Despite the HIV/AIDS epidemic, government has cut health spending over the past year and it will spend even less per capita next year. This was revealed yesterday [fri] by Health Minister Dr Manto Tshabalala-Msimang, who said real spending on health had declined by 5.4% over the past year – once population growth and inflation were taken into account. In 1996/97, government spent R614 per capita on health but by 2001 it will only spend R552 per person. A slight increase of R3 can be expected in 2002. “Add to this the pressure of HIV/AIDS and it becomes clear that we have more difficulties ahead of us,” Tshabalala-Msimang told the first-ever consultative meeting between herself, health MECs, MPs and MPLs dealing with health matters.

Health services are already battling to cope with their current lack of resources, and in many hospitals 50% of beds are already taken up by AIDS patients. This will only worsen as more HIV positive people develop full-blown AIDS.

The minister said that the health budget was also under pressure from health workers, and that the current rate of salary increases was “unsustainable”.

“Our salary bill has increased from 58% [of the budget] to 65%,” said the minister, adding that there was no place in the public service for automatic promotions.

KwaZulu-Natal health MEC DR Zweli Mkhize added that overtime and weekend pay provisions in the Basic Conditions of Employment Act [No 75 of 1997] – where employers must pay time and a half for such work – would have a “serious impact on hospitals”.

Tshabalala-Msimang urged health legislators across the political spectrum to work together to “highlight these difficulties” – implicitly urging them to unite to get more funds for health services.

Mkhize said one way of getting more money into public health was to attract more people with medical aids to state hospitals, and that government employees and politicians should set an example by doing this.

Mkhize also noted that, while government had hoped to save money by directing people to clinics rather than hospitals, “this reduction of costs had not happened”. Those hospitalised needed special care, and healthcare was being hard hit by HIV/AIDS. – Health-e news service 12/11/99.