By Lehlohonolo Lehana.
Finance Minister Enoch Godongwana has allocated R848 billion to the public health system over the medium term expenditure, including almost R1.4 billion for the National health Insurance (NHI) grant over the next three years.
The health allocation also includes R11.6 billion to address the 2023 public health sector wage agreement and R27.3 billion for infrastructure for the period, Godongwana said in his budget speech.
The allocation for the NHI is a demonstration of the government’s commitment to this policy. There remain a range of system-strengthening activities, that are key enablers of an improved public health care system, that must be undertaken,” Godongwana said.
He said these activities include:
- Building a national health information system and digital patient records;
- Upgrading health facilities and improving quality of care to ensure that they meet the minimum criteria to be certified and accredited for contracting under NHI;
- Strengthening facility and district management in preparation for contracting;
- Granting semi-autonomous status for central (and potentially other) hospitals; and
- Developing reference prices and provider payment methods for hospitals.
In the 2024 Budget Review, National Treasury noted that the budget for the sector is expected to grow slower than inflation over the MTEF “due to the R23.7 billion baseline reductions over the medium term”.
“The function will prioritise greater efficiency, better management of commuted overtime and intensified promotion of preventative care. Spending reviews in the sector have led to some savings in vaccine and antiretroviral tenders. The health sector continues to recover from service disruptions due to the COVID‐19 pandemic, particularly in antiretroviral treatment and tuberculosis screening and treatment.
“The Department of Health and its provincial counterparts will prioritise building tertiary services like oncology through earmarked funds in the national tertiary services grant in provinces with inadequate services. This grant grows by 8.8% in 2024/25 as funding is shifted into it from the oncology portion of the national health insurance conditional grant,” He said.
A total of R279.1 billion will be allocated to public health in 2024-25 with R120 billion going to district health services; R52,8 billion to central hospital services; R47.5 billion to provincial hospital services; R40.2 billion to other health services; and R11.3 billion to facilities management and maintenance.
Turning to education, he said the sector will receive some R25.7 billion “carry-through costs of the wage increase over the medium term”.
“At the same time, we were able to protect the budgets of critical programmes such as the school nutrition programme. The programme provides food to pupils in almost 20 000 schools.
“The early childhood development grant is allocated R1.6 billion rising to R2 billion over the medium term,” he said.
Government is expected to keep a firm eye on value for money as consolidated government spending is expected to reach R2.37 trillion in 2024/25, R2.47 trillion in 2025/26 and R2.6 trillion in 2026/27.