/ 10 June 2003

SA health budget needs a shot in the arm

South Africa’s health budget has increased steadily over recent years, but if inflation and population growth are taken into account, the country is spending little more on the treatment of individual patients than it was in the mid-1990s.

This is according to Health Minister Manto Tshabalala-Msimang, who told members of Parliament on Tuesday that the gap between health spending in the wealthier urban provinces and the poorer rural ones remained unacceptably wide.

Opening debate on her department’s budget in the National Council of Provinces, she said ”resource restraints” remained an ever-present reality in the operation of South Africa’s health services.

”We have seen respectable nominal increases in health spending for several years.

”However, when these increases are adjusted for inflation and population growth, we are spending only a little more on the health of each individual than we were in the mid-1990s.”

Tshabalala-Msimang said some obvious pressures on resources were emerging, even in the better-off provinces.

Of the total amount of R8,38-billion in the national health budget, an amount of R7,32-billion is to be transferred to provinces as conditional grants.

”Whilst the gap in per capita spending between the wealthier urban provinces and the poorer rural provinces continues to be narrowed… it has not been eradicated and remains unacceptably wide.”

She said the budgeted per capita spending in provinces ranged from R1 670, at the top of the scale, to a low of R630.

”This pattern of inequity is also reflected in large disparities in the number of health professionals available in various provinces.”

The minister also said there was an acute shortage of specialised engineers and technicians in the public health system.

An audit of hospital equipment had revealed it was sometimes not available due to ”lack of maintenance and excessive downtime”.

There were plans to train 500 engineers and technicians over the next five years.

As an interim measure, however, ”we have reached agreement with the Cuban government for engineers and technicians to work in South Africa on short-term contracts”.

On the growing number of those killed or injured as a result of violence, Tshabalala-Msimang said adult men ”constitute a major category of victims”.

”In recent years, nearly half of all deaths among young men — in the age group 15 to 29 — are due to unnatural causes: suicide, homicide and accidents.

”So you can see that the problem of violence is certainly bigger than we thought five years ago,” she said. – Sapa