
TS, D
ON
ATIO
NS
AND
SPO
NSO
RSH
IPS
RECE
IVED
NAM
E O
F O
RG
ANIS
ATIO
NN
ATU
RE
OF
GIF
T, D
ON
ATIO
N O
R S
PON
SOR
SHIP
2012
/13
2011
/12
R’0
00R
’000
Rec
eive
d in
cas
h
Vario
us in
divi
dual
don
ors
203
68
Subt
otal
203
68
Rec
eive
d in
kin
d
Vario
us in
divi
dual
don
ors
Vario
us in
divi
dual
don
ors
1,21
010
,545
Nat
iona
l Dep
artm
ent o
f Hea
lth
Med
ical
Sup
plie
s-
922,
699
The
Auru
m In
stitu
teVe
hicl
es (2
)16
4-
Vario
us D
onor
sCo
mpu
ter E
quip
men
t30
7-
Vario
us D
onor
sFu
rnitu
re a
nd O
ffi ce
Equ
ipm
ent
371
-
Vario
us D
onor
sO
ther
Mac
hine
ry a
nd E
quip
men
t1,
159
-
Subt
otal
3,41
493
3,24
4
TOTA
L3,
414
933,
312
319
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 1
GST
ATEM
ENT
OF
AID
ASSI
STAN
CE R
ECEI
VED
NAM
E O
F DO
NO
R
PUR
POSE
OPE
NIN
GBA
LAN
CER
’000
REV
ENU
ER
’000
EXPE
NDI
TUR
ER
’000
CLO
SIN
GBA
LAN
CER
’000
Rec
eive
d in
cas
h lo
cal
Vario
us D
onat
ions
For
exp
endi
ture
on
vario
us h
ealth
pro
ject
s55
6-
556
0
Fore
ign
Euro
pean
Uni
on
Del
iver
y of
prim
ary
heal
th c
are
incl
udin
g H
IV a
nd A
IDS
12
0-
120
-
TOTA
L67
6-
676
0
320
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 3
AST
ATEM
ENT
OF
FIN
ANCI
AL G
UARA
NTE
ES IS
SUED
AS
AT 3
1 M
ARCH
201
2 –
LO
CAL
Gua
rant
or in
stitu
tion
Gua
rant
ee in
re
spec
t of
Orig
inal
gu
aran
teed
ca
pita
l am
ount
Ope
ning
ba
lanc
e 1
April
201
2
Gua
rant
ees
draw
dow
ns
durin
g th
e ye
ar
Gua
rant
ees
repa
ymen
ts/
canc
elle
d/
redu
ced/
re
leas
ed
durin
g th
e ye
ar
Rev
alua
tions
Clos
ing
bala
nce
31 M
arch
20
13
Gua
rant
eed
inte
rest
for
year
end
ed
31 M
arch
20
13
Rea
lised
loss
es n
ot
reco
vera
ble
i.e. c
laim
s pa
id o
ut
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
R’0
00R
’000
ABSA
3045
745
718
5(4
79)
-16
3-
-
FIR
ST R
AND
BAN
K (F
NB)
551,
376
1,37
6(2
37)
(89)
-1,
050
--
FIR
ST N
ATIO
NAL
BAN
K LI
MIT
ED (F
NB)
175
75(6
1)-
-14
--
GR
EEN
STAR
T H
OM
E LO
ANS
-38
38(3
8)-
--
--
NED
BAN
K LI
MIT
ED49
1,21
81,
218
(384
)(7
04)
-13
0-
-
NED
BAN
K LT
D (N
BS)
139
39(2
1)(1
8)-
--
-
NED
COR
INV
BAN
K-
2929
(29)
--
--
-
OLD
MU
TUAL
(NED
B/PE
RM
)21
725
725
(393
)(2
22)
-11
0-
-
OLD
MU
TUAL
FIN
ANCE
LTD
-21
921
9(2
19)
--
--
-
PEO
PLE
BAN
K LT
D (F
BC)
--
--
--
--
-
STAN
DAR
D B
ANK
2346
946
9(1
8)-
-45
1-
-
VBS
MU
TUAL
BAN
K1
--
13-
-13
--
STD
BU
ILD
ING
-
--
-(7
4)-
(74)
--
TOTA
L-
4,64
54,
645
(1,2
02)
(1,5
86)
-1,
857
--
321
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 3
BST
ATEM
ENT
OF
CON
TIN
GEN
T LI
ABIL
ITIE
S AS
AT
31 M
ARCH
201
2
Nat
ure
of L
iabi
lity
Ope
ning
Ba
lanc
e 1
April
20
12
Liab
ilitie
s in
curr
ed d
urin
g th
e ye
ar
Liab
ilitie
s pa
id/
canc
elle
d/re
duce
d du
ring
the
year
Liab
ilitie
s re
cove
rabl
e (P
rovi
de
deta
ils
here
unde
r)
Clos
ing
Bala
nce
31
Mar
ch 2
013
R’0
00R
’000
R’0
00R
’000
R’0
00
Clai
ms
agai
nst t
he d
epar
tmen
t
Med
ico-
Lega
l1,
426,
967
1,28
5,06
818
9,07
3-
2,53
2,96
2
Civi
l Cla
ims
192
,637
26,
446
100
-21
8,98
3
Vehi
cle
Liab
ility
5,92
352
916
1-
6,29
1
Win
ston
Kol
osa
and
Taka
lani
Map
holis
a (C
rimen
Inju
ria)
900
-90
0-
-
Accr
uals
--
32,5
80-
(32,
580)
Subt
otal
1,63
6,42
71,
312,
043
222,
814
-2,
725,
656
Oth
er
Occ
upat
iona
l Spe
cifi c
Dis
pens
atio
n (S
ocia
l Wor
kers
)1,
622
-1,
622
--
Subt
otal
1,62
21,
312,
043
1,62
2-
-
TOTA
L1,
638,
049
1,31
2,04
322
4,43
6-
2,72
5,65
6
322
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 4
CLAI
MS
RECO
VERA
BLE
Confi
rm
ed b
alan
ce
outs
tand
ing
Unc
onfi r
med
bal
ance
outs
tand
ing
Tot
al
Gov
ernm
ent e
ntity
31
/03/
2013
31
/03/
2012
3
1/03
/201
3 3
1/03
/201
2 3
1/03
/201
3 3
1/03
/201
2
R
’000
R
’000
R
’000
R
’000
R
’000
R
’000
Depa
rtm
ent
Mpu
mal
anga
: D
epar
tmen
t of H
ealth
(C5
) -
-
171
9
1
71
9
East
ern
Cape
: Dep
artm
ent o
f Hea
lth (D
2) -
-
11
-
11
-
Nor
th W
est:
Hea
lth (3
Y) -
-
75
-
75
-
Gau
teng
: Dep
artm
ent o
f Edu
catio
n (K
5) -
18
-
-
18
Lim
popo
Dep
artm
ent o
f Hea
lth a
nd S
ocia
l Dev
elop
men
t (P4
)
-
-
94
97
94
97
Wes
tern
Cap
e: D
epar
tmen
t of
Hea
lth (U
3)
-
16
5
-
- -
16
5
Free
Sta
te: D
epar
tmen
t of H
ealth
(V5)
-
-
- 3
- 3
Gau
teng
: Agr
icul
ture
and
Rur
al D
evel
opm
ent (
G4)
1
3
-
- -
13
-
Dep
artm
ent o
f Wat
er A
ffai
rs(T
radi
ng A
ccou
nt) W
7
-
-
-
10
-
10
Lim
popo
: Soc
ial D
evel
opm
ent(
Q7)
-
-
- 51
- 51
Nor
th W
est:
Educ
atio
n (8
Y)
-
-
-
4
8 -
48
Gau
teng
: Dep
artm
ent o
f Fin
ance
(I1)
-
-
-
9
- 9
Nat
iona
l Dep
artm
ent o
f Hom
e Af
fairs
(18)
-
-
-
29
-
29
Nat
iona
l Dep
artm
ent o
f Hea
lth(2
0)
-
-
-
3
5 -
35
Nat
iona
l Dep
artm
ent o
f Cor
rect
iona
l Ser
vice
s(95
)
-
-
34
2
5 34
2
5
Sout
h Af
rican
Pol
ice
Serv
ice
-
-
-
103
- 1
03
Nat
iona
l: D
epar
tmen
t of J
ustic
e &
Cons
titut
iona
l Dev
elop
men
t (12
)
-
-
-
5
2 -
5
2
Nat
iona
l: D
epar
tmen
t of W
ater
Aff
airs
and
For
estr
y (3
6)
-
-
-
2
0 -
20
Nat
iona
l: D
epar
tmen
t of T
ouris
m(5
4)
-
-
-
1
8 -
18
Gov
ernm
ent P
rintin
g
-
-
11
- 1
1 -
Nor
th W
est :
Dep
artm
ent o
f Hea
lth a
nd S
ocia
l Dev
elop
men
t (67
)
-
-
-
92
7 -
927
323
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
Confi
rm
ed b
alan
ce
outs
tand
ing
Unc
onfi r
med
bal
ance
outs
tand
ing
Tot
al
Gov
ernm
ent e
ntity
31
/03/
2013
31
/03/
2012
3
1/03
/201
3 3
1/03
/201
2 3
1/03
/201
3 3
1/03
/201
2
R
’000
R
’000
R
’000
R
’000
R
’000
R
’000
Mpu
mal
anga
: Dep
artm
ent o
f Soc
ial D
evel
opm
ent(
L9)
-
-
-
147
-
147
Mpu
mal
anga
: Dep
artm
ent o
f Hea
lth &
Soc
ial S
ervi
ces(
Patie
nt fe
es)
-
-
4
4,98
6
20,
113
44,9
86
20,1
13
Dep
artm
ent o
f Cor
rect
iona
l Ser
vice
s (P
atie
nt fe
es)
-
-
3
4,66
7
33,
758
34,
667
33,7
58
Sout
h Af
rican
Pol
ice
Serv
ices
(Pat
ient
fees
)
-
-
26,
105
2
1,54
4 26
,105
2
1,54
4
Lim
popo
: Dep
artm
ent o
f Hea
lth a
nd S
ocia
l Dev
elop
men
t (Pa
tient
fees
)
-
-
39,
077
1
9,08
5 39
,077
19,0
85
Nor
th W
est:
Dep
artm
ent o
f Hea
lth a
nd S
ocia
l Dev
elop
men
t(Pa
tient
fees
)
-
-
316,
065
27
9,46
0 31
6,06
5 2
79,4
60
SA N
atio
nal D
efen
ce F
orce
(Pat
ient
fees
)
-
-
3,
725
4,01
6 3,
725
4,01
6
Nat
iona
l Dep
artm
ent o
f Hea
lth (P
atie
nt F
ees)
-
-
-
20,
948
-
20,
948
Nat
iona
l Dep
artm
ent o
f Jus
tice
(Pat
ient
Fee
s)
-
-
18,
346
- 18
,346
-
KZN
: Dep
artm
ent o
f Hea
lth (3
K)
-
-
193
- 19
3
-
Nor
ther
n Ca
pe: D
epar
tmen
t of H
ealth
(H5)
-
-
5
0
-
50
-
Wes
tern
Cap
e Pr
ovin
cial
Par
liam
ent (
U4)
-
-
3
4
-
3
4
-
Tota
l13
18
3
483,
644
40
0,50
7
483,
657
40
0,69
0
324
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 5
INTE
R-G
OVER
NM
ENT
PAYA
BLES
C
onfi r
med
bal
ance
outs
tand
ing
Unc
onfi r
med
bal
ance
outs
tand
ing
Tot
al
GO
VER
NM
ENT
ENTI
TY
31/0
3/20
13
31/0
3/20
12
31/0
3/20
13
31/0
3/20
12
31/0
3/20
13
31/0
3/20
12
R
’000
R
’000
R
’000
R
’000
R
’000
R
’000
DEPA
RTM
ENTS
Curr
ent
Gau
teng
Dep
artm
ent o
f Fin
ance
(GSS
C) (L
8) 6
,805
7,
625
- -
6,80
5
7,
625
Wes
tern
Cap
e D
epar
tmen
t of H
ealth
8
--
-8
-
East
ern
Cape
Dep
artm
ent o
f Hea
lth (D
2)
-
6
0
-
118
-
178
Free
Sta
te: D
epar
tmen
t of H
ealth
(V5)
7
5
8
-
1
87
7
5
1
95
Free
Sta
te: D
epar
tmen
t of
Soci
al D
evel
opm
ent (
V7)
-
12
- -
-
12
Sout
h Af
rican
Pol
ice
Serv
ices
(Hea
lth) (
90)
-
35
-
62
-
97
Sout
h Af
rican
Pol
ice
Serv
ices
(Soc
ial)
(90)
-
23
6
42
6
65
Nor
th W
est D
epar
tmen
t of H
ealth
& S
ocia
l Dev
elop
men
t (67
)
-
768
-
-
-
768
Gau
teng
Dep
artm
ent o
f Tra
nspo
rt G
-Fle
et (
K8)
2
0,63
0
1
40,6
09
-
-
20,6
30
1
40,6
09
Wes
tern
Cap
e D
epar
tmen
t of S
ocia
l Dev
elop
men
t (U
3)
148
104
-
7
7
1
48
181
Sout
h Af
rican
Def
ence
For
ce (W
1)
-
-
-
680
-
680
Nat
iona
l Dep
artm
ent o
f Bas
ic E
duca
tion
-
13
-
-
-
13
Gau
teng
Dep
artm
ent o
f Soc
ial D
evel
opm
ent
213
-
-
- 21
3
-
Lim
popo
Dep
artm
ent o
f Hea
lth (Q
7)63
1
5
83
-
-
631
583
Lim
popo
Dep
artm
ent o
f Soc
ial D
evel
opm
ent
-
81
-
-
-
81
Dep
artm
ent o
f Cor
rect
iona
l Ser
vice
s21
-
-
12
21
1
2
Gau
teng
Dep
artm
ent o
f Loc
al G
over
nmen
t & H
ousi
ng
-
1
6
-
-
-
1
6
Gau
teng
Dep
artm
ent o
f Roa
ds &
Tra
nspo
rt
-
1
0
-
-
-
1
0
Kwaz
ulu-
Nat
al D
epar
tmen
t of S
ocia
l Dev
elop
men
t
-
1
-
-
-
1
Nat
iona
l Dep
artm
ent o
f Lab
our(
33)
-
12
-
-
-
12
Nat
iona
l Dep
artm
ent o
f Soc
ial D
evel
opm
ent
-
5
4
-
2,81
6 -
2,87
0
325
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
C
onfi r
med
bal
ance
outs
tand
ing
Unc
onfi r
med
bal
ance
outs
tand
ing
Tot
al
GO
VER
NM
ENT
ENTI
TY
31/0
3/20
13
31/0
3/20
12
31/0
3/20
13
31/0
3/20
12
31/0
3/20
13
31/0
3/20
12
R
’000
R
’000
R
’000
R
’000
R
’000
R
’000
Nat
iona
l Dep
artm
ent o
f Wat
er A
ffai
rs &
For
estr
y(36
)17
-
-
1
5 17
1
5
Gau
teng
Dep
artm
ent o
f inf
rast
ruct
ure
8
7,61
0
-
-
-
8
7,61
0
-
Nat
iona
l Dep
artm
ent o
f Hig
her E
duca
tion
-
12
-
-
-
12
Mpu
mal
anga
Dep
artm
ent o
f Soc
ial D
evel
opm
ent
-
28
-
-
-
28
Mpu
mal
anga
Dep
artm
ent o
f Hea
lth1,
500
- 88
-
1,58
8
-
Gau
teng
Dep
artm
ent o
f Com
mun
ity S
afet
y
-
3
4
-
-
-
3
4
Nat
iona
l Dep
artm
ent o
f Hea
lth
183
994
-
- 18
3
9
94
Stat
istic
s So
uth
Afric
a56
-
-
- 56
-
Tota
l Dep
artm
ents
117
,897
1
51,0
82
94
4,00
9
1
17,9
91
155
,091
OTH
ER G
OVE
RN
MEN
T EN
TITY
Curr
ent
Med
ical
Sup
plie
s D
epot
(K7)
285
,762
8
54,4
74
--
285
,762
854
,474
Subt
otal
285
,762
854
,474
-
-
2
85,7
62
8
54,4
74
TOTA
L IN
TER
GO
VER
NM
ENTA
L
4
03,6
59
1
,005
,556
94
4,
009
403
,753
1,0
09,5
65
326
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANN
EXU
RE 6
INVE
NTO
RY
201
2/13
201
1/12
Not
eQ
uant
ity R
’000
Qua
ntity
R’0
00
Inve
ntor
y
Ope
ning
bal
ance
- 56
4,12
6 -
638,
231
Add:
Add
ition
s/Pu
rcha
ses
- Cas
h-
4,47
3,72
6 -
4,16
6,33
3
(Les
s): D
ispo
sals
-
(8
,394
) -
(1,2
84)
(Les
s): I
ssue
s
- (4
,523
,156
)-
(4,2
39,1
54)
Clos
ing
bala
nce
-
50
6,30
2 -
564
,126
327
Department of Health Vote 4ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANNEXURE 7MOVEMENT IN CAPITAL WORK IN PROGRESS
Opening
balance
Current Year
Capital WIP
Closing
balance
R’000 R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES 639,609 457,386 1,096,995
Other fi xed structures 639,609 457,386 1,096,995
TOTAL 639,609 457,386 1,096,995
328
Department of Health Vote 4ANNEXURESTO THE ANNUAL FINANCIAL STATEMENTSfor the year ended 31 March 2013.
Gauteng Provincial Government | Health | Annual Report 2012/2013
MEDICAL SUPPLIES DEPOT 329
Gauteng Provincial Government | Health | Annual Report 2012/2013
TABLE OF CONTENTS
REPORT OF THE AUDIT COMMITTEE 331REPORT OF THE ACCOUNTING OFFICER 334REPORT OF THE AUDITOR-GENERAL 347STATEMENT OF FINANCIAL POSITION 351STATEMENT OF COMPREHENSIVE INCOME 352STATEMENT OF CHANGES IN EQUITY 353STATEMENT OF CASH FLOW 354NOTES TO THE ANNUAL FINANCIAL STATEMENTS 355
MSD Financial Information
330
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOT AUDIT COMMITTEE REPORTfor the year ended 31 March 2013.Medical Supplies Depot
We are pleased to present our report for the fi nancial
year ended 31 March 2013
Composition of the Audit Committee and Attendance:
The Audit Committee consists of the external
members listed hereunder and is required to meet
a minimum of at least three 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), fi ve
meetings were held during the current year, i.e.3
meetings for Quarterly Performance Reporting
(fi nancial and non-fi nancial) and two meetings to
review and discuss the Annual Financial Statements
and the Auditor-General Report.
Non-Executive Members:
Name of Member Number of Meetings
Attended
Lungelwa Sonqishe
(Chairperson)
5
Mandla Ncube
(Member)
5
Nkateko Mabaso
(Member)
5
Executive Members:
In terms of the GPG Audit Committee Charter, the
Offi cials listed hereunder are obliged to attend the
meetings of the Audit Committee:
Compulsory Attendees Number of Meetings
Attended
Nocawe Thipa (Acting
Chief Executive Offi cer)
3
Kobie Smidt (Acting
Chief Financial Offi cer)
3
Mohamed Kasumba
(Chief Risk Offi cer)
5
The Audit Committee noted that the CEO did not
attend two meetings. The CEO is expected to
prioritise and attend future meetings. This will be
monitored going forward.
The Members of the Audit Committee met with the
Senior Management of the entity and Internal Audit,
collectively to address risks and challenges facing
the entity. A number of in-committee meetings were
held to address control weaknesses and conflicts
with 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 affairs in
compliance with this Charter and has discharged
all its responsibilities as contained therein.
331
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOT AUDIT COMMITTEE REPORTfor the year ended 31 March 2013.
The effectiveness of internal control
The Audit Committee has observed that the overall
control environment has continued to improve
during the year under review. However, there
are still some concerns with the level of internal
controls within the entity where evidence of
lapses of effective monitoring and enforcement by
Management were observed.
During the year under review, several defi ciencies
in the system of internal control and of deviations
were reported by the Auditor-General South Africa.
In certain instances, the matters reported previously
have not been fully and satisfactorily addressed.
The quality of in year management and monthly / quarterly reports submitted in terms of the PFMA and the Division of Revenue Act
The Audit Committee is satisfi ed with the content
and quality of monthly and quarterly reports
prepared and issued by the Accounting Offi cer
of the entity during the year under review were in
compliance with the statutory reporting framework.
Evaluation of Financial Statements
The Audit Committee has:
• reviewed and discussed the audited Annual
Financial Statements to be included in the
Annual Report, with the Auditor-General and the
Accounting Offi cer;
• reviewed the Auditor-General’s management
report and Management’s response thereto;
• reviewed the Auditor-General’s audit report
• reviewed the Department’s compliance with
legal and regulatory provisions; and
• reviewed signifi cant adjustments resulting from
the audit.
The Audit Committee concurs with and accepts
the Auditor-General’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 Auditor-
General.
Internal Audit
The Audit Committee is satisfi ed that the Internal
Audit plans addresses a clear alignment with
the major risks, adequate information systems
coverage, a good balance between different
categories of audits, i.e. risk-based, mandatory,
performance and follow-up audits.
The Audit Committee has noted considerable
improvement in the communication between the
Executive Management, the Auditor-General and
the Internal Audit Function, which has strengthened
the Corporate Governance initiatives.
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, it requires
more capacity and skills. This is being addressed
and corrective action is being implemented.
Risk Management
Progress on entity's risk management was reported
to the Audit Committee on a quarterly basis. The
Audit Committee is not entirely satisfi ed that the
actual management of risk is receiving attention
as there areas that still require improvement.
Management should take full responsibility for the
entire Enterprise Risk Management process and
support the Chief Risk Offi cer.
332
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOT AUDIT COMMITTEE REPORTfor the year ended 31 March 2013.Forensic Investigations
The Audit Committee is not satisfi ed that the
forensic investigations are properly reported with
age-analysis of all reported issues indicated. Details
of results in respect of investigations conducted as
a result of calls through the fraud hotline were not
provided to the Committee.
One-on-One Meetings with the Accounting Offi cer
The Audit Committee has met with the Accounting
Offi cer 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 him on the
performance of the entity.
Auditor-General South Africa
The Audit Committee has met with the Offi ce of the
Auditor-General of South Africa to ensure that there
are no unresolved issues
Lungelwa Sonqishe
CHAIRPERSON OF THE AUDIT COMMITTEE
333
GAUTENG MEDICAL SUPPLIES DEPOTREPORT OF THE ACCOUNTING OFFICERfor the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
The Accounting Offi cer 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 affairs
The Medical Supplies Depot is responsible
for the supply of essential medicines and
medically related items 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
and medically related items 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-Entry-Expiry-First-Out, (FEEFO)
system is applied to ensure that correct
stock levels are maintained.
The Depot prepares fi nancial statements
for each fi nancial year in accordance with
the prescribed practice that can be found
in chapter 18.4 of the Treasury Regulations,
where it is stated that annual fi nancial
statements for trading entities must
conform to Statements of South African
Generally Accepted Accounting Practice
(Statements of SA GAAP). The fi nancial
statements are therefor 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 identifi ed and procedures to ensure
the completeness of stock requisitioning
and receiving were designed. Cost centre
implementation was further enhanced for
the fi nancial year ending 31 March 2013
where various implementation concerns
were addressed and are frequently reviewed.
It is possible to reconcile the relevant cost
centres with the records of the fi nance
section. This will further enhance the
monitoring of some expense items through
a budget process.
The Acting Chief Director: Pharmaceutical
Services of Gauteng Department of Health
was appointed as the Acting Chief Executive
Offi cer of the Depot. The Chief Executive
Offi cer’s duties are time-apportioned in an
equal split (50:50) between the Depot and
the Department. The Gauteng Department of
Health carries the compensation expenses
of the Acting Chief Executive Offi cer.
1.1 Signifi cant events that have taken place during the year
Implementation of the New Gauteng Department of Health Turnaround Strategy
Turnaround Strategy
The Department is pleased to inform the
public that in order to bring about the
much needed improved health services in
334
GAUTENG MEDICAL SUPPLIES DEPOTREPORT OF THE ACCOUNTING OFFICERfor the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
the province, a Turnaround Strategy with
the primary objective of transforming the
Department towards effective service
delivery and achieving a clean audit in 2014
was developed for implementation from
April 2012. The Medical Supplies Depot as its
trading entity was also affected by changes
in the turnaround strategy for alignment
purposes.
New Key Management Personnel
The implementation of the Turnaround
Strategy required that some form of
restructuring took place not only at
Departmental level but also at the Medical
Supplies Depot. These new changes
culminated in, for instance, the appointment
of Mrs Nocawe Thipa as the Depot’s Acting
Chief Executive Offi cer (CEO) effective
from 15 March 2012. This being a key
management position, the Department is
prioritizing, among other things, the fi lling of
this position with a more permanent offi ce
bearer.
Re-engineering the Depot’s Processes
In line with the Turnaround Strategy, the
Depot’s people, systems and processes
in the procurement and warehousing
functional areas have been assessed by
the re-engineering team of consultants
from Supply Chain Management Services
(SCMS) funded by the USAID. Phase one:
situation analysis and phase 2: solution
development were completedduring the year
whilst phase 3: implementation of solutions
is 99% complete and phase 4: Handover is
expected to be completed in October 2013.
A key position already identifi ed by re-
engineering team is that of quality assurance
manager who will ensure that processes and
procedures are monitored. Management is
pleased to report that this critical post was
fi lled and the manager reported for duty on
1 May 2013.
Revival of the Provincial Pharmacy and Therapeutics Committee (PPTC)
The Provincial Pharmacy and Therapeutics
Committee has been revived. Through
its subcommittees (Formulary, Rationale
medicine use, Safety & quality and
Procurement advisory subcommittees), it
will assist in:
• the standardisation of medicines
used in accordance with the Essen-
tial Drugs Programme
• the rationale utilisation of medicines
aligned to evidence-based medicine
principles.
• Improved medicine procurement
through the tender system and de-
termination of pack sizes to be re-
packed or purchased
• Refi ning the provincial medicine for-
mulary such that non-EDL medicines
allowed for use are not greater than
20% of the total medicines used
• Monitoring of expenditure on medi-
cines 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
focussing primarily on the A medi-
cines.
It is therefore expected that the cost of
medicines used will be reduced.
335
GAUTENG MEDICAL SUPPLIES DEPOTREPORT OF THE ACCOUNTING OFFICERfor the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
Capitalisation of G-Fleet motor vehicles
The Depot had a total of 5 G-Fleet motor vehicles during the year under review of which 4 met the criteria for fi nance lease and 1 motor vehicle continued to be treated as an operating lease. The capitalisation of these vehicles result in fi nance charges amounting to R237 417 (2012: R269 153), refer to note 12 to the fi nancial statements.
Spending Trends
A summary of major spending trends indicates that medicines price increased at a rate higher than the consumer price index (CPI). This has the effect that revenue increases at a higher rate and has
a favourable influence on the net profi t of the Depot. Cost containment measures were implemented which further improved the net profi t, unfortunately non-delivery by suppliers due to non-payment still occurred but frequent timely payment occurred from November 2012. This also had an impact on the priority objective of the Depot in ensuring the availability of essential medicines and medically related items. Items not on the Essential Medicines List that used to be procured through the Gauteng Department of Finance (GDF) are procured via the Depot’s buy-out function since July 2009
and has dramatically increased the turnover
of the Depot.
Major accounts
Description 2013 Amount R
Variance from Prior
year
2012 Amount R Variance from Prior
year
2011 Amount R
Variance from
Prior year
2010 Amount R
Revenue 2 928 979 725 22.09% 2 399 029 813 (10.03)% 2 666 262 368 17.91% 2 261 431 896Expenditure: Personnel
48 684 146 4.07% 46 778 513 5.86% 44 188 916 44.25% 30 635 305
Expenditure: General
37 560 706 10.00% 34 094 761 (18.03)% 41 590 596 (61.99)% 109 401 037
Net profi t / (loss)
35 205 211 >100% (65 738 035) (246.87)% 44 761 981 >100% (9 553 798)
Personnel expenses increased as more
scarce skills posts on the staff establishment
were fi lled. A general moratorium on the
fi lling of posts were in place for other posts.
The Depot management has identifi ed areas
where career development constraints
exist and where risks identifi ed need to be
addressed. The proposed organisational
structure that was forwarded to our Head
Offi ce has been reviewed, amended and
approved. The vacancies were not fi lled due
to space limitations and other restrictions.
This exercise will continue after the re-
engineering processes project has been
completed.
2. Services rendered
The Medical Supplies Depot is responsible
for the effective and effi cient procurement,
quality testing, storage and distribution of
essential medicines and medically related
items to all the Provincial Health Care
Facilities in Gauteng. The Depot ensures that
Essential Medicines List (EML) medicines
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and medically related items are available
to our clients at all times. This involves the
evaluation of medicine and surgical sundry
items 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 of medicines
received. The Depot’s laboratory is the
only laboratory in South-Africa where the
fi ndings on quality tests performed are also
communicated to other provinces.
Tariff policy
The tariff 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 fi ve percent 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 fi ve
percent levy charge.
3. Capacity constraints
The Medical Supplies Depot delivers a vital
service to all the Health Care Institutions in
Gauteng.
Currently the Medical Supplies Depot
has 336 posts on the approved staff
establishment, with 117 vacant. The high
vacancy rate is as a result of compliance
with cost saving measures implemented in
the Department. Measures have been taken
to strengthen the operations of the Depot
and its management.
The average percentage of orders fulfi lled
on fi rst request improved from 73.25% for
the prior year to 76%. The service level was
also measured based on availability of stock
at institutional level which ranged between
80% – 85% for the same period.
In 2010/11, systems for measuring the
indicator "% of orders supplied to institutions
on fi rst requests" were strengthened, and
the actual performance is calculated
according to the following defi nition: "If an
order / request (which could consist of multiple
different items) is fulfi lled 100% within 24 hours,
then that order counts towards the achieving of
the target. If even one item is not captured as
part of the request within 24 hours, the order
does not count as being fulfi lled". This is an
extremely high standard to fulfi l, but it is
specifi c, measurable and time-bound. Also,
it holds the Depot to higher standards as
meeting orders within 24 hours 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.
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A constraint to ensure effective, economical
and effi cient 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
GAAP for disclosure purposes:• Basic Accounting System (BAS)
• Personnel and Salary Administration
System (PERSAL)
• Medical Stock Administration Sys-
tem (MEDSAS)
• Asset Management System (ASSET-
WARE)
• Manual systems to perform reconcil-
iation procedures and accrual based
accounting
4. Utilisation of donor funds
The Depot receives a donation of Nevirapine
Solution and Tablets from Boehringer
Ingelheim for the Prevention of Mother-to-
Child Transmission of HIV, and a further
donation of Fluconazole from Pfi zer
Laboratories for use by AIDS patients with
Oesophageal Candidiasis and Cryptococcal
Meningitis. This type of donor funding is
received on a continuous basis.
ITEM DESCRIPTION
Supplied by/
Arranged by
QUANTITY ISSUED
Current Market Value
per Unit (Single Exit
Price – (SEP)
Total SEP Value
Fluconazole Powder for oral suspension
50mg/5ml 35mlNDoH 600 R 168.94 R 101 364.00
Fluconazole Injection 2mg/ml, 100ml NDoH 9 000 R 163.93 R 1 475 370.00
Fluconazole tablets 200mg 28’s NDoH 26 017 R1 954.43 R 50 848 405.31
Nevirapine Tablets 200mg 60,s NDoH 20 R 193.61 R 3 872.20
Total R 52 429 011.51
The quantity of medicine, received and
issued, and the approximate value of the
donations for the fi nancial year under review
are as follows:
The current market value of the donation
issued is approximately R52 429 011.51 for
the tablets and powder suspension. This
medicine was 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 R3.62.
Please note that the Depot does not account
for the economic benefi t received in the
Statement of Comprehensive Income, as
the Depot is considered to be only a conduit
for hospitals and to control the receipt of
donations for the Department.
US-Aid Funding for re-engineering the
Depot’s Processes
The re-engineering of the Depot processes
was funded by US-Aid (Implementation
partner of Presidents Emergency Plan For
Aids Relief - PEPFAR). In April 2012 SCMS
completed a 4 week survey of the Auckland
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Park Medical Supplies Depot (MSD).
Procurement was identifi ed as an area of
weakness within the GDoH supply chain,
and the SCMS Survey Report indicated that
Contract Compliance could conservatively
achieve R30 million savings for GDoH with
regard to improved contract compliance.
(The total Project target for all improvements
was set at R116 Million in the SCMS Survey
Report)
Subsequently, the SCMS project was given
the green light and the projects’ phase
2 started in August 2012. The project
procurement stream was established with
senior managers at MSD and facilitated
by SCMS Technical advisors. This project
became known as “Kenako Kitima”. Please
note that the cost of the project is unknown.
One of the key benefi ts from the project
was the fact that a contract database was
developed to assist in ensuring compliance
national and provincial contracts. The
contract compliance database developed by
SCMS and implemented with MSD support
to improve contract compliance for National
(HP) contracts has resulted in undiscounted
savings amounting to R95million in the
fi nancial year. Back orders was reduced.
Warehouse management practices were
improved with the introduction of trolley
consolidations, streamlining of schedules
for supervisors that assists in effective staff
utilisation. Quality assurance processes
were improved with a complete overhaul of
the standard operating procedures coupled
with it. Internal audits were done and a
process to allow for interim contracts are
under way which will save management
time. Training was provided to both Depot
personnel and to procurement managers of
health institutions on stock management to
enhance sustainability of the implemented
processes.
5. Trading entities
The Medical Supplies Depot operates as a
trading entity, also 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 and surgical sundry items
to the Department’s Health Care Institutions
in Gauteng.
Comparative information
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 payments have been made by
the Depot in this fi nancial year.
7. Public/Private Partnership (PPP)
No Public Private Partnership has been
entered into by the Depot in this fi nancial
year.
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The following non-core services have
been outsourced to the private sector of
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 De-
pot.
• General maintenance contracts,
such as lifts, air conditioners, stand-
by generator, fi re equipment and ac-
cess control mechanisms.
Refer to note 21 of the fi nancial statements
for operating lease and commitments detail.
8. Corporate governance arrangements
Management, with the objective of
safeguarding the assets of the Depot and
ensuring a high quality of service delivery,
performs an annual risk assessment. The
following fi nancial 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 im-
plemented whereby hospitals recon-
cile stock received, with charges on
their accounting system (BAS) and
MEDSAS (Budget Expenditure Re-
port).
• The asset management system (AS-
SETWARE) was implemented and all
assets are recorded and capitalized.
• The Depot’s controls and operations
are evaluated together with the Au-
dit Committee of the Department of
Health and Social Development.
• The Depot utilises and follows the
Fraud Prevention Plan of the Depart-
ment of Health and Social Develop-
ment.
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 March 2012.
9. Discontinued activities
No activities were discontinued during the year under review.
10. New / proposed activities
The re-engineering of the Medical Supplies
Depot project underway referred to in
paragraph 1.1 above which is nearing
completion is expected to recommend
a more effective inventory management
system, among other things.
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11. InventoriesThe valuation method used by the Medical Supplies Depot is the moving weighted average method
as per the MEDSAS:
Medicine and medically related items
2013
R
2012
R
2011
R
2010
R
Closing stock 164 252 270 104 130 374 147 332 339 155 419 885
Medicine and medically related items
2013
R
2012
R
2011
R
2010
R
Breakages 27 584 24 753 114 107 103 195
Expired stock 2 648 327 2 332 284 3 290 151 3 713 103
The value of breakages and expired stock
combined for the fi nancial years ended
31 March 2013 and 2012 represents
0.09% and 0.10% of a percent of turnover
respectively. The main reason for expired
stock relates to the fact that the Medical
Supplies Depot receives late communication
regarding regimen changes, for instance,
for TB treatment resulting in doctors not
prescribing the already stocked medicines.
Control measures in place
Whilst the long term solutions for ensuring
effi cient and effective 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 identify-
ing items expiring in 6 months.
• Stock on hand is fi rst issued before
replacement items are issued when
regimens (treatment protocols) are
changed.
• Reviewing the list of items to be kept
at the Depot.
• Discuss regimen changes with Na-
tional Department of Health to align
with current stock levels
12. Events after the reporting date
12.1 Forensic investigation
A forensic investigation was requested by
the Head of Department: Health and Social
Development with regards to irregularities
at the medical Supplies Depot and the
investigation commenced on Monday, 7 May
2012. This investigation was completed in
the 2012/2013 fi nancial year and the report
was provided to the relevant authorities who
are taking the necessary steps as per the
outcomes of the report which led to three
senior managers and one manager being
suspended with pay on 4 June 2013.
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The Department has promised a speedy
fi nalization of due processes.
13. Information on predetermined objectives
The Gauteng Department of Health'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 year 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
whilst other input information was collected
manually or a combination of IT and manual
systems.
The key performance indicators per the
operational plan based on measurable
objectives and our actual achievement are
reflected in the table below:
No.Key Performance
Indicator
Target for the fi nancial year
ended 31 March 2013
Percentage achieved at
fi nancial year ended 31 March
2013
Details on achievement of Target
1 Percentage of Essential Medicines List (EML) items available at the depot.
90% 74% The performance is far below the 90% target. This is mainly due to non-payment of suppliers by the entity during 2011/12 and part of 2012/13 as a result of cash flow challenges in the Department which negatively affected the supply of medicines and therefore stock levels at the Depot.
2 % of EML orders supplied to institutions on fi rst request.
90% 76% The service level and how fast the MSD provides EML items to institutions is also in many ways dependent on the EML availability hence linked to indicator No 1 above.
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No.Key Performance
Indicator
Target for the fi nancial year
ended 31 March 2013
Percentage achieved at
fi nancial year ended 31 March
2013
Details on achievement of Target
3 Number of staff trained per annum on: MEDSAS (Drug Supply Management System) and Supply Chain Management (SCM)
10 18 Training is generally offered by Central Offi ce (Head Offi ce) with the Medical Supplies Depot (MSD) having little or no control over the type and frequency of training to be offered. The demand for training in the department is huge and therefore not enough depot staff are trained to management’s satisfaction.
Number of staff trained per annum on: Risk management, fi nancial management and performance management
10 15 Training is generally offered by Central Offi ce (Head Offi ce) with the Medical Supplies Depot (MSD) having little or no control over the type and frequency of training to be offered. The demand for training in the department is huge and therefore not enough depot staff are trained to management’s satisfaction.
4 % expired stock on average stock holding
< 2.00% 0.44% Performance target met
5 Laboratory Testing Turnaround time not to exceed 48 hours of working days
95% 99.0% Performance target met
6 Number of Pre-packed stock units
4 000 000 units 3 941 392 units Performance target not met (short by 58 608)
7 % completion of timely
reports of and review
of identifi ed Key Control
Accounts . (Refer to
Monitoring Tool for
Performance Info:
Objective No 7)
>70 % 80% Performance target met
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Given the performance results above, the
Depot achieved 4 out of the 7 objectives.
Management is however not satisfi ed with
the annual average performance level
of 74% relating to the availability of EML
items as this measurement relates to the
core purpose of the Depot. This objective
outweighs the supporting objectives in
the value chain of the Depot. It is however
encouraging that the continued payment
of suppliers which is one of the key factors
in achieving good results is taking place.
Coupled with the re-engineering process
as mentioned in paragraph 1.1 above,
management is confi dent that the service
level will continue to improve.
14. SCOPA Resolutions
There were no adopted resolutions for the
Medical Supplies Depot (MEDSAS) for the
year ended 31 March 2012.
15. Prior modifi cations to audit report
The turnaround strategy referred to in
paragraph 1 above is intended to address,
among other things, risks identifi ed by the
Auditor-General as well as the Internal Audit
and improve future audit outcomes.
The following are issues emanating from the
previous audit report:
Nature of qualifi cation (Extracted from Auditor-General report)
Financial year in which
the matter fi rst arose
Progress made in resolving the matter
Material stock losses (Asset management)
As disclosed in note 3 to the fi nancial
statements, material stock losses to the
amount of R3 404 258 (2009-10: R3 816
298) was incurred as a result of stock
breakages and expired stock.
2009/10 • The Depot’s Operational Plan for
2011/12 was revised to include
the objective “Ensure minimum
levels of expired stock” as a con-
tinuous monitoring tool for this
(risk) stock losses in the form of
expiry and breakages. Although
this objective is reported on
quarterly with the other Pre-de-
termined objectives, management
has actually gone further to
report monthly on this particular
objective as an additional control
measure. (Refer to paragraph 11
for control measures in place)
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Nature of qualifi cation (Extracted from Auditor-General report)
Financial year in which
the matter fi rst arose
Progress made in resolving the matter
Financial and Performance management -
(Internal Control defi ciencies)
Management did not implement controls
over daily and monthly processing and
reconciling of transactions.
2010/11 • The depot’s operational Plan for
2011/12 was revised to include
Key Pre-determined Performance
Objectives which are “SMART”. In
particular, objective No 7 “Im-
proved Financial management
and internal control system”
with performance indicator “ %
completion of timely reports and
review of Key Control Accounts”
is earmarked for improving these
areas as the name suggests.
• A checklist/ monitoring tool has
been developed which identifi es
all Key Control Accounts and their
reporting timeframes. On-going
supervision and review is key to
this process.
Payments not made within 30 days
Payments due to creditors amounting
to Rx at year end were not settled within
30 days from receipt of an invoice as per
the requirements of section 38(1) (f) of
the PFMA as well as TR 8.2.3. Further
non compliance amounting to Rx was
identifi ed for audit procedures performed on
payments made during the year which was
not settled within 30 days from receipt of an
invoice as per the above requirements.
2010/11
&
2011/12
• Normality is being restored in
compliance with Section 38.f of
the Public Finance Management
Act, (Act 1 of 1999). Conse-
quently, the Depot has reported
an amount due to suppliers of
R262 787 394 in comparison
with that of 2012: amounting
to R900 657 700 (refer to note
9 to the fi nancial statements).
The current year fi gure relates to
current invoices only.
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Nature of qualifi cation (Extracted from Auditor-General report)
Financial year in which
the matter fi rst arose
Progress made in resolving the matter
Surrender of funds at year end An
accounting offi cer of a department
operating a trading entity must, at the end
of each fi nancial year and after books of
account have been closed, declare any
surplus to the relevant treasury. The relevant
treasury may apply such surplus to reduce
any proposed allocation to the trading
entity, or require that all or part of it be re-
deposited in the Exchequer bank account.
The accounting offi cer did not at the end of
the fi nancial year declare the net surplus for
the 31 March 2011 fi nancial year end to the
Provincial Treasury as required by section
30(2)(g) and 31(2)(g) of the PFMA and TR
6.4.
2009/10 • The challenge for the 2009/10
fi nancial year was the fact that
the depot obtained a disclaimer
audit opinion hence it was not
possible to determine the extent
of the prior period error until such
a time that the Auditor-General
had concluded the 2010/11 audit.
• After the Auditor-General issued
an Unqualifi ed audit opinion in
respect of the 2010/11, it was
possible to determine the exact
profi t. We are pleased to report
that a submission was made to
the Provincial Treasury during Au-
gust 2011 declaring and therefore
surrendering outstanding profi ts.
This matter has therefore been
resolved.
16. Exemptions and deviations received from the Treasury
The Depot has no record of any new
exemptions and deviations either from the
Gauteng Provincial Treasury or the National
Treasury.
17. Other
The Depot was still incurring a cost relating
to price increases not recovered from
demanders. This is mostly attributable to
the back dated approval of contract price
increases by the Gauteng Department of
Finance.
18. Approval
The annual fi nancial statements set out on
pages 351 to 382 have been approved by
the Accounting Offi cer.
Ndoda Biyela
Acting Head of Department
31 May 2013
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REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG PROVINCIAL LEGISLATURE ON THE GAUTENG MEDICAL SUPPLIES DEPOT
Introduction
1. I have audited the fi nancial statements of the Gauteng Medical Supplies Depot (MSD), set out on pages 351 to 382, which comprise the statement of fi nancial position as at 31 March 2013, the statement of comprehensive income, statement of changes in equity and statement of cash flows for the year then ended, and the notes, comprising a summary of signifi cant accounting policies and other explanatory information.
Accounting offi cer’s responsibility for the fi nancial statements
2. The accounting offi cer is responsible for the preparation of these fi nancial statements in accordance with South African Statements of Generally Accepted Accounting Practice ( SA Statements of GAAP) and the requirements of the Public Finance Management Act, 1999 (Act No.1 of 1999) (PFMA), and for such internal control as the accounting offi cer determines necessary to enable the preparation of fi nancial 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 fi nancial statements based on my audit. I conducted my audit in accordance with the Public Audit Act of South Africa, 2004 (Act No. 25 of 2004) (PAA), the General Notice issued in terms thereof and 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 fi nancial statements are free
from material misstatement.
4. An audit involves performing procedures
to obtain audit evidence about the
amounts and disclosures in the fi nancial
statements. The procedures selected
depend on the auditor’s judgement,
including the assessment of the risks of
material misstatement of the fi nancial
statements, whether due to fraud or error.
In making those risk assessments, the
auditor considers internal control relevant
to the trading entity’s preparation and fair
presentation of the fi nancial statements in
order to design audit procedures that are
appropriate in the circumstances, but not
for the purpose of expressing an opinion
on the effectiveness 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
fi nancial statements.
5. I believe that the audit evidence I have
obtained is suffi cient and appropriate to
provide a basis for my audit opinion.
Opinion
6. In my opinion, the fi nancial statements
present fairly, in all material respects,
the fi nancial position of the MSD as
at 31 March 2013, and its fi nancial
performance and cash flows for the
year then ended in accordance with SA
Statements of GAAP and the requirements
of the PFMA.
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REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG PROVINCIAL LEGISLATURE ON THE GAUTENG MEDICAL SUPPLIES DEPOT
REPORT ON OTHER LEGAL AND REGULATORY REQUIREMENTS
7. In accordance with the PAA and the General
Notice issued in terms thereof, I report the
following fi ndings relevant to performance
against predetermined objectives,
compliance with laws and regulations and
internal control, but not for the purpose of
expressing an opinion.
Predetermined objectives
8. I performed procedures to obtain evidence
about the usefulness and reliability of the
information in the annual performance
matrix as set out on pages 342 to 343 of
the annual report.
9. The reported performance against
predetermined objectives was evaluated
against the overall criteria of usefulness
and reliability. The usefulness of
information in the annual performance
report relates to whether it is presented in
accordance with the National Treasury’s
annual reporting principles and whether the
reported performance is consistent with
the planned objectives. The usefulness
of information further relates to whether
indicators and targets are measurable
(i.e. well defi ned, verifi able, specifi c,
measurable and time bound) and relevant
as required by the National Treasury
Framework for managing programme
performance information. The reliability of
the information in respect of the selected
objectives is assessed to determine
whether it adequately reflects the facts (i.e.
whether it is valid, accurate and complete).
10. There were no material fi ndings on the
annual performance report concerning the
usefulness and reliability of the information.
Compliance with laws and regulations
11. I performed procedures to obtain evidence
that the entity has complied with applicable
laws and regulations regarding fi nancial
matters, fi nancial management and other
related matters. My fi ndings on material
non-compliance with specifi c matters in
key applicable laws and regulations as set
out in the General Notice issued in terms of
the PAA are as follows:
Annual fi nancial statements
12. The fi nancial statements submitted for
auditing were not prepared in accordance
with the prescribed fi nancial reporting
framework as required by section 55(1)
(a) and) (b) of the PFMA. Material
misstatements identifi ed during the audit
were subsequently corrected. Material
misstatements identifi ed during the audit
were subsequently corrected, resulting
in the fi nancial statements receiving an
unqualifi ed audit opinion.
Asset management
13. Proper control systems to safeguard and
maintain inventory were not implemented,
as required by section 38(1)(d) of the PFMA
and Treasury Regulation (TR)10.1.1(a).
Expenditure management
14. The accounting offi cer did not take effective
steps to prevent and detect irregular and
fruitless and wasteful expenditure as
required by section 38(1)(c)(ii) and 39(1) (b)
of the PFMA.
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15. Contractual obligations and money owed
by the trading entity were not settled within
30 days or an agreed period, as required by
section 38(1)(f) of the PFMA and TR8.2.3.
Procurement and contract management
16. Goods and services with a transaction value below R500 000 were procured without obtaining the required price quotations, as required by TR16A6.1.
17. Goods and services of a transaction value above R500 000 were procured without inviting competitive bids, as required by TR16A6.1. Deviations were approved by the accounting offi cer even though it was not impractical to invite competitive bids, in contravention of TR16A6.4.
18. Quotations were awarded to suppliers whose tax matters had not been declared by the South African Revenue Services to be in order as required by TR16A9.1 (d) and Practice Note 8 of 2007-08.
Internal control
19. I considered internal control relevant to my audit of the fi nancial statements, the annual performance report and compliance with laws and regulations. The matters reported below under the fundamentals of internal control are limited to the signifi cant defi ciencies that resulted in the basis for an unqualifi ed opinion, the fi ndings on the annual performance report and the fi ndings on compliance with laws and regulations included in this report.
Leadership
20. There was no formal code of ethics at the entity and many instances of management override and cases of fraud and theft are being investigated as indicated under the
“other reports” section of this report.
21. Inadequate oversight and monitoring
responsibility over certain documented
policies and procedures, resulting in certain
instances of non compliance with the
PFMA.
22. An action plan was developed to address
internal and external audit fi ndings and
adherence to the plan was monitored on a
monthly basis by the appropriate level of
management, however the action plan was
not implemented timorously and key prior
year fi ndings there for re-occurred during
the current year audit.
Financial and performance management
23. The fi nancial statements submitted for
audit were subject to material amendments
due to inadequate and untimely review
for completeness and accuracy prior to
submission for audit.
24. Management did not comply with certain
laws and regulations.
25. Management did not always implement
proper record keeping in a timely manner
to ensure that complete, relevant and
accurate information was accessible and
available to support fi nancial reporting.
26. Management did not implement controls
over daily and monthly processing and
reconciling of transactions.
349
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department of Health Vote 4REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG PROVINCIAL LEGISLATURE ON THE GAUTENG MEDICAL SUPPLIES DEPOT
OTHER REPORTS
Investigations
An investigation was conducted by an independent
consulting fi rm on request of the accounting
offi cer. The investigation was initiated based on
concerns surrounding the procurement process.
The investigation has resulted in four suspensions
and other disciplinary proceedings. Certain
individuals have resigned from the employment
of MSD due to number of transgressions revealed
from the investigation.
Johannesburg
31 July 2013
350
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOTSTATEMENT OF FINANCIAL POSITIONas at 31 March 2013.
2013 2012
Note R R
ASSETS
Non-current assets 8 319 318 9 585 040
Property, plant and equipment 2 8 319 318 9 585 040
Current assets 470 421 319 1 056 238 980
Inventories 3 164 252 270 104 130 374
Trade and other receivables 4 305 118 256 944 218 177
Cash and cash equivalents 5 1 050 793 7 890 429
Total assets 478 740 637 1 065 824 020
EQUITY AND LIABILITIES
Equity
Capital and reserves 193 828 513 158 623 302
Medsas capital account 6 104 376 790 104 376 790
Retained earnings 89 451 723 54 246 512
Non-current liabilities 728 291 744 461
Finance lease obligation 7 728 291 744 461
Current liabilities 284 183 833 906 456 257
Leave accruals 8 2 966 266 2 607 150
Trade and other payables 9 280 777 721 903 188 014
Finance lease obligation 7 439 846 661 093
Total equity and liabilities 478 740 637 1 065 824 020
351
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOTSTATEMENT OF COMPREHENSIVE INCOMEfor the year ended 31 March 2013.
Revenue 10 2 928 979 725 2 399 029 813
Cost of sales 24 (2 803 521 784) (2 381 948 004)
Gross profi t 125 457 941 17 081 809
Other income 10 66 781 73 385
Operating expenditure 11 ( 86 244 852) ( 80 873 274)
Distribution cost ( 11 876 523) ( 11 308 665)
Administrative expenses ( 66 246 334) ( 64 812 172)
Other expenses ( 8 121 995) ( 4 752 437)
Operating profi t/ (loss) 39 279 870 ( 63 718 080)
Finance income ( 79 080 816) 2 014 207
Finance cost 12 75 006 157 ( 4 034 162)
Profi t\ (loss) before taxation 35 205 211 ( 65 738 035)
Taxation 13 - -
Profi t/ (loss) for the year 35 205 211 ( 65 738 035)
Other comprehensive income, net of tax: - -
Total comprehensive income/ (loss) attributable to:
Gauteng Department of Health 35 205 211 ( 65 738 035)352
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
GAUTENG MEDICAL SUPPLIES DEPOTSTATEMENT OF CHANGES IN EQUITYfor the year ended 31 March 2013.
MEDSAS capital account
Retained earnings
Total
Note R R R
Balance at 31 March 2011 6 104 376 790 119 984 547 224 361 337
Loss for the year - ( 65 738 035) ( 65 738 035)
Balance at 31 March 2012 104 376 790 54 246 512 158 623 302
Profi t for the year - 35 205 211 35 205 211
Balance at 31 March 2013 104 376 790 89 451 723 193 828 513
353
Gauteng Provincial Government | Health | Annual Report 2012/2013
Department of Health Vote 4GAUTENG MEDICAL SUPPLIES DEPOTSTATEMENT OF CASH FLOWSfor the year ended 31 March 2013.
2013 2012
Note R R
Cash fl ows from operating activities
Cash generated by operations 14 (5 006 123) 5 604 662
Interest income - 2 014 207
Finance costs 12 - (4 034 162)
Net cash generated by operating activities (5 006 123) 3 584 707
Cash fl ows from investing activities
Purchase of property, plant and equipment 2 (1 088 042) (2 822 206)
Proceeds on disposal of property, plant and equipment 18 963 494 363
Net cash utilized by investing activities (1 069 079) (2 327 843)
Cash fl ows from fi nancing activities
Finance lease obligation ( 764 434) 946 416
Net cash (utilized)/ generated by fi nancing activities ( 764 434) 946 416
Net (decrease)/ increase in cash and cash equivalents (6 839 636) 2 203 280
Cash and cash equivalents at the beginning of the year 5 7 890 429 5 687 149
Cash and cash equivalents at the end of the year 5 1 050 793 7 890 429
354
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
1. ACCOUNTING POLICIES
The annual fi nancial statements were prepared in accordance with Statements of South African
Generally Accepted Accounting Practice (Statements of SA GAAP) and 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).
The following are the principal accounting policies of the Depot which are, in all material respects,
consistent with those applied in the previous year, except as otherwise indicated:
1.1 Basis of preparation
The fi nancial statements were prepared on the historical cost basis and incorporate the principal
accounting policies set out below.
1.2 Revenue recognition
Revenue is recognised when it is probable that future economic benefi ts will flow to the Depot and
these benefi ts can be measured reliably. Revenue is measured at the fair value of the consideration
received or receivable.
Revenue from the sale of goods is recognised when signifi cant risks and rewards of ownership of
the goods have been transferred to the buyer.
1.3 Irregular and fruitless and wasteful expenditure
Irregular expenditure means expenditure incurred in contravention of, or not in accordance with, a
requirement of any applicable legislation, including:
• The PFMA, or
• Any provincial legislation providing for procurement procedures in that provincial govern-
ment.
Fruitless and wasteful expenditure means expenditure that was made in vain and would have been
avoided had reasonable care been exercised.
All irregular and fruitless and wasteful expenditure is charged against income in the period in which
they are incurred.
355
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
1.4 Employee costs
1.4.1 Short-term employee benefi ts
The cost of short-term employee benefi ts is expensed in the Statement of Comprehensive Income
in the reporting period when the payment is made. Short-term employee benefi ts, that give rise
to a present legal or constructive obligation, are deferred until they can be reliably measured and
then expensed. Details of these benefi ts and the potential liabilities are disclosed as a disclosure
note to the fi nancial statements where applicable and are not recognised in the Statement of
Comprehensive Income.
1.4.2 Termination benefi ts
Termination benefi ts are recognised and expensed only when the payment is made.
1.4.3 Retirement benefi t cost s
The Depot provides retirement benefi ts for its employees through a defi ned benefi t plan for
government employees. These benefi ts 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
benefi t accounting is disclosed for retirement benefi ts in the fi nancial 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.
1.4.4 Medical benefi ts
The Depot provides medical benefi ts for its employees. These benefi ts are funded by employer and
employee contributions. Employer contributions to the fund are expensed when money is paid to the
fund. No provision is made for medical benefi ts in the fi nancial statements.
1.5 Property, plant and equipment
Property, plant and equipment are stated at cost less accumulated depreciation and any impairment
in value. Costs include costs incurred initially to acquire or construct an item of property, plant and
equipment and costs incurred subsequently to add to, replace part of, or service it.
If a replacement cost is recognised in the carrying amount of an item of property, plant and
equipment, the carrying amount of the replaced part is derecognised.
ACCOUNTING POLICIES (continued)
356
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
Depreciation is provided on all property, plant and equipment to write down the cost, less residual
value, on a straight line basis over their estimated useful lives as follows:
Classifi cation of assets Depreciation rates (Straight line method)
Fixtures and fi ttings
System alarm 20%
Building 2%
Irrigation systems 20%
Lifts and escalators 10%
Property and buildings 0% - 2%
Motor vehicles
Cars, minibuses, trucks 20%
Plant and Equipment
Air-conditioning 15%
Instruments 0%
Laundry equipment 15%
Medical equipment 15%
Vehicles 20%
Parking equipment 15%
Radio equipment 15%
Telephone system 15%
Workshop and tools 15%
Computer equipment
Computer equipment 33.3%
Offi ce furniture
Bed 15%
Crockery and cutlery 0%
Furniture and fi ttings 15%
Kitchen equipment 15%
Linen, curtains and mattresses 0%
Offi ce equipment 20%
ACCOUNTING POLICIES (continued)
357
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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Depreciation commences when the asset is available for use. Each part of an item of property,
plant and equipment with a cost that is signifi cant in relation to the total cost of the item shall be
depreciated separately. The depreciation charge for each period is recognised in profi t or loss unless
it is included in the carrying amount of another asset.
The carrying values of property, plant and equipment are reviewed for impairment when events
or circumstances indicate that the carrying value may not be recoverable. Impairment losses are
recognised in the Statement of Comprehensive Income.
The item of property, plant and equipment is derecognised upon disposal or when no future
economic benefi ts are expected from its use or disposal.
Valuations to property, plant and equipment are performed frequently enough to ensure that the fair
value of a revalued asset does not differ materially from its carrying amount.
1.6 Impairment
At each balance sheet date, the Depot reviews the carrying amounts of its tangible assets to
determine whether there is any indication that those assets may be impaired. For the year under
review no impairments were done. Assets that may not be effi ciently utilised for their intended use
were disposed of. If any such indication exists, the recoverable amount of the asset is estimated in
order to determine the extent of the impairment loss (if any). Where it is not possible to estimate
the recoverable amount for an individual asset, the recoverable amount is determined for the cash-
generating unit to which the asset belongs.
If the recoverable amount of an asset (cash-generating unit) is estimated to be less than its carrying
amount, the carrying amount of the asset (cash-generating unit) is reduced to its recoverable
amount. Impairment losses are immediately recognised as an expense, unless the relevant asset is
carried at a revalued amount under another standard, in which case the impairment loss is treated
as a revaluation decrease under the standard.
Where an impairment loss subsequently reverses, the carrying amount of the asset (cash-generating
unit) is increased to the revised estimate of its recoverable amount, but so that the increased
carrying amount does not exceed the carrying amount that would have been determined had no
impairment loss been recognised for the asset (cash-generating unit) in prior years.
A reversal of an impairment loss is recognised as income immediately, unless the relevant asset is
carried at a revalued amount under another standard, in which case the reversal of the impairment
loss is treated as a revaluation increase under that other standard.
ACCOUNTING POLICIES (continued)
358
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
1.7 Leasing/Operating contracts
1.7.1 Operating leases as the lessee
Leases of assets under which all the risks and rewards of ownership are effectively retained by the
lessor are classifi ed as operating leases. Payments made under operating leases are charged to the
Statement of Comprehensive Income on a straight-line basis over the period of the relevant lease.
1.7.2 Finance leases as the lessee
Leases of assets are classifi ed as fi nance leases whenever the terms of the lease transfer
substantially all the risks and rewards of ownership to the lessee. All other leases are classifi ed as
operating leases.
Assets held under fi nance leases are recognised as assets at their fair value at the inception of the
lease or, if lower, at the present value of the minimum lease payments. The corresponding liability
to the lessor is included in the Statement of Financial Position as a fi nance lease obligation. Lease
payments are apportioned between fi nance charges and reduction of the lease obligation so as to
achieve a constant rate of interest on the remaining balance of the liability. Finance charges are
charged to surplus or defi cit.
Leases of assets under which all the risks and rewards of ownership are effectively retained by the
lessor are classifi ed as operating leases.
Maintenance contracts as arranged by the Department of Transport, Roads and Public Works are
recognized as commitments, but not as payables. Refer to note 21.
1.8 Inventories
Inventory is measured at the lower of cost price and net realisable value (NRV). Net realisable value
is the estimated selling price in the ordinary course of business less the estimated costs of the
completion and the estimated costs necessary to make the sale. The cost of inventories comprises
of all costs of purchase, costs of conversion and other costs incurred in bringing the inventories to
their present location and condition. Inventories are stated at the weighted average moving basis.
The same cost formula is used for all inventories having a similar nature and use to the Depot. When
inventories are sold, the carrying amounts of those inventories are recognised as an expense in the
period in which the related revenue is recognised. The amount of any write-down, the period the
write-down or loss occurs. The amount of any reversal of any write-down of inventories, arising from
an increase in the net realisable value, are recognised as a reduction in the amount of inventories
recognised as an expense in the period in which the reversal occurs.
ACCOUNTING POLICIES (continued)
359
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
1.9 Financial instruments
Initial recognitio n
The Depot classifi es fi nancial instruments, or their component parts, on initial recognition as a
fi nancial asset, a fi nancial liability or an equity instrument in accordance with the substance of the
contractual arrangement.
Financial assets and fi nancial liabilities are recognised on the Depot’s Statement of Financial
Position when the Depot becomes party to contractual provisions of the instrument.
Financial instruments recognised on the Statement of Financial Position include trade and other
receivables, cash and cash equivalents and trade and other payables.
Trade and other receivable s
Trade and other receivables are measured at initial recognition at fair value, and are subsequently
measured at amortised cost using the effective interest rate method less any impairment.
Impairment is determined on a specifi c basis, whereby each asset is individually assessed for
impairment indicators. Appropriate allowances for estimated irrecoverable amounts are recognised
in profi t or loss when there is objective evidence that the asset is impaired.
Trade and other payable s
Trade and other payables are initially measured at fair value, and are subsequently measured at
amortised cost, using the effective interest rate method.
Cash and cash equivalents
Cash and cash equivalents comprise cash on hand and demand deposits and other short term
highly liquid investments that are readily convertible to a known amount of cash and are subject to
an insignifi cant risk of changes in value. These are initially and subsequently recorded at amortised
cost. Due to the short nature of cash, the amortised cost would equal the cash balance.
Gains and losses
A gain or loss from a change in a fi nancial asset or fi nancial liability is recognised as follows:
• Gains and losses on trade and other receivables and cash and cash equivalents are recog-
nised in income when receivables are derecognised or impaired.
• Gains and losses on trade and other payables are recognised in profi t and loss when liabili-
ties are derecognised.
ACCOUNTING POLICIES (continued)
360
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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Derecognition
Financial assets
Financial assets (or part thereof) are derecognised when the entity realises the rights to benefi ts
specifi ed in the contract, the right expires, or the company surrenders or otherwise loses control of
the contractual rights that comprise the fi nancial asset.
The rights to receive cash flows from the asset have expired; the entity retains the right to receive
cash flows from the asset, but has assumed an obligation to pay them in full without any material
delay to a third party under a ‘pass-through’ arrangement; or, the entity has transferred its rights to
receive cash flows from the asset and either has transferred substantially all the risks and rewards
of the asset; or has neither transferred nor retained substantially all the risks and rewards of the
asset but has transferred control of the asset.
Financial liabilities
Financial liabilities (or part thereof) are derecognised when the obligation specifi ed in the contract
is discharged, cancelled or expired.
Impairment of fi nancial instruments
The entity assesses on each balance sheet date whether a fi nancial asset of the entity is impaired.
Impairments are made when there is objective evidence that cash flows from specifi c fi nancial
assets would not materialise. Cash flow values estimated not to materialise are impaired. The
amount of the impairment is measured as the difference between the fi nancial asset’s carrying
amount and the present value of estimated future cash flows discounted at the effective interest
rate computed at initial recognition. The amount of the impairment is recognised in the Statement
of Comprehensive Income.
Off-setting of fi nancial instruments
Financial assets and fi nancial liabilities are offset, if a legally enforceable right exists to set off
fi nancial assets against fi nancial liabilities and the fi nancial instrument relate to the same entity.
1.10 Provisions
A provision is a liability of uncertain timing or amount. Provisions are recognised when the entity has
a present obligation, legal or constructive, as a result of a past event, it is probable that an outflow
of resources embodying economic benefi ts will be required to settle the obligation and a reliable
estimate can be made of the obligation.
The amount of a provision is the present value of the expenditure expected to be required to settle
the obligation. Contingent assets and contingent liabilities are not recognised as provisions as they
do not comply with the recognition criteria.
ACCOUNTING POLICIES (continued)
361
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
The Depot is not exposed to environmental liabilities relating to its operations.
1.11 Comparative fi gures
Where necessary, comparative fi gures have been adjusted to conform to changes in presentation
in the current year, limited to audited fi gures. Reasonably, calculated, comparative fi gures are
disclosed in the notes to the annual fi nancial statements for better understanding of changes that
have occurred in presentation.
1.12 Taxation
In terms of section 10.1 of the Income Tax Act, Act Number 59 of 1962, the Depot, as a government
institution, is not liable for any income taxation. Employees’ tax is paid over to SARS by the Gauteng
Department of Finance at the time when the employee expenses are programmatically recognised.
1.13 Presentation of fi nancial statements
The fi nancial statements are presented in South African Rand and amounts presented are rounded
to the nearest Rand.
1.14 Related parties
The Depot operates in an economic environment currently dominated by entities directly or indirectly
owned by the South African government. Other related party transactions are also disclosed in
terms of the requirements of the accounting standards.
1.15 Signifi cant judgements, estimates and assumptions
The preparation of annual fi nancial statements in conformity with Statements of SA GAAP requires
the use of certain critical accounting estimates. It also requires management to exercise its
judgment in the process of applying the company’s accounting policies in areas that involve a higher
degree of judgment or complexity, or areas where assumptions and estimates are signifi cant to the
fi nancial statements. Although these estimates are based on management’s best knowledge of
current events and actions they may undertake in the future, actual results may differ from these
estimates.
The key assumptions concerning the future and other key sources of estimation uncertainty at the
balance sheet date, that have a signifi cant risk of causing a material adjustment to the carrying
amount of the assets and liabilities in the next fi nancial year are listed below:
Estimates
Provisions
Provisions were raised and management determined an estimate based on the information available.
ACCOUNTING POLICIES (continued)
362
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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Gauteng Provincial Government | Health | Annual Report 2012/2013
Property, plant and equipment
Management has made certain estimates with regards to the determination of estimated useful
lives and residual values of items of property, plant and equipment.
Judgments
Leases
Management has applied judgment to classify all lease agreements that the Depot is party to as
operating leases if the leases do not transfer substantially all risks and rewards of ownership to the
entity, or the other recognition criteria is met in terms of IAS 17 to classify leases as fi nance leases.
Impairment of trade receivables
Management has applied judgment in estimating the extent of any impairment deemed necessary
on the gross carrying value of trade receivables and have impaired all accounts in arrears for a
period longer than normal expected trading terms.
1.16 Cash and cash equivalents
Cash and cash equivalents are carried at face value. Cash and cash equivalents comprise cash on
hand and cash held in current accounts with registered and approved banks.
1.17 Borrowing costs
Borrowing costs that are directly attributable to the acquisition, construction or production of a
qualifying asset are capitalized as part of the cost of that asset. All other borrowing costs are
recognized as an expense in the period in which it occurs.
1.18 New standards and interpretations issued but not yet effective
The following new or revised fi nancial reporting standards, amendments and interpretations of
those standards which are applicable to the Depot are not yet effective for the year ended 31 March
2012 and were not applied in preparing these fi nancial statements.
On review of these amendments and interpretations, the impact (if any) has not yet been estimated,
or is not expected to have a material impact on the Depot’s fi nancial statements:
ACCOUNTING POLICIES (continued)
363
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
Standard or interpretation Title Effective date
IAS 1 (amendment) Presentation of
Financial Statements
• Annual periods beginning on or after 01
January 2011.
• Clarifi cation of statement of changes in
equity 01 January 2011.
• New requirements to group together
items within OCI that may be reclassifi ed
to the profi t or loss section of the income
statement in order to facilitate the as-
sessment of their impact on the overall
performance of an entity. 01 July 2012
IAS 19 Employee Benefi ts • Amendments to the accounting for cur-
rent and future obligations resulting from
the provision of defi ned benefi t plans 01
January 2013
IAS 24 (revised) Related Party
Disclosures
• Annual periods beginning on or after 01
January 2011
IAS 32 Financial Instruments:
Presentation
• Amendments require entities to disclose
gross amounts subject to rights of set-
off, amounts set off in accordance with
the accounting standards followed, and
the related net credit exposure. This in-
formation will help investors understand
the extent to which an entity has set off
in its balance sheet and the effects of
rights of set-off on the entity’s rights and
obligations 01 January 2013
IAS 34 (amendment) Interim Financial
Reporting
• Annual periods beginning on or after 01
January 2011.
IFRS 1
(amendment)
First-time Adoption of
IFRS
• Annual periods beginning on or after 1
January 2011 and 01 July 2011
IFRS 7 (amendment) Financial Instruments:
Disclosures
• Annual periods beginning on or after 01
January 2011.
IFRS 9
(new)
Financial Instruments • Annual periods beginning on or after 01
January 2013.
• New standard that forms the fi rst part
of a three-part project to replace IAS 39
Financial Instruments: Recognition and
Measurement 01 January 2015
364
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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Standard or interpretation Title Effective date
IFRS 13
(new)
Fair Value Measurement • Annual periods beginning on or after 01
January 2013.
1.19 Accounting for Black Economic Empowerment (BEE) transactions
The South African interpretation (AC 503) effective for annual periods beginning on or after 1 May
2006 is not applicable for the Depot. No share-based transactions are allowed for the Depot.
365
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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2. PROPERTY, PLANT AND EQUIPMENT
2013 2012
Cost/ valuation
Accumulated Depreciation
Carrying value at the end of the
year
Cost/Valuation
Accumulated Depreciation
Carrying value at
the end of the year
R R R R R R
Owned equipmentComputer equipment 5 833 665 (5 347 108) 486 557 5 679 749 (4 740 099) 939 650
Fixtures and fi ttings 5 161 247 (3 750 962) 1 410 285 5 136 395 (3 662 845) 1 473 550
Offi ce furniture 5 654 214 (3 761 551) 1 892 663 5 656 276 (3 050 084) 2 606 192 Plant and equipment 7 188 140 (3 438 676) 3 749 464 6 330 058 (2 550 728) 3 779 330
23 837 266 (16 298 297) 7 538 969 22 802 478 (14 003 756) 8 798 722
Leased assetsMotor vehicles- G-Fleet 946 416 ( 585 913) 360 503 946 416 ( 265 545) 680 871
Offi ce equipment 720 178 ( 469 037) 251 141 313 449 ( 244 292) 69 157
Cell phones 378 256 ( 209 550) 168 706 158 896 ( 122 606) 36 290
2 044 850 (1 264 500) 780 350 1 418 761 ( 632 443) 786 318
25 882 116 (17 562 797) 8 319 318 24 221 239 (14 636 199) 9 585 040
2013
Carrying value at the beginning of
the year
Additions Disposals/Impairment
Accumulative depreciation on disposal / impairment
Depreciation current year value at the end of the
year
Carryingvalue at
the end of the year
R R R R R R
Owned equipmentComputer equipment 939 650 154 450 ( 534) 204 ( 607 213) 486 557 Fixtures and fi ttings 1 473 550 24 852 - - ( 88 117) 1 410 285
Offi ce furniture 2 606 192 24 766 ( 26 828) 16 049 ( 727 516) 1 892 663 Plant and equipment 3 779 330 883 974 ( 25 892) 14 501 ( 902 449) 3 749 464
8 798 722 1 088 042 ( 53 254) 30 754 (2 325 295) 7 538 969
Leased assets
Motor vehicles – gFleet 680 871 - - - ( 320 369) 360 502
Offi ce equipment 69 157 406 729 - - ( 224 745) 251 141
Cell phones 36 290 219 360 - - ( 86 943) 168 707
786 318 626 089 - - ( 632 057) 780 350
9 585 040 1 714 131 ( 53 254) 30 754 (2 957 352) 8 319 319
366
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
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2. PROPERTY, PLANT AND EQUIPMENT (Continued) 2012
Carrying value at the beginning of
the year
Additions Disposals/ Impairment
Accumulative depreciation on disposal / impairment
Depreciation current year
Carryingvalue at the end of the
yearR R R R R R
Owned equipmentComputer equipment 1 106 234 631 591 ( 174 920) 166 535 ( 789 790) 939 650 Fixtures and fi ttings 1 407 584 160 790 - - ( 94 824) 1 473 550 Offi ce furniture 3 371 535 226 810 ( 228 636) 111 801 ( 875 318) 2 606 192 Plant and equipment 3 852 145 775 476 ( 108 886) 78 285 ( 817 690) 3 779 330
9 737 498 1 794 667 ( 512 442) 356 621 (2 577 622) 8 798 722 Leased assetsMotor vehicles - 946 416 - - ( 265 545) 680 871 Offi ce equipment 283 383 78 076 ( 195 353) - ( 96 949) 69 157 Cell phones 102 217 3 047 ( 51 299) - ( 17 675) 36 290
385 600 1 027 539 ( 246 652) - ( 380 169) 786 318 10 123 098 2 822 206 ( 759 094) 356 621 (2 957 791) 9 585 040
3. INVENTORIES2013 2012
R R
Trading stock - Main warehouse 115 142 050 80 224 099
Trading stock - Pre-pack store 6 411 962 5 592 246
Trading stock - ARV store 42 109 286 17 799 247
Operational stock 588 972 514 782
164 252 270 104 130 374
The valuation method used by the Depot was the weighted average moving basis based on cost price. There were no impairment of inventory raised at 31 March 2013 (2012: Nil). Management has assessed impairment at year end individually and based on this assessment no impairment of inventory has been raised.
2013 2012
R R
Breakages 27 584 24 753
Expired stock 2 648 327 2 332 284
2 675 911 2 357 037
Stock shortage of R2 283 151 (2012: R1 306 894) were recognised during the year. Damaged
and obsolete stock is excluded from the total inventory value shown above. No write down of
inventory to net realisable value was required at fi nancial year end (2012: Nil).
367
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
4. TRADE AND OTHER RECEIVABLES
2013 2012
R R
Trade receivables 302 782 324 943 141 098
Other receivables 2 335 932 1 077 079
(Refer to note 15 for fair values) 305 118 256 944 218 177
Trade receivables are non-interest bearing and are generally repayable between 30 and 90 days.
Although 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 carried out (2012: R Nil). These accounts have however been discounted due
to the fact that normal trading terms had been violated during the year under review and were in
excess of 90 days.
As at 31 March 2013, the age analysis of trade receivables that were due but not impaired is as
follows:
Total < 30 days > 30 days
R R R
2013 302 782 324 302 782 324 -
2012 943 141 098 267 730 572 675 410 526
5. CASH AND CASH EQUIVALENTS2013 2012
R R
Bank balance 1 049 293 7 889 112
Petty cash 1 500 1 317
(Refer to note 15 for fair values) 1 050 793 7 890 429
Cash and cash equivalents earn interest at
floating rates based on daily bank deposit
rates.
368
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
6. MEDSAS CAPITAL ACCOUNT2013 2012
R R
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 retained earnings and an additional transfer of R 24 376 790 in
2009.
7. FINANCE LEASE OBLIGATIONSPresent value
of minimum
lease payments
Future fi nance
charges
Minimum lease
payments
2013 R R R
Amount payable under fi nance
lease:
Within one year 439 846 76 144 363 702
In the second to fi fth year inclusive 728 291 117 831 610 460
After fi ve years - - -
1 168 137 193 975 974 162
Less: Amount due for settlement
within 12 months
( 439 846)
728 291
2012 R R R
Amount payable under fi nance lease:
Within one year 661 093 295 453 365 640
In the second to fi fth year inclusive 744 461 464 504 279 957
After fi ve years - - -
1 405 554 759 957 645 597
Less: Amount due for settlement
within 12 months
( 661 093)
744 461
Obligations under fi nance leases are secured by the lessor’s title to the leased asset. Finance
leases bear interest at an average rate of 9%.
369
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
8. LEAVE ACCRUALS 2013 2012
R R
Balance at beginning of the year 2 607 150 2 537 629
Additional accruals made during the year 359 116 69 521
Amount used during the year - -
Balance at end of the year 2 966 266 2 607 150
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 realise within the following year when the
employees request leave or is paid out.
9. TRADE AND OTHER PAYABLES 2013 2012
R R
Trade payables 275 900 473 900 657 700
Sundry creditors 4 877 248 2 530 314
(Refer to note 15 for fair values) 280 777 721 903 188 014
Trade payables are non-interest bearing and are generally repayable within 30 days. Although
there were amounts older than 30 days as at year end, management has assessed trade payables
individually and collectively and has come to the conclusion that there is no reason to believe that
these amounts will not be paid within 90 days after year end and thereafter all payments to be
paid within 30 days hence no impairment of trade receivables carried out for the year (2012: R Nil).
These accounts have however been discounted due to the fact that normal trading terms had been
violated during the year under review and were in excess of 90 days.
As at 31 March 2013, the age analysis of trade payables that were due but not impaired is as
follows:
Total < 30 days > 30 days
R R R
2013 275 900 473 275 900 473 -
2012 900 657 700 294 320 785 606 336 915
370
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
10. REVENUE AND OTHER INCOME 2013 2012
R R
Turnover - sales of medical supplies 2 928 979 725 2 399 029 813
Other 66 781 73 385
2 929 046 506 2 399 103 198
There were no discontinued operations for the period under review.
371
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
11. OPERATING EXPENDITURE 2013 2012
R R
Distribution cost: 11 876 523 11 308 665
Fees for distribution costs 11 787 925 11 251 806
Rental of vehicles 88 598 56 859
Administrative expenses 66 246 334 64 812 172
Staff Costs 44 628 080 46 778 513
Contribution to defi ned benefi t plan 4 056 066 -
Communication 661 591 471 014
Maintenance and repairs 2 465 879 4 812 136
Stationery and printing 916 069 1 073 502
Other administrative expenses 6 926 880 2 450 146
Fees for services:
Lease rentals of equipment 388 445 118 733
Audit fees 1 107 819 2 122 271
Technical 356 499 2 029 805
Security 4 739 006 4 956 052
Other expenses: 8 121 995 4 752 437
Depreciation owned assets 2 325 295 2 577 622
Depreciation leased assets 632 058 380 169
External training 205 580 175 387
Staff entertainment - 312 365
Stock price adjustments not recovered 2 283 151 -
Stock expiry 2 675 911 1 306 894
Total operating expenditure 86 244 852 80 873 274
372
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
12. FINANCE COST AND FINANCE INCOME 2013 2012
R R
Finance cost:
Interest expense - fi nance lease 237 417 269 153
Interest on discounting of trade payables (75 243 574) 3 765 009
(75 006 157) 4 034 162
Interest expense consists of interest paid on fi nance
leases and discounting of trade payables
Finance income:
Interest on discounting of trade receivables 79 080 816 2 014 207
Interest on trade receivables consists of discounting of
trade receivables
13. TAXATION
No provision has been made for taxation as the Depot is exempt from income taxation in terms of
section 10 (1).
373
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
14. RECONCILIATION OF PROFIT/ (LOSS) BEFORE TAXATION TO CASH GENERATED BY OPERATIONS
2013 2012
R R
Profi t/ (loss) before taxation 35 205 211 (65 738 035)
Adjusted for:
Depreciation on property, plant and equipment 2 957 352 2 957 791
Leave pay accrual 359 116 69 521
Profi t on the disposal of property, plant and equipment ( 18 963) ( 512 442)
Stock expiry 2 675 911 -
Discounting journals (6 827 141) -
Finance income 79 080 816 (2 014 207)
Finance costs (75 006 157) 4 034 162
Operating profi t/ (loss) before changes in working capital 38 426 145 (61 203 210)
Movement in working capital
(Increase)/ decrease in inventories (60 121 896) 43 201 965
Decrease/ (increase) in trade and other receivables 639 099 921 (42 699 422)
(Decrease)/ increase in trade and other payables (622 410 293) 66 305 329
(43 432 268) 66 807 872
(5 006 123) 5 604 662
374
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
15. RISK MANAGEMENT
General
The main risks faced by the trading entity are interest rate risk, credit risks, liquidity risks and currency
risk. 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 signifi cant interest rate risk as there is no internal funding other than
cash and fi nance leases. The following table set out the carrying amount, by maturity, of the entity’s
fi nancial instruments exposed to interest rate risk:
2013 Within 1 year 1 - 5 years Total
R R R
Cash and cash equivalents 1 050 793 - 1 050 793
Finance lease obligations 439 846 728 291 1 168 137
Trade receivables 305 118 256 - 305 118 256
Trade payables 280 777 721 - 280 777 721
2012 Within 1 year 1 - 5 years Total
R R R
Cash and cash equivalents 7 890 429 - 7 890 429
Finance lease obligations 661 093 744 461 1 405 554
Trade receivables 944 218 177 - 944 218 177
Trade payables 903 188 014 - 903 188 014
The entity’s fi nancial instruments are linked to the South African prime rate.
375
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
15. RISK MANAGEMENT (Continued)
Increase in interest rate
Effects on profi t before
taxation
2013
Cash and cash equivalents 1% 10 508
Finance lease obligations 1% 11 681
Trade receivables 1% 3 027 823
Trade payables 1% 2 750 900
2012
Cash and cash equivalents 1% 78 904
Finance lease obligations 1% 14 056
Trade receivables 1% 9 433 466
Trade payables 1% 9 006 577
Credit riskFinancial assets, which potentially subject the Depot to the risk of non-performance by counter parties, consist mainly of cash and accounts receivable, consisting trade receivables and staff debtors. Trade accounts receivable consist of a small consumer base. The Depot limits its treasury counter-party exposure by only dealing with well-established fi nancial institutions approved by National Treasury. Trade debtors – The Gauteng Department of Health is effectively the only client of the Depot, although deliveries occur to various health institutions.
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 affected to suppliers for direct deliveries. This claim is normally paid within a week by Central Offi ce 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.
Staff debtors – Section 17, 30 and 38 of the Public Service Act indicate that any overpayment or wrongly granted remuneration to staff 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 Offi ce) where the staff debt is recovered before payment to the employee or employee benefi ciaries occur. Where the debt recovered is inadequate
the Gauteng Shared Service Center’s debt recovery section recovers outstanding monies.
376
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
15. RISK MANAGEMENT (Continued)
Financial assets and liabilities exposed to credit risk at the reporting date were as follows:
2 013 2 012
R R
Trade and other receivables ( less than 3 months) 305 118 256 944 218 177
Cash and cash equivalents (less than 3 months) 1 050 793 7 890 429
Finance lease obligation - long term (2 to 5 years) 728 291 744 461
Finance lease obligation - short term ( less than 1 year) 439 846 661 093
Trade and other payables ( Less than 3 months) 280 777 721 903 188 014
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. On-going
cyclic stock counts are conducted 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 fluctuations.
Suppliers therefore request, through an application to either National Treasury (State Tender Board)
or the GDF/GSSC, for a price adjustment based on the fluctuation of foreign exchange rates.
Fair values
At 31 March 2013, 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:-
377
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
15. RISK MANAGEMENT (Continued)Carrying Amount Fair Value
2013 2012 2013 2012
R R R R
Financial assets:
Cash and cash equivalents 1 050 793 7 890 429 1 050 793 7 890 429
Trade and other receivables 305 118 256 947 196 080 305 118 256 944 218 177
Financial liabilities:
Trade and other payables 280 777 721 902 340 608 280 777 721 903 188 014
Finance lease obligations 1 168 137 1 405 554 1 168 137 1 405 554
Capital Management
The primary objective of the entity’s capital management is to ensure that it maintains a strong
credit rating and healthy ratio’s in order to support its business and maximise value.
2013 2012
R R
Trade and other payables 280 777 721 903 188 014
Finance obligations 1 168 137 1 405 554
Less: cash and cash equivalents (1 050 793) (7 890 429)
Net debt 280 895 065 896 703 139
Equity/capital 193 828 513 158 623 302
Capital and net debt 87 066 552 738 079 837
Gearing ratio 31.00% 82.31%
16 CONTINGENT LIABILITIES
The total housing guarantees outstanding as at 31 March 2013 amounted to R Nil (2012: R Nil).
There were no other contingent liabilities.
378
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
17. FRUITLESS AND WASTEFUL EXPENDITURE2013 2012
R R
Opening Balance - -
Prior year expenditure identifi ed in current year 18 377 661 -
Current year wasteful expenditure 2 675 911 -
Closing Balance 21 053 572 -
18. IRREGULAR EXPENDITURE2013 2012
R R
Opening Balance 129 960 -
Irregular from prior year identifi ed in current year 367 811 127 -
Current year Irregular 758 596 866 129 960
Closing Balance 1 126 537 953 129 960
The above irregular expenditure relates to non-compliance with supply chain management
policies for a number of national, provincial and Departmental Bid Adjudication Committee (BAC)
contracts.
19. GOING CONCERN
The annual fi nancial statements have been prepared on the basis of accounting policies applicable
to a going concern. This basis presumes that funds will be available to fi nance future operations and
that the realisation of assets and settlement of liabilities, contingent obligations and commitments
will occur in the ordinary course of business.
20. EVENTS AFTER THE BALANCE SHEET DATE
There were no signifi cant events between the fi nancial year end and the date of this report that
warranted adjustment to or disclosure in the annual fi nancial statements.
379
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
21. 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 effect 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 loans, profi t sharing or similar schemes are available to key personnel and all personnel
of the Depot are considered as offi ce holders as defi ned in the Public Service Act.
2013
Salary Bonuses and performance
payments
Expense allowance
Pension contributions
Total
R R R R R
Director Administration: Mr. J M Smidt
431 589 35 981 163 272 32 376 663 218
Director: Pharmaceutical Services: Mr. M S Choma
431 589 35 981 163 272 32 376 663 218
863 178 71 962 326 544 64 752 1 326 436
2012
Salary Bonuses and performance
payments
Expense allowance
Pension contributions
Total
R R R R R
Chief Executive Offi cer:
Dr. D C Mondzanga
251 019 20 763 234 735 37 653 544 170
(50:50 split)
Director Administration:
Mr. J M Smidt
380 923 31 743 187 071 61 909 661 646
Director: Pharmaceutical
Services: Mr. M S. Choma
412 662 34 260 187 071 61 909 695 902
1 044 604 86 766 608 877 161 471 1 901 718
380
GAUTENG MEDICAL SUPPLIES DEPOTNOTES TO THE ANNUAL FINANCIAL STATEMENTS for the year ended 31 March 2013.
Department of Health Vote 4
Gauteng Provincial Government | Health | Annual Report 2012/2013
22. OPERATING LEASE/ CONTRACT ARRANGEMENTS
At the balance sheet date the Depot had outstanding commitments under non-cancellable operating
leases and/or contracts, which fall due as follows:
2013 2012
Operating leases - maintenance contracts R R
Up to 1 year 76 144 174 895
1 to 5 years 117 831 58 736
193 975 233 631
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. The lease agreements do not impose any restrictions. The
lease agreements’ escalation rate is 0%.
381
Gauteng Provincial Government | Health | Annual Report 2012/2013
23. RELATED PARTY TRANSACTIONS
Name of Related Party Relationship
Gauteng Department of Health Controlling entity
Gauteng Department of Roads & Transport Fellow Department
The Medical Supplies Depot is a trading entity under the control of the Gauteng Department
ofHealth. All transactions with the Department of Health are considered to be related party
transactions and are at arm’s length.
Related party balances at year end
2013 2012
R R
Gauteng Department of Health – Receivables 284 854 703 946 119 002
Sales to related parties
Gauteng Department of Health 2 832 878 596 2 404 021 925
The above amounts exclude the discounting effect
Other related party transactions
The building currently occupied by the Depot is owned by the Department of Infrastructure
Development (DID). Market related rentals for the buildings occupied amounts to R9 300 000 per
year.
24. COST OF SALESDuring the fi nancial year the following corrections were made to cost of sales. Due to the corrections
made, the gross profi t margin of the entity is not 5 % as the adjustments are not related to normal
terms of trade.
2013 2012
R R
Actual cost of sales prior to adjustments 2 803 521 784 2 384 892 608
Price adjustments - 2 944 604
Total 2 803 521 784 2 381 948 004
382
OTHER INFORMATION 383
Gauteng Provincial Government | Health | Annual Report 2012/2013
ANNEXURE: LEGISLATION
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.
Foodstuffs, Cosmetics and Disinfectants Act, 54 of 1972
Provides for the regulation of foodstuffs, cosmetics and disinfectants, in relation to 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 in
the mining industry 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
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.
384
Gauteng Provincial Government | Health | Annual Report 2012/2013
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, certifi cation 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 offi cials.
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 amplifi cation of the constitutional principle of accountable governance, and incidental
matters
385
Gauteng Provincial Government | Health | Annual Report 2012/2013
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 fi nancial 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.
Sterilisation 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 affi rmative action.
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.
386
Gauteng Provincial Government | Health | Annual Report 2012/2013
Tobacco Products Control Amendment Act, 12 of 1999Provides for the control of tobacco products, prohibi on of smoking in public places and regula on of adver sements of tobacco products as well as sponsoring of events by the tobacco industry.
Promotion of Access to Information Act, 2 of 2000
Amplifi es the constitutional provision pertaining to accessing information under the control of various
bodies.
Promotion of Administrative Justice Act, 3 of 2000
Amplifi es 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 amplifi cation of the constitutional principles of equality and elimination of unfair
discrimination.
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 fi ght 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.
387
Gauteng Provincial Government | Health | Annual Report 2012/2013
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 formalization of relations between (and within) the three spheres of government through
facilitating coordination in the implementation of policy and the establishment of intergovernmental
structures.
Specifi c 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 fi ve-year strategic programme of action.
• Gauteng fi ve-year strategic plan for health.
• The Provincial Growth and Development Strategy.
• The Gauteng Global City Region Strategy.
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GOALS AND STRATEGIC OBJECTIVES 2009-14
Goals
Strategic goal 1Improved health and wellbeing with an emphasis on vulnerable groups
Goal statement
Health (physical and mental) and wellbeing (psychosocial and
empowerment of vulnerable groups) improved from average to good
by 2014 (See defi nition of ‘average’ and ‘good’ below.)
Rationale
This is the core business of the Department.
The Department’s mandate is to achieve the Millennium
Development Goals, implement the GPG priority 3:‘Better health
care’, 7: Building cohesive, sustainable communities, and the
NDOH’s 10-point plan (priority 8: mass mobilisation for health
outcomes).
Baseline
Average is:
MMR: 167,6 per 100 000
CMR: 45 per 1000
IMR: 36.3 per 1000
Malnutrition rate: 0,27%
Hypertension rate: 17,9 % in female and 12,5% in males
Rate of type 2 diabetes: 2,7%
Percentage of PHC facilities providing psychiatric care: 40%
Number of assistive devices received by PWD: 31 092
Expected outcomes
Good is achievement of at least 6 of the 8 indicators below:
MMR: 100 per 100 000
CMR: 30 per 1000
IMR: 25 per 1000
Malnutrition rate: 0,24%
Hypertension rate: 15% females and 10% males
Rate of type 2 diabetes:2,2%
Percentage of PHC facilities providing psychiatric care: 60%
Number of assistive devices received by PWD: 34 000
Strategic goal 2Reduce the rate of new HIV infections by 50% in youth, adults and babies in GautengReduce deaths from TB and AIDS by 20%
Goal statement 2.1
Reduce new HIV infections by 50% through mass education to
increase safe sex behaviours, and prevention of mother to child
transmission of HIV (PMTCT).
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Strategic goal 2Reduce the rate of new HIV infections by 50% in youth, adults and babies in GautengReduce deaths from TB and AIDS by 20%
Goal statement 2.2Reduce deaths from TB and AIDS through increased results of
treatment (TB and ARV).
Rationale
National Strategic Plan on HIV and AIDS 2007 - 2011
Achievement of the MDGs
ANC Election Manifesto 2009
GDHSD Re-Prioritisation Document
National DOH 10-Point Plan
Baseline
1 36% HIV incidence in 2010
70% of people who require ART are on treatment
TB death rate: 9%
Expected outcomes
0,47% HIV incidence in 2016
80% of people who require ART are on treatment
TB death rate: 6%
Strategic goal 3 Increased effi ciency of service implementation
Goal statement
Increased effi ciency of implementation of service delivery at
community level, district level, institutions and support services,
from average to good by 2014.
(‘Average’ and ‘good’ are defi ned in the indicator protocol reference
sheet.)
Rationale
NDOH 10 Point Plan: Priority 3: Improving quality; 4: Overhaul the
health system, and 6: Revitalisation of infrastructure
GPG priority 3: Better health care for all and 7: Strengthening the
developmental state and good governance
Baseline
Average
3.1 Client satisfaction rate of 67%
3.2 Adequate effi ciency of PHC facilities
3.3 Adequate effi ciency of hospitals
3.4 57% of P1 calls responded to within 15 minutes
Expected outcomes
Good: at least 3 of the 4
3.1 Client satisfaction rate of 70%
3.2 Good effi ciency of PHC facilities
3.3 Good effi ciency of hospitals
3.4 70% of P1 calls responded to within 15 minutes
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Strategic goal 4Human capital management and development for better health outcomes
Goal statement
Human capital management and development improved from
adequate to good by 2014
(‘Adequate’ and ‘good’ are defi ned in the indicator protocol reference
sheet.)
Rationale
NDOH 10 Point Plan Priority 4: Overhaul the health care system and
improve its management, and 5: Improvement of Human Resources.
GPG priority 3: Better health care for all and 7: Strengthening the
developmental state and good governance.
Baseline
Adequate is:
4.1 Partial compliance to national norms (health professionals per
100,000 people)
4.2 60% employee satisfaction rate
4.3 Adequate employee equity
4.4 50% labour cases resolved
Expected outcomes
Good is achievement of at least 3 of the following 4 indicators:
4.1 Full compliance to national norms (health professionals per
100,000 people)
4.2 75% employee satisfaction rate
4.3 Good employee equity
4.4 70% labour cases resolved
Strategic goal 5 Organisational excellence
Goal statementOrganisational excellence improved from inadequate to good by
2014 (‘Inadequate’ and ‘good’ defi ned below.)
Rationale
NDOH 10 Point Plan Priority 1: Provision of Strategic leadership
and creation of Social compact for better health outcomes, and 10:
Research and Development.
GPG Priority 3: Better health care for all and 7: Strengthening the
developmental state and good governance.
Social compact.
Baseline
Inadequate means:
5.1 Stakeholder satisfaction rate of 60%
5.2 Disclaimer
5.3 Over expenditure of 5%
5.4 Adequate effi cacy of supply chain management system
5.5 Nascent M&E system
5.6 Average compliance rate to legislative framework
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Strategic goal 5 Organisational excellence
Expected outcomes
Good means achieving at least 4 of the following 6 indicators:
5.1 Stakeholder satisfaction rate of 75%
5.2 Unqualifi ed audit
5.3 Over- / under-expenditure <2%
5.4 Good effi cacy of supply chain management system
5.5 Mature M&E system
5.6 Good compliance rate to legislative framework
Strategic objectives
Please note: Some of these strategic objectives will need to be reformulated/adjusted if budget is not
available to conduct baseline and follow up surveys.
STRATEGIC GOAL 1IMPROVED HEALTH AND WELLBEING WITH AN EMPHASIS ON VULNERABLE GROUPS
Strategic Objective 1.1 Reduce preventable causes of maternal deaths
Objective statement
Maternal mortality reduced from 167 to 100 by 2014
Note: This is classifi ed as an impact measure and as such should
be a ‘goal’ but is included here as a strategic objective (usually
corresponding to outcomes)
RationaleMDGs
10 Point Plan
Baseline MMR: 167
Expected outcome MMR: 100
Strategic Objective 1.2 Reduce infant mortality
Objective statement
Infant mortality reduced from 34 per 1000 to 25 per 1000 by 2014
Note: This is classifi ed as an impact measure and as such should
be a ‘goal’ but is included here as a strategic objective (usually
corresponding to outcomes)
Rationale
MDGs
10 Point Plan
Improve the health and wellbeing of children under six years and
those at risk due to poverty
Baseline IMR: 34 per 1000
Expected outcome IMR: 25 per 1000
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Strategic Objective 1.3 Reduce child mortality
Objective statement
Child mortality reduced from 43 per 1000 to 30 per 1000 by 2014
Note: This is classifi ed as an impact measure and as such should
be a ‘goal’ but is included here as a strategic objective (usually
corresponding to outcomes)
Rationale
MDGs
10 Point Plan
Improve the health and wellbeing of children under six years and
those at risk due to poverty
Baseline CMR: 43 per 1000
Expected outcome CMR: 30 per 1000
Strategic Objective 1.4 Reduce malnutrition in children
Objective statementIncidence rate of severe malnutrition of children under 5 years
reduced from 0.27% to 0.24% by 2014
Rationale
MDGs
10 Point Plan
Improve the nutritional status of vulnerable groups, with special
emphasis on people with chronic and debilitating conditions
Baseline Rate of severe malnutrition: 0.27%
Expected outcome Rate of severe malnutrition: 0.24%
Strategic Objective 1.5 Reduce rate of hypertension
Objective statementIncidence of hypertension reduced from 17.9% (females) and 12.5%
(males) to 15% (females) and 10% (males) by 2014
Rationale10 Point Plan
Healthy Lifestyles
Baseline17.9% (f)
12.5% (m)
Expected outcome15% (f)
10% (m)
Strategic Objective 1.6 Reduce rate of type 2 diabetes
Objective statement Incidence of diabetes reduced from 2.7% (2003) to 2.2% by 2014
Rationale10 Point Plan
Healthy Lifestyles
Baseline 2.7%
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Strategic Objective 1.6 Reduce rate of type 2 diabetes
Expected outcome 2.2%
Strategic Objective 1.7 Reduce referrals for specialised psychiatric care
Objective statementNumber of patients admitted into specialised psychiatric care
reduced by 2014
Rationale
10 Point Plan
Reduction in the number of referrals for specialised psychiatric
care suggests fewer relapses, better management of psychiatric
patients, improved outpatient and community care, improved
capacity.
Strategic Objective 1.8 Increased mobility amongst people with disabilities
Objective statementIncrease the number of people with disabilities that have received
assistive devises by 2014 from 31092 to 34000.
Rationale Provide rehabilitation and support to people with disabilities
Baseline 31092
Expected outcome 34000
STRATEGIC GOAL 2REDUCE THE RATE OF NEW HIV INFECTIONS BY 50% IN YOUTH, ADULTS AND BABIES IN GAUTENGREDUCE DEATHS FROM TB AND AIDS BY 20%
Strategic Objective 2.1Reduced new infections in youth and adults through increased
safe sex behaviours
Objective statementIncreased safe sex behaviours from low to high among youth and
adults by 20151
Rationale
MDGs
UNGASS (United Nations General Assembly on HIV and AIDS)
National Strategic Plan 2007 - 2011
GDHSD Re-Prioritisation Document
National DOH 10-Point Plan
Baseline
Very high safe sex behaviours in youth in schools, 15 – 19 years
Low safe sex behaviours in youth out of school, 20 – 24 years
Safe sex behaviours in adults needs to be improved
Expected outcomeIncreased safe sex behaviours for (BSS standards) among youth
and adults in Gauteng
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Strategic Objective 2.2 Reduce new HIV infections in babies
Objective statementReduced % of babies born to HIV positive mothers who test positive
to HIV, from 10% to 4% by 2014
Rationale
MDG target to reduce infant mortality by 50% in 2015
National Strategic Plan
Saving Babies Report
Baseline 10% of babies born to HIV positive mothers are HIV positive
Expected outcome Reduced % of infants infected with HIV from 10% to <5%
Strategic Objective 2.3 Increased Male circumcision among Gauteng youth
Objective statementIncreased % of men aged 15 – 45 years who are circumcised from
35% to 50% by 2015 (tbc)
Rationale
National Strategic Plan for HIV and AIDS 2007 – 2011
SANAC/NDOH Male circumcision guidelines
UNAIDS recommendation
Baseline 35% of males in tertiary institution (2008)
Expected outcome
Reduction in female to male transmission of HIV
Effective combination prevention strategy
Increased safe circumcision in the traditional sector
Strategic Objective 2.4 Reduce deaths from TB through effective TB treatment
Objective statementReduce deaths from TB by increasing TB cure rates from 78% to
85% by 2015
Rationale
National Strategic Plan for TB
NSP 2007 – 2011
NDOH 10 Point Plan
Baseline 78% cure rate
Expected outcome Increase in TB cure rate to 85% by 2014
Strategic Objective 2.5Reduce death from AIDS through appropriate treatment, care and
support for 80% of people living with HIV (PLHIV)
Objective statement
Reduce AIDS morbidity and mortality as well as its socioeconomic
impacts by providing appropriate packages of treatment, care and
support to 80% of HIV positive people by 2011.
Rationale
NSP 2007 – 2011
ANC manifesto 2009
GDHSD Re-prioritisation
NDOH 10 Point Plan
Baseline 185,126 on ART (cumulative) 2008/09
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Strategic Objective 2.5Reduce death from AIDS through appropriate treatment, care and
support for 80% of people living with HIV (PLHIV)
Expected outcomePrimary health care for people living with HIV (PLHIV)
Viral suppression on ART
STRATEGIC GOAL 3 INCREASED EFFICIENCY OF SERVICE IMPLEMENTATION
Strategic Objective 3.1 Improved client satisfaction rate
Objective statement Improved client satisfaction rate from 67% to 70% by 2014
Rationale
10 Point Plan
GPG priority 3: Better health care for all
Batho Pele
Baseline
PHC: Not yet measured
District hospitals:
Regional hospitals:
Central hospitals:
Indicator Client satisfaction rate
Expected outcome
PHC:
District hospitals:
Regional hospitals:
Central hospitals:
Strategic Objective 3.2 Increased level of effi ciency in PHC facilities
Objective statementLevel of effi ciency in PHC facilities increased from adequate to good
by 2014 (see defi nition of ‘adequate’ and ‘good’ below)
Rationale
10 Point Plan
GPG priority 3: Better health care for all
Batho Pele
Baseline
‘Adequate’ was understood to be ‘reasonable’ – not good, but not
terrible.
Adequate in 2010 =
Total headcount: 19,6 million
Utilisation rate : 1,8 million
Utilisation rate - under 5: 4 million
Supervision rate: 80%
Provincial PHC expenditure per head count: R265.35
% complaints resolved within 25 days: 100%
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Strategic Objective 3.2 Increased level of effi ciency in PHC facilities
Expected outcome
‘Good’ = achieving at least 4 of the following 6:
Total headcount: 24 million
Utilisation rate: 2,7 million
Utilisation rate - under 5: 5 million
Supervision rate: 100%
Provincial PHC expenditure per head count: R425
% complaints resolved within 25 days: 100%
Strategic Objective 3.3 Increased level of effi ciency in hospitals
Objective statement
Level of effi ciency in hospitals (district, regional and central)
increased from adequate to good by 2014
(see defi nition of ‘adequate’ and ‘good’ below)
Rationale
10 Point Plan
GPG priority 3: Better health care for all
Batho Pele
Baseline
‘Adequate’ was understood to be ‘reasonable’ – not good, but not terrible. Adequate in 2010 =District hospitals:• Average length of stay: 3,5 days• Caesarean section rate: 16% • Bed utilisation rate: 75% • Expenditure per patient day equivalent: R1 600• Patient Day Equivalents: 825 000• OPD total headcount: 870 950
Regional hospitals:• Average length of stay: 4,3 days• Caesarean section rate: 20%• Bed utilisation rate: 81%• Expenditure per patient day equivalent: R1309• Patient Day Equivalents: 2646102• OPD total headcount: 2435938
Central hospitals:• Average length of stay: 5,7 days• Caesarean section rate: 37,5%• Bed utilisation rate: 77%• Expenditure per patient day equivalent: R2304• Patient Day Equivalents: 2421612• OPD total headcount: 2139909
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Strategic Objective 3.3 Increased level of effi ciency in hospitals
Expected outcome
‘Good’ = achieving at least 4 of the following 6 for each category of
hospital:
District hospitals:
• Average length of stay: 3 days
• Caesarean section rate: 17%
• Bed utilisation rate: 67%
• Expenditure per patient day equivalent:R1 044
• Patient Day Equivalents:789140
• OPD total headcount:875887
Regional hospitals:
• Average length of stay:4,8 days
• Caesarean section rate: 18%
• Bed utilisation rate:80%
• Expenditure per patient day equivalent: R1857
• Patient Day Equivalents: 3 million
• OPD total headcount: 2,5million
Central hospitals:
• Average length of stay: 5.3 days
• Caesarean section rate: 46,2%
• Bed utilisation rate: 80,5%
• Expenditure per patient day equivalent: R2496
• Patient Day Equivalents: 2624902
• OPD total headcount: 2758103
Strategic Objective 3.4 Increase the number of P1 calls responded to within 15 minutes
Objective statementIncrease the number of P1 calls responded to within 15 minutes
from 57% to 70% by 2014
Rationale
10 Point Plan
GPG priority 3: Better health care for all
Batho Pele
Baseline 57%
Expected outcome 70%
Note: Infrastructure (new construc on, maintenance, revite), equipment, security contribute towards effi ciency of PHC and hospitals; as do most support services – blood, NHLS, DHIS.
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STRATEGIC GOAL 4HUMAN CAPITAL MANAGEMENT AND DEVELOPMENT FOR BETTER HEALTH OUTCOMES
Strategic Objective 4.1 Improve achievement of national norms
Objective statement
Improve achievement of national norms (health professionals per
100,000 population) by 2014 from partial to full compliance
(see defi nition of ‘partial’ and ‘full’ below)
Rationale10 Point Plan
GPG priority 3: Better health care for all
Baseline
Partial compliance to norms in 2010 =
Medical offi cers: 22,6 per 100,000
Medical specialists: 9,3 per 100,000
Professional nurses: 87 per 100,000
Pharmacists: 3 per 100,000
Expected outcome
Full compliance to norms in 2014 =
Medical offi cers: 25 per 100,000
Medical specialists: 20 per 100,000
Professional nurses: 111 per 100,000
Pharmacists: 7,50 per 100,000
Strategic Objective 4.2 Employee satisfaction
Objective statementIncrease employee satisfaction from an 60% (estimate) to 75% by
2014 (SURVEY REQUIRED).
Rationale
10 Point Plan
GPG priority 3: Better health care for all
Batho Pele
Baseline 60% (estimate)
Expected outcome 75%
Strategic Objective 4.3 Employment equity and diversity management
Objective statement
Level of implementation of employment equity improved from
adequate to good by 2014
(see defi nition of ‘adequate’ and ‘good’ below)
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Strategic Objective 4.3 Employment equity and diversity management
Rationale
10 Point Plan
GPG priority 3: Better health care for all
GPG priority 7: Strengthening the developmental state and good
governance
Baseline
‘Adequate’ in 2010 =
• PWD: 0,68%
• Women in SMS: 38%
Indicator Success rate of the employment equity act
Expected outcome
‘Good’ =
PWD: 2%
• Women in SMS: 50D: xte’ ate)ted 60% to 75%
• ceollowing 8: Social Development programmes.%
Strategic Objective 4.4 Labour peace (Industrial relations )
Objective statementIncreased grievance and disputes amicably resolved within specifi ed
timeframes from 50% to 70% by 2014
Rationale
10 Point Plan
GPG priority 3: Better health care for all
GPG priority 7: Strengthening the developmental state and good
governance
BaselineX number of cases out of y number of cases solved within x months
(50%)
Expected outcomeX number of cases out of y number of cases solved within x months
(70%)
STRATEGIC GOAL 5 ORGANISATIONAL EXCELLENCE
Strategic Objective 5.1Improved stakeholder satisfaction rate through enhanced
corporate governance
Objective statementStakeholder satisfaction improved from 60% (estimate) to 75% by
2014 (SURVEY REQUIRED).
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Baseline60% (estimate) – opinion of the department by hospital boards,
clinic committees, and other oversight bodies
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Strategic Objective 5.1Improved stakeholder satisfaction rate through enhanced
corporate governance
Expected outcome75% (survey required of hospital boards, clinic committees, other
oversight bodies)
Strategic Objective 5.2 Unqualifi ed audit opinion
Objective statementNature of audit opinion improved from disclaimer to unqualifi ed by
2014
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Baseline Disclaimer
Expected outcome Unqualifi ed audit
Strategic Objective 5.3 Reduce over- and/or under-expenditure against budget
Objective statement Reduce over-expenditure from 5% to <2% by 2014
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Baseline Over-expenditure of 5%
Expected outcome Over or under expenditure within 2% as permitted by the PFMA
Strategic Objective 5.4 Increased level of effi cacy of supply chain management system
Objective statement
Increased level of effi cacy of supply chain management system
from adequate to good by 2014
(see defi nition of ‘adequate’ and ‘good’ below)
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Ensure implementation and management of an effi cient and cost
effective supply chain management system
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Strategic Objective 5.4 Increased level of effi cacy of supply chain management system
Baseline
‘Adequate’ in 2010 was understood to be ‘reasonable’, i.e.
• Departmental Acquisition Committee exists but no TORs
• No asset management plan
• No demand plans
• BBBEE spend as a % of total procurement budget: 56%
• Percentage of procurement awarded to women owned enter-
prises: 15%
Expected outcome
Good (at least 4 of the 5)
• Departmental Acquisition Committee exists with TORs
• Approved asset management plan
• Each hospital has a demand plan
• BBBEE spend as a % of total procurement budget: 70%
• Percentage of procurement awarded to women owned enter-
prises: 15%
Strategic Objective 5.5 Increased level of implementation of the M&E system
Objective statement
Increased level of implementation of the M&E system from nascent
to mature by 2014
(see defi nition of ‘nascent’ and ‘mature’ below)
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Baseline
Nascent
• No approved M&E framework
• AG AOPO opinion: Disclaimer
• No Provincial Health Research Committee
• No approved list of provincial research priorities
Expected outcome
Mature (at least 3 of the 4)
• Approved M&E framework
• AG AOPO opinion: unqualifi ed
• Provincial Health Research Committee established, 2 meet-
ings per year
• Approved list of provincial research priorities
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Strategic Objective 5.5 Compliance rate to the legislative framework
Objective statement
Improve compliance rate to the legislative framework from average
to good by 2014.
(see defi nition of ‘average’ and ‘good’ below)
Rationale
Batho Pele
10 Point Plan
GPG priority 7: Strengthening the developmental state and good
governance
Baseline
Average
• IYMs, Quarterly reports, Annual Report, APP submitted on
time
• 0 quarterly reviews held
• 0 SMS declaration of interests
Expected outcome
Good (at least 3 of the 4)
• IYM, Quarterly reports, Annual Report, APP submitted on
time
• 4 quarterly reviews held
• 100% SMS declaration of interests
• 100% Level 1-12 declaration of interests
1 Defi nitions of low and high safe sex behaviours, youth and adults will be provided
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Notes
404