REPORT TO THE NCOP ON
HOSPITAL REVITALISATION GRANT PERFORMANCE
AS AT END OF 2010/11 QUARTER 2
DR S DHLOMO
MEC FOR HEALTH- KWAZULU NATAL
AND
Ms M GOVENDER
MEC FOR HUMAN SETTLEMENTS AND PUBLIC WORKS- KWAZULU NATAL
CONTENT
•
•
•
•
•
•
Spending on grant for first 2 quarters
Projected 2010/11 Outcome
Performance and monitoring by project and category
Co-ordination of Hospital Revite projects
Performance of contractors and consultants
Reporting and co-ordination between Health and Public
Works
• Capacity to implement programme
• Way forward
2
TRENDS IN GRANT FINANCIAL
PERFORMANCE 2005/06 TO 2009/10
2005/06
2006/07
2007/08
2008/09
2009/10
Adjusted Appropriation
R 223,938
R 317,300
R 360,194
R 330,404
R 449,558
Actual Outcome
R 111,821
R 225,900
R 333,684
R 330,404
R 225,000
Nominal Difference
R 112,117
R 91,76
R 26,510
R 0,00
R 224,558
-50.06%
-28,93%
-7,35%
0%
-49,95%
R'000
% Variance
•HRG budgets have grown rapidly over the past five years
•Planning and project management has not kept pace, resulting in under
expenditure due to delays – explained later
3
2010/11 MTEF HRG ALLOCATIONS
R'000
2010/11
2011/12
2012/13
Main Appropriation
R 500,815
R 551,698
R 572,560
•Grant allocation increases by a nominal 27 percent from R449.5 million in 2009/10 to
R500,8 in 2010/11
•Projected allocations are expected to increase further than currently shown due to
rescheduling on the 2009/10 under spent funds, currently negotiated with the National
Treasury.
•To be finalised during Adjustment Estimates process
4
BUDGET REVISIONS (cumulative)
Quarter 1
Quarter 2
Quarter 3
Quarter 4
Original Optimised Adjusted Actual
54,003
50,048
54,003
54,002
109,288
100,385 100,535 101,011
293,989
282,206 199,191
500,815
500,815 384,277
• The original budget was revised in conjunction
with NDoH as part of the optimisation plan;
• Adjusted budget is as per DG (NDoH) directive,
to be formalised in the Adjustments Estimates
5
QUARTER 2 FINANCIAL PERFORMANCE
-by project
2010/11 MAIN
BUDGET
Institution
PIA
King George V
DoPW
Lower Umfolosi
DoPW
Ngwelezane
DoPW
Rietvlei
DoPW
Dr John Dube
DoPW
Edendale
DoPW
Madadeni
DoPW
Hlabisa
IDT
Dr Pixley ka Seme
IDT
King Edward VIII
PPP
Empangeni Tertiary
DoH
Grant Management
DoH
Total
END OF Q2
ACTUAL
VARIANCE
% SPENT
201,294,000
43,812,238
157,481,762
21.77%
22,903,000
3,655,639
19,247,361
15.96%
49,510,000
10,477,453
39,032,547
21.16%
26,877,000
6,530,551
20,346,449
24.30%
2,425,000
0
2,425,000
0.00%
59,427,000
8,296,000
51,131,000
13.96%
35,500,000
0
35,500,000
0.00%
10,572,000
1,245,424
9,326,576
11.78%
28,010,000
622,721
27,387,279
2.22%
56,637,000
24,079,533
32,557,467
42.52%
250,000
0
250,000
0.00%
7,410,000
2,291,000
5,119,000
30.92%
500,815,000
101,010,558
399,804,442
20.17%
6
QUARTER 2 FINANCIAL PERFORMANCE
-by category
INFRASTRUCTURE
Institution
PIA
King George V
DoPW
Lower Umfolosi
DoPW
Ngwelezane
DoPW
Rietvlei
DoPW
Dr John Dube
DoPW
Edendale
DoPW
Madadeni
DoPW
Hlabisa
IDT
Dr Pixley ka Seme IDT
KE8
PPP
Empangeni
Tertiary
DoH
Grant Management DoH
Total
2010/11
MAIN
BUDGET
HEALTH TECHNOLOGY
END OF Q2
ACTUAL
2010/11
MAIN
BUDGET
END OF Q2
ACTUAL
93,257,000 41,962,479 106,000,000
963,335
ORGANISATIONAL
DEVELOPMENT
2010/11
MAIN
BUDGET
QUALITY
ASSURANCE
END OF
Q2
ACTUAL
1,815,000
2010/11
MAIN
BUDGET
GRANT
MANAGEMENT
END OF 2010/11
Q2
MAIN
ACTUAL BUDGET
END OF
Q2
ACTUAL
886,424
222,000
0
0
0
18,292,000
1,407,814
851,000
3,762
3,027,000 2,052,315
733,000
191,748
0
0
34,826,000
8,826,043
12,632,000
417,893
1,830,000 1,233,516
222,000
0
0
0
21,770,000
4,272,003
2,200,000
804,583
2,597,000 1,453,965
310,000
0
0
0
2,425,000
0
0
0
0
0
0
0
0
0
44,323,000
8,296,000
15,104,000
0
0
0
0
0
0
0
3,000,000
0
32,500,000
0
0
0
0
0
0
0
7,071,000
0
1,200,000
504,631
1,841,000
740,793
460,000
0
0
0
27,710,000
622,721
300,000
0
0
0
0
0
0
0
47,637,000 24,079,533
9,000,000
0
0
0
0
0
0
0
0
0
250,000
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 7,410,000 2,291,000
300,561,000 89,466,593 179,787,000
2,694,205
11,110,000 6,367,013
1,947,000
191,748 7,410,000 2,291,000
7
QUARTER 2 FINANCIAL PERFORMANCE
-Infrastructure
INFRASTRUCTURE
2010/11 MAIN
BUDGET
END OF Q2
ACTUAL
VARIANCE
% SPENT
Institution
PIA
King George V
DoPW
93,257,000
41,962,479
51,294,521
45%
Lower Umfolosi
DoPW
18,292,000
1,407,814
16,884,186
8%
Ngwelezane
DoPW
34,826,000
8,826,043
25,999,957
25%
Rietvlei
DoPW
21,770,000
4,272,003
17,497,997
20%
Dr John Dube
DoPW
2,425,000
0
2,425,000
0%
Edendale
DoPW
44,323,000
8,296,000
36,027,000
19%
Madadeni
DoPW
3,000,000
0
3,000,000
0%
Hlabisa
IDT
7,071,000
0
7,071,000
0%
Dr Pixley ka Seme
IDT
27,710,000
622,721
27,087,279
2%
KE8
PPP
47,637,000
24,079,533
23,557,467
51%
Empangeni Tertiary
N/A
250,000
0
250,000
0%
Grant Management
DoH
0
0
0
0%
300,561,000
89,466,593
211,094,407
30%
Total
8
QUARTER 2 FINANCIAL PERFORMANCE
-Health Technology
2010/11
MAIN
Institution
BUDGET
King George V106,000,000
Lower Umfolosi 851,000
END OF
Q2
ACTUAL
963,335
VARIANCE
% SPENT
105,036,665
1%
3,762
847,238
0%
12,632,000
417,893
12,214,107
3%
Hlabisa
1,200,000
504,631
695,369
42%
Rietvlei
2,200,000
804,583
1,395,417
37%
Dr Pixley ka Seme 300,000
0
Dr John Dube
0
300,000
0%
0
0
0%
Edendale
15,104,000
0
15,104,000
0%
Madadeni
32,500,000
0
32,500,000
0%
9,000,000
0
9,000,000
0%
0
0
0
0%
0
Grant Management
179,787,000
Total
0
0
0%
2,694,205
177,092,795
1%
Ngwelezane
KE8
Empangeni Tertiary
9
QUARTER 2 FINANCIAL PERFORMANCE
-Organisational Development
Institution
2010/11 MAIN END OF Q2
BUDGET
ACTUAL
VARIANCE
%SPENT
1,815,000
886,424
928,576
49%
Lower Umfolosi 3,027,000
1,830,000
Ngwelezane
2,052,315
974,685
68%
1,233,516
596,484
67%
Hlabisa
1,841,000
740,793
1,100,207
40%
Rietvlei
2,597,000
1,453,965
1,143,035
56%
Dr Pixley ka Seme
0
0
0
0%
Dr John Dube
0
0
0
0%
Edendale
0
0
0
0%
Madadeni
0
0
0
0%
KE8
0
0
0
0%
Empangeni Tertiary
0
0
0
0%
0
Grant Management
11,110,000
Total
0
0
0%
6,367,013
4,742,987
57%
King George V
10
QUARTER 2 FINANCIAL PERFORMANCE
-Quality Assurance
2010/11
MAIN
Institution
BUDGET
King George V 222,000
Lower Umfolosi 733,000
END OF
Q2
ACTUAL
0
Ngwelezane
VARIANCE
% SPENT
222,000
0%
191,748
541,252
26%
222,000
0
222,000
0%
Hlabisa
460,000
0
460,000
0%
Rietvlei
310,000
0
310,000
0%
Dr Pixley ka Seme
0
0
0
0%
Dr John Dube
0
0
0
0%
Edendale
0
0
0
0%
Madadeni
0
0
0
0%
KE8
0
0
0
0%
Empangeni Tertiary
0
0
0
0%
0
Grant Management
1,947,000
Total
0
0
0%
191,748
1,755,252
10%
11
QUARTER 2 FINANCIAL PERFORMANCE
-Grant Management
2010/11
MAIN
Institution
BUDGET
0
King George V
0
Lower Umfolosi
END OF
Q2
ACTUAL
VARIANCE
% SPENT
0
0
0%
0
0
0%
Ngwelezane
0
0
0
0%
Hlabisa
0
0
0
0%
Rietvlei
0
0
0
0%
Dr Pixley ka Seme
0
0
0
0%
Dr John Dube
0
0
0
0%
Edendale
0
0
0
0%
Madadeni
0
0
0
0%
KE8
0
0
0
0%
0
Empangeni Tertiary
7,410,000
Grant Management
0
0
0%
2,291,000
5,119,000
31%
7,410,000
2,291,000
5,119,000
31%
Total
12
Q2 EXPENDITURE PERFORMANCE AGAINST
REVISED BUDGET
Revised
Budget
Actual
TOTAL
R 384,276
R 101,011
26%
Budget revised fron R 500 815 to fund other
priority programmes
Infrastructure
R 243,457
R 89,466
37%
Actual performance 48% including a Lag
Payment of R27,865 million for Public Works
R 122,383
R 2,694
2%
Equipment on tender, most expenditure on
Q4 mainly for King George V Hospital
R 12,100
R 6,368
53%
Spending as planned
R 1,947
R 192
10%
To spend on Q3 & Q4
R 4,389
R 2,291
52%
Spending as planned
Health
Technology
Organisational
Development
Quality
Assurance
Programme
Management
% Spent Comments
13
PERFORMANCE AND COORDINATION
MONITORING OF THE PROGRAMME
• Each project has a Joint Project Management Team
which is involved with implementation and monitoring
• Programme Steering Committee meetings held
quarterly
• Additional Operational and Strategic monthly meetings
held for all infrastructure programmes
• Health Weekly Progress meetings held to ensure
timeous interventions on each project
• DPW in the process of procuring a web-enabled project
management tool by February 2011 to ensure effective
management of project milestones – to interface with
WIMS
14
PERFORMANCE OF CONTRACTORS
AND CONSULTANTS
• Contractors
– No contract terminations in 2010/11, however where
necessary procedures will be followed
– Delays experienced through tender appeals process have
negative impact on expenditure (Lower Umfolozi War
Memorial Hospital and King George V Creche)
– Need to enhance tender technical evaluation process
• Consultants
– Review of Professional Service Providers terms of
appointment currently underway e.g. imposition of
penalties
– Introduction of Project Managers to manage professional
disciplines within each project to eliminate risk & conflict of
interest
15
REPORTING AND CO-ORDINATION
BETWEEN DOH AND DPW
• Monthly Infrastructure Programme Management
Committee meetings are in place with the DOH
and Implementing Agents
• Monthly Progress Reporting through the
Standard Reporting Format
• Co-ordination by provincial treasury through the
IDIP Technical Management Committee in place
• Political Leadership will be involved through the
establishment of the Provincial Programme
Steering Committee.
16
CAPACITY TO IMPLEMENT
PROGRAMME
Health
• Lack of Project Management System by
IAs make Grant management ineffective
– Intervention: DPW in the process to source
the web-based project management tool
• Limited Project Managers within Health.
– Intervention: Process to fill the GM:
Infrastructure and critical project managers
posts including dedicated Health Technology
and Quality Assurance specialists has started
17
CAPACITY TO IMPLEMENT
PROGRAMME
Public Works
• Lack of Project Management System by
IAs make Grant management ineffective
– Intervention: DPW in the process to source
the web-based project management tool
• Limited Project Managers within Health.
– Intervention: 11 project managers have been
appointed with effect from 01 September
2010, 25 project managers interns to be
appointed by January 2011
18
PROJECT UPDATES: PUBLIC WORKS
King George V Hospital
• Outstanding variation orders and expansion of
contracts approved
• 3 projects currently forwarded for advertising
• Creche project in Appeals process, Hearing
scheduled for 26 October 2010
Lower Umfolozi War Memorial Hospital.
• Construction of the hospital has started
• Optimisation plan developed to ensure projected
cashflows are met
19
PROJECT UPDATES: PUBLIC WORKS
Ngwelezane Hospital
• 4 tenders in adjudication stage, contractors to be
on site on December 2010
Rietvlei Hospital.
• Poor performance by contractor has resulted to
poor expenditure, however, the contractor has
been assisted to improve performance
• Phase 3B (Staff Accommodation) preparing for
tender in Mid-November 2010
20
PROJECT UPDATES: PUBLIC WORKS
Edendale Hospital
• Delays due to review of the Master Plan
by National Department of Health.
However National Health have committed
to finalise this matter before end of
October 2010
Dr John Dube and Madadeni Hospitals.
• Professional team to be appointed by end
of October 2010.
21
PROJECT UPDATES: IDT
Dr Pixley ka Seme Hospital
• Delays in approving design by National
Health. National Health have committed to
finalise this by end of October 2010
Hlabisa Hospitals.
• Construction of the Hospital suspended.
Enabling works to proceed to construction
in January 2011
22
WAY FORWARD
• Health
– Weekly meetings are held to expedite decisions
– The dept will make use of Health Technology service
providers in the interim to expedite equipment
purchases, until vacancies are filled
– Stricter financial reporting is in place with all
expenditures being closely monitored.
– HR have been requested to fast track the recruitment of
new staff.
23
WAY FORWARD
• Public Works
– DoPW is currently in a process of procuring the Project
Management tool and planned to be finalised by February
2011.
– Effective implementation of IDIP and ensuring that
infrastructure plans are submitted in July of the planning
year to promote forward planning.
– Interventions as presented in each hospital will be followed
up.
– Projection to be revised inline with fast-track plan by end of
October 2010.
24