This year’s budget for health appeared to keep pace with overall national expenditure. But although it outstrips inflation, it doesn’t attempt to deal with the backlog of the past few years caused by population growth and inflation.
The budget for healthcare is set to rise by more than 10% a year for the next three years, although the real increase will be much lower because CPIX inflation was running at 8,6% in December 2007.
Among the health sound bites was a planned increase of 25 000 filled healthcare posts by 2010, after an increase of 39 600 health professionals in the public sector in the past four years.
But Manuel did not specify at which level these positions would be. Nor did he mention how the posts are going to be filled: the supply of healthcare workers is still short of the numbers required, especially for professional nurses and specialists.
Manuel acknowledged one of the problems plaguing the public healthcare system — the disconnect between national and provincial decision-making and spending. ”In some instances, provincial budgets do not always reflect national priorities, while national departments sometimes introduce priorities that are not well costed,” he said.
Allocations to provinces will amount to R238-million in 2008/09; the increase in the next three years amounts to R46-billion. Manuel said this was to provide for improvements in social welfare in particular — health, welfare, education and housing. He raised the need to consider linking child-support grants to childcare.
Conditional grants — money designated for a specific use — for HIV/Aids will increase by R2,1-billion in the next three years. This is to allow another 500 000 people access to antiretroviral therapy, in addition to the 418 000 already being treated. One advantage of such earmarked funding is that it demonstrates whether provincial departments of health have been able to spend their budgets.
Whether the money has been spent effectively is another issue — one alluded to by Manuel, who said: ”We call on provincial legislatures and the public to raise their vigilance to ensure that priorities we hold dearly, especially education and health, are funded adequately.”
Manuel said priority would be given to the state of the tertiary healthcare institutions, acknowledging a growing chorus of concern about these facilities. The development of primary healthcare centres has failed to be effective enough to take the strain off higher-level hospitals.
Health infrastructure will also receive a boost, with further allocations of R2,1-billion for the revitalisation of hospitals, including 33 new ones.
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