Health-e News gives you a rundown of key issues highlighted in recent budget speeches. We will update this as other provincial health budgets become available.

Free State
Total budget for 2014/15: About R8.2 billion

Delivered by Free State MEC for Health Dr Benny Malakoane on 9 July 2014, the speech outlines a 2 percent growth in the province’s total health budget over that of the previous financial year.

The speech also notes a decrease in administration budgets and a roughly commiserate increase in district health spending. As part of the 12-page speech, the province outlines a number of specific goals, including:

-Establishing a dedicated unit to treat multidrug- (MDR) and extensively-drug resistant tuberculosis (TB)in Mantsopa;
– Creating a 20-bed paediatric MDR-TB unit in Pelonomi;
– Ensuring all district and regional hospitals comply with regulations to allow them to admit and treat mental health patients; and
– Operationalised emergency medical services call centres in Bethlehem, Kroonstad and Welkom.

KwaZulu-Natal
Total budget for 2014/15: About R31 billion

KwaZulu-Natal delivered its budget vote on 13 August. The speech begins by reviewing the province’s achievements, including ramping up the number of antiretroviral (ARV) treatment initiation sites. As of March 2013, 608 health facilities in the province were starting patients on treatment and the province had cleared its ARV waiting lists. Since October, about 274,000 HIV patients have been started on the country’s new fixed-dose combination.

The province has also medically circumcised about 392,000 men in the last four years as part of a national HIV prevention campaign.

In this financial year, the province has set goals including:
– Training 40 nurses to initiate multidrug-resistant tuberculosis treatment;
– Install new CT scanners at Ngwelezana, King Edward VIII, Stanger, Madadeni and Addington Hospitals;
– Consider the establishment of a specialised eye care facility at McCord Hospital as the province does not yet have one;
– Appoint a service provider for chronic medication deliveries to patients; and
– The roll out of mobile hospitals.

Gauteng
Total budget for 2014/15: R31.5 billion, of which R2.8 is devoted to HIV and AIDS; 100 million in accruals

In its speech, the Gauteng Department of Health committed to turning all public health institutions around and stabilising its finances in the next five years.

The speech adds that the province has ward-based outreach teams in 133 wards and will be rolling them out to a further 375 wards. With a new hospital recently opening in Soweto, the province also plans to open the new 821-bed Natalspruit Regional Hospital by the end of this year.

The department acknowledges that there is a deficit of 800 emergency medical service (EMS) vehicles. To respond to this, the department plans to form public-private partnerships with major EMS providers such as Netcare and ER24 to ensure more suitable coverage across the province.

Western Cape
Total budget: R54.73 billion

The province has six broad priorities including addressing service pressures, and focusing on priority conditions such as mental, child and women’s health as well as chronic disease. The province has allocated about R14 million for auditory screening shortly after birth as well as hearing aids. Another R2 million is dedicated to supporting people living with intellectual disabilities.

The budget also plans for a new 30-bed, 72-hour psychiatric observation facility to be commissioned for the Mitchell’s Plain Hospital. New health facilities are slated for Delft, Hermanus, De Noon and Rawsonville.

Like several other provinces, the Western Cape notes that it also continues to make progress replacing 393 older EMS vehicles with new ones.

The province adds that it has developed a board health care strategy, dubbed Healthcare 2013, set to guide the province moving forward. It will be distributed in coming weeks.

Download the provincial speeches below:

• Free State Health Budget Speech 2014-15
• KwaZulu-Natal Health Budget Speech 2014-15
• Gauteng Health Budget Speech 2014-15
• Western Cape Health Budget Speech 2014-15