The Treasury should not be congratulated on its R48-billion allocation to health because the R8-billion increase has not kept up with inflation or with the increase in health practitioners’ salaries, say health analysts.
On the surface, the Budget allocation for health focuses on building hospitals, clinics and human resources, says Nzapfurundi Chabikuli, director at the Centre for Health Policy at the University of the Witwatersrand. But this does not translate into spending on the “processes of care”.
“You can have beautiful clinics, but if there is no one [motivated] to work in them, what is the point?”
Chabikuli says spending needs to focus on boosting morale, not trying to compete with First World salaries, but rather to ensure that health practitioners feel valued.
The impact of Aids is pulling resources away from primary health care back to hospitals.
“The real danger is that conditional grants [funds allocated by government to provinces for specific projects] have an indirect impact on other services but … [the HIV/Aids conditional grants] are not directly strengthening health services.”
There were no major changes in the HIV/Aids allocation, with conditional grants set to “again double over the medium term”, to R1,6-billion in 2007/2008, as the plan reaches full implementation.
But the Budget contained useful information for practitioners in the HIV/Aids field.
Despite the claim by Minister of Health Manto Tshabalala-Msimang in a ministry briefing that patient numbers were not available, the Budget report states: “In the first year, provinces identified 113 facilities and 28Â 786 patients who are on treatment.”
“I have not seen the full Budget, but there should be accountability for the failure to spend HIV/Aids Budget allocations from last year,” says Nicoli Nattrass, professor of economics at the University of Cape Town.
She says the Treasury should show how its allocation is being spent. Finance Minister Trevor Manuel cannot “just give [the minister] a blank cheque”.