A patient first approach towards budgeting

Delivering his budget speech Theuns Botha, MEC for health in the Western Cape said he was allocating R2.8-billion (the largest amount) to provincial health care services this is 24% of his R11.9-billion budget which is set to rise to R13.5-billion by 2012.

Up to R178-million of these funds will go towards hospitals treating Tuberculosis, psychiatric hospitals will get R507-million, rehabilitation services will receive R122-million and the Somerset Hospital trauma unit will receive a R30-million upgrade.

Botha said the rise in alcohol consumption and substance abuse in the province exerted enormous pressure on hospitals, psychiatric units and trauma units.

He allocated R397-million to administration which will encompass the restructuring of key management positions in hospitals, infection control, patient safety and satisfaction.

Botha identified the increase in the number of patients and the large percentage who rely on state health services as some of the great challenges faced by his department. Botha also announced that the department planned to initiate an independent complaints commission to make sure that patients received quality health care.

The department would also train and employ home based care workers.

‘€œIt is a challenge to make people understand that this is an opportunity. Most organisations argue these people are going to be paid half salaries, not recognising this as offering people employment and a chance for them to get further training.’€

Botha said his department was pursuing three initiatives to strengthen its capacity in the battle against HIV. From the beginning of April patients will be offered a routine HIV test when they walk into any health facility in the province. He said they were in talks with the private sector to do the same.

Current World Health Organisation guidelines state that HIV positive patients are to be started on treatment when their CD4 counts fall below 350. Botha said his department would work towards starting patients on treatment when their CD4 counts are below 350.

Hospitals would offer triple therapy for prevention of mother to child transmission which will reduce the HIV infection by 50% by 2015 causing an 8% decrease in infection in ages 15- 24 by the that year.

He also announced moves towards expanding the DOTS system as well as testing new models of TB testing that would produce faster sputum results and ensure that patients start treatment sooner.

Some of the hospitals such as the Hermanus and Karl Bremer hospitals were receiving facelifts while new ones would be built in the Khayelitsha and Mitchell’€™s plain.  

Up to R217-million was allocated to training staff. This included R49-million for the Western Cape College of Nursing, R66-million in bursaries with a focus on nursing staff as well as training for emergency medical services staff. Botha stressed there remained a great need for nurses in the province and the country in general.

He added that the cost of personnel had risen due to the Occupation Specific Dispensation (OSD) for nurses, medical and dental practitioners, pharmacy staff and emergency personnel that was implemented two years ago, but was underfunded by R35-million.

He said part of the reason the province suffered due to the OSD was that there was confusion with regards to who was supposed to pay the OSD for specialists that were shared by tertiary hospitals and universities.

He added that the province was not facing a similar budget problem that had hampered a lot of services in the to the rest of the provinces as it will remain largely within budget as a result of tight financial and human resources management.

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