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- Accruals in the provincial health department added to the ongoing lack of financial management capacity.
- Provinces making progress with managing down accruals and medico-legal claims to be rewarded.
- All stakeholders, including unions to lobby Treasury.
The national health department has reported on challenges it faces in managing its financial resources.
This was announced by President Cyril Ramaphosa's special advisor on social policy, Olive Shisana, at the 2nd Presidential Health Summit.
Shisana said audit findings, irregular fruitless and wasteful expenditures, and accruals in provincial health departments pointed to an ongoing lack of financial management capacity.
"Major effort led by the finance team from the Department of Health needs to be implemented to increase staffing, expertise, and dedication in provincial health finance departments and their senior management," she said.
Accruals and medico-legal claims put significant pressure on the provincial health budgets, she added.
"Provinces that make progress with managing down accruals and medico-legal claims, like the Eastern Cape province, should be rewarded for progress with additional above-budget allocations and incentivised to continue on this path."
But she added that those provinces that showed no progress should not be bailed out.
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"Improvement in service delivery can only be generated through efficiencies and reducing non-essential administration costs."
Shisana said the view of Treasury that the 7.5% salary increase would have to be funded by reducing headcounts was unsustainable, and should be addressed in the adjustment budgets.
"All stakeholders, including unions, must lobby Treasury."
She added that the proposed interventions for 2024-2029 included establishing a parallel system for managing non-pharmaceutical products with similar governance processes to those used for medicines.
"Appropriately skilled personnel to be appointed to manage non-pharmaceuticals. The non -pharmaceuticals to have their separate warehousing and possibly supply chain, where appropriate."
Shisana said all South African Health Products Regulatory Authority (Sahpra) registered products must have a single exit price for data sharing, transparency, and benchmarking.
"One of the proposed interventions is to develop a standardised organisational structure for pharmaceutical services across provinces aligned to service requirements."
