comments from health on the mtbps
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Comments from Health on the MTBPS. General comments. Medium term expenditure framework Adjustment appropriation 2003/04 Direct benefit to public health Indirect benefit to public health Concerns to public health. Health Acknowledges the key initiatives i.e: - PowerPoint PPT PresentationTRANSCRIPT
Comments from Health on the MTBPS
General comments
• Medium term expenditure framework
• Adjustment appropriation 2003/04
• Direct benefit to public health
• Indirect benefit to public health
• Concerns to public health
Health Financing & Economics 3
General Comments (2)
• Health Acknowledges the key initiatives i.e:– The expanded public works programme– The social security programmes to support
the most vulnerable– Black Economic Empowerment – Strengthened partnerships and local
development initiatives.
Health Financing & Economics 4
Concerns of the National Department of Health
• Indirect concerns– The social sector consists of three main players i.e.
• Health• Social Development• Education
– A certain “competition” exist between these players.– In terms of the allocation to Social Development –
child support and disability grants and the allocations made available to Education, the previous balance between the Social Sector partners are disturbed.
Health Financing & Economics 5
Figure 1 Consolidated public health expenditure per uninsured person in 2002 prices (R)
800
850
900
950
1,000
1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06
Health Financing & Economics 6
Comparison between SectorsFigure 2 Sectoral breakdown of government expenditure (%)
0.00%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00% Debt Interest/Payments as% of govt spending
Health as % of GovtSpending
Education as % of GovtSpending
Social development as % ofGovt Spending
Defence as % of GovtSpending
Police as % of GovtSpending
Correctional Services as %of Govt Spending
Health Financing & Economics 7
% of GDPFigure 3 Consolidated public health expenditure as % GDP
2.70%
2.78%
2.85%
2.93%
3.00%
3.08%
3.15%
3.23%
3.30%
3.38%
3.45%
Health Financing & Economics 8
Sector ComparisonFigure 4 Consolidated health, education and social development
expenditure as % GDP
0.00%0.50%1.00%1.50%2.00%2.50%3.00%3.50%4.00%4.50%5.00%5.50%6.00%6.50%7.00%
1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06
Health as % of GDP
Education as % of GDP
Social Development as % of GDP
Health Financing & Economics 9
Increased service workload
• 700+ clinics built serving 7m people
• 60%+ clinics provide PHC package
• per capita PHC visits:- '92/93 1.8 per year (incl. OPD)- '01/02 2.3 per year (excl. OPD)
• annual admissions up 100,000 since '94inpatients more gravely ill
Health Financing & Economics 10
Figure: Ratios of health expenditure per uninsured person of provinces to lowest spending province (100)
-
50
100
150
200
250
300
350
400
450
1995/96 1996/97 1997/98 1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06
Eastern Cape
Free State
Gauteng
Kw aZulu Natal
Limpopo
Mpumalanga
North West
Northern Cape
Western Cape
Total
Health Financing & Economics 11
Figure: PHC expenditure by health district relative to a district deprivation score 2001/02
0.00
50.00
100.00
150.00
200.00
250.00
300.00
350.00
R pe
r cap
ita
-10
-8
-6
-4
-2
0
2
4
6
8
DIS
R pc
DIS
Linear (DIS)
Health Financing & Economics 12
Conclusion
• Whilst the budgetary increases seem rosy for the health sector
• Upon closer reflection and in the greater context of challenges that are being experienced by Health,– Insufficient resources being allocated