Department of Health Annual Report 2018/19
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DEPARTMENT OF HEALTH ANNUAL REPORT 2018/19 Together, Moving Gauteng City Region Forward GAUTENG PROVINCE HEALTH REPUBLIC OF SOUTH AFRICA DISTRIBUTION OF SERVICE PLATFORMS EXPENDITURE PER BUDGET PROGRAMME DISTRICT PROVINCIAL CENTRAL & EMERGENCY HEALTH SERVICES HEALTH SERVICES TERTIARY HOSPITALS MEDICAL SERVICES 14 516 480 8 746 469 17 135 226 1 330 508 FINANCIAL INPUTS ACTUAL EXPENDITURE HEALTHCARE HEALTH SCIENCES HEALTH FACILITIES ADMINISTRATION SUPPORT SERVICES & TRAINING MANAGEMENT 339 048 1 106 708 1 536 120 1 360 786 Department of Health Annual Report 2018/19 HUMAN RESOURCES FOR HEALTH 65 821 Total Health Workforce Clinical Nursing Engineering Support Staff Administration Professionals Professionals Support Staff 11 398 Staff 31 168 10 9 169 6 386 Allied Engineering Allied Management Professionals Professionals Support Staff 103 5 589 69 1 929 Clinical Professionals Nursing Professionals DENTAL DENTAL REGISTRARS PRACTITIONERS 41 308 STUDENT PROFESSIONAL MEDICAL DENTAL NURSES NURSES REGISTRARS SPECIALISTS 2 437 14 897 1 215 116 MEDICAL MEDICAL NURSING STAFF NURSES SPECIALISTS PRACTITIONERS ASSISTANTS 7 424 1 276 3 430 6 410 Adminstration Staff Support Staff Management Professionals 9 169 11 398 LEVEL 13 LEVEL 14 73 23 JUNIOR LOWER LOWER JUNIOR MIDDLE MANAGERS LEVELS LEVELS MANAGERS MANAGERS (LEVELS 9-10) Management (LEVELS 1-8) (LEVELS 11-12) (LEVELS 1-8) (LEVELS 9-10) 2 Professionals 8 478 457 234 11 396 LEVEL 15 LEVEL 16 3 1 Department of Health Annual Report 2018/19 A SNAPSHOT OF HEALTH SERVICES Reproductive health We provided 179 689 307 contraceptives to Medroxyprogesterone injection 1 148 458 women of reproductive age Norethisterone injection 346 766 1 432 002 pills provided 183 719 women over 30 year old 33 383 implants inserted screened for cervical cancer Maternal and Neonatal Health Child Health 268 008 pregnant women given 126 788 learners immunized for HPV antenatal care services Supported 222 115 deliveries 167 100 learners screened for potential at our facilities learning barriers Outreach to Households Chronic Medicine Dispensing Programme 3 374 445 visits by 490 518 patients received their ward-based outreach teams treatment through the Chronic Medicine Programme at convenient locations Non-Communicable conditions and Rehabilitation services 2 295 851 hypertensive patients 552 537 diabetic patients treated treated 85 283 Mental health care patients 73 772 assistive devices provided to treated patients Communicable Conditions 1 037 212 HIV patients 34 190 TB patients treated provided with treatment Department of Health Annual Report 2018/19 GAUTENG DEPARTMENT OF HEALTH ANNUAL REPORT FINANCIAL YEAR 2018/2019 PR 223/2019 ISBN: 978-0-621-47565-4 Department of Health Annual Report 2018/19 1 TABLE OF CONTENTS PART A GENERAL INFORMATION 1. DEPARTMENT GENERAL INFORMATION 4 2. ABBREVIATIONS AND ACRONYMS 6 3. FOREWORD BY THE MEC FOR HEALTH 8 4. REPORT OF THE ACCOUNTING OFFICER 10 5. STATEMENT OF RESPONSIBILITY AND CONFIRMATION OF THE ACCURACY OF THE ANNUAL REPORT 15 6. STRATEGIC OVERVIEW 16 7. ORGANISATIONAL STRUCTURE 17 8. ENTITIES REPORTING TO THE MEC 18 9. LEGISLATIVE AND OTHER MANDATES 18 PART B PERFORMANCE INFORMATION 1. AUDITOR-GENERAL’S REPORT: PREDETERMINED OBJECTIVES 20 2. OVERVIEW OF DEPARTMENTAL PERFORMANCE 20 3. STRATEGIC OUTCOME-ORIENTATED GOALS 26 4. PERFORMANCE INFORMATION BY PROGRAMME 27 5. TRANSFER PAYMENTS 81 6. DONOR FUNDS 82 7. CONDITIONAL GRANTS 83 8. CAPITAL INVESTMENT 87 PART C GOVERNANCE 1. INTRODUCTION 99 2. RISK MANAGEMENT 99 3. MINIMISING CONFLICTS OF INTEREST 99 4. FRAUD AND CORRUPTION 100 5. CODE OF CONDUCT 100 6. HEALTH, SAFETY AND ENVIRONMENTAL ISSUES 100 7. PORTFOLIO COMMITTEES 102 8. SCOPA RESOLUTIONS 108 9. PRIOR MODIFICATIONS TO AUDIT REPORTS 116 10. INTERNAL CONTROL UNIT 116 11. REPORT OF THE AUDIT COMMITTEE 117 2 Department of Health Annual Report 2018/19 TABLE OF CONTENTS PART D HUMAN RESOURCE MANAGEMENT 1. INTRODUCTION 121 2. OVERVIEW OF HUMAN RESOURCES 121 3. HUMAN RESOURCES OVERSIGHT STATISTICS 122 PART E FINANCIAL INFORMATION 1. REPORT OF THE AUDITOR-GENERAL 153 2. ANNUAL FINANCIAL STATEMENTS 162 PART F MSD FINANCIAL INFORMATION 1. REPORT OF THE ACCOUNTING OFFICER 282 2. REPORT OF THE AUDITOR-GENERAL 294 3. ANNUAL FINANCIAL STATEMENTS 399 Department of Health Annual Report 2018/19 3 PART A: GENERAL INFORMATION 4 Department of Health Annual Report 2018/19 1. DEPARTMENT GENERAL INFORMATION The Department’s service platforms nevertheless remain resilient and, ABOUT THE DEPARTMENT during the year, It was able to provide approximately 27.7 million Information about the patient visits for patients presenting at PHCs, emergency and 4-18 mandate, location and outpatient hospital Departments. Thus 183 851 additional patients messages from the MEC and the accounting visits were catered for during the year under review. This increasing ocer on performance of the Department. demand requires improved and efficient business processes which the Department is implementing using appropriate technology. Part of ADMINISTRATIVE this has involved putting in place a recovery roadmap, focusing on six OVERVIEW strategic drivers of clinical and clinical support services: Leadership A performance report outlining quality improve- 20-78 and Governance; ICT Optimisation for Evidence Based Health Care; ment, technology and Financial Discipline and Prudence; Patient Safety and Improved Health transformation agenda. Outcomes; and Human Resources for Health and Health Wellness and Happiness. DISTRICT HEALTH CARE SERVICES Performance of the priority The drivers relating to Clinical Services (Patient Safety and Improved 30-44 health programmes Health Outcomes) have resulted in the development of the Mental accessibility, treatment and support provided at primary This annual report reviews the performance of the Gauteng Health Recovery plan, the Maternal and Neonatal Health Recovery health care facilities plan and the establishment of an accreditation committee to assess including reengineering of Department of Health (GDOH) for the year 2018/2019, the final year the PHC system of the previous administration, underlining the work that the quality across the health facilities. The overwhelming evidence HOSPITAL AND Department has done in implementing the province’s generated in the Department reflects recurring underperformance in EMERGENCY these strategic programmes and they are therefore being prioritised SERVICES Transformation, Modernisation and Re-Industrialisation policy Performance of the emergency 45-59 framework. within the Recovery Road Map currently being used. medical services, various categories of hospital eciency and quality initiatives starting with hospitals that The report reflects the milestones and difficulties that the While our focus and some of the expectations of the communities we provide specialised, tertiary care to quaternary health care services. Department has overcome, in the face of particular pressures during serve have tended to be on curative care, it is well recognised that HEALTH CARE SUPPORT the year, in ensuring that the health care needs of the people of delivery of healthcare requires a much broader approach. As part of SERVICES OVERVIEW Gauteng are met. The effects of rapid urbanisation and increased pushing back the frontiers of ill-health, the GDoH launched a A brief overview on three-year Health, Wellness and Happiness programme on 16 30-44 pharmaceutical, blood migration are amongst the Department’s greatest challenges. The and supply chain, human November 2018 with the aim of increasing health promotion and resources capacity report therefore reflects these challenges and their effects on the development initiatives health service. disease prevention for better health outcomes. and capital investments. In developing the report and in planning for the next five years, the Despite the many challenges facing its health system, Gauteng has GOVERNANCE, Department has taken stock of government’s priorities. Gauteng is a the highest proportion of primary health facilities certified as Ideal HUMAN FINANCIAL diverse, multi-racial and multi-class society where, in providing Clinics in South Africa; this is confirmed by the Office of Health A brief overview on risk adequate health services, “the people must always come first”. This Standards Compliance which is responsible for guiding, monitoring Gauteng Provincial Government | Health | management, human 60-88 resources statistics is the spirit that drives Team Gauteng Health during this new term. and enforcing health care safety and quality standards in the Annual Report 2018/2019 overview , financial Taking full account of the pressures and challenges that currently country’s health facilities. We have worked hard to introduce the Ideal Physical address: 45 Commissioner Street statements and legislationtin Hospitals Accreditation system in line with the Ideal Clinics System, Marshalltown prevent our public healthcare system from meeting the standards of and have appointed a panel of eight professionals as the Gauteng Johannesburg excellence to which we aspire, we must persist in our objective of Health Accreditation Committee (GHAC) whose main purpose is to 2001 improving the quality of healthcare for all the province’s residents. The GDoH is the largest health service provider in South Africa, sustain and expand the province’s Ideal Clinics status and to realise Postal address: Private Bag X085 the Ideal Hospitals system. Marshalltown serving 14,6 million residents (25 % of the country’s population). 2107 Over the past