The National Department of Health has been allocated with a budget of R62.2 billion, a 3.5% increase from last year’s R60.1 billion. 

Dr Aaron Motsoaledi tabled the Health Budget vote for the financial year 2024/25 in the National Assembly in Parliament today, seven days after he was re-appointed as the health minister. 

He says 79% of the total budget has been allocated for communicable and non-communicable diseases (R25.4 billion), and hospital systems which include the maintenance of facilities (R23.9 billion).  Hospital systems have seen an increase of 10.4% from R3.0 billion to R3.3 billion. 

The National Health Insurance (NHI) indirect grant has an allocation of R6.9 billion which is expected to strengthen health systems and also improve the dispensing of medicine through the Central Chronic Medicines Dispensing and Distribution (CCMD),  a programme that allows patients who are stable to collect their medication at pickup points in their communities. 

Health systems financing

Highlighting the “six building blocks” of health systems- leadership and governance, access to essential medicines and other commodities, health workforce, health system financing, health information systems and health service delivery-he says only one has generated intense debate.

“All these building blocks seem to be acceptable to everybody and debates around them are straightforward and clear. However, one of them which is the health systems financing which we have decided to call NHI in our country has generated a lot of heat, and sometimes fury, in some quarters,” he says.  

He says some believe that the NHI is a system which South Africa is not ready for, while others believe it is a vintage, very expensive health system that the country has no money for. 

“However this is a health financing system which is meant to be an equaliser between the rich and the poor. We can no longer sustain such gross inequality. If there is something we can do about it, we must do it here and now and not in some distant, ill-defined future.” 

Budget will not solve health challenges 

Motsoaledi says 33% of the allocated budget will go to conditional grants. To address service delivery backlogs, and resolve the unequal distribution of tertiary services the National Tertiary Service grant has been protected from reductions. The grant is meant to expand and improve tertiary-level health services. It receives an additional R1.1 billion over the medium term to support provinces to fund salary increases.

“We should see how the conditional is spent on provinces. We need to know how much of this conditional grant is spent in hospitals,” says Russel Rensburg, the director of The Rural Health Advocacy Project (RHAP) a division of Wits Health Consortium. 

He tells Health-e News that there are a couple of questions that need to be answered from the budget speech. 

“We need to understand what lays the baseline on where we are in terms of funding. The increased budget allocation will not solve our problems as we have a funding crisis in the healthcare system,” he says. 

He says there is a need for the department to figure out how it will deliver health care to the people.  

A need for oversight to various provinces

The Parliamentary Health Committee has welcomed the department’s annual performance plan and budget. However, the report by the committee says there are many challenges in the health facilities, and there is a need for oversight in various provinces.

The report reads that cardiovascular diseases are on the increase and it was concerning that this area is not given enough attention. 

“It is concerning that there is inadequate infrastructure and facilities for mental health services. There is a need to look  into existing hospitals that have underutilised buildings that can be upgraded and refurbished.There is also a need for centralisation  of healthcare through a unified ICT platform.” 

Committee recommendations

Some of the recommendations by the committee is that the department provide a progress report on the reduction of maternal and infant mortality. 

The department also has to fast-track the medico legal reforms and report to the committee quarterly. 

In addition, it has to ensure cross-sectoral collaborations with other government departments in dealings with social risk factors of Tuberculosis. – Health-e News