In delivering the Health budget speech, the Minister of Health, Dr Joe Phaahla, said the budget allocation for this financial year 2022/23 is R64,5 billion, but he is concerned that in the medium term the health budget will decrease by 1,7% each year, before inflation has been considered.

Dr Phaahla informed Members of the National Assembly that 86% of the total allocation, or some R55 billion will be transferred to provinces as conditional grants to support various health service activities related to HIV and TB, as well as human resource needs, such as medical interns and community services doctors, and infrastructure support.

He admitted that more healthcare workers are needed and said that at least R7.5 billion had been set aside for the hiring and training of community healthcare workers and medical interns over the next two financial years.

Additionally, he said 2 429 medical interns and community service personnel, among them doctors, nurses, and pharmacists, were employed during the current financial year. Progress has been achieved in stability in the employment of more than 47 000 community health workers. Dr Phaahla said: “We are grateful for an additional R2,1 billion over the next two financial years allocated for medical interns; and a total amount of R5,4 billion is allocated in this financial year to support various aspects of health professions’ training in provinces, including additional personnel.”

In the current financial year, provinces will share R6,8 billion in direct conditional grants managed by them under the Health Facilities Revitalisation grants to construct, revitalise and maintain hospitals, clinics and other facilities. Staffing of health facilities is the key to the improvement of quality service.

The presidential stimulus package, which was announced by the President in 2020 for Covid-19, continued in 2021/22 and enabled the province to employ over 73 000 additional staff, many of them on short-term contracts.

Participating in the debate, the Chairperson of the Portfolio Committee on Health, Dr Kenneth Jacobs, said the coronavirus pandemic has tested the health system’s capacity and the commitment and resilience of healthcare workers. The pandemic also laid bare the weaknesses in our healthcare system such infrastructure and health equipment backlogs.

The government has an obligation to provide a healthcare system that benefits every single man, woman and child and for this reason the Department of Health has proposed to transform health by introducing a National Health Insurance (NHI) Bill to ensure that every South African has access to healthcare services, regardless of their socio-economic status. Parliamentary processes are at an advanced stage on the Bill and will be with the committee soon.

 Dr Phaahla informed Members of Parliament that the budget includes a ring-fenced provision to prepare for the NHI, such as the benefits design and pricing, provider accreditation, management of health products procurement, further development of the digital information systems and developing risk management and anti-corruption systems.

Committee Member Ms Michelle Clarke was of the view that the R8.8 billion already allocated towards the NHI should rather be used to alleviate the critical shortage of medical personnel.

In his speech during the budget vote debate, the Deputy Minister of Health, Dr Sibongiseni Dhlomo, highlighted the government’s work to treat cancer. He acknowledged that South Africa faces a serious shortage of oncologists but that nonetheless, these services have been expanded in most provinces, especially in areas such as childhood cancers and palliative care.

“The audits have been done on the equipment at all facilities and plans are in place to replace ageing equipment. During this financial year, 2022/23, R257m has been allocated in NHI grant to six provinces to support oncology services,” said Dr Dhlomo.

Dr Jacobs said the budget vote has addressed communicable and non-communicable diseases and the department will also be scaling up mental health promotion, prevention, treatment and rehabilitation.

Dr Dhlomo added that various interventions will be put in place to improve mental health services, including building capacity by establishing district specialist mental health teams to plan, coordinate and facilitate integrated mental health services across the priority programmes.

Yoliswa Landu
16 May 2022