BUDGET SPEECH VOTE 7 FOR THE DEPARTMENT OF
HEALTH 2023/24.
SPEECH DELIVERED BY LIMPOPO HEALTH MEC, DR PHOPHI
RAMATHUBA AT THE LIMPOPO PROVINCIAL LEGISLATURE,
LEBOWAKGOMO, TUESDAY, 18 APRIL 2023.
Hon. Speaker and Deputy Speaker;
Hon. Premier Chupu Stanley Mathabatha;
Colleagues in the Executive Council;
Hon. Chief Whip and Chair of chairs;
The Chairperson of the Portfolio Committee on Health Hon. Simon Mathe;
Leader of the official opposition;
Hon. Members of the Provincial Legislature (MPLs);
Director General of the Province and all HODs;
Leaders of the religious community;
Invited guests, ladies and gentlemen.
Ndi Matsheloni; Avuxeni; Thobela; Goeie more; Silotjhile;
Good morning!
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 3
The curtain is surely closing on this 6th Administration.
Honourable Speaker, we come from a dark financial and administrative period,
wherein we could not even appoint critical personnel like nurses, doctors,
pharmacists etc. on a permanent basis. We could not procure
necessary life-saving devices, and our workers were denied
tools of trade. We want to thank Team Bophelong for their
resilience and endurance in ensuring that the Department is
kept afloat.
We have stabilized our financial outlook and set the
department on an upward trajectory. This budget will cement
the strides we have made over the years and further ignite hope for the future.
There is no doubt that this was the most challenging term for the healthcare
sector. This will go down in the annals of history as an administration that was
largely disrupted by the COVID-19 pandemic.
Our healthcare system was tested and stretched to the maximum. It was during
this period that the resilience of our public health system was demonstrated. It was
during this period that the patriotism and commitment of our public healthcare
workers was demonstrated.
The COVID-19 pandemic was a sad and devastating occurrence but also pushed
us into finding innovative and creative ways in the continuous rendering of
healthcare services. It thrust us, like all sectors into the 4th industrial revolution
where the use of technology was up-scaled. The Department has had to find new
ways of doing things. Staff training and development was increasingly delivered
online. Recruitment is also automated and continues to improve on the turnaround
time.
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
Honorable speaker;
As we continue on the previous commitment of
accelerating service delivery to the rural arears using
technology, the last outstanding CT Scan was installed and
commissioned at Sekhukhune district, ST Ritas Hospital
and handed over by both the Minister of Health Dr. Joe
Phaahla and the Premier, Chupu Stanley Mathabatha.
Honourable Speaker, breast cancer is currently number
two leading cause of death amongst cancers in women.
We have lost so many lives as a result of breast cancer due
to late diagnosis.
Honourable speaker, we are pleased to report to this legislature that technology
has once more made it possible for us to deliver on our
commitment of procuring mammograms and installing them in all
our five districts, with units in Tshilidzini, Letaba, Mokopane,
St Ritas and Mankweng hospitals.
While we do not have radiologists stationed in some of these
facilities, it is through technology that even those women in the
rural areas can access this life-saving service.
Honourable Speaker, we are currently operating with one Magnetic Resonance
Imaging (MRI) machine stationed at Pietersburg Tertiary and Academic Hospital.
This has posed a major challenge regarding turnaround time for patients requiring
this service. Teaching and training of both radiologists and radiographers has been
difficult hence in addition two more MRI will be procured this financial year, one for
Pietersburg hospital and another one for Mankweng hospital, bringing the total to
three (03).
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 5
One of the setbacks on service delivery by COVID-19, especially the lockdown
period was compromising other healthcare services which resulted in amongst
others surgical backlogs. This led us into finding new ways of addressing the
surgical backlogs. What started as a catch-up strategy following the COVID-19
lockdown period, is now a unique and highly successful Rural Health Matters
campaign which is a legacy.
Since its inception, the campaign has seen over 6000 patients benefitting from a
variety of surgical procedures ranging from orthopaedic, urogynecology,
paediatric surgery, ophthalmology, maxillofacial surgery, gynaecology, amongst
others.
This campaign has changed the face of healthcare in the far-flung, rural parts of
our Province.
The Rural Health Matters is made possible through the dedication of department’s own specialists and other health professionals, who embark on district
surgical outreach every 6 weeks. These professionals are joined by volunteer
specialists from other provinces and private
sector.
These are indeed our real “Thuma mina” brigades.
Allow us, Honourable Speaker, to single out
Professor Steve Matshidze from the University of
Free State, a son of the soil, who has consistently
over the years mobilised without failure a team of
orthopaedic surgeons to join him during this
outreach programme. He has since its inception performed at over 1600
orthopaedic
operations of which about 200 are hip and knee replacements. Some of these
operations can cost one patient up to R250 000.00 in private facilities hence we
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
must jealously guard against abuse of this project which might lead to collapse.
Honourable Members;
COVID-19 exposed our inefficiencies in the management of the healthcare
system. The World Health Organisation defines health as a state of complete
physical, mental and social well-being and not merely the absence of
disease and infirmity.
This means that we must start doing things differently by reverting to basics and
focusing on primary healthcare as our first step.
We have declared the year ahead as the year of Primary Healthcare. This
declaration is not a mere slogan or a rhetoric without significance. This
declaration is a living commitment to build on our existing capacity to prevent
disease, prolong life and promote a healthy lifestyle among the people of
Limpopo.
We have our fingers firmly on the pulse. We are able to feel the vibrations of life.
At the heart of our rejuvenated approach to primary healthcare is the provisioning
of a 24-hour service at most of our primary healthcare facilities.
We are remodelling our clinics and healthcare centres to be reliable, dependable
and attractive first points of entry for those in need of primary healthcare. We want
our people to believe and have confidence in their local clinics and healthcare
centres.
Our approach is to reposition our Primary Healthcare Centres (PHC) as trusted
points for routine care, screenings, preventative care, and professional medical
attention for acute illness and chronic disease management.
Through this approach, we aim to broaden access to quality primary healthcare,
reduce the cost of medical care – most importantly, we aim to alleviate the burden
on our hospitals.
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 7
Hospitals should only deal with serious emergencies and complicated
procedures. This will make the entire healthcare value chain to be effective and
responsive.
It is in this context that we are purposefully building capacity in our local clinics
and healthcare centres.
This capacity includes the improvement of infrastructure, recruitment of more
nurses, and adequate supply of medicines especially children vaccines.
Primary Health Care (PHC) is the first level of contact between the community
and the formal health system. It is the foundation upon which the entire health
system relies on for improved health outcomes.
In preparation for this deliberate effort to strengthen the base of the health
system, the Limpopo Department of Health has during the last half of the
2022/23 financial year embarked on several initiatives to ensure that service
delivery at Primary Health Care is optimized.
To this end, we have since appointed 20 additional suitably qualified and
competent PHC facility managers.
The Department has introduced a competency-based recruitment process to
identify suitable candidates with the capacity to take PHC to the new heights.
In this financial year, a further 52 posts of OPMs will be advertised to increase
capacity in the largest platform of the health system. We invite all young
professional nurses to take up the challenge- be on the lookout for an advert
soon.
Another progressive move was to convene a nine-day seminal
capacity-building training and workshop of all Operational Managers (OPMs)
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
including those in acting capacity from PHC facilities in all districts.
The training was designed to address service delivery improvement, minimize
adverse events that leads to medico-legal cases, and close monitoring of
medicine stock availability through the Stock Visibility System (SVS).
The workshop would not have been complete without empowering them on
governance and information management improvement in their respective
clinics in an effort to realize a clean audit outcome and ultimately improved
patient outcomes.
Tools of trade to facilitate communication and efficiency in management that
comes with access to telephonic, internet and virtual platforms were issued.
This will also aid referral of patients and soliciting of medical advice from higher
levels of care.
Honorable Speaker, the Honorable Premier was spot on during SOPA debate
when he said the department was at an advanced stage in activating a number
of earmarked clinics to operate 24 hours, a programme which was previously
disrupted by COVID-19.
2023/24 being the year of primary health care means we will be hard at work
insuring successful rollout of 24 hour services. This we will do in collaboration
with our traditional leaders, Unions, community members and other
stakeholders.
Honorable speaker
Currently, only 50 clinics are operating fixed 24hours services, followed by a
further 57 providing 24hour coverage on an on-call system.
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 9
We are therefore committing to this august house to work towards doubling the
number of clinics rendering 24hour services. At the end of this financial year, we
must be able to register around 229 clinics operating either on-call or straight shift
24hour coverage.
In order to achieve this objective, we obviously require qualified, dedicated and
passionate adequate staff. To date, the recent recruitment drive brought in an
additional 278 Professional Nurses with midwifery on a permanent basis to some of
those clinics earmarked for 24 hour services. Another 300 professional nurses will
be recruited in this financial year to further improve the pool of PHC staff. This will
go a long way towards strengthening and enabling efficient service delivery across
the various platforms of PHC such as the fixed clinics, mobile outreach services
(mobile clinics), integrated school health services and community outreach services
(CHW/CCGs).
Honorable Members; change is painful and unfortunately for transformation to
takeoff there must be changes, for primary health care to improve and function
better, the health department of 2010 must be dismantled. The Department is
focusing on rearranging the management of primary health care services, wherein
mobile clinics, community healthcare workers and fixed clinics will be managed
by an operational manager stationed at a fixed clinic within the geographic area.
This will enable the operational manager to oversee mobile services resulting in
resources maximally utilized by effective allocation. A cluster of these clinics will
be accountable to the local area manager. Clinics within a certain municipal area
will be managed and supervised by their district hospitals. Consultations regarding
this matter are underway. We hope the implementation will improve service delivery and response time. A pipe-burst or blocked toilet at a clinic in Moutse area will
have to be fixed by a plumber at Philadelphia hospital not to wait for a plumber
from Sekhukhune district offices, which by the way their offices are here in
Lebowakgomo.
The Geographic Service Area model which will define levels of healthcare from
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
community healthcare worker to tertiary health services will assist in integration of
healthcare services. The main focus being on preventative healthcare services,
mainly communicable and non-communicable diseases which are responsible for
premature death. While we have seen a reduction in mother-to-child HIV
transmission from to 0,59, we are concerned about our failure to achieve the
90-90-90 targets, especially the second and the third 90. The recent reports
suggesting that there is an increase in new infection amongst young women and a girl
child. Working with sister departments, civil society and business under the umbrella
of Limpopo AIDS Council led by Honorable Premier, we commit towards reduction of
new HIV infections, increasing number of people tested for both TB and HIV, increase
people initiated on ARVs and finally reduce the viral load of those infected.
Honorable speaker;
The World Health Organization judges the functionality of a healthcare system by its
low maternal and under-five mortality. It gives us pleasure to report that our
maternal mortality has decreased from 93/100 000 deliveries in April 2022 to 75/100
000 in February 2023. This is an improvement after a regression that was registered
in 2020/21/22 financial years due to COVID-19. The reduction was made possible by
our obstetrics response teams which came up with initiatives focusing on capacity
building of our clinicians. While attitude of staff is still a challenge within the department especially when it comes to maternal healthcare services. We must take time
to celebrate and appreciate those who goes beyond their call of duty. It is against this
background that we invited our professional nurse, a midwife sister Tshililo
Mphaphuli who distinguished herself during an emergency when her clinic which does
not operate 24 hours was closed and a woman in labor arrived. Sister Mphaphuli, like
Florence Nightingale, did not ask any questions, instead focused on the emergency at
hand which was to deliver the baby, little did she know that not one, not two, not three
but four heads will pop-out from the perineum.
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 11
Honorable Members, meet our own “Cicilia Makiwane”.
Honourable Speaker;
An effective, responsive healthcare system means we must have a
reliable emergency medical services vehicles.
The Honourable Premier Stanley Mathabatha administration has consistently
insisted on a minimum of 50 ambulances annually owing to financial constraints to
ensure that the fleet does not collapse.
It is my distinct pleasure to inform this august house that this Department as
indicated earlier has made tremendous strides in the management of its
finances such that it has become possible to reprioritize within our budget allocation
an amount of R500 million to augment R50 million earmarked funding provided by
the provincial treasury as presented by MEC Hon. Seaparo Sekoati.
Honourable Speaker;
We therefore commit for the first time in the
history of our province, in a single financial
year, since the dawn of democracy that we
shall procure 500 Emergency Medical
Services vehicles. This will simply mean that
each crew will be allocated its own ambulance which will result in accountability and
proper care, therefore response time will improve and lives will be prolonged and
preserved.
Honourable Speaker, the Health Professional Council of South Africa is busy
with the restructuring of the profession, as we speak, basic ambulance assistance
course has been faced out, so is the ambulance emergency assistant. As a
province we are working with different institutions of higher learning towards
partnership of new curriculum, however, as a department we are proud of some of
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
our personnel amongst the EMS whom whenever there is a disaster in the
province they always respond without failure.
Our rescue mission team continue to make us proud. Last year, during the KZN
floods they were amongst the first to respond to the call by the President to go on
a rescue mission. When disaster hit both Turkey and Syria, and the ambassador
made a plea for assistance, our selfless warriors did not hesitate- once more
they volunteered and were in the midst of that dangerous situation. They did that
all in the name of serving humanity.
Honourable Members, allow me to present our heroic
team comprising of Robert Masubelele, Vicky Shipalane,
Nicholas Nekhumbe, and Louis Markram.
Honourable speaker;
Essential medicines are defined by the World Health
Organisation as medicines that satisfy the priority health
needs of the population. People should have access to
these medications at all times.
As part of strengthening primary healthcare essential medication availability
becomes central. We have seen major improvements in terms of stock
availability in our facilities, however more efforts are put in place to address the
shortfall. We have seen stability in key programmes amongst others chilhood
vaccines, antiretroviral and anti-TB medicines that are being tracked continuosly
for availability in our facilities.
To sustain the stability and improve in other programmes an amount of R1.849
Billion has been allocated just for medicine and a further R217 million towards
dry dispensary.
Honourable Speaker
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 13
Continue the fight against malaria
Limpopo remains prone to malaria epidemics and
it has been reported in the past, malaria cases are
remaining at lower levels, with 1 745 cases and 24
deaths reported in 2022/23, even though one death is
too many. Just to remind the august house where we
are coming from, in the 2017/18 financial year we
recorded 18 977 and 160 deaths. We are confident
that the numbers will continue to plummet until we
record zero malaria related death.
Measles Outbreak
Limpopo province regrets being the leading province in the prevalence of measles
despite fully implementing the Extended Programme on
Immunization without charge. Of the 1095 suspected
cases, 347 were confirmed laboratory and 347 completed
their isolation period. The positive news is that since the
outbreak healthcare workers managed all cases well, hence
we registered zero death. The unfortunate situation is that
only 20 out of three hundred and forty-seven were fully
vaccinated translating to only 5,76%.
As with COVID-19, the department responded swiftly by conducting and completing
measles vaccination campaign for children aged 6 months to 59 months. The
campaign covered 74% of the target population hence we registered zero death.
We have now decided as of the beginning of April 2023 to extend the vaccination
to the 5-15 years’ age group who are currently predominantly affected. This will be
done at schools, fixed health facilities, mobile clinics as well as within the
communities in collaboration with the Department of Basic Education and other
stakeholders.
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
Honorable Speaker,
Once again, our savings came in handy because this vaccination program is made
possible by the current 867 COVID-19 contractual vaccination employees whom as
the department we have decided to extend their contract for the sole purpose of
assisting in this vaccination.
Cholera
The department has taken note of the cholera outbreak in other parts of the country
and our outbreak response team is ready and has a plan in place.
We will be working closely with our municipalities, as is customary, to do regular water
testing and all other modes of surveillance.
Health is one of those sectors that are inherently labor intensive, therefore the
structure must address the core business of the department.
We come from a painful past with a structure that was bloated at the top with no foot
soldiers, for example, we reported in this august house previously that this department
spends 76 percent of its budget on the compensation of employees, leaving us with a
mere 24 percent for goods and services, including capital spending while at the same
time with serious shortages on critical personnel like nurses, doctors etc. we want to
report to you honorable members that unpopular decisions were taken, painfully so,
which resulted in us reducing Compensation of Employees.
The structure has been reorganized from eight (08) DDGs for example to only four
(04) DDGs. Similar work was done on other managerial categories.
The department has submitted to the Office of the Premier a proposed structure for
the district which continues on this trend of removing duplications of functions and
fostering efficiency. For example, where there would have been a deputy manager
HIV testing, deputy manager ARVs, and deputy manager condom distribution. Even in
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 15
finance, splitting of orders is not allowed, so it is in law where splitting of charges is not
allowed. These are highly paid managers who will be best suited in managing some of
our facilities at primary healthcare level and hospitals.
Consultations with relevant stakeholders will continue, however for the sake of the
health of the people of this province this work cannot be postponed any further.
The department’s increasing improvement in management of the personnel budget
has resulted in treasury and Office the Premier approving 1426 posts which were filled
within a space of 4 months, amongst which there were doctors, psychologists and
various types of specialists.
Management of Medico-Legal Matters
The war against the medico-legal problem continues. An interesting development in
this area is the Noyila case in the Eastern Cape where the judge ordered that the
Department of Health must provide some of the service that are required by the
successful applicant instead of the department being required to pay a huge amount
for future medical care. Although the judgment is under appeal, it is worth noting due
to its seminal impact.
Following engagements with the Auditor General of South Africa, benchmarking and
consultations the Department has halved its medico-legal to R7 billion by changing
accounting methods. The campaign continued with the launch of first of a series of
conferences on medico-legal matters that aimed at identifying root causes of the
problem with a view to prevention of new cases as well as cascading the management
of cases to the lower level of management. A programme of District visits has been
developed and will be rolled-out.
During the course of 2022/23 the Department appointed 03 Heads of Clinical
Department, 2 Heads of Clinical Unit and 23 medical specialists. The province
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
currently has 124 registrars (doctors training to be specialists).
Honourable Speaker,
We are proud to announce that finally the contractor has been appointed by the
National Department of Health to resume the construction of the long-awaited
Limpopo Academic and Central hospital as pronounced by both the minister of
finance and the Premier.
This facility will require highly specialised professionals since we will be expected to
render services amongst others organ transplant hence the department has
embarked on a four-year strategy to prepare for those skills.
To this end, the province plans on building up on this numbers to have 240 local
registrars by 2025. In addition, the department will send supernumerary registrars
to other universities to augment the number of specialists that will be required in the
central hospital.
Forensic pathology
We have observed a rise in the number of
unnatural deaths in the province and the
majority of those cases are attributed to the
behaviour of members of the society
particularly road traffic accidents and
interpersonal violence. We had a total of
5473 deceased persons that were subjected to medico-legal investigation through
Forensic Pathology Services, this is 219 more than the previous year.
The service is experiencing pressure as a result of this rise in number of cases that
is not proportional to the available resources and this will be considered as an area
of priority. As a result, Forensic Pathology Services have been overstretched but
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 17
have managed to render services under those difficult circumstances.
This service continues to excel in the delivery of autopsies in high volume incidents
within relatively short periods.
Honourable members we must remember while forensic pathologist might not be too
visible and amongst the most celebrated of our health professionals, they are our
voices and they are our advocates when we cease to exist, but needs justice.
Today we celebrate the head of Forensic pathology department
Dr. Thakadu Mamashela, the man who throw his diary and gets to work whenever the
needs arises. We will continue to provide them with the necessary resources and
personal care focusing on debriefing.
INFRASTRUCTURE
Honourable Speaker;
Health infrastructure is one of the building blocks and critical pillars for healthcare
delivery and it is a specialized kind of infrastructure, hence as a department we also
spent time building capacity internally towards realization of this objective.
The department during the year under review has completed
the following projects:
Pietersburg hospital ward –F was repurposed into an ICU; the
ward is 17 beds with the state of art technology.
The Mankweng hospital has completed the maintenance
and refurbishment of the following section: theatres, OPD,
Thuthuzela and ICU. All this is made with the sole purpose
of making sure that our patients are treated in a place that is
safe and preserve their dignity.
We have handed over State-of-the-Art maternity ward in FH Odendaal hospital, with a
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
theatre and work is in progress to complete neonatal and paediatric wards. At the
end of the day, we want to have a maternal and child healthcare centre of
excellence.
Nursing colleges are also not left behind, to date the department completed the
refurbishment of Giyani Nursing college resident block D.
This comes at the right time now that the department has received accreditation to
train professional nurses on a new curriculum, the first group of 118 students have
already started with the training.
Repairs and maintenance at WF Knobel Hospital: Male & Female Wards, Storm
Damaged Staff Houses, Laundry, Stores & Kitchen while Male & Female ward,
Houses 1,2, 3 & 9 have been completed.
Major Repairs and Maintenance were also completed at Zava and Mudimeli
clinics. Enviroloo maintenance and repairs were completed at 142 facilities. Due to
the aggressive nature of water in the province, there was a need by the department
to attend to the water softening plants at the facilities.
As part of preparation for 24 hour services, we have prioritized the security at our
facilities by upgrading our fences.
To this end, upgrades were completed at 16 facilities, namely:
Kgapane Hospital, Hoedspruit EMS, Mudimeli Clinic, Letaba Hospital, Sehlale
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 19
Clinic, Blydrift Clinic, Mamabolo Clinic, Thomo Clinic, Warmbaths Hospital, Van
Velden Hospital, Relela Clinic, Thohoyandou Nursing College, Thlogotlou Clinic,
Marishane Clinic, Seobi Dikgale, Ellisras Hospital.
Pharmaceutical units required extra room for storage and the following prefabs
were delivered at 12 facilities, namely:
Ellisras Hospital, George Masebe Hospital, Witpoort Hospital, Kgapane Hospital,
Van Velden Hospital, Letaba Hospital, Malamulele Hospital, Messina Hospital,
Botlokwa Hospital, Helene Franz Hospital, Zebediela Hospital, Helene Franz
Hospital Gateway Clinic.
As the country, and indeed the province, continue to grapple with the effects
of loadshedding, the department has invested in the procurement of standby
generators to curtail the impact on our facilities.
The Limpopo Department of Health has delivered generators for installation
(connected and stationed) to 7 facilities, namely:
Messina hospital, Evuxakene hospital, Jane Furse hospital, Blouberg CHC,
Witpoort Hospital, Dr CN Phatudi Hospital, and Duiwelskoof CHC.
All the generators are new, and upgrades were conducted to some existing
generators.
19 mobile generators were procured, out of the
nineteen, seventeen have been delivered and are
stationed at Provincial Head Office. They are mobile and
will be dispatched to facilities as and when required.
One has since been dispatched to Dr. CN Phatudi
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
Hospital, another one dispatched to Seshego Pharmaceutical depot.
Another 01 generator will be permanently installed at Mokopane Hospital, while the
other one will be permanently installed at FH Odendaal hospital.
The department is looking into alternatives energy supplies i.e. the supply of inventors
in facilities. Heat pumps for the boiling of water of which the department has done
energy workload study to determine the sizes of batteries to be installed. The project
will be rolled out in few facilities as a pilot project.
Following the pronouncement of the premier on the installation of solar panels, the
department will conduct all preliminary works and await guidance from the Provincial
Treasury and Office of the Premier.
We are pleased to announce to this House that engagements on finding alternative
energy supply has begun. The department has met with the new Minister of
Electricity on how best we can spare our healthcare facilities from the challenges of
loadshedding.
Revenue collection
Honourable speaker
The Department has prioritised revenue collection as the only alternative source to
augment its budget deficit over this Medium Term Expenditure Framework. Through
the implementation of the Revenue Enhancement Strategy and continuous support
from the Provincial Treasury, we are pleased to report to this august house that the
Department managed to surpass the third quarter revenue targets of R193 791 Million.
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 21
Honourable Speaker, there is currently a public perception that health services are free
for all who visit our health facilities, leading to huge outstanding amount. This is incorrect
as patients are categorized in terms of affordability. Members of the communities that fall
within the paying categories including those with medical aids, are urged to pay for the
health services they receive in our health facilities as this will contribute to the funding of
the health services in the province. The public is however informed that services are still
free at primary healthcare facilities such as clinics, mobile clinics, gateway clinics and
health-centres. We call on all our communities to visit these facilities for their wellbeing.
Free services have also been extended for all COVID-19 related and Mental health
services at hospital level for low income group, unemployed and those that are not
members of medical schemes.
Honourable Speaker;
This financial year should allow us the platform to continue to build an efficient, effective,
comprehensive and inclusive healthcare system capable of delivering on the promises we
made to the people of Limpopo. We will do this guided by the oath and promise to meet
the electoral, constitutional and legislative mandates given to us by the people of our
province.
This budget should propel us to new heights of service delivery. It should resonate with the
expectations of the people of Limpopo and assist in meeting their health needs.
Honorable Speaker,
BUDGET SPEECH: 2023 – BUDGET BREAKDOWN: VOTE 07: HEALTH
The 2023/24 overall budget for Health vote has increased by 4.6% from the 2022/23 Main
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Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
Appropriation and increased by 0.8% from the Adjusted Appropriation. Within this
allocation, Equitable share grows by 7.1% from main appropriation whereas
conditional grants decreases by 6.4%.
The increase in Equitable Share is towards stabilizing the baseline from previous
MTEFs reduction. Equitable Share increase by 3.7 % from the 2022/23 adjusted
allocation whereas conditional grants decrease by 11.7 % from the 2022/23
adjusted allocation. The decrease in the Conditional Grants is due to discontinuation of
Covid-19 funding. Covid-19 activities will be rendered within the total allocated budget
of the Department. In monetary terms, the total budget increases from the budget of
R23.6 billion in 2022/23 to R23.8 billion in 2023/24. The total allocation increase by
an average of 3.5% over the Medium-Term Expenditure Framework.
Honourable speaker, I am therefore honoured and indeed privileged to table to this
noble house the budget for Health-Vote 7, for the year 2023/24 to the value of R23.8
billion, which consists of R19.6 billion equitable share, R3.9 billion conditional grants
and R210.5 million own revenues.
Honorable speaker, the budget has been allocated to fund the following key priorities
of the Department:
· Strengthening District Health Services (Primary Healthcare) and district hospital
delivery systems: R12.6 billion. This shows an increase of 6.9% from 2022/23. This
as a backbone of health delivery system and is therefore allocated 52.9% of the total
budget of the department. The budget of this priority grows by an average of 4.8%
over the Medium Term Expenditure Framework (MTEF).
· R2.9 billion has been allocated for Regional, Tuberculosis and Psychiatric
hospitals.
Tabled by MEC for Health Dr Phophi Ramathuba: Tuesday, 18 April 2023 23
This allocation is important for the provision of specialized health services not primarily
rendered in district hospital services as well as primary health care.
· Malaria Control services are allocated R73. million in equitable share. Furthermore, an
amount of R65.2 million has been allocated within the conditional grant framework in order to
prevent and control malaria in the affected areas of this Province.
· Comprehensive HIV and AIDS programme funding including TB services has been
provided at R1.9 billion.
· R1.3 billion has been set aside for the running of Emergency Medical Services in the
Province. Included in this allocation is an amount to purchase 500 ambulances.
· Tertiary services in the Province, has been provided for at R2.1 billion. These services
continue to be provided in Pietersburg and Mankweng Tertiary hospitals.
· An amount of R851.6 million has been allocated to Health Infrastructure
Programme. This allocation will be used mainly for hospital revitalization, clinics building and
upgrades as well as buildings and equipment maintenance.
· An amount of R97.3 million has been set aside for the training of health professionals
as part of our commitment to reduce vacancy rate in these categories. This amount covers
medical students in the Republic of Cuba, Limpopo Medical School, Nursing students and
other Medical Schools in the country.
· Honorable speaker, in order to maintain the stock level at our clinics, health centres
and hospitals across the province, R1.8 billion medicine allocation has been provided.
This includes amount of R 642.2 million for the provision of antiretroviral drugs to HIV positive
patients and new intake, and R240 million for Vaccines to reduce infant and child mortality.
I remain eternally grateful for the continued support and confidence I receive from the
Honourable Premier in the execution of my responsibilities.
The Premier is also central in guiding us to spend our budget allocation efficiently and within
the prescripts of the Public Finance Management Act.
Tuesday, 18 April 2023
24
Department of Health: BUDGET VOTE 7 SPEECH FOR 2023/24
A special thanks goes to the portfolio committee on health for their robust, frank and
constructive engagements and continuous oversight.
We also want to take this opportunity to thank the Standing Committee
on Public Accounts for ensuring that the work we do is within the proper
legal and constitutional framework.
Gratitude to our Acting-HOD Dr. Mutheiwana Dombo and all those who
put in the effort to ensure that our loyalty to this government and the
people of Limpopo remains intact and unquestionable.
Let me conclude by drawing from an astute revolutionary, the former
President of Burkina Faso, A Pan-Africanist, Thomas Sankara, who said:
“You cannot carry out fundamental change without a certain
amount of madness. In this case, it comes from nonconformity, the
courage to turn your back on the old formulas, the courage to
invent the future. Besides, it took the madmen of yesterday for us to
be able to act with extreme clarity today. I want to be one of those
madmen.”
I thank you!
