Select Committee on Finance and Appropriations National Council of Provinces Presented by:

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Provincial Budgets and Expenditureas at 30 June 2009

(2009/10 Financial Year)[Section 32 of PFMA]

Select Committee on Finance and Appropriations

National Council of Provinces

Presented by:Intergovernmental RelationsNational Treasury

18 September 2009

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Key highlights (1)

• The presentation covers provincial spending as at 30 June 2009 (first quarter)

– Based on Section 40(4) PFMA reports (IYM) submitted by PTs

– Published in Government Gazette on 30 July 2009– Press Release published on 14 August 2009

• Health at 28.3% of total provincial budgets– 7 provinces projecting to overspend their health budgets

(EC – R727.9m, KZN – R486m, LP – R478.9m, MP – R350.3m)

– Capital - Provinces spent R1.6bn or 21.2% which is 39.5% compared to the same period in 2008/09

– Spending against budgets on health conditional grants is 19.3% excluding schedule 4 grants

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Health (1)

• Spending at R20.9bn or 25.4% against R82.4bn main budget– 7 provinces projecting to overspend their main budgets

• EC – R727.9m, KZN – R486m, LP – R478.9m, MP – R350.3m– Increase of R3.8bn or 22.2% compared to the previous year – Low rate of health spending in FS (22.1%) and LP (22.2%) – EC (28.3%) and MP (27.9%) reflects the highest rate of spending in

health

• Health Personnel spending at R11.4bn or 24.7% (R46bn main budget)

• Goods and Services spending at R7bn or 27.9% of R25.2bn budget– Projected overspending of R1.3bn in 6 provinces

• KZN – R518.9m, MP – R336.1m, LP – R278.3m, FS – R159.3m

• Capital spending at R1.6bn or 21.2% of R7.8bn budget – Increase of 39.5% compared to spending over the same period last year– Low rate of capital spending in NC (14.2%) and LP (15.2%) – NW, KZN (both at 30.6%) and MP (26.5%) reflects the highest rate of

capital spending in health

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Health (2)

Table: Provincial Health Expenditure as at 30 June 2009

Eastern Cape 11 328 346 12 056 203 3 206 610 28.3% -727 857 – -6.4% 28.4% 37.4% 2 809 381 14.1%

Free State 5 197 838 5 398 018 1 150 880 22.1% -200 180 – -3.9% 27.4% 35.8% 1 200 596 -4.1%

Gauteng 16 589 941 16 589 941 4 290 190 25.9% – – 0.0% 28.6% 43.2% 3 033 066 41.4%

Kw aZulu-Natal 17 769 956 18 255 975 4 679 772 26.3% -486 019 – -2.7% 32.0% 42.3% 3 924 731 19.2%

Limpopo 9 017 772 9 496 658 2 000 617 22.2% -478 886 – -5.3% 24.8% 32.4% 1 884 781 6.1%

Mpumalanga 5 429 452 5 779 749 1 514 616 27.9% -350 297 – -6.5% 26.5% 35.2% 971 914 55.8%

Northern Cape 2 213 662 2 213 662 528 823 23.9% – – 0.0% 28.6% 38.3% 426 412 24.0%

North West 4 919 308 4 934 508 1 207 064 24.5% -15 200 – -0.3% 24.9% 36.3% 964 409 25.2%

Western Cape 9 892 798 9 928 373 2 349 684 23.8% -35 575 – -0.4% 34.6% 45.9% 1 909 897 23.0%

Total 82 359 073 84 653 087 20 928 256 25.4% -2 294 014 – -2.8% 28.9% 39.4% 17 125 187 22.2%

% share of Health to

total provincial

expenditure

% share of Health to

total Social Services

expenditure

2008/09: Outcome as at 30 June

2008

Year-on-year

growth

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

R thousand

Main budgetProjected outcome

Actual payments as

at 30 June 2009

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Health: Programme Analyses

• Programme 2: Provincial District Health Services– Spending at R8.4bn or 24.9% of R33.9bn main budget– Projected over-expenditure of R1.4bn in 6 provinces

• LP – R408.7m, KZN – R369.1m, EC – R360.1m– Lowest rate of spending in GP (21.4%) and NC (22.2%)– Highest in EC (29.4%) and MP (29.3%)

• Programme 4: Provincial Hospital Services– Spending at R4.8bn or 25.8% of R18.6bn main budget– Projected over-expenditure of R873.9m in 6 provinces

• EC – R429.2m, KZN – R243.9m– Lowest rate of spending in WC (18.7%) and NC (22.5%) – Highest in EC (30.6%) and KZN (28.2%)

• Programme 5: Central Hospital Services– Spending at R3.2bn or 28.9% of R11bn main budget– Projected over-expenditure of R515.8m in 4 provinces

• KZN – R369.1m, WC – R65.8m, MP – R46.9m– Lowest rate of spending in NW (17.2%) and LP (22.2%) – Highest in WC (32.6%) and KZN (31.3%)

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Health: District Services

Table: Provincial District Health Services Expenditure (Programme 2) as at 30 June 2009

Eastern Cape 4 935 518 5 295 584 1 450 206 29.4% -360 066 – -7.3% 12.9% 45.2% 1 328 382 9.2%

Free State 1 852 863 1 903 937 433 742 23.4% -51 074 – -2.8% 10.3% 37.7% 401 891 7.9%

Gauteng 4 209 772 4 209 772 901 758 21.4% – – 0.0% 6.0% 21.0% 809 966 11.3%

Kw aZulu-Natal 8 394 655 8 763 725 2 078 331 24.8% -369 070 – -4.4% 14.2% 44.4% 1 760 464 18.1%

Limpopo 4 760 089 5 168 769 1 106 871 23.3% -408 680 – -8.6% 13.7% 55.3% 994 862 11.3%

Mpumalanga 2 762 324 2 945 129 809 523 29.3% -182 805 – -6.6% 14.1% 53.4% 541 799 49.4%

Northern Cape 988 906 988 906 219 874 22.2% – – 0.0% 11.9% 41.6% 196 965 11.6%

North West 2 494 797 2 509 997 572 620 23.0% -15 200 – -0.6% 11.8% 47.4% 479 827 19.3%

Western Cape 3 503 630 3 495 625 859 324 24.5% – 8 005 0.2% 12.6% 36.6% 648 144 32.6%

Total 33 902 554 35 281 444 8 432 249 24.9% -1 386 895 8 005 -4.1% 11.7% 40.3% 7 162 300 17.7%

R thousand


Actual payments as

at 30 June 2009

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

% share of DHS to total provincial

expenditure

% share of DHS to total

Health expenditure


2008

Year-on-year

growth

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Health: Hospital Services

Table: Provincial Hospital Services Expenditure (Programme 4) as at 30 June 2009

Eastern Cape 2 831 727 3 260 889 865 940 30.6% -429 162 – -15.2% 7.7% 27.0% 692 381 25.1%

Free State 1 296 510 1 341 271 293 809 22.7% -44 761 – -3.5% 7.0% 25.5% 338 795 -13.3%

Gauteng 3 851 667 3 851 667 1 018 145 26.4% – – 0.0% 6.8% 23.7% 816 432 24.7%

Kw aZulu-Natal 4 523 489 4 767 402 1 274 144 28.2% -243 913 – -5.4% 8.7% 27.2% 1 216 007 4.8%

Limpopo 1 065 547 1 135 753 258 526 24.3% -70 206 – -6.6% 3.2% 12.9% 246 775 4.8%

Mpumalanga 689 566 772 887 189 275 27.4% -83 321 – -12.1% 3.3% 12.5% 114 984 64.6%

Northern Cape 532 721 532 721 120 053 22.5% – – 0.0% 6.5% 22.7% 133 439 -10.0%

North West 1 175 428 1 175 428 284 352 24.2% – – 0.0% 5.9% 23.6% 271 416 4.8%

Western Cape 2 621 311 2 623 817 490 572 18.7% -2 506 – -0.1% 7.2% 20.9% 418 897 17.1%

Total 18 587 966 19 461 835 4 794 816 25.8% -873 869 – -4.7% 6.6% 22.9% 4 249 126 12.8%

R thousand


Actual payments as

at 30 June 2009

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

% share of PHS to total provincial

expenditure

% share of PHS to total

Health expenditure


2008

Year-on-year

growth

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Health: Central Hospital Services

Table: Central Hospital Services Expenditure (Programme 5) as at 30 June 2009

Eastern Cape 509 429 509 429 146 603 28.8% – – 0.0% 1.3% 4.6% – 0.0%

Free State 976 082 1 010 032 219 431 22.5% -33 950 – -3.5% 5.2% 19.1% 212 655 3.2%

Gauteng 4 414 571 4 414 571 1 298 442 29.4% – – 0.0% 8.6% 30.3% 906 826 43.2%

Kw aZulu-Natal 1 673 626 2 042 742 524 379 31.3% -369 116 – -22.1% 3.6% 11.2% 429 154 22.2%

Limpopo 800 210 800 210 177 520 22.2% – – 0.0% 2.2% 8.9% 148 538 19.5%

Mpumalanga 586 374 633 312 171 712 29.3% -46 938 – -8.0% 3.0% 11.3% 140 163 0.0%

North West 134 416 134 416 23 085 17.2% – – 0.0% 0.5% 1.9% 14 235 62.2%

Western Cape 1 911 422 1 977 177 623 727 32.6% -65 755 – -3.4% 9.2% 26.5% 576 044 8.3%

Total 11 006 130 11 521 889 3 184 899 28.9% -515 759 – -4.7% 4.4% 15.2% 2 435 678 30.8%

% share of CHS to total provincial

expenditure

% share of CHS to total

Health expenditure


2008

Year-on-year

growth

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

R thousand


Actual payments as

at 30 June 2009

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Health: Personnel

Table: Provincial Personnel Expenditure: Health as at 30 June 2009

Eastern Cape 6 066 040 6 873 544 1 835 547 30.3% -807 504 – -13.3% 28.2% 57.2% 1 534 432 19.6%

Free State 3 048 360 3 040 473 706 938 23.2% – 7 887 0.3% 28.8% 61.4% 691 333 2.3%

Gauteng 9 037 304 9 037 304 2 139 136 23.7% – – 0.0% 34.9% 49.9% 1 888 992 13.2%

Kw aZulu-Natal 10 362 138 10 738 084 2 565 332 24.8% -375 946 – -3.6% 32.4% 54.8% 2 435 258 5.3%

Limpopo 5 380 928 5 581 528 1 307 345 24.3% -200 600 – -3.7% 25.2% 65.3% 1 096 605 19.2%

Mpumalanga 2 926 127 2 877 840 687 584 23.5% – 48 287 1.7% 22.6% 45.4% 602 936 14.0%

Northern Cape 1 050 683 1 050 575 231 187 22.0% – 108 0.0% 23.2% 43.7% 214 481 7.8%

North West 2 767 277 2 769 738 646 377 23.4% -2 461 – -0.1% 25.7% 53.5% 597 741 8.1%

Western Cape 5 364 971 5 395 115 1 258 611 23.5% -30 144 – -0.6% 36.2% 53.6% 1 154 337 9.0%

Total 46 003 828 47 364 201 11 378 057 24.7% -1 416 655 56 282 -3.0% 29.8% 54.4% 10 216 115 11.4%

R thousand


Actual payments as

at 30 June 2009

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

% share of Health

Personnel to total

personnel expenditure

% share of Health

personnel to total Health

expenditure


2008

Year-on-year

growth

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Health: Goods and Services

Table: Provincial Goods and Services Expenditure: Health as at 30 June 2009

Eastern Cape 3 241 144 3 233 567 978 445 30.2% – 7 577 0.2% 30.5% 868 870 12.6%

Free State 1 619 039 1 778 369 337 393 20.8% -159 330 – -9.8% 29.3% 379 905 -11.2%

Gauteng 5 103 843 5 103 843 1 618 157 31.7% – – 0.0% 37.7% 801 190 102.0%

Kw aZulu-Natal 5 537 626 6 056 535 1 558 090 28.1% -518 909 – -9.4% 33.3% 1 183 413 31.7%

Limpopo 2 451 457 2 729 743 476 387 19.4% -278 286 – -11.4% 23.8% 611 162 -22.1%

Mpumalanga 1 742 835 2 078 923 621 780 35.7% -336 088 – -19.3% 41.1% 294 470 111.2%

Northern Cape 700 209 699 291 228 751 32.7% – 918 0.1% 43.3% 173 105 32.1%

North West 1 520 288 1 521 432 375 632 24.7% -1 144 – -0.1% 31.1% 262 617 43.0%

Western Cape 3 273 336 3 292 863 843 281 25.8% -19 527 – -0.6% 35.9% 559 782 50.6%

Total 25 189 777 26 494 566 7 037 916 27.9% -1 313 284 8 495 -5.2% 33.6% 5 134 514 37.1%

% share of G&S to

total Health expenditure


2008

Year-on-year growth

Actual payments

as % of main

budget

(Over) Under

% (Over)/ under of

main budget

R thousand


Actual payments as

at 30 June 2009

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Health: CapitalTable: Provincial Capital Expenditure: Health as at 30 June 2009

Eastern Cape 1 265 480 1 193 355 202 897 16.0% – 72 125 5.7% 23.7% 6.3% 232 716 -12.8%

Free State 439 982 479 727 69 398 15.8% -39 745 – -9.0% 21.1% 6.0% 107 945 -35.7%

Gauteng 1 460 021 1 460 021 302 211 20.7% – – 0.0% 57.2% 7.0% 247 731 22.0%

Kw aZulu-Natal 1 366 178 979 481 418 179 30.6% – 386 697 28.3% 29.3% 8.9% 185 224 125.8%

Limpopo 905 879 905 879 137 882 15.2% – – 0.0% 27.5% 6.9% 124 537 10.7%

Mpumalanga 643 530 690 471 170 701 26.5% -46 941 – -7.3% 36.7% 11.3% 63 947 166.9%

Northern Cape 423 869 423 983 60 110 14.2% -114 – 0.0% 36.7% 11.4% 34 282 75.3%

North West 519 067 519 602 158 979 30.6% -535 – -0.1% 26.5% 13.2% 99 011 60.6%

Western Cape 749 206 737 908 125 063 16.7% – 11 298 1.5% 21.7% 5.3% 83 846 49.2%

Total 7 773 212 7 390 427 1 645 420 21.2% -87 335 470 120 4.9% 30.2% 7.9% 1 179 239 39.5%

% share of Health

Capital to total

Capital expenditure

Projected outcome

(Over)Year-on-year

growth


2008

% share of Capital to

total Health expenditure

% (Over)/ under of

main budget

R thousand

Main budget

Actual payments

as % of main

budget

Under

Actual payments as

at 30 June 2009

Capital spending at R1.6bn or 21.2% of R7.8bn budget – Increase of 39.5% compared to spending over the same period last year– Low rate of capital spending in NC (14.2%) and LP (15.2%) – NW, KZN (both at 30.6%) and MP (26.5%) reflects the highest rate of

capital spending in health

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Conditional Grants

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Conditional Grants: OutcomesHealth – 2008/09

• Free Sate problems with ART roll out.

• KZN overspent, however in the previous year, R100 million was withheld and reallocated to other provinces

• Two contractors in Western Cape went bankrupt, hence the delay – unspent funds to be rolled over

COMPREHENSIVE HIV AND AIDS

PROVINCE TOTAL AMOUNT % SPENTAVAILABLE SPENT

Eastern Cape 300 522 301432 100.3%Free State 189 630 189630 100.0%Gauteng 649 631 581456 89.5%KwaZulu-Natal 757 213 757615 100.1%Limpopo 234 410 234364 100.0%Mpumalanga 177 419 186663 105.2%Northern Cape 91 444 91363 99.9%North West 247 930 245997 99.2%Western Cape 241 467 268931 111.4%Total 2 889 666 2 857 451 98.9%

FORENSIC PATHOLOGY SERVICES


Eastern Cape 90 324 95265 105.5%Free State 46 698 35814 76.7%Gauteng 79 972 80779 101.0%KwaZulu-Natal 127 757 149093 116.7%Limpopo 48 318 48834 101.1%Mpumalanga 66 302 65571 98.9%Northern Cape 29 376 18022 61.3%North West 32 531 32530 100.0%Western Cape 86 017 69958 81.3%Total 607 295 595 866 98.1%

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Conditional Grants: OutcomesHealth – 2008/09

• Poor performance by contractors in Mpumalanga

• R171 million to be rolled over in Western Cape, due to project delays experienced in Mitchell’s plain and Khayelitsha hospital

HEALTH PROFESSIONS TRAINING AND DEVELOPMENT



HOSPITAL REVITALISATION



NATIONAL TERTIARY SERVICES


Eastern Cape 472 542 414774 87.8%Free State 550 539 550718 100.0%Gauteng 2 207 424 2207424 100.0%KwaZulu-Natal 911 892 911898 100.0%Limpopo 152 239 143555 94.3%Mpumalanga 67 255 44666 66.4%Northern Cape 153 567 151965 99.0%North West 118 433 118433 100.0%Western Cape 1 503 749 1500193 99.8%Total 6 137 640 6 043 626 98.5%

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Conditional GrantsTable: Provincial Conditional Grants Expenditure as at 30 June 2009

Health 15 578 392 4 173 698 1 388 926 19.3%

Comprehensive HIV and Aids Grant 3 476 186 940 256 658 820 19.0%

Forensic Pathology Services Grant 491 662 128 781 132 061 26.9%

Health Disaster Response (Cholera) Grant 50 000 – 1 039 2.1%

1. Health Professions Training and Development Grant 1 759 799 402 096

Hospital Revitalisation Grant 3 186 303 1 048 941 597 006 18.7%

1. National Tertiary Services Grant 6 614 442 1 653 624

1. Spending of these grants is subsumed in the spending of a range of programmes across provincial departments and therefore no reporting is required on these grants.

R thousand

Division of Revenue Act, 2009

(Act No. 12 of 2009)

Received by province

Actual payments as

at 30 June 2009

Payments as % of main

budget (excluding Schedule 4,

8 grants)

• The total conditional grant allocation is R49.3bn (including Schedule 4 and 8 grants) with health making up the bulk at R15.6bn

• Specific health grants that show low rates of spending include: – Health Disaster Response (Cholera) (2.1%)– Hospital Revitalisation (18.7%)– Comprehensive HIV and AIDS (19%)

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HIV and AIDS

17

Hospital Revitalisation

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Conditional Grants – Spending Rates

Table: Selected Conditional Grants Spending Rates as at 30 June 2009

Number of provinces spent less than 15%

Number of provinces spent between 15% and 25%

(inclusive)

Number of provinces spent more than 25%

Health

Comprehensive HIV and Aids Grant 2 EC, GT 5 FS, KZN, MPU, NC, NW 2 LIM, WC

Forensic Pathology Services Grant 1 EC 3 LIM, MPU, NC 5 FS, GT, KZN, NW, WC

Hospital Revitalisation Grant 2 KZN, LIM 6 EC, FS, GT, MPU, NC, WC 1 NW Percentages represent actual expenditure of Main budgets as published in the Division of Revenue Act, 2009 (Act No.12 of 2009).

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THANK YOU

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Documents

Select Committee on Finance and Appropriations National Council of Provinces Presented by: