Parliament, Friday, 18 October 2024 – The Portfolio Committee on Health heard yesterday that the Department of Health has developed a model for Contracting of primary healthcare services under the National Health Insurance (NHI) programme although the testing of the model in nine pilot sites was delayed.
The committee heard that in communicable and non-communicable diseases, the department exceeded targets for HIV self-screening and youth zones in facilities but faced challenges in TB treatment success rates. The district health system policy framework and strategy was not finalised due to extended consultations, but the department exceeded targets for community outreach services and clinic committees.
The department appeared before the committee to brief it on its annual report for the 2023/24 financial year where the department informed the committee that it achieved an unqualified audit opinion in the 2023/24 financial year, and that it paid 90% of invoices within 30 days.
The department informed the committee that the remaining 10% of invoices were delayed due to support the department provided to provincial departments on medical legal claims. The committee heard that audit outcomes showed improvements with the national department and several provinces receiving unqualified audits.
The department's financial performance showed that it spent 99.59% of its R58.5 billion budget, with the lowest spending in the NHI programme. According to the briefing, provinces spent 98.5% of the R52.6 billion in conditional grants, with preliminary approval for R604 million in rollover funds.
The committee raised concerns about the department's performance on TB treatment success rates, the delay in the release of the digital vibes report, and the lack of consequence management for irregular expenditure. The department highlighted challenges it encounters and outlined interventions, such as mortality audits, patient tracing, and collaboration with the community health worker programme, to improve TB outcomes.
Regarding the digital vibes report, the Minister of Health, Dr Aaron Motsoaledi, told the committee that it was an SIU report which was referred to the previous administration, and that consequence management had been implemented. The department also committed to strengthening internal controls and supporting provinces to improve audit outcomes.
The committee questioned the department's oversight and support for community health workers that are employed on grant-funded positions, as well as the status of the Alcohol Bill which Dr Motsoaledi told the committee that it faced delays due to concerns from the economic cluster.
Concerning the Auditor-General's findings on the department's financial statements, the department informed the committee about the challenges it faced in preparing the statements in accordance with the prescribed reporting framework and the steps being taken to improve internal controls and review processes.
The committee expressed concern over the persistent accruals and irregular expenditure reported by the AG in several provinces such as the Eastern Cape and Northern Cape. Members of the committee requested the department to provide more details on strategies and support mechanisms in place to assist these provinces in addressing their audit findings and improving their financial management.
The Chairperson of the committee, Dr Sibongiseni Dhlomo, drew attention to the office of the Health Ombud's continuous requests to improve staffing and requested the department to assist in finalising the secondment of staff from the Office of Health Standards Compliance.
Dr Dhlomo also emphasised the importance of addressing the employment and remuneration issues faced by community health workers as they are a crucial component of the primary healthcare system. He urged the department to find a sustainable solution that provides stability and fair compensation for this frontline workforce.
The committee was pleased to learn that the department is actively preparing agenda items for South Africa's G20 presidency in 2024. The department outlined its preliminary priorities which are aligned with the African Union's health priorities, including strengthening public health institutions, expanding local and regional manufacturing of vaccines and therapeutics, and increasing domestic resources for health security.
The committee raised concerns about the significant impact of foreign nationals on the health services particularly in provinces like the North West where up to 50% of maternity patients are reported to be from outside South Africa. Minister Motsoaledi committed to working with other relevant Ministers to develop a comprehensive plan to address the strain on health infrastructure.
The committee told Minister Motsoaledi about the urgency of this matter and urged the department to prioritise finding sustainable solutions in collaboration with other government departments.
ISSUED BY THE PARLIAMENTARY COMMUNICATION SERVICES ON BEHALF OF THE CHAIRPERSON OF THE PORTFOLIO COMMITTEE ON HEALTH, DR SIBONGISENI DHLOMO
For media inquiries or interviews with the Chairperson, please contact the committee’s Media Officer:
Name: Yoliswa Landu (Ms)
Cell: 081 497 4694
E-mail: ylandu@parliament.gov.za
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