DEPARTMENT OF HEALTH AND SOCIAL DEVELOPMENT

VOTE 07: HEALTH

Third QUARTER

Provincial Budget Review

PRESENTED BY

HONOURABLE Mme M.R.K SEGABUTLAMEMBER OF EXECUTIVE COUNCIL

HOSPITAL REVITALIZATION GRANT (HRG) 3rd QUARTER EXPENDITURE TRENDS

2007/08-2009/102007/08 2008/09 2009/10

HRP COMPONENT Budget

R’000

Actual

R’000

% Budget

R’000

Actual

R’000

% Budget

R’000

Actual

R’000

%

Infrastructure Development (ID)

129,207 96,049 74 225,440 108,289 48 186,442 113,966 61

Health Technology (HT) 5,000 5,531 111 6,082 4,347 72 7,189 407,152 7

Organizational Development (OD)

3,150 2,944 93 2,700 2,288 85 2,500 378,622 15

Quality Improvement (QI)

5,750 5,651 98 9,318 7,481 80 5,000 616,780 12

Project Office 5,094 4,594 90 5,000 3,075 62 5,800 2,528 44

Roll Over 3,489 5,427

TOTAL 148,201 114,769 77 252,029 125,480 51 212,360 117,897 55,5

HOSPITAL REVITALIZATION GRANT (HRG) EXPENDITURE AS AT 31 DECEMBER

2009

HRP COMPONENT BUDGET ACTUAL BALANCE %EXPEND SPENT

R'000 R'000 R'000

Infrastructure Development (ID) 186,442 113,966 72,476 61.1%

Health Technology (HT) 7,189 407 6,782 5.7%

Organizational Development (OD) 2,500 379 2,121 15.2%

Quality Improvement (QI) 5,000 617 4,383 12.3%

Project Office 5,800 2,528 3,272 43.6%

Roll Over 5,427 5,427TOTAL 212,358 117,897 94,461 55.5%

EXPENDITURE NORM 75.0%

2009/10 FINANCIAL YEAR

HOSPITAL REVITALIZATION GRANT (HRG)

HRP COMPONENT & HOSITAL SITES

BUDGET (R’000) QUARTER 3 EXPENDITURE (R’000)

PERCENTAGE (%)

INFRASTRUCTURE

Letaba 47,806 31,248 65

Thabamoopo 38,749 28,938 75

Maphutha Malatji

43,494 34,016 78

Thabazimbi 33,893 12,775 38

Dilokong 2,000 1,111 56

Nkhensani 3,000 5,158 172

Jane Furse 18,000 690 0.04

Musina 3,000 29 0.009

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

LETABA HOSPITAL Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Contract B1 Demolish existing wards and Walkways, underground services, podiums…

800 658 82.2 Completed, final account paid. A saving of 142 recorded

Contract B2 New Health Support, Dental Unit, Sub Acute… 1,121 653 58 Completed and occupied. Final account could be released due outstanding snag items.

Contract B3 Administration, Visitors Waiting, Gate House… 10,991 14,740 134 Delayed due to slow performance by contractor. Project within the fast tracked HRP improvement plan

Contract A1Recreation and Residential Facilities 3,292 1,569 48 Completed and occupied. Final account not released due outstanding snag items

Contract A2 Oncology Ward, Demolish existing nurse residence, new Orthotic & Prosthetic centre…

8,803 2,258 26 Delayed due to slow performance and contract terminated in February 2009. New contractor appointed in September 2009 under the fast tracked HRP improvement plan

Contract A3 (a) New Maternity Ward and Walk Ways… 13,391 8,324 62 Contractor appointed in June 2009. Project progressing well and on track

Contract A3 (b) New Boiler and Upgrade 3,200 2,063 65 Completed and commissioned. Final payment and training of boiler operators are still outstanding.

Professional Fees and Disbursements

900 701 79 Proportional to work done so far. Saving of 142 in Contract B1 will be used to offset the anticipated over expenditure

TOTAL 47,806 30,966 65%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

THABAMOOPO HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

% Spent Comments

Contract A1 Podiums, Sewer Reticulation, Storm Water, Internal Roads

300 0 0.0 Final account could not be paid due to unattended storm damage repair

Contract A2 Pharmacy, Female Acute, Sub-Acute, Chronic Ward, Security Ward…

7,000 5,711 82 Project delayed for 16 months due to slow performance and contract terminated in March 2009. New contractor appointed in September under the fast tracked HRP improvement plan

Contract A3 Sewer, Roads, Storm water, building

podiums, demolitions… 3,000 2,578 69 Delayed due to dependency on A2. Project

attended to under HRP improvement plan

Contract A4 Kitchen, Dining Hall, Bulk Store 10,595 4,888 46 Delayed due to dependency on A2. Project attended to under HRP improvement plan

Contract A4 New Male Acute, Sub Acute, Chronic Wards…

10,300 6,639 58 Delayed due to dependency on A2. Project attended to under HRP improvement plan

Contract B1 Water supply, reticulation, reservoir… 1,900 0 0 Delayed due contractor and consultant conflict. Matter resolved and project back on track

Contract B2 Administration, Admission, Mortuary… 2,000 2,388 118 Completed and final account due in December 2009

Contract B3 Workshop 3,142 3,142 100 Completed, occupied and final account paid

Professional Fees and Disbursements

4,100 3,592 87 Proportional to progress on site

TOTAL 38,749 28,938 75%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

MAPHUTHA MALATJIE HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Contract A1 Administration, Gateway Clinic, Gate House…

5,000 3,441 67 Project delayed for 8 months due to slow performance. On track and completion rescheduled for end of September 2009.

Contract B1 Paedriatic, Female & Male Wards upgrade, Theatre…

12,000 12,324 102 On track and progressing well

Contract B2 Transport Offices, Linen Store, Kitchen Upgrade…

12,000 8,308 69 Delayed for 3 months due revision of designs whilst on site. Project attended to under HRP improvement plan

Contract D New Access Road 4,500 3,255 72 Physical progress far exceeds financial progress. On track and progressing well

Contract C New OPD, Casualty 6,936 5,212 0 Delayed due to dependency on A1. Award and site hand over due in October 2009

Professional Fees and Disbursements: Team P

3,058 2,486 81 Proportional to progress on site

TOTAL 43,494 34,016 78%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

THABAZIMBI HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Contract: Bulk Earthworks and Civil Works

14,000 276 19 Delayed for 7 months due to finalization of Environmental Impact Assessment (EIA).

Contract: EMS, Gateway Clinic and Gate House

15,483 11,999 77 Contractor appointed in June 2009 hence no expenditure recorded. Project progressing well and on track

Design: Various Buildings Main Hospital

4,410 500 7 On track

TOTAL 33,893 12,775 38%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

DILOKONG HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Transport Control 2,000 1,112 56 On track

Wards

Final accounts on completed projects

TOTAL 2,000 1,112 56%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

NKHENSANIHOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Gateway 3,000 5,158 172 Project delayed for 10 months due to slow performance and contract terminated in January 2009. New contractor appointed in September under the fast tracked HRP improvement plan

Step Down Project delayed for 18 months. Back on track under the HRP improvement plan and due for completion by end of October 2009

Final accounts on completed projects

Final accounts long overdue. HRP improvement to address this matter

TOTAL 3,000 5,158 172%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

MUSINA

HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

% Spent

Comments

PRE-PLANNING & DESIGN 3,000 29 .009 Delayed due to site relocation. Back on track

TOTAL 3,000 29 0.009%

HRG: DETAILED INFRASTRUCTURE BY INSTITUTION: quarter 3

JANE FURSE HOSPITAL

Budget 2009/10

(R’000)

Expenditure (R’000)

%

Spent

Comments

Civil - Roads 18,000 690 0.04 Tender advertised.

Correct Theatre

Correct OPD & Casualty

Gateway Clinic

Linen Bank

TOTAL 18,000 690 0.04%

CHALLENGES

Slow construction progress on site Civil and building contracts delayed at Thabazimbi due to finalization of

Environmental Impact Assessment (EIA) Dependencies within sites have a ripple effect on all other projects due to

follow Musina site changes: from current hospital site, to 2nd site and now

ultimately to 3rd site Musina 3rd Site confirmed in August 2009 but official allocation not yet

attained Determination of specifications and scope of work for corrective work at

Jane Furse Hospital

VALUE OF RE-AWARDED PROJECTS (Those that were terminated)

Hospital Description Construction

Contract Value

Nkhensani Completion of Gate Way Clinic, Two Gate Houses, Library, ARV Clinic and Fencing

R 4,187,243.94

Letaba Construction of a New Gynecology Ward, Demolition of Existing Nurses Residence and Construction of Orthortotic and Prosthetic Centre

R 35,000,000.00

Thabamoopo Completion of Female Acute, Sub Acute and Chronic Ward

R 9,038,384.21

Thabamoopo Completion of Male Security Ward R 3,086,088.20

Thabamoopo Completion of Substance Abuse Ward R 7,939,960.00

Thabamoopo Completion of Hostels, Flats, Bachelor’s Flats, Halfway House, Pharmacy and Shelter (Kiosk)

R 1,147,032.00

Total Construction Contract Value R 60,398,708.35

Estimated Professional Fees and Disbursements R 4,000,000.00

TOTAL R 64,398,708.35

VALUE OF DELAYED PROJECTS (progress dependent on the terminated projects)

Hospital Description Construction

Contract Value

Thabamoopo Finalization of Earthworks for Phases 2 and 3 dependent on Completion of Hostels, Flats, Bachelor’s Flats, Halfway House, Pharmacy and Shelter (Kiosk)•Contractor for Earthworks could not proceed with work since May 2009

R 3,836,543.65

Letaba Part of Contract A2-Construction of a New Gynecology Ward, Demolition of Existing Nurses Residence and Construction of Orthortotic and Prosthetic Centre dependent on Completion of Recreation and Residential Facilities, that is Contract A1

R 3,300,000.00

Total Value of Delayed Projects R 7,136,543.35

Total Value of Re-Awarded Projects (those that have been terminated) R 64,398,708.35

GRAND TOTAL (projected to be spent Sept 09- March 10) R 71,535,252.00

MONITORING AND EVALUATION: HRP IMPROVEMENT PLAN

• Performance Monitoring and Evaluation:

Resident clerks of works appointed to assist in ensuring performance of contractors per site on a daily basis.

Measurement of construction works to be undertaken and paid for twice per month

Projects monitored closely by DPW and professional teams; and Health PMU and professional teams

IN CONCLUSION

• The HRG below targeted Expenditure noted in all components

• An HRP Improvement Plan supported a Provincial level (Premier’s Office, Provincial Treasury, the Department and Implementing Agents) implemented as of September 2009

• Dependencies and slow performance of contractors delayed expenditure plan

• Projected under spending R40,247due to the above stated reasons

Summary 4th Quarter -31 March 2010

EXPEND SPENTR'000 R'000 R'000

Roll over added to IDInfrastructure Development (ID) 191,060 161,661 29,399 84.6%

Health Technology (HT) 8,000 3,407 4,593 42.6%

Organizational Development (OD) 2,500 1,103 1,397 44.1%

Quality Improvement (QI) 5,000 2,685 2,315 53.7%

Project Office 5,800 3,230 2,570 55.7%

Roll Over 5,427TOTAL 212,360 172,086 40,274 81.0%

EXPENDITURE NORM 100.0%