Presenting the health budget for this year, Finance Minister Trevor Manuel on Wednesday said: “We are profoundly conscious of the complexity of the challenges facing our health services, and strain on resources associated with a rising disease burden.”
Policy intervention supported in the budget will therefore focus both on health and on more aggressively combating the causes of ill health. Quality improvements will be targeted through developing and implementing health facility improvement plans and strengthening management skills, capacity and accountability.
A new unit to address the quality of service provision has been included in the health-spending proposal. This will be named the National Office for Standards Compliance and it will set and audit norms and standards for the hospitals and primary care centres.
Critical challenges have been identified: the rate of mortality in young adults has deteriorated, driven primarily by the HIV/Aids pandemic and tuberculosis. Infant and child mortality rates are also high. Manuel allocated an additional R1,8-billion to introduce three new child vaccines, which have proved effective in preventing infant and child deaths. The tuberculosis and HIV/Aids programmes will both receive additional resources.
The budget will also extend screening of pregnant mothers coming into the public health system and phase in an improved drug regimen to prevent mother-to-child HIV transmission. The current antiretroviral programme covers 630 000 people; the medium-term expenditure framework provides for an increase to 1,4-million by 2011/12.
The 2009 budget makes provision for further improvements in the remuneration of health professionals, and for the continued expansion of the hospital revitalisation programme. At present a total of 31 hospitals are under construction, 18 of which are due to be completed over the next three years.
Another intervention is the development of a national health insurance system aimed at improving the quality of healthcare financing and enhancing the quality of care for South Africans. To see these complex reforms become a reality a task team on social security has been mandated to conduct research and advise on the way forward.
The new health-reform strategy aims to improve the performance, efficiency and value for money of the health system. The provision of human resources will continue to be strengthened.