Burden: Medical staff at Tembisa Hospital in East Rand are working hard with limited resources to support the large number of people seeking medical care. (Guillem Sartorio/Getty Images)
FFinance Minister Enoch Godongwana has allocated R848 billion for the public health system in medium-term spending, including almost R1.4 billion in National Health Insurance (NHI) grants over the next three years.
In his budget speech on Wednesday, Mr Godongwana said the health allocation also included R11.6 billion to support the public health wage agreement in 2023 and R27.3 billion for infrastructure development over the same period. Stated.
“The allocation to the National Health Insurance is an expression of the government's commitment to this policy. There are a number of system strengthening activities that remain to be carried out, which will be key enablers of improvements in the public health system,” he said. said.
He said these activities include building a national health information system and digital patient records. Upgrade health facilities to improve the quality of care and ensure they meet minimum standards for contract accreditation and accreditation under the NHI.
Facility and district management would also need to be strengthened in preparation for the contract, and the central hospital and “potentially other hospitals” would need to be given “semi-autonomous” status under the scheme.
Activities also include developing reference prices for hospitals and payment methods for providers.
“Many of these activities are already underway, but further development is needed to deploy NHI at scale,” Godongwana said.
According to the revenue sharing bill tabled by Godongwana on Wednesday, the government proposes that the NHI subsidy fund, to which R1.4 billion will be transferred, remain in place until the NHI fund is created through the bill. A total of R456 million will be paid into the fund in 2024-25, R462 million in 2025-26 and R471 million in 2026-27.
The bill also provides for further funding for the system through the NHI indirect grant, which will receive R2.2 billion in 2024-25. R2.4 billion will be allocated in 2025-2026 and R2.3 billion in 2026-27 for the revitalization of health facilities and health systems.
Funds allocated for the revitalization of health facilities will be used “to create alternative trajectories to improve spending, performance, monitoring and evaluation of infrastructure in preparation for the National Health Insurance… “To enhance the ability and ability to…'' Meeting occupational safety and health requirements. ”
Health system spending will go toward “improving access to and quality of care by expanding alternative dispensing and distribution models for chronic medicines” and “improving quality health care services in all primary health care facilities.” .
An enterprise architecture design for the NHI digital information system will be built and implemented, a drug inventory management and procurement system will be developed and implemented, and all public health facilities will be certified by the Health Standards Compliance Office.
Mpho Modise, deputy director-general of the Treasury Department for Fiscal Affairs, said the amount allocated in the 2024-25 budget was for the pilot, in line with the government's 2019 study that showed R30 billion was needed to start the system. He said the funds would be directed to the program.
He said additional funding would be allocated after the third and fourth years, but did not indicate when the national health insurance would be implemented.
“For the first few years, we will have to use the funds that have already been allocated and in the third and fourth years we will have to start allocating additional funds, but that funding will not start at, say, R30 billion. “R10 billion, R9 billion and increasing over time… So we need to work with health to understand when this plan will be implemented.” “There is,” Modise said.
A total of R279.1 billion will be allocated to public health in 2024-2025, of which R120 billion will be earmarked for district health services. R52.8 billion for central hospital services. R47.5 billion for state hospital services. R40.2 billion for other health services. R11.3 billion for facilities management and maintenance.
