2019 Gauteng Health Annual Report

DEPARTMENT OF HEALTH
ANNUAL REPORT
2018/19
Together, Moving Gauteng City Region Forward
GAUTENG PROVINCE
HEALTH
REPUBLIC OF SOUTH AFRICA
DISTRIBUTION OF SERVICE PLATFORMS
EXPENDITURE PER BUDGET PROGRAMME
DISTRICT PROVINCIAL CENTRAL & EMERGENCY

HEALTH SERVICES HEALTH SERVICES TERTIARY HOSPITALS MEDICAL SERVICES
14 516 480 8 746 469 17 135 226 1 330 508
FINANCIAL INPUTS
ACTUAL EXPENDITURE
HEALTHCARE HEALTH SCIENCES HEALTH FACILITIES ADMINISTRATION

SUPPORT SERVICES & TRAINING MANAGEMENT
339 048 1 106 708 1 536 120 1 360 786
Department of Health Annual Report 2018/19

HUMAN RESOURCES FOR HEALTH
65 821
Total Health Workforce
Nursing Engineering Administration Clinical

Support Staff
Professionals Support Staff Staff Professionals
11 398
31 168 10 9 169 6 386
Allied Allied Management

Engineering
Support Staff Professionals 103
Professionals
1 929 5 589
69
Clinical Professionals Nursing Professionals
DENTAL DENTAL
REGISTRARS PRACTITIONERS
41 308
STUDENT PROFESSIONAL
MEDICAL DENTAL NURSES NURSES
REGISTRARS SPECIALISTS 2 437 14 897
1 215 116
MEDICAL MEDICAL NURSING STAFF NURSES

SPECIALISTS PRACTITIONERS ASSISTANTS 7 424
1 276 3 430 6 410
Adminstration Staff Support Staff Management

Professionals
9 169 11 398
LEVEL 13 LEVEL 14
73 23
JUNIOR LOWER
LOWER JUNIOR MIDDLE MANAGERS LEVELS
LEVELS MANAGERS MANAGERS (LEVELS 9-10) Management
(LEVELS 1-8) (LEVELS 9-10) (LEVELS 11-12) (LEVELS 1-8)
2 Professionals
8 478 457 234 11 396
LEVEL 15 LEVEL 16
3 1

A SNAPSHOT OF HEALTH SERVICES
Reproductive health
We provided 179 689 307 contraceptives to

Medroxyprogesterone injection 1 148 458
women of reproductive age
Norethisterone injection 346 766
1 432 002 pills provided
183 719 women over 30 year old

33 383 implants inserted screened for cervical cancer
Maternal and Neonatal Health Child Health
268 008 pregnant women given 126 788 learners immunized for HPV
antenatal care services
Supported 222 115 deliveries 167 100 learners screened for potential
at our facilities learning barriers
Outreach to Households Chronic Medicine Dispensing Programme
3 374 445 visits by 490 518 patients received their

ward-based outreach teams treatment through the Chronic
Medicine Programme at convenient
locations
Non-Communicable conditions and Rehabilitation services
2 295 851 hypertensive patients 552 537 diabetic patients treated

treated
85 283 Mental health care patients 73 772 assistive devices provided to

treated patients
Communicable Conditions
1 037 212 HIV patients 34 190 TB patients treated

provided with treatment

GAUTENG DEPARTMENT OF HEALTH
ANNUAL REPORT
FINANCIAL YEAR 2018/2019
PR 223/2019
ISBN: 978-0-621-47565-4
Department of Health Annual Report 2018/19 1

TABLE OF CONTENTS
PART A
GENERAL INFORMATION
1. DEPARTMENT GENERAL INFORMATION 4
2. ABBREVIATIONS AND ACRONYMS 6
3. FOREWORD BY THE MEC FOR HEALTH 8
4. REPORT OF THE ACCOUNTING OFFICER 10
5. STATEMENT OF RESPONSIBILITY AND CONFIRMATION OF
THE ACCURACY OF THE ANNUAL REPORT 15
6. STRATEGIC OVERVIEW 16
7. ORGANISATIONAL STRUCTURE 17
8. ENTITIES REPORTING TO THE MEC 18
9. LEGISLATIVE AND OTHER MANDATES 18
PART B
PERFORMANCE INFORMATION
1. AUDITOR-GENERAL’S REPORT: PREDETERMINED OBJECTIVES 20
2. OVERVIEW OF DEPARTMENTAL PERFORMANCE 20
3. STRATEGIC OUTCOME-ORIENTATED GOALS 26
4. PERFORMANCE INFORMATION BY PROGRAMME 27
5. TRANSFER PAYMENTS 81
6. DONOR FUNDS 82
7. CONDITIONAL GRANTS 83
8. CAPITAL INVESTMENT
PART C
87
GOVERNANCE
1. INTRODUCTION 99
2. RISK MANAGEMENT 99
3. MINIMISING CONFLICTS OF INTEREST 99
4. FRAUD AND CORRUPTION 100
5. CODE OF CONDUCT 100
6. HEALTH, SAFETY AND ENVIRONMENTAL ISSUES 100
7. PORTFOLIO COMMITTEES 102
8. SCOPA RESOLUTIONS 108
9. PRIOR MODIFICATIONS TO AUDIT REPORTS 116
10. INTERNAL CONTROL UNIT 116
11. REPORT OF THE AUDIT COMMITTEE 117
2 Department of Health Annual Report 2018/19

TABLE OF CONTENTS
PART D
HUMAN RESOURCE MANAGEMENT
1. INTRODUCTION 121
2. OVERVIEW OF HUMAN RESOURCES 121
3. HUMAN RESOURCES OVERSIGHT STATISTICS 122
PART E
FINANCIAL INFORMATION
1. REPORT OF THE AUDITOR-GENERAL 153
2. ANNUAL FINANCIAL STATEMENTS 162
PART F
MSD FINANCIAL INFORMATION
1. REPORT OF THE ACCOUNTING OFFICER 282
2. REPORT OF THE AUDITOR-GENERAL 294
3. ANNUAL FINANCIAL STATEMENTS 399

PART A:
GENERAL INFORMATION

1. DEPARTMENT GENERAL INFORMATION
ABOUT THE
4-18
DEPARTMENT
Information about the
mandate, location and
messages from the MEC
and the accounting
officer on performance
of the Department.
ADMINISTRATIVE
OVERVIEW
A performance report
outlining quality improve-
ment, technology and
20-78
transformation agenda.
DISTRICT HEALTH
CARE SERVICES
30-44 Performance of the priority

health programmes
accessibility, treatment and
support provided at primary
health care facilities
including reengineering of
the PHC system
HOSPITAL AND
EMERGENCY
SERVICES
Performance of the emergency
medical services, various categories of
45-59
hospital efficiency and quality
initiatives starting with hospitals that
provide specialised, tertiary care to
quaternary health care services.
HEALTH CARE SUPPORT
SERVICES OVERVIEW
30-44 A brief overview on

pharmaceutical, blood
and supply chain, human
resources capacity
development initiatives
and capital investments.
GOVERNANCE,
HUMAN FINANCIAL
Gauteng Provincial Government | Health |

A brief overview on risk
management, human
resources statistics
60-88
Annual Report 2018/2019 overview , financial
statements and
Physical address: 45 Commissioner Street legislationtin
Marshalltown
Johannesburg
2001
Postal address: Private Bag X085
Marshalltown
2107
South Africa
Email: mediaenquiries@gauteng.gov.za
Website address: http://www.health.gpg.gov.za
Facebook: Gauteng Provincial Health Department
Twitter: @GautengHealth
Instagram: @gautenghealth

2. ABBREVIATIONS AND ACRONYMS
A&E Accident and Emergency DPME Department of Planning, Monitoring and Evaluation
ACLS Advanced Cardiac Life Support DPSA Department of Public Service and Administration
AET Adult Educational and Training DR TB Drug-resistant Tuberculosis
AGSA Auditor-General of South Africa DSD Department of Social Development
AGYW Adolescent Girls and Young Women ECA Emergency Care Assistant
AIDS Acquired Immune Deficiency Syndrome ECC Emergency Communication Centre
ALS Advanced Life Support ECD Early Childhood Development
ALOS Average Length of Stay ECT Emergency Care Training
ANC Antenatal Care EHWP Employee Health and Wellness Programme
AO Accounting Officer EML Essential Medicines List
APC Advanced Primary Care EMS Emergency Medical Services
API Active Pharmaceutical Ingredient ENT Ear, Nose and Throat
APP Annual Performance Plan EPWP Expanded Public Works Programme
APP Annual Procurement Plan ERM Enterprise Risk Management
ART Antiretroviral Treatment ES Equitable Share
ARV Antiretroviral ESMOE Essential Steps in Managing Obstetric Emergencies
BAA Basic Ambulance Assistant EXCO Executive Committee
B-BBEE Broad-Based Black Economic Empowerment FCSU Family Violence, Child Protection and Sexual Offences Unit
BHVI Brien Holden Vision Institute FPS Forensic Pathology Service
BLS Basic Life Support GCRA Gauteng City Region Academy
BMH Bheki Mlangeni Hospital GDE Gauteng Department of Education
BoQ Bill of Quantity GDID Gauteng Department of Infrastructure Development
CAD Computer Aided Dispatch GDoH Gauteng Department of Health
CCMDD Centralised Chronic Medicine Dispensing and Distribution GHAC Gauteng Health Accreditation Committee
CCPGP Co-ordinating Chamber of the Public Service Co-ordinating Bargaining Council CBC for Gauteng Province GP Gauteng Province
CDC Communicable Disease Control GP General Practitioner
CEO Chief Executive Officer GPG Gauteng Provincial Government
CFMS Clinical Forensic Medical Service GPT Gauteng Provincial Treasury
CFO Chief Financial Officer GRV Goods Receipt Voucher
CHC Community Health Centre GSSC Gauteng Shared Services Centre
CHBAH Chris Hani Baragwanath Academic Hospital HAST HIV, AIDS, STIs and TB
CHW Community Health Worker HBB Helping Baby Breathe
CMJAH Charlotte Maxeke Johannesburg Academic Hospital HC Higher Certificate
CMR Child Mortality Rate HCW Health Care Waste
CoE Cost of Employment HCWM Health Care Waste Management
CoJ City of Johannesburg HFM Health Facilities Management
COPC Community-oriented Primary Care HFRG Hospital Facility Revitalisation Grant
COPD Chronic Obstructive Pulmonary Disease HIFU High-intensity Focused Ultrasound
CoT City of Tshwane HIS Health Information System
CPD Continuing Professional Development HIV Human Immunodeficiency Virus
CPSI Centre for Public Service Innovation HOD Head of Department
CRO Chief Risk Officer HPCSA Health Professions Council of South Africa
CSD Central Supplier Database HPRS Health Patient Registration System
CT Computerised Tomography HPV Human Papilloma Virus
DCST District Clinical Specialist Team HR Human Resources
DDG Deputy Director General HRD Human Resources Development
DGMAH Doctor George Mukhari Academic Hospital HWSETA Health & Welfare Sector Education & Training Authority
DHIS District Health Information System ICSP Internship and Community Service Programme
DID Department of Infrastructure Development ICT Information and Communications Technology
DOH Department of Health (national) ICU Intensive Care Unit
DORA Division of Revenue Act ILS Intermediate Life Support

IMCI Integrated Management Of Childhood Illnesses PMIS Project Management Information System
IMCI CC Integrated Management Of Childhood Illnesses Community Component PMTCT Prevention Of Mother-To-Child Transmission
IMMR In-Facility Maternal Mortality Ratio PPP Public Private Partnership
IRS Integrated Reporting System PPE Personal Protective Equipment
ISHP Integrated School Health Programme PRAAD Policy On Reasonable Accommodation And Assistive Devices
IT Information Technology PrEP Pre-Exposure Prophylaxis
JPSA Justice Project South Africa PSC Public Service Commission
LAN Local Area Network PSCBC Public Service Co-Ordinating Bargaining Council
LBC Liquid Base Cytology PSETA Public Service Education And Training Authority
LTDOT Long Term Domiciliary Oxygen Therapy PSRMF Public Sector Risk Management Framework
M&E Monitoring And Evaluation PSS Professional Services Support
MAM Moderate Acute Malnutrition PWDs People With Disabilities
MDPSA Member of Directed Pension Scheme Administration QA Quality Assurance
MDR-TB Multi-Drug Resistant Tuberculosis RADU Remote Automated Dispensing Units
MEC Member Of Executive Council RDT Rapid Diagnostic Test
MIS Management Information System RFQ Request For Quotation
MMC Medical Male Circumcision RM Risk Management
MMR Maternal Mortality Rate RMC Risk Management Committee
MOU Memorandum Of Understanding RTC Regional Training Centre
MPAT Management Performance Assessment Tool SABS South African Bureau Of Standards
MPET Management Performance Enhancement Tool SADC Southern African Development Community
MPSA Minister Of Public Service And Administration SAM Severe Acute Malnutrition
MSD Medical Supplies Depot SAMEC South African Malaria Elimination Committee
MSSN Management Of Small And Sick New-Borns SANC South African Nursing Council
MTCT Mother To Child Transmission SAPS South African Police Service
NCD Non-Communicable Disease SASSA South African Social Security Agency
NCS National Core Standard SBAH Steve Biko Academic Hospital
NDoH National Department Of Health SCM Supply Chain Management
NDP National Development Plan SCOPA Standing Committee On Public Accounts
NDPW National Department Of Public Works SETA Sector Education And Training Authority
NGO Non-Governmental Organisation SIPDM Standard For Infrastructure Procurement And Delivery Management
NHA National Health Act SITA State Information Technology Agency
NHI National Health Insurance SLA Service-Level Agreement
NHLS National Health Laboratory Services SLU Specialised Litigation Unit
NIDS National Information Data System SMME Small, Medium Or Micro Enterprise
NIMART Nurse-Initiated Management Of ART SMS Senior Management Service
NMC Notifiable Medical Condition SOCP Sexual Offences Care Practitioner
NSI Needle Stick Injury SOP Standard Operating Procedure
NTSG National Tertiary Services Grant STI Sexually Transmitted Infection
OD Organisational Design TB Tuberculosis
OHS Occupational Health And Safety Td Tetanus-Diphtheria
OHSC Office Of The Health Standards And Compliance TER Township Economy Revitalisation
OPD Outpatient Department TOR Terms of Reference
PACS Picture Archiving And Communication System TR Treasury Regulation
PALS Paediatric Advanced Life Support TROA Total Remaining On ART
PCU Physically Challenged Unit UCT University Of Cape Town
PDE Patient-Day Equivalent UP University Of Pretoria
PEP Post-Exposure Prophylaxis UPFS Uniform Patient Fees Schedule
PEPFAR President's Emergency Plan For AIDS Relief VHF Viral Haemorrhagic Fever
PFMA Public Finance Management Act VMMC Voluntary Medical Male Circumcision
PHC Primary Health Care WBOT Ward-Based Outreach Team
PHSDSBC Public Health And Social Development Bargaining Council Wits University Of the Witwatersrand
PIR Project Initiation Report

3. FOREWORD BY THE MEC FOR HEALTH
The Department’s service platforms nevertheless remain resilient and,

during the year, It was able to provide approximately 27.7 million
patient visits for patients presenting at PHCs, emergency and
outpatient hospital Departments. Thus 183 851 additional patients
visits were catered for during the year under review. This increasing
demand requires improved and efficient business processes which the
Department is implementing using appropriate technology. Part of
this has involved putting in place a recovery roadmap, focusing on six
strategic drivers of clinical and clinical support services: Leadership
and Governance; ICT Optimisation for Evidence Based Health Care;
Financial Discipline and Prudence; Patient Safety and Improved Health
Outcomes; and Human Resources for Health and Health Wellness and
Happiness.
The drivers relating to Clinical Services (Patient Safety and Improved

Health Outcomes) have resulted in the development of the Mental
This annual report reviews the performance of the Gauteng Health Recovery plan, the Maternal and Neonatal Health Recovery
Department of Health (GDOH) for the year 2018/2019, the final year plan and the establishment of an accreditation committee to assess
of the previous administration, underlining the work that the quality across the health facilities. The overwhelming evidence
Department has done in implementing the province’s generated in the Department reflects recurring underperformance in
Transformation, Modernisation and Re-Industrialisation policy these strategic programmes and they are therefore being prioritised
framework. within the Recovery Road Map currently being used.
The report reflects the milestones and difficulties that the While our focus and some of the expectations of the communities we
Department has overcome, in the face of particular pressures during serve have tended to be on curative care, it is well recognised that
the year, in ensuring that the health care needs of the people of delivery of healthcare requires a much broader approach. As part of
Gauteng are met. The effects of rapid urbanisation and increased pushing back the frontiers of ill-health, the GDoH launched a
migration are amongst the Department’s greatest challenges. The three-year Health, Wellness and Happiness programme on 16
report therefore reflects these challenges and their effects on the November 2018 with the aim of increasing health promotion and
health service. disease prevention for better health outcomes.
In developing the report and in planning for the next five years, the Despite the many challenges facing its health system, Gauteng has
Department has taken stock of government’s priorities. Gauteng is a the highest proportion of primary health facilities certified as Ideal
diverse, multi-racial and multi-class society where, in providing Clinics in South Africa; this is confirmed by the Office of Health
adequate health services, “the people must always come first”. This Standards Compliance which is responsible for guiding, monitoring
is the spirit that drives Team Gauteng Health during this new term. and enforcing health care safety and quality standards in the
Taking full account of the pressures and challenges that currently country’s health facilities. We have worked hard to introduce the Ideal
prevent our public healthcare system from meeting the standards of Hospitals Accreditation system in line with the Ideal Clinics System,
excellence to which we aspire, we must persist in our objective of and have appointed a panel of eight professionals as the Gauteng
improving the quality of healthcare for all the province’s residents. Health Accreditation Committee (GHAC) whose main purpose is to
The GDoH is the largest health service provider in South Africa, sustain and expand the province’s Ideal Clinics status and to realise
serving 14,6 million residents (25 % of the country’s population). the Ideal Hospitals system.
Over the past two and half decades, the province’s population has
doubled and the number of patient visits almost tripled. Only 25% Average life expectancy in Gauteng has increased from 56 to 67
of the population have adequate medical aid coverage (according to years, and mother-to-child transmission of HIV has been reduced over
a 2017 report by Statistics South Africa). This increases demand for the past five year term of government to 0,9% ushering in the
public healthcare services as, when medical aid scheme benefits do possibility that South Africa will be amongst the first countries in the
not exist or are exhausted, people turn to the public sector. world to do so. A decentralisation policy underlies this success, with
delegations to strengthen district management.

Programmes that previously showed areas of underperformance Awards and our own Khanyisa awards, a number have been publicly
have improved since implementation of the Recovery Road Map and acknowledged for their service excellence. Public appreciation of
the Department has achieved an increased number of its targets those who have shown great commitment to the Department’s
compared with the previous financial year. It is hoped that, with work is a pattern that the Department needs to maintain and
even more determination and implementation of the Road Map, this reinforce. A good public healthcare system depends on the profes-
trend will continue strongly. sionalism and compassion of its workers.
The Department has reduced past year accruals and irregular As we chart a way forward for the next five years, we will continue
expenditure and has progressively improved the rate of payments to to position ourselves as a leader in the country, particularly in
suppliers within 30 days. Much more remains to be done to ensure relation to the roll-out of National Health Insurance. I encourage all
that business processes become more efficient, with officials and of us to re-commit ourselves to diligence in service as we forge
management held accountable for their actions and inactions in ahead towards high quality healthcare for all. In the next five years,
areas of recurring underperformance. we will as a Department continue to implement the Recovery Road
Map strategy and to provide the people of Gauteng with a
In his State of the Province address, Gauteng Premier David Makhura transformed, responsive and effective public health service.
pointed to the profound challenges relating to service delivery in the
health system and that these have to be resolved as soon as possible.
The financial and structural challenges facing the public healthcare
system are the subject of urgent attention by the Provincial Executive
Council and National Cabinet, with President Ramaphosa
announcing measures to deal with these matters as part of the ___________________________
Economic Stimulus and Recovery Plan. This includes addressing Gauteng MEC for Health
shortages in hospitals, making funding available to buy new medical 31 May 2019
equipment and linen and filling critical medical posts.
The Department has moved with speed and great care in

implementing all the recommendations of the Life Esidimeni report
tabled by retired Deputy Chief Justice Dikgang Moseneke. It is
important to emphasise that the recommendations did not relate
only to financial recourse on the part of the Department. It brought
to the centre broader questions about how to position mental health
as a priority for GDoH and has enhanced the Department’s
partnership with the Office of Health Standards Compliance and
with the Family Committee to ensure a collaborative, appropriate
and professional approach to managing mental health issues. The
lessons from the Life Esidimeni tragedy must compel us to ensure
that nothing like it happens again. The health and wellness of the
people of Gauteng are paramount and it is our responsibility to
ensure that they are always provided with the best quality of
healthcare.
With the support of the wide range of stakeholders concerned with

and participating in our activities, we remain convinced that the
province’s health care system will continue to improve. This will be
supported by collaboration with the Health Sciences Faculties in our
eight universities, specialised research institutions, NGOs, civil
society and other stakeholders. We are also encouraged by our
employees who serve daily with diligence; Through the Premier’s

4. REPORT OF THE ACCOUNTING OFFICER
During the year under review, the Department implemented a

Recovery Plan as outlined in my introduction. The plan has six pillars,
three of which focus on clinical support and the remaining three on
the strengthening of health systems.
The theory of change behind the pillars was that, by reshaping

governance and stewardship, modernizing information and
performance management systems and using such information for
decision making coupled with maximum use of competent human
resources and prudent fiscal discipline, we should be able to put the
Department in a positive performance trajectory which will see the
envisaged health outputs and outcomes achieved.
Results from the implementation of the Recovery Plan include a

comprehensive governance system and management structures
which take collective decisions in a transparent manner, including
4.1 OVERVIEW OF THE DEPARTMENT’S re-establishment of secretariat services. The primary recovery
NON-FINANCIAL RESULTS roadmap included the development of recovery plans for priority
programme, namely, Mental health care programme, the Maternal
The current annual reporting season coincides with the final year of
and Neonatal health care programme and the framework for Health,
the 5th administrative term of government and the implementation
Wellness and Revolution. Other fundamental changes that took
of the Recovery Plan of the Gauteng Department of Health. Thus,
place as a result of the implementation of the Recovery Plan include
the work of the Department not only continued to focus on
the decision to decentralise care to districts followed by the
improving the quality of patient care but sought to strengthen
delegation of various powers to district managers and hospital
systems critical for improving patient experience of care. As a result
CEOs. In addition, the Department with the support of universities
of these initiatives, real improvements in key human development
embarked on an initiative to strengthen sub-district clinical and
indicators such as average life expectancy at birth were apparent.
administrative governance.
According to Stats SA, the 2017 mid-year estimates for average life
expectancy at birth for Gauteng is approximately 67 years.
Finally, GDoH launched a Health, Wellness and Happiness
Revolution programme earmarked for implementation over three
Over the five years, the Department made notable progress on
years. As regards financial and human resources management and
several other strategic and developmental goals. In this regard, the
leadership, the process of ensuring readiness to implement in the
Department contributed to producing a generation of under-20s
new financial year commenced by the end of the fiscal year. By the
that is mostly free of HIV. Significant improvement in the prevention
end of March, operational plans, performance contracts and
of Mother to Child Transmission (MTCT) of HIV, approaching zero
demand and equipment plans were available from management.
infection rate, is slowly becoming a reality. We have managed to
This is a significant improvement in management practices, as such
reduce MTCT of HIV from 2% to 0.99% at ten weeks after birth and
documents were never previously submitted on time. To this end,
will have increased antiretroviral coverage among pregnant women
the Department has been able to resource these plans using the
living with HIV to over 90% by 2019/20. We have managed also to
stimulus package.
exceed the five-year targets for the reduction of the infant mortality
and under-5 mortality rates. The neonatal mortality rate, however,
The Department further augmented critical posts in accordance with
remains stubbornly unchanged. A comprehensive recovery plan to
its recovery journey through a reprioritisation exercise. Two
address the determinants of the deaths of new borns has been
thousand posts aligned to the budget were approved by the Post
developed in this regard. In addition, the Department has also
Filling Committee. In addition, it benefitted from the human
observed tremendous increases in the demand for health care
resources capacitation grant element in the stimulus package.
services across its various service platforms.

There were also notable improvements in financial management and The Department moved swiftly with the support of the provincial
accountability. As a result, accruals were reduced from R6.8 billion government, WITS Health Consortium, Standard Bank, PEPFAR
to R4.4 billion. Despite the improvements, debt collection remains a partners, the Life Health group, Zwavelstream Psychiatric Hospital
challenge. and Nashua to ensure that service delivery was impacted minimally.
A business continuity policy has since been approved and the
Matters under investigation include allegations of officials doing Department has now completed the business continuity maturity
business with the state, fraudulent overtime claims, employees assessment which forms the basis for the development of business
doing remunerative work without approval and ghost employees. continuity plans for the health facilities.
For the first time in the 5th term of government, the equity target for
persons with disabilities was met. Although the Departmental Efforts are under way to ensure that there is continuous
targets have been attained, more still needs to be done in these improvement in compliance with Occupational Health and Safety
areas to ensure that the transformation targets of 50% female SMS (OHS) regulations. Training on OHS compliance was undertaken for
and 2% of persons with disability are reached in accordance with all head office employees.
the law. As part of improving efficiencies and building a
high-reliability organisation, the Department now has 12 hospitals Assessments have also been made pertaining to the safety of
that are implementing Lean Management in phased in manner. The patients and staff in all health facilities. Our commitment to
percentage of hospitals with an upgraded Local Area Network (LAN) implementing the national vision as reflected in the National
infrastructure was also exceeded through the adoption of a lean Development Plan and the Departmental quality improvement
LAN infrastructure design. This resulted in an additional four initiatives aimed at improving experience of care for our
hospitals being incorporated into the LAN. communities is ever before our eyes.
Despite the acute challenges to the health system, the Department In this regard, we were saddened by an increasing number of attacks
continued to strive for improved quality of service, as indicated by on our staff, predominantly emergency medical services staff with
the fact that the GDoH has the highest proportion of clinics that are some isolated attacks at our health facilities. We will continue to use
Ideal Clinics in the country, at 89%. Also, 30 of its 32 Community every avenue to educate and increase the awareness of communities
Health Centres (CHCs) provide comprehensive 24 hour services. of their responsibilities to health care delivery and advocate for
Efforts to improve access to medicines saw enrolment of clients in communities that are comprised of public health activists. The
the Centralised Chronic Medicine Dispensing and Distribution Department in collaboration with the Department of Community
programme rising to 490 518. Safety, the South African Police Service and the Private Security
Industry Regulatory Authority have undertaken a process of
Notwithstanding the efforts of the Department to provide quality strengthening physical security at health facilities through insourcing
health care, it has been hampered by several instances of labour physical security using police reservists and community safety
unrest, namely those by student nurses, community health workers patrollers.
and general staff demanding payment of performance bonuses.
4.2 OVERVIEW OF THE DEPARTMENT’S FINANCIAL
RESULTS
Another significant event that unsettled the Department's
administrative operations was the fire at the Bank of Lisbon building The Department surpassed its revenue collection target by R272
on the 5th of September 2018. Although the impact on service million (54%). The notable improvement in revenue collection is a
delivery of the fire was minimal, the administrative functioning of result of increased payments received from medical schemes, the
the Department was significantly impacted particularly in that access Road Accident Fund and self-paying patients. Despite this, payment
to records was restricted, it became difficult to account fully for delays from some provinces are still encountered, with no payments
assets and employees underwent emotional trauma. In addition, received from Limpopo and Mpumalanga provinces. There will be
there was loss of administrative productivity as support staff were at continuous engagement with revenue collecting agencies regarding
home due to lack of office space, tools of their trade and operational outstanding debts.
infrastructure.

DEPARTMENTAL RECEIPTS
Table: Breakdown of revenue collected per source
2018/19 2017/18
Estimate Actual (Over)/Under Estimate Actual (Over)/Under

Departmental receipts Amount Collection Amount Collection
Collected Collected
R’000 R’000 R’000 R’000 R’000 R’000
Sale of goods and services other than capital assets 475 648 657 -173 322 449 821 503 424 -53 603
Transfers received - - - - 1 -1
Fines, penalties and forfeits 335 97 -39 55 48 7
Sales of capital assets 58 1 -1 - 401 -401
Interest, dividends and rent on land 1 422 764 658 1 344 974 370
Financial transactions in assets and liabilities 31 134 131 284 -100 150 29 427 42 470 -13 043
Total 507 949 780 803 -272 854 480 647 547 318 -66 671
The following information outlines in detail how tariffs charged by the Department were determined.
Tariff Policy
Patient Fee Tariff
The Department charges according to the Uniform Patient Fee • Free health services for pregnant women and children under the
Schedule (UPFS) tariffs for patients using public hospitals. These age of six (Notice 657 of 1994, 1 July 1994).
tariffs are determined by a steering committee consisting of the • Free primary health care services (Notice 1514 of 1996, 17
National Department of Health and the health Departments of the October 1996).
nine provinces. Tariffs are reviewed and revised annually in • Termination of pregnancy (Act 92 of 1996).
accordance with Section 7.3.1 of the Treasury Regulations. Patients • Social Pensioners (Act 81 of 1967 as amended by Act 100 of
accessing public institutions are classified into three main groups for 1998).
service fee determination. The classifications are listed below: • Medico-legal services for survivors of rape, assault and post
mortem (Criminal Procedure Act 51 of 1977).
Full Paying • Donors (Human Tissue Act 63 of 1965).
This category of patients is liable to pay full UPFS fees for all services • Children who are committed to the care of a children’s home,
provided. industrial school or foster parents (Child Care Act 74 of 1983,
Section 15).
Subsidised and Exempted Patients
• Persons with mental disorders (Mental Health Act 18 of 1973).
These patients are classified into six categories (PH, PG, HG, H0, H1,
• Treatment of infectious, formidable and notifiable diseases
H2 and H3) based on statutory requirements. The PG and HG
(National Health Act 61 of 2003).
categories are exempted from paying fees because of statutorily
• Services to the formally unemployed (Unemployment Insurance
determined circumstances: for example, pregnant women and
Act 63 of 2001).
children under the age of six.
• Patients receiving HIV and AIDS treatment (Notice 1 of August
2006).
The H0 category receives services free of charge only when they
provide proof of status: for example, social pensioners. The H1, H2
and H3 category pay discounted fees which are expressed as a Meals and Crèche Fees Tariffs
percentage of the fees payable by full-paying patients. The tariffs for meals and crèches are reviewed and revised annually
in accordance with Section 7.3.1 of the Treasury Regulations. Tariff
adjustments are also negotiated and agreed upon with employee
Free Services
organisations.
The following free services are provided in line with national and
Other Tariffs
provincial policies:
Other tariffs such as parking and accommodation are determined
externally with the involvment of relevant Departments.

Table: Patient Fees Debt
HOSPITALS BAD DEBTS WRITTEN OFF R’000
Central Hospitals 251 881

Regional Hospitals 59 231
Tertiary Hospitals 47 683
District Hospitals 18 912
Dental Hospitals 1 528
Tuberculosis Hospitals 44
Psychiatric Hospitals 818
Other specialised Hospitals 46
TOTAL 380 142
The table below summarises the performance of the appropriated budget and expenditure per programme from 2017/18 to 2018/19.
Table: Programme Expenditure
2018/2019 – Preliminary Unaudited 2017/2018
Final Actual (Over)/Under Final Actual (Over)/Under

Programme Name Appropriation Expenditure Expenditure Appropriation Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Administration 1 361 130 1 360 786 344 1 085 267 1 085 177 90
District Health Services 15 073 917 14 516 480 557 437 13 712 101 13 683 513 28 588
Emergency Medical Services 1 423 203 1 330 508 92 695 1 268 154 1 219 274 48 880
Provincial Hospital Services 8 746 469 8 686 653 59 816 7 892 663 7 892 277 386
Central and Tertiary Hospitals 17 135 226 17 134 256 970 15 333 041 15 316 687 16 354
Health Sciences and Training 1 123 296 1 106 708 16 588 928 471 918 987 9 484
Health Care Support Services 339 156 339 048 108 289 838 289 767 71
Health Facilities Management 1 559 933 1 536 120 23 813 1 683 299 1 607 777 75 522
Total 46 762 330 46 010 559 751 771 42 192 834 42 013 459 179 375
4.3 VIREMENT/ROLLOVERS 4.4.2 SCM Achievements and Challenges

The Department applied for a roll-over of conditional grants funds Supply Chain Management (SCM) remains a challenge for the
that were committed but could not be spent and any other funds Department. Problems are manifested in not spending on machinery
that were not utilised before the closure of the 2018/19 financial and equipment, underspending on grants intended for machinery
year. These funds were meant to assist the Department to reduce and equipment and very poor performance by SCM in meeting
the burden of accruals. annual performance targets. Supply chain business processes,
technical capacity and augmenting of staff will receive priority.
4.4. SUPPLY CHAIN MANAGEMENT
4.4.1 Unsolicited bid proposals concluded for the year under The Department did not meet the preferential procurement spend
review
targets for black ownership, woman ownership, youth ownership
The Department did not receive any unsolicited bid proposals.
and disabled ownership. The Department has identified the
following strategies in support of small, medium and
micro-enterprise (SMME) suppliers:

• Health institutions to utilise the Central Supplier Database • Investigation of irregular expenditure
(CSD) to obtain a list of prospective SMME suppliers in various • Continuous training on SCM processes and procedures
corridors. • Ensuring technical capacity of staff
• Health institutions to utilise service providers on a rotational • Consequence management
basis in procuring goods and services to promote ongoing • Ensuring that bids are awarded within the validity period to
competition amongst SMME suppliers. avoid extensions of contract.
• Health institutions to request price quotations for requirements • Fast-tracking finalisation of the procurement process of the
up to R500 000 from as many suppliers as possible that are consignment stock tender.
registered on the CSD.
• Health institutions to ensure the uplifting of SMME suppliers 4.6 GIFTS AND DONATIONS IN KIND RECEIVED FROM
by encouraging subcontracting for bids above R500 000. NON-RELATED PARTIES
The Department received various donations in kind, including
Despite the challenges cited above, the Department was able to computer equipment, office furniture and other machinery.
engage with both large and small suppliers. To demonstrate our
commitment to the transformation of the health sector, the 4.7 EXEMPTIONS AND DEVIATIONS RECEIVED FROM
Department engaged with the large suppliers to assist it to spend its THE PROVINCIAL TREASURY
budgets in a fair, equitable and just manner. The Department also The Department obtained approval to deviate from the normal
engaged with cooperatives, small and medium enterprises (SMMEs) supply chain processes for the leasing of 45 Commissioner Street for
and Military Veterans, communicating opportunities available for staff relocated following the Bank of Lisbon fire.
service provision and financing.

4.8 EVENTS AFTER THE REPORTING PERIOD
The Department has applied for the condonation of irregular
Despite the challenges, there are still best practices across some of
expenditure after conclusion of the disciplinary processes of
the institutions. Initiatives include implementation of the SAP
implicated staff. An application for writing off previous years’
Inventory Management System at Steve Biko Academic Hospital, and
expenditure is being processed.
rolling out the SAP Inventory Management System to all institutions
within the Department is under way.
4.9 ACKNOWLEDGEMENTS AND APPRECIATION
The Department wishes to thank officials and management,
In an effort to reduce the number of items procured through the
including implementing partners, for their commitment to improving
request for quotation (RFQ) process which results in the Department
healthcare delivery in Gauteng. Additional acknowledgement goes
paying exorbitant prices, vetting and quotation adjudication
to agencies of government such as the Public Service Commission
committees were established to ensure that institutions procure
(PSC) and the Human Rights Commission in helping support
goods and services in a cost-effective manner.
governance in the Department.
The Department successfully compiled the Annual Procurement Plan

4.10 APPROVAL
which was aligned to the budget and implemented stringent control
The Annual Financial Statements set out on pages 162 to 279 have
measures to ensure that no item is procured that does not appear in
been approved by the Accounting Officer.
the Annual Procurement Plan.
4.5 IRREGULAR EXPENDITURE

Irregular expenditure for the year under review amounted to R2,8
billion. This was mainly as a result of the month to month security
___________________________________
contracts, lack of a contract for cardio and nuclear consignment
Prof M. Lukhele
stock items as well as failure to follow SCM processes in procuring
Accounting Officer
goods and services.
Gauteng Department of Health
4.5.1 SCM processes and systems in place to prevent irregular 31 May 2019
expenditure
Management has implemented control measures to ensure
compliance with Treasury Regulations and Instruction Notes relating
to deviations from the normal procurement processes. Management
will implement the following:

5. STATEMENT OF RESPONSIBILITY AND CONFIRMATION
OF THE ACCURACY OF THE ANNUAL REPORT
To the best of my knowledge and belief, I confirm the following:
All information and amounts disclosed throughout the Annual

Report are consistent. The Annual Report is complete, accurate and
free from any omissions and has been prepared in accordance with
the guidelines on Annual Reports as issued by National Treasury.
The Annual Financial Statements (Part E) have been prepared in

accordance with the modified cash standard and the relevant
frameworks and guidelines issued by National Treasury.
The Accounting Officer is responsible for the preparation of the

Annual Financial Statements and the judgements made on this
information.
The Accounting Officer is responsible for establishing and

implementing a system of internal control designed to provide
reasonable assurance as to the integrity and reliability of the
performance information, the human resources information and the
Annual Financial Statements.
External auditors were engaged to express an independent opinion

on the Annual Financial Statements. In my opinion, the Annual
Report fairly reflects the operations, performance information,
human resources information and financial affairs of the
Department for the financial year ended 31 March 2019.
Yours faithfully
_____________________________________
Accounting Officer
Gauteng Department of Health
31 May 2019

6. STRATEGIC OVERVIEW
VISION
Daily, we provide high-quality, efficient and accessible healthcare to

transform people’s lives.
MISSION
To create an effective public healthcare system in Gauteng by

ensuring we have the right people, skills, systems and equipment to
provide the care our patients need to live healthy, good-quality lives.
VALUES
Patient-focused: Everything we do should benefit the patient.
Accountability: We take ownership of our responsibilities and go

above and beyond and expect our colleagues to do the same to
achieve the best outcome for our patients.
Transparency: We make decisions based on facts and are willing to

explain them to those affected by those decisions.
Efficiency: We work efficiently to optimise the scarce resources to

achieve more with less. We know that budgets are tight, and human
resources are few.
Provincial values: We are passionate and contribute to patriotism,

integrity, purposefulness, accountability and activism.

7. ORGANISATIONAL STRUCTURE
MEC: GAUTENG
DEPARTMENT OF HEALTH
Head Of Department
Head Office
DDG: Human
CD: Information and Chief of Operations Resources & CD: Corporate Chief Financial DDG: Facility
Technology (L14) (L15) OD (L15) Services (L14) Officer 9L15) Management (L15)
Dir: Health Information

CD: Financial CD: Infrastructure
Management & CD: Health Programs CD: Human Resources Dir:Legal & Corporate Management & Management
Technology Management Secretarial Services Accounting
CD: Supply Chain

Dir: IT Risk CD: Human Resources Management & Dir Heailth Care
Management CD: Hospital Services CD: Communication
Development Corporate Waste Management
Governance
CD: Policy, Strategic

Planning & Monitoring
Dir: Information CD: District CD: Special Projects
CD: Risk Management
Systems Management
CD: Budget & CD: Infrastructure

Dir: IT Infrastructure CD: Health Service Revenue Project Management
Support
CD: Tuberculosisi
(TB)
CD: Health
Economics &
Financing
CD: Forensic &

Medico Legal
CD: EMS
CD: Pharmacetical
Services
CD: HIV & AIDS

8. ENTITIES REPORTING TO THE MEC
Except for the Medical Supplies Depot (MSD), a trading entity, no

public entities fall under the control of the MEC. The performance of
the MSD in respect of pharmaceutical services is described in Part F
of this report.
The table below gives information about the MSD.
Name of Entity Legislative Mandate Financial Relationship Nature of Operations
Registered as ‘The Central The depot charges a levy of The MSD is responsible for the
Medical Supplies Depot (MSD)
Medical Trading Account’ 5% on stock supplied to the supply of essential medicines
since 1 April 1992 under the provincial healthcare facilities. and disposable sundry items
Exchequer Act, Act 1 of 1976 to the Gauteng provincial
healthcare facilities.
9. LEGISLATIVE AND OTHER MANDATES

The Department derives its mandate from the South African
Constitution, the National Health Act and other legislation
promulgated by Parliament.
The Department’s core mandate is to:

• Improve the health status of the population
• Improve health services
• Secure better value for money
• Ensure effective organisation
• Provide integrated services and programmes that
promote and protect health
• Assist with ensuring good quality and sustainable
livelihoods for the poor, vulnerable and marginalised
groups in society.
In fulfilling its mandate, the Department is guided by
the legislation listed in the annexure at the end of this
report.

PART B:
PERFORMANCE INFORMATION

1.PERFORMANCE INFORMATION
1.1 AUDITOR-GENERAL’S REPORT: PREDETERMINED OBJECTIVES
The Auditor-General of South Africa (AGSA) performs certain audit

procedures on Departments’ performance information to provide
reasonable assurance in the form of an audit conclusion. The audit
conclusion in relation to predetermined objectives is included in the
report to management, with material findings reported under the
Predetermined Objectives section which deals with legal and regulatory
requirements.
Refer to page 153 of the Report of the Auditor-General, published as

Part E: Financial Information.
2. OVERVIEW OF DEPARTMENTAL PERFORMANCE

2.1 SERVICE DELIVERY ENVIRONMENT IN 2018/19
The Department’s service delivery catered for primary prevention Apart from work with households, the Department further increased
and curative and quaternary/specialised services. As regards primary access to health through its integrated school health programme.
prevention, the Department provided both educationally oriented This involved visits to 746 schools where 167 100 pupils were
and outreach programmes at health facilities, households and screened for various health-related conditions which have the
schools. potential to impact negatively on learning. In this regard, 86 015
learners were referred for speech, oral health, eye care and hearing
As a result of these programmes access to health care services was problems and suspected TB. The table below provides a breakdown
improved. For instance, the number of patients cared for at of the provision of such services.
household level through the 796-strong ward-based outreach teams
came to 3 374 445 patients, a 44 % increase from the previous year.
Of the clients seen at household level, 63097 were referred to health
facilities and/or to social workers.
Integrated school health services
Type of service 2018/19 2017/18
School learners given a deworming dose 12 632 16 986
School learners immunised 2 984 702
School learners overweight 4 060 5 264
School learners referred for eye care 9 287 9 344
School learners referred for hearing problems 2 077 1 889
School learners referred for oral health 21 535 23 660
School learners referred for speech problems 292 395
School learners referred for suspected TB 417 236
School learners underweight 1 212 1 417
Td dose at 12 years 27 202 12 956
Td dose at 6 years 27 954 13 166

A range of preventative and curative health care services were Significant investments are made in the prevention of HIV and
provided through our primary health care facilities on an estimated related sexually transmitted diseases and tuberculosis. In the case of
21 079 658 occasions, representing the headcounts at Primary HIV, over 3 million patients counselled and tested, and those found
Health Care (PHC) facilities. Hospitals, on the other hand, to be positive put on treatment. By the end of the financial year over
experienced variable demand for services according to the level of 173 923 patients were placed on treatment, including 28 982
care with a significant number of patients still presenting at central pregnant women who were provided with treatment to ensure
national hospitals without referral letters. prevention of mother to child transmission of HIV.
A range of initiatives are being implemented to improve access to Innovative measures are also being implemented to decongest
health care services and in this regard the Department continues to health facilities and ensure that chronic medicines are provided
provide 24-hour comprehensive health care services in 30 of its 32 closer to where users live and work. As a result, 490 518 clients have
CHCs. All CHCs with Maternity Obstetric Units continue to provide access to various centres where they can collect their medicine
24-hour care services for supported deliveries. As a result 44 059 supplies conveniently.
deliveries across our primary health care facilities were supported by
a professional midwife. Complicated cases are also supported Notable improvements were also observed in rehabilitative services,
through specialist obstetricians across our regional and tertiary levels with provision of various assistive devices aimed at enhancing the
of care. By the end of the financial year under review, 222 115 quality of life of patients.
deliveries were attended to at our various health facilities, with only
7 439 born before arrival at the hospital.
The table below shows the devices issued and requested, and the issue rate for the reporting period.
Table: Assistive devices issued
Number issued Requested Issue rate
Device 2018/19 2017/18 2018/19 2017/18 2017/18 2018/19

Hearing aid 4 821 5 108 10 550 7 975 64.1% 45.7%
Orthosis 25 128 22 587 25 169 23 763 95.1% 99.8%
Podiatry 1 408 1 854 1 578 2 255 82.2% 89.2%
Prostheses 815 668 1 664 1 567 42.6% 49.0%
Walking aids 37 491 33 572 n/a 33 572 100% n/a
Wheelchairs 4 109 4 103 4 756 4 228 97% 86.4%
Total 73 772 67 892 43 717 73 360 92% -
Efforts to improve the immunity of children under five years Emergency transport services between health facilities also played a
continued, in addition to other interventions aimed at improving critical role in the survival of patients. The Department in the
child survival. This included immunisation of 221 437 children under financial year increased the fleet to 5 859 and helped enhance the
one year on various vaccine schedules. While the numbers capacity of emergency transport personnel to ensure that these
immunised increased, coverage of over 90% is still not being services are operated by highly technically qualified professionals. To
reached, and REACH outreach programmes are continuing to this end, 479 147 priority patients were transported to hospitals
ensure that every child is immunised. presenting with a range of conditions.
Challenges related to late presentation of children at health facilities Specialised services provided through the National Tertiary Service
by health caregivers are also being tackled directly through the grants reflect an increase in demand, with over 1.4 million patients
continued Integrated Management of Childhood Illnesses (IMCI) attending clinics whose services range from burns to oncology
community training and health education to ensure that no child services. Various hospital related services were also provided to
dies from dehydration due to diarrhoea, severe malnutrition or 5 730 255 and 887 382 patients who presented at outpatient and
pneumonia. Clinical governance to help improve these areas emergency Departments, respectively.
through the support of district clinical specialists is taking place.

2.2 ORGANISATIONAL ENVIRONMENT
The period under review coincided with the fire at the Bank of On 26 June 2018, Gauteng Department of Health hosted a supplier
Lisbon building and with labour unrest. Departmental responses engagement dinner at the Emoyeni Conference Centre with large
included efforts to minimise any effects of the fire on service suppliers that do business with the Department. A supplier summit
delivery. As a result, through its business continuity plan the at Turffontein Racecourse was also successfully held on 29 June
Department prioritised units that are critical to its operations, 2018 with the SMMEs providing services to the Department. This
including temporary accommodation and prioritising relocation to full-day summit brought together entrepreneurs with supply chain
new premises. A relocation committee comprising of labour specialists and finance and business external stakeholders who
movement representatives and management was formed to oversee facilitated the discussions which will enable the SMMEs to sustain
the relocation process. themselves.
It became clear from the last quarter of the 2017/18 financial year The following summary provides highlights from the recovery
that drastic measures were required to turn around the performance roadmap:
trajectory of the priority health programmes including a
LEADERSHIP, GOVERNANCE AND ACCOUNTABILITY
commitment to an iron clad policy position which required
partnership with and the consent of suppliers if the Department was i. Governance Charter developed outlines the various Executive
to fare better and exercise financial prudence. Committee system and management structures of the
Department. The assessment of the management structures is
As a result, several key engagements were convened with various intended to rationalise them and ensure that their purpose
stakeholders to help support the Department in its journey of aligns to the strategy of the Department.
recovery. By the first quarter of the year under review, the MEC and ii. SOPs focusing on performance accountability from primary
HOD had convened a two-day summit titled: "Commitment to health care facilities to Head Office are being implemented.
Quality Health Services: Accelerating Service Delivery Accountability on performance has been changed from
Improvement for Maternal, Neonatal and Child Health". The quarterly to weekly/monthly to ensure proactive dealing with
summit provided a platform for 300 nursing and medical personnel, potential glitches in service delivery while addressing the
policymakers, health systems leaders, specialists in reproductive, strategic objectives of the Department.
maternal and child health, community representatives, health iii. A Management Performance Enhancement Tool has been
information management specialists, monitoring and evaluation developed to provide a framework for assessing performance at
(M&E) specialists and advocacy groups on women and child related a glance for each hospital. This will help the organisation to
issues to engage on how to accelerate performance improvements ensure that management practices comply fully with legislation
in services for women and neonates. and frameworks for effective governance.
iv. Weekly accountability by the Big Seven hospitals is consistently
A committee comprising obstetricians, neonatologists, monitored through Microsoft teams while the other platforms
paediatricians, midwives and policymakers has been formed to (regional, district and sub-district hospitals) are being assisted to
develop a service-oriented recovery plan. This will ensure that the achieve consistent reporting.
persisting challenges pertaining to maternal and child health-related v. Loading of portfolios of evidence gained momentum during the
care are addressed in a comprehensive manner covering short to third quarter, and all hospital and district folders have been
long term interventions. created on the SharePoint and evidence can be uploaded.
ICT OPTIMISATION
Through this committee, the Department hosted a Maternal and
Neonatal Health Summit. A recovery plan was developed, and its i. Video-conferencing implemented at three main sites in the
costed implementation plan is being finalised. Through the advocacy province to help optimise management processes.
of this committee, a Clinical Governance Group comprising various ii. ICT Strategy finalised.
heads of clinical Departments was established to cover all other iii. LAN implemented across four hospitals, including broad access.
specialities. iv. Health Patient Registration System deployed in 69% of 372 PHC
facilities with 2.8 million patient registrations on the system.
Another important organisational process was the finalisation of the
Mental Health Recovery Plan following the conclusion of the
arbitration processes.

FINANCIAL DISCIPLINE
Financial and SCM business processes have been re-engineered, HEALTH, WELLNESS AND HAPPINESS
standardised and integrated. The tracking process for finance and
i. The GDoH developed a policy framework, the first of its kind in
SCM performance includes the implementation of electronic
the history of the Gauteng health system, for implementation
invoicing, improvement of demand plan processes, the introduction
over three years. The policy is benchmarked on models from
of an electronic demand management plan, workshops and
other countries, e.g. Community-oriented Primary Care (COPC)
strengthening of the DBAC’s controls by ensuring that all deviations
in the Cuban health care system.
are approved at the appropriate level.
ii. The framework was launched 16 November 2019 by the
HUMAN RESOURCES FOR HEALTH Gauteng Premier.
iii. It provides a paradigm shift, seeking to revolutionise health
i. A total of 2 056 posts were approved by the post-filling outcomes and give focus to health promotion.
committee, inclusive of sessional posts. Of these, 828 were iv. It has the potential to strengthen the health sector, reversing the
nursing posts in all categories. focus from treating to preventing disease.
ii. All SMS personnel signed their performance contracts at the v. Disease prevention and health promotion as outlined in the
beginning of the financial year. policy takes a multi-sectoral approach, with inter-Departmental
iii. Training of Human Resources (HR) managers on HR ethics has collaboration bringing all Departments together to address
been completed. Training of the trainer will ensure that all HR challenges that impact on the health of communities before
managers are trained in this area, with a focus on HR they manifest as illnesses.
professionals.
Several management structures and posts that are critical to the
CLINICAL
recovery of the Department have been prioritised. Important posts
i. The CEOs and governance structures Management Performance filled include the appointment of the two central hospital heads and
Enhancement Tool (MPET) Management Information of a Chief Risk Officer for the Department. Business continuity was
Performance Framework was completed with the support of the also implemented following the Bank of Lisbon building fire,
Department of Planning, Monitoring and Evaluation (DPME) and assisting in minimising the impact of business interruptions.
some of its components are being implemented while awaiting
its automation. Finally, the Department, as part of efforts to improve governance,
ii. Implementation of the Ideal Hospitals prrogramme commenced redefined the mandate of the hospital boards from advisory to
with the Gauteng Health Accreditation Committee oversight. This will go a long way in improving governance and
Implementation in progress. The committee was established to accountability. Key challenges relating to labour peace were also
help prepare Gauteng hospitals for external assessments by the tackled head-on and efforts are being made to strengthen the
Office of Health Care Standards and Compliance (OHSC). effectiveness of labour relations Departments, thus improving
Inspections are continuing. relations in the health sector between labour and management.
iii.A Mental Health Recovery Plan was developed and is being
implemented. Additional resources have been provided to cater
for mental health in the 2019/20 financial year

2.3 SERVICE DELIVERY IMPROVEMENT PLAN
The Department has completed a Service Delivery Improvement Plan. The tables below highlight the nature of the plan and its achievements
to date.
Table: Main services and standards
Current/Actual Desired Actual

Main Service Beneficiaries standard of Standard
Service (2018/19-2019/20) Achievement
Antenatal Services provided to Pregnant women attending antenatal 58.4% 70% Antenatal care was provided to
women with a first visit before 20 care with Antenatal 1st visit before 20 64.7% of pregnant women during
weeks from 58.4% to 75% weeks of gestation the first 20 weeks of pregnancy
Roll out of the pregnancy testing Women of reproductive age N/A 2500 36 153 screened for pregnancy
by WBOTs at household level (5000)
Promotion of Sexual and Teenagers and youth N/A 250 000 3500 youth and teenagers who
Reproductive Health services with received sexual reproductive health
a focus on teenagers and youth education
WBOTS promotion of early Pregnant women N/A 10% increase During household outreach visits 540
antenatal booking and post-natal (3.3%) of pregnant women were
care referred for antenatal care
1000 trained nurses and doctors Pregnant women N/A 45% of clinicians 1000 midwives, doctors, medical
on ESMOE trained on associates and paramedics were
ESMOE trained
Table: Batho Pele arrangements with beneficiaries
Current Standard Desired Year Cycle 2018/19 2018/19 Progress In This

Reporting Period
Consultation 5 community dialogues/consultations 500 Targted Community dialogues in 3 community dialogues were
conducted at least once per year per sub-districts with low uptake of early conducted
Health District Antenatal care bookings (less than 50%)
1 Symposium 1 Symposium Midwifery-Obstetric New-born

Conference was held and attended
by 250 Midwives
1 Radio station and 1 Print Media 2 Radio stations and Print Media N/A
Courtesy Analysis of all MOMCONNECT complaints Implementation of the mitigation Analysis of the datasets in the
database to determine the trends linked to strategy. Provision of Antenatal Services database is still to be carried out
antenatal service and develop mitigation in a respectful manner and reduction in
strategy Antenatal related complaints by 5%
Access 30151 households visited by WBOT teams 31587 households visited by WBOT During household outreach visits 8
where pregnant women were referred to teams where pregnant women were 540 (3.3%) of pregnant women
facilities referred to facilities were referred for antenatal care

Table: Service delivery information tool
Current Current Status Desired Year Cycle 2018/19 2018/19 Progress In This
Standard Reporting Period
Information Provide information pertaining 30151 households visited by 31587 households visited by During household outreach visits
to pregnancy and child birth WBOT teams where pregnancy WBOT teams where pregnancy 8 540 (3.3%) of pregnant women
through dialogues, care was given care was given were referred for antenatal care
MOMCONNECT and SBCC
materials / media / WBOT
Provide information to Provide information to 90% of pregnant women were

communities pertaining to communities pertaining to registered for “stage message” –
pregnancy and child birth through pregnancy and child birth information focusing on the stage
dialogues, MOMCONNECT and through dialogues, of the pregnancy and until
BCC materials/media/ MOMCONNECT and BCC postnatal care
materials/media/
Openness and Sharing of the annual Distribute citizens report to Distribute citizens report to On an annual basis the
Transparency citizens report with clients focusing on antenatal clients focusing on Department prints infographics
communities based on clients antenatal clients which are distributed during
planned targets community sessions on the annual
performance of the Department.
Table: Complaints mechanism
Current Standard Current Status Desired Year Cycle 2018/19 Progress In This
Reporting Period
Redress Resolve all received complaints within 25 Resolve all received complaints within 25 95-98% of complaints are resolved
working days working days within the agreed 25 days
Resolve all received MOMCONNECT Resolve all received complaints within 10 85% of complaints were resolved
complaints within 10 working days working days within 10 days
Inform patients upon consultation should All Antenatal care patients are informed Communities are made aware of
there be changes in the staffing or service upon consultation should there be the changes
delivery patterns changes in the staffing or service
delivery patterns
Service Standards Provision of antenatal care every day five Provision of antenatal care every day 177 facilities are providing
days a week from 08h00 to 16h00, five days a week as per the maternity antenatal care 5 days a week
including extended service hours as per the guidelines
maternity guidelines

3. STRATEGIC OUTCOME-ORIENTED GOALS
The following are the strategic oriented goals: Goals of the National Negotiated Service Delivery Agreement
• Improve health and wellbeing with an emphasis on vulnerable of the National Department of Health
groups • Increase life expectancy
• Reduce the rate of new HIV infections by 50% in youth, adults • Decrease maternal and child mortality
and babies in Gauteng, and reduce deaths from TB and AIDS by • Combat HIV and AIDS and decrease the burden of disease from
20% TB
• Increase efficiency of service implementation • Improve health system effectiveness
• Human capital management and development for better health
outcomes
• Organisational excellence
Table: Progress towards achievement of the 5-year targets, 2017/18-2018/19
Gauteng
Goals Indicator Baseline 2018/19
Performance
2017/18
Improved health and wellbeing Under-5 mortality rate (U5MR) per 1000 live births
of all citizens, with an emphasis 6.9 6.1
on children and women
Infant mortality rate (per 1000 live births) 10.1 10
Maternal mortality rate (per 100 000) 108.5 10
Neonatal mortality rate (<28 days) (per 1 000 live births) 13.6 13/1 000 live births
Reduced rate of new infections Mother-to-child transmission rate of HIV <2 months of age 0.99% 1.19%
and the burden of HIV & AIDS The proportion of eligible HIV positive pregnant women initiated 94.7% 96.8%
and TB
on antiretroviral treatment (ART)
Number of patients (adults and children) on ART 927 825 1 037 212
Medical male circumcisions 112 608 102 325
Proportion of TB treatment successes among all TB cases 87.5% (84%) 28 705/34 190
TB defaulter rate at the end of TB treatment among all TB cases 5.2% 5.2%
Percentage of HIV-TB co-infected patients on ART on completion 90.3% 88.2%
of TB treatment
Increased equal and timely PHC utilisation rate 1.5 visits per person 1.5 visits per person
access to efficient and quality
health care services, thereby
preparing for the roll-out of
National Health Insurance (NHI)

4. PERFORMANCE INFORMATION BY PROGRAMME
4.1 PROGRAMME 1: ADMINISTRATION
Purpose of the programme
To provide strategic direction and leadership; guide and support the increase was the result of encouraging employees who had not
development of policy frameworks and guidelines for priority declared their disability status to do so. However, the majority of
programmes; develop policies and legislation on healthcare people with disabilities do not have Health Sciences qualifications
provision;and ensure that norms and standards are followed in the and particularly in medicine and nursing, and the Department has
course of implementation. few vacancies in Administration and Support where people with
disabilities could be placed. Ongoing prioritisation of such people
Sub-programmes will include sourcing CVs from organisations working with people
• Human Resource Management with disabilities and encouraging walk-in applications.
• Quality Assurance
• Information and Communications Technology. Efforts to improve the experience of health care services by persons
with disabilities included changes to physical infrastructure at health
Strategic objectives
facilities. Roadshows and advocacy workshops were carried out in
• Improved client satisfaction rates.
three health districts and at five hospitals to sensitise staff to the
• Improved achievement against national norms for health
need to treat colleagues with disabilities with the dignity and
professionals.
respect they deserve. Workshops on Policy on Reasonable
• Employment equity and diversity management.
Accommodation and Assistive Devices (PRAAD) took place in most
of the province’s hospitals and districts.
Significant achievements, and strategies to address areas of
underperformance
QUALITY ASSURANCE
HUMAN RESOURCE MANAGEMENT Efforts to improve the quality of care and patient safety and
experience of health services included the establishment of a
During Women’s Month, Youth Month and in August during the Gauteng Accreditation Committee which will support institutions’
Service Delivery Expos organised by the Office of the Premier, the self-assessment before external assessment by the Office of Health
Department provided a range of health promotion services Care Standards. Compared with the previous reporting year, six
including screening for diabetes, high blood pressure, cholesterol, priority areas across all hospitals showed performance
HIV/AIDS, breast and cervical cancer and dental health. improvement. However, scores and performance levels for
Cleanliness and Infection Prevention and Control still need to
During the year under review, the number of people with improve, and Positive and Caring Attitudes and Patient Safety both
disabilities employed increased from 450 in 2017/18 to 1100. This scored below 75%.
The table below shows average scores per level of care in relation to core standards
Table: National core standards comparison report
Hospitals 2015/16 2016/17 2017/18 2018/19
Central 4/4 (100%) 4/4 (100%) 4/4 (100%) 4/4 (100%)
Tertiary 3/3 (100%) 2/3 (75%) 3/3(100%) 3/3(100%)
Regional 100% 9/9 (100%) 8/9 (88.9%) 9/9 (100%)
Districtis 82% 11/11 (100%) 11/12 (92%) 11/12 (92%)
Six Priority Areas 2015/16 2016/17 2017/18 2018/19
Availability of Medicines 80% 83% 87% 100%
Cleanliness 73% 73% 79% 86% (24/28)
Patient Safety 75% 81% 83% 89% ( 25/28)
Infection Prevention and Control 75% 85% 84% 82% (23/28)
Positive and Caring Attitude 76% 83% 87% 89% (25/28)
Waiting Times 9/11(82%) 86% 87% 89% (25/28)

Interventions to address patient concerns included activities to reduce INFORMATION AND COMMUNICATIONS TECHNOLOGY
waiting times. However, challenges remain and are being addressed;
The Department continued with the implementation of the eHealth
these are descibed below.
multi-year initiative aimed at strengthening the province’s health
system. Two key focus areas were the ongoing implementation of a
Challenges
single integrated, interoperable Health Information System for
The introduction of the Deliverology strategy for monitoring patient hospitals; and complete deployment of the Health Patient
treatment waiting times included: Registration System (HPRS) across all Primary Healthcare facilities;
effective ICT security mechanisms will be in place to safeguard
• Facilities struggling with demarcating patients’ point of arrival organisational and patient data. The remaining hospitals and
at all service points; with the support of the Provincial Waiting Primary Health Centres will also benefit from deployment of PACS
Times Team, specific points of arrival per facility were agreed. to these facilities to enable radiology services at both service levels.
• Some doctors not recording the time when they consult
patients, making it difficult to measure patient treatment To assure health information systems operations across the province,
waiting times. Doctors have been made aware of the need to the refresh of outdated and obsolete Local Area Network (LAN)
record the time before starting each consultation. infrastructure at hospitals and Primary Healthcare facilities will
• Some facilities using the Excel monitoring tool incorrectly and continue. The expansion of Business Intelligence with an emphasis
changing the formula that automatically calculates waiting on artificial intelligence and automation of data collection tools will
time in minutes. The facilities were informed that they must continue, as will strengthening of ICT Governance, Risk and
use the tool correctly so that the original tool is saved. Compliance by implementing the ICT Governance Framework across
the province’s health facilities.
PERFORMANCE INDICATORS: PROGRAMME 1 - ADMINISTRATION

Programme 1: Administration
Strategic objective Actual Planned Actual Deviation Comment ondeviation

achievement target achievement from planned
2017/18 2018/19 2018/19 target for
2018/19
(over/(under))
Reduce Outpatient Department (OPD), Accident and Emergency Department waiting times across all facilities by 60% by 2019/20
Number of hospitals # 8/37 12/37 4 Target exceeded due to implementation by

implementing Lean four additional hospitals (Mamelodi, Bheki
Management Project Mlangeni, Tara and Thelle Mogoerane).
The project is being implemented in a
phased manner, targeting various units
within hospitals. Its components include
rapid training, 5-day rapid improvement
week and value stream. Six hospitals are
already at an advanced stage of value
streaming.
Increase diversity, verification of qualifications and equity of our workforce thus increasing the number of women in senior
management positions from adequate (41%) to good (50%) and the percentage of people with disabilities employed to 2% by
2019/20.
Percentage of women 46.5% 48% 46.2% (1.8%) Target could not be achieved because of
in senior management (53/114) (56/117) (48/104) the termination of a female SMS member
posts (117 senior in the last quarter of the year. In the new
managers) financial year, the Department will target
female candidates for SMS posts.

Strategic objective Actual Planned Actual Deviation Comment on deviation

2017/18 2018/19 2018/19 target for
2018/19
(over/(under))
Increase diversity, verification of qualifications and equity of our workforce thus increasing the number of women in senior
management positions from adequate (41%) to good (50%) and the percentage of people with disabilities employed to 2% by
2019/20.
Percentage of people with 0.5% 1.5% 1.5% 0% Target achieved.
disabilities employed (336/67 499) (1 119/74 197)
Percentage of newly 100% 100% 100% 0% Target achieved.

appointed clinical staff
members with verified
qualifications
Percentage of newly 23.2% 100% 0% (100%) Verification of non- clinical staff continued,
appointed non-clinical staff albeit using internal mechanisms. Target
members with verified not achieved due to budgetary challenges.
qualifications The Department will prioritise procurement
of a service provider to conduct
verifications and consider policy revisions.
Enforce performance management at Senior Management Service (SMS) level thus increasing SMS signed contracts to 100% by
2019/20.
Percentage of SMS 100% 100% 100% 0% Target achieved

members entering into (117/117)
Performance Management
Agreements within
stipulated time frames
Improve the relationship between employer and employees in the workplace thus resolving grievances within 30 working days and
misconduct cases within 90 days.
Percentage of 90% 100% 87.9% (12.1%) Target not achieved due to the
grievances cases (327/372) unavailability of critical parties to finalise
resolved within 30 grievance cases. The Department has
working days developed a labour relations framework
aimed at improving case management,
including building labour relations capacity
in institutions.
[1] There was no strategic objective statement attached to this performance indicator; this has been included as part of the Strategic Plan review that the SCM branch conducted.
The results will be fully documented when the process is completed in October 2016. It includes: Maintain percentage of linen contracts awarded to women cooperatives at 100%
by 2019/20; Increase percentage of hospitals procuring/buying vegetables from local farmers to 90% by 2019/20; Increase percentage of hospitals procuring dairy products from
local farmers to 80% by 2019/20; Increase percentage of hospitals procuring bread from small/medium scale bakeries to 70% by 2019/20.

Strategic objective Actual Planned Actual Deviation Comment on deviation

2017/18 2018/19 2018/19 target for
2018/19
(over/(under))
Establish accurate cost base for Health Department budget
Percentage of budget # 40% 29.5% (10.5%) Target not achieved because of limited
spent on township R86.4/R292,8 marketing of business opportunities. In
enterprises against collaboration with National Empowerment
identified commodities Fund and the Gauteng Enterprise Propeller,
the Department has held supplier
workshops to boost the township
economy and will continue to strengthen
marketing and improve access.
Increase revenue collection from qualifying paying patients from R527/709 million in 2013/14 to >530 million in 2019/20.
Rand value of revenue R535m R507m R780.8m R273.8m Target exceeded due to increased
collected collection from medical aids, self-paying
patients, Correctional Services and the
Road Accident Fund as a result of
continuous engagement with collection
service providers.
Improve efficient and effective functioning and performance of hospitals and clinics and quality of patient care through functional
hospital boards; increase to 100% and clinic committees to 100% by 2019/20.
Percentage of hospitals 77% 100% 94.6% (5.4%) All hospitals had a full complement of
with functional hospital (37/37) (35/37) Board members with requisite skills.
boards Functionality for 2 of the 37 hospitals
however reduced due to resignations and
secondments. The reasons given include
lack of incentives and administrative
problems. The Department fills vacancies
when they arise. It will further explore
ways to incentivise appointed members.

Actual Planned Actual Deviation Comment on deviation

Strategic objective achievement
achievement target from planned
2017/18 2018/19 2018/19 target for
2018/19
(over/(under))
Improve efficient and effective functioning and performance of hospitals and clinics; and quality of patient care through functional
hospital boards; increase to 100% and clinic committees to 100% by 2019/20.
Percentage of Primary 76% 80% 80% 0% Target achieved
Health Care (PHC) (279/369)
facilities with
functioning clinic
committees
Implement an integrated and interoperable eHealth architecture in 100% of hospitals and clinics by 2019/2020.
Percentage of hospitals # 62% 0% (62%) Target not achieved because of delays in

with health information (23/37) acquiring the Health Information System
system implemented (HIS) by SITA.
It is expected that the HIS contract will be
concluded in the new financial year.
Percentage of PHC # 100% 68.5% (31.5 %) Target not achieved because of technical
facilities’ Health Patient (372/372) (255/372) integration and data synchronisation
Registration Systems challenges. These are being addressed
deployed through a comprehensive programme
planned for the new financial year.
Percentage of hospitals # 30% 40.5% 10.5% Target exceeded due to adoption of a lean
with an upgraded Local (11/37) (15/37) LAN infrastructure design. The benefit of
Area Network this design resulted in four additional
infrastructure institutions (Edenvale, Heidelberg, ODI and
Helen Joseph hospitals) being
incorporated into the LAN project scope.
Percentage of hospitals # 62% 5.4% (56.6%) Target not achieved because NDoH, the
with Health Patient (23/37) (2/37) custodian of the system only approved
Registration System rollout to additional hospitals in December
deployed 2018.
It is envisaged that the remaining 6
facilities will be incorporated in the new
financial year.
Number of hospitals # 37/37 22/37 (15) Target not achieved. The acquisition of a
implementing PACS new PACS contract faced procurement
delays and was not awarded as planned. It
is envisaged that the 100% target will be
achieved in the new financial year.


Strategic objective achievement target achievement from planned
2017/18 2018/19 2018/19 target for
2018/19
(over/(under))
Number of hospitals # 23/37 (7/37) 16 The target was not achieved due to lack of
with scanned patient 62% (18.9%) (43.1%) an enabling contract. A contract has been
records linked to an submitted for ratification; once approved,
electronic health it should enable achievement of the target
repository in the new financial year.
Receive unqualified audit opinion from Auditor-General by 2016/17 and a clean audit by 2019/20
Percentage of service 29% 100% 47.3% (52.7%) Payment of suppliers within 30 days of
providers’ invoices (77 357/163 655) receipt of invoices significantly improved
without dispute paid in 2018/19. However, the target could not
within 30 days be achieved due to delays in clearing of
work cycles. The Financial Reporting unit is
to be capacitated to ensure improved
payment of invoices within 30 days of
receipt, including decentralisation of SCM
processes to improve efficiencies.
Audit opinion from Unqualified Unqualified Unqualified Unqualified None

Auditor: General
Increase broadband provision in the Department so that 100% of PHC facilities and hospitals have broadband network access and
100% of total staff have email access by 2019/2020.
Percentage of hospitals 100% 100% 100% 0% Target achieved

with broadband access (37/37)
Percentage of fixed 48% 80% 47% (33%) Target not achieved because E-Gov did
PHC facilities with (176/369) (297/372) (175/372) not receive the promised funding for
broadband access broadband.
PROGRAMME 1: EXPENDITURE TABLES

Sub-programme 2017/2018 2018/2019: Preliminary unaudited
Name
Sub-programme Final
R’000 Actual
R’000 (Over) /Under
R’000 Final
R’000 Final Actual
R’000
Name Appropriation Expenditure Expenditure Appropriation Expenditure Expenditure
R’000 R’000 R’000 R’000 R’000 R’000
Office of the MEC 20 358 12 349 8 009 21 581 10 038 11 543
Management 1 064 909 1 072 828 (7 919) 1 339 549 1 350 748 (11 199)
Total 1 085 267 1 085 177 90 1 361 130 1 360 786 344

4.2 PROGRAMME 2: DISTRICT HEALTH SERVICES
Purpose of the programme Significant achievements and strategies to address areas of
To provide comprehensive PHC services, district hospital services and underperformance
comprehensive HIV and AIDS care; and to deliver priority health
programmes, including the nutrition programme. DISTRICT HEALTH MANAGEMENT AND PHC SERVICES
Ward Based Outreach Teams (WBOTs) and Expanded Public
The district health system, the vehicle for delivering PHC, covers a Works Programme (EPWP)
range of basic health services including health promotion, disease During the 2018/19 financial year, WBOTs increased from 775 to
prevention, curative care and rehabilitation. Along with equitable 791 The team supports 44 most departures by identifying
access to decent housing, clean water, sanitation, nutrition and households’ health needs and ensuring compliance with treatment
education, PHC has been shown to have a highly significant impact regimes. The Department is currently placing all CHWs on PERSAL;
on health and health outcomes. salaries will be paid through this system. During the year, 4015
EPWP participants, based at clinics as data capturers, clerks, general
Sub-programmes workers, pharmacy assistant learners and gardeners, were
contracted.
• District health management and PHC services
• District hospitals Ideal Clinic realisation and maintenance
• Maternal, child and women’s health and nutrition Ideal Clinics performance improved significantly, resulting in
• HIV and AIDS, STIs and TB care improved infrastructure, equipment procurement and availability of
• Disease prevention and control medication, and fewer essential medication stock-outs. The table
• Forensic pathology services. below shows the progress being made in realising the Ideal Clinics
project.
Districts Number of Ideal Clinics % of Ideal Clinics
Ekurhuleni 93/93 100%
Johannesburg 88/111 79%
Tshwane 72/73 98%
Sedibeng 38/38 100%
West Rand 39/48 81%
Total 330/363 90%
DISTRICT HOSPITALS One strategy directs staff and beds to units in need from those which
District hospitals are a key component of district health provision are under less pressure. To increase surgical skills and experience at
and of the referral system to PHCs. district hospitals, interested medical officers are encouraged to
rotate through regional hospital surgical units, and some surgical
Efficiency Measures procedures are directed to district hospitals from central hospitals.
Utilisation of district hospitals’ medical wards and maternity unit This reduces congestion at the central hospitals and improves
services is very high, reflecting the general burden of disease and the utilisation of district hospitals. Examples include redirection of the
health needs of the population, with under-utilisation in paediatric elective caesarean section list to South Rand Hospital from Chris
and surgical units. The low utilisation of the paediatric wards may Hani Baragwanath Academic Hospital and the breast clinic and
reflect the success of various child health programmes; in the case of theatre list to Bertha Gxowa Hospital from Charlotte Maxeke
surgical wards, it relates to district hospitals’ inability to attract Johannesburg Academic Hospital.
sufficiently experienced medical officers
.
To improve efficiency and the ability to cope with extreme needs
with the available resources, a number of efficiency measures have
been put in place in district hospitals.

Rehabilitation and Therapeutic Services
Burden of disease Radiography Services:
Rehabilitation services see around 350 new stroke patients every As the availability of radiography services must be highly
month, an enormous strain on rehabilitation and therapeutic dependable, all institutions have to ensure that their imaging and
services that has led to the formation of a multi-disciplinary task radiography equipment complies fully with the statutory
team to attend to these patients. The team is made up of staff of the requirements of the Radiation Control Directorate.
National Department of Health and the Universities of Stellenbosch
and the Witwatersrand. Clinical guidelines have been completed To ensure standardised norms and practices in the profession, the
and it is envisaged that these will be used in public and private sector Radiography Leadership forum, led by Head Office, has been
rehabilitation services for stroke patients throughout the country. restructured to enable active engagement with all radiography,
facility and district managers; HPCSA; training and development
Early Childhood Intervention committees; and higher education institutions.
In line with the wider early childhood development (ECD) agenda,
the Department’s early childhood intervention programme has now HIV, AIDS, STIS AND TB
been established at all general hospitals and CHCs. The aim of the
Significant achievements
programme is to identify disability or the risk of disability in a child as
The testing target achieved (123%) had a positivity rate of 7.2%.
early as possible.
Particularly in the fourth quarter of the reporting year, there were
Assistive Devices improved linkages between treatment and accelerated ART
During the reporting period, the rehabilitation services component initiations, with 93% of the target reached. The mother to child
issued 81 186 assistive devices compared with 67 931 reported in transmission target rate of 1.19% was achieved; and retention in
the previous year. At the same time, there has been an increase in care has improved with TROA at 94%.
demand with the overall issue rate falling to 90.8% compared with
Strategy to address areas of underperformance
92% in 2017/2018. Except for walking aids and wheelchairs, the
There have been ART initiations at all targeted focal points, with
numbers of a range of assistive devices issued and requested was
Community Mobile Clinics providing ART services. There is a need
higher than in the previous reporting period. Continuous efforts
for NIMART trained clinicians at all TB focal points; for GP Care Cell
were made to improve data quality, with devices reported separately
Expansion where GPs provide ART to the uninsured population; and
to ensure targeted interventions in the case of devices where there
for active down-referral linkages with hospitals through WBOTS.
are particular challenges, such as hearing aids and prostheses.
ACSM is to be scaled up through a range of media platforms
Social Work Services including seventeen community radio stations. Capturing of data is
The provincial Social Work Programme has been engaging with being strengthened at facility level, with facility managers
various stakeholders, including the Departments of Home Affairs performing daily audits of patient records and verification of data;
and Immigration, Social Development and SASSA and Education; weekly data verification at sub-district and district level; weekly
and child protection services and substance abuse service providers, submission of statistics to district offices on patients diagnosed and
to address issues affecting the social determinants of health. Strong initiated by hospitals; and monthly data reviews and reports on the
emphasis has been placed on services to vulnerable groups (women, status of performance.
children and older persons); addressing gender-based violence and
TB CONTROL PROGRAMME
substance; and child protection and mental health services. Forums
have been set up to capacitate and liaise with these stakeholders to Significant achievements
improve access to these programmes. To improve the quality of The introduction and roll out of Gen-Expert as the first line of TB
clinical practice, delivery of social work services at hospital and testing and diagnosis has increased the number of patients
district levels and adherence to legislation and policies, the Province diagnosed with TB in the province and continuous availability of TB
has developed and finalised SOPs; the District Mental Health drugs with necessary partner support has led to an increased
Programme has incorporated the component of social work in number of patients started on treatment. Implementation of the
monitoring of and service provision by mental health NGOs; and, LAM test for improvement of case detection is in progress. The
with district social work supervisors, has developed a province has also continued to decentralise Drug-Resistant TB (DR
profession-specific tool to audit these NGOs. All district social TB) management; all sub-districts within the five districts have a
workers have been trained on the draft tool. facility dedicated to DR TB.

Treatment outcomes
In 2018/19, of a total of 18 009 patients aged 5 and older diagnosed MATERNAL, CHILD AND WOMEN’S HEALTH AND NUTRITION
with TB, 16281 (90.4%) started on treatment, exceeding the target
of 90% because of community education on the importance of Maternal and New-born Health
testing for TB and starting on treatment immediately after diagnosis The Department continues to implement the 1st Thousand Days
and remaining on it. The province has appointed 44 retired nurses to Programme aimed at improving the health of children from
assist the WBOT officers with tracing lost patients in all districts. confirmation of pregnancy to 2 years of age through social
mobilisation and behaviour change relating to early booking for
Social mobilisation antenatal care before 14 weeks; antenatal services, including
The provincial TB programme has partnered with development provision of early ultrasound; and promotion of exclusive
partners and health officials in all districts to ensure community breastfeeding for at least six months to, where possible, two years.
education, social mobilisation and advocacy in fighting TB and During the reporting period, 16 060 obstetric ultrasounds were
related diseases. As well as its day-to-day activities, the Advocacy, performed by advanced midwives among 173 316 (64.7% of the
Communication and Social Responsibility (ACSM) subprogramme total) first booking visits province-wide.
was engaged in an intensive package of TB care and management
for the whole of March 2019. This included TB screening/testing, These took place at targeted PHC facilities as part of outreach to
contact tracing of TB index cases, condom distribution, VMMC satellite clinics in all five health districts. Eight hundred and forty-five
referral and health screening. A report on this is in progress. pregnant women were referred for higher level of care for reasons
including multiple pregnancies, gross abnormalities, abnormal body
TB/HIV collaboration
fluids, low lying placenta and other potential abnormalities. Despite
During the reporting period, 11 980 people were diagnosed with
ongoing training on Essential Steps in Managing Obstetric
TB/HIV co-infection. 10 057 (84%) were started on ART to ensure
Emergencies (ESMOE), the in-facility maternal mortality ratio (IMMR)
increased HIV immunosuppression and successful TB treatment. All
increased in comparison to the previous year from below 110 to
treatment and cares strategies are carried out in collaboration with
122.8 per 100 000 live births. The neonatal death in-facility ratio
the main HIV/ AIDS programme in the province.
was 13 per 1000 live births which could be attributed to training
nurses and doctors on Helping Baby Breathe (HBB), intended to
Drug-Resistant TB (DR TB)
improve emergency care of neonates, infants and young children,
The TB Programme is implementing the Drug-Resistant TB (DR TB)
and on Management of Sick and Small New-borns (MSSN), among
Policy, including the Decentralised DR TB policy. Centralised DR TB
other interventions.
deals with admission and management of complicated cases
diagnosed across the province. Decentralised management deals
Child Health Programme
with uncomplicated DR TB diagnosed patients who are treated and
The province has started to roll out and implement the Standardised
managed at the district facilities. In 2018/19, 361 patients were
Paediatric Register in all hospitals; this is aligned with the National
diagnosed with MDR TB and started on the new drugs on the short
Information Data System (NIDS) and is intended to enable correct
regime; 203 (56.2%) were treated successfully due to the availability
recording of paediatric admissions and separations. The number of
of new drugs and patients’ adherence to treatment.
Integrated Management of Childhood Illnesses (IMCI) trained and
mentored professional nurses has increased to 501 against the
Research
target of 400; the aim is to increase Nurse Initiatied Management of
Development partners are carrying out research on shortening the
Antiretroviral Treatment (NIMART) of children and reduce infant and
long treatment of TB and on new clinical work for the province on
child morbidity and mortality rates. Four hundred and fifty four
managing children with TB. The Aurum Institute and NGO Right to
professional nurses were trained on HBB. In the period under review,
Care are implementing the studies in Sizwe Tropical Diseases
diarrhoea deaths increased by 2.1% to 88; the target was a decrease
Hospital and in the districts. The universities are also carrying out
of 1.6%. There were 132 pneumonia deaths, an increase of 2.8%,
research into TB. In June 2018, team members from the province’s
against a targeted decrease of 1.6%.
TB programme, in collaboration with the National TB Programme
and the World Bank, presented two papers at the Durban TB
Conference; they dealt with strategies to improve TB management
and how to use the TB budget effectively in the province.

Integrated School Health Programme (ISHP) Termination of Pregnancy Services
During the year, 15 463 learners were identified with health To prevent and reduce maternal deaths from unsafe abortions, the
problems and were referred for further management at PHCs and/or Department started to provide medical abortion services in seven
hospitals. Preventative catch-up doses of Tetanus-Diphtheria (Td) hospitals (Carletonville, Heidelberg, Dr Yusuf Dadoo, South Rand,
immunisations were given to 13 166 six-year-old learners and to 12 Kalafong, Tembisa and Bertha Gxowa). Twenty professional nurses
956 twelve-year-olds. During routine health screening, 16 986 and two medical doctors were trained in medical and surgical
learners were dewormed. Health problems identified and abortion.
appropriately managed and/or referred included underweight (1
417), overweight (5 264), speech problems (395), oral health (23 Breast Cancer Services
660), eye problems (9 344) and suspected TB (236). Tembisa, Thelle Mogoerane, Rahima Moosa, Sebokeng and
Mamelodi hospitals rolled out mammogram services, with eleven
Human Papillomavirus (HPV) Vaccination Campaign 1st Dose hospitals (Chris Hani Baragwanath, Charlotte Maxeke Johannesburg
and 2nd Dose
HPV Campaign 1st Dose Academic, Helen Joseph, Rahima Moosa, Kalafong, Mamelodi,
To protect Grade 4 girls against future cervical cancer, the Human Steve Biko Academic, Dr George Mukhari Academic, Tembisa, Thelle
Papilloma Virus (HPV) Vaccination campaign was conducted in all Mogoerane and Sebokeng) currently offering mammography
health districts and schools visited during the reporting year, with 1 services; 47 444 mammograms were performed during the
433 first doses administered. reporting period.
Nutrition and Food Services

HPV Campaign 1st and 2nd Dose
All health care facilities promote breastfeeding and support mothers
During the period under review, 61 031 learners received the second
in doing so; 94% of healthcare facilities provide maternity services
dose of HPV against a target of 60 000.
accredited as Mother and Baby Friendly. During the reporting
Adolescent and Youth Health period, the percentage of severe acute malnutrition (SAM) death
During the reporting period, 2600 young people attended the Youth under 5 years was 6.8% (105 deaths) against a target of 6%.
Indaba where discussions took place on teenage sexual reproductive
health and rights, pregnancy, violence, suicide, drug and substance The Vitamin A dose rate for children 12-59 months of age stood at
abuse and HIV and personal development. Following interventions in 55.1%, with 5.76% of children under 5 years on food
the previous year in two schools in Orange Farm, there was a supplementation. The increase in this rate of supplementation is
decrease in learner pregnancy. attributed to the increased number of SAM cases identified and
supplemented to prevent admissions and readmission: the revolving
One young person from Ekurhuleni Health district was appointed by door syndrome. To measure the success of the SAM Treatment
the Minister of Health to participate in the National Advisory Group Protocol and provide an integrated approach to treating children
for two years; and, as a strategy to reduce the number of new HIV with SAM or Moderate Acute Malnutrition (MACM), training was
infections among Adolescent Girls and Young Women (AGYW), the conducted for 607 health care professionals, with SAM clinical
Department has rolled-out pre-exposure prophylaxis (PrEP) in the audits and death reviews implemented in all hospitals.
health districts in the Ekurhuleni, Johannesburg and Tshwane
metros. To promote patient recovery, reduce patient care costs and length of
hospital stay, food services in public health establishments strive to
Reproductive and Women’s Health provide patients with good quality, safe, adequate, nutrious and
Contraception and Fertility Planning culturally acceptable meals. Food safety standards are critical in all
The Couple Year Protection Rate of 54.1% translates into an food service units and the national DoH carries out annual quality
increased number of IUD insertions from 5 146 in 2014/15 to 7 005 audits. In the reporting period, 31 took place with food service units
in 2018/19; 481 professional nurses, 1 doctor and 44 enrolled achieving a score of 90%, above the national target of 75%.
nurses were trained in contraceptive and fertility planning.
Children in need in crèches and at pre-schools are provided with
Cervical Cancer Screening
growth monitoring, health promotion and subsidised nutrition
Training took place during the reporting period on the new method
funding, with 1 013 ECD centres (50 449 beneficiaries) reached
of obtaining cervical smear-liquid base cytology (LBC) to reduce the
during the year and a budget of R58 million (R5.27 per child per
incidence and prevalence of cervical cancer with early diagnosis and
day).
enrolment to care. The cervical screening rate was 52% 2018/19.

Obesity is a major public health problem facing the country, with its Geriatrics
impact and cost affecting individuals, families, communities, the In collaboration with DSD, the Department ensures that the rights of
health service and society as a whole. Training was provided for 35 older persons as outlined in the Older Persons Act No.13 of 2006 are
caterers on the Gauteng Treasury database, with special emphasis protected and promoted. It fully supports the 69 old age homes
on healthy meal provision in the workplace. DoH and GDE subsidised by DSD, all of which along with some private homes are
established an Obesity Mandate Committee to develop an visited and audited to ensure compliance with the Act and with
Implementation Plan for the Obesity Strategy, with the focus on applicable health standards; 54 subsidised residential facilities are
Grade R, 1, 4, 8, 10 learners and on selected learners presenting visited weekly by a doctor from the Department. They are also
with obesity and overweight. A referral system to weight provided with medical supplies, oxygen therapy services and dry
management professionals at health care facilities is in place. dispensary including napkins. Also in collaboration with DSD, 117
health professionals from Ekurhuleni Health District were trained on
InterDepartmental collaboration with SASSA on providing food the Elderly Abuse Strategy, and the Department supported the
parcels benefited 3 634 children under the age of five presenting Active Aging Programme, with a medical team consisting of one
with SAM and MAM (Moderate Acute Malnutrition); the aim is to doctor, two physiotherapists and two professional nurses
prevent children with MAM from progressing to SAM and those accompanying Team Gauteng to the National Older Persons’ Golden
with SAM from regressing. Games in Bloemfontein in October 2018.
DISEASE PREVENTION AND CONTROL Long Term Domiciliary Oxygen Therapy

The Department Provided Long Term Domiciliary Oxygen Therapy
Health Promotion (LTDOT) to 1 618 patients, of whom 8 patients are school going
Health promotion is a process of enabling people to increase control children and students supplied with portable freestyle oxygen
over and improve their health. The Health Promotion Programme is concentrators to assist them as they attend school and university.
available to people and groups of all ages and aims to increase their The aim of the programme is to prolong the life expectancy of
involvement in activities that improve their lifestyles. It operates patients diagnosed with respiratory diseases such as Chronic
through drives and participates in campaigns, events, community Obstructive Pulmonary Disease (COPD), lung cancer and diseases
development and health education activities. During the reporting secondary to COPD.
year, the programme planned for 250 outreach health promotion
activities and achieved 536, conducted in a wide variety of settings Eye care
and reaching 2 793 182 people. This exceeded the target of 2 000 During the financial year, 13 626 cataract operations (957.3/mil)
000. were performed in 14 facilities, almost reaching the Department’s
target of 11 232 (1000/mil); 31 102 spectacles were issued to
Non-Communicable Diseases (NCDs), geriatrics, and eye-care patients with refractive errors. In collaboration with Onsight, the
Early Detection and Treatment Impact
Department established an eye clinic at Carletonville Hospital. This
During the reporting period, 2 660 857 people were counselled and
provides eye health services to the general Carletonville community
screened for diabetes and 2 974 226 screened for hypertension,
who previously had to travel a considerable distance to Leratong
with 44 192 new diabetic patients aged 40 and older diagnosed and
Hospital for such services. Through a collaboration with the Brien
started on treatment. Of 2 295 851 hypertension patient visits, 1
Holden Vision Institute (BHVI), 13 optometrists were trained on the
736 640 patients (83%) had a normal blood pressure below 140/90
diagnostics course at the University of Johannesburg.
mmHg, and of 552 537 diabetes patient visits 367 711 patients
(73%) had normal blood glucose levels.
Five optometrists trained with bursary support from the Department
Leadership and Governance – multi-sectoral approach at various training institutions were placed the West-Rand Health
During the financial year, the Department’s NCD Control and District (one optometrist), Sedibeng Health District (two) and
Prevention Committee, consisting of stakeholders such as academic Tshwane Health District (two). This brings the total of optometrists
institutions, NGOs, advocacy groups, development partners and in the Department’s service to 62; together with the eight
other government Departments, continued its work. It meets district-based, dedicated ophthalmic nurses, this represents a
quarterly to ensure implementation of the National capable workforce at PHC to provide comprehensive eye health care
Non-Communicable Diseases Strategy. The Tshwane and Ekurhuleni services, helping to ensure early diagnosis, treatment, management
Health Districts have established their District Non-Communicable and referrals.
Diseases Prevention and Control Committees as a multi-sectoral

approach to the prevention and management of NCDs.

Communicable Disease Control and Surveillance Environmental Health services
It is South Africa’s aim to eliminate malaria by 2023. Gauteng is not Environmental health services are provided in all district
malaria endemic but the increased movement of people (local, and municipalities and metros to enable identification and monitoring of
foreign nationals) into the province results in increasing number of environmental conditions that may have adverse effects on public
cases and deaths; free malaria chemoprophylaxis for travellers is not health; and all public hospitals have access to the services of
available. Two members of the Communicable Disease Control environmental health practitioners to assist management to comply
(CDC) team are part of the South African Malaria Elimination with environmental health related legislation. Water quality is
Committee (SAMEC), where country decisions towards elimination monitored through sampling; during the financial year, the
are made.Surveillance of notifiable medical conditions (NMCs) is a bacteriologic compliance rate was 76%; this is below the national
pillar of communicable disease control, serving as an early warning target of 100%, with the non-compliance attributed to the practice
system in preventing infectious disease outbreaks. of storing water in containers at end user level.
A new web-based NMC system rolled out in all of the province’s Food safety is continuously monitored and food premises inspected,
health care facilities has provided real-time notification of infectious particularly following the public outcry about the sale of fake and
diseases, with all reported outbreaks attended to within 24 hours. unsound food stuffs. Joint investigation operations were conducted
All hospitals and clinics submit weekly surveillance reports. The with law enforcement agencies to address complaints; out of 55 586
target for submission is 80%; at 93%, the province has exceeded food premises inspected, 68.3 % were found to comply with food
this. safety legislation. Illegal operations, not compliant with zoning
regulations, contributed to the low compliance rate. Some premises
Annual Influenza vaccinations have been provided in all districts, were served with compliance notices and others were closed.
with a particular focus on vulnerable groups: people with chronic
illnesses; pregnant women; people aged 65 years and above; and During the reporting period, the premises of 530 hazardous
residents of old age homes and rehabilitation centres. In 2018, 260 substances dealers were inspected in accordance with the
000 influenza vaccine doses were distributed to such facilities, Hazardous Substance Act 15 of 1973; the compliance rate was
attaining a coverage of 97%. 94.3%, higher than the 75% of the previous financial year. The
improvement is attributed to intensified monitoring strategies.
Strategies to Address Underperformance in Communicable
Disease Control and Surveillance As part of active surveillance to reduce malaria deaths and eliminate
Training on malaria elimination strategies, targeting environmental the disease from the country, all malaria cases were investigated and
health practitioners, doctors, nurses and other healthcare in almost all cases, the patient had travelled to malaria endemic
practitioners, has been provided. malaria death audits are conducted areas.
on all patients who die from malaria; the most common cause of
fatality is patients presentating late at health facilities. A malaria Strategy to address areas of underperformance
Rapid Diagnostic Test (RDT) is availed at all health care facilities to Awareness creation about safe water storage and food safety
allow early diagnosis in the these facilities. Intravenous artesunate, measures will continue, as will workshops for environmental health
the drug of choice for complications of malaria, is now available in practitioners on food safety and water quality monitoring.
public as well as private hospitals. PHC nurses in all districts have
been trained on the use of the rapid diagnostic test and on
administering Coartem, the treatment for malaria without
complications. Doctors and environmental health practitioners have
been trained on the management and investigation of malaria.
Information has been provided to communities about how to

recognise the signs and symptoms of the disease when returning
from endemic areas, protecting themselves from mosquito bites by
using mosquito repellents, wearing long-sleeved clothing after dusk,
early presentation to health facilities if not well and taking
chemo-prophylaxis before visiting malaria-endemic areas. Malaria
awareness events are also organised by health promoters to target
communities with high case loads of malaria.

PERFORMANCE INDICATORS: PROGRAMME 2 - DISTRICT HEALTH SERVICES
Sub-programme: District Health Management and PHC Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Increase PHC facilities rendering 24 hours service provision in all CHCs; integration of mental health and rehabilitation services in
100% of PHC facilities by 2019/20
Number of CHCs 30/32 30/32 30/32 0 Target achieved

providing 24-hour
services
Percentage of PHC 100% 100% 100% 0% Target achieved

facilities with (372/372) (372/372)
integrated mental
health services
Increase the number of fully-fledged, functional Ward Based Outreach Teams from 103 to 533 by 2019/20
Number of fully 754 775 791 16 Target exceeded through the

fledged, functional establishment of additional 16 teams.
Ward Based Outreach More Community Health Workers
Teams employed in Tshwane Health District.
Reduce Outpatient Department (OPD), Accident and Emergency Department waiting times across all facilities by 60% in 2019/20
Percentage of PHC # 50% 58% 8% PHC facilities have achieved the set target
facilities with average of 100 minutes.
treatment waiting
times below agreed
benchmark of 100
minutes
Improve staff (health professionals and administration) attendance at PHC facilities and OPD and Accident and Emergency across all
health facilities by 90%
Percentage of PHC # 100% 100% 0% Target achieved
facilities with staff
attendance of 90%
and above
Increase fixed PHC clinics with Ideal Clinic status to 100%; 100% of PHC facilities and district hospitals compliant with national core
standards; and complete self assessments in 100% of hospitals and >95% of PHC facilities by 2019/20
Ideal Clinic status rate # 75% 89.2% 14.2% Target exceeded due to an additional five
(330/370) clinics (Khutsong West, Khutsong CHC,
Beverly Hills, Evaton Main and Rabie
Ridge) achieving Ideal Clinic status.

Sub-programme: District Health Management and PHC Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce the number of primary care patient cases seen at regional, tertiary and central hospitals by 20% in 2019/20 to increase
utilisation of PHC services
PHC utilisation rate - 1.5% 1.6 1.5 (0.1) Target not achieved because of
total (210 796 58 / implementation of community-based
141 042 42) interventions aimed at decongesting clinics
which led to lower numbers presenting at
health facilities.
Percentage complaints within 25 working days will be over 95% by 2019/20
Complaints resolutions 95.9% 100% 96.1% (3.9%) Target not achieved due to
within 25 working days (2 080/2 165) capacity-related challenges particularly in
rate (PHCs) Ekurhuleni District
Sub-programme: District Hospitals
Increase % of health facilities with annual quality improvement plan based on a PHC facilities self-assessment to 100%, fixed PHC
clinics scoring above 80% on the Ideal Clinic dashboard, 90% of PHC facilities and district hospitals compliance with national core
standards and percentage of PHC facilities and district hospitals that conduct self-assessment to 100% by 2019/20
Hospital achieved 75% and (11/12) 11/12 11/12 0 Target achieved

more on the National Core 92%
Standards self-assessment
rate (district hospitals)
Improve the efficiency of hospitals by reducing the average length of stay to less than 5 days
Average length of stay 4.4 days 4.5 days 4.1 days 0.4 days Within target
(district hospitals) (662 745/161 050)
Increase bed utilisation to 80% and decrease expenditure per PDE in hospitals by 2019/20
Inpatient bed utilisation 66.9% 70% 68.1% 1.9% Within target

(662 745/
rate (district hospitals)
973 835.46)
Percentage of complaints resolved within 25 working days will be over 95% by 2019/20
Expenditure per PDE R3 198 R3629 R 3 339.3 R 289.7 Target achieved

(district hospitals) (3 307 834 273/
990 568)
Percentage of complaints resolved within 25 working days to be over 95% by 2019/20
Complaint resolution 99.4% 99.4% 99.1% 0.3% Target exceeded; the Provincial Office’s
within 25 working days (529/534) monitoring of complaints has been
rate (district hospitals) strengthened and physical visits to facilities
have started.

Sub-programme: District Hospitals

Performance indicator achievement target achievement from planned
2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce Outpatient Department (OPD), Accident and Emergency Department waiting times across all facilities by 60% in 2019/20
Percentage of hospitals 75% 66% 91.6% 25.6% Three more hospitals were measured, and
with OPD average (9/12) the same was an inductive exercise in
treatment waiting times preparation for an increase in 2019/20
below agreed benchmark
of 180 minutes
Improve staff attendance (health professionals and administration) at PHC facilities and OPD and Accident and Emergency across all
health facilities by 90%
Percentage of hospitals # 100% 0% (100%) Currently not reported on due to limited
with staff attendance understanding of the tool. Training will be
of 90% and above done by Quality Assurance Directorate
during 2019/20 financial year.
Sub-programme: HIV And AIDS, STI And TB Control

Reduce Mother to Child Transmission of HIV from 2% to <1,3% at 10 weeks after birth and from <5% to 1.38% at 18 months after
birth by increasing antiretroviral coverage among pregnant women living with HIV by 2019/20
Transmission rate from 0.99% <1.38% 1.19% 0.19% Target achieved

mother to child (656/55 147)
Increase the number of female condoms distributed annually from 1 451 696 to 5.6 million by 2019/20
Female condoms 7 289 873 5 091 314 3 760 346 (1 330 968) Target not achieved due to inability of the
distributed new contractor to meet the condom
demands, payment delays, fewer primary
distribution sites in Ekurhuleni and delays
in approval by SABS. The Department will
be increasing PDS sites and facilitate
quicker resolution of work cycles. It will
also intervene through NDOH to facilitate
fast-tracking of the assessments with SABS
management.
Increase the proportion of the HIV positive population on ART from 80% in 2013/14 to 90% by 2019/20
Total new clients # 185 700 173 923 (11 777) The target was not achieved due to poor
started on ART linkage to care. Improvement in this was
observed following the introduction of
linkage officers, whose functionality will
be strengthened.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Increase the proportion of HIV positive population on ART from 80% in 2013/14 to 90% by 2019/20
ART clients remain on 927 825 1 093 1 037 212 (56 645) The target was not achieved due to
ART end of month: total 857 declining initiation trends; these improved
in the last quarter of the year under review
due to multi-stakeholder engagement.
Strengthening the functionality of linkage
officers; initiating at multiple focal points;
and monitoring supervision of daily
capturing to continue.
TB/HIV co-infected 87.5% 90% 88.2% (1.8%) Target not achieved due to limited
clients on ART rate (17 690/20051) integration across health facilities and
incomplete capturing of data onto
ETR.net. Monitoring supervision of daily
capturing and advocate for limited
rotation of technical staff to a minimum of
1 year.
Increase the number of people tested for HIV, including pregnant women, from 3 257 478 in 2013/14 to 2 498 007 by 2019/20
HIV tests done - total 3 083 921 2 641 848 3 253 783 61 1 935 Multi-stakeholder and multisectoral
collaboration contributed to this
achievement.
Increase percentage of people treated for TB from 84% in 2013/14 to 92% of total population with HIV by 2019/20
TB clients 5 years and older 88.1% 90% 90.5% 0.5% Target exceeded due to improved contact
started on treatment - rate tracing.
Increase number of male condoms distributed annually from 69 480 738 to 176 million by 2019/20
Male condoms distributed 190 349 748 160 524 172 953 486 12 429 486 Target exceeded due to increased uptake
000 of variety of scented condoms and
increased primary distribution sites in
Tshwane district.
Increase number of men medically circumcised from 132 095 in 2013/14 to 136 752 by 2019/20
Medical male circumcisions - 112 608 124 320 102 325 (21 995) Target not achieved due to delays in the
total awarding of the General Practitioners
Tender for medical male circumcision.
The tender will be concluded and awarded
during the 2019/20 financial year.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Increase TB treatment success rate from 84.5% in 2013/14 to 90% by 2019/20
TB client treatment 84.2% 89% 84% (5%) Target not achieved. The ETR.net
success rate (30998/36800) (28705/34190) erroneously reported fewer treatment
successes particularly in COJ, Tshwane and
Ekurhuleni. The system has since been
discontinued and replaced by a more
reliable system (TIER.NET).
Increase the percentage of people cured of TB from 83% in 2013/14 to 85% by 2019/20 by reducing lost to follow up rate from
5.1% to 5%
TB clients lost to follow 6.3% 5.5% 6.3% (0.8%) Target not achieved due to inability to
up rate (2318/36800) (2149/34190) trace patients because of provision of
incorrect addresses and highly mobile
community. Community education on the
importance of provision of correct
demographic information and strengthen
surveillance.
Decrease TB death rate from 6.1% in 2013/14 to 5.3% by 2019/20
TB client death rate 6.2% <5% 6.3% (1.3%) Target not achieved due to late
(2159/34190) presentation with advanced TB disease
and high co-infection rate. Strengthen
community awareness about TB and
importance of early presentation.
Increase percentage of patients with MDR-TB started on treatment from 45% in 2013/14 to 80% by 2019/20 and success rate from
40% in 2013/14 to 65% by 2019/20
TB-MDR treatment success 53.1% 60% 58.0% (1.9%) Target not achieved due to high death
rate (662/1246) (199/343) rates and loss to follow-up
Sub-programme: Maternal, Child and Women’s Health and Nutrition
Reduce in-facility maternal mortality ratio from 143 in 2013/14 to 85 per 100 000 live births by 2019/2020
Maternal mortality in-facility 108.5 / 100 <100 (122.8/ 100 000) 22.8/ 100 000 Target not achieved because pregnant
ratio 000 live births women book late for first visit under 20
weeks and according to Saving Mothers
Report, a high proportion of late booking
women die due to hypertensive disorders
of pregnancy. The Department will be
implementing maternal quality standards
for management of these disorders.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce neonatal mortality from 15/1 000 live births in 2013/14 to 8.5/1 000 live births by 2019/20
Neonatal death in facility 13.6 <14 13/1000 live (1/1000 live Target achieved
rate births births
Increase number of mothers whose first antenatal visit is before 20 weeks from 43.7% in 2013/2014 to 70% by 2019/20
Antenatal first visit 61.4% 66% 64.7% (1.3%) Target not achieved because pregnant
before 20 weeks rate 173 316/268 008 women book late for first visit under 20
weeks. Strengthen household testing by
WBOTS in the new financial year to detect
pregnancies well before they reach 20
weeks of gestation.
Decrease number of mothers visited within 6 days of delivery of their babies from 86.5% in 2013/14 to 85% by 2019/20
Mother postnatal visit within 70.8% 80% 75.1% (4.9%) Target not achieved. Reported data
6 days rate 166 728/222 115 include only PHC facilities as hospitals did
not report on the measurement.
Orientation of nursing managers and
hospital information officers on the tool
for reporting of postnatal visits for
mothers who remain in Kangaroo Mother
Care (KMC), visiting mothers and lodger
mothers staying in with their sick babies.
Reduce mother to child transmission of HIV from 2% to <1.3% at 10 weeks after birth and from 3.1% to less than 2% at 18 weeks by
increasing antiviral coverage among pregnant women living with HIV from 81% to 98% by 2019/20
Antenatal client starts on 94.7% 97.5% 96.9% (0.6%) Target not achieved due to late
ART rate 43845/44969 28 982/29 920 presentation of pregnant women wishing
to be enrolled in the PMTCT programme.
Infant 1st PCR test positive 0.99% 1.40% 0.73% 0.67% Target exceeded due to slight
around ten weeks rate 510/36 541 294/40251 improvement in infant testing rate in
Tshwane.
Sustain immunisation coverage at 98% for children under 1 year by 2019/20
Immunisation under 1 year 77% 98% 84.3% (13.7%) Target not achieved due to erratic
coverage (200139/259772) 197525/201556 (221 437/262 623) reporting by private providers who receive
state vaccines and migrant population.
Establish and strengthen partnerships with
private providers for improved reporting
and surveillance.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Increase measles 2nd dose coverage from 85% to 98% by 2019/20
Measles 2nd dose 74.5% 97% 77.2% (19.8%) Target not achieved due to erratic
coverage (189446/254306) (197 844/ (202 725/ reporting by private providers who receive
203 963)
262 623) state vaccines and mobile communities.
Establish and strengthen partnerships with
private providers for improved reporting
and surveillance.
Decrease child (under 5 years) diarrhoea case fatality rate from 3% in 2013/14 to 1.56% by 2019/20
Diarrhoea case fatality rate 2.3% <1.6% 2.1% (0.5%) Late presentation of dehydrated children
(88/4205) at health facilities. The Department will be
adopting and implementing the death
review form for diarrhoea case fatalities
and continue with caregiver/community
awareness on hand washing and the
importance of oral rehydration at home.
Decrease child (under 5 years) pneumonia and severe acute malnutrition case fatality rate from 12% in 2013/14 to <6% by 2019/20
Pneumonia case fatality rate 2.6% <1.6% 2.8% (1.2%) Late presentation of sick children at health
132/4678 facilities. The Department will be adopting
and implementing the death review form
used for case fatalities and continue with
caregiver and community awareness
raising.
Severe acute malnutrition 6.2% <6% 6.8% (0.8%) Target not achieved due to various
case fatality rate (105/1544) reasons including improper
implementation of SAM treatment
protocol. Increase supervision of
compliance with treatment protocols
whilst increasing advocacy of exclusive
breastfeeding and linkages to social
services where required.
Increase coverage of Grade 1 learners’ health screening in Quintile 1 – 5 public primary schools from 20% to 60% and Grade 4, 8 and
10 learners’ health screening (annualised) in Quintile 1 -2 from 10% to 20% respectively in 2019/2020
School Grade 1 learners 83 402 74000 88 200 14 200 Target exceeded due to employment of
screened additional nurses to support the HPV
campaign and learner screening.
School Grade 8 learners 46 612 40 000 48 818 8 818 Target exceeded due to employment of
screened additional nurses to support the HPV
campaign and support learner screening.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce the levels of unwanted pregnancies for 10 to 19 years from 5.7% to 4.2%
Delivery in 10 to 19 years 8.1% 4.4% 6.7% (2.3%) More teenage pregnancies are attended to
in-facility rate 14 920/222 115 at health facilities by a skilled birth
attendant.
Increase couple year protection rate from 24.9% in 2013/14 to 60% by 2019/20
Couple year protection rate 59% 55% 54.1% (0.9%) Target not achieved due to inconsistent
(int) availability of injectables nationally.
Expansion of choice of contraceptives for
users.
Increase cervical cancer screening coverage from 41.7% in 2013/14 to 65% of women by 2019/20
Cervical cancer screening 47.4% 55% 52% 3% Target not achieved due to unavailability
coverage, 30 years and of liquid-based cytology consumables.
above older Continue to monitor SLA compliance.
Increase HPV vaccine coverage rate from 87.1% for 1st dose to 80% by 2019/20
HPV 1st dose 51 352 60 000 65 543 5 543 Target exceeded due to employment of
additional nurses to support the HPV
Increase HPV vaccine coverage rate for 2nd dose to 80% by 2019/20
HPV 2nd dose 57 150 60 000 61 031 1 031 Target exceeded due to employment of
additional nurses to support with the HPV
Decrease child (under 5 years) severe acute malnutrition case fatality rate from 6.1% in 2013/14 to <6% by 2019/2020
Vitamin A 12-59 months 50% 62% 55.1% (6.9%) Vitamin A capsules were out of stock in
coverage the last quarter of the year under review.
Provide accurate estimates of required
amounts to NDOH for procurement
purposes.

Sub-programme: Disease Prevention And Control

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce cataract surgery rate from 1408 per million in 2013/14 to 1000 per million; malaria case fatality rate
reduced to <0.4% by 2019/20
Cataract surgery rate 917.1 (1000/mil) 957.3/mil (42.7) Target not achieved. The DHIS does not
operations have the uninsured population
denominator which results in false lower
surgery rates. Correct population figures
on the DHIS and improve documentation.
Malaria case fatality rate 1.5% <1% 1.4% (0.4%) Most malaria cases are imported from
(18/1280) malaria endemic countries. The reports of
the malaria death audits indicate that
patients die from complications of malaria
because of late health care seeking
behaviour.
Reduce cataract surgery rate from 1408 per million in 2013/14 to 1000 per million; malaria case fatality rate
reduced to <0.4% by 2019/20
Sexual assault prophylaxis # 100% 99% (1%) Target not achieved due to assault clients
rate refusing to be provided with ARV
treatment prophylaxis.
PROGRAMME 2: DISTRICT HEALTH SERVICES EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 (Over) / Under
R’000 Final
R’000 (Over)/Under
R’000
R’000 R’000 R’000 R’000 R’000 R’000
District Management 516 536 524 552 (8 016) 505 175 527 767 (22 592)
Community Health Clinics 2 425 500 2 416 248 9 252 2 472 905 2 382 980 89 925
Community Health Centres 1 778 040 1 792 265 (14 225) 2 001 669 1 941 214 60 455
Community Based Services 1 780 080 1 780 657 (577) 1 996 989 2 082 027 (85 038)
HIV/AIDS 3 957 203 3 890 431 66 772 4 465 616 4 096 480 369 136
Nutrition 55 583 49 557 6 026 58 548 55 993 2 555
Coroner Services 215 243 214 321 922 240 133 225 305 14 828
District Hospitals 2 983 916 3 015 482 (31 566) 3 332 882 3 204 714 128 168
Total 13 712 101 13 683 513 28 588 15 073 917 14 516 480 557 437

4.3 PROGRAMME 3: EMERGENCY MEDICAL SERVICES

The purpose of the EMS is to ensure rapid and effective emergency medical care, as well as three hundred and forty-six First Responder
medical care and transport as well as efficient planned patient training sessions in vulnerable communities.
transport, in accordance with provincial norms and standards.
Fleet
Significant Achievements In 2018/2019, we procured an additional ninety-five ambulances
GDoH EMS has successfully provincialised City of Tshwane EMS and refurbished one hundred and ninety vehicles in the following
since 1st July 2018; this has been done towards achieving categories: one hundred and thirty-five ambulances, response
economies of scale and operational efficiencies in services to our vehicle, twelve transporters and forty-two logistical vehicles, to
clients. improve operations efficiencies and support function in EMS. This
brings the total of emergency medical services vehicles from 977 to
Training and Development 1087 units.
Our training facility, Lebone College of Emergency Care, has
received full accreditation for Higher Certificate (HC) Emergency Human Resources
Care Assistant (ECA) and Diploma in Emergency Medical Care. Our We attracted the following scarce skills and ambulance staff during
first intake of twenty-four students for HC ECA started in March the year to capacitate our Operational and Emergency
2019, which makes Gauteng the only province in South Africa to Communication Centre in line with staff norms for EMS: fifteen
have started this course. We have also upskilled our staff on quality advanced life support operatives, fifteen basic ambulance assistants
of care through short and refresher courses, namely the training of and seventy-nine intermediate life support operatives.
forty-one ambulance emergency assistants, one hundred and
sixteen rescue and high angle courses, four hundred and ninety-six
updates and refreshers on all qualification levels of emergency
PERFORMANCE INDICATORS: PROGRAMME 3 – EMERGENCY MEDICAL SERVICES
Programme: Emergency Medical Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Improve EMS response time for P1 patients within 15 minutes for primary calls in urban areas from 77.4% to 90%
EMS P1 urban response 81.2% 75% 82.3% 7.3% Target exceeded due to improvements in
under 15 minutes rate (4983/6055) the steps of an emergency call,
incorporating proper triage by the call
taker and appropriate dispatch, with the
direct involvement of managers of these
calls in their areas. Also public information,
education and relations programmes in
communities.
Improve EMS response time for P1 rural within 40 minutes in rural areas for primary calls to 100%
EMS P1 rural response 100% 100% 100% 0% Target achieved

under 40 minutes rate (156/156)

Programme: Emergency Medical Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Reduce utilization rate of inter-facility transfer clients from 31.2% to 15% by 2019/20
EMS inter-facility transfer 32.3% 20% 35% (15%) Target not achieved due to an increase in
rate transfers between health institutions. The
following is being done to correct the
anomaly:
1. Present statistics to Cluster Heads, for
mitigation through clinical heads of
Departments.
2. Request the Office of DDG Clinical
Services to review Referral Policy and
Diversion Policy.
PROGRAMME 3: EMERGENCY MEDICAL SERVICES EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000 Comment
R’000
Name Appropriation Expenditure Expenditure Appropriation Expenditure ondeviation
R’000 R’000 R’000 R’000 R’000 R’000
Emergency transport 1 158 450 1 125 937 32 513 1 253 364 1 168 905 84 459
Planned patient transport 109 694 93 337 16 357 169 839 161 603 8 236
Total 1 268 154 1 219 274 48 880 1 423 203 1 330 508 92 695

4.4 Programme 4: Provincial Hospital Services

To provide general and specialised hospital services by general Leratong Hospital procured a new CT scan machine and had a
specialists through regional hospitals, TB hospitals, successful cataract surgery campaign; Sebokeng Hospital
psychiatric/mental hospitals, dental training hospitals and other established mammogram services and also installed and
specialised hospitals. commissioned a fluoroscopy unit; Sebokeng Hospital’s
Environmental Health Unit was recognised for excellence by
List of sub-programmes receiving the Alfred Nzo Award which is a national environmental
• General (regional) hospitals health award.
• Tuberculosis hospitals
• Psychiatric hospitals. There are pressures across the platform relating to mental health
care and neonatal capacity. Mental health services are in extremely
Significant Achievements and Strategies to address areas of
high demand with a capacity well below the need. A provincial
underperformance
initiative has been mapped out to increase capacity.
Collectively and individually regional hospitals face extreme
utilisation in the medical wards and maternity units. The utilisation
Neonatal services across the platform are also severely constrained
of the medical wards largely reflects the burden of disease in the
with special emphasis on Ekurhuleni and in particular Thelle
province. Initiatives to improve efficiency include daily specialist
Mogoerane Regional Hospital. Thelle Mogoerane faces multiple
reviews. Alternative referral pathways have been piloted to assist in
human resource constraints as well as significant structural
equitable distribution of maternal care across the health platform.
impediments in the neonatal unit. A Provincial Task Team has been
appointed by the GDoH HoD to oversee and support the hospital
The caesarean section rate remains well above the expected norm
management so that it can overcome these hurdles effectively.
for all hospitals. The indications for a caesarean section are purely
based on clinical need and so this indicator may need to be revised.
The key indicators of bed utilisation rate, average length of stay and
cost per patient day equivalent are all within the acceptable norm for
the programme.
Performance indicators: Programme 4 - Provincial Hospitals
Sub-programme: General Regional Hospitals

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Decrease average Outpatient Department (OPD) waiting times in all hospitals by 60% in 2019/20
Percentage of hospitals # 100% 78% 22% Two hospitals, Edenvale with an average of
prioritising P1-patients (9/9) 4 minutes and Mamelodi 16 minutes, were
requiring immediate above the 3 minute set benchmark
attention because their triaging was incorrect. A
proper triage system on patients to be
adhered to by all hospitals.
Percentage of hospitals # 77% 77% 0% The hospitals achieved the set benchmark.
adhering to average (7/9) (7/9)
waiting times of 160
minutes for P2-patients
with acute injuries and
pain


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Decrease average Outpatient Department (OPD) waiting times in all hospitals by 60% in 2019/20
Percentage of hospitals # 77% 77% 0% The hospitals achieved the set benchmark
adhering to average (7/9) (7/9)
waiting times of 160
minutes for P3-patients
with acute injuries and
pain
Percentage of hospitals 77% 77% 0% (77%) Intervention not implemented due to

with OPD average (7/9) (7/9) limited understanding of the tool. Training
treatment waiting times will be done by Quality Assurance
below agreed benchmark Directorate during 2019/20 FY.
of 180 minutes .
Improve staff attendance across all health facilities by 90% in 2019/20
Percentage of hospitals # 100% 0% (100%) Currently not reported on due to

with staff attendance of limited understanding of the tool.
90% and above Training will be done by Quality
Assurance during 2019/20 FY.
Quality of care will be improved by increasing compliance with national core standards and self-assessment in all regional and
specialised hospitals to 100%
Hospital achieved 75% 88.9% 9/9 8/9 1/9 Thelle Mogoerane was audited by the
and more on the National (100%) (88.9%) (11.1%) Office of Health Standards Compliance
Core Standard (NCS) (OHSC) and obtained 70%. It is the only
self-assessment rate regional hospital with an NCS assessment
(regional hospital) of less than 75%. The predominant factor
which contributed to this
underperformance was infection
prevention and control. The hospital is
now implementing the new SOPs, and
there is a task team appointed to provide
over-sight and monitoring


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Improve the efficiency of hospitals by reducing the average length of stay to less than 5.5 days, increasing bed utilisation to 85%
and decreasing expenditure per patient day equivalent (PDE) in hospitals by 2019/20
(regional hospital) (1 465 467.5
/ 270 134)
Inpatient bed utilisation 79.7% 85% 84.3% 0.7% Within target

rate (regional hospital) (1 465 467.5/
1 739 080.98)
Expenditure per PDE R3 082 R3 562 R 3291.9 R 270.1 Target achieved

(regional hospital) (6,544,595,239
/198 8114.5)
Increase complaints resolved within 25 working days to over 95% in 2019/20
Complaint resolution 100.5% 90% 97.2% 7.2% Target exceeded due to improved
within 25 working days monitoring of complaints by the
(regional hospital) Provincial Office and support visits
to facilities which were assisted in
implementation of the SOP.
Sub-programme: Specialised Hospitals

Quality of care will be improved by increasing compliance to extramental measures core standards and self-assessment in all
regional and specialised hospitals to 100%
Hospital achieved 75% 50% (4/9) (4/9) 0 Four hospitals were scheduled for
and more on National 44% 44% self-assessments, and all obtained 75%
Core Standards and above. Sterkfontein – 81%, Cullinan
self-assessment rate – 81%, Wits Oral & Dental - 97%,
(specialised hospitals) Weskoppies - 93%

Sub-programme: Specialised hospitals

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
The percentage of complaints resolved within 25 working days to over 95% in 2019/20
Complaints resolution 98% 90% 96.4% 6.4% Target exceeded, monitoring of complaints
within 25 working days (81/84) by the Provincial Office has been
rate (Specialised hospitals) strengthened, and a checklist on
complaints has been developed to assist
facilities to comply.
Reduce Outpatient Department (OPD, Accident and Emergency and Pharmacy departments’ waiting times across all facilities by
60% in 2019/20
Percentage of hospitals 75% 100% 100% 0% Target achieved.
with OPD average (7/7) (7/7)
treatment waiting times
below the agreed
benchmark of 180 minutes
Improve staff attendance across all health facilities by 90% in 2019/20
Percentage of specialized # 100% 100% 0% Target achieved

hospitals with staff (9/9) (9/9)
attendance of 90% and
above
Improve the efficiency of hospitals by increasing bed utilisation to 85% and decreasing expenditure per PDE in hospitals by 2019/20
Inpatient bed utilisation # 80% 53.6% 26.4% Target not achieved because of
rate (specialised hospitals) (116 301/ 216 decentralization of multi-drug resistant
833.76) tuberculosis (MDR TB) treatment and
limited use of mental health beds at
Cullinan Hospital due to staffing
challenges. A psychiatrist has been
appointed at Cullinan Hospital.
Expenditure per PDE # R2 799 R 3 437.2 (638.2) Closer monitoring of prices paid for goods
(specialised hospitals) (411 457 and services to ensure market related
440.6/119 708) prices are paid

PROGRAMME 4: PROVINCIAL HOSPITAL SERVICES EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000 Comment
R’000
Name Appropriation Expenditure Expenditure Appropriation Expenditure on deviation
R’000 R’000 R’000 R’000 R’000 R’000
General (regional) hospitals 5 719 131 5 738 (18 895) 6 431 824 6 351 096 80 728
Tuberculosis hospitals 396 292 026 112 408 379 744 290 044 89 700
Psychiatric/mental hospitals 1 164 077 283 884 (74 142) 1 261 857 1 393 015 (131 158)
Dental training hospitals 535 399 1 238 219 (13 257) 581 625 560 989 20 636
Other specialised hospitals 77 764 548 656 (5 728) 91 419 91 509 (90)
Total 7 892 663 83 492 386 8 746 469 8 686 653 59 816
4.5 Programme 5: Tertiary and Central Hospitals
Purpose of the programme the ICU so that it can attract clinicians who need intensive care
To provide highly specialised health care services, platforms for training. The hospital also appointed two additional orthopaedic
training health workers and sites for research and to serve as specialists with interest in arthroplasty and this had a positive impact
specialist referral centres for regional hospitals and neighbouring on the arthroplasty backlog. Head of department posts in psychiatry
provinces. and orthopaedics were filled after they had been vacant for more
than two years.
Significant Achievements by the Tertiary and Central
Hospitals
Established the much-needed spiritual wellness for employees and
TERTIARY HOSPITALS healthy lifestyle activities attendance has improved. The hospital’s
Achievements wound clinic received a golden trophy during the Premier’s Awards.
Installation of MRI scan facilities has improved services at Helen The Khanyisa Awards was received for “Most Efficient Health Care
Joseph Hospital, Rahima Moosa Mother and Child Hospital, Facility – Tertiary Hospital”.
Leratong Hospital, Sterkfontein Hospital, Tara Hospitalz, South Rand
Hospital and Bertha Gxowa Hospital. Expansion of Mammography To improve service efficiency, the implementation of an electronic
services by installing stereotactic guided vacuum assisted core biopsy queue management system to measure patient waiting time at the
and a three dimensional breast tomosynthesis unit This contributes OPD reception area was introduced as well as an improved booking
to accuracy of diagnosis which decreases dose radiation exposure system. This operates by phoning patients to remind them about
and improves patient throughput, thereby reducing waiting times. their appointment a day prior to their visit. Patient safety has been
Installation of a fluoroscopy unit in September 2018 improved prioritised through the opening of a 24/7 enquiries department.
patient care as patients no longer have to go to Rahima Moosa OHSC external assessment also scored the hospital 100% in Patient
Mother and Child hospital for services. Transport Services and it was evaluated as one of the cleanest
hospitals in the Province.
Kalafong Hospital opened a newly renovated human milk bank in
2018/19. The hospital also achieved improved Patient Experience of
Care, to 87%, which was the highest among tertiary hospitals; and
achieved improved performance on Core Standards Self-Assessment
with a score of 91%.
Tembisa Hospital acquired a 160 slice CT scan, replacing an old 16

slice scan that had become difficult to service or repair. The hospital
also appointed an intensivist to run the Adult Intensive Care Unit
(ICU) and High Care Unit. The plan is to apply for accreditation of

Challenges
There is an increasing demand for services that is leading to ever activities after strokes, rheumatoid arthritis progression and Trauma.
greater headcounts in out-patient departments and accident and Several Khanyisa Awards were bestowed on Prof. Luvengho, HOD
emergency (A&E) units; overflowing of wards with up to 70 patients Surgery, who received the overall top individual award; Prof. Chauke
in 40 bed wards; inadequate space for mental health care patients HOD Obstetrics & Gynaecology, runner up in the individual award;
who end up being admitted in medical wards; insufficient ICU beds Ms V. Yip, HOD Occupational Therapy, third runner up individual
(currently only 10 beds); insufficient A&E resuscitation beds award; Radiology: Dr Smilg, HOD Breast Department, first prize for
(currently only four beds); the hospital has also experienced long stay projects.
patients due to families not coping with mental health care users
and mentally retarded children who do not get placement; Highlights of the achievements at Chris Hani Baragwanath
infrastructure challenges are evident in noncompliance with Academic Hospital (CHBAH) are: in 2018/19 the hospital managed
isolation norms due to insufficient isolation facilities, especially for to fill the position of Head of Radiology which was difficult due to
VHF, TB, diarrhoeal and pulmonary conditions; the lack of cashier the scarcity of this specialism; the Clinical Team’s regular ward
facilities in the clinics and pharmacy; the non-availability of a rounds and other outreach activities to Bheki Mlangeni Hospital
bereaved family waiting area at the mortuary and all frontline areas; (BMH) continue to prevent the overcrowding of patients in the
no counselling rooms for families in the wards as well as the medical wards, providing opportunities to treat patients who are
inadequate infrastructure impacting on: appropriate to central hospital level; through a Public-Private
Partnership (PPP) the construction of Zakithi Nkosi Haematology
• Increasing number of missing patients. Centre of Excellence has begun, and the unit will be operational by
• Department of Labour inspection on 29/11/2018 with a Q2 in 2019/2020; the establishment of high volume cataract surgery
prohibition notice for stores issued. Relocation of staff and services and its extension to BMH; the output for cataract surgery is
stock to be done immediately. currently at 300 cases monthly between the two hospitals which will
• Lack of recreational hall for events and of training venues. go a long way in reducing both the backlog and waiting times for
• Old ICT infrastructure. new cases; the service was also rolled out to Lenasia South in
2018/19; establishment of the 28-bed acute surgical care unit,
Kalafong Hospital had to close crèche services due to staff shortage which has significantly reduced costs, length of stay and
and poor infrastructure, leading to absenteeism. The hospital also complications for patients, and has improved access and reduced
experienced an increase in theft, including theft of cars from the the waiting time for surgery.
institution. Shortage of staff is a challenge across all tertiary
hospitals. However, though the plan is to set up similar units at BMH and
Sebokeng Hospital, due to staff shortage the unit is still operating
CENTRAL HOSPITALS from 08h00 to 16h00. The orthopaedic emergency surgery service
Achievements
has resulted in immediate access to surgery for orthopaedic patients
Charlotte Maxeke Hospital added pacing to the Electrophysiology
thus preventing complications and additional costs to the hospital.
Laboratory: the branch of cardiology that deals with the diagnosis of
The doctor who championed this initiative received a Khanyisa
heart rhythm disorders and electrical activity of the heartbeat. The
Award in 2018 for Best Doctor.
infrastructure improvements included the installation of five new
generators which are more reliable, modern and with spare parts
Also at CHBAH, among the interventions to address the surgical
readily available. Renovations were completed of Neonatal ICU
backlog list, surgeons have continued to do operations at BMH. This
(Ward 177). It has the only functional Liver Transplant Unit in South
has eliminated the waiting list for the breast clinic. High-Intensity
Africa and sees an increase caseload in related paediatric cases. The
Focused Ultrasound (HIFU) services were established as another
hospital has established improved stroke interventions, which
treatment option for fibroids in 2015; the service is currently fully
include immediate interventions that yield results within an hour of
functional treating 8-10 women per month. This reduces the waiting
a patient receiving it, with significantly improved clinical outcomes.
list and time for surgical treatment, with added benefits to patients
Its Radiation Oncology Breast Clinic collaborated with Cricket SA
such as reduced length of stay in hospital and reduced risk of
which raised over R1.68m, and promoted awareness with positive
infection compared to surgery. The project was a runner-up for the
messaging at a Wanderers event.
Khanyisa Award. Procurement of vascular and neurosurgery C-arms,
and the ENT and neurology microscopes which have been long
The Occupational Therapy Master Chef and Taxi projects are
outstanding, was completed in 2018/19: having this equipment on
interventions implemented to assist patients in adjusting to daily

site will go far in reducing waiting times and improving overall Challenges
patient care. CHBAH reached its 100th cochlear implant procedure At Charlotte Maxeke Johannesburg Academic Hospital (CMJAH),
in February 2018. treatment of foreign patients remains a challenge as they tend to
access health services late when they are very ill. In maternity,
This milestone has led the audiology department to increase the foreign patients often access health services without antenatal care,
annual target for implants from 10 to 20. This was achieved as the and this contributes to morbidity and mortality (especially maternal
targeted 20 cases were successfully implanted in FY 2018/19. The mortality). The institution also has challenges of ageing
standing frames project emerged from a partnership between the infrastructure, which is unreliable, prone to break down, requires
Physiotherapy Department and a local NGO, creating an opportunity intensive maintenance and leads to rising maintenance costs.
for local economic empowerment. Through this project, patients can Because of the lack of an electronic asset management system, the
have their standing frames at home regularly at a reduced hospital cannot account for all its assets. Increased waiting time in
procurement cost of R200 versus almost R2000 market value, casualty has been experienced because of beds blocked by
reducing the cost of coming to the hospital and prevention of more psychiatric patients waiting at casualty for admission, due to
deformities if the patients are mainly dependent on hospital-based decreased bed capacity in a psychiatric ward under construction.
devices. This project earned the Centre for Public Service Innovation There has been an increase of theft in the hospital, especially of
(CPSI) award. The early childhood intervention clinic in the Speech copper pipes and electrical cables.
and Audiology Department has grown from strength to strength
over the last five years with screening services rolled out to all At CHBAH, the allocated budget is not adequate for the demands of
high-risk cases in 2018/19. Through this universal screening, the serviced population. Overcrowding of psychiatric patients in the
unilateral hearing loss was diagnosed in a one-month-old baby. The emergency department continued to be an issue, with concerns for
clinic has an established partnership with the appropriate SETA for the safety of staff and other patients. Stakeholder meetings to
training in screening for basic hearing, targeting learners with some address this challenge have resumed, and the teams are looking
disabilities. Currently, six learners are in the advanced stage of forward to the implementation of sustainable solutions. Drug
training and they provide extra personnel to the unit. The hospital unavailability, mainly of epileptic drugs and water for injection, is
has also established an earlobe keloid intervention programme using problematic. Such challenges often emanate from the limited
non-invasive treatment methods. Patients are accessing this service capacity of the contracted service providers to meet the demand.
monthly. Pharmacy management continues to engage doctors about
alternatives, urging them to use other procurement methods to
Dr. George Mukhani Academic Hospital (DGMAH) has successfully ensure that patients’ treatment compliance is not interrupted.
separated conjoined twins. It has also sustained cutting edge Nursing staff shortage continues to be a barrier to optimum use of
laparoscopic procedures in the General Surgery Departments. The highly specialised beds in ICU, high care areas and the maternity
hospital successfully produced pediatric and neuro surgeons. Five theatre.
managers attained Advanced Management Diplomas with the
Southern Business School through the Gauteng City Region At DGMAH, infrastructure is a challenge. There is 4% underfunding
Academy (GCRA). A medical waste company was appointed to on the Compensation of Employees Budget. There is an abnormal
remove waste that had accumulated in the hospital. A Southern referral route due to lack of tertiary and regional institutions in the
African Development Community (SADC) orthotic and prosthetic cluster. There is an insufficient supply of clean linen, resulting in
training project for putting running blades on children with service delivery disruptions. A fire in the doctors’ quarters led to an
amputations was held. DGMAH has also managed to retain a emergency situation. There is overcrowding in the wards and OPD
specialist doctor in pediatric oncology, nephrology and ICU post due to an increase in the population served. There is a need to fill
training in Wits, UP, UCT, including training of and retention of key clinical HOD posts and to appoint more specialty nurses. There
specialty nurses are several vacant key SMS posts in the hospital.

PERFORMANCE INDICATORS: PROGRAMME 5 – TERTIARY HOSPITAL SERVICES
Sub-programme: Tertiary Hospitals

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Increase compliance with national core standards to 100% in 2019/20, and complete self-assessments in all hospitals
Hospital achieved 75% (3/3) 100% 3/3 0 Target achieved

and more on National (3/3)
Core Standards
self-assessment rate
(tertiary hospitals)
Improve efficiency of hospitals by reducing average length of stay to 6.5 days, increasing bed utilisation to 85% and decreasing
expenditure per PDE in hospitals by 2019/20
(tertiary hospitals) (689 409.5/ 112
865)
Inpatient bed utilisation 85.3% 85% 87% 2% Within target

rate (tertiary hospitals) (689 409.5/792
471.42)
Expenditure per PDE R3 472 R3 676 R 4 086.7 (R410.7) Target not achieved. Due to services at
(tertiary hospitals) (3 978 400 higher cost at T3 level. Prudent
056/973 505.5) management of the fiscus to ensure that
procurement is in accordance with demand
plans.
The percentage of complaints resolved within 25 working days will be over 95% in 2019/20
Complaints resolution 100% 90% 101% 11% Target exceeded, monitoring of complaints
within 25 working days: (769/760) by the Provincial Office has been
rate (tertiary hospitals) strengthened and physical visitation to
facilities has commenced.
Reduce Outpatient Department (OPD), Accident and Emergency departments waiting times across all facilities by 60% in 2019/20
Percentage of hospitals # 100% 100% 0% Target achieved

prioritising P1 patients (3/3) (3/3)
requiring immediate
attention in A&E
Department
Percentage of hospitals 0% 66% 100% 34% Target exceeded due to inclusion of

with P2-3 patients (0/3) (2/3) 3/3 Tembisa in the assessment of waiting
attended to within 160 times.
minutes average
A&E Department

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Percentage of hospitals 2/3 66% 100% 34% Target exceeded due to inclusion of
with OPD average (2/3) 3/3 Tembisa in the assessment of waiting
treatment waiting times times.
of 240 minutes
Improve staff (health professionals, administration clerks, cleaners and porters) attendance at OPD and Accident and Emergency
across all health facilities by 90%
Percentage tertiary 100% 100% 100% 0% Target achieved

hospitals with staff (3/3) 3/3
above
PERFORMANCE INDICATORS: PROGRAMME 5 – CENTRAL HOSPITAL SERVICES

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Increase compliance with national core standards to 100% in 2019/20, and complete self-assessments in all hospitals
Hospital achieves 75% 100% 100% 100% 0% Target achieved

and more on the National (4/4) (4/4) (4/4)
Core Standards
(central hospitals)
Improve the efficiency of hospitals such that waste, expense and unnecessary effort is reduced and bed utilisation in each hospital
will not be too high or too low
Average length of stay 7.9 days 8 days 7.8 days 0.2 day Within target range.
(central hospitals) (1 804
690.0/232 063)
In-patient bed utilisation 82.6% 85% 81.1% 3.9% Within target range.
rate (central hospitals) (1 804 690/2
224 310.4)
Expenditure per PDE R4 137 R4 229 R4 563.0 (R334) Expenditure higher than expected due to
(Central Hospitals) (13 080 631 increased expenditure by some of the
181/2 866 central hospitals because of increased
674.667) accrual payments.
The percentage of complaints resolved within 25 working days over 95% in 2019/20
Complaint resolution 99.2% 90% 98.4% 8.4% Target exceeded due to improved capacity
within 25 working days: (974/990) support through clusters systems
rate (central hospitals)

Central Hospital Services

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Percentage of hospitals # 100% 100% 0% Target achieved

prioritising P1 patients (4/4) 4/4
requiring immediate
attention in A&E
Department

with P2-3 patients (0/4) (3/4) 4/4 DGMAH in the assessment.
attended to within 160
minutes average
A&E Department
with OPD average (3/4) (3/4) (4/4) DGMAH in the assessment.
of 240 minutes
Improve staff (health professionals, administration clerks, cleaners and porters) attendance at OPD and Accident and Emergency
across all health facilities by 90%
Percentage of central 79% 100% 100% 0% Target achieved
hospitals with staff (53%) (4/4) (4/4)
above
Steve Biko Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Hospital achieved 75% Yes Yes Yes 0% Target achieved

and more on National
Core Standards
(central hospitals)
Average length of stay 8 days 8 8 days 0 days Target achieved

(central hospitals) (264 531/ 33
062)
In-patient bed utilisation 85.9% 85% 85.8% 0.8% Within target range
rate (central hospitals) (264 531/ 308
458.8)

Steve Biko Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Expenditure per PDE R4 862 R4 676 R5 477.9 (R 801.9) Expenditure high due to payment of prior
(central hospitals) (2 538 177 538/ year accruals
463 352)
Complaint resolution 98.3% 90% 96.7% 6.7% Target exceeded because the Provincial
within 25 working days: (177/183) Office has strengthened monitoring of
rate (central hospitals) complaints and physical visitation to Steve
Biko Academic Hospital (SBAH)
Percentage of hospitals # Yes Yes None Target achieved

prioritizing P1 patients
requiring immediate
attention in A&E
Department
Percentage of hospitals Yes Yes Yes None Target achieved

with OPD waiting times
of 240 minutes

with P2 -3 patients
minutes waiting time in
A&E Department
Percentage central 60% Yes Yes None Target achieved

hospitals with staff
Dr George Mukhari Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Hospital achieved 75% Yes No Yes Yes Target achieved. The no in the target
and more on National was an omission because no Central
Core Standards Hospital must never be left out of
self-assessment rate assessment in any given year.
(central hospitals)
Average length of stay 7.8 days 8 days 7.9 days 0.1 days Within target range.
(central hospitals) (416 148/52
703)

Dr George Mukhari Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/under)
In-patient bed utilisation 77.9% 85% 76.0% 9% Not within target range due to the
rate (central hospitals) (416 148/ 547 renovation of wards 16 and 37 which
682) resulted in the closure of the two wards.
Thus 80 beds were not available for one
full quarter during the financial year.
Expenditure per PDE R4154 R4304 R 4534.6 R230.6 Payments of outstanding accruals
(central hospitals) (2 741 865 resulting in over expenditure. Prudent
095/604 652.7) management and monitoring of
expenditure patterns to be implemented.
Complaint resolution 98.6% 90% 96.9% 6.9% Target exceeded because the Provincial
within 25 working days: (310/320) Office has strengthened the monitoring
rate (central hospitals) of complaints and physical visitation to
DRGMAH
Percentage of hospitals # Yes Yes None Target achieved. Triage system fully
prioritizing P1 patients implemented and supported by a medical
requiring immediate practitioner.
attention in A&E
Department
Percentage of hospitals No Yes Yes None Target achieved.

of 240 minutes
Percentage of hospitals No No Yes Yes Target achieved. The No in the target was
with P2-P3 patients an omission because no central hospital
attended to within 160 must be left out of assessment in any
minutes waiting time A&E given year.
Department
Percentage of central # Yes Yes None Target achieved.

above

Charlotte Maxeke Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Hospital achieved 75% 100% Yes Yes None Target achieved

Core Standards
(central hospitals)
Average length of stay 7.5 days 8 7.4 days 0.6 Target achieved
(central hospitals) 320 720/ 43 125
In-patient bed utilisation 86.8% 85% 82.3% 2.7% Within target range
rate (central hospitals) (320 720/389 863)
Expenditure per PDE R4407 R4 429 R4 842.9 (R 413.9) Abnormal expenditure for PDE,
(central hospitals) (3 374 933 Department will be investigating further
847/696 887.7) with the hospital directly
Complaint resolution 100% 90% 100% 10% Target exceeded due to monitoring of
within 25 working days: (222/222) complaints by the Provincial Office
rate (central hospitals)
Percentage of hospitals # Yes Yes None Target achieved

requiring immediate
attention in A&E
Department

of 240 minutes

with P2-P3 patients
minutes waiting time A&E
Department
Percentage of central # Yes Yes None Target achieved

above

Chris Hani Baragwanath Academic Hospital

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Hospital achieved 75% Yes Yes Yes None Target achieved

Core Standards
Average Length of Stay 8 days 8 Days 7.8 days 0.2 day Within target range
(803 291/103 173)
In-patient bed utilisation 82.6% 85% 82.1% 2.9% Within target
rate (803 291/978 307)
Expenditure per PDE R3 661 R3 282 R4 016.8 R734.8 Abnormal expenditure for PDE,
(4 425 654 701/1 101 Department will be investigating further
782.3) with the hospital directly
Complaint resolution 100% 90% 100% 10% Target exceeded because the Provincial
within 25 working days: (265/265) Office has strengthened the monitoring
rate of complaints
Percentage of hospitals # Yes Yes None The hospital achieved the set benchmark
requiring immediate
attention in A&E
Department
Percentage of hospitals Yes No Yes None The hospital achieved the set benchmark
below the agreed
benchmark of 240 minutes
Percentage of hospitals Yes Yes Yes None The hospital achieved the set benchmark
with P2-P3 patients
minutes waiting times in
A&E Department
Percentage of central # Yes Yes None Target achieved

above

PROGRAMME 5: CENTRAL HOSPITAL SERVICES EXPENDITURE TABLE
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000
R’000 R’000 R’000 R’000 R’000 R’000
Central Hospitals 11 839 981 11 988 788 (146 785) 13 219 797 13 218 982 815
Provincial Tertiary Hospital 3 493 060 3 329 921 163 139 3 915 429 3 915 274 155
Services
Total 15 333 041 15 316 687 16 354 17 135 226 17 134 256 970

4.6 PROGRAMME 6: HEALTH SCIENCES AND TRAINING
Programme Purpose
The Health Sciences and Training Programme is strategically Achievements
positioned to plan for, produce and manage the education, training The RTCs in collaboration with institutions of learning, NGOs,
and development needs of the GDoH. It is designed to comply with development support partners such as PEPFAR and external training
relevant legislative and policy mandates at the national, provincial providers have developed 63 training programmes which are meant
and local level and to respond to service transformation imperatives. for healthcare workers such as doctors, professional nurses, other
Priorities include support for the Service Transformation Plan, professional allied workers and Community Health Workers (CHWs).
re-engineering of PHC, expansion of the HIV and AIDS, sexually These programmes address issues such as those relating to HIV and
transmitted infection (STI) and TB programmes and implementation AIDS/STIs/TB, non-communicable diseases and maternal and
of NHI. neonatal mortality. A number of the 63 training programmes are
identified as priorities in the Annual Performance Plan (APP) of
List of Sub-Programmes 2018/2019.
The Professional Development Directorate includes:
• Regional Training Centres (RTCs)
• Professional development
• Professional service support
• Bursary Section
• Lebone College of Emergency Care
• Leadership Management and Skills Development Directorate
• Employee Health and Wellness Programme Directorate
Strategic Objectives
• Improve achievement of national norms for the supply of
health professionals
• Improve compliance with the legislative framework
• Respond to the GDoH’s staff education, training and
development needs.
Challenges and recommendations
Challenges Measures to overcome challenges
All HIV, AIDS, STIs and TB (HAST) related training planned for A new training plan, which was agreed upon by Tshwane HAST
Tshwane district was put on hold. The District took a resolution unit, Tshwane Training Unit and Right to Care, has been
to focus on mentorship for those already trained. developed according to the needs of the District. Training will
commence in April 2019.
The Health Promotion Officer qualification was suspended by the NDoH will inform the RTC when the review has been completed.
National Department of Health (NDoH) as they were reviewing
the training content.
CHW training phases 1 & 2 did not happen as NDoH in The material has been developed, and CHW skills development
collaboration with I-TECHSA were developing new material that training will be conducted in 2019/20.
will be used as in-service training for CHWs already trained in
phases 1 & 2.
Shortage of staff due to vacant posts not filled. Three posts for Deputy Directors and four posts for clinical
coordinators have been advertised and are to be filled in the first
quarter of 2019/2020
Approval for filling the vacant post for Region B to be approved.

Challenges and recommendations
Challenges Measures to overcome challenges
The unavailability of training manuals for various training Submissions to procure manuals were made, and POs were
programmes such as NIMDR TB, Kidz Alive, Adherence finally released, though late.
Guidelines, Prevention of Mother-to-child Transmission (PMTCT),
Advanced Primary Care (APC ) etc. due to the delay caused by a Tender for training manuals to be in place and senior managers
new procurement process, procedures that are not documented to approve as soon as possible.
and delays by senior managers in approving submissions.
Some of the training was shifted or cancelled by districts and Districts and supporting partners have been consulted, and
supporting partners. This led to some targets not being training will take place in the new financial year.
achieved, for instance:
• Medical male circumcision for all categories – the District clinical specialist teams (DCSTs) will now report their
supporting partner Justice Project South Africa (JPSA ) did training to the RTC, and these will form part of the RTC reports
get funding from PEPFAR in 2019-2020.
• ART initiation management for doctors and
pharmacovigilance for professional nurses – Pulse Health
lost funding from PEPFAR
• Not enough training on Kidz Alive for enrolled nurses,
health promoters, social workers and lay counsellors as
manuals were delivered late
• Trauma containment, sexual assault for professional nurses,
are conducted from the Medico-Legal Unit. Regional
Training Centre (RTC) staff are not trained on these
programmes.
SUB DIRECTORATE – PROFESSIONAL DEVELOPMENT
The Professional Development Sub-directorate coordinates Special programmes under Sub-directorate Professional
Continuing Professional Development (CPD) programmes that are Development
critical for all medical doctors and allied professionals in accordance 1. Pharmacist assistant training, basic and post basic course
with the requirements set by statutory bodies for professional to 2. Six months of midwifery skills training for enrolled nurses
maintain their registration status. The sub-directorate also manages 3. Emergency medical care courses, e.g. basic life support (BLS),
the development and accreditation of mid-level worker Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life
qualifications and training for lower categories and mid-level Support (PALS)
workers. This is in support of task shifting and the accreditation of 4. Structured clinical in-service training including on-boarding
identified qualifications. in-service training
5. South African Cuban medical training.
Structured in-service training in all health sciences related areas in
teaching institutions is also coordinated. The sub-directorate
participates in the development of short courses and skills
programmes to bridge those skills gaps identified as critical in
minimising incidences of malpractice and in achieving the strategic
objectives of the Department. It also coordinates the South African
Cuban Medical Programme in line with the Bilateral Cooperation
Agreement between South Africa and Cuba.

Table: Achievements
Training Programme Planned Actual
Patient safety in-service training: PIH; post and 100 271

antepartum haemorrhage; partogram
CPD training 400 1358
Enrolled nurses: midwifery skills training programme 25 22
Pharmacist assistant training programme 12 2
Basic life support 50 104
Basic life support instructor 20 1
Table: Challenges and recommendations
Challenges Recommendations
Insufficient budget for professional development training activities including Allocate more funding. Seek sponsorship to fund
purchasing training manuals. training.
Accreditation of Lillian Ngoyi CHC as BLS training centre negatively affected. Ring fence funds for patient safety courses,
Training put on hold. especially life support programmes.
Termination of contract for the retired nurse midwives leading to most patient Allocate more funding. Seek sponsorship to fund
safety training put on hold. training. Ring fence funds for patient safety
courses, especially life support programmes.
Shortage of staff due to absenteeism following the fire at Bank of Lisbon Employ advanced midwives and neonatal nurse
building. specialists by the RTC for the training of midwives.
Approval for filling of posts to be granted

PROFESSIONAL SERVICES SUPPORT
Purpose
Professional Services Support (PSS) in the health sciences component Placement for community service is based entirely on service needs
contributes to the development, management and support of and availability of funded vacant posts. All health professionals must
medical and allied health professionals, facilitating their placements be registered with the relevant professional body, South African
in institutions according to the identified needs. The sub-directorate Nursing Council (SANC), PCSA or Health Professionals Council of
also facilities the accreditation of facilities for placement of interns as South Africa (HPCSA) before commencing community service.
prescribed by the professional council’s quality standards and the
appropriate transfer of skills to interns and community service Achievements
professionals. The recruitment and management of the For 2019, the annual total of 1 430 health professionals has been
appointment of foreign health professionals in accordance with placed.
national policy and immigration laws are also managed under PSS.
The breakdown of placement per category is presented in the
Background tables below:
A community service programme for medical doctors, pharmacists,
dentists and allied health professionals is a legislative mandate. This
applies for one year to all persons who are South African citizens and
those with permanent residency who are registering.
Table: Internship programme
Category No of approved funded posts Total Placed Additional Placements
Medical interns 429 526 97
Pharmacists 61 61 0
Clinical psychologists 61 61 0
TOTAL 551 648 97
Table: One year community service placements
Category No of approved funded posts Total Placed Additional Placements
Pharmacists 85 88 3
Medical doctors 226 251 25
Dentists 15 23 8
Dieticians 54 55 1
Environmental health practitioners 34 34 0
Occupational therapists 84 91 7
Pharmacists 85 88 3
Physiotherapists 94 102 8
Radiographers 95 76 19
Speech & hearing therapists 62 62 0
TOTAL 834 870 36

Challenges
Despite the achievements above, the Unit was faced with many The Bursary Fund
challenges, such as: The Bursary Sub-directorate is responsible for health sciences human
1. Late approval of submissions by senior management resource needs. This includes scarce skills and, in consultation with
2. Late submissions for creation of posts to Office of the Premier human resources management aligned to the Human Resource Plan
and Human Resource Management (HRM ) which resulted in of the Department, providing financial assistance to those
applicants receiving late salaries (mid-February) undertaking external full-time studies which are intended to address
3. Internship and Community Service Programme (ICSP) double the human resource needs of the province. The unit also provides
placements of health professionals financial assistance to qualifying staff members to improve
4. ICSP access not user-friendly and system frequently down performance in functional areas according to education gaps
(offline) identified as a priority in the Department, and monitors return on
5. Uncertainty over commencement dates of health professionals investment by enforcing the implementation of the contractual
(some cannot commence on time due to registration etc.) bursary obligation.
Recommendations
We recommend that if the following can be changed and adhered
to, the above issues can be resolved:
1. ICSP placement commences earlier in the year and results are
communicated to all provinces by latest mid-October (not
December).
2. Ensure that double placements are checked by an ICSP team or
provinces are given the allocations early to check for any double
placements or bursary holders of other provinces (2 weeks prior)
before notifying all applicants of their final placement.
3. ICSP system must always be online for users and the national
desk team to be available always for provincial coordinators.
4. ICSP guidelines should include a clause on commencement
dates so that all provinces are guided lawfully as this reduces
court cases and litigation.
Table: Bursary intake for 2018 academic year:
Field of study Number
MBCHB 251
Pharmacy 33
Occupational therapy 27
Dietetics 16
Oral hygiene 1
Optometry 7
Speech, audiology, pathology 21
Medical, orthotics & prosthetics 7
Clinical technology 2
Physiotherapy 22
Radiography 51
Emergency medical care 3
TOTAL 441

The South African Cuban Medical Training Programme
This programme was implemented as part of the Bilateral Corporation Agreement between South Africa and Cuba for training medical
students. In the 2018/2019 financial year, the following obtained:
Table: SA Cuban numbers:
Items Number % of total
Integrated for 18 months in SA universities 8 6 completed MBCHB successfully in December 2018
Remaining in Cuba from 01 April to July 2018 438
Integrated in SA Universities in August 2018 73
Numbers remaining in Cuba in the 3rd and 4th quarter of 2018/2019 352
Numbers who fell ill due to mental health and were repatriated back to SA 3 1 returned to Cuba in February 2019 and will be
completing her final year of medical studies in July
2019. 2 came to SA in March 2019 and are
attending outpatient psychiatric care.
Costing:
Cost for the 18 months integration in SA universities 73 R 17 118 050 – paid 5 July 2018
Cost for the 438 students which was not paid in 2017/2018 as accrual 438 R 140 066 822 – paid 5 July 2018
Academic fees for 2018/2019 financial year 352 Invoice still not sent by National: estimated at R
107 000 000
Cost of chartered flight for 195 students 195 R 6 435 000 (to be paid in 2019/2020 financial
year).
Cost for July vacations for students on vacation 38 R 939 171.00 paid to the provider.
R 68 301 still not paid. A submission to the HoD is
with the CD Human Resource Development (HRD )
/Employee Health and Wellness Programme
(EHWP)

PERFORMANCE INDICATORS: PROGRAMME 6 – HEALTH SCIENCES AND TRAINING
Programme: Health Sciences and Training

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Increase employee satisfaction rate to 85 % by 2019/20

Employee satisfaction rate 50.13% 80% 54% (26% ) The Department did not reach the 80%
target as planned due to employees’
dissatisfaction with the work
environment specifically performance
management and labour relations.
Increase access to training opportunities for staff Including heads of institutions to 95% by 2019/20
Percentage of hospital 83% 85% 124.3% 39.3% Target exceeded due to multiple training
CEOs trained in leadership (30/36 46/37 programmes participated in by several
and management CEOs) CEOs. Nine of them attended more than
one training programme during the
reporting period.
Percentage of PHC facility 71% 75% 114.8% 39.8% Target exceeded due to multiple training
managers trained in (263/372) 427/372 programmes participated in by several
leadership and PHC managers. Fifty-five were trained in
management more than one programme during the
reporting period.
Increase awareness of ethical conduct for all staff by offering code-of-conduct training to 30% of our employees in 2019/20
Percentage of employees 33% 25% 26.2% 1.2% Target exceeded because code of
trained in code of conduct (8451) (17 259/65 821) conduct training was included in multiple
in-house training programmes
Increase the number and quality of health professionals by increasing the number of health professionals trained annually to 1 500
by 2020
Number of nursing # 1 500 1 007 (493) 1500 is a departmental target and was
students graduating not achieved. Graduate output is
dependent on student enrolment. Intake
rates vary depending on factors such as
available finances, applicants meeting the
admission criteria, etc. Actual intake was
1 205. Outcomes are impacted by
attrition rates which are affected by
course terminations, failures and deaths.
Increase the number and quality of health professionals by increasing the number trained annually to 1 500 by 2020
Number of bursaries 50 0 0 0 The Gauteng Department Executive

awarded to first-year Management Committee decided not to
medical students fund due to financial constraints for the
year under review as outlined in the
Annual Performance Plan (APP ) of
2018/19.

PERFORMANCE INDICATORS: PROGRAMME 6 – HEALTH SCIENCES AND TRAINING

2017/18 2018/19 2018/19 target 2018/19
(over/under)
Increase the number of new nursing students to fulfil replacement annually to 800 by 2019/20
Number of bursaries 984 700 671 (29) Total bursaries awarded include public
awarded to first-year nursing colleges and universities. With
nursing students implementation of higher education
funding in 2018, some university
students opted for this funding which
had no contractual obligations as
opposed to the GDoH nursing bursary
funding. Terminations at the nursing
colleges also impacted on the total
number of bursaries awarded.
PROGRAMME 6: HEALTH SCIENCES AND TRAINING EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000
R’000 R’000 R’000 R’000 R’000 R’000
Nurse training colleges 738 389 747 136 (8 767) 848 937 778 971 69 966
EMS training colleges 34 981 34 953 28 37 859 27 175 10 684
Bursaries 86 548 68 676 17 872 142 498 211 282 (68 784)
Other training 68 595 68 222 373 94 002 89 280 4 722
Total 928 471 981 987 9 484 1 123 296 1 106 708 16 588

4.7 PROGRAMME 7: HEALTHCARE SUPPORT SERVICES
Programme Purpose • The buy-out procedure to compensate for non-awards and

The purpose of this programme is to provide support services to the poor supplier performance is lengthy and cumbersome.
Department so that it can achieve its aims. The sub-programmes are:
• Laundry services: Providing a laundry service to hospitals, care Strategy to address underperformance
and rehabilitation centres and certain local authorities Strategies to address these challenges include:
• Engineering Services: Providing a maintenance service to • Continuing with the buying out of items outside the
equipment and engineering installations, and minor contractual system, as well as those not delivered due to poor
maintenance to buildings supplier performance
• Forensic services: Providing specialised forensic and • Continuing to institute penalties on non-performing suppliers
medico-legal services to establish the circumstances and • Continuously and closely monitoring medicine availability so
causes surrounding unnatural deaths that action is taken immediately an early warning sign is
• Orthotic and prosthetic services: Providing specialised orthotic noticed
and prosthetic services • Holding frequent demand planning sessions with users.
• Medical trading account (Medical Supplies Depot): Managing
the supply of pharmaceuticals and medical sundries to CENTRAL CHRONIC MEDICINE DISPENSING AND
DISTRIBUTION (CCMDD)
hospitals, CHCs and local authorities.
The CCMDD programme, implemented to decongest public facilities

Summary of the significant achievements
and to improve waiting times, has seen a total of 490 518 patients
Pharmaceutical Services: enrolled by the end of the 2018/19 financial year. The 2018/19
During the year under review, the key achievements of CCMDD target of 350 000 patients was exceeded.
Pharmaceutical Services include:
• Exceeding the CCMDD target of 350 000. Currently, there are The number of patients collecting their medicines from external pick
490 518 patients enrolled in the CCMDD programme. up points at the end of financial year 2018/19 was 179 653. The
• All facilities, with two exceptions, are now utilising the RX balance of patients still collect their medicine from Internal (GDoH)
Solution stock control system. This has improved the facilities where there is a special fast queue designed to serve them
monitoring of the essential medicines stock holding compared quickly.
to the previous manual stock management. The two hospitals
are currently upgrading their ICT network and will soon be The Remote Automated Dispensing Units (RADU) installed in the
using the system. Johannesburg Health District at four different sites currently serves
27 129 patients. This innovation has increased patient convenience
MEDICINE AVAILABILITY and flexibility in patient medicine access by offering extended
operating hours, which include weekends and public holidays – an
Monitoring of medicine availability in the province is a key indicator
extra 80 hours/month. Although initially restricted to PHCs, the
of the APP. Availability of both vital and essential medicines was
RADU system has now been extended to hospitals and is thus
96% for the financial year 2018/19. Ensuring medicine availability
covering patients with chronic conditions who are stable compared
increases the possibility of better health outcomes. The province
to just a few at the start of the programme.
had targeted to maintain the availability of both vital and essential
medicines at an average of 98%, as had been achieved in 2017/18, Challenges
but in the reporting year challenges cited below were experienced There is a need to incorporate more external pick up sites to
nationally. contribute to decongesting internal facilities.
Challenges Strategy to address underperformance

The main causes of being out of stock were: There is a big drive for 2019/20 to initiate more external pick up
• Essential medicines not awarded on contracts due to: points. All hospitals will be enrolled on the programme in 2019.
• Non-participation of some pharmaceutical suppliers particularly
those who are sole suppliers of specific essential medicines RX SOLUTION IMPLEMENTATION
• Challenges in the sourcing of the active pharmaceutical The Rx Solution inventory management system has been installed at
ingredient (API) all hospitals and at five district pharmacies.
• Poor supplier performance exceeding the contractual lead
times

Ten facilities have started using the system for dispensing. The aim Anti-Rape strategy was developed in conjunction with all relevant
is to have paperless pharmaceutical services by the year 2030 in line stakeholders, the lead department being the Family Violence Child
with the 4th Industrial Revolution. Protection and Sexual Offences Unit (FCS) of the SAPS.
Both the FPS and CFMS play an important role in the government’s
Strategy to further improve Rx performance overall strategic objective of creating safer communities and
Scanners and printers purchased by NDoH have been delivered, and adopting zero tolerance for crime, especially violent crime.
NDoH is in the process of delivering computers to augment those
already in use at the pharmacies. Training sessions in inventory Summary of Significant Achievements
management have been held with institutions, with good outcomes. • The building of a new state of the art Johannesburg Forensic
Training in the dispensing system will be rolled out in 2019 as Pathology Service (FPS) mortuary costing R 600m. This is being
additional equipment is delivered. built in Auckland Park adjacent to Helen Joseph hospital and is
estimated 40% complete.
Sub-programme: Forensic Medical Services (Pathology & • An open day on 19 April 2018 was attended by CFMS staff at
Clinical) Baragwanath Hospital where community, learners and
This subprogramme consists of the Forensic Pathology Service and employees of the hospital were provided with information
the Clinical Forensic Medical Service (CFMS). regarding victims, PEP, prevention of injuries and human
trafficking.
The FPS is divided into two regions (North and South) comprising • Debriefing sessions are done for CFMS and FPS staff.
three clusters, with 11 medico-legal laboratories (mortuaries). • Community campaigns, events and training were conducted as
follow:
The CFMS has 27 facilities offering comprehensive 24-hour services. o Child Protection Week was supported through
Services are generally rendered within various facilities in the district build-up events. The main event was held on the 5th
viz hospitals and clinics. All health facilities are expected to manage of June, and 1 482 children were reached during this
survivors of violence, take blood for suspected drunken driving etc. period.
These come under various names such as crisis centres, o Basic first aid and fire safety training was conducted
post-exposure prophylaxis (PEP) centres and comprehensive for 254 community members.
medico-legal centres. Currently, all hospitals and some clinics offer o Youth Expo Week was supported at Nasrec, with 1
PEP. Services to victims of crime have been gazetted as the 119 community members reached.
designated responsibility of the Department of Health. o Burns Week was supported, and 129 community
members were reached.
Purpose of the sub-programme: o Continuous medical education was provided to 72
The role of the FPS is, inter alia, to investigate the cause of any employees.
unnatural death or sudden unexpected death, using internationally o 37 clinicians were trained in a Sexual Offences Care
accepted scientific methods thereby assisting the South African Practitioner course (SOCP).
Police Service (SAPS) in the collection of evidence and its o Men’s event was held on 16 November to improve
presentation in a court of law. The service is also required to keep gender relations and promote unity for 150 men.
statistics on trends that can be used in prevention strategies for o 16 Days of Activism was held with the theme “Peace
unnatural causes of death. This includes trauma such as motor Begins at Home” on the 5th December in Evaton. 282
vehicle accidents, violence, drowning and suicide. Through its community members attended the event.
partnerships with medical universities, the service appoints medical o A CFMS facility was opened in Evaton, and intake
doctors and trains medical, legal and law enforcement practitioners started in December 2018.
in the field of forensic medicine. o 4 238 comfort packs were issued in financial year
2018/2019.
The CFMS manages survivors of crime with specific emphasis on o A Lodox Statscan was repaired and transferred from
rape, domestic violence against women and man and child abuse. In Bertha Gxowa Hospital to FPS Germiston to ensure
the process, it supports judicial processes through collection of that people are no longer transported to FPS
evidence and providing expert witnesses in a court of law. The Johannesburg for necessary scans.
service also examines alleged perpetrators of crime. The CFMS is also • The post mortem turnaround time improved from 4 days in
involved in taking blood from alleged drunken drivers. The Gauteng quarter 2 to 2 days in quarter 4.
• The body release turnaround time improved at FPS Germiston
from 7 days in quarter 3 to 4 days in quarter 4.

PERFORMANCE INDICATORS: PROGRAMME 7 - HEALTHCARE SUPPORT SERVICES
Programme 7 – Healthcare Support Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Increase % of vital medicine available and accessible from 82% in 2013/14 to 99% by 2019/20
Percentage of vital 96.8% 98% 96.3% (1.7%) Vital medicines items not awarded on
medicine availability at (406/418) contracts; poor supplier performance
health facilities exceeding the lead times. EML items not
on contract; buy out procedure lengthy
and cumbersome. Continue with the
buyout of items not on contract or not
delivered including penalties on
non-performing suppliers and close
monitoring of medicines
Increase % of essential medicine available and accessible from 82% in 2013/14 to 99% by 2019/20
Percentage of essential 97.6% 98% 96.2% (1.8%) EML items not awarded on contracts;
medicine availability at (527/538) poor supplier performance exceeding the
health facilities lead times. EML Items not on contract;
buy out procedure lengthy and
cumbersome. Continue with the buyout
of items not on contract or not delivered
including penalties on non-performing
suppliers and close monitoring of
medicines
Increase access to chronic medication for stable patients through the use of central chronic dispensing and distribution centres and
pick-up points from 0 in 2013/14 to 600 000 by 2019/20
Number of patients 410 075 350 000 490 518 140 518 Roll out of the programme beyond the
enrolled on centralised pilot district and to some hospitals.
chronic medicine
dispensing and distribution
programme (cumulative)

Programme 7 – Healthcare Support Services

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Improve the quality of NHLS services delivered to GDoH by increasing turn-around times for laboratory test results by 33% by 2019/20
Percentage of Gene-xpert 96.7% 90% 94.9% 4.9% Target achieved and exceeded. Periodic
results available within 48 (284 765/294 reporting and continued monitoring of
hours 463) the indicator has enabled the NHLS to
develop appropriate intervention
measures.
Improve availability of essential medical equipment needed in 100% of hospitals by 2019/20
Number of hospitals with # 100% 100% 0 Target achieved. All hospitals are
essential medical 37/37 37/37 procuring equipment based on the
equipment recommended service package
equipment list whilst awaiting finalisation
of the essential equipment policy and list.
Reduce post mortem and mortuary body release turnaround time to 4 days
Post mortem turnaround # 3 days 2 days 1 day Target achieved

time
Mortuary body release # 5 days 5 days 0 day Target achieved

turnaround time
Increase quality and access in PHC facilities through 24 hours service provision in all CHCs, integration of mental health and
rehabilitation services in 100% of PHC facilities by 2019/20
Percentage of assistive 92% 71% 90.8% 19.8% Target exceeded due to large amount of
devices issued hearing aids and prosthetic parts
purchased from the central office to
alleviate waiting lists.
PROGRAMME 7: HEALTHCARE SUPPORT SERVICES EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000 R’000
(Over)/Under
R’000 R’000 R’000 R’000 R’000 R’000
Laundries 213 145 208 732 4 413 251 462 250 982 480
Food Supply Services 76 692 81 035 (4 343) 87 693 88 066 (373)
Medicine Trading Account 1 - 1 1 - 1
Total 289 838 289 767 71 339 156 339 048 108

4.8 PROGRAMME 8: HEALTH FACILITIES MANAGEMENT
Purpose
The purpose of the programme is to plan and deliver new health • Construction at Kekanastad New Clinic commenced in
facilities and to refurbish, upgrade and maintain existing facilities. February 2018
• Construction at the new Eersterus Clinic in Soshanguve is 25%
Strategic Objective completed
Increased efficiency of service implementation through • Upgrading of psychiatric wards at Charlotte Maxeke
infrastructure delivery, good governance practices and sustainable Johannesburg Academic Hospital is 75% completed
maintenance of moveable and immovable assets. • Construction of new Khutsong South Clinic is 88%
completed.
LIST OF SUB-PROGRAMMES
• District Health Services
• Community Health Facilities
• Provincial Hospital Services
• Central Hospital Services
• Emergency Medical Services
• Other facilities
FUNDING SOURCES
Programme 8 is funded through:
• Hospital Facility Revitalisation Grant (HFRG)
• Equitable Share (ES)
• Extended Public Works Programme (EPWP)
SIGNIFICANT ACHIEVEMENTS
During 2018/19, there were the following significant achievements:
• A contractor for the refurbishment of nurses residences at

Helen Joseph Hospital was appointed on 24 May 2018
• Construction for additions and renovations at Dilopye Clinic
commenced on 23 July 2018
• A replacement contractor for the renovation of Helen Joseph
psychiatric ward was appointed. Construction expected to be
completed 31 May 2019
• Upgrading of Ga-Rankuwa Nursing College was completed on
5 October 2018
• Construction of New Kekana Gardens Clinic was completed
on 14 December 2018, and the facility was officially opened
on 6 April 2019
• New Dewagensdrift Clinic was completed on 29 July 2018

Performance indicators: Programme 8

2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Build 10 new clinics/community health centres; commence with the construction of two additional new hospitals; refurbish 21
health care facilities by 2019/20, of which 100% will comply with the gazetted norms and standards for facilities
Number of health facilities 2 2 2 projects 0 Tshwane ward 4A has been refurbished

that have undergone completed completed including the upgrading of the water
major and minor reticulation system. In addition, we have
refurbishment in NHI Pilot upgraded the Garankuwa Nursing
District College.
Number of health facilities 1 1 0 completed (1) 3 construction projects commenced at

that have undergone major completed projects Charlotte Maxeke (Pych ward and staff
and minor refurbishments residence), Chris Hani Bara (staff
outside NHI pilot district residence, ICU and Neonatal) and Forensic
(excluding facilities in NHI Pathology building – City of Johannesburg
Pilot District) (COJ).
The resolution taken by Exco pertaining to
infrastructure led to the deferment of
planned construction.
Build 10 new clinics/community health centres by 2019/20 of which 100% will comply with the gazetted norms and standards
Number of additional 2 3 2 clinics (1) 2 of the targeted clinics completed namely

clinics and community completed Completed completed Dewagensdrift and Kekana Gardens
health centres constructed
7/8 clinics under construction namely:
6 under 8 under 7 under (1) Finetown, Greenspark, Kekanastad,
construction construction construction Khutsong South, New Eersterust, Dilopye,
Boikhutsong
1 in 5 in 4 4 additional clinics in planning phase
planning planning namely: Chiawelo, Zola CHC, Dark City,
Refilwe, Orange Farm


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Build 10 new clinics/community health centres; commence with the construction of two additional new hospitals; refurbish 21 health
care facilities by 2019/20, of which 100% will comply with the gazetted norms and standards for facilities
Number of additional new 9 in 10 in 11 in 1 Lilian Ngoyi Hospital:

hospitals constructed or planning planning planning The new hospital was planned and designed as
revitalised a district hospital, but due to current demand
0 under the designs must be changed into those for a
construction regional hospital. Target not reached.
Soshanguve Hospital:
Follow up meeting with CoT was held to
confirm bulk services and usable space in terms
of the current buffer zone on the proposed site.
Target reached.
Daveyton Hospital, Khayalami Hospital,

Sebokeng Hospital,
Dr Yusuf Dadoo Hospital,
Tambo Memorial Hospital
Projects were put on hold. Target reached.
Diepsloot Hospital:
Initially, the identified site was privately owned.
COJ identified alternative land for transfer to
GDOH. Target reached.
Jubilee Hospital:
The process of acquiring an appropriate site for
proposed new facilities is under way with GDoH
and the Gauteng Deparment of Infrastructure
Development (GDID) Town Planner discussing
options with the City of Tshwane. The initial
identified site was environmentally sensitive; the
2nd identified site is tribal land. Target reached.
Kalafong Hospital:
Identified sites belong to City of Tshwane (CoT)
and Public Works. GDID is in negotiations with
the respective owners. Target reached.
The CoT needs township establishment for all
uses to be erected on site.
Hillbrow Hospital in planning phase.

The resolution taken by Exco pertaining to
infrastructure led to the deferment of planned
construction.


2017/18 2018/19 2018/19 target 2018/19
(over/(under))
Build 10 new clinics/community health centres; commence with the construction of two additional new hospitals; refurbish 21
health care facilities by 2019/20, of which 100% will comply with the gazetted norms and standards for facilities
Number of new EMS bases # 5 in 5 In planning: 0 Target exceeded, additional 5 EMS bases
revitalised planning in planning phase namely: Westonaria,
Mohlakeng, Heidelberg, Devon,
Dewagensdrift. Construction could not
commence due to the resolution taken
by Exco pertaining to Dewagensdrift
base.
Number of mortuaries # 1 in 1 in planning 0 Target achieved. Bronkhorstspruit FPS

refurbished planning 1 under and Johannesburg FPS are under
1 under construction planning and construction respectively
constru-
ction
EXPENDITURE: PROGRAMME 8 – HEALTH FACILITIES MANAGEMENT EXPENDITURE TABLES
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000
R’000 R’000 R’000 R’000 R’000 R’000
Community Health Facilities R 341 042 R 317 227 R 23 815 432 134 390 045 42 089
Emergency Medical Rescue R 7 046 R 1 739 R 5 307 9 628 1 299 8 329
Services
District Hospital Services R 260 789 R 214 806 R 45 983 218 580 172 998 45 582
Provincial Hospital Services R 288 934 R 282 716 R 6 218 264 803 202 304 62 499
Central Hospital Services R 311 287 R 335 462 -R 24 175 314 344 315 650 (1 306)
Other facilities R 474 201 R 455 827 R 18 374 320 444 453 824 (133 380)
Total R 1 683 299 R 1 607 777 R 75 522 1 559 933 1 536 120 23 813

Changes to planned targets
The table below shows the main appropriation, adjustments and proposed second adjustment for the 2018/19 financial year.
2018/19 Financial Year
Category Main Adjusted 2nd adjustment Decrease Increase

New Infrastructure assets R 645 991 R 797 141 R 711 276 R 85 865 R0
Renovations & rehabilitation R 143 500 R 173 452 R 136 017 R 37 435 R0
Upgrades and additions R 229 700 R 142 110 R 135 410 R 6 700 R0
Maintenance and repairs R 797 343 R 707 073 R 517 073 R 190 000 R0
Total R 1 816 534 R 1 819 776 R 1 499 776 R 320 000 R0
The table below shows the infrastructure allocation per funding source. The provincial equitable share (ES) reduced by R 320 million (34%)
compared to the Mid-Year Adjustment Budget.
Funding Original Adjusted Second Decrease Increase

budget budget adjustment
Equitable Share R 939 368 R 925 368 R 605 368 R 320 000 R0
Health Facility Revitalisation Grant R 874 842 R 892 084 R 892 084 R0 R0
EPWP R 2 324 R 2 324 R 2 324 R0 R0
Total R 1 816 534 R 1 819 776 R 1 499 776 R 320 000 R0
5. TRANSFER PAYMENTS
Table: Transfer payments to other public entities, 2018/19
Name of Type of R’000 Purpose

R’000 for Did the
R’000 Amount
R’000 Amount R’000
spent Reasons for
R’000
transferee organisation which the department transferred by the entity the funds
funds were comply with s (R’000) unspent by
used 38 (1) (j) of the the entity
PFMA?
Local Government Municipalities Primary Health Care Yes 316,463 316,463 -
Local Government Municipalities HIV/AIDS Yes 67,012 67,015 -
Local Government Municipalities Emergency Yes 338,514 338,514 -
Health Welfare and Sector Non-profit Medical Services Yes 20,962 20,962 -
Training Authority institution
Universities Higher Education Learnerships Yes 13,681 13,421 Delays in tax

clearance certificate
Institutions
A number of
Mental Health Non-profit Training of Health Yes 191,207 150,495
non-profit institutions
institutions professionals
did not meet the
Psychiatric Community
requirements
Based Services

Name of Type of R’000 Purpose
R’000 for Did the
R’000 Amount
R’000 Amount R’000
spent Reasons for
R’000
transferee organisation which the department transferred by the entity the funds
funds were comply with s (R’000) unspent by
used 38 (1) (j) of the the entity
PFMA?
Expanded Public Works Non-profit Community Based Yes 120,511 120,346 A number of
beneficiaries
Programme institutions Services Yes terminated service
Nutrition Non-profit Nutrition supplement 58,548 55,984 A number of crèches

did not meet the
institutions to crèches Yes qualifying criteria
HIV/AIDS Non-profit Primary Health Care 79,264 73,652 A number of non-profit
institutions did not meet
institutions Yes the qualifying criteria
Witkoppen clinic Non-profit Primary Health Care 13,308 13,115
institution Yes
Rehabilitation Services Non-profit Rehabilitation Yes 1,690 1,690
institutions
Nelson Mandela Children’s Non-profit Paediatric services Yes 200,000 200,000
Hospital institution
Increased payments of
Households Non-profit Service benefits and Yes 535,809 921,439 claims against the state
and its reclassification
institution households
from goods and services
6. DONOR FUNDS
DONOR FUND 1
Name of donor Health care waste and occupational hygiene risk management, Mamelodi Hospital
Full amount of the funding Compass Medical Waste donated Assets to the value of R494820.00
Period of commitment None
Purpose of the funding Kickabout bucket, med waste trolley small and med waste trolley large for the patient
Expected outputs Kickabout bucket, med waste trolley small and med waste trolley large for the patient
Actual outputs achieved Kickabout bucket, med waste trolley small and med waste trolley large for the patient
Amount received in the current period (R’000) R494820.00(Kickabout bucket, med waste trolley small, med trolley large)
Amount spent by the department (R’000) None
Reasons for funds unspent
Monitoring mechanisms by the donor None

DONOR FUND 2
Name of donor Mevi Mercant donoted to Pretoria Paediatric Fund
Full amount of the funding R85850.00(Refrigerator, Microwave)
Period of commitment None
Purpose of the funding Refrigerator, microwave used by patient at Paediatric by the Kangaroo Mother care unit.
Expected outputs Refrigerator, Microwave used by Patient at Paediatric by the Kangaroo Mother care unit.
Actual outputs achieved Refrigerator, Microwave used by Patient at Paediatric by the Kangaroo Mother care unit.
Amount received in the current period (R’000) R10835.00 (Refrigerator, Microwave)
Amount spent by the department (R’000) None
Reasons for the funds unspent
Monitoring mechanisms by the donor None
DONOR FUND 3
Name of donor BroadReach Corporation
Full amount of the funding R23474.83 (Dell Latitude E7470)
Period of the commitment none
Purpose of the funding Dell Latitude E7470 for staff
Expected outputs Dell Latitude E7470 for staff
Actual outputs achieved Dell Latitude E7470 for staff
Amount received in the current period (R’000) R23474.83 (Dell Latitude E7470)
Amount spent by the department (R’000) none
Reasons for the funds unspent N/A
Monitoring mechanisms by the donor none
7. CONDITIONAL GRANTS
The table below shows the conditional grants and earmarked funds paid to the Department.
Table 7.1: Conditional Grant: Health Facility Revitalisation Grant
Department/municipality to which the grant was GDOH
transferred
Purpose of the grant The purpose of the grant, made in terms of DORA, was to:
• Help accelerate the construction, maintenance, upgrading and rehabilitation of new
and existing infrastructure in health including health technology, organisational design
(OD) systems and quality assurance (QA)
• Supplement expenditure on health infrastructure delivered through public-private
partnerships
• Enhance capacity to deliver health infrastructure.
Expected outputs of the grant Number of health facilities planned: 5
Number of facilities designed: 3
Number of facilities constructed: 6
Number of facilities equipped: 5
Number of facilities operationalised: 3
Number of facilities maintained: 88

7. CONDITIONAL GRANTS
The table below shows the conditional grants and earmarked funds paid by the Department.
Table 7.1: Conditional Grant: Health Facility Revitalisation Grant
Department/municipality to which the grant was GDOH

transferred
Actual outputs achieved Number of health facilities planned: 0

Number of facilities designed: 0
Number of facilities constructed: 1
Number of facilities equipped: 3
Number of facilities operationalised: 0
Number of facilities maintained: 7
Amount per amended DORA R 892 084 000

Amount transferred (R’000) R 892 084 000
Reasons if amount as per DORA not transferred Not applicable
Amount spent by the department/municipality (R’000) R 777 939 000
Reasons for the funds unspent by the entity • Projects started construction later than anticipated
• Probity process delayed procurement at GDID
• Contracts had to be terminated because contractor could not complete the work
• Contractor had cash flow limitations which delayed projects
• Contractors performed poorly
• Projects on tender were sent back to planning due to non-compliance
• Late payment of invoices
• Contractor abandoned site due to community unrests/service delivery protests
• Late approval of planning documents
• Long process to get approval of end user
• Land challenges
Monitoring mechanisms by the transferring department National Health Infrastructure Progress Reviews
Standard for Infrastructure Delivery and Procurement Management (SIPDM)
Division of Revenue Act (DORA).
Table 7.2: Conditional Grant: National Tertiary Services Grant
Department/municipality to which the grant was National Health Department

transferred
Purpose of the grant Ensure the provision of tertiary health services in South Africa
Compensate tertiary facilities for the additional costs associated with provision of these
services
Expected outputs of the grant
NTSG - Service Outputs 2017/18 Target outs as per SLA 2018/19
Day patient separations - Total 170,765
Inpatient days - Total 1,768,217
Inpatient separations - Total 305,089
Outpatient first attendances 566,934
Outpatient follow up attendances 1,362,128

Actual outputs achieved
NTSG - Service Outputs 2017/18 Measured outputs
Day patient separations - Total 205,203
Inpatient days - Total 1,719,446
Inpatient separations - Total 315,024
Outpatient first attendances 587,256
Outpatient follow up attendances 1,355,237
Amount per amended DORA (R’000) R 4,390,192,000
Amount transferred (R’000)
Reasons if amount as per DORA not transferred R 4,137,620,922
Reasons for the funds unspent by the entity (R’000) This item is projected to be underspent due to the processes of sourcing
quotations and finalisation of tenders regarding MTS equipment. However, there
are commitments of R252 million as of 31 March 2019. The department is in the
process of applying a rollover of R252 million.
Monitoring mechanisms by the transferring department Monthly, quarterly and annual monitoring of expenditure and equipment progress
Table 7.3: Conditional Grant: Health Professions Training and Development Grant
Department/municipality to which the grant was National Health Department

transferred
Purpose of the grant Support provinces to fund service costs associated with clinical training and
supervisors of health science trainees on the public service platform
Expected outputs of the grant Increased supply of trained health professionals: medical doctors, nurses and allied
health professionals
Actual outputs achieved COMMUNITY SERVICE PLACEMENTS

251
Medical Doctors
23
Dentists
55
Dieticians
34
Environmental Health Practitioners
91
Occupational Therapists
88
Pharmacists
102
Physiotherapists
76
Radiographers
62
Speech & Hearing Therapists
Internship programme:
526
Medical Interns
61
Pharmacists
61
Clinical Psychologists
648
TOTAL:

Amount per amended DORA (R’000)
Amount transferred (R’000) R 983, 712,000
Reasons if amount as per DORA not transferred
Amount spent by the department/municipality (R’000) R 947,885,000
Reasons for the funds unspent by the entity (R’000) The under-expenditure is mainly attributed to slow supply chain processes with
regard to procurement of and payment for training and medical equipment. There
were unpaid invoices to the value of R1, 7 million and commitments amounting to
R32, 3 million as of 31 March 2019. The department will apply for a roll-over
amounting to R34 million.
Monitoring mechanisms by the transferring department Monthly, quarterly and annual monitoring of expenditure
Table 7.4: Social Sector EPWP Incentives Grant
Department/municipality to which the grant was National Public Works (NPW)

transferred
Purpose of the grant To improve service delivery by strengthening and expanding social sector programmes
that have employment potential
Expected outputs of the grant Employment created and stipends paid to EPWP participants.
Service delivery improved.
Improved opportunities for sustainable jobs through work experience and training.
Actual outputs achieved 58 job opportunities (Facilities Base Assistant Workers) created.
58 health facilities serviced
Amount per amended DORA 1 470 000
Amount transferred (R’000) 1 470 000
Reasons if amount as per DORA not transferred N/A
Amount spent by the department/municipality (R’000) 1 404 000 (96%)
Reasons for the funds unspent by the entity Training was not conducted.
Monitoring mechanism by the transferring department Monthly and quarterly reports (Monthly In Year Monitoring Reports and quarterly
narrative reports)

8. CAPITAL INVESTMENT, MAINTENANCE AND ASSET MANAGEMENT PLAN
Progress made in implementing the capital, investment and asset management plan
By implementing a range of capital and maintenance infrastructure projects, the programme spent 98% of its allocated budget in the 2018/19
financial year.
Table 8.1: Infrastructure projects completed during the financial year and progress compared with what was planned at the
beginning of the year
PMIS Project name Current

R’000 Construction
R’000 Planned
R’000 Actual
R’000 R’000 Reason for
R’000
Project stage start date construction construction deviation
Number end date as completion date
at 1 April or new planned
2018 completion date
143 Boitumelo clinic Construction 29 March 2017 15 March 2018 31 March 2023 The site was handed over to the
New clinic contractor prematurely on 28 March
2017. The contractor could not start
with the work as the municipal
approval for the project and the
construction documentation were not
completed. The contractor was
chased off-site by the community.
GDID cancelled the contract with the
contractor and the project was
re-advertised for tender; a new
contractor is to be appointed.
241 Charlotte Maxeke Construction 09 November 30 June 2018 31 May 2019 Previous ward councillor influenced
Johannesburg 2015 general workers that their rate per
Academic Hospital day is supposed to be R288 instead of
Upgrading and the R150 which the contractor bid
renovation of the entailed. This led to community
existing Psychiatric unrest which was resolved by the
unit establishment of a Project Steering
Committee.
179 Dewagensdrift Clinic Construction 01 August 2016 31 March 2018 29 July 2018 All construction works completed; HT
Construction of the completed items need to be fitted and
new clinic commissioned. The official opening
took place on 26 April 2019.
129 Finetown Clinic Construction 28 September 28 February 31 January 2020 There was a contractual dispute due
Construction of new 2016 2019 to the Department’s lengthy payment
clinic procedures which eventually led to
contract cancellation in November
2018. Replacement contractor to be
appointed.

R’000 Planned
R’000 Actual
R’000 R’000 Reason for
R’000
Project stage start date construction construction deviation
540 Ga-Rankuwa Nursing Construction 25 May 2015 30 July 2018 5 October 2018 Challenges were experienced with
College roofs on lecture halls, linkages
Upgrading and between the old buildings and the
renovations to new building, Auditorium, ITC
college infrastructure, ground civil works, late
payment of contractor’s claims, access
to the existing building, Power of
Attorney. The subcontractor for ICT
was only appointed in December
2017 by the main contractor
following approval of ICT as a
Variation Order to the contract.
6793113 Greenspark Clinic Construction 15 February 29 March 2019 30 October 2019 Progress has been slow due to cash
New clinic 2017 flow problems by the contractor.
Scope of work changes on the
contract allowing additional
extension of time. Additional scope
to bulk earthworks and ICT had to be
added. Delays on site due to
community unrest.
291 Kekanastad Clinic Construction 27 February 14 December 31 December Construction was at 35% when the
Construction of the 2018 2018 2019 contract was terminated.
new clinic Replacement contractor had to be
appointed.
6793111 Khutsong South Ext2 Construction 12 April 2016 31 August 2018 31 July 2019 Slow progress on site due to
Clinic community unrest. Contractor off-site
New Clinic due to late payments from
Department. Community unrest.
GDID requested additional scope.
170 Mandisa Shiceka Construction 03 October 2017 14 December 14 December The land is too small for the clinic. An
Clinic 2018 2019 additional land parcel ERF 355 (a
Replace current clinic portion) was requested to
and upgrade to CDC accommodate parking for the clinic.
The requested land is owned by the
City of Tshwane, which was
requested to allocate this piece of
land or to relax the parking bylaws.
Construction commenced for a
temporary structure.

R’000 Planned
R’000 ActualR’000 Reason for deviation
R’000 R’000
Project stage start date construction construction
New Kekana Gardens Construction 16 January 2016 29 June 2018 Construction of the facility has
183 Clinic completed progressed to 100% with all
New clinic construction completed. ICT and
medical equipment to be procured,
installed and commissioned. The
official opening was on 6 April 2019.
283 Tshwane District Construction 06 May 2015 09 March 2018 09 March 2018 Completion of Ward 1 has
Refurbishment completed commenced; practical completion was
Contract 4 A reached on 9 March 2018
Table 8.2: Infrastructure projects currently in progress and their expected completion dates
PMIS Stage Construction Construction

Project Project name
start date end date
Number
30309905 Atteridgeville CHC Construction of new CHC Feasibility 30 November 2018 31 August 2021
84 Bertha Gxowa Hospital Upgrading of hospital Design 01 February 2020 31 March 2021
31007931 Bheki Mlangeni Hospital New Nurses Residences Feasibility 01 December 2022 31 March 2025
143 Boikhutsong CDC Replacement of existing clinic and Construction 51% - 75% 29 May 2017 29 May 2020
upgrade to new CDC
6792486 Boitumelo Clinic New Clinic Construction 1% - 25% 01 April 2020 31 March 2023
6793105 Braam Fischerville Clinic New Clinic Pre-feasibility 05 March 2020 31 March 2023
445 Bronkhorstspruit FPS Mortuary New mortuary Feasibility 06 September 2020 06 January 2022
212 Carletonville Hospital Refurbishment of TB ward Design 30 October 2019 31 January 2022
241 Charlotte Maxeke Johannesburg Academic Hospital Construction 76% - 99% 09 November 2015 31 May 2019
Upgrading and renovation of the existing Psychiatric unit
30309680 Charlotte Maxeke Johannesburg Academic Hospital Design 01 June 2019 01 July 2020
Wet Services
6793027 Chiawelo Clinic Replace asbestos with brick and upgrade Feasibility 15 February 2020 24 February 2022
existing clinic to CHC
428 Chris Hani Baragwanath Hospital Critical repairs and Tender 01 March 2019 11 November 2021
refurbishment of staff accommodation, walkways,
neo-natal ICU and Labour ward.
6793012 Cosmo City Clinic New Clinic Identified 01 April 2021 31 March 2023
103 Dark City CHC Additions and Rehabilitation Design 02 November 2019 30 September 2021
6793117 Daveyton Main Clinic Construction of the new clinic Feasibility 01 April 2021 31 March 2024
30309906 Dewagensdrift EMS New EMS base Design 05 August 2019 29 September 2020
6793154 Diepkloof FPS Pre-feasibility 01 April 2021 31 March 2024

start date end date
Number
105 Dilopye Clinic Additions and rehabilitation Construction 1% - 25% 31 March 2021
319 Discoverers CHC Convert CHC into District Hospital Design 01 May 2024
6793031 Dr George Mukhari Hospital Construction of helipad Pre-feasibility 30 July 2021
350 Dr Yusuf Dadoo Hospital Revitalisation Feasibility 31 December 2024
30309678 Edenvale Hospital Upgrades Upgrading and new AET, Feasibility 01 September 2021
113 additional wards, linen room, additional theatre
6793121 Ekangala Clinic New clinic Design 01 November 2020
6793129 Eldorado CHC Construction of new CHC Feasibility 31 March 2022
129 Evaton West clinic Construction of new clinic Tender 31 March 2022
540 Finetown Clinic Construction of new clinic Construction 26% - 50% 31 January 2020
6793113 Ga-Rankuwa Nursing College Upgrading and renovations Practical completion 05 October 2018
to college
659 Greenspark Clinic New clinic Helen Joseph Hospital Construction 51% - 75% 30 October 2019
Refurbishment of Oorkant, Susan Hof, Querani and
Strydom Hof Nurses residences at the hospital
656 Helen Joseph Hospital Renovations to Psychiatric ward and Construction 1% - 25% 30 November 2021
observation units
31006404 Hillbrow District HospitalConversion of CHC into District Construction 76% - 99% 31 May 2019
6793118 Hospital. Additions and revitalisation Feasibility 31 March 2024
J Dumani CHC Extensions of the pharmacy storeroom
467 Johannesburg FPS Mortuary New mortuary Design 31 March 2024
753 Jubilee Hospital Revitalisation Construction 26% - 50% 30 November 2020
760 Kagiso CHC New CHC Identified 30 June 2027
759 Kalafong Hospital Revitalisation/construction of new Design 31 March 2023
hospital
291 Kekanastad Clinic Construction of new clinic Feasibility 28 May 2026
292 Kgabo CHC New CHC Construction 26% - 50% 31 December 2019
765 Khayalami Hospital Complete refurbishment of existing Feasibility 29 November 2022
unused hospital into a functional District Hospital
31007745 Khayalami Hospital Demolition of current empty hospital Pre-feasibility 28 June 2024
6793111 Khutsong South Ext2 Clinic New clinic Feasibility 30 April 2021
6793107 Kokosi CHC New CHC Construction 76% - 99% 31 July 2019
849 Kopanong Hospital Refurbishment of Psychiatric wards Design 31 March 2022
1&2 Tender 01 May 2021
161 KT Motubatse New clinic Feasibility 26 October 2020
6793036 Lebone college Health council upgrades Design 03 July 2021
6793048 Lehae CHC Construction of a new CHC Feasibility 28 February 2023
31008679 Lenasia District Hospital Phase1 - Gateway Clinic Tender 01 December 2024

start date end date
Number
908 Lenasia South CHC Convert CHC into District Hospital. Tender 01 April 2020 31 March 2024
Phase 1 Gateway Clinic
30309679 Leratong Nurses Res Upgrade Feasibility 30 June 2020 30 September 2022
31006389 Lillian Ngoyi Hospital Staff accommodation Tender 01 April 2020 31 March 2025
53 Lillian Ngoyi Construct new 500 bed District Hospital Design 01 April 2020 31 March 2025
adjacent to existing CHC
170 Mandisa Shiceka Clinic Replace current clinic and upgrade Construction 76% - 99% 03 October 2017 14 December 2019
to CDC
6793112 Mayibuye clinic Construction of new clinic Design 28 October 2019 16 January 2021
180 New Eersterus Clinic Construction of new clinic in Construction 1% - 25% 31 August 2018 31 August 2023
Soshanguve
6793120 Northmead Clinic Upgrades and additions Feasibility 01 April 2020 31 March 2022
OR Tambo MOU Upgrading and renovation of the existing Identified 11 September 2019 11 September 2021
clinic using MOU
6793122 Orange Farms Replacement of Ext 7 Clinic Tender 01 December 2022 01 December 2025
195 Phedisong 4 CHC Additions and rehabilitation Design 05 October 2019 05 October 2020
6793119 Phillip Moyo CHC Extension and refurbishment of Construction 51% - 75% 31 July 2017 01 November 2020
maternity unit
Pholosong Hospital Stepdown beds Design 01 April 2017 31 March 2089
198 Pretoria North Clinic Additions and rehabilitation Design 01 April 2019 19 April 2024
202 Ramotse Clinic New clinic Design 01 July 2020 31 March 2022
6793106 Randfontein Clinic Replace small clinic and upgrade to CHC Construction 1% - 25% 31 January 2020 31 May 2022
6793149 Refentse Clinic Additions and rehabilitation. Design 01 April 2019 31 March 2021
205 Refilwe Clinic Replace small clinic and upgrade to CHC Design 30 April 2019 30 September 2021
629 S G Lourens Nursing College Construction of new training Design 01 April 2020 31 March 2021
facility
739 Sebokeng Hospital Revitalisation Feasibility 25 July 2019 24 July 2024
6793128 Sebokeng Zone 17 Clinic Construction of new clinic Tender 31 October 2019 31 October 2020
223 South Rand Hospital Conversion and renovation of old Design 02 February 2020 02 February 2021
compound/pharmacy
South Rand Hospital Maternity homes Identified 01 March 2020 02 June 2020
901 Tambo Memorial Hospital Revitalisation Feasibility 01 August 2020 28 May 2026
31006387 Tara Hospital Construction of new secure adolescent ward Design 01 August 2019 31 August 2020
Tembisa Hospital Encroachment and dolomite risk Feasibility 01 April 2020 31 March 2021
Tembisa Hospital New bulk store Design 01 April 2020 30 April 2022
4640 Thelle Mogoerane Hospital New staff residences Handed over 25 February 2015 31 December 2017
1006 Tshwane District HospitalExternal wet services contract Practical Completion 21 January 2016 14 December 2017
283 Tshwane District Refurbishment Contract 4 A Practical completion 06 May 2015 09 March 2018

start date end date
Number
1010 Tshwane Rehabilitation Centre Renovation and upgrading Design 30 November 2019 30 September 2023
of the facility
245 Weskoppies Hospital Condition assessment and Design 16 November 2019 01 June 2022
refurbishment of heritage buildings
Winnie Mandela CHC Construction of a new CHC Design 01 April 2021 31 March 2024
Zola Clinic Construction of a new clinic Feasibility 01 April 2021 31 March 2024
Table 8.3: Procurement of medical equipment was completed by 31 March 2018 for the following three health facilities:
Project Name (as part of Incentive Grant)
Helen Joseph Hospital
Kalafong Hospital
Tembisa Hospital
Plans to close down or down-grade any current facilities

There were no plans to close or down-grade any facilities in the 2018/19 financial year.
Table 8.4: Progress was made on maintenance of the following infrastructure:
Maintenance category Final appropriation (R’000) Expenditure (R’000) % spent against budget (R’000)
Maintenance & Repairs R 514 751 R 648 866 126%
Electro-mechanical R 87 338 R 78 397 90%
EPWP R 2 324 R 2 160 93%
Total R 604 413 R 729 423 121%
Developments relating to the above that are expected to

impact on the department’s current expenditure 3. On 24 December 2018, GDOH requested GDID to urgently
appoint contractors to implement Occupational Health and
1. In 2018/19, there was over-expenditure on maintenance Safety (OHS) maintenance projects at various health
projects. This was offset by under-expenditure on capital institutions. GDID consequently appointed Professional Service
projects, leading to the department spending 100% of its Providers (PSPs) to prepare specifications and Bills of Quantities
allocation for infrastructure. (BOQs) for 32 hospitals. On 10 April 2019, at a meeting
between GDOH, GDID and GPT it was decided to intensify
2. The MECs of Health and Infrastructure Development jointly departmental consultations by including CEOs, District
approved a new strategy according to which the maintenance Managers, Facility Managers and OHS Committees to approve
of all health facilities and infrastructure will be carried out in the scope of work and recommended solutions for all
future. It takes a proactive approach of preventing breakages hospitals. It was also recommended that the tender
and facility deterioration, synonymous with service documents received from GDID would be workshopped with
interruptions and negative consequences. Due to the financial institutions and presented to the CEOs and hospital
implications of the strategy and in line with the Standard for management for approval before contractors were appointed.
Infrastructure Procurement and Delivery Management (SIPDM), The programme will be implemented in 2019/20 after all
a Project Initiation Report (PIR) must be approved by Gauteng consultations have been completed.
Provincial Treasury before implementation can commence.
Preparation of the PIR is underway.

4. Changes to asset holdings during the period under review, immovable assets is responsible for disposal of the building.
including information on disposals, scrapping and loss due to Measures have been taken to ensure that the Department’s Asset
theft. Register remained up-to-date during the period under review;
On 5 September 2018, the GDOH Head Office in the Bank of Lisbon GDID, as custodian of immovable assets, is responsible for
Building (BOL) caught fire. This was a major disaster, with the entire maintaining this register.
building evacuated. The building was largely destroyed and
declared unsafe for further use. GDID as the custodian of
Table 8.5: Percentage of the Department’s capital assets in good, fair or bad condition
The table below shows the condition ratings of facilities as per the User Asset Management Plan (UAMP) for 2018/19.
Index Number of facilities Percentage

Condition Rating C4 12 2%
Table 8.6:The following major maintenance projects were undertaken during the period under review.
PMIS Stage 2018/19 Second Actual

Project name expenditure to
Project Adjustment
Number date for this
financial year
81 Ann Latsky Nursing College All maintenance activities R 1 000 R 1 253
175 Auckland Park Medical Supply Depot Depot maintenance R 4 000 R 1 791
82 Bank of Lisbon Building All maintenance activities R 2 500 R 2 938
85 Bertha Gxowa Hospital All maintenance activities R 5 482 R 6 157
6793065 Bheki Mlangeni Hospital Maintenance R 2 000 R 3 215
87 Bona Lesedi College All maintenance activities R 2 300 R 1 926
31007928 Bronkhorstspruit EMS Maintenance R 2 324 R 390
30309699 Bronkhorstspruit FPS Mortuary Maintenance R 500 R 255
30309930 Bronkhorstspruit Hospital Maintenance R 2 724 R 2 451
88 Carletonville FPS Maintenance R 1 799 R 330
89 Carletonville Hospital All maintenance activities R 2 000 R 3 245
30309693 Charlotte Maxeke EMS All maintenance activities R 985 R0
93 Charlotte Maxeke Johannesburg Academic Hospital All maintenance activities R 36 772 R 50 809
95 Chris Hani Baragwanath Hospital All maintenance activities R 38 353 R 37 297
97 Chris Hani Laundry All maintenance activities R 3 589 R 1 507
30309441 Chris Hani Nursing College Maintenance R 2 528 R 481
6792275 Cullinan Care Rehabilitation Hospital All maintenance activities R 5 587 R 10 802
30309695 Cullinan EMS All maintenance activities R 555 R0
30309697 Diepkloof FPS Maintenance R 1 580 R 1 725
107 Dr George Mukhari Hospital All maintenance activities R 33 054 R 27 228
108 Dr Yusuf Dadoo Hospital All maintenance activities R 10 189 R 7 412
110 Dunswart Provincial Laundry All maintenance activities R 749 R 23 197
255 Edenvale Hospital All maintenance activities R 8 211 R 10 632

Project Project name Adjustment expenditure to
financial year
114 Ekurhuleni District CHCs All maintenance activities R 9 709 R 1 197
117 Ekurhuleni District Clinics All maintenance activities R 9 605 R 3 145
121 Ekurhuleni District Health Office All maintenance activities R 500 R 860
30309931 Emergency Maintenance R 20 000 R 141 548
256 Far East Rand Hospital All maintenance activities R 7 275 R 11 399
30309694 Fochville EMS All maintenance activities R 455 R 34
134 Ga-Rankuwa FPS Maintenance R 1 523 R 1 200
135 Ga-Rankuwa Nursing College All maintenance activities R 861 R0
30309698 Germiston FPS Maintenance R 2 323 R 880
30309700 Heidelberg FPS Maintenance R 762 R 1 159
147 Heidelberg Hospital All maintenance activities R 5 809 R 3 058
257 Helen Joseph Hospital All maintenance activities R 9 995 R 14 549
149 Johannesburg District CHCs All maintenance activities R 8 139 R 15 595
151 Johannesburg District Clinics All maintenance activities R 9 522 R 9 948
154 Johannesburg District Office All maintenance activities R 1 880 R 156
30309701 Johannesburg Forensic Mortuary All maintenance activities R 2 148 R 1 295
4664 Johannesburg Provincial Laundry All maintenance activities R 1 857 R 3 772
159 Jubilee Hospital All maintenance activities R 6 250 R 10 475
258 Kalafong Hospital All maintenance activities R 6 548 R 8 356
163 Kopanong Hospital All maintenance activities R 5 894 R 6 600
166 Lebone College of Emergency Care All maintenance activities R 1 365 R 70
294 Lebone EMS College All maintenance activities R 942 R 73
259 Leratong Hospital All maintenance activities R 10 000 R 11 360
171 Masakhane Cook freeze All maintenance activities R 289 R 2 071
173 Masakhane Laundry All maintenance activities R 6 122 R 5 413
260 MEDUNSA Oral Health Centre All maintenance activities R 2 159 R 1 799
184 New Mamelodi Hospital All maintenance activities R 6 628 R 4 286
186 Nicol House All maintenance activities R 2 443 R 2 471
188 Odi Hospital All maintenance activities R 4 148 R 1 356
190 Old Germiston Hospital All maintenance activities R 48 R 901
192 Old Mamelodi Hospital All maintenance activities R 16 134 R 4 874
266 Pholosong Hospital All maintenance activities R 8 000 R 7 756
30309702 Pretoria FPS Maintenance R 6 964 R 4 005
Pretoria Oral & Dental All maintenance activities R 1 433 R0
199 Pretoria West Hospital All maintenance activities R 3 372 R 4 221
201 Radio Communication System All maintenance activities R 1 038 R 1 444
268 Rahima Moosa Mother and Child Hospital All maintenance activities R 7 908 R 11 035
101 Rahima Moosa Nursing College All maintenance activities R 742 R 3 660
30309703 Roodepoort FPS Maintenance R 1 140 R 633

financial year
300 S G Lourens Nursing College All maintenance activities R 1 775 R 1 837
30309696 Sebokeng EMS All maintenance activities R 1 368 R 91
737 Sebokeng FPS Maintenance R 5 000 R 486
270 Sebokeng Hospital All maintenance activities R 5 000 R 16 156
213 Sedibeng District CHCs All maintenance activities R 5 000 R 4 123
215 Sedibeng District Clinics All maintenance activities R 1 463 R 4 185
Sedibeng District Office All maintenance activities R 5 552 R5
271 Sizwe Tropical Diseases All maintenance activities R 7 307 R 5 328
4651 South Rand Hospital All maintenance activities R 1 413 R 4 431
30309690 Springs FPS Maintenance R 6 000 R 148
275 Sterkfontein Hospital All maintenance activities R 40 000 R 5 236
229 Steve Biko Academic Hospital All maintenance activities R 6 962 R 45 829
277 Tambo Memorial Hospital All maintenance activities R 5 824 R 6 406
279 Tara H Moss Hospital All maintenance activities R 6 559 R 1 951
281 Tembisa Hospital All maintenance activities R 2 000 R 12 083
4640 Thelle Mogoerane Hospital All maintenance activities R 4 936 R 2 134
234 TMI boiler house All maintenance activities R 3 452 R 142
236 Tshwane District CHCs All maintenance activities R 5 000 R 2 268
238 Tshwane District Clinics All maintenance activities R 4 437 R 6 114
4658 Tshwane District Hospital All maintenance activities R 3 129 R 1 360
243 Tshwane District Office All maintenance activities R 2 942 R 2 181
6792272 Tshwane Rehabilitation All maintenance activities R 5 326 R 1 403
288 Weskoppies Hospital All maintenance activities R 3 464 R 14 932
246 West Rand District CHCs All maintenance activities R 11 825 R 1 113
248 West Rand District Clinics All maintenance activities R 4 774 R 6 400
6793146 West Rand District Office All maintenance activities R 1 469 R 2 675

Electro-mechanical projects in the 2018/19 financial year

financial year
31008660 Carletonville Hospital Compressed natural gas infrastructure R0 R 779
30309861 Carletonville Hospital Electro-mechanical equipment R 500 R0
30309836 Charlotte Maxeke Academic Hospital Electro-mechanical equipment R 13 000 R 19 727
30309835 Chris Hani Baragwanath Hospital Electro-mechanical equipment R 700 R 14 147
31008656 Chris Hani Baragwanath Laundry Laundry Electro-mechanical equipment R 22 000 R 6 046
30309844 Dr George Mukhari Hospital Electro-mechanical equipment R 2 900 R0
30309862 Dr Yusuf Dadoo Hospital Electro-mechanical equipment R 700 R0
30309825 Dunswart Laundry Electro-mechanical equipment R 12 000 R 10 443
30309826 Edenvale Hospital Electro-mechanical equipment R 500 R0
30309824 Ekurhuleni District Clinics Electro-mechanical equipment R 1 964 R0
30309827 Far East Rand Hospital Electro-mechanical equipment R 1 500 R0
31008665 Heidelberg Hospital Compressed natural gas infrastructure R0 R 779
30309857 Heidelberg Hospital Electro-mechanical equipment R 1 500 R0
30309838 Helen Joseph Hospital Electro-mechanical equipment R 2 750 R 529
31008663 Johan Heyns CHC Compressed natural gas infrastructure R0 R 779
30309837 Johannesburg District Clinics Electro-mechanical equipment R 3 487 R 2 584
30309839 Johannesburg Laundry Electro-mechanical equipment R 11 000 R 10 309
30309863 Leratong Hospital Electro-mechanical equipment R 900 R0
30309847 Masakhane Laundry Electro-mechanical equipment R 166 R0
30309840 Auckland Park Medical Supply Depot Electro-mechanical equipment R 1 000 R 185
Odi Hospital Compressed natural gas infrastructure R0 R 779
30309828 Pholosong Hospital Electro-mechanical equipment R 1 000 R0
Pretoria West Hospital Compressed natural gas infrastructure R0 R 1 009
30309850 Pholosong Hospital Electro-mechanical equipment R 900 R0
30309841 Rahima Moosa Hospital Electro-mechanical equipment R 2 490 R 3 366
30309859 Sebokeng Hospital Electro-mechanical equipment R 1 000 R0
30309856 Sedibeng District Clinics Electro-mechanical equipment R 1 000 R 3 501
Sterkfontein Hospital Compressed natural gas infrastructure R0 R 779
30309852 Steve Biko Hospital Electro-mechanical equipment R 400 R0
Tambo Memorial Hospital Compressed natural gas infrastructure R0 R 779
TMI Boiler House Piped natural gas infrastructure R0 R0
Tshwane District Clinics Electro-mechanical equipment R 1 000 R 1 876
Tshwane Medico-Legal Electro-mechanical equipment R 1 017 R0
Electro-mechanical equipment Electro-mechanical equipment R 1 964 R0

Table 8.7: Progress made in addressing maintenance backlogs during the period under review
Sub-programme 2017/2018 2018/2019

Name
Sub-programme Final
R’000 Actual
R’000 Final
R’000
R’000 R’000 R’000 R’000 R’000 R’000
New and replacement assets R 632 306 R 612 897 R 19 409 R 710 276 R 521 837 R 188 439
Existing infrastructure assets R 994 134 R 949 298 R 44 836 R 789 500 R 944 739 -R 155 239
Upgrades and additions R 170 617 R 137 291 R 33 326 R 136 410 R 181 549 -R 45 139
Rehabilitation, renovations R 89 648 R 65 605 R 24 043 R 136 017 R 114 324 R 21 693
and refurbishments
Maintenance and repairs R 733 869 R 746 402 -R 12 533 R 517 073 R 648 866 -R 131 793
Infrastructure transfer
Current R 733 869 R 746 402 -R 12 533 R 517 073 R 648 866 -R 131 793
Capital R 892 571 R 815 793 R 76 778 R 982 703 R 817 711 R 164 992
Total 1 626 440 1 562 195 R 64 245 R 1 499 776 R 1 466 576 R 33 200

PART C:
GOVERNANCE

9. GOVERNANCE
1. Introduction
The Gauteng Department of Health is committed to sound The following key strategic risks were identified in the 2018/2019
corporate governance in its delivery of health care services to the financial year:
public. The Department assures taxpayers that systems of internal • Inadequate access to quality health services for mental health
control are in place to enable effective, efficient and economical use patients.
of state resources. • Increase in maternal, new-born, infant and child morbidity/
mortality.
2. Risk Management • High death rate due to an increase in the number of HIV and
TB infections.
The Accounting Officer (AO) of the Department takes responsibility • Inadequate resources for the Primary Health Care
for implementing Enterprise Risk Management (ERM) in accordance reengineering programme.
with the National Treasury Public Sector Risk Management • Serious adverse events.
Framework (PSRMF). The Chief Director: Risk Management (RM) and • Poor quality of the EMS referral/call system due to incorrect
Internal Control is the Chief Risk Officer (CRO) for the Department. use of the system.
In compliance with the PSRMF and to embed risk management, the • Shortages of pharmaceutical supplies.
Department has adopted an ERM Policy Statement which sets out its • Aging infrastructure and health technology.
overall intentions with regard to ERM. • Non-adherence to prescripts.
• Lack of standardised information technology platforms to
A detailed Risk Management Strategy and Risk Management enable the provision of quality health care.
Implementation Plan were approved and implemented for the • Delays/late payments to suppliers (30-day payment period).
2018/2019 financial year. The ERM Implementation Plan gives effect • Inadequate human capital management.
to the departmental RM Policy and Strategy and outlines the roles • Inability of Supply Chain Management to support the provision
and responsibilities of management and staff in embedding risk of quality health care.
management in the Department. • Financial losses due to litigation.
• Inability to achieve revenue targets.
The Department has assessed significant risks that could have an • Fraud and corruption.
impact on its ability to achieve its strategic and operational • Fruitless and wasteful expenditure.
objectives. Risks have been prioritised based on their likelihood and • Irregular expenditure.
impact (inherently and residually), and mitigations were agreed • Inability to function in the event of a disaster (business
upon to reduce the risks to acceptable levels. Risk owners have been disruption).
identified for each risk and are responsible for monitoring risk levels • Compromised safety of patients and employees.
and the extent to which mitigating strategies are in place. • Insufficient, irrelevant, inaccurate and incomplete performance
reports.
Progress on mitigation measures is tabled at the Risk Management • Industrial action at Forensic Pathology.
Committee meeting (RMC) and the Audit Committee every quarter.
New/emerging risks are identified and assessed on an ongoing basis. Plans are in place to mitigate these risks.
The Department has an established and functional departmental
Risk Management Committee, chaired by an external chairperson, 3. Minimising Conflicts of Interest
to assist the Accounting Officer in carrying out his responsibilities
relating to risk management. The Committee operates within Terms SMS members disclose their financial interests using the eDisclosure
of Reference approved by the Head of the Department and consists system. In 2018, the Department achieved 100% (106 employees
of identified risk owners for each risk, representatives of all out of 106) disclosure by the SMS members. The Department has a
programmes and representatives of the four academic hospitals and circular on financial disclosures for other categories; 426 employees
of Gauteng Provincial Treasury. The committee meets quarterly to were trained on the circular and how to submit disclosures on the
review and assess departmental risks recorded and to evaluate the eDisclosure system.
action plan’s progress in the strategic risk register.

The Department has rolled out phase 2 of edisclosure. Conflict of efficient for the Department, which generated over 4.7 million kg of
interest is monitored for salary levels 11 and 12 and for all Finance HCW for the financial year under review.
and Supply Chain staff categories. The Department carries out Various additional activities are in place to continuously increase
ongoing training and awareness programmes on Other awareness and advocacy and thus ensure improved quality and
Remunerative Work (ORW) and conflict of interest as well as efficiency in management of the services. These include but are not
financial disclosure. The Department has communicated policies and limited to district and provincial awareness projects, awards for
procedures relating to remunerative work outside the public service various categories of performance such as the facility with the best
and intensively monitors submission, recording, approval and HCW services, best and runner ups for individual acknowledgements
reporting on this. of achievements, HCW SETA- accredited training programmes for all
categories of workers including medical doctors and allied health
4. Fraud and Corruption staff. Our training modules are registered with the HPCSA for
The departmental Investigation and Integrity Management Continuing Professional Development (CPD) points, and all
Directorate coordinates the investigation of various investigations in professional staff are exposed to such training. There is also a
the Department. The Department has in place a Fraud Prevention distance learning module for doctors who can submit a portfolio of
Plan and Whistle Blowing Policy and uses the Gauteng Ethics and evidence and also gain from the training.
Anti-Corruption Hotline, the Premier’s Office and the Public Service
Commission Hotline to receive allegations of fraud and corruption Highly effective and further refined M + E tools with specific
for investigation. Because of the diversity of cases within the indicators have been developed over the last few years and, through
Department, some forensic investigations are referred to Provincial internal auditing and inspection activities, identified risks are
Treasury. amicably addressed and mitigated through regular feedback of
findings and required feedback from facilities. Where required and
5.Code of Conduct identified, site-specific training is carried out, targeting areas of
All employees are expected to comply with the Code of Conduct. concern.
The Public Service Act requires that employees adhere to the Code.
The Department has a formally appointed ethics champion who The identified risks are also included in our monthly risk register,
reports directly to the Head of Department. Four departmental reported upon and discussed in the departmental Risk Management
officials, some qualified as certified Ethics Officers with the Ethics Committee. Substantial progress has been made in reducing risks.
Institute of South Africa, have been appointed as ethics officers. The However, late payments of contracted service providers remain a
Department trained 3 612 employees on the Code of Conduct and serious challenge; when services are suspended, serious
Ethics during the 2018/2019 financial year. Training for awareness life-threatening and public health problems are created which have
of the Code is ongoing to ensure a strong ethical culture proven very difficult to manage effectively.
underpinned by the values of the Code within the organisation. The
Integrity Management Unit assists the Department to manage ethics GDoH is regarded as the benchmark provincial department of health
risks through communication and awareness, conflict management, in the country, with many others using what we have developed
secure reporting channels and ethics incidence monitoring and here including methodologies and practises, standard operating
reporting. procedure (SOP) technical guidelines, tender specifications and the
like. This situation is highly motivational for all in the Department.
6. Health, Safety and Environmental Issues
Occupational Hygiene Risk Management Challenges
Challenges • Late payment of service providers (sometimes up to 120 days
behind).
Effects
• Non-collection of HCW due to late payment.
• Underestimated quantities of HCW tender items due to
Health Care Waste Management (HCW)
additional demands.
All HCW services for the collection, collection, transportation,
• Incomplete rollout of the HCW disposal system.
treatment and final disposal of residue/ashes and supply of re-usable
• Electronic tracking system for HCW containers used not 100%
and disposable containers have been outsourced to private
reliable.
contracted service providers. This scenario has been reviewed over
• Delays in processes for the new tender award resulting in
the past few years, and the outcome of due diligence processes has
continuous extensions of the existing contracts, exposing the
supported these arrangements as the most cost-effective and
Department to possible litigation.

• Efficiency of penalty implementation for service failure negated • Non-compliance of HCW consumables with tender
due to the late payments. requirements. This will lead to audit queries and financial loss
• Some external auditor findings contradict tender and other for the Department as inferior quality containers are provided
statutory requirements resulting in confused employees. to facilities.
• Lack of exact role clarity with reference to roles, responsibilities • Incorrect placement of the Directorate will affect career
and functions in hospitals, districts and other health facilities. development of professionals and contravention of compliance
• Non-compliance of HCW consumables with tender with the professional scope of practice for registered and
requirements. professional allied health personnel.
• Challenges with organisational structures and HCW not being • Illegal and unprocedural migration of the Directorate of Health
integrated with Environmental Health. Care Waste and Occupational Hygiene Risk Management
• Unprocedural migration of environmental health directorate resulted in confusion, lack of motivation, almost unruly staff,
HCW and occupational hygiene risk management to the low staff morale and decreased focused productivity. The lack
Integrated Employee Health and Wellness CD. of policies from the national level leads to each province
• Lack of national policies to guide the management of HCW in managing HCW differently and auditors are confused because
a coordinated and uniform manner. of differences and disparities between sets of legal and other
requirements.
Effects
Achievements
• Late payments of service provider lead to suspension of
services by the service provider. Serious public health nuisances • Successful awareness events in all districts.
are created. • Stable and productive district and provincial forum meetings.
• Non-collection of waste lead to obnoxious smells, spread of • On-going training conducted in all facilities by service
infection and contravention of HCW statutory requirements providers, with increased awareness contributing to improved
which can result in serious financial and legal implications for management.
the Department. • Provision of spill kits at all facilities and provision of freezers at
• Underestimated quantities of HCW tender items and all facilities generating anatomical waste.
incomplete rollout of HCW disposal system lead to incorrect • Regular audits and peer reviews conducted at health care
use of containers due to undersupply of such containers and facilities resulting in continuous improvement of facilities and
durable items. management of HCW.
• Partial functioning of container tracking system will lead to • Development of SOPs and technical guidelines to ensure
financial loss to the Department which is paying for a system compliance with legislation creating a sense of unity, support
that is not functioning properly. It will also have legal and improved standards.
implications for the Department, especially related to illegal • Provision of calibrated scales at hospitals and mobile scales at
dumping if the service provider fails to track the exact location all other facilities.
of our HCW containers. • A reliable, scientific and comprehensive database with a
• Delay of the new tender award which causes extension of the confidence interval of 98% has been established and is
current tender will cause irregularities in the tender and updated every quarter. Information is a reliable strategic
contravention of PFMA requirements and will lead to audit management tool for decision making.
queries • Detailed strategic tender specification document developed
• Non-effective penalty implementation for service failure will and recently approved for advertising which will also be used
lead to the service provider not providing an effective service. as an SLA once the new awards are made. Experiences of the
• Auditors contradicting findings regarding the tender and other past have been built into the provisions and HCW mix will
statutory requirements will lead to confusion in facilities and again be taken to the next level of continuous improvement
deviations from statutory requirements by facilities. and greater legal compliance by GDoH.
• Poorly-defined role clarity results in duplications, grey areas not
being addressed and central office staff being involved in
operational matters instead of the policy and M+ E functions.

7. Portfolio Committees
The table below shows the dates of the meetings of the Portfolio Committees, the matters discussed and how the Department addressed
them.
Date of meeting Matters raised How matters were addressed
16 October 2018 Plans to ensure proper (a) The Department developed a strategy to address spending
Request for responses on House spending and achievement and the achievement of targets for Emergency Medical Services.
resolutions emanating from the of targets under The Strategy is based on the following pillars:
Health Portfolio Committee Emergency Medical • Post-filling approved for 49 Intermediate Learner Students
Oversight Report on the Annual Services and Health
(ILS) and 30 Ambulance Learner Students (ALS). Only 3 ALS
Report of the Gauteng Facilities Management
Department of Health for the and 35 ILS were appointed at 31 March 2019. Recruitment
2017/18 Financial Year process under way to fill remaining posts before the end of
the financial year to increase the quality of care of circulating
ambulances.
• Expedite the re-advertisement of CAD tender with the
involvement of the Chief Information Officer (CIO) office.
This will add a resource scheduling and management
component that will also assist in fleet and staff
management and efficiency.
• Vehicle Tracking: expedite the evaluation of an award for a
vehicle tracking solution to have the added business
intelligence component that will assist with fleet
management; it will also increase the life span of our fleet as
it will assist in curbing vehicle abuse and improve driver
behaviour.
• Fleet status to procure 200 ambulances as per
recapitalisation plan; only managed to procure 60
ambulances (R 44 358 400.00) leaving the Department with
a shortfall of 140 (R118 289 065.60) for the 2018/2019
financial year.
An indicative budget of R 156 000 000.00 has been allocated for

financial year 2019/2020 to procure ambulance fleet.
• Refurbishment of ageing vehicles still in good working

condition; also ensured that SLAs are in place with the fleet
management provider Transit Solutions to improve
efficiencies in fleet management and turnaround time of
available fleet.
Achievements realised thus far:
• We have managed to improve response times by opening

EMS satellite stations closer to caller locations, which has
shown some positive gains on P1 response times in the
specific areas. Operations have opened new EMS satellite
stations in the north of Gauteng, Mamelodi, Laudium and
Soshanguve Block JJ; this has increased our footprint from
34 to 37 EMS stations.

• We increased our Public Information Education and

Awareness campaigns through our social media sites
(Facebook, Instagram and Twitter) and had acknowledged
many followers and hits.
• Gauteng EMS has invested in high-value assets and
specialised equipment, not limited to low birth ventilators
and 12 lead electrocardiograms (ECGs) to improve patient
treatment and patient outcomes by moving critically ill
patients from district and regional hospitals to academic and
specialised hospitals.
• By rolling out a pilot phase of Employee Self Service
platforms at Head Office and with all managers, we are
improving our Human Resource management practices
through automation and self-service.
• We have procured specialised fleet (Physically Challenged
Units: PCU) that cater for the needs of wheelchair-using and
physically challenged customers and patients.
• We have fully rolled out two-way radio communications
(Tetra radios) in all areas of Gauteng; this has decreased the
use of telephonic communications and improved operational
efficiencies in communication.
• Our operational ICUs have been increased to eight across the
province, significantly minimising expenditure on
outsourcing to private service providers and giving us a
market edge over our private service counterparts through
our highly skilled advanced life support paramedics and
multiple patient ventilators and monitors.
(b) With regard to the proper spending and achievement of targets

under EMS and Health Facilities Management:
• We have expedited the approval of invoices and transfer of

funds to DID.
• Tracking of invoices is done jointly with DID.
• Systems relating to invoice scanning (e-invoicing) have been
improved.
• Appointment of maintenance project contractors is being
expedited.
• Approval of planning documents is being expedited.
• There is continuous interaction with DID involving HODs to
enable better tracking of projects and expenditure.
• Consequence management will be applied to officials

Strategies to be As part of the Finance Strategy developed by the Chief Financial

implemented to ensure Officer, all deviations are now tabled with the Head of
adherence with SCM Department for consideration. Where deviations are required due
policies and procedures to poor planning or negligence of employees, disciplinary action
when procuring goods of is taken against such employees.
the value above R500 000
as required by PFMA compliance checklists have been developed to ensure
Treasury Regulations compliance with applicable prescripts.
In instances where the Department does not have a contract in

place, it has opted to participate in the Transversal Contract
arranged by the national and provincial Treasuries in line with
Treasury Regulations (TR) 16A.6.5 and participate in the contract
arranged by any organ of state in line with TR 16A.6.6.
Strategies to be The Department has committed to an ironclad approach where

implemented to ensure spending outside the budget will not be tolerated and pooling
compliance of contractual of funds is not being carried forward.
obligations and monies
owed being settled within Part of the strategy includes delegations of authority to
30 days institutions, specifically around turnaround times of clearing
exceptions (web cycle) on an operational basis. This improves
the payment rate of 30 days. Head Office is also implementing
the move to electronic submission of invoices. This will also
improve record keeping.
In addition to the above, an audit Implementation plan has been

developed to address other audit weaknesses identified on the
operational levels. Monitoring compliance with the approach is
carried out every month, including weekly reporting of clearing
of web cycles by institutions.
Strategies to be Internal controls around irregular expenditure have been

implemented to avoid improved to curb recurring irregular expenditure. Priorities
irregular expenditures and amongst these include curbing the security contract, nursing
the sourcing of proper agencies and Finance/HR/Governance support partners and
approvals from Provincial consignment stock irregularities that contributed significantly to
Treasury the R1.7 billion incurred irregular expenditure .
Security
All security contracts of the Department are on a
month-to-month basis until an alternative security arrangement
in all health facilities is found.
Nursing agencies
The current practice is that different institutions source their
nurses for Trauma, Intensive Care and Theatre Units. This has
been found to constitute a splitting of orders practice and thus
irregular as all contracts above R500k must be subjected to a
bidding process.
This bidding process is now being carried through a cluster

approach.

Strategies to be Consignment stock

implemented to ensure The current practice is that consignment stock is not subjected to
adherence with SCM the manual process of the Purchase Order, GRV and invoice
policies and procedures matching. This is because cataloguing of such commodities has
when procuring goods of not been performed in the past; this leads to inabilities during the
the value above R500 000 audit to produce sufficient appropriate audit evidence that
as required by the procurement processes were followed.
Treasury Regulations
During year under review, cataloguing of this commodity was
performed, bringing an end to irregular expenditure in this regard.
Finance/HR/Governance support partners contracts

SCM regulations allow for two instances where deviating from a
process of competitive bidding: in cases of emergency and where
there is a sole supplier for the goods or services being sourced.
It was the view of the Department that the current partner

contracts for finance and human resources constituted sole
suppliers. This view was disputed by the Auditor General and thus
these contracts constituted irregular expenditure as a bidding
process was not followed.
The contracts were stopped on 31 December 2018 and the

Department is now following a competitive bidding process.
New PFMA compliance testing will take place from February 2019
to tests and ensure compliance with the PFMA.
Plans to ensure adherence The Department is committed to complying with the provisions
of the Employment Equity of the Employment Equity Act (No.55 of 1998) and the targets
Act by appointing people set for the recruitment of PWDs. To date, the Department has
with disabilities (PWDs) achieved remarkable growth in the number of PWDs employed.
This time last year, 0.5% of GDoH employees were PWDs. By the
end of the second quarter, the number had risen to 1.61%
(1071 people).

By the end of the third quarter, the number of PWDs employed by

the Department had increased by 178 (from 1071 to 1178: 1.8%
of all employees). This was mainly due to the campaign of
encouraging employees with disabilities who had not declared
their disability status to do as well as through workshops on Policy
on Reasonable Accommodation and Assistive Devices (PRAAD).
Plan to reach the set target of 2%

Challenges to achieving the 2% target
• Critical clinical positions are prioritised when filling vacant
funded posts. No applications were received from the pool of
prospective applicants with disabilities.
• Some PWDs are not captured as such on the PERSAL system
(incorrect capturing of PWDs)
• The increase in the number of employees on the staff
establishment offsets the gains achieved in recruiting PWDs.
Remedies to address the challenges:

What will be done
• Ringfence 2% of funded vacant posts to be filled by PWDs by
line managers and CEOs as and when vacant funded posts
are advertised.
• Correct capturing of PWDs on the PERSAL system by HR and
Transformation and OD: ongoing
• Marketing of bursary opportunities for learners who are
interested in Health Sciences by HRD 2 Year end.
• Continue with PRAAD workshops and encourage staff who
have not yet declared their disability status to do so.
Reasons for not achieving Coordination between the Department of Health and the
the number of health Department of Infrastructure was not as good as it should have
facilities that have been. This resulted in weaknesses in project management and
undergone major and monitoring of programmes between the two Departments.
minor refurbishments for There were also complications in terms of contract manage-
both 2016/17FY and ment, with some service providers not adhering to contractual
2017/18FY obligations. This delayed completion of some of the work.
The Department will introduce a project steering committee

tasked with coordination and management of the projects
being implemented by the Department of Infrastructure
Development. This should lead to better management of the
signed service delivery agreement (SDA) already in place.

Plans to remedy the In the previous financial year (2017/2018), the Department,
unachieved target for the jointly with the GDED, conducted two TER change manage-
percentage of budget ment workshops. The purpose was to make SCM officials and
spent on township those involved in SCM processes aware of the imperatives of the
enterprises against TER and the target set.
identified commodities
The Department will resuscitate the quarterly stakeholder
workshops as a means of linking township enterprises with
corporates.
The Department will also implement procurement strategies

that are biased towards township enterprises, and track
township procurement spends from DID through the infrastruc-
ture projects that they are implementing on behalf of the
Department and spent towards township-based NGOs.
Strategies to be The Department is in the process of implementing the following:

implemented to ensure • Training of PHC facility staff on medicine supply
achievement of the vital management.
medicines target
• Weekly monitoring of the stock visibility system: stock on

hand is captured weekly by the PHC facility.
• Scheduled district PTC meetings: attendees discuss and

identify alternative medication to be used if a national out of
stock situation occurs.
• Borrow stock from neighboring institutions in case a stock

out is an isolated case for that facility.
• Seek alternative pack sizes if appropriate (Standard

Treatment Guidelines).
• Continuous engagements with suppliers with regard to direct

deliveries and communication with the Medical Supplies
Depot (MSD) with regard to poor performance.

8. Scopa Resolutions
29 January 2019
REQUEST FOR RESPONSES ON HOUSE RESOLUTIONS EMANATING FROM SCOPA REPORT ON THE AUDITOR-GENERAL’S REPORT ON THE
FINANCIAL STATEMENTS AND PERFORMANCE INFORMATION OF THE DEPARTMENT OF HEALTH FOR THE YEAR ENDED 31 MARCH 2018
Resolution No. Details How matters were addressed Resolved

(Yes/No)
1 In terms of Rule 179 (4), 1.1 The Department will comply with the request to provide
the Accounting Officer quarterly updates to SCOPA and the Health Portfolio.
submits a quarterly update
to SCOPA and the Health
1.2 The Department has developed a litigation strategy (still in
Portfolio Committee on
intensifying performance draft form) aimed at improving the management of
and consequence medico-legal claims. The strategy is based on the following six
management processes to pillars:
mitigate instances of
findings on lawsuits and i. Prevention of harm and promotion of patient safety with the
provides the Committee
support of internal audit processes against a risk register with
with a quarterly progress
report detailing the quarterly reports.
effectiveness of measures
put in place to address ii. Staff-related risk management, including in areas of
challenges related to Performance Agreements, absenteeism, supervision and
lawsuits every quarter and disciplinary action for negligence.
continuing up until June
2019.
iii. Appointment of an external independent expert team on
Patient Safety and a Medico-legal team.
iv. Establishing a Medico-litigation Centre as a data management

and intelligence centre for patient safety, mediation
coordination and litigation management.
v. Implementation and coordination of mediation and legally

privileged peer review processes.
vii. e-Health system that ensures interoperability and validity of

data.
1.3 The litigation system will not only enable tracking of claims
but monitoring of disciplinary cases instituted because of
employee negligence. and civil cases instituted by the
Department to recover costs incurred because of employee
negligence.
i. Cases must be thoroughly researched to examine pathogenesis

to exclude non-clinical causes to avoid exorbitant costs against
the Department.

Resolution No. Details Matters raised Resolved
(Yes/No)
2 The Accounting Officer ii. There is a need for a body of legal research to inform
provides the Committee investigative approaches to medical litigation
with a progress report
regarding the effectiveness
iii. Appropriate monitoring of labour by skilled birth attendants;
of measures put in place to
curb the recurrence of correct and consistent use of the partogram for all patients in
re-statement every quarter labour
and continuing up and to
the end of June 2019. iv. Where there is a potential case of cerebral palsy, investigations
must to be carried out immediately after birth to determine gas
levels and possible anaemic condition of the pregnant woman
v. Establishment of a partnership with the Nelson Mandela

Children’s Hospital to treat children born with cerebral palsy to
ensure that they receive quality health care and that research into
this condition is carried on a continuous basis
1.4 The following are the long-term solutions intended to deal with
incidences of medical negligence:
1.4.1 Case management team staffed by well qualified legal officers
1.4.2 Clinical review team providing medical experts’ opinions
1.4.3 Consortium of attorneys to deal with cases
1.4.4 Partnership with the Specialized Investigating Unit (SIU)

focusing mainly on data analysis and physical files verification to
identify possible fraudulent and duplicate claims, theft of medical
records and prosecutions of these cases.
1.5 The Department has already started with consequence

management in respect of employees found to have been
negligent and who did not follow the Patients’ Rights Charter
and guidelines for the treatment of patients. The following is the
report on consequence management:
1.6 As well as the above strategies, the Office of the Premier has
established a Specialized Litigation Unit (SLU) to deal with all
medico-legal matters. The SLU will have the following
components:
1.7 The Human Resource report indicates the number of disciplinary

matters investigated by the Department as part of consequence
management

(Yes/No)
2 The Accounting Officer An audit approach is being undertaken where a full set of
provides the Committee disclosures are performed monthly. Reconciliation is performed
with a progress report between supporting schedules and data information and weak-
regarding the effectiveness
nesses are reported for corrective action to senior management
of measures put in place to
curb the recurrence of and the Accounting Officer.
re-statement every quarter
and continuing up and to Request for information letters are being sent monthly, and
the end of June 2019. management orientation takes place before year-end with regard
to the requirements of the audit to improve the response rate and
the quality of information submitted.
Operationally, an audit implementation plan was developed and is

being monitored to ensure corrections and improvement in risk
areas identified by the Auditor General.
Continuous engagement is taking place during the year with both

infrastructure and legal services to improve internal controls in
these areas as the main contributors to the material adjustments
required in 2017/2018 to maintain an unqualified audit opinion.
The effectiveness and efficiency of the interventions vary. Monthly
reconciliations are taking place and where needed corrections are
made.
Information requests are being sent to management to test

response times as well as the quality of performance evidence
submitted. Currently, there are still challenges in this regard that
need to be addressed. The Monitoring and Evaluation Unit is
working with managers to improve the quality of evidence
submitted.
The AG Action Plan developed to track managements response to

the risk raised by the Auditor General was not yielding the desired
results due to poor responses from management. A new approach
has been adopted whereby the Executive Management Commit-
tee will take direct responsibility for resolution of the identified
risks.
Interventions to improve cooperation between the Department

and the Department of Infrastructure Development also did not
prove to be effective and efficient. New monthly project steering
committee meetings will be introduced.

Resolution No. Details Matters raised Resolved
(Yes/No)
3 The Department The Department has committed to an ironclad approach where

implements proper control spending outside the budget will not be tolerated. The pooling of
measures to ensure that funds approach is not being carried forward, and the following have
there are no further over
been agreed upon:
commitments and provide
the Committee with a • Over-expenditure on budget will not be tolerated. To this end, a
progress report detailing linking of demand plans to institutional budgets has taken
the effectiveness of those place, and Purchase Orders are not being generated outside of
measures every quarter and those demand plans. This ensures ring-fencing of the
continuing up and until the 2018/2019 budget.
end of June 2019.
• Spending takes place only on necessities with heads of
institutions taking responsibility for expenditure
• Consequence management for over-spending or frivolous
expenses; prioritisation of essential goods being acquired
• Stringently controlling COE
• Infrastructure budget reallocation to fund accruals
• Effective management of medico-legal claims
• A moderate reduction in headcount
• Review of prices paid for commodities
• Reviewing large and high-risk contracts to ensure effective
contract management
• Negotiating with suppliers owed the most money to settle
accruals over three years with ring-fenced budget allocation.
Plans to collect revenue include:

• Continued engagement with universities around funding of joint
posts through the Academic Governance Committee. This
includes discussions around research, teaching, training and
service platforms and the funding of such platforms. This is to
alleviate pressure on the compensation of employees’ budget
that leads to accruals as it cannibalises the goods and services
budget line.
• Continued engagement with provinces that owe the
Department: specifically Limpopo, Mpumalanga and North
West.
Part of the strategy also includes delegations of authority to institu-

tions, specifically around turnaround times for clearing exceptions
(web cycle) on an operational basis. This improves the payment rate
of 30 days. Head Office is also implementing the move to electronic
submission of invoices. This will improve record keeping.
As well as the above, an Audit Implementation Plan was developed

to address other audit weaknesses identified on an operational level;
these are being monitored every month, with weekly reporting of
clearing of web cycles by institutions.

(Yes/No)
4 The Department provides The following measures have been put in place to address the
the Committee with a weaknesses of predetermined objectives:
progress report detailing • Since the implementation of the WEB DHIS system, the
the effectiveness of
Department can track data violations through data
measures put in place to
address weaknesses of visualisations tools built into the system; data quality indices
predetermined objectives are also being tracked monthly and feedback on violations
every quarter and provided to institutions for corrections to be effected on the
continuing up and until the data.
end of June 2019. • Through implementation of the performance accountability
sessions and establishment of service intervention units, the
Department has achieved higher levels of awareness in terms
of tracking data management outcomes; districts that used to
have poor data quality scores have consistently and
significantly improved their timely submission of data and
ensuring that datasets submitted are complete.
• Because of the above initiatives, the Department has seen an
improvement regarding the completeness of data
• Training of WEB DHIS has been continuing since the previous
financial years (2017/18). This training targets different
groups of personnel from data capturers to programme
managers at different levels. The training for data capturers
aims to achieve accuracy of data captured at source points.
Training for programme managers is in line with the vision to
improve information by ensuring that managers can access
their programme specific data to review and to analyse data
about their respective programmes. By so doing, they can
intervene quickly where performance is not according to plan
and help identify any potential errors in the reported data.
• The next sets of training were planned for the fourth quarter
with emphasis laid on building capacity to carry out rapid
data quality audits at the coalface. Additional workshops
were provided to clinical and administrative managers so that
they understand the audit requirements including the records
management process and how POE can be loaded onto
SharePoint to ensure that all performance claims submitted
can be supported by verifiable evidence.
• It is anticipated that with the roll-out of the digitised registers
following rationalisation of registers that the data quality
outputs will further improve.
• The Department currently captures data at selected PHC
facilities and plans are afoot to increase these daily data
capturing sites.
• The full effectiveness of the Monitoring and Accountability
Governance Framework is also anticipated to be felt once
compliance with the SOP expectations becomes consistent,
enabling weekly performance tracking at the coalface. With
its initial implementation, we have seen monthly sharing of
data quality status and managers requested to account.

Resolution Details How matters were addressed Resolved
No. (Yes/No)
5 The Accounting Officer provides An audit approach is being undertaken where a full set of disclosures
the Committee with a progress are performed monthly. Reconciliation is performed to supporting
report on the measures put in schedules/information and weaknesses are reported for corrective
place to ensure carrying out of
action to senior management and the Accounting Officer.
monthly reconciliations in
compliance with Section 40 (1) of
the PFMA every quarter and Request for information letters are sent monthly and management
continuing up and until the end of orientation takes place before year-end with regard to the require-
June 2019. ments of the audit to improve the response rate and the quality of
submitted information.
Operationally, an audit implementation plan was developed and

monitored to ensure corrections and improvement in risk areas
identified by the Auditor General.
Continuous engagement during the year is taking place with both

infrastructure and legal so that internal controls are improved in these
areas as the main contributors to the material adjustments required in
2017/2018 to maintain an unqualified audit opinion.
6 The Accounting Officer ensures that An Audit Implementation Plan was developed and is being monitored
transparent financial and to ensure that corrective action takes place and that risk areas identi-
performance management reporting
fied by the Auditor General are improved.
systems are regularly maintained
and provides the Committee with a
progress report detailing the A new approach has been adopted whereby the Executive Manage-
effectiveness of measures put in ment Committee will take direct responsibility for the resolution of
place in addressing matters related identified risks.
to annual financial statements
within 30 days of adoption hereof,
and after that every quarter
continuing up and until the end of
June 2019.
7 The MEC provides the The Department has developed a Combined Assurance Model that will
Committee with a progress strengthen monitoring of compliance, risks and internal controls. The
report on measures put in place model provides for four levels of insurance to be provided before a
to monitor the adequacy of
matter is resolved. The first level is by management, the second by the
internal controls to avoid
recurrence of non-compliance Internal Control and Risk Committee, the third by Internal Audit and
with applicable legislation every Auditor General and the fourth by the Audit Committee and the
quarter and continuing up and Legislature.
until the end of June 2019.
The Department is also in the process of developing a Compliance
Strategy and Compliance Framework that will be implemented and
monitored by the Compliance Unit.
Compliance checklists for PFMA compliance will be introduced as from

February 2019. A new Risk Management Strategy, Policy and Frame-
work has been adopted and will be implemented to strengthen risk
management within the Department and to improve the internal control
environment.

Resolution Details Matters raised Resolved
No. (Yes/No)
An action plan was developed to monitor progress in respect to the

findings of the Auditor General. The plan will be monitored monthly. A
similar action plan is being developed to monitor the Department's
response to Internal Audit findings.
Gauteng Audit Services has worked with the Department to develop a

three-year audit plan aimed at testing the internal control environment.
These reports will then be added to the Internal Audit Action plan and
monitored.
8 In terms of GPL Rule 179(4), the Internal controls around irregular expenditure have been improved to
MEC provides the Committee curb recurring irregular expenditure. Priority amongst these are curbing
(SCOPA) and Portfolio of security, nursing agencies and Finance/HR/Governance support
Committee on Health with a
partners and consignment stock irregularities that have contributed
monthly report detailing its
adherence and compliance to significantly to the R1.7 billion incurred irregular expenditure.
the requirements of all applicable
legislation to ensure that Security
effective measures are All the Department’s security contracts are on a month-to-month basis.
implemented to prevent irregular This is irregular in terms of the Public Finance Management Act as this
expenditure as required by
practice does not constitute fairness and transparency.
Section 38(1)(c)(ii) and Treasury
Regulation 9.1.1. Every quarter The Department is in the process of insourcing security services; this
and continuing up and until the will bring an end to irregular expenditure related to security contracts.
end of June 2019.
Nursing agencies
Current practice is that different institutions source their nurses for
Trauma, Intensive Care and Theatre Units. This has been found to
constitute a splitting of orders practice and thus irregular as all
contracts above R500k must be subjected to a bidding process.
This bidding process is now being carried out through a cluster
approach.
Consignment stock
Current practice is that consignment stock is not subjected to the
manual process of Purchase Order, GRV and invoice matching. This is
because the cataloguing of such commodities has not been performed
in the past. This leads to the inability during audit to produce sufficient
appropriate audit evidence that procurement processes were followed.
During the reporting year, cataloguing of this commodity was
Supply Chain Management regulations allow for two instances where

deviating from the process of competitive bidding is allowed: in cases
of emergency and where there is a sole supplier of the goods or
services being sourced.

No. (Yes/No)
It was the view of the Department that the current partner contracts
for Finance and Human Resources constituted sole suppliers. This view
was disputed by the Auditor General; thus these contracts constituted
irregular expenditure as a bidding process was not followed.
The contracts were stopped on 31 December 2018 and the Depart-
ment is now following a competitive bidding process.
New PFMA compliance testing will take place from February 2019 to
test and ensure compliance with the PFMA.
9 The Accounting Officer intensify The Accounting Officer is currently in the process of instituting
performance and consequence disciplinary action against senior managers responsible for allowing
management processes to irregular expenditure to take place. These managers have been served
eliminate findings on irregular
with disciplinary letters and the process is unfolding. Internal controls
expenditure and provides the
have around irregular expenditure have been improved to curb
Committee with a progress
report detailing the effectiveness recurring irregular expenditure. Priority amongst these includes curbing
of measures put in place to of security, nursing agency and Finance/HR/Governance support
address challenges relating to partners and consignment stock irregularities that contributed signifi-
irregular expenditure every cantly to the R1.7 billion incurred in irregular expenditure.
quarter and continuing up and
until the end of June 2019.
Security
All the Department’s security contracts are on a month-to-month basis.
This is irregular in terms of the Public Finance Management Act as the
practice does not constitute fairness and transparency. The Department
is in the process of insourcing security services which will then bring an
end to irregular expenditure related to security contracts.
Nursing agencies
Current practice is that different institutions source their nurses for
Trauma, Intensive Care and Theatre Units. This has been concluded to
constitute a splitting of orders practice and thus irregular as all
contracts above R500k must be subjected to a bidding process. This
bidding process is now being carried out through a cluster approach.
Consignment stock
Current practice is that consignment stock is not subjected to the
manual process of Purchase Order, GRV and invoice matching. This is
because cataloguing of such commodities has not been performed in
the past. This leads to the inability during audit to produce sufficient
appropriate audit evidence that procurement processes were followed.
During the reporting year, cataloguing of this commodity was

Supply Chain Management regulations allow for two instances where
deviation from competitive bidding is allowed: in cases of emergency
and where there is a sole supplier for the goods or services being
sourced.

No. (Yes/No)
It was the view of the Department that the current partner contracts
for Finance and Human Resources constituted sole suppliers. This view
was disputed by the Auditor General; thus these contracts constituted
irregular expenditure as a bidding process was not followed.
The contracts were stopped on 31 December 2018 and the Depart-
ment is now following a competitive bidding process.
New PFMA compliance testing will take place from February 2019 to
test and ensure compliance with the PFMA.
9. Prior Modifications to Audit Reports
The table below shows the steps taken to address matters in the AGSA’s report for the previous financial year ending 31 March 2018.
Nature of qualification, disclaimer, The financial year in which it first Progress made in resolving the matter
adverse opinion and matters of arose
non-compliance
None.
10. Internal Control Unit

Internal Audit and Audit Committees
The table below gives details of the Audit Committee members.
Name Qualifications Internal or If the internal, Date Date Date No. of

external position in the appointed Resigned
Resigned Meetings
department attended
Shelmadene Petzer • Chartered Accountant (SA) External - 01 September 2018 Current
• Certificate in the Theory of

Accountancy
• Advanced Executive
Programme
Janice Meissner • Chartered Accountant (SA) External - 01 October 2014 Current
• B. Com
• B. Com. Honours
Leon Langalibalele • B. Compt. Honours External - 08 November 2017 Current
• B. Compt. (Accounting)
Japie Du Plessis • National Diploma in State External - 01 October 2013 Appointed until 31
August 2018
Accounting and Finance
Precious Sibiya • B. Accounting External - 01 October 2014 Contract has expired
(31 August 2018)
• Post Graduate Diploma in
Accounting
• Chartered Accountant (SA)

11.Report of the Audit Committee – Cluster 03
Department of Health
We are pleased to present our report for the financial year ended 31 March 2019.
Audit Committee and Attendance

The Audit Committee consists of the external independent Members listed hereunder and is required to meet a minimum of twice per
annum as per provisions of the Public Finance Management Act (PFMA). In terms of the approved Terms of Reference (GPG Audit Commit-
tee Charter), five meetings were held during the current year, i.e. three meetings to consider the Quarterly Performance Reporting (financial
and non-financial) and two meetings to review and discuss the Annual Financial Statements and the Auditor-General of South Africa’s
(AGSA) Audit and Management Reports.
Non-Executive Members
Name of Member Number of Meetings attended

Ms. Janice Meissner (Chairperson) 04
Mr. Leon Langalibalele 04
Ms. Shelmadene Petzer 04
Mr. Japie du Plessis (Former Chairperson) 01
Ms. Precious Sibiya (Former member 01
Executive Members
In terms of the GPG Audit Committee Charter, officials listed hereunder are obliged to attend meetings of the Audit Committee:
Compulsory Attendees Number of Meetings attended

Mr. Mkhululi Lukhele (Accounting Officer) 05
Ms. Kabelo Lehloenya (Chief Financial Officer) 02
Mr. Chris du Preez (Chief Risk Officer) 02
Mr. Luthendo Makhadi (Acting Chief Audit Executive) 04
Mr. Kweyama Velile (Chief Audit Executive) 01
The Audit Committee noted that the Accounting Officer attended all five scheduled Audit Committee meetings. The Audit Committee is
satisfied that the Department adhered to the provisions of the GPG Audit Committee Charter.
The Members of the Audit Committee met with the Accounting Officer, Senior Management of the Department, Internal Audit and the
AGSA, individually and collectively to address risks and challenges facing the Department. A number of in-committee meetings were held to
address control weaknesses and deviations within the Department.
Audit Committee Responsibility

The Audit Committee reports that it has complied with its responsibilities arising from section 38(1)(a) of the PFMA and Treasury Regulation
3.1.13. The Audit Committee also reports that it has adopted appropriate formal terms of reference as its Audit Committee Charter, has
regulated its affairs in compliance with this Charter and has discharged all its responsibilities as contained therein.
The effectiveness of internal control and Information and Communication Technology (ICT) Governance
The Audit Committee has observed that the overall control environment of the Department has regressed during the year under review.
Significant deficiencies in the system of internal control and deviations were reported in the Internal Audit and Auditor-General Reports. The
overall opinion of Internal Audit on the internal control design at the Department is adequate but ineffective. It is recommended that
Management pay special attention to the core business processes as most findings raised are related to the core mandate of the Department.
Furthermore, it was reported that significant challenges are being experienced at the operational institutions and the Department should
design and implement strict measures to ensure proper oversight and monitoring over them.

Management should urgently address the weaknesses in the performance information, especially regarding the reporting, collation and
monitoring of the achievements reported.
The Audit Committee also reviewed the progress with respect to the ICT Governance in line with the ICT Framework issued by the
Department of Public Services and Administration. Controls regarding the ICT environment and system implementation require urgent
attention as many repeat findings are raised and inefficiencies experienced. Based on the unfortunate event of the Bank of Lisbon, business
continuity, disaster recovery and document management remain a high risk for the Department and significant effort must be made with the
implementation of proper document management systems, Disaster Recovery and Business Continuity plans.
The reporting on material irregularities by the AGSA is noted. The audit committee has emphasised the need to address the matters raised in
particular finalisation of irregular and fruitless and wasteful expenditure investigations. The collection of debtors also remains a matter of
great concern.
The Audit Committee advised that management should implement an overall strategy to address the findings raised by the AGSA and Internal
Audit effectively and on time.
Internal Audit
The Audit Committee is satisfied that the Internal Audit plan represents a clear alignment with the key risks, has adequate information
systems coverage, and a good balance across the different categories of audits, i.e. risk-based, mandatory, performance, computer and
follow-up audits.
The Audit Committee has noted improvement in the communication between the Executive Management, the AGSA and the Internal Audit
Function, which has strengthened the Corporate Governance initiatives within the Department, however further improvement is required if
proper effect is to be given to combined assurance.
Risk Management
Progress on the departmental risk management was reported to the Audit Committee on a quarterly basis. The Audit Committee is satisfied
that the management of risk received increased attention in the latter part of the year, although there are areas that still require improvement.
Management should take full responsibility for the entire Enterprise Risk Management Process and continue to support the Chief Risk Officer
to even further enhance the performance of the Department.
Forensic Investigations
Investigations based on the allegations of procurement irregularities, fraud, theft and negligence are being performed on matters dating back
from prior periods. Some of these investigations have been finalised and others were still in progress at the reporting date. The
recommendations of investigations should be implemented with decisiveness.
The quality of quarterly reports submitted in terms of the PFMA and the Division of Revenue Act
The Audit Committee is satisfied with the content and quality of financial and non-financial quarterly reports prepared and submitted by the
Accounting Officer of the Department during the year under review and confirms that the reports were in compliance with the statutory
reporting framework.
Evaluation of Reporting by the Department

The Audit Committee has:
• Reviewed and discussed the audited Annual Financial Statements to be included in the Annual Report, with the AGSA and the
Accounting Officer;
• Reviewed the Audit Report of the AGSA;
• Reviewed the AGSA’s Management Report and Management’s response thereto;
• Reviewed the Department’s compliance with legal and regulatory provisions;
• Reviewed significant adjustments resulting from the audit; and
• Reviewed the appropriate accounting policies and relevant disclosures.

The Audit Committee concurs with and accepts the AGSA’s conclusions on the Annual Financial Statements, performance information and
compliance and is of the opinion that the audited Annual Financial Statements be accepted and read together with the report of the AGSA.
One-on-One Meeting with the Accounting Officer

The Audit Committee has met with the Accounting Officer for the Department to address unresolved issues.
One-on-One Meetings with the Executive Authority

The Audit Committee has met with the Executive Authority for the Department to apprise the MEC on the performance of the Department.
Auditor-General of South Africa

The Audit Committee has met with the AGSA to ensure that there are no unresolved issues.
Ms. Janice Meissner
Chairperson of the Audit Committee
Date: 31 July 2019

PART D:
HUMAN RESOURCE MANAGEMENT

12. HR OVERSIGHT STATISTICS
1. INTRODUCTION
The information contained in this part of the Annual Report has
been prescribed by the Minister of Public Service and Administration
for all Departments in the public service.
2.OVERVIEW OF HUMAN RESOURCES
There was a marked improvement in HR information management

in the past year. The branch was able to use data to inform
management decisions and monitor employees’ behaviour. Analysis
of all types of leave, including sick leave, helped in understanding
trends and the branch will use this information to develop tools for
monitoring leave. Another area of improvement was management
of Compensation o Employees (CoE) which was supported by
coaches and a team effort between HR and Finance.
Over-expenditure was reduced, although a downside was a
shortage of staff in hospitals. The Department mitigated the effects
of the CoE intervention through the Economic Stimulus Package
grant which targeted clinical areas and critical posts.
Expenditure on CoE is indicative of the move to PHC and

preparation for NHI. Provincial hospitals have become part of
districts, whose budgets have therefore increased.
Push and pull factors have continued to exert pressure on the

management of HR, with high attrition rates in nursing and other
clinical posts. Exit interviews show that patient load and conflict
with managers contribute to high turnover, exacerbated by the
policy decision to reduce post-retirement contracts.
Over the past two years, the Department has sought to increase
accountability and compliance. In doing so, the Department has
experienced an increase in the number of labour cases, disputes,
grievances and of cases reported through Chapter 9 Institutions.
Whilst this was positive, it increased Labour Relations’ workload.
This has required the development of a cadre of internal and
external presiding officers to improve turnaround times in all
labour-related matters.

3. HUMAN RESOURCES OVERSIGHT STATISTICS
The tables below give HR patterns for the financial year 2018/19
Table 3.1.1: Personnel expenditure by programme: 1 April 2018 to 31 March 2019
Total Personnel Training Professional Personnel Average Employment

Expenditure Expenditure Expenditure and Special Cost as Personnel
(R'000) (R'000) (R'000) Services (R'000) Percent of Total Cost per
Programme Employee
Expenditure
(R'000)
1. Administration 1,360,786 410,609 6,864 92,546 30% 323 1,273
2. District health services 14,516,480 7,762,182 4,327 45,897 53.5% 416 18,656
3. Emergency medical services 1,330,508 552,681 80 - 41.5% 302 1,832
4. Provincial hospital services 8,686,653 6,244,387 850 279,379 71.9% 295 21,132
5. Central hospital services 17,134,256 10,956,631 555 35,523 63.9% 592 18,522
6. Health sciences and training 1,106,708 762,053 11,019 - 68.9% 207 3,680
7. Health care support services 339,048 182,145 31 - 53.7% 261 698
8. Health facilities management 1,536,120 31,610 46 - 2.1% 1,129 28
- HWSETA accounts - - - - * *
MedSAS trading account - - - - * *
Total 46,010,559 26,902,298 23,772 453,345 58.5% 409 65,821

Table 3.1.2 Personnel costs by Salary Band: 1 April 2018 - 31 March 2019
Personnel % of Total % of Total % of Total

Expenditure Personnel Personnel Personnel
Salary Band (R'000) Costs Costs Costs
Lower Skilled (Levels 1 - 2) 1,313,779 4.8% 7,527 175
Skilled (Levels 3 - 5) 5,793,492 21.3% 23,365 248
Highly Skilled Production (Levels 6 - 8) 6,002,451 22.1% 16,050 374
Highly Skilled Supervision (Levels 9 - 12) 10,539,566 38.8% 12,551 840
Senior and Top Management (Levels 13 - 16) 204,049 0.8% 91 2,242
Contract (Levels 1 - 2) 95 0.0% 667 0
Contract (Levels 3 -5) 21,571 0.1% 87 248
Contract (Levels 6 - 8) 197,368 0.7% 543 363
Contract (Levels 9 - 12) 2,694,137 9.9% 2,970 907
Contract (Levels 13 - 16) 18,880 0.1% 14 1,349
Periodical Remuneration 298,734 1.1% 921 324
Abnormal Appointment 53,908 0.2% 1,035 52
Total 27,138,029 100.0% 65,821 -

Table 3.1.3: Salaries, Overtime, Home Owners’ Allowance and Medical aid by programme: 1 April 2018 to 31 March 2019
Salaries Salaries as % Overtime Overtime as % HOA HOA as % of Medical Ass. Medical Ass. as Total
Programme (R'000) of Personnel (R'000) of Personnel (R'000) Personnel Costs (R'000 % of Personnel Personnel Cost
Costs Costs Costs (R'000
Administration 382,688 1.4% 4,425 0.0% 8,404 0.0% 0.1% 15,092 410,609
District health services 6,802,656 25.3% 368,226 1.4% 232,666 0.9% 1.3% 358,633 7,762,181
Emergency medical services 476,076 1.8% 8,900 0.0% 24,254 0.1% 0.2% 43,451 552,681
Provincial hospital services 5,236,782 19.5% 562,471 2.1% 179,659 0.7% 1.0% 265,475 6,244,387
Central hospital services 9,104,579 33.8% 1,182,107 4.4% 278,684 1.0% 1.5% 391,260 10,956,630
Health sciences and training 707,634 2.6% 1,505 0.0% 22,193 0.1% 0.1% 30,722 762,054
Health care support services 136,466 0.5% 14,853 0.1% 12,015 0.0% 0.1% 18,812 182,146
Health facilities management 30,767 0.1% - 0.0% 295 0.0% 0.0% 548 31,610
HWSETA accounts -
Total 22,877,648 85.0% 2,142,487 8.0% 758,170 2.8% 4.2% 1,123,993 26,902,298

Table 3.1.4: Salaries, Overtime, Home Owners’ Allowance, and Medical aid by Salary Band: 1 April 2018 to 31 March 2019
Salaries Overtime Home Owners Allowance Medical Aid
Salaries as a Amount Overtime as a Amount HOA as a % Amount Medical aid

Salaries % of (R'000) % of (R'000) of Personnel (R'000) as a % of
Programme (R'000) Personnel Personnel Costs
Personnel
Costs Costs
Costs
Lower Skilled (Levels 1-2) 2,307,123,594 11.3% 156,188,453 7.3% 158,538,064 20.0% 211,140,401 18.8%
Skilled (Levels 3-5) 4,257,427,901 20.8% 194,402,743 9.1% 306,625,678 38.8% 393,323,200 35.0%
Highly Skilled Production (Levels 6-8) 4,499,891,382 22.0% 133,699,851 6.3% 210,284,319 26.6% 315,069,506 28.0%
Highly Skilled Supervision (Levels 9-12) 9,305,777,826 45.5% 1,648,585,861 77.1% 114,863,506 14.5% 203,977,190 18.1%
Senior and Top Management (Levels 13-16) 102,937,697 0.5% 5,824,462 0.3% 839,907 0.1% 1,565,097 0.1%
Total 20,473,158,399 100.0% 2,138,701,370 100.0% 791,151,475 100.0% 1,125,075,394 100.0%

Table 3.2.1: Employment and Vacancies by Programme as at 31 March 2019
Number Number of Vacancy Number of Posts

of Posts on Posts Filled Rate Filled Additional
Programme to the
Approved
Establishment Establishment
1. Health administration 1,486 1,022 31.2% 31
2. District health services 20,587 18,411 10.6% 866
3. Emergency medical services 2,095 1,833 12.5% 1
4. Provincial health service 22,476 20,745 7.7% 1,216
5. Academic health services 20,509 18,336 10.6% 664
6. Health sciences 4,266 2,889 32.3% -
7. Health care support services 788 698 11.4% -
8. Health facility management 37 28 24.3% 7
Total 72,244 63,962 11.5% 2,785
Table 3.2.2: Employment and Vacancies by Salary Band as at 31 March 2019
Number Number of Vacancy Number of

of Posts on Posts Filled Rate Posts Filled
Salary Band Description Approved Additional
Establishment to the
Establishment
1. Lower skilled (Levels 1 - 2) 7,524 7,524 8.4% 5
2. Skilled (Levels 3 - 5) 23,450 23,450 15.2% 183
3. High skilled production (Levels 6 - 8) 16,651 16,641 11.3% 1,087
4. Highly skilled supervision (Levels 9 - 12) 15,674 15,575 13.8% 1,508
5. Senior management (Levels 13 - 16) 105 105 46.7% 2
Total 63,404 63,295 13.1% 2,785

Table 3.2.3 Employment and Vacancies by Critical Occupation as at 31 March 2019
Programme Number Number of Vacancy Number of

of Posts on Posts Filled Rate Employees
Approved Additional to
Establishment the Establishment
Dental practitioner 257 218 14.4% 20
Dental specialist 153 115 20.9%
Medical practitioner 2,514 2,122 25.6% 241
Medical practitioner (intern) 1,198 968 16.2% 917
Medical specialist 2,604 2,327 10.9% 2
Emergency care practitioner 1,984 1,733 13.0%
Pharmacist 549 498 12.4% 83
Pharmacist (intern) 71 58 12.7% 62
Professional nurse 16,198 14,893 9.5% 864
Staff nurse 7,957 7,408 4.4% 23
Nursing assistant 6,962 6,404 4.6% 19
Professional nurse (student) 3,524 2,432 36.6% 7
Total 43,971 39,176 11.4% 2,238
Table 3.3.1 SMS Post information as at 31 March 2019
Total
Total Number Total % of SMS % of SMS
Number
Salary Band Description of Funded Number of posts Filled posts
of SMS
SMS posts SMS posts Vacant
posts
Filled
Vacant
Director-General/Head of Department 1 1 100% 0 0.0%
Salary Level 16 1 1 100% 0 0.0%
Salary Level 15 8 6 75% 2 25.0%
Salary Level 14 41 25 61% 16 39.0%
Salary Level 13 103 72 70% 31 30.1%
Total 154 105 49 31.8%

Table 3.3.2 SMS Post information as at 30 September 2018
Total Number of Total % of SMS posts Total % of SMS

Funded Number of Filled Number posts
SMS Level of SMS Vacant
SMS posts SMS posts posts
Filled Vacant
Director-General/Head of Department 1 1 100% 0.0%
Salary Level 16 1 1 100% 0.0%
Salary Level 15 8 6 75% 3 37.5%
Salary Level 14 41 25 61% 16 39.0%
Salary Level 13 103 74 70% 28 27.2%
Total 154 107 47 30.5%
Table 3.3.3 Advertising and Filling of SMS Posts 1 April 2018 to 31 March 2019
Total Total Total % of Total % of SMS

Number of number of Number of SMS Number of Vacant
SMS Level Funded posts SMS Vacant Funded
SMS posts SMS posts Filled Funded posts
SMS posts filled Advertised posts
Director-General/Head of Department 1 1 0 100% 2 0.0%

Salary Level 16 1 1 0 100% 16 0.0%
Salary Level 15 8 6 3 75% 31 25.0%
Salary Level 14 41 25 10 61% 49 39.0%
Salary Level 13 103 72 14 70% 30.1%
Total 154 105 27 31.8%
Table 3.3.4 Reasons for not having complied with the filling of funded vacant SMS posts Advertised within 6 months and filled
within 12 months after becoming vacant: 1 April 2018 to 31 March 2019
Reasons for vacancies not advertised within six months
Budget constraints
Reasons for vacancies not filled within twelve months
Unavailability of senior managers to conduct the shortlisting and interviews Cancellation of scheduled
Recruitment processes due to the Executive Management's urgent meetings
Table 3.3.5 Disciplinary steps taken for not complying with the prescribed timeframes for filling SMS posts within 12 months
the prescribed timeframes for filling SMS posts within 12 months
Posts were
Reasons foradvertised andadvertised
vacancies not documentswithin
were six
caught in the fire at the Bank of Lisbon building. An erratum advertisement
months
was placed in national newspapers and attracted one candidate.
Reasons for vacancies not filled within six months
As above

Table 3.4.1 Job Evaluation by Salary Band: 1 April 2018 to 31 March 2019
Posts Upgraded Posts Downgraded
Posts on Number of Jobs % of Jobs Number % of Posts Number % of Posts

Salary Band Establishment Evaluated Evaluated Evaluated Evaluated
Lower skilled (Levels 1-2) 7,626 0 0 0 0 0 0

Skilled (Levels 3-5) 25,057
Highly skilled production (Levels 6-8) 14,731 0 0 0 0 0 0
Highly skilled supervision (Levels 9-12) 12,116 1 0,01 0 0 0 0
Senior management Band A 68 0 0 0 0
Senior management Band B 19 0 0 0 0 0
Senior management Band C 2 0 0 0 0 0
Senior management Band D 2 0 0 0 0 0
Contract (Levels 1-2) 2 0 0 0 0 0
Contract (Levels 3-5) 751 0 0 0 0 0 0
Contract (Levels 6-8) 580 0 0 0 0
Contract (Levels 9-12) 2,994 0 0 0 0 0 0
Contract Band A 4 0 0 0 0 0 0
Contract Band B 6 0 0 0 0 0
Contract Band C 4 0 0 0 0 0
Contract Band D 0 0 0 0 0 0 0
Total 63,962 0 0,01 0 0 0 0
Notes:
Some Health lower level posts are currently being co-ordinated by the DPSA and we are awaiting the results.
DPSA has also facilitated the job evaluation benchmark exercise for all Middle Managament, Supply Chain, Finance, and Risk management posts

Table 3.4.2 Profile of employees whose positions were upgraded due to their posts being upgraded: 1 April 2018 to 31
March 2019
Gender African Asian Coloured White Total
Female 0 0 0 0 0
Male 0 0 0 0 0
Total 0 0 0 0 -
Employees with Disability - - - - -
Table 3.4.3 Employees with salary levels higher than those determined by job evaluation by occupation: 1 April 2018 to 31
March 2019
Occupation Number of Job Evaluation Remuneration Reasons for

Employe Level Level Deviation
0 0 0 0
Percentage of Total Employed 0
Table 3.4.4 profile of employees whose salary levels are higher than those determined by Job evaluation: 1 April 2018 to 31
March 2019
Total
Gender African Asian Coloured White
0
Female 0 0 0 0
0
Male 0 0 0 0
0
Total 0 0 0 0
-
Employees with Disability - - - -
Notes:
Total number of employees whose salaries exceeded the level determined by job evaluation is ZERO
Table 3.5.1 Annual turnover rates by salary band: 1 April 2018 to 31 March 2019
Number of Appointments Vacancy Turnover

Employees and Transfers Rate Rate
Programme Into the
at Beginning of Period
(1 April 2018) Department
1. Lower skilled (Levels 1 - 2) 9,574 1,168 1,166 12.2%
2. Skilled (Levels 3 - 5) 25,188 437 906 3.6%
3. Highly skilled production (Levels 6 - 8) 15,952 269 1,113 7.0%
4. Highly skilled supervision (Levels 9 - 12) 12,580 635 1,045 8.3%
5. Senior management service Band A 73 1 7 9.6%
5. Senior management service Band B 20 - 2 10.0%
5. Senior management service Band C 2 - - 0.0%
5. Senior management service Band D 1 2,514 - 0.0%
6. Contracts 4,503 5,024 2,807 62.3%
Total 67,893 7,046 10.4%

Table 3.5.2 Annual turnover rates by critical occupation: 1 April 2018 to 31 March 2019
Number of Employees Appointments Terminations Turnover Rate

at Beginning of and Transfers and Transfers
Critical Occupation
Period (1 April 2018) Into the Out of the
Department Department
Dental practitioner 304 49 37 12.2%
Dental specialist 178 10 28 15.7%
Medical practitioner 2,578 1,158 1,153 44.7%
Medical practitioner (intern) 919 513 491 53.4%
Medical specialist 2,518 413 514 20.4%
Emergency care practitioner 1,668 110 38 2.3%
Pharmacists 557 144 183 32.9%
Pharmacists (intern) 60 59 63 -
Professional nurse 14,958 580 1,503 10.0%
Staff nurse 7,707 138 215 2.8%
Nursing assistant 6,526 107 166 2.5%
Professional nurse (student) 3,109 8 118 3.8%
Total 41,082 3,289 4,509 11.0%
Table 3.5.3 Reasons why staff left the Department: 1 April 2018 to 31 March 2019
% of Total
Termination Type Number Resignations
1. Death 259 3.7%
2. Resignation 2,035 28.9%
3. Expiry of contract 3,556 50.5%
4. Dismissal: operational changes 1 0.0%
5. Dismissal: misconduct 100 1.4%
6. Dismissal: inefficiency 0.0%
7. Discharged due to ill-health 49 0.7%
8. Retirement 1,045 14.8%
9. Transfer to other public service Departments 1 0.0%
10. Other - 0.0%
Total 7,046 100.0%
Total number of employees who left as a % of total employment: 10.4%

Table 3.5.4 Promotions by critical occupation: 1 April 2018 to 31 March 2019
Salary Level Progression Notch

Number of Promotions to Promotions as to another Progression as
Employees another Salary a % of Notch within a % of
Occupational Class (1 April 2018) Level Employees a Salary Level Employees by
Occupation
Dental Practitioner 374 2 0.53% 17 4.55%
Dental Specialist 124 3 2.42% 5 4.03%
Medical Practitioner 3,754 24 0.64% 81 2.16%
Medical Practitioner (Intern) 947 0 0.00% 1 0.11%
Medical Specialist 1,321 11 0.83% 72 5.45%
Emergency Care Practitioner 1,669 3 0.18% 46 2.76%
Pharmacist 528 2 0.38% 42 7.95%
Pharmacist (Intern) 90 0 0.00% 0 0.00%
Professional Nurse 15,116 90 0.60% 445 2.94%
Staff Nurse 7,728 20 0.26% 467 6.04%
Nursing Assistant 6,539 16 0.24% 228 3.49%
Professional Nurse (Student) 3,120 0 0.00% 0 0.00%
Total 41,310 171 - 1,404 -
Table 3.5.5 Promotions by salary band: 1 April 2018 to 31 March 2019
Number of Number of Promotions to Progression to Notch

Progression as a
Employees Employees another Salary another Notch
Salary Band % of Employees
(1 April 2018) (1 April 2018) Level within a Salary
by Occupation
Level
1. Lower Skilled (Levels 1 - 2) 7,524 35 0.47% 12 0.16%
2. Skilled (Levels 3 - 5) 25,329 51 0.20% 7 0.03%
3. Highly Skilled Production (Levels 6 - 8) 16,701 64 0.38% 13 0.08%
4. Highly Skilled Supervision (Levels 9 - 12) 15,727 117 0.74% 3 0.02%
5. Senior Management (Levels 13 - 16) 114 0 0.00% 0 0.00%
Total 65,395 267 - 35 -

Table 3.6.1 Total number of employees (including employees with disabilities) in occupational categories as at 31 March 2019
Male Female
African Coloured Indian Total White African Coloured Indian Total White Total
Occupational Category Black Black
1. Legislators, senior officials and managers 65 3 3 71 6 60 3 6 69 4 150
2. Professionals 1,774 67 420 2,261 796 1,945 84 500 2,529 993 6,579
3. Technicians and associate professionals 2,614 39 57 2,710 139 17,162 471 364 17,997 1,006 21,852
4. Clerks 2,404 47 16 2,467 55 5,472 90 14 5,576 262 8,360
5. Service workers and shop and market sales workers 2,639 20 15 2,674 51 14,363 107 17 14,487 136 17,348
7. Craft and related trades workers 0 0 0 0 0 0 0 0 0 2 2
8. Plant and machine operators and assemblers 382 8 1 391 7 32 - - 32 430
9. Elementary occupations 3,828 52 6 3,886 64 6,942 134 1 7,077 73 11,100
Total 13,706 236 518 14,460 1,118 45,976 889 902 47,767 2,476 65,821
Employees with Disabilities 268 11 4 283 35 682 34 7 723 79 1,120

Table 3.6.2 Total number of employees (including employees with disabilities) in occupational bands as at 31 March 2019
Male Female
Occupational Bands Black Black
1.Top management 2 - - 2 - 5 - - 5 - 7
2. Senior management 44 3 2 49 6 35 2 2 39 4 98
3. Professionally qualified and experienced specialists and 2,598 89 412 3,099 730 9,267 318 660 10,245 1,447 15,521
mid-management 31
4. Skilled technical and academically qualified workers, junior 2,584 37 2,652 129 12,637 274 172 13,083 72 16,593
management, supervisors
13 9
5. Semi-skilled and discretionary decision making 5,350 68 5,431 69 17,590 189 21 17,800 152 23,452
6. Unskilled and defined decision-making 3,128 39 60 3,227 184 6,442 106 47 6,595 144 10,150
Total 13,706 236 518 14,460 1,118 45,976 889 902 47,767 2,476 65,821
Employees with Disabilities 268 11 4 283 35 682 34 7 723 79 1,120

Table 3.6.3 Recruitment: 1 April 2018 to 31 March 2019
Male Female
African Coloured Indian White African Coloured Indian White Total

Occupational Bands
1.Top management 1 - - - - - - - 1
2. Senior management 1 - - - 1 - - - 2
3. Professionally qualified and experienced specialists and 414 28 93 230 865 135 188 406 2,259
mid-management 523 20
4. Skilled technical and academically qualified workers, junior 101 3 3 18 56 196 920
management, supervisors
468 5
5. Semi-skilled and discretionary decision making 184 4 2 2 2 4 671
6. Unskilled and defined decision-making 356 5 21 34 701 12 12 30 1,171
Total 1,057 40 119 284 2,558 72 258 636 5,024
Employees with Disabilities 1 - - 1 2 - - - 4

Table 3.6.4 Promotions: 1 April 2018 to 31 March 2019
Male Female
Salary Band Black Black
1.Top management - - - 0 - 1 - - 1 - 1
2. Senior management 1 - - 1 - - - - 0 - 1
3. Professionally qualified and experienced specialists and 102 3 23 128 23 369 18 31 418 42 611
mid-management 6
4. Skilled technical and academically qualified workers, junior 77 1 3 81 3 764 12 782 11 877
management, supervisors, foreman and superintendents
-
5. Semi-skilled and discretionary decision making 73 - - 73 286 - 286 1 360
6. Unskilled and defined decision-making 2 - - 2 26 1 - - 1 3
Total 255 4 26 285 1 1,421 30 37 1,488 54 1,853
Employees with Disabilities 1 - - 1 1 3 - - 3 - 9

Table 3.6.5 Terminations: 1 April 2018 to 31 March 2019
Male Female
Salary Band Black Black
1.Top management 1 - - 1 - 5 - - 0 - 1
2. Senior management 4 1 - 5 2 1,190 - - 5 2 14
3. Professionally qualified and experienced specialists and 492 29 106 627 235 1,188 72 198 1,460 482 2,804
mid-management
4. Skilled technical and academically qualified workers, junior 261 5 6 272 18 806 49 67 1,304 282 1,876
management, supervisors, foreman and superintendents
5. Semi-skilled and discretionary decision making 292 9 4 305 9 624 21 1 828 15 1,157
6. Unskilled and defined decision-making 411 5 26 442 49 3,813 18 24 666 37 1,194
Total 1,461 49 142 1,652 313 58 160 290 4,263 818 7,046
Employees with Disabilities 10 - - 10 4 - 3 - 61 8 154
Table 3.6.6 Disciplinary action: 1 April 2018 to 31 March 2019
Male Female
African Coloured Indian White African Coloured Indian White Total

Disciplinary action
Disciplinary action
437 4 2 12 457 5 1 12 930

Table 3.6.7 Skills development: 1 April 2018 to 31 March 2019
Male Female
Occupational Category Black Black
1. Legislators, senior officials and managers 9 1 0 10 0 6 0 0 6 0 16
2. Professionals 914 47 65 1,026 11 2,446 81 37 2,564 23 3,624
3. Technicians and associate professionals 1,606 449 206 2,261 61 2,751 692 121 3,564 37 5,923
4. Clerks 1,510 311 72 1,893 49 2,664 299 69 3,032 31 4,005
5. Service workers and shop and market sales workers 201 12 4 217 1 701 4 3 708 2 928
7. Craft and related trades workers 3 0 0 3 0 1 0 0 1 0 4
8. Plant and machine operators and assemblers 1 1 0 2 0 11 0 0 11 0 13
9. Elementary occupations 661 53 14 728 12 1,713 114 12 1,839 19 2,598
Total 4,905 874 361 6,140 134 10,293 1,190 242 11,725 112 17,111
Employees with Disabilities - - - - - - - - - - -
Legend
• Legislators, Senior Officials and Managers Officials responsible for determining and formulating policy and strategy, planning, directing and coordinating the policies and activities of the organisation;
for example: CEOs, Senior Managers, College Principals
• Technicians and Associate Professionals This group includes occupations whose main tasks require technical knowledge and experience such as Clinical Technologists, Industrial Technicians,
Environmental Health Officers, Professional Nurses
• Clerks This group includes occupations whose tasks require the knowledge and experience necessary to organise, store, compute and retrieve information such as
Accounting Clerks, Stores Officers, Administration Clerks
This group includes occupations whose main tasks require the knowledge and experience necessary to provide personal and protective services such as
• Service Workers and Shop and Market Sales Workers
auxiliary services officers (ward attendants), Emergency Care practitioners, firefighters, food services aides
• Craft and Related Trades Workers This group includes occupations whose main tasks require the knowledge and experience of skilled trades and handicrafts such as clinical photographers,
plumbers and electricians
• Plant and Machine Operators and Assemblers The main tasks of this occupational grouping involve the use of automated industrial machinery and equipment such as drivers and tradesmen’s aides

Table 3.7.1 Signing of Performance Agreements by SMS members as on 31 May 2019
Total Total Number Total Number Signed Reason for not

Number of of SMS of signed Performance having
Funded SMS members Performance Agreements as concluded
posts Agreements % of Total Performance
Number of Agreements
SMS Level SMS members
Director-General/Head of Department: Salary
Level 16 2 1 1 100% N/A
Salary Level 15 8 6 6 100% N/A
Salary Level 14 41 25 25 100% N/A
Salary Level 13 103 74 74 100% N/A
Total 154 106 106 100% N/A
Table 3.7.2 Reasons for not having concluded Performance Agreements for all SMS members as on 31 March 2019
Total Total Number Total Number Signed Reason for not

Number of of SMS of signed Performance having
Funded SMS members Performance Agreements as concluded
posts Agreements % of Total Performance
Number of Agreements
SMS Level SMS members
Director-General/Head of Department: Salary
Level 16 2 1 1 100% N/A
Salary Level 15 8 6 6 100% N/A
Salary Level 14 41 25 25 100% N/A
Salary Level 13 103 74 74 100% N/A
Total 154 106 106 100% N/A
Table 3.7.3 Disciplinary steps taken against SMS members for not having concluded Performance Agreements
Reason
None
Table 3.8.1 Performance rewards by race and gender: financial year 2017/2018
Demographics Number of Total Total Number Cost (R'000) Average Cost

Beneficiaries Employment of Funded per
SMS posts Beneficiary (R)
African, Female 34,793 44,921 77.50 7253,000,632 7,272
African, Male 9,703 13,191 73.60 70,761,206 7,293
Asian, Female 377 861 43.80 2,786,326 7,391
Asian, Male 189 459 41.20 1,377,232 7,287
Coloured, Female 615 879 70.00 4,492,594 7,305
Coloured, Male 141 226 62.40 1,035,879 7,347
White, Female 1,253 2,380 52.60 9,341,676 7,455
White, Male 387 941 41.10 2,827,891 7,307
TOTAL 47,458 63,858 345,623,436 7,283

Table 3.8.2 Performance rewards by salary band for personnel below SMS: financial year 2017/2018
Number of Total Percentage of Cost (R'000) Average Cost

Beneficiaries Employment Total per
Salary Band
Employment Beneficiary
Lower skilled (Levels 1-2) 6,535 7,485 87.3% 47,572,694 7,280
Skilled (Levels 3-5) 18,633 24,154 77.1% 135,560,060 7,275
Highly skilled production (Levels 6-8) 12,758 16,676 76.5% 92,876,364 7,280
Highly skilled supervision (Levels 9-12) 9,532 15,650 60.9% 69,589,654 7,301
Periodical remuneration - - 0.0% - 0
Abnormal appointment - - 0.0% - 0
Total 47,458 63,965 - 345,598,772 7,282
Table 3.8.3 Performance rewards by critical occupation: Financial Year 2017/2018
Number of Total Percentage of Cost (R'000) Average Cost

Beneficiaries Employment Total per
Salary Band
Employment Beneficiary
Dental practitioners 141 216 65.3% 1,021,919 7,248
Dental specialists 36 67 53.7% 262994 7,305
Emergency services related 1162 1645 70.6% 8398764 7,228
Medical practitioners 666 1790 37.2% 4,839,448 7,266
Medical specialists 552 1116 49.5% 4,095,874 7,420
Nursing assistants 5402 6647 81.3% 39,132,354 7,244
Pharmacists 261 350 74.6% 1,942,311 7,442
Professional nurse 11624 14561 79.8% 84,431,481 7,264
Staff nurses and pupil nurses 6293 7600 82.8% 45,597,688 7,246
Total 26,137 33,992 - 189,722,833 7,259
Table 3.8.4 Performance related rewards (Cash Bonus) by salary band for SMS: Financial year 2017/2018
Beneficiary Profile Cost

Number of Number of % of Total Total Cost Average Cost Total Cost as a % of
Salary Band
Beneficiaries Beneficiaries within Salary (R'000) per the Total Personnel
Employee Expenditure
Band A Nil 2 0.0% 0 0 0
Band B Nil 8 0.0% 0 0 0
Band C Nil 41 0.0% 0 0 0
Band D Nil 103 0.0% 0 0 0
Total Nil 154 _ 0 0 0

Table 3.9.1 Foreign workers by salary band: 1 April 2018 to 31 March 2019
01-Apr-18 31-Mar-19 Change
Salary Band Number % of Total Number % of Total Number % of Total
Lower skilled 57 5.2% 60 6.3% 3 -2.0%
Highly skilled (Levels 6-8) 84 7.6% 67 7.0% -17 11.6%
Highly skilled supervision (Levels 9-12) 701 63.4% 651 67.9% -50 34.0%
Contract (Levels 9-12) 264 23.9% 181 18.9% -83 56.5%
Contract (Levels 13-16) 0.0% 0 0.0% 0 0.0%
Total 1,106 - 959 - -147 -
Table 3.9.2 Foreign workers by major occupation: 1 April 2018 to 31 March 2019
01-Apr-18 31-Mar-19 Change
Salary Band Number % of Total Number % of Total Number % of Total
Administrative office workers 8 1.0% 7 0.9% -1 1.6%
Elementary occupations 6 0.7% 6 0.8% 0 0.0%
Information technology personnel 0 0.0% - 0.0% 0 0.0%
Professionals and managers 653 78.3% 615 79.9% -38 59.4%
Social natural technical and medical sciences + supp 1 0.1% 1 0.1% 0 0.0%
Technicians and associated professionals 166 19.9% 141 18.3% -25 39.1%
Total 834 - 770 - -64 -

Table 3.10.1 Sick Leave: 01 April 2018 to 31 March 2019
Total Days % Days with Number of % of Total Average Estimated Total Total
Medical Employees Employees Days per Cost (R'000) Number of Number of
Salary Band Certification using Sick using Sick Employee Employees Employees
Leave Leave using Sick using Sick
Leave Leave
Contract (Levels 13-16) 40.00 90.00 7.00 0.00 6.00 163.00 48,536.00 36.00
Contract (Levels 3-5) 189.00 72.50 47.00 0.10 4.00 147.00 48,536.00 137.00
Contract (Levels 6-8) 3,064.00 73.10 564.00 1.20 5.00 3,618.00 48,536.00 2,241.00
Contract (Levels 9-12) 6,358.00 73.00 1,378.00 2.80 5.00 15,190.00 48,536.00 4,644.00
Contract Other 612.00 90.40 223.00 0.50 3.00 208.00 48,536.00 553.00
Highly skilled production (Levels 6-8) 88,404.00 83.50 12,973.00 26.70 7.00 110,729.00 48,536.00 73,848.00
Highly skilled supervision (Levels 9-12) 63,812.00 83.20 9,122.00 18.80 7.00 163,812.00 48,536.00 53,117.00
Lower skilled (Levels 1-2) 39,919.00 88.10 5,657.00 11.70 7.00 20,627.00 48,536.00 35,172.00
Other 8.00 100.00 2.00 0.00 4.00 10.00 48,536.00 8.00
Senior management (Levels 13-16) 420.00 82.90 67.00 0.10 6.00 1,681.00 48,536.00 348.00
Skilled (Levels 3-5) 122,146.00 84.00 18,496.00 38.10 7.00 94,365.00 48,536.00 102,644.00
TOTAL 324,972.00 - 48,536.00 - 7.00 410,549.00 48,536.00 272,748.00

Table 3.10.2 - Disability Leave (Temporary and Permanent personnel): January 2018 to December 2018
Total Days % Days with Number of % of Total Average Estimated Total Total
Medical Employees Employees Days per Cost (R'000) Number of Number of
Salary Band Certification using Sick using Sick Employee Employees Employees
Leave Leave using Sick using Sick
Leave Leave
Contract (Levels 6-8) 125.00 100.00 6.00 0.20 21.00 141.00 125.00 3,599.00
Contract (Levels 9-12) 354.00 100.00 12.00 0.30 30.00 795.00 354.00 3,599.00
Highly skilled production (Levels 6-8) 19,894.00 100.00 1,086.00 30.20 18.00 25,230.00 19,894.00 3,599.00
Highly skilled supervision (Levels 9-12) 15,444.00 99.80 757.00 21.00 20.00 38,340.00 15,418.00 3,599.00
Lower skilled (Levels 1-2) 6,940.00 100.00 445.00 12.40 16.00 3,668.00 6,940.00 3,599.00
Senior management (Levels 13-16) 5.00 100.00 1.00 0.00 5.00 18.00 5.00 3,599.00
Skilled (Levels 3-5) 25,318.00 100.00 1,292.00 35.90 20.00 19,527.00 25,312.00 3,599.00
TOTAL 68,080.00 100.00 3,599.00 100.00 19.00 87,719.00 68,048.00 3,599.00
Table 3.10.3 Annual Leave: 01 April 2018 to 31 March 2019
Average Number of
Total Days Employees who
Salary Band Days per
Taken took leave
Employee
Contract (Levels 13-16) 1250.00 15.00 17.00
Contract (Levels 3-5) 923.00 10.00 90.00
Contract (Levels 6-8) 11,744.92 17.00 690.00
Contract (Levels 9-12) 48,115.76 16.00 3,052.00
Contract Other 2,301.00 8.00 275.00
Highly skilled production (Levels 6-8) 388,264.43 23.00 16,735.00
Highly skilled supervision (Levels 9-12) 305,932.28 24.00 12,835.00
Lower skilled (Levels 1-2) 163,583.87 22.00 7,493.00
Senior management (Levels 13-16) 2,081.00 22.00 95.00
Skilled (Levels 3-5) 559,511.64 23.00 24,842.00
Other 68.00 23.00 3.00
TOTAL 1,482,775.90 22.00 66,127.00

Table 3.10.4 - Capped Leave: 01 April 2018 to 31 March 2019
Total days of Average Average capped Number of Total number Number of

Salary Band capped number of leave per Employees who of capped Employees as at
leave taken days taken employee as at took Capped leave available end of period
per employee end of period leave at end of
Contract (Levels 1-2) 0.00 0.00 0.00 0.00 0.00 0.00
Contract (Levels 13-16) 0.00 0.00 32.00 0.00 32.14 1.00
Contract (Levels 3-5) 0.00 0.00 0.00 0.00 0.00 0.00
Contract (Levels 6-8) 0.00 0.00 0.00 0.00 0.00 0.00
Contract (Levels 9-12) 0.00 0.00 0.00 0.00 0.00 0.00
Contract Other 0.00 0.00 0.00 0.00 0.00 0.00
Highly skilled production (Levels 6-8) 590.43 4.00 30.00 165.00 97,480.99 3,286.00
Highly skilled supervision (Levels 9-12) 741.30 5.00 33.00 154.00 100,496.40 3,053.00
Lower skilled (Levels 1-2) 5.00 5.00 22.00 1.00 770.27 35.00
Senior management (Levels 13-16) 15.00 15.00 63.00 1.00 2,500.56 40.00
Skilled (Levels 3-5) 433.02 4.00 22.00 120.00 72,113.81 3,324.00
Other 0.00 0.00 6.00 0.00 6.00 1.00
TOTAL 1,784.75 4.00 28.00 441.00 273,400.17 9,740.00
Table 3.10.5 Leave Pay-outs (Estimated)
Total Number of Average

Salary Band Estimated Employees Estimated
Amount Payment per
(R'000) Employee (R
Annual - discounting with resignation (work days) 18,058.00 913.00 19,779.00
Annual - discounting: unused vac credits (suspension) 33.00 1.00 33,000.00
Annual - discounting: unused vacation credits (work days) 105.00 3.00 35,000.00
Annual - gratuity: death/retirement/medical retirement (work days) 32,950.00 1,010.00 32,624.00
Annual - Heads of Departments (gratuity) (work days) 5.00 1.00 5,000.00
Capped - gratuity: death/retirement/medical retirement (work days) 43,212.00 765.00 56,486.00
Capped - Heads of Departments (gratuity) (work days) 24.00 1.00 24,000.00
TOTAL 94,387.00 - -

Units/categories of employees identified to be at high risk of contracting HIV & related diseases (if any)
3.11. HIV/AIDS and Health Promotion Programmes
Units/categories of employees identified to be at high risk of Key steps taken to reduce the risk
contracting HIV & related diseases (if any)
Health Care Professionals (Biological Exposure through cuts, Policy, protocols & PPE
splashes, NSI, bites)
Table 3.11.2 Details of Health Promotion and HIV/AIDS Programmes
Question Yes No Details, if yes
1. Has the Department designated a member of the SMS to YES Dr Sipho Senabe
implement the provisions contained in Part VI E of Chapter 1 Chief Director: HRD & EHWP
of the Public Service Regulations, 2001? If so, provide her/his
name and position.
2. Does the Department have a dedicated unit or has it YES No of staff: 4

designated specific staff members to promote the health and
well-being of your employees? If so, indicate the number of Conditional Grant: 30,000,000
employees who are involved in this task and the annual
budget that is available for this purpose.
3. Has the Department introduced an Employee Assistance or YES Psychosocial services

Health Promotion Programme for your employees? If so, - Debriefing
indicate the key elements/services of this programme. - Counselling
- Resilience building
PHC Services
- Management of Chronic Diseases
- NIMART
4. Has the Department established (a) committee(s) as Palesa Koetsi

contemplated in Part VI E.5 (e) of Chapter 1 of the Public Thabo Nkagisang
Service Regulations, 2001? If so, please provide the names of Hospital HIV/AIDS Coordinators
the members of the committee and the stakeholder(s) that Peer Educators
they represent.
5. Has the Department reviewed its employment policies and National HIV, TB & STI Strategic Plan of Gauteng HIV &
practices to ensure that these do not unfairly discriminate AIDS Strategic 2017-22
against employees on the basis of their HIV status? If so, list HR Recruitment Policy
the employment policies/practices so reviewed. Medical Surveillance Policy
6. Has the Department introduced measures to protect Establishment of Support Groups

HIV-positive employees or those perceived to be HIV-positive Peer Education / Wellness Champions
from discrimination? If so, list the key elements of these
measures.
7. Does the Department encourage its employees to undergo Wellness Days, Peer Education Programmes, Medical
Voluntary Counselling and Testing? If so, list the results that Surveillance, Support Groups, STI & Condom Week
you have you achieved. Results are poor
1311 tested
138 males
1173 females
8. Has the Department developed measures/indicators to MPAT Indicators

monitor and evaluate the impact of its health promotion Operational Plans
programme? If so, list these measures/indicators. Monthly Reports
Annual Reports
- Number of employees tested for HIV and know their
HIV status
- Number of employees tested HIV positive
- Number of eligible employees who are started ART
- Number of employees started on ART and are still alive
and in care at 12 months after ART initiation

Table 3.12.1 Collective agreements: 1 April 2018 to 31 March 2019
Subject Matter Date
PHSDSBC
12 June 2018
Resolution 1 Of 2018 - Agreement on The Standardisation Of Remuneration For Community Health Workers In
The Department Of Health
PHSDSBC 10 September 2018

Resolution 2 of 2018 - Agreement on payment of annual statutory registration fees
PSCBC
08 June 2018
Resolution 1 of 2018: Agreement on the salary adjustments and improvements in conditions of service for the
period 2018 to 2021
PSCBC 26 October 2018

Resolution 2 of 2018: Redress of Discriminatory Pension Practices
PHSDSBC - GAUTENG CHAMBER

Resolution 1 of 2018: Payment of PMDS bonusses for the 2017-2018 cycle.
Notes:
The CCPGP did not sign any resolutions during the reporting period.
Data supplied by Labour Relations Management & Development
Table 3.12.2 Misconduct and disciplinary hearings finalised: 1 April 2018 to 31 March 2019
Outcomes of disciplinary hearings Number % of total
Abscondment 23 3%
Dismissal 4 0.50%
Suspension without salary 45 6%
Corrective counselling 13 2%
Final written warning 219 28%
Written warning 301 40%
Verbal warning 92 12%
Withdrawn 23 3%
Not guilty 2 0.20%
Closed e.g. insufficient evidence, employees resigned, key witness not available, decease etc. 49 6%
TOTAL 771 100%

Table 3.12.3 Types of misconduct addressed at disciplinary hearings: 1 April 2018 to 31 March 2019
Type of misconduct Number % of total
Absenteeism 246 26%
Assault 27 3%
Dereliction of duties 28 3%
Dishonesty 17 2%
Fraud and corruption 21 2%
Improper conduct 67 7%
Insubordination 157 17%
Negligence 89 10%
Theft 78 8%
Others, e.g. late coming, damage to state property, misuse of state property, irregular appointment, dress code etc. 178 2%
TOTAL 930 100%
Table 3.12.4 Grievances lodged: 1 April 2018 to 31 March 2019
Number of grievances resolved 327 87%

Number of grievances not resolved 45 12%
Total number of grievances lodged 372 100%
Table 3.12.5 Disputes lodged with Council: 1 April 2018 to 31 March 2019
Number of grievances resolved 86 100%

Number of grievances not resolved 42 49%
Total number of grievances lodged 44 51%
Notes: Outcome of the Disputes
Withdrawn 11
In favour of the Department 15
In favour of the applicant 03
Dismissed 04
Settled 09

Table 3.12.6 Strike action: 1 April 2018 to 31 March 2019
Total number of person working days lost 371.00
Total cost (R'000) of working days lost 111,226.05
Amount (R'000) recovered as a result of no work no pay 111,226.05
Table 3.12.7 Precautionary suspensions: 1 April 2018 to 31 March 2019
Number of people suspended 12
Number of people whose suspension exceeded 30 days 12
Average number of days suspended 54
Cost (R’000) of suspensions 1,550,118

Table 3.13.1 Training needs identified: 1 April 208 to 31 March 2019
Training needs at the start of the reporting period
Occupational Categories Gender Number of Learnerships Skills Programmes Other forms of Total
Employees (1 & other short training
April 2018) courses
1. Legislators, Senior Officials and Managers Female 76 - 8 - 8
Male 84 - 6 - 6
2. Professionals Female 3,548 - 1,500 0 1,500
Male 3,167 - 1,000 - 1,000
3. Technicians and Associate Professionals Female 19,964 0 5,500 - 5,500
Male 3,030 0 3,100 - 3,100
4. Clerks Female 5,937 1,000 3,000 - 4,000
Male 2,613 500 1,500 - 2,000
5. Service Workers and Shop and Market Sales Workers Female 15,036 - 750 -- 750
Male 2,727 - 310 - 310
7. Craft and Related Trades Workers Female 2 - 0 - 0
Male 0 - 0 -- 0
8. Plant and Machine Operators and Assemblers Female 34 - 15 - 15
Male 407 - 5 - 5
9. Elementary Occupations Female 7,436 - 2,500 -- 2,500
Male 4,057 - 1,400 - 1,400
Total 68,118 1,500 20,594 0 22,094
Notes:
a. Data provided by the Directorate Human Resource Development: Skills Development
b. Number of employees is as at the beginning of the reporting period (i.e. April 2018) as required by the reporting guideline.
c. Learnerships, Skills Programmes and other forms of training are training needs identified as per Workplace Skills Plan of 2018/2018

Table 3.13.2 Training provided: 1 April 208 to 31 March 2019
Training needs at the start of the reporting period
Occupational Categories Gender Number of Learnerships Skills Programmes Other forms of Total
Employees (1 & other short training
April 2018) courses
1. Legislators, Senior Officials and Managers Female 76 - 6 0 6
Male 84 - 10 0 10
2. Professionals Female 3,548 - 2,587 0 2,587
Male 3,167 - 1,037 0 1,037
3. Technicians and Associate Professionals Female 19,964 0 3,601 0 3,601
Male 3,030 0 2,322 0 2,322
4. Clerks Female 5,937 783 2,063 0 2,846
Male 2,613 421 1,942 0 2,363
5. Service Workers and Shop and Market Sales Workers Female 15,036 - 710 0 710
Male 2,727 - 218 0 218
7. Craft and Related Trades Workers Female 2 - 1 0 1
Male 0 - 3 0 3
8. Plant and Machine Operators and Assemblers Female 34 - 2 0 2
Male 407 - 11 0 11
9. Elementary Occupations Female 7,436 - 1,858 0 1,858
Male 4,057 - 740 0 740
Total 68,118 1,204 17,111 0 18,315
Notes:
a. a. Data provided by the Directorate Human Resource Development
b. Number of employees is extracted from PERSAL as at the beginning of the reporting period (i.e. April 2019) as required by the reporting guideline.
c. Learnerships, Skills Programmes and other forms of training is training provided as per Annual Training Report of 2018/2019

Table 3.14.1 Injuries on Duty: 1 April 2018 to March 2019
Nature of Injury on Duty Number % of Total
Required basic medical attention only 566 Including NSI 100.0%

Temporary Total Disablement 0 0.0%
Permanent Disablement 0 0.0%
Fatal 0 0.0%
Total 566 -
Table 3.16.1 Granting of employee-initiated severance packages for the period 1 April 2018 to 31 March 2019
Number of Number of Number of Number of

Salary Band Applications Applications Applications Packages
received referred to the supported by approved by
MPSA MPSA Department
Lower skilled (Levels 1-2) 0 0 0 0
Skilled (Levels 3-5) 0 0 0 0
Highly skilled production (Levels 6-8) 0 0 0 0
Highly skilled supervision (Levels 9-12) 0 0 0 0
Senior management (Levels 13-16) - 0 0 0
Total 0 0 0 0
Notes:
The Department does not have the competence/mandate to approve severance packages.
The competence lies with the MDPSA.

GAUTENG DEPARTMENT
VOTE 4OF HEALTH VOTE 4
APPROPRIATION STATEMENT FOR THE YEAR ENDED 31 MARCH 2019
PART E:
FINANCIAL INFORMATION
GAUTENG DEPARTMENT OF HEALTH VOTE 4
REPORT OF THE AUDITOR-GENERAL TOAPPROPRIATION
THE GAUTENG PROVINCIAL
STATEMENT LEGISLATURE
FOR THE YEAR ENDED 31 MARCH 2019
ON VOTE NO. 4: GAUTENG DEPARTMENT OF HEALTH
REPORT ON THE AUDIT OF THE FINANCIAL STATEMENTS 8. As disclosed in note 19.2 to the financial statements, payables of
Opinion R2 855 623 000 exceeded the payment term of 30 days, as
1. I have audited the financial statements of the Gauteng Depart- required by treasury regulation 8.2.3. This amount, in turn,
ment of Health set out on pages 162 to 271, which comprise the exceeded the R439 466 000 of voted funds to be surrendered by
appropriation statement, the statement of financial position as R2 416 157 000 as per the statement of financial performance.
at 31 March 2019, the statement of financial performance, The amount of R2 416 157 000 would therefore have constitut-
statement of changes in net assets and cash flow statement for ed unauthorised expenditure had the amounts due been paid in
the year then ended, as well as the notes to the financial time.
statements, including a summary of significant accounting
policies. Other matter
2. In my opinion, the financial statements present fairly, in all 9. I draw attention to the matter below. My opinion is not modified
material respects, the financial position of the Gauteng Depart- in respect of this matter.
ment of Health as at 31 March 2019, and its financial perfor-
mance and cash flows for the year then ended in accordance UNAUDITED SUPPLEMENTARY SCHEDULES
with the Modified Cash Standard (MCS) prescribed by the 10. The supplementary information set out on pages 272 to 279
National Treasury and the requirements of the Public Finance does not form part of the financial statements and is presented
Management Act of South Africa, 1999 (Act No. 1 of 1999) as additional information. I have not audited this/ these sched-
(PFMA) and the Division of Revenue Act of South Africa, 2018 ule(s) and, accordingly, I do not express an opinion on it/ them
(Act No. 1 of 2018) (Dora).
RESPONSIBILITIES OF THE ACCOUNTING OFFICER FOR
Basis for opinion THE FINANCIAL STATEMENTS
3. I conducted my audit in accordance with the International 11. The accounting officer is responsible for the preparation and
Standards on Auditing (ISAs). My responsibilities under those fair presentation of the financial statements in accordance with
standards are further described in the auditor-general’s respon- the MCS prescribed by the National Treasury and the require-
sibilities for the audit of the financial statements section of this ments of the PFMA and Dora, and for such internal control as
auditor’s report. the accounting officer determines is necessary to enable the
4. I am independent of the department in accordance with sections preparation of financial statements that are free from material
290 and 291 of the International Ethics Standards Board for misstatement, whether due to fraud or error.
Accountants’ Code of ethics for professional accountants (IESBA 12. In preparing the financial statements, the accounting officer is
code), parts 1 and 3 of the International Ethics Standards Board responsible for assessing the Gauteng Department of Health’s
for Accountants’ International Code of Ethics for Professional ability to continue as a going concern, disclosing, as applicable,
Accountants (including International Independence Standards) matters relating to going concern and using the going concern
and the ethical requirements that are relevant to my audit in basis of accounting unless the appropriate governance structure
South Africa. I have fulfilled my other ethical responsibilities in either intends to liquidate the department or to cease opera-
accordance with these requirements and the IESBA codes. tions, or has no realistic alternative but to do so.
5. I believe that the audit evidence I have obtained is sufficient and
appropriate to provide a basis for my opinion.
AUDITOR-GENERAL’S RESPONSIBILITIES FOR THE AUDIT
OF THE FINANCIAL STATEMENTS
13. My objectives are to obtain reasonable assurance about wheth-
Emphasis of matters
er the financial statements as a whole are free from material
6. I draw attention to the matters below. My opinion is not modi-
misstatement, whether due to fraud or error, and to issue an
fied in respect of these matters.
auditor’s report that includes my opinion. Reasonable assurance
is a high level of assurance, but is not a guarantee that an audit
MATERIAL UNCERTAINTIES RELATING TO LITIGATIONS
conducted in accordance with the ISAs will always detect a
7. With reference to note 17.1 to the financial statements, the
material misstatement when it exists. Misstatements can arise
department is the defendant in various lawsuits. The ultimate
from fraud or error and are considered material if, individually or
outcome of the matters cannot presently be determined and no
in aggregate, they could reasonably be expected to influence the
provision for any liability that may result has been made in the
economic decisions of users taken on the basis of these financial
financial statements.
PAYMENTS WHICH EXCEEDED VOTED FUND TO BE statements.
SURRENDERED

REPORT OF THE AUDITOR-GENERAL TO THE GAUTENG PROVINCIAL LEGISLATURE
14. A further description of my responsibilities for the audit of the completeness and appropriateness of the performance
financial statements is included in the annexure to this auditor’s indicators included in the planning documents. My procedures
report. also did not extend to any disclosures or assertions relating to
planned performance strategies and information in respect of
REPORT ON THE AUDIT OF THE ANNUAL PERFORMANCE future periods that may be included as part of the reported
REPORT INTRODUCTION AND SCOPE performance information. Accordingly, my findings do not
15. In accordance with the Public Audit Act of South Africa, 2004 extend to these matters.
(Act No. 25 of 2004) (PAA) and the general notice issued in 17. I evaluated the usefulness and reliability of the reported perfor-
terms thereof, I have a responsibility to report material findings mance information in accordance with the criteria developed
on the reported performance information against from the performance management and reporting framework,
predetermined objectives for selected programmes presented in as defined in the general notice, for the following selected
the annual performance report. I performed procedures to programmes presented in the annual performance report of the
identify findings but not to gather evidence to express department for the year ended 31 March 2019:
assurance.
16. My procedures address the reported performance information, .
which must be based on the approved performance planning
documents of the department. I have not evaluated the
Programmes Pages in the annual performance report

Programme 2 – District Health Services 33 – 47
Programme 5 – Tertiary and Central Hospital Services 54 – 64
18. I performed procedures to determine whether the reported performance information was properly presented and whether perfor-
mance was consistent with the approved performance planning documents. I performed further procedures to determine whether the
indicators and related targets were measurable and relevant, and assessed the reliability of the reported performance information to
determine whether it was valid, accurate and complete.
19. The material findings in respect of the usefulness and reliability of the selected programmes are as follows:
PROGRAMME 2 – DISTRICT HEALTH SERVICES

Various indicators
20. I was unable to obtain sufficient appropriate audit evidence to support the reasons for the variances between the planned targets and
the achievements reported in the annual performance report. This was due to limitations placed on the scope of my work. I was unable
to confirm the reported reasons for the variances by alternative means. Consequently, I was unable to determine whether any adjust-
ments were required to the reported reasons for the variances. Furthermore, the reported achievements in the annual performance
report did not agree to the supporting evidence provided for the indicators listed below. It was impractical to determine the audited
values.
No Performance indicator Reported achievement

1 PHC utilisation rate – Total 1,5
2 ART client remain on ART end of month – total 1 037 212
3 HIV test done – total 3 253 783
4 Male condom distributed 172 953 486
5 TB MDR treatment success rate 58,0%
6 Infant 1st PCR test positive around 10 weeks rate 0,73%
7 Diarrhoea case fatality rate 2,1%
8 Pneumonia case fatality rate 2,8%
9 HPV 1st dose 65 543
10 HPV 2nd dose 61 031
11 Malaria case fatality rate 1,4%
12 TB client death rate 6,3%
13 School Grade 1 - learners screened 88 200
14 School Grade 8 - learners screened 48 818

Various indicators
21. The reasons for the variances between the planned targets and the reported achievements were not explained in the annual perfor-
mance report for the indicators listed below. Furthermore, the reported achievements in the annual performance report did not agree
to the supporting evidence provided for the indicators listed below. It was impractical to determine the audited values.
No Performance indicator Reported achievement

1 Inpatient Bed Utilisation Rate (District Hospitals) 68,1%
2 TB client treatment success rate 84%
3 Antenatal 1st visit before 20 weeks’ rate 64,7%
4 Mother postnatal visit within 6 days' rate 75,1%
5 Couple year protection rate (Int) 54,1%
6 Cervical cancer screening coverage 30 years and older 52%
7 Immunisation under 1-year coverage 84,3%
8 Severe acute malnutrition case fatality rate 6,8%
9 TB/HIV co-infected client on ART rate 88,2%
10 Antenatal client start on ART rate 96,9%
IDEAL CLINIC STATUS RATE

22. I was unable to obtain sufficient appropriate audit evidence to validate the existence of systems and processes that enable reliable
reporting of actual service delivery against the indicator for the reported achievement of 89.2%. This was due to the limitation placed
on the scope of my work as the information documented in the checklists completed during the assessments could not be re-per-
formed as no corroborating evidence was provided to support the ratings in the checklists. I was unable to validate the existence of
systems and processes by alternative means. Consequently, I was unable to determine whether any further adjustments were required
to the reported achievement. Furthermore, the reason for variance between planned target and reported achievement was not
explained in the annual performance report.
HOSPITAL ACHIEVED 75% AND MORE ON NATIONAL CORE STANDARDS SELF-ASSESSMENT RATE (DISTRICT
HOSPITALS).
reporting of actual service delivery against the indicator for the reported achievement of 91.7%. This was due to the limitation placed
on the scope of my work as the information documented in the checklists completed during the assessments could not be
re-performed as no corroborating evidence was provided to support the ratings in the checklists. I was unable to validate the existence
of systems and processes by alternative means. Consequently, I was unable to determine whether any further adjustments were
required to the reported achievement. Furthermore, the reason for the variance between the planned target of 92% and the reported
achievement of 91.7% was not reported in the annual performance report.
MEDICAL MALE CIRCUMCISION – TOTAL

24. The achievement for target 124 320 reported in the annual performance report was 102 325. However, the supporting evidence
provided did not agree to the reported achievement and indicated an achievement of 97 933.
VARIOUS STRATEGIC OBJECTIVES

25. The reported strategic objectives approved in the strategic plan were not consistent when compared with strategic objectives in the
approved annual performance plan.

No Planned strategic objectives per annual performance plan Reported strategic objectives per annual performance report
1 Increase number of fully-fledged, functional Ward Based Increase the number of fully-fledged, functional Ward Based
Outreach Teams from 130 to 775 targeted wards by 2019/20 Outreach Teams from 103 to 533 by 2019/20
2 Increase number of female condoms distributed annually from 1 Increase number of female condoms distributed annually from
451 696 to 5 600 445 million and male condoms from 69 480 1 451 696 to 5.6 million by 2019/20
738 in 2013/14 to 176 576 4 by 2019/20
3 Increase number of male condoms distributed annually from: 69 Increase number of male condoms distributed annually from 69
480 000 to 176 576 400 by 2019/20 480 738 to 176 million by 2019/20
4 Decrease TB death rate from 5,2% in 2013/14 to <5% by Decrease TB death rate from 6,1% in 2013/14 to 5,3% by
2019/20 2019/20
5 Decrease child (under 5 years) severe acute malnutrition case Decrease child (under 5 years) pneumonia and severe acute
fatality rate from 6,1% in 2013/2014 to <6% by 2019/20 malnutrition case fatality rate from 12% in 2013/14 to <6% by
2019/20
6 Increase HPV vaccine coverage rate for 1st dose from 87,1% to Increase HPV vaccine coverage rate from 87,1% for 1st dose to
90% by 2019/20 80% by 2019/20
7 Increase HPV vaccine coverage rate for 2nd dose to 90% by Increase HPV vaccine coverage rate for 2nd dose to 80% by
2019/20 2019/20
8 Increase percentage of people treated for TB from 84% in Increase percentage of people treated for TB from 84% in
2013/14 to 92% by 2019/20 2013/14 to 92% of total population with HIV by 2019/20
9 Increase number of mothers whose first antenatal visit is before Increase number of mothers whose first antenatal visit is before
20 weeks from 43,7% in 2013/2014 to 65% by 2019/20 20 weeks from 43,7% in 2013/2014 to 70% by 2019/20
INCREASE NUMBER OF MEN/WOMEN AGED 15-49 TESTED FOR HIV FROM 1.8 MILLION TO 4 MILLION
26. The strategic objective approved in the annual performance plan was Increase number of men/women aged 15-49 tested for HIV from
1.8 million to 4 million. However, the strategic objective was not reported in the annual performance report.
NEONATAL DEATH IN FACILITY RATE

27. The reason for the variance between the planned target of 14 and the reported achievement of 13/1000 live births was not reported in
the annual performance report and the achievement for target 14 reported in the annual performance report was 13/1000 live births.
However, the supporting evidence provided did not agree to the reported achievement and indicated an achievement of 3.48. Further-
more, the planned indicator and target were Neonatal death in facility rate <14, but the reported achievement referred to was 13/ 1000
live births.
MATERNAL MORTALITY IN FACILITY RATIO

28. I was unable to obtain sufficient appropriate audit evidence to support the reason for the variance between the planned target of <100
and the achievement of 122.8 / 100 000 live births reported in the annual performance report. This was due to limitation placed on the
scope of my work. I was unable to confirm the reported reason for the variance by alternative means. Consequently, I was unable to deter-
mine whether any adjustments were required to the reported reason for the variance. Furthermore, the achievement for target <100
reported in the annual performance report was 122.8/ 100 000 live births. However, the supporting evidence provided did not agree to
the reported achievement and indicated an achievement of 27.96 and the planned indicator and target were Maternal mortality in facility
ratio <100, but the reported achievement referred to was 122.8 / 100 000 live births.
PROGRAMME 5 – TERTIARY AND CENTRAL HOSPITAL SERVICES

Various indicators
29. The reasons for the variances between the planned targets and the reported achievements were not explained in the annual performance
report for the indicators listed below. The reported achievement in the annual performance report also did not agree to the supporting
evidence provided for these indicators.
No Performance indicators Reported achievement Audited value

1 Inpatient Bed Utilisation Rate (Tertiary Hospitals) 87% 1042%
2 Inpatient Bed Utilisation Rate (Central Hospitals) 81% 983%

HOSPITAL ACHIEVED 75% AND MORE ON NATIONAL CORE STANDARDS SELF-ASSESSMENT RATE (TERTIARY
HOSPITALS)
reporting of actual service delivery against the indicator for the reported achievement of 3/3. This was due to the limitation placed on the
scope of our work as the information documented in the checklists completed during the assessments could not be re-performed as no
corroborating evidence was provided to support the ratings in the checklists. I was unable to validate the existence of systems and
processes by alternative means. Consequently, I was unable to determine whether any further adjustments were required to the reported
achievement. Furthermore, reported achievement was not consistent when compared with planned target as the approved target in the
annual performance plan was 100% (3/3). However, the target achievement in the annual performance report was 3/3.
HOSPITAL ACHIEVED 75% AND MORE ON NATIONAL CORE STANDARDS SELF-ASSESSMENT RATE (CENTRAL
HOSPITALS)
reporting of actual service delivery against the indicator for the reported achivement of 100%. This was due to the limitation placed on
the scope of my work as the information documented in the checklists completed during the assessments could not be re-performed as
no corroborating evidence was provided to support the ratings in the checklists. I was unable to validate the existence of systems and
processes by alternative means. Consequently, I was unable to determine whether any further adjustments were required to the reported
achievement.
VARIOUS STRATEGIC OBJECTIVES

32. The reported strategic objectives approved in the strategic plan were not consistent when compared with strategic objectives in the
approved annual performance plan.
No Planned strategic objectives per annual performance plan Reported strategic objectives per annual performance report
1 Improve efficiency of hospitals by reducing average length of Improve efficiency of hospitals by reducing average length of
stay to 5.5 days increasing bed utilisation to 85% and decreasing stay to 6. 5 days, increasing bed utilisation to 85% and decreas-
expenditure per PDE in hospitals by 2019/20 (Tertiary Hospital) ing expenditure per PDE in hospitals by 2019/20
2 Reduce the number of primary care patient cases that are seen Reduce Outpatient Department (OPD), Accident and Emergen-
at regional, tertiary and central hospitals by 20% in 2019/20 cy departments waiting times across all facilities by 60% in
(Tertiary Hospital) 2019/20
3 Increase compliance to extreme and vital measures of core Increase compliance with national core standards to 100% in
standards to 100% in 2019/20, and complete self- assessments 2019/20, and complete self-assessments in all hospitals
in all hospitals by 2019/20 (Tertiary Hospital)
OTHER MATTER
33. I draw attention to the matter below.
ACHIEVEMENT OF PLANNED TARGETS

34. Refer to the annual performance report on pages x to x for information on the achievement of planned targets for the year and explana-
tions provided for the under/ over achievement of a significant number of targets. This information should be considered in the context
of the material findings on the usefulness and reliability of the reported performance information in paragraphs x to x of this report.
REPORT ON THE AUDIT OF COMPLIANCE WITH LEGISLATION

Introduction and scope
35. In accordance with the PAA and the general notice issued in terms thereof, I have a responsibility to report material findings on the
compliance of the department with specific matters in key legislation. I performed procedures to identify findings but not to gather
evidence to express assurance.
36. The material findings on compliance with specific matters in key legislations are as follows:

ANNUAL FINANCIAL STATEMENTS

37. The financial statements submitted for auditing were not prepared in accordance with the prescribed financial reporting framework as
required by section 40(1)(b) of the Public Finance Management Act. Material misstatements on commitments and contingent liabilities
identified by the auditors in the submitted financial statement were subsequently corrected, resulting in the financial statements receiving
an unqualified audit opinion.
PROCUREMENT AND CONTRACT MANAGEMENT

38. Sufficient appropriate audit evidence could not be obtained that all contracts were awarded in accordance with the legislative require-
ments as a result of tender files which were destroyed by fire at the Bank of Lisbon building.
39. Goods and services with a transaction value below R500 000 were procured without obtaining the required price quotations, as required
by treasury regulation 16A6.1. Similar non-compliance was also reported in the prior year.
40. Goods and services of a transaction value above R500 000 were procured without inviting competitive bids as required by treasury
regulation 16A6.1. Similar non-compliance was also reported in the prior year. The non-compliance resulted in a material irregularity as
reported in the section on material irregularities.
41. Some of the contracts were extended or modified without the approval of a properly delegated official as required by section 44 of the
PFMA and treasury regulation 8.1 and 8.2. Similar finding was identified in the prior year.
EXPENDITURE MANAGEMENT
42. Effective and appropriate steps were not taken to prevent irregular expenditure, as required by section 38(1)(c)(ii) of the PFMA and
treasury regulation 9.1.1. The value, as disclosed in note 23 to the financial statements, may not be complete as awards to the value of
R77 510 081 could not be tested due to missing/ incomplete information. The majority of the irregular expenditure disclosed in the
financial statements was caused by non-compliance with the treasury regulations on competitive bidding.
43. Effective steps were not taken to prevent fruitless and wasteful expenditure amounting to R26 682 000, as disclosed in note 24 to the
annual financial statements, as required by section 38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1. The majority of the fruitless and
wasteful expenditure was caused by interest levied on overdue accounts.
44. Payments were not made within 30 days or an agreed period after receipt of an invoice, as required by treasury regulation 8.2.3. The
non-compliance resulted in a material irregularity as reported in the section on material irregularities.
REVENUE MANAGEMENT
45. Effective and appropriate steps were not taken to collect all money due, as required by section 38(1)(c)(i) of the PFMA.
46. All reasonable steps were not taken to recover debts before writing them off, as required by treasury regulation 11.4.1.
47. Bad debt was written off contrary to the requirements of the Department of Health’s write-off policy, as required by treasury regulation
11.4.2.
48. Interest was not charged on debts as required by treasury regulation 11.5.1.
CONDITIONAL GRANT
49. The Comprehensive HIV/AIDS,National Tertiary Services and Health Professions Training and Development were not spent for the
purposes stipulated in the Schedule concerned / in accordance with the applicable framework, as required by section 17(1) of the Division
of Revenue Act (Act 1 of 2018).
CONSEQUENCE MANAGEMENT
50. Disciplinary steps were not taken against the officials who had permitted irregular expenditure, as required by section 38(1)(h)(iii) of the
PFMA.

STRATEGIC PLANNING AND PERFORMANCE MANAGEMENT

51. Specific information systems were not implemented to enable the monitoring of progress made towards achieving targets, core objec-
tives and service delivery as required by public service regulation 25(1)(e)(i) and (iii).
OTHER INFORMATION
52. The accounting officer is responsible for the other information. The other information comprises the information included in the annual
report which includes the audit committee’s report. The other information does not include the financial statements, the auditor’s report
and those selected programmes presented in the annual performance report that have been specifically reported in this auditor’s report.
53. My opinion on the financial statements and findings on the reported performance information and compliance with legislation do not
cover the other information and I do not express an audit opinion or any form of assurance conclusion thereon.
54. In connection with my audit, my responsibility is to read the other information and, in doing so, consider whether the other information
is materially inconsistent with the financial statements and the selected programmes presented in the annual performance report, or my
knowledge obtained in the audit, or otherwise appears to be materially misstated.
55. If based on the work I have performed, I conclude that there is a material misstatement in this other information, I am required to report
that fact. I have nothing to report in this regard.
INTERNAL CONTROL DEFICIENCIES

56. I considered internal control relevant to my audit of the financial statements, reported performance information and compliance with
applicable legislation; however, my objective was not to express any form of assurance on it. The matters reported below are limited to
the significant internal control deficiencies that resulted in the findings on the annual performance report and the findings on compliance
with legislation included in this report.
57. The accounting officer did not exercise adequate oversight responsibility over internal controls relating to procurement and contract
management and over the preparation of the annual financial statements and annual performance report.
58. Senior management did not ensure that sufficient controls are in place to prepare accurate and complete annual performance report
and annual financial statements that are supported by reliable information.
59. Senior management did not adequately ensure that they perform their responsibilities as outlined in the PFMA to mitigate the risk of
non-compliance with laws and regulations.
MATERIAL IRREGULARITIES
60. In accordance with the PAA and the material irregularities regulations, I have a responsibility to report on material irregularities identified
during the audit.
61. The material irregularities identified are as follows:
MEDICAL CLAIMS NOT PAID WITHIN THE PERIOD SPECIFIED IN THE COURT JUDGEMENT
62. Payments for medical claims were not made within the period specified in the court judgement, as required by treasury regulation 8.2.3.
As a result of the late payments interest was charged, resulting in a material financial loss of R7 977 322, which forms part of the
amount disclosed as interest on litigation in note 24 of the financial statements.
63. The accounting officer has not taken appropriate action in response to being notified of the material irregularity. I recommend that the
accounting officer should take the following actions to address the material irregularity, which should be implemented by 31 January
2020:
• The accounting officer should investigate the fruitless and wasteful expenditure incurred as a result of the interest paid.
• Effective and appropriate disciplinary steps should be taken against any official that the investigation found to be responsible, as
required by section 38(1)(h) of the PFMA and in accordance with treasury regulation 9.1.3.
• Appropriate action should be taken to determine whether the responsible official is liable by law for the losses suffered by the
department for the purpose of recovery, as required by treasury regulations 9.1.4 and 12.7.1.

PROCUREMENT OF V-BLOCKS IT INFRASTRUCTURE WITHOUT INVITING COMPETITIVE BIDS

64. The R538 718 000 contract for Vblocks IT infrastructure was awarded during March 2015 without inviting competitive bids as required
by treasury regulations 16A6.1.
65. An investigation was completed on 28 September 2018 by the accounting officer, concluded that by not following a competitive
bidding process the department suffered a financial loss of R148 921 151 as there were cheaper alternatives.
66. The accounting officer following the recommendation as per the investigation report,
• referred the matter to the National Prosecuting Authority on 24 July 2019 to consider whether criminal charges can be instituted
against the implicated officials.
• referred the matter to the State Attorney on 19 July 2019 to consider possible civil claims against the implicated officials.
• plans to take disciplinary actions against the implicate officials on or before 31 January 2020.
67. I will follow up on the implementation of the planned actions during my next audit.
OTHER REPORTS
68. In addition to the investigations relating to material irregularities, I draw attention to the following engagements conducted by various
parties that had, or could have, an impact on the matters reported in the department’s financial statements, reported performance
information, compliance with applicable legislation and other related matters. These reports did not form part of my opinion on the
financial statements or my findings on the reported performance information or compliance with legislation.
INVESTIGATIONS
69. Various investigations, based on the allegations of procurement irregularities, fraud, theft and negligence, are being performed by the
department dating back from prior periods. Some of these investigations were finalised by the Special Investigation Unit and the depart-
ment whilst others were still in progress at the date of this auditor’s report
Johannesburg
31 August 2019

ANNEXURE – AUDITOR-GENERAL’S RESPONSIBILITY FOR THE AUDIT
1. As part of an audit in accordance with the ISAs, I exercise professional judgement and maintain professional scepticism throughout my
audit of the financial statements, and the procedures performed on reported performance information for selected programmes and
on the department’s compliance with respect to the selected subject matters.
FINANCIAL STATEMENTS
2. In addition to my responsibility for the audit of the financial statements as described in this auditor’s report, I also:
• identify and assess the risks of material misstatement of the financial statements whether due to fraud or error, design and
perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis
for my opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error,
as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control
• obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the
circumstances, but not for the purpose of expressing an opinion on the effectiveness of the department’s internal control
• evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures
made by the accounting officer
• conclude on the appropriateness of the accounting officer’s use of the going concern basis of accounting in the preparation of
the financial statements. I also conclude, based on the audit evidence obtained, whether a material uncertainty exists related to
events or conditions that may cast significant doubt on the department’s ability to continue as a going concern. If I conclude that
a material uncertainty exists, I am required to draw attention in my auditor’s report to the related disclosures in the financial
statements about the material uncertainty or, if such disclosures are inadequate, to modify the opinion on the financial
statements. My conclusions are based on the information available to me at the date of this auditor’s report. However, future
events or conditions may cause a department to cease continuing as a going concern
• evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the
financial statements represent the underlying transactions and events in a manner that achieves fair presentation
COMMUNICATION WITH THOSE CHARGED WITH GOVERNANCE

3. I communicate with the accounting officer regarding, among other matters, the planned scope and timing of the audit and significant
audit findings, including any significant deficiencies in internal control that I identify during my audit.
4. I also confirm to the accounting officer that I have complied with relevant ethical requirements regarding independence, and commu-
nicate all relationships and other matters that may reasonably be thought to have a bearing on my independence and, where applica-
ble, related safeguards.

Appropriation per programme 2018/19 2017/18
Adjusted Shifting of Virement Final Actual Variance Expenditure Final Actual

Appropriation Funds Appropriation Expenditure as % of final Appropriation Expenditure
appropriation
Voted funds and Direct charges R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Programme
1 Administration 1 074 130 - 287 000 1 361 130 1 360 786 344 100,0% 1 085 267 1 085 177
2 District Health Services 15 360 917 - -287 000 15 073 917 14 516 480 557 437 96,3% 13 712 101 13 683 513
3 Emergency Medical Services 1 483 203 - -60 000 1 423 203 1 330 508 92 695 93,5% 1 268 154 1 219 274
4 Provincial Hospital Services 9 030 469 - -284 000 8 746 469 8 686 653 59 816 99,3% 7 892 663 7 892 277
5 Central Hospital Services 16 818 226 - 317 000 17 135 226 17 134 257 969 100,0% 15 333 041 15 316 687
6 Health Sciences and Training 1 123 296 - - 1 123 296 1 106 708 16 588 98,5% 928 471 918 987
7 Health Care Support Services 312 156 - 27 000 339 156 339 048 108 100,0% 289 838 289 767
8 Health Facilities Management 1 559 933 - - 1 559 933 1 536 120 23 813 98,5% 1 683 299 1 607 777
Programme sub total 46 762 330 - - 46 762 330 46 010 560 751 770 98,4% 42 192 834 42 013 459
Statutory Appropriation - - - - - - - - -
Reconciliation with Statement of Financial Performance
Add: Departmental receipts 780 803 546 916
" Actual amounts per Statement of Financial Performance 47 543 133 42 739 750
(Total Revenue) "
" Actual amounts per Statement of Financial Performance
Expenditure " R46 010 560 R42 013 459

Appropriation per economic classification 2018/19 2017/18

appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000

Current payments 42 849 173 - -287 000 42 562 173 42 139 596 422 577 99,0% 38 413 851 38 669 349
1 Compensation of employees 26 994 470 - - 26 994 470 26 902 299 92 171 99,7% 24 965 403 25 085 331
2 Salaries and wages 23 294 170 - -8 000 23 286 170 23 740 315 -454 145 102,0% 21 852 778 22 113 279
3 Social contributions 3 700 300 - 8 000 3 708 300 3 161 984 546 316 85,3% 3 112 625 2 972 052
4 Goods and services 15 854 703 - -287 000 15 567 703 15 229 503 338 200 97,8% 13 448 448 13 583 390
5 Administrative fees 5 137 - - 5 137 4 162 975 81,0% 5 575 4 212
6 Advertising 3 899 - - 3 899 1 819 2 080 46,7% 6 791 2 154
7 Minor assets 98 732 - - 98 732 22 612 76 120 22,9% 105 054 32 319
8 Audit costs: External 23 710 - - 23 710 23 276 434 98,2% 22 368 20 731
Bursaries: Employees 9 139 - - 9 139 1 285 7 854 14,1% 8 622 4 067
Catering: Departmental activities 4 940 - - 4 940 2 332 2 608 47,2% 4 842 2 600
Communication (G&S) 101 021 - - 101 021 70 437 30 584 69,7% 92 948 74 378
Computer services 359 651 - - 359 651 64 711 294 940 18,0% 289 092 264 615
Consultants: Business and advisory services 189 526 - - 189 526 370 023 -180 497 195,2% 215 299 370 900
Laboratory services 2 513 707 - -425 000 2 088 707 2 138 382 -49 675 102,4% 1 541 789 1 535 121
Legal services 17 967 - - 17 967 101 023 -83 056 562,3% 121 452 314 227
Contractors 805 706 - - 805 706 741 416 64 290 92,0% 571 824 536 468
Agency and support / outsourced services 223 617 - - 223 617 245 764 -22 147 109,9% 349 979 255 725
Fleet services (including government motor transport) 323 232 - -60 000 263 232 254 328 8 904 96,6% 237 224 235 509
Inventory: Clothing material and accessories - - - - 2 298 -2 298 - 500 3 918
Inventory: Food and food supplies 380 445 - - 380 445 331 714 48 731 87,2% 342 080 338 723
Inventory: Fuel, oil and gas 218 466 - 8 000 226 466 262 538 -36 072 115,9% 171 642 220 779
Inventory: Learner and teacher support material 3 402 - - 3 402 15 003 -11 601 440,9% 1 652 813
Inventory: Materials and supplies 40 650 - - 40 650 29 593 11 057 72,8% 43 162 37 564


appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Inventory: Medical supplies 2 767 724 - 317 000 3 084 724 3 619 141 (534 417) 117.3% 2 470 058 2 618 205
-
Inventory: Medicine 4 935 506 - 138 000 4 797 506 4 132 206 665 300 86,1% 3 895 518 3 826 095
Inventory: Other supplies 123 698 - - 123 698 121 992 1 706 98,6% 134 388 112 339
Consumable supplies 522 431 - 11 000 533 431 485 743 47 688 91,1% 457 197 452 908
Consumable: Stationery, printing and office supplies 164 545 - - 164 545 166 441 -1 896 101,2% 159 849 152 092
Operating leases 171 019 - - 171 019 173 127 -2 108 101,2% 118 995 143 779
Property payments 1 653 998 - - 1 653 998 1 796 426 -142 428 108,6% 1 932 427 1 965 002
Transport provided: Departmental activity 8 702 - - 8 702 317 8 385 3,6% 13 075 4 875
Travel and subsistence 37 251 - - 37 251 16 518 20 733 44,3% 35 823 22 104
Training and development 58 094 - - 58 094 23 773 34 321 40,9% 48 699 23 391
Operating payments 65 395 - - 65 395 3 062 62 333 4,7% 45 263 5 336
Venues and facilities 22 582 - - 22 582 7 045 15 537 31,2% 4 526 1 457
Rental and hiring 811 - - 811 996 -185 122,8% 735 984
Interest and rent on land - - - - 7 794 -7 794 - - 628
Interest (Incl. interest on unitary payments (PPP)) - - - - 7 794 -7 794 - - 628


appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000

Transfers and subsidies 1 669 969 287 000 1 956 969 2 293 095 336 126 117,2% 1 655 504 1 858 894
Provinces and municipalities 721 989 - - 721 989 721 992 -3 100,0% 739 104 739 104
Municipalities 721 989 - - 721 989 721 992 -3 100,0% 739 104 739 104
Municipal bank accounts 721 989 - - 721 989 721 992 -3 100,0% - -
Municipal agencies and funds - - - - - - - 739 104 739 104
Departmental agencies and accounts 20 962 - - 20 962 20 962 - 100,0% 19 812 19 812
Departmental agencies (non-business entities) 20 962 - - 20 962 20 962 - 100,0% 19 812 19 812
Higher education institutions 13 681 - - 13 681 13 421 260 98,1% 12 061 9 786
Non-profit institutions 664 528 - - 664 528 615 281 49 247 92,6% 698 608 556 250
Households 248 809 - 287 000 535 809 921 439 -385 630 172,0% 185 919 533 942
Payments for capital assets 2 243 187 - - 2 243 187 1 572 106 671 081 70,1% 2 123 479 1 476 113
Buildings and other fixed structures 900 267 - - 900 267 785 617 114 650 87,3% 818 917 615 434
Buildings 900 027 - - 900 027 785 617 114 410 87,3% 818 917 615 434
Other fixed structures 240 - - 240 - 240 - - -
Machinery and equipment 1 342 920 - - 1 342 920 786 489 556 431 58,6% 1 304 562 860 679
Transport equipment 159 710 -5 000 - 154 710 143 970 10 740 93,1% 199 910 139 335
Other machinery and equipment 1 183 210 5 000 - 1 188 210 642 519 545 691 54,1% 1 104 652 721 344
Payment for financial assets - - - - 5 763 -5 763 - - 9 103
46 762 330 - - 46 762 330 46 010 560 751 770 98,4% 42 192 834 42 013 459

Programme 1: Administration 2018/19 2017/18

appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme 21 581 - - 21 581 10 038 11 543 46,5% 20 358 12 349

1 Office of the MEC 1 052 549 - 287 000 1 339 549 1 350 748 -11 199 100,8% 1 064 909 1 072 828
2 Management 1 074 130 - 287 000 1 361 130 1 360 786 344 100,0% 1 085 267 1 085 177
Economic classification 964 214 - - 767 466 196 748 79,6% 1 010 693 907 593
Current payments 436 135 - - 410 609 25 526 94,1% 421 250 381 314
Compensation of employees 360 041 - - 964 214 359 874 167 100,0% 372 816 334 340
Salaries and wages 76 094 - - 436 135 50 735 25 359 66,7% 48 434 46 974
Social contributions 528 079 - - 360 041 356 809 171 270 67,6% 589 443 525 651
Goods and services 1 538 - - 76 094 2 128 -590 138,4% 1 451 1 903
Administrative fees 1 003 - - 528 079 1 311 -308 130,7% 3 956 1 067
Advertising 223 - - 1 538 9 214 4,0% 210 298
Minor assets 23 710 - - 1 003 23 268 442 98,1% 22 368 20 731
Audit costs: External - - - 223 - - - - 56
Bursaries: Employees 566 - - 23 710 203 363 35,9% 628 625
Catering: Departmental activities 21 433 - - - 26 705 -5 272 124,6% 20 086 12 969
Communication (G&S) 348 479 - - 566 62 532 285 947 17,9% 277 831 260 337
Computer services 47 452 - - 21 433 92 570 -45 118 195,1% 80 678 70 767
Consultants: Business and advisory services 16 167 - - 348 479 100 625 -84 458 622,4% 121 452 123 791
Legal services 376 - - 47 452 248 128 66,0% 354 303
Contractors - - - 16 167 - - - - 66
Agency and support / outsourced services 2 710 - - 376 2 849 -139 105,1% 2 557 2 512
Fleet services (including government motor transport) 29 - - - 15 14 51,7% 27 52
Inventory: Food and food supplies 40 - - 2 710 - 40 - 37 50
Inventory: Materials and supplies - - - 29 161 -161 - - 351


appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000

Inventory: Medical supplies - - - - 161 -161 - - 351
Inventory: Medicine - - - - 11 003 -11 003 - - 108
Inventory: Other supplies - - - - 4 667 -4 667 - 2 084 1 489
Consumable supplies 28 757 - - 28 757 118 28 639 0,4% 592 483
Consumable: Stationery, printing and office supplies 4 944 - - 4 944 1 628 3 316 32,9% 7 493 3 268
Property payments 5 990 - - 5 990 4 873 1 117 81,4% 22 840 9 746
Transport provided: Departmental activity 2 - - 2 - 2 - 2 -
Training and development 6 194 - - 6 194 6 865 -671 110,8% 1 175 7 347
Operating payments - - - - - - - - 111
Venues and facilities 1 802 - - 1 802 839 963 46,6% 181 104
Interest and rent on land - - - - 48 -48 - - 628
Interest (Incl. interest on unitary payments (PPP)) - - - - 48 -48 - - 628
Transfers and subsidies 2 450 - 287 000 289 450 588 392 -298 942 203,3% 2 313 165 909
Higher education institutions - - - - 566 -566 - - -
Households 2 450 - 287 000 289 450 587 826 -298 376 203,1% 2 313 165 909
Social benefits 1 074 - - 1 074 1 805 -731 168,1% 1 013 1 637
Other transfers to households 1 376 - 287 000 288 376 586 021 -297 645 203,2% 1 300 164 272
Payments for capital assets 107 466 - - 107 466 4 814 102 652 4,5% 72 261 11 744
Machinery and equipment 107 466 - - 107 466 4 814 102 652 4,5% 72 261 11 744
Transport equipment 4 753 - - 4 753 1 382 3 371 29,1% 4 485 3 549
Other machinery and equipment 102 713 - - 102 713 3 432 99 281 3,3% 67 776 8 195
Payment for financial assets - - - - 114 -114 - - -69
1 074 130 - 287 000 1 361 130 1 360 786 344 100,0% 1 085 267 1 085 177

Subprogramme: 1.1: Office of the MEC 2018/19 2017/18

appropriation
Economic classification R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Current payments 20 918 - - 20 918 9 618 11 300 46,0% 19 732 11 647

Compensation of employees 16 059 - - 16 059 8 399 7 660 52,3% 15 150 10 265
Social contributions 1 558 - - 1 558 825 733 53,0% 1 470 921
Goods and services 4 859 - - 4 859 1 219 3 640 25,1% 4 582 1 382
Administrative fees 108 - - 108 - 108 - 102 10
Minor assets 33 - - 33 5 28 15,2% 31 -
Catering: Departmental activities 100 - - 100 34 66 34,0% 93 61
Communication (G&S) 303 - - 303 - 303 - 286 33
Fleet services (including government motor transport) 412 - - 412 254 158 61,7% 389 480
Inventory: Food and food supplies 29 - - 29 2 27 6,9% 27 11
Inventory: Materials and supplies - - - - - - - - 33
Inventory: Other supplies - - - - - - - - 1
Consumable supplies 67 - - 67 8 59 11,9% 63 24

Subprogramme: 1.1: Office of the MEC 2018/19 2017/18

appropriation
Consumable: Stationery, printing and office supplies 506 - - 506 37 469 7,3% 477 56
Operating leases - - - - 626 -626 - - 506
Travel and subsistence 3 113 - - 3 113 240 2 873 7,7% 2 937 112
Venues and facilities 170 - - 170 13 157 7,6% 160 54
Rental and hiring 18 - - 18 - 18 - 17 -
Transfers and subsidies - - - - 76 -76 - - -
Households - - - - 76 -76 - - -
Social benefits - - - 76 -76 - - -
Payments for capital assets 663 - - 663 303 360 45,7% 626 702
Machinery and equipment 663 - - 663 303 360 45,7% 626 702
Transport equipment 513 - - 513 238 275 46,4% 485 534
Other machinery and equipment 150 - - 150 65 85 43,3% 141 168
Payment for financial assets - - - - 41 -41 - - -
Total 21 581 - - 21 581 10 038 11 543 46,5% 20 358 12 349

Subprogramme: 1.2: Management

2018/19 2017/18
appropriation
Salaries and wages 345 540 345 540 352 300 (6 760) 102,0% 359 136 324 996
Social contributions 74 536 74 536 49 910 24 626 67,0% 46 964 46 053
Administrative fees 1 430 1 430 2 128 (698) 148,8% 1 349 1 893
Advertising 1 003 1 003 1 311 (308) 130,7% 3 956 1 067
Minor assets 190 190 4 186 2,1% 179 298
Audit costs: External 23 710 23 710 23 268 442 98,1% 22 368 20 731
Bursaries: Employees - - - - - - 56
Catering: Departmental activities 466 466 169 297 36,3% 535 564
Communication (G&S) 21 130 21 130 26 705 (5 575) 126,4% 19 800 12 936
Computer services 348 479 348 479 62 532 285 947 17,9% 277 831 260 337
Consultants: Business and advisory services 47 452 47 452 92 570 (45 118) 195,1% 80 678 70 767
Legal services 16 167 16 167 100 625 (84 458) 622,4% 121 452 123 791
Contractors 376 376 248 128 66,0% 354 302
Agency and support / outsourced services - - - - - - 66
Fleet services (including government motor transport) 2 298 2 298 2 595 (297) 112,9% 2 168 2 032
Inventory: Food and food supplies - - 13 (13) - - 41
Inventory: Fuel, oil and gas - - - - - 13 -
Inventory: Materials and supplies 40 40 - 40 - 37 17
Inventory: Medical supplies - - 161 (161) - - 351
Inventory: Medicine - - 11 003 (11 003) - - 108
Inventory: Other supplies - - 4 667 (4 667) - 2 084 1 488
Consumable supplies 28 690 28 690 110 28 580 0,4% 529 459
Consumable: Stationery, printing and office supplies 4 438 4 438 1 591 2 847 35,8% 7 016 3 212

Subprogramme: 1.2: Management

2018/19 2017/18
appropriation
Operating leases 8 528 8 528 9 342 (814) 109,5% 15 381 2 894
Property payments 5 990 5 990 4 873 1 117 81,4% 22 840 9 746
Transport provided: Departmental activity 2 2 - 2 - 2 -
Travel and subsistence 4 830 4 830 3 626 1 204 75,1% 4 927 3 271
Training and development 6 194 6 194 6 865 (671) 110,8% 1 175 7 347
Operating payments - - - - - - 111
Venues and facilities 1 632 1 632 826 806 50,6% 21 50
Rental and hiring 175 175 358 (183) 204,6% 166 334
Interest and rent on land - - - - 48 (48) - - 628
Interest (Incl. interest on unitary payments (PPP)) - 48 (48) - - 628
Transfers and subsidies 2 450 - 287 000 289 450 588 316 (298 866) 203,3% 2 313 165 909
Higher education institutions - 566 (566) - -
Households 2 450 - 287 000 289 450 587 750 (298 300) 203,1% 2 313 165 909
Social benefits 1 074 1 074 1 729 (655) 161,0% 1 013 1 637
Other transfers to households 1 376 287 000 288 376 586 021 (297 645) 203,2% 1 300 164 272
Transport equipment 4 240 4 240 1 144 3 096 27,0% 4 000 3 015
Other machinery and equipment 102 563 102 563 3 367 99 196 3,3% 67 635 8 027
Payment for financial assets - 73 (73) - - (69)
Total 1 052 549 - 287 000 1 339 549 1 350 748 (11 199) 100,8% 1 064 909 1 072 828

Programme 2: District Health Services 2018/19 2017/18

appropriation
Sub programme
District Management 505 175 - - 505 175 527 767 -22 592 104,5% 516 536 524 552
Community Health Clinics 2 472 905 - - 2 472 905 2 382 980 89 925 96,4% 2 425 500 2 416 248
Community Health Centres 2 001 669 - - 2 001 669 1 941 214 60 455 97,0% 1 778 040 1 792 265
Community Based Services 1 996 989 - - 1 996 989 2 082 026 -85 037 104,3% 1 780 080 1 780 657
HIV, AIDS 4 465 616 - - 4 465 616 4 096 480 369 136 91,7% 3 957 203 3 890 431
Nutrition 58 548 - - 58 548 55 993 2 555 95,6% 55 583 49 557
Coroner Services 240 133 - - 240 133 225 305 14 828 93,8% 215 243 214 321
District Hospitals 3 619 882 - -287 000 3 332 882 3 204 715 128 167 96,2% 2 983 916 3 015 482
15 360 917 - -287 000 15 073 917 14 516 480 557 437 96,3% 13 712 101 13 683 513
Economic classification
Current payments 14 367 406 - -287 000 14 080 406 13 566 475 513 931 96,4% 12 688 348 12 713 689
Compensation of employees 7 795 903 - - 7 795 903 7 762 182 33 721 99,6% 7 093 354 7 155 763
Salaries and wages 6 699 920 - - 6 699 920 6 759 196 -59 276 100,9% 6 155 015 6 219 445
Social contributions 1 095 983 - - 1 095 983 1 002 986 92 997 91,5% 938 339 936 318
Goods and services 6 571 503 - -287 000 6 284 503 5 804 293 480 210 92,4% 5 594 994 5 557 926
Administrative fees 798 - - 798 223 575 27,9% 910 370
Advertising 564 - - 564 330 234 58,5% 1 318 220
Minor assets 25 489 - - 25 489 11 421 14 068 44,8% 27 215 14 487
Catering: Departmental activities 3 930 - - 3 930 2 070 1 860 52,7% 3 630 1 807
Computer services - - - - 15 -15 - - 1 032
Consultants: Business and advisory services 29 080 - - 29 080 29 397 -317 101,1% 29 324 35 217
Laboratory services 1 153 872 - -275 000 878 872 956 687 -77 815 108,9% 756 855 840 331
Legal services - - - - - - - - 6 047


appropriation
Contractors 578 780 - - 578 780 423 037 155 743 73,1% 354 331 346 772
Agency and support / outsourced services 61 179 - - 61 179 30 978 30 201 50,6% 60 903 43 563
Fleet services (including government motor transport) 33 295 - - 33 295 24 009 9 286 72,1% 38 571 34 116
Inventory: Clothing material and accessories - - - - 677 -677 - - 1 807
Inventory: Fuel, oil and gas 75 711 - - 75 711 74 673 1 038 98,6% 85 872 52 088
Inventory: Learner and teacher support material - - - - 4 333 -4 333 - 43 -
Inventory: Medical supplies 536 755 - - 536 755 484 008 52 747 90,2% 525 976 463 091
Inventory: Medicine 3 158 696 -12 000 3 146 696 3 021 249 125 447 96,0% 2 785 627 2 872 048
Inventory: Other supplies 29 057 - - 29 057 21 316 7 741 73,4% 35 662 35 706
Consumable supplies 129 624 - - 129 624 82 042 47 582 63,3% 126 894 107 703
Property payments 374 169 - - 374 169 433 510 -59 341 115,9% 453 437 463 037
Transport provided: Departmental activity 1 821 - - 1 821 10 1 811 0,5% 2 145 200
Training and development 39 696 - - 39 696 4 326 35 370 10,9% 34 671 8 428
Operating payments 59 827 - - 59 827 438 59 389 0,7% 39 638 673
Venues and facilities 15 830 - - 15 830 6 206 9 624 39,2% 4 345 1 235


appropriation
Transfers and subsidies 874 495 - - 874 495 825 077 49 418 94,3% 802 260 834 240
Provinces and municipalities 383 475 - - 383 475 383 478 -3 100,0% 361 769 361 769
Municipalities 383 475 - - 383 475 383 478 -3 100,0% 361 769 361 769
Municipal bank accounts 383 475 - - 383 475 383 478 -3 100,0% - -
Non-profit institutions 464 528 - - 464 528 415 281 49 247 89,4% 411 459 406 250
Households 26 492 - - 26 492 26 318 174 99,3% 29 032 66 221
Social benefits 26 492 - - 26 492 26 150 342 98,7% 29 032 27 644
Other transfers to households - - - - 168 -168 - - 38 577
Payments for capital assets 119 016 - - 119 016 122 969 -3 953 103,3% 221 493 133 457
Buildings and other fixed structures 240 - - 240 - 240 - - -
Other fixed structures 240 - - 240 - 240 - - -
Machinery and equipment 118 776 - - 118 776 122 969 -4 193 103,5% 221 493 133 457
Transport equipment 31 688 - - 31 688 50 573 -18 885 159,6% 50 142 32 913
- - - - 1 959 -1 959 - - 2 127
Payment for financial assets 15 360 917 - -287 000 15 073 917 14 516 480 557 437 96,3% 13 712 101 13 683 513

Subprogramme: 2.1: District Management

2018/19 2017/18
appropriation
Salaries and wages 309 394 309 394 296 346 13 048 95,8% 314 398 296 167
Goods and services 125 118 - - 125 118 137 336 (12 218) 109,8% 113 250 147 536
Administrative fees 135 135 5 130 3,7% 103 63
Advertising 153 153 1 152 0,7% 467 5
Minor assets 500 500 350 150 70,0% 3 217 1 789
Communication (G&S) 8 366 8 366 4 874 3 492 58,3% 8 950 9 940
Computer services - - - - - - 880
Consultants: Business and advisory services - - 15 (15) - - 6
Legal services - - - - - - 76
Contractors 2 788 2 788 94 2 694 3,4% 1 868 416
Agency and support / outsourced services 1 033 1 033 286 747 27,7% 1 039 1 045
Inventory: Clothing material and accessories - - - - - - 362
Inventory: Food and food supplies 1 307 1 307 382 925 29,2% 1 752 560
Inventory: Fuel, oil and gas 3 104 3 104 2 197 907 70,8% 1 029 1 598
Inventory: Learner and teacher support material - - - - - - -
Inventory: Materials and supplies 1 890 1 890 189 1 701 10,0% 1 728 2 301
Inventory: Medical supplies 12 939 12 939 35 336 (22 397) 273,1% 10 398 33 277
Inventory: Medicine - - - - - - 64
Inventory: Other supplies 3 080 3 080 2 891 189 93,9% 3 955 7 568
Consumable supplies 7 436 7 436 3 828 3 608 51,5% 9 551 4 716

Subprogramme: 2.1: District Management

2018/19 2017/18
appropriation
Consumable: Stationery, printing and office supplies 16 019 16 019 16 365 (346) 102,2% 9 840 14 956
Operating leases 18 848 18 848 18 547 301 98,4% 16 325 31 307
Property payments 28 666 28 666 36 049 (7 383) 125,8% 30 366 19 993
Transport provided: Departmental activity 100 100 - 100 - 550 -
Training and development 1 713 1 713 45 1 668 2,6% 1 522 291
Operating payments 172 172 1 171 0,6% 80 16
Venues and facilities 6 020 6 020 5 991 29 99,5% 5 1
Rental and hiring 52 52 - 52 - 52 -
Transfers and subsidies 2 330 - - 2 330 2 007 323 86,1% 1 904 2 790
Households 2 330 - - 2 330 2 007 323 86,1% 1 904 2 790
Social benefits 2 330 2 330 2 007 323 86,1% 1 904 2 588
Other transfers to households - - - - - - 202
Payments for capital assets 19 937 - - 19 937 45 700 (25 763) 229,2% 40 327 31 388
Machinery and equipment 19 937 - - 19 937 45 700 (25 763) 229,2% 40 327 31 388
Transport equipment 12 494 12 494 41 845 (29 351) 334,9% 16 226 21 563
Payment for financial assets - 416 (416) - - 284
Total 505 175 - - 505 175 527 767 (22 592) 104,5% 516 536 524 552

Subprogramme: 2.2: Community Health Clinics 2018/19 2017/18

appropriation
Current payments 2 122 143 - - 2 122 143 2 025 577 96 566 95,4% 2 067 798 2 055 693
Compensation of employees 1 272 718 - - 1 272 718 1 280 266 -7 548 100,6% 1 205 239 1 193 224
Salaries and wages 1 103 942 - - 1 103 942 1 096 654 7 288 99,3% 1 049 989 1 017 627
Social contributions 168 776 - - 168 776 183 612 -14 836 108,8% 155 250 175 597
Administrative fees - - - - 1 -1 - 20 6
Minor assets 5 221 - - 5 221 3 424 1 797 65,6% 6 210 4 660
Consultants: Business and advisory services - - - - - - - 500 316
Laboratory services 93 601 93 601 98 787 -5 186 105,5% 82 087 50 936
Legal services - - - - - - - - 426
Contractors 2 398 - - 2 398 7 963 -5 565 332,1% 5 443 6 001
Agency and support / outsourced services 3 368 - - 3 368 1 209 2 159 35,9% 2 235 1 284
Fleet services (including government motor transport) 100 - - 100 73 27 73,0% 4 656 705
Inventory: Clothing material and accessories - - - - 6 -6 - - 62
Inventory: Fuel, oil and gas 3 166 - - 3 166 1 018 2 148 32,2% 10 921 2 273
Inventory: Materials and supplies 1 578 - - 1 578 1 073 505 68,0% 2 365 1 766
Inventory: Medical supplies 50 000 - - 50 000 25 028 24 972 50,1% 93 257 36 805
Inventory: Medicine 500 947 - - 500 947 450 872 50 075 90,0% 445 250 569 779
Inventory: Other supplies 2 068 - - 2 068 1 157 911 55,9% 1 996 2 523
Consumable supplies 13 800 - - 13 800 8 561 5 239 62,0% 21 267 9 752
Operating leases 2 989 - - 2 989 1 720 1 269 57,5% 3 114 1 074

Subprogramme: 2.2: Community Health Clinics 2018/19 2017/18

appropriation
Operating leases 2 989 2 989 1 720 1 269 57,5% 3 114 1 074
Transport provided: Departmental activity - - - - - 50 25
Travel and subsistence 435 435 94 341 21,6% 884 43
Training and development 474 474 - 474 - 451 3
Rental and hiring - - 69 (69) - -
Transfers and subsidies 335 762 - - 335 762 336 893 (1 131) 100,3% 318 848 333 412
Provinces and municipalities 316 463 - - 316 463 316 463 - 100,0% 298 550 298 550
Municipalities 316 463 - - 316 463 316 463 - 100,0% 298 550 298 550
Municipal bank accounts 316 463 316 463 316 463 - 100,0% -
Municipal agencies and funds - - - - 298 550 298 550
Non-profit institutions 13 308 13 308 13 115 193 98,5% 12 578 12 578
Households 5 991 - - 5 991 7 315 (1 324) 122,1% 7 720 22 284
Social benefits 5 991 5 991 7 315 (1 324) 122,1% 7 720 4 851
Other transfers to households - - - - - 17 433
Transport equipment 450 450 208 242 46,2% 2 500 90
Other machinery and equipment 14 550 14 550 19 766 (5 216) 135,8% 36 354 26 643
Total 2 472 905 - - 2 472 905 2 382 980 89 925 96,4% 2 425 500 2 416 248

Subprogramme: 2.3: Community Health Centres

2018/19 2017/18
appropriation
Salaries and wages 1 246 062 1 246 062 1 192 485 53 577 95,7% 1 068 542 1 097 011
Administrative fees 10 10 15 (5) 150,0% 14 12
Minor assets 4 795 4 795 1 714 3 081 35,7% 6 666 2 458
Catering: Departmental activities - - - - - - 1
Computer services - - 15 (15) - - 37
Consultants: Business and advisory services - - - - - - -
Laboratory services 47 800 47 800 41 847 5 953 87,5% 21 981 21 256
Scientific and technological services - - - - - - -
Contractors 7 495 7 495 4 910 2 585 65,5% 4 714 4 823
Agency and support / outsourced services 4 955 4 955 3 259 1 696 65,8% 4 529 2 576
Inventory: Clothing material and accessories - - 1 (1) - - 277
Inventory: Farming supplies - - - - - - -
Inventory: Food and food supplies 2 813 2 813 298 2 515 10,6% 1 940 701
Inventory: Fuel, oil and gas 20 410 20 410 17 115 3 295 83,9% 18 338 5 381
Inventory: Materials and supplies 2 591 2 591 1 544 1 047 59,6% 1 421 834
Inventory: Medical supplies 25 508 25 508 20 931 4 577 82,1% 44 438 23 890
Inventory: Medicine 231 976 231 976 287 513 (55 537) 123,9% 248 854 248 265
Inventory: Other supplies 3 701 3 701 1 621 2 080 43,8% 2 446 2 714

Subprogramme: 2.3: Community Health Centres 2018/19 2017/18

appropriation

Operating leases 7 852 7 852 12 609 (4 757) 160,6% 847 6 219
Transport provided: Departmental activity - - - - - - -
Travel and subsistence 164 164 199 (35) 121,3% 50 241
Operating payments 26 26 55 (29) 211,5% 441 85
Non-profit institutions - - - 16
Households 7 056 - - 7 056 5 718 1 338 81,0% 6 718 6 893
Social benefits 7 056 7 056 5 718 1 338 81,0% 6 718 6 665
Other transfers to households - - - - - 228
Transport equipment 1 918 1 918 2 205 (287) 115,0% 16 547 5 321
Heritage assets - - - -
Total 2 001 669 - - 2 001 669 1 941 214 60 455 97,0% 1 778 040 1 792 265

Subprogramme: 2.4: Community Based Services 2018/19 2017/18

Subprogramme: 2.4: Community Based Services
2018/19 2017/18
Adjusted
Appropriation Shifting of
Funds Virement Final
Appropriation Actual
Expenditure Variance Expenditure Final
as % of final Appropriation Actual
Expenditure
appropriation
appropriation
Economicclassification
Economic classification R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 %% R'000
R'000 R'000
R'000
Current payments 1 648 673 - - 1 648 673 1 804 812 (156 139) 109,5% 1 512 352 1 513 178
Compensation of employees 1 238 350 - - 1 238 350 1 245 490 (7 140) 100,6% 1 081 261 1 121 509
Salaries and wages 1 076 549 1 076 549 1 122 091 (45 542) 104,2% 947 070 1 006 818
Advertising 220 220 - 220 - 600 20
Minor assets 2 309 2 309 314 1 995 13,6% 2 205 1 622
Catering: Departmental activities 1 262 1 262 119 1 143 9,4% 1 458 768
Consultants: Business and advisory services - - 333 (333) - - -
Laboratory services 4 014 4 014 4 726 (712) 117,7% 6 648 2 572
Contractors 7 022 7 022 3 808 3 214 54,2% 6 369 3 813
Agency and support / outsourced services 2 091 2 091 971 1 120 46,4% 922 562
Inventory: Food and food supplies 10 390 10 390 12 017 (1 627) 115,7% 10 228 14 132
Inventory: Fuel, oil and gas 4 954 4 954 5 824 (870) 117,6% 15 657 7 567
Inventory: Materials and supplies 644 644 70 574 10,9% 1 377 1 085
Inventory: Other supplies 593 593 402 191 67,8% 1 084 428

Subprogramme: 2.4: Community Based Services 2018/19 2017/18

appropriation
Consumable supplies 7 978 7 978 (3 870) 11 848 (48,5%) 5 960 5 281
Consumable: Stationery, printing and office supplies 3 313 3 313 2 332 981 70,4% 5 157 4 096
Operating leases 1 098 1 098 276 822 25,1% 788 319
Transport provided: Departmental activity 774 774 - 774 - 568 24
Training and development 3 130 3 130 1 067 2 063 34,1% 2 584 1 077
Venues and facilities - - - - - 50
Rental and hiring 36 36 - 36 - -
Non-profit institutions 313 408 313 408 272 531 40 877 87,0% 257 338 257 151
Households 2 113 - - 2 113 2 354 (241) 111,4% 2 760 4 736
Social benefits 2 113 2 113 2 265 (152) 107,2% 2 760 2 638
Other transfers to households - - 89 (89) - - 2 098
Transport equipment 3 888 3 888 119 3 769 3,1% 824 28
Total 1 996 989 - - 1 996 989 2 082 026 (85 037) 104,3% 1 780 080 1 780 657

Subprogramme: 2.5: HIV, AIDS

2018/19 2017/18
appropriation
Compensation of employees 894 538 - - 894 538 935 210 (40 672) 104,5% 896 112 842 421
Goods and services 3 416 300 - - 3 416 300 3 017 262 399 038 88,3% 2 886 004 2 890 682
Administrative fees 6 6 - 6 - 29 9
Advertising - - 329 (329) - - 170
Minor assets 72 72 (26) 98 (36,1%) 366 304
Catering: Departmental activities 1 752 1 752 1 719 33 98,1% 1 222 563
Communication (G&S) 759 759 17 742 2,2% 279 28
Consultants: Business and advisory services 29 000 29 000 28 843 157 99,5% 28 700 34 697
Laboratory services 617 532 617 532 701 951 (84 419) 113,7% 600 444 720 171
Contractors 538 941 538 941 391 732 147 209 72,7% 316 320 316 433
Agency and support / outsourced services 11 500 11 500 1 214 10 286 10,6% 11 550 -
Fleet services (including government motor transport) 809 809 28 781 3,5% 1 132 75
Inventory: Food and food supplies 13 631 13 631 6 849 6 782 50,2% 6 239 5 902
Inventory: Materials and supplies 1 1 4 (3) 400,0% 1 62
Inventory: Medicine 2 027 533 2 027 533 1 746 195 281 338 86,1% 1 654 234 1 632 219
Inventory: Other supplies - - 2 (2) - 1 477 5

Subprogramme: 2.5: HIV, AIDS 2018/19 2017/18

appropriation
Consumable supplies 6 742 6 742 6 507 235 96,5% 14 722 21 356

Operating leases - - 19 (19) - - 101
Property payments (112 472) (112 472) 659 (113 131) (0,6%) 1 953 799
Travel and subsistence 2 888 2 888 2 282 606 79,0% 2 616 1 292
Training and development 30 521 30 521 2 973 27 548 9,7% 27 166 6 697
Operating payments 58 134 58 134 165 57 969 0,3% 37 044 24
Venues and facilities 9 310 9 310 11 9 299 0,1% 3 790 871
Rent on land - - - -
Provinces and municipalities 67 012 - - 67 012 67 015 (3) 100,0% 63 219 63 219
Municipalities 67 012 - - 67 012 67 015 (3) 100,0% 63 219 63 219
Municipal bank accounts 67 012 67 012 67 015 (3) 100,0% -
Municipal agencies and funds - - - 63 219 63 219
Households 1 200 - - 1 200 1 783 (583) 148,6% 2 995 2 704
Social benefits 1 200 1 200 1 783 (583) 148,6% 2 995 2 704
Buildings and other fixed structures 240 - - 240 - 240 - - -
Other fixed structures 240 240 240 - -
Transport equipment 550 550 25 525 4,5% - 19
Total 4 465 616 - - 4 465 616 4 096 480 369 136 91,7% 3 957 203 3 890 431

Subprogramme: 2.6: Nutrition

2018/19 2017/18
appropriation
Current payments - - - - 10 (10) - - -
Compensation of employees - - - - 10 (10) - - -
Salaries and wages - 10 (10) -
Total 58 548 - - 58 548 55 993 2 555 95,6% 55 583 49 557
Subprogramme: 2.7: Coroner Services appropriation
Salaries and wages 165 877 165 877 165 655 222 99,9% 152 715 158 206
Advertising 90 90 - 90 - 158 24
Minor assets 567 567 77 490 13,6% 535 193
Communication (G&S) 1 661 1 661 305 1 356 18,4% 1 777 558
Consultants: Business and advisory services - - - - - 52 25

Subprogramme: 2.7: Coroner Services 2018/19 2017/18

appropriation
Laboratory services 592 592 56 536 9,5% 275 211
Contractors 821 821 118 703 14,4% 775 78
Agency and support / outsourced services 2 022 2 022 855 1 167 42,3% 1 908 1 075
Fleet services (including government motor transport) 5 056 5 056 6 607 (1 551) 130,7% 4 770 5 142
Inventory: Fuel, oil and gas - - 5 (5) - 30 5
Inventory: Materials and supplies 282 282 72 210 25,5% 394 111
Inventory: Medicine 38 38 3 35 7,9% - 16
Inventory: Other supplies 50 50 5 45 10,0% - 5
Consumable: Stationery, printing and office supplies 1 000 1 000 1 179 (179) 117,9% 924 1 040
Operating leases - - - - - - -
Property payments 12 500 12 500 12 770 (270) 102,2% 11 827 11 813
Transport provided: Departmental activity - - - - - - -
Venues and facilities 500 500 204 296 40,8% 500 363
Transfers and subsidies 637 - - 637 391 246 61,4% 175 952
Households 637 - - 637 391 246 61,4% 175 952
Social benefits 637 637 391 246 61,4% 175 952
Other transfers to households - - - -
Transport equipment 4 103 4 103 3 256 847 79,4% 3 870 1 081
Total 240 133 - - 240 133 225 305 14 828 93,8% 215 243 214 321

Subprogramme: 2.8: District Hospitals

2018/19 2017/18
appropriation
Current payments 3 588 129 - (287 000) 3 301 129 3 163 568 137 561 95,8% 2 916 012 2 950 870
Salaries and wages 2 054 940 2 054 940 2 077 131 (22 191) 101,1% 1 872 911 1 914 934
Goods and services 1 193 335 - (287 000) 906 335 777 414 128 921 85,8% 757 538 746 939
Advertising 101 101 - 101 - 93 1
Minor assets 12 025 12 025 5 568 6 457 46,3% 8 016 3 461
Catering: Departmental activities 52 52 - 52 - 200 3
Consultants: Business and advisory services 80 80 206 (126) 257,5% 72 173
Laboratory services 390 333 (275 000) 115 333 109 320 6 013 94,8% 45 420 45 185
Legal services - - - - - - 5 156
Contractors 19 315 19 315 14 412 4 903 74,6% 18 842 15 208
Fleet services (including government motor transport) 14 481 14 481 3 256 11 225 22,5% 9 533 4 440
Inventory: Clothing material and accessories - - 637 (637) - - 1 069
Inventory: Fuel, oil and gas 44 077 44 077 48 514 (4 437) 110,1% 39 897 35 264
Inventory: Learner and teacher support material - - 4 333 (4 333) - 43 -
Inventory: Materials and supplies 8 681 8 681 2 663 6 018 30,7% 10 082 6 450

Subprogramme: 2.8: District Hospitals 2018/19 2017/18

appropriation
Inventory: Medicine 133 457 (12 000) 121 457 106 119 15 338 87,4% 146 588 146 564
Operating leases 6 299 6 299 13 227 (6 928) 210,0% 5 424 4 493
Transport provided: Departmental activity 947 947 10 937 1,1% 977 151
Travel and subsistence 1 206 1 206 563 643 46,7% 1 238 330
Training and development 2 558 2 558 241 2 317 9,4% 2 214 280
Rental and hiring - - 445 (445) - - 437
Transfers and subsidies 7 165 - - 7 165 6 750 415 94,2% 6 760 25 862
Households 7 165 - - 7 165 6 750 415 94,2% 6 760 25 862
Social benefits 7 165 7 165 6 671 494 93,1% 6 760 7 246
Other transfers to households - 79 (79) - - 18 616
Total 3 619 882 - (287 000) 3 332 882 3 204 715 128 167 96,2% 2 983 916 3 015 482

Programme 3: Emergency Medical Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 Emergency Transport 1 313 364 - (60 000) 1 253 364 1 168 905 84 459 93,3% 1 158 460 1 125 937
2 Planned Patient Transport 169 839 - - 169 839 161 603 8 236 95,2% 109 694 93 337
1 483 203 - (60 000) 1 423 203 1 330 508 92 695 93,5% 1 268 154 1 219 274
Current payments 996 466 - (60 000) 936 466 890 319 46 147 95,1% 759 074 745 181
Goods and services 406 839 - (60 000) 346 839 333 258 13 581 96,1% 271 874 260 896
Administrative fees 2 412 - - 2 412 1 608 804 66,7% 2 811 1 600
Advertising 1 500 - - 1 500 8 1 492 0,5% - -
Minor assets 8 610 - - 8 610 301 8 309 3,5% 5 010 2 074
Computer services 512 - - 512 - 512 - 504 52
Legal services 1 800 - - 1 800 110 1 690 6,1% - 146
Contractors 10 534 - - 10 534 21 250 (10 716) 201,7% 4 234 2 095
Agency and support / outsourced services 1 028 - - 1 028 412 616 40,1% 1 228 983
Fleet services (including government motor transport) 267 037 - (60 000) 207 037 213 478 (6 441) 103,1% 176 012 179 728
Inventory: Clothing material and accessories - - - - 347 (347) - - 37
Inventory: Materials and supplies 546 - - 546 126 420 23,1% 2 212 28
Inventory: Medical supplies 20 844 - - 20 844 43 615 (22 771) 209,2% 24 526 20 911
Inventory: Medicine 1 150 - - 1 150 (8 455) 9 605 (735,2%) 588 393

Programme 3: Emergency Medical Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
Inventory:
1 Emergency Other supplies
Transport 1 313257
364 - -
(60 000) 1 253257
364 36
1 168 905 84221
459 14,0%
93,3% -
1 158 460 -
1 125 937
Consumable
2 Planned supplies
Patient Transport 9 974
169 839 - - 9 974
169 839 13 603
161 698 (3 724)
8 236 137,3%
95,2% 5 728
109 694 5 679
93 337
Consumable: Stationery, printing and office supplies 7 853
1 483 203 - - -
(60 000) 7 853
1 423 203 6 106
1 330 508 192747
695 77,8%
93,5% 6 353
1 268 154 6 569
1 219 274
Operating leases 37 117 - - 37 117 22 952 14 165 61,8% 12 904 13 060
Transport provided: Departmental activity
Economic classification 5 910 - - 5 910 238 5 672 4,0% 8 910 4 512
Travel
Current and subsistence
payments 996286
466 - -
(60 000) 936286
466 890205
319 81
46 147 71,7%
95,1% 1 059
759 074 745749
181
Training and development
Compensation of employees 589690
627 - - 589690
627 80
552 681 36610
946 11,6%
93,7% 487687
200 484147
285
Venues and
Salaries and facilities
wages 491660
415 - - 491660
415 -
462 344 29660
071 -
94,1% -
402 814 -
402 683
Interest
Social and rent on land
contributions -
98 212 - - -
98 212 4 380
90 337 (4 380)
7 875 -
92,0% -
84 386 -
81 602
Interest
Goods and(Incl. interest on unitary payments (PPP))
services 406 839- - -
(60 000) 346 839- 4 380
333 258 (4 380)
13 581 -
96,1% 271 874- 260 896-
Transfers and subsidies
Administrative fees 341 164
2 412 - - 341 164
2 412 339 659
1 608 1 804
505 99,6%
66,7% 379 835
2 811 379 207
1 600
Provinces and municipalities
Advertising 338 514
1 500 - - 338 514
1 500 338 514
8 -
1 492 100,0%
0,5% 377 335
- 377 335
-
Municipalities
Minor assets 338 514
8 610 - - 338 514
8 610 338301
514 -
8 309 100,0%
3,5% 377 335
5 010 377 335
2 074
Municipal
Catering: bank accounts
Departmental activities 338 514
50 - - 338 514
50 338 514
16 -
34 100,0%
32,0% 71- 70-
Municipal agencies
Communication (G&S) and funds -
6 934 - - -
6 934 -
2 581 -
4 353 -
37,2% 377 335
2 434 377 335
2 342
Households
Computer services 2 512
650 - - 2 512
650 1 145
- 1 512
505 43,2%
- 2 504
500 1 872
52
Social
Legal benefits
services 2 800
1 650 - - 2 800
1 650 1 110
145 505
1 690 43,2%
6,1% 2 500
- 1 146
336
Other transfers to households
Contractors -
10 534 - - -
10 534 -
21 250 -
(10 716) -
201,7% 4 234- 536
2 095
Payments
Agencyfor
andcapital assets
support / outsourced services 145 573
1 028 - - 145 573
1 028 100412
388 45616
185 69,0%
40,1% 129 245
1 228 94983
613
Machinery and equipment
Fleet services (including government motor transport) 145 573
267 037 - -
(60 000) 145 573
207 037 100 478
213 388 45 185
(6 441) 69,0%
103,1% 129 012
176 245 94 613
179 728
TransportClothing
Inventory: equipment
material and accessories 95 933
- - - 95 933
- 85347
296 10(347)
637 88,9%
- 121 000
- 81 485
37
Other machinery
Inventory: Food and and equipment
food supplies 49 640
15 - - 49 640
15 15 092
4 34 548
11 30,4%
26,7% 8 245
15 13 128
6
Payment for financial
Inventory: Materialsassets
and supplies -
546 - - -
546 142
126 (142)
420 -
23,1% -
2 212 273
28
Inventory: Medical supplies 20 844
1 483 203 - - -
(60 000) 20 844
1 423 203 43 615
1 330 508 (22
92771)
695 209,2%
93,5% 24 526
1 268 154 20 911
1 219 274
Inventory: Medicine 1 150 - - 1 150 (8 455) 9 605 (735,2%) 588 393

Subprogramme: 3.1: Emergency Transport

2018/19 2017/18
appropriation
Goods and services 317 584 - (60 000) 257 584 239 761 17 823 93,1% 238 237 227 592
Administrative fees 2 412 2 412 1 608 804 66,7% 2 811 1 600
Advertising 1 500 1 500 8 1 492 0,5% - -
Minor assets 8 610 8 610 301 8 309 3,5% 5 010 2 074
Computer services 512 512 - 512 - 504 52
Legal services 1 800 1 800 110 1 690 6,1% - 146
Contractors 10 534 10 534 21 250 (10 716) 201,7% 4 234 2 095
Agency and support / outsourced services 1 028 1 028 412 616 40,1% 1 228 983
Fleet services (including government motor transport) 183 692 (60 000) 123 692 120 007 3 685 97,0% 151 285 151 200
Inventory: Food and food supplies 15 15 4 11 26,7% 15 6
Inventory: Fuel, oil and gas 1 265 1 265 1 217 48 96,2% - -
Inventory: Materials and supplies 546 546 126 420 23,1% 2 212 28
Inventory: Medicine 1 150 1 150 (8 455) 9 605 (735,2%) 588 393

Subprogramme: 3.1: Emergency Transport

2018/19 2017/18
appropriation
Current payments
Inventory: Other supplies 827 227
257 - (60 000) 767 227
257 729 034
36 38 193
221 95,0%
14,0% 649 980- 652 026-
Compensation of employees
Consumable supplies 509 643
9 974 - - 509
9 643
974 487
13 823
698 21
(3 820
724) 95,7%
137,3% 411
5 743
728 424
5 434
679
Salaries and wages
Consumable: Stationery, printing and office supplies 424
7 598
853 424
7 598
853 407
6 663
102 16
1 935
751 96,0%
77,7% 339
6 779
353 352
6 860
569
Social contributions
Operating leases 85
37 045
117 85
37 045
117 80
22 160
952 4 885
14 165 94,3%
61,8% 71
12 964
904 71
12 574
796
Goods andpayments
Property services 317
19 584
855 - (60 000) 257
19 584
855 239
13 761
325 17
6 823
530 93,1%
67,1% 238
16 237
588 227
19 592
715
Administrative fees Departmental activity
Transport provided: 2 412- 2 412- 1 608
216 804
(216) 66,7%
- 2 811- 1 600-
Advertising
Travel and subsistence 1 500
286 1 500
286 8
205 1 492
81 0,5%
71,7% 1 059- 749-
Minor assets
Training and development 8 610
690 8 610
690 301
80 8 309
610 3,5%
11,6% 5 010
687 2 074
147
Catering:
Venues andDepartmental
facilities activities 50
660 50
660 16- 34
660 32,0%
- 71- 70
Communication
Interest (G&S)
and rent on land 6 934- - - 6 934- 21 581
450 4 353
(1 450) 37,2%
- 2 434- 2 342-
Computer services
Interest (Incl. interest on unitary payments (PPP)) 512 512- 1 450- (1 512
450) - 504- 52
Legal services
Transfers and subsidies 1 800
340 564 - - 1 800
340 564 339 110
356 1 690
208 6,1%
99,6% 379 235- 379 146
025
Contractors
Provinces and municipalities 10 534
338 514 - - 10 534
338 514 21 250
338 514 (10 716)
- 201,7%
100,0% 4 234
377 335 2 095
377 335
Agency and support / outsourced services
Municipalities 1 028
338 514 - - 1 028
338 514 338 412
514 616- 40,1%
100,0% 1 228
377 335 377 983
335
FleetMunicipal
services (including government motor transport)
bank accounts 183
338 692
514 (60 000) 123
338 692
514 120
338 007
514 3 685- 97,0%
100,0% 151 285- 151 200
Inventory: Clothing
Municipal material
agencies andand accessories
funds - - 347 (347)
- - 377 335- 37
377 335
Inventory: Food and food supplies
Households 15
2 050 - - 15
2 050 4
842 11
1 208 26,7%
41,1% 15
1 900 6
1 690
Inventory: Fuel, oil and gas
Social benefits 1
2 265
050 1
2 265
050 1 217
842 48
1 208 96,2%
41,1% 1 900- 1 154-
Inventory: Materials
Other transfers and supplies
to households 546 546- 126- 420- 23,1%
- 2 212- 28
536
Inventory:
Payments Medicalassets
for capital supplies 20 844
145 573 - - 20 844
145 573 43 615
100 388 (22
45 771)
185 209,2%
69,0% 24 526
129 245 20
94 911
613
Inventory:and
Machinery Medicine
equipment 1 150
145 573 - - 1 150
145 573 (8 455)
100 388 9 605
45 185 (735,2%)
69,0% 129 588
245 94 393
613
Total 1 313 364 - (60 000) 1 253 364 1 168 905 84 459 93,3% 1 158 460 1 125 937

Subprogramme: 3.2: Planned Patient Transport

2018/19 2017/18
appropriation
Fleet services (including government motor transport) 83 345 83 345 93 471 (10 126) 112,1% 24 727 28 528
Consumable: Stationery, printing and office supplies - - 4 (4) - - -
Operating leases - - - - - 264
Transport provided: Departmental activity 5 910 5 910 22 5 888 0,4% 8 910 4 512
Interest and rent on land - - - - 2 930 (2 930) - - -
Interest (Incl. interest on unitary payments (PPP)) - 2 930 (2 930) - -
Households 600 - - 600 303 297 50,5% 600 182
Social benefits 600 600 303 297 50,5% 600 182
Payment for financial assets - 15 (15) - -
Total 169 839 - - 169 839 161 603 8 236 95,2% 109 694 93 337

Programme 4: Provincial Hospital Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 General Hospitals 6 707 824 - (276 000) 6 431 824 6 351 096 80 728 98,7% 5 719 131 5 738 026
2 Tuberculosis Hospitals 387 744 - (8 000) 379 744 290 044 89 700 76,4% 396 292 283 884
3 Psychiatric/Mental Hospital 1 261 857 - - 1 261 857 1 393 015 (131 158) 110,4% 1 164 077 1 238 219
4 Dental Training Hospitals 581 625 - - 581 625 560 989 20 636 96,5% 535 399 548 656
5 Other Specialised Hospitals 91 419 - - 91 419 91 509 (90) 100,1% 77 764 83 492
9 030 469 - (284 000) 8 746 469 8 686 653 59 816 99,3% 7 892 663 7 892 277
Compensation of employees 6 446 669 - (8 000) 6 438 669 6 244 388 194 281 97,0% 5 824 757 5 812 575
Salaries and wages 5 630 733 - (8 000) 5 622 733 5 512 747 109 986 98,0% 5 182 517 5 128 045
Goods and services 2 441 927 - (276 000) 2 165 927 2 334 479 (168 552) 107,8% 1 782 100 1 855 192
Advertising 7 - - 7 10 (3) 142,9% 284 28
Minor assets 13 254 - - 13 254 3 539 9 715 26,7% 12 553 4 094
Computer services 583 - - 583 1 190 (607) 204,1% 660 144
Consultants: Business and advisory services 112 098 - - 112 098 247 967 (135 869) 221,2% 7 640 182 551
Laboratory services 376 952 - (150 000) 226 952 239 135 (12 183) 105,4% 203 107 117 559
Legal services - - - - - - - - 12 025

Programme 4: Provincial Hospital Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Contractors
Sub programme 42 108 - - 42 108 53 431 (11 323) 126,9% 40 506 35 885
Agency
1 General and support / outsourced services
Hospitals 58 824
6 707 507 - -
(276 000) 58 824
6 431 507 83 096
6 351 770 (25 263)
80 728 143,2%
98,7% 147 131
5 719 651 92 026
5 738 532
Fleet services
2 Tuberculosis (including government motor transport)
Hospitals 8 915
387 744 - -
(8 000) 8 915
379 744 3 719
290 044 5 196
89 700 41,7%
76,4% 11 292
396 355 6 796
283 884
3 Psychiatric/Mental Hospital
Inventory: Clothing material and accessories -
1 261 857 - - -
1 261 857 1 393463
015 (131(463)
158) -
110,4% -
1 164 077 1 079
1 238 219
4 Dental TrainingFood
Inventory: Hospitals
and food supplies 119 625
581 584 - - 119 625
581 584 122 989
560 294 (2 710)
20 636 102,3%
96,5% 107 399
535 301 125 656
548 627
5 Other Specialised
Inventory: Hospitals
Fuel, oil and gas 43 419
91 123 - - 43 419
91 123 92 509
91 865 (49 (90)
742) 215,3%
100,1% 40 764
77 178 42 492
83 327
Inventory: Learner and teacher support material 9 030121
469 - - -
(284 000) 8 746121
469 8 686 14
653 59107
816 11,6%
99,3% 7 892122
663 7 892 29
277
Inventory: Medical supplies 597 197 - - 597 197 709 709 (112 512) 118,8% 494 139 532 477
Inventory: Medicine
Economic classification 548 176 - (126 000) 422 176 308 244 113 932 73,0% 264 646 276 894
Inventory:
Current Other supplies
payments 32 596
8 888 077 - -
(284 000) 32 596
8 604 077 30 867
8 578 306 1 771
25 729 94,5%
99,7% 30 857
7 606 271 28 767
7 667 774
Consumable supplies
Compensation of employees 119 669
6 446 202 - -
(8 000) 119 669
6 438 202 88 388
6 244 243 30 281
194 959 74,0%
97,0% 80 757
5 824 492 85 575
5 812 337
Consumable:
Salaries Stationery, printing and office supplies
and wages 24 733
5 630 646 - -
(8 000) 24 733
5 622 646 27 747
5 512 652 (3 006)
109 986 112,2%
98,0% 19 517
5 182 382 20 045
5 128 771
Operating
Social leases
contributions 23 936
815 942 - - 23 936
815 942 25 641
731 629 (1 687)
84 295 107,0%
89,7% 19 240
642 893 21 530
684 110
Property
Goods andpayments
services 285 927
2 441 531 - -
(276 000) 285 927
2 165 531 282 479
2 334 094 3 437
(168 552) 98,8%
107,8% 272 100
1 782 731 246 192
1 855 200
Transport provided:
Administrative fees Departmental activity 659
152 - - 659
152 63
109 596
43 9,6%
71,7% 628
172 159
172
Travel and subsistence
Advertising 2 058
7 - - 2 058
7 670
10 1 388
(3) 32,6%
142,9% 1 284
886 989
28
Training
Minor and development
assets 2 798
13 254 - - 2 798
13 254 850
3 539 1 715
9 948 30,4%
26,7% 3 104
12 553 995
4 094
Operating payments
Catering: Departmental activities 2 160
038 - - 2 160
038 258
13 1 147
780 12,7%
8,1% 684
158 570
2
Venues and facilities
Communication (G&S) 4 290
12 551 - - 4 290
12 551 -
5 871 4 680
6 290 -
46,8% -
12 363 118
9 832
Rental andservices
Computer hiring 530
583 - - 530
583 124
1 190 406
(607) 23,4%
204,1% 500
660 213
144
Consultants: Business and advisory services 18 098
112 429 - - 18 098
112 429 21 967
247 480 (3 051)
(135 869) 116,6%
221,2% 154 487
7 640 142 551
182 890
Non-profit
Laboratoryinstitutions
services -
376 952 - -
(150 000) -
226 952 -
239 135 -
(12 183) -
105,4% 137 107
203 149 -
117 559
Households
Legal services 18 429
- - - 18 429
- 21 480
- (3 051)
- 116,6%
- 17 338
- 142 890
12 025
Social benefits 18 429 - - 18 429 21 285 (2 856) 115,5% 17 338 22 913
Other transfers to households - - - - 195 (195) - - 119 977
Buildings and other fixed structures - - - - - - - - 16
Buildings - - - - - - - - 16
Payment for financial assets - - - - 978 (978) - - 1 750
9 030 469 - (284 000) 8 746 469 8 686 653 59 816 99,3% 7 892 663 7 892 277

Subprogramme: 4.1: General Hospitals

2018/19 2017/18
appropriation
Salaries and wages 3 997 315 3 997 315 3 987 557 9 758 99,8% 3 683 002 3 704 645
Goods and services 2 021 338 - (276 000) 1 745 338 1 765 618 (20 280) 101,2% 1 500 044 1 351 389
Advertising 7 7 - 7 - 84 28
Minor assets 7 927 7 927 2 551 5 376 32,2% 7 937 2 681
Audit costs: External - - - - - - -
Bursaries: Employees - - - - - - -
Catering: Departmental activities 10 10 10 - 100,0% 8 2
Computer services 583 583 1 179 (596) 202,2% 660 76
Consultants: Business and advisory services 250 250 200 50 80,0% 368 243
Laboratory services 365 530 (150 000) 215 530 209 467 6 063 97,2% 192 080 104 994
Legal services - - - - - - 12 006
Contractors 36 719 36 719 45 610 (8 891) 124,2% 35 956 31 052
Agency and support / outsourced services 56 303 56 303 81 504 (25 201) 144,8% 145 440 89 635
Inventory: Learner and teacher support material 106 106 - 106 - 100 -

Subprogramme: 4.1: General Hospitals

2018/19 2017/18
appropriation
Current paymentsStationery, printing and office supplies
Consumable: 6 597 619
18 024 - (276 000) 6 321 619
18 024 6 265 171
22 524 56
(4 448
500) 99,1%
125,0% 5 601
14 598
245 5 534
15 725
937
Operating leases 4 576 281
13 778 - - 4 576 281
13 778 4 499
18 553
075 76
(4 728
297) 98,3%
131,2% 4 101
12 554
137 4 183
11 336
554
Salaries and
Property wages
payments 3 213
997 620
315 3 997
213 315
620 3 987
211 557
481 9
2 758
139 99,8%
99,0% 3 683
213 002
296 3 704
167 645
525
Transport provided: Departmental activity 578 619
966 578 619
966 511 996
59 66 970
560 88,4%
9,5% 418 552
584 478 691
158
Goods
Traveland
andservices
subsistence 2 021 338
1 352 - (276 000) 1 745 338
1 352 1 765 618
472 (20 880
280) 101,2%
34,9% 1 500
1 044
130 1 351 389
579
Administrative
Training fees
and development 81
1 919 81
1 919 32
633 49
1 286 39,5%
33,0% 91
2 136 110
675
Advertisingpayments
Operating 7
373 7
373 173- 7
200 -
46,4% 84
424 28
298
Minor and
Transfers assets
subsidies 7 927
12 374 - - 7 927
12 374 2 551
15 884 5 376
(3 510) 32,2%
128,4% 7 937
11 673 2 681
137 373
Audit costs: External
Households 12 374- - - 12 374- 15 884- -
(3 510) -
128,4% 11 673- 137 373-
Bursaries: Employees
Social benefits 12 374- 12 374- 15 884- -
(3 510) -
128,4% 11 673- 17 396-
Catering: Departmental
Other transfers activities
to households 10 10- 10 - 100,0%
- 8- 2
119 977
Communication
Payments for capital(G&S)
assets 8 604
97 831 - - 8 604
97 831 4 024
69 291 4 580
28 540 46,8%
70,8% 8 380
105 860 7 255
64 767
Computer
Buildings services
and other fixed structures 583- - - 583- 1 179- (596)
- 202,2%
- 660- 76
16
Consultants:
Buildings Business and advisory services 250 250- 200 50- 80,0%
- 368- 243
16
Laboratory
Machinery services
and equipment 365 530
97 831 - (150 000)
- 215 530
97 831 209 467
69 291 6 063
28 540 97,2%
70,8% 192
105 080
860 104
64 994
751
Scientific
Transport and technological services
equipment 6 434- 6 434- 2 679- 3 755- -
41,6% 6 693- 5 193-
Legal
Otherservices
machinery and equipment 91 397- 91 397- 66 612- 24 785- -
72,9% 99 167- 12
59 006
558
Contractors
Payment for financial assets 36 719 36 719- 45 610
750 (8(750)
891) 124,2%
- 35 956- 31 052
1 161
Total
Agency and support / outsourced services 56 824
6 707 303 - (276 000) 56 303
6 431 824 81 504
6 351 096 (25 201)
80 728 144,8%
98,7% 5 145
719 440
131 89 635
5 738 026
Inventory: Learner and teacher support material 106 106 - 106 - 100 -

Subprogramme: 4.2: Tuberculosis Hospitals

2018/19 2017/18
appropriation
Compensation of employees 312 430 - (8 000) 304 430 239 668 64 762 78,7% 315 107 214 397
Salaries and wages 260 318 (8 000) 252 318 205 695 46 623 81,5% 263 114 183 327
Advertising - - 8 (8) - 200 -
Minor assets 1 441 1 441 195 1 246 13,5% 1 454 457
Computer services - - - - - - -
Contractors 1 141 1 141 964 177 84,5% 1 076 930
Agency and support / outsourced services 593 593 129 464 21,8% 560 123
Fleet services (including government motor transport) 1 060 1 060 394 666 37,2% 1 000 368
Inventory: Fuel, oil and gas 1 060 1 060 23 1 037 2,2% 50 174
Inventory: Learner and teacher support material - - - - - - 7
Inventory: Medicine 26 899 26 899 22 009 4 890 81,8% 31 251 40 761
Inventory: Other supplies 240 240 151 89 62,9% 180 324

Subprogramme: 4.2: Tuberculosis Hospitals

2018/19 2017/18
appropriation
Consumable supplies R'000
4 539 R'000 R'000 R'000
4 539 R'000
4 587 R'000 (48) %101,1% R'0004 122 R'000
3 487
Consumable:
Current paymentsStationery, printing and office supplies 1 173
384 461 - (8 000) 1 173
376 461 287 985
614 188
88 847 84,0%
76,4% 900
393 497 987
280 402
Operating leases
430 - (8 000) 304 500
430 239 815
668 64(315)
762 163,0%
78,7% 315 107- 413
214 397
Property payments
Salaries and wages 14 569
260 318 (8 000) 14 569
252 318 7 613
205 695 6 623
46 956 52,3%
81,5% 19 114
263 000 8 327
183 222
Social contributions 52 159
112 52 159
112 38
33 973 121
18 139 23,9%
65,2% 150
51 993 11
31 070
Goods andand
Training services
development 72 106
031 - - 72 031
106 47 946
17 24 085
89 66,6%
16,0% 78 390
100 66 005
15
Administrative
Operating fees
payments 9
53 9
53 2
5 7
48 22,2%
9,4% 9
50 2
25
Advertising
Venues and facilities - - 8- (8)
- - 200- 118-
Minor assets
Rental and hiring 1 441
530 1 441
530 195
124 1 246
406 13,5%
23,4% 1 454
500 457
166
Communication
Transfers (G&S)
and subsidies 742
687 - - 742
687 345
887 397
(200) 46,5%
129,1% 700
600 365
891
Computer services
Households 687- - - 687- 887- -
(200) -
129,1% 600- 891-
Consultants: Business and advisory services
Social benefits 53
687 53
687 14
887 39
(200) 26,4%
129,1% 50
600 25
891
Laboratory services
Other transfers to households 4 611 4 611- 2 466 2 145- 53,5%
- 4 298- 1 871
Contractors
Payments for capital assets 1 596
2 141 - - 1
2 141
596 1 964
536 1 177
060 84,5%
59,2% 1
2 076
195 2 930
505
Agency and
Machinery andsupport / outsourced services
equipment 593
2 596 - - 593
2 596 129
1 536 1 464
060 21,8%
59,2% 2 560
195 2 123
505
Fleet services
Transport (including government motor transport)
equipment 060
1 110 1 060
110 394
87 1 666
023 37,2%
7,8% 1 000
047 368
414
Inventory: Food and
Other machinery food
and supplies
equipment 6 486
1 390 6
1 390
486 4
1 311
449 2 079
37 67,5%
97,5% 6
1 500
148 5
2 036
091
Inventory:
Payment Fuel, oil assets
for financial and gas 1 060 1 060- 23
7 1 037
(7) 2,2%
- 50- 174
86
Total
Inventory: Learner and teacher support material 387 744- - (8 000) 379 744- 290 044- 89 700- -
76,4% 396 292- 7
283 884

Subprogramme: 4.3: Psychiatric/Mental Hospital

2018/19 2017/18
appropriation
Current payments 1 253 407 - - 1 253 407 1 386 292 (132 885) 110,6% 1 015 159 1 228 441
Social contributions 123 546 123 546 130 886 (7 340) 105,9% 115 845 122 426
Minor assets 2 868 2 868 572 2 296 19,9% 2 465 444
Catering: Departmental activities 148 148 - 148 - 147 -
Communication (G&S) 1 955 1 955 888 1 067 45,4% 1 927 1 215
Consultants: Business and advisory services 111 763 111 763 247 739 (135 976) 221,7% 7 157 182 270
Legal services - - - - - - -
Contractors 734 734 676 58 92,1% 399 170
Agency and support / outsourced services 1 165 1 165 1 013 152 87,0% 1 235 1 101
Fleet services (including government motor transport) 1 922 1 922 1 135 787 59,1% 1 869 2 167
Inventory: Materials and supplies 1 139 1 139 282 857 24,8% 1 000 (2)
Inventory: Other supplies 1 500 1 500 4 609 (3 109) 307,3% 4 171 6 158
Consumable supplies 16 473 16 473 20 159 (3 686) 122,4% 14 114 16 342

Subprogramme: 4.3: Psychiatric/Mental Hospitals

2018/19 2017/18
appropriation
Current payments
Operating leases 1 253 407
700 - - 1 253 407
700 1 386
4 292
872 (132
(4 885)
172) 110,6%
696,0% 1 015 159
235 1 228
2 441
135
Property payments 983
51 332
209 - - 983
51 332
209 967
47 594
812 15
3 738
397 98,4%
93,4% 882
33 806
635 897
47 685
692
Salaries
Transportand wages Departmental activity
provided: 859 786
40 859 786
40 836 708
4 23 078
36 97,3%
10,0% 766 961
44 775 259
1
Social
Travel contributions
and subsistence 123 546
442 123 546
442 130 886
147 (7 340)
295 105,9%
33,3% 115 845
525 122 426
332
Goods andand
Training services
development 270 075
238 - - 270 075
238 418 698
21 (148 623)
217 155,0%
8,8% 132 353
367 330 756
97
Administrative fees
Operating payments 48
32 48
32 66- (18)
32 137,5%
- 59
32 52
70
Minor
Venuesassets
and facilities 2
4 868
290 24 868
290 572- 24 296
290 19,9%
- 2 465- 444-
Catering:
Transfers andDepartmental
subsidies activities 3 148
642 - - 3 148
642 3 260- 148
382 -
89,5% 140 147
585 3 317-
Communication (G&S)
Households 1
3 955
642 - - 1
3 955
642 3 888
260 1 067
382 45,4%
89,5% 13 927
436 13 215
317
Computer services
Social benefits 3 642- 3 642- 11
3 260 (11)
382 -
89,5% 3 436- 68
3 317
Consultants: Business
Other transfers and advisory services
to households 111 763- 111 763- 247 739 (135 976)
- 221,7%
- 7 157- 182 270
Laboratory
Payments services
for capital assets 3
4 721
808 - - 3
4 721
808 53 069
272 (1
1 348)
536 136,2%
68,1% 28 735
333 16 172
048
Scientific and equipment
Machinery technological services 4 808- - - 4 808- 3 272- 1 536- -
68,1% 8 333- 6 048-
Legal services
Transport equipment 540- 540- 675- -
(135) -
125,0% 1 498- 2 374-
Contractors
Other machinery and equipment 4 734
268 4 734
268 2 676
597 58
1 671 92,1%
60,8% 6 399
835 3 170
674
Agency
Payment forand support
financial / outsourced services
assets 1 165 1 165- 1 013
191 152
(191) 87,0%
- 1 235- 1 101
413
Total
Fleet services (including government motor transport) 1 922
1 261 857 - - 1 922
1 261 857 1 135
1 393 015 (131 787
158) 59,1%
110,4% 1 869
1 164 077 2 167
1 238 219
Inventory: Materials and supplies 1 139 1 139 282 857 24,8% 1 000 (2)

Subprogramme: 4.4: Dental Training Hospitals

2018/19 2017/18
appropriation
Advertising - - 2 (2) - - -
Minor assets 966 966 215 751 22,3% 647 490
Catering: Departmental activities 2 2 3 (1) 150,0% 3 -
Communication (G&S) 1 050 1 050 581 469 55,3% 1 156 840
Contractors 3 384 3 384 5 935 (2 551) 175,4% 2 895 3 684
Agency and support / outsourced services 270 270 845 (575) 313,0% 250 1 430
Fleet services (including government motor transport) 213 213 122 91 57,3% 950 295
Inventory: Food and food supplies 6 6 422 (416) 7033,3% 5 5 933
Inventory: Fuel, oil and gas 217 217 159 58 73,3% 460 83
Inventory: Medical supplies 32 528 32 528 32 965 (437) 101,3% 29 601 33 554
Inventory: Other supplies 1 257 1 257 1 251 6 99,5% 1 631 1 903

Subprogramme: 4.4: Dental Training Hospitals

2018/19 2017/18
appropriation
Current payments
8 362 - - 563 412
8 362 548 942
4 797 14 470
3 565 97,4%
57,4% 520 463
6 350 541 588
3 311
Compensation
Consumable: of employees
Stationery, printing and office supplies 495 724
2 941 - - 495 724
2 941 459 243
2 281 36 660
481 92,6%
77,6% 459 345
2 033 446 723
1 823
Salaries and
Operating wages
leases 446 771
8 930 446 771
8 930 416 152
1 419 30 619
7 511 93,1%
15,9% 413 173
7 490 405 212
6 717
Property payments 48 691
953 48 691
953 43 013
11 091 5 862
(10 322) 88,0%
1593,8% 46 172
1 666 41 809
17 511
Goods
Traveland
andservices
subsistence 67 688
46 - - 67 688
46 89 699
13 (22 011)
33 132,5%
28,3% 61 118
25 94 865
30
Administrative
Training fees
and development 10
285 10
285 2
57 8
228 20,0% 9
272 3
58
Advertisingpayments
Operating 1 580- 1 580- 2
80 (2)
1 500 -
5,1% 178- 177-
Minor assets
Rental and hiring 966- 966- 215- 751- 22,3%
- 647- 490
47
Catering:
Transfers andDepartmental
subsidies activities 2
1 563 - - 2
1 563 3
1 380 (1)
183 150,0%
88,3% 3
1 475 1 175-
Communication (G&S)
Households 050
1 563 - - 050
1 563 581
1 380 469
183 55,3%
88,3% 156
1 475 840
1 175
Consultants: Business and advisory services
Social benefits 16
1 563 16
1 563 5
1 185 11
378 31,3%
75,8% 50
1 475 3
1 175
Laboratory services
Other transfers to households 3 020 3 020- 21 195
929 (18(195)
909) 726,1%
- 3 908- 9 474
Legal services
Payments for capital assets 16 650- - - 16 650- 10 652- 5 998- -
64,0% 13 461- 19
5 815
Contractors
Machinery and equipment 3 650
16 384 - - 3 650
16 384 5 652
10 935 (2 551)
5 998 175,4%
64,0% 2 461
13 895 3 815
5 684
Agency andequipment
Transport support / outsourced services 270
600 270
600 845
96 (575)
504 313,0%
16,0% 250
900 430
1 471
Fleet services (including
Other machinery government motor transport)
and equipment 213
16 050 213
16 050 122
10 556 91
5 494 57,3%
65,8% 950
12 561 295
4 344
Inventory:
Payment Clothingassets
for financial material and accessories - - 15- -
(15) - - 9
78
TotalInventory: Food and food supplies 6
581 625 - - 6
581 625 422
560 989 20(416)
636 7033,3%
96,5% 5
535 399 5 656
548 933

Subprogramme: 4.5: Other Specialised Hospitals

2018/19 2017/18
appropriation
Current payments 89 697 - - 89 697 90 848 (1 151) 101,3% 76 140 82 611
Compensation of employees 78 902 - - 78 902 78 330 572 99,3% 65 945 70 434
Salaries and wages 66 543 66 543 66 635 (92) 100,1% 56 267 59 602
Social contributions 12 359 12 359 11 695 664 94,6% 9 678 10 832
Minor assets 52 52 6 46 11,5% 50 22
Laboratory services 70 70 204 (134) 291,4% 86 48
Contractors 130 130 246 (116) 189,2% 180 49
Agency and support / outsourced services 176 176 279 (103) 158,5% 166 243
Fleet services (including government motor transport) 30 30 51 (21) 170,0% 61 94
Inventory: Food and food supplies 710 710 1 353 (643) 190,6% 643 1 134
Inventory: Fuel, oil and gas 50 50 1 49 2,0% - -
Inventory: Learner and teacher support material 15 15 14 1 93,3% 22 22
Inventory: Medicine 854 854 1 232 (378) 144,3% 807 975

Subprogramme: 4.5: Other Specialised Hospitals

2018/19 2017/18
appropriation
Inventory: Other supplies 135 135 416 (281) 308,1% 100 234
Consumable supplies 653 653 672 (19) 102,9% 816 572
Consumable: Stationery, printing and office supplies 159 159 275 (116) 173,0% 150 476
Operating leases 34 34 448 (414) 1317,6% 31 291
Travel and subsistence 59 59 - 59 - 56 37
Training and development 250 250 122 128 48,8% 229 150
Households 163 - - 163 69 94 42,3% 154 134
Social benefits 163 163 69 94 42,3% 154 134
Payments for capital assets 1 559 - - 1 559 577 982 37,0% 1 470 735
Machinery and equipment 1 559 - - 1 559 577 982 37,0% 1 470 735
Transport equipment 212 212 46 166 21,7% 200 166
Other machinery and equipment 1 347 1 347 531 816 39,4% 1 270 569
Total 91 419 - - 91 419 91 509 (90) 100,1% 77 764 83 492

Programme 5: Central Hospital Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 Central Hospitals 13 034 797 - 185 000 13 219 797 13 218 822 975 100.0% 11 839 981 11 986 766
2 Provincial Tertiary Hospital Services 3 783 429 - 132 000 3 915 429 3 915 435 -6 100.0% 3 493 060 3 329 921
16 818 226 - 317 000 17 135 226 17 134 257 969 100.0% 15 333 041 15 316 687
Current payments 15 815 866 - 317 000 16 132 866 16 458 011 -325 145 102.0% 14 471 001 14 633 592
Compensation of employees 10 657 379 - - 10 657 379 10 956 631 -299 252 102.8% 10 194 649 10 319 570
Salaries and wages 9 188 411 - - 9 188 411 9 798 744 -610 333 106.6% 8 931 433 9 224 717
Social contributions 1 468 968 - - 1 468 968 1 157 887 311 081 78.8% 1 263 216 1 094 853
Goods and services 5 158 487 - 317 000 5 475 487 5 498 014 -22 527 100.4% 4 276 352 4 314 022
Administrative fees 162 - - 162 68 94 42.0% 158 54
Advertising 445 - - 445 134 311 30.1% 800 558
Minor assets 49 633 - - 49 633 6 571 43 062 13.2% 50 822 10 429
Catering: Departmental activities 45 - - 45 19 26 42.2% 64 28
Communication (G&S) 16 018 - - 16 018 16 596 -578 103.6% 17 734 19 671
Computer services 10 077 - - 10 077 974 9 103 9.7% 10 097 2 881
Consultants: Business and advisory services 613 - - 613 89 524 14.5% 97 150 82 166
Laboratory services 982 830 - - 982 830 942 560 40 270 95.9% 581 769 577 214
Scientific and technological services - - - - - - - - -
Legal services - - - - 288 -288 - - 165 194
Contractors 169 411 - - 169 411 239 720 -70 309 141.5% 169 286 148 734
Agency and support / outsourced services 102 411 - - 102 411 129 999 -27 588 126.9% 139 848 118 229
Entertainment - - - - - - - - -
Fleet services (including government motor transport) 6 003 - - 6 003 6 348 -345 105.7% 6 025 6 826
Inventory: Food and food supplies 147 304 - - 147 304 126 457 20 847 85.8% 142 863 123 287
Inventory: Fuel, oil and gas 76 248 - - 76 248 62 078 14 170 81.4% 43 494 47 046
Inventory: Learner and teacher support material - - - - - - - - 34
Inventory: Materials and supplies 13 067 - - 13 067 16 762 -3 695 128.3% 11 698 14 371
Inventory: Medical supplies 1 609 630 - 317 000 1 926 630 2 374 133 -447 503 123.2% 1 421 051 1 597 376
Inventory: Medicine 1 226 744 - - 1 226 744 799 743 427 001 65.2% 843 786 676 246
Inventory: Other supplies 59 977 - - 59 977 64 025 -4 048 106.7% 64 932 43 213
Consumable supplies 183 445 - - 183 445 231 276 -47 831 126.1% 178 062 188 469

Programme 5: Central Hospital Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
Consumable: Stationery, printing and office supplies 50 368 - - 50 368 69 785 -19 417 138.6% 51 805 45 036
1 Central Hospitals
Operating leases 20 797
13 034 419 - -
185 000 20 797
13 219 419 27 822
13 218 559 -7 975
140 135.0%
100.0% 5 689
11 839 981 13 766
11 986 870
2 Provincial
PropertyTertiary
paymentsHospital Services 3 783
428 429
241 - 132 000
- 3 915
428 429
241 3 915
379 435
321 -6
48 920 100.0%
88.6% 3 493
429 060
899 3 329
426 921
760
Transport provided: Departmental activity 16 818310
226 - - -
317 000 17 135310
226 6
17 134 257 304
969 1.9%
100.0% 1 390
15 333 041 4
15 316 687
Travel and subsistence 1 302 - - 1 302 1 342 -40 103.1% 1 616 1 528
Training and development 1 394 - - 1 394 555 839 39.8% 2 573 2 438
Operating payments 2 390 - - 2 390 1 555 835 65.1% 3 741 2 354
Current
Interestpayments
and rent on land 15 815 866
- - 317 000
- 16 132 866
- 16 458 011
3 366 -325 145
-3 366 102.0%
- 14 471 001
- 14 633 592
-
Compensation
Interest (Incl. of employees
interest on unitary payments (PPP)) 10 657 379
- - - 10 657 379
- 10 956 631
3 366 -299 252
-3 366 102.8%
- 10 194 649
- 10 319 570
-
Salaries
Rent and wages
on land 9 188 411
- - - 9 188 411
- 9 798 744
- -610 333
- 106.6%
- 8 931 433
- 9 224 717
-
Social and
Transfers contributions
subsidies 1 468
247 968
640 - - 1 468
247 968
640 1 157
247 887
111 311 529
081 78.8%
99.8% 1 263
196 216
448 1 094
226 853
873
Goods andinstitutions
Non-profit services 5 158
200 487
000 - 317 000
- 5 475
200 487
000 5 498
200 014
000 -22 527
- 100.4%
100.0% 4 276
150 352
000 4 314
150 022
000
Administrative fees
Households 47162
640 - - 47162
640 68
47 111 94
529 42.0%
98.9% 46158
448 54
76 873
Advertising
Social benefits 47445
640 - - 47445
640 46134
953 311
687 30.1%
98.6% 46800
448 40558
244
Minor
Otherassets
transfers to households 49 633
- - - 49 633
- 6 571
158 43-158
062 13.2%
- 50 822
- 10
36 429
629
Catering:
Payments for Departmental activities
capital assets 45
754 720 - - 45
754 720 19
427 220 26
327 500 42.2%
56.6% 64
665 592 28
453 778
Communication
Machinery (G&S)
and equipment 16 018
754 720 - - 16 018
754 720 16 596
427 220 327-578
500 103.6%
56.6% 17 734
665 592 19 671
453 778
Computer
Transportservices
equipment 10 077
937 -
-5 000 - 10 077
5 937 1 974
354 94 103
583 9.7%
22.8% 10 097
5 475 25 881
572
Consultants: Business
Other machinery and and advisory services
equipment 743613
783 -
5 000 - 748613
783 89
425 866 322524917 14.5%
56.9% 97 150
660 117 82 166
448 206
Laboratory
Payment servicesassets
for financial 982 830
- - - 982 830- 942 560
1 915 40 270
-1 915 95.9%
- 581 769- 577 214
2 444
Scientific and technological services -
16 818 226 - - -
317 000 -
17 135 226 -
17 134 257 -
969 -
100.0% -
15 333 041 -
15 316 687
Legal services - - - - 288 -288 - - 165 194
Contractors 169 411 - - 169 411 239 720 -70 309 141.5% 169 286 148 734
Agency and support / outsourced services 102 411 - - 102 411 129 999 -27 588 126.9% 139 848 118 229
Entertainment - - - - - - - - -
Fleet services (including government motor transport) 6 003 - - 6 003 6 348 -345 105.7% 6 025 6 826
Inventory: Food and food supplies 147 304 - - 147 304 126 457 20 847 85.8% 142 863 123 287
Inventory: Fuel, oil and gas 76 248 - - 76 248 62 078 14 170 81.4% 43 494 47 046
Inventory: Learner and teacher support material - - - - - - - - 34
Inventory: Materials and supplies 13 067 - - 13 067 16 762 -3 695 128.3% 11 698 14 371
Inventory: Medical supplies 1 609 630 - 317 000 1 926 630 2 374 133 -447 503 123.2% 1 421 051 1 597 376
Inventory: Medicine 1 226 744 - - 1 226 744 799 743 427 001 65.2% 843 786 676 246
Inventory: Other supplies 59 977 - - 59 977 64 025 -4 048 106.7% 64 932 43 213
Consumable supplies 183 445 - - 183 445 231 276 -47 831 126.1% 178 062 188 469

Subprogramme: 5.1: Central Hospitals

2018/19 2017/18
appropriation
Current payments 12 197 461 - 185 000 12 382 461 12 671 804 (289 343) 102,3% 11 125 624 11 418 560
Compensation of employees 8 109 199 - - 8 109 199 8 478 522 (369 323) 104,6% 7 904 995 8 007 026
Social contributions 1 053 507 1 053 507 890 516 162 991 84,5% 909 616 843 965
Goods and services 4 088 262 - 185 000 4 273 262 4 189 916 83 346 98,0% 3 220 629 3 411 534
Advertising 260 260 60 200 23,1% 467 354
Minor assets 36 238 36 238 7 141 29 097 19,7% 34 528 5 741
Communication (G&S) 11 969 11 969 14 575 (2 606) 121,8% 12 788 15 592
Computer services 10 077 10 077 467 9 610 4,6% 10 097 2 198
Consultants: Business and advisory services 163 163 63 100 38,7% 95 900 82 120
Legal services - - 288 (288) - - 164 340
Contractors 126 727 126 727 205 902 (79 175) 162,5% 128 891 118 649
Agency and support / outsourced services 84 101 84 101 115 616 (31 515) 137,5% 118 288 97 585
Inventory: Fuel, oil and gas 58 248 58 248 58 490 (242) 100,4% 25 831 38 496
Inventory: Materials and supplies 8 267 8 267 10 883 (2 616) 131,6% 7 798 10 773
Inventory: Medical supplies 1 236 896 185 000 1 421 896 1 749 336 (327 440) 123,0% 1 090 013 1 230 611
Inventory: Medicine 1 056 497 1 056 497 643 508 412 989 60,9% 675 895 547 649

Subprogramme: 5.1: Central Hospitals

2018/19 2017/18
appropriation
Current payments
197 270
461 - 185 000 12 129
382 270
461 12 156
671 109
804 (289 343)
(26 839) 102,3%
120,8% 11 122
125 291
624 11 148
418 041
560
Compensation
Consumable: of employees
Stationery, printing and office supplies 8 109 199
24 623 - - 8 109 199
24 623 8 478 522
35 477 (369 323)
(10 854) 104,6%
144,1% 7 904 995
27 417 8 007 026
23 901
Salaries and
Operating wages
leases 7 055 692
15 869 7 055 692
15 869 7 588 006
20 332 (532 314)
(4 463) 107,5%
128,1% 6 995 379
2 893 7 163 061
10 382
Property payments 1 326
053 231
507 1 326
053 231
507 890 310
278 516 162 991
47 921 84,5%
85,3% 909 453
323 616 843 460
319 965
Goods and services
Transport provided: Departmental activity 4 088 270
262 - 185 000 4 273 270
262 4 189 916
1 83 269
346 98,0%
0,4% 3 220 330
629 3 411 534-
Administrative
Travel fees
and subsistence 46
1 137 46
1 137 66
1 219 (20)
(82) 143,5%
107,2% 51
1 014 40
1 427
Advertising
Training and development 260
1 139 260
1 139 60
346 200
793 23,1%
30,4% 467
1 225 354
704
Minor assets
Operating payments 36 238
2 205 36 238
2 205 7 943
141 29 097
1 262 19,7%
42,8% 34 528
2 471 15 585
741
Catering:
Interest andDepartmental
rent on land activities 45- - - 45- 19
3 366 26
(3 366) 42,2%
- 64- 22-
Communication
Interest (G&S)on unitary payments (PPP))
(Incl. interest 11 969 11 969- 14 575
3 366 (2 366)
(3 606) 121,8%
- 12 788- 15 592
Computer
Transfers and services
subsidies 10 450
235 077 - - 10 450
235 077 467
238 142 9 692)
(2 610 4,6%
101,1% 10 948
184 097 2 347
206 198
Consultants:
Non-profit Business and advisory services
institutions 163
200 000 163
200 000 63
200 000 100- 38,7%
100,0% 95 000
150 900 82 000
150 120
Laboratory services
Households 813 189
35 450 - - 813 189
35 450 748 882
38 142 64 307
(2 692) 92,1%
107,6% 387 623
34 948 466 638
56 347
Legal services
Social benefits 35 450- 35 450- 288
37 984 (2 (288)
534) -
107,1% 34 948- 164 340
31 173
Contractors
Other transfers to households 126 727 126 727- 205 158
902 (79(158)
175) 162,5%
- 128 891- 118 649
25 174
Agencyfor
Payments and support
capital / outsourced services
assets 84 886
601 101 - - 84 886
601 101 115 174
307 616 (31 712
294 515) 137,5%
51,0% 118 409
529 288 97 537
359 585
Fleet services
Machinery (including government motor transport)
and equipment 4 886
601 584 - - 4 886
601 584 4 174
307 729 294 (145)
712 103,2%
51,0% 4 409
529 311 5 537
359 314
Inventory:
TransportClothing material and accessories
equipment 8 075- (5 000) 3 075- 51
1 132 (51)
1 943 -
36,8% 2 775- 3 1535
Inventory: Food and
Other machinery food
and supplies
equipment 93 811
593 682 5 000 93 811
598 682 87 042
306 461 6 769
292 221 93,4%
51,1% 90 634
526 856 88 384
356 668
Inventory:
Payment Fuel, oil assets
for financial and gas 58 248 58 248- 58 490
1 702 (1(242)
702) 100,4%
- 25 831- 38 496
2 322
Total
Inventory: Materials and supplies 8 797
13 034 267 - 185 000 8 797
13 219 267 10 822
13 218 883 (2 975
616) 131,6%
100,0% 7 981
11 839 798 10 766
11 986 773
Inventory: Medical supplies 1 236 896 185 000 1 421 896 1 749 336 (327 440) 123,0% 1 090 013 1 230 611
Inventory: Medicine 1 056 497 1 056 497 643 508 412 989 60,9% 675 895 547 649

Subprogramme: 5.2: Provincial Tertiary Hospital Services

2018/19 2017/18
appropriation
Current payments 3 618 405 - 132 000 3 750 405 3 785 056 (34 651) 100,9% 3 345 377 3 215 032
Goods and services 1 070 225 - 132 000 1 202 225 1 306 947 (104 722) 108,7% 1 055 723 902 488
Advertising 185 185 74 111 40,0% 333 204
Minor assets 13 395 13 395 (570) 13 965 (4,3%) 16 294 4 688
Catering: Departmental activities - - - - - - 6
Consultants: Business and advisory services 450 450 26 424 5,8% 1 250 46
Contractors 42 684 42 684 33 818 8 866 79,2% 40 395 30 085
Inventory: Fuel, oil and gas 18 000 18 000 3 588 14 412 19,9% 17 663 8 550
Inventory: Materials and supplies 4 800 4 800 5 879 (1 079) 122,5% 3 900 3 598
Inventory: Medical supplies 372 734 132 000 504 734 624 797 (120 063) 123,8% 331 038 366 765
Inventory: Other supplies 13 448 13 448 14 383 (935) 107,0% 8 798 12 008

Subprogramme: 5.2: Provincial Tertiary Hospital Services 2018/19 2017/18

appropriation
Consumable: Stationery, printing and office supplies 25 745 25 745 34 308 (8 563) 133,3% 24 388 21 135
Property payments 102 010 102 010 101 011 999 99,0% 106 446 107 300
Transport provided: Departmental activity 40 40 5 35 12,5% 1 060 4
Training and development 255 255 209 46 82,0% 1 348 1 734
Operating payments 185 185 612 (427) 330,8% 1 270 769
Households 12 190 - - 12 190 8 969 3 221 73,6% 11 500 20 526
Social benefits 12 190 12 190 8 969 3 221 73,6% 11 500 9 071
Other transfers to households - - - - 11 455
Total 3 783 429 - 132 000 3 915 429 3 915 435 (6) 100,0% 3 493 060 3 329 921

Programme 6: Health Sciences and Training

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 Nurse Training Colleges 848 937 - - 848 937 778 971 69 966 91,8% 738 369 747 136
2 EMS Training Colleges 37 859 - - 37 859 27 175 10 684 71,8% 34 961 34 953
3 Bursaries 142 498 - - 142 498 211 282 (68 784) 148,3% 86 546 68 676
4 Other Training 94 002 - - 94 002 89 280 4 722 95,0% 68 595 68 222
1 123 296 - - 1 123 296 1 106 708 16 588 98,5% 928 471 918 987
Advertising 28 - - 28 26 2 92,9% 100 90
Minor assets 943 - - 943 535 408 56,7% 296 145
Audit costs: External - - - - 8 (8) - - -
Bursaries: Employees 9 139 - - 9 139 1 285 7 854 14,1% 8 622 4 011
Communication (G&S) 1 276 - - 1 276 601 675 47,1% 1 446 847

Programme 6: Health Sciences and Training

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
Computer services - - - - - - - - 169
1 Nurse Training Colleges
Consultants: Business and advisory services 848283
937 -- -- 848283
937 778 971
- 69283
966 91,8%
- 738507
369 747199
136
2 EMSLaboratory
Training Colleges
services 37 859
53 -- -- 37 859
53 27 175
- 10 684
53 71,8%
- 34 961
58 34 953
17
3 Bursaries
Contractors 142 498
2 075 -- -- 142 498
2 075 211 282
1 527 (68548
784) 148,3%
73,6% 86742
546 68925
676
4 Other Training
Agency and support / outsourced services 94110
002 -- -- 94110
002 89 280
4 4 106
722 95,0%
3,6% 68306
595 68351
222
Fleet services (including government motor transport) 1 123 296
2 140 - - - - 1 123 296
2 140 1 106 708
1 290 16 588
850 98,5%
60,3% 928 471
1 783 918 987
2 915
Current payments
Inventory: Food and food supplies 922150
090 -- -- 922150
090 832 065
65 90 025
85 90,2%
43,3% 800115
873 796 456
73
Compensation of oil
Inventory: Fuel, employees
and gas 850 291
4 -- -- 850 291
4 762 052
4 88 239
- 89,6%
100,0% 740 162
2 738 605
5
Salaries and
Inventory: wages
Learner and teacher support material 742 714
3 281 -- -- 742 714
3 281 668 263
10 656 74375)
(7 451 90,0%
324,7% 645 161
1 487 644750
596
Inventory: Materials and supplies 107292
577 -- -- 107292
577 93355
789 13 (63)
788 87,2%
121,6% 95227
001 94122
009
Goods and services
2 807 -- -- 71 799
2 807 70 013
3 628 1(821)
786 97,5%
129,2% 60581
711 57814
851
Administrative fees
Inventory: Medicine 75
740 -- -- 75
740 26
422 49
318 34,7%
57,0% 73
871 113
406
AdvertisingOther supplies
Inventory: 28
385 -- -- 28
385 26
326 592 92,9%
84,7% 100
407 90
323
Minor assets supplies
Consumable 943
7 481 -- -- 943
7 481 535
9 713 408
(2 232) 56,7%
129,8% 296
5 353 145
5 920
Audit costs: External
Consumable: Stationery, printing and office supplies 4 404- -- -- 4 404- 2 5738 (8)
1 831 -
58,4% 2 967- 2 836-
Bursaries:leases
Operating Employees 29 320
139 -- -- 29 320
139 61 097
285 (37 777)
854 14,1%
262,8% 28 100
622 54 292
011
Catering:payments
Property Departmental activities 72
13 462 -- -- 72
13 462 11
16 723 61
(3 261) 15,3%
124,2% 13 180
300 68
18 087
Communication (G&S)
Travel and subsistence 1 276
14 098 -- -- 1 276
14 098 601
3 049 11 675
049 47,1%
21,6% 1 446
12 977 847
9 234
Training and development 5 781 - - 5 781 11 020 (5 239) 190,6% 6 011 3 636
Operating payments 400 - - 400 45 355 11,3% 200 93
Departmental agencies (non-business entities) 20 962 - - 20 962 20 962 - 100,0% 19 812 19 812
Higher education institutions 13 681 - - 13 681 12 855 826 94,0% 12 061 9 786
Households 150 503 - - 150 503 236 962 (86 459) 157,4% 87 680 79 406
Social benefits 1 861 - - 1 861 2 877 (1 016) 154,6% 1 956 3 721
Other transfers to households 148 642 - - 148 642 234 085 (85 443) 157,5% 85 724 75 685
Payment for financial assets - - - - 582 (582) - - 2 526
1 123 296 - - 1 123 296 1 106 708 16 588 98,5% 928 471 918 987

Sub Programme 6.1: Health Sciences and Training 2018/19 2017/18

Subprogramme: 6.1: Nurse Training Colleges
2018/19 2017/18
Adjusted
Appropriation Shifting of
Funds Virement Final
Appropriation Actual
Expenditure Variance Expenditure Final
as % of final Appropriation Actual
Expenditure
appropriation
appropriation
Economicclassification
Economic classification R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 R'000
R'000 %% R'000
R'000 R'000
R'000
Administrative fees - - 16 (16) - - -
Advertising 10 10 9 1 90,0% - 2
Minor assets 628 628 67 561 10,7% 275 123
Audit costs: External - - 8 (8) - - -
Communication (G&S) 973 973 562 411 57,8% 1 065 749
Consultants: Business and advisory services 18 18 - 18 - 257 43
Contractors 1 055 1 055 691 364 65,5% 52 41
Agency and support / outsourced services 50 50 - 50 - - -
Fleet services (including government motor transport) 550 550 454 96 82,5% 283 1 463
Inventory: Fuel, oil and gas 4 4 4 - 100,0% 2 2
Inventory: Learner and teacher support material 2 631 2 631 10 403 (7 772) 395,3% 1 162 639
Inventory: Medical supplies 1 407 1 407 289 1 118 20,5% 102 267

Programme 6.1: Health Sciences and Training 2018/19 2017/18

appropriation
Inventory: Medicine - - 55 (55) - 21 91

Operating payments - - 18 (18) - -
Higher education institutions - - - 10 000
Households 9 123 - - 9 123 13 939 (4 816) 152,8% 9 736 14 632
Social benefits 1 840 1 840 2 753 (913) 149,6% 1 936 3 608
Other transfers to households 7 283 7 283 11 186 (3 903) 153,6% 7 800 11 024
Payment for financial assets - 569 (569) - - 2 508
Total 848 937 - - 848 937 778 971 69 966 91,8% 738 369 747 136

Subprogramme: 6.2: EMS Training Colleges

2018/19 2017/18
appropriation
Advertising 18 18 17 1 94,4% 100 88
Minor assets 300 300 266 34 88,7% 6 22
Contractors 1 020 1 020 836 184 82,0% 690 884
Fleet services (including government motor transport) 1 590 1 590 836 754 52,6% 1 500 1 452
Inventory: Fuel, oil and gas - - - - - - 3
Inventory: Learner and teacher support material 650 650 253 397 38,9% 325 111
Inventory: Medical supplies 1 400 1 400 3 339 (1 939) 238,5% 479 547
Inventory: Medicine 740 740 367 373 49,6% 850 315
Inventory: Other supplies - - 19 (19) - 20 6

Subprogramme: 6.2: EMS Training Colleges 2018 2017/18

appropriation
Consumable supplies 1 329 1 329 542 787 40,8% 1 290 1 136

Consumable: Stationery, printing and office supplies 500 500 475 25 95,0% 500 188
Operating leases 200 200 61 139 30,5% 100 108
Training and development 813 813 438 375 53,9% 1 300 1 381
Transfers and subsidies 21 - - 21 124 (103) 590,5% 20 107
Households 21 - - 21 124 (103) 590,5% 20 107
Social benefits 21 21 124 (103) 590,5% 20 107
Payments for capital assets 4 301 - - 4 301 872 3 429 20,3% 4 058 6 892
Machinery and equipment 4 301 - - 4 301 872 3 429 20,3% 4 058 6 892
Transport equipment 1 000 1 000 1 000 - 2 000 1 652
Other machinery and equipment 3 301 3 301 872 2 429 26,4% 2 058 5 240
Total 37 859 - - 37 859 27 175 10 684 71,8% 34 961 34 953

Subprogramme: 6.3: Bursaries

2018/19 2017/18
appropriation
Bursaries: Employees 9 139 9 139 1 285 7 854 14,1% 8 622 4 011
Communication (G&S) - - - - - - 4
Households 133 359 - - 133 359 209 997 (76 638) 157,5% 77 924 64 661
Other transfers to households 133 359 133 359 209 997 (76 638) 157,5% 77 924 64 661
Total 142 498 - - 142 498 211 282 (68 784) 148,3% 86 546 68 676

Subprogramme: 6.4: Other Training

2018/19 2017/18
appropriation
Social contributions 2 726 2 726 2 544 182 93,3% 2 572 2 317
Minor assets 15 15 202 (187) 1346,7% 15 -
Communication (G&S) 153 153 - 153 - 154 -
Consultants: Business and advisory services 265 265 - 265 - 250 156
Laboratory services 53 53 - 53 - 58 17
Inventory: Clothing material and accessories - - 24 (24) - - -
Inventory: Food and food supplies - - - - - - 1
Inventory: Materials and supplies - - 12 (12) - - 2
Inventory: Other supplies - - 6 (6) - - 10
Consumable supplies 181 181 11 170 6,1% 170 54
Training and development 4 888 4 888 10 544 (5 656) 215,7% 4 571 2 244
Departmental agencies (non-business entities) 20 962 20 962 20 962 - 100,0% 19 812 19 812
Higher education institutions 13 681 13 681 12 855 826 94,0% 2 061 9 786
Households 8 000 - - 8 000 12 902 (4 902) 161,3% - 6
Social benefits - - - - 6
Other transfers to households 8 000 8 000 12 902 (4 902) 161,3% -
Payments for capital assets 486 - - 486 87 399 17,9% 457 1
Machinery and equipment 486 - - 486 87 399 17,9% 457 1
Other machinery and equipment 486 486 87 399 17,9% 457 1
Total 94 002 - - 94 002 89 280 4 722 95,0% 68 595 68 222

Programme 7: Health Care Support Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 Laundries 224 462 - 27 000 251 462 250 982 480 99,8% 213 145 208 732
2 Food Supply Services 87 693 - - 87 693 88 066 (373) 100,4% 76 692 81 035
3 Medicine Trading Account 1 - - 1 - 1 - 1 -
312 156 - 27 000 339 156 339 048 108 100,0% 289 838 289 767
Current payments 302 581 - 27 000 329 581 337 043 (7 462) 102,3% 281 817 284 106
Compensation of employees 180 597 - 8 000 188 597 182 146 6 451 96,6% 168 354 162 379
Social contributions 25 954 - 8 000 33 954 32 263 1 691 95,0% 30 068 30 282
Goods and services 121 984 - 19 000 140 984 154 897 (13 913) 109,9% 113 463 121 727
Minor assets 61 - - 61 13 48 21,3% 457 42
Communication (G&S) 409 - - 409 389 20 95,1% 809 449
Contractors 98 - - 98 40 58 40,8% 371 14
Agency and support / outsourced services 382 - - 382 446 (64) 116,8% 43 1
Fleet services (including government motor transport) 2 481 - - 2 481 2 597 (116) 104,7% 306 2 609
Inventory: Fuel, oil and gas 22 115 - 8 000 30 115 31 701 (1 586) 105,3% 2 083 9 761

Programme 7: Health Care Support Services

2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
Inventory: Materials and supplies 370 - - 370 500 (130) 135,1% 426 83
1 Laundries
Inventory: Medical supplies 224491
462 - 27 000
- 251491
462 250 982
1 894 (1 480
403) 99,8%
385,7% 213785
145 208 732
1 226
2 FoodInventory:
Supply Services
Other supplies 87 693
1 945 - - 87 693
1 945 88 066
1 316 (373)
629 100,4%
67,7% 76 692
1 032 81 035
2 598
3 Medicine Trading Account
Consumable supplies 1
43 848 - -
11 000 1
54 848 -
62 951 1
(8 103) -
114,8% 1
58 976 -
59 246
Consumable: Stationery, printing and office supplies 312401
156 - - -
27 000 339401
156 339344
048 57
108 85,8%
100,0% 289529
838 289267
767
Operating leases 1 900 - - 1 900 9 051 (7 151) 476,4% - 1 581
Travel and subsistence 5 - - 5 - 5 - 35 -
Current payments
Training and development 302 581
41 - 27 000
- 329 581
41 337 043
31 (7 462)
10 102,3%
75,6% 281 817
78 284 106
3
597 - 8 000
- 188240
597 182722
146 6(482)
451 96,6%
300,8% 168 354
- 162 379
1 222
Salaries
Transfers andand wages
subsidies 154645
643 - - 154645
643 149597
883 4 760
48 96,9%
92,6% 138608
286 132613
097
Households 25645
954 - 8 000
- 33645
954 32597
263 1 691
48 95,0%
92,6% 30608
068 30613
282
Goods and
Social services
benefits 121645
984 - 19 000
- 140645
984 154597
897 (13 913)
48 109,9%
92,6% 113608
463 121613
727
Minor assets
Payments for capital assets 61
8 930 - - 61
8 930 13
1 335 48
7 595 21,3%
14,9% 7 457
413 42
5 005
Communication
Machinery (G&S)
and equipment 8 409
930 - - 8 409
930 1 389
335 20
7 595 95,1%
14,9% 7 809
413 5 449
005
Contractors
Transport equipment 98
4 468 - - 98
4 468 40
708 58
3 760 40,8%
15,8% 4 371
550 14
2 300
Agency and support
Other machinery / outsourced
and equipmentservices 4 382
462 - - 4 382
462 446
627 (64)
3 835 116,8%
14,1% 43
2 863 1
2 705
Fleet for
Payment services (including
financial assetsgovernment motor transport) 2 481
- - - 2 481
- 2 597
73 (116)
(73) 104,7%
- 306
- 2 609
43
Inventory: Clothing material and accessories -
312 156 - - -
27 000 -
339 156 339736
048 (736)
108 -
100,0% -
289 838 289579
767
Inventory: Fuel, oil and gas 22 115 - 8 000 30 115 31 701 (1 586) 105,3% 2 083 9 761

Subprogramme: 7.1: Laundries

2018/19 2017/18
appropriation
Current payments 217 182 - 27 000 244 182 249 169 (4 987) 102,0% 206 278 204 132
Compensation of employees 154 392 - 8 000 162 392 159 518 2 874 98,2% 144 199 138 043
Social contributions 20 635 8 000 28 635 31 136 (2 501) 108,7% 23 713 25 848
Goods and services 62 790 - 19 000 81 790 89 651 (7 861) 109,6% 62 079 66 089
Minor assets 27 27 13 14 48,1% 388 6
Contractors 17 17 40 (23) 235,3% 299 14
Agency and support / outsourced services 379 379 445 (66) 117,4% 13 -
Fleet services (including government motor transport) 2 481 2 481 2 597 (116) 104,7% 306 2 609
Inventory: Fuel, oil and gas 12 736 8 000 20 736 20 812 (76) 100,4% 301 5 755
Inventory: Medical supplies 291 291 726 (435) 249,5% 625 438
Inventory: Other supplies 1 575 1 575 988 587 62,7% 678 2 022
Consumable supplies 26 404 11 000 37 404 39 057 (1 653) 104,4% 41 930 39 393

Subprogramme: 7.1: Laundries

2018/19 2017/18
appropriation
Consumable:
Current paymentsStationery, printing and office supplies 217 168
182 - 27 000 244 168
182 249 129
169 39
(4 987) 76,8%
102,0% 206 309
278 96
204 132
Operating leases
154 392 - 8 000 1 900
162 392 9 051
159 518 (7 151)
2 874 476,4%
98,2% 144 199- 1 581
138 043
Property payments
Salaries and wages 15 757
133 15 757
133 13 413
128 382 2 375
5 344 85,1%
96,0% 15 903
120 486 11 833
112 195
Social contributions 5
20 635 8 000 5
28 635 31 136- 5
(2 501) -
108,7% 35
23 713 25 848-
Goods andand
Training development
services 29
62 790 - 19 000 29
81 790 30
89 651 (1)
(7 861) 103,4%
109,6% 58
62 079 66 089-
Operating payments
Minor assets 240
27 240
27 722
13 (482)
14 300,8%
48,1% 388- 1 222
6
Communication (G&S) 470
406 - - 470
406 500
389 (30)
17 106,4%
95,8% 443
803 501
449
Households
Contractors 470
17 - - 470
17 500
40 (30)
(23) 106,4%
235,3% 443
299 501
14
Social and
Agency benefits
support / outsourced services 470
379 470
379 500
445 (30)
(66) 106,4%
117,4% 443
13 501-
Payments for capital assetsgovernment motor transport)
Fleet services (including 6 810
2 481 - - 6 810
2 481 1 240
2 597 5(116)
570 18,2%
104,7% 6 306
424 4 056
2 609
Machinery
Inventory:and equipment
Clothing material and accessories 6 810- - - 6 810- 1 240
736 5(736)
570 18,2%
- 6 424- 4 579
056
TransportFood
Inventory: equipment
and food supplies 4 468
20 4 468
20 708
5 3 760
15 15,8%
25,0% 4 550
30 2 300
9
Other machinery
Inventory: Fuel, oil and equipment
gas 2 342
12 736 8 000 2 342
20 736 532
20 812 1 810
(76) 22,7%
100,4% 1 874
301 1 755
5 756
Inventory: Materialsassets
and supplies 355 355- 73
498 (73)
(143) -
140,3% 401- 43
83
Total
462 - 27 000 251 291
462 250 726
982 480
(435) 99,8%
249,5% 213 625
145 208 438
732
Inventory: Other supplies 1 575 1 575 988 587 62,7% 678 2 022
Consumable supplies 26 404 11 000 37 404 39 057 (1 653) 104,4% 41 930 39 393

Subprogramme: 7.2: Food Supply Services

2018/19 2017/18
appropriation
Salaries and wages 20 886 20 886 21 501 (615) 102,9% 17 800 19 902
Minor assets 34 34 - 34 - 69 36
Contractors 80 80 - 80 - 71 -
Inventory: Materials and supplies 15 15 2 13 13,3% 25 -
Inventory: Medical supplies 200 200 1 168 (968) 584,0% 160 788
Property payments 3 420 3 420 3 669 (249) 107,3% 4 400 4 484
Households 175 - - 175 97 78 55,4% 165 112
Social benefits 175 175 97 78 55,4% 165 112
Payments for capital assets 2 120 - - 2 120 95 2 025 4,5% 989 949
Machinery and equipment 2 120 - - 2 120 95 2 025 4,5% 989 949
Other machinery and equipment 2 120 2 120 95 2 025 4,5% 989 949
Total 87 693 - - 87 693 88 066 (373) 100,4% 76 692 81 035

Subprogramme: 7.3: Medicine Trading Account
2018/19 2017/18
appropriation
Current payments 1 - - 1 - 1 - 1 -
Goods and services 1 - - 1 - 1 - 1 -
Administrative fees - - - -
Contractors 1 1 1 - 1
Total 1 - - 1 - 1 - 1 -
Programme 8: Health Facilities Management
2018/19 2017/18
appropriation
R'000 R'000 R'000 R'000 R'000 R'000 % R'000 R'000
Sub programme
1 Community Health Facilities 432 134 - - 432 134 390 045 42 089 90,3% 341 042 317 234
2 Emergency Medical Rescue Services 9 628 - - 9 628 1 299 8 329 13,5% 7 046 1 733
3 District Hospital Services 218 580 - - 218 580 172 998 45 582 79,1% 260 789 214 807
4 Provincial Hospital Services 264 803 - - 264 803 202 304 62 499 76,4% 288 934 264 246
5 Central Hospital Services 314 344 - - 314 344 315 650 (1 306) 100,4% 311 287 335 462
6 Other Facilities 320 444 - - 320 444 453 824 (133 380) 141,6% 474 201 474 295
1 559 933 - - 1 559 933 1 536 120 23 813 98,5% 1 683 299 1 607 777
Salaries and wages 26 293 - - 26 293 29 264 (2 971) 111,3% 24 736 27 356
Advertising 352 - - 352 - 352 - 333 191
Minor assets 519 - - 519 223 296 43,0% 8 491 750
Catering: Departmental activities 117 - - 117 - 117 - 111 -
Legal services - - - - - - - - 7 024
Contractors 2 324 - - 2 324 2 163 161 93,1% 2 000 1 740
Agency and support / outsourced services - - - - 155 (155) - - -
Inventory: Clothing material and accessories - - - - - - - 500 -
Inventory: Food and food supplies - - - - 41 (41) - - 15
Subprogramme: 8.2: Emergency Medical Rescue Services
Inventory: Fuel, oil and gas - - - - - - - - 69 552
2018/19 2017/18
Inventory: Materials and supplies - - - - (12) 12 - 1 500 398
Inventory: Medical supplies - - - - 1 993 (1 993) - 3 000 1 959
appropriation
Current payments 6 628 - - 6 628 495 6 133 7,5% 7 046 1 272
Programme 8: Health Facilities Management

2018/19 2017/18
appropriation
Current payments -1 - - - - -1 - - -1 - - -1 236 -
Consumable
Goods supplies
and services 100 1 - - - - 100 1 4- 96 1 4,0%- 1 100 1 71 -
Consumable:
AdministrativeStationery,
fees printing and office supplies 334 - - 334 - 4 330 - 1,2%
- 216 - 25
Operating
Contractorsleases 39 7071 - - 39 7071 25 473 14 2341 64,2%
- 36 5301 41 953
Total
Property payments 507 5731 - - - - 507 5731 649 498- (141 925)
1 128,0%
- 703 3291 765 140-
Programme Travel
8: Health Facilities Management
and subsistence 222 - - 222 369 (147) 166,2% 210 352
Training and development 1 500 - - 1 500
2018/19 46 1 454 3,1% 400
2017/18 397
Adjusted -
Shifting of Virement- Final500 Actual44 456
Variance 8,8%
Expenditure 1 000
Final 313
Actual
Transfers and subsidies Appropriation
- Funds - - Appropriation
- Expenditure
- - as % of final
- Appropriation
- Expenditure
158
- - - - - - appropriation
- - 158
Households
R'000 - R'000 - R'000 - R'000 - R'000 - R'000 - % - R'000 - R'000158
Social benefits
Sub programme
1 Community Health Facilities 432 027
900 134 -- -- 432 027
900 134 390 617
785 045 42 410
114 089 90,3%
87,3% 341 917
818 042 317 418
615 234
Buildings and other fixed structures
2 Emergency Medical Rescue Services 9 628 - - 9 628 1 299 8 329 13,5% 7 046 1 733
Buildings 900 027 - - 900 027 785 617 114 410 87,3% 818 917 615 418
3 District Hospital Services 218 580 - - 218 580 172 998 45 582 79,1% 260 789 214 807
4 Provincial Hospital Services 264 803 - - 264 803 202 304 62 499 76,4% 288 934 264 246
5 Central Hospital Services 314 344 - - 314 344 315 650 (1 306) 100,4% 311 287 335 462
Payment for financial assets - - - - - - - - 9
6 Other Facilities 320 444 - - 320 444 453 824 (133 380) 141,6% 474 201 474 295
1 559 933 - - 1 559 933 1 536 120 23 813 98,5% 1 683 299 1 607 777
1 559 933 - - 1 559 933 1 536 120 23 813 98,5% 1 683 299 1 607 777
Salaries and wages 26 293 - - 26 293 29 264 (2 971) 111,3% 24 736 27 356
Advertising 352 - - 352 - 352 - 333 191
Minor assets 519 - - 519 223 296 43,0% 8 491 750
Catering: Departmental activities 117 - - 117 - 117 - 111 -
Legal services - - - - - - - - 7 024
Contractors 2 324 - - 2 324 2 163 161 93,1% 2 000 1 740
Agency and support / outsourced services - - - - 155 (155) - - -
- - - - - - - 500 -
Inventory: Food and food supplies - - - - 41 (41) - - 15
Inventory: Fuel, oil and gas - - - - - - - - 69 552
Inventory: Materials and supplies - - - - (12) 12 - 1 500 398
Inventory: Medical supplies - - - - Department
1 993 of Health
(1 993) Annual
- Report 2018/19
3 000 1 959
226
Subprogramme: 8.1: Community Health Facilities

2018/19 2017/18
appropriation
Minor assets - - 151 (151) - - 337
Inventory: Medical supplies - - 265 (265) - - 889
Inventory: Other supplies - - - - - - 236
Buildings and other fixed structures 379 742 - - 379 742 331 032 48 710 87,2% 255 412 223 316
Buildings 379 742 379 742 331 032 48 710 87,2% 255 412 223 316
Payment for financial assets - - - -
Total 432 134 - - 432 134 390 045 42 089 90,3% 341 042 317 234

Subprogramme: 8.2: Emergency Medical Rescue Services

2018/19 2017/18
appropriation
Current payments 6 628 - - 6 628 495 6 133 7,5% 7 046 1 272
Goods and services 6 628 - - 6 628 495 6 133 7,5% 7 046 1 272
Payments for capital assets 3 000 - - 3 000 804 2 196 26,8% - 461
Buildings and other fixed structures 3 000 - - 3 000 804 2 196 26,8% - 461
Buildings 3 000 3 000 804 2 196 26,8% - 461
Total 9 628 - - 9 628 1 299 8 329 13,5% 7 046 1 733
Subprogramme: 8.3: District Hospital Services
2018/19 2017/18
appropriation
Compensation of employees - - - - - - - - 47
Salaries and wages - - - - 47
Minor assets - - 49 (49) - - 2
Communication (G&S) - - 3 (3) - -
Contractors - - 3 (3) - -

Buildings 3 000 3 000 804 2 196 26,8% - 461
Total 9 628 - - 9 628 1 299 8 329 13,5% 7 046 1 733
Subprogramme: 8.3: District Hospital Services GAUTENG DEPARTMENT OF HEALTH VOTE 4
2018/19 2017/18
appropriation
Fleet services (including government motor transport) R'000 - R'000 R'000 R'000 - R'000 35 R'000 (35) % - R'000 - R'000 7
Inventory:
Current Food and food supplies
payments 116 755- - - 116 755- 53 863- 62 892- -
46,1% 98 239- 15
86 512
Inventory: Materials
Compensation and supplies
of employees - - - - (12)
- 12- - - 47
Inventory:
Salaries Medical
and wagessupplies - - 120 (120)
- - - 453
47
Consumable
Goods supplies
and services 116 755- - - 116 755- 1
53 863 (1)
62 892 -
46,1% 98 239- 3
86 465
Property
Minor payments
assets 116 755- 116 755- 53 664
49 63 091
(49) 46,0%
- 98 239- 85 985
2
Other transfers(G&S)
Communication to households - - 3 -
(3) - -
Payments for capital assets
Contractors 101 825- - - 101 825- 119 135
3 (17 310)
(3) 117,0%
- 162 550- 128 295
Buildings and other fixed structures 89 436 - - 89 436 112 987 (23 551) 126,3% 150 850 113 027
Buildings 89 436 89 436 112 987 (23 551) 126,3% 150 850 113 027
Transport equipment - - - -
Total 218 580 - - 218 580 172 998 45 582 79,1% 260 789 214 807
Subprogramme: 8.4: Provincial Hospital Services
2018/19 2017/18
appropriation
Minor assets - - - - - 8 000 363
Communication (G&S) - - - - - - 2
Contractors - - - - - - 202
Fleet services (including government motor transport) - - 3 (3) - - -
Inventory: Materials and supplies - - - - - 1 500 397
Inventory: Medical supplies - - - - - 3 000 617
Consumable supplies - - - - - 1 000 40
Buildings 37 367 37 367 74 965 (37 598) 200,6% 71 589 47 770
Machinery and equipment - - - - - - - 43 739 46 094
Other machinery and equipment - - - 43 739 46 094
Payment for financial assets - - - -
Total 264 803 - - 264 803 202 304 62 499 76,4% 288 934 264 246

Subprogramme: 8.5: Central Hospital Services

2018/19 2017/18
appropriation
Minor assets - - 23 (23) - - -
Contractors - - - - - - 49
Agency and support / outsourced services - - 155 (155) - - -
Inventory: Food and food supplies - - 41 (41) - - -
Inventory: Fuel, oil and gas - - - - - - 1
Inventory: Materials and supplies - - - - - - 1
Inventory: Medical supplies - - 1 608 (1 608) - - -
Buildings 73 133 73 133 85 791 (12 658) 117,3% 105 536 97 526
Machinery and equipment 44 910 - - 44 910 28 283 16 627 63,0% - -
Other machinery and equipment 44 910 44 910 28 283 16 627 63,0% -
Total 314 344 - - 314 344 315 650 (1 306) 100,4% 311 287 335 462

Subprogramme: 8.6: Other Facilities

2018/19 2017/18
appropriation
Goods and services (36 374) - - (36 374) 242 161 (278 535) (665,8%) 200 939 309 070
Advertising 352 352 - 352 - 333 191
Minor assets 519 519 - 519 - 491 48
Catering: Departmental activities 117 117 - 117 - 111 -
Legal services - - - - - - 7 024
Contractors 2 324 2 324 2 160 164 92,9% 2 000 1 489
Fleet services (including government motor transport) 651 651 - 651 - 615 -
Inventory: Clothing material and accessories - - - - - 500 -
Inventory: Fuel, oil and gas - - - - - - 69 551
Consumable supplies 100 100 3 97 3,0% 100 11
Operating leases 39 707 39 707 25 473 14 234 64,2% 36 530 41 953

Subprogramme: 8.6: Other Facilities

2018/19 2017/18
appropriation
Economic
Propertyclassification
payments R'000
(82 886) R'000 R'000 R'000
(82 886) R'000
214 062 R'000
(296 948) %
(258,3%) R'000
158 257 R'000
187 716
Transport
Current provided: Departmental activity
payments 1 495- - - 1 495- 273 771- -
(272 276) -
18312,4% 236 616- 339 863-
869 - - 37 222
869 31 369
610 6(147)
259 166,2%
83,5% 35 210
677 30 352
793
Training
Salaries and development
wages 1 500
26 293 1 500
26 293 46
29 264 1 454
(2 971) 3,1%
111,3% 24 400
736 27 397
309
Operating payments
Social contributions 11 500
576 11 500
576 44
2 346 9 456
230 8,8%
20,3% 1 000
10 941 3 313
484
Transfers andservices
Goods and subsidies -
(36 374) - - -
(36 374) 242 161- -
(278 535) -
(665,8%) 200 939- 309 158
070
Households
Advertising 352- - - 352- - 352- - 333- 158
191
Social
Minor benefits
assets 519 519- - 519- - 491- 158
48
Payments for Departmental
Catering: capital assetsactivities 318 949
117 - - 318 949
117 180 053- 138 896
117 56,5%
- 237 585
111 134 265-
Buildings and other
Communication fixed structures
(G&S) 317 349
186 - - 317 349
186 180 038- 137 311
186 56,7%
- 235 530
176 133 318-
Buildings
Legal services 317 349- 317 349- 180 038- 137 311- 56,7%
- 235 530- 133
7 318
024
Machinery and equipment
Contractors 1
2 600
324 - - 1
2 600
324 15
2 160 1 585
164 0,9%
92,9% 2 055
000 1 947
489
Other
Fleet machinery
services and equipment
(including government motor transport) 1 600
651 1 600
651 15- 1 585
651 0,9%
- 2 055
615 947-
Inventory: Clothingassets
material and accessories - - - - - 500- 9-
Total
Inventory: Fuel, oil and gas 320 444- - - 320 444- 453 824- (133 380)
- 141,6%
- 474 201- 474
69 295
551

VOTE 4 NOTES TO THE APPROPRIATION STATEMENT
1. a Detail of transfers and subsidies as per Appropriation Act 3. Detail on payments for financial assets
(after Virement):
Detail of these transactions per programme can be viewed in the
Detail of these transactions can be viewed in the note on Transfers note on Payments for financial assets to the Annual Financial
and subsidies, disclosure notes and Annexures (1-7) to the Annual Statements.
Financial Statements.
4. Explanations of material variances from Amounts Voted
2. Detail of specifically and exclusively appropriated amounts (after Virement):
voted (after Virement):
Detail of these transactions can be viewed in note 1 (Annual

Appropriation) to the Annual Financial Statements.
4.1 Per programme Final Appropriation Actual Expenditure Variance as a % of

Variance R’000 Final Appropriation
Administration 1 361 130 1 360 786 344 0%
District Health Services 15 073 917 14 516 480 557 437 3.7%
Emergency Medical Services 1 423 203 1 330 508 92 695 6.5%
Provincial Hospital Services 8 746 469 8 686 653 59 816 0.7%
Central Hospital Services 17 135 226 17 134 257 969 0.0%
Health Sciences & Training 1 123 296 1 106 708 16 588 1.5%
Health Care Support Services 339 156 339 048 108 0.0%
Health Facilities Management 1 559 933 1 536 120 23 813 1.5%
46 762 330 46 010 559 751 770 1.6%
Under expenditure was due to delays in the creation of posts and in payment of
District Health Services
the National Health Laboratory Services (NHLS) account. Underspending on the
HIV and AIDS grant also contributed to the Programme underspending. All
under spent funds have been committed. The Department has applied for
rollovers.
Emergency Medical Services Under expenditure was due to delays in the creation of posts. All underspent
resources have been committed. The Department has applied for rollovers.

Final Appropriation Actual Expenditure Variance as a % of

4.2 Per economic classification
R’000 R’000 R’000
Current payments
Compensation of employees 26 994 470 26 902 299 92 171 -
Goods and services 15 567 703 15 229 503 338 200 2%
Interest and rent on land - 7 794 (7 794) -100%
Transfers and Subsidies
Provinces and Municipalities 721 989 721 992 (3) -
Departmental Agencies and Accounts 20 962 20 962 - -
Higher education institutions 13 681 13 421 260 2%
Non-profit institutions 664 428 615 281 49 247 7%
Households 535 809 921 439 (385 630) -72%
Payments for Capital Assets
Buildings and other fixed structures 900 267 785 617 114 650 13%
Machinery and equipment 1 342 920 786 489 556 431 41%
Payments for financial assets - 5 763 (5 763) -100%
46 762 330 46 010 560 751 770 1.6%
Non-Profit Institutions (NPOs): Non-compliance with the minimum requirements were not met by some of the NPOs resulted in
under-expenditure.
Households: Over-spending in this line item was due payment of Medico Legal claims.
Payment of Capital Assets: Maintenance and Occupational Health & Safety (OHS) projects were prioritized, however, late submission of
invoices by the implementing agent led to underspending within the programme. Machinery and Equipment underspending is due to long
lead times for items that have already been ordered. Delays in procurement processes also contributed to the underspending. The Department
has applied for roll-overs for all unspent funds to reduce accruals.

Final Appropriation Actual Expenditure Variance as a % of

4.2 Per economic classification
R’000 R’000 R’000 %
Comprehensive HIV & AIDS GRANT 4 239 277 3 965 836 273 441 6%
National Tertiary Services Grant 4 390 192 4 137 621 252 571 6%
Health PROF Training & DEV Grant 983 712 947 885 35 527 4%
EPWP Integrated Grant for PROV 2 324 2 160 164 7%
Health Facility REVIT Grant 892 084 779 939 112 145 13%
SOC SEC EPWP INCEN Grant for PROV 1 470 1 404 66 4%
Human Papillomavirus Vaccine Grant 27 312 21 670 5 642 21%
TOTAL 10 536 371 9 856 515 679 856 6%
COMPREHENSIVE HIV & AIDS GRANT HEALTH FACILITY REVITALISATION GRANT

Underspending was incurred on the following items: The under expenditure was due to the late submission of invoices as
• Medicine – this was due to late receipt of invoices and less well as contracts having to be terminated due to poor performance
intake by the users which resulted in the underachievement of by contractors. In some instances, contractors abandoned sites due
set targets. to community unrests/ service delivery protests which affected
• Operating payments – a provision made for courier services projected expenditure on the grant.
towards expansion of Chronic CMDD programme couldn’t be
spent as the expense was paid for the National Department of The Department has submitted a roll-over application to the value of
Health on behalf of the province. R112.1 million.
• Non-profit institutions – a number of Non-Profit Institutions
did not meet the qualifying funding criteria.
HUMAN PAPILLOMAVIRUS VACCINE GRANT
The Department has submitted a roll-over application to the value of The underspending on the grant is due to the delays in receiving the
R273.4 million. invoices for medicine, training materials and travel claims.
NATIONAL TERTIARY SERVICES GRANT The Department has submitted a roll-over application to the value of
The Department incurred the commitments to the value of R252.6 R5.6 million.
million as at 31 March 2019, this is due to the nature of medical
equipment procurement processes as some the items are sourced
internationally. The
Department has submitted a roll-over application to the value of

R252.6 million.
HEALTH PROFESSIONS TRAINING & DEVELOPMENT

GRANT REPORT
The under expenditure is mainly attributed to the delays from
suppliers delivering medical equipment within the stipulated
timeframes and this resulted in delays in processing of R1.7 million
invoices and commitments amounting to R32.3 million as at 31
March 2019.
The Department has submitted a roll-over application to the value of

R34.0 million.

GAUTENG DEPARTMENT OF HEALTH VOTE 4 STATEMENT
OF FINANCIAL PERFORMANCE
NOTES 2018/19 2017/18

R'000 R'000
REVENUE
Annual Appropriation 1 46 762 330 42 192 834

Departmental Revenue 2 780 803 546 916
TOTAL REVENUE 47 543 133 42 739 750
EXPENDITURE
Current Expenditure
Compensation of Employees 3 26 902 298 25 085
331
Goods and Services 4 229 501 13 583 391
Interest and Rent on Land 5 7 794 628
Total Current Expenditure 42 139 593 38 669 350
Transfers and Subsidies

Transfers and Subsidies 7 2 293 096 1 858 898
Total Transfers and Subsidies 2 293 096 1 858 898
Expenditure for Capital Assets

Tangible Assets 8 1 572 107 1 476 108
Total expenditure for Capital Assets 1 572 107 1 476 108
Payments for Financial Assets 6 5 764 9 103
TOTAL EXPENDITURE 46 010 560 42 013 459
SURPLUS/(DEFICIT) FOR THE YEAR 1 532 573 726 291
Reconciliation of Net Surplus/(Deficit) for the year
Voted funds 751 770 179 375

Annual Appropriation 71 914 25 817
Conditional Grants 679 856 153 558
Departmental Revenue 2 780 803 546 916
SURPLUS/(DEFICIT) FOR THE YEAR 1 532 573 726 291

VOTE 4 STATEMENT OF FINANCIAL POSITION
AS AT 31 MARCH 2019
NOTES 2018/19 2017/18

R'000 R'000
ASSETS
Current assets 707 744 438 662
Cash and Cash Equivalents 9 685 392 283 773

Receivables 10 22 352 154 889
Non-Current Assets 142 962 115 654
Investments 11 54 000 54 000

Receivables 10 88 962 61 654
TOTAL ASSETS 850 706 554 316
LIABILITIES 717 283 449 380
Current liabilities
Voted funds to be surrendered to the Revenue Fund 12 439 466 -

Departmental revenue to be surrendered to
the Revenue Fund 13 70 454 57 864
Payables 14 207 363 391 516
Non-Current liabilities - -
TOTAL LIABILITIES 717 283 449 380
NET ASSETS 133 423 104 936
Represented by:
Capitalisation Reserve 54 000 54 000
Recoverable Revenue 79 423 50 936
TOTAL 133 423 104 936

STATEMENT OF CHANGES IN NET ASSETS
AS AT 31 MARCH 2019
NOTES 2018/19 2017/18

R'000 R'000
Capitalisation Reserves
Opening balance 54 000 54 000
Closing balance 54 000 54 000
Recoverable revenue
Transfers: 28 487 16 190
Debts recovered 628 1 694
Debts raised 27 859 14 496
TOTAL 133 423 104 936
The amount of R54.0 million is the initial capital investment in Medical Supplies Depot (MSD). No additional investment was made during the
period.

VOTE 4 CASH FLOW STATEMENT
NOTES 2018/19 2017/18

R'000 R'000
CASH FLOWS FROM OPERATING ACTIVITIES
Receipts
Annual Appropriated funds received 1.1 47 543 133 42 739 750
Departmental Revenue Received 2 46 762 330 42 192 834
Interest received 2 780 039 545 942
764 974
Net (increase)/decrease in working capital (78 924) (8 140)
Surrendered to Revenue Fund (1 080 517) (768 070)
Current Payments (42 131 799) (38 668 722)
Interest Paid 5 (7 794) (628)
Payments for Financial Assets (5 764) (9 103)

Transfers and Subsidies paid (2 293 096) (1 858 898)
Net Cash Flow available from operating activities 15 1 945 239 1 426 189
CASH FLOWS FROM INVESTING ACTIVITIES
Payments for Capital Assets 8 (1 572 107) (1 476 108)

Net cash Flows from investing activities (1 572 107) (1 476 108)
CASH FLOWS FROM FINANCING ACTIVITIES
Increase/(decrease) in net assets 28 487 16 190

Net cash flows from financing activities 28 487 16 190
Net increase/(decrease) in cash and cash equivalents 401 619 (33 729)
Cash and cash equivalents at beginning of period 283 773 317 502
Cash and cash equivalents at end of period 16 685 392 283 773

VOTE 4 ACCOUNTING POLICIES
PART A: ACCOUNTING POLICIES

Summary of significant accounting policies
The financial statements have been prepared in accordance with the following policies, which have been applied consistently in all
material aspects, unless otherwise indicated. Management has concluded that the financial statements present fairly the Department’s
primary and secondary information.
The historical cost convention has been used, except where otherwise indicated. Management has used assessments and estimates in
preparing the annual financial statements. These are based on the best information available at the time of preparation.
Where appropriate and meaningful, additional information has been disclosed to enhance the usefulness of the financial statements
and to comply with the statutory requirements of the Public Finance Management Act (PFMA), Act 1 of 1999 (as amended by Act 29
of 1999), and the Treasury Regulations issued in terms of the PFMA and the annual Division of Revenue Act.
1 Basis of preparation
The financial statements have been prepared in accordance with the Modified Cash Standard.
2 Going concern
The financial statements have been prepared on a going concern basis.
3 Presentation currency
Amounts have been presented in the currency of the South African Rand (R) which is also the functional currency of the
Department.
4 Rounding
Unless otherwise stated financial figures have been rounded to the nearest one thousand Rand (R’000).
5 Comparative information
5.1 Prior period comparative information

Prior period comparative information has been presented in the current year’s financial statements. Where necessary figures
included in the prior period financial statements have been reclassified to ensure that the format in which the information is
presented is consistent with the format of the current year’s financial statements.
5.2 Current year comparison with budget

A comparison between the approved, final budget and actual amounts for each programme and economic classification is
included in the appropriation statement.
6 Revenue
6.1 Appropriated funds

Appropriated funds comprises of Departmental allocations as well as direct charges against the revenue fund (i.e. statutory
appropriation).
Appropriated funds are recognised in the statement of financial performance on the date the appropriation becomes effective.
Adjustments made in terms of the adjustments budget process are recognised in the statement of financial performance on the
date the adjustments become effective.
The net amount of any appropriated funds due to / from the relevant revenue fund at the reporting date is recognised as a
payable / receivable in the statement of financial position.
6.2 Departmental revenue

Departmental revenue is recognised in the statement of financial performance when received and is subsequently paid into the
relevant revenue fund, unless stated otherwise.
Any am ount owing to the relevant revenue fund at the reporting date is recognised as a payable in the statement of financial
position.
6.3 Accrued Departmental revenue

Accruals in respect of Departmental revenue are recorded in the notes to the financial statements when:
• it is probable that the economic benefits or service potential associated with the transaction
will flow to the Department; and
• the amount of revenue can be measured reliably.
The accrued revenue is measured at the fair value of the consideration receivable.
Write-offs are made according to the Department’s debt write-off policy.

7 Expenditure
7.1 Compensation of employees
7.1.1 Salaries and wages

Salaries and wages are recognised in the statement of financial performance on the date of payment.
7.1.2 Social contributions

Social contributions made by the Department in respect of current employees are recognised in the statement of financial
performance on the date of payment.
Social contributions made by the Department in respect of ex-employees are classified as transfers to households in the
statement of financial performance on the date of payment.
7.2 Other expenditure

Other expenditure (such as goods and services, transfers and subsidies and payments for capital assets) is recognised in the
statement of financial performance on the date of payment. The expense is classified as a capital expense if the total
consideration paid is more than the capitalisation threshold.
7.3 Accruals and payables not recognised

Accruals and payables not recognised are recorded in the notes to the financial statements at cost at the reporting date.
7.4 Leases
7.4.1 Operating leases

Operating lease payments made during the reporting period are recognised as current expenditure in the statement of financial
The operating lease commitments are recorded in the notes to the financial statements.
7.4.2 Finance leases

Finance lease payments made during the reporting period are recognised as capital expenditure in the statement of financial
The finance lease commitments are recorded in the notes to the financial statements and are not apportioned between the
capital and interest portions.
Finance lease assets acquired at the end of the lease term are recorded and measured at the lower of:
• cost, being the fair value of the asset; or
• the sum of the minimum lease payments made, including any payments made to acquire ownership at the end of the lease
term, excluding interest.
8 Cash and cash equivalents

Cash and cash equivalents are stated at cost in the statement of financial position.
Bank overdrafts are shown separately on the face of the statement of financial position as a current liability.
For the purposes of the cash flow statement, cash and cash equivalents comprise cash on hand, deposits held, other short-term
highly liquid investments and bank overdrafts.
Prepayments and advances
Prepayments and advances are recognised in the statement of financial position when the Department receives or disburses the
cash.
Prepayments and advances are initially and subsequently measured at cost.
9 Loans and receivables

Loans and receivables are recognised in the statement of financial position at cost plus accrued interest, where interest is
charged, less amounts already settled or written-off. Write-offs are made according to the Department’s write-off policy.
10 Investments
Investments are recognised in the statement of financial position at cost.
11 Financial assets
Financial assets (not covered elsewhere)

A financial asset is recognised initially at its cost plus transaction costs that are directly attributable to the acquisition or issue
of the financial asset.
At the reporting date, a Department shall measure its financial assets at cost, less amounts already settled or written-off, except
for recognised loans and receivables, which are measured at cost plus accrued interest, where interest is charged, less amounts
already settled or written-off.

12.2 Impairment of financial assets

Where there is an indication of impairment of a financial asset, an estimation of the reduction in the recorded carrying value, to
reflect the best estimate of the amount of the future economic benefits expected to be received from that asset, is recorded in
the notes to the financial statements.
13 Payables
Payables recognised in the statement of financial position are recognised at cost.
14 Capital Assets
14.1 Immovable capital assets

Immovable assets reflected in the asset register of the Department are recorded in the notes to the financial statements at cost
or fair value where the cost cannot be determined reliably. Immovable assets acquired in a non-exchange transaction are
recorded at fair value at the date of acquisition. Immovable assets are subsequently carried in the asset register at cost and are
not currently subject to depreciation or impairment.
Subsequent expenditure of a capital nature forms part of the cost of the existing asset when ready for use.
Additional information on immovable assets not reflected in the assets register is provided in the notes to financial statements.
14.2 Movable capital assets

Movable capital assets are initially recorded in the notes to the financial statements at cost. Movable capital assets acquired
through a non-exchange transaction is measured at fair value as at the date of acquisition.
Where the cost of movable capital assets cannot be determined reliably, the movable capital assets are measured at fair value
and where fair value cannot be determined; the movable assets are measured at R1.
All assets acquired prior to 1 April 2002 (or a later date as approved by the OAG) may be recorded at R1.
Movable capital assets are subsequently carried at cost and are not subject to depreciation or impairment.
14.3 Intangible assets

Intangible assets are initially recorded in the notes to the financial statements at cost. Intangible assets acquired through a
non-exchange transaction are measured at fair value as at the date of acquisition.
Internally generated intangible assets are recorded in the notes to the financial statements when the Department commences
the development phase of the project.
Where the cost of intangible assets cannot be determined reliably, the intangible capital assets are measured at fair value and
where fair value cannot be determined; the intangible assets are measured at R1.
All assets acquired prior to 1 April 2002 (or a later date as approved by the OAG) may be recorded at R1.
Intangible assets are subsequently carried at cost and are not subject to depreciation or impairment.
Subsequent expenditure of a capital nature forms part of the cost of the existing asset when ready for use.
14.4 Project Costs: Work-in-progress

Expenditure of a capital nature is initially recognised in the statement of financial performance at cost when paid.
Amounts paid towards capital projects are separated from the amounts recognised and accumulated in work-in-progress until
the underlying asset is ready for use. Once ready for use, the total accumulated payments are recorded in an asset register.
Subsequent payments to complete the project are added to the capital asset in the asset register.
Where the Department is not the custodian of the completed project asset, the asset is transferred to the custodian subsequent
to completion.
15 Provisions and Contingents
15.1 Provisions
Provisions are recorded in the notes to the financial statements when there is a present legal or constructive obligation to forfeit
economic benefits as a result of events in the past and it is probable that an outflow of resources embodying economic benefits
or service potential will be required to settle the obligation and a reliable estimate of the obligation can be made. The provision
is measured as the best estimate of the funds required to settle the present obligation at the reporting date.
15.2 Contingent liabilities

Contingent liabilities are recorded in the notes to the financial statements when there is a possible obligation that arises from
past events, and whose existence will be confirmed only by the occurrence or non-occurrence of one or more uncertain future
events not within the control of the Department or when there is a present obligation that is not recognised because it is not
probable that an outflow of resources will be required to settle the obligation or the amount of the obligation cannot be
measured reliably.

15.3 Contingent assets

Contingent assets are recorded in the notes to the financial statements when a possible asset arises from past events, and
whose existence will be confirmed by the occurrence or non-occurrence of one or more uncertain future events not within the
control of the Department.
15.4 Commitments
Commitments (other than for transfers and subsidies) are recorded at cost in the notes to the financial statements when there
is a contractual arrangement or an approval by management in a manner that raises a valid expectation that the Department
will discharge its responsibilities thereby incurring future expenditure that will result in the outflow of cash.
16 Unauthorised expenditure
Unauthorised expenditure is recognised in the statement of financial position until such time as the expenditure is either:
• approved by Parliament or the Provincial Legislature with funding and the related funds are received; or
• approved by Parliament or the Provincial Legislature without funding and is written off against the appropriation in the
statement of financial performance; or
• transferred to receivables for recovery.
Unauthorised expenditure is measured at the amount of the confirmed unauthorised expenditure.
17 Fruitless and wasteful expenditure

Fruitless and wasteful expenditure is recorded in the notes to the financial statements when confirmed. The amount recorded
is equal to the total value of the fruitless and or wasteful expenditure incurred.
Fruitless and wasteful expenditure is removed from the notes to the financial statements when it is resolved or transferred to
receivables for recovery.
Fruitless and wasteful expenditure receivables are measured at the amount that is expected to be recoverable and are
de-recognised when settled or subsequently written-off as irrecoverable.
18 Irregular expenditure
Irregular expenditure is recorded in the notes to the financial statements when confirmed. The amount recorded is equal to
the value of the irregular expenditure incurred unless it is impracticable to determine, in which case reasons therefor are
provided in the note.
Irregular expenditure is removed from the note when it is either condoned by the relevant authority, transferred to receivables
for recovery or not condoned and is not recoverable.
Irregular expenditure receivables are measured at the amount that is expected to be recoverable and are de-recognised when
settled or subsequently written-off as irrecoverable.
19 Changes in accounting policies, accounting estimates and errors

Changes in accounting policies that are effected by management have been applied retrospectively in accordance with MCS
requirements, except to the extent that it is impracticable to determine the period-specific effects or the cumulative effect of
the change in policy. In such instances the Department shall restate the opening balances of assets, liabilities and net assets
for the earliest period for which retrospective restatement is practicable.
Changes in accounting estimates are applied prospectively in accordance with MCS requirements.
Correction of errors is applied retrospectively in the period in which the error has occurred in accordance with MCS
requirements, except to the extent that it is impracticable to determine the period-specific effects or the cumulative effect of
the error. In such cases the Department shall restate the opening balances of assets, liabilities and net assets for the earliest
period for which retrospective restatement is practicable.
20 Events after the reporting date

Events after the reporting date that are classified as adjusting events have been accounted for in the financial statements. The
events after the reporting date that are classified as non-adjusting events after the reporting date have been disclosed in the
notes to the financial statements.
21 Capitalisation reserve
The capitalisation reserve comprises of financial assets and/or liabilities originating in a prior reporting period but which are
recognised in the statement of financial position for the first time in the current reporting period. Amounts are recognised in
the capitalisation reserves when identified in the current period and are transferred to the National/Provincial Revenue Fund
when the underlying asset is disposed and the related funds are received.
22 Recoverable revenue
Amounts are recognised as recoverable revenue when a payment made in a previous financial year becomes recoverable from
a debtor in the current financial year. Amounts are either transferred to the National/Provincial Revenue Fund when
recovered or are transferred to the statement of financial performance when written-off.

23 Related party transactions

A related party transaction is a transfer of resources, services or obligations between the reporting entity and a related party.
Related party transactions within the Minister/MEC’s portfolio are recorded in the notes to the financial statements when the
transaction is not at arm’s length.
Key management personnel are those persons having the authority and responsibility for planning, directing and controlling
the activities of the Department. The number of individuals and their full compensation is recorded in the notes to the
24 Inventories
At the date of acquisition, inventories are recognised at cost in the statement of financial performance.
Where inventories are acquired as part of a non-exchange transaction, the inventories are measured at fair value as at the
date of acquisition.
Inventories are subsequently measured at the lower of cost and net realisable value or where intended for distribution (or
consumed in the production of goods for distribution) at no or a nominal charge, the lower of cost and current replacement
value.
The cost of inventories is assigned by using the weighted average cost basis.
25 Employee benefits
The value of each major class of employee benefit obligation (accruals, payables not recognised and provisions) is disclosed in
the Employee benefits note.

VOTE 4 NOTES TO THE ANNUAL FINANCIAL STATEMENTS
1. Annual Appropriation
1.1 Annual Appropriation
Included are funds appropriated in terms of the Appropriation Act (and the Adjustments Appropriation Act) for National
Departments (Voted funds) and Provincial Departments
2018/19 2017/18
Final Actual Funds Funds not Final Appropriation
Appropriation Received requested/not Appropriation received
received
R’000 R’000 R’000 R’000 R’000
1. Administration 1 361 130 1 361 130 - 1 085 267 1 085 267
2.District Health Services 15 073 917 15 073 917 - 13 712 101 13 712 101
3.Emergency Medical Services 1 423 203 1 423 203 - 1 268 154 1 268 154
4.Provincial Hospital Services 8 746 469 8 746 469 - 7 892 663 7 892 663
5.Central Hospitals 17 135 226 17 135 226 - 15 333 041 15 333 041
6. Health Science and Training 1 123 296 1 123 296 - 928 471 928 471
7. Health Care Support Services 339 156 339 156 - 289 838 289 838
8. Health Facilities Management 1 559 933 1 559 933 - 1 683 299 1 683 299
Total 46 762 330 46 762 330 - 42 192 834 42 192 834
1.2 Conditional grants
Note 2018/19 2017/18

R’000 R’000
Total grants received 31 10 536 371 9 755 788
2. Departmental Revenue
Note 2018/19 2017/18

R’000 R’000
Sales of goods and services other than capital assets 2.1 648 660 503 424
Fines, penalties and forfeits 2.2 95 48
Interest, dividends and rent on land 2.3 764 974
Transactions in financial assets and liabilities 2.4 131 284 42 470
Departmental revenue collected 780 803 546 916
Sales of Goods and Services include patient fees charged according to the 2018 gazetted Uniform Patient Fee Schedule (UPFS) tariffs. During the period,
the Department exceeded its revenue collection target by R273.8 million.

2.1 Sales of goods and services other than capital assets
Note 2018/19 2017/18

2 R’000 R’000
Sales of goods and services produced by the Department 647 218 501 207
Sales by market establishment 36 547 28 099
Administrative fees 5 381 5 077
Other sales 605 290 468 031
Sales of scrap, waste and other used current goods 1 442 2 217
Total 648 660 503 424
“Other sales” include sales of crutches, access cards, boarding of staff, advertisements, immunisation fees, patient transport and special events for EMS.
The increase of 29% in other sales is due to amplified efforts by the Department to increase revenue collection.
2.2 Fines, penalties and forfeits
Note 2018/19 2017/18

2 R’000 R’000
Fines 95 48
Total 95 48
Fines and penalties are charged in respect of illegal parking at the Department’s facilities. The increased collection is due to revised parking tariffs and
the establishment of parking committees.
2.3 Interest, dividends and rent on land
Note 2018/19 2017/18

2 R’000 R’000
Interest Charged 764 974
Total 764 974
2.4 Transactions in financial assets and liabilities
Note 2018/19 2017/18

2 R’000 R’000
Receivables 46 064 26 550
Other Receipts including Recoverable Revenue 85 220 15 920
Total 131 284 42 470

3. Compensation of Employees
3.1 Salaries and Wages
Note 2018/19 2017/18

R’000 R’000
Basic salary 16 939 103 16 327 543
Performance award 692 423 16 614
Service Based 19 964 24 106
Compensative/circumstantial 2 559 298 2 362 404
Periodic payments 261 890 252 657
Other non-pensionable allowances 3 267 635 3 129 957
Total 23 740 313 22 113 281
The overall increase of 7% is due to the annual cost of living adjustment (COLA) during the period under review. The R675.8 million increase in
performance award is due to payment of performance bonuses in June 2018 and December 2018.
Other Non-Pensionable Allowances: Amounts disclosed under this line item represents amongst others service bonus and housing allowances.
Compensative/ circumstantial: The amounts disclosed under this line item represents overtime paid to Health Professionals.
Periodic payments: These are payments made to retired doctors, session doctors and employees being paid a once off salary related payment.
3.2 Social Contributions
Note 2018/19 2017/18

R’000 R’000
Employer contributions
Pension 2 032 851 1 940 728
Medical 1 123 994 1 025 907
UIF 161 157
Bargaining council 4 979 5 258
Total 3 161 985 2 972 050
Total compensation of employees 26 902 298 25 085 331
Average number of employees 66 281 67 950

4. Goods and services
Note 2018/19 2017/18

R’000 R’000
Administrative fees 4 163 4 212
Advertising 1 819 2 153
Minor assets 4.1 22 614 32 318
Bursaries (employees) 1 285 4 067
Catering 2 333 2 600
Communication 70 436 74 379
Computer services 4.2 64 712 264 615
Consultants: Business and advisory services 370 024 370 900
Laboratory services 2 138 383 1 535 120
Legal services 101 023 314 226
Contractors 741 416 536 466
Agency and support / outsourced services 245 763 255 725
Audit cost – external 4.3 23 276 20 731
Fleet services 254 328 235 509
Inventory 4..4 8 514 481 7 158 434
Consumables 4.5 652 183 604 999
Operating leases 173 128 143 780
Property payments 4.6 1 796 428 1 965 009
Rental and hiring 996 984
Transport provided as part of the Departmental activities 317 4 876
Travel and subsistence 4.7 16 515 22 104
Venues and facilities 7 045 1 458
Training and development 23 772 23 389
Other operating expenditure 4.8 3 061 5 336
Total 15 229 501 13 583 391
Other operating expenditure: Relates to courier and laundry services.

Property Payments: Relates to the maintenance and utility payments for health facilities.
Inventory: Relates to purchases of medication and medical supplies.
Consumables: Relates to payments for laboratory consumables.
Agency and support / outsourced services: Relates to payments, amongst others, for medical waste removal, payments to nursing agencies and
security services.
Legal Services represent legal costs paid to the State Attorney.
Laboratory Services: The increase in Laboratory services is due to the payment of accruals at the beginning of 2018/19 financial year, as well as the
settlement of NHLS debt in line with the agreement signed in December 2017 by the Department, Gauteng Provincial Treasury and NHLS
.

4.1 Minor assets
Note 2018/19 2017/18

4 R’000 R’000
Tangible assets 22 614 32 318
Machinery and equipment 22 614 32 318
Total 22 614 32 318
4.2 Computer services
Note 2018/19 2017/18

4 R’000 R’000
External computer service providers 64 712 264 615
Total 64 712 264 615
“External Computer Service Providers” include software licences for operating systems and specialized computer services. The decrease in expenditure
was due to withholding of payments of ICT projects which were under investigation.
4.3 Audit cost – External
Note 2018/19 2017/18

4 R’000 R’000
Regularity audits 23 263 20 731
Investigations 13 -
Total 23 276 20 731
“Investigations” relate to payments made for investigations done by the Special Investigation Unit (SIU).
4.4 Inventory
Note 2018/19 2017/18

4 R’000 R’000
Clothing material and accessories 2 296 3 918
Food and food supplies 331 712 338 722
Fuel, oil and gas 262 538 220 779
Learning, teaching and support material 15 003 814
Materials and supplies 29 596 37 565
Medical supplies 3 619 139 2 618 205
Medicine 4 132 205 3 826 093
Other supplies 4.4.1 121 992 112 338
Total 8 514 481 7 158 434
Other supplies consist of toiletries, plastics, paper and related items. The 18% increase in expenditure is due to an increase of demand in health care
services as well as higher inflation on medical supplies.

4.4.1 Other supplies
Note 2018/19 2017/18

2 R’000 R’000
Other 121 992 112 338
Total 121 992 112 338
4.5 Consumables
Note 2018/19 2017/18

4 R’000 R’000
Consumable supplies 485 743 452 908
Uniform and clothing 116 950 109 733
Household supplies 287 549 273 960
Building material and supplies 32 313 24 900
Communication accessories - 1 078
IT consumables 11 472 8 899
Other consumables 37 459 34 338
Stationery, printing and office supplies 166 440 152 091
Total 652 183 604 999
The increase in expenditure is due to higher medical inflation and increased demand on the service platform.
Household supplies: Includes linen, groceries and cleaning detergents.
Other consumables: Includes fuel supplies, gas supplies, laboratory consumables and medical kits.
4.6 Property payments
Note 2018/19 2017/18

4 R’000 R’000
Municipal services 547 479 518 227
Property management fees - -
Property maintenance and repairs 646 426 778 209
Other 602 523 668 573
Total 1 796 428 1 965 009
The amount disclosed under other includes security services, cleaning and payments of laundry services.
4.7 Travel and subsistence
Note 2018/19 2017/18

4 R’000 R’000
Local 13 323 13 521
Foreign 3 192 8 583
Total 16 515 22 104
The expenditure in foreign travel decreased by 63% due to austerity measures (iron clad) put in place to curb expenditure.
The amount disclosed under other includes security services, cleaning and payments of laundry services.

4.8 Other operating expenditure
Note 2018/19 2017/18

4 R’000 R’000
Professional bodies, membership and subscription fees 312 210
Resettlement costs 315 1 227
Other 2 434 3 899
Total 3 061 5 336
5. Interest and rent on land
Note 2018/19 2017/18

R’000 R’000
Interest paid 7 794 628
Total 7 794 628
The increase in interest paid amount is as a result of interest paid which was misallocated in the 2017/18 financial year. A major portion of interest paid
is due to interest charged on court judgements for medico legal claims. Total interest paid for the 2018/19 financial year is R25.7 million.
6. Payments for financial assets
Note 2018/19 2017/18

R’000 R’000
Debts written off 6.1 5 764 9 103
Total 5 764 9 103
This amount represents staff and supplier debts that was written off during the year. Debts was written off in accordance with the Department’s policy
and the Prescription Act. All possible measures were taken to ensure that all debt due to the Department is recovered.
6.1. Debts written off
Note 2018/19 2017/18

6 R’000 R’000
Nature of debts written off 6.1
Ex employees as supplier debts written off 5 764 9 103
Total debt written off 5 764 9 103
7. Transfers and Subsidies
Note 2018/19 2017/18

R’000 R’000
Provinces and municipalities 32 721 992 739 108
Departmental agencies and accounts Annex 1B 20 962 19 812
Higher education institutions Annex 1C 13 421 9 786
Non-profit institutions Annex 1D 615 281 556 250
Households Annex 1E 921 440 533 942
Total 2 293 096 1 858 898

8. Expenditure for Capital Assets
Note 2018/19 2017/18

4 R’000 R’000
Tangible assets 1 572 107 1 476 108
Buildings and other fixed structures 30 785 617 615 431
Machinery and equipment 28 786 490 860 677
Total 1 572 107 1 476 108
8.1 Analysis of funds utilised to acquire capital assets – 2018/19
Note Voted funds 2017/18

4 R’000 R’000
Total 1 572 107 1 572 107
8.2 Analysis of funds utilised to acquire capital assets – 2017/18
Note Voted funds Total

4 R’000 R’000
Total 1 476 108 1 572 107
8.3 Finance Lease expenditure included in Expenditure for Capital Assets
Note 2018/19 2017/18

6 R’000 R’000
Tangible assets 6.1
Machinery and equipment 75 776 81 472
Total 75 776 81 472
Finance lease expenditure relates to rental of cell phones, Government Garage vehicles as well as photocopiers.
9. Cash and cash equivalents
Note 2018/19 2017/18

R’000 R’000
Consolidated Paymaster General Account 684 181 306 223
Cash receipts 69 303
Outstanding payments - (23 890)
Cash on hand 1 142 1 137
Total 685 392 283 773

10. Receivables
2018/19 2017/18
Note Current Non-current Total Current Non-current 2017/18
9 R’000 R’000 R’000 R’000 R’000 R’000
Claims recoverable 10.1 1 511 - 1 511 552 - 552
Recoverable expenditure 10.2 1 383 - 1 383 1 327 - 1 327
Staff debt 10.3 16 949 88 962 105 911 15 690 61 654 77 344
Other debtors 10.4 2 509 - 2 509 137 320 - 137 320
Total 22 352 88 962 111 314 154 889 61 654 216 543
10.1 Claims recoverable
Note 2018/19 2017/18

10 R’000 R’000
Provincial Departments 1 511 552
Total 1 511 552
Claims Recoverable include amounts owed by other Departments due to staff transfers.
10.2 Recoverable expenditure (disallowance accounts)
Note 2018/19 2017/18

10 R’000 R’000
Disallowance Damages & Losses 1 383 1 327
Total 1 383 1 327
The disallowance damages & losses represents thefts and losses that are under investigation
10.3 Staff Debt
Note 2018/19 2017/18

10 R’000 R’000
Breach of Contract 58 189 33 030
Employees 9 122 8 049
Ex-employees 31 637 30 035
Fraud 132 20
Suppliers 6 583 5 963
GG Accidents 248 247
Total 105 911 77 344
Staff Debt includes salary related, supplier and bursary debts.

10.4 Other Debtors
Note 2018/19 2017/18

4 R’000 R’000
Other Debtors * - 135 609
Salary Disallowance Account 23 23
Salary reversal Control Account 1 930 1 629
Salary: Deduction Disallowance 19 19
Salary: Tax Debt 522 40
Garnishee 2 -
Medical Aid 13 -
Total 2 509 137 320
* Refer to Note 12 for current year balance.
10.5 Impairment of receivables
Note 2018/19 2017/18

R’000 R’000
Estimate of impairment of receivables 33 000 158 948
Total 33 000 158 948
Staff debtors older than three years are impaired as the likelihood of recoverability is low.
11. Investments
Note 2018/19 2017/18

R’000 R’000
Non-Current
Shares and other equity
Investment in Medical Supplies Depot 54 000 54 000
Total 54 000 54 000
Total non-current 54 000 54 000
The investments amount represents the initial investment in Medical Supplies Depot, no further investment was made during the period.
12. Voted funds to be surrendered to the Revenue Fund
Note 2018/19 2017/18

R’000 R’000
Opening balance - -
Transfer from statement of financial performance 751 771 179 375
Paid during the year (312 305) (179 375)
Closing balance 439 466 -
The Department is engaging Provincial Treasury to resolve the R135.6 million amount which is included in “Paid during the year”. This amount is as a
result of previous years’ unauthorized expenditure surrenders and the disclosure of Health and Welfare Sector Training Authority funding in the Revenue
Fund.

13. Departmental revenue to be surrendered to the Revenue Fund
Note 2018/19 2017/18

R’000 R’000
Transfer from Statement of Financial Performance 780 803 546 916
Paid during the year (768 213) (588 695)
14. Payables – current
Note 2018/19 2017/18

R’000 R’000
Amounts owing to other entities (Medical Supplies Depot) 174 627 369 606
Other payables 14.1 32 736 21 910
Total 207 363 391 516
14.1 Other payables
Note 2018/19 2017/18

14 R’000 R’000
Housing Loan Guarantees 2 -
Medical Aid - 170
Salary: ACB Recalls 661 574
Salary: Bargaining Council 12 8
Salary: Income Tax 5 852 7 798
Salary: Pension Fund 990 298
Telkom Account 10 202 -
Unauthorised expenditure 12 956 12 956
Other 2 061 106
Total 32 736 21 910
The “Unauthorized expenditure” of R12.9 million is disclosed as a result of an unresolved condonation from previous years’ unauthorized expenditure.
The Department is engaging Provincial Treasury to resolve the matter.

15. Net cash flow available from operating activities
Note 2018/19 2017/18

R’000 R’000
Net surplus/(deficit) as per Statement of Financial Performance 1 532 573 726 291
Add back non cash/cash movements not deemed operating activities 412 666 699 898
(Increase)/decrease in receivables 105 229 (28 102)
(Increase)/decrease in prepayments and advances - 45
(Increase)/decrease in Payables - Current (184 153) 19 917
Expenditure on capital assets 1 572 107 1 476 108
Surrenders to Revenue Fund (1 080 517) (768 070)
Net cash flow generated by operating activities 1 945 239 1 426 189
The “Unauthorized expenditure” of R12.9 million is disclosed as a result of an unresolved condonation from previous years’ unauthorized expenditure.
The Department is engaging Provincial Treasury to resolve the matter.
16. Reconciliation of cash and cash equivalents for cash flow purposes
Note 2018/19 2017/18

R’000 R’000
Consolidated Paymaster General account 684 181 306 223
Fund requisition account - -
Cash receipts 69 303
Outstanding Payments - (23 890)
Cash on hand 1 142 1 137
Total 685 392 283 773
17. Contingent liabilities and contingent assets

17.1 Contingent liabilities
Note 2018/19 2017/18

4 R’000 R’000
Liable to
Claims against the Department Annex 3B 24 754 605 20 932 408
Intergovernmental payables (unconfirmed balances) Annex 5 1 543 300
Total 24 756 148 20 932 708
Claims against the Department include medico legal and civil claims and claims against state vehicle accidents. Claims against the Department are
classified as contingent liabilities in line with Chapter 14, paragraph 04 of the Modified Cash Standard which defines a contingent liability as a possible
obligation that arises from past events, and whose existence will be confirmed only by the occurrence or non-occurrence of one or more uncertain future
events not wholly within the control of the Department. The Department has appointed the Special Investigation Unit (SIU) to assist with investigating
medico legal related claims, with the aim of eliminating fraudulent claims.

17.2. Contingent assets
Note 2018/19 2017/18

R’000 R’000
Nature of contingent asset
Claims against employees 29 429 32 192
Total 29 429 32 192
18. Commitments
Note 2018/19 2017/18

R’000 R’000
Current expenditure
Approved and contracted 976 855 909 690
976 855 909 690
Capital expenditure
Approved and contracted 2 096 563 1 202 254
Approved but not yet contracted 12 410 461 214
2 108 973 1 663 468
Total Commitments 3 085 828 2 573 158
Included in the total commitments are commitments amounting to R1.9 billion which exceeding one year.
19. Accruals and payables not recognised

19.1 Accruals
2018/19 2017/18
R’000 R’000
Included in the above totals are the following: 30 Days 30+ Days Total Total
Sales of goods and services other than capital assets 55 653 442 232 497 885 227 317
Total 55 653 442 232 497 885 227 317
Listed by programme level Note 2018/19 2017/18

R’000 R’000
Administration 37 423 27 915
District Health Services 104 231 34 545
Emergency Medical Services 10 966 1 407
Provincial Hospital Services 176 710 64 944
Central Hospital Services 160 895 96 570
Health Training and Sciences 3 117 439
Health Care Support Services 4 543 1 497
Total 497 885 227 317

19.2 Payables not recognised
2018/19 2017/18
R’000 R’000
Listed by economic classification 30 Days 30+ Days Total Total
Goods and services 1 488 661 2 851 662 4 340 323 6 516 019
Transfers and subsidies 16 16 16
Capital assets 3 945 3 945 50 782
Total 1 488 661 2 855 623 4 344 284 6 566 817
Note 2018/19 2017/18

Listed by programme level
R’000 R’000
Administration 1 257 991 1 905 746
District Health Services 485 132 648 250
Emergency Medical Services 148 394 253 011
Provincial Hospital Services 951 002 1 237 616
Central Hospital Services 1 257 063 2 393 315
Health Training and Sciences 5 787 5 109
Health Care Support Services 21 077 20 677
Health Facilities Management 217 838 103 093
Total 4 344 284 6 566 817
Included in the above totals are the following:
Confirmed balances with other Departments 101 693 244 334
Confirmed balances with other government entities 754 543 1 156 892
Total 856 236 1 401 226
20. Employee benefits
Note 2018/19 2017/18

R’000 R’000
Leave entitlement 1 007 514 907 179
Service bonus 644 633 615 324
Performance awards 404 917 712 950
Capped leave commitments 357 254 383 590
Long Service Award 19 688 16 502
Total 2 434 006 2 635 545

21. Lease commitments

21.1 Operating leases
Buildings and other Machinery and Total

fixed structures equipment
2018/19 R’000 R’000 R’000
Not later than 1 year 50 187 70 272 120 459

Later than 1 year and not later than 5 years 193 277 78 113 271 390
Total lease commitments 243 464 148 384 391 848
Buildings and other Machinery and Total

fixed structures equipment
2017/18 R’000 R’000 R’000
Not later than 1 year 11 460 28 339 39 799

Later than 1 year and not later than 5 years 19 207 17 386 36 593
Total lease commitments 30 667 45 725 76 392
Current year lease commitments for Buildings and Other Fixtures mainly relate to leases that will expire within the next two to five years.
21.2 Finance leases
Machinery and Total

equipment
2018/19 R’000 R’000
Not later than 1 year 28 841 28 841

Later than 1 year and not later than 5 years 13 700 13 700
Total lease commitments 42 541 42 541
Machinery and Total

equipment
2017/18 R’000 R’000
Not later than 1 year 23 025 23 025

Later than 1 year and not later than 5 years 6 366 6 366
Total lease commitments 29 392 29 392
22. Accrued Departmental revenue
Note 2018/19 2017/18

R’000 R’000
Sales of goods and services other than capital assets 2 982 039 2 665 804
Total 2 982 039 2 665 804

22.1 Analysis of Accrued Departmental revenue
Note 2018/19 2017/18

R’000 R’000
Opening balance 2 665 804 2 190 242
Less: amounts received 504 520 450 718
Add: amounts recorded 1 200 897 1 372 964
Less: amounts written-off/reversed as irrecoverable 380 142 446 684
Closing balance 2 982 039 2 665 804
22.2 Accrued Department revenue written off
Nature of losses Note 2018/19 2017/18

R’000 R’000
Patient Debts written off 380 142 446 684
Total 380 142 446 684
Patient debt is written off where the cost to recover the outstanding debt is assessed to exceed the debt owed. The Department will be investing in
upgrading the ICT infrastructure to assist with patient traceability which will improve revenue collection.
22.3 Impairment of accrued Departmental revenue
Nature of losses Note 2018/19 2017/18

R’000 R’000
Estimate of impairment of accrued Departmental revenue 2 602 411 2 236 902
Total 2 602 411 2 236 902
The amount that has been impaired against accrued Departmental revenue relates to patient debts and is according to the Department’s Policy.
23. Irregular Expenditure

23.1 Reconciliation of irregular expenditure
Note 2018/19 2017/18

R’000 R’000
Opening balance 10 688 489 8 985 284
Add: Irregular expenditure – relating to prior year 570 088 351 001
Add: Irregular expenditure – relating to current year 2 292 068 1 352 204
Closing balance 13 550 645 10 688 489
Analysis of awaiting condonation per age classification
Current year 2 292 068 1 352 204
Prior years 11 258 577 9 336 285

13 550 645
Total 10 688 489

23.2 Details of irregular expenditure – added current year
Incident Disciplinary steps taken/criminal Way Forward 2018/19

proceedings R’000
Consignment Disciplinary steps finalized, Tender process at an advanced stage. 226 938
Stock condonation to be applied for.
Security Disciplinary steps finalized, Security In-Sourcing strategy to be fully 587 979
Contracts condonation to be applied for. implemented by end of the 2019/20 financial year.
Outsourced Disciplinary steps finalized, Tender to be advertised before end of the second 35 499
Nursing Staff condonation to be applied for. quarter.
South African Disciplinary steps finalized, Contract terminated. 16 284

Institute of condonation to be applied for.
Chartered
Accountants
(SAICA)
SA Board of Disciplinary steps finalized, Contract terminated. 7 711

People Practice condonation to be applied for.
(SABPP)
Institute of Disciplinary steps finalized, Contract terminated. 9 235

People condonation to be applied for.
Management
(IPM)
Overtime 2000 Critical Posts have been Posts are being advertised. 323
exceeding 30% approved.
Supply Chain Training and up skilling of officials is Stringent monitoring of compliance. 1 268 698
Processes not being implemented.
Followed
Contracts Training and up skilling of officials is Stringent monitoring of compliance. 74 863

extensions being implemented.
Procurement of * Awaiting criminal proceedings to be concluded. 397 717

V-Blocks IT
Infrastructure
Conditional Disciplinary steps finalized, Business plans sent to National Health 236 909
Grants not condonation to be applied for
utilised as per
business plan
Total 2 862 156
A forensic investigation was done which found that the process of procuring V-Blocks IT infrastructure was irregular. Persons implicated have been
reported to the National Directorate of Public Prosecutions for investigations.

24. Fruitless and wasteful expenditure

24.1 Reconciliation of fruitless and wasteful expenditure
Note 2018/19 2017/18

R’000 R’000
Fruitless and wasteful expenditure – relating to current year 26 682 37 918
Less: Amounts resolved - -
24.2 Analysis of awaiting resolution per economic classification
Note 2018/19 2017/18

R’000 R’000
Current 484 378 457 696
Total 484 378 457 696
24.3 Analysis of Current year’s (relating to current and prior years) fruitless and wasteful expenditure
2018/19
Incident Disciplinary steps taken/criminal proceedings
R’000
Interest on Litigations Corrective measures are being implemented. 12 334
Interest on overdue accounts Corrective measures are being implemented. 12 103
Interest paid by DID for Health Corrective measures are being implemented. 2 245
Total 26 682
The Department is in the process of condoning the Fruitless and Wasteful expenditure that has accumulated over the years. Processes have been put in
place to reduce interest payable to Suppliers.
25. Related party transactions
Note 2018/19 2017/18

Payments made R’000 R’000
Goods and services 4 496 602 3 899 204
Total 4 496 602 3 899 204
25. Related party transactions
Note 2018/19 2017/18

Year end balances arising from payments
R’000 R’000
Payables to related parties 614 687 1 023 222
Total 614 687 1 023 222
Medical Supplies Depot (MSD) is a related party to the Department. MSD is an entity of the Department and is accountable to the same Accounting
Officer. All other Gauteng Provincial Government Departments’ are related parties to the Department, by virtue of being under the control of Gauteng
Provincial Government Legislature.

26. Key Management Personnel
No. of 2018/19 2017/18

Individuals R’000 R’000
Political Office Bearers (MEC) 1 1 978 1 978
Level 15 to 16 5 5 288 7 655
Level 14 17 20 090 21 542
Family members of key management personnel 4 1 192 1 410
Total 27 28 548 32 585
Key management include all staff members who drive the strategy of the department. Employees who are on level 14 but are not driving the
Departmental strategy are not included in this list.
27. Provisions
Note 2018/19 2017/18

R’000 R’000
OSD for Engineers - 9 274
Litigation Claims Against the Department 140 599 140 599
Performance Bonuses for 2008/2009, 2009/2010 and 2010/2011 - 413 000
Total 140 599 562 873
27.1 Reconciliation of movement in provisions – 2018/19
Legal Bonuses OSD Total provisions

R’000 R’000 R’000 R’000
Opening balance 140 599 413 000 9 274 562 873
Reversal of Provision (413 000) (9 274) (422 274)
Closing balance 140 599 - - 140 599
27.2 Reconciliation of movement in provisions – 2017/18
Legal Bonuses OSD FPS Payback Total provisions

R’000 R’000 R’000 R’000 R’000
Opening balance 140 599 413 000 9 274 8 805 571 678
Settlement of provision - - - (8 805) (8 805)
Closing balance 140 599 413 000 9 274 - 562 873

28. Movable Tangible Capital Assets

MOVEMENT IN MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019
Closing Balance Value adjustments Additions Disposals Closing Balance

R’000 R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 5 826 424 - 760 151 (37 763) 6 548 812
Transport assets 528 898 - 123 353 - 652 251
Computer equipment 252 760 - 19 680 (1 114) 271 326
Furniture and office equipment 160 547 - 5 254 (714) 165 087
Other machinery and equipment 4 884 219 - 611 864 (35 935) 5 460 148
TOTAL MOVABLE TANGIBLE CAPITAL ASSETS 5 826 424 - 760 151 (37 763) 6 548 812
2 268 Movable Tangible Capital Assets under Investigation included in the Assets Register 38 429
Machinery and equipment include assets which are under investigation due to the damage from the fire which occurred during the year.
28.1 Additions
ADDITIONS TO MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019
(Capital Work Received

in Progress current, not
current costs paid
and finance (Paid current
lease year, received
Cash Non-cash payments) prior year Total
R’000 R’000 R’000 R’000 R’000

MACHINERY AND EQUIPMENT 786 489 11 448 (75 776) 37 990 760 151
Transport assets 143 972 - (53 195) 32 576 123 353
Computer equipment 7 331 11 053 - 1 296 19 680
Furniture and office equipment 5 089 - - 165 5 254
Other machinery and equipment 630 097 395 (22 581) 3 953 611 864
TOTAL MOVABLE TANGIBLE CAPITAL ASSETS 786 489 11 448 (75 776) 37 990 760 151
28.2 Disposals
DISPOSALS OF MOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019
Sold for cash Non-cash disposal Total disposals
R’000 R’000 R’000

MACHINERY AND EQUIPMENT 37 763 - 37 763
Transport assets -
Computer equipment 1 114 - 1 114
Furniture and office equipment 714 - 714
Other machinery and equipment 35 935 35 935
TOTAL DISPOSAL OF MOVABLE TANGIBLE CAPITAL ASSETS 37 763 - 37 763
The value of assets sold for cash is include in the Department’s Revenue collected under sales of scrap.

28.3 Movement for 2017/18

MOVEMENT IN TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2018
Opening Prior period Closing

balance error Additions Disposal Balance
R’000 R’000 R’000 R’000 R’000
MACHINERY AND EQUIPMENT 5 227 033 - 720 248 (120 857) 5 826 424
Transport assets 447 727 - 85 806 (4 635) 528 898
Computer equipment 228 637 - 28 438 (4 315) 252 760
Furniture and office equipment 149 853 - 14 386 (3 692) 160 547
Other machinery and equipment 4 400 816 - 591 618 (108 215) 4 884 219
TOTAL MOVABLE TANGIBLE CAPITAL ASSETS 5 227 033 - 720 248 (120 857) 5 826 424
28.4 Minor assets
Machinery
and equipment
2017/18
R’000 R’000
Additions 11 687 11 687
Disposals (5 852) (5 852)
TOTAL MINOR ASSETS 707 338 707 338
7 315 Minor Capital Assets under Investigations included in the Asset Register 12 538
MOVEMENT IN MINOR ASSETS PER THE ASSET REGISTER FOR THE YEAR ENDED AS AT 31 MARCH 2018
Machinery
and equipment
2017/18
R’000 R’000
Additions 29 457 29 457
Disposals (23 590) (23 590)
TOTAL MINOR ASSETS 701 503 701 503

29. Intangible Capital Assets

MOVEMENT IN INTANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019
Opening balance Additions Disposals Closing Balance

R’000 R’000 R’000 R’000
SOFTWARE 55 637 - - 55 637
TOTAL INTANGIBLE CAPITAL ASSETS 55 637 - - 55 637
29.1 Movement for 2017/18

MOVEMENT IN INTANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019Fkey
Opening balance Disposals Closing Balance

R’000 R’000 R’000
SOFTWARE 263 244 (207 607) 55 637
29.1.1 Prior Year Adjustment
2017/18
R’000
Overstatement of Intangible Assets
Opening balance 108 334
Adjustment of Disposals (52 697)
Closing Balance 55 637
*The opening balance had to be amended as items that do not meet the definition of Intangible Assets were capitalised.
29.1.2 Immovable Tangible Capital Assets

MOVEMENT IN IMMOVABLE TANGIBLE CAPITAL ASSETS PER ASSET REGISTER FOR THE YEAR ENDED 31 MARCH 2019
Opening Additions Closing

balance Balance
R’000 R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES 1 632 824 608 272 2 241 096
Other fixed structures 1 632 824 608 272 2 241 096
TOTAL IMMOVABLE TANGIBLE CAPITAL ASSETS 1 632 824 608 272 2 241 096
4 projects were completed in the current financial year and 13 in the previous financial years. These projects are due to be transferred to the Gauteng Department
of Infrastructure Development after all certification has been completed.

30.1 Additions
(Capital Work in
Progress current
costs and
finance lease
Cash Non- Cash payments) Total
R’000 R’000 R’000 R’000

BUILDING AND OTHER FIXED STRUCTURES 770 532 608 272 (770 532) 608 272
Other fixed structures 770 532 608 272 (770 532) 608 272
TOTAL ADDITIONS TO IMMOVABLE 770 532 608 272 (770 532) 608 272
TANGIBLE CAPITAL ASSETS
*The difference between the amount above and R786.4 million is due to lease payments which were incorrectly allocated.
30.2. Movement for 2017/18
Opening Additions Closing

balance Balance
R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES 70 949 1 561 875 1 632 824
Other fixed structures 70 949 1 561 875 1 632 824
TOTAL IMMOVABLE TANGIBLE CAPITAL ASSETS 70 949 1 561 875 1 632 824
R’000
30.3. Capital Work-in-progress
CAPITAL WORK-IN-PROGRESS AS AT 31 MARCH 2019
Note Opening balance Current Ready for use Closing balance

Annex 7 1 April 2018 Year WIP (Assets to the AR 31 March 2019
R’000 R’000 R’000 R’000
Buildings and other fixed structures 2 306 300 770 532 (608 272) 2 468 560
TOTAL 2 306 300 770 532 (608 272) 2 468 560
The opening balance was adjusted by R255.6 million after a clean-up of the asset register was performed by the Department.
2018/19
Age analysis on ongoing projects R’000
0 to 1 Year 95 871
1 to 3 Years 422 159
3 to 5 Years 604 752
Longer than 5 Years 1 345 778
Total 2 468 560

30.3. Capital Work-in-progress
CAPITAL WORK-IN-PROGRESS AS AT 31 MARCH 2018
Opening balance Prior Year Current Ready for use Closing balance
1 April 2017 adjustments Year WIP (Assets to the AR) 31 March 2018
R’000 R’000 R’000 R’000 R’000
Buildings and other fixed structures 3 599 029 (434 308) 703 454 1 561 875 2 306 300
TOTAL 3 599 029 (434 308) 703 454 1 561 875 2 306 300
In the annual report of 2017/18, a printing error occurred, and a closing balance was recorded as 2 470 608 instead of 2 740 608. This error has since
been corrected.
The opening balance had to be amended as items that do not meet the definition of Immovable Assets were capitalised.
2017/18
Age analysis on ongoing projects R’000
0 to 1 Year 345 618
1 to 3 Years 209 030
3 to 5 Years 547 241
Longer than 5 Years 1 204 411
Total 2 306 300
R’000
30.4. Prior year errors
Correction of prior Note Amount before Prior period Restated

period errors error correction error amount
Contingent Liabilities 17 25 091 851 (4 159 143) 20 932 708

VOTE 4 ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2019
31. STATEMENT OF CONDITIONAL GRANTS RECEIVED
GRANT ALLOCATION SPENT 2017/18
Division of
Revenue Act/ Roll Total Amount received Amount spent by Under / % of available funds Division of Amount spent
Provincial Grants Overs Available by Department Department (Overspending) spent by Department Revenue Act by Department
R’000 R’000 R’000 R’000 R'000 R'000 % R’000 R’000
Comprehensive HIV and

4 239 277 - 4 239 277 4 239 277 3 965 836 273 441 94% 3 744 381 3 744 381
AIDS
Health Professional
Training & Development 972 759 10 953 983 712 983 712 947 885 35 827 96% 919 431 904 053
Hospital Facilities
Revitalisation Grant 874 842 17 242 892 084 892 084 779 939 112 145 87% 976 828 839 444
National Tertiary
Services 4 390 192 - 4 390 192 4 390 192 4 137 621 252 571 94% 4 110 484 4 110 049
Human Papillomavirus
27 312 - 27 312 27 312 21 670 5 642 79% - -
Vaccine Grant
EPWP Social Sector
1 470 - 1 470 1 470 1 404 66 96% 2 663 2 611
Incentive Grant
EPWP Integrated Grant to -
2 324 2 324 2 324 2 160 164 93% 2 000 1 691
Provinces
Total 10 508 176 28 195 10 536 371 10 536 371 9 856 515 679 856 - 9 755 787 9 602 229

32. STATEMENT OF CONDITIONAL GRANTS AND OTHER TRANSFERS PAID TO MUNICIPALITIES
GRANT ALLOCATION TRANSFER

Re-allocations by
Total National Treasury or
DoRA and other transfers Adjustments Available Adjustments National Department
NAME OF MUNICIPALITY R’000 R’000 R’000 R’000
City of Johannesburg Metro 272 638 9 420 282 058 282 061 -
City of Tshwane Metro 165 563 (60 833) 104 730 104 680 -
Ekurhuleni Metro 328 985 (9 779) 319 206 319 206 -
West Rand District Council 7 796 - 7 796 7 796 -
Sedibeng District Council 8 288 (39) 8 249 8 249 -
TOTAL 783 270 (61 231) 722 039 721 992 -

ANNEXURE 1A
STATEMENT OF CONDITIONAL GRANTS AND OTHER TRANSFERS PAID TO MUNICIPALITIES (Unaudited Annexure)
GRANT ALLOCATION TRANSFER SPENT 2017/18
Re-allocations % of
by National Amount available
DoRA and Treasury or received Amount funds Division
other Roll Total Actual Funds National by spent by Unspent spent by of Revenue Actual
transfers Overs Adjustments Available Transfer Withheld Department municipality municipality funds municipality Act transfer
NAME OF MUNICIPALITY R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000 R’000
Primary Health Care
Category A
City of Johannesburg Metro 128 726 128 726 128 726 121 669 121 669
City of Tshwane Metro 49 837 49 837 49 837 46 541 46 541
Ekurhuleni Metro 137 900 137 900 137 900 130 340 130 340
HIV AND AIDS
Category A
City of Johannesburg Metro 13 580 9 420 23 000 23 003 22 072 22 072
City of Tshwane Metro 13 591 398 13 989 13 989 12 720 12 720

Ekurhuleni Metro 23 757 (9 779) 13 978 13 978 13 236 13 236
Category B
West Rand District Council 7 796 7 796 7 796 7 424 7 424

Sedibeng District Council 8 288 (39) 8 249 8 249 7 767 7 767
Emergency Medical Services
Category A
City of Johannesburg Metro 130 332 130 332 130 332 123 187 123 187
City of Tshwane Metro 102 135 40 854 40 854 95 993 95 993
Ekurhuleni Metro 167 328 (61 281) 167 328 167 328 158 155 158 155
Category C
West Rand District Council
TOTAL 783 270 (61 281) 721 989 721 992 739 104 739 104

ANNEXURE 1B
STATEMENT OF TRANSFERS TO DEPARTMENTAL AGENCIES AND ACCOUNTS (Unaudited Annexure)
TRANSFER ALLOCATION SPENT 2017/18
% of Final
Adjusted Roll Total Actual Available funds
Appropriation Overs Adjustments Appropriation
Available Transfer Transferred
DEPARTMENTAL AGENCY/ ACCOUNT R’000 R’000 R’000 R’000 R’000 % R’000
Health and Welfare Seta (HW-SETA) 20 962 - 20 962 20 962 20 962 100% 19 812
Total 20 962 - 20 962 20 962 20 962 100% 19 812
ANNEXURE 1C
STATEMENT OF TRANSFERS TO HIGHER EDUCATION INSTITUTIONS (Unaudited Annexure)
TRANSFER ALLOCATION TRANSFER 2017/18
% of
Adjusted Roll Total Actual Amount not Available funds Final
Appropriation Overs Adjustments Available Transfer transferred Transferred Appropriation
R’000 R’000 R’000 R’000 R’000 R’000 % R’000
University of Witwatersrand 2 000 - - 2 000 2 289 2 289 -13% 434
University of Johannesburg 5 000 - - 5 000 4 819 4 819 4% 892
Sefako Makgatho Health Science University 2 681 - - 2 681 2 702 2 702 -1% 210
University of Pretoria 4 000 - - 4 000 3 611 3 611 11% 10 525
TOTAL 13 681 - - 13 681 13 421 13 421 12 061

ANNEXURE 1D STATEMENT OF TRANSFERS TO NON-PROFIT INSTITUTIONS (Unaudited Annexure)
TRANSFER ALLOCATION EXPENDITURE 2017/18

Adjusted % of
Appropriation Roll Total Actual Available funds Final
Act Overs Adjustments Available Transfer Transferred Appropriation
NON-PROFIT INSTITUTIONS R’000 R’000 R’000 R’000 R’000 %
R’000
R’000
Transfers
Subsidy Chronic PSYCH Care (Life Esidimeni) - - - - 13 749
Community Based Services (Mental Health NPOs) 191 207 191 207 150 495 79% 224 367
HIV and AIDS (NGO's) 79 264 79 264 73 651 93% 85 960
Nutrition Provincial (NGO's) 58 548 58 548 55 984 96% 55 583
Community Health Clinics (Witkoppen Clinic) 13 308 13 308 13 115 99% 12 578
Community Based Services (EPWP NPOs) 120 511 120 511 120 346 100% 112 791
Community Based Services (Specialised Services
NPOs & Rehabilitation) 1 690 1 690 1 690 100% 1 597
Nelson Mandela Children’s Hospital 200 000 200 000 200 000 100% 150 000
TOTAL 664 528 - - 664 528 615 281 93% 656 625

ANNEXURE 1E
STATEMENT OF TRANSFERS TO HOUSEHOLDS (Unaudited Annexure
TRANSFER ALLOCATION EXPENDITURE 2017/18

Adjusted % of
Appropriation Roll Total Actual Available funds Final
Act Overs Adjustments Available Transfer Transferred Appropriation
HOUSEHOLDS R’000 R’000 R’000 R’000 R’000 %
R’000
R’000
Transfers
Household Employee Benefit: Injury on Duty 9 310 - - 9 310 3 834 41% 15 545
Household Employee Benefit: Leave Gratuity 89 481 - - 89 481 96 979 108% 81 350
Household Employee Benefit: Post-retirement benefit - - - - - - -
Household: Other Transfers(Cash)
Household Bursaries: -
(non-employee) 148 642 - - 148 642 234 174 158% 85 724
Household Claims against State (Cash) 1 376 - 287 000 288 376 586 543 203% 3 300
TOTAL 248 809 - 287 000 535 809 921 440 172% 185 919
ANNEXURE 1 F- STATEMENT OF GIFTS, DONATIONS AND SPONSORSHIPS RECEIVED (Unaudited Annexure)

2018/19 2017/18
NAME OF THE DONOR NATURE OF GIFT, DONATION OR SPONSORSHIP R’000 R’000
Received in Cash
Various Donors 5 530
5 530
Received in Kind Various Items
Various Donors Computer Equipment 23 8 525
Other Machinery and 18 3 252
Equipment - -
Furniture and office equipment 46 157 6 940
Pharmaceuticals - -
Sub-Total Accommodation 46 198 18 718
TOTAL 46 203 19 248

ANNEXURE 3B STATEMENT OF CONTINGENT LIABILITIES AS AT 31 MARCH 2019
Liabilities paid/ Liabilities recoverable

Opening Balance Liabilities incurred during cancelled/reduced (Provide details Closing Balance
1 April 2018 the year during the year here under) 31 March 2019
Nature of Liability
R’000 R’000 R’000 R’000 R’000
Claims against the Department
Medico – Legal matters 17 542 371 4 229 890 541 961 - 21 230 300
Civil Claims 1 869 597 135 183 1 310 - 2 003 470
Vehicle Liability 12 348 600 205 - 12 743
Premature termination of contracts 1 508 092 - - - 1 508 092
TOTAL 20 932 408 4 365 673 543 476 - 24 754 605
ANNEXURE 4
CLAIMS RECOVERABLE
Confirmed balance outstanding Unconfirmed balance outstanding Total
31/03/2019 31/03/2018 31/03/2019 31/03/2018 31/03/2019 31/03/2018

GOVERNMENT ENTITY
R’000 R’000 R’000 R’000 R’000 R’000
Department
Mpumalanga: Department of Health (C5) - - 26 26 26 26

Eastern Cape: Department of Health (D2) - - 26 15 26 15
Gauteng Department of Agriculture & Rural Development - 16 - - - 16
Gauteng Infrastructure Development (1G) - 13 - - - 13
National Department of Social Development (07) - - - 11 - 11
Eastern Cape Department of Education (D5) 63 63 63 63
Limpopo Department of Health and Social Development (P4) - - 345 - 345 -
Western Cape Department of Health (U3) - 199 272 199 272
SA National Defence Force (W1) - - 49 49 49 49
Free State Department of Health (V5) - - 112 - 112 -
North West Health (3Y) - 253 - 253 -

ANNEXURE 4
CLAIMS RECOVERABLE
31/03/2019 31/03/2018 31/03/2019 31/03/2018 31/03/2019 31/03/2018

GOVERNMENT ENTITY
R’000 R’000 R’000 R’000 R’000 R’000
Mpumalanga Department of Health & Social Services (Patient fees) - - 26 759 20 862 26 759 20 862
Department of Correctional Services (Patient fees) - - 30 920 29 532 30 920 29 532
South African Police Services (Patient fees) - - 17 811 11 216 17 811 11 216
Limpopo Department of Health and Social Development (Patient fees) - - 26 748 21 809 26 748 21 809
North West Department of Health and Social Development (Patient fees) - - 62 995 55 753 62 995 55 753
SA National Defence Force (Patient fees) - - 1 106 233 1 106 233
National Department of Justice (Patient Fees) - - 26 653 4 968 26 653 4 968
Gauteng Emergency Medical Services (Special event fees) 1 061 - - - 1 061 -
Gauteng Provincial Treasury (Provincial Revenue Fund) - - - 135 609 - 135 609
Other Government Entities - - - - -
TOTAL 1 061 29 194 521 280 525 195 582 280 554

ANNEXURE 5
INTER-GOVERNMENT PAYABLES
31/03/2019 31/03/2018 31/03/2019 31/03/2018 31/03/2019 31/03/2018

GOVERNMENT ENTITY
R’000 R’000 R’000 R’000 R’000 R’000
Gauteng Office of the Premier (G6) - 20 - - - 20
Department of Justice 101 638 101 499 - - 101 638 101 499
Correctional Services - 37 - - - 37
Gauteng Department of Social Development - 54 - - - 54
Eastern Cape Department of Health (D2) - 155 - - - 155
Nation Department of Public Service and Administration - 103 - - - 103
South African Police Services (90) - 79 - 140 - 219
North West Department of Health 28 28 - - 28 28
Department of Planning and Monitoring - 19 - - - 19
Limpopo Department of Health (Q7) - 32 - - - 32
Kwa Zulu Natal Department of Social Development - 27 - - - 27
Kwa-Zulu Natal Department of Health - - - 160 - 160
National Department of Public Works - 1 978 - - 1 978
Department of Defence - - - - - -
Mpumalanga Department of Health - 176 - - - 176
Department of Labour - 59 - - - 59
National Department of Health 27 140 068 - - 27 140 068
Subtotal 101 693 244 334 - 300 101 693 244 634

ANNEXURE 5
INTER-GOVERNMENT PAYABLES
31/03/2019 31/03/2018 31/03/2019 31/03/2018 31/03/2019 31/03/2018

GOVERNMENT ENTITY
R’000 R’000 R’000 R’000 R’000 R’000
Current
Medical Supplier Deport 614 687 1 023 222 - - 614 687 1 023 222
Medical Supplies Deport (Salary) - - - - -
G-Fleet 110 194 111 082 - 1 543 111 737 111 082
Special Investigating Units 29 662 22 588 - 29 662 22 588
Subtotal 754 543 1 156 892 - 1 543 556 472 1 156 892
TOTAL 856 236 1 401 226 - 1 543 857 779 1 401 526
ANNEXURE 6
INVENTORIES
Note 2018/19 2017/18
R’000 R’000
Opening balance 981 336 1 148 873
Add/(Less): Adjustments to prior year balance - (125 230)
Add: Additions/Purchases – Cash 8 514 481 7 158 435
Add: Additions - Non-cash - -
(Less): Disposals (3 503) (6 095)
(Less): Issues (8 228 071) (7 067 159)
Add/(Less): Received current, not paid (Paid current year, received prior year) - -
Add/(Less): Adjustments (186 283) (127 488)
- -
Closing balance 1 077 960 981 336
Inventory issues increased by 16% compared to the 2017/18 financial period, from R7 067 159 000 to R8 228 071 000. This was a result of increased demand for health care as well as general inflationary increases. Inventory
purchases increased by 18% compared to the 2017/18 financial year in line with the increased demand for health care services provided.

VOTE 4 ANNEXURES TO THE ANNUAL FINANCIAL STATEMENTS
ANNEXURE 7
MOVEMENT IN CAPITAL WORK IN PROGRESS
MOVEMENT IN CAPITAL WORK IN PROGRESS FOR THE YEAR ENDED 31 MARCH 2019
Ready for use (Asset

Opening Current Year register) / Contract Closing
balance Capital WIP terminated balance
Nature of Liability R’000
R’000 R’000 R’000
BUILDINGS AND OTHER FIXED STRUCTURES 2 306 300 770 532 (608 272) 2 468 560
Other fixed structures 2 306 300 770 532 (608 272) 2 468 560
TOTAL 2 306 300 770 532 (608 272) 2 468 560
ANNEXURE 7
MOVEMENT IN CAPITAL WORK IN PROGRESS
MOVEMENT IN CAPITAL WORK IN PROGRESS FOR THE YEAR ENDED 31 MARCH 2018
Ready for use (Asset

Opening Opening Current Year register) / Contract Closing
balance balance Capital WIP terminated balance
Nature of Liability R’000
R’000 R’000 R’000 R’000
BUILDINGS AND OTHER
FIXED STRUCTURES 3 599 029 (434 308) 703 454 (1 561 875) 2 306 300
Dwellings
Non-residential buildings
Other fixed structures 3 599 029 (434 308) 703 454 (1 561 875) 2 306 300
Services and operating rights
TOTAL 3 599 029 (434 308) 703 454 (1 561 875) 2 306 300

PART F:
ANNUAL REPORT
GAUTENG MEDICAL SUPPLIES DEPOT (MSD)
TRADING ENTITY OF THE GAUTENG DEPARTMENT OF HEALTH

TABLE OF CONTENTS
Report of the Accounting Officer 282

Report of the Auditor-General 294
Statement of Financial Position 299
Statement of Financial Performance 300
Statement of Change in Net Assets 301
Statement of Cash Flows 302
Accounting Policies 303
Notes to the Financial Statements 311
Report of the Audit Committee - Cluster 3 328

GAUTENG MEDICAL SUPPLIES DEPOT
REPORT OF THE ACCOUNTING OFFICER
The Accounting Officer of the Gauteng Department of Health (the Prior to MSD online, the depot had to fax or email or physically
Department) hereby submits the annual report for the Gauteng deliver the copy of the orders to the demanders for them to be able
Medical Supplies Depot, to the Executive Authority of the Gauteng to receive stock from the suppliers but since the introduction of MSD
Department of Health, and the Gauteng Provincial Legislature of the online, demanders are now able to see their orders on MSD online.
Republic of South Africa. Prior to MSD online, suppliers had to deliver their payment packs at
the depot so that they can be paid on time but with the introduction
1. General review of the state of affairs of MSD online, suppliers can now
The Medical Supplies Depot (the Depot) operating as a trading entity
of the department is responsible for the supply of essential Significant events that have taken place during the year (Continued)
medicines to Provincial Health institutions and facilities in Gauteng.
In this regard, a levy of 5% is charged on stock issued to the upload their payment packs on MSD online and their payment can
Provincial Health Care Facilities. be effected timeously and if they did not submit all the required
documents, their payment pack will be rejected and the reason for
Essential medicines are procured on contract or quotations and their rejection will be indicated so that they are able to correct and
either store these items at the Depot or orders are placed with submit the correct documentation.
suppliers on behalf of institutions for direct delivery to the various
institutions. Accurate usage of items, as well as money spent by The introduction of the MSD online system improved the payment of
hospitals, can be obtained from the Medical Stock Administration supplier invoices to an extent that in Q3, an average of 98% of
System (MEDSAS). The Economic Order Quantity (EOQ) together supplier invoices were paid within thirty (30) days. Maintenance of
with the First-Expiry-First-Out, (FEFO) system is applied to ensure that the system could not be guaranteed in Q4. Thus, MSD had to
correct stock levels are maintained. partially revert back to the manual document management system
resulting in a reduction of the percentage of suppliers paid within
The Depot prepares financial statements for each financial year in thirty (30) days
accordance with the prescribed practice (Statements of South
African Generally Recognised Accounting Practice- GRAP). The
financial statements are prepared and reported on accordingly. MEDSAS
MEDSAS has given early warnings that its life span will soon come to
The Medical Supplies Depot has a re-packing function, where bulk an end. After crashing in January 2018, the depot has also
medicine is repacked into patient ready packs. The re-packing experienced a few limitations including its inability to allow
expenses are recovered from the normal levy charged. Managers for monitoring antivirus and security patch updates on the MEDSAS
each cost centre were identified and procedures to ensure the servers and end-user workstation environments since Microsoft does
completeness of stock requisitioning and receiving were designed. not support the operating system.
The various cost centre costs are consolidated at finance and reports
are timeously provided to cost centre managers for their use and This could lead to viruses not being effectively detected in the
provide a basis for comparison, monitoring and review purposes. environment. Malware could result in unauthorised access to data
and information resulting in unauthorised activity and possible
1.1 Significant events that have taken place during the year incorrect financial reporting. This could also result in systems being
MSD Online unavailable, due to malfunction, which can impact productivity of
end users and ultimately affect service delivery.
The MSD Online was introduced in April 2017 which assists in the
tracking of orders that have been placed by the depot on behalf of To circumvent this potential risk, management is in the process of
health institutions for their direct delivery orders. implementing a new inventory management system with at least the
following functionalities:
Prior to MSD online, orders had to be manually signed by the • Demand management;
relevant pharmacists and now orders are being signed electronically • Ordering;
and sent off electronically to the supplier and the supplier accepts • Warehousing;
the order on their end as proof of acknowledgement of the order by • Issuing, and
the supplier. • Payment of suppliers

Implementation of new Monitoring and Evaluation document for A summary of major spending trends indicates that medicine prices
the different units in the depot increased at a rate higher than the consumer price index (CPI). This
has the effect that revenue increases at a higher rate and has a
The monitoring and evaluation unit has developed a document for favourable influence on the net profit of the Depot. Cost
the management of the different units in the depot with workplans containment measures and increased demand from healthcare
and targets set to ensure that the depot achieves targets on the providers were also responsible for the improved net profit.
KPI’s. The workplans are monitored on a monthly basis and that is
why the depot was able to achieve all targets on the KPI’s in the
operational plan.
Spending Trends
Description 31 March Variance 31 March Variance 31 March Variance 31 March

2019 from Prior 2018 from Prior 2017 from Prior 2016
R Year R Year R Year R
Revenue 4 088 067 270 6.89% 3 824 656 198 28.46% 3 718 817 485 22.17% 2 894 248 189
Cost of Sales 3 893 397 373 6.89% 3 642 542 348 28.46% 3 541 730 922 24.61% 2 842 329 263
Expenditure: Personnel 70 316 592 2.90% 68 334 539 11.18% 61 460 965 0.62% 61 841 794
Expenditure: General 30 435 193 6.27% 28 639 876 -26.46% 38 944 850 32.74% 29 584 910
Net Profit 128 076 586 17.85% 108 678 509 25.68% 86 469 740 30.09% 60 447 734
The Universal Test and Treat Campaign that started in September reported to the South African Health Products Regulatory Authority
2016 was a driving force behind the increase in Revenue which saw for further management. Other Provincial Medicine Depots are
more orders for medical supplies being placed with the depot during alerted through the Affordable Medicines Unit at the National
the financial year. Department of Health.
communicated to other provinces.
Personnel expenses increased due to annual salary increases as well
as more scarce skills / Occupation Specific Dispensation (OSD) posts Tariff policy
on the staff establishment being filled. The tariff policy for the trading account was approved on 1 April
1992 as per the Exchequer Act, Act No. 66 of 1975. Approval was
General Expenditure was slightly higher in the 2018/2019 financial granted for a five percent (5%) levy on the average carrying value of
year when compared to the prior year. This is mainly due to the stock issued to customer hospitals.
increase in distribution costs (R1.8m) and increase in expenditure on
repairs and maintenance (R0.6m). Free Service
The Depot does not provide any free service. The quality control of
2. Services rendered the medicines performed by the laboratory on site is part of the
The Medical Supplies Depot is responsible for the effective and administrative expenses of the Depot, which are recovered as part of
efficient procurement, quality testing, warehousing and distribution the five percent levy charge.
of essential medicines to all the Provincial Health Care Facilities in
Gauteng. The Depot ensures that Essential Medicine List (EML) 3. Capacity constraints
medicines are available to our clients at all times. This involves the The Medical Supplies Depot delivers a vital service to all the Health
evaluation of samples for tender purposes, participation in tender Care Institutions in Gauteng.
adjudication meetings, procurement and distribution of these items,
as well as quality control of medicines distributed to our institutions. As at the end of the year under review the Medical Supplies Depot
had 266 posts on the approved staff establishment, with 75 vacant.
Quality control is carried out in a fully equipped laboratory, where Current year vacancy rate of 28% has a negative impact in terms of
samples are tested from each batch of medicines received. The the depot achieving its objectives.
Depot’s laboratory is the only public sector laboratory in South- This is as a result of a moratorium on the replacement of posts by the
Africa where the findings on quality tests performed are also Department. The Department established a post filling plan
committee. Having submitted a list of its most critical, vacant posts,

MSD was authorised to fill 23 positions in Phase 1 of the process. collated. Information from the following systems is used and
The recruitment process is on-going. involves time-consuming reconciliation procedures to enable
compliance with Statements of SA GRAP for disclosure purposes:
Measures have been taken to strengthen the operations of the
Depot and its management. Despite these challenges nonetheless • Basic Accounting System (BAS)
the depot has managed to put in place compensating measures • Personnel and Salary Administration System (PERSAL)
• Medical Stock Administration System (MEDSAS)
The measures can be demonstrated by two of our key performance • Asset Management System (ASSETWARE)
indicators: • MSDONLINE;
• Manual systems to perform reconciliation procedures and
• KPI 1 “Availability “refers to a situation where stock on hand at accrual based accounting
the depot is sufficient to meet the demand created on MEDSAS
in full, it was measured at 92.32% against a target of 90.00%. 4. Utilisation of donor funds
The Depot received Fluconazole from Pfizer Laboratories for use in
• KPI 2 “Service level” refers to how quickly the MSD takes to the treatment of Oesophageal Candidiasis and Cryptococcal
issue stock in full on MEDSAS. The measurement of this KPI is Meningitis and a further donation of Mebendazole for the
therefore time-based. This KPI ensures that all orders are issued deworming of school children from Janssen Pharmaceutical. This
within 24 hours and the Service level was measured at 85.34% type of donor funding is received on a continuous basis.
against a target of 80.00%.
Please note that the Depot does not account for the economic
Systems for measuring the indicator ‘% of orders supplied to benefit received in the Statement of Financial Performance, as the
institutions on first requests’ were strengthened, and the actual Depot is considered to be only a conduit for hospitals and to control
performance is calculated according to the following definition: ‘If a the receipt of donations for the Department. The donation is
demand/ request (which could consist of multiple different items) is reflected in the financial statements of the Department.
fulfilled 100% within 24 hours, then that order counts towards the
achieving of the target. If even one item is not issued on the system The current market value of donations issued and charged at a value
as part of the request within 24 hours, the order does not count as of one-hundredth of one cent (R0.0001) to all clients of the Depot.
being fulfilled’. This is an extremely high standard to fulfil, but it is The total charge to health institutions for donations received
specific, measurable and time- bound. Also, it holds the Depot to amounted to under R10.
higher standards – meeting orders within 24 hours could have a
life-saving impact at the level of institutions. However, the more
rigorous monitoring system makes it appear that performance is
lower than planned.
A constraint to ensure effective, economical and efficient reporting
exists in that information from various systems needs to be manually
Below is the breakdown of donations received during the financial period.
Item Supplied by/ Quantity Market Value Total

Description Arranged by Received Per Unit SEP
ICN # Single Exit Value
Price
(SEP)
181931183 MEBENDAZOLE 500MG TABLETS; 1's Janssen Pharmaceuticals 17480 R 589.50 R 10 304 460
180963203 FLUCANAZOLE INJECTION 2MG/ML;100ML Pfizer Laboratories 3500 R 233 .37 R816 795
181791499 FLUCONAZOLE POWDER FOR ORAL Pfizer Laboratories 700 R 235.36 R164 752
SUSPENSION 50MG/5ML;35ML
180962874 FLUCONAZOLE TABLETS 200MG; 28'S Pfizer Laboratories 12520 R 2785.25 R 34 871 330
R 46 157 337

5. Trading entities
The Medical Supplies Depot operates as a trading entity, known as management has continued to engage with suppliers in a
“The Central Medical Trading Account” since 1 April 1992. The number of ways such as the following:
trading entity acts as a shared supply chain for the procurement and o General meetings with all suppliers - quarterly;
provisioning of pharmaceuticals to the Department’s Health Care o One-on-one-meetings as and when necessary, and
Institutions in Gauteng. o Carrying out supplier satisfaction surveys by way of
suggestion boxes.
Comparative information
A four-year comparative analysis of major accounts is disclosed
• Although it is inevitable not to have expired medicines in a depot
under paragraph 1 above.
environment and where best practices industry estimate as a
benchmark is between 3% and 5% of average stock holding,
6. Organisation to whom transfer payments have been
the Depot adopted a more conservative approach by setting a
made
target not exceeding 2% of the stock holding. This performance
No transfer payment has been made by the Depot in this financial
indicator is reported on to the audit committee quarterly.
year.
9 Discontinued activities
7. Public/Private Partnership (PPP)
No activities were discontinued during the year under review.
No Public Private Partnership has been entered into by the Depot in
this financial year.
10. New/Proposed Activities
The Depot continues to be assisted by the Office of the Chief
The following non-core services have been outsourced to the private
Information Officer (CIO) in the implementation of the possible
sector which consists mostly of Black Economic Empowerment
alternative to the current inventory management systems (MEDSAS)
companies:
which is due for replacement in Q2 of 2019/20.
• Maintenance and support of the MEDSAS computer system; 11. Supply chain management (SCM)
• Distribution of stock to health care institutions; The MSD has a fully-fledged supply chain management system in
• Security of the property and vehicle access control; place including the Pharmaceutical Procurement Committee (PPC)
• Accounting services; with membership comprising of pharmacists, accountants and SCM
• Maintenance, pest control and minor landscaping of the garden personnel. A number of pharmaceutical items are on tenders which
at the Depot; and are administered at national level. The PPC, therefore, only deals
• Cleaning services with procurement sourced from quotations for values not exceeding
R500 000.
8. Corporate governance arrangements
Management has, with the objective of safeguarding the assets of 12. Asset management
the Depot and ensuring high quality of service delivery, prioritised Management is pleased to report that it carried out a full asset
the following areas: verification project on its approximately 6000 moveable assets of
property, plant and equipment (PPE) as required by paragraphs
• The Depot performs an annual strategic risk assessment which is 17.56 – 58 of Generally Recognised Accounting Practice (GRAP) and
followed by quarterly reviews and reporting to the audit in particular GRAP 17. This standard requires an entity to assess the
committee residual values of its PPE at least for each reporting period.
• The Depot has submitted the list of all critical vacant posts to the 13. Inventories
post filling committee for consideration and approval. The valuation method used by the Medical Supplies Depot is the
Implementation of Phase 1 authorised posts once completed moving weighted average method as per the MEDSAS:
will reduce the current vacancy rate at the Depot.
• ICT – Depot is currently considering the replacement of its
current ineffective inventory management system (MEDSAS)
with a new system.
• In an effort to increase Medicines availability, the Depot

Medicine
Description 31 March 2019 31 March 2018 31 March 2017 31 March 2016

R R R R
Closing stock 208 205 999 253 425 024 170 575 222 311 096 708
Medicine
31 March 2019 31 March 2018 31 March 2017 31 March 2016
Description R R R R
Breakages 2 306 7 633 3 288 13 273
Expired stock 1 006 956 1 166 028 2 016 734 2 568 494
Control measures in place

Whilst the long-term solutions for ensuring efficient and effective 14. Information on predetermined objectives
stock management at the depot require an appropriate The Gauteng Department of Health’s Strategic Plan, was used as a
infra-structure (new warehouse), an integrated information system basis for developing the Depot’s Operational Plan. This approach
and adequate workforce in terms of numbers and skills, the ensured that the Depot’s predetermined objectives are clearly
following short term controls have been instituted: aligned to those of the Department as far as the Depot’s relevance
to the Department is concerned.
• Shelf marshals continue to play a key role in the monitoring
stock expiry dates and identifying items expiring in 6 months; For the year under review, the Depot had a total of six (6)
• Stock on hand is first issued before replacement items are issued predetermined objectives which were reported on quarterly. Each of
when regimens (treatment protocols) are changed; the six objectives had at least one indicator whose measurement
• Reviewing the list of items to be kept at the Depot; variable inputs were collected either through the current IT Systems
• Discuss regimen changes with National Department of Health to in use such as MEDSAS or collected manually or a combination of IT
align with current stock levels; and manual systems.
• Back orders were reduced;
• Warehouse management practices were improved with the
introduction of trolley consolidations, streamlining of schedules
for supervisors that assists in effective staff utilization;
• Quality assurance processes were improved with a complete
overhaul of the standard operating procedures.

The key performance indicators per the strategic plan based on measurable objectives and our actual achievement are reflected in the table
below:
# Indicator Target Actual Deviations Comments/Challenges

Performance from
Target
1 Percentage of EML 90.00% 92.32% 2.32 % • Target Achieved:

medicines available at above The Depot holds regular meetings with suppliers to ensure
the Medical Supplies proper plans are in place to avoid medicine/stock shortages.
Depot. However, suppliers would still not comply with targets they
set themselves.
Suppliers that deliver late to the depot are being penalised
for late deliveries. MSD also procures out of stock items
through Buy-out and charges the difference in price against
the contracted supplier.
2 Percentage of orders 80.00% 85.34% 5.34% • Target Achieved:

satisfied in full within Above The follow-up centre is following up on all outstanding
one working day. orders with suppliers and that is why MSD have achieved
on this KPI. Suppliers that deliver late to the depot are
being penalised for late deliveries.
3 Percentage of expired <2% 1.06% 0.94% •Target Achieved:

stock. Below Suppliers that deliver short dated stock are expected to
deliver stock with a protection letter which states that if the
stock expires at MSD, the supplier will uplift the stock and
re-imburse us for the stock that has expired.
There are shelf marshals in every store who monitor batch
expiry dates of stock to ensure that stock that expires first
must be used first (First Expiry First Out).
4 95% of medicines 95% 69.39% 25.61% • Target Not Achieved:

tested within 2 Below The laboratory had sytem licence challenges. 25,61%
working days by the of the medicines were tested beyond the required 2
laboratory. workings days.
5 Percentage of staff <5% of 1.00% 4.00% • Target Achieved:

turnover. staff Below The Depot has created favourable working conditions for
turnover Threshold its staff participates in pharmacy month fun run as an MSD
team, exercises in an in-house gymnasium at lunch time,
opportunity to join the MSD choir which performs at
provincial functions.
6 Percentage of 70.00% 78.65% 8.65% • Target Achieved:
essential medicines Above Continuous monitoring of items that must be moved into
delivered directly to the DDV procurement system in order to increase the
health facilities number of items that are procured through the DDV
(DDVs). system

15. SCOPA Resolutions
At a duly constituted sitting for the Gauteng Provincial Legislature held on 03 September 2018, the House adopted the following SCOPA resolutions
relating to the 2017/2018 financial year:
Sitting Adopted Resolutions/Matters Raised How The Matters Were Addressed

Date
03 Sep Expenditure Management: • Effective and appropriate steps were implemented to try and avoid
2018 Irregular Expenditure irregular expenditure, however, due to the nature of business to ensure
Accounting officer did not always take medicines availability at all healthcare facilities across the province
effective steps to prevent irregular management requested a deviation from BAC which was approved for
expenditure amounting to XJM Consultants and Safranic.
R5 973 944.
• Distribution of Medicines Services-Safranic. This was due to delays in
1. Why were no effective and appropriate supply chain processes which have since been corrected and as such the
steps taken to prevent irregular distribution contract was awarded in January 2018.
expenditure as required by Section
38(1)(c)(ii) of the Public Finance • Financial Services-XJM
Management Act and Treasury Permission for the advertisement of relevant posts to replace the consultants
Regulation 9.1.1? was granted in December 2018. The necessary recruitment processes are
currently underway and are expected to be completed during the
2018/2019 financial year.
• Cleaning Services-Fumigation Worx

The process to appoint a service provider is underway to ensure that MSD
does not continue to incur an irregular expenditure in this regard.
03 Sep Provide the detailed transactions of each

instance of irregular expenditure including Name of Service provider Type of service rendered Value of Irregular expenditure
2018
the name of the service provider and the XJM Consultants Financial services R2,373,721
service provided. Safranic Distribution of medicines R2,936,223
services
Fumigation Worx Cleaning services R664,000
03 Sep What investigations have been undertaken Name of Service Type of service Value of Irregular Action Taken
2018 regarding irregular expenditure reported in provider rendered expenditure
2017/2018 financial year and what • Posts have now been made
XJM Consultants Financial services R2,373,721
disciplinary measures have been / will be available. Specifications for
taken against those responsible for irregular adverts have been submitted
to the department
expenditure?
Safranic Distribution of R2,936,22 • A new contract was awarded
effective January 2018 for 3
medicines services
years
Fumigation Cleaning services R664,0003 • The department is in the final

stage of appointing a service
Worx
provider (Negotiations with
selected service provider
underway).


Date
03 Sep Considering the numerous turn around • Unavailability of relevant posts to advertise and replace consultants (XJM
2018 strategies actioned in the Entity including Consultants)
setting up the Pharmaceutical Procurement • Delay in the processes leading to the appointment of the service provider
Committee, explain why the irregular (Safranic) medicine distribution.
expenditure recurred? • Delay in the processes leading to the appointment of the service provider
(Fumigation Worx) Cleaning Services
Name of Service Type of service Value of Irregular Root cause

provider rendered expenditure
XJM Consultants Financial services R2,373,721 • Unavailability of

relevant posts to
advertise and replace
consultants
Safranic Distribution of R2,936,223 • Delay in the processes

medicines services leading to the
appointment of the
service provider.
Fumigation Cleaning services R664,000 • Delay in the processes

Worx leading to the
appointment of the
service provider.
03 Sep What disciplinary steps will be taken against • A new service provider has been appointed for distribution of medicines
2018 the Accounting Officer for non-compliance • A new contract was awarded effective January 2018 for 3 years
with Section 38(1)(c)(ii) of the Public Finance • MSD management has analysed the above 3 categories of irregular
Management Act and Treasury Regulation expenditure. One report is complete and the others are still in progress.
9.1.1?
03 Sep 30 Days Payment

• There were not enough funds to pay suppliers towards the end of the
2018 Why payments were not made within 30
financial year 2017/2018 and hence the suppliers were not paid within
days or an agreed period after receipt of an
30 days.
invoice, as required by Treasury Regulation
8.2.3.
03 Sep Has the Department developed a strategy to • Please refer to iron clad approach presentation which is included as
2018 address spending on non-essential items? If Annexure A – Presentation
yes, provide the Committee with a copy of
the strategy.
Paragraph 21-22, PG 296 Procurement and • The process of inviting competitive bids had already started and the
03 Sep
Contract Management entity therefore could not afford to have the institution without any
2018
1.Why goods and services with a cleaning services, which would have compromised infection control
transaction value above R500 000 were hence management requested for approval from the Accounting
procured without inviting competitive Officer.
bids and in some instances, deviations
were approved by the Accounting
Officer even though it was practical to
invite competitive bids as prescribed by
Treasury Regulation 16A6.1 and
16A6.4.


Date
03 Sep To the Accounting Officer:

Name of Service Type of service Value of Irregular Root cause
2018 provider rendered expenditure
a. Provide a detailed list of all the
XJM Consultants Financial services R2,373,721 • There was BAC
transactions entered violating Treasury
approval. Please see
Regulation 16A.6.1 and 16A.6.4.
attached
Safranic Distribution of R2,936,223 • There was BAC
medicines services approval. Please see
attached
03 Sep b. Provide portfolio of evidence detailing

• There was no need to take disciplinary action against any official due to
2018 the officials implicated plus the
the fact that the entity applied for deviation which was approved.
disciplinary steps taken against the said
• Please refer to Portfolio of evidence attached.
officials in respect of goods and
services purchased which were
approved without acquiring the
sufficient quotations.
03 Sep c. The list should include the name of the Name of Service Type of service Value of Irregular Root cause
provider rendered expenditure
2018 provider and service rendered and the
amount involved. XJM Consultants Financial services R2,373,721 • There was BAC
approval. Please see
attached
Safranic Distribution of R2,936,223 • There was BAC
medicines services approval. Please see
attached
03 Sep d. What is the status quo of the • In both cases, there was a BAC approval for the extension of the
2018 investigations conducted for this contracts.
financial misconduct?
03 Sep e. Provide the Committee with corrective • The matter has been reported to the Risk and Internal Controls Unit and
2018 measures and/or disciplinary steps that are assessing the documentation to determine circumstances around
the MEC will take against the each matter. The outcome of the investigation will determine the action
Accounting Officer for contravening to be taken against the Accounting Officer.
Treasury Regulation 16A.6.1 and
16A.6.4.
a. Why were some quotations awarded to • The points were allocated based on the old PPPFA and not the amended
Bidders based on preference that were PPPFA. The depot was not aware of the amended PPPFA at that time.
not allocated and calculated in We acknowledge the incorrect application of the regulation but it must
accordance with the requirements of be pointed out that no bidder was prejudiced because of the incorrect
the Preferential Procurement Policy application of the regulation.
Framework Act of South 2000 (Act No.
5 of 2000) and its Regulations? • Due to the fact that the correct bidder had been appointed even when
the new regulations were applied, no disciplinary action was taken.


Date
03 Sep 8. INTERNAL CONTROLS

2018 • The audit action plan is being monitored and progress reported on a
PARAGRAPH 27-28, PG 297 LEADERSHIP quarterly basis to the External Audit committee.
The Accounting Officer did not adequately

exercise effective oversight responsibility
over the internal controls relating to the
procurement and contract management as
well as expenditure management.
To the Accounting Officer:
a. Why was the action plan to address

audit findings not monitored on a
timely basis by the appropriate level of
management?
03 Sep What action is being taken to enhance • Middle managers are scheduled to attend a workshop on the 2017
2018 leadership in the department with PPPFA regulations
emphasis on: • The Depot manager is attending a course on Albertina Sisulu Leadership
Course for Health.
b. lack of monitoring controls to ensure • At least 8 officials are scheduled to attend training on various areas
compliance with laws and regulations inclusive of risk management and supply chain/procurement.
• All pharmacists are doing short courses in Continuing Professional
Development.
03 Sep c. Procurement and contract • Please see response in part (a) above
2018 management
03 Sep d. Expenditure management and revenue • The Depot produces monthly management accounts as well as monthly
2018 management. budget vs Expenditure reports in-house hence providing on-going
coaching and mentoring.


Date
03 Sep Other Matters of Interest Year (a) The Allegation(s) (a) The name and (a) The action taken
designation of the because of the
2018 Investigations accused investigation
2015/16 Theft of medicines Mr B Nyaku, • Initially Dismissed but

To the MEC: later appealed
driver
• Outcome of appeal: 3
months suspension
1. Provide the status report on the with no pay
implementation of recommendations • Official back in his
of investigations for irregular original post as driver
expenditure relating to the syndicate
on the alleged illicit activities identified
in 2015-16 details thereof should
include the following:
a. The allegation
b. The name and designation of the
accused
c. The action taken because of the
investigation
03 Sep General • The control deficiencies related to operating systems, are largely due to the
2018 Information Technology Controls use of legacy systems. The replacement of the before-mentioned systems
is included in the eHealth implementation architecture, which was defined
What actions have the Trading Entity taken, in partnership with the Department of e-Government.
in partnership with the Department of
e-Government to find solutions to • The legacy systems are due to be replaced in a phased approach with some
information technology controls deficiencies earmarked for replacement by the end of March 2019, and the balance by
to resolve operating systems problems? the end of the 19/20 financial year.
03 Sep What action did the Trading Entity take • The ICT infrastructure was not neglected for 20 years but had been
2018 against the management for neglecting to upgraded in the last seven years.
refurbish the ICT infrastructure for 20 years • The matter is part of the SIU investigation. There is a new Chief Information
and over-reliance on the external service Officer who was not involved in the process and has been tasked to
provider for securing the system? refurbish the ICT infrastructure in collaboration with the department of
e-Government.
03 Sep Does the Trading Entity have a scheduled • The Department currently does not have an ICT infrastructure maintenance
2018 maintenance plan for ICT infrastructure? plan. The Department is in the process to migrate all the systems and data
to the Provincial Fully Managed Data Centre. It is envisaged that this
process will be concluded by the end of the 18/19 financial year.
To mitigate high risk to the Trading Entity, • The current disaster recovery plan is centred around the use of the VBlock
provide the Committee with a progress infrastructure and related technologies. The pending migration of the
report on the implementation of the disaster Departments systems and data, to the Provincial Fully Managed Data
recovery plan. Centre, will result in a Disaster Recovery Plan being defined and restricted
to the before-mentioned data centre.

16. Prior modifications to audit reports 22. Approval and sign off
There were no prior modifications to the audit reports for the entity. The financial statements set out on pages ……. have been approved
by the Accounting Officer.
17. Exemptions and deviations received from the
National Treasury
The entity did not receive any deviations from the National Treasury
or the Gauteng Provincial Treasury (GPT).
18. Investigation
No Investigations were conducted for the Medical Supplies Depot MS NOCAWE THIPA
(MSD) for the year ended 31 March 2019. CHIEF EXECUTIVE OFFICER
19. Other
The Depot was still incurring a cost relating to price increases not 31 May 2019
recovered from demanders. This is mostly attributable to the back
dated approval of contract price increases by the Gauteng
Department of Finance.
20. Acknowledgement(s)/ or Appreciation

Management would like to acknowledge the enormous
contributions made towards the entity by all our stakeholders
including our patients, the Gauteng Department of Health, Gauteng
Provincial Treasury and other organs of State. Our sincere
appreciation also goes to our valued suppliers especially those in the
pharmaceutical industry who ensured that medicines were available
to the Gauteng Medical Supplies Depot as well as all public
healthcare institutions and facilities in the province. MSD
management cannot forget our workforce at all levels who tirelessly
ensured that the most important stakeholders, the patients, were
put first.
21. Conclusion
The financial year 2018/2019 has had many challenges facing both
the department and the MSD. Despite these challenges
management is pleased to report a success story in terms of service
delivery towards the people of Gauteng. The MSD achieved 100%
of all its predetermined objectives making it possible for medicines
to be available in all the public hospitals and clinics in Gauteng
throughout the year. We look forward to even a better year in
2019/2020.

REPORT OF THE AUDITOR-GENERAL
Report of the Auditor-General to the Gauteng Provincial Legislature on the Gauteng Medical
Suplies Depot
Report on the audit of the financial statements
Opinion Restatement of corresponding figures
1. I have audited the financial statements of the Gauteng Medical 7. As disclosed in note 31 to the financial statements, the
Supplies Depot set out on pages 299 to 327, which comprise corresponding figures for 31 March 2018 have been restated
the statement of financial position as at 31 March 2019, the as a result of errors discovered in the financial statements of
statement of financial performance, the statement of changes the entity for the year ended 31 March 2019.
in net assets and the statement of cash flows for the year then
ended, as well as the notes to the financial statements, Responsibilities of the accounting officer for the financial
including a summary of significant accounting policies. statements
2. In my opinion, the financial statements present fairly, in all 8. The accounting officer is responsible for the preparation and
material respects, the financial position of the Gauteng Medical fair presentation of the financial statements in accordance
Supplies Depot as at 31 March 2019, and its financial with the SA Standards of GRAP and the requirements of the
performance and cash flows for the year then ended in PFMA, and for such internal control as the accounting officer
accordance with the South African Standards of Generally determines is necessary to enable the preparation of financial
Recognised Accounting Practice (SA Standards of GRAP) and statements that are free from material misstatement, whether
the requirements of the Public Finance Management Act of due to fraud or error.
South Africa, 1999 (Act no. 1 of 1999) (PFMA).
9. In preparing the financial statements, the accounting officer is
Basis for opinion responsible for assessing the trading entity’s ability to
3. I conducted my audit in accordance with the International continue as a going concern, disclosing, as applicable, matters
Standards on Auditing (ISAs). My responsibilities under those relating to going concern and using the going concern basis
standards are further described in the auditor-general’s of accounting unless the appropriate governance structure
responsibilities for the audit of the financial statements section either intends to liquidate the trading entity or to cease
of this auditor’s report. operations, or has no realistic alternative but to do so.
4. I am independent of the trading entity in accordance with Auditor-general’s responsibilities for the audit of the
sections 290 and 291 of the International Ethics Standards financial statements
Board for Accountants’ Code of ethics for professional
accountants, parts 1 and 3 of the International Ethics Standards 10.My objectives are to obtain reasonable assurance about
Board for Accountants’ International code of ethics for whether the financial statements as a whole are free from
professional accountants (including International Independence material misstatement, whether due to fraud or error, and to
Standards) (IESBA codes) and the ethical requirements that are issue an auditor’s report that includes my opinion. Reasonable
relevant to my audit in South Africa. I have fulfilled my other assurance is a high level of assurance, but is not a guarantee
ethical responsibilities in accordance with these requirements that an audit conducted in accordance with the ISAs will
and the IESBA codes. always detect a material misstatement when it exists.
Misstatements can arise from fraud or error and are
5. I believe that the audit evidence I have obtained is sufficient and considered material if, individually or in aggregate, they could
appropriate to provide a basis for my opinion. reasonably be expected to influence the economic decisions
of users taken on the basis of these financial statements.
Emphasis of matter
6. I draw attention to the matter below. My opinion is not 11. A further description of my responsibilities for the audit of the
modified in respect of this matter. financial statements is included in the annexure to this
auditor’s report.

Report on the audit of the annual

performance report
12. In accordance with the Public Audit Act of South Africa, 2004 15. I performed procedures to determine whether the reported
(Act no. 25 of 2004) (PAA) and the general notice issued in performance information was properly presented and whether
terms thereof, I have a responsibility to report material findings performance was consistent with the approved performance
on the reported performance information against planning documents. I performed further procedures to
predetermined objectives for selected programmes presented in determine whether the indicators and related targets were
the annual performance report. I performed procedures to measurable and relevant, and assessed the reliability of the
identify findings but not to gather evidence to express reported performance information to determine whether it was
assurance. valid, accurate and complete.
13.My procedures address the reported performance information, 16. I did not raise any material findings on the usefulness and
which must be based on the approved performance planning reliability of the reported performance information for the
documents of the trading entity. I have not evaluated the selected programme.
completeness and appropriateness of the performance
indicators included in the planning documents. My procedures Other matters
also did not extend to any disclosures or assertions relating to 17. I draw attention to the matters below.
planned performance strategies and information in respect of
future periods that may be included as part of the reported Achievement of planned targets
performance information. Accordingly, my findings do not 18. Refer to the annual performance report on page 287 for
extend to these matters. information on the achievement of planned targets for the year
and explanations provided for the under/overachievement of a
14. I evaluated the usefulness and reliability of the reported significant number of targets.
performance information in accordance with the criteria
developed from the performance management and reporting
Adjustment of material misstatements
19. I identified material misstatements in the annual performance
framework, as defined in the general notice, for the following
report submitted for auditing. These material misstatements
selected programme presented in the annual performance
were on the reported performance information of medical
report of the trading entity for the year ended 31 March 2019:
supplies depot health care support. As management
subsequently corrected the misstatements, I did not raise any
Pages in the annual material findings on the usefulness and reliability of the
Programme performance report
reported performance information.
Programme 7 – Health care support 73 - 76
Sub-programme medical supplies 287
depot

Report on the audit of compliance with legislation

20. In accordance with the PAA and the general notice issued in 27. My opinion on the financial statements and findings on the
terms thereof, I have a responsibility to report material findings reported performance information and compliance with
on the compliance of the trading entity with specific matters in legislation do not cover the other information and I do not
key legislation. I performed procedures to identify findings but express an audit opinion or any form of assurance conclusion
not to gather evidence to express assurance. thereon.
21. The material findings on compliance with specific matters in key 28. In connection with my audit, my responsibility is to read the
legislations are as follows: other information and, in doing so, consider whether the other
information is materially inconsistent with the financial
Annual financial statements statements and the selected programme presented in the
22.The financial statements submitted for auditing were not annual performance report, or my knowledge obtained in the
prepared in accordance with the prescribed financial reporting audit, or otherwise appears to be materially misstated.
framework as required by section 40(1)(b) of the PFMA.
Material misstatements on commitments identified by the 29. If, based on the work I have performed, I conclude that there is
auditors in the submitted financial statement were a material misstatement in this other information, I am required
subsequently corrected, resulting in the financial statements to report that fact. I have nothing to report in this regard.
receiving an unqualified audit opinion.
Internal control deficiencies
Procurement and contract management 30. I considered internal control relevant to my audit of the financial
23. Some goods and services with a transaction value above R500 statements, reported performance information and compliance
000 were procured without inviting competitive bids and with applicable legislation; however, my objective was not to
deviations were approved by the accounting officer although it express any form of assurance on it. The matters reported
was practical to invite competitive bids, as required by treasury below are limited to the significant internal control deficiencies
regulations 16A6.1 and 16A6.4. Similar non-compliance was that resulted in the findings on compliance with legislation
reported in the previous year. included in this report.
31. The accounting officer did not exercise adequate oversight
Expenditure management responsibility relating to internal controls for procurement and
24.Effective and appropriate steps were not taken to prevent contract management and the preparation of the annual
irregular expenditure amounting to R10 778 051 as disclosed in financial statements.
note 27 to the financial statements, as required by section 32.The entity developed a plan to address the prior year audit
38(1)(c)(ii) of the PFMA and treasury regulation 9.1.1. The findings, but the accounting officer did not provide adequate
majority of the irregular expenditure was caused by oversight relating to implementation and adherence to the
procurement of goods and services without following plan.
competitive bidding processes.
25.Payments were not made within 30 days or an agreed period

after receipt of an invoice, as required by treasury regulation
8.2.3.
Other information
26.The accounting officer is responsible for the other information.
The other information comprises the information included in
the annual report, which includes the audit committee’s report.
The other information does not include the financial
statements, the auditor’s report and the selected programme
presented in the annual performance report that has been
specifically reported in this auditor’s report.

33. Senior management did not ensure that sufficient controls are
in place to prepare accurate and complete annual financial
statements that are supported by reliable information. This
resulted in material amendments to the annual financial
statements. Furthermore, there was a lack of adequate
monitoring of controls to ensure compliance with laws and
regulations relating to expenditure and procurement and
contract management.
Johannesburg
31 July 2019

Annexure – Auditor-general’s responsibility for the

audit
1. As part of an audit in accordance with the ISAs, I exercise • evaluate the overall presentation, structure and content of the
professional judgement and maintain professional scepticism financial statements, including the disclosures, and whether the
throughout my audit of the financial statements, and the financial statements represent the underlying transactions and
procedures performed on reported performance information for events in a manner that achieves fair presentation.
the selected programme and on the trading entity’s compliance
with respect to the selected subject matters. Communication with those charged with governance
3. I communicate with the accounting officer regarding, among
Financial statements other matters, the planned scope and timing of the audit and
2. In addition to my responsibility for the audit of the financial significant audit findings, including any significant deficiencies
statements as described in this auditor’s report, I also: in internal control that I identify during my audit.
• identify and assess the risks of material misstatement of the 4. I also confirm to the accounting officer that I have complied with
financial statements whether due to fraud or error, design and relevant ethical requirements regarding independence, and
perform audit procedures responsive to those risks, and obtain communicate all relationships and other matters that may
audit evidence that is sufficient and appropriate to provide a reasonably be thought to have a bearing on my independence
basis for my opinion. The risk of not detecting a material and, where applicable, related safeguards.
misstatement resulting from fraud is higher than for one
resulting from error, as fraud may involve collusion, forgery,
intentional omissions, misrepresentations, or the override of
internal control
• obtain an understanding of internal control relevant to the audit

in order to design audit procedures that are appropriate in the
circumstances, but not for the purpose of expressing an opinion
on the effectiveness of the trading entity’s internal control
• evaluate the appropriateness of accounting policies used and

the reasonableness of accounting estimates and related
disclosures made by the accounting officer
• conclude on the appropriateness of the accounting officer’s use

of the going concern basis of accounting in the preparation of
the financial statements. I also conclude, based on the audit
evidence obtained, whether a material uncertainty exists related
to events or conditions that may cast significant doubt on the
Gauteng Medical Supplies Depot’s ability to continue as a going
concern. If I conclude that a material uncertainty exists, I am
required to draw attention in my auditor’s report to the related
disclosures in the financial statements about the material
uncertainty or, if such disclosures are inadequate, to modify the
opinion on the financial statements. My conclusions are based
on the information available to me at the date of this auditor’s
report. However, future events or conditions may cause a
trading entity to cease continuing as a going concern

STATEMENT OF FINANCIAL POSTION
AS AT 31 MARCH 2019
Figures in Rand Note 2019 2018*
ASSETS
Current Assets
Inventories 2 208 666 717 253 964 393

Trade and other receivables from exchange transactions 3 615 410 548 1 024 065 168
Cash and cash equivalents 4 242 702 338 31 419 193
1 066 779 603 1 309 448 754
Non-Current Assets
Property, plant and equipment 5 7 657 329 9 581 215

Intangible assets 6 - -
7 657 329 9 581 215
Total Assets 1 074 436 932 1 319 029 969
LIABILITIES
Current Liabilities
Trade and other payables from exchange transactions 7 381 448 557 751 495 854
Provisions 8 1 307 383 3 601 652
Finance lease obligations 9 145 963 328 057
382 901 903 755 425 563
Non-Current Liabilities
Financial lease obligations 9 166 339 312 302

166 339 312 302
Total Liabilities 383 068 242 755 737 865
Net Assets 691 368 690 563 292 104
Contributed Capital 10 104 376 790 104 376 790

Accumulated surplus 586 991 900 458 915 314
Total Net Assets 691 368 690 563 292 104

* Restated. Refer note 31.

STATEMENT OF FINANCIAL PERFORMANCE
REVENUE
Revenue from exchange transactions

Sale of Goods 11 4 088 067 270 3 824 656 198
Finance income 12 9 816 888 10 919 455
Other income 13 150 576 350 523
Total revenue from exchange transactions 4 098 034 734 3 835 926 176
Revenue from non-exchange transactions

Penalties 14 24 194 254 12 489 525
Total revenue from non-exchange transactions 24 194 254 12 489 525
TOTAL REVENUE 4 122 228 988 3 848 415 701
EXPENSES
Employee related costs 15 (70 316 592) (68 334 539)

Depreciation and amortization expense 16 (2 624 282) (4 041 579)
Finance costs 17 (125 142) (220 429)
Cost of goods sold 18 (3 893 397 373) (3 642 542 348)
Distribution costs 19 (7 945 580) (6 191 817)
Operational costs 20 (19 740 189) (18 364 580)
TOTAL EXPENSES (3 994 149 158) (3 739 695 292)
OTHER GAINS/(LOSSES)
Loss on disposal of assets (3 244) (41 900)
TOTAL OTHER GAINS/(LOSSES) (3 244) (41 900)
OPERATING SURPLUS BEFORE TAX 128 076 586 108 678 509
TAXATION 21 - -
TOTAL SURPLUS FOR THE YEAR NET OF TAX 128 076 586 108 678 509

* Restated. Refer note 31

STATEMENT OF CHANGES IN NET ASSETS
Figures in Rand Contributed Capital Accumulated Surplus TOTAL
Balance at 31 March 2017 104 376 790 350 236 805 454 613 595
Surplus for the period - 108 678 509 108 678 509
Balance at 31 March 2018* 104 376 790 458 915 314 563 292 104
Surplus for the period - 128 076 586 128 076 586
Balance at 31 March 2019 104 376 790 586 991 900 691 368 690
* Restated. Refer note 31.

STATEMENT OF CASH FLOWS
Cash flows from operating activities
Receipts
Sale of goods and services 4 496 721 890 3 900 047 030
Finance income 12 9 816 888 10 919 455
Other receipts 150 576 211 071
Total receipts 4 506 689 354 3 911 177 556
Payments
Compensation of employees (70 175 557) (66 230 539)
Goods and services (4 224 073 813) (3 811 041 357)
Finance costs 18 (125 142) (220 429)
Total payments (4 294 374 512) (3 877 492 325)
Net cash generated from operating activities 212 314 842 33 685 231
Cash flows from investing activities
Purchase of property, plant and equipment 5 (703 640) (4 589 525)
Net cash outflow from investing activities (703 640) (4 589 525)
Cash flows from financing activities
Repayment of finance lease liability 9 (328 057) (302 154)
Net cash outflow from financing activities (328 057) (302 154)
Increase/(decrease) in cash and cash equivalents 211 283 145 28 793 552
Cash and cash equivalents at the beginning of the year 31 419 193 2 625 641
Cash and cash equivalents at the end of the year 4 242 702 338 31 419 193
*Restated. Refer note 31.

ACCOUNTING POLICIES
1.1 Basis of preparation

These financial statements were prepared in accordance with the Provisions
standards of Generally Recognized Accounting Practices (GRAP) Provisions are measured as the present value of the estimated future
issued by the Accounting Standards Board in accordance with the outflows required to settle the obligation. In the process of
Public Finance Management Act, 1999 (Act No.1 of 1999) as determining the best estimate of the amounts that will be required
amended by the Public Finance Management Amendment Act (Act in future to settle the provision management considers the weighted
No. 29 of 1999). average probability of the potential outcomes of the provisions
raised. This measurement entails determining what the different
1.2 Presentation currency potential outcomes are for a provision as well as the financial impact
The financial statements are presented in South African Rand, which of each of those potential outcomes. Management then assigns a
is the functional currency of the entity. weighting factor to each of these outcomes based on the probability
that the outcome will materialise in future. The factor is then applied
1.3 Rounding to each of the potential outcomes and the factored outcomes are
Unless otherwise stated, all financial figures have been rounded to then added together to arrive at the weighted average value of the
the nearest Rand (R). provisions.
1.4 Going concern assumption

The annual financial statements were prepared on a going concern
basis, which assumes that the entity will continue to operate as a
going concern for at least the next 12 months.
1.5 Comparative information

Prior year comparatives
Where necessary, comparative figures have been reclassified to
conform to changes in presentation in the current year.
1.6 Significant judgements and estimates

The use of judgment, estimates and assumptions is inherent to the
process of preparing annual financial statements. These judgements,
estimates and assumptions affect the amounts presented in the
annual financial statements. Uncertainties about these estimates
and assumptions could result in outcomes that require a material
adjustment to the carrying amount of the relevant asset or liability in
future periods.

ACCOUNTING POLICIES
1.6 Significant judgements and estimates
Depreciation and amortization Cash and cash equivalents

Depreciation and amortization recognised on property, plant and Cash and cash equivalents are measured at amortised cost using the
equipment is determined with reference to the useful lives and effective interest rate method.
residual values of the underlying items. The useful lives and residual
values of assets are based on management’s estimation of the Cash includes cash on hand and cash with banks. Cash equivalents
asset’s condition, expected condition at the end of the period of use, are short-term highly liquid investments that are held with registered
its current use, expected future use and the entity’s expectations banking institutions with maturities of three months or less and are
about the availability of finance to replace the asset at the end of its subject to an insignificant risk of change in value. For the purposes
useful life. In evaluating the how, the condition, and use of the asset of the Cash Flow Statement, cash and cash equivalents comprise
inform the useful life and residual value. Management considers the cash on hand and deposits held on call with banks.
impact of technology and minimum service requirements of the
assets. Trade and other payables
Trade payables are initially measured at fair value plus transaction
Fair value determination of property, plant and equipment costs that are directly attributable to the acquisition and are
(excluding heritage assets) subsequently measured at amortised cost using the effective interest
rate method.
In determining the fair value of property, plant and equipment the
entity applies a valuation methodology to determine the fair value Gains and losses
based on any one of, or a combination of the following factors: A gain or loss arising from a change in the fair value of a financial
asset or financial liability measured at fair value is recognised in
- The market related selling price of the item; or surplus or deficit.
- The material composition of the item; or
- The item’s special features which include design, For financial assets and financial liabilities measured at amortised
appendages and improvements; or cost or cost, a gain or loss is recognised in surplus or deficit when the
- The item’s condition with regards to whether it is broken, financial asset or financial liability is derecognised or impaired or
in a poor, fair, good or excellent condition. through the amortization process.
1.7 Financial instruments Off-setting

The entity does not offset financial assets and financial liabilities in
Initial recognition the Statement of Financial Position unless a legal right of set-off
The entity recognises a financial asset or a financial liability in its exists and the parties intend to settle on a net basis.
Statement of Financial Position when, and only when, the entity
becomes a party to the contractual provisions of the instrument. This Impairments
is achieved through the application of trade date accounting.
All financial assets measured at amortised cost are subject to an
Upon initial recognition the entity classifies financial instruments or impairment review. The entity assesses at the end of each reporting
their component parts as financial liabilities or financial assets in period whether there is any objective evidence that a financial asset
conformity with the substance of the contractual arrangement and or group of financial assets is impaired.
to the extent that the instrument satisfies the definitions of a
financial liability or a financial asset, in accordance with the If there is objective evidence that an impairment loss on financial
standards of GRAP on Financial instruments - GRAP 104. assets measured at amortised cost has been incurred, the amount of
the loss is measured as the difference between the asset‘s carrying
Trade and other receivables amount and the present value of estimated future cash flows
Trade and other receivables are initially recognised at fair value plus (excluding future credit losses that have not been incurred)
transaction costs that are directly attributable to the acquisition and discounted at the financial asset‘s original effective interest rate (i.e.
subsequently stated at amortised cost, using the effective interest the effective interest rate computed at initial recognition). The
rate method. carrying amount of the asset is reduced through the use of an
allowance account. The amount of the loss is recognised in surplus
or deficit.

ACCOUNTING POLICIES
1.8 Inventories
Initial recognition and measurement Depreciation

Inventories are initially recognised at cost. Cost refers to the Depreciation is calculated on the depreciable amount, using the
purchase price, plus taxes, transport costs and any other costs in straight-line method over the estimated useful lives of the assets.
bringing the inventories to their current location and condition. Components of assets that are significant in relation to the whole
asset and that have different useful lives are depreciated separately.
Subsequent measurement The depreciable amount is determined after taking into account an
Inventories will be measured at the lower of cost and the net assets’ residual value, where applicable.
realizable value. Inventories are stated on a weighted average
moving basis with the same cost formula being used for all The assets’ residual values, useful lives and depreciation methods are
inventories having a similar nature and use at the entity. reviewed at each financial year-end and adjusted prospectively, if
appropriate.
Redundant and slow-moving inventories are identified and written
down from cost to net realisable value with regard to their estimated
economic or realisable values. The amount of any reversal of any
write-down of inventories arising from an increase in net realisable
value is recognised as a reduction of inventories recognised as an
expense in the period in which the reversal occurs.
Derecognition
The carrying amount of inventories is recognized as an expense in
the period that the inventory was sold, distributed, written off or
consumed, unless that cost qualifies for capitalization to the cost of
another asset.
1.9 Property, plant and equipment
Initial recognition and measurement

The cost of an item of property, plant and equipment is the purchase
price and other costs directly attributable to bring the asset to the
location and condition necessary for it to be capable of operating in
the manner intended by the entity. Trade discounts and rebates are
deducted in arriving at the cost at which the asset is recognised. The
cost also includes the estimated costs of dismantling and removing
the asset.
Items of property, plant and equipment are initially recognised as

assets on acquisition date and are initially recorded at cost where
acquired through exchange transactions. However, when items of
property, plant and equipment are acquired through non-exchange
transactions, those items are initially measured at their fair values as
at the date of acquisition.
Subsequent measurement
Subsequent to initial recognition, items of property, plant and
equipment are measured at cost less accumulated depreciation and
impairment losses.

ACCOUNTING POLICIES
1.9 Property, plant and equipment (Continued)

The annual depreciation rates are based on the following estimated asset useful lives:
Asset classification Average useful lives (Years)
Fixtures and fittings
Buildings 10
Motor vehicles -
Cars, minibuses, trucks 3-5
Plant and equipment -
Air-conditioning 4 - 15
Medical equipment 1 - 21
Radio equipment 5 - 10
Telephone system 5 - 10
Audio visual 3 - 19
Domestic equipment 3 - 16
Laboratory equipment 3 - 21
Security equipment 1 - 21
Vehicles 9 - 19
Warehouse equipment 3 - 16
Workshop and tools 3 - 21
Office furniture -
Kitchen appliances 3 - 21
Office equipment 1 - 23
Computer equipment 1 - 18
Cellphones & Accessories 2
Impairment
The entity tests for impairment where there is an indication that an
asset may be impaired. An assessment of whether there is an
indication of possible impairment is done at each reporting date.
Where the carrying amount of an item of property, plant and
equipment is greater than the estimated recoverable amount (or
recoverable service amount), it is written down immediately to its
recoverable amount (or recoverable service amount) and an
impairment loss is charged to the Statement of Financial
Performance.
Where items of property, plant and equipment have been impaired,

the carrying value is adjusted by the impairment loss, which is
recognised as an expense in the Statement of Financial Performance
in the period that the impairment is identified.

ACCOUNTING POLICIES
1.10 Intangible Assets

Impairments
Initial recognition and measurement The entity tests intangible assets with finite useful lives for
An intangible asset is an identifiable non-monetary asset without impairment where there is an indication that an asset may be
physical substance. The entity recognises an intangible asset in its impaired. An assessment of whether there is an indication of
Statement of Financial Position only when it is probable that the possible impairment is performed at each reporting date. Where the
expected future economic benefits or service potential that are carrying amount of an item of an intangible asset is greater than the
attributable to the asset will flow to the entity and the cost or fair estimated recoverable amount (or recoverable service amount), it is
value of the asset can be measured reliably. written down immediately to its recoverable amount (or recoverable
service amount) and an impairment loss is charged to the Statement
Intangible assets are initially recognised at cost. of Financial Performance.
Where an intangible asset is acquired by the entity for no or nominal
consideration (i.e. a non-exchange transaction), the cost is deemed Derecognition
to be equal to the fair value of that asset on the date acquired. Intangible assets are derecognised when the asset is disposed of or
when there are no further economic benefits or service potential
Subsequent measurement expected from the asset. The gain or loss arising on the disposal or
Intangible assets are subsequently carried at cost less accumulated retirement of an intangible asset is determined as the difference
amortization and impairments. between the sales proceeds and the carrying value and is recognised
in the Statement of Financial Performance.
The cost of an intangible asset is amortised over the useful life where
that useful life is finite. The amortization expense on intangible
assets with finite lives is recognised in the Statement of Financial
Performance in the expense category consistent with the function of
the intangible asset.
Intangible assets with indefinite useful lives are not amortised, but
are tested for impairment annually, either individually or at the cash
generating unit level. The assessment of indefinite life is reviewed
annually to determine whether the indefinite life assumption
continues to be supportable. If not, the change in useful life from
indefinite to finite is made on a prospective basis.
Amortization and impairment

Amortization is charged to write-off the cost of intangible assets
over their estimated useful lives using the straight-line method.
The annual amortization rates are based on the following estimated

average asset lives:
Intangible Asset Average Useful Life

Computer Software 3-5 years
The amortization period, the amortization method and residual

value for intangible assets with finite useful lives are reviewed at
each reporting date and any changes are recognised as a change in
accounting estimate in the Statement of Financial Performance.

ACCOUNTING POLICIES
1.11 Leases
The entity as lessee in an operating lease

Assets subject to operating leases, i.e. those leases where The finance lease liabilities are derecognised when the entity’s
substantially all of the risks and rewards of ownership are not obligation to settle the liability is extinguished. The assets capitalised
transferred to the lessee through the lease, are not recognised in the under the finance lease are derecognised when the entity no longer
Statement of Financial Position. The operating lease expense is expects any economic benefits or service potential to flow from the
recognised over the course of the lease arrangement. asset.
The lease expense recognised for operating leases is charged to the 1.12 Contributed Capital
Statement of Financial Performance on a straight-line basis over the "The purpose of this reserve is to ensure that there are sufficient
term of the relevant lease. To the extent that the straight-lined lease cash resources to fund the working capital requirements of the
payments differ from the actual lease payments the difference is entity.
recognised in the Statement of Financial Position as either lease
payments in advance (operating lease asset) or lease payments Contributed capital consists of the following items:
payable (operating lease liability) as the case may be. This resulting • Cash received from the Gauteng Department of Health; and
asset and / or liability is measured as the undiscounted difference • Transfers from accumulated surplus based on Treasury approval
between the straight-line lease payments and the contractual lease in terms of Treasury Regulations."
payments.
1.13 Revenue from exchange transactions
The operating lease liability is derecognised when the entity’s
obligation to settle the liability is extinguished. The operating lease Revenue is only recognised when all of the following criteria are
asset is derecognised when the entity no longer anticipates satisfied:
economic benefits to flow from the asset. • The entity retains neither continuing managerial involvement to
the degree usually associated with ownership nor effective
The entity as lessee in a finance lease control over the goods sold;
Leases are classified as finance leases where substantially all the risks • The amount of revenue can be measured reliably; and
and rewards associated with ownership of an asset are transferred • It is probable that the economic benefits or service potential
to the entity through the lease agreement. Assets subject to finance associated with the transaction will flow to the entity and the
leases are recognised in the Statement of Financial Position at the costs incurred or to be incurred in respect of the transaction can
inception of the lease, as is the corresponding finance lease liability. be measured reliably.
1.14 Revenue from non-exchange transactions- Penalties, gifts,

Assets subject to a finance lease, as recognised in the Statement of
donations, including goods in-kind.
Financial Position, are measured (at initial recognition) at the lower
of the fair value of the assets and the present value of the future
Penalties, gifts and donations, including goods in kind, shall be
minimum lease payments. Subsequent to initial recognition these
recognised as income in the period it is received provided that all of
capitalised assets are depreciated over the contract term.
the following conditions have been satisfied:
• The amounts of the penalties, donations, gifts and goods-in-kind
The finance lease liability recognised at initial recognition is
can be measured reliably;
measured at the present value of the future minimum lease
• There is an existing signed contract with the supplier that
payments. Subsequent to initial recognition this liability is carried at
includes a paragraph on penalties; and
amortised cost, with the lease payments being set off against the
• It is probable that the economic benefits comprising of the
capital and accrued interest. The allocation of the lease payments
penalty, gift, donations and goods in kind will flow to the
between the capital and interest portion of the liability is effected
entity.
through the application of the effective interest method.
With regards to donations received ,Gauteng Medical Supplies
Depot does not account for the economic benefit received in the
The finance charges resulting from the finance lease are expensed,
Statement of Financial Performance, as the depot is considered to be
through the Statement of Financial Performance, as they accrue. The
only a conduit for hospitals and to control the receipt of donations
finance cost accrual is determined using the effective interest
for the Department.
method.

ACCOUNTING POLICIES
1.15 Irregular expenditure

Irregular expenditure is recognised as expenditure in the Statement Retirement benefit costs
of Financial Performance. If the expenditure is not condoned by the The Depot provides retirement benefits for its employees through a
relevant authority, it is treated as an asset until recovered or written defined benefit plan for government employees. These benefits are
off as irrecoverable. funded by both employer and employee contributions. Employer
contributions to the fund are expensed when money is paid to the
1.16 Fruitless and wasteful expenditure fund. No provision is disclosed for retirement benefits in the
"Fruitless and wasteful expenditure is defined as expenditure that financial statements as the obligation and plan assets is the
was made in vain and would have been avoided had reasonable care responsibility of the multi-employer Government Employee Pension
been exercised, therefore: Fund reporting under the control of National Treasury.
• It must be recovered from a responsible official (a debtor
account should be raised); or The defined benefit plan is accounted for as a defined contribution
• Written off (If responsibility cannot be determined). plan due to insufficient information being available to apply the
rules of the defined benefit plan.
Such expenditure is treated as expenditure in the Statement of
Financial Performance and where recovered, it is subsequently 1.18 Events after reporting date
accounted for as revenue in the Statement of Financial Performance.
Due to nature of business at the entity (where expired stock and Two types of events can be identified:
stock breakages is inherent to its business), expired and stock • those that provide evidence of conditions that existed at the
breakages will only be recognised as fruitless and wasteful reporting date (adjusting events after the reporting date); and
expenditure if their total value is higher than 2% of average stock • those that are indicative of conditions that arose after the
holding. Qualitative consideration would also be considered to reporting date (non-adjusting events after the reporting date).
disclose fruitless and wasteful expenditure."
The entity will adjust the amounts recognised in the financial
Recovery of Irregular and fruitless and wasteful expenditure statements to reflect adjusting events after the reporting date once
The recovery of unauthorised, irregular, fruitless and wasteful the event occurred.
expenditure is based on legislated procedures, and is recognised
when the recovery thereof from the responsible officials is probable. The entity will disclose the nature of the event and estimate its
The recovery of unauthorised, irregular, fruitless and wasteful financial effect or a statement that such estimate cannot be made in
expenditure is treated as other income. respect of all material non-adjusting events, where non-disclosure
could influence the economic decisions of users taken on the basis
1.17 Employee Benefits of the financial statements.
Short term employee benefits

Short term employee benefits encompasses all those benefits that
become payable in the short term, i.e. within a financial year or
within 12 months after the financial year. Therefore, short term
employee benefits include remuneration, compensated absences
and bonuses.
Short term employee benefits are recognised in the Statement of

Financial Performance as services are rendered, except for non-ac-
cumulating benefits, which are recognised when the specific event
occurs. These short-term employee benefits are measured at their
undiscounted costs in the period the employee renders the related
service or the specific event occurs.

ACCOUNTING POLICIES
1.19 Related Parties Key Management Personnel
The entity has processes and controls in place to aid in the identifica- Key Management Personnel includes all persons having the authori-
tion of related parties. A related party is a person or an entity with ty and responsibility for planning, directing and controlling the
the ability to control or jointly control the other party, or exercise activities of the entity. This includes:
significant influence over the other party, or vice versa, or an entity
that is subject to common control, or joint control. Related party - The senior management team of the entity, including the chief
relationships where control exists are disclosed regardless of wheth- executive officer, the pharmaceutical services director and the
er any transactions took place between the parties during the director of finance and administration.
reporting period.
1.20 Commitments
Where transactions occurred between the entity any one or more
related parties, and those transactions were not within: Commitments are recorded at cost in the notes to the financial
• normal supplier and/or client/recipient relationships on terms statements when there is a contractual arrangement or an approval
and conditions no more or less favorable than those which it is by management in a manner that raises a valid expectation that the
reasonable to expect the entity to have adopted if dealing entity will discharge its responsibilities thereby incurring future
with that individual entity or person in the same expenditure that will result in the outflow of cash.
circumstances; and
• terms and conditions within the normal operating parameters 1.21 Standards, amendments to standards and interpre-
established by the reporting entity’s legal mandate. tations issued not yet effective.
"Further details about those transactions are disclosed in the notes The following Standards of GRAP and / or amendments thereto have
to the financial statements. been issued by the Accounting Standards Board, but will only
Information about such transactions is disclosed in the financial become effective in future periods or have not been given an
statements." effective date by the Minister of Finance. The entity has not early-ad-
opted any of these new Standards or amendments thereto, but has
referred to them for guidance in the development of accounting
policies in accordance with GRAP 3 as read with Directive 5:
Standard name and number Effective date( if applicable)
GRAP 20 - Related Party Disclosures Approved and effective for periods on or after 1 April 2019.
GRAP 105 - Transfer of Functions Between Entities Under Common Control Approved and not yet effective.
GRAP 106 - Transfer of Functions Between Entities Not Under Common Control Approved and not yet effective.
GRAP 107 - Mergers Approved and not yet effective.
GRAP 108 - Statutory Receivables Approved and not yet effective.
GRAP 109 - Accounting by Principles and Agents Approved and not yet effective.

NOTES TO THE ANNUAL FINANCIAL STATEMENTS
Figures in Rand 2019 2018
2. INVENTORIES
Finished goods 208 205 999 253 425 024

Consumable stores 460 718 539 369
Total Inventories 208 666 717 253 964 393
The amount of inventories recognised as an expense during the period

amounted to R 3 896 123 135 (2018: R 3 645 008) and details thereof are as follows:
Inventory utilised in cost of goods sold 3 893 397 373 3 642 542 348
Inventory utilised in consumable stores 1 671 625 1 603 617
Write-down of inventory 1 054 137 1 198 043
Total inventory recognised as an expense 3 896 123 135 3 645 344 008
The valuation method used by the Depot is the weighted average cost.
No write down of inventory to net realizable value was required during the current year.
No inventory was pledged as security (2018: Nil).
3. TRADE AND OTHER RECEIVABLES FROM EXCHANGE TRANSACTIONS
Gross Balances 614 687 499 1 023 221 913

Trade receivables - Provincial Government 4 970 974 4 970 974
Trade creditor overpayments 3 860 966 3 860 966
Stock losses - Department of Infrastructure and Development 1 635 055 1 755 261
Other receivables 625 154 494 1 033 809 114
Less: Allowance for impairment

Trade creditor overpayments (4 970 974) (4 970 974)
Stock losses - Department of Infrastructure and Development (3 860 966) (3 860 966)
Other receivables (912 006) (912 006)
(9 743 946) (9 743 946)
Net balance 615 410 548 1 024 065 168
As at 31 March 2019, the ageing of trade receivables from exchange

transactions that were due but not impaired is as follows:
< 30 days 445 620 399 469 861 373

> 30 days 169 067 100 553 360 540
Total 614 687 499 1 023 221 913
Reconciliation of allowance for impairment

Balance at the beginning of the year (9 743 946) (9 743 946)
Allowance raised - -
Debt impairment written off against allowance - -
Balance at the end of the year (9 743 946) (9 743 946)

4 CASH AND CASH EQUIVALENTS
Cash and cash equivalents consists of:
Bank balance 242 700 838 31 417 693

Petty cash 1 500 1 500
Total Cash and cash equivalents 242 702 338 31 419 193
Cash and cash equivalents earn interest at floating rates based on daily bank
deposit rates. The finance income is recognized in the Statement of Financial Performance.
No cash and cash equivalents were pledged as security at 31 March 2019.
The entity had the following bank accounts at 31 March 2019:
FNB Cheque Account - 62299318800 242 700 838 31 417 693

Total 242 700 838 31 417 693


Cost Accumulated Carrying value Cost Accumulated Carrying value
depreciation at end of the depreciation at end of the
year year
5. PROPERTY, PLANT AND EQUIPMENT
Owned assets
Computer equipment 4 151 830 (3 357 706) 794 124 3 666 290 (3 310 433) 355 857
Cellphones & Accessories 54 185 (35 851) 18 334 54 185 (8 758) 45 427
Fixtures and fittings 10 625 (10 625) - 10 625 (10 625) -
Office furniture 5 019 652 (4 491 801) 527 851 5 047 284 (4 271 430) 775 854
Plant and equipment 23 346 008 (17 262 313) 6 083 695 23 359 094 (15 471 575) 7 887 519
32 582 300 (25 158 296) 7 424 004 32 137 478 (23 072 821) 9 064 657
Leased Assets
Motor vehicles - G-Fleet 499 900 (288 983) 210 917 792 816 (399 260) 393 556
Office equipment 192 658 (170 250) 22 408 395 874 (272 872) 123 002
692 558 (459 233) 233 325 1 188 690 (672 132) 516 558
Total 33 274 858 (25 617 529) 7 657 329 33 326 168 (23 744 953) 9 581 215
2019- Reconciliation of Property Plant & Equipment

Owned assets
Computer equipment 355 857 684 469 (198 929) 198 331 (245 604) 794 124
Cellphones & Accessories 45 427 - - - (27 093) 18 334
Fixtures and fittings - - - - - -
Office furniture 775 854 16 067 (43 699) 41 928 (262 299) 527 851
Plant and equipment 7 887 519 3 104 (16 190) 15 315 (1 806 053) 6 083 695
9 064 657 703 640 (258 818) 255 574 (2 341 049) 7 424 004
Leased Assets
Motor vehicles - G-Fleet 393 556 - (292 916) 292 916 (182 639) 210 917
Office equipment 123 002 - (203 216) 203 216 (100 594) 22 408
516 558 - (496 132) 496 132 (283 233) 233 325
Total 9 581 215 703 640 (754 950) 751 706 (2 624 282) 7 657 329

2018 - Reconciliation of Property Plant & Equipment
Carrying value at Additions Disposals/ Accumulated Depreciation Carrying value

beginning Impairment depreciation on Charge at end of
Figures in Rand of the year disposals/ impairment the year
Owned assets
Computer equipment 289 968 199 514 (158 387) 158 026 (133 264) 355 857
Cellphones & Accessories - 54 185 - - (8 758) 45 427
Fixtures and fittings - - - - - -
Office furniture 999 454 101 575 (71 924) 65 754 (319 005) 775 854
Plant and equipment 6 797 352 4 373 700 (770 183) 734 814 (3 248 164) 7 887 519
8 086 774 4 728 974 (1 000 494) 958 594 (3 709 191) 9 064 657
Leased Assets
Motor vehicles - G-Fleet 591 175 - - - (197 619) 393 556
Office equipment 254 960 - - - (131 958) 123 002
846 135 - - - (329 577) 516 558
Total 8 932 909 4 728 974 (1 000 494) 958 594 (4 038 768) 9 581 215
Note 1 - The Gauteng Medical Supplies Depot has 1061 assets that are fully depreciated but still in use. These are on the Asset Register with a NBV of R100,88.
Note 2 - Included in the 31 March 2018 NBV is an amount of R 3 986 680,39 relating to security equipment will be transferred to Department of Infrastructure &
Development in the 2018/19 financial year.

6 INTANGIBLE ASSETS
Computer software
Cost
Accumulated amortization - 82 422
Carrying value - (82 422)
-
Reconciliation of intangible assets:
Carrying value at beginning of the year -
Additions - 2 810
Disposals/ Impairment - -
Accumulated amortization on disposals/ impairment - (15 732)
Amortization Charge - 15 732
Carrying value at end of the year - (2 810)
-
7 TRADE AND OTHER PAYABLES FROM EXCHANGE TRANSACTIONS
Trade payables from exchange transactions 372 016 667 738 071 477

Accrued leave pay* 3 605 314 3 208 367
Service bonus accrual** 2 140 531 1 995 855
Audit fee accrual 1 892 566 1 655 187
Other accruals 1 793 479 6 564 968
Total Trade and other payables from exchange transactions 381 448 557 751 495 854
At 31 March 2019, the ageing of trade payables was as follows:
< 30 days 302 478 510 433 655 240

> 30 days 69 538 157 304 416 237
Total 372 016 667 738 071 477
* A leave accrual is recognised for leave due to employees at each reporting period. The accrual for leave is calculated by
multiplying the number of leave days due to each employee by a daily rate based on the total cost to the company. The accrual
is expected to be realised within 12 months of the reporting date.
**Service bonus is accrued and the calculation is based on employee’s number of years in service and their gross salary. It is
normally paid out in the employee’s birthday month.
8 PROVISIONS
Provision for Performance Bonus 1 307 383 3 601 652
Reconciliation of Provision for Performance Bonus:
Balance at the beginning of the year 3 601 652 1 497 652

Amount utilised (2 435 304) -
Unused amount reversed (1 166 348) -
Amount raised 1 307 383 2 104 000
Balance at the end of the year 1 307 383 3 601 652
Provision for performance bonus was calculated based on the amount paid for 2017/2018 financial year as the 2018/2019 performance
appraisals were yet to be concluded at the reporting date. An incremental factor of 6,5% was applied which is the best estimate for the
current year. The provision is anticipated to be paid within 12 months from the reporting date.

9. FINANCE LEASE OBLIGATIONS
Minimum lease payments

Within 1 year 206 714 453 199
Within the 2nd to 5th year inclusive 191 919 398 633
398 633 851 832
Less: Future finance charges (86 331) (211 473)
Present value of lease obligations 312 302 640 359
The present value of lease obligations can be analysed as follows:

Within 1 year 145 963 328 057
Within the 2nd to 5th year inclusive 166 339 312 302
312 302 640 359
Disclosed as:
Current liabilities 145 963 328 057
Non-Current Liabilities 166 339 312 302
312 302 640 359
The finance lease obligations at 31 March 2019 was in respect of 6 photocopier machines and a motor vehicle.
The average interest rate implicit in the leases of the photocopier machines is 17,5% whilst it is 25,3% for the motor vehicle.
10. CONTRIBUTED CAPITAL
Cash received from Gauteng Department of Health* 54 000 000 54 000 000

Transfers from accumulated surplus** 50 376 790 50 376 790
104 376 790 104 376 790
* The Gauteng Department of Health contributed capital this amount to the entity to fund its working capital requirements.
** Transfers from accumulated surplus to increase contributed capital occurred in 2007 (R 26 000 000) and in 2009 (R 24 376
790) after treasury approval was obtained.
11. REVENUE FROM EXCHANGE TRANSACTIONS - SALE OF GOODS
Revenue from exchange transactions - sale of goods 4 088 067 270 3 824 656 198
12 REVENUE FROM EXCHANGE TRANSACTIONS - FINANCE INCOME
Finance income - bank balances 9 816 888 10 919 455
13 REVENUE FROM EXCHANGE TRANSACTIONS - OTHER INCOME
Parking income 88 520 89 740

Garnishee orders 43 840 40 920
Recycling of paper 1 320 69 611
Initial recognition of assets at fair value* - 139 452
Other income 16 896 10 800
TOTAL OTHER INCOME 150 576 350 523
*Initial recognition of items of property, plant and equipment found on the floor.

14 REVENUE FROM NON-EXCHANGE TRANSACTIONS - PENALTIES
Late delivery of inventory and Buy-Out-of-Contract penalties 24 194 254 12 489 525
15 EMPLOYEE RELATED COSTS
Basic salary 49 008 366 46 345 707

Allowance for acting positions 131 331 9 886
Qualification bonus 29 971 -
Overtime 41 032 356 039
Standby allowance 235 355 93 492
Housing allowance 3 083 280 2 949 049
Non-pensionable salary 2 754 803 2 633 554
Service bonus 4 112 002 3 896 586
Bargaining council 16 271 15 681
Performance bonus 141 035 2 104 000
Medical aid contributions 3 936 751 3 421 323
Travel claims 35 756 57 612
Leave 455 675 453 552
Pension fund contributions 6 334 964 5 998 058
Total 70 316 592 68 334 539
At 31 March 2019, the entity's employee head count was 191 (2018: 192).
Defined benefit plan

The Depot provides retirement benefits for its employees through a defined benefit plan for government employees. These benefits are
funded by both employer and employee contributions. Employer contributions to the fund are expensed when money is paid to the
fund. No provision is disclosed for retirement benefits in the financial statements as the obligation and plan assets is the responsibility
of the multi-employer Government Employee Pension Fund reporting under the control of National Treasury.
"The entity contributes to a multi-employer pension fund on behalf of its employees. The fund has a defined benefit plan but is
accounted for as a defined contribution plan due to insufficient information being available to apply the rules of the defined benefit
plan. "
The reason why there is insufficient information is because the entity is not assessed separately being part of a multi-employer
Government Employee Pension Fund reporting under the control of National Treasury.
The assets generated by this plan consists of contributions made by both the entity and the employees and are generally held in a
separate administered fund, namely the Government Employees’ Pension Fund. This fund is administered on behalf of the entity by
pension fund administrators and is governed by the Pensions Fund Act, 1956 as amended. The following rates of contribution are
applied: employee contribution is 7.5 % of pensionable salary (basic salary plus annual bonus) as well as entity contribution of 13.0 %
on the same basis.
Surplus/(deficit) for the year

Contribution payable for the year 6 371 088 6 024 942
Contributions paid 6 334 964 5 998 058
Deficit (36 124) (26 884)

16 DEPRECIATION AND AMORTIZATION EXPENSE
Depreciation of property, plant and equipment 2 624 282 4 038 769

Amortization of intangible assets - 2 810
Total 2 624 282 4 041 579
17 FINANCE COSTS
Capitalized finance leases 125 142 220 429
18 COST OF GOODS SOLD
Cost of inventories sold 3 893 397 373 3 642 542 348
19 DISTRIBUTION COSTS
Fees for distribution costs 7 945 580 6 191 817
20 OPERATIONAL COSTS
Rental and hiring 534 010 443 875

Repairs and maintenance 2 515 468 1 964 453
Communication 346 969 311 769
Stationery and printing 1 005 920 851 214
SITA computer services 1 951 103 2 071 312
Audit fees 1 962 288 1 833 716
External training 91 902 226 770
Inventory written off 1 054 137 1 198 043
Cleaning services 1 778 519 1 893 969
Professional accounting and other advisory services 2 909 041 2 645 633
Security 3 658 299 3 265 448
Other operational costs 1 932 533 1 658 378
Total 19 740 189 18 364 580
20.1 AUDIT FEES
Current year external audit fees 1 962 288 1 833 716
21 TAXATION
No provision has been made for taxation as the entity is exempt from income taxation in terms of section 10 (1) of the South
African Income Tax Act No.58 of 1962.

22 OPERATING LEASE/ CONTRACT ARRANGEMENTS
At the reporting date the Depot had outstanding commitments under non-cancellable operating leases and/or contracts, which
fall due as follows:
Minimum lease payments due

Within 1 year 460 978 187 553
Within 2 to 5 years inclusive 71 473 17 100
532 451 204 653
The lease agreements are not renewable at the end of the lease terms. The operating leases are in respect of office equipment,
motor vehicles and plant and equipment. There is no escalation clause in all operating leases at 31 March 2019 and thus no
straight-lining adjustment was required.
Amount paid in respect of operating leases in the current year amounted to R 468 900 (2018: R 385 321).
23 RELATED PARTIES
Relationships
Controlling entity Gauteng Department of Health
The Medical Supplies Depot is a trading entity under the control of the MEC of Gauteng Department of Health. All transactions
with the Department of Health are considered to be related party transactions and are at arm's length.
Related party balances

Amounts included in trade receivables regarding related parties:
Gauteng Department of Health 614 687 499 1 023 221 913
Related party transactions

Amounts included in revenue regarding related parties:
Gauteng Department of Health 4 088 067 270 3 824 656 198
REMUNERATION OF KEY MANAGEMENT
The entity's key management personnel are the following:

- Chief Executive Officer
- Director : Pharmaceutical Services
- Director : Finance and Administration

Figures in Rand 2019 2018 2018
23 RELATED PARTIES (Continued)
REMUNERATION OF KEY MANAGEMENT

2019 Director Director Finance Acting Director Total
Pharmaceutical and Finance and
Services: Mr D Administration: Administration:
Malele Mr J M Smidt* Mr K M Kasumba**
Salary 727 384 237 043 523 023 1 487 450

Bonuses and performance payments 61 330 - 43 584 104 914
Expense allowance 132 441 107 460 169 173 409 074
Pension Contribution 94 560 30 816 42 495 167 871
Acting allowance - - 138 006 138 006
Total 1 015 715 375 319 916 281 2 307 315
2018
Director Director Finance Acting Director Total
Pharmaceutical and Finance and
Services: Mr D Administration: Administration:
Malele Mr J M Smidt* Mr K M Kasumba**
Salary 682 726 554 076 497 662 1 734 464

Bonuses and performance payments 57 003 47 409 41 472 145 884
Expense allowance 122 829 251 181 160 974 534 984
Pension Contribution 88 757 72 029 40 437 201 223
Total 951 315 924 695 740 545 2 616 555
* With effect from 01 September 2018, Mr JM Smidt was transferred to the Gauteng Department of Health.
** Appointed 1 December 2017. Acting allowance only paid from July 2018.
Service in-kind
In the 2018/19 financial year, the Gauteng Department of Health rendered the services listed below at no cost to the entity:
- Corporate Services (Including Human Resources, Risk management and Finance and IT services). The value of these services
could not be reliably estimated.
- Remuneration of Chief Executive Officer of the entity (Ms N Thipa). Her remuneration was paid by the Department of Health.
Her gross remuneration was R 1 422 012 (2018: R 1 347879).

24 RISK MANAGEMENT
General
The main risks faced by the trading entity are interest rate risk, credit risks and liquidity risks. The Depot has developed a
comprehensive risk strategy in terms of Treasury Regulation 3.2 in order to monitor and control these risks. The risk
management process relating to each of these risks is discussed under the headings below.
Interest rate risk

The entity is not exposed to significant interest rate risk as there is no internal funding other than cash and finance leases. The
following table set out the carrying amount, by maturity, of the entity’s financial instruments exposed to interest rate risk:
2019 Within 1 year Within 2 - 5 years Total
F igures in Rand
Cash and cash equivalents 242 702 338 - 242 702 338

Finance lease obligations 145 963 166 339 312 302
Trade and other receivables 615 410 548 - 615 410 548
Trade payables 372 016 667 - 372 016 667
2018 Within 1 year Within 2 - 5 years Total

Figures in Rand
Cash and cash equivalents 31 419 193 - 31 419 193

Finance lease obligations 328 057 312 302 640 359
Trade and other receivables 1 024 065 168 - 1 024 065 168
Trade payables 738 071 477 - 738 071 477
The entity's financial instruments are linked to the South African prime rate.
The following table demonstrates the sensitivity to a reasonable possible change in interest rates, with all other variables held
constant of the entity’s surplus before taxation:
Figures in Rand Increase in Increase in

2019 interest rate by: interest rate by:
Cash and cash equivalents 1% 1%

Finance lease obligations 1% 1%
Trade receivables 1% 1%
Trade payables 1% 1%
2018
Cash and cash equivalents 1% 1%

Finance lease obligations 1% 1%
Trade receivables 1% 1%
Trade payables 1% 1%

Credit Risk
Financial assets, which potentially subject the Depot to the risk of non-performance by counter parties, consist mainly of
cash and accounts receivable, consisting of trade receivables and staff debtors. Trade accounts receivable consist of a small
consumer base. The Depot limits its treasury counter-party exposure by only dealing with well-established financial
institutions approved by National Treasury. Trade debtors – The Gauteng Department of Health is effectively the only client
of the Depot, although deliveries occur to various health institutions.
Credit risk with regards to receivables is managed as follows:
Trade debtors – A monthly claim is compiled of all issues from the Depot to health institutions and of payments affected to
suppliers for direct deliveries. This claim is normally paid within a month by Central Office as the Depot follows-up strongly
on outstanding monies to ensure that there is money available to release a weekly run of payments to suppliers.
Staff debtors – Section 17, 30 and 38 of the Public Service Act indicate that any overpayment or wrongly granted
remuneration to staff irrespective of whose fault it is may be recovered from the employee. There are built-in control
measures in Persal to limit overpayments and adjustments have a three-tier approval process. The employee applies or
provides approved documents, a practitioner records the transaction on Persal, a senior reviews the transaction on Persal
and a third person is required to approve the transaction. With death, retirement or resignation there is a prescribed debt
form that needs to be completed and is forwarded with the pension withdrawal form (Z102) to the Department of Finance
where the staff debt is recovered before payment to the employee or employee beneficiaries occur. Where the debt
recovered is inadequate the Department of Finance’s debt recovery section recovers outstanding monies.
Financial assets and liabilities exposed to credit risk at the reporting date were as follows:
Figures in Rand 31 March 2019 31 March 2018
Trade and other receivables ( less than 3 months) 614 687 499 1 023 221 913

Cash and cash equivalents (less than 3 months) 242 702 338 31 419 193
Finance lease obligation - long term (2 to 5 years) 166 339 312 302
Finance lease obligation - short term ( less than 1 year) 145 963 328 057
Trade and other payables ( Less than 3 months) 375 702 712 746 291 632
Liquidity Risk
The Depot maintains a large amount of inventory, the maximum turnover period for the inventory kept however is twelve weeks
or three months.
Liquidity risk is managed as follows:
Proper stock management processes are in place where stock is ordered based on economic order quantities. The maximum
turnover period of stock kept at the Depot is three months. At least a monthly exercise is done to identify slow moving items and
a memo is issued to health institutions every six months with an inventory list of the items as a reminder that the stock is
available.

Currency Risk
The Depot does not transact with any supplier or customer outside the South African borders and this risk is therefore not
directly applicable. However, this risk arises as suppliers purchase raw material from international suppliers which is subject to
foreign exchange rate fluctuations. Suppliers therefore request, through an application to either National Treasury (State
Tender Board) or the Department of Finance, for a price adjustment based on the fluctuation of foreign exchange rates.
Fair values
At 31 March 2019, the carrying values of cash and cash equivalents, trade and other receivables and trade and other payables
approximate the fair values due to short term maturities of these assets and liabilities as disclosed below:-
Financial Assets
Carrying Amount 242 702 338 31 419 193

Trade and other receivables from exchange transactions
Fair Value
Cash and cash equivalents 242 702 338 31 419 193
Trade and other receivables from exchange transactions 615 410 548 1 024 065 168
Financial Liabilities
Carrying Amount
Trade and other payables from exchange transactions 375 702 712 746 291 632
Finance lease obligation 145 963 328 057
Fair Value
25 CONTINGENT LIABILITIES
There were no contingent liabilities outstanding as at 31 March 2019 (2018: Nil)

Currency Risk
The Depot does not transact with any supplier or customer outside the South African borders and this risk is therefore not
directly applicable. However, this risk arises as suppliers purchase raw material from international suppliers which is subject to
foreign exchange rate fluctuations. Suppliers therefore request, through an application to either National Treasury (State
Tender Board) or the Department of Finance, for a price adjustment based on the fluctuation of foreign exchange rates.
Fair values
At 31 March 2019, the carrying values of cash and cash equivalents, trade and other receivables and trade and other payables
approximate the fair values due to short term maturities of these assets and liabilities as disclosed below:-
Financial Assets
Carrying Amount 242 702 338 31 419 193

Trade and other receivables from exchange transactions
Fair Value
Cash and cash equivalents 242 702 338 31 419 193
Trade and other receivables from exchange transactions 615 410 548 1 024 065 168
Financial Liabilities
Carrying Amount
Fair Value
25 CONTINGENT LIABILITIES
There were no contingent liabilities outstanding as at 31 March 2019 (2018: Nil)

26 FRUITLESS AND WASTEFUL EXPENDITURE
Reconciliation of fruitless and wasteful expenditure:

Opening Balance 25 742 325 25 742 325
Current year fruitless and wasteful expenditure - -
Condoned or written off by relevant authority - -
Transfer to receivables for recovery-not condoned - -
Closing Balance 25 742 325 25 742 325
* Broken and expired stock is only recorded as fruitless and wasteful expenditure only if it exceeds 2% of the average inventory on
hand.
Action taken by management regarding fruitless and wasteful expenditure
27 IRREGULAR EXPENDITURE
Reconciliation of irregular expenditure:

Opening Balance 1 378 614 421 1 372 640 477
Current year Irregular expenditure** 10 778 051 5 973 944
Prior Year Incurred in the Current Financial Year - -
Condoned or written off by relevant authority - -
Transfer to receivables for recovery-not condoned - -
Irregular Expenditure Awaiting condonement - -
Closing Balance 1 389 392 472 1 378 614 421
Action taken by management regarding irregular expenditure
**Current year irregular expenditure
There are three (3) contracts that accounted for the current year irregular expenditure:
- Cleaning services 1 437 794
- Security services 6 822 060
- Accounting services 2 518 197
10 778 051
Management has taken the following steps to eliminate the reoccurrence of this irregular expenditure:
• The Department is in the process of insourcing security services for the province which will include Medical Supplies Depot.
• Posts for the replacement of consultants that provide accounting services were created and the recruitment process in the final
stages for appointment.
• The previous cleaning services contract has been terminated and a new service provider was awarded a contract with effect from
October 2018.
Prior year irregular expenditure

Management has referred the cases to risk management and internal control unit within medical supplies depot, who are currently
in the process of assessing documentation and referral of further investigation if need arises for the amounts disclosed in the current
and prior years for the process of applying for condonation (where possible),consequence management will be determined after
assessment.

28 COMMITMENTS
Approved, contracted and not provided for in the statement of financial position.
Contractual commitments
- Distribution services** 9 597 615 18 052 125
- Cleaning services*** 950 781 -
- IT services 2 243 694 2 116 692
- Orders placed but goods not delivered 453 560 755 663 124 551
466 352 845 683 293 368
Approved, not yet contracted for and not provided for in the statement of financial
position.
- Capital Commitments 12 048 237 5 355 321

* Restated, refer to note 32.
** Contract awarded 1 January 2018 and terminates on 31 December 2020.
*** Contract awarded 7 November 2018 and terminates on 6 November 2019.
29 CHANGE IN ACCOUNTING ESTIMATE
Property, Plant & Equipment original useful lives have been reassessed as per table below in the beginning of the current financial
period to reflect the actual pattern service potential derived from the assets. The depreciation is to be calculated on a straight line
basis for the remaining useful lives of the assets.
Asset class Useful life

Computer Equipment 1 - 18 years
Office Furniture 1 - 23 years
Plant & Equipment 1 - 21 years
The change in the useful lives of the assets had the following impact on depreciation
Current year (Decrease)

Computer Equipment (19 790)
Office Furniture (64 410)
Plant & Equipment (1 389 288)
30 COMPARATIVES
There were improvements to the presentation and disclosure in the current year. Changes to the prior year presentation and
disclosure was also made to ensure comparability for users of the annual financial statements. No prior year figures were
changed.

31 PRIOR PERIOD ERROR
While preparing the annual financial statements of the entity for the year ended 31 March 2019, management noted that
the disclosure of commitments the entity had at 31 March 2018 was not complete. Commitments relating to IT services,
Orders placed but goods not delivered and Capital commitments were erreneously omitted from the disclosure in the annual
There is no impact on the Statement of Financial Position, Statement of Financial Performance, Statement of Changes in
Equity or the Statement of Cash Flows for the year ended 31 March 2018.
The impact on the disclosure in the annual financial statements presented at 31 March 2018 is as follows:
As previously Correction of Restated

stated error
Commitments
Approved, contracted and not provided for in the

statement of financial position.
- IT services - 2 116 692 2 116 692
- Orders placed but goods not delivered - 663 124 551 663 124 551
Approved, not yet contracted for and not provided for in

the statement of financial position.
-
- Capital Commitments 5 355 321 5 355 321
32 EVENTS AFTER REPORTING DATE
There were no events identified after the reporting date that may have a significant impact on the entity's financial position
at 31 March 2019, its financial performance or its cash flows for the year then ended.

REPORT OF THE AUDIT COMMITTEE
Report of the Audit Committee
Medical Supplies Depot
We are pleased to present our report for the financial year ended 31 March 2019.
Audit Committee and Attendance

The Audit Committee consists of the external independent Members listed hereunder and is required to meet a minimum of twice per
annum as per provisions of the Public Finance Management Act (PFMA). In terms of the approved Terms of Reference (GPG Audit
Committee Charter), five meetings were held during the current year, i.e. three meetings to consider the Quarterly Performance
Reporting (financial and non-financial) and two meetings to review and discuss the Annual Financial Statements and the
Auditor-General of South Africa’s (AGSA) Audit and Management Reports.
Non-Executive Members
Name of Member Number of Meetings attended
Ms. Janice Meissner (Chairperson) 04
Mr. Leon Langalibalele 04
Ms. Shelmadene Petzer 04
Mr. Japie du Plessis (Former Chairperson) 04
Ms. Precious Sibiya (Former member) 01
Executive Members
Compulsory Attendees Number of Meetings attended
Ms. Nocawe Thipa (Chief Executive Officer) 04
Mr. Mkhululi Lukhele (Accounting Officer) 05
Mr. Luthendo Makhadi (Acting Chief Audit Executive) 04
Mr. Kweyama Velile (Chief Audit Executive) 01
The Audit Committee noted that the Chief Executive Officer attended four out of five scheduled Audit Committee meetings and was
duly represented. The Audit Committee is satisfied that the Entity adhered to the provisions of the GPG Audit Committee Charter in
relation to ensuring that there is proper representation for the Chief Executive Officer.
The Members of the Audit Committee met with the Senior Management of the Entity, Internal Audit and the AGSA, individually and
collectively to address risks and challenges facing the Entity. A number of in-committee meetings were held to address control
weaknesses and deviations within the Entity.
Audit Committee Responsibility
The Audit Committee reports that it has complied with its responsibilities arising from section 38(1)(a) of the PFMA and Treasury
Regulation 3.1.13. The Audit Committee also reports that it has adopted appropriate formal terms of reference as its Audit Committee
Charter, has regulated its affairs in compliance with this Charter and has discharged all its responsibilities as contained therein.

The effectiveness of internal control and Information and Communication Technology (ICT) Governance
The Audit Committee has observed that the control environment of the Entity has not significantly improved during the year under
review. Some deficiencies in the system of internal control and deviations were reported in the Internal Audit and Auditor-General
Reports. The overall opinion of Internal Audit on the internal control design at the Entity is partially adequate and effective.
Management should pay special attention to IT general controls and Occupational Health and Safety processes.
The Audit Committee also reviewed the progress with respect to the ICT Governance in line with the ICT Framework issued by the
Department of Public Services and Administration. Although there was some progress on the ICT internal control, special attention
must be given to the IT general controls as well as the implementation of the Disaster Recovery Plan and the Business Continuity Plan.
This continued to be a high risk for the Entity.
The governance of the MSD and its reliance on the department of health requires resolution to enable it progress and effectively
improve the internal control environment.
Internal Audit
The Audit Committee is satisfied that the Internal Audit plan represents a clear alignment with the key risks, has adequate information
systems coverage, and a good balance across the different categories of audits, i.e. risk-based, mandatory, performance, computer and
follow-up audits.
The Audit Committee has noted improvement in the communication between the Executive Management, the AGSA and the Internal
Audit Function, but more needs to be done to strengthen the Corporate Governance initiatives within the Entity.
Risk Management
Progress on the departmental risk management was reported to the Audit Committee on a quarterly basis. The Audit Committee
stresses that risk management should receive urgent attention. Management should take full responsibility for the entire Enterprise
Risk Management process and continue to support the risk function to even further enhance the performance of the Entity.
Forensic Investigations
Limited forensic investigations were requested for the Entity during the financial year under review.
The quality of quarterly reports submitted in terms of the PFMA and the Division of Revenue Act
The Audit Committee notes the content of financial and non-financial quarterly reports prepared and submitted by the Accounting
Officer of the Entity during the year under review and confirms that the reports were in compliance with the statutory reporting
framework although significant effort must be made to further the quality of these reports .
Evaluation of reporting by the Department

The Audit Committee has:
• Reviewed and discussed the audited Annual Financial Statements to be included in the Annual Report, with the AGSA and the
Accounting Officer;
• Reviewed the Audit Report of the AGSA;
• Reviewed the AGSA’s Management Report and Management’s response thereto;
• Reviewed the Entity’s compliance with legal and regulatory provisions;
• Reviewed significant adjustments resulting from the audit; and
• Reviewed the appropriate accounting policies and relevant disclosures.

The Audit Committee concurs with and accepts the AGSA’s conclusions on the Annual Financial Statements, performance information
and compliance and is of the opinion that the audited Annual Financial Statements be accepted and read together with the report of
the AGSA.
One-on-One Meeting with the Accounting Officer
The Audit Committee has met with the Accounting Officer for the Entity to address unresolved issues.
One-on-One Meetings with the Executive Authority
The Audit Committee has met with the Executive Authority for the Entity to apprise the MEC on the performance of the Entity.
Auditor-General of South Africa
The Audit Committee has met with the AGSA to ensure that there are no unresolved issues.
Chairperson of the Audit Committee
Date: 31 July 2019

2019 Gauteng Health Annual Report

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2019 Gauteng Health Annual Report

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DEPARTMENT OF HEALTH

EXPENDITURE PER BUDGET PROGRAMME

DISTRICT PROVINCIAL CENTRAL & EMERGENCY

14 516 480 8 746 469 17 135 226 1 330 508

HEALTHCARE HEALTH SCIENCES HEALTH FACILITIES ADMINISTRATION

339 048 1 106 708 1 536 120 1 360 786

Department of Health Annual Report 2018/19

Nursing Engineering Administration Clinical

Allied Allied Management

Clinical Professionals Nursing Professionals

MEDICAL MEDICAL NURSING STAFF NURSES

Adminstration Staff Support Staff Management

Department of Health Annual Report 2018/19

We provided 179 689 307 contraceptives to

183 719 women over 30 year old

Maternal and Neonatal Health Child Health

Outreach to Households Chronic Medicine Dispensing Programme

3 374 445 visits by 490 518 patients received their

Non-Communicable conditions and Rehabilitation services

2 295 851 hypertensive patients 552 537 diabetic patients treated

85 283 Mental health care patients 73 772 assistive devices provided to

1 037 212 HIV patients 34 190 TB patients treated

Department of Health Annual Report 2018/19

Department of Health Annual Report 2018/19 1

2 Department of Health Annual Report 2018/19

Department of Health Annual Report 2018/19 3

4 Department of Health Annual Report 2018/19

30-44 Performance of the priority

30-44 A brief overview on

Gauteng Provincial Government | Health |

Department of Health Annual Report 2018/19 5

AET Adult Educational and Training DR TB Drug-resistant Tuberculosis

AGSA Auditor-General of South Africa DSD Department of Social Development

AIDS Acquired Immune Deficiency Syndrome ECC Emergency Communication Centre

ALS Advanced Life Support ECD Early Childhood Development

ALOS Average Length of Stay ECT Emergency Care Training

ANC Antenatal Care EHWP Employee Health and Wellness Programme

AO Accounting Officer EML Essential Medicines List

APC Advanced Primary Care EMS Emergency Medical Services

API Active Pharmaceutical Ingredient ENT Ear, Nose and Throat

APP Annual Performance Plan EPWP Expanded Public Works Programme

APP Annual Procurement Plan ERM Enterprise Risk Management

ART Antiretroviral Treatment ES Equitable Share

ARV Antiretroviral ESMOE Essential Steps in Managing Obstetric Emergencies

BAA Basic Ambulance Assistant EXCO Executive Committee

BHVI Brien Holden Vision Institute FPS Forensic Pathology Service

BLS Basic Life Support GCRA Gauteng City Region Academy

BMH Bheki Mlangeni Hospital GDE Gauteng Department of Education

BoQ Bill of Quantity GDID Gauteng Department of Infrastructure Development

CAD Computer Aided Dispatch GDoH Gauteng Department of Health

CDC Communicable Disease Control GP General Practitioner

CEO Chief Executive Officer GPG Gauteng Provincial Government

CFMS Clinical Forensic Medical Service GPT Gauteng Provincial Treasury

CFO Chief Financial Officer GRV Goods Receipt Voucher

CHC Community Health Centre GSSC Gauteng Shared Services Centre

CHW Community Health Worker HBB Helping Baby Breathe

CMJAH Charlotte Maxeke Johannesburg Academic Hospital HC Higher Certificate

CMR Child Mortality Rate HCW Health Care Waste

CoE Cost of Employment HCWM Health Care Waste Management

CoJ City of Johannesburg HFM Health Facilities Management

COPC Community-oriented Primary Care HFRG Hospital Facility Revitalisation Grant

COPD Chronic Obstructive Pulmonary Disease HIFU High-intensity Focused Ultrasound

CoT City of Tshwane HIS Health Information System

CPD Continuing Professional Development HIV Human Immunodeficiency Virus